Treatment of endometriosis depends on understanding the symptoms and the area of endometriosis. Depending on the area where the endometriosis lesions are formed, there are three main classifications of endometriosis.
- Superficial Peritoneal Endometriosis
Superficial endometriosis is, as the name suggests, a less advanced form of endometriosis in the peritoneum membrane. It usually has 1mm – 2mm endometriosis lesions without much mass.
The peritoneum is a thin membrane that lines your abdomen and pelvis.
- Deep Infiltrating Endometriosis
When endometriosis is formed in the uterosacral ligaments, rectovaginal space, the bowel, posterior vaginal wall, and the urinary tract, it is deep infiltrating endometriosis.
The Enzian classification was proposed to identify deep endometriosis outside the pelvic cavity; in the vagina, rectovaginal space, uterosacral ligaments, cardinal ligaments/pelvic sidewall, rectum, and other locations.
Deep Infiltrating Endometriosis is rare, but sometimes a lot of scar tissue can bond organs so they become stuck in place.
- Ovarian Endometriosis
Endometriosis can be found on the surface of one or both ovaries, but it can also be found deep within them too. Deep ovarian endometriosis forms dark fluid-filled cysts that can vary in size known as endometriomas or “chocolate cysts”. The chocolate cysts are often associated with infertility and they are usually coming with a disease in other parts of the pelvis/body.
Laparoscopy / robotic surgery remains the only way to precisely diagnose and excise endometriosis.