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Marco Zaccaria: Parametrial Endometriosis Is a Severe and Complex Form of Deep Infiltrating Endometriosis
Marco Zaccaria/LinkedIn
Jun 28, 2026, 14:59

Marco Zaccaria: Parametrial Endometriosis Is a Severe and Complex Form of Deep Infiltrating Endometriosis

Marco Zaccaria, Global Product Manager at ESGE European Society Gynecology Endoscopy, shared a post on LinkedIn:

“Parametrial endometriosis is a severe and complex form of deep infiltrating endometriosis (DIE)

It occurs when endometrium-like tissue penetrates more than 5 millimeters into the parametrium—that is, the retroperitoneal connective and ligamentous tissue that extends from the sides of the uterus and cervix to the lateral pelvic wall

This specific location is considered particularly critical and ‘hidden,’ as the area contains vital anatomical structures: the major pelvic blood vessels, the ureters and important nerve fibers of the autonomic and somatic nervous systems

How can it be diagnosed

Transvaginal Ultrasound (TVUS): performed by experienced operators according to the updated criteria of the IDEA (International Deep Endometriosis Analysis) group and it allows for the detection of parametrial nodules, which typically appear as hypoechoic formations with irregular or ‘star-shaped’ margins

Pelvic Magnetic Resonance Imaging (MRI): essential for mapping the exact extent of the lesion and assessing the involvement of the somatic nerves and ureters prior to any potential surgery.”

Marco Zaccaria: Parametrial Endometriosis Is a Severe and Complex Form of Deep Infiltrating Endometriosis

Stay updated on all scientific advances in the field of fertility with Fertility News.

anatomical structures autonomic and somatic nervous systems cervix Fertility Fertility News hypoechoic formations Infiltrating Endometriosis International Deep Endometriosis Analysis lateral pelvic wall ligamentous tissue Parametrial endometriosis parametrial nodules Pelvic Magnetic Resonance Imaging (MRI): potential surgery reproductive health Reproductive Medicine retroperitoneal connective Transvaginal Ultrasound (TVUS) Uterus
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