Selection of medical or surgical treatment of endometriosis

The use of the culdoscope and now the laparoscope has made the accurate diagnosis of endometriosis possible so that each case can be clinically staged. A suggested staging of endometriosis similar to that used for carcinoma of the cervix, i.e., consisting of four stages, is proposed. Surgical or hormonal treatment, or a combination of both, can be chosen on the basis of the stage of the disease. Success of therapy can be determined and compared to results of other investigators using the same staging or classification. The choice and extent of surgical treatment, stage for stage, is discussed. The several hormonal regimens, progestins alone, progestins plus estrogen or danazol, are outlined. Previously reported results in the treatment of endometriosis demonstrated a close correlation between stage of disease and percentage of patients who conceive.