CLASSIFICATION

Among the external genital endometriosis classifications appropriate to the degree of extent the most often is used the classification of A. Acosta and co-authors (1973):

“Minimal” types of endometriosis:

· Solitary endometrioid heterotopias on pelvic peritoneum;

· Solitary endometrioid heterotopias on ovaries without commissural and scarry processes;

Moderate endometriosis:

· Endometrioid heterotopias on the surface of one or both ovaries with small cysts formation;

· Periovarial or peritubal commissural process not full-blown;

· Endometrioid heterotopias on the rectouterine (Douglas') pouch peritoneum with scarring and metrectopy, without colon involvement;

Severe endometriosis:

· One or both ovaries endometriosis with cysts more than 2 cm across diameter formation;

· Ovarian lesion with most evident periovarial and peritubal process;

· Uterine tubes lesion with deformation, scarring and passability disturbances;

· Pelvic peritoneum lesion with rectouterine (Douglas') pouch obliteration;

· Sacrouterine ligaments lesion and peritoneum of rectouterine (Douglas') pouch lesion with obliteration;

· Urinary tracts and/or bowels involvement.

Classification of adenomyosis:

In compliance with penetration into myometrium 4 degrees of diffuse type of uterus endometriosis extent are differentiated:

1. Not profound invasion.

2. Invasion before the middle of myometrium.

3. All wall of uterus involving.

4. Parietal peritoneum and neighboring organs involving.

Staging the disease as minimal, mild, moderate, or severe is important to formulate a treatment strategy and evaluate response to therapy. The revised staging criteria are based on the location of implants, presence of superficial or deep endometriosis, and presence of filmy or dense adhesions. This classification scheme divides the degree of endometriosis into minimal, mild, moderate, or severe categories.

Risk factors:

· Japanese race.

· Family history.

· Age 30 – 44 years.

· Alcohol – caffeine intake.

· Increased peripheral fat.

In the International Hystological Classification of ovarian tumors is written that endometriosis is not a tumour but tumor-like mass in spite of the endometriosis can have similarity with tumour.

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