Thomassin-Naggara et al reported the Deep Pelvic Endometriosis Index (dPEI) to determine the severity of the endometriosis. This can help to decide how best to manage the patient. The authors are from from multiple institutions in France.
Patient selection: woman with endometriosis
Compartment
Contents
Extra Point
right anterolateral
distal round ligament
right mediolateral
parametrium, ureter
pelvic wall
right posterolateral
distal uterosacral ligament, sacro rectal septum
pelvic wall
anterocentral
bladder, proximal round ligament
mediocentral
tourus and proximal uterosacral ligament, posterior vaginal fornix, external adenomyosis
posterocentral
rectum
left anterolateral
distal round ligament
left mediolateral
parametetrium, ureter, pelvic wall
pelvic wall
left posterolateral
distal uterosacral ligament, sacro rectal septum
pelvic wall
extrapelvic
cecum, ileum, appendix, sigmoid colon, abdominal wall, inguinal region, ureter at level of common iliac artery
Extra points:
(1) lesion in vagina or bladder trigone
(2) ureteral dilatation
total score =
= SUM(points for all of the 10 compartments) + SUM(extrapoints)
Interpretation:
• minimum score: 0
• maximum score: 16
Score
Extent of Endometriosis
0
none or microscopic (no lesion seen on MRI)
1 or 2
mild
3 or 4
moderate
>= 5
severe
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