Classifications of endometriosis

Abstract

In the article a review of the main classifications of endometriosis is presented. Main drawbacks of existing classifications have been revealed. A need for a new classification of the disease, which has to be empirical, evidence-based, containing terms that have unambiguous definitions, applicable for various clinical situations, taking into account new clinical forms and able to predict a course of the disease (including the development of pain syndrome and infertility), it’s outcomes and a risk of recurrence is stressed. The new classification of endometriosis has to be based on resolutions of a consensuses and applicable for new guidelines for diagnosis and treatment. For the new classification it is essential to be approachable and easy-to-use in routine clinical practice. It has to allow a physician to determine a stage the disease promptly and meaningfully. A new Protocol taking into account a combination of different forms of endometriosis (superficial, deep infiltrative, adenomyosis, endometriomas, extragenital), color of endometriotic lesions, special aspects of clinical course, results of hormonal examination, reproductive plans and prior hormonal therapy is proposed.

Clinical effectiveness of surgical treatment of stage I–II endometriosis according to rASRM

“…Все общества (ESHRE, ACOG, SGC, ASRM и FEBRASGO) согласны с тем, что при выявлении поверхностного эндометриоза при лапароскопии предпочтительна хирургическая резекция, поскольку она дополнительно обеспечивает гистологическое подтверждение, а также уменьшает болевые ощущения, свойственные эндометриозу [20,25] 3,4,5,6 . Многие исследователи солидарны в том, что хирургическая резекция глубоких очагов эндометриоза уменьшает боль и улучшает качество жизни женщин [10,17,23,24,[26][27][28].…”

“…Адамян (1998), С. Chapron (ГИЭ, 2003), F. Tuttlies и соавт. (ENZIaN, 2011) [3]. Однако наиболее часто используемой считается пересмотренная в 1996 году классификация Американского общества фертильности (The revised American Society for Reproductive Medicine, rASRM) 1 .…”

Childbirth: The Genetic-Psychosomatic Mother-Child Tango.To the new theory of parturition

“…Article selection was predicated on their citation, ensuring a foundation of reliable and widely acknowledged research. Additionally, seminal works such as the Williams Obstetrics Manual [1] and the National Manual of Obstetrics [5] were scrutinized. In a nod to our predecessors and to maintain a continuum of knowledge, we paid homage to the Multivolume Guide to Obstetrics and Gynecology [6].…”

“…The contractile-inhibitory system is pivotal. Childbirth involves the myometrium's contractile activity, regulated by uterotonic biologically active substances (BAS) like oxytocin, prostaglandins, acetylcholine, serotonin, adrenaline, nor-epinephrine, histamine, endothelins, angiotensin-ll, and the kinin system [5] p. 134. These BAS are delivered by the nervous and endocrine organs, circulating blood cells, and fetal structures, with an increase in the number of receptors on the SMC membranes.…”

Sclerotic adenomyosis: a case report

“…В 80 % случаев у больных выявляется диффузная форма аденомиоза, значительно реже диагностируют узловые и кистозные формы. На конгрессе по эндометриозу в Барселоне в 2016 г. было принято решение к описанным формам (диффузная, узловая, кистозная) добавить склеротическую форму [1,2,4].…”