According to the revised ASRM 1997 staging system for endometriosis, a patient has superficial peritoneal endometriotic lesions totalling 3 cm (3 points), filmy unilateral adnexal adhesions (4 points), and no ovarian endometrioma. Cul-de-sac is partially obliterated (4 points). Total score is 11. What stage is this?
- A Stage I (minimal, 1–5 points)
- B Stage III (moderate, 16–40 points)
- C Stage II (mild, 6–15 points) ✓
- D Stage IV (severe, > 40 points)
Correct answer: C. Stage II (mild, 6–15 points)
Explanation
Revised ASRM (rASRM) scoring: Stage I = 1–5, Stage II = 6–15, Stage III = 16–40, Stage IV = > 40. Total score of 11 falls within 6–15 = Stage II (Mild endometriosis). The rASRM staging does not correlate well with pain or fertility outcomes, which is a recognized limitation, but it remains the most widely used surgical classification system.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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