Endometriosis

Endometriosis is a chronic gynecologic disease characterized by the development and presence of histological elements like endometrial glands and stroma in anatomical positions and organs outside the uterine cavity. The main clinical manifestations of the disease are chronic pelvic pain and impaired fertility. The localization of endometriosis lesions can vary, with the most commonly involved focus of the disease being the ovaries, followed by the posterior broad ligament, the anterior cul-de-sac, the posterior cul-de-sac, and the uterosacral ligament. Endometriotic nodules also affect the intestinal tract and the urinary system, like the ureter, the bladder, and the urethra. Nevertheless, endometriosis is not limited to the pelvis but can damage extra pelvic structures like the pleura, the pericardium, or the central nervous system. The main theories utilized to explain the pathogenesis of endometriosis are Sampson’s theory, the coelomic metaplastic theory, the stem cell theory, the Müllerian remnant theory, and the vascular and lymphatic metastasis theory.