Diagnosis
What is the AAGL endometriosis classification system?
The short answer
The AAGL endometriosis classification system is a standardized way surgeons describe where endometriosis is found at surgery, how extensive it is, and how complex it appears. It is meant to better capture deeper disease that may affect surgical planning.
The AAGL endometriosis classification system is a standardized way for surgeons to describe what they found at surgery: where endometriosis is located, how extensive it is, and how complex the disease appears. Its goal is to create a more consistent shared language than older staging alone provides, especially when symptoms and imaging don’t tell the full story.
Unlike simple stage labels, AAGL-style classification is meant to better capture surgical complexity, including deeper disease that can involve structures such as the uterosacral ligaments, rectovaginal space, bowel, bladder, or ureters. This matters because location and depth (for example, deep infiltrating disease) can drive very different symptoms and may change imaging choices and surgical planning. If you’re reading an operative report or trying to make sense of what a surgeon told you, our team can help explain what the classification likely means for your body, your symptoms, and the treatment path you’re considering.
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Make your surgery findings make sense
AAGL classification can clarify where endometriosis is and how complex it is—beyond a simple stage number. Our specialists can review your reports, explain what it means for your pain and fertility, and plan next steps.
Questions people ask next
All diagnosis questionsWhat is the Enzian score for endometriosis?
The Enzian score describes where deep infiltrating endometriosis is located and how extensive it is. It helps surgical teams plan imaging, surgery, and support from multiple specialties when organs such as the bowel, bladder, or ureters may be involved.
What do endometriosis stages 1–4 mean?
Endometriosis stages 1–4 describe surgical findings, from minimal to severe, based on lesions, ovarian endometriomas, and adhesions. Stage does not reliably predict pain or case complexity; disease type, location, and completeness of safe removal also guide care.
Does pelvic pain severity match endometriosis stage?
Pelvic pain severity does not reliably match endometriosis stage. Minimal visible disease can cause severe pain, while advanced disease may cause mild or intermittent symptoms. Location, adhesions, inflammation, and pelvic floor and nerve sensitivity also influence pain.
Standard pelvic ultrasound vs endometriosis-focused scan: what’s different?
A standard pelvic ultrasound surveys the uterus and ovaries, while an endometriosis-focused scan maps suspected disease and checks organ movement. Mapping can help assess deep disease, adhesions, and bowel involvement for surgical planning, but it can miss disease.
Further reading
What is Deep Infiltrating Endometriosis? Understanding the Basics
Discover deep infiltrating endometriosis, its symptoms, and diagnosis. Learn how it differs from other types of endometriosis for better management.
Deep Infiltrating Endometriosis Treatment Today and What May Change
Explore deep infiltrating endometriosis symptoms, imaging limits, medical support, excision surgery, and what future treatments may offer.
Can Scans and Tests Find Endometriosis? Know the Limits
Discover why ultrasounds may miss endometriosis. Learn about imaging limits and recent research in our latest blog. Find clarity in your diagnosis.
