The Problem of Endometriosis: A Review

No condition in the field of gynaecology exhibits such a variety of manifestations as (loes endometriosis. No other condition has in consequence been so prolific of speculation an(l theory to explain it. 'T he first (lescriptionl of endometriosis or alenomyoma as an entity is attributed to Rokitanskyl in 1860. In 1870 Waldeyer2 conclu(ded that nearly all epithelial new growths of the ovary originate from a downward proliferationl of the surface epithelium of the ovary, thus constitutinig invasions of the ovarian stroma by its own covering germinal epithelium. This theory was later to be adapted and developed to explain endometrial invasions of the ovary and developmentally kindlred tissues. Von Recklinghausen3 in 1896, when trying to explain the presence of endometrial tissue in the uterine wall, propounded the theory that when the \\NVolffian and Miullerian ducts cross in early life there may be an intermingling of these tissues at this site with at times a persistence of embryonic rests of Wolffian origin. 'rhis explanation failed entirely to explain why these so-called "rests " constantly develop a Miullerian rather than a Wolffian structure.