Advances in preoperative diagnostics as well as in surgical techniques for the treatment
of endometriosis, especially for deep endometriosis, call for a classification system,
that includes all aspects of the disease such as peritoneal endometriosis, ovarian
endometriosis, deep endometriosis, and secondary adhesions. The widely accepted revised
American Society for Reproductive Medicine classification (rASRM) has certain limitations
because of its incomplete description of deep endometriosis. In contrast, the Enzian
classification, which has been implemented in the last decade, has proved to be the
most suitable tool for staging deep endometriosis, but does not include peritoneal
or ovarian disease or adhesions. To overcome these limitations, a comprehensive classification
system for complete mapping of endometriosis, including anatomical location, size
of the lesions, adhesions and degree of involvement of the adjacent organs, that can
be used with both diagnostic and surgical methods, has been created through a consensus
process and will be described in detail-the #Enzian classification.
