Laser Surgery for endometriosis

The definitions and our understanding of endometriosis have changed over time. Endometriosis was introduced clinically at the beginning of this century, as ovarian “chocolate cysts” and as adenomyosis externa. 3;4 It was defined as endometrial glands and stroma outside the uterus, and this morphological definition still is the gold standard. Using this definition, black puckered lesions in the pelvis were soon recognized as endometriosis, making it a frequently diagnosed disease from the seventies onwards, i.e. after the introduction of endoscopy. When, in the 1980’s non-pigmented endometriotic lesions were described, the prevalence of the disease increased from 5% to 20% to over 60% to 80% in women with infertility and/or pelvic pain. In parallel with the changing meaning of the word ‘endometriosis’, the increasing awareness and prevalence of endometriosis, our concepts of etiology, pathophysiology, natural history and therapy have evolved.