La Revue du praticien
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Natural history of endometriosis is unpredictable. Some recent data show that endometriosis is a progressive disease. Minimal lesions are transient and peritoneal implants are reorganized continuously. ⋯ In favourable statement such as the decreased activation of NK cells, the variable secretions of cytokines, pelvic macrophages and growth factors, the peritoneal implants evoluted like a progressive disease until severe endometriosis. Endometriosis is a frequent cause of pelvic pain with dysmenorrhea, dyspareunia, chronic pelvic pain and infertility. The diagnosis can be suspected by a clinical examination preferentially during menstruation with fixed uterine retroversion peritoneal infiltration, retraction of the rectum and retrovaginal endometriosis, and adnexal cyst.