Atypical endometriosis revisited: clinical and biochemical evaluation of the different forms of superficial implants

Objective: To investigate the activity of different forms of endometriosis implants by clinical and biochemical evaluation. Design: Prospective, blinded study. Setting: Tertiary-care university hospital. Patient(s): Forty-seven infertile patients with minimal or mild endometrios is diagnosed at laparoscopy were included in the clinical investigation. Intervention(s): Patients were submitted to a preoperative evaluation of en dometriosis-associated dysmenorrhea by means of a 10-point linear analog sc ale and to laparoscopic staging of endometriosis following a current classi fication system. In the biochemical investigation, tissue samples from diff erent endometriosis lesions and control tissues were assessed for prostagla ndin (PG) F-2 alpha production. Main Outcome Measure(s): Evaluation of the correlation between endometriosi s-associated dysmenorrhea and the extent of the disease. Evaluation of the production of PGF(2 alpha) by the different tissues sampled. Result(s): No positive correlation was present between any of the implant s ubgroups and the associated dysmenorrhea. White peritoneal implants were as sociated with milder pain symptoms than black or red lesions. The biologic activity of red and black superficial implants, expressed as the production of PGF(2 alpha), was similar. Conclusion(s): No positive correlation was demonstrated between endometrios is-associated dysmenorrhea and the current classification of endometriosis, which includes characterization of the different morphologic aspects of su perficial endometriosis implants. (Fertil Steril (R) 2000;74:739-42. (C) 20 00 by American Society for Reproductive Medicine.).