Endometriosis

Recent advances in endometriosis research are reviewed. Factors relating to the increasing frequency of laparoscopic diagnosis as well as potential diagnostic tests utilizing endometrial antibody and CA 125 assays of both serum and peritoneal fluids are discussed. A new classification is proposed that takes into consideration depth of endometriotic lesions. The pathophysiology of endometriosis is an area of increased research activity with attention directed toward autoimmune theories of impaired surveillance. A variety of autoantibodies have been found to be increased in patients with endometriosis, and peritoneal macrophage activation is also thought to play a role. Laparoscopic treatment options are reviewed, including investigations of various laser methods as well as electrocautery. Medical therapy comparing various gonadotropin-releasing hormone agonists and danazol and the effects of these treatment options on bone density are presented. New directions in immunomodulatory drug therapy are discussed.