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Deeply Infiltrating Endometriosis(DIE)

Deeply infiltrating endometriosis (DIE) is a kind of functional endometrial growth that invades the deep peritoneum and pelvic organs and invades the tissue more than 5mm, which is called DIE.
 
 
Pathogenesis
 
There are two explanations for the occurrence of DIE: the theory of meridians and blood flow and the theory of metaplasia. At present, most scholars believe that the DIE is caused by endometrial glandular epithelial cells and stromal cells implanted in the pelvic peritoneum with the menstrual blood flow back.
 
The endometrial cells with different characteristics flow back to the pelvic cavity and adhere to the surface of the peritoneum. Under the joint action of abnormal hormone level, inflammatory factors, and immune mechanism, new blood vessels are formed, and the lesions move to the deep peritoneum Infiltrate and grow and stimulate the proliferation of deep fibrous connective tissue or smooth muscle tissue to form nodules together. The latter refers to the formation of DIE from the cells on the remnant of the peritoneum or Mullerian tube to the endometrial cells.
 
Symptoms
 
The clinical manifestation is closely related to the lesion site. Patients with endometriosis of vagina, rectum, diaphragm, and uterosacral ligament often complain of pain in the lower abdomen and lumbosacral part during menstruation, which is persistent and sometimes aggravated. The most severe pain is before and at the beginning of menstruation, and it will be relieved after menstruation is clean. Deep sexual intercourse pain is a common symptom of this kind of patient.
 
Some patients may have increased menstrual volume and prolonged menstrual period, which is characterized by bleeding before and after menstruation. Gynecological examination of the utero rectal fovea and uterosacral ligament can reach the tenderness nodule.

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