Peritoneal fluid flow influences anatomical distribution of endometriotic lesions: Why Sampson seems to be right
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.
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Women's pain is mainly pelvic because most endometriosis lesions are found in that region.
“Thus, in women, pain occurs mostly in the pelvis because most lesions are located there (Vercellini et al., 2007;Bricou et al., 2008).”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Bricou et al., 2008
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Self-citation
- Authors
- Bricou, A., Batt, R. E., & Chapron, C.
- Affiliations
- Hôpital Cochin (FR)
- University at Buffalo, State University of New York (US)
- Corresponding author
- Chapron, Charles
- Venue
- European Journal of Obstetrics & Gynecology and Reproductive Biology
- Publisher
- Elsevier BV
- Published
- 2008-06
- Volume
- 138
- Issue
- 2
- Pages
- 127-134
- ISSN
- 0028-2243 (ISSN-L)
- 0301-2115
- OpenAlex
- W2000333628
- Cited by
- 121
- References
- 53
- Citations by year
- 2026: 4 · 2025: 13 · 2024: 6 · 2023: 7 · 2022: 6 · 2021: 13 · 2020: 7 · 2019: 5 · 2018: 7 · 2017: 5 · 2016: 5 · 2015: 3 · 2014: 6 · 2013: 6 · 2012: 8
- FWCI
- 0.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Obstetrics & Gynecology and Reproductive Biology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Keywords
- endometriosis, endometrioma, superficial endometriosis, deep infiltrating endometriosis, endometriosis pathophysiology
- MeSH terms
- Ascitic Fluid, Endometriosis, Female, Humans, Menstruation
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