Current Thinking on the Pathogenesis of Endometriosis
Abstract
This manuscript is a review of new ideas regarding the pathogenesis of peritoneal endometriosis, ovarian endometriosis, and retroperitoneal adenomyosis. Peritoneal endometriosis, the different aspects of which (black, red and white) represent distinctive steps in the evolutionary process, can be explained by the transplantation theory. Red lesions are the most active and most highly vascularized lesions and are considered to be the first stage of peritoneal endometriosis. The retroperitoneal nodule is an adenomyotic nodule whose histopathogenesis is not related to the implantation of regurgitated endometrial cells but to metaplasia of Müllerian remnants located in the rectovaginal septum. Metaplastic changes of Müllerian rests into adenomyotic glands involving the rectovaginal septum and the retroperitoneal space are responsible for the striking proliferation of the smooth muscle, creating an adenomyomatous appearance similar to that of adenomyosis in the endometrium.
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DE lesions typically have higher fibromuscular content than ovarian endometriomas (OE) lesions.
“DE lesions typically have higher fibromuscular content than that of ovarian endometriomas (OE) lesions, but the underlying reason remains elusive.”
From Neuropeptides Substance P and Calcitonin Gene Related Peptide Accelerate the Development and Fibrogenesis of Endometriosis (2019) · cites this paper as [16]
DE is characterized by the presence of smooth muscle metaplasia (SMM) and a high degree of fibrotic tissues.
“One feature that DE stands out from other subtypes of endometriosis is its presence of smooth muscle metaplasia (SMM) and its high degree of fibrotic tissues4,15–17”
From Neuropeptides Substance P and Calcitonin Gene Related Peptide Accelerate the Development and Fibrogenesis of Endometriosis (2019) · cites this paper as [16]
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- Authors
- Donnez, J., van Langendonckt, A., Casanas-Roux, F., van Gossum, J.-P., Pirard, C., Jadoul, P., Squifflet, J., & Smets, M.
- Affiliations
- Cliniques Universitaires Saint-Luc (BE)
- Venue
- Gynecologic and Obstetric Investigation
- Publisher
- S. Karger AG
- Published
- 2002
- Volume
- 54
- Issue
- Suppl. 1
- Pages
- 52-62
- ISSN
- 0378-7346 (ISSN-L)
- 1423-002X
- OpenAlex
- W2054034692
- Cited by
- 100
- References
- 42
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 2 · 2022: 2 · 2021: 6 · 2020: 3 · 2019: 5 · 2018: 6 · 2017: 4 · 2016: 5 · 2015: 4 · 2014: 3 · 2013: 4 · 2012: 9
- FWCI
- 3.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Gynecologic and Obstetric Investigation (publishedVersion)
- PubMed (publishedVersion)
- DIAL (Catholic University of Leuven) (submittedVersion)
- 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 pathogenesis, peritoneal endometriosis, endometrioma, Müllerian remnants, metaplasia, rectovaginal septum, adenomyosis, smooth muscle cell proliferation
- MeSH terms
- Uterine Cervical Diseases, Endometriosis, Female, Humans, Muscle, Smooth, Peritoneal Diseases, Rectal Diseases, Recurrence, Retroperitoneal Space, Vaginal Diseases, Treatment Outcome, Oxidative Stress
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