# Deep Infiltrating Endometriosis (DIE) - Link: https://sifsof.com/clinical-apps/deep-infiltrating-endometriosis-die/ - Published: 2020-02-01T10:23:20+00:00 - Author: Developer Deep Infiltrating Endometriosis DIE is defined by lesions that penetrate under the peritoneum by more than 5 mm and affects approximately 20% of patients with endometriosis. DIE nodules will not just superficially implant in the pelvis, but it will infiltrate into pelvic structures, mainly into bowel, bladder, the vagina and ligaments behind the uterus (uterosacral ligaments). It can be present in multiple pelvic sites including the vagina, rectum, rectosigmoid, rectovaginal septum (RVS), uterosacral ligaments (USL), fallopian tube, Pouch of Douglas (POD), bladder and ureters. The preoperative diagnosis with ultrasound allows for better preoperative preparation and outcomes for patients. Ultrasound can detect DIE with a high degree of accuracy. ### **Which ultrasound scanner is best for Deep Infiltrating Endometriosis (DIE) assessment?** [Transvaginal ultrasound (TVUS)](https://sifsof.com/product-category/ultrasound-scanners/transvaginal-ultrasound-scanner-tvus/) has been shown to be an accurate and reliable diagnostic tool in detecting ovarian endometrioma and deep infiltrating endometriosis. The [SIFULTRAS-5.36](https://sifsof.com/product/wireless-transvaginal-ultrasound-scanner-sifultras-5-36/) allows the practitioner to visualize not just the uterus and ovaries but also the bladder, the ligaments behind the uterus, the vaginal wall and the bowel Needless to say that It is important to have a detailed ultrasound prior to considering a laparoscopy to look for deep infiltrating endometriosis. TVUS also involves assessing the mobility of the ovaries and checking whether there is sliding between the bowel and the uterus. The preoperative diagnosis of deep infiltrating endometriosis may give a first explanation for symptoms but more importantly, it gives an indication of the extent of the disease, it provides patients with the time to think about the extent of the surgery they are prepared to submit to; and gives the surgeons an idea of what they will find during the surgery so they can prepare better for the operation and advise patients better regarding other treatment options available. Endometriosis lesions on ultrasound look darker on ultrasound. When the rectum is empty, the views of the bowel are generally better since faeces and gas in the bowel cause shadows on ultrasound. For this reason some doctors prefer you to take a mild bowel preparation prior to the ultrasound when you have had a past history of severe endometriosis or when you have significant bowel pain during your periods. This assessment is typically performed by a [radiologist](https://sifsof.com/product-category/doctor-specialties/radiologist/), a trained [gynecologist](https://sifsof.com/product-category/doctor-specialties/gynecologist/), [OB/GYN](https://sifsof.com/product-category/doctor-specialties/obstetrician/).. References: [A step‐by‐step guide to sonographic evaluation of deep infiltrating endometriosis](https://onlinelibrary.wiley.com/doi/full/10.1002/sono.12149), [Can you diagnose Endometriosis via Ultrasound?](https://www.endometriosisaustralia.org/post/2016/09/03/can-you-diagnose-endometriosis-via-ultrasound). ![Deep Infiltrating Endometriosis (DIE)](https://sifsof.com/wp-content/uploads/2020/ 02/Deep-Infiltrating-Endometriosis-DIE-ultrasound-imaging.jpg) * ![Wireless Transvaginal Ultrasound Scanner FDA SIFULTRAS-5.36 main pic](https:// sifsof.com/wp-content/uploads/2017/06/SIFULTRAS-5.36-Transvaginal-Wireless-Ultrasound- Scanner-probe-300x300.jpg) * Wireless Transvaginal Ultrasound Scanner FDA SIFULTRAS-5.36 * ![Color Transvaginal Ultrasound Scanner 6'' Touch Screen, 4-9 MHz, SIFULTRAS- 1.3 main](https://sifsof.com/wp-content/uploads/2017/11/MU2-02-1-300x300.jpg) * Color Transvaginal Ultrasound Scanner 6” Touch Screen, 4-9 MHz, SIFULTRAS-1.3 * ![Convex and Transvaginal Color Double Head WiFi Ultrasound Scanner SIFULTRAS- 5.43 main](https://sifsof.com/wp-content/uploads/2019/02/SIFULTRAS-5.43-Double- head-color-doppler-ultrasound-Transvaginal-and-convex-300x300.jpg) * Convex and Transvaginal Color Double Head Wireless Ultrasound Scanner SIFULTRAS- 5.43 [launchpad_feedback] _Although the information we provide is used but doctors, radiologists, medical staff to perform their procedures, clinical applications, the Information contained in this article is for consideration only. We can’t be responsible for misuse of the device nor for the device suitability with each clinical application or procedure mentioned in this article. Doctors, radiologists or medical staff must have the proper training and skills to perform the procedure with each ultrasound scanner device.