Clinical characteristics and location of lesions in patients with deep infiltrating endometriosis: using the revised Enzian classification

Objective: To describe clinical characteristics and location of lesions in patients with deeply infiltrating endometriosis using the revised Enzian (rEnzian) classification.

Methods: Clinical records of 60 patients undergoing laparoscopy for deeply infiltrating endometriosis at Hospital Civil de Culiacán, Sinaloa and Hospital San Javier, Jalisco, México were reviewed. Age, body mass index (BMI), number of pregnancies, childbearing, previous abortions, laparoscopic suggestion (pelvic pain, bleeding, infertility), size and location of the lesions, were assessed according to rEnzian classification.

Results: Mean age was 30.5 years with a Body Mass Index of 25.6 kg/m2SC. 68% of them were nulliparous and 13% had at least one birth. 85% got pelvic pain and 8.3% infertility. 70% (n = 42) of the cases had ovarian endometriomas (middle compartment); uterosacral and torus uterinus´ ligaments were affected in 23.3%, rectum and sigmoid colon in 35% (posterior compartment) and appendix and small intestine in 3.3%. According to the rEnzian Classification the most affected compartment was C2 (rectum and sigmoid colon with 1-3cm lesions).

Conclusions: Pelvic pain was the main symptom of patients with deeply infiltrating endometriosis, mainly in nulliparous. According to the rEnzian classification the compartment C2 was the most affected (rectum and sigmoid colon).