Stages of Endometriosis

OVERVIEW

What are the stages of endometriosis?

Endometriosis is classified into four stages; I-minimal, II-mild, III-moderate, and IV-severe. Staging has been defined by the American Society for Reproductive Medicine (ASRM), with criteria based on the location of the disease, extent, depth of endometriosis implants, presence and size of ovarian endometriomas, and the presence and severity of adhesions.

StageAmerican Society of Reproductive Medicine Severity Classifications
Stage I Mild
Stage II Minimal
Stage III Moderate
Stage IV Severe

How are these stages of endometriosis assigned?

These criteria that make up the stages of endometriosis are graded on a point system to determine classification. First developed in 1973, the classification scheme has been revised and refined three times for a more precise method of documentation. A score of 1-15 indicates minimal or mild endometriosis, while a score of 16 or higher indicates moderate to severe.

What is the problem with this method of classification?

The scoring and stage of the disease are not indicative of the pain level. Instead, this system was fundamentally developed as an indicator of endometriosis-associated infertility, and, therefore, has no specific correlation to any symptoms. This means that a woman in stage IV can be asymptomatic, while a stage 1 patient might be in debilitating pain.

Our Approach

What is the best way to obtain a thorough classification of endometriosis?

For an accurate diagnosis, a direct visual inspection inside of the pelvis and abdomen, as well as tissue biopsy of the implants are necessary. A pathologist will observe the obtained biopsy sample under a microscope in order to view any inflammatory changes or signs of cancer, which they will then report back to the surgeon. This ultimately allows your surgeon to gain a better understanding of the extent of your disease and thus provide a more descriptive classification of your particular case of endometriosis.

What are our “Descriptive Classifications of Endometriosis?”

Due to all the factors mentioned above, your normal one through four classification of endometriosis may be of less significance than our “Descriptive Classifications.” This represents four different forms of the disease that must be considered: peritoneal disease, ovarian endometrioma, deep infiltrating endometriosis (DIE) and Frozen Pelvis. Though different, they are not altogether clinically distinct, and the pathophysiological mechanisms involved in all four remain poorly understood.

Dr. Seckin’s Prefered ClassificationDescription
Early peritoneal endometriosis
  • Infiltration to the lining of the abdomen (peritoneum)
Ovarian endometriomas
  • Large, "chocolate" fluid-filled cysts that form on, and even encapsulate, the ovaries
Cul-de-sac obliteration
  • Infiltration of the tissue lining the back wall of the uterus and rectum (cul-de-sac), an extension of the peritoneum
Deep infiltrating endometriosis (DIE)
  • Invasive endometriosis that penetrates to the bladder and bowel wall
Frozen pelvis
  • Rare condition, in which there are deep infiltrative attachments to pelvic ligaments, nerves and muscle tissue that partially or totally cements pelvic organs

For patients suffering from endometriosis, it is crucial to monitor and keep in my mind the extent of your symptoms and the disease itself. It is disheartening to hear when patients feel they need to mask their suffering and are told by their physician that their pain is simply “emotional stress.” We believe that you deserve the care and attention that a complicated disease such as endometriosis deserves. This includes opening up a personal, private discussion to the descriptive classification and extent of which you may be suffering from endometriosis.

Our office is located on 5th Ave and 68th NY, NY.
You may call us at 212-988-1444 or have your case reviewed by clicking here.

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Endometriosis Definition, Stages, Symptoms, Causes, and Treatments
Endometriosis Definition, Stages, Symptoms, Causes, and Treatments

OVERVIEW What is Endometriosis? Endometriosis is a female disease in which endometrial-like tissue is found outside of the uterus in…

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Peritoneal Endometriosis
Peritoneal Endometriosis

Overview The present classification of endometriosis is defined by the American Society of Reproductive Medicine for patients who have fertility…

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Reviews

  • Kim Molinaro

    Kim Molinaro

    Prior to meeting Dr. Seckin and reading his book, “The Doctor Will See You Now”, I knew little to nothing about endometriosis. I was led to believe that endometriosis was not a serious condition. I was told that the pain could be managed by taking the “pill”. I was told that the cysts on my ovaries were harmless. I was…

  • Rebecca Black

    Rebecca Black

    Fast forward 5 years to find out incidentally I had a failing kidney. My left kidney was only functioning at 18%. During this time, I was preparing all my documents to send to Dr. Seckin to review. However, with this new information I put everything on hold and went to a urologist. After a few months, no one could figure…

  • Monique Roberts

    Monique Roberts

    I'll never stop praising Dr. Seckin and his team. He literally gave me back my life.

  • Erin Brehm

    Erin Brehm

    I had a wonderful experience working with Dr. Seckin and his team before, during and after my surgery. I came to Dr. Seckin having already had laparoscopic surgery for endometriosis 5 years prior, with a different surgeon. My symptoms and pain had returned, making my life truly challenging and my menstrual cycle unbearable. Dr. Seckin was quick to validate my…

  • Anita Schillhorn

    Anita Schillhorn

    I came to Dr. Seckin after years of dealing with endometriosis and doctors who didn't fully understand the disease. He quickly ascertained what needed to be done, laid out the options along with his recommendation and gave me the time to make the right decision for me. My surgery went without a hitch and I'm healing very well. He and…