Endometriosis is characterized by the presence of endometrial tissue outside the uterus, commonly causing pelvic pain and infertility. It is a progressive disease that is diagnosed via laparoscopy. Treatment options include hormone therapy, surgery, or a combination, with the goal of relieving symptoms and potentially improving fertility. Recurrence rates after surgery are estimated to be around 19% after 5 years but are lower with more extensive surgical intervention such as oophorectomy.

1. Endometriosis ENDOMETRIOSIS

6. Ovary with endometrioma.

8. Rupture endometrioma

16. Classification of Endometriosis 16 8* 4 * Dense 4 2 1 L Filmy 16 8* 4 * Dense 4 2 1 R Filmy Tube 16 8 4 Dense 4 2 1 L Filmy 16 8 4 Dense 4 2 1 R Filmy >2/3enclosure 1/3-2/3 enclosure < 1/3 enclosure Adhesions Ovary

17. Classification of Endometriosis 20 16 4 Deep 4 40 partial complete posterior cul de sac obliteration 20 16 4 Deep 4 2 1 L Superficial 4 2 1 R Superficial Ovary 6 4 2 Deep 4 2 1 Superficial >3cm 1-3 cm < 1CM Endometriosis Peritoneum

18. Common site of endometriosis

37. Surgical treatment

38. Surgical Treatment Laparoscopic excision of nodular endometrial lesions overlying the rectum Nodular endometrial lesions in the posterior cul-de-sac.