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Is mild endometriosis always a disease?
P Vercellini1, L Bocciolone, P G Crosignani
1L. Mangiagalli Department of Obstetrics and Gynaecology, University of Milano School of Medicine, Italy.
Human Reproduction (Oxford, England)
|May 1, 1992
Summary
Laparoscopic diagnosis increased endometriosis detection, but minimal lesions in asymptomatic women question clinical significance. Early endometriosis may resolve naturally, not always progressing to severe stages.
Area of Science:
- Gynecology
- Reproductive Medicine
- Surgical Diagnostics
Background:
- Laparoscopy has increased endometriosis diagnosis in women with infertility or pain.
- Increased detection may reflect improved visualization of minimal/mild lesions, not necessarily rising incidence.
- Estimates of endometriosis prevalence may be unreliable due to diagnostic variables.
Purpose of the Study:
- To evaluate the clinical significance of minimal/mild endometriosis.
- To question the necessity of treating early-stage endometriosis.
- To explore the natural progression of endometriosis.
Main Methods:
- Analysis of prospective data from asymptomatic women undergoing tubal sterilization.
- Review of diagnostic criteria and progression patterns of endometriosis.
Main Results:
- A higher-than-expected frequency of endometriosis was found in asymptomatic women.
- This suggests minimal lesions may not always be clinically significant.
- The concept of mandatory early treatment lacks strong scientific evidence.
Conclusions:
- Minimal/mild endometriosis might be a transient phase, often resolving spontaneously.
- Progression to severe stages occurs in a subset of immunologically 'tolerant' individuals.
- The clinical significance and management of minimal/mild endometriosis require further investigation.