Lesion distribution characteristics of deep infiltrating endometriosis with ovarian endometrioma: An observational clinical study

Lesion distribution characteristics of deep infiltrating endometriosis with ovarian endometrioma: An observational clinical study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research article Lesion distribution characteristics of deep infiltrating endometriosis with ovarian endometrioma: An observational clinical study Hungling Kwok, Hongye Jiang, Tian Li, Huan Yang, Hui Fei, Li Cheng, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.2.19864/v2 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 20 May, 2020 Read the published version in BMC Women's Health → Version 2 posted 15 You are reading this latest preprint version Show more versions Abstract Background: To investigate the characteristics of deep infiltrating endometriosis (DIE) lesion distribution when associated with ovarian endometrioma (OEM). Methods: The present study analyzed retrospective data obtained by the First Affiliated Hospital of Sun Yat-sen University, between June 2008 to June 2016. A total of 304 patients underwent laparoscopic surgery for complete removal of endometriosis by one experienced surgeon, and histological confirmation of OEM associated with DIE was conducted for each patient. Clinical data were recorded for each patient from medical, operative and pathological reports. Patients were then divided into two groups according to unilateral or bilateral OEM. Patients with unilateral OEM were subsequently divided into two subgroups according to OEM location (left- or right-hand side) and the diameter of the OEM (≤50 and >50 mm). The distribution characteristics of DIE lesions were then compared between the groups. Results: DIE lesions were widely distributed, 30 anatomical sites were involved. Patients with associated unilateral OEM (n=184 patients) had a significantly increased number of DIE lesions when compared with patients with bilateral OEM (n=120 patients; 2.76±1.52 vs. 2.33±1.34; P=0.006). Compared with bilateral OEM with DIE, there was a higher rate of intestinal (39.1% vs. 18.3%; P<0.01) and vaginal (17.4% vs. 6.7%; P<0.01) infiltration by DIE lesions in unilateral OEM with DIE. The mean number of DIE lesions was not significantly correlated with the location or size of the OEM (2.83±1.56 vs. 2.74±1.53; P=0.678; and 2.65±1.42 vs. 2.80±1.43; P=0.518, respectively). There was no significant difference between the groups with OEM ≤50 mm and >50 mm. Conclusion: Lesion distribution characteristics in women diagnosed with histologically proven OEM associated with DIE were frequently multifocal and severe. Key Words: ovarian endometrioma, deep infiltrating endometriosis, lesion distribution characteristics Obstetrics & Gynecology ovarian endometrioma deep infiltrating endometriosis lesion distribution characteristics Background Endometriosis is a common benign diseases of women of childbearing age[1]. According to histology, endometriosis is characterized into three main types: superficial endometriosis, ovarian endometrioma and deep infiltrating endometriosis (DIE)[2]. DIE is an aggressive form of the disease, penetrating to more than 5mm under the peritoneal surface[3].DIE is associated with infertility and a variable degree of pelvic pain. It is a multifocal disease primarily affecting the posterior area, and frequently involves the uterosacral ligament, uterine rectum pouch and vaginal rectal diaphragm, as well as the bladder, ureter and rectal wall[4]. For patients with multifocal characteristics of DIE, meaningful improvements in clinical symptoms and quality of life are dependent on the radical exeresis of the lesions[5, 6]. When surgical treatment has been recommended, an accurate diagnosis and knowledge of the precise distribution of the extending lesions are required [4]. However, there are currently no adequately sensitive and specific symptoms nor diagnostic tests for the clinical diagnosis of DIE. The perfect solution would be to utilize a preoperative label for the distribution of DIE to generate a precise map of the DIE lesions. Ovarian endometrioma (OEM) is the most common type of endometriosis, ~50% of DIE patients are also diagnosed with OEM [7]. Previous studies have demonstrated that associated OEM is a marker for greater DIE severity. Compared with patients without OEM, patients with OEM have more pelvic and intestinal areas involved by DIE[8, 9]. In case of OEM, severe pelvic pain is significantly associated with DIE[10]. Indeed, Maria et al.[11] created a predictive model to predict DIE in patient with OEM. However, these studies do not refer to the characteristics of the lesion distribution in OEM patients with DIE. Therefore, the present study investigated OEM in order to determine the lesion distribution characteristics of DIE associated with OEM. Methods Patients. The present retrospective study was approved by the Institutional Review Board of the First Affiliated Hospital of Sun Yat-sen University (Guangzhou, China). All patients provided written informed consent. A total of 304 consecutive patients underwent laparoscopic surgery for complete removal of endometriosis in the First Affiliated Hospital of Sun Yat-sen University, between June 2008 to June 2016; histological confirmation of OEM associated with DIE was conducted for each patient. Histological diagnoses were based on characteristics previously defined in a standard histological description, comprised of a combination of endometrial glands and stroma [12]. The exclusion criteria were as follows: i) laparoscopic surgery converted to open surgery; ii) lack of histological confirmation of endometriosis; iii) previous history of hysterectomy or oophorectomy; and iv) patients with pelvic malignant tumors. Between June 2008 to June 2016, clinical data were recorded retrospectively for each patient from medical, operative and pathological reports; data were blinded for examination by two of the authors. For each patient, general data were recorded, including age, parity, the diameter and location of the OEM (right or left), and past history of surgical treatment for endometriosis, pain symptoms and other specific symptoms. Pain symptoms included dysmenorrhea, dyspareunia, chronic pelvic pain, and bowel pain. Other specific symptoms including hematochezia, urinary frequency and urgency, and hydro-nephrosis. Histological confirmation was obtained for all endometriotic lesions and a description of the location of the DIE lesions was recorded. All of the patients underwent extensive preoperative tests, including clinical examinations, transvaginal sonography, urological ultrasound and MRI. Patients were treated surgically due to ineffective conservative treatment or serious complications. All of the operations were performed by an experienced surgeon (Professor Shuzhong Yao). All visible endometriosis lesions, including ovarian endometrioma and DIE lesions, were surgically removed. For patients with adenomyosis, local resection or hysterectomy was performed according to the severity of the disease and bearing requirement. In addition to DIE resection, surgical treatment involves adhesion separation as well as resection and reconstruction of the urinary organs and bowel. When these procedures were employed, urologists and gastroenterologists were necessary. Patients were divided into two groups according to the type OEM: unilateral or bilateral. Patients with unilateral OEM were subsequently divided into subgroups according to the location of the OEM (left- or right-hand side) and the diameter of the OEM (≤50 and >50 mm). The distribution characteristics of DIE lesions were then compared between the groups. Statistical analysis Statistical analysis was performed using SPSS version 23.0 for Windows (IBM Corp., Armani, NY, USA). P<0.05 was considered to indicate a statistically significant difference. Statistical analysis was conducted stepwise after assessing quantitative variable distributions. Statistical studies using parametric tests were only conducted after checking the normal distribution of the studied variables. Correlations between qualitative variables were analyzed by a Pearson’s chi-square test. In case of significant reciprocal correlation, the relative risk was calculated with 95% confidence intervals. Results Patient characteristics are presented in Table I. A total of 304 patients were included in the present study. The female patients had a mean age of 34.2±5.8 (range, 17-49) years. All the patients with OEM associated with DIE have different symptoms. According to the different symptoms, they were divided into two types: non-specific symptoms and specific symptoms. Non-specific symptoms include dysmenorrhea (89.5%), dyspareunia (12.8%) and chronic pelvic pain (4.3%), while specific symptoms include intestinal symptoms and urinary symptoms. Intestinal symptoms include rectal tenesmus (24%), difficulty in defecation (4.3%), defecation pain (3.6%), diarrhea (2.0%) and hematochezia (2.6%). Urinary symptoms include urinary frequency and urgency (3.0%), hematuria (0.7%) and hydronephrosis (8.6%). In the cohort of 304 patients with an associated OEM, the OEM was located on the left-hand side in 98 patients (32.2%), on the right-hand side in 86 patients (28.3%), and was bilateral in 120 patients (39.5%). The mean size of the OEM was 55.9±23.9 mm (range, 10-150 mm). The anatomical locations of the DIE lesions are presented in Table II. A total of 788 histologically confirmed DIE lesions were observed in the present study. The mean number of DIE lesions per patient was 2.60±1.46 (range, 1-9). DIE lesions were widely distributed; there were 30 anatomical sites recorded in the present study, which were mainly located in the posterior pelvic cavity. A total of 532 lesions were recorded, of which 274 (51.5%) were located on the left-hand side and 258 (48.5%) on the right-hand side. The uterosacral ligament represented the most frequent location site with a prevalence of 80.6%, followed by the intestine (30.6%), ureter (15.5%), vagina (13.2%), posterior fornix (10.9%), fallopian tube (9.54%), vaginal-rectum (6.91%), rectovaginal pouch (2.96%) and bladder (1.32%). Intestinal endometriosis includes rectum and sigmoid endometriosis. There were also 4 cases of appendiceal endometriosis that were not included in the intestinal endometriosis. Patients with associated unilateral OEM (n=184 patients) had a significantly increased number of DIE lesions when compared with patients with bilateral OEM (n=120 patients; 2.76±1.52 vs. 2.33±1.34; P=0.006; Table III). Compared with bilateral OEM with DIE, a higher rate of intestinal (39.1% vs. 18.3%; P<0.01) and vaginal (17.4% vs. 6.7%; P<0.01) infiltration by DIE lesions was observed in unilateral OEM with DIE. The mean number of DIE lesions was not significantly correlated with the location or size of the OEM (2.83±1.56 vs. 2.74±1.53, P=0.678; 2.65±1.42 vs. 2.80±1.43, P=0.518, respectively). There were no significant differences between the groups with OEMs ≤50 mm and >50mm. Discussion Previous studies have revealed that, for patients with histologically confirmed DIE, an associated ovarian OEM is a marker for the severity of the disease [8]. However, the related research on the distribution characteristics of the DIE lesions in patients with OEM is still limited. The present study investigated lesion distribution characteristics in women diagnosed with histologically confirmed OEM and DIE, as this combined diagnosis is often indicative of a more multifocal and severe disease. There was a greater frequency of anatomic DIE lesion sites in patients with unilateral OEM (unilateral OEM size ≤50 mm) than in patients with bilateral OEM (unilateral OEM size ≤50 mm), and DIE lesions were often associated with intestinal and vaginal infiltration. These data suggested that DIE lesions were widely distributed. There were 30 anatomical sites observed in the present study, which were primarily located in the posterior pelvic cavity, but also in the uterosacral ligaments, intestines, ureter, vagina, posterior fornix and rectovaginal pouch. The distribution of DIE lesions was associated with the flow pattern of peritoneal fluid and the morphology of the pelvic cavity [13]. When compared with the uterosacral ligaments, intestines and vagina, the reduced frequency of deep bladder endometriosis observed can be explained by anatomical location as the lower limit of the vesico-uterine pouch is located well above the lower limit of the Pouch of Douglas[14]. The anatomical differences between the left- and right-hand sides of the hemipelvis are that the sigmoid colon is located on the left-hand side of the hemipelvis, and when combined with the left adnexa it forms a barrier to prevent menstrual blood reflux, resulting in an anatomical situation that could promote adhesions and the growth of refluxed endometrial cells on the left-hand side of the pelvic wall[15]. According to the literature, intestinal endometriosis and urinary tract endometriosis account for ~5-12% and 0.3-12%, respectively, of all women with endometriosis [16-18]. However, in the present study, intestinal endometriosis accounted for 30.9%, and urinary tract endometriosis accounted for 15.2% of cases, which are greater frequencies than those recorded by previous research. According to the theory of Kondo et al, women presenting with OEM had a stronger association with the presence of DIE lesions and intestinal DIE[19]. There is lack of research on OEM associated with urinary tract endometriosis. The present results indicated that, for patients diagnosed with histologically verified OEM associated with DIE, there was an increased risk of lesions involving the intestine and ureter. Thus, when the clinical examination suggests OEM with DIE, the practitioner should search for severe lesions, especially intestinal and ureteral lesions. Surgery for intestinal endometriosis and urinary endometriosis is difficult, with a number of postoperative complications[20, 21]. The literature reports distinguish between major and minor complications. Major complications include anastomotic insufficiencies, intestinal perforation, retovaginal fistulas, severe infections, and bleeding requiring transfusion, which are reported in 7.4%[22] to 25%[23]. Minor complications include slight-to-moderate infections, peripheral sensory disturbances, bladder voiding dysfunction, and postoperative urinary obstruction, which are reported in 0.6%[24] to 57%[25]. Therefore, full clinical evaluations, as aforementioned, before operating may be very important for OEM patients with DIE. As mentioned above, intestinal endometriosis refers to the rectum and sigmoid endometriosis. However, there are a special intestinal endometriosis, appendiceal endometriosis, which is considered as an uncommon finding, in the literature its prevalence varies widely [26]. In our study, there are 4 patients with appendiceal endometriosis，are responsible for approximately 4% of all intestinal lesions. Diego Raimondo et al.[27] pointed out that appendiceal endometriosis was associated with adenomyosis, large right endometrioma, deep posterior pelvic endometriosis, left deep lateral pelvic endometriosis, and ileocecal involvement. The 4 patients in our study who had appendiceal endometriosis were all combined with adenomyosis, and the diameter of OEM was greater than 5cm, which was further validated the conclusions of Diego Raimondo et al. Patients with simple OEM often have no typical clinical manifestations, and some patients only find the presence of OEM in routine physical. Previous studies have conducted multivariate regression analysis on the relationship between dysmenorrhea and OEM. The results showed that the severity of dysmenorrhea had nothing to do with the existence of OEM. Intestinal endometriosis and deep pelvic invasive endometriosis were the main related factors of dysmenorrhea[28]. Of the 304 patients in our study, 272 (89.5%) with symptoms of dysmenorrhea, 39 (12.8%) with dyspareunia, and 17 (5.6%) with chronic pelvic pain. Dai et al reported that 61.6% of patients with OEM but non-DIE had dysmenorrhea, and 10.2% had severe dysmenorrhea[29]. It is suggested that when patients with OEM have obvious pain symptoms, it should be considered that they may be complicated with DIE. During the early stages of ureteral endometriosis, the clinical symptoms are not typical, and are easily overlooked during surgery. Some researchers have suggested that urinary tract endometriosis may occur more frequently than it is currently thought to[30, 31]. Raimondo D et al. observed that ureteral involvement was always associated with endometriosis in other locations in the pelvis. And the most frequent endometriosis associations with ureteral involvement are ovarian lesions[32]. In this case, when there is an associated OEM, ultrasonic examination of the urogenital system is necessary. Ureteral endometriosis should be considered when B mode ultrasound reveals ureter stenosis and hydronephrosis. Hydroureter and hydronephrosis are the severe forms of ureteral endometriosis. In case of hydronephrosis, renal scintigraphy to evaluate renal function should be needed. Patients with associated unilateral OEM have an increased number of DIE lesions and have a greater risk of lesions involving the intestine and vagina when compared with patients with bilateral OEM. It was hypothesized that a clinical case of bilateral OEM may be more complex than unilateral OEM, and the distribution of the DIE lesions may be more extensive and deeper in patients with larger OEM. However, some researchers maintain that in patients with OEM ≥30 mm, OEM size was the most influential contributor to the total number of follicles and oocytes retrieved. OEM results in a reduced response to ovarian stimulation, when compared with the response of the contralateral normal ovary in the same individual [33]. The oppression of the ovary was more obvious in bilateral OEM and the response to ovarian stimulation was markedly reduced. In the clinic, patients with unilateral OEM or an OEM with a diameter of ≤50 mm should not be taken lightly, and should be evaluated for the presence of DIE lesions, especially intestinal DIE. The aim of the present study was to potentially provide the basis for avoiding underestimation of the extent of the DIE lesions. Misunderstanding the severity of DIE lesions is the main reason why it is difficult to completely remove lesions during surgical treatments. Incomplete exeresis of DIE lesions explains the high risk of recurrence; this recurrence is in fact the continued progression of the lesions left behind during previous operations[34, 35]. Repeated surgery is positively associated with increased health care costs and morbidity [36]. Repeated surgery with damage to ovarian reserves is particularly frequent in ovarian endometriosis[37-39]. In addition, the risk of repeated operations is associated with uncertainty regarding surgical outcomes and pain. Therefore, completely excising the DIE lesions during the initial surgery is particularly important. For the first time, our study analyses the characteristic of DIE lesion distribution in patient with ovarian endometrioma. However, this was a retrospective single center study, results were limited by a lack of random, patient selection, and incomplete data acquisition. The data on the history of previous endometriosis treatment were incomplete, which prevented us from evaluate the effect of previous treatment on the recurrence. A large multicenter prospective trial will be necessary to further assess this lesion distribution characteristic. Conclusions In summary, lesion distribution of DIE associated with OEM was frequently multifocal and severe. For patients with OEM that requires surgical treatment, it cannot be treated only by cystectomy; it should be combined with the patient’s clinical symptoms, and be carefully explored during surgery to avoid the omission of the lesions. Abbreviations DIE: Deep Infiltrating Endometriosis OEM: Ovarian Endometrioma Declarations Acknowledgements The authors want to warmly thank staff members from our department of medical record management for their expert assistance with data collection. The authors also thank Dr. Xiao Lin for his help in preparing the statistical analysis. Funding This work was supported by the Natural Science Foundation of China (81070472) and the Science and Technology Planning Project of Guangdong Province (2012B031800121). Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Author information Affiliations Department of Obstetrics and Gynecology, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China. Hungling Kwok, Tian Li, Hui Fei, Li Cheng Center for Reproductive Medicine, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China. Huan Yang Department of Obstetrics and Gynecology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. Shuqin chen, Hongye Jiang, Shuzhong Yao Corresponding author Correspondence to Shuqin Chen Authors’ Contributions Shuqin Chen and Shuzhong Yao: conceived and designed the study. Hungling Kwok and Hongye Jiang: contributed to data analysed and interpreted the data, writing the manuscript. Tian Li and Huan Yang: involved in manuscript writing. Hui Fei and Li Cheng: collected the Data. All the authors approve the final version of the manuscript. Ethics declarations Ethics approval and consent to participate The study was approved by Ethics Committee of the First Affiliated Hospital of Sun Yat-sen University, and the written consent was obtained from participants. Consent for publication Not applicable. Competing interests The authors declare that they have no competing interest and nothing to disclose. 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Patients’ characteristics (N= 304) Values a Age(years) 34.2±5.8(range17-49) Parity Para≥1 158(52.0%) Nulliparous 146(48.0%) Infertility 78(25.7%) Previous surgery for OEM 88(28.9%) Presenting symptoms b No symptoms 32(10.5%) Dysmenorrhea 272(89.5%) Dyspareunia 39(12.8%) Chronic pelvic pain 17(5.6%) Rectal tenesmus 73(24.0%) Difficulty in defecation 13(4.3%) Diarrhea 6(2.0%) Defecation pain 11(3.6%) Hematochezia 8(2.6%) Urinary frequency and urgency 9(3.0%) Haematuria 2(0.7%) Hydronephrosis 26(8.6%) Endometrioma laterality Left 98(32.2%) Right 86(28.3%) Bilateral 120(39.5%) Endometrioma size (mm) 55.9±23.9 (range10-150) Number of DIE lesions 2.60±1.5 (range1-9) OEM, ovarian endometrioma; DIE, deep infiltrating endometriosis. a Values are shown as mean ± standard deviation or N(%). b Different symptoms can be associated in the same patient. Table II The prevalence of anatomical distribution of DIE lesions. (n=304 patients) Main lesion a Number of patients(%) b Uterosacral ligament 245(80.6) Left 57 Right 53 Bilateral 135 Intestine 93(30.6) Ureter 47(15.5) Left 22 Right 18 Bilateral 7 Vaginal 40(13.2) Posterior fornix 33(10.9) Fallopian tube 29(9.54) Left 12 Right 4 Bilateral 13 Recto-vaginal septum 21(6.91) Rectovaginal pouch 9(2.96) Bladder 4(1.32) DIE, deep infiltrating endometriosis. a According to the location of the lesion recorded during the operation. b Number of patients whose lesions histologically proven deep infiltrating endometriosis. Table III Characteristics of deeply infiltrating endometriosis lesion distribution associated ovarian endometrioma. Variables Comparison P -value OR 95% CI OEM laterality a Unilateral n=184(%) Bilateral n=120(%) Number of DIE lesions 2.76 ± 1.52 2.33 ± 1.34 0.006 * Uterosacral ligament 151(82.1) 94(78.3) 0.421 1.266 0.712-2.249 Intestine 72(39.1) 21(17.5) 0.000 * 3.031 1.738-5.286 Vagina 32(17.4) 8(6.70) 0.007 * 2.947 1.308-6.641 Posterior fornix 23(12.5) 10(8.3) 0.100 1.571 0.720-3.431 Ureter 29(15.8) 18(15.0) 0.858 1.060 0.560-2.009 Fallopian tube 19(10.3) 10(8.3) 0.563 1.267 0.568-2.827 Rectovaginal pouch 16(8.7) 14(11.7) 0.396 0.767 0.359-1.637 Side of OEM a Left side n=98(%) Right side n=86 (%) Number of DIE lesions 2.83±1.56 2.74±1.53 0.678 Uterosacral ligament 81(82.7) 70(81.4) 0.824 1.089 0.512-2.315 Intestine 40(40.8) 32(37.2) 0.617 1.164 0.642-2.109 Vagina 18(18.4) 15(17.4) 0.870 1.065 0.500-2.268 Posterior fornix 15(15.3) 8(9.3) 0.219 1.762 0.078-4.386 Ureter 16(16.3) 13(15.1) 0.822 1.096 0.494-2.431 Fallopian tube 8(8.2) 11(12.8) 0.303 0.606 0.232-1.584 Rectovaginal pouch 9(9.2) 7(8.1) 0.802 1.141 0.406-3.207 Unilateral OEM size a ≤ 50mm n=112(%) >50mm n=72 (%) Number of DIE lesions 2.77±1.4 2.82±1.4 0.960 Uterosacral ligament 87(77.7) 64(88.9) 0.053 0.435 0.184-1.027 Intestine 54(48.2) 17(23.6) 0.001 * 3.012 1.560-5.817 Vagina 25(22.3) 6(8.3) 0.013 * 3.161 1.226-8.164 Posterior fornix 11(9.8) 12(16.7) 0.171 0.545 0.226-1.311 Ureter 15(13.4) 14(19.4) 0.272 0.641 0.289-1.423 Fallopian tube 10(8.9) 9(12.5) 0.437 0.686 0.264-1.781 Rectovaginal pouch 11(9.8) 12(16.7) 0.171 0.545 0.226-1.311 a Values are shown as mean ± standard deviation or N(%). * Statistically significant Cite Share Download PDF Status: Published Journal Publication published 20 May, 2020 Read the published version in BMC Women's Health → Version 2 posted Review # 5 received at journal 19 Apr, 2020 Editorial decision: Minor revision 19 Apr, 2020 Review # 4 received at journal 14 Apr, 2020 Reviewer # 5 agreed at journal 22 Mar, 2020 Reviewer # 3 agreed at journal 18 Mar, 2020 Review # 3 received at journal 18 Mar, 2020 Reviewer # 4 agreed at journal 18 Mar, 2020 Editor assigned by journal 17 Mar, 2020 Reviewers invited by journal 17 Mar, 2020 Reviewer # 1 agreed at journal 17 Mar, 2020 Reviewer # 2 agreed at journal 17 Mar, 2020 Review # 1 received at journal 17 Mar, 2020 Review # 2 received at journal 17 Mar, 2020 Submission checks completed at journal 16 Mar, 2020 Editor invited by journal 16 Mar, 2020 You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-10476","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research article","associatedPublications":[],"authors":[{"id":419854,"identity":"a29b654e-8b59-4d84-8491-8b9f5160b6eb","order_by":1,"name":"Hungling Kwok","email":"","orcid":"","institution":"the Seventh Affiliated Hospital, Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Hungling","middleName":"","lastName":"Kwok","suffix":""},{"id":419855,"identity":"21263dd6-a674-4720-8330-7fcba946c6ea","order_by":2,"name":"Hongye Jiang","email":"","orcid":"","institution":"Sun Yat-sen University First Affiliated Hospital","correspondingAuthor":false,"prefix":"","firstName":"Hongye","middleName":"","lastName":"Jiang","suffix":""},{"id":419856,"identity":"b0f0f61f-8c57-4e4a-a60c-31f861eb611a","order_by":3,"name":"Tian Li","email":"","orcid":"","institution":"the Seventh Affiliated Hospital, Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Tian","middleName":"","lastName":"Li","suffix":""},{"id":419857,"identity":"e264b16d-2c01-4934-a1ec-c1b8bceeda39","order_by":4,"name":"Huan Yang","email":"","orcid":"","institution":"the seventh Affiliated Hospital, Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Huan","middleName":"","lastName":"Yang","suffix":""},{"id":419858,"identity":"3cd423c0-df5e-4f35-9708-6d0fcd76e94d","order_by":5,"name":"Hui Fei","email":"","orcid":"","institution":"the Seventh Affiliated Hospital, Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Hui","middleName":"","lastName":"Fei","suffix":""},{"id":419859,"identity":"b266519a-d06b-487d-a7b4-2eb5add0e73c","order_by":6,"name":"Li Cheng","email":"","orcid":"","institution":"the Seventh Affiliated Hospital, Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Li","middleName":"","lastName":"Cheng","suffix":""},{"id":419860,"identity":"b033c83b-4578-4a1c-845e-6923740865c6","order_by":7,"name":"Shuzhong Yao","email":"","orcid":"","institution":"Sun Yat-sen University First Affiliated Hospital","correspondingAuthor":false,"prefix":"","firstName":"Shuzhong","middleName":"","lastName":"Yao","suffix":""},{"id":419861,"identity":"d79cc938-139c-48c0-8fd2-7ccd9294a0c0","order_by":8,"name":"Shu-Qin Chen","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA70lEQVRIie3RsYrCMBjA8ZRCXVKyplTf4YOCh5x4r1IR7FLQR0gJZLw54uBbHI4pASfRVdDBLs51EQQHA+JwyMWON+RPErL8SEIQcrn+Y9RMjyEUmFXV0MeEsMbELyo5HbcjqRoShFo8wbXuA0vtgsz5qroudec7LgTFsMWAlFefc8shh1WWhGudiHYpKIU9/vCZH81+/iZA827sCT0U1AwwpMdU4IdWMrlE1ydJYYNBpe9IHtDwQTgoUO8J3Y27cSiyxJCiYjDCkSy59S1Ejk7mYp+dhcyO+nYbfBHCy/psIc8eX/O6b0hcLpfL9bs7myJUfGSmWOgAAAAASUVORK5CYII=","orcid":"","institution":"Sun Yat-sen University First Affiliated Hospital","correspondingAuthor":true,"prefix":"","firstName":"Shu-Qin","middleName":"","lastName":"Chen","suffix":""}],"badges":[],"createdAt":"2019-12-28 13:53:53","currentVersionCode":2,"declarations":"","doi":"10.21203/rs.2.19864/v2","doiUrl":"https://doi.org/10.21203/rs.2.19864/v2","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12905-020-00974-y","type":"published","date":"2020-05-20T18:24:24+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":14033907,"identity":"35eb2b9c-9439-4f50-9dea-022d87b3ac7d","added_by":"auto","created_at":"2021-09-27 18:29:21","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":290934,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-10476/v2/08cd63ec-b1ad-4b63-a0fd-4adec3265fc3.pdf"}],"financialInterests":"","formattedTitle":"Lesion distribution characteristics of deep infiltrating endometriosis with ovarian endometrioma: An observational clinical study","fulltext":[{"header":"Background","content":"\u003cp\u003eEndometriosis is a common benign diseases of women of childbearing age[1]. According to histology, endometriosis is characterized into three main types: superficial endometriosis, ovarian endometrioma and deep infiltrating endometriosis (DIE)[2]. DIE is an aggressive form of the disease, penetrating to more than 5mm under the peritoneal surface[3].DIE is associated with infertility and a variable degree of pelvic pain. It is a multifocal disease primarily affecting the posterior area, and frequently involves the uterosacral ligament, uterine rectum pouch and vaginal rectal diaphragm, as well as the bladder, ureter and rectal wall[4].\u003c/p\u003e\n\u003cp\u003eFor patients with multifocal characteristics of DIE, meaningful improvements in clinical symptoms and quality of life are dependent on the radical exeresis of the lesions[5, 6]. When surgical treatment has been recommended, an accurate diagnosis and knowledge of the precise distribution of the extending lesions are required [4]. However, there are currently no adequately sensitive and specific symptoms nor diagnostic tests for the clinical diagnosis of DIE. The perfect solution would be to utilize a preoperative label for the distribution of DIE to generate a precise map of the DIE lesions.\u003c/p\u003e\n\u003cp\u003eOvarian endometrioma (OEM) is the most common type of endometriosis, ~50% of DIE patients are also diagnosed with OEM [7]. Previous studies have demonstrated that associated OEM is a marker for greater DIE severity. Compared with patients without OEM, patients with OEM have more pelvic and intestinal areas involved by DIE[8, 9]. In case of OEM, severe pelvic pain is significantly associated with DIE[10]. Indeed, Maria et al.[11] created a predictive model to predict DIE in patient with OEM. However, these studies do not refer to the characteristics of the lesion distribution in OEM patients with DIE. Therefore, the present study investigated OEM in order to determine the lesion distribution characteristics of DIE associated with OEM.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cem\u003ePatients.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe present retrospective study was approved by the Institutional Review Board of the First Affiliated Hospital of Sun Yat-sen University (Guangzhou, China). All patients provided written informed consent. A total of 304 consecutive patients underwent laparoscopic surgery for complete removal of endometriosis in the First Affiliated Hospital of Sun Yat-sen University, between June 2008 to June 2016; histological confirmation of OEM associated with DIE was conducted for each patient. Histological diagnoses were based on characteristics previously defined in a standard histological description, comprised of a combination of endometrial glands and stroma [12].\u003c/p\u003e\n\u003cp\u003eThe exclusion criteria were as follows: i) laparoscopic surgery converted to open surgery; ii) lack of histological confirmation of endometriosis; iii) previous history of hysterectomy or oophorectomy; and iv) patients with pelvic malignant tumors.\u003c/p\u003e\n\u003cp\u003eBetween June 2008 to June 2016, clinical data were recorded retrospectively for each patient from medical, operative and pathological reports; data were blinded for examination by two of the authors. For each patient, general data were recorded, including age, parity, the diameter and location of the OEM (right or left), and past history of surgical treatment for endometriosis, pain symptoms and other specific symptoms. Pain symptoms included dysmenorrhea, dyspareunia, chronic pelvic pain, and bowel pain. Other specific symptoms including hematochezia, urinary frequency and urgency, and hydro-nephrosis. Histological confirmation was obtained for all endometriotic lesions and a description of the location of the DIE lesions was recorded.\u003c/p\u003e\n\u003cp\u003eAll of the patients underwent extensive preoperative tests, including clinical examinations, transvaginal sonography, urological ultrasound and MRI. Patients were treated surgically due to ineffective conservative treatment or serious complications. All of the operations were performed by an experienced surgeon (Professor Shuzhong Yao). All visible endometriosis lesions, including ovarian endometrioma and DIE lesions, were surgically removed. For patients with adenomyosis, local resection or hysterectomy was performed according to the severity of the disease and bearing requirement. In addition to DIE resection, surgical treatment involves adhesion separation as well as resection and reconstruction of the urinary organs and bowel. When these procedures were employed, urologists and gastroenterologists were necessary. Patients were divided into two groups according to the type OEM: unilateral or bilateral. Patients with unilateral OEM were subsequently divided into subgroups according to the location of the OEM (left- or right-hand side) and the diameter of the OEM (\u0026le;50 and \u0026gt;50 mm). The distribution characteristics of DIE lesions were then compared between the groups.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eStatistical analysis\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eStatistical analysis was performed using SPSS version 23.0 for Windows (IBM Corp., Armani, NY, USA). P\u0026lt;0.05 was considered to indicate a statistically significant difference. Statistical analysis was conducted stepwise after assessing quantitative variable distributions. Statistical studies using parametric tests were only conducted after checking the normal distribution of the studied variables. Correlations between qualitative variables were analyzed by a Pearson\u0026rsquo;s chi-square test. In case of significant reciprocal correlation, the relative risk was calculated with 95% confidence intervals.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003ePatient characteristics are presented in Table I. A total of 304 patients were included in the present study. The female patients had a mean age of 34.2\u0026plusmn;5.8 (range, 17-49) years. All the patients with OEM associated with DIE have different symptoms. According to the different symptoms, they were divided into two types: non-specific symptoms and specific symptoms. Non-specific symptoms include dysmenorrhea (89.5%), dyspareunia (12.8%) and chronic pelvic pain (4.3%), while specific symptoms include intestinal symptoms and urinary symptoms. Intestinal symptoms include rectal tenesmus (24%), difficulty in defecation (4.3%), defecation pain (3.6%), diarrhea (2.0%) and hematochezia (2.6%). Urinary symptoms include urinary frequency and urgency (3.0%), hematuria (0.7%) and hydronephrosis (8.6%). In the cohort of 304 patients with an associated OEM, the OEM was located on the left-hand side in 98 patients (32.2%), on the right-hand side in 86 patients (28.3%), and was bilateral in 120 patients (39.5%). The mean size of the OEM was 55.9\u0026plusmn;23.9 mm (range, 10-150 mm).\u003c/p\u003e\n\u003cp\u003eThe anatomical locations of the DIE lesions are presented in Table II. A total of 788 histologically confirmed DIE lesions were observed in the present study. The mean number of DIE lesions per patient was 2.60\u0026plusmn;1.46 (range, 1-9). DIE lesions were widely distributed; there were 30 anatomical sites recorded in the present study, which were mainly located in the posterior pelvic cavity. A total of 532 lesions were recorded, of which 274 (51.5%) were located on the left-hand side and 258 (48.5%) on the right-hand side. The uterosacral ligament represented the most frequent location site with a prevalence of 80.6%, followed by the intestine (30.6%), ureter (15.5%), vagina (13.2%), posterior fornix (10.9%), fallopian tube (9.54%), vaginal-rectum (6.91%), rectovaginal pouch (2.96%) and bladder (1.32%). Intestinal endometriosis includes rectum and sigmoid endometriosis. There were also 4 cases of appendiceal endometriosis that were not included in the intestinal endometriosis.\u003c/p\u003e\n\u003cp\u003ePatients with associated unilateral OEM (n=184 patients) had a significantly increased number of DIE lesions when compared with patients with bilateral OEM (n=120 patients; 2.76\u0026plusmn;1.52 vs. 2.33\u0026plusmn;1.34; P=0.006; Table III). Compared with bilateral OEM with DIE, a higher rate of intestinal (39.1% vs. 18.3%; P\u0026lt;0.01) and vaginal (17.4% vs. 6.7%; P\u0026lt;0.01) infiltration by DIE lesions was observed in unilateral OEM with DIE. The mean number of DIE lesions was not significantly correlated with the location or size of the OEM (2.83\u0026plusmn;1.56 vs. 2.74\u0026plusmn;1.53, P=0.678; 2.65\u0026plusmn;1.42 vs. 2.80\u0026plusmn;1.43, P=0.518, respectively). There were no significant differences between the groups with OEMs \u0026le;50 mm and \u0026gt;50mm.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003ePrevious studies have revealed that, for patients with histologically confirmed DIE, an associated ovarian OEM is a marker for the severity of the disease [8]. However, the related research on the distribution characteristics of the DIE lesions in patients with OEM is still limited. The present study investigated lesion distribution characteristics in women diagnosed with histologically confirmed OEM and DIE, as this combined diagnosis is often indicative of a more multifocal and severe disease. There was a greater frequency of anatomic DIE lesion sites in patients with unilateral OEM (unilateral OEM size \u0026le;50 mm) than in patients with bilateral OEM (unilateral OEM size \u0026le;50 mm), and DIE lesions were often associated with intestinal and vaginal infiltration.\u003c/p\u003e\n\u003cp\u003eThese data suggested that DIE lesions were widely distributed. There were 30 anatomical sites observed in the present study, which were primarily located in the posterior pelvic cavity, but also in the uterosacral ligaments, intestines, ureter, vagina, posterior fornix and rectovaginal pouch. The distribution of DIE lesions was associated with the flow pattern of peritoneal fluid and the morphology of the pelvic cavity [13]. When compared with the uterosacral ligaments, intestines and vagina, the reduced frequency of deep bladder endometriosis observed can be explained by anatomical location as the lower limit of the vesico-uterine pouch is located well above the lower limit of the Pouch of Douglas[14]. The anatomical differences between the left- and right-hand sides of the hemipelvis are that the sigmoid colon is located on the left-hand side of the hemipelvis, and when combined with the left adnexa it forms a barrier to prevent menstrual blood reflux, resulting in an anatomical situation that could promote adhesions and the growth of refluxed endometrial cells on the left-hand side of the pelvic wall[15].\u003c/p\u003e\n\u003cp\u003eAccording to the literature, intestinal endometriosis and urinary tract endometriosis account for ~5-12% and 0.3-12%, respectively, of all women with endometriosis [16-18]. However, in the present study, intestinal endometriosis accounted for 30.9%, and urinary tract endometriosis accounted for 15.2% of cases, which are greater frequencies than those recorded by previous research. According to the theory of Kondo et al, women presenting with OEM had a stronger association with the presence of DIE lesions and intestinal DIE[19]. There is lack of research on OEM associated with urinary tract endometriosis. The present results indicated that, for patients diagnosed with histologically verified OEM associated with DIE, there was an increased risk of lesions involving the intestine and ureter. Thus, when the clinical examination suggests OEM with DIE, the practitioner should search for severe lesions, especially intestinal and ureteral lesions. Surgery for intestinal endometriosis and urinary endometriosis is difficult, with a number of postoperative complications[20, 21]. The literature reports distinguish between major and minor complications. Major complications include anastomotic insufficiencies, intestinal perforation, retovaginal fistulas, severe infections, and bleeding requiring transfusion, which are reported in 7.4%[22] to 25%[23]. Minor complications include slight-to-moderate infections, peripheral sensory disturbances, bladder voiding dysfunction, and postoperative urinary obstruction, which are reported in 0.6%[24] to 57%[25]. Therefore, full clinical evaluations, as aforementioned, before operating may be very important for OEM patients with DIE.\u003c/p\u003e\n\u003cp\u003eAs mentioned above, intestinal endometriosis refers to the rectum and sigmoid endometriosis. However, there are a special intestinal endometriosis, appendiceal endometriosis, which is considered as an uncommon finding, in the literature its prevalence varies widely [26]. In our study, there are 4 patients with appendiceal endometriosis，are responsible for approximately 4% of all intestinal lesions. Diego Raimondo et al.[27] pointed out that appendiceal endometriosis was associated with adenomyosis, large right endometrioma, deep posterior pelvic endometriosis, left deep lateral pelvic endometriosis, and ileocecal involvement. The 4 patients in our study who had appendiceal endometriosis were all combined with adenomyosis, and the diameter of OEM was greater than 5cm, which was further validated the conclusions of Diego Raimondo et al.\u003c/p\u003e\n\u003cp\u003ePatients with simple OEM often have no typical clinical manifestations, and some patients only find the presence of OEM in routine physical. Previous studies have conducted multivariate regression analysis on the relationship between dysmenorrhea and OEM. The results showed that the severity of dysmenorrhea had nothing to do with the existence of OEM. Intestinal endometriosis and deep pelvic invasive endometriosis were the main related factors of dysmenorrhea[28]. Of the 304 patients in our study, 272 (89.5%) with symptoms of dysmenorrhea, 39 (12.8%) with dyspareunia, and 17 (5.6%) with chronic pelvic pain. Dai et al reported that 61.6% of patients with OEM but non-DIE had dysmenorrhea, and 10.2% had severe dysmenorrhea[29]. It is suggested that when patients with OEM have obvious pain symptoms, it should be considered that they may be complicated with DIE.\u003c/p\u003e\n\u003cp\u003eDuring the early stages of ureteral endometriosis, the clinical symptoms are not typical, and are easily overlooked during surgery. Some researchers have suggested that urinary tract endometriosis may occur more frequently than it is currently thought to[30, 31]. Raimondo D et al. observed that ureteral involvement was always associated with endometriosis in other locations in the pelvis. And the most frequent endometriosis associations with ureteral involvement are ovarian lesions[32]. In this case, when there is an associated OEM, ultrasonic examination of the urogenital system is necessary. Ureteral endometriosis should be considered when B mode ultrasound reveals ureter stenosis and hydronephrosis. Hydroureter and hydronephrosis are the severe forms of ureteral endometriosis. In case of hydronephrosis, renal scintigraphy to evaluate renal function should be needed.\u003c/p\u003e\n\u003cp\u003ePatients with associated unilateral OEM have an increased number of DIE lesions and have a greater risk of lesions involving the intestine and vagina when compared with patients with bilateral OEM. It was hypothesized that a clinical case of bilateral OEM may be more complex than unilateral OEM, and the distribution of the DIE lesions may be more extensive and deeper in patients with larger OEM. However, some researchers maintain that in patients with OEM \u0026ge;30 mm, OEM size was the most influential contributor to the total number of follicles and oocytes retrieved. OEM results in a reduced response to ovarian stimulation, when compared with the response of the contralateral normal ovary in the same individual [33]. The oppression of the ovary was more obvious in bilateral OEM and the response to ovarian stimulation was markedly reduced. In the clinic, patients with unilateral OEM or an OEM with a diameter of \u0026le;50 mm should not be taken lightly, and should be evaluated for the presence of DIE lesions, especially intestinal DIE.\u003c/p\u003e\n\u003cp\u003eThe aim of the present study was to potentially provide the basis for avoiding underestimation of the extent of the DIE lesions. Misunderstanding the severity of DIE lesions is the main reason why it is difficult to completely remove lesions during surgical treatments. Incomplete exeresis of DIE lesions explains the high risk of recurrence; this recurrence is in fact the continued progression of the lesions left behind during previous operations[34, 35]. Repeated surgery is positively associated with increased health care costs and morbidity [36]. Repeated surgery with damage to ovarian reserves is particularly frequent in ovarian endometriosis[37-39]. In addition, the risk of repeated operations is associated with uncertainty regarding surgical outcomes and pain. Therefore, completely excising the DIE lesions during the initial surgery is particularly important.\u003c/p\u003e\n\u003cp\u003eFor the first time, our study analyses the characteristic of DIE lesion distribution in patient with ovarian endometrioma. However, this was a retrospective single center study, results were limited by a lack of random, patient selection, and incomplete data acquisition. The data on the history of previous endometriosis treatment were incomplete, which prevented us from evaluate the effect of previous treatment on the recurrence. A large multicenter prospective trial will be necessary to further assess this lesion distribution characteristic.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIn summary, lesion distribution of DIE associated with OEM was frequently multifocal and severe. For patients with OEM that requires surgical treatment, it cannot be treated only by cystectomy; it should be combined with the patient\u0026rsquo;s clinical symptoms, and be carefully explored during surgery to avoid the omission of the lesions.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eDIE: Deep Infiltrating Endometriosis\u003c/p\u003e\n\u003cp\u003eOEM: Ovarian Endometrioma\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors want to warmly thank staff members from our department of medical record management for their expert assistance with data collection. The authors also thank Dr. Xiao Lin for his help in preparing the statistical analysis.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by the Natural Science Foundation of China (81070472) and the Science and Technology Planning Project of Guangdong Province (2012B031800121).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAffiliations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDepartment of Obstetrics and Gynecology, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.\u003c/p\u003e\n\u003cp\u003eHungling Kwok, Tian Li, Hui Fei, Li Cheng\u003c/p\u003e\n\u003cp\u003eCenter for Reproductive Medicine, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.\u003c/p\u003e\n\u003cp\u003eHuan Yang\u003c/p\u003e\n\u003cp\u003eDepartment of Obstetrics and Gynecology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.\u003c/p\u003e\n\u003cp\u003eShuqin chen, Hongye Jiang, Shuzhong Yao\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorresponding author\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCorrespondence to Shuqin Chen\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eShuqin Chen and Shuzhong Yao: conceived and designed the study. Hungling Kwok and Hongye Jiang: contributed to data analysed and interpreted the data, writing the manuscript. Tian Li and Huan Yang: involved in manuscript writing. Hui Fei and Li Cheng: collected the Data. All the authors approve the final version of the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics declarations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by Ethics Committee of the First Affiliated Hospital of Sun Yat-sen University, and the written consent was obtained from participants.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interest and nothing to disclose.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eVercellini, P., et al., \u003cem\u003eEndometriosis: pathogenesis and treatment.\u003c/em\u003e Nat Rev Endocrinol, 2014. \u003cstrong\u003e10\u003c/strong\u003e(5): p. 261-75.\u003c/li\u003e\n\u003cli\u003eCornillie, F.J., et al., \u003cem\u003eDeeply infiltrating pelvic endometriosis: histology and clinical significance.\u003c/em\u003e Fertil Steril, 1990. \u003cstrong\u003e53\u003c/strong\u003e(6): p. 978-83.\u003c/li\u003e\n\u003cli\u003eKoninckx, P.R., et al., \u003cem\u003eSuggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pelvic pain.\u003c/em\u003e Fertil Steril, 1991. \u003cstrong\u003e55\u003c/strong\u003e(4): p. 759-65.\u003c/li\u003e\n\u003cli\u003eChapron, C., et al., \u003cem\u003eAnatomical distribution of deeply infiltrating endometriosis: surgical implications and proposition for a classification.\u003c/em\u003e Hum Reprod, 2003. \u003cstrong\u003e18\u003c/strong\u003e(1): p. 157-61.\u003c/li\u003e\n\u003cli\u003eDai, Y., et al., \u003cem\u003e[Clinico-pathologic characteristics of posterior deeply infiltrating endometriosis lesions, pain symptoms and its treatment using laparoscopic surgery].\u003c/em\u003e Zhonghua Fu Chan Ke Za Zhi, 2010. \u003cstrong\u003e45\u003c/strong\u003e(2): p. 93-8.\u003c/li\u003e\n\u003cli\u003eCao, Q., et al., \u003cem\u003eComparison of complete and incomplete excision of deep infiltrating endometriosis.\u003c/em\u003e Int J Clin Exp Med, 2015. \u003cstrong\u003e8\u003c/strong\u003e(11): p. 21497-506.\u003c/li\u003e\n\u003cli\u003eSomigliana, E., et al., \u003cem\u003eAssociation rate between deep peritoneal endometriosis and other forms of the disease: pathogenetic implications.\u003c/em\u003e Human Reproduction, 2004. \u003cstrong\u003e19\u003c/strong\u003e(1): p. 168-171.\u003c/li\u003e\n\u003cli\u003eChapron, C., et al., \u003cem\u003eAssociated ovarian endometrioma is a marker for greater severity of deeply infiltrating endometriosis.\u003c/em\u003e Fertil Steril, 2009. \u003cstrong\u003e92\u003c/strong\u003e(2): p. 453-7.\u003c/li\u003e\n\u003cli\u003eRedwine, D.B., \u003cem\u003eOvarian endometriosis: a marker for more extensive pelvic and intestinal disease.\u003c/em\u003e Fertil Steril, 1999. \u003cstrong\u003e72\u003c/strong\u003e(2): p. 310-5.\u003c/li\u003e\n\u003cli\u003eChapron, C., et al., \u003cem\u003eOvarian endometrioma: severe pelvic pain is associated with deeply infiltrating endometriosis.\u003c/em\u003e Human Reproduction, 2012. \u003cstrong\u003e27\u003c/strong\u003e(3): p. 702-711.\u003c/li\u003e\n\u003cli\u003ePerello, M., et al., \u003cem\u003eMarkers of deep infiltrating endometriosis in patients with ovarian endometrioma: a predictive model.\u003c/em\u003e Eur J Obstet Gynecol Reprod Biol, 2017. \u003cstrong\u003e209\u003c/strong\u003e: p. 55-60.\u003c/li\u003e\n\u003cli\u003eKamergorodsky, G., et al., \u003cem\u003eHistologic classification of specimens from women affected by superficial endometriosis, deeply infiltrating endometriosis, and ovarian endometriomas.\u003c/em\u003e Fertil Steril, 2009. \u003cstrong\u003e92\u003c/strong\u003e(6): p. 2074-7.\u003c/li\u003e\n\u003cli\u003eAbbott, J.A., et al., \u003cem\u003eThe effects and effectiveness of laparoscopic excision of endometriosis: a prospective study with 2-5 year follow-up.\u003c/em\u003e Hum Reprod, 2003. \u003cstrong\u003e18\u003c/strong\u003e(9): p. 1922-7.\u003c/li\u003e\n\u003cli\u003eBricou, A., R.E. 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How to manage?].\u003c/em\u003e J Gynecol Obstet Biol Reprod (Paris), 2014. \u003cstrong\u003e43\u003c/strong\u003e(1): p. 12-8.\u003c/li\u003e\n\u003cli\u003eGuo, S.W., \u003cem\u003eRecurrence of endometriosis and its control.\u003c/em\u003e Hum Reprod Update, 2009. \u003cstrong\u003e15\u003c/strong\u003e(4): p. 441-61.\u003c/li\u003e\n\u003cli\u003eHachisuga, T. and T. Kawarabayashi, \u003cem\u003eHistopathological analysis of laparoscopically treated ovarian endometriotic cysts with special reference to loss of follicles.\u003c/em\u003e Hum Reprod, 2002. \u003cstrong\u003e17\u003c/strong\u003e(2): p. 432-5.\u003c/li\u003e\n\u003cli\u003eCandiani, M., et al., \u003cem\u003eOvarian recovery after laparoscopic enucleation of ovarian cysts: insights from echographic short-term postsurgical follow-up.\u003c/em\u003e J Minim Invasive Gynecol, 2005. \u003cstrong\u003e12\u003c/strong\u003e(5): p. 409-14.\u003c/li\u003e\n\u003cli\u003eRagni, G., et al., \u003cem\u003eDamage to ovarian reserve associated with laparoscopic excision of endometriomas: a quantitative rather than a qualitative injury.\u003c/em\u003e Am J Obstet Gynecol, 2005. \u003cstrong\u003e193\u003c/strong\u003e(6): p. 1908-14.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-size: 12px; color: rgb(0, 0, 0); font-family: Helvetica;\"\u003eTable\u0026nbsp;\u003c/span\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eI\u0026nbsp;Preoperative characteristics of the study population.\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"width:325.6pt;border-collapse:collapse;border:none;\" width=\"434\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;height: 17.7pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003ePatients’ characteristics (N=\u0026nbsp;304)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;height: 17.7pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eValues\u003csup\u003e\u0026nbsp;a\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eAge(years)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e34.2±5.8(range17-49)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eParity\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; Para≥1\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e158(52.0%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; Nulliparous\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e146(48.0%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; Infertility\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e78(25.7%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003ePrevious surgery for OEM\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e88(28.9%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003ePresenting symptoms\u003csup\u003eb\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; No symptoms\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e32(10.5%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; Dysmenorrhea\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e272(89.5%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; Dyspareunia\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e39(12.8%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;height: 17pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eChronic pelvic pain\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;height: 17pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e17(5.6%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;height: 18.35pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"background: white;\"\u003eRectal tenesmus\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;height: 18.35pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e73(24.0%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eDifficulty in defecation\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e13(4.3%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;height: 16.95pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; Diarrhea\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;height: 16.95pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e6(2.0%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; Defecation pain\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e11(3.6%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; Hematochezia\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e8(2.6%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; Urinary frequency and urgency\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e9(3.0%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; Haematuria\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2(0.7%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; Hydronephrosis\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e26(8.6%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;height: 14.2pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eEndometrioma laterality\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;height: 14.2pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;height: 14.2pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; Left\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;height: 14.2pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e98(32.2%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;height: 16.25pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; Right\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;height: 16.25pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e86(28.3%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;height: 16.25pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eBilateral\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;height: 16.25pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e120(39.5%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border: none;padding: 0in 5.4pt;height: 14.2pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eEndometrioma size (mm)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border: none;padding: 0in 5.4pt;height: 14.2pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e55.9±23.9\u0026nbsp;(range10-150)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.1pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.2pt;vertical-align: top;\" valign=\"top\" width=\"62.903225806451616%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eNumber of DIE lesions\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.5pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.2pt;vertical-align: top;\" valign=\"top\" width=\"37.096774193548384%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2.60±1.5 (range1-9)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eOEM, ovarian endometrioma; DIE, deep infiltrating endometriosis.\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003csup\u003ea\u003c/sup\u003eValues are shown as mean\u0026nbsp;±\u0026nbsp;standard deviation or N(%).\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003csup\u003eb\u003c/sup\u003eDifferent symptoms can be associated in the same patient.\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\n \u003cbr\u003e\n\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eTable II The prevalence of\u0026nbsp;anatomical distribution of DIE lesions. (n=304 patients)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border-collapse:collapse;border:none;\" width=\"442\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.55pt;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"61.990950226244344%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eMain lesion\u003csup\u003ea\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.9pt;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"38.009049773755656%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eNumber of patients(%)\u003csup\u003eb\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"61.990950226244344%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eUterosacral ligament\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"38.009049773755656%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e245(80.6)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"61.990950226244344%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; Left\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"38.009049773755656%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e57\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"61.990950226244344%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; Right\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"38.009049773755656%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e53\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"61.990950226244344%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; Bilateral\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"38.009049773755656%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e135\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"61.990950226244344%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eIntestine\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"38.009049773755656%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e93(30.6)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.55pt;border: none;padding: 0in 5.4pt;height: 17.65pt;vertical-align: top;\" valign=\"top\" width=\"61.990950226244344%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eUreter\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.9pt;border: none;padding: 0in 5.4pt;height: 17.65pt;vertical-align: top;\" valign=\"top\" width=\"38.009049773755656%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e47(15.5)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"61.990950226244344%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; Left\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"38.009049773755656%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e22\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.55pt;border: none;padding: 0in 5.4pt;height: 16.95pt;vertical-align: top;\" valign=\"top\" width=\"61.990950226244344%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; Right\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.9pt;border: none;padding: 0in 5.4pt;height: 16.95pt;vertical-align: top;\" valign=\"top\" width=\"38.009049773755656%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e18\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"61.990950226244344%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; Bilateral\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"38.009049773755656%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e7\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"61.990950226244344%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eVaginal\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"38.009049773755656%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e40(13.2)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"61.990950226244344%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003ePosterior fornix\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"38.009049773755656%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e33(10.9)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"61.990950226244344%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eFallopian tube\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"38.009049773755656%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e29(9.54)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"61.990950226244344%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; Left\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"38.009049773755656%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e12\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"61.990950226244344%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; Right\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"38.009049773755656%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e4\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"61.990950226244344%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-indent:20.0pt;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eBilateral\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"38.009049773755656%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e13\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"61.990950226244344%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eRecto-vaginal septum\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"38.009049773755656%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e21(6.91)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"61.990950226244344%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eRectovaginal pouch\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"38.009049773755656%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e9(2.96)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205.55pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"61.990950226244344%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eBladder\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.9pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"38.009049773755656%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e4(1.32)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:justify;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eDIE, deep infiltrating endometriosis.\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:justify;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003csup\u003ea\u003c/sup\u003eAccording to the location of the lesion recorded during the operation.\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:justify;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003csup\u003eb\u003c/sup\u003eNumber of patients whose lesions histologically proven deep infiltrating endometriosis.\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:justify;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:justify;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:justify;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:justify;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:justify;\"\u003e\n \u003cbr\u003e\n\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eTable III\u0026nbsp;Characteristics of deeply infiltrating endometriosis lesion distribution associated ovarian endometrioma.\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"width:411.2pt;margin-left:5.3pt;border-collapse:collapse;border:none;\" width=\"548\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:116.15pt;border:none;border-top:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:52.5pt;\" width=\"28.284671532846716%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eVariables\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:113.5pt;border:none;border-top:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:52.5pt;\" width=\"27.554744525547445%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eComparison\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:48.2pt;border:none;border-top:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:52.5pt;\" width=\"11.678832116788321%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cem\u003eP\u003c/em\u003e-value\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.65pt;border:none;border-top:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:52.5pt;\" width=\"10.401459854014599%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eOR\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:90.7pt;border:none;border-top:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:52.5pt;\" width=\"22.080291970802918%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e95% CI\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width:116.15pt;border-top:solid windowtext 1.0pt;border-left:none;border-bottom:dashed windowtext 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:17.3pt;\" width=\"28.284671532846716%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:113.5pt;border-top:solid windowtext 1.0pt;border-left:none;border-bottom:dashed windowtext 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:17.3pt;\" width=\"27.554744525547445%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eOEM laterality\u003csup\u003ea\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" rowspan=\"2\" style=\"width:181.55pt;border-top:solid windowtext 1.0pt;border-left:none;border-bottom:dashed windowtext 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:17.3pt;\" width=\"44.160583941605836%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:57.9pt;border:none;border-bottom:dashed windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:13.25pt;\" width=\"50.99337748344371%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eUnilateral\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003en=184(%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:55.6pt;border-top:dashed windowtext 1.0pt;border-left:none;border-bottom:dashed windowtext 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:13.25pt;\" width=\"49.00662251655629%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eBilateral\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003en=120(%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 116.15pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"28.284671532846716%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eNumber of DIE lesions\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"14.05109489051095%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2.76\u003cspan style=\"background: white;\"\u003e±\u003c/span\u003e1.52\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55.6pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"13.503649635036496%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2.33\u003cspan style=\"background: white;\"\u003e±\u003c/span\u003e1.34\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"11.678832116788321%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.006\u003csup\u003e*\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"10.401459854014599%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90.7pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"22.080291970802918%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 116.15pt;border: none;padding: 0in 5.4pt;height: 16.3pt;vertical-align: top;\" valign=\"top\" width=\"28.284671532846716%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eUterosacral ligament\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.9pt;border: none;padding: 0in 5.4pt;height: 16.3pt;vertical-align: top;\" valign=\"top\" width=\"14.05109489051095%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e151(82.1)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55.6pt;border: none;padding: 0in 5.4pt;height: 16.3pt;vertical-align: top;\" valign=\"top\" width=\"13.503649635036496%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e94(78.3)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48.2pt;border: none;padding: 0in 5.4pt;height: 16.3pt;vertical-align: top;\" valign=\"top\" width=\"11.678832116788321%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.421\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.65pt;border: none;padding: 0in 5.4pt;height: 16.3pt;vertical-align: top;\" valign=\"top\" width=\"10.401459854014599%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.266\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90.7pt;border: none;padding: 0in 5.4pt;height: 16.3pt;vertical-align: top;\" valign=\"top\" width=\"22.080291970802918%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.712-2.249\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 116.15pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"28.284671532846716%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eIntestine\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"14.05109489051095%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e72(39.1)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55.6pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"13.503649635036496%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e21(17.5)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"11.678832116788321%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.000\u003csup\u003e*\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"10.401459854014599%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e3.031\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90.7pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"22.080291970802918%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.738-5.286\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 116.15pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"28.284671532846716%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eVagina\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"14.05109489051095%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e32(17.4)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55.6pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"13.503649635036496%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e8(6.70)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"11.678832116788321%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 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style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.100\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"10.401459854014599%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.571\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90.7pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"22.080291970802918%\"\u003e\n 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none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"11.678832116788321%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.858\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"10.401459854014599%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.060\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90.7pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"22.080291970802918%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.560-2.009\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 116.15pt;border: none;padding: 0in 5.4pt;height: 16.25pt;vertical-align: top;\" valign=\"top\" width=\"28.284671532846716%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eFallopian 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style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eRectovaginal pouch\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57.9pt;border: none;padding: 0in 5.4pt;height: 17.65pt;vertical-align: top;\" valign=\"top\" width=\"14.05109489051095%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e16(8.7)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55.6pt;border: none;padding: 0in 5.4pt;height: 17.65pt;vertical-align: top;\" valign=\"top\" width=\"13.503649635036496%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e14(11.7)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48.2pt;border: none;padding: 0in 5.4pt;height: 17.65pt;vertical-align: top;\" valign=\"top\" width=\"11.678832116788321%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.396\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.65pt;border: none;padding: 0in 5.4pt;height: 17.65pt;vertical-align: top;\" valign=\"top\" width=\"10.401459854014599%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.767\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90.7pt;border: none;padding: 0in 5.4pt;height: 17.65pt;vertical-align: top;\" valign=\"top\" width=\"22.080291970802918%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.359-1.637\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width:116.15pt;border:none;border-bottom:dashed windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:23.8pt;\" width=\"28.284671532846716%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:113.5pt;border:none;border-bottom:dashed windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:23.8pt;\" width=\"27.554744525547445%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eSide of OEM\u003csup\u003ea\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" rowspan=\"2\" style=\"width:181.55pt;border:none;border-bottom:dashed windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:23.8pt;\" width=\"44.160583941605836%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:57.9pt;border:none;border-bottom:dashed windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:27.45pt;\" width=\"50.99337748344371%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"background: white;\"\u003eLeft side\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003en=98(%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:55.6pt;border-top:dashed windowtext 1.0pt;border-left:none;border-bottom:dashed windowtext 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:27.45pt;\" width=\"49.00662251655629%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"background: white;\"\u003eRight side\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"background: white;\"\u003en=86\u003c/span\u003e(%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:116.15pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"28.284671532846716%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eNumber of DIE lesions\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.9pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"14.05109489051095%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2.83±1.56\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:55.6pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"13.503649635036496%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2.74±1.53\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:48.2pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"11.678832116788321%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.678\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.65pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"10.401459854014599%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:90.7pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"22.080291970802918%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:116.15pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"28.284671532846716%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eUterosacral ligament\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.9pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"14.05109489051095%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e81(82.7)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:55.6pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"13.503649635036496%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e70(81.4)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:48.2pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"11.678832116788321%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.824\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.65pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"10.401459854014599%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.089\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:90.7pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"22.080291970802918%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.512-2.315\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:116.15pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"28.284671532846716%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eIntestine\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.9pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"14.05109489051095%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e40(40.8)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:55.6pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"13.503649635036496%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e32(37.2)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:48.2pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"11.678832116788321%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.617\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.65pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"10.401459854014599%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.164\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:90.7pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"22.080291970802918%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.642-2.109\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:116.15pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"28.284671532846716%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eVagina\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.9pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"14.05109489051095%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e18(18.4)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:55.6pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"13.503649635036496%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e15(17.4)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n 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0);\"\u003e1.065\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:90.7pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"22.080291970802918%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.500-2.268\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:116.15pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"28.284671532846716%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003ePosterior fornix\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.9pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"14.05109489051095%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e15(15.3)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:55.6pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"13.503649635036496%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e8(9.3)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:48.2pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"11.678832116788321%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.219\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.65pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"10.401459854014599%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.762\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:90.7pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"22.080291970802918%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.078-4.386\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:116.15pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"28.284671532846716%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eUreter\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.9pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"14.05109489051095%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e16(16.3)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:55.6pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"13.503649635036496%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e13(15.1)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:48.2pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"11.678832116788321%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.822\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.65pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"10.401459854014599%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.096\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:90.7pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"22.080291970802918%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.494-2.431\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:116.15pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"28.284671532846716%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eFallopian tube\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.9pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"14.05109489051095%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e8(8.2)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:55.6pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"13.503649635036496%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e11(12.8)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:48.2pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"11.678832116788321%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.303\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.65pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"10.401459854014599%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.606\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:90.7pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"22.080291970802918%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.232-1.584\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:116.15pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"28.284671532846716%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eRectovaginal pouch\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.9pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"14.05109489051095%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e9(9.2)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:55.6pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"13.503649635036496%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e7(8.1)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:48.2pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"11.678832116788321%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.802\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.65pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"10.401459854014599%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.141\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:90.7pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:1.0pt;\" width=\"22.080291970802918%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.406-3.207\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width:116.15pt;border:none;border-bottom:dashed windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:23.4pt;\" width=\"28.284671532846716%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:113.5pt;border:none;border-bottom:dashed windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:23.4pt;\" width=\"27.554744525547445%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eUnilateral OEM size\u003csup\u003ea\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" rowspan=\"2\" style=\"width:181.55pt;border:none;border-bottom:dashed windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:23.4pt;\" width=\"44.160583941605836%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:57.9pt;border:none;border-bottom:dashed windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:27.3pt;\" width=\"50.99337748344371%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"background: white;\"\u003e≤\u003c/span\u003e50mm\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003en=112(%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:55.6pt;border-top:dashed windowtext 1.0pt;border-left:none;border-bottom:dashed windowtext 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:27.3pt;\" width=\"49.00662251655629%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"background: white;\"\u003e\u0026gt;50mm\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"background: white;\"\u003en=72\u003c/span\u003e(%)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:116.15pt;border:none;padding:0in 5.4pt 0in 5.4pt;\" width=\"28.284671532846716%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eNumber of DIE lesions\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.9pt;border:none;padding:0in 5.4pt 0in 5.4pt;\" width=\"14.05109489051095%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2.77±1.4\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:55.6pt;border:none;padding:0in 5.4pt 0in 5.4pt;\" width=\"13.503649635036496%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2.82±1.4\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:48.2pt;border:none;padding:0in 5.4pt 0in 5.4pt;\" width=\"11.678832116788321%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New 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style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e87(77.7)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:55.6pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:16.3pt;\" width=\"13.503649635036496%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e64(88.9)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:48.2pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:16.3pt;\" width=\"11.678832116788321%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.053\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.65pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:16.3pt;\" width=\"10.401459854014599%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.435\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:90.7pt;border:none;padding:0in 5.4pt 0in 5.4pt;height:16.3pt;\" width=\"22.080291970802918%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.184-1.027\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:116.15pt;border:none;padding:0in 5.4pt 0in 5.4pt;\" width=\"28.284671532846716%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eIntestine\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:57.9pt;border:none;padding:0in 5.4pt 0in 5.4pt;\" width=\"14.05109489051095%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e54(48.2)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:55.6pt;border:none;padding:0in 5.4pt 0in 5.4pt;\" width=\"13.503649635036496%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e17(23.6)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:48.2pt;border:none;padding:0in 5.4pt 0in 5.4pt;\" width=\"11.678832116788321%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.001\u003csup\u003e*\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.65pt;border:none;padding:0in 5.4pt 0in 5.4pt;\" width=\"10.401459854014599%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e3.012\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n 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Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.226-1.311\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003csup\u003ea\u003c/sup\u003eValues are shown as mean\u0026nbsp;±\u0026nbsp;standard deviation or N(%).\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"font-family: \n Helvetica;\"\u003e\u003cspan style=\"font-size: \n 12px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003csup\u003e*\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003cspan style=\"font-size: 12px; color: rgb(0, 0, 0); font-family: Helvetica;\"\u003eStatistically significant\u003c/span\u003e\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-womens-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmwh","sideBox":"Learn more about [BMC Women's Health](http://bmcwomenshealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmwh/default.aspx","title":"BMC Women's Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"ovarian endometrioma, deep infiltrating endometriosis, lesion distribution characteristics","lastPublishedDoi":"10.21203/rs.2.19864/v2","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.2.19864/v2","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground:\u0026nbsp;To investigate the characteristics of deep infiltrating endometriosis (DIE) lesion distribution when associated with ovarian endometrioma (OEM). Methods:\u0026nbsp;The present study analyzed retrospective data obtained by the First Affiliated Hospital of Sun Yat-sen University, between June 2008 to June 2016. A total of 304 patients underwent laparoscopic surgery for complete removal of endometriosis by one experienced surgeon, and histological confirmation of OEM associated with DIE was conducted for each patient. Clinical data were recorded for each patient from medical, operative and pathological reports. Patients were then divided into two groups according to unilateral or bilateral OEM. Patients with unilateral OEM were subsequently divided into two subgroups according to OEM location (left- or right-hand side) and the diameter of the OEM (≤50 and \u0026gt;50 mm). The distribution characteristics of DIE lesions were then compared between the groups. Results:\u0026nbsp;DIE lesions were widely distributed, 30 anatomical sites were involved. Patients with associated unilateral OEM (n=184 patients) had a significantly increased number of DIE lesions when compared with patients with bilateral OEM (n=120 patients; 2.76±1.52 vs. 2.33±1.34; P=0.006). Compared with bilateral OEM with DIE, there was a higher rate of intestinal (39.1% vs. 18.3%; P\u0026lt;0.01) and vaginal (17.4% vs. 6.7%; P\u0026lt;0.01) infiltration by DIE lesions in unilateral OEM with DIE. The mean number of DIE lesions was not significantly correlated with the location or size of the OEM (2.83±1.56 vs. 2.74±1.53; P=0.678; and 2.65±1.42 vs. 2.80±1.43; P=0.518, respectively). There was no significant difference between the groups with OEM ≤50 mm and \u0026gt;50 mm. Conclusion: Lesion distribution characteristics in women diagnosed with histologically proven OEM associated with DIE were frequently multifocal and severe. Key Words:\u0026nbsp;ovarian endometrioma, deep infiltrating endometriosis, lesion distribution characteristics\u003c/p\u003e","manuscriptTitle":"Lesion distribution characteristics of deep infiltrating endometriosis with ovarian endometrioma: An observational clinical study","msid":"","msnumber":"","nonDraftVersions":[{"code":2,"date":"2020-03-23 14:36:22","doi":"10.21203/rs.2.19864/v2","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2020-04-19T12:00:00+00:00","index":5,"fulltext":"Recommendation: Accept without revision\nForm responses:\n---\n\nComments to Author:\n---\nThanks for your answers.* Are the methods appropriate and well described?: **Yes**\n* Does the work include the necessary controls?: **Yes**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **I am able to assess the statistics**\n* Quality of written English: **Acceptable**\n* Declaration of competing interests: **I declare that I have no competing interests**\n* I agree to the open peer review policy of the journal. I understand that my name will be included on my report to the authors and, if the manuscript is accepted for publication, my named report including any attachments I upload will be posted on the website along with the authors' responses. I agree for my report to be made available under an Open Access Creative Commons CC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any comments which I do not wish to be included in my named report can be included as confidential comments to the editors, which will not be published.: ** I agree to the open peer review policy of the journal**\n"},{"type":"decision","content":"Minor revision","date":"2020-04-19T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2020-04-14T12:00:00+00:00","index":4,"fulltext":"Recommendation: Accept without revision\nForm responses:\n---\n\nComments to Author:\n---\nmanuscript does not require any further revisions and all issues have been adequately addressed by authors' response* Are the methods appropriate and well described?: **Yes**\n* Does the work include the necessary controls?: **Unable to assess**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **Not relevant to this manuscript**\n* Quality of written English: **Acceptable**\n* Declaration of competing interests: **I declare that I have no competing interests**\n* I agree to the open peer review policy of the journal. I understand that my name will be included on my report to the authors and, if the manuscript is accepted for publication, my named report including any attachments I upload will be posted on the website along with the authors' responses. I agree for my report to be made available under an Open Access Creative Commons CC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any comments which I do not wish to be included in my named report can be included as confidential comments to the editors, which will not be published.: ** I agree to the open peer review policy of the journal**\n"},{"type":"reviewerAgreed","content":"","date":"2020-03-22T12:00:00+00:00","index":5,"fulltext":""},{"type":"reviewerAgreed","content":"","date":"2020-03-18T12:00:00+00:00","index":3,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2020-03-18T12:00:00+00:00","index":3,"fulltext":"Recommendation: Accept without revision\nForm responses:\n---\n\nComments to Author:\n---\n* Are the methods appropriate and well described?: **Yes**\n* Does the work include the necessary controls?: **Yes**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **I am able to assess the statistics**\n* Quality of written English: **Acceptable**\n* Declaration of competing interests: **'I declare that I have no competing interests'**\n* I agree to the open peer review policy of the journal. I understand that my name will be included on my report to the authors and, if the manuscript is accepted for publication, my named report including any attachments I upload will be posted on the website along with the authors' responses. I agree for my report to be made available under an Open Access Creative Commons CC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any comments which I do not wish to be included in my named report can be included as confidential comments to the editors, which will not be published.: ** I agree to the open peer review policy of the journal**\n"},{"type":"reviewerAgreed","content":"","date":"2020-03-18T12:00:00+00:00","index":4,"fulltext":""},{"type":"editorAssigned","content":"","date":"2020-03-17T12:00:00+00:00","index":"","fulltext":""},{"type":"reviewersInvited","content":"","date":"2020-03-17T12:00:00+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"","date":"2020-03-17T12:00:00+00:00","index":1,"fulltext":""},{"type":"reviewerAgreed","content":"","date":"2020-03-17T12:00:00+00:00","index":2,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2020-03-17T12:00:00+00:00","index":1,"fulltext":"Recommendation: Accept after discretionary revisions\nForm responses:\n---\n\nComments to Author:\n---\nHowever:\n- I do not agree with what they point out about the symptom dyspareunia: \"There are no corresponding relationship between dyspareunia and DIE lesions in ligaments, vaginal, posterior fornix, etc. The presence of these lesions is often associated with dysmenorrhea\". I believe that deep dyspareunia is the most specific symptom in women with DIE (if they have sexual intercourse) and corresponds to the pain induced by vaginal touch in the Douglas cul de sac and in the touch of nodules like pellets on the uterosacral ligaments.\n- You should review the bibliographic citations in the text: \"Indeed, Maria et al. [11] created a predictive model…\" \"Diego Raimondo et al. [27] pointed…\". Maria is de name (M) \"11. Perello, M., et al., Markers .. \" and it should also be Raimondo D.\n* Are the methods appropriate and well described?: **Yes**\n* Does the work include the necessary controls?: **Unable to assess**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **Not relevant to this manuscript**\n* Quality of written English: **Acceptable**\n* Declaration of competing interests: **I declare that I have no competing interests**\n* I agree to the open peer review policy of the journal. I understand that my name will be included on my report to the authors and, if the manuscript is accepted for publication, my named report including any attachments I upload will be posted on the website along with the authors' responses. I agree for my report to be made available under an Open Access Creative Commons CC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any comments which I do not wish to be included in my named report can be included as confidential comments to the editors, which will not be published.: ** I agree to the open peer review policy of the journal**\n"},{"type":"editorInvitedReview","content":"","date":"2020-03-17T12:00:00+00:00","index":2,"fulltext":"Recommendation: Accept after minor essential revisions\nForm responses:\n---\n\nComments to Author:\n---\nthe authors answered the questions adequately.\nplease consider the first author for reference number 27 in the manuscript (Mabrouk et al.)* Are the methods appropriate and well described?: **Yes**\n* Does the work include the necessary controls?: **Yes**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **I am able to assess the statistics**\n* Quality of written English: **Acceptable**\n* Declaration of competing interests: **I declare that I have no competing interests**\n* I agree to the open peer review policy of the journal. I understand that my name will be included on my report to the authors and, if the manuscript is accepted for publication, my named report including any attachments I upload will be posted on the website along with the authors' responses. I agree for my report to be made available under an Open Access Creative Commons CC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any comments which I do not wish to be included in my named report can be included as confidential comments to the editors, which will not be published.: ** I agree to the open peer review policy of the journal**\n"},{"type":"checksComplete","content":"","date":"2020-03-16T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2020-03-16T12:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-womens-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmwh","sideBox":"Learn more about [BMC Women's Health](http://bmcwomenshealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmwh/default.aspx","title":"BMC Women's Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2020-01-02 17:00:35","doi":"10.21203/rs.2.19864/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revision","date":"2020-02-04T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2020-01-24T12:00:00+00:00","index":4,"fulltext":"Recommendation: Accept after minor essential revisions\nForm responses:\n---\n* Are the methods appropriate and well described?: **Yes**\n* Does the work include the necessary controls?: **Unable to assess**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **I am able to assess the statistics**\n* Quality of written English: **Acceptable**\n* Declaration of competing interests: **I declare that I have no competing interests**\n\nComments to Author:\n---\nThe aim of study of Kwok et al. was to investigate the characteristic of deep infiltrating endometriosis lesion distribution when associated with ovarian endometrioma.\nThe study is very interesting, all the more, it brings a new direction to the diagnostics of endometriosis. However, I have a few questions:\n\n1.Have you considered use the ENZIAN classification of DIE? Can it together with yours results be useful to create map of DIE?\n2.In what phase of the menstrual cycle the surgery was performed?\n3.Except for these changes, were another lesion in peritoneal cavity? Superficial endometriosis? adhesion?\n4.Almost 90% of studied women had previously surgery for OEM, did they have any additional pharmacological treatment?\nCould you check, did the previous operation concern the same places?\n5.It could be more useful when you present results on figures.\n6.In Discussion part, it is not clear, where is your observations or conclusions and observations from other Authors.\n"},{"type":"editorInvitedReview","content":"","date":"2020-01-24T12:00:00+00:00","index":3,"fulltext":"Recommendation: Reject\nForm responses:\n---\n* Are the methods appropriate and well described?: **No**\n* Does the work include the necessary controls?: **Unable to assess**\n* Are the conclusions drawn adequately supported by the data shown?: **Unable to assess**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **I am able to assess the statistics**\n* Quality of written English: **Needs some language corrections before being published**\n* Declaration of competing interests: **declare that I have no competing interests**\n\nComments to Author:\n---\nThe patient records of 304 patients operated by a single surgeon in a single center were evaluated retrospectively.\nPatient who had both ovarian endometriosis as well as deep infiltrating endometriosis were evaluated.\nMedical, surgical and pathological records were evaluated. There are several important data missing from the manuscript.\n\nIt would appear that the patients were carefully evaluated before the surgery as the extensive preoperative tests included transvaginal sonography, urological ultrasound as well as MRI.\nThe symptoms are carefully listed, however nothing is mentioned about the medical treatment that the patients received prior to the surgery. In most (if not all ) guidelines the medical treatment should be the primary form of treatment and only if no sufficieint relief is observed then surgical interventions should be used.\n\nIt appears that during the period of 2008 - 2016 a large number of cases with ovarian disease only may have /(probably) have been operated. How many cases of unilateral ovarian endometriosis with no DIE were operated during that period? How many cases of bilateral cases of ovarian endometriosis with no DIE were operated during that period? How many of these were symptom less or had very little symptoms (compared to the one with DIE), This was enable the evaluation of the importance of symptoms in suspicion of DIE. Whereas the symptoms have been documented, there is no effort to find an association with specific symptoms and the location of the DIE. Not being familiar with the Chinese patient records and the reliability of details it is not possible to estimate whether this could be possible, certainly in many centers the routine surgical and medical notes are unlikely to give reliable and detailed information on this important issues.\nAs the goal in the study is to investigate the association between DIE and unilateral and bilateral OEM why has the imaging been completely ignored in this study? Would the findings be different if the analysis was done solely based on the imaging findings? Did the imaging findings match the surgical findings?"},{"type":"reviewerAgreed","content":"","date":"2020-01-04T12:00:00+00:00","index":7,"fulltext":""},{"type":"reviewerAgreed","content":"","date":"2019-12-30T12:00:00+00:00","index":5,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2019-12-30T12:00:00+00:00","index":6,"fulltext":"Recommendation: Accept after discretionary revisions\nForm responses:\n---\n* Are the methods appropriate and well described?: **Yes**\n* Does the work include the necessary controls?: **No**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **I am able to assess the statistics**\n* Quality of written English: **Acceptable**\n* Declaration of competing interests: **'I declare that I have no competing interests'**\n\nComments to Author:\n---\nThank you for giving me the opportunity to review this interesting study \"Lesion distribution characteristics of deep infiltrating endometriosis with ovarian endometrioma: An observational clinical study\".\nHowever, I have some comments and recommendations:\nComments:\nTitle:\n- Is appropriate for the content of the article.\nAbstract:\n- Represents a suitable summary of the work.\nArticle content:\n- The design, methods and analysis of the results are appropriate for the study.\nConclusions:\n- Are justified on the basis of the results of the study.\nRecommendations:\nIntroduction:\n- Emphasize the relation between OEM and DIE.\nMethods:\n- Mention appropriate details of surgical techniques.\nResults:\n- Do not duplicate, the text should complement the tables.\nDiscussion:\n- Mention the limitations of the study.\nReferences:\n- Update some references.\nGeneral:\n- Revise language, grammar and syntax.\n"},{"type":"editorInvitedReview","content":"","date":"2019-12-30T12:00:00+00:00","index":5,"fulltext":"Recommendation: Accept without revision\nForm responses:\n---\n* Are the methods appropriate and well described?: **Yes**\n* Does the work include the necessary controls?: **Unable to assess**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **Not relevant to this manuscript**\n* Quality of written English: **Acceptable**\n* Declaration of competing interests: **I declare that I have no competing interests**\n\nComments to Author:\n---\nWell-designed study that investigated the characteristics of the lesion distribution in ovarian endometrioma patients with deep infiltrating endometriosis"},{"type":"editorInvitedReview","content":"","date":"2019-12-30T12:00:00+00:00","index":2,"fulltext":"Recommendation: Major revisions required\nForm responses:\n---\n* Are the methods appropriate and well described?: **Yes**\n* Does the work include the necessary controls?: **Yes**\n* Are the conclusions drawn adequately supported by the data shown?: **No**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **I am able to assess the statistics**\n* Quality of written English: **Needs some language corrections before being published**\n* Declaration of competing interests: **no competing interests to declare**\n\nComments to Author:\n---\n\nThe Authors performed a good analysis on a very interesting topic in endometriosis management. However, further details are needed in the Results and Discussion section.\n\n1. The title is clear and accurately reflects the study contents\n\n2. Introduction:\na. The description of the background is correct.\nb. main objective: what do you mean with \"When do OEM patients also develop DIE?\". Please explain better.\n\n\n3. Materials and methods:\na. Study design is well mentioned.\nb. Could you perform a sample size or power analysis calculation?\nc. Population: overall seems appropriate. Data about previous surgery for deep endometriosis and preoperative medical therapy lack. Please add;\nWhy were patients operated on?\nd. Outcomes: well documented; data about ileocecal and appendiceal involvement lack. Please add some data about ileoceal and appendiceal endometriosis and discuss with adequate reference in the discussion (i.e. Mabrouk M et al. Endometriosis of the Appendix: When to Predict and How to Manage-A Multivariate Analysis of 1935 Endometriosis Cases. J Minim Invasive Gynecol. 2020).\n\ne. Description: well done.\n\nf. Statistics: Appropriately described\n\n\n4. Results:\na. Tables and figures are overall easy to understand.\nTable 1: what do you mean with \"anus bulge\"? It is so frequent in your endoemtriotic patients? Why?\nTable 2: What do you mean with \"Vaginal rectum\"?\n\nb. I. Clarity of results: seems appropriate.\n\nii. Reported objectives: deep lesion distribution and characteristics according to OMA presentations.\n\niii. Clinical interpretability: Seems appropriate\n\n5. Discussion:\na. Clinical relevance: addressed.\n-Please modify the paragraph including lines 166-171:\n\" Some researchers have suggested that urinary tract endometriosis may occur more frequently than it is currently thought to, particularly in patients with DIE\" Urinary tract endometriosis is a part of DIE, it is not? Please clarify this sentence.\n\"In this case, when there is an associated OEM, ultrasonic examination of the urogenital system is necessary.\"\nIn accordance with previous study (i.e. Raimondo D et al. Severe ureteral endometriosis: frequency and risk factors. J Obstet Gynaecol. 2018 Feb;38(2):257-260) the Authors found an association between the presence of OMA and ureteral involvement by the disease. Please add some references.\n\" Ureteral endometriosis should be considered when B mode ultrasound reveals ureter straitness and hydronephrosis. If the ureters are involved, renal function should be assessed by intravenous pyelography\". Please modify.\nWe perform renal scintigraphy to evaluate renal function in case of hydronephrosis. Hydroureter and hydronephrosis are the severe forms of ureteral endometriosis (Knabben et al., 2015. Urinary tract endometriosis in patients with deep infiltrating endometriosis: prevalence, symptoms, management, and proposal for a new clinical classification); the mild forms can be diagnosed also using uroCT or uroMRI and in many cases only during retroperitoneal dissection .\nIt is better to say \"stricture\" or \"stenosis\".\n- Please explain better why monolateral endometrioma are more associated to bowel and vaginal endometriosis. Please remove the paragraph including lines 184-190. It is not in line with the study aim.\n\nb. Strengths of the study: addressed\nc. Limitations of the study: not addressed. Please add.\nd. Recommendations for further research: not addressed. Please add.\n\n\n6. Abstract: Seems appropriate\n\n\n7. Grammar, overall flow, etc comments:\nI suggest to reduce length of discussion.\n"},{"type":"editorInvitedReview","content":"","date":"2019-12-30T12:00:00+00:00","index":1,"fulltext":"Recommendation: Major revisions required\nForm responses:\n---\n* Are the methods appropriate and well described?: **Unable to assess**\n* Does the work include the necessary controls?: **Unable to assess**\n* Are the conclusions drawn adequately supported by the data shown?: **Unable to assess**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **Not relevant to this manuscript**\n* Quality of written English: **Needs some language corrections before being published**\n* Declaration of competing interests: **'I declare that I have no competing interests'**\n\nComments to Author:\n---\nThis is an observational study on the distribution of DIE lesions in a large number of patients (n = 304) with OEM, and all operated by one of the authors (S. Yao). They observed these DIE lesions in up to 30 anatomical sites. However, they are cited: vagina, posterior fornix, vaginal rectum and rectovaginal pouch, as different seating sites for DIE implants and I cannot clarify these locations.\nThe results show that there were more DIE lesions among women with unilateral OEM, especially intestinal (¿), which seems logical as the other OEM does not prevent its display. There were no other significant differences between the OEM groups.\nBut I also have some doubts:\n1. Why were cases with laparoscopic surgery converted to open surgery excluded?\n2. The correspondence of the location of the lesions that I mentioned before: rectum, vaginal rectum, rectovaginal pouch ?, should be clarified.\n3. The importance of the complete exeresis of all DIE lesions is strongly insisted, don't you think that, as Dmowski said many years ago, counting the number of endometriosis lesions is like counting the number of spots of disseminated lupus erythematosus to see its severity ?, do the recurrences correspond to the implants without a complete exeresis ?.\n4. How do you explain that DIE implants are so frequent in uterosacral ligaments (80.6%), vaginal, posterior fornix ?, etc, the DYSPAREUNIA symptom is only present in 12.8% of patients? And chronic pelvic pain in 5.6% ?.\n"},{"type":"reviewerAgreed","content":"","date":"2019-12-30T12:00:00+00:00","index":6,"fulltext":""},{"type":"reviewerAgreed","content":"","date":"2019-12-30T12:00:00+00:00","index":4,"fulltext":""},{"type":"reviewerAgreed","content":"","date":"2019-12-30T12:00:00+00:00","index":3,"fulltext":""},{"type":"reviewerAgreed","content":"","date":"2019-12-30T12:00:00+00:00","index":2,"fulltext":""},{"type":"reviewerAgreed","content":"","date":"2019-12-30T12:00:00+00:00","index":1,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2019-12-30T12:00:00+00:00","index":"","fulltext":""},{"type":"submitted","content":"","date":"2019-12-19T12:00:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2019-12-19T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2019-12-18T12:00:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2019-12-18T12:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-womens-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmwh","sideBox":"Learn more about [BMC Women's Health](http://bmcwomenshealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmwh/default.aspx","title":"BMC Women's Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ccdf377d-9be8-49a8-b05a-8864e9e1477b","owner":[],"postedDate":"March 23rd, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":46310,"name":"Obstetrics \u0026 Gynecology"}],"tags":[],"updatedAt":"2021-09-27T18:29:18+00:00","versionOfRecord":{"articleIdentity":"rs-10476","link":"https://doi.org/10.1186/s12905-020-00974-y","journal":{"identity":"bmc-womens-health","isVorOnly":false,"title":"BMC Women's Health"},"publishedOn":"2020-05-20 18:24:24","publishedOnDateReadable":"May 20th, 2020"},"versionCreatedAt":"2020-03-23 14:36:22","video":"","vorDoi":"10.1186/s12905-020-00974-y","vorDoiUrl":"https://doi.org/10.1186/s12905-020-00974-y","workflowStages":[]},"version":"v2","identity":"rs-10476","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"identity":"rs-10476","version":["v2"]},"buildId":"WvIrzKhiLBfengagbw6Ux","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}