The “neurologic hypothesis”: a new concept in the pathogenesis of the endometriosis?

Marc Possover, Kerstin Rhiem, Vito Chiàntera
In: Gynecological Surgery · 2005 · vol. 2(2) , pp. 107–111 · doi:10.1007/s10397-004-0070-8 · W2067166022
article OA: bronze CC0 ⤵ 13 in-corpus citations
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-07 ⓘ

This study analyzed 467 patients with deep endometriosis, finding its infiltration pattern correlates with the pelvic sympathetic nervous system's anatomical distribution, proposing a new "neurologic theory" for its pathogenesis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This paper analyzes the operative “cartography” of deep-infiltrating endometriosis/adenomyosis in the rectovaginal space in 467 consecutive patients undergoing laparoscopic-vaginal radical surgery (with prospective intraoperative documentation of which pelvic sites were infiltrated). The authors report that isolated rectovaginal space lesions were rare (0.6%), while infiltration of the posterior cervix and at least one rectovaginal ligament was present in 99.4%, and the distribution of involved sites showed an absolute correlation with the anatomical distribution of the pelvic sympathetic nervous system; they propose a “neurologic hypothesis” in which endometriosis spreads along or is supported by sympathetic innervation. A key caveat is that recurrence/recut outcomes were reported only in subsets where specific resections were performed, without a broader long-term, comparative design described for validating the neurologic mechanism. This paper is centrally about endometriosis — it proposes a “neurologic hypothesis” linking sympathetic nerve anatomy to the invasion pattern of deep infiltrating endometriosis affecting the rectovaginal space.

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endometriosis

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