Table I.
Historical overview of endometriosis classification/staging systems.
| Endometriosis classification/ staging system | Publication year | Classification/staging based on | Intended purpose |
Details | Reference | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Diagnosis/pre-operativeassessment | Description | Staging | Treatment selection | Prediction of difficultyof surgery | Prediction of pain remediation/improved QoL | Prediction of conception | |||||
| #ENZIAN classification | 2021 | Surgical observation or imaging | √ | √ | Non-invasive and surgical description system for endometriosis | Keckstein et al. (2021) | |||||
| Adhesion scoring system | 2020 | US | √ | √ | Pre-operative prediction of the pelvic adhesion status | Ichikawa et al. (2020) | |||||
| ENDOGRAM | 2019 | Disease markers in biopsy sample | √ | Analysis of endometriotic tissues supporting therapeutic decisions | Bouquet de Joliniere et al. (2019) | ||||||
| ENDORECT | 2019 | Clinical examination, US, MRI | √ | Preoperative score to predict rectosigmoid involvement | Chattot et al. (2019) | ||||||
| Bowel Endometriosis Syndrome (BENS) score | 2017 | Symptoms | √ | Identify bowel endometriosis syndrome based on patient reported symptoms and QoL | Riiskjær et al. (2017) | ||||||
| Preoperative ultrasound-based endometriosis staging system (UBESS) | 2016 | US | √ | √ | Pre-operative staging and prediction of the level of complexity of laparoscopic surgery. | Menakaya et al. (2016) | |||||
| Classification of ureteral endometriosis | 2015 | Surgical observation | √ | √ | √ | Clinical classification of urinary tract endometriosis | Knabben et al. (2015) | ||||
| EPHect SSF—EPHect MSF (surgical form) | 2014 | Surgical observation | √ | Recording of surgical phenotypic information and related sample collections obtained at laparoscopy | Becker et al. (2014) | ||||||
| Clinical score | 2014 | Symptoms | √ | √ | Predict DE presence before endometrioma surgery | Lafay Pillet et al. (2014) | |||||
| LSD/MURO Classification | 2013 | Modified Virtual Colonoscopy | √ | Descriptive imaging classification, with implied severity for rectogenital and disseminated endometriosis | van der Wat et al. (2013) | ||||||
| ECO system | 2012 | Extent, symptoms and objectives | √ | Determine most appropriate management | Lasmar et al. (2012), Lasmar et al. (2015) | ||||||
| Deep endometriosis staging form | 2011 | US | √ | Staging system for DE based on ultrasonographic finding | Coccia and Rizzello (2011) | ||||||
| Endometriosis Fertility Index (EFI) | 2010 | Surgical observation + Patient parameters | √ | Prediction of (non-IVF) pregnancy after surgery | Adamson and Pasta (2010) | ||||||
| ENZIAN classification | 2005 | Surgical observation (or MRI) | √ 1 | √ | Surgical classification for DE | Keckstein et al. (2021), Tuttlies et al. (2005) | |||||
| Chapron classification | 2003 | Surgical observation | √ | √ | Surgical classification for DE with suggested operative procedure | Chapron et al. (2003a), Chapron et al. (2003b) | |||||
| Revised ASRM classification | 1997 | Surgical observation | √ | √ | Adapted from rAFS score | American Society for Reproductive Medicine (1997) | |||||
| TOP classification | 1993 | Surgical observation | √ | √ | Evaluate the severity of endometriosis by site, i.e., fallopian tubes (T), ovaries (O) and the peritoneum (P) and impact on PR | Kurata et al. (1993) | |||||
| Revised American Fertility Society (rAFS) classification | 1985 | Surgical observation | √ | Point system to determine stage/degree of endometriosis involvement | American Fertility Society (1985) | ||||||
| American Fertility Society (AFS) classification | 1979 | Surgical observation | √ | American Fertility Society (1979) | |||||||
| Buttram classification | 1978 | Surgical observation | √ | √ | Classification of endometriosis in the infertile female (expanded from Acosta et al. (1973)) | Buttram (1978) | |||||
| Kistner classification | 1977 | Surgical observation | √ | √ | Classification as a tool to link pregnancy rates with the presence/extent of disease | Kistner et al. (1977) | |||||
| Acosta classification | 1973 | Surgical observation | √ | √ | Classify the extent of disease and relationship with pregnancy rate | Acosta et al. (1973) | |||||
#
ENZIAN, the recently updated ENZIAN classification, which incorporates all types of endometriosis; DE, deep endometriosis; ECO, disease extent complaints, objectives system; PR, pregnancy rate; QoL, quality of life; US, ultrasound.
1
In case of ENZIAN score based on MRI.