Obstetrics & Gynaecology · Endometriosis, Adenomyosis and Fibroids

The #ENZIAN classification (2021) is the most comprehensive staging system for deep infiltrating endometriosis (DIE). It classifies DIE into four compartments. Which compartment does the 'F' subdivision in the #ENZIAN classification represent?

  • A Other locations (non-DIE endometriosis: peritoneal, superficial, ovarian)
  • B Posterior compartment (rectovaginal septum, vagina, rectum)
  • C Anterior compartment (bladder, vesico-uterine space)
  • D Lateral compartment (parametria, ureters)
Correct answer: A. Other locations (non-DIE endometriosis: peritoneal, superficial, ovarian)

Explanation

In the #ENZIAN classification (2021 update), the compartments are: A = posterior (rectovaginal septum, vagina, rectum), B = lateral (parametria, sacrouterine ligaments, ureters, pelvic sidewall), C = anterior (bladder), and F = other/additional endometriosis not classified as DIE (including superficial peritoneal endometriosis, ovarian endometrioma, adenomyosis). The 'F' compartment captures all non-DIE endometriosis with sub-categories FA (superficial peritoneal), FB (endometrioma), FC (adenomyosis). This classification is used alongside the rASRM staging (which grades pelvic adhesion extent) to provide comprehensive mapping for surgical planning and research.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

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