title: Enzian classification: does it correlate with clinical symptoms and the rASRM score?
abstract: OBJECTIVE
  To assess the extent to which the Enzian classification correlates with the revised American Society for Reproductive Medicine (rASRM) score and clinical symptoms in women with deeply infiltrating endometriosis.
  
  
  METHODS
  Retrospective cohort study (Canadian Task Force classification II-2).
  
  
  METHODS
  Endometriosis competence center specializing in minimally invasive surgery.
  
  
  METHODS
  Between 1 January 2009 and 31 December 2011, a total of 194 women underwent surgery due to deeply infiltrating endometriosis. After histological confirmation, they were classified using the rASRM and Enzian systems. Clinical symptoms were recorded preoperatively.
  
  
  METHODS
  Operative laparoscopy to treat endometriosis.
  
  
  RESULTS
  A clear correlation was seen between grades of severity in the rASRM score and the Enzian classification (p < 0.001). In addition, the rASRM severity grade and clinical symptoms correlated with the locations in the Enzian classification in relation to deeply infiltrating endometriosis. Pain and dysmenorrhea correlated strongly (p = 0.002, p < 0.001) with the severity grade in the Enzian classification.
  
  
  CONCLUSIONS
  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.
authors: Department of Obstetrics and Gynecology, Linz General Hospital, Krankenhausstrasse 9, Linz, Austria. dr.haas@hotmail.com
authors: Dietmar
authors: D
authors: Haas
authors: Peter
authors: P
authors: Oppelt
authors: Omar
authors: O
authors: Shebl
authors: Andreas
authors: A
authors: Shamiyeh
authors: Wolfgang
authors: W
authors: Schimetta
authors: Richard
authors: R
authors: Mayer
mesh_terms: D015331:Cohort Studies; D004412:Dysmenorrhea / Q000209:etiology; D004715:Endometriosis / Q000145:classification* / Q000150:complications / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy; D010146:Pain / Q000209:etiology; D012189:Retrospective Studies; D012720:Severity of Illness Index