Abstract
Endometriosis is a frequent pathology for which the dominant signs and symptoms are
pelvic pain and infertility. The physiopathology remains the subject of controversy.
Four physiopathological hypotheses have been put forward: regurgitation, metaplasia,
induction and (vascular and lymphatic) embolization. The anatomical distribution of
endometriotic lesions would appear to be fundamental for a better understanding of
Sampson's menstrual regurgitation theory of endometriosis. Analysis of the results
in the literature and comparison with our experience clearly shows that the distribution
of endometriotic lesions is asymmetrical in several respects. Abdominopelvic anatomy
and peritoneal fluid flow can explain this asymmetrical distribution of endometriotic
lesions in the great majority of cases. These observations are a very strong argument
in favour of the crucial role played by tubal regurgitation and the peritoneal fluid
in the physiopathology of endometriosis. The similarity in anatomical distribution
of endometriomas, superficial and deeply invasive endometriotic lesions would tend
to indicate a common origin for these different types of lesions.
Keywords
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Article info
Publication history
Published online: March 12, 2008
Accepted:
January 21,
2008
Received in revised form:
December 16,
2007
Received:
September 5,
2007
Identification
Copyright
© 2008 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
