Efficacy of the revised Enzian classification: a retrospective analysis. Does the revised Enzian classification solve the problem of duplicate classification in rASRM and Enzian?

Purpose The most widely accepted classification for endometriosis is the Revised American Society for Reproductive Medicine (rASRM) system, but this does not take deeply infiltrating endometriosis (DIE) into account. The Enzian classification enables clinicians to classify DIE. Due to complexity and...

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Bibliographic Details
Published in:Archives of gynecology and obstetrics 2013-05, Vol.287 (5), p.941-945
Main Authors: Haas, Dietmar, Wurm, Peter, Shamiyeh, Andreas, Shebl, Omar, Chvatal, Radek, Oppelt, Peter
Format: Article
Language:English
Subjects:
Classification
Colon - pathology
Endocrinology
Endometriosis - classification
Endometriosis - pathology
Endometriosis - surgery
Female
General Gynecology
Gynecology
Human Genetics
Humans
Medicine
Medicine & Public Health
Obstetrics/Perinatology/Midwifery
Pelvis - pathology
Rectum - pathology
Retrospective Studies
Ureter - pathology
Urinary Bladder - pathology
Vagina - pathology
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Summary:Purpose The most widely accepted classification for endometriosis is the Revised American Society for Reproductive Medicine (rASRM) system, but this does not take deeply infiltrating endometriosis (DIE) into account. The Enzian classification enables clinicians to classify DIE. Due to complexity and partial overlap with rASRM, it was revised for a second time in February 2011. Using both the systems to classify lesions would be inappropriate, as they refer to different locations. The aim of this study was to analyze whether the revised Enzian classification is easier to use and avoids duplicate classifications. Methods Retrospective study of 460 women admitted for endometriosis. Results One hundred and eighty-seven of 460 patients (41 %) had histologically confirmed DIE based on the revised Enzian classification. Further classification of these 187 patients using Enzian revealed 270 retroperitoneal lesions, as some patients had several DIE-type lesions simultaneously: 66 in compartment A (rectovaginal septum, vagina), 112 in compartment B (sacrouterine ligaments, pelvic wall), 58 in compartment C (bowel), 15 with adenomyosis uteri, 7 with bladder involvement, 8 with intrinsic involvement of the ureter, and 4 with bowel involvement. All 270 lesions were classified using Enzian alone and not with the rASRM score. There were no duplicate classifications (rASRM and Enzian). Conclusions The revised Enzian classification is an excellent complement to the rASRM score for morphological description of DIE.
ISSN:0932-0067
1432-0711
DOI:10.1007/s00404-012-2647-1