[Endometriosis--new perspectives. 2. Classification and treatment]

Area of Science:

• Gynecology
• Reproductive Medicine
• Surgical Innovation

Context:

• Endometriosis presents with diverse clinical manifestations and severity.
• Traditional classification systems like Acosta's have limitations.
• The need for a standardized, detailed endometriosis classification is recognized.

Purpose:

• To review the current landscape of endometriosis classification and treatment.
• To highlight the advantages of the revised American Fertility Society (R-AFS) classification.
• To discuss contemporary and classical therapeutic strategies for endometriosis.

Summary:

• The revised American Fertility Society (R-AFS) classification system, based on scoring endometriosis elements, provides a more differentiated disease description and better assessment of bilateral involvement.
• The review covers various treatment options, including the debate on treating minimal-mild endometriosis, laser surgery, GnRH analogues for medical oophorectomy, and in vitro fertilization.
• Classical treatments like danazol, oral contraception, gestagens, and surgery are also reviewed, with recommendations for patient selection for each modality.

Impact:

• Adoption of the R-AFS classification facilitates standardized reporting and comparison of endometriosis cases globally.
• The discussion on treatment efficacy and patient selection aids in personalized management strategies for endometriosis.
• Integration of novel therapies like GnRH analogues and IVF expands therapeutic options for patients with endometriosis.