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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  • nikoletta pados

    I am a physician who suffered from deep infiltrative endometriosis. I needed laparoscopic surgery, so I went to see my former gynaecologist and he performed the procedure (a surgery which he supposedly does hundreds of times a year) last November. I had severe pain again when I had my period in January and was advised to go on taking a…

  • Grace Larsen

    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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  • Jacqueline Galindo

    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.…

  • Anna Lu

    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!

  • Sheena Wright

    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.