Deep Infiltrating Endometriosis 2 (DIE II) The most severe form, it affects organs within and without the pelvic cavity, including the bowels, appendix, diaphragm, heart, lungs, and (rarely) the brain.
Some groups may refer to category or stage 5 endometriosis when a patient has many dense endometrial adhesions on several organs and is at high risk of needing surgery or experiencing infertility. These categories can help your physician explain your condition and identify the best treatment.
Stage 4 (Point score 40 or more): In Stage 4, or “severe” endometriosis, there are many deep endometrial implants. Implants can be located on the fallopian tubes and bowels. Adhesions can be thick and dense, and they can cause severe pain.
You may also have small cysts on one or both ovaries, and thick bands of scar tissue called adhesions. Stage 4 or severe: This is the most widespread. You have many deep implants and thick adhesions. There are also large cysts on one or both ovaries.
Stage IV: This is also known as severe endometriosis. With stage IV, deep implants and dense adhesions are present. There may be superficial endometriosis and filmy adhesions, but the disease is more widespread than in Stage III. Any score greater than 40 indicates severe endometriosis.
If obstruction of the bowel or urinary tract occurs due to infiltration of endometriosis, urgent surgical management plays a vital role in minimalizing the loss of organ function.
Patients who have more advanced endometriosis, pain that does not resolve with other treatments or are trying to conceive may need surgery. Laparoscopy is the most common surgery doctors use to treat endometriosis.
Endometriosis has significant social, public health and economic implications. It can decrease quality of life due to severe pain, fatigue, depression, anxiety and infertility. Some individuals with endometriosis experience debilitating pain that prevents them from going to work or school.
Endometriosis can affect women across all ethnic backgrounds and at any age, but it most commonly affects women during their reproductive years between the ages of 25 and 35.
And there's no genetic trait associated with endometriosis that could lead to cancer. Some rare types of ovarian cancer, like clear cell ovarian cancer and endometrioid ovarian cancer, are more common in women with endometriosis. But even with those cancer types, the risk is still lower than 1%.
Deep infiltrating endometriosis (DIE) is the most aggressive of the three phenotypes that constitute endometriosis. It can affect the whole pelvis, subverting the anatomy and functionality of vital organs, with an important negative impact on the patient's quality of life.
There is no cure for endometriosis. Hormone therapy or taking out tissue with laparoscopic surgery can ease pain. But pain often returns within a year or two. Taking out the ovaries (oophorectomy) and the uterus (hysterectomy) usually relieves pain.
According to the United Kingdom's National Health Service, endometriosis is among the 20 most painful medical conditions, along with cancer, appendicitis and childbirth, and yet women's pain is on average ignored for seven years.
The type of symptoms and severity of pain depends on where the endometrial-like tissue growths are located. Nonetheless, endometriosis is the top cause of painful sex and pelvic pain.
Is endometriosis painful like labor? Though symptoms vary from person to person, some describe their endometriosis cramps as feeling like contractions that come and go and mimic those of labor pains. It's important to note that not all people will experience such intense pain.
Even if you've been diagnosed with severe stage 4 endometriosis, you can still be surgically treated in a completely minimally invasively way, without resorting to a large incision (laparotomy), without having to remove your uterus or ovaries, and without leaving behind any disease.
Endometriosis flare-ups are periods of worsened pain and other symptoms that hormonal changes and increased inflammation trigger in the body. These triggers can occur with stress, lack of sleep, alcohol use, and inflammatory foods.
Nonetheless, about a quarter of women hospitalized for initial surgical treatment for endometriosis will undergo additional surgical treatment within 4 years, and one in 10 will have a hysterectomy.
Stage 4 endometriosis life expectancy
Although it can affect your quality of life, it isn't considered to be a fatal disease. Endometriosis is associated with a small number of potentially fatal conditions, such as small bowel obstruction and ectopic pregnancy.
If you had laparoscopy, you'll probably go home from the hospital on the same day. But you'll need to rest in a recovery area until your medical team clears you. You'll likely feel tired for a few days. But you should be able to return to normal routines in about two weeks, though it could take longer for some people.
Cysts of endometriosis on the ovaries (endometriomas), are unlikely to disappear on their own and generally cannot be treated with medicine. They may be removed surgically if they are causing symptoms or they are large. Small endometriomas that are not causing symptoms may be observed with regular ultrasounds.