Regarding the depth classification of endometriosis per ASRM revised scoring, which type of lesion contributes the most points to the total score?
- A Deep endometriosis of the cul-de-sac with complete obliteration ✓
- B Superficial peritoneal implants on the ovary
- C Dense adhesions enclosing the ovary (partial)
- D Endometrioma >3 cm on the ovary
Correct answer: A. Deep endometriosis of the cul-de-sac with complete obliteration
Explanation
In the ASRM revised classification, complete cul-de-sac obliteration by deep endometriosis scores 40 points — the highest single score in the entire classification system, placing the patient directly into Stage IV regardless of other findings. Endometrioma >3 cm scores 20 points; dense ovarian adhesions score 16 points; superficial ovarian implants score 1–2 points. The heavy weighting of cul-de-sac obliteration reflects its severe impact on fertility and surgical difficulty.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.