Surgery for endometriosis

Surgical treatment for endometriosis is a great challenge for surgeons in training, especially the deep infiltrating forms, and requires a long learning curve and study of important anatomical correlations. Endometriosis is currently one of the most prevalent and studied diseases in gynecology and is defined as the presence of endometrial stromal or glandular cells outside the uterine cavity. It affects between 10%–15% of women of reproductive age, and its exact pathogenetic mechanisms remain unclear to date. The symptoms are variable and not necessarily related to the extent of disease. The most frequent symptoms are dysmenorrhea, deep dyspareunia, chronic pelvic pain, intestinal and/or urinary that are cyclic and infertility, impacting on physical, mental and social well-being. It is often underdiagnosed and takes an average of 10 years before the proper diagnosis is established. In 1996, the ASRM revised an established surgical classification, categorizing the disease in 4 different stages, which are defined by a point system according to the surgical findings.