caa a22 4500 445363568 CHVBK 20180317142922.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1007/s10397-010-0626-8 doi (NATIONALLICENCE)springer-10.1007/s10397-010-0626-8 An endometriosis classification, designed to be validated [Elektronische Daten] [Philippe Koninckx, Anastasia Ussia, Leila Adamyan, Arnaud Wattiez] Several endometriosis classifications were proposed, based on the assumption that endometriosis is a progressive disease, and designed to score severity of visible lesions. In addition, several specific classifications, e.g., for deep endometriosis, were proposed. None of these classifications however, have been validated to be predictive for diagnosis, treatment prognosis, recurrence, progression or for the associated infertility or pain. The difficulties derive from the fact that pathophysiology and the natural history are still uncertain. A classification should avoid assumptions. It seems established beyond reasonable doubt that endometriosis presents as subtle, typical, cystic, and deep lesions and that severity of each lesion is related to size or volume. By pathology, these four lesions present as active, burnt-out, inactive, and active lesions, respectively. Besides this, there are many uncertainties. It is unclear whether endometriosis is one disease progressing ultimately into severe endometriosis or whether typical, cystic, and deep endometriosis represents three different diseases, each being an end stage. It is unclear whether endometriotic cells are different from endometrial cells or whether only the environment is different. It is unclear how adenomyosis, Müllerianosis, and peritoneal pockets should be considered. We therefore suggest a descriptive classification with the severity of Subtle, Typical, Cystic, Deep, Adenomyotic, and peritoneal pocket lesions, estimated by their area or volume. This classification should permit to evaluate the actual uncertainties in order to build subsequently a validated classification. The similarity of the classes for superficial and cystic lesions with the rAFS classification is considered an advantage. It is discussed why adhesions need not to be scored. In conclusion, a simple classification scoring separately severity of subtle, typical, cystic, deep, adenomyotic, and peritoneal pocket lesions is suggested. This will permit to confirm or reject statistically many of the actual uncertainties on endometriosis and to evaluate what the predictive power of the severity of each type of lesion is, both essential elements for a validated endometriosis classification. Springer-Verlag, 2010 Classification nationallicence Endometriosis nationallicence Adenomyosis nationallicence Peritoneal pockets nationallicence Müllerianosis nationallicence Koninckx Philippe Department of Obstetrics and Gynaecology, U. Z. Gasthuisberg, K. U. Leuven, 3000, Leuven, Belgium aut Ussia Anastasia Gruppo Italo Belga, Rome, Italy aut Adamyan Leila Moscow State University, Moscow, Rusland aut Wattiez Arnaud Ircad, Strassbourg University, Strassbourg, France aut Gynecological Surgery Springer-Verlag 8/1(2011-02-01), 1-6 1613-2076 8:1<1 2011 8 10397 https://doi.org/10.1007/s10397-010-0626-8 text/html Onlinezugriff via DOI 1 brief-communication jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10397-010-0626-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Koninckx Philippe Department of Obstetrics and Gynaecology, U. Z. Gasthuisberg, K. U. Leuven, 3000, Leuven, Belgium aut NATIONALLICENCE 700 1- Ussia Anastasia Gruppo Italo Belga, Rome, Italy aut NATIONALLICENCE 700 1- Adamyan Leila Moscow State University, Moscow, Rusland aut NATIONALLICENCE 700 1- Wattiez Arnaud Ircad, Strassbourg University, Strassbourg, France aut NATIONALLICENCE 773 0- Gynecological Surgery Springer-Verlag 8/1(2011-02-01), 1-6 1613-2076 8:1<1 2011 8 10397 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer