What are the most common sites of endometriosis in the pelvic area?
A. If we accept the theory of retrograde menstruation as the main cause for the initiation of endometriosis, the ovaries are the most frequently involved organ (in 75 percent of cases) because of the unique characteristics of their site. The next most common areas are the posterior cul-de-sac (70 percent of cases), the area between the uterus and the bowel, and the anterior fold of the uterus between the uterus and the bladder (35 percent of cases). Presumably, this is due to the effects of gravity. The next most common area is the posterior aspect of the pelvic wall and the uterosacral ligaments (35 percent) which are attached behind the uterus. The ureters are the most commonly affected pelvic organs also due to their site, which is again sitting close to the ovarian bed or opening of the tube to the pelvis. The next most common sites are the uterus (10 percent), the tubes, the sigmoid colon and the appendix. Due to high motility and active peristalsis, the small bowel is the least f
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