The staging of peritoneal endometriosis by the type of active lesion in addition to the revised American Fertility Society classification

Abstract

Objective: To evaluate changes in peritoneal endometriosis by the type of lesion in comparison with the scoring system of the revised American Fertility Society (AFS) classification.

Design: Prospective evaluation at laparoscopy before and 6 months after discontinuance of a 3-month medical therapy with either dydrogesterone or danazol.

Setting: A general hospital.

Patients: Forty cycling women with endometriosis and infertility. Fourteen patients could be fully evaluated by their revised AFS score and type of peritoneal lesion.

Interventions: Laparoscopy before and 6 months after discontinuance of medical therapy.

Main outcome measure: Revised AFS score and type of peritoneal lesions.

Results: The revised AFS score decreased or remained unchanged in 13 of 14 patients, whereas red papular or vesicular lesions were present at both laparoscopies in 5, absent in 4, disappeared in 3, and appeared de novo in 2. A changing pattern also was seen in other types of small peritoneal lesions.

Conclusion: In contrast with the revised AFS score, the study of the type of peritoneal lesions shows a changing pattern of activity. The significance in pathophysiological and clinical studies should be investigated further.