Regional lymphatic spread in women with pelvic endometriosis

Endometriosis is defined by the presence of endometrial tissue outside the uterine cavity and is associated with chronic pelvic pain and infertility. After surgical and/or medical treatment, endometriosis has a high recurrence rate which increases with the length of follow-up. To delay or to eliminate recurrence is a main task in the control of this disease. To date, little is known about the mechanism of recurrence and its management is not efficacious. Recently, it has been observed that regional lymph node involvement by endometriosis is a common phenomenon in women with endometriosis. Endometriotic cells in regional lymph node are a potential target of hormonal stimulation in the postoperative period and may be a major source of disease recurrence. We hypothesize that the resection of regional lymph nodes can decrease the recurrence rate of endometriosis and hence should become part of the surgical treatment of this disease.