Authors: M. Fanta;  P. Koliba;  H. Hrušková
Authors‘ workplace: Centrum pro komplexní léčbu endometriózy, Gynekologicko-porodnická klinika VFN a 1. LF UK, Praha, přednosta prof. MUDr. A. Martan, DrSc.
Published in: Čes. Gynek.2012, 77, č. 4 s. 314-319


To summarize current knowledge of pathogenesis, diagnostics and treatment of endometriosis.

Review article.

Centre for diagnostics and treatment of endometriosis, Department of Gynecology and Obstetrics, General Faculty Hospital and 1st Faculty of Medicine of Charles University, Prague.

Methods and results:
Endometriosis is defined as the presence of endometrial-like tissue outside the uterus, which induces a chronic, inflammatory reaction. The condition is predominantly found in women of reproductive age, from all ethnic and social groups.

The associated symptoms – pain, infertility – can impact on general physical, mental and social well being. Treatment must be individualised, taking the clinical problem in its entirety into account, including the impact of the disease and the effect of its treatment on quality of life. Pain symptoms may persist despite seemingly adequate medical and/or surgical treatment of the disease. In such circumstances, a multi-disciplinary approach involving a pain clinic and counselling should be considered early in the treatment plan.

Endometriosis is a medical condition with high recurrence rate and especially those patients with deep infiltrating endometriosis should be centralized to the centres experienced in diagnostics, complicated surgical treatment and providing multi-disciplinary approach with adequate postoperative care.

Key words:
endometriosis, pain, classification, deep infiltrating endometriosis (DIE), laparoscopy. 


1. Bulun, SE. Endometriosis. N Engl J Med, 2009, 360, p. 268–279.

2. D’Hooghe, T., Hummelshoj, L. Multi-disciplinary centres/networks of excellence for endometriosis management and research: a proposal. Hum Reprod, 2006, 21, p. 2743–2748.

3. ESHRE Guidelines for diagnosis and treatment of endometriosis. 2007 endometriosis.org

4. Forte, A., Schettino, MT., Finicelli, M., et al. Expression pattern of stemness-related genes in human endometrial and endometriotic tissues. Mol Med, 2009, 15, p. 392–401.

5. Giudice, LC. Endometriosis. N Engl J Med, 2010, 362, p. 2389-2398.

6. Leyendecker, G., Herbertz, M., Kunz, G., Mall, G. Endometriosis results from the dislocation of basal endometrium. Hum Reprod, 2002, 17, p. 2725–2736.

7. Leyendecker, G., Kunz, G., Noe, M., et al. Endometriosis: a dys-function and disease of the archimetra. Hum Reprod Update, 1998,4, p. 752–762.

8. Leyendecker, G., Wildt, L., Mall, G. The pathophysiology of endometriosis and adenomyosis: tissue injury and repair. Arch Gynecol Obstet, 2009, 280, p. 529–538.

9. Marcoux, S., Maheux, R., Bérubé, S. Laparoscopic surgery in infertile women with minimal or mild endometriosis. Canadian Collaborative Group on Endometriosis. N Engl J Med, 1997, 337, p. 217–222.

10. Mechsner, S., Schwarz, J., Thode, J., et al. Growth-associated protein 43-positive sensory nerve fibers accompanied by immature vessels are located in or near peritoneal endometriotic lesions. Fertil Steril, 2007, 88, p. 581–587.

11. Otkán, S., Arici, A. Advances in treatment options of endometriosis. Gynecol Obstet Invest, 2009, 67, p. 81–91.

12. Slak, A., Child, T., Lindsey, I., et al. Urological and colorectal complications following surgery for rectovaginal endometriosis. BJOG, 2007, 114, p. 1278–1282.

13. Vercellini, P., Carmignani, L., Rubino, T., et al. Surgery for deep endometriosis: a pathogenesis-oriented approach. Gynecol Obstet Invest, 2009, 68, p. 88–103.

14. Wang, G., Tokushige, N., Russell, P., et al. Hyperinnervation in intestinal deep infiltrating endometriosis. J Minim Invasive Gynecol, 2009, 16, p. 713–719.

Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

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