[The mechanisms of endometriosis]

Endometriosis is characterised by the presence in abnormal situation of a tissue resembling the endometrium with glands and stroma. Several assumptions try to explain the development of this tissue. The oldest, the theory of the metaplasia, suggests that under various influences the coelomic tissues would be transformed into endometrium. Most often agreed, the theory known as the implantation theory, explains why the endometrial cells and fragment desquamated during menstrual period transported through the fallopian tubes into the peritoneal cavity (physiological phenomenon) could under certain conditions implant, proliferate and develop overcoming the local mechanisms of defence. The peritoneal cavity of the normal women have the capacity to prevent the evolution towards endometriosis. The reasons of an evolution towards the endometriosis and its symptoms (pain, sterility, adherences are probably numerous implying the immune system, the endometrium, the macrophages, the cells natural killer, the peritoneum the fallopian tubes. The failure to removes the peritoneal cavity of the fragments would induce an inflammatory local state with hyperactivation of the macrophages which secrete many molecules, of which some could lead the metaplasia of the peritoneum or the development of müllerian residues.