The classification of endometriosis. A literature overview and a proposal for a new classification system for endometriosis and infertility

Performance of ultrasound‐based endometriosis staging system (UBESS) for predicting level of complexity of laparoscopic surgery for endometriosis

“…In clinical practice, the extent of endometriosis may vary from a few small lesions on the peritoneum (revised American Fertility Society classification (rAFS) Stages I and II) to nodular disease, with extensive fibrosis and adhesion formation causing marked distortion of pelvic anatomy (rAFS III and IV). Using principles similar to those of gynecological oncology staging systems, cognizant of the progressive nature of endometriosis and considering the ease of its clinical applicability, we developed a three‐stage preoperative UBESS (Table ), based on the principal histological phenotypes of endometriosis (peritoneal endometriosis, ovarian endometrioma, adenomyosis, non‐bowel and bowel DIE nodules), the anatomical locations of DIE (bowel or non‐bowel) and their markers of local invasiveness (ovarian adhesions and adhesions involving the POD). These various phenotypes of endometriosis, which may occur either in isolation or in combination, present different levels of complexity and require different levels of laparoscopic expertise to ensure optimal treatment in symptomatic women in whom surgical treatment is planned.…”

Interpreting the real-time dynamic ‘sliding sign’ and predicting pouch of Douglas obliteration: an interobserver, intraobserver, diagnostic-accuracy and learning-curve study

“…Endometriosis is a heterogeneous multiform and multiplex disease that affects up to 15% of women of reproductive age. Its histological phenotypes include peritoneal, ovarian and deep infiltrating (DIE) endometriosis, with their markers of local invasiveness: ovarian adhesions and obliteration of the pouch of Douglas (POD). These phenotypes of endometriosis can occur singly or in combination.…”