**Section 1**

**Endometriosis** 

**1** 

*Iran* 

**Endometriosis** 

Mohammad Reza Razzaghi1,

*1Chairman of Urology Department,* 

*2Medical Laser Application Research Center, Urology Department of Shohada Tajrish Hospital, Shahid Beheshti University (MC), Teheran,* 

Mohammad Mohsen Mazloomfard2 and Anahita Ansari Jafari2

Endometriosis is classically defined as the growth of endometrial glands and stroma at extra-uterine sites, most commonly implanted over visceral and peritoneal surfaces within the female pelvis (1). Though endometriosis has been described for the first time in 1690 by the German physician, Daniel Shroen, researchers remain still unsure as to the definitive cause of this disease (2). The most widely accepted theory for the pathogenesis of endometriosis (retrograde menstruation/transplantation), proposed in the 1927 by Sampson (3). Although a great deal has been learned about endometriosis since Sampson's land mark studies, there is still a lot about it that is unclear and controversial. It remains an enigmatic disorder in that the cause, the natural history, and the precise mechanisms of its

Endometriosis is most commonly found on the pelvic peritoneum but may also be found on the ovaries, rectovaginal septum, ureter, and rarely in the bladder, pericardium, and pleura. More rarely, colon, small intestine, appendix, umbilical scar and even sites not closely contiguous to the pelvis (e.g., lung and brain tissue) may also be involved (5). It is a leading cause of disability in women of reproductive age, responsible for dysmenorrhea, pelvic pain and subfertility. The most common symptoms for women who have endometriosis are pelvic pain and infertility; both adversely affecting the quality of life. The pregnancy rate in women with endometriosis is about half of women with tubal factor infertility and is negatively correlated with the severity of disease. The cause of reproductive failure may be due to poor oocyte development, implantation or embryogenesis. In addition to infertility, a strong cause–effect relationship between endometriosis and pelvic pain is commonly observed (6, 7). Dysmenorrhoea is associated with cyclic recurrent microbleeding within various entities of ectopic endometriotic implants and consequent inflammation. Endometriosis-related adhesions and compression or infiltration of nerves in the

subperitoneal pelvic space by ectopic lesions also cause painful symptoms (8, 9).

In the last few years, there is a growing interest in endometriosis, because of the large number of women it affects (about 3–10% of the female population in the reproductive age, and up to 40–80% of women complaining of pelvic pain) and the significant morbidity

**1. Introduction** 

presentation are not known (4).
