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Deep Infiltrating Endometriosis (DIE)

What is Deep Infiltrating Endometriosis (DIE)?

Deep Infiltrating Endometriosis (DIE) is a highly invasive form of endometriosis that is often characterized by rectovaginal nodules (in the space between the vagina and rectum) and disease of the uterosacral ligaments, rectum, rectovaginal septum, vagina, and bladder.

What is Deep Infiltrating Endometriosis (DIE)
This image depicts DIE scar tissue between the obliterated cul-de-sac and outer uterus. As it can be seen, the scar tissue has started to serve as a sort of "glue" between the two organs, which is the first sign of DIE beginning to lead to frozen pelvis.

What causes DIE?

When ovarian endometriomas become large enough and invade the wall of the ovaries, they begin to leak and even rupture. When this happens, the thickened blood, inflammatory enzymes and other debris that was contained in these fluid-filled enzymes, spill onto other areas within the abdominal and pelvic cavity. The contents will then adhere to these areas and begin to form the nodules and scar tissue that are often seen in cases of deep infiltrating endometriosis.

Leaking or ruptured endometriomas
Leaking or ruptured endometriomas fill other areas of the body with the “chocolate” like fluid they contain, which goes on to form nodules of DIE in areas outside of the uterus and ovaries

What are common Symptoms associated with DIE?

This significant and severe form of endometriosis is strongly associated with high levels of pelvic pain, anatomic distortion, infertility, dysuria, dysmenorrhea, dyspareunia, and gastrointestinal distress, which may include symptoms that present as irritable bowel.

What is the common surgical treatment for DIE?

Because DIE is surgically treated through the same procedure as Frozen Pelvis, more information can be seen under Frozen Pelvis (click here).

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Ovarian Endometrioma (Chocolate cysts)
Ovarian Endometrioma (Chocolate cysts)

What are ovarian endometriomas (Chocolate cysts)? Ovarian endometriomas are highly common and may be present in up to 30-40% of…

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    After years of excessively painful periods, a serious loss of quality of life, and a series of uninformed and uninterested doctors, Dr. Seckin and Dr. Goldstein turned my life around. I was told I woke up from my surgery almost a year ago with a smile on my face, and I haven't stopped since. Before I heard of Dr. Seckin,…

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    Dr Seckin and his team gave me back my life! Tomorrow will be 1 month since my surgery and I feel great. Dr. Seckin, Dr Liu, and Dr Goldstein are not only beyond words talented and amazing Doctors, but they are also genuinely wonderful and caring people. I cannot say enough great things about Holly, Asiye and Kim as well.…

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    Dr. Seckin and his staff spared me from years and years of heavy periods and unbearable endometriosis pain. After having surgery with him (my first) I can now function like a regular human. No more eating NSAIDs like candy and calling out sick from work. Thank you, Dr. Seckin!

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    I underwent surgery with Dr. Seckin in 2017 and have felt like a new woman ever since. If you have, or suspect you have endometriosis, Dr. Seckin and his compassionate team of surgeons and staff are a must-see.

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    I have struggled with endometriosis and adenomyosis since first starting my period at 13. I was diagnosed at 21 and what followed was a series of unsuccessful surgeries and treatments. My case was very aggressive and involved my urinary tract system and my intestines. After exhausting all of my local doctors I was lucky enough to find Dr. Seckin. We…

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    Seckin and Dr. Goldstein changed my life!

  • Kristin Sands

    Like so many women who have tirelessly sought a correct diagnosis and proper, thorough medical treatment for endometriosis, I found myself 26 years into this unwanted journey without clear answers or help from four previous gynecological doctors and two emergency laparoscopic surgeries. I desperately wanted to avoid the ER again; a CT scan for appendicitis also revealed a likely endometrioma…

  • Wilfredo Reyes

    Dr. Seckin literally gave my wife her life back. I am eternally grateful to him for his generous, determined spirit to see that Melanie finally live free from the prison bonds of Endometriosis.

  • Carla

    I am so grateful to Dr Seckin and Dr. Goldstein. My experience was nothing short of amazing. I was misdiagnosed with the location of my fibroids and have had a history of endometriosis. Dr. Seckin was the one who accurately diagnosed me. Dr Seckin and Dr. Goldstein really care about their patients and it shows. They listened to my concerns,…

  • Melissa Boudreau

    When I think of Dr. Seckin these are the words that come to mind. Gratitude, grateful, life-changing, a heart of gold. I feel compelled to give you a bit of background so you can understand the significance of this surgery for me. I am passionate about Endometriosis because it has affected me most of my life and I have a…

  • Jaclyn Harte

    Dr. Seckin and Dr. Goldstein radically changed my quality of life. They treat their patients with dignity & respect that I've personally never seen in the literally 25+ doctors I've seen for endometriosis. This summer, I had a surgery with Dr. Seckin & Goldstein. It was my first with them, but my 5th endo surgery. I couldn't believe the difference,…

  • Megan Rafael Moreno

    I was in pain for 2 years. I was getting no answers, and because dr Goldstein and dr seckins were willing to see and treat me I'm finally feeling almost back to normal. They were very down to earth and helpful in my time of need. Dr Goldstein was easy to talk to and caring, she took care of me…

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    Dr. Seckin is one of the best endometriosis surgeon. Every time I go to the office, he really listens to me and is always concerned about my issues. Dr Seckin's office staff are a delight and they always work with me. I feel I can leave everything to them and they will take care of it. Thank you to the…