Adenomyosis externa, also known as deep endometriosis, typically manifests as a solitary, more than one centimeter-diameter nodule in the vesicouterine fold or close to the lower 20 centimetres of the colon. Most nodules are no longer progressing when they are diagnosed. Deep endometriosis is frequently accompanied by excruciating pain (in >95% of cases), which is likely a contributing reason to infertility. Its prevalence is thought to be between 1% and 2%. Clinical suspicion of deep endometriosis might be supported by ultrasonography or magnetic resonance imaging. The effectiveness of a contrast enema in determining the severity of sigmoid occlusion The difficulty of surgery grows with the size of the nodules, and it takes experience to locate tiny nodule intestinal wall. s in the Endometriosis externa is the presence of endometrial tissue implants in all other sites, whether they are physically close to the uterus (like the fallopian tubes and ovaries) or as far away as the brain. Endometriosis interna , now known as adenomyosis, describes the growth of benign endometrial tissue into the myometrium. Endometriosis externa differs from endometriosis interna in terms of epidemiology, pathogenesis, diagnosis, and natural history.98 However, it is unclear whe ther endometriosis externa that develops in locations other than the pelvis is the same disease and can be treated with the same methods and success as pelvic endometriosis externa.
