17/03/2026
EXTRA-PELVIC ENDOMETRIOSIS
While endometriosis predominantly affects pelvic structures, it is clinically important to recognise that endometriosis is not confined to the pelvis.
Extra-pelvic endometriosis refers to disease occurring in anatomical sites beyond the reproductive organs, and although less common, it carries significant diagnostic and clinical implications.
Common extra-pelvic sites include:
1.Gastrointestinal tract (especially rectosigmoid colon):
Patients may present with cyclical dyschezia, altered bowel habits, bloating, or re**al bleeding - often misdiagnosed as irritable bowel syndrome or other gastrointestinal disorders.
2: Urinary tract (bladder, ureters):
Symptoms may include dysuria, urinary frequency, urgency, or cyclical hematuria. In severe cases, ureteric involvement may lead to silent kidney compromise.
3: Thoracic cavity (thoracic endometriosis):
Involvement of the lungs or diaphragm may result in catamenial chest pain, dyspnea, hemoptysis, or recurrent pneumothorax temporally associated with menstruation.
4: Abdominal wall and surgical scars:
Frequently observed in prior surgical sites (e.g., cesarean section scars), presenting as localised, cyclical pain and palpable nodules.
Extra-pelvic endometriosis is often under diagnosed due to its atypical presentation and the tendency to evaluate symptoms in isolation rather than in relation to the menstrual cycle.
This contributes to prolonged diagnostic delays and inappropriate management pathways.
Endometriosis should be approached as a systemic condition with potential multi-organ involvement, rather than a disease limited to the pelvis. Improved clinical awareness of extra-pelvic manifestations is essential for early diagnosis, targeted treatment, and improved patient outcomes.
