roximately one-quarter are diagnosed during a laparoscopy procedure performed for some other reason (9:33).
Such a diagnosis is generally based on the visual appearance of the peritoneal endometrial implants. These implants may include both endometrial glands and cytogenic stroma presenting in various different colors and forms (7:6). For example, red, yellow, brownish, and blue-black lesions may occur. These can grow like polyps above the serosa of the pelvic organs and/or invade the subperitoneal connective tissue. Often the implants form cystic structures having the potential for spontaneous rupture. In particular, ovarian cysts can become quite large. Their size usually derives from repeated bleedings which result in the accumulation of a chocolate-like material (9:35).
Pelvic endometriosis may be defined as "endometriotic lesions involving the uterus, fallopian tubes, ovaries, and the surrounding peritoneum in the anterior and posterior cul-de-sac and on the pelvic side walls (10:151-180)." However, endometriosis is not restricted merely to the pelvis. Extrapelvic disease has also been found to occur. The four major subdivisions of extrapelvic endometriosis are as follows: (1) intestinal tract endometriosis; (2) urinary tract endometriosis; (3) pulmonary and thoracic endometriosis; and (4) endometriosis of other sites. In general, lesion frequency tends to decrease with distance from the uterus and fallopian tubes. Moreover, within the abdominal cavity, endometriosis of the intestinal tract occurs more frequently than disease of the urinary tract. Furthermore, although virtually every organ system and tissue in the human female body is susceptible to endometriosis, outside of the abdominal cavity the most common disease site is the thorax. The only organ which exhibits resistance to endometriotic involvement is the spleen (10:151-180).
It has been approximated that 10-15% of all premenopausal women ha...