The concept of 'adenomyotic disease of the retroperitoneal space' is born

The concept that peritoneal endometriosis, ovarian endometriosis and adenomyotic nodules of the rectovaginal septum are three different entities has been clearly demonstrated by Nisolle & Donnez in 1997. In other words, peritoneal and ovarian endometriosis are diseases of the intraperitoneal space while the adenomyotic rectovaginal nodule is a retroperitoneal disease. If we agree that the most widely accepted theory, the transplantation theory, proposed by Sampson in 1927, can explain the pathogenesis of peritoneal endometriosis, there is strong evidence of an extraperitoneal origin for the adenomyotic nodule. We suggest that the retroperitoneal space should be definitely considered to be the origin of this adenomyotic disease, and the concept of deeply infiltrating endometriosis should be finally abandoned.