Time to Redefine Endometriosis Including Its Pro-fibrotic Nature

P. Vigano; M. Candiani; A. Monno; E. Giacomini; P. Vercellini; E. Somigliana


Hum Reprod. 2018;33(3):347-352. 

In This Article


The present definition of endometriosis based on the histologic feature of the concomitant presence of endometrial stroma and epithelium in ectopic sites has been developed in order to guarantee a uniform identification of the condition. However, with increasing knowledge of the disease mechanisms and the improvement of the diagnostic tools, nowadays this definition appears too simplicistic to represent the different histologic forms and clinical manifestations of this complex disease. Therefore, whilst on the one hand the identification of the specific histopathologic characteristics remains extremely important to diagnose endometriosis, on the other hand other aspects need to be taken into account from both a diagnostic and a therapeutic point of view. In our view, the endometriosis definition should be reconsidered. 'A fibrotic condition in which endometrial stroma and epithelium can be identified' could represent a realistic starting point.