Enzian classification: does it correlate with clinical symptoms and the rASRM score?

Abstract

Deeply infiltrating endometriosis is well characterized using the Enzian classification as a supplement to the rASRM score. There is also a clear correlation between the rASRM and Enzian classifications, because of the way in which the disease crosses morphological boundaries. The locations in the Enzian classification correlate partially with clinical symptoms, and the classification's severity grades correlate substantially with pain and dysmenorrhea. In view of these clinical results, use of the Enzian classification can be recommended as a supplement to the rASRM score for detailed description of endometriosis.

World Endometriosis Society consensus on the classification of endometriosis

“…In addition to the r-ASRM classification, emerging systems include the Enzian classification for deep endometriosis (Keckstein et al, 2003;Haas et al, 2013), the endometriosis fertility index (EFI) (Adamson and Pasta, 2010), and the American Association of Gynecological Laparoscopists (AAGL) classification (http://www. aagl.org/wp-content/uploads/2013/03/NewsScope_Oct-Dec_2012.pdf; accessed 1 February 2016; unpublished to date).…”

Reproductive Microbiomes: Using the Microbiome as a Novel Diagnostic Tool for Endometriosis

“…However, the rASRM staging criteria is limited by visual detection at the time of surgery and does not take into consideration pelvic organ involvement and deeply infiltrating endometriosis. Therefore, the ENZIAN staging criteria was developed that incorporated disease involvement of peritoneal structures and DIE to be used as a supplement to the rASRM [11]. Neither of these staging criteria account for patient factors such as pain and infertility and therefore cannot be used to estimate patient fertility status.…”

Endometriotic Pain Is Associated with Adenomyosis but Not with the Compartments Affected by Deep Infiltrating Endometriosis

“…These results are in agreement with previous findings [23,30] . Another study conducted by Haas et al [31] showed an association between adenomyosis and dysmenorrhea as well as with dyspareunia. However, adenomyosis was present in only 9.3% of patients, which clearly differs from what was observed in our study and can be a reason for not making a direct comparison.…”