WorldWideScience

Sample records for surgically confirmed endometriosis

  1. SURGICAL TREATMENT OF ENDOMETRIOSIS IN INFERTILE PATIENTS

    Directory of Open Access Journals (Sweden)

    Andrej Vogler

    2003-12-01

    group A 31 (60.8% out of the 51 patients conceived spontaneously within 24 months after surgery. In group B 30 (61.2% out of the 49 patients conceived spontaneously after surgery. The difference in pregnancy rates between the groups was not statistically significant.Conclusions. Surgical treatment of endometriosis in infertile patients is by all means effective and most appropriate, although some have not confirmed its value in patients with minimal or mild endometriosis comparing it with the no-treatment protocol. The limitations of this study should be considered. The main drawback is its design: the trial was not a randomised controlled one. We advocate that endometriosis once diagnosed must be surgically treated, to prevent progression of the disease at least. Endometriosis appears to progress in two-thirds of patients within a year from the diagnosis, and it is impossible to predict, in which patients it will progress. It would be unethical, and even unprofessional not to remove even the smallest endometriotic implants when the disease is confirmed by laparoscopy.

  2. Cutaneous endometriosis--Surgical presentations of a gynaecological condition.

    Science.gov (United States)

    Chiang, David T; Teh, Wan T

    2006-11-01

    Endometriosis is a common gynaecological condition; cutaneous endometriosis is a subtype of endometriosis. Although cutaneous endometriosis involving the abdominal wall is not common, preoperative diagnosis of cutaneous endometriosis can be easily mistaken for a suture granuloma, lipoma, abscess, cyst or hernia. We report two common surgical presentations of this gynaecological condition.

  3. World Endometriosis Research Foundation Endometriosis Phenome and Biobanking Harmonisation Project: I. Surgical phenotype data collection in endometriosis research

    DEFF Research Database (Denmark)

    Becker, Christian M.; Laufer, Marc R.; Stratton, Pamela;

    2014-01-01

    ObjectiveTo standardize the recording of surgical phenotypic information on endometriosis and related sample collections obtained at laparoscopy, allowing large-scale collaborative research into the condition.......ObjectiveTo standardize the recording of surgical phenotypic information on endometriosis and related sample collections obtained at laparoscopy, allowing large-scale collaborative research into the condition....

  4. Characteristics of histologically confirmed endometriosis in cynomolgus monkeys

    Science.gov (United States)

    Nishimoto-Kakiuchi, A.; Netsu, S.; Matsuo, S.; Hayashi, S.; Ito, T.; Okabayashi, S.; Yasmin, L.; Yuzawa, K.; Kondoh, O.; Kato, A.; Suzuki, M.; Konno, R.; Sankai, T.

    2016-01-01

    STUDY QUESTION What are the characteristics of spontaneous endometriosis in cynomolgus monkeys? SUMMARY ANSWER Spontaneous endometriosis in cynomolgus monkeys exhibited similar characteristics to the human disease. WHAT IS KNOWN ALREADY One previous report described the prevalence and the basic histopathology of spontaneous endometriosis in cynomolgus monkeys. STUDY DESIGN, SIZE, DURATION Endometriotic lesions that had been histologically confirmed in 8 female cynomolgus monkeys between 5 and 21 years old were subjected to study. PARTICIPANTS/MATERIALS, SETTING, METHODS The monkeys died of, or were sacrificed because of, sickness consequent on endometriosis. Specimens were evaluated histopathologically with haematoxylin and eosin staining, iron staining and immunohistochemistry (CD10, CD31, α-SMA and PGP9.5), and by observing them under a microscope. MAIN RESULTS AND THE ROLE OF CHANCE Endometriotic and stromal cells (CD10-positive) with haemorrhage and inflammation were observed. Smooth muscle metaplasia and nerve fibres were also noted in the endometriotic lesions. Endometriotic lesions in lymph nodes were incidentally found. LIMITATIONS AND REASONS FOR CAUTION Since laparoscopic analysis for monitoring the disease state was not set as a parameter of the current study, time course changes (progression) of the disease were not assessed. WIDER IMPLICATIONS OF THE FINDINGS Further investigation of spontaneous endometriosis in cynomolgus monkeys may contribute to better understanding of the disease pathobiology. STUDY FUNDING/COMPETING INTEREST(S) No external funds were used for this study. A.N.K., S.M., S.H., T.I., O.K., A.K. and M.S. are full-time employees of Chugai Pharmaceutical Co., Ltd. R.K. received lecture fees from Chugai Pharmaceutical Co., Ltd., unrelated to the submitted work. S.N., S. O., L.Y., K.Y. and T.S. have nothing to declare. TRIAL REGISTRATION NUMBER N/A. PMID:27591226

  5. The Surgical Treatment of Severe Endometriosis Positively Affects the Chance of Natural or Assisted Pregnancy Postoperatively

    Directory of Open Access Journals (Sweden)

    Erin M. Nesbitt-Hawes

    2015-01-01

    Full Text Available Objective. To report reproductive outcomes following laparoscopic surgical excision of histologically confirmed r-ASRM stage III-IV endometriosis. Study Design. A retrospective cohort study was performed at the Royal Hospital for Women, a university teaching hospital, Sydney, Australia. Women who had fertility-preserving laparoscopic excision of stage III-IV endometriosis from 1997 to 2009 were contacted regarding reproductive outcomes. Results. In the study period, 355 women underwent surgery for stage III-IV endometriosis. Follow-up data are available for 253/355 (71% women. Postoperatively, 142/253 (56% women attempted to conceive with a conception rate of 104/142 (73%. Confidence intervals for pregnancy for women who were attempting conception (including the nonresponders range from 104/262 (40% to 224/262 (85%. Median time to conception was 12 months. No positive prognostic factors for pregnancy were identified on regression analyses. Conclusions. These data provide information to women with suspected severe disease preoperatively concerning their likely postoperative fertility outcomes. Ours is a population with severe endometriosis, rather than an infertile population with endometriosis, so caution needs to be applied when applying these data to women with fertility issues alone.

  6. Endometriosis

    Science.gov (United States)

    ... a baby grows when a woman is pregnant. Endometriosis is a disease in which tissue that normally ... may be the first sign. The cause of endometriosis is not known. Surgery, usually a laparoscopy, is ...

  7. Endometriosis

    African Journals Online (AJOL)

    laparoscopy for pelvic pain, and in about 20 - 40% of infertile women.1. Pathogenesis ... aims of treatment are therefore to relieve symptoms of pain and. Endometriosis ... gonadotrophin-releasing hormone (goserelin) with the pill for relief of ...

  8. Endometriosis

    OpenAIRE

    2007-01-01

    Ectopic endometrial tissue is found in up to 20% of asymptomatic women, up to 60% of those with dysmenorrhoea, and up to 30% of women with subfertility, with a peak incidence at around 40 years of age. However, symptoms may not correlate with laparoscopic findings. Without treatment, endometrial deposits may resolve spontaneously in up to a third of women, deteriorate in nearly half, and remain unchanged in the remainder.Oral contraceptives reduce the risk of endometriosis, whereas an earl...

  9. Co-micronized palmitoylethanolamide/polydatin treatment causes endometriotic lesion regression in a rodent model of surgically-induced endometriosis

    Directory of Open Access Journals (Sweden)

    Rosanna Di Paola

    2016-10-01

    Full Text Available Endometriosis is a chronic, painful disease characterized by the presence of endometrial glands and stroma outside the uterine cavity. Palmitoylethanolamide (PEA, an endogenous fatty acid amide, has anti-inflammatory and neuroprotective effects. PEA lacks free radical scavenging activity, unlike polydatin (PLD, a natural precursor of resveratrol. The aim of this study was to investigate the effect of orally administered co-micronized PEA/polydatin (m(PEA/PLD in an autologous rat model of surgically-induced endometriosis. Endometriosis was induced in female Wistar albino rats by auto-transplantation of uterine squares (implants into the intestinal mesentery and peritoneal cavity. Rats were distributed into one control group and one treatment group (10 animals each: m(PEA/PLD 10 mg/kg/day. At 28 days after surgery the relative volume of the endometrioma was determined. Endometrial-like tissue was confirmed by histology: Masson trichrome and toluidine blue were used to detect fibrosis and mast cells, respectively. The treated group displayed a smaller cyst diameter, with improved fibrosis score and mast cell number decrease. m(PEA/PLD administration decreased angiogenesis (vascular endothelial growth factor, nerve growth factor, intercellular adhesion molecule, matrix metalloproteinase 9 expression and lymphocyte accumulation. m(PEA/PLD treatment also reduced peroxynitrite formation, (poly-ADPribose polymerase activation, IkBα phosphorylation and nuclear facor-kB traslocation in the nucleus. Our results suggested that m(PEA/PLD may be of use to inhibit development of endometriotic lesions in rats.

  10. Co-micronized Palmitoylethanolamide/Polydatin Treatment Causes Endometriotic Lesion Regression in a Rodent Model of Surgically Induced Endometriosis

    Science.gov (United States)

    Di Paola, Rosanna; Fusco, Roberta; Gugliandolo, Enrico; Crupi, Rosalia; Evangelista, Maurizio; Granese, Roberta; Cuzzocrea, Salvatore

    2016-01-01

    Endometriosis is a chronic, painful disease characterized by the presence of endometrial glands and stroma outside the uterine cavity. Palmitoylethanolamide (PEA), an endogenous fatty acid amide, has anti-inflammatory and neuroprotective effects. PEA lacks free radical scavenging activity, unlike polydatin (PLD), a natural precursor of resveratrol. The aim of this study was to investigate the effect of orally administered co-micronized PEA/polydatin [m(PEA/PLD)] in an autologous rat model of surgically induced endometriosis. Endometriosis was induced in female Wistar albino rats by auto-transplantation of uterine squares (implants) into the intestinal mesentery and peritoneal cavity. Rats were distributed into one control group and one treatment group (10 animals each): m(PEA/PLD) 10 mg/kg/day. At 28 days after surgery the relative volume of the endometrioma was determined. Endometrial-like tissue was confirmed by histology: Masson trichrome and toluidine blue were used to detect fibrosis and mast cells, respectively. The treated group displayed a smaller cyst diameter, with improved fibrosis score and mast cell number decrease. m(PEA/PLD) administration decreased angiogenesis (vascular endothelial growth factor), nerve growth factor, intercellular adhesion molecule, matrix metalloproteinase 9 expression, and lymphocyte accumulation. m(PEA/PLD) treatment also reduced peroxynitrite formation, (poly-ADP)ribose polymerase activation, IkBα phosphorylation and nuclear facor-kB traslocation in the nucleus. Our results suggested that m(PEA/PLD) may be of use to inhibit development of endometriotic lesions in rats. PMID:27790149

  11. Endometriosis: Does It Cause Infertility?

    Science.gov (United States)

    ... Society for Reproductive Medicine Endometriosis: Does It Cause Infertility? This fact sheet was developed in collaboration with ... a surgical procedure called laparoscopy. Does endometriosis cause infertility? If you have endometriosis, it may be more ...

  12. Effects of Letrozole Compared with Danazol on Patients with Confirmed Endometriosis: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Navid Koleini

    2010-01-01

    Full Text Available Background: Letrozole is an aromatase inhibitor which can decrease estrogen production inperipheral tissues and endometriosis. Danazol, as an androgen, inhibits estrogen production inovaries and recently has been introduced as an aromatase inhibitor. This study was designed tocompare the effects of Danazol with Letrozole on endometriosis symptom relief.Materials and Methods: This study was a randomized clinical trial in which 105 patients withconfirmed endometriosis were randomly assigned to one of three groups. Group 1 received Letrozoletablets (2.5 mg/day, calcium (1000 mg/day and vitamin D (800 IU/day. Group 2 received Danazoltablets (600 mg/day, calcium (1000 mg/day and vitamin D (800 IU/day. Group 3 (placebo groupwere assigned to take two calcium tablets daily (500 mg/tablet and vitamin D (800 IU/day. Pelvicpain, dysmenorrhea and dyspareunia were assessed in participants at baseline and monthly duringthe study for a total of six months. Data were analyzed via SPSS version 15 software with Freidmanand Wilcoxon tests.Results: Mean age in three groups has no significant difference. Of the 105 participants who wereenrolled in this study, 38 patients were assigned to group 1 (Letrozole group, 37 patients in group 2(Danazol group and 31 patients were placed in group 3 (placebo group. This study showed that themean scores for chronic pelvic pain, dysmenorrhea and dyspareunia for the Letrozole group wereless than the Danazol and placebo groups.Conclusion: This study showed that Letrozole can be more effective than Danazol for reducingchronic pelvic pain, dyspareunia and dysmenorrhea in patients suffering from recurrent endometriosis(Registeration Number: IRCT138812043414N1.

  13. Expression of estrogen and progesterone receptors in subcutaneous endometriosis

    Directory of Open Access Journals (Sweden)

    Đorđević M.

    2010-01-01

    Full Text Available Endometriosis is a clinical disorder defined by the presence of functional endometrial tissue outside the uterine cavity. Depending on the localization of the endometrial tissue related to the pelvis, the endometriosis can be classified either as intrinsic or extrinsic. The prevalence of endometriosis is difficult to determine. Statistical data show that endometriosis could be associated both with female infertility (20% and pelvic pains (24%, while in 4.1% of affected women, endometriosis has asymptomatic forms. The total prevalence of endometriosis is estimated to be between 5-10%. A 35-year-old woman from Knic, Serbia, was admitted to the Obstetrics and Gynecology Clinic of the Clinical Center in Kragujevac for surgical treatment of a suspicious swelling in the pubic region. Following surgical intervention, a nut-sized tumor was removed and sent for both pathohistological and immunohistochemical analysis. The results confirmed the presence of subcutaneous endometriosis positive for both estrogen and progesterone receptors. Endometriosis is usually described as a steroid hormone-dependent change that resembles the eutopic endometrial tissue characteristic for the presence of both glandular and stromal tissues. Given the fact that endometrial lesions are estrogen-dependent tumors, a crucial factor in the development of endometriosis is a late exposure to the hormone, mostly estrogen. Spontaneous subcutaneous endometriosis is rarely observed, but it could be assumed if there is recurrent pelvic pain which intensifies during menstruation. Given the fact that endometriosis coexists with different autoimmune diseases, multidisciplinary approaches are required for its proper diagnosis. .

  14. Endometriosis in teenagers.

    Science.gov (United States)

    Sarıdoğan, Ertan

    2015-08-01

    Endometriosis affects a significant proportion of teenagers. Published studies suggest that laparoscopically confirmed endometriosis could be found in over 60% of adolescent girls undergoing laparoscopic investigation for pain, in 75% of girls with chronic pelvic pain resistant to treatment and in 70% of girls with dysmenorrhea and in approximately 50% of girls with chronic pelvic pain not necessarily resistant to treatment. Both early and advanced forms, including deep endometriosis have been reported to be present in teenagers. It has recently been claimed that deep endometriosis has its roots in teenage years. Risk factors include obstructive mullerian anomalies, family history, early menarche and early onset dysmenorrhea. Both surgical and medical treatment approaches are used for treatment in this age group, but care should be taken when treatment with GnRHa and progestins is being considered due to their potential impact on bone formation. Further studies are urgently needed to determine whether early diagnosis and treatment of teenage endometriosis lead to better long term outcomes or simply increase number of interventions without preventing progression of the disease.

  15. MR diagnosis of diaphragmatic endometriosis

    Energy Technology Data Exchange (ETDEWEB)

    Rousset, Pascal [Lyon 1 Claude Bernard University, Villeurbanne (France); Centre Hospitalier Lyon Sud, Radiology Department, Pierre Benite (France); Gregory, Jules; Coste, Joel [Paris Descartes University, Sorbonne Paris Cite, Paris (France); Groupe Hospitalier Cochin Hotel-Dieu, Biostatistics and Epidemiology department, Paris (France); Rousset-Jablonski, Christine [Centre Hospitalier Lyon Sud, Obstetric and Gynecologic Department, Pierre Benite (France); Hugon-Rodin, Justine [Paris Descartes University, Sorbonne Paris Cite, Paris (France); Groupe Hospitalier Cochin Hotel-Dieu, Gynecology Endocrinology Department, Paris (France); Regnard, Jean-Francois [Paris Descartes University, Sorbonne Paris Cite, Paris (France); Groupe Hospitalier Cochin Hotel-Dieu, Thoracic Surgery Department, Paris (France); Chapron, Charles [Paris Descartes University, Sorbonne Paris Cite, Paris (France); Groupe Hospitalier Cochin Hotel-Dieu, Obstetric and Gynecologic Department, Paris (France); Golfier, Francois [Lyon 1 Claude Bernard University, Villeurbanne (France); Centre Hospitalier Lyon Sud, Obstetric and Gynecologic Department, Pierre Benite (France); Revel, Marie-Pierre [Paris Descartes University, Sorbonne Paris Cite, Paris (France); Groupe Hospitalier Cochin Hotel-Dieu, Radiology Department, Paris (France)

    2016-11-15

    To evaluate magnetic resonance imaging (MRI) for diaphragmatic endometriosis diagnosis. Over a 2-year period, all diaphragmatic MRI performed in the context of diaphragmatic endometriosis were reviewed. Axial and coronal fat-suppressed T1- and T2-weighted sequences were analyzed by two independent readers for the presence of nodules, plaque lesions, micronodule clustering, or focal liver herniation. MR abnormalities were correlated to surgical findings in women surgically treated. Interobserver agreement was assessed by κ statistics. Twenty-three women with diaphragmatic endometriosis criteria comprised the population; 14 had surgical confirmation and nine had symptoms relief with hormonal treatment. MRI sensitivity was 83 % (19/23; 95 % confidence interval [CI]: 68, 98) for reader 1 and 78 % (18/23; 95 % CI: 61, 95) for reader 2. Kappa value was 0.86 (95 % CI: 0.47, 1.00). Readers 1 and 2 detected 35 and 36 lesions, respectively, all right-sided and agreed for 32 lesions on the type, location, and signal. Lesions were mostly nodules (23/32, 72 %), predominantly posterior (28/32, 87.5 %) and hyperintense on T1 (20/32, 63 %). MRI was negative for both readers in 2 surgically treated patients with small nodules or isolated diaphragmatic holes. MRI allows diaphragmatic endometriosis diagnosis with 78 to 83 % sensitivity and excellent interobserver agreement. (orig.)

  16. Problems with the diagnosis of endometriosis.

    Science.gov (United States)

    Berker, Bulent; Seval, Murat

    2015-08-01

    Endometriosis is classically defined as the presence of endometrial glands and stroma in outside the uterine cavity. As the definition suggests that confirming the ectopic endometrial stroma and glands in ectopic location histopathologically should be necessary for the diagnosis of endometriosis. Therefore, this situation leads to the need for surgery like laparoscopy for diagnosis. However, this surgical diagnostic approach will not be reliable for all patients with suspected endometriosis. It seems to be an important problem that there is still no reliable clinically diagnostic method or pathognomonic clinical finding, which may allow accurate diagnosis of endometriosis without the need for surgery or histopathologic evaluation. While these clinical features are not pathognomonic for the endometriosis, they should be used as markers for creating high-risk population for endometriosis. Clinical features and the available diagnostic methods, their advantages and limitations for the endometriosis will be discussed in this article. The different options for clinical assessment, laboratory tests and imaging techniques will be summarized and the advantages and disadvantages of these methods will be evaluated. We will also discuss the gold standard definitive diagnostic options with their problematic aspects.

  17. Endometriosis of episiotomy scar: a case report.

    Science.gov (United States)

    Mihmanli, V; Ózkan, T; Genc, S; Cetinkaya, N; Uctas, H

    2015-01-01

    Endometriosis is characterized by the presence of histologically normal endometrial glands and stroma outside the uterine cavity. Endometriosis predominantly locates on peritoneal surfaces, but it also affects the vagina, vulva, and perineum, usually secondary to surgical or obstetric trauma. Endometriosis in an episiotomy scar is a fairly rare phenomenon. The authors present a case of endometriosis in an episiotomy scar.

  18. Effects of Previous Laparoscopic Surgical Diagnosis of Endometriosis on Pregnancy Outcomes

    Science.gov (United States)

    Li, Hui; Zhu, Hong-Lan; Chang, Xiao-Hong; Li, Yi; Wang, Yue; Guan, Jing; Cui, Heng

    2017-01-01

    Background: The association between the previous history of endometriosis and obstetric outcomes is still ambiguous. This study aimed to evaluate the effects of previous history of operatively diagnosed endometriosis on pregnancy outcomes. Methods: A total of 98 primiparous women who had been diagnosed with endometriosis by previous laparoscopic surgery were included in this retrospective cohort study. Pregnancy outcomes were compared between these women (study group) who had a live birth and 300 women without endometriosis (control group) who had a live birth. In the study group, the pregnancy outcomes of 74 women who conceived naturally (no assisted reproductive technology [ART] subgroup) were simultaneously compared with 24 women who conceived by ART (ART subgroup). Results: Miscarriage was observed in 23 of 98 women with endometriosis (23.5%). There were 75 women who had a live birth after laparoscopic diagnosis of endometriosis in the study group eventually. On multivariate analysis, the postpartum hemorrhage rate increased significantly in the study group when compared with the control group (adjusted odds ratio: 2.265, 95% confidence interval: 1.062, 4.872; P = 0.034). There was an upward tendency of developing other pregnancy-related complications, such as preterm birth, placental abruption, placenta previa, cesarean section, fetal distress/anemia, and others in the study group than in the control group. However, the differences showed no statistical significance. Within the study group, the occurrence rate of postpartum hemorrhage and preterm birth was both higher in the ART subgroup than in the no ART subgroup. The differences both had statistical significance (44.4% vs. 17.5%, P = 0.024 and 27.8% vs. 1.8%, P = 0.010, respectively). At the same time, median (interquartile range) for gestational age at delivery in the ART subgroup was significantly shorter than that in the no ART subgroup (38 weeks [36–39 weeks] vs. 39 weeks [38–40 weeks]; P = 0

  19. Women with endometriosis have a higher DNA repair capacity and diminished breast cancer risk

    Science.gov (United States)

    Matta, Jaime L.; Flores, Idhaliz; Morales, Luisa M.; Monteiro, Janice; Alvarez-Garriga, Carolina; Bayona, Manuel

    2014-01-01

    Introduction Breast cancer (BC) and endometriosis are important reproductive health diseases for women. Although endometriosis is not a malignant condition, some of its characteristics mimic that of a malignancy. Endometriosis is associated with increased risk of certain cancers; however, whether it alters BC risk is unclear. This study evaluates the association of endometriosis and BC and explores whether DNA repair capacity (DRC) plays a role in such a relationship. Materials and Methods A case-control study of 991 women (385 with BC and 606 controls, all recruited over 5 years) was undertaken in Puerto Rico. Eighty participants with self-reported surgically diagnosed endometriosis were identified, 20 of whom also had a diagnosis of BC. Data from a structured questionnaire and DRC measurements were assessed to determine the association between BC, DRC, and endometriosis. Results Participants with BC cases were 50% less likely to have history of endometriosis (OR = 0.5 95%CI: 0.3, 0.9, p = 0.038) than women without BC controls. Findings that did not reach statistical significance included the following: women with history of endometriosis had a slightly higher DRC level than those without it; BC cases and history of endometriosis were less likely to have had endometriosis diagnosis before age 38 as compared to controls with endometriosis. Discussion Here we report an inverse association between endometriosis and BC, the former possibly conferring a protective effect on the latter. Although the mechanisms involved are unknown they may include protection provided by higher DRC and or hormonal treatments for endometriosis. A larger sample of endometriosis cases is necessary to confirm these results and answer the question of whether a higher DRC capacity may contribute to this potential protection, and to identify other factors at play. PMID:25473592

  20. Endometriose em cicatriz cirúrgica: uma série de 42 pacientes Surgical scar endometriosis: a series of 42 patients

    Directory of Open Access Journals (Sweden)

    Fabia Lima Vilarino

    2011-03-01

    patients that were diagnosed with scar endometriosis. From these 42 cases, 37 were of endometriosis on cesarean section scar; 3 cases of episiotomies and 2 cases on bladder in scar of hysterography. The mean age of the patients was 32.4 years old, standard deviation of ±6.2 years. All of them had previous obstetric surgery, and the main complaint was nodulation with perimenstrual pain in 40% of the cases. In 57% of the patients, the clinical evaluation was confirmed by pelvic or transvaginal ultrasonography. Patients were treated with total resection, and recurrence occurred in only two cases. CONCLUSION: scar surgical endometriosis is uncommon; however, the clinical diagnosis is easy when the signs and symptoms are known. The effective treatment is surgical resection.

  1. Thoracic endometriosis: 3 case reports

    Institute of Scientific and Technical Information of China (English)

    Song Ying-na; Lang Jing-he; Zhu Lan

    2006-01-01

    Abstract:Thoracic endometriosis is a rare disorder. It can be divided into pleural and pulmonary parenchymal endometriosis according to the site of the lesion. In this article 3 typical cases of thoracic endometriosis (case 1 is pleural endometriosis, case 2 and 3 are pulmonary parenchymal endometriosis) were described, and the various presentations, pathogenesis, diagnosis, and therapies of thoracic endometriosis were reviewed. The pathogenesis of thoracic endometriosis has not been established clearly yet. Recurrent right-sided pneumothorax or hemoptysis that occurs within days of the onset of menstruation is the most common manifestation. The correlation between the patient's symptoms and menses is essential to establish the diagnosis. Radiographic studies, bronchoscopy, and thoracoscopy may support the diagnosis. Pathologic evidence is not present universally. Therapeutic interventions include medical and surgical options, which should be individualized for each patient.

  2. A PROSPECTIVE STUDY ON LAPAROSCOPIC AND HISTOPATHOLOGIC DIAGNOSIS OF ENDOMETRIOSIS

    Directory of Open Access Journals (Sweden)

    Shilpi Mukherjee

    2016-08-01

    Full Text Available BACKGROUND Endometriosis is a common benign gynaecological disorder. The true prevalence is difficult to quantify as women with disease are often asymptomatic and imaging modalities have low sensitivities for diagnosis. The primary method of diagnosis is Laparoscopy with or without biopsy for histologic diagnosis. Strict histologic criteria will confirm the surgical diagnosis in approximately 50-65% of cases. DESIGN, SETTING AND METHODS This is a prospective observational institution based study. A total of 50 patients undergoing laparoscopy were included in the study in accordance with the inclusion and exclusion criteria. The results were tabulated for comparison and standard statistical software were used for data presentation. RESULTS In this study, we observed that laparoscopy although adequately sensitive to diagnose endometriosis lacks the specificity except in the case of ovarian endometriosis. So laparoscopy without histological confirmation may give rise to false positive results, which may lead to overtreatment of patients. Due to the high negative predictive value of laparoscopy, absence of lesion anywhere on laparoscopy can virtually exclude the diagnosis of endometriosis, saving both time and expertise. CONCLUSION We conclude that laparoscopy should always be combined with histopathology for accurate diagnosis in presence of any suggestive or doubtful lesion, but is not mandatory in absence of lesion anywhere in the pelvis. The laparoscopic staging of endometriosis has a positive correlation with histologic diagnosis of endometriosis.

  3. Increased expression of stathmin in eutopic endometrium of patients with endometriosis

    Institute of Scientific and Technical Information of China (English)

    LI Chun-yan; LIU Hai-yuan; LANG Jing-he; WANG Hong-qing; FAN Xiu-ling

    2010-01-01

    Background Stathmin was identified as an endometriosis-related protein by comparative proteomics in our previous study.As a microtubule-destablizing factor, stathmin was shown to participate in the relay and integration of diverse intracellular signaling pathways involved in cell proliferation, differentiation, and many other cellular activities.To investigate whether stathmin is involved in the pathogenesis of endometriosis, we examined the expression of stathmin in eutopic endometrium of women with or without endometriosis.Methods Eutopic endometrium samples were collected from thirty-six patients who were diagnosed as endometriosis and the nineteen age-matched patients who were confirmed to be free of endometriosis surgically and histologically.The expression of stathmin mRNA was detected by real-time PCR, and its protein was detected by Western blotting and immunohistochemistry.Results Stathmin was overexpressed in eutopic endometrium of women with endometriosis detected by real-time PCR in mRNA levels and by Western blotting in protein levels, without significant difference between proliferative and 0secretory phase.Immunohistochemistry showed that stathmin protein was localized in both endometrial glandular and stromal cells throughout the menstrual cycle.Conclusions Stathmin is overexpressed in endometrium of patients with endometriosis and may play a role in the pathogenesis of endometriosis.

  4. Scar Endometriosis: a Case Report with Literature Review.

    Science.gov (United States)

    Gupta, Pratiksha; Gupta, Sangeeta

    2015-12-01

    Endometriosis is defined as the presence of functioning endometrial tissue outside the uterine cavity. Endometriosis can sometimes occur in a previous surgical scar. Scar endometriosis is rare and difficult to diagnose. It mostly follows obstetrical and gynecological surgeries. This condition is often confused with other surgical conditions. We are reporting one case of scar endometriosis involving rectus sheath following cesarean section. The patient required wide surgical excision of the lesion. The pathogenesis, diagnosis, and treatment of this rare condition are being discussed.

  5. Diagnosis, management, and long-term outcomes of rectovaginal endometriosis

    Directory of Open Access Journals (Sweden)

    Moawad NS

    2013-11-01

    Full Text Available Nash S Moawad,1 Andrea Caplin21Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, University of Florida, 2University of Florida College of Medicine, Gainesville, FL, USAAbstract: Rectovaginal endometriosis is the most severe form of endometriosis. Clinically, it presents with a number of symptoms including chronic pelvic pain, dysmenorrhea, deep dyspareunia, dyschezia, and rectal bleeding. The gold standard for diagnosis is laparoscopy with histological confirmation; however, there are a number of options for presurgical diagnosis, including clinical examination, transvaginal/transrectal ultrasound, magnetic resonance imagining, colonoscopy, and computed tomography colonography. Treatment can be medical or surgical. Medical therapies include birth control pills, oral progestins, gonadotropin-releasing hormone agonists, danazol, and injectable progestins. Analgesics are often used as well. Surgery improves up to 70% of symptoms. Surgery is either ablative or excisional, and is conducted via transvaginal, laparoscopic, laparotomy, or combined approaches. Common surgical techniques involve shaving of the superficial rectal lesion, laparoscopic anterior discoid resection, and low anterior bowel resection and reanastomosis. Outcomes are generally favorable, but postoperative complications may include intra-abdominal bleeding, anastomotic leaks, rectovaginal fistulas, strictures, chronic constipation, and the need for reoperation. Recurrence of rectal endometriosis is a possibility as well. Other outcomes are improved pain-related symptoms and fertility. Long-term outcomes vary according to the management strategy used. This review will provide the most recent approaches and techniques for the diagnosis and treatment of rectovaginal endometriosis.Keywords: pelvic pain, dyspareunia, bowel resection, endometriosis, rectovaginal

  6. Pharmacological treatment of endometriosis: review of current and new options for treatment

    Directory of Open Access Journals (Sweden)

    Maja Jakič

    2016-10-01

    Full Text Available Endometriosis is a gynecological disease that is defined as the presence of endometrium-like tissue outside the uterine cavity, and it is one of the main causes of female infertility. Although there is unfortunately no known ‘optimal’ treatment for endometriosis, there are three treatment options: medication, surgical treatment, and a combination of both. The gold standard for diagnosis of endometriosis is a diagnostic laparoscopy, which is also therapeutic. Indications for pharmacological treatment of endometriosis include empirical treatment for patients with pelvic pain who are normal on gynecological examination, or who have recurrent disease after surgical treatment or in combination with surgical treatment. In everyday practice, non-steroid anti-inflammatory drugs, oral contraceptives, and progestins per os are used as first-line pharmacological treatments of endometriosis. Gonadoliberin agonists can be used as second-line treatment, although their use is discouraged. These medications can be used alone or in combination. Studies over the last 10 years have shown that many other agents have potential for treatment of endometriosis. These can be broadly classified into several groups: anti-inflammatory agents, and agents that interfere with the hormonal system, or with other pathophysiological processes, such as a disturbed immune system, reduced apoptosis, enhanced angiogenesis, degradation of the extracellular matrix, increased oxidative stress, and epigenetic changes. However, their introduction into routine use requires more convincing clinical studies to confirm their effectiveness.

  7. Endometriosis intestinal Intestinal endometriosis

    Directory of Open Access Journals (Sweden)

    C.I. González

    2008-08-01

    Full Text Available La endometriosis es un trastorno ginecológico crónico, benigno y frecuente entre las mujeres en edad fértil, estimándose que existe algún grado de endometriosis hasta en el 15% de las mujeres premenopáusicas, asociándose a historia de infertilidad, antecedente de cesárea, dismenorrea y anormalidad en el sangrado uterino. Se cree que es debida al ascenso por las trompas de Falopio de contenido menstrual (menstruación retrógrada. En la afectación intestinal, el colon es el segmento más frecuentemente afectado, sobre todo a nivel rectosigmodeo. La clínica de presentación es inespecífica, siendo lo más frecuente el dolor abdominal y/o pélvico de tipo cólico que coincide o se exacerba con la menstruación. El diagnóstico diferencial incluye la enfermedad inflamatoria intestinal, diverticulitis, colitis isquémica y procesos neoplásicos, siendo el diagnóstico definitivo anatomopatológico. En cuanto al tratamiento, éste dependerá de la clínica y de la edad de la paciente, así como de sus deseos de embarazo.Endometriosis is a chronic, benign gynaecological disorder that is frequent in women of a child-bearing age. It is estimated that there is some degree of endometriosis in as many as 15% of pre-menopausal women, associated with a history of infertility, caesarean antecedents, dysmenorrhoea and abnormality in uterine bleeding. It is believed to be due to the rise of menstrual contents through the Fallopian tubes (retrograde menstruation. In the intestinal affectation, the colon is the segment most frequently affected, above all at the rectosigmoidal level. The clinical features are unspecific, with abdominal pain the most frequent and/or pelvic pain of a cholic type that coincides with, or is exacerbated by, menstruation. Differential diagnosis includes intestinal inflammatory disease, diverticulitis, ischemic colitis and neoplastic processes, with the definitive diagnosis being anatomopathological. With respect to treatment

  8. Endometriosis in an episiotomy scar

    Directory of Open Access Journals (Sweden)

    Mine islimye Taskin

    2016-03-01

    Full Text Available Endometriosis that is defined as the presence of functional endometrial tissue outside the uterine cavity is seen 5-10% of reproductive age women. Endometriosis can be seen any other site of the body; but the most frequently affected areas are ovaries, pelvic peritoneum, uterosacral ligament and Douglas pouche. Several teories exist for the development of endometriosis including retrograde menstruation, venous or lymphatic metastasis and immun dysfunction. Endometriosis of the perineum and vulva are extremely rare with the most common sites being episiotomy scars. Scar endometriosis is likely to be caused by mechanical transplantation of endometrium from the uterine cavity into the wound at the time of the surgery. The primary treatment for scar endometriosis is total surgical excision of the lesion. It is important not to leave residual tissue during surgery to prevent the recurrence. Here we present a patient who had her vaginal delivery 5 years ago, have a complaint of painful vulvar lump at the right mediolateral episiotomy scar since 1 year during her every menstruation period and whose final diagnosis was endometriosis after surgical removal and histopathologic examination. Althought vulvar endometrosis is rare, it should be considered in the patients who had a vaginal delivery and complaining painful vulvar lump with swelling in her mestrual cycle. [Cukurova Med J 2016; 41(1.000: 164-166

  9. Treatment strategies for endometriosis.

    Science.gov (United States)

    Rodgers, Allison K; Falcone, Tommaso

    2008-02-01

    Endometriosis is a common chronic disease that causes symptoms of pain and infertility. The pain syndrome can be quite incapacitating. The pain symptoms usually originate in the reproductive organs but can also involve the urinary or intestinal tracts if endometriosis implantation has occurred there. The presentation and physical appearance of endometriosis is extremely variable and can be characterized by a chronic intraperitoneal inflammatory process and adhesions. The only definitive diagnostic technique is laparoscopy. To review current literature on the treatment strategies for endometriosis. Review of Pubmed, Cochrane database and Medline for current review articles and studies regarding the current treatment strategies for endometriosis. Initial treatment is surgical or medical. Medical therapy is often used as a first-line therapy and can also be used in conjunction with those patients who undergo surgical therapy for pain. No medical therapy has proven effective for infertility. Medical therapy consists mostly of hormonal suppressive therapy in which the medication causes a downregulation of the hypothalamus-pituitary-ovarian pathway. Non-steroidal anti-inflammatory drugs and oral contraceptives are often used as an initial approach even without a definitive diagnosis. Progestins, such as oral norethindrone and depot medroxyprogesterone, are effective while using them but have a high recurrence rate. The norgestrol intrauterine device is also quite effective at relieving pain associated with endometriosis, especially pain arising during menses as well as from lesions in the rectovaginal tissue. Gonadotropin-releasing hormone agonists induce a pseudomenopausal state and have significant side effects, such as hot flashes and genital atrophy. 'Add-back' therapy with a progestin has been shown to relieve most of these drug related symptoms. Gonadotropin-releasing hormone agonists are also very effective at relieving symptoms of pain during treatment but are

  10. Elevated Vascular Endothelia Growth Factor-A in the Serum and Peritoneal Fluid of Patients with Endometriosis

    Institute of Scientific and Technical Information of China (English)

    Hongbo WANG; Nowiah Gorpudolo; Yanhui LI; Dilu FENG; Zehua WANG; Yuan ZHANG

    2009-01-01

    There has been emergence of evidence suggesting that specific variants of the vascular en-dothelia growth factor (VEGF) family, based on their ability to regulate angiogenesis, would be pivotal in the pathogenesis of endometriosis. This study was aimed at determining whether high levels of VEGF-A could be found in the serum and peritoneal fluid (PF) of patients with endometriosis. VEGF-A levels were measured by enzyme-linked immunosorbent assay (ELISA) in serum and PF from 46 pa-tients with surgically confirmed endometriosis, and 40 controls with no clinical evidence of the disease or detectable endometriotic lesions at the time of surgical examination. The results showed the mean VEGF-A levels were significantly higher in the serum and PF of patients with endometriosis than in the controls. The VEGF-A levels in the serum and PF of patients with severe endometriosis (stages Ⅲ-Ⅳ) were significantly higher than in those with minimal endometriosis (P<0.001). It was concluded that endometriosis was associated with significant modulation in the levels of circulating VEGF-A.

  11. Living with endometriosis

    Science.gov (United States)

    Pelvic pain - living with endometriosis; Endometrial implant - living with endometriosis; Endometrioma - living with endometriosis ... counter pain relievers can reduce the pain of endometriosis. These include: Ibuprofen (Advil) Naproxen (Aleve) Acetaminophen (Tylenol) ...

  12. [Bladder endometriosis and barrenness: diagnostic and treatment strategy].

    Science.gov (United States)

    Piketty, M; Bricou, A; Blumental, Y; de Carné, C; Benifla, J-L

    2008-09-01

    Deep infiltrating endometriosis is a well-known female disease responsible for chronic pelvic pain, urinary dysfunction, infertility, and altered quality of life. Endometriosis and infertility are complex entities and the optimal choice of management of both of them remains obscure. Mechanism of development of the disease has to be understood to optimize patients care. The link between barrenness and endometriosis is well known, but there is no direct link between bladder lesion and infertility. Bladder endometriosis is a deeply infiltrating endometriosis lesion. Its management is first diagnostic and then remedial. In case of ineffectiveness of medical strategy, surgical treatment is indicated. However, for patient suffering from symptomatic isolated bladder endometriosis, surgical management can be offered in first intention. Isolated bladder injuries due to endometriosis are mostly treated by conservative laparoscopic surgery, after a complete evaluation of endometriosis disease and barrenness by clinical exam and imaging techniques.

  13. Intrauterine endometriotic cyst at the site of previous cesarean scar; scar endometriosis.

    Science.gov (United States)

    Isci, H; Gonenc, G; Yigiter, A B; Guducu, N; Dünder, I

    2015-01-01

    Uterine scar endometriosis is an extremely rare entitiy. As the surgical procedures of the uterus increases through time, scar endometriosis may be diagnosed more often in the future. A case of uterine scar endometriosis is presented with complaints of menstruation lasting one day with associated pelvic pain. When a cystic mass in the site of previous surgery is diagnosed, scar endometriosis must be considered.

  14. Randomized comparison of superovulation with letrozole vs. clomiphene citrate in an IUI program for women with recently surgically treated minimal to mild endometriosis.

    Science.gov (United States)

    Abu Hashim, Hatem; El Rakhawy, Mohamed; Abd Elaal, Ibrahim

    2012-03-01

    To evaluate pregnancy rates with letrozole and clomiphene citrate (CC) alone for superovulation in an intrauterine insemination program for women with recently surgically treated minimal to mild endometriosis. A randomized controlled trial following the CONSORT criteria. University teaching hospital and a private practice setting. 136 women with primary infertility due to minimal to mild endometriosis who did not achieve pregnancy after six to 12 months following laparoscopic treatment. Superovulation using 5 mg letrozole/day (69 women, 220 cycles) or 100 mg CC/day (67 women, 213 cycles) for five days combined with intrauterine insemination up to four cycles. Clinical pregnancy rate per cycle, cumulative pregnancy rate after four cycles, number of follicles, serum estradiol, endometrial thickness on the day of human chorionic gonadotropin administration, serum progesterone, miscarriage and live birth rates. The clinical pregnancy rate per cycle and the cumulative pregnancy rate after four cycles were comparable (15.9 vs. 14.5% and 64.7 vs. 57.2%; p=0.82, p=0.71 in letrozole and CC groups, respectively). Two twin pregnancies occurred in the CC/intrauterine insemination group. Miscarriage and live birth rates were comparable (11.4 vs. 12.9% and 44.9 vs. 40.3%; p=0.47, p=0.62 in letrozole and CC groups, respectively). The total number of follicles and serum estradiol on the day of human chorionic gonadotropin administration were significantly increased in the CC group. Superovulation with letrozole is not more effective than clomiphene citrate alone in an intrauterine insemination program for women with minimal to mild endometriosis who did not achieve pregnancy after six to 12 months following laparoscopic treatment. ClinicalTrials.gov ID: NCT01334762. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  15. Diagnostic confidence analysis in the magnetic resonance imaging of ovarian and deep endometriosis: comparison with surgical results

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca; Sulcis, Rosa; Ibba, Giannina; Piga, Mario [Azienda Ospedaliero Universitaria, Department of Radiology, Monserrato (Italy); Melis, Gian Benedetto; Guerriero, Stefano [Azienda Ospedaliero Universitaria, Department of Gynecology, Monserrato (Italy); Alcazar, Juan Luis [University of Navarra, Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, Pamplona (Spain)

    2014-02-15

    To assess the diagnostic confidence of multiple readers in the magnetic resonance imaging (MRI) diagnosis of endometriosis. Sixty-five patients (mean age 33; range 19-45 years) who had undergone MRI were retrospectively evaluated. Five regions were analysed and the presence of endometriosis was scored on a five-point scale in order to assess the diagnostic confidence. Statistical analysis included receiver operating characteristic (ROC) curve analysis, the Cohen weighted test and sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, positive likelihood ratio (LR+) and negative likelihood ratio (LR-). The areas under the curve (AUC) in the detection of ovarian endometrioma were 0.942, 0.893 and 0.883 for readers 1, 2 and 3, respectively; in the uterosacral ligament (USL) AUCs were 0.907, 0.804 and 0.842; in the vaginal fornix (VF) 0.819, 0.733 and 0.69; in the anterior compartment 0.916, 0.833 and 0.873; and in the rectum/sigma/pouch of Douglas (RSD) 0.936, 0.856 and 0.834. Diagnostic confidence of the observers is different according to the region of the nodules of endometriosis and it can be challenging in the VF and for the less experience readers also in the AC and RSD. Moreover the degree of uncertain diagnosis for the less expert readers may reach up to one third of the examinations. (orig.)

  16. Risk factors for laboratory-confirmed bloodstream infection in neonates undergoing surgical procedures

    Directory of Open Access Journals (Sweden)

    Roberta Maia de Castro Romanelli

    Full Text Available Background Healthcare Associated Infections constitute an important problem in Neonatal Units and invasive devices are frequently involved. However, studies on risk factors of newborns who undergo surgical procedures are scarce. Objective To identify risk factors for laboratory-confirmed bloodstream infection in neonates undergoing surgical procedures. Methods This case–control study was conducted from January 2008 to May 2011, in a referral center. Cases were of 21 newborns who underwent surgery and presented the first episode of laboratory-confirmed bloodstream infection. Control was 42 newborns who underwent surgical procedures without notification of laboratory-confirmed bloodstream infection in the study period. Information was obtained from the database of the Hospital Infection Control Committee Notification of infections and related clinical data of patients that routinely collected by trained professionals and follow the recommendations of Agência Nacional de Vigilância Sanitária and analyzed with Statistical Package for Social Sciences. Results During the study period, 1141 patients were admitted to Neonatal Unit and 582 Healthcare Associated Infections were reported (incidence-density of 25.75 Healthcare Associated Infections/patient-days. In the comparative analysis, a higher proportion of laboratory-confirmed bloodstream infection was observed in preterm infants undergoing surgery (p = 0.03 and use of non-invasive ventilation was a protective factor (p = 0.048. Statistically significant difference was also observed for mechanical ventilation duration (p = 0.004, duration of non-invasive ventilation (p = 0.04, and parenteral nutrition duration (p = 0.003. In multivariate analysis duration of parenteral nutrition remained significantly associated with laboratory-confirmed bloodstream infection (p = 0.041. Conclusions Shortening time on parenteral nutrition whenever possible and preference for non-invasive ventilation in neonates

  17. Perfluoroalkyl substances and endometriosis-related infertility in Chinese women.

    Science.gov (United States)

    Wang, Bin; Zhang, Rongrong; Jin, Fan; Lou, Hangying; Mao, Yuchan; Zhu, Wenting; Zhou, Wei; Zhang, Ping; Zhang, Jun

    2017-05-01

    Endometriosis is one of the main causes for female infertility. Previous studies suggested that perfluoroalkyl substances (PFASs), a group of ubiquitous environmental chemicals with properties of endocrine disruption and reproductive toxicity, were risk factors for endometriosis but there lacks direct evidence on the possible role of PFASs in endometriosis-related infertility. To fill this gap, we examined the association between PFASs and endometriosis-related infertility among Chinese reproductive-age women in a case-control study, which comprised 157 surgically confirmed endometriosis cases and 178 controls seeking infertility treatment because of male reproductive dysfunction in 2014 and 2015. Blood specimens were collected at the enrollment and analyzed for ten PFASs. Logistic regression was utilized to estimate the adjusted odds ratios (OR) and 95% confidence intervals (CI) for individual PFAS compound. Plasma concentrations of perfluorobutane sulfonic acid (PFBS) were associated with an increased risk of endometriosis-related infertility (second vs. lowest tertile: OR=3.74, 95% CI: 2.04, 6.84; highest vs. lowest tertile: OR=3.04, 95% CI: 1.65, 5.57). This association remained consistent when we restricted to subjects with no previous pregnancy (second vs. lowest tertile: OR=2.91, 95% CI: 1.28, 6.61; highest vs. lowest tertile: OR=3.41, 95% CI: 1.52, 7.65) or to subjects without other gynecologic pathology (second vs. lowest tertile: OR=4.65, 95% CI: 2.21, 9.82; highest vs. lowest tertile: OR=3.36, 95% CI: 1.58, 7.15). Plasma concentrations of perfluoroheptanoic acid (PFHpA), perfluorohexane sulfonic acid (PFHxS) and perfluorononanoic acid (PFNA) were inversely associated with endometriosis-related infertility, but the associations were attenuated in the sensitivity analyses. Our preliminary evidence suggests that exposure to PFBS may increase the risk of female infertility due to endometriosis. Future prospective studies are necessary to confirm these

  18. An atypical manifestation of inguinal endometriosis in the extra pelvic part of the round ligament: a case report

    Directory of Open Access Journals (Sweden)

    Vito Chiantera

    2016-09-01

    Full Text Available Establishing the diagnostic and surgical management of the inguinal Endometriosis, with further investigation of the biological character. The imaging findings of CT and PET-CT, biopsy, ultrasound, open surgery of the inguinal region with intraoperative cryosection, confirmation and evaluation of tissue infiltration by endometriosis, laparoscopic removal of all endometriotic lesions, reconstruction of the groin. Based on the history of the 29-year-old patient, suffering from a painful growing induration of the inguinal region. Immunohistochemistry performed, in order to analyze the character of the inguinal endometriosis. CT, PET-CT and biopsy did not confirm the diagnosis of endometriosis. Considering, the progressive symptoms of the patient, was performed the surgical intervention. Open surgery of the inguinal region, with a preparation and separation of the groin fibrotic mass lead to the finding of an affected extra-peritoneal portion of the round ligament. Intraoperative cryosection confirmed endometriosis. Simultaneous laparoscopy showed peritoneal endometriosis (rASRM I and an alteration of the inner round ligament, involving the inner inguinal channel in this process. All endometriotic lesions were removed and the inguinal region reconstructed. The immunohistochemical staining gave evidence of the endometriotic tissue, surrounded by smooth muscle metaplasia. We consider that, reporting this rare case of endometriosis, based on a case report and a literature review, affecting intra and extra peritoneal portion of the round ligament, is an important aid to avoid a wrong diagnosis and method of therapy in future. Our data demonstrated the fully recovery of the patient, after surgical treatment, reporting symptom-free status. [Int J Reprod Contracept Obstet Gynecol 2016; 5(9.000: 3202-3207

  19. ULTRASOUND DIAGNOSTICS OF RETROCERVICAL ENDOMETRIOSIS

    Directory of Open Access Journals (Sweden)

    R. A. Barto

    2015-01-01

    Full Text Available Background: Endometriosis is one of the major problems in current gynecology due to steady increase of its incidence, involvement of young females, high frequency of infertility and difficulties with diagnostics and treatment. Confirmation of diagnosis of advanced endometriosis is still within the competence of research centers and big federal treatment establishments.Aim: To improve ultrasound diagnostics and to develop an algorithm of assessment in retrocervical endometriosis.Materials and methods: Seventy two females were assessed laparoscopically due to a gynecology disorder or infertility. Based on intraoperational data and results of pathomorphological assessments, two groups were formed: group 1 (control group, n = 26 comprised patients in reproductive age who had been admitted for elective surgery due to a gynecological disorder. Group 2 (main group, n = 46 included patients with various types of endometriosis. Patients from group 2 were divided into 3 subgroups: 2а (n = 17 – with superficial forms of external genital endometriosis; 2b (n = 18 – with endometrioid cysts; 2c (n = 11 – with deep infiltrative types of endometriosis.Results: Patients with superficial external genital endometriosis were characterized by positive symptom of “folding” (“freezing” of posterior uterine surface and of the walls of adjacent intestine. In endometriosis of posterior surface of cervix uteri, the diagnosis made by an ultrasound assessmentin 100% matched the diagnosis set during surgery, whereas if sacrouterine ligaments were involved, the diagnostic match was only 3%. In the group of patients with endometrioid cysts, in most of cases the cysts had specific ultrasound signs; coincidence of an ultrasound and a morphological diagnosis was seen in 98% of cases. Most cases of deep infiltrative endometriosis showed involvement of sacrouterine ligaments (72% and of parametrium (81%. There was a positive folding sign and a “Indian headdress

  20. Scar Endometriosis: a Case Report with Literature Review

    Directory of Open Access Journals (Sweden)

    Pratiksha Gupta

    2015-12-01

    Full Text Available Endometriosis is defined as the presence of functioning endometrial tissue outside the uterine cavity. Endometriosis can sometimes occur in a previous surgical scar. Scar endometriosis is rare and difficult to diagnose. It mostly follows obstetrical and gynecological surgeries. This condition is often confused with other surgical conditions. We are reporting one case of scar endometriosis involving rectus sheath following cesarean section. The patient required wide surgical excision of the lesion. The pathogenesis, diagnosis, and treatment of this rare condition are being discussed.

  1. Association Between Endometriosis and Hypercholesterolemia or Hypertension.

    Science.gov (United States)

    Mu, Fan; Rich-Edwards, Janet; Rimm, Eric B; Spiegelman, Donna; Forman, John P; Missmer, Stacey A

    2017-07-01

    An altered hormonal or chronic systemic inflammatory milieu characterizing endometriosis may result in a higher risk of hypercholesterolemia and hypertension. Conversely, elevated low-density lipoprotein in hypercholesterolemia and chronic systemic inflammation resulting from hypertension may increase the risk of endometriosis. We assessed the association of laparoscopically confirmed endometriosis with hypercholesterolemia and hypertension in a large prospective cohort study. In 1989, 116 430 registered female nurses aged 25 to 42 completed the baseline questionnaire and were followed for 20 years. Multivariable Cox proportional hazards models were applied. In 1989, there were 4244 women with laparoscopically confirmed endometriosis and 91 554 women without. After adjusting for demographic, anthropometric, family history, reproductive, dietary, and lifestyle risk factors prospectively, comparing women with laparoscopically confirmed endometriosis to women without, the relative risks were 1.25 (95% confidence interval, 1.21-1.30) for development of hypercholesterolemia and 1.14 (95% confidence interval, 1.09-1.18) for hypertension. Conversely, the relative risks of developing laparoscopically confirmed endometriosis were 1.22 (95% confidence interval, 1.15-1.31) comparing women with hypercholesterolemia to women without and 1.29 (95% confidence interval, 1.18-1.41) comparing women with hypertension to women without. The strength of associations of laparoscopically confirmed endometriosis with hypercholesterolemia or hypertension was strongest among women aged ≤40 and weakened as age increased (P values for interaction hypercholesterolemia and hypertension could be accounted for by treatment factors after endometriosis diagnosis, including greater frequency of hysterectomy/oophorectomy and earlier age for this surgery. In this large cohort study, laparoscopically confirmed endometriosis was prospectively associated with increased risk of hypercholesterolemia

  2. Recent advances in gene therapy of endometriosis.

    Science.gov (United States)

    Shubina, Anastasia N; Egorova, Anna A; Baranov, Vladislav S; Kiselev, Anton V

    2013-12-01

    Endometriosis is a gynecological disease that affects up to 10%-15% of all reproductive-age women worldwide. It is characterized by the presence of endometrial tissues outside the uterine cavity. Endometriosis is a complex disease; its pathogenesis includes altered steroid metabolism and immune system abnormalities such as inflammation, increased angiogenic activity in the peritoneal fluid and impaired recognition of ectopic endometrial cells. The development of endometriosis also depends on genetic, anatomical and environmental factors. Numerous surgical and medical approaches to treat endometriosis have been developed to date. However, complete resolution of the problem has not been achieved so far. Gene therapy holds exciting promise for the treatment of numerous disorders and current studies have indicated it can also be applied to endometriosis. The focus of this review is to summarize the pathogenetic background of the disease and to highlight current gene therapy approaches for this common gynecological disorder.

  3. Pathogenic mechanisms in endometriosis-associated infertility.

    Science.gov (United States)

    Gupta, Sajal; Goldberg, Jeffrey M; Aziz, Nabil; Goldberg, Eric; Krajcir, Natalie; Agarwal, Ashok

    2008-08-01

    To review the mechanisms by which endometriosis may affect reproductive function. Review of the English literature from 1986 to 2007 after searching Medline, EMBASE, Cochrane, and BIOSIS, as well as relevant meeting abstracts. Fertility research center and obstetrics and gynecology department in a tertiary care hospital. There is compelling evidence in the literature that endometriosis has detrimental effects on ovarian and tubal function and uterine receptivity, resulting in female infertility. The mechanisms of infertility associated with endometriosis remain controversial and include abnormal folliculogenesis, elevated oxidative stress, altered immune function, and hormonal milieu in the follicular and peritoneal environments, and reduced endometrial receptivity. These factors lead to poor oocyte quality, impaired fertilization, and implantation. Through unraveling the mechanisms by which endometriosis leads to infertility, researchers are sure to find a nonsurgical means to diagnose endometriosis, most likely through serum and peritoneal markers. Cytokines, interleukins, oxidative stress markers, and soluble cellular adhesion molecules all show potential to be used as a reliable marker for diagnosing endometriosis. After analyzing the pathogenic mechanisms of endometriosis, it seems that the future treatment of this entity may include cyclo-oxygenase-2 inhibitors, immunomodulators, or hormonal suppressive therapy to eliminate the need for surgical treatment of endometriosis.

  4. Magnetic resonance imaging of surgically confirmed anterior cruciate ligament graft disruption

    Energy Technology Data Exchange (ETDEWEB)

    Collins, Mark S.; Bond, Jeffrey R. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Unruh, Kenneth P. [Mayo Clinic, Mayo Medical School, Rochester, MN (United States); Mandrekar, Jayawant N. [Mayo Clinic, Department of Biostatistics, Rochester, MN (United States)

    2008-03-15

    To evaluate previously described primary and secondary MRI signs of disruption to anterior cruciate ligament (ACL) grafts in surgically proven cases. We retrospectively analyzed MR images of 48 patients (mean age 29 years) with clinically suspected ACL graft disruption. All patients had surgical confirmation of the MRI findings. The reviewers analyzed the cases blinded to the surgical results and assessed each of the primary and secondary MRI signs of graft disruption individually. Subsequently, a final impression of the graft integrity based on a comprehensive assessment of all of the primary and secondary findings was made. Utilizing a comprehensive assessment of previously described primary and secondary MR findings of ACL graft disruption, the blinded reviewers were able to identify correctly full-thickness graft tears with test accuracy of 85%, sensitivity of 72%, and specificity of 100%. Individual assessment of the primary finding of graft fiber discontinuity had sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 72%, 100%, 100%, 77% and 85%, respectively, for full-thickness tears. Other individual primary and secondary findings were less reliable; however, the primary findings of marked segmental thinning of the graft and markedly abnormal graft orientation, and the secondary findings of bone contusions in the lateral compartment and large joint effusion, had high specificity and positive predictive value. Of the four missed cases, two had associated arthrofibrosis. The comprehensive assessment of previously described primary and secondary MRI findings of ACL graft disruption has high test specificity and moderately high test accuracy. The presence of graft fiber discontinuity is the most reliable primary or secondary finding when assessed individually. Marked segmental thinning of the graft and abnormal fiber orientation, and the presence of bone contusions in the lateral compartment and large joint effusion

  5. Abdominal Incisional Endometriosis Following Cesarean Section: Report of 2 Cases

    Directory of Open Access Journals (Sweden)

    Azam Azargoon

    2008-06-01

    Full Text Available Endometriosis is described as the presence of functioning endometrial tissue (glands and stroma outside the uterine cavity. The most common location is within the pelvis. However, extra pelvic endometriosis is a fairly uncommon disorder and difficult to diagnose. It can sometimes occur in a surgical scar. Scar endometriosis is a rare condition and difficult to diagnose. It mostly follows obstetrical and gynecological surgeries. It presents as a painful, slowly growing mass in or near a surgical scar. We report two cases of abdominal wall endometriosis following hysterotomy and cesarean section. Consequently the pathogenesis, diagnosis and treatment are discussed.

  6. Umbilical endometriosis associated with large umbilical hernia. Case report.

    Science.gov (United States)

    Stojanovic, M; Radojkovic, M; Jeremic, L; Zlatic, A; Stanojevic, G; Janjic, D; Mihajlovic, S; Dimov, I; Kostov, M; Zdravkovic, M; Stojanovic, M

    2014-01-01

    Umbilical endometriosis is a rare condition, usually following laparoscopic and surgical procedures involving the umbilicus.Spontaneous umbilical endometriosis occurring without any previous abdominal or uterine surgery is extremely rare. The maximal depth of penetration of the umbilical endometriosis described is up to fascial level. There have been only two cases of endometriosis reported arising within umbilical hernia. The authors report a case of a patient with spontaneous umbilical endometriosis associated with a large umbilical hernia, treated by surgical excision and mesh repair of the abdominal wall. To the best of our knowledge, this is the first described case of the association of umbilical endometriosis with a large umbilical hernia that requires prosthetic mesh repair of the abdominal wall defect.

  7. Acupuncture for pain in endometriosis.

    Science.gov (United States)

    Zhu, Xiaoshu; Hamilton, Kindreth D; McNicol, Ewan D

    2011-09-07

    Endometriosis is a prevalent gynaecological condition, significantly affecting women's lives. Clinical presentations may vary from absence of symptoms to complaints of chronic pelvic pain, most notably dysmenorrhoea. The management of pain in endometriosis is currently inadequate. Acupuncture has been studied in gynaecological disorders but its effectiveness for pain in endometriosis is uncertain. To determine the effectiveness and safety of acupuncture for pain in endometriosis.  We searched the Cochrane Menstrual Disorders and Subfertility Group (MSDG) Specialised Register of controlled trials, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE, EMBASE, CINAHL, AMED, PsycINFO, CNKI and TCMDS (from inception to 2010) and reference lists of retrieved articles. Randomised single or double-blind controlled trials enrolling women of reproductive age with a laparoscopically confirmed diagnosis of endometriosis and comparing acupuncture (body, scalp or auricular) to either placebo or sham, no treatment, conventional therapies or Chinese herbal medicine. Three authors independently assessed risk of bias and extracted data; we contacted study authors for additional information. Meta-analyses were not performed as only one study was included. The primary outcome measure was decrease in pain from endometriosis. Secondary outcome measures included improvement in quality of life scores, pregnancy rate, adverse effects and rate of endometriosis recurrence. Twenty-four studies were identified that involved acupuncture for endometriosis; however only one trial, enrolling 67 participants, met all the inclusion criteria. The single included trial defined pain scores and cure rates according to the Guideline for Clinical Research on New Chinese Medicine. Dysmenorrhoea scores were lower in the acupuncture group (mean difference -4.81 points, 95% confidence interval -6.25 to -3.37, P New Chinese Medicine for Treatment of Pelvic Endometriosis

  8. MANAGEMENT OF URETERAL ENDOMETRIOSIS:A REPORT OF TEN CASES

    Institute of Scientific and Technical Information of China (English)

    Chun-yan Li; Hong-qing Wang; Hai-yuan Liu; Jing-he Lang

    2008-01-01

    Objective To investigate the clinical features and management ofureteral endometriosis.Methods Patients surgically and histologically diagnosed as ureteral endometriosis from January 2001 to January 2007 in Peking Union Medical College Hospital were retrospectively reviewed.Results Ten patients were diagnosed as ureteral endometriosis among 7561 cases with surgically and histologically proved diagnosis of endometriosis,with an incidence of 0.132%.Nine out of 10 patients were extrinsic ureteral endometriosis and concomitant with severe pelvic endometriosis,and the other was intrinsic ureteral endometriosis.Hormone therapy failed in 2 patients with urinary tract obstruction.Ureterolysis was performed in 6 patients and ureterectomy was performed in 4 patients.One ease of ureteral recurrence was observed in a postmenopausal woman without hormonal replacement therapy who received laparoscopic ureterolysis and hysterectomy with bilateral adnexectomy.No relapse was observed in the other 9 patients.Conclusions Ureteral endometriosis is a rare entity.The upper urinary tract should be evaluated in patients with severe endometriosis,even in postmenopausal women.The treatment of ureteral endometriosis usually requires surgery,while ureterolysis should not be performed in patients with extensive disease.As a form of adjuvant therapy of surgery,hormonal therapy is an appropriate option.

  9. Laparoscopic conservative management of ureteral endometriosis: a survey of eighty patients submitted to ureterolysis

    Science.gov (United States)

    Camanni, Marco; Bonino, Luca; Delpiano, Elena Maria; Berchialla, Paola; Migliaretti, Giuseppe; Revelli, Alberto; Deltetto, Francesco

    2009-01-01

    Background this study aims to evaluate the effectiveness and safety of laparoscopic conservative management of ureteral endometriosis. Methods Eighty cases of histologically confirmed endometriosis affecting the ureter, 10 of which with bladder involvement were prospectively studied. In detail, patients were 13 women with ureteral stenosis (7 with hydronephrosis), 32 with circular lesions totally encasing the ureter, and 35 with endometriotic foci on the ureteral wall, but not completely encasing it. They were submitted to laparoscopic ureterolysis with or without partial cystectomy, ureteroneocistostomy. The rate of surgical complications, the recurrence rate, the patients' satisfaction rate was assessed during 22 months (median) follow-up. Results Laparoscopic ureterolysis was employed for all patients and set free the ureter from the disease in 95% of cases, whereas ureteroneocystostomy was necessary for 4 patients showing severe stenosis with hydronephrosis, among which 2 had intrinsic endometriosis of the ureteral muscularis. Three post-surgery ureteral fistulae occurred in cases with ureteral involvement longer than 4 cm: two cases were successfully treated placing double J catheter, the third needed ureteroneocistostomy. During follow-up, ureteral endometriosis recurred in 2 patients who consequently underwent ureteroneocystostomy. Most patients expressed high satisfaction rate throughout the whole follow-up period. Conclusion laparoscopic ureterolysis is effective and well tolerated in most cases of ureteral endometriosis. Ureteroneocystostomy is a better strategy for patients with extended (more than 4 cm) ureteral involvement or with severe stenosis with or without hydronephrosis. PMID:19818156

  10. Laparoscopic conservative management of ureteral endometriosis: a survey of eighty patients submitted to ureterolysis

    Directory of Open Access Journals (Sweden)

    Migliaretti Giuseppe

    2009-10-01

    Full Text Available Abstract Background this study aims to evaluate the effectiveness and safety of laparoscopic conservative management of ureteral endometriosis. Methods Eighty cases of histologically confirmed endometriosis affecting the ureter, 10 of which with bladder involvement were prospectively studied. In detail, patients were 13 women with ureteral stenosis (7 with hydronephrosis, 32 with circular lesions totally encasing the ureter, and 35 with endometriotic foci on the ureteral wall, but not completely encasing it. They were submitted to laparoscopic ureterolysis with or without partial cystectomy, ureteroneocistostomy. The rate of surgical complications, the recurrence rate, the patients' satisfaction rate was assessed during 22 months (median follow-up. Results Laparoscopic ureterolysis was employed for all patients and set free the ureter from the disease in 95% of cases, whereas ureteroneocystostomy was necessary for 4 patients showing severe stenosis with hydronephrosis, among which 2 had intrinsic endometriosis of the ureteral muscularis. Three post-surgery ureteral fistulae occurred in cases with ureteral involvement longer than 4 cm: two cases were successfully treated placing double J catheter, the third needed ureteroneocistostomy. During follow-up, ureteral endometriosis recurred in 2 patients who consequently underwent ureteroneocystostomy. Most patients expressed high satisfaction rate throughout the whole follow-up period. Conclusion laparoscopic ureterolysis is effective and well tolerated in most cases of ureteral endometriosis. Ureteroneocystostomy is a better strategy for patients with extended (more than 4 cm ureteral involvement or with severe stenosis with or without hydronephrosis.

  11. Conservative management in ureteric hydronephrosis due to deep endometriosis: Could the levonorgestrel-intrauterine device be an option?

    Science.gov (United States)

    Simón, Elisa; Tejerizo, Álvaro; Muñoz, José Luis; Álvarez, Carmen; Marqueta, Laura; Jiménez, Jesús S

    2017-07-01

    Endometriosis can affect up to 10% of women of reproductive age, in a wide range of clinical presentations that vary from mild to severe or deep endometriosis. Deep endometriosis can affect the urinary tract in 1-5% to 15-25% cases. Even though deep endometriosis' surgeries are usually complex with higher rate of complications, conservative management is not always considered as an option because of its high failure rates. This paper describes two cases of deep endometriosis with ureteric involvement (hydronephrosis) treated conservatively with a double-pigtail stent plus a Levonorgestrel intrauterine device, after conservative surgery, who remained symptom free with no evidence of recurrence at 3 years follow-up, avoiding radical high-risk surgery. Impact statement Several treatments have been described for endometriosis. From a symptomatic perspective, conservative medical management has been proposed with a variable response. Concerning deep endometriosis (affecting the urinary or digestive tract), the definitive treatment has always been thought to be radical surgery. However, this can lead to several complications. To illustrate a possible more conservative approach this paper describes two cases of deep infiltrating endometriosis affecting the ureter, treated conservatively with a temporary pigtail ureter stent plus a Levonorgestrel intrauterine device. The management demonstrates that, in a selected population, conservative treatment solves the urinary disease avoiding the surgical complications and, what is more, improving patients' symptoms in a permanent way. Further prospective studies are needed to confirm whether the introduction of this management in clinical practice would reduce the need for surgery thereby, avoiding high-risk surgery and improving the success rate of conservative management.

  12. Detection and localization of deep endometriosis by means of MRI and correlation with the ENZIAN score

    Energy Technology Data Exchange (ETDEWEB)

    Di Paola, V., E-mail: dipaola.valerio@libero.it; Manfredi, R.; Castelli, F.; Negrelli, R.; Mehrabi, S.; Pozzi Mucelli, R.

    2015-04-15

    Highlights: •The accuracy of MRI for deep endometriosis was 95%. •The agreement between histopathological and MRI ENZIAN score was excellent (k = 0.824). •The highest agreement was for adenomyosis (1.000) and lesions of utero-sacral ligaments (0.890). •MRI ENZIAN score allows to obtain a correct preoperative staging of deep endometriosis. -- Abstract: Purpose: To determine the accuracy of ENZIAN score, as detected on MR imaging, compared to surgical-pathologic findings. Materials and methods: This retrospective study was approved by the investigational review board and the requirement for informed patient consent was waived. 115 patients were included according to following criteria: tubo-ovarian and/or deep endometriosis suspected at physical examination and transvaginal ultrasound; availability of MR examination; histopathological results from laparoscopic or surgical treatment. Exclusion criteria: lack of available MR examination, and/or (b) lack of a definitive histopathological results. Histopathological findings from bioptic specimens obtained during laparoscopic or laparotomic treatment were considered as reference standard. For all detected lesions a score according to ENZIAN score (revised 2010) was assigned both for MRI and histopathological findings. By comparing MRI-ENZIAN score and histopathological-ENZIAN score the overall sensitivity, specificity, accuracy, positive and negative predictive values in relation to presence/absence of deep endometriosis in each patient were calculated. k-Cohen to evaluate the degree of concordance between MRI-ENZIAN score and histopathological-ENZIAN score was also measured. Moreover the sensitivity, specificity, accuracy, positive and negative predictive values for each specific localization provided by ENZIAN score were also calculated. Results: At histopathology, the diagnosis of deep endometriosis was confirmed in 82/115 (71.3%) patients. The sensitivity, specificity, accuracy, PPV and NPV of MRI were 94%, 97

  13. First Report of Preoperative Imaging Diagnosis of a Surgically Confirmed Case of Valentino′s Syndrome

    Directory of Open Access Journals (Sweden)

    Parag Suresh Mahajan

    2014-01-01

    Full Text Available Perforation of a duodenal ulcer (DU into the retroperitoneal space presenting with clinical features of acute appendicitis is known as Valentino′s syndrome. Post duodenal perforation, the gastric and duodenal fluids tend to settle in the right paracolic gutter causing peritonitis and clinically mimicking acute appendicitis. Only three cases of Valentino′s syndrome have been reported till date in the published literature and there is only one previous report of its preoperative imaging diagnosis. To our knowledge, this is the first reported case of preoperative imaging diagnosis in a surgically confirmed case of Valentino′s syndrome. In most cases, patients with undiagnosed Valentino′s syndrome are operated for acute appendicitis, and on finding a normal appendix, search is made for the cause of peritonitis, which then leads to retroperitoneal perforation of duodenum. The diagnosis of Valentino′s syndrome by computed tomography (CT imaging is easy and can help in avoiding the surgery or directing the surgeon directly to the repair of the duodenal perforation. It is, therefore, essential for emergency physicians, surgeons, and radiologists to know about this entity and consider it in the differential diagnosis.

  14. Blood biomarkers for the non-invasive diagnosis of endometriosis

    NARCIS (Netherlands)

    Nisenblat, Vicki; Bossuyt, Patrick M. M.; Shaikh, Rabia; Farquhar, Cindy; Jordan, Vanessa; Scheffers, Carola S.; Mol, Ben Willem J.; Johnson, Neil; Hull, M. Louise

    2016-01-01

    Background About 10% of reproductive-aged women suffer from endometriosis, a costly chronic disease causing pelvic pain and subfertility. Laparoscopy is the gold standard diagnostic test for endometriosis, but is expensive and carries surgical risks. Currently, there are no non-invasive or minimally

  15. MANAGEMENT OF ENDOMETRIOSIS IN TWO CAPTIVE MANDRILLS (MANDRILLUS SPHINX).

    Science.gov (United States)

    Okeson, Danelle M; Higbie, Christine T; Mylniczenko, Natalie D; Haynes, April; Bennett, Suzanne; Klocke, Emily; Carpenter, James W

    2016-06-01

    Endometriosis has been reported in humans, great apes, and Old World monkeys. Although cases are noted anecdotally in Mandrillus spp., and a previously reported case was noted on postmortem examination, to the authors' knowledge, no previous reports of case management have been published in the peer-reviewed literature. This paper describes the medical and surgical management of endometriosis in two mandrills (Mandrillus sphinx).

  16. In vitro fertilization for endometriosis-associated infertility.

    Science.gov (United States)

    Polat, Mehtap; Yaralı, İrem; Boynukalın, Kübra; Yaralı, Hakan

    2015-08-01

    Endometriosis is an enigmatic disease affecting 10-15% of reproductive aged women and is encountered in 25-35% of women suffering from infertility. IVF is an effective tool to overcome endometriosis-associated infertility when expectant management or surgery fails. Direct IVF should be envisioned if the female age is greater than 38 year and infertility is long lasting. Likewise, semen characteristics or tubal status that is incompatible with natural conception mandates going straight to IVF. IVF, not only bypasses the distortion of pelvic anatomy associated with advanced stage endometriosis, but also removes gametes from a hostile peritoneal environment. In this article, we address the impact, if any, of endometriosis and endometriomason IVF outcome, whether surgical treatment of early-stage disease, endometriomas or deep infiltrating endometriosis would enhance pregnancy rates in IVF, which protocol to employ for controlled ovarian hyperstimulation for IVF and finally the impact, if any, of controlled ovarian hyperstimulation for IVF on progression of endometriosis.

  17. Treatment of endometriosis: a hormonal approach.

    Science.gov (United States)

    Budinetz, T; Sanfilippo, J S

    2010-08-01

    Endometriosis continues to plague women of reproductive age. It is a chronic disease leading to a decreased quality of life, infertility, and increased societal costs. The gold standard for diagnosis remains visualization and or biopsy of lesions at the time of intraoperative diagnosis, i.e. laparoscopy or laparotomy. The severity of pain does not correlate with the stage of endometriosis, which complicates the treatment process. Hormonal therapies have long been used as a treatment for endometriosis. Therapy is targeted at symptom relief as a cure is lacking. While some regimes use hormonal therapy exclusively, others combine such with surgical excision of lesions. Although hormonal modalities are successful in alleviating or suppressing symptoms, they fail to treat the infertility associated with endometriosis. Therefore, those, desiring to achieve pregnancy should be excluded from hormonal treatment in the short term. Future studies are needed to understand the pathophysiology and allow design of specific, targeted treatment.

  18. Evaluation of Risk Factors Associated with Endometriosis in Infertile Women

    Science.gov (United States)

    Ashrafi, Mahnaz; Sadatmahalleh, Shahideh Jahanian; Akhoond, Mohammad Reza; Talebi, Mehrak

    2016-01-01

    Background Endometriosis affects women’s physical and mental wellbeing. Symptoms include dyspareunia, dysmenorrhea, pelvic pain, and infertility. The purpose of this study is to assess the correlation between some relevant factors and symptoms and risk of an endometriosis diagnosis in infertile women. Materials and Methods A retrospective study of 1282 surgical patients in an infertility Institute, Iran between 2011 and 2013 were evaluated by laparoscopy. Of these, there were 341 infertile women with endometriosis (cases) and 332 infertile women with a normal pelvis (comparison group). Chi-square and t tests were used to compare these two groups. Logistic regression was done to build a prediction model for an endometriosis diagnosis. Results Gravidity [odds ratio (OR): 0.8, confidence interval (CI): 0.6-0.9, P=0.01], parity (OR: 0.7, CI: 0.6-0.9, P=0.01), family history of endometriosis (OR: 4.9, CI: 2.1-11.3, Pgalactorrhea (OR: 2.3, CI: 1.5-3.5, P=0.01), history of pelvic surgery (OR: 1.9, CI: 1.3-2.7, P0.05). Fatigue, diarrhea, constipation, dysmenorrhea, dyspareunia, pelvic pain and premenstrual spotting were more significant among late-stage endometriosis patients than in those with early-stage endometriosis and more prevalent among patients with endometriosis than that of the comparison group. In the logistic regression model, gravidity, family history of endometriosis, history of galactorrhea, history of pelvic surgery, dysmenorrhoea, pelvic pain, dysparaunia, premenstrual spotting, fatigue, and diarrhea were significantly associated with endometriosis. However, the number of pregnancies was negatively related to endometriosis. Conclusion Endometriosis is a considerable public health issue because it affects many women and is associated with the significant morbidity. In this study, we built a prediction model which can be used to predict the risk of endometriosis in infertile women. PMID:27123195

  19. Evaluation of Risk Factors Associated with Endometriosis in Infertile Women

    Directory of Open Access Journals (Sweden)

    Mahnaz Ashrafi

    2016-05-01

    Full Text Available Background: Endometriosis affects women’s physical and mental wellbeing. Symptoms include dyspareunia, dysmenorrhea, pelvic pain, and infertility. The purpose of this study is to assess the correlation between some relevant factors and symptoms and risk of an endometriosis diagnosis in infertile women. Materials and Methods: A retrospective study of 1282 surgical patients in an infertility Institute, Iran between 2011 and 2013 were evaluated by laparoscopy. Of these, there were 341 infertile women with endometriosis (cases and 332 infertile women with a normal pelvis (comparison group. Chi-square and t tests were used to compare these two groups. Logistic regression was done to build a prediction model for an endometriosis diagnosis. Results: Gravidity [odds ratio (OR: 0.8, confidence interval (CI: 0.6-0.9, P=0.01], parity (OR: 0.7, CI: 0.6-0.9, P=0.01, family history of endometriosis (OR: 4.9, CI: 2.1-11.3, P0.05. Fatigue, diarrhea, constipation, dysmenorrhea, dyspareunia, pelvic pain and premenstrual spotting were more significant among late-stage endometriosis patients than in those with early-stage endometriosis and more prevalent among patients with endometriosis than that of the comparison group. In the logistic regression model, gravidity, family history of endometriosis, history of galactorrhea, history of pelvic surgery, dysmenorrhoea, pelvic pain, dysparaunia, premenstrual spotting, fatigue, and diarrhea were significantly associated with endometriosis. However, the number of pregnancies was negatively related to endometriosis. Conclusion: Endometriosis is a considerable public health issue because it affects many women and is associated with the significant morbidity. In this study, we built a prediction model which can be used to predict the risk of endometriosis in infertile women.

  20. Medical treatments for endometriosis.

    Science.gov (United States)

    Kappou, D; Matalliotakis, M; Matalliotakis, I

    2010-10-01

    Despite the extensive research, endometriosis remains an enigmatic disease as up to now there is no consensus regarding the exact underlying mechanisms which could explain its development and progress. A local environment enriched in estrogens, progesterone resistance, local inflammatory response and multiple other molecular alterations appear to be pivotal events in the establishment and development of ectopic tissue. In the light of the evidence produced by molecular pathology research, in vivo and in vitro studies, modifications in current treatment options are anticipated. Current management of endometriosis is based on pharmacologic treatment and surgical intervention. In particular, combined oral contraceptives, danazol, gonadotropin-releasing hormone (GnRH) analogues and progestins have been extensively used in clinical practice. Novel agents that will hopefully improve the therapeutic potential include aromatase inhibitors, immunomodulators, anti-inflammatory agents, steroids receptor modulators and GnRH antagonists. It is still early for enthusiasm as there is limited knowledge about their short- and long-term side effects, their optimal administration route, their selectivity towards their target genes and the duration of treatment. Although there is a continual report of novel findings, the application of them in clinical practice is a long-lasting procedure requiring longitudinal clinical trials so as to achieve a balance between efficacy and safety.

  1. ENDOMETRIOSIS WITH LYMPHATIC SPREAD

    Directory of Open Access Journals (Sweden)

    Narmadha

    2014-10-01

    Full Text Available Pelvic endometriosis is a common gynaecologic problem. But the histogenesis of endometriosis was not so clear. Various theories have been proposed by Pathologist in the past. Here we present a case of endometriosis of fallopian tube by lymphatic spread which has been proved histopathologically

  2. Towards endometriosis diagnosis by gadofosveset-trisodium enhanced magnetic resonance imaging.

    Directory of Open Access Journals (Sweden)

    Marc H Schreinemacher

    Full Text Available Endometriosis is defined as the presence of endometrial tissue outside the uterus. It affects 10-15% of women during reproductive age and has a big personal and social impact due to chronic pelvic pain, subfertility, loss of work-hours and medical costs. Such conditions are exacerbated by the fact that the correct diagnosis is made as late as 8-11 years after symptom presentation. This is due to the lack of a reliable non-invasive diagnostic test and the fact that the reference diagnostic standard is laparoscopy (invasive, expensive and not without risks. High-molecular weight gadofosveset-trisodium is used as contrast agent in Magnetic Resonance Imaging (MRI. Since it extravasates from hyperpermeable vessels more easily than from mature blood vessels, this contrast agent detects angiogenesis efficiently. Endometriosis has high angiogenic activity. Therefore, we have tested the possibility to detect endometriosis non-invasively using Dynamic Contrast-Enhanced MRI (DCE-MRI and gadofosveset-trisodium as a contrast agent in a mouse model. Endometriotic lesions were surgically induced in nine mice by autologous transplantation. Three weeks after lesion induction, mice were scanned by DCE-MRI. Dynamic image analysis showed that the rates of uptake (inwash, persistence and outwash of the contrast agent were different between endometriosis and control tissues (large blood vessels and back muscle. Due to the extensive angiogenesis in induced lesions, the contrast agent persisted longer in endometriotic than control tissues, thus enhancing the MRI signal intensity. DCE-MRI was repeated five weeks after lesion induction, and contrast enhancement was similar to that observed three weeks after endometriosis induction. The endothelial-cell marker CD31 and the pericyte marker α-smooth-muscle-actin (mature vessels were detected with immunohistochemistry and confirmed that endometriotic lesions had significantly higher prevalence of new vessels (CD31 only

  3. The Assessment of reliability and validity of Persian Version of the Endometriosis Health Profile (EHP-30

    Directory of Open Access Journals (Sweden)

    Marzieh Nojomi

    2011-06-01

    Full Text Available Background: The Endometriosis Health Profile-30 (EHP-30 is a disease-specific questionnaire to measure the health-related quality of life in patients with endometriosis. The aim of this study was to evaluate the validity and reliability of the Persian version of Endometriosis Health Profile (EHP-30 in women with endometriosis referring to three Gynecology Clinics in Tehran, Iran. Methods: One hundred women (20 to 50 years old with surgically confirmed endometriosis recruited from three outpatient Gynecology Clinics affiliated to the Iran University of Medical Sciences. All 100 patients were asked to complete EHP-30 questionnaire while referring to the Clinics. The findings were analyzed using descriptive statistics, internal reliability consistency, construct validity (using short form-36, which had already been validated in Iran, factor analysis (with principle component analysis method, and item total correlation to assess the validity and reliability of the questionnaire. Results: The internal consistency reliability of the questionnaire was high (Cronbach’s α ranged between 0.80 and 0.93 for core, and 0.78 and 0.90 for modular parts. All items were loaded on their own factors except item 17 (feeling aggressive or violent and item 18 (feeling unwell, which were loaded on pain and social support domains, respectively. Construct validity of EHP-30, established by using SF-36, indicates good correlations in several similar scales of these two questionnaires. Conclusion: The findings of the study demonstrate that Persian version of EHP-30 is a valid and reliable measure to assess the quality of life in women with endometriosis

  4. Pharmacological treatment and regional anesthesia techniques for pain management after completion of both conservative and surgical treatment of endometriosis and pelvic adhesions in women with chronic pelvic pain as a mandated treatment strategy

    Directory of Open Access Journals (Sweden)

    Małgorzata Malec-Milewska

    2015-05-01

    Full Text Available Introduction. Chronic pelvic pain syndrome occurs in 4–14% of women. Pain pathomechanism in this syndrome is complex, as it is common to observe the features of nociceptive, inflammatory, neuropathic and psychogenic pain. The common findings in women with pelvic pain are endometriosis and pelvic adhesions. Objective. Aim of the study was to test the effectiveness of pharmacological treatment and regional anesthesia techniques for pain control as the next step of treatment after the lack of clinical results of surgical and pharmacological methods normally used in the management of endometriosis and pelvic adhesions. Materials and method. 18 women were treated between January 2010 – October 2013 in the Pain Clinic of the Department of Anaesthesiology and Intensive Care at the Centre for Postgraduate Education in Warsaw due to chronic pelvic pain syndrome related to either endometriosis or pelvic adhesions. During the previous step of management, both conservative and surgical treatments were completed without achieving satisfactory results. Initial constant pain severity was 3–9 points on the Numeric Rating Scale, while the reported paroxysmal pain level was 7–10. The pharmacological treatment implemented was based on oral gabapentinoids and antidepressants, aided by neurolytic block of ganglion of Walther, pudendal nerve blocks and topical treatment (5% lidocaine, 10% amitriptyline, 10% gabapentin. Results. In 17 women, a significant reduction of both constant and paroxysmal pain was achieved, of which complete and permanent cessation of pain occurred in 6 cases. One patient experienced no improvement in the severity of her symptoms. Conclusions. The combination of pain management with pharmacological treatment, pudendal nerve blocks, neurolysis of ganglion impar (Walther and topical preparations in cases of chronic pelvic pain syndrome seems to be adequate medical conduct after failed or otherwise ineffective causative therapy.

  5. Polymorphisms in exons 1B and 1C of the type I interleukin-1 receptor gene in patients with endometriosis.

    Science.gov (United States)

    D'Amora, Paulo; Sato, Hélio; Girão, Manoel J B C; Silva, Ismael D C G; Schor, Eduardo

    2006-09-01

    To study possible correlation between the prevalence of polymorphisms in the type I interleukin-1 receptor gene and pelvic endometriosis. Genotypes of 223 women were analyzed: 109 women with surgically and histologically confirmed endometriosis and 114 healthy women. Distributions of two single-base polymorphisms of the human interleukin-1 receptor type I (IL-1RI) gene were evaluated: PstI, due to a C-->T transition in exon 1B and BsrBI a C-->A transition at position 52 in exon 1C. Polymorphisms were detected by polymerase chain reaction (PCR) followed by restriction fragment length polymorphism analysis (RFLP) resolved on 3% agarose gels stained with ethidium bromide. Genotypes for PstI polymorphisms did not differ significantly among control and endometriosis (P = 0.058). However, in relation to BsrBI polymorphism, protective risk was observed for the development of endometriosis [OR 0.39-IC 95% (0.2-0.9)]. BsrBI heterozygote genotype (C/A) showed protective effect against endometriosis development.

  6. Visible and occult microscopic lesions of endometriosis

    Directory of Open Access Journals (Sweden)

    Khaleque Newaz Khan

    2014-11-01

    Full Text Available Endometriosis is a multifactorial disease mostly affecting women of reproductive age and is associated with chronic pelvic pain and infertility. Even after 300 years, most of the literature claims that pathogenesis and/or pathophysiology of endometriosis is still elusive. Recurrence of pain and lesion continues to occur after effective medical or surgical therapies. Once generated within the pelvis due to retrograde entry of menstrual debris, peritoneal endometriotic lesions time-dependently change their color appearance resulting from certain biochemical change within lesions. A variable pattern of endometriotic lesions within the pelvis can be detected by laparoscopy as visible peritoneal endometriosis. It is generally believed that besides ovarian steroid hormones, the growth of endometriosis can be regulated by the innate immune system in the pelvic microenvironment by their interaction with endometrial cells and immune cells. Even with the careful eyes of an expert surgeon, we may sometimes miss detecting peritoneal lesion within the peritoneal cavity or deep into the peritoneum. In such a case, random collection of normal peritoneum may carry the possibility to identify some hidden endometriotic lesions by microscopy and these lesions can be named as occult (invisible microscopic endometriosis (OME. Here, we discuss the color appearance of peritoneal lesions and activity of these lesions by analysis of a panel of activity markers. Finally we discuss our recent findings on OME, their biological and clinical significance, and try to make a possible link in the origin between visible endometriosis and OME.

  7. [Endometriosis and surviving adolescence].

    Science.gov (United States)

    Belaisch, J; Allart, J-P

    2006-03-01

    Endometriosis is a recurrent and painful disease which sometimes disturbs severely the quality of life of women who suffer from it. It is then logical to include a psychological back-up to its medical and surgical treatment. Nevertheless this support is not often offered to patients. One can hypothesize another and completely different way of seeing the problem: the mood swings and depression of endometriotic patients could possibly be, at least in some of them, the cause of the graft of endometrial cells and not the effect of pain and infertility. The mechanism of the development of endometriotic lesions could be related to a lowering of immune defences due to an alteration of the psycho-neuro-endocrino-immunologic network, resulting from difficult life experiences which mostly happen during adolescence. This concept may have beneficial effects for the patient whose case would be more understood in depth. But very few medical teams consider it worthwhile to include in their practices.

  8. Severe teenage acne and risk of endometriosis.

    Science.gov (United States)

    Xie, Jing; Kvaskoff, Marina; Li, Yunhui; Zhang, Mingfeng; Qureshi, Abrar A; Missmer, Stacey A; Han, Jiali

    2014-11-01

    Is there a relationship between severe teenage acne and endometriosis? Endometriosis is positively associated with severe teenage acne. No studies have specifically explored a possible association between severe acne in adolescence and risk of endometriosis. This prospective cohort study used data collected from 88 623 female nurses from September 1989 to June 2009 as part of the Nurses' Health Study II (NHS II) cohort. Regression models were used to calculate hazard ratios (HRs) and confidence intervals (CIs) for endometriosis among women with and without severe teenage acne. Multivariate models were adjusted for established risk factors of endometriosis. A total of 4 382 laparoscopically confirmed endometriosis cases were documented during 1 132 272 woman-years of follow-up. Compared with women without a history of severe teenage acne, women who had severe teenage acne had a 20% increased risk of endometriosis (HR = 1.20, 95% CI: 1.08-1.32). The association was not affected by adjusting for use of tetracycline or isotretinoin. The HR is likely to be underestimated since we only included endometriosis cases confirmed by laparoscopy. Although geographically diverse, the NHS II cohort is primarily Caucasian, which may limit generalization to more ethnically diverse populations. The results of this study suggest that severe teenage acne is associated with an increased risk of endometriosis. As a visible and non-invasive clinical indicator, severe teenage acne may be useful for early detection of endometriosis. We bring this counter-intuitive association to the attention of clinicians for the benefit of the patient and an early diagnosis of endometriosis. This study was funded by research grant CA176726 from the National Institute of Health. M.K. is supported by a Marie Curie International Outgoing Fellowship within the 7th European Community Framework Programme (#PIOF-GA-2011-302078). The funding agencies had no role in the design of the study, in the analysis and

  9. Increased levels of dioxin-like substances in adipose tissue in patients with deep infiltrating endometriosis.

    Science.gov (United States)

    Martínez-Zamora, M A; Mattioli, L; Parera, J; Abad, E; Coloma, J L; van Babel, B; Galceran, M T; Balasch, J; Carmona, F

    2015-05-01

    Are the levels of biologically active and the most toxic dioxin-like substances in adipose tissue of patients with deep infiltrating endometriosis (DIE) higher than in a control group without endometriosis? DIE patients have higher levels of dioxins and polychlorinated biphenyls (PCBs) in adipose tissue compared with controls without endometriosis. Some studies have investigated the levels of dioxin-like substances, in serum samples, in patients with endometriosis, with inconsistent results. Case-control study including two groups of patients. The study group (DIE group) consisted of 30 patients undergoing laparoscopic surgery because of DIE. In all patients, an extensive preoperative work-up was performed including clinical exploration, magnetic resonance imaging (MRI) and transvaginal sonography. All patients with DIE underwent a confirmatory histological study for DIE after surgery. The non-endometriosis control group (control group), included the next consecutive patient undergoing laparoscopic surgery in our center due to adnexal benign gynecological disease (ovarian or tubal procedures other than endometriosis) after each DIE patient, and who did not present any type of endometriosis. During the surgical procedure 1-2 g of adipose tissue from the omentum were obtained. Dioxin-like substances were analyzed in adipose tissue in DIE patients and controls without endometriosis. The total toxic equivalence and concentrations of both dioxins and PCBs were significantly higher in patients with DIE in comparison with the control group (P dioxins (2,3,7,8-tetrachlorodibenzo-p-dioxin [2,3,7,8-TCDD] and 1,2,3,7,8-pentachlorodibenzo-p-dioxin [1,2,3,7,8-PeCDD]) (P dioxins and PCBs widely vary in different countries. Furthermore, the strict eligibility criteria used may preclude generalization of the results to other populations and the surgery-based sampling frame may induce a selection bias. Finally, adipose tissue was obtained only from the omentum, and not from other

  10. [Endometriosis: physiopathology and investigation trends (first part)].

    Science.gov (United States)

    Ayala Yánez, Rodrigo; Mota González, Manuel

    2007-08-01

    Until today endometriosis continues to be a diagnostic challenge since the only way to confirm a diagnosis, based on clinical criteria, is through direct visualization of the endometriosis lesions. This has a direct impact in the development of proper statistics on the incidence and prevalence of endometriosis. Current research has been focused on the basis of the Retrograde Menstruation theory, establishing the involvement of various biochemical, immunologic and molecular factors within the physiopathology of endometriosis. The development of endometriosis has been divided into 5 basic processes: adhesion, invasion, recruiting, angiogenesis and proliferation, here, we have revised the first two due to the importance they potentially contain with regards to diagnosis and therapy. Research on adhesion has led to studies on the peritoneal epithelium structure, the role of integrins, intercellular adhesion molecules (ICAM), cadherins and hyaluronic acid; invasiveness has led to the study of the tumor necrosis factor alpha (TNF-alpha), various protocols on metaloproteinases and their inhibitors as well as their interactions and response to sexual steroids, tumor growth factor beta (TGF-beta), interleukins and metalloproteinase polymorphisms. These advances have been crucial, though various observations leads us to believe that the etiology is multifactorial, there are factors whose antagonists, inhibitors or suppressors may actually have a role as molecular markers or therapeutic agents of endometriosis.

  11. The actual role of robotics in the management of endometriosis.

    Science.gov (United States)

    Cela, Vito; Obino, Maria E; Sergiampietri, Claudia; Simi, Giovanna; Papini, Francesca; Pinelli, Sara; Freschi, Letizia; Artini, Paolo G

    2017-03-07

    The advent of robot-assisted laparoscopy (RAL) represents an important innovation and has opened new perspectives for treatment of endometriosis, in particular in deep infiltrating endometriosis (DIE). RAL could offer several technical advantages in treating this complex disease, such as 3D vision, tremor filtration and better surgical ergonomy, would be able to improve surgical performances without increasing in surgical time, blood loss, intra- and postoperative complications and it reduces the rates of conversion to laparotomy. Additionally thanks to its reduced learning curve compared to conventional laparoscopy, facilitates the training of less experienced surgeons. For these reason DIE might be one of the best indications for robot assisted laparoscopy in gynecologic surgery. However, very few retrospective studies, small cases series and only a randomized clinical trial were reported. Further randomized control trial comparing CL to RAL for different stage of endometriosis and the different type of procedure performed would be mandatory in order to define potential benefits of RAL for endometriosis surgery.

  12. Acupuncture for pain in endometriosis

    Directory of Open Access Journals (Sweden)

    Xiaoshu Zhu

    Full Text Available BACKGROUND: Endometriosis is a prevalent gynaecological condition, significantly affecting women's lives. Clinical presentations may vary from absence of symptoms to complaints of chronic pelvic pain, most notably dysmenorrhoea. The management of pain in endometriosis is currently inadequate. Acupuncture has been studied in gynaecological disorders but its effectiveness for pain in endometriosis is uncertain. OBJECTIVE: To determine the effectiveness and safety of acupuncture for pain in endometriosis. METHODS: Search methods: We searched the Cochrane Menstrual Disorders and Subfertility Group (MSDG Specialized Register of controlled trials, Cochrane Central Register of Controlled Trials (CENTRAL (The Cochrane Library, MEDLINE, EMBASE, CINAHL, AMED, PsycINFO, CNKI and TCMDS (from inception to 2010 and reference lists of retrieved articles. Selection criteria: Randomized single or double-blind controlled trials enrolling women of reproductive age with a laparoscopically confirmed diagnosis of endometriosis and comparing acupuncture (body, scalp or auricular to either placebo or sham, no treatment, conventional therapies or Chinese herbal medicine. Data collection and analysis: Three authors independently assessed risk of bias and extracted data; we contacted study authors for additional information. Meta-analyses were not performed as only one study was included. The primary outcome measure was decrease in pain from endometriosis. Secondary outcome measures included improvement in quality of life scores, pregnancy rate, adverse effects and rate of endometriosis recurrence. MAIN RESULTS: Twenty-four studies were identified that involved acupuncture for endometriosis; however only one trial, enrolling 67 participants, met all the inclusion criteria. The single included trial defined pain scores and cure rates according to the Guideline for Clinical Research on New Chinese Medicine. Dysmenorrhoea scores were lower in the acupuncture group (mean

  13. Multicystic mesothelioma with endometriosis.

    Science.gov (United States)

    Groisman, G M; Kerner, H

    1992-12-01

    A multicystic mesothelioma of the omentum in a 36 year old woman consisted of a multicystic mass with foci of typical endometriosis and 'necrotic pseudoxanthomatous nodules'. The presence of endometriosis within multicystic mesothelioma has never been reported. Our findings support the hypothesis that endometriosis plays a rôle in the pathogenesis of multicystic mesothelioma and that this is a reactive rather than a neoplastic lesion.

  14. Successful pregnancy after excision of cesarean scar endometriosis with uterovesicocutaneous fistula: A rare case report

    Science.gov (United States)

    Juneja, Sunil Kumar; Tandon, Pooja; Chopra, Isha

    2016-01-01

    Scar endometriosis is an infrequent type of extrapelvic endometriosis. The most common extrapelvic form of endometriosis is cutaneous endometriosis, involving scar tissues occurring after obstetric or gynecologic procedures such as episiotomy, hysterotomy, cesarean section, and even laparoscopic surgery. The clinical presentation of scar endometriosis, i.e., tender swellings, mimics other dermatological and/or surgical conditions and delays the diagnosis. Scar endometriosis very rarely can get complicated with uterocutaneous fistula with a reported incidence of very few cases in world literature. We report a case of a 36-year-old woman presenting with scar endometriosis with complicated uterocutaneous fistula 11 years after her last lower segment cesarean section, managed successfully with laparotomy-fistulectomy and sleeve resection of the bladder with repair followed by successful subsequent spontaneous conception and pregnancy terminated by lower segment cesarean section. PMID:27857904

  15. Endometriosis after menopause.

    Science.gov (United States)

    Inceboz, Umit

    2015-08-01

    Endometriosis is a common but an enigmatic disease in which endometrial glands and stroma are found outside the uterus. Worldwide, 80 million women are affected by the disease. It has generally been accepted as a problem of reproductive ages and affects 6-10% of those women. It is more common in women with infertility. Moreover, since it is an estrogen dependent problem, it is generally believed that endometriosis connotes 'active ovarian function' and is 'healed' after the menopause. However, there are reports on endometriosis beyond the reproductive ages. In this article, endometriosis after the menopause will be discussed.

  16. Subaxial cervical synovial cysts: report of 35 histologically confirmed surgically treated cases and review of the literature.

    Science.gov (United States)

    Lyons, Mark K; Birch, Barry D; Krauss, William E; Patel, Naresh P; Nottmeier, Eric W; Boucher, Orland K

    2011-09-15

    Retrospective study The authors' aim of the present study is to report their experience with subaxial cervical synovial cysts hoping to provide further insight into these lesions including the presenting symptoms, possible mechanisms of cyst development associated with cervical level, surgical treatments and clinical outcomes. Synovial cysts are relatively common in the lumbar spine and very uncommonly identified in the subaxial cervical spine. Several case reports and a few small series have been reported in the literature over the past four decades. The authors retrospectively reviewed the cases of 35 patients who underwent surgical treatment for histologically confirmed symptomatic subaxial cervical synovial cysts between 1993 and 2009. The presenting symptoms, age, sex, cervical level, operation, complications and outcomes were analyzed in this cohort. Preoperative and postoperative neurologic assessments were done by staff neurologists independent of the operating surgeon. This study was approved by the Mayo Clinic institutional review board. Thirty-five patients underwent surgical treatment for their synovial cysts and follow-up for at least 12 months postoperatively. The mean follow-up time was 49 months (range, 12-134). There were no deaths associated with the surgery. There was one postoperative infection in a patient undergoing a decompressive laminectomy and posterior instrumented fusion. Patient outcomes were assessed using the Modified Rankin Score for 12 patients was 0, 17 patients was 1, 4 patients was 2, and 2 patients was 3. This series of 35 patients with subaxial cervical synovial cysts surgically treated over a period of 17 years illustrates the relative rarity of these lesions. Magnetic resonance imaging is currently the optimal radiographic study to identify these lesions. Surgical resection can be an effective treatment.

  17. Magnetic resonance imaging of pelvic endometriosis.

    Science.gov (United States)

    Méndez Fernández, R; Barrera Ortega, J

    Endometriosis is common in women of reproductive age; it can cause pelvic pain and infertility. It is important to diagnose endometriosis and to thoroughly evaluate its extension, especially when surgical treatment is being considered. Magnetic resonance imaging (MRI) with careful examination technique and interpretation enables more accurate and complete diagnosis and staging than ultrasonography, especially in cases of deep pelvic endometriosis. Furthermore, MRI can identify implants in sites that can be difficult to access in endoscopic or laparoscopic explorations. In this article, we describe the appropriate MRI protocol for the study of pelvic endometriosis and the MRI signs of pelvic organ involvement. It is necessary to know the subtle findings and to look for them so we can ensure that they are not overlooked. We describe clinical grading systems for endometriosis and review the diagnostic efficacy of MRI in comparison with other imaging techniques and surgery. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. A Novel Endometriosis Inducing Factor In Women with Endometriosis

    Directory of Open Access Journals (Sweden)

    Ramzy A,

    2010-01-01

    Full Text Available Aim: To confirm the hypothesis of the presence of a possible endometriosis inducing factor(s (EIF in the blood of women with endometriosis. Patients and Methods: Forty infertile women were studied. The study group compromised of fifteen women of each three different degrees of endometriosis and fifteen women without endometriosis as a control group. Stem cells are characterized by being spindle shaped and proliferate in appropriate culture indefinitely. The women sera were co-cultured with mesenchymal stem cells (MSCs which were followed up weekly to look for morphological changes and to detect Annexin 1 marker and ß-actin gene by reverse transcriptase polymerase chain reaction. Results: MSCs cultured with sera of cases with, mild, moderate and severe endometriosis, showed morphological changes to be columnar and cuboidal shaped cells -resembling endometrial cells and glands- by the 4th week in 60%, 60% & 100% respectively. These cells were detected from as early as the first week in women with moderate and severe types (20% for each group. The percentage of the change into endometrial like cells increased among the three groups where it was 30±25.8%, 45±29.9% and 75±37.9% respectively. Moreover, increasing number of endometrial like cells are detected weekly, the more severe the disease is. None of the cultures of serum of the control group had made such changes all over the study. Furthermore, with more differentiation there was a considerable decrease in number of stem cells. These differentiated cells expressed the Annexin-1 marker. Conclusion: It was evident that serum of women with endometriosis posses a factor(s that enables the MSCs to be transformed into endometrial like cells and glands in vitro. This finding supports a new theory for the etiology of endometriosis. This observation may have a tremendous effect on the therapeutic implications of this debilitating condition.Introduction: Endometriosis is a common condition that

  19. Stress Exacerbates Endometriosis Manifestations and Inflammatory Parameters in an Animal Model

    OpenAIRE

    Cuevas, Marielly; Flores, Idhaliz; Thompson, Kenira J.; Ramos-Ortolaza, Dinah L.; Torres-Reveron, Annelyn; Appleyard, Caroline B

    2012-01-01

    Women with endometriosis have significant emotional distress; however, the contribution of stress to the pathophysiology of this disease is unclear. We used a rat model of endometriosis to examine the effects of stress on the development of this condition and its influence on inflammatory parameters. Female Sprague-Dawley rats were subjected to swim stress for 10 consecutive days prior to the surgical induction of endometriosis by suturing uterine horn implants next to the intestinal mesenter...

  20. Scar Endometriosis: A Case Report of This Uncommon Entity and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Cihangir Uzunçakmak

    2013-01-01

    Full Text Available Scar endometriosis is an infrequent type of extrapelvic endometriosis that is rather close together with obstetrical and gynecological surgeries. It is mostly confused with other dermatological or surgical conditions and delays the diagnosis. We report a case of a 50-year-old woman presenting with scar endometriosis 23 years after her last lower segment caesarean section. The epidemiology, diagnosis, pathogenesis, and treatment of the situation are discussed.

  1. Dioxins and endometriosis: cohort study of women in West Virginia

    Energy Technology Data Exchange (ETDEWEB)

    Diliberto, J.; Birnbaum, L. [U.S. Environmental Protection Agency, NHEERL, ETD, Research Triangle Park, NC (United States); Staats, D.A. [West Virginia Dept. of Environmental Protection, Charleston, WV (United States); Staats, D.A.; Becker, J.; Jude, D.; Chouinard, S.C.; Smith, T. [Marshall Univ. Medical Center, Huntington, WV (United States); Sirinek, L. [West Virginia Dept. of Environmental Protection, Wheeling, WV (United States); Clark, G. [Xenobiotic Detection Systems Inc., Durham, NC (United States); Landy, R. [U.S. Environmental Protection Agency, Region 3, ESC, Ft. Meade, MD (United States)

    2004-09-15

    The women in this endometriosis/dioxin health study reside in the Kanawha/Ohio River Valley area of West Virginia and comprise a potential cluster (cohort) of individuals who have been exposed to dioxins (dioxin and dioxin-like chemicals) at background levels higher than those seen in other areas of the United States. The emissions from an unique constellation of chemical industries appear to have led to high levels of environmental dioxin contaminants. In addition, this area has a high incidence of endometriosis. Previous animal studies, both in nonhuman primates and rodents, have demonstrated a correlation between dioxin exposure and endometriosis. Human epidemiology studies have suggested an association but have not demonstrated a statistically significant correlation, possibly due to limitations in study design such as insufficient numbers, measurement of only TCDD rather than total equivalents to TCDD (TEQs), and/or lack of surgical ascertainment of endometriosis. The present study is addressing these issues. Thus, we have the unusual congruence of identified emission sources and high background levels of dioxins and a potentially related elevation of endometriosis. Endometriosis is a condition suffered by women in which the endometrial tissue, that usually lines the uterus, migrates to other areas. Most commonly it is found in the abdomen, bladder, ovaries or bowel. Patients with endometriosis experience pelvic pain, irregular bleeding, infertility and other problems. Immune suppression has been associated with severe endometriosis. This debilitating condition is a poorly understood disease. In the United States, this condition affects millions of women in their reproductive years and is showing up more frequently in very young women. Endometriosis will seriously impact future fertility and health care utilization. Data suggest that the rate of endometriosis in the Kanawha and Ohio River valleys is higher than is seen in other regions of the United States.

  2. Reproductive prognosis in endometriosis

    DEFF Research Database (Denmark)

    Hjordt Hansen, Maj V; Dalsgaard, Torur; Hartwell, Dorthe

    2014-01-01

    OBJECTIVE: To assess the reproductive long-term prognosis of women with and without endometriosis, to explore changes over time, and to quantify the contribution of artificial reproductive techniques. DESIGN: Cohort study. SETTING: Denmark 1977-2009. SAMPLE: Data retrieved from four national...... registries. Among 15-49-year-old women during the period 1977-82, 24 667 were diagnosed with endometriosis and 98 668 (1:4) women without endometriosis were age-matched. METHODS: To assess long-term reproductive prognosis, all pregnancy outcomes were identified among the women with and without endometriosis......, but this was restricted to pregnancies from assisted reproduction. CONCLUSION: Women with endometriosis have slightly fewer children, but this lessened over time due to artificially conceived pregnancies. The risk for miscarriages and ectopic pregnancies was increased compared with women without the disease....

  3. Experimental treatments of endometriosis.

    Science.gov (United States)

    Attar, Rukset; Attar, Erkut

    2015-08-01

    Endometriosis is defined as the presence of endometrial gland and stroma outside the uterine cavity. It is an estrogen-dependent disease and is associated with chronic pelvic pain, dysmenorrhea, dyspareunia and infertility. The treatment of endometriosis is conservative or radical surgery, medical therapies or their combination. All currently used hormonally active treatments are effective in the treatment of endometriosis; however, the adverse effects of these hormonal treatments limit their long-term use. Moreover, recurrence rates are high after cessation of therapy, and the treatments have no benefit in endometriosis-associated infertility. Therefore, researchers are working on new treatment modalities with improved side effects, mainly focusing on the molecular targets involved in etiopathogenesis of endometriosis. Here we summarized these novel treatments modalities.

  4. Thyroid nodules classified as atypia or follicular lesions of undetermined significance deserve further research: Analysis of 305 surgically confirmed nodules.

    Science.gov (United States)

    Turkyilmaz, S; Ulusahin, M; Celebi, B; Cekic, A B; Mungan, S; Kucuktulu, U; Tasdelen, A; Guner, A; Cinel, A

    2017-07-17

    The objective of the present study was to determine the malignancy risk for nodules categorised as atypia or follicular lesions of undetermined significance atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) and to investigate the predictors of malignancy. All nodules diagnosed as AUS/FLUS on fine needle aspiration (FNAs) performed between January 2011 and December 2015 were retrospectively reviewed. Clinical data, ultrasonographic features, follow-up data and the final pathological results were recorded. After further exclusion, only nodules that underwent surgical excision were included in the final analysis. The malignancy rate and the range of malignancy rates were calculated. Clinical and ultrasound features were examined to determine the predictors of malignancy. During the study period, FNA was performed on 9938 nodules, and 1019 (10.2%) nodules were diagnosed as AUS/FLUS. After further exclusion, 976 nodules were evaluated. After the initial diagnosis of AUS/FLUS, 139 (14.2%) patients underwent surgery, 518 (53.1%) had repeated FNAs. A total of 305 (31%) had undergone surgical excision at different time points. For surgically confirmed nodules, the malignancy rate after the initial FNA was 34.5% (the lower and upper thresholds for the malignancy rate were 19.3% and 66.3%, respectively), and 37.9% after the repeated FNA. No ultrasound feature was determined as a predictor, whereas age (>55 years) was a predictor for malignancy. The overall malignancy rate for nodules diagnosed as AUS/FLUS and the malignancy rate for nodules that underwent repeated FNA after AUS/FLUS were higher than the expected malignancy rates of the National Cancer Institute. It is, therefore, suggested that the current recommendations should be reconsidered. © 2017 John Wiley & Sons Ltd.

  5. A RARE CASE OF SCAR ENDOMETRIOSIS FOLLOWING EPISIOTOMY

    Directory of Open Access Journals (Sweden)

    Rajlaxmi Jaysing

    2014-10-01

    Full Text Available Endometriosis is defined as ectopic presence of endometrial glands and stroma. It mainly affects pelvic peritoneal surfaces, ovaries and uterine ligaments. Even it can rarely affect vulva, vagina or perineum secondary to obstetric and surgical trauma. We are presenting a case of scar endometriosis following episiotomy in a woman with a positive history and classical physical findings who underwent wide surgical excision. The recovery was good with excellent functional results. The optimal management is wide surgical excision with additional tissue pathology to reduce recurrence and rule out malignancy.

  6. Abdominal wall endometriosis.

    Science.gov (United States)

    Upadhyaya, P; Karak, A K; Sinha, A K; Kumar, B; Karki, S; Agarwal, C S

    2010-01-01

    Endometriosis of abdominal wall scar following operation on uterus and tubes is extremely rare. The late onset of symptoms after surgery is the usual cause of misdiagnosis. Scar endometriosis is a rare disease which is difficult to diagnose and should always be considered as a differential diagnosis of painful abdominal masses in women. The diagnosis is made only after excision and histopathology of the lesion. Preoperative differentials include hernia, lipoma, suture granuloma or abscess. Hence an awareness of the entity avoids delay in diagnosis, helps clinicians to a more tailored treatment and also avoids unnecessary referrals. We report a case of abdominal endometriosis. The definitive diagnosis of which was established by histopathological studies.

  7. Research Priorities for Endometriosis

    DEFF Research Database (Denmark)

    Rogers, Peter A W; Adamson, G David; Al-Jefout, Moamar;

    2016-01-01

    The 3rd International Consensus Workshop on Research Priorities in Endometriosis was held in São Paulo on May 4, 2014, following the 12th World Congress on Endometriosis. The workshop was attended by 60 participants from 19 countries and was divided into 5 main sessions covering pathogenesis...... stratification, and research in emerging nations, in addition to an increased focus on translational research. A revised and updated set of research priorities that builds on this document will be developed at the 13th World Congress on Endometriosis to be held on May 17-20, 2017, in Vancouver, British Columbia...

  8. Umbilical Nodule with Cyclical Bleeding: A Case Report and Literature Review of Atypical Endometriosis

    Science.gov (United States)

    de Freitas, Cláudia V. Marques; Câmara, Sara Filipa Camacho; Vieira, José Joaquim Nunes

    2016-01-01

    Endometriosis is defined as the presence of endometrial glands and stroma outside the uterus. It affects 3 to 10 percent of women of reproductive age. Umbilical endometriosis is rare, with an estimated incidence of 0.5–1.0% among all cases of endometriosis, and is usually secondary to prior laparoscopic surgery involving the umbilicus. In this report, we described a case of umbilical endometriosis treated with surgical resection and highlight the great importance of medical history compared to complementary diagnostic tests that can be sometimes inconclusive. PMID:27747115

  9. Umbilical Nodule with Cyclical Bleeding: A Case Report and Literature Review of Atypical Endometriosis

    Directory of Open Access Journals (Sweden)

    Marlene Teixeira Andrade

    2016-01-01

    Full Text Available Endometriosis is defined as the presence of endometrial glands and stroma outside the uterus. It affects 3 to 10 percent of women of reproductive age. Umbilical endometriosis is rare, with an estimated incidence of 0.5–1.0% among all cases of endometriosis, and is usually secondary to prior laparoscopic surgery involving the umbilicus. In this report, we described a case of umbilical endometriosis treated with surgical resection and highlight the great importance of medical history compared to complementary diagnostic tests that can be sometimes inconclusive.

  10. Ovarian irradiation in recurrent endometriosis; Irradiation ovarienne pour endometriose refractaire inoperable

    Energy Technology Data Exchange (ETDEWEB)

    Kochbati, L.; Chaari, N.; Besbes, M.; Maalej, M. [Institut Salah-Azaiz, Service de Radiotherapie Carcinologique Tunis (Tunisia); Neji, K.; Ben Amara, F. [Centre de Maternite et de Neonatologie de Tunis, Service B (Tunisia); Ben Romdhane, N.K. [Hopital La-Rabta, Service d' Hematologie, Tunis (Tunisia)

    2005-09-15

    We describe a case of a young woman with a history of an aplastic anaemia in which pelvic radiotherapy was used successfully in the management of a recurrent and inoperable endometriosis. The use of therapeutic pelvic or ovarian irradiation in endometriosis may be considered, when surgical and medical treatments have been exhausted and have failed. (authors)

  11. Endometriosis: alternative methods of medical treatment

    Directory of Open Access Journals (Sweden)

    Muñoz-Hernando L

    2015-06-01

    Full Text Available Leticia Muñoz-Hernando,1 Jose L Muñoz-Gonzalez,1 Laura Marqueta-Marques,1 Carmen Alvarez-Conejo,1 Álvaro Tejerizo-García,1 Gregorio Lopez-Gonzalez,1 Emilia Villegas-Muñoz,2 Angel Martin-Jimenez,3 Jesús S Jiménez-López1 1Endometriosis Unit, Service of Obstetrics and Gynecology, Hospital Universitario 12 de Octubre, Madrid, Spain; 2Endometriosis Unit, Service of Obstetrics and Gynecology, Hospital Carlos Haya, Malaga, Spain; 3Endometriosis Unit, Service of Obstetrics and Gynecology, Hospital Son Llatzer, Palma de Mallorca, Spain Abstract: Endometriosis is an inflammatory estrogen-dependent disease defined by the presence of endometrial glands and stroma at extrauterine sites. The main purpose of endometriosis management is alleviating pain associated to the disease. This can be achieved surgically or medically, although in most women a combination of both treatments is required. Long-term medical treatment is usually needed in most women. Unfortunately, in most cases, pain symptoms recur between 6 months and 12 months once treatment is stopped. The authors conducted a literature search for English original articles, related to new medical treatments of endometriosis in humans, including articles published in PubMed, Medline, and the Cochrane Library. Keywords included “endometriosis” matched with “medical treatment”, “new treatment”, “GnRH antagonists”, “Aromatase inhibitors”, “selective progesterone receptor modulators”, “anti-TNF α”, and “antiangiogenic factors”. Hormonal treatments currently available are effective in the relief of pain associated to endometriosis. Among new hormonal drugs, association to aromatase inhibitors could be effective in the treatment of women who do not respond to conventional therapies. GnRh antagonists are expected to be as effective as GnRH agonists, but with easier administration (oral. There is a need to find effective treatments that do not block the ovarian function

  12. Development of a nonsurgical diagnostic tool for endometriosis based on the detection of endometrial leukocyte subsets and serum CA-125 levels.

    Science.gov (United States)

    Gagné, Danièle; Rivard, Michèle; Pagé, Martin; Lépine, Manon; Platon, Christèle; Shazand, Kamran; Hugo, Patrice; Gosselin, Diane

    2003-10-01

    To determine whether the proportion of several leukocyte subsets is modulated in the endometrium of patients with endometriosis and, if yes, whether it can be used for diagnostic purposes. Case-control study. Eight clinical institutions of the Montreal area. Women who underwent laparoscopy or laparotomy between 1997 and 2001, who had regular menstrual cycles and were not under hormone treatment for the previous 3 months were selected. This study included 368 women, 173 with surgically confirmed endometriosis and 195 controls with no surgical evidence of endometriosis. Cytometry analysis was used to measure the proportion of several leukocyte subsets among CD45(+) endometrial cells. The proportion of CD3(+), CD16(+), CD3(-)HLADR(-), CD3(-)CD45RA(-), CD3(+)CD16(-), CD3(+)CD56(-), CD56(-)CD16(+), and CD16b(+) leukocytes was significantly altered in the endometrium of cases compared with controls. A multiple logistic regression model was adjusted with these endometrial leukocytes, serum CA-125 levels, risk factors, and confounders. The diagnostic performance of this predictive model was defined by a specificity of 95% and a sensitivity of 61%. Furthermore, the positive and negative predictive values were 91% and 75%, respectively. This predictive model represents a novel diagnostic tool to identify women with a high likelihood of suffering from endometriosis.

  13. Dienogest in long-term treatment of endometriosis

    Directory of Open Access Journals (Sweden)

    Schindler AE

    2011-07-01

    Full Text Available Adolf E SchindlerInstitute for Medical Research and Education, Essen, GermanyAbstract: Endometriosis is a chronic disease primarily affecting women of childbearing age, in which endometriotic lesions form outside the uterus, typically leading to painful symptoms, fatigue, and infertility. The symptoms of endometriosis may cause significant impairment in quality of life and represent a substantial economic burden to patients, families, and society. There is no cure for endometriosis; management consists of alleviating pain and other symptoms, reducing endometriotic lesions, and improving quality of life. Recurrence after surgical intervention is common, while the clinical evidence to support the efficacy and safety of many medications currently used in endometriosis is limited. Dienogest is an oral progestin that has been investigated extensively in the treatment of endometriosis in two clinical programs performed in Europe and Japan, including dose-ranging, placebo-controlled, active comparator-controlled, and long-term (up to 65 weeks studies. These studies demonstrated that dienogest 2 mg daily effectively alleviates the painful symptoms of endometriosis, reduces endometriotic lesions, and improves indices of quality of life. Dienogest showed a favorable safety and tolerability profile in these studies, with predictable adverse effects, high rates of patient compliance, and low withdrawal rates. This review article describes the clinical trial evidence that characterizes the efficacy and safety of dienogest in endometriosis, including two studies characterizing dienogest in long-term use. The relevance of these findings to the management of endometriosis in clinical practice is discussed.Keywords: dienogest, endometriosis, progestins, long-term treatment, quality of life, symptoms, pain

  14. Magnetic resonance imaging in deep pelvic endometriosis: iconographic essay

    Energy Technology Data Exchange (ETDEWEB)

    Coutinho Junior, Antonio Carlos; Coutinho, Elisa Pompeu Dias; Lima, Claudio Marcio Amaral de Oliveira; Ribeiro, Erica Barreiros; Aidar, Marisa Nassar [Clinica de Diagnostico por Imagem (CDPI), Rio de Janeiro, RJ (Brazil); Clinica Multi-Imagem, Rio de Janeiro, RJ (Brazil); E-mail: cmaol@br.inter.net; Gasparetto, Emerson Leandro [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Dept. de Radiologia

    2008-03-15

    Endometriosis is characterized by the presence of normal endometrial tissue outside the uterine cavity. In patients with deep pelvic endometriosis, uterosacral ligaments, rectum, rectovaginal septum, vagina or bladder may be involved. Clinical manifestations may be variable, including pelvic pain, dysmenorrhea, dyspareunia, urinary symptoms and infertility. Complete surgical excision is the gold standard for treating this disease, and hence the importance of the preoperative work-up that usually is limited to an evaluation of sonographic and clinical data. Magnetic resonance imaging is of paramount importance in the diagnosis of endometriosis, considering its high accuracy in the identification of lesions intermingled with adhesions, and in the determination of peritoneal lesions extent. The present pictorial review describes the main magnetic resonance imaging findings in deep pelvic endometriosis. (author)

  15. What Is Endometriosis?

    Science.gov (United States)

    ... 2010). Management of endometriosis (Practice Bulletin No. 114). Obstetrics & Gynecology, 116 (1), 223-236. [top] What causes it? » Related A-Z Topics Infertility and Fertility NICHD News and Spotlights Selected NICHD ...

  16. Endometriosis e infertilidad = Endometriosis and infertility

    Directory of Open Access Journals (Sweden)

    Restrepo Cano, Gustavo Adolfo

    2012-01-01

    Full Text Available Objetivo: revisar la literatura sobre endometriosis en cuanto se relaciona con la infertilidad.Metodología: búsqueda en PubMed / Medline, Hinari y Cochrane con los términos Infertilidad, Endometriosis, Endometrioma, Laparoscopia y Cistectomía. Se seleccionaron investigaciones originales, artículos de revisión y meta-análisis, en inglés, francés y español, publicados entre enero de 2000 y diciembre de 2010. Se eligieron los que evaluaban la fisiopatología, etiología, diagnóstico y tratamiento de la endometriosis en relación con la infertilidad.Resultados: la endometriosis es responsable hasta del 15% de los casos de infertilidad femenina. Los mecanismos comprobados son: obstrucción tubárica, adherencias y endometriomas. La sobreproducción de prostaglandinas y citocinas podría afectar la función del ovario, las trompas y el endometrio. En los estadios I y II es superior el tratamiento quirúrgico frente al farmacológico; este último comprende tres ciclos de clomifeno más inseminación intrauterina (IIU; de no lograrse el embarazo, se debe proceder a administrar gonadotropinas más IIU y por último a la fertilización in vitro (FIV.Conclusiones: la endometriosis afecta la fertilidad por mecanismos comprobados pero puede haber otros aún no bien esclarecidos. Se deben tener en cuenta los avances recientes para ofrecer el mejor tratamiento posible.

  17. Strategies for Management of Colorectal Endometriosis.

    Science.gov (United States)

    Abrão, Mauricio Simões; Borrelli, Giuliano Moysés; Clarizia, Roberto; Kho, Rosanne Marie; Ceccaroni, Marcello

    2017-01-01

    Endometriosis has clearly three distinct clinical presentations and deep endometriosis, especially compromising the rectosigmoid is probably the most concerning one for both patients and surgeons. Currently, with the available tools, it is mandatory to have a precise diagnostic of this type of disease prior to indication of treatment. Strategies to manage this form of endometriosis will take into account several involved aspects, such as age of the patient, reproductive desire or infertility, clinical symptoms, as well as the extension and localization of the disease. Treatment could vary from more conservative to more radical depending on those aspects. As we pointed out in this article, the key to manage colorectal endometriosis is to start with a good diagnosis. Knowing exactly what is the extension and localization of the disease and knowing the patient's wishes as well as the clinical complaints, surgeons are able to define the best option for each patient. Critical points should always be discussed; for example, patients chosen to have clinical treatment should be aware of important issues regarding the follow-up, while patients undergoing surgery must be advised about all surgical possibilities and related complications.

  18. Endometriosis In Cesarean Scar: A Case Report

    Directory of Open Access Journals (Sweden)

    Nejat Özgül

    2013-11-01

    Full Text Available A patient with surgical scar endometriosis, a rare condition, was presented. The patient was 30 years old, gave birth twice by cesarean section, her last delivery was seven years ago. She appealed to the outpatients’ clinic because of the complaints of pain, swelling and redness on the scar site, her complaints began one year after the last delivery and continued. The complaints did not alter by menstrual cycle. On the examination, there was a painful hyperemic lesion 2x2cm in size which was raised from the skin, located at the right of the scar, assumed to be associated with the fixed fascia and another lesion 2x2cm in size which could not be noticed by inspection but be palpated was found. The lesions described were totally excised. The result of paraffin block examination of the material was reported as endometriosis. Pain on the scar site with menstrual period, enlargement and discoloration of the lesions are classical signs of scar endometriosis. But the patients do not always present these findings. Endometriosis should also be remembered along with other reasons when lesions occur on the scar site after surgery.

  19. The history of endometriosis.

    Science.gov (United States)

    Benagiano, Giuseppe; Brosens, Ivo; Lippi, Donatella

    2014-01-01

    A dispute has recently emerged whether early descriptions exist of the condition we name endometriosis. A first question is: 'Who identified endometriosis?' To respond, two non-complementary methods have been employed: searching for ancient descriptions of symptoms associated with endometriosis or, alternatively, identifying researchers who described pathological features we associate with the presence of endometriosis in its various forms. We opted for the latter and found no evidence that in older times anyone delineated the macroscopic features of endometriosis; descriptions of menstrual or cyclic pain cannot be taken as proof of knowledge of what caused it. During the mid-part of the 19th century, Rokitansky had a great intuition: endometrial glands and stroma can be present in ovarian and uterine neoplasias. However, using histological parameters of endometrial structure and activity, the first scientist to delineate peritoneal endometriosis under the name 'adenomyoma' was Cullen. On the other hand, Rokitansky was the first to describe a form of adenomyosis (an adenomatous polyp). Early descriptions of ovarian endometrioma as 'haematomas of the ovary' or 'chocolate cysts' date back to the end of the 19th century. The first mention of an 'ovary containing uterine mucosa' was published in 1899 by Russel, but Sampson was the first to demonstrate specific endometrial activities, such as desquamation at the time of menstruation and decidualization in pregnancy; subsequently, he presented a theory on its pathogenesis.

  20. [Intrinsic ureteral endometriosis: description of a striking instance].

    Science.gov (United States)

    Antonelli, Alessandro; Finotto, Elena; Zambolin, Tiziano; Fisogni, Simona; Simeone, Claudio

    2015-01-01

    Intrinsic ureteral endometriosis is a very rare condition. A 41 y. o. woman with right hydroureteronephrosis and other aspecific symptoms came to our attention. The CT scan showed an ureteral obstacle causing the hydroureteronephrosis. She underwent ureterorenoscopy with biopsies of the lesion that did not result to be diriment. Suspecting a ureteral neoplasm, the patient then underwent ureteral resection and ureterocystoneostomy, and the extemporary histological examination resulted as endometriosis. The abdominal exploration showed a parametrial and a peritoneal growth - both compatible with the extemporary histological examination - that were also excised. The post-operative course was uneventful. The definitive hystological examination confirmed the perioperatory diagnosis. Intrinsic ureteral endometriosis is confirmed as a rare pathology with an indefinite clinical presentation; its typical presentation, namely cyclic hematuria, seems to be an anecdotal feature. Therefore the diagnostics of intrinsic ureteral endometriosis is still difficult even despite such a striking presentation.

  1. Clinical Prediction of Deeply Infiltrating Endometriosis before Surgery: Is It Feasible? A Review of the Literature

    Directory of Open Access Journals (Sweden)

    Márcia Mendonça Carneiro

    2013-01-01

    Full Text Available Background. Endometriosis is a chronic benign gynecologic disease that can cause pelvic pain and infertility affecting almost 10% of reproductive-age women. Deeply infiltrating endometriosis (DIE is a specific entity responsible for painful symptoms which are related to the anatomic location of the lesions. Definitive diagnosis requires surgery, and histological confirmation is advisable. The aim of this paper is to review the current literature regarding the possibility of diagnosing DIE accurately before surgery. Despite its low sensitivity and specificity, vaginal examination and evaluation of specific symptoms should not be completely omitted as a basic diagnostic tool in detecting endometriosis and planning further therapeutic interventions. Recently, transvaginal ultrasound (TVUS has been reported as an excellent tool to diagnose DIE lesions in different locations (rectovaginal septum, retrocervical and paracervical areas, rectum and sigmoid, and vesical wall with good accuracy. Conclusion. There are neither sufficiently sensitive and specific signs and symptoms nor diagnostic tests for the clinical diagnosis of DIE, resulting in a great delay between onset of symptoms and diagnosis. Digital examination, in addition to TVS, may help to gain better understanding of the anatomical extent and dimension of DIE which is of crucial importance in defining the best surgical approach.

  2. Radiologic findings of abdominal wall endometriosis

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Jung Wook [Inje Univ. Ilsan Paik Hospital, Goyang (Korea, Republic of)

    2003-12-01

    To evaluate the imaging findings of abdominal wall endometriosis. In seven of 17 patients with surgically proven endometriosis of the abdominal wall, we retrospectively reviewed the findings of radiologic studies such as abdominal US (n=3), CT (n=4), and MRI (n=1). One patient under went more than one type of imaging, apparently. The surgical history of the seven, and their symptoms and preoperative diagnosis were reviewed, and the size, location, margin and nature of the mass, and the contrast enhancement patterns observed at radiologic studies, were assessed. The chief symptoms were palpable abdominal wall mass (n=5) and lower abdominal pain (n=2) around a surgical scar. Previous surgery included cesarean section (n=5), cesarean section with oophorectomy (n=1) and appendectomy (n=1). Masses were located in the subcutaneous fat layer (n=5) or rectus abdominis muscle (n=2), and their maximum diameter was 2.6 cm. Imaging findings, which correlated closely with the pathologic findings, included a well (n=5) or poorly marginated (n=2) solid mass, with a focal cystic area apparent in two cases. Although imaging findings of abdominal wall endometriosis may not be specific for diagnosis, the presence of a solid abdominal mass in female patients of reproductive age with a history of surgery is a diagnostic pointer.

  3. Role of fine needle aspiration cytology and cell block in diagnosis of scar endometriosis: A case report

    Directory of Open Access Journals (Sweden)

    Sashibhusan Dash

    2015-01-01

    Full Text Available Presence of endometrial glands and stroma in places other than the uterus is called endometriosis. It can be pelvic or extra-pelvic. Abdominal scar endometriosis is an extra-pelvic endometriosis that can occur after surgery involving the uterus. Post-caesarean section, scar endometriosis is a rare event. The diagnosis is frequently made only after excision of disease tissue. We present a case of post-caesarean section abdominal scar endometriosis presenting as a tumor on the abdominal wall, which was diagnosed by fine needle aspiration cytology and confirmed by cell block preparation.

  4. Comparison of efficacy of bromocriptine and cabergoline to GnRH agonist in a rat endometriosis model.

    Science.gov (United States)

    Ercan, Cihangir Mutlu; Kayaalp, Oya; Cengiz, Mehmet; Keskin, Ugur; Yumusak, Nihat; Aydogan, Umit; Ide, Tayfun; Ergun, Ali

    2015-05-01

    To determine the effect of dopamine agonists in a surgically induced endometriosis model on rats. In this prospective randomized experimental study, surgical induction of endometriosis was performed by autotransplantation technique on 52 adult female Wistar-Albino rats. Endometriosis formation was confirmed by a second-look laparotomy (n:48) 1 month later. Four study groups were randomly generated according to their treatment regimens: group 1 (leuprolide acetate, n = 12), group 2 (bromocriptine, n = 12), group 3 (cabergoline, n = 12) and group 4 (control, n = 12). Endometriotic implants were excised for histopathological examination after treatment at the setting of laparotomy. The mean surface areas and histopathological glandular tissue (GT) and stromal tissue (ST) scores of endometriotic implants were studied and compared among groups. After 30 days of treatment, the mean surface area of the endometriotic implants of leuprolide acetate, bromocriptine and cabergoline groups was significantly decreased. The regression of endometriotic foci size in comparison to control was highest in group 1, followed by group 2, then group 3. In the histopathological evaluation both the ST and GT scores of group 1, 2 and 3 were significantly decreased in comparison to controls without a statistically significant difference between the groups. Dopamine agonists are as effective as GnRH agonists in the regression of experimental endometriotic implants in rats. Further trials are needed to elucidate the pathways affected by dopamine agonists.

  5. Female sexual dysfunction in patients with endometriosis: Indian scenario

    Directory of Open Access Journals (Sweden)

    Vineet V Mishra

    2016-01-01

    Full Text Available Background: Female sexual dysfunction (FSD in Indian women is often overlooked due to cultural beliefs and considered as social taboos. Sexuality is an important and integral part of life. There are many causes of sexual dysfunction, but the prevalence of FSD in endometriotic patients is still underdiagnosed. Materials and Methods: Study design - Cross-sectional observational study conducted at tertiary care center, from June 2015 to March 2016. Sample size - Fifty-one patients in reproductive age group (18-47 years who were diagnosed with endometriosis on diagnostic laparoscopy were included. Methods - FSD was assessed with a detailed 19-item female sexual function index questionnaire. All six domains of sexual dysfunction, i.e., desire, arousal, lubrication, orgasm, satisfaction, and pain were studied. Exclusion - Patients with other gynecological, medical or surgical history were excluded. Results: Out of 51 patients with endometriosis, 47.06% of patients had sexual dysfunction. With the increase in staging of endometriosis, sexual dysfunction prevalence is also rising. FSD was 100% in patients with severe endometriosis as compared to 33.33% in minimal endometriosis. Conclusion: Every individual deserves good sexual life. The sexual dysfunction associated with endometriosis should also be taken into consideration while managing these patients.

  6. Aromatase inhibitors in post-menopausal endometriosis

    Directory of Open Access Journals (Sweden)

    Devroey Paul

    2011-06-01

    Full Text Available Abstract Postmenopausal endometriosis is a rare clinical condition. The diagnosis and treatment of an endometriotic lesion in postmenopausal women is complicated. First line treatment choice should be surgical, given that there is a potential risk of malignancy. Medical treatment may be considered as second line or as an alternate first line treatment whenever surgery is contradicted and aims to alter the hormonal pathway leading to endometriosis progress. Different hormonal regimens have been administered to these patients, with conflicting however results. Aromatase inhibitors (AIs represent one of the most recently used drugs for postmenopausal endometriosis. Clinical data for the use of (AIs in postmenopausal patients is scarce. Up to date only 5 case reports are available regarding the use of these agents in postmenopausal women. Although definite conclusions may be premature, AIs appear to considerably improve patients' symptoms and reduce endometriotic lesions size. Nonetheless the subsequent induced reduction in estrogen production, leads to certain short-term and long-term adverse effects. Despite the limited available data, AIs appear to represent a new promising method which may improve symptoms and treat these patients, either as first line treatment, when surgery is contraindicated or as a second line for recurrences following surgical treatment. However, careful monitoring of patients' risk profile and further research regarding long-term effects and side-effects of these agents is essential prior implementing them in everyday clinical practice.

  7. Endometriosis and pain

    Directory of Open Access Journals (Sweden)

    Guido Orlandini

    2011-03-01

    Full Text Available In some patients endometriosis causes persistent or chronic pain and is a specialistic algologic problem. Considering various possible pathogenic pain mechanisms, when pain therapy of endometriosis cannot be etiologic, far from be only symptomatic, it is based on a pathogenetic criterion. We must consider that in endometriosis can be a pain due to activation of nociceptors sensibilized by endometriosic tissues (tissutal nociceptive pain unresponding to NSAIDs and opioids or a pain due to the nerve damage by nerve compression from endometriosic cistis or by involvement of nerve structures in scar tissue (neuropathic pain unresponding to antinociceptive therapy but responding, at least partially, to some neuropathic specific pain drugs and to electrostimulation of the nerve system.

  8. Defining future directions for endometriosis research: workshop report from the 2011 World Congress of Endometriosis In Montpellier, France.

    Science.gov (United States)

    Rogers, Peter A W; D'Hooghe, Thomas M; Fazleabas, Asgerally; Giudice, Linda C; Montgomery, Grant W; Petraglia, Felice; Taylor, Robert N

    2013-05-01

    Endometriosis, defined as estrogen-dependent lesions containing endometrial glands and stroma outside the uterus, is a chronic and often painful gynecological condition that affects 6% to 10% of reproductive age women. Endometriosis has estimated annual costs of US $12 419 per woman (approximately €9579), comprising one-third of the direct health care costs with two-thirds attributed to loss of productivity. Decreased quality of life is the most important predictor of direct health care and total costs. It has been estimated that there is a mean delay of 6.7 years between onset of symptoms and a surgical diagnosis of endometriosis, and each affected woman loses on average 10.8 hours of work weekly, mainly owing to reduced effectiveness while working. To encourage and facilitate research into this debilitating disease, a consensus workshop to define future directions for endometriosis research was held as part of the 11th World Congress on Endometriosis in September 2011 in Montpellier, France. The objective of this workshop was to review and update the endometriosis research priorities consensus statement developed following the 10th World Congress on Endometriosis in 2008.(1) A total of 56 recommendations for research have been developed, grouped under 6 subheadings: (1) diagnosis, (2) classification and prognosis, (3) clinical trials, treatment, and outcomes, (4) epidemiology, (5) pathophysiology, and (6) research policy. By producing this consensus international research priorities statement, it is the hope of the workshop participants that researchers will be encouraged to develop new interdisciplinary research proposals that will attract increased funding support for work on endometriosis.

  9. Effectiveness of laparoscopic surgeries in treating infertility related to endometriosis

    Directory of Open Access Journals (Sweden)

    Aneta Słabuszewska-Jóźwiak

    2015-05-01

    Laparoscopy is a vital therapeutic method. Operative laparoscopy is an efficient method for treating infertility related to endometriosis, and the procedure seems to be the most effective particularly at stage III rAFS. The period for expectant management after a surgical procedure should last 6 months.

  10. Endometriosis (For Teens)

    Science.gov (United States)

    ... a pelvic exam a very heavy period lower back pain constipation, diarrhea, or feeling pain or seeing blood ... diet, moderate exercise, and relaxation techniques such as yoga and meditation can sometimes ... from the pain, other things can make living with endometriosis a ...

  11. Art and Endometriosis.

    Science.gov (United States)

    Berstein, Jane C.

    1995-01-01

    Relation of an art therapist's personal story concerning her struggle to overcome endometriosis, and how her artwork has played a vital role in coping with the disease. Illustrated with a chronology of artwork produced during a bout with the illness. (JPS)

  12. Tratamento da endometriose Treatment of endometriosis

    Directory of Open Access Journals (Sweden)

    Paula Andrea de Albuquerque Salles Navarro

    2006-10-01

    reduzir a dor e os riscos de recidiva. Por fim, é importante ressaltar que há muita controvérsia e que as recomendações acima descritas deverão ser revistas à medida que estudos clínicos randomizados, controlados e com casuística adequada gerarem evidências mais concretas e confiáveis.Despite a wide heterogeneity of clinical manifestations related to endometriosis, a high prevalence of the disease is observed in infertile women and in those with chronic pelvic pain. This enigmatic condition has a high socioeconomic impact, and the described data regarding efficacy of the therapeutic approaches are quite conflicting. Thus, the purpose of the present study was to describe the available scientific evidence about the applicable therapeutic modalities and to provide recommendations for the treatment of infertility and the chronic pelvic pain related to endometriosis. Although suppression of ovarian function in patients with minimal or mild endometriosis is not effective in improving fertility, ablation of the lesions associated with adhesiolysis seems to be more effective than exclusive diagnostic laparoscopy. There is no sufficient evidence to determine whether surgical excision in cases of moderate or severe disease would improve the pregnancy rates. In vitro fertilization seems to be an adequate approach, especially in cases of coexistence of infertility factors and/or failure of other treatments. The possibility of using GnRH for 3 to 6 months before in vitro fertilization should be considered. Regarding pain relief, suppression of ovarian function for 3 to 6 months in patients with laparoscopically-confirmed disease reduces the pain associated with endometriosis. All studied medication seem to have similar efficacy, differing only in terms of adverse effects and costs. Ablation of endometriotic lesion reduces the pain associated with endometriosis, being less effective in cases of minimal disease. Exeresis of endometriomas with diameter > 4 cm seems to improve

  13. Spontaneous abdominal wall endometriosis: a case report.

    Science.gov (United States)

    Papavramidis, Th S; Sapalidis, K; Michalopoulos, N; Karayanopoulou, G; Raptou, G; Tzioufa, V; Kesisoglou, I; Papavramidis, S T

    2009-01-01

    Endometriosis is the presence of endometrial glands and stroma outside the uterus. Spontaneous abdominal wall endometriosis (AWE) is any ectopic endometrium found superficial to the peritoneum without the presence of any previous scar. Rarely, endometriosis represents a disease of specific interest to the general surgeon, on account of its extrapelvic localisations. We describe a case with spontaneous AWE presenting as a painful mass with cyclic symptoms. A 28-year-old woman presented to the day-surgery division of our department, suffering from a painful mass in the left lower abdominal quadrant. A mobile mass of 5 x 4 cm was identified. The initial diagnosis was lipoma and excision was planned. During the operation two masses were spotted, very close to one another, and were excised within healthy limits. Pathology revealed endometrial glands surrounded by a disintegrating mantle of endometrial stroma and fibrous scar tissue in which there was a scattering of leucocytes. The woman had no scars. She was discharged from hospital after 2 hours. Two years after the excision she is free of disease and no recurrence has been observed. Spontaneous AWE is rare, accounting for 20% of all AWEs. The triad ; mass, pain and cyclic symptomatology helps in the diagnosis, but unfortunately it is not present in all cases. Spontaneous endometriomas are usually diagnosed by pathology and the treatment of choice is surgical excision.

  14. The development of endometriosis in a murine model is dependent on the presence of dendritic cells.

    Science.gov (United States)

    Pencovich, Niv; Luk, Janelle; Hantisteanu, Shay; Hornstein, Mark D; Fainaru, Ofer

    2014-04-01

    Endometriosis is a common condition associated with pelvic pain and infertility. This study group has previously shown that supplementation of dendritic cells led to enhancement of endometriosis lesion growth and angiogenesis. This study determined whether endometriosis is dependent on the presence of endogenous dendritic cells. Surgical induction of endometriosis was performed in CD11c⁺ DTR/GFP transgenic (Tg) female mice in which dendritic cells were ablated upon injection of diphtheria toxin (DT). Mice were allocated into four groups (n=5 each): group I, wild-type mice treated with vehicle; group II, wild-type mice treated with DT; group III, Tg mice treated with DT; and group IV, Tg mice treated with vehicle. After 10 days, mice were killed and endometriosis lesions were analysed by flow cytometry. DT treatment led to ablation of dendritic cells in spleens and endometriosis lesions in Tg mice while no ablation was observed in controls. Corresponding to dendritic cell ablation, endometriosis lesions in group III were ∼5-fold smaller than in the control groups (ANOVA Pdendritic cells. Therapies designed to inhibit dendritic cell infiltration as possible treatments for endometriosis warrant further study.

  15. Potential role of aromatase inhibitors in the treatment of endometriosis.

    Science.gov (United States)

    Abu Hashim, Hatem

    2014-01-01

    Endometriosis is an estrogen-dependent chronic inflammatory disease affecting 5%-10% of reproductive-age women, with a prevalence of 5%-50% in infertile women and >33% of women with chronic pelvic pain. Third-generation aromatase inhibitors (AIs) are approved adjuvants for the treatment of estrogen receptor-positive breast cancer. Molecular studies have revealed the presence of aromatase P450, the key enzyme in the biosynthesis of ovarian estradiol, inside the endometriotic tissue, indicating local synthesis of estradiol. Thereby, AIs represent an appealing medical option for the management of different aspects of this enigmatic disease, especially pelvic pain and infertility. Accordingly, this review aims to evaluate the potential role of AIs in the treatment of endometriosis-associated symptoms, mainly pain and infertility. Notably, several studies have demonstrated that the combination of AIs with conventional therapy as oral contraceptive pills, progestins, or gonadotropin-releasing hormone analogs can be used to control endometriosis-associated pain and pain recurrence in premenopausal women, particularly those with pain due to rectovaginal endometriosis refractory to other medical or surgical treatment. Some case reports have shown promising results in the treatment of postmenopausal endometriosis as first-line treatment, when surgery is contraindicated, or as second-line treatment in the case of postoperative recurrence. Third-generation AIs, especially letrozole, have challenged clomiphene citrate as an ovulation-induction agent in patients with polycystic ovary syndrome and in cases of unexplained infertility. However, few studies are available regarding the use of AIs to treat endometriosis-associated infertility. Therefore, larger multicenter randomized trials using AIs for the treatment of endometriosis-associated infertility are needed to clarify its effect. The safety of AIs for ovulation induction or superovulation has generated a lively discussion

  16. Contraception and endometriosis: challenges, efficacy, and therapeutic importance

    Directory of Open Access Journals (Sweden)

    Weisberg E

    2015-07-01

    Full Text Available Edith Weisberg,1 Ian S Fraser2 1Family Planning NSW, 2School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia Abstract: Endometriosis is a benign gynecological condition that is estimated to affect 10% of women in the general population and appears to be increasing in incidence. It is an estrogen-dependent inflammatory disease, and is primarily characterized by dysmenorrhea, deep dyspareunia, chronic pelvic pain, and variable effects on fertility. The symptoms may greatly affect quality of life, and symptom control may be the primary aim of initial management, while contraceptive effect is often secondary. It is estimated that 30%–50% of women with endometriosis have an infertility problem, so a considerable number of endometriosis sufferers will require effective, planned contraception to maximize “protection of fertility” and prevent progression of the endometriotic condition. Ideally, this contraception should also provide symptom relief and improvement of physical, mental, and social well-being. At the present time, long-term progestogens appear to be the most effective choice for meeting all of these requirements, but other options need to be considered. It is becoming increasingly recognized that hormonal contraceptive systems are necessary for prevention of disease recurrence following surgical treatment of endometriosis. The personal preferences of the woman are an integral part of the final contraceptive choice. This article discusses the advantages and disadvantages of the contraceptive options available to women with endometriosis. Keywords: pelvic pain, disease recurrence, progestogens, delivery systems, long-acting

  17. Appendiceal endometriosis differentially diagnosed from acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    Gastón Astroza; Victor Faundes; René Nanjarí; Marcelo Fleiderman; Carlos Rodriguez

    2010-01-01

    @@ Endometriosis is a common disease in premenopausal women involving pelvic organs specially. However endometriosis that affects the appendix is rarely seen except appendiceal endometriosis that mimics acute appendicitis. In a patient with acute appendicitis we diagnosed and operated on, histopathological examination of the appendix revealed appendiceal endometriosis which caused symptoms.

  18. Effectiveness of ovarian suspension in preventing post-operative ovarian adhesions in women with pelvic endometriosis: A randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Pandis George

    2011-05-01

    Full Text Available Abstract Background Endometriosis is a common benign condition, which is characterized by the growth of endometrial-like tissue in ectopic sites outside the uterus. Laparoscopic excision of the disease is frequently carried out for the treatment of severe endometriosis. Pelvic adhesions often develop following surgery and they can compromise the success of treatment. Ovarian suspension (elevating both ovaries to the anterior abdominal wall using a Prolene suture is a simple procedure which has been used to facilitate ovarian retraction during surgery for severe pelvic endometriosis. The study aims to assess the effect of temporary ovarian suspension following laparoscopic surgery for severe pelvic endometriosis on the prevalence of post-operative ovarian adhesions. Methods A prospective double blind randomised controlled trial for patients with severe pelvic endometriosis requiring extensive laparoscopic dissection with preservation of the uterus and ovaries. Severity of the disease and eligibility for inclusion will be confirmed at surgery. Patients unable to provide written consent, inability to tolerate a transvaginal ultrasound scan, unsuccessful surgeries or suffer complications leading to oophorectomies, bowel injuries or open surgery will be excluded. Both ovaries are routinely suspended to the anterior abdominal wall during surgery. At the end of the operation, each participant will be randomised to having only one ovary suspended post-operatively. A new transabdominal suture will be reinserted to act as a placebo. Both sutures will be cut 36 to 48 hours after surgery before the woman is discharged home. Three months after surgery, all randomised patients will have a transvaginal ultrasound scan to assess for ovarian mobility. Both the patients and the person performing the scan will be blinded to the randomisation process. The primary outcome is the prevalence of ovarian adhesions on ultrasound examination. Secondary outcomes are the

  19. Integrative treatment in endometriosis

    Institute of Scientific and Technical Information of China (English)

    Yu Jin; Yu Chao-qin

    2006-01-01

    Objective: To study the effectiveness of Yu's Neiyi Recipe on endometriosis.Methods: Yu's Neiyi Recipe was administrated in 48 patients with endometriosis (including 20 infertile cases). The clinical manifestations, ultrasonography, basal body temperature (BBT) and hormonal levels were observed before and 3 months after the treatment. The pregnancy outcome was followed up within 2 years.Results: Efficacy of Yu's Neiyi Recipe in the 48 cases was 93.75% within 3 months of treatment, 15 of the 20 infertile women become pregnant (80%) within 2 years. After the treatment, scores of dysmenorrhea, chronic pelvic pain or dyspareunia, and the size of ovarian endometrioma obviously decreased (P<0.01, P<0.01, P<0.01), meanwhile, the BBT type and high phase score (HPS) significantly improved (P<0.05). During herbal treatment, serum high PRL levels significantly dropped (P<0.05), and serum LH and E2 levels elevated significantly (P<0.05).Conclusions: Yu's Neiyi Recipe not only relieves the symptoms and signs of patients with endometriosis significantly, but also shows a good regulation on patients' ovarian function to improve the rate of ovulation and pregnancy.

  20. Endometriosis e infertilidad

    Directory of Open Access Journals (Sweden)

    O. Emilio Fernández, Dr.

    2010-05-01

    Full Text Available Este artículo revisa la evidencia reciente relacionada con el impacto de la endometriosis sobre la fertilidad. La endometriosis se presenta durante la vida reproductiva y es diagnosticada frecuentemente en mujeres en estudio de infertilidad. Tiene múltiples formas de presentación: peritoneal, infiltración profunda, ovárica y/o nódulo rectovaginal. En las etapas avanzadas la infertilidad se explica por la distorsión anatómica de los órganos reproductivos, y en las etapas iniciales, sin distorsión anatómica, se debería a la presencia una de reacción inflamatoria peritoneal, que compromete eventos reproductivos claves como el desarrollo folicular, la ovulación, el desarrollo embrionario y la implantación. El tratamiento de la endometriosis es quirúrgico y consiste en la resección tumoral máxima que permite restablecer la fecundidad natural. Tratamientos complementarios como IO, IIU e IVF, resultan apropiados cuando la cirugía no logra recuperar la fertilidad, en estadios avanzados y/o frente a la presencia de otros factores asociados de infertilidad.

  1. Anxiety and depression in patients with endometriosis: impact and management challenges

    Directory of Open Access Journals (Sweden)

    Laganà AS

    2017-05-01

    Full Text Available Antonio Simone Laganà,1 Valentina Lucia La Rosa,2 Agnese Maria Chiara Rapisarda,3 Gaetano Valenti,3 Fabrizio Sapia,3 Benito Chiofalo,1 Diego Rossetti,4 Helena Ban Frangež,5 Eda Vrtačnik Bokal,5 Salvatore Giovanni Vitale1 1Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood “G Barresi”, University of Messina, Messina, 2Unit of Psychodiagnostics and Clinical Psychology, 3Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, 4Department of Maternal and Child Health, Gavardo Hospital, Brescia, Italy; 5Department of Reproduction, University Medical Center Ljubljana, Ljubljana, Slovenia Abstract: Endometriosis is one of the most common gynecological diseases and affects ~10% of women in reproductive age. The most common clinical signs of endometriosis are menstrual irregularities, chronic pelvic pain (CPP, dysmenorrhea, dyspareunia and infertility. Symptoms of endometriosis often affect psychological and social functioning of patients. For this reason, endometriosis is considered as a disabling condition that may significantly compromise social relationships, sexuality and mental health. Considering this point, the aim of this narrative review is to elucidate the impact of anxiety and depression in the management of women with endometriosis. Psychological factors have an important role in determining the severity of symptoms, and women who suffer from endometriosis report high levels of anxiety, depression and other psychiatric disorders. In addition, endometriosis is one of the most important causes of CPP; women with endometriosis suffer from a wide range of pelvic pain such as dysmenorrhea, dyspareunia, nonmenstrual (chronic pelvic pain, pain at ovulation, dyschezia and dysuria. Several studies have underlined the influence of CPP on quality of life and psychological well-being of women with endometriosis. Data suggest that the experience of pelvic pain is an

  2. Patients’ report on how endometriosis affects health, work, and daily life

    Science.gov (United States)

    Fourquet, Jessica; Gao, Xin; Zavala, Diego; Orengo, Juan C.; Abac, Sonia; Ruiz, Abigail; Laboy, Joaquín; Flores, Idhaliz

    2009-01-01

    NARRATIVE ABSTRACT The objective of this study was to assess the burden of endometriosis by obtaining Patient Reported Outcome (PRO) data describing the experience of living with this disease. Survey data from one hundred and seven women with self-reported, surgically diagnosed endometriosis showed that living with this disease may be characterized by physical limitations that disrupt health, work and daily life. PMID:19926084

  3. Patients' report on how endometriosis affects health, work, and daily life.

    Science.gov (United States)

    Fourquet, Jessica; Gao, Xin; Zavala, Diego; Orengo, Juan C; Abac, Sonia; Ruiz, Abigail; Laboy, Joaquín; Flores, Idhaliz

    2010-05-01

    The objective of this study was to assess the burden of endometriosis by obtaining patient-reported outcome data describing the experience of living with this disease. Survey data from 107 women with self-reported, surgically diagnosed endometriosis showed that living with this disease may be characterized by physical limitations that disrupt health, work, and daily life. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  4. Endometriosis-Induced Vaginal Hyperalgesia in the Rat: Role of the Ectopic Growths and their Innervation

    OpenAIRE

    McAllister, Stacy L.; McGinty, Kristina A.; Resuehr, David; Berkley, Karen J

    2009-01-01

    Endometriosis is a painful disorder defined by extrauteral endometrial growths whose contribution to pain symptoms is poorly understood. Endometriosis is created in rats by autotransplanting on abdominal arteries pieces of either uterus (ENDO), which form cysts, or fat (shamENDO), which do not form cysts. ENDO, but not shamENDO induces vaginal hyperalgesia. We tested the hypothesis that the cysts are necessary to maintain vaginal hyperalgesia by assessing the effect of surgically removing the...

  5. What Is Endometriosis? | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Endometriosis What Is Endometriosis? Past Issues / Summer 2016 Table of Contents A ... to the location of the pain. What causes endometriosis? The exact cause of endometriosis is not known, ...

  6. Follicular fluid lipid peroxidation levels in women with endometriosis during controlled ovarian hyperstimulation.

    Science.gov (United States)

    de Lima, Camila Bruna; Cordeiro, Fernanda Bertuccez; Camargo, Mariana; Zylbersztejn, Daniel Suslik; Cedenho, Agnaldo Pereira; Bertolla, Ricardo Pimenta; Lo Turco, Edson Guimarães

    2017-04-01

    This observational study aimed to establishing a relationship between lipid peroxidation and endometriosis in women undergoing controlled ovarian hyperstimulation. A total of 79 women were divided into two groups: (i) controls (tubal or male factor); and (ii) endometriosis (stages III/IV). The endometriosis diagnosis was confirmed by videolaparoscopy and the controlled ovarian stimulation protocol was similar to all patients. Follicular fluid (FF) lipid peroxidation levels were determined through the quantification of malondialdehyde. Statistical analysis was performed using parametric and non-parametric tests, logistic regression was performed to estimate the chance of achieving a pregnancy in each group and a moving average was calculated for the endometriosis group. Peroxidation levels in the endometriosis group were significantly higher when compared to controls. The moving average showed a decrease of MDA levels in the endometriosis group with increasing female age. Moreover, women with endometriosis who were under 33 years of age were 4.3 times more likely to achieve a pregnancy than women above that age. In conclusion, endometriosis is associated with increased FF oxidative stress (OS) in patients undergoing in vitro fertilization (IVF). Also, increasing age is associated with a decrease in severity of the oxidative status, but a decreased chance of pregnancy.

  7. Scar endometriosis developing after an umbilical hernia repair with mesh.

    Science.gov (United States)

    Majeski, James; Craggie, James

    2004-05-01

    A 44-year-old female was initially evaluated for a 3-cm umbilical hernia, which developed after a laparoscopic myomectomy performed seven years prior. The umbilical hernia was repaired using a synthetic mesh. Eight months after the umbilical hernia repair, the patient returned with chronic pain in a 3-cm raised mass originating from the umbilical hernia repair incision. The mass and mesh were surgically removed. The umbilical fascial defect was repaired with a primary fascia-to-fascia closure and the umbilicus was reconstructed from adjacent skin. The mass was found histologically to be endometriosis and fascial scarring with a foreign body reaction to synthetic mesh. Umbilical endometriosis developed either from peritoneal endometrial seeding from a laparoscopic myomectomy or from metaplasia of multipotential cells, which developed into endometriosis due to inflammatory stimulation by the synthetic mesh. Synthetic mesh probably should be avoided in the surgical repair of a laparoscopically caused umbilical hernia in a premenopausal female especially if there is a history of pelvic endometriosis.

  8. Pelvic pain in endometriosis: painkillers or sport to alleviate symptoms?

    Science.gov (United States)

    Koppan, A; Hamori, J; Vranics, I; Garai, J; Kriszbacher, I; Bodis, J; Rebek-Nagy, G; Koppan, M

    2010-06-01

    To assess potential individual factors influencing quality of life and pain scores of patients suffering from histologically confirmed endometriosis. Study using a questionnaire among patients of reproductive age undergoing laparoscopy with a presumed diagnosis of endometriosis. Details of fertility, previous treatments and quality of life, sexual activity, as well as linear pain scores for several symptoms, were recorded. Details of intraoperative findings were also collected and only those data were used where endometriosis was intraoperatively and histologically proven. A questionnaire before surgery gathered information from women on the following groups of variables: age, marital status, education, reproductive and medical history including previous pregnancies and parity, knowledge of accompanying pelvic disorders, regular sport activity, as well as general quality of life estimates including self-image. Pelvic pain was scored using a visual analogue scale. Data were statistically evaluated. Eighty-one patients complaining about persistent pelvic pain were later intraoperatively and histologically proven to have endometriosis. Thirty-one of them (38.2%) reported regular sport as part of their daily life schedule while 50 of them (61.8%) performed no physical activity at all. Fourteen patients among regular exercisers and 33 patients among those without physical activity reported the effectiveness of painkillers for pelvic pain, corresponding to 45.1% and 66% of these subgroups, respectively (difference statistically significant, ppainkillers might be less effective among endometriosis patients performing regular daily sport activities, and, thus it might impose them to an unnecessary burden of possible side-effects.

  9. Reproductive prognosis in daughters of women with and without endometriosis

    DEFF Research Database (Denmark)

    Dalsgaard, T; Hansen, Maj Vadskjær Hjordt; Hartwell, D;

    2013-01-01

    Do daughters of women with endometriosis exhibit an increased risk of endometriosis and impaired long-term reproductive prognosis when compared with daughters of women without endometriosis?......Do daughters of women with endometriosis exhibit an increased risk of endometriosis and impaired long-term reproductive prognosis when compared with daughters of women without endometriosis?...

  10. Shared genetics underlying epidemiological association between endometriosis and ovarian cancer

    DEFF Research Database (Denmark)

    Lu, Yi; Cuellar-Partida, Gabriel; Painter, Jodie N;

    2015-01-01

    Epidemiological studies have demonstrated associations between endometriosis and certain histotypes of ovarian cancer, including clear cell, low-grade serous and endometrioid carcinomas. We aimed to determine whether the observed associations might be due to shared genetic aetiology. To address...... this, we used two endometriosis datasets genotyped on common arrays with full-genome coverage (3194 cases and 7060 controls) and a large ovarian cancer dataset genotyped on the customized Illumina Infinium iSelect (iCOGS) arrays (10 065 cases and 21 663 controls). Previous work has suggested...... that a large number of genetic variants contribute to endometriosis and ovarian cancer (all histotypes combined) susceptibility. Here, using the iCOGS data, we confirmed polygenic architecture for most histotypes of ovarian cancer. This led us to evaluate if the polygenic effects are shared across diseases. We...

  11. Characteristics of women with endometriosis from the USA and Puerto Rico

    Science.gov (United States)

    Fourquet, Jessica; Sinaii, Ninet; Stratton, Pamela; Khayel, Fareed; Alvarez-Garriga, Carolina; Bayona, Manuel; Ballweg, Mary Lou; Flores, Idhaliz

    2016-01-01

    Purpose To describe lifetime differences in clinical characteristics of women with endometriosis between the USA and Puerto Rico. Methods A descriptive study using self-administered demographic and clinical questionnaires was undertaken. Women with self-reported surgically diagnosed endometriosis who completed questionnaires from the Endometriosis Association (EA), Wisconsin, USA (n = 4358) and the Endometriosis Research Program (ERP) in Puerto Rico (n = 878), were included in this study. We compared demographic, gynecological and clinical history, frequency of endometriosis-associated symptoms and co-morbidities. Results Although both groups have similar symptomatology, EA respondents had significantly higher rates of chronic pelvic pain and incapacitating pain than ERP participants. EA respondents were significantly more likely to report a history of problems getting pregnant, heavy bleeding, and hysterectomy than ERP respondents. Miscarriages were more frequently reported by the ERP group. Co-morbidities such as allergies, chronic fatigue syndrome, and fibromyalgia were more prevalent in EA respondents, whereas asthma was significantly more frequent in participants from ERP. Conclusions Overall, women with endometriosis from the USA and Puerto Rico reported high rates of pain and infertility and a similar spectrum of symptoms. Those from the EA reported longer time to diagnosis, and diagnostic delays than those from the ERP, which may explain the observed increased in rates of endometriosis-related symptoms and co-morbidities in EA as compared to ERP. PMID:27331050

  12. Ictal vomiting as a sign of temporal lobe epilepsy confirmed by stereo-EEG and surgical outcome.

    Science.gov (United States)

    Pietrafusa, Nicola; de Palma, Luca; De Benedictis, Alessandro; Trivisano, Marina; Marras, Carlo Efisio; Vigevano, Federico; Specchio, Nicola

    2015-12-01

    Vomiting is uncommon in patients with epilepsy and has been reported in both idiopathic and symptomatic epilepsies. It is presumed to originate in the anterior part of the temporal lobe or insula. To date, 44 cases of nonidiopathic focal epilepsy and seizures associated with ictal vomiting have been reported. Of the 44 cases, eight were studied using invasive exploration (3 stereo-EEG/5 subdural grids). Here, we report a 4-year-and-7-month-old patient with a history of febrile convulsion in the second year of life and who developed episodes of vomiting and complex partial seizures at 3 years of age. Scalp EEG showed no electrical modification during vomiting while the complex partial seizure displayed a clear right temporal origin. Brain MR showed hippocampal volume reduction with mild diffuse blurring of the temporal lobe. Stereoelectroencephalography study confirmed the mesiotemporal origin of the seizures and showed that the episodes of vomiting were strictly related to an ictal discharge originating in the mesial temporal structures without insular diffusion. The patient is now seizure-free (18 months) after removal of the right anterior and mesial temporal structures. In all the reported patients, seizures seemed to start in mesial temporal structures. The grid subgroup is more homogeneous, and the most prominent characteristic (4/5) is the involvement of both mesial and lateral temporal structures at the time of vomiting. In the S-EEG group, there is evidence of involvement of either the anterior temporal structures alone (2/3) or both insular cortices (1/3). Our case confirms that vomiting could occur when the ictal discharge is limited to the anterior temporal structure without insular involvement. Regarding the pathophysiology of vomiting, the role of subcortical structures such as the dorsal vagal complex and the central pattern generators (CPG) located in the reticular area is well established. Vomiting as an epileptic phenomenon seems to be related to

  13. Potential role of aromatase inhibitors in the treatment of endometriosis

    Directory of Open Access Journals (Sweden)

    Abu Hashim H

    2014-07-01

    Full Text Available Hatem Abu HashimDepartment of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura, EgyptAbstract: Endometriosis is an estrogen-dependent chronic inflammatory disease affecting 5%–10% of reproductive-age women, with a prevalence of 5%–50% in infertile women and >33% of women with chronic pelvic pain. Third-generation aromatase inhibitors (AIs are approved adjuvants for the treatment of estrogen receptor-positive breast cancer. Molecular studies have revealed the presence of aromatase P450, the key enzyme in the biosynthesis of ovarian estradiol, inside the endometriotic tissue, indicating local synthesis of estradiol. Thereby, AIs represent an appealing medical option for the management of different aspects of this enigmatic disease, especially pelvic pain and infertility. Accordingly, this review aims to evaluate the potential role of AIs in the treatment of endometriosis-associated symptoms, mainly pain and infertility. Notably, several studies have demonstrated that the combination of AIs with conventional therapy as oral contraceptive pills, progestins, or gonadotropin-releasing hormone analogs can be used to control endometriosis-associated pain and pain recurrence in premenopausal women, particularly those with pain due to rectovaginal endometriosis refractory to other medical or surgical treatment. Some case reports have shown promising results in the treatment of postmenopausal endometriosis as first-line treatment, when surgery is contraindicated, or as second-line treatment in the case of postoperative recurrence. Third-generation AIs, especially letrozole, have challenged clomiphene citrate as an ovulation-induction agent in patients with polycystic ovary syndrome and in cases of unexplained infertility. However, few studies are available regarding the use of AIs to treat endometriosis-associated infertility. Therefore, larger multicenter randomized trials using AIs for the treatment of endometriosis

  14. Deep Infiltrating Colorectal Endometriosis Treated With Robotic-Assisted Rectosigmoidectomy

    Science.gov (United States)

    Schraibman, Vladimir; Okazaki, Samuel; Maccapani, Gabriel; Chen, Winston Jenning; Domit, Cassia Danielle; Kaufmann, Oskar Grau; Advincula, Arnold P.

    2013-01-01

    Background and Objective: Deep infiltrating pelvic endometriosis with bowel involvement is one of the most aggressive forms of endometriosis. Nowadays, robotic technology and telemanipulation systems represent the latest developments in minimally invasive surgery. The aim of this study is to present our preliminary results and evaluate the feasibility of robotic-assisted laparoscopic colorectal resection for severe endometriosis. Methods: Between September 2009 and December 2011, 10 women with colorectal endometriosis underwent surgery with the da Vinci robotic surgical system (Intuitive Surgical, Sunnyvale, CA, USA). We evaluated the following parameters: short-term complications, clinical outcomes and long-term follow-up, pain relief recurrence rate, and fertility outcomes. Results: Extensive ureterolysis was required in 8 women (80%). Ovarian cystectomy with removal of the cystic wall was performed in 7 women (70%). Torus resection was performed in all women, with unilateral and bilateral uterosacral ligament resection in 1 woman (10%) and 8 women (80%), respectively. In addition to segmental colorectal resection in all cases, partial vaginal resection was necessary in 2 women (20%). An appendectomy was performed in 2 patients (20%). The mean operative time with the robot was 157 minutes (range, 90–190 minutes). The mean hospital stay was 3 days. Six patients had infertility before surgery, with a mean infertility time of 2 years. After a 12-month follow-up period, 4 women (67%) conceived naturally and 2 (33%) underwent in vitro fertilization. Conclusion: We show that robotic-assisted laparoscopic surgery for the treatment of deep infiltrating bowel endometriosis is feasible, effective, and safe. PMID:23925016

  15. Scar endometriosis after caesarean section: a case series and review of literature

    Directory of Open Access Journals (Sweden)

    Sandeep S. Nanaware

    2016-04-01

    Full Text Available Endometriosis is defined as extra-uterine localization of ectopic functional endometrial gland and stroma. Cystic or solid tumoral masses caused by endometriosis are named as endometrioma. Although these pathologic conditions mostly encountered in ligaments of uterus, ovaries, pouch of douglos and pelvic peritoneum; endometriosis has also been reported in nose, breast, lung, spleen, gastrointestinal tract, kidney, abdominal wall, but scar endometriomais extremely rare. Scar endometriosis is rare and difficult to diagnose. This condition can be confused with other surgical conditions, however imaging techniques and FNAC are indicated towards better diagnostic approach. Medical treatment is helpful in selected cases but wide excision is the treatment of choice. By presenting this paper, and conducting a review of the literature, we intend to increase the awareness of this rather, rare condition. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 948-952

  16. Transvaginal ultrasonography of rectal endometriosis

    DEFF Research Database (Denmark)

    Egekvist, Anne Gisselmann; Seyer-Hansen, Mikkel; Forman, Axel

    Objectives: The aim of this present study was to evaluate the interobserver variation of transvaginal ultrasonographic measurements of endometriosis infiltrating the rectosigmoid wall. Methods: Transvaginal ultrasonography was performed independently by two observers. Observer 1 had several years...... of experience in ultrasonography while observer 2 was a medical student with no prior experience in ultrasonography or endometriosis. In 24 patient length, width and depth of endometriosis infiltrating the rectosigmoid bowel was measured. The differences between the observers were analysed by Bland and Altman...... for a relatively short period gives comparable scanning results between the two observers. It seems that transvaginal ultrasound could be used as a diagnostic tool for rectal endometriosis in most departments. However, the irregular morphology of the lesions makes the measurements very complex, and a strict...

  17. Intraspinal endometriosis: a case report

    Institute of Scientific and Technical Information of China (English)

    孙正义; 汪玉良; 赵琳; 马璐琪

    2002-01-01

    @@ Endometriosis (EM) is defined by the presence of tissue histologically and functionally similar to the endometrium outside the uterus. EM has been mostly reported in the pelvis. Intraspinal endometriosis (IEM) is so rare that only four cases have been reported in the literature, to our knowledge.1-4 Two years ago, a patient was admitted to the Second Affiliated Hospital of Lanzhou Medical College and was treated successfully (with 2 years of follow-up).

  18. The International Endometriosis Evaluation Program (IEEP Study) – A Systematic Study for Physicians, Researchers and Patients

    Science.gov (United States)

    Burghaus, S.; Fehm, T.; Fasching, P. A.; Blum, S.; Renner, S. K.; Baier, F.; Brodkorb, T.; Fahlbusch, C.; Findeklee, S.; Häberle, L.; Heusinger, K.; Hildebrandt, T.; Lermann, J.; Strahl, O.; Tchartchian, G.; Bojahr, B.; Porn, A.; Fleisch, M.; Reicke, S.; Füger, T.; Hartung, C.-P.; Hackl, J.; Beckmann, M. W.; Renner, S. P.

    2016-01-01

    Introduction: Endometriosis is a heterogeneous disease characterized by a range of different presentations. It is usually diagnosed when patients present with pain and/or infertility, but it has also been diagnosed in asymptomatic patients. Because of the different diagnostic approaches and diverse therapies, time to diagnosis can vary considerably and the definitive diagnosis may be delayed, with some cases not being diagnosed for several years. Endometriosis patients have many unmet needs. A systematic registration and follow-up of endometriosis patients could be useful to obtain an insight into the course of the disease. The validation of biomarkers could contribute to the development of diagnostic and predictive tests which could help select patients for surgical assessment earlier and offer better predictions about patients who might benefit from medical, surgical or other interventions. The aim is also to obtain a better understanding of the etiology, pathogenesis and progression of the disease. Material and Methods: To do this, an online multicenter documentation system was introduced to facilitate the establishment of a prospective multicenter case-control study, the IEEP (International Endometriosis Evaluation Program) study. We report here on the first 696 patients with endometriosis included in the program between June 2013 and June 2015. Results: A documentation system was created, and the structure and course of the study were mapped out with regard to data collection and the collection of biomaterials. Conclusion: The documentation system permits the history and clinical data of patients with endometriosis to be recorded. The IEEP combines this information with biomaterials and uses it for scientific studies. The recorded data can also be used to evaluate clinical quality control measures such as the certification parameters used by the EEL (European Endometriosis League) to assess certified endometriosis centers. PMID:27582581

  19. Endometriosis Vulvar. Reporte de Caso

    Directory of Open Access Journals (Sweden)

    Duly Torres Cepeda

    2014-04-01

    Full Text Available La endometriosis es una patología ginecológica común caracterizada por el crecimiento de glándulas y estroma endometrial fuera del endometrio. Los implantes se encuentran comúnmente en la pelvis, pero pueden aparecer en diferentes sitios. La afección vulvar de la endometriosis es rara. Se presenta el caso de paciente de 19 años de edad quien consultó por presentar dolor e inflamación en la zona vulvar por más de dos años, síntomas que se hacían más persistentes durante la menstruación. Vulvar Endometriosis. Case Report Abstract Endometriosis is a common gynecologic pathology characterized by growth of endometrial glands and stroma outside the endometrium. Implants are most commonly found in the pelvis but can occur in many other sites. Vulvar involvement of endometriosis is extremely rare. A case of vulvar endometriosis is presented. A case of a 19-years old patient who was assisted for presenting pain and inflammation in vulvar zone for more than two years, symptoms that was more severe during menses

  20. Innervation of ectopic endometrium in a rat model of endometriosis

    OpenAIRE

    Berkley, Karen J; Dmitrieva, Natalia; Curtis, Kathleen S.; Papka, Raymond E

    2004-01-01

    Endometriosis (ENDO) is a disorder in which vascularized growths of endometrial tissue occur outside the uterus. Its symptoms include reduced fertility and severe pelvic pain. Mechanisms that maintain the ectopic growths and evoke symptoms are poorly understood. One factor not yet considered is that the ectopic growths develop their own innervation. Here, we tested the hypothesis that the growths develop both an autonomic and a sensory innervation. We used a rat model of surgically induced EN...

  1. ENVIRONMENTAL PCB EXPOSURE AND RISK OF ENDOMETRIOSIS

    Science.gov (United States)

    BACKGROUND: Hormonally active environmental agents recently have been associated with the development of endometriosis. METHODS: We undertook a study to assess the relation between endometriosis, an estrogen dependent gynecologic disease, and 62 individual polychlorinated biphe...

  2. What Are the Symptoms of Endometriosis?

    Science.gov (United States)

    ... the case. Hormone therapy such as estrogen or birth control pills, given to reduce menopausal symptoms, may cause these endometriosis symptoms to continue. Endometriosis-Related Pain Researchers know that pain is a primary symptom ...

  3. Genetic polymorphisms of cytochrome P450cl7alpha (CYP17) and progesterone receptor genes (PROGINS) in the assessment of endometriosis risk.

    Science.gov (United States)

    De Carvalho, Cristina Valleta; Nogueira-De-Souza, Naiara Correa; Costa, Ana Maria Massad; Baracat, Edmund Chada; Girão, Manoel J B C; D'Amora, Paulo; Schor, Eduardo; da Silva, Ismael D C G

    2007-01-01

    We designed the present study in order to evaluate the eventual role of polymorphisms in the genes encoding cytochrome P450c17alpha (CYP17) and the progesterone receptor (PROGINS) as risk factors for endometriosis development. Eligible cases consisted of 121 women with surgically confirmed endometriosis who underwent treatment in a hospital in São Paulo, Brazil during the period from September 2003 to September 2005. The 281 controls were participants with normal gynecological as well as pelvic ultrasound evaluation, who did not have any gynecological conditions during their reproductive lives such as pelvic pain and/or dyspareunia nor infertility history. Genomic DNA was obtained from buccal cells and processed for DNA extraction using the GFX DNA extraction kit (GE Healthcare). The CYP17 (-34T-->C) polymerase chain reaction-restriction fragment length polymorphism assay has been described previously, as has the progesterone receptor polymorphism (PROGINS) detection assay. PROGINS heterozygosis genotype frequencies were shown to be statistically higher in endometriosis cases compared with controls. On the other hand, differences in the CYP17 polymorphism (-34T-->C) frequencies were not even close to significance (p = 0.278) according to our findings.

  4. Obstetric Outcomes in Chinese Women with Endometriosis: A Retrospective Cohort Study

    Institute of Scientific and Technical Information of China (English)

    Hong Lin; Jin-Hua Leng; Jun-Tao Liu; Jing-He Lang

    2015-01-01

    Background:The effect of endometriosis on obstetric outcomes is still ambiguous.The aim of our study was to determine the association between endometriosis and adverse obstetric outcomes in a cohort of Chinese women.Methods:A retrospective cohort study was undertaken to compare obstetric outcomes between 249 women with endometriosis and 249 women without endometriosis.All women were nulliparous and achieved singleton pregnancies naturally.Women with endometriosis were diagnosed during surgery and confirmed histologically.Odds ratios (ORs) and 95% confidence intervals (CIs) of measures of obstetric outcomes were calculated.Results:Women with endometriosis showed significantly increased risks of preterm labor (adjusted OR,2.42; 95% CI,1.05-5.57),placenta previa (adjusted OR,4.51; 95% CI,1.23-16.50),and cesarean section (adjusted OR,1.93; 95% CI,1.31-2.84).No significant differences were observed in the incidence of pregnancy-induced hypertension,fetal growth restriction,small for gestational age,placental abruption,or luteal support in the first trimester between the two groups.Conclusions:Women with endometriosis are at a higher risk of preterm labor,placenta previa,and cesarean section during pregnancy and need additional care.

  5. Soluble ligands for the NKG2D receptor are released during endometriosis and correlate with disease severity.

    Directory of Open Access Journals (Sweden)

    Iñaki González-Foruria

    Full Text Available Endometriosis is a benign gynaecological disease. Abundant bulk of evidence suggests that patients with endometriosis have an immunity dysfunction that enables ectopic endometrial cells to implant and proliferate. Previous studies show that natural killer cells have a pivotal role in the immune control of endometriosis.This is a prospective laboratory study conducted in a tertiary-care university hospital between January 2011 and April 2013. We investigated non-pregnant, younger than 42-year-old patients (n= 202 during surgery for benign gynaecological conditions. After complete surgical exploration of the abdominopelvic cavity, 121 women with histologically proven endometriosis and 81 endometriosis-free controls women were enrolled. Patients with endometriosis were classified according to a surgical classification in three different types of endometriosis: superficial peritoneal endometriosis (SUP, ovarian endometrioma (OMA and deep infiltrating endometriosis (DIE. Peritoneal fluid samples were obtained from all study participants during the surgery in order to detect soluble NKG2D ligands (MICA, MICB and ULBP-2. When samples with undetectable peritoneal fluid levels of MICA, MICB and ULBP-2 were excluded, MICA ratio levels were significantly higher in endometriosis patients than in controls (median, 1.1 pg/mg; range, 0.1-143.5 versus median, 0.6 pg/mg; range, 0.1-3.5; p=0.003. In a similar manner peritoneal fluid MICB levels were also increased in endometriosis-affected patients compared with disease-free women (median, 4.6 pg/mg; range, 1.2-4702 versus median, 3.4 pg/mg; range, 0.7-20.1; p=0.001. According to the surgical classification, peritoneal fluid soluble MICA, MICB and ULBP-2 ratio levels were significantly increased in DIE as compared to controls (p=0.015, p=0.003 and p=0.045 respectively. MICA ratio levels also correlated with dysmenorrhea (r=0.232; p=0.029, total rAFS score (r=0.221; p=0.031 and adhesions rAFS score (r=0.221; p=0

  6. Bowel endometriosis: Recent insights and unsolved problems

    OpenAIRE

    2011-01-01

    Bowel endometriosis affects between 3.8% and 37% of women with endometriosis. The evaluation of symptoms and clinical examination are inadequate for an accurate diagnosis of intestinal endometriosis. Transvaginal ultrasonography is the first line investigation in patients with suspected bowel endometriosis and allows accurate determination of the presence of the disease. Radiological techniques (such as magnetic resonance imaging and multidetector computerized tomography enteroclysis) are use...

  7. Diagnostic Delay in Women with Endometriosis

    Institute of Scientific and Technical Information of China (English)

    Xiao-man Ding; Jing-he Lang

    2005-01-01

    @@ Women affected by endometriosis claim that delayed diagnosis of endometriosis is a great problem. Studies have shown a delay from 3 to 11 years between the onset of pain symptom and the final diagnosis of endometriosis. But the diagnostic time of Chinese patients has not been reported.

  8. Functional MicroRNA Involved in Endometriosis

    Science.gov (United States)

    Creighton, Chad J.; Han, Derek Y.; Zariff, Azam; Anderson, Matthew L.; Gunaratne, Preethi H.; Matzuk, Martin M.

    2011-01-01

    Endometriosis is a common disease seen by gynecologists. Clinical features involve pelvic pain and unexplained infertility. Although endometriosis is pathologically characterized by endometrial tissue outside the normal uterine location, endometriosis is otherwise not easily explained. Endometriomas, endometriotic cysts of the ovary, typically cause pain and distortion of pelvic anatomy. To begin to understand the pathogenesis of endometriomas, we describe the first transcriptome-microRNAome analysis of endometriomas and eutopic endometrium using next-generation sequencing technology. Using this approach, we generated a total of more than 54 million independent small RNA reads from our 19 clinical samples. At the microRNA level, we found 10 microRNA that were up-regulated (miR-202, 193a-3p, 29c, 708, 509-3-5p, 574-3p, 193a-5p, 485-3p, 100, and 720) and 12 microRNA that were down-regulated (miR-504, 141, 429, 203, 10a, 200b, 873, 200c, 200a, 449b, 375, and 34c-5p) in endometriomas compared with endometrium. Using in silico prediction algorithms, we correlated these microRNA with their corresponding differentially expressed mRNA targets. To validate the functional roles of microRNA, we manipulated levels of miR-29c in an in vitro system of primary cultures of human endometrial stromal fibroblasts. Extracellular matrix genes that were potential targets of miR-29c in silico were significantly down-regulated using this biological in vitro system. In vitro functional studies using luciferase reporter constructs further confirmed that miR-29c directly affects specific extracellular matrix genes that are dysregulated in endometriomas. Thus, miR-29c and other abnormally regulated microRNA appear to play important roles in the pathophysiology of uterine function and dysfunction. PMID:21436257

  9. MUC1 in endometriosis and ovarian cancer.

    Science.gov (United States)

    Vlad, Anda M; Diaconu, Iulia; Gantt, Kira R

    2006-01-01

    Endometriosis is a chronic, debilitating disease, associated with pelvic pain and infertility. Recent epidemiological studies suggest that women with endometriosis are at increased risk for ovarian cancer. Although the causative factors for both endometriosis and ovarian cancer remain largely unknown, several similarities between the proposed etiology of ovarian cancer and the observed pathophysiology of endometriosis have been reported. MUC1 glycoprotein is present in endometriotic lesions and overexpressed in epithelial ovarian tumors. We are currently studying immunity to MUC1 antigen in newly emerging preclinical models for endometriosis and ovarian cancer and exploring the potential for immune therapy/prevention with MUC1 in both diseases.

  10. Application of Mini-abdominoplasty after Conservative Excision of Extensive Cesarean Scar Endometriosis

    Directory of Open Access Journals (Sweden)

    Eui Tai Lee

    2012-09-01

    Full Text Available Endometriosis is defined as the presence of functioning endometrial tissue outside the uterine cavity, and the standard treatment is extensive surgical excision. Cesarean scar endometriosis is a type of cutaneous endometriosis arising on or near a Cesarean section scar. A 44-year-old woman presented with a 9×6 cm sized dark-brown, stony-hard, irregular, lower abdominal mass of four years duration. The patient had a history of two Cesarean deliveries, 14 and 16 years ago. Suspecting endometriosis, we excised the tumor conservatively rather than extensively to prevent incisional hernia considering the benign nature of the tumor and the low possibility of recurrence because the patient's age was near menopause, along with simultaneous bilateral salpingo-oophorectomy that was performed in this case. On reconstruction, mini-abdominoplasty was adopted to avoid possible wound complications and cosmetic deformities. The patient was satisfied with the cosmetic results, and neither recurrence nor functional problems occurred during the 1-year follow-up period. Plastic surgeons should keep in mind the possibility of cutaneous endometriosis in an abdominal mass of a female of reproductive age with a previous history of pelvic or intra-abdominal surgery. An optimal result from oncological, functional, and cosmetic standpoints can be achieved with conservative excision followed by mini-abdominoplasty of extensive Cesarean scar endometriosis.

  11. Pelvic inflammatory disease in women with endometriosis is more severe than in those without.

    Science.gov (United States)

    Elizur, Shai E; Lebovitz, Oshrit; Weintraub, Adi Y; Eisenberg, Vered H; Seidman, Daniel S; Goldenberg, Mordechai; Soriano, David

    2014-04-01

    To determine the incidence and severity of acute pelvic inflammatory disease (PID) or tubo-ovarian abscess (TOA) in hospitalised women with and without a history of endometriosis. Retrospective analysis of hospital records retrieved for all women hospitalised with PID or TOA between January 2008 and December 2011 in a tertiary referral centre. Women were compared with regard to a history of endometriosis for demographic, clinical and fertility data. 26 (15%) of the 174 women hospitalised due to PID or TOA were excluded because of age older than 45 years, leaving 148 for analysis. The mean age was 35.7 ± 9.3 years and mean duration of hospitalisation was 5.9 ± 3.7 days. The women were divided into two groups: Group 1 with endometriosis (n = 21) and Group 2 without endometriosis (n = 127). Women in Group 1 as compared with Group 2 were significantly more likely to have undergone a fertility procedure prior to being admitted to the hospital with PID (9/27 (45%) vs 22/121 (17%), P Pelvic inflammatory disease in women with endometriosis is more severe and refractory to antibiotic treatment, often requiring surgical intervention. It is likely that endometriosis is a risk factor for the development of severe PID, particularly after IVF treatment. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  12. Polymorphic variants in the dopamine receptor D2 in women with endometriosis-related infertility.

    Science.gov (United States)

    Szczepańska, Malgorzata; Mostowska, Adrianna; Wirstlein, Przemyslaw; Skrzypczak, Jana; Misztal, Matthew; Jagodziński, Paweł P

    2015-08-01

    Data suggests that dopamine receptor DRD2 gene variants may contribute to hyperprolactinemia and that they may be risk factors for endometriosis-related infertility. The purpose of the present study was to determine whether nucleotide variants of the DRD2 gene may be associated with infertility related to endometriosis. Five DRD2 SNPs, rs1800497, rs6277, rs2283265, rs4245146 and rs4648317, which are located in different blocks of linkage disequilibrium, were studied in 151 cases and 381 controls. No significant differences between DRD2 rs1800497, rs6277, rs2283265, rs4245146 and rs4648317 genotype, allele nor haplotype frequencies were observed in women with endometriosis-related infertility compared with the control group. The present results did not confirm DRD2 gene variants to be genetic risk factors for endometriosis-related infertility.

  13. Aromatase inhibitors in the treatment of deep endometriosis

    Directory of Open Access Journals (Sweden)

    Simone Ferrero

    2009-09-01

    Full Text Available Recent case reports and pilot studies suggested that aromatase inhibitors might be effective in treating pain symptoms related to the presence of endometriosis. We present the case of a 32-year-old woman who suffered dysmenorrhea, dyspareunia, chronic pelvic pain, and dyschezia caused by rectovaginal endometriosis. Pain symptoms recurred after treatment with the oral contraceptive pill; the patient refused surgery. Therefore a double-drug regimen including letrozole (2.5 mg/day and norethisterone acetate (2.5 mg/day was offered to the patient. The scheduled length of treatment was six months. This double-drug regimen determined a quick and significant improvement in all pain symptoms. During treatment, the patient complained mild arthralgia. After the interruption of treatment, pain symptoms quickly recurred and at 6-month follow-up their intensity was similar to baseline values. Operative laparoscopy was performed, the presence of rectovaginal endometriosis was confirmed and all visible endometriotic lesions were excised. Aromatase inhibitors might be offered when pain symptoms caused by endometriosis persist during the administration of other hormonal therapies and the patient refuses surgery. However, women must be informed that these drugs determine only a temporary relief of pain symptoms and might cause adverse effects (such as arthralgia.

  14. [Gestrinone in pelvic endometriosis. A one-year evaluation].

    Science.gov (United States)

    Cervantes Villarreal, E; García Zamarripa, H R; Herrera Prado, E; Barrón Vallejo, J

    1995-08-01

    The therapeutical effectiveness of gestrinone in endometriosis treatment, as well as its long term side effects, were evaluated. Prospective, clinical trial. At "Dr. Alejandro Castanedo Kimball" Hospital (PEMEX). Salamanca, Guanajuato. México. Thirty women with laparoscopically confirmed endometriosis, were studied. Subjects received 2.5 mg. of gestrinone two times per week for 6 months. Laparoscopy was performed before treatment, and clinical response was determined by second laparoscopy after 6 months. The pregnancy rate, frequency of side effects and recurrence of symptoms were determined. Median total endometriosis scores and symptoms decreased significantly after treatment. Four pregnancies were observed after treatment. The principal side effects were: ponderal increase, changes in the voice and hirsutism. However, the side effects disappeared after one year of clinical survey. The results indicate that gestrinone is effective in the treatment of pelvic endometriosis. In despite of a clear benefic effect on stage of the disease and symptoms; the use of gestrinone should weigh the risk-benefit (cost versus metabolic side effects) of treatment.

  15. Interstitial Cystitis and Endometriosis in Patients With Chronic Pelvic Pain: The “Evil Twins” Syndrome

    Science.gov (United States)

    Chung, Rosemary P.; Gordon, David

    2005-01-01

    Objective: To determine the prevalence of interstitial cystitis and endometriosis in patients with chronic pelvic pain. Methods: A prospective analysis was conducted in 178 women with CPP who presented with bladder base/anterior vaginal wall and/or uterine tenderness, with or without irritative voiding symptoms. The Potassium Sensitivity Test was used to assess bladder epithelial dysfunction. Patients were evaluated with concurrent laparoscopy and cystoscopy with hydrodistention. Results: Laparoscopic findings among the 178 patients with chronic pelvic pain supported a diagnosis of endometriosis in 134 (75%) patients, and cystoscopy confirmed a diagnosis of interstitial cystitis in 159 (89%) patients. Both interstitial cystitis and endometriosis were diagnosed in 115 patients (65%). The Potassium Sensitivity Test was positive in 146 (82%) patients, with 140 (96%) of these patients diagnosed with interstitial cystitis and 105 (72%) with endometriosis. Conclusions: Results of this prospective study show that interstitial cystitis and endometriosis may frequently coexist in patients with chronic pelvic pain. A positive Potassium Sensitivity Test accurately predicted the presence of interstitial cystitis in 96% of these patients with chronic pelvic pain, as confirmed by cystoscopic hydrodistention. It is necessary to consider the diagnosis of endometriosis and interstitial cystitis concurrently in the evaluation of patients with chronic pelvic pain to avoid unnecessary delay in identifying either condition. PMID:15791965

  16. Robotic Shaving Technique in 25 Patients Affected by Deep Infiltrating Endometriosis of the Rectovaginal Space.

    Science.gov (United States)

    Pellegrino, Antonio; Damiani, Gianluca Raffaello; Trio, Claudia; Faccioli, Paolo; Croce, Paolo; Tagliabue, Fulvio; Dainese, Emanuele

    2015-01-01

    Minimally invasive surgery represents the gold standard for the management of deep infiltrating endometriosis (DIE) involving the rectovaginal septum (RVS). This analysis aimed to evaluate the feasibility of robotic-assisted laparoscopy (RAL) and clinical outcomes in terms of long-term complications, pain relief, and recurrence rate for the treatment of DIE of the RVS. A prospective cohort study of robotic procedures was performed between October 2010 and July 2014, including removal of endometriotic nodules from the RVS with rectal shaving alone or in combination with accessory procedures. In all cases, the revised American Society for Reproductive Medicine (rASRM) score for endometriosis was >40 points (stage IV). Twenty-five consecutive patients underwent RAL, with a successful complete nodule debulking by the wall shaving technique. Pathology confirmed the adequacy of the surgical specimen and the median largest endometriotic nodule was of 21 mm (range, 10-60 mm), with free margins in all cases. The median operative time from skin opening to closure was 174 minutes (range, 75-300 minutes), and blood loss was close to 0 mL. The median revised Enzian score for location A (RVS) was 2 (range, 1-3). The most frequent Enzian class was A2B0C0 (48%), followed by A3B0C0 (12%). In 3 cases (12%), partial vaginal resection was required to remove endometriotic nodules of the RVS (1 each in classes A3B0C1FI, A3B0C0FO, and A3B0C0). No intraoperative complications occurred. This series has a median long-term follow up of 22 months (range, 6-50 months) currently available with an optimal operative time, demonstrating good long-term outcomes. Our data support robotics as a safe and attractive alternative for comprehensive surgical treatment of DIE.

  17. Surgery for endometriosis-associated infertility: do we exaggerate the magnitude of effect?

    Science.gov (United States)

    Rizk, B.; Turki, R.; Lotfy, H.; Ranganathan, S.; Zahed, H.; Freeman, A.R.; Shilbayeh, Z.; Sassy, M.; Shalaby, M.; Malik, R.

    2015-01-01

    Objective: Surgery remains the mainstay in the diagnosis and management of endometriosis. The number of surgeries performed for endometriosis worldwide is ever increasing, however do we have evidence for improvement of infertility after the surgery and do we exaggerate the magnitude of effect of surgery when we counsel our patients? The management of patients who failed the surgery could be by repeat surgery or assisted reproduction. What evidence do we have for patients who fail assisted reproduction and what is their best chance for achieving pregnancy? Material and methods: In this study we reviewed the evidence-based practice pertaining to the outcome of surgery assisted infertility associated with endometriosis. Manuscripts published in PubMed and Science Direct as well as the bibliography cited in these articles were reviewed. Patients with peritoneal endometriosis with mild and severe disease were addressed separately. Patients who failed the primary surgery and managed by repeat or assisted reproduction technology were also evaluated. Patients who failed assisted reproduction and managed by surgery were also studied to determine of the best course of action. Results: In patients with minimal and mild pelvic endometriosis, excision or ablation of the peritoneal endometriosis increases the pregnancy rate. In women with severe endometriosis, controlled trials suggested an improvement of pregnancy rate. In women with ovarian endometrioma 4 cm or larger ovarian cystectomy increases the pregnancy rate, decreases the recurrence rate, but is associated with decrease in ovarian reserve. In patients who have failed the primary surgery, assisted reproduction appears to be significantly more effective than repeat surgery. In patients who failed assisted reproduction, the management remains to be extremely controversial. Surgery in expert hands might result in significant improvement in pregnancy rate. Conclusion: In women with minimal and mild endometriosis, surgical

  18. Confronting Endometriosis | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Endometriosis Confronting Endometriosis Past Issues / Summer 2016 Table of Contents left ... condition. Would you share your personal history with endometriosis? My symptoms started with my first period when ...

  19. Nutritional aspects related to endometriosis

    Directory of Open Access Journals (Sweden)

    Gabriela Halpern

    2015-12-01

    Full Text Available SUMMARY This literature review analyzed the evidence on nutritional aspects related to the pathogenesis and progression of endometriosis. Diets deficient in nutrients result in changes in lipid metabolism, oxidative stress and promote epigenetic abnormalities, that may be involved in the genesis and progression of the disease. Foods rich in omega 3 with anti-inflammatory effects, supplementation with Nacetylcysteine, vitamin D and resveratrol, in addition to the increased consumption of fruits, vegetables (preferably organic and whole grains exert a protective effect, reducing the risk of development and possible regression of disease. Dietary re-education seems to be a promising tool in the prevention and treatment of endometriosis.

  20. Evaluation of endometriosis-associated pain and influence of conventional treatment: a systematic review

    Directory of Open Access Journals (Sweden)

    Alessandra Bernadete Trovó de Marqui

    2015-12-01

    Full Text Available SUMMARY Endometriosis is a chronic gynecological disease characterized by sustained painful symptoms that are responsible for a decline in the quality of life of sufferers. Conventional treatment includes surgical and pharmacological therapy aiming at reducing painful symptoms. This study aimed to evaluate pain levels in women with endometriosis, focusing on the influence of conventional treatment in controlling this variable. To do so, a literature search was conducted in the Medline/Pubmed databases, with 119 scientific articles found. After applying the inclusion and exclusion criteria, 27 were selected for reading and elaboration of this review. Thus, 9 studies evaluated the contribution of surgery, 17 the use of drugs to reduce pain levels in patients with endometriosis and one assessed surgical and medical treatment. The main results of these searches are presented and discussed in this revision. Surgery and the use of drugs provided reduced pain scores in patients with endometriosis but nevertheless exhibit disadvantages, such as risk of recurrence and side effects, respectively. Treatment of endometriosis is, therefore, a challenge for gynecologists and patients, as they must select the best therapeutic approach for this disease. However, improved quality of life in these patients has been obtained with the use of conventional treatment.

  1. Perineal endometriosis without perineal trauma: a case report

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    @@ Endometriosis is a common disease in women. It frequently occurs in the ovaries, uterosacral ligament and other pelvic organs. Perineal endometriosis is very rare. The incidence of perineal endometriosis in our hospital was 0.87‰.1 Most perineal endometriosis occurred after vaginal delivery with perineal tearing or episiotomy. Perineal endometriosis without perineal trauma is even rarer. Extraperitoneal endometriosis, although of minor significance in clinical practice, may prove to be important in understanding the pathophysiology of this disease.

  2. Role of robotic surgery in the management of deep infiltrating endometriosis.

    Science.gov (United States)

    Sussfeld, Julie; Segaert, An; Rubod, Chrystèle; Collinet, Pierre

    2016-02-01

    Standard laparoscopy (SL) is the gold standard for endometriosis surgery including deep infiltrating endometriosis (DIE). DIE laparoscopic surgery can require complex surgical procedures performed by multidisciplinary surgical team. Robotic assisted laparoscopy (RAL) could offer technical advantages such as 3D vision, tremor filtration and better surgical ergonomy. RAL would be able to improve surgical performances compared to SL, decrease perioperative morbidity and decrease the risk of laparo-conversion. For these reasons, DIE could be one of the best indications for RAL in gynecologic surgery. Demonstrating the feasibility of RAL for DIE surgery, few series of cases have been already published. None of them have demonstrated differences in surgical outcomes. One randomized control trial comparing SL to RAL would be mandatory in order to define potential benefits of RAL for DIE surgery.

  3. Abdominal Wall Endometrioma after Laparoscopic Operation of Uterine Endometriosis

    Directory of Open Access Journals (Sweden)

    Tihomir Vukšić

    2016-01-01

    Full Text Available Endometriosis is presence of functional endometrium outside of uterine cavum. As a pluripotent tissue, endometrium has the possibility of implanting itself almost everywhere; even implantation in abdominal wall was described, but it is not common site. This case report presents implantation of functional endometrium in abdominal wall, inside scar tissue, and after insertion of a laparoscopic trocar port. Final diagnosis was confirmed by pathohistological examination.

  4. CCAAT/enhancer-binding protein α is epigenetically silenced by histone deacetylation in endometriosis and promotes the pathogenesis of endometriosis.

    Science.gov (United States)

    Kawano, Yukie; Nasu, Kaei; Hijiya, Naoki; Tsukamoto, Yoshiyuki; Amada, Kohei; Abe, Wakana; Kai, Kentaro; Moriyama, Masatsugu; Narahara, Hisashi

    2013-09-01

    Accumulating evidence suggests that various epigenetic aberrations play definite roles in the pathogenesis of endometriosis. The objective of the study was to determine the epigenetically silenced genes by histone deacetylation in endometriosis. Histone deacetylase-1 target mRNAs that were up-regulated by valproic acid (VPA) treatment in endometriotic cyst stromal cells (ECSCs) were identified by a global mRNA microarray technique. We identified 5 candidate genes and chose CCAAT/enhancer-binding protein α (C/EBPα) for further functional experiments. C/EBPα mRNA and protein expression is attenuated in ECSCs, and the expression was up-regulated by VPA stimulation. Immunohistochemical stainings also confirmed the decreased staining for C/EBPα protein in endometriotic tissues. VPA treatment resulted in an accumulation of acetylated histones H3 and H4 in the promoter region of the C/EBPα gene in ECSCs. The compulsory expression of C/EBPα in ECSCs directed the inhibition of cell proliferation and the induction of apoptosis. C/EBPα knockdown by small interfering RNA directed the stimulation of cell proliferation and the resistance to apoptosis in normal eutopic endometrial stromal cells. The expressions of peroxisome proliferator-activated receptor-γ (PPARγ), period homolog 2 (PER2), p53, apoptosis-inducing factor, mitochondrion-associated 1 (AIFM1), Bax, caspase-8, caspase-10, p16(INK4a), p21(Waf1/Cip1), cyclin-dependent kinase (cdk) 2, and cdk4 were down-regulated by C/EBPα knockdown. Our findings suggest that an epigenetically suppressed tumor suppressor gene is involved in the pathogenesis of endometriosis by creating the proliferative, antiapoptotic, and other disease-specific characteristics of endometriosis. The results also suggest that histone deacetylase inhibitors are promising agents for the treatment of endometriosis.

  5. Vulvar endometriosis and Nuck canal.

    Science.gov (United States)

    Mazzeo, Carmelo; Gammeri, Emanuele; Foti, Agata; Rossitto, Maurizio; Cucinotta, Eugenio

    2014-12-29

    L’endometriosi è una patologia non ancora del tutto conosciuta che colpisce il 6-10% della popolazione femminile generare e il 35-50% della popolazione femminile affetta da dolore pelvico e infertilità. La sede più frequente di malattia è rappresentata dall’ovaio e ciò sostiene l’ipotesi patogenetica della mestruazione retrograda. Viene descritto un caso di non comune localizzazione vulvare di endometriosi riscontrata in una paziente precedentemente operata per una cisti di Nuck. La donna aveva notato da qualche mese l’insorgenza di una tumefazione nella regione vulvare che le causava dolore e dispareunia che si accentuavano nel periodo mestruale. Il sospetto clinico di endometriosi non aveva avuto conferma negli esami strumentali preoperatori che non avevano evidenziato alterazioni patognomoniche, nè differenze dei reperti in fase pre mestruale e mestruale. Solo l’esame istologico della neoformazione asportata ha confermato la diagnosi. Inoltre gli Autori con la presente nota desiderano sottolineare come nella patogenesi dell’endometriosi vulvare debba essere tenuta in considerazione la presenza della pervietà del dotto peritoneovaginale o dotto di Nuck. Nel caso clinico descritto, infatti, la paziente era stata sottoposta due anni prima ad asportazione di una cisti di Nuck con obliterazione del dotto peritoneovaginale. Tuttavia già in quella fase clinica poteva essersi determinato un impianto endometriosico, che si era poi evidenziato con la formazione del nodulo in sede vulvare asportato chirurgicamente.

  6. MRI atlas of ectopic endometriosis.

    Science.gov (United States)

    Dallaudière, B; Salut, C; Hummel, V; Pouquet, M; Piver, P; Rouanet, J-P; Maubon, A

    2013-03-01

    Ectopic endometriosis is a common condition which is often underdiagnosed, where MRI can help make a diagnosis simply, non-invasively and without irradiation. However, imagery signs of it are enormously polymorphic with a wide range of possible locations. In this paper, we have tried to illustrate comprehensively all its MRI appearances depending on the different locations where it occurs.

  7. NIH Seeks Answers for Endometriosis

    Science.gov (United States)

    ... be transmitted to future generations Investigating the stem cell origins of the disease Researching ways to better understand how endometriosis and infertility effect and relate to each other Continuing development of animal and in vitro models to study how the disease begins, progresses, ...

  8. Surgical Assisting

    Science.gov (United States)

    ... Insert and remove Foley urinary bladder catheter Place pneumatic tourniquet Confirm procedure with surgeon Drape patient within ... Technology and Surgical Assisting (NBSTSA) offers the CertifiedSurgical First Assistant (CSFA) credential, and the National Surgical Assistant ...

  9. Innovations in classical hormonal targets for endometriosis.

    Science.gov (United States)

    Pluchino, Nicola; Freschi, Letizia; Wenger, Jean-Marie; Streuli, Isabelle

    2016-01-01

    Endometriosis is a chronic disease of unknown etiology that affects approximately 10% of women in reproductive age. Several evidences show that endometriosis lesions are associated to hormonal imbalance, including estrogen synthesis, metabolism and responsiveness and progesterone resistance. These hormonal alterations influence the ability of endometrial cells to proliferate, migrate and to infiltrate the mesothelium, causing inflammation, pain and infertility. Hormonal imbalance in endometriosis represents also a target for treatment. We provide an overview on therapeutic strategies based on innovations of classical hormonal mechanisms involved in the development of endometriosis lesions. The development phase of new molecules targeting these pathways is also discussed. Endometriosis is a chronic disease involving young women and additional biological targets of estrogen and progesterone pharmacological manipulation (brain, bone and cardiovascular tissue) need to be carefully considered in order to improve and overcome current limits of long-term medical management of endometriosis.

  10. Endometriosis & infertility: How and when to treat?

    Directory of Open Access Journals (Sweden)

    Anis eFadhlaoui

    2014-07-01

    Full Text Available Endometriosis is defined as the presence of endometrial-like tissue (glands or stroma outside the uterus, which induces a chronic inflammatory reaction. Although endometriosis impairs fertility, it does not usually completely prevent conception. The question of evidence based-medicine guidelines in endometriosis-associated infertility is week in many situations. Therefore, we will highlight in this issue where the challenges are.

  11. [Vesical endometriosis after cesarean section: diagnostico-therapeutic aspects].

    Science.gov (United States)

    García González, J I; Extramiana Cameno, J; Esteban Calvo, J M; Díez Rodríguez, J M; Esteban Artiaga, R; Arrizabalaga Moreno, M; Paniagua Andrés, P

    1997-09-01

    Endometriosis is a benign condition with an aggressive behaviour defined by the presence of ectopic endometrial tissue, outside the uterus. It occurs in 15-20% women with child bearing potential. Most commonly it affects organs such as the ovaries, uterine ligaments, fallopian tubes, rectum and the cervico-vaginal region. Involvement of the urinary tract, however, is rare. It can be seen in just about 1% cases, vesical location being the most frequent of these presentations (84% cases). We describe one case of vesical endometriosis that developed after a cesarean section. The intra-operative findings confirmed the existence of infiltration of the detrusor muscle and the vesical mucosa by endometrial tissue from the area of the uterine incision. A discussion of the different diagnostic and therapeutic options is also included.

  12. Elevated levels of whole blood nickel in a group of Sri Lankan women with endometriosis: a case control study

    Directory of Open Access Journals (Sweden)

    Silva Nalinda

    2013-01-01

    Full Text Available Abstract Background Endometriosis is characterized by the persistence of endometrial tissue in ectopic sites outside the uterine cavity. Presence of nickel, cadmium and lead in ectopic endometrial tissue has been reported previously. While any association between blood levels of nickel and endometriosis is yet to be described in literature, conflicting reports are available with regards to cadmium and lead levels in blood and urine. Findings In fifty patients with endometriosis and fifty age-matched controls confirmed by laparoscopy or laparotomy, whole blood samples were collected and digested using supra pure 65% HNO3. Whole blood levels of nickel and lead were measured using Total Reflection X-ray Fluorescence (TXRF while cadmium levels were evaluated using graphite furnace atomic absorption spectroscopy (GFASS. Women with endometriosis had significantly higher (P=0.016 geometric mean (95% CI whole blood nickel levels [2.6(1.9-3.3 μg/L] as compared to women without endometriosis [0.8 (0.7-0.9 μg/L]. Whole blood levels of cadmium and lead were similar between the two groups. Conclusions Although women with endometriosis in this study population had higher levels of nickel in whole blood compared to controls, whether nickel could be considered as an aetiological factor in endometriosis remains inconclusive in view of the smaller sample that was evaluated.

  13. Management of patients with chronic pelvic pain associated with endometriosis refractory to conventional treatment.

    Science.gov (United States)

    Martínez, Blanca; Canser, Enrique; Gredilla, Elena; Alonso, Eduardo; Gilsanz, Fernando

    2013-01-01

    The literature contains numerous studies on the diagnosis, pathogenesis, atypical locations, and clinical (hormonal) and surgical management of the disorder. However, no information is available on the management of endometriosis involving pain refractory to the usual treatment from the perspective of a pain unit. Our hospital has a pain unit specifically dedicated to pain in gynecology and obstetrics. The unit has been functioning since December 2005, and 52% of the attended patients have CPP of different origins. Endometriosis is present in 48% of all patients with CPP and is the most prevalent pathology in our practice. It moreover poses an important challenge in view of its enormous complexity. A descriptive study was made of the management of 44 patients with endometriosis refractory to therapy, evaluated and treated over a period of 3 years in the Pain Unit of the Maternity Center of La Paz University Hospital (Madrid, Spain).

  14. Stress Management Affects Outcomes in the Pathophysiology of an Endometriosis Model

    Science.gov (United States)

    Cruz, Myrella L.; Hernández, Siomara; Thompson, Kenira J.; Bayona, Manuel; Flores, Idhaliz

    2014-01-01

    We have previously shown detrimental effects of stress in an animal model of endometriosis. We now investigated whether the ability to control stress can affect disease parameters. Endometriosis was surgically induced in female Sprague-Dawley rats before exposing animals to a controllable (submerged platform) or uncontrollable (no platform) swim stress protocol. Corticosterone levels and fecal pellet numbers were measured as an indicator of stress. Uncontrollable stress increased the number and size of the endometriotic cysts. Rats receiving uncontrollable stress had higher anxiety than those exposed to controllable stress or no stress and higher corticosterone levels. Uncontrollable stressed rats had more colonic damage and uterine cell infiltration compared to no stress, while controllable stress rats showed less of an effect. Uncontrollable stress also increased both colonic and uterine motility. In summary, the level of stress controllability appears to modulate the behavior and pathophysiology of endometriosis and offers evidence for evaluating therapeutic interventions. PMID:25015902

  15. Application of Mini-abdominoplasty after Conservative Excision of Extensive Cesarean Scar Endometriosis

    Directory of Open Access Journals (Sweden)

    Eui Tai Lee1

    2012-09-01

    Full Text Available Endometriosis is defined as the presence of functioning endometrial tissue outside the uterinecavity, and the standard treatment is extensive surgical excision. Cesarean scar endometriosisis a type of cutaneous endometriosis arising on or near a Cesarean section scar. A 44-year-oldwoman presented with a 9×6 cm sized dark-brown, stony-hard, irregular, lower abdominalmass of four years duration. The patient had a history of two Cesarean deliveries, 14 and16 years ago. Suspecting endometriosis, we excised the tumor conservatively rather thanextensively to prevent incisional hernia considering the benign nature of the tumor andthe low possibility of recurrence because the patient’s age was near menopause, alongwith simultaneous bilateral salpingo-oophorectomy that was performed in this case. Onreconstruction, mini-abdominoplasty was adopted to avoid possible wound complicationsand cosmetic deformities. The patient was satisfied with the cosmetic results, and neitherrecurrence nor functional problems occurred during the 1-year follow-up period. Plasticsurgeons should keep in mind the possibility of cutaneous endometriosis in an abdominalmass of a female of reproductive age with a previous history of pelvic or intra-abdominalsurgery. An optimal result from oncological, functional, and cosmetic standpoints can beachieved with conservative excision followed by mini-abdominoplasty of extensive Cesareanscar endometriosis.

  16. World Endometriosis Research Foundation Endometriosis Phenome and Biobanking Harmonization Project: III. Fluid biospecimen collection, processing, and storage in endometriosis research

    DEFF Research Database (Denmark)

    Rahmioglu, Nilufer; Fassbender, Amelie; Vitonis, Allison F.;

    2014-01-01

    ObjectiveTo harmonize standard operating procedures (SOPs) and standardize the recording of associated data for collection, processing, and storage of fluid biospecimens relevant to endometriosis.......ObjectiveTo harmonize standard operating procedures (SOPs) and standardize the recording of associated data for collection, processing, and storage of fluid biospecimens relevant to endometriosis....

  17. World Endometriosis Research Foundation Endometriosis Phenome and Biobanking Harmonisation Project: IV. Tissue collection, processing, and storage in endometriosis research

    DEFF Research Database (Denmark)

    Fassbender, Amelie; Rahmioglu, Nilufer; Vitonis, Allison F.;

    2014-01-01

    ObjectiveTo harmonize standard operating procedures (SOPs) and standardize the recording of associated data for collection, processing, and storage of human tissues relevant to endometriosis.......ObjectiveTo harmonize standard operating procedures (SOPs) and standardize the recording of associated data for collection, processing, and storage of human tissues relevant to endometriosis....

  18. World Endometriosis Research Foundation Endometriosis Phenome and biobanking harmonization project: II. Clinical and covariate phenotype data collection in endometriosis research

    DEFF Research Database (Denmark)

    Vitonis, Allison F.; Vincent, Katy; Rahmioglu, Nilufer;

    2014-01-01

    ObjectiveTo harmonize the collection of nonsurgical clinical and epidemiologic data relevant to endometriosis research, allowing large-scale collaboration.......ObjectiveTo harmonize the collection of nonsurgical clinical and epidemiologic data relevant to endometriosis research, allowing large-scale collaboration....

  19. Endometriosis in the north Italian province of South Tyrol.

    Science.gov (United States)

    Steinkasserer, Martin; Engl, Bruno

    2009-11-01

    Here, we report regarding the health status and medical support for patients suffering from endometrioisis in South Tyrol, which is a politically autonomous province in the north of Italy containing three different ethnic groups. The health service is administered largely by the autonomous regional government. Because of the establishment of a centre for reproductive medicine and the introduction of laparoscopy as a prime surgery method, the gynaecological department of the hospital in Bruneck developed into a reference centre for diagnosis and surgical treatment for endometriosis. The planned future social, health care and insurance developments on local and national level regarding this illness will be discussed.

  20. Relationship between Endometriosis and Subfertility

    Institute of Scientific and Technical Information of China (English)

    DJ Cahill

    2003-01-01

    An association between minor endometriosis and subfertility is shown by prevalence studies but a clear causal relationship has not yet been demonstrated. This review presents the evidence for pituitary-ovarian dysfunction as a cause for subfertility in women with minor endometriosis. Using tubal infertility cases as controls, group comparison has shown effects on the following: follicular growth (impaired), preovulatory circulating oestradiol levels (reduced) and early luteal phase oestradiol and progesterone (reduced) , and LH surge patterns (disordered). preovulatory follicular fluid LH concentration (reduced), and granulosa cell steroidogenic capacity (impaired) . However, these findings are not consistent in the literature. Compared with controls, reduced oocyte fertilisation and implantation rates are reported in natural and gonadotrophin stimulated cycles. An inherent disorder of follicular function is possible as a cause, with LH surge impairment probably a secondary phenomenon. Natural subfertility is substantially disordered as a result of oocyte fertilisation impairment. However, as excess numbers of oocytes are available in bitrofertility in vitro fertility (IVF) is still successful.

  1. Full-Thickness Excision versus Shaving by Laparoscopy for Intestinal Deep Infiltrating Endometriosis: Rationale and Potential Treatment Options

    Directory of Open Access Journals (Sweden)

    Antonio Simone Laganà

    2016-01-01

    Full Text Available Endometriosis is defined as the presence of endometrial mucosa (glands and stroma abnormally implanted in locations other than the uterine cavity. Deep infiltrating endometriosis (DIE is considered the most aggressive presentation of the disease, penetrating more than 5 mm in affected tissues, and it is reported in approximately 20% of all women with endometriosis. DIE can cause a complete distortion of the pelvic anatomy and it mainly involves uterosacral ligaments, bladder, rectovaginal septum, rectum, and rectosigmoid colon. This review describes the state of the art in laparoscopic approach for DIE with a special interest in intestinal involvement, according to recent literature findings. Our attention has been focused particularly on full-thickness excision versus shaving technique in deep endometriosis intestinal involvement. Particularly, the aim of this paper is clarifying from the clinical and methodological points of view the best surgical treatment of deep intestinal endometriosis, since there is no standard of care in the literature and in different surgical settings. Indeed, this review tries to suggest when it is advisable to manage the full-thickness excision or the shaving technique, also analyzing perioperative management, main complications, and surgical outcomes.

  2. The Evil Twins of Chronic Pelvic Pain Syndrome: Endometriosis and Interstitial Cystitis

    Science.gov (United States)

    Chung, Rosemary P.; Gordon, David; Jennings, Charles

    2002-01-01

    Objective: To determine the value in the initial laparoscopic and cystoscopic evaluation of avoiding the unnecessary delay in diagnosing the “evil twins” of chronic pelvic pain syndrome, endometriosis and interstitial cystitis. Methods: We performed a retrospective review of 60 women ranging in age from 19 to 62. They underwent concurrent laparoscopy, cystoscopy, and hydrodistentions from January 1999 to October 2000. A gynecology and urology team performed these procedures in these 60 patients at a regional pelvic pain center in Northwest Ohio. Results: Fifty-eight patients (96.6%) were diagnosed with interstitial cystitis by the presence of glomerulation and terminal hematuria according to National Institutes of Health criteria. A diagnosis of (active and inactive) endometriosis was found in 56 patients (93.3%). Biopsy-confirmed active endometriosis was found in 48 patients (80%). In the interstitial cystitis patient group (58), 54 patients had a diagnosis of (active and inactive) endometriosis (93.1%), and 47 patients had biopsy-confirmed active endometriosis (81%). In the group of 56 patients with a diagnosis of (active and inactive) endometriosis, 54 patients were found to have interstitial cystitis (96.4%). In the group of 48 patients with active biopsy-confirmed endometriosis, 47 have interstitial cystitis (97.7%). Conclusion: Patients with chronic pelvic pain syndrome are very difficult to manage. Eighty percent were found to have endometriosis and had numerous previous operations. Many patients failed to respond to multiple therapies. In many cases, pain persists even after a hysterectomy. Through our study, we showed the high prevalence and association of interstitial cystitis and endometriosis, the evil twins of chronic pelvic pain syndrome. It is absolutely necessary to perform both laparoscopic and cystoscopic examinations concurrently with the patient anesthetized in the initial evaluation and treatment of chronic pelvic pain syndrome to avoid

  3. Full-thickness endometriosis of the bladder

    DEFF Research Database (Denmark)

    Kjer, Jens Jørgen; Kristensen, Jens; Hartwell, Dorthe

    2014-01-01

    was urinary frequency. All patients had significant relief of symptoms after operation, and none had recurrence of the bladder endometriosis judged by ultrasound or reported symptoms. Twenty-six (87%) patients had endometriosis in another location as well. Eight had nodules in the recto-vaginal septum...

  4. Endometriosis: A Highly Unexpected Skin Lesion

    Directory of Open Access Journals (Sweden)

    Tolga Dinc

    2016-04-01

    4. Malebranche AD, Bush K. Umbilical endometriosis: A rare diagnosis in plastic and reconstructive surgery. Can J Plast Surg. 2010;18:147-8. 5. Bagade PV, Giurguis MM. Menstruating from the umbilicus as a rare case of primary umbilical endometriosis: A case report. J Med Case Rep. 2009;3:9326.

  5. Clinical analysis of 94 cases of ovarian endometriosis cyst laparoscopic treatment%卵巢子宫内膜异位囊肿腹腔镜治疗94例临床分析

    Institute of Scientific and Technical Information of China (English)

    李娜

    2013-01-01

    Objective To investigate the laparoscopic treatment of endometriosis treatment advantages and Treatment. Methods Retrospective analysis of 94 cases of ovarian endometriosis laparoscopic clinical treatment process. Results 94 cases of surgery, endometriosis cystectomy in 93 cases, 1 case of laparotomy, Meilan pass fluid technique in 24 cases, 14 cases of tubal ostomy. Patients were followed up 24 cases of pregnancy 15 cases of infertility, pregnancy rate 62.5%;5 cases confirmed recurrence, the recurrence rate was 5.3%. Conclusions Laparoscopic surgical trauma, quicker recovery, pelvic clear vision, releasable pelvic adhesions in patients with increased pregnancy rate of infertility, ovarian endometriosis should be used as the preferred method of cyst.%目的探讨腹腔镜治疗子宫内膜异位囊肿的优势及治疗体会。方法回顾分析94例卵巢子宫内膜异位囊肿的腹腔镜临床治疗过程。结果94例手术中,内膜异位囊肿剥除93例,1例中转开腹,美兰通液术24例,输卵管造口术14例。术后随访24例不孕症患者受孕15例,受孕率62.5%;5例确认术后复发,复发率为5.3%。结论腹腔镜手术创伤小、恢复快、盆腔视野清晰、可松解盆腔粘连增加不孕症患者受孕率,应作为卵巢子宫内膜异位囊肿手术的首选方法。

  6. The use of biochemical markers in the diagnosis of pelvic endometriosis.

    Science.gov (United States)

    Abrão, M S; Podgaec, S; Filho, B M; Ramos, L O; Pinotti, J A; de Oliveira, R M

    1997-11-01

    The aim of this study was to evaluate CA 125 II, C-reactive protein (CRP) and serum amyloid A (SAA) and anticardiolipin antibody (aCL) concentrations for the diagnosis of pelvic endometriosis. The study population consisted of 15 women without endometriosis, as confirmed by laparoscopy (group A), and 35 patients with pelvic endometriosis diagnosed by laparoscopy or laparotomy (group B). Group B patients were divided into those at stages I and II of the disease (BI/II) and those at stages III and IV (BIII/IV). Blood samples were obtained twice during the menstrual cycle: on day 1, 2 or 3 of the cycle and on day 8, 9 or 10 of the cycle. CA 125 II and CRP concentrations were higher in group III/IV patients compared with healthy controls, mainly during the first 3 days of the menstrual cycle; SAA concentrations were also higher in this group of patients compared with healthy controls, but only during the first 3 days of the menstrual cycle. Immunoglobulin (Ig) M aCL concentrations were higher in all patients with endometriosis compared with healthy controls, mainly during the first 3 days of the menstrual cycle. It is concluded that these determinations may contribute to the diagnosis and the indication of treatment for pelvic endometriosis. Determination of CA 125 II concentrations at the beginning of the menstrual cycle may aid the diagnosis of stage III and IV endometriosis. IgM aCL appears to be associated with the presence of all stages of the disease, while SAA values are elevated in severe situations. Measurement of these molecules may therefore provide a valuable tool in the diagnosis and management of endometriosis.

  7. 1H NMR- based metabolomics approaches as non- invasive tools for diagnosis of endometriosis

    Directory of Open Access Journals (Sweden)

    Negar Ghazi

    2016-01-01

    Full Text Available Background: So far, non-invasive diagnostic approaches such as ultrasound, magnetic resonance imaging, or blood tests do not have sufficient diagnostic power for endometriosis disease. Lack of a non-invasive diagnostic test contributes to the long delay between onset of symptoms and diagnosis of endometriosis. Objective: The present study focuses on the identification of predictive biomarkers in serum by pattern recognition techniques and uses partial least square discriminant analysis, multi-layer feed forward artificial neural networks (ANNs and quadratic discriminant analysis (QDA modeling tools for the early diagnosis of endometriosis in a minimally invasive manner by 1H- NMR based metabolomics. Materials and Methods: This prospective cohort study was done in Pasteur Institute, Iran in June 2013. Serum samples of 31 infertile women with endometriosis (stage II and III who confirmed by diagnostic laparoscopy and 15 normal women were collected and analyzed by nuclear magnetic resonance spectroscopy. The model was built by using partial least square discriminant analysis, QDA, and ANNs to determine classifier metabolites for early prediction risk of disease. Results: The levels of 2- methoxyestron, 2-methoxy estradiol, dehydroepiandrostion androstendione, aldosterone, and deoxy corticosterone were enhanced significantly in infertile group. While cholesterol and primary bile acids levels were decreased. QDA model showed significant difference between two study groups. Positive and negative predict value levels obtained about 71% and 78%, respectively. ANNs provided also criteria for detection of endometriosis. Conclusion: The QDA and ANNs modeling can be used as computational tools in noninvasive diagnose of endometriosis. However, the model designed by QDA methods is more efficient compared to ANNs in diagnosis of endometriosis patients.

  8. Stem cells in endometrium and endometriosis.

    Science.gov (United States)

    Ulukus, Murat

    2015-08-01

    Endometriosis is a common chronic gynecological disease that is classically defined by the presence of endometrial stromal and glandular tissues outside the uterine cavity. Pelvic pain and infertility are the nonspecific but the most common symptoms of the disease; however, no currently definitive treatment has been developed since its pathogenesis has not been completely understood. Currently, none of the proposed conventional theories can explain all aspects of endometriosis. Recent evidence supports the presence of endometrial stem/progenitor cells and their possible involvement in endometrial regeneration and differentiation. The stem cell theory is a new hypothesis which may clarify the underlying pathophysiologic mechanisms of endometriosis. However, this theory could not only account for an alternative pathogenic mechanism of endometriosis but could also be involved in all conventional theories. This article will review the evidence for the presence of endometrial stem/progenitor cells, their possible sources and their possible involvement in the pathogenesis of endometriosis.

  9. A CASE-CONTROL EPIDEMIOLOGIC STUDY OF ENDOMETRIOSIS

    Institute of Scientific and Technical Information of China (English)

    韩美玲; 潘凌亚; 吴葆桢; 边旭明

    1994-01-01

    A case-control study involving 203 cases of pelvic endometriosis seen from 1987-1989,and 406 randomly selected and age-matched community controls was conducted in order to provide information relevant to effective prophylxaix of the disease.The diagnosis was confirmed by pathology from laparotomy and/or laproscopy.A questionnaire focused on menstrual,marital and reproductive status,professional exposurs and physical activities,and the results were analyzed by a conditional logistic regression model.Women characterized by earlier menarche (≤12 years)and longer period(≥8 days)were found to be saaociated with an elevated incurring risk,and a trend of increasing risk associated with primary dysmenorrhea(RR=2.1 for mild to moderate and RR=5.2 for severe dysmenorrhea),energetic physical activity during menstruation(RR=2.1),and allergic diathesis (RR=1.8)was seen.An inverse relationship was observed between the number of pregnancies and risk of endometrio-sis,and the protective effect was most significant when only the number of full-term pregnancies was counted.The risk factors of endometriosis are discussed,and intensive treatment of primary dysmenorrhea and avoidance of strenuous exercise during menstruation are identified as important as important measures in the prevention of endometriosis.

  10. Clear cell ovarian cancer and endometriosis: is there a relationship?

    Directory of Open Access Journals (Sweden)

    Maria Szubert

    2016-07-01

    Full Text Available Introduction: Ovarian clear cell carcinoma is a rare type of ovarian cancer. In recent years, issues of the common genetic origin of endometriosis and ovarian clear cell carcinoma have been raised. Aim of this study was to evaluate the prevalence of this type of cancer, risk factors, prognosis and its potential aetiological association with endometriosis. Material and methods: In a retrospective study, we analysed histopathological data of patients operated in the First Department of Gynaecology and Obstetrics (MU, Lodz due to ovarian cancer in 2004-2014. Among the 394 patients operated on for ovarian cancer, clear cell carcinoma was found in 0.02% (9/394. Menstrual history, parity, comorbidities, data from physical examination, operational protocols and histopathological diagnoses were analysed. Follow-up was obtained from 77.8% of patients. Statistical analysis was performed using Microsoft Excel 2013. Results: The mean age of patients at diagnosis was 57.6 years; the BMI in the study group was 27.2; the majority of patients were multiparous (77.8%. Clear cell carcinoma was detected mostly at stage Ia (n = 4. The concentration of Ca125 in the study group had an average of 142.75 U/ml and a median of 69.3 U/ml. The coexistence of endometriosis could not be clinically or histologically confirmed amongst our patients. The most common comorbidity in the study group was hypertension. Conclusions : In our clinical material, ovarian clear cell carcinoma is a rare histopathological specimen with a prognostic value comparable to that of serous ovarian cancer. Due to the rarity of this histopathological subtype, proving a cause-and-effect relationship between it and endometriosis can only be elucidated through statistical studies of the entire population.

  11. Utility of vaginal and rectal contrast medium in MRI for the detection of deep pelvic endometriosis

    Energy Technology Data Exchange (ETDEWEB)

    Chassang, M.; Novellas, S.; Bloch-Marcotte, C.; Chevallier, P. [Hopital Archet 2, Service d' Imagerie Diagnostique et Interventionnelle, Centre Hospitalier Regional et Universitaire de Nice, 151 route de Saint Antoine de Ginestiere, B.P. 3079, Nice Cedex 3 (France); Delotte, J.; Bongain, A. [Hopital Archet 2, Service de Gynecologie-Obstetrique, Centre Hospitalier Regional et Universitaire de Nice, 151 route de Saint Antoine de Ginestiere, B.P. 3079, Nice Cedex 3 (France); Toullalan, O. [Hopital de Cannes, Service de Gynecologie, 15 avenue des Broussailles, B.P. 264, Cannes Cedex (France)

    2010-04-15

    To study the sensitivity of MRI performed utilising vaginal and rectal opacification with ultrasound gel in the detection of deep pelvic endometriosis. This was a prospective monocentric study. All patients evaluated by the gynaecologist for pelvic pain, endometriosis or infertility were included. Axial and sagittal T2-weighted images were performed both with and without vaginal and rectal opacification with ultrasound gel. Three radiologists, all blinded, interpreted the images with a minimum of 15 days between the two readings. MRI performance with and without vaginal and rectal opacification was evaluated by calculating sensitivity, specificity and both positive and negative predictive values. Seventy-eight patients were included. Among these, 31 patients had deep pelvic endometriosis of which 24 were confirmed by laparoscopy. Seventy-six locations of deep pelvic endometriosis were discovered on MRI. For the three reviewers there was a significant improvement in sensitivity between pre- and post-contrast MRI (p < 0.0002). Opacification of the vagina and rectum significantly improved the sensitivity of MRI for the detection of deep pelvic endometriosis by expanding the vagina and rectum, thus allowing better delineation of the pelvic organs. This was especially apparent for lesions localised to the vagina and rectovaginal septum. (orig.)

  12. Endometriosis: A New Cellular and Molecular Genetic Approach for understanding the pathogenesis and evolutivity

    Directory of Open Access Journals (Sweden)

    Jean eBouquet De Joliniere

    2014-05-01

    Full Text Available ABSTRACT. Endometriosis is a benign disease with high prevalence in women of reproductive age estimated between 10 and 15% and is associated with considerable morbidity. Its etiology and pathogenesis are controversial but it is believed to involve multiple genetic, environmental, immunological, angiogenic and endocrine processes. Altered expressions of growth factors, cytokines, adhesion molecules, matrix metalloproteinases, and enzymes for estrogen synthesis and metabolism have been frequently observed in this condition. The possibility of genetic basis of endometriosis is demonstrated in studies of familial disease, in which the incidence of endometriosis is higher for first-degree relatives of probands as compared to controls. This review describes mainly the cellular, cytochemical, cytogenetic and molecular genetic features of endometriotic lesions and cultured endometriotic cells. In attempts to identify candidate gene (s involved in the pathogenesis of endometriosis, a tissue-based approaches including conventional cytogenetics (RHG-banding, loss of heterozygosity (LOH and Comparative Genomic Hybridization (CGH were employed. In addition to the karyotipic anomalies, consistent chromosome instability was confirmed by CGH and Fluorescence in Situ Hybridization (FISH. The nature and significance of the molecular genetic aberrations in relation to the locations and function of oncogenes and tumor supressor genes will be discussed. At last, a possible pathogenic role of embryonic duct remnants was observed in 7 female foetal reproductive tract in endometriosis and may induce a discussion about the begining of ovarian tumors and malignant proliferations

  13. Deep endometriosis of the colon.

    Science.gov (United States)

    Ropacka-Lesiak, Mariola; Świder-Musielak, Joanna; Wójcicka, Małgorzata; Łyczywek, Anna; Skrzypek, Maciej; Waliszewski, Wojciech

    2013-01-01

    The article presents a case of deep intestinal endometriosis in a 27-year-old woman who complained of dysmenorrhea and infertility. The diagnostic process included ultrasonography as well as colonoscopy, barium enema and CT imaging. Because of the presence of two distant changes which involved nearly the full thickness of the rectal wall and the major part of its circumference, the decision to perform an anterior rectal resection with a simultaneous retroperitoneal colorectostomy was made. The Knight technique was implemented. The surgery involved the anterior rectal resection, the transverse rectal stump closure by use of a stapling device (TA50), and the creation of colorectal circular anastomosis with the CEEA 31 stapler.

  14. The prognostic analysis of GnRHa following conservative laparoscopic surgical treatment for ovarian endometriosis%腹腔镜手术联合GnRHa治疗卵巢子宫内膜异位症的预后分析摘要

    Institute of Scientific and Technical Information of China (English)

    张硕

    2014-01-01

    Objective To investigate the short-term and long-term recurrence rate and pregnancy rate of adjuvant treatment with gonadotropin-releasing-hormone agonist (GnRHa) following conservative laparoscopic surgical treatment of ovarian endometriosis.Methods Patients with ovarian endometriosis undergoing conservative laparoscopic surgery in our Hospital from January 2008 to July 2011 were collected. All the patients were grouped in two groups:surgery alone group and combination group. Subsequent follow-up of the surviving patients was performed until the end of Dec 2012 and the recurrence rate and pregnancy rate were compared.Results A total of 195 patients with ovarian endometriosis underwent conservative laparoscopic surgical treatment and finally 183 patients, 59 in surgery alone group and 124 in combination group, were included in the analysis. The total pregnancy rate, six-month pregnancy rate and one-year pregnancy rate were 45.8%, 22.0% and 39.0% in surgery alone group and 55.6%, 9.7% and 29.0% in combination group. There was significant difference between two groups in six-month pregnancy rate (P<0.05); The total recurrent rate, six-month recurrent rate and one-year recurrent rate were 10.2%, 5.1% and 6.8% in surgery alone group and 11.3%, 1.6% and 6.5% in combination group. There was no significant difference between two groups in terms of total recurrent rate, six-month recurrent rate, one-year recurrent rate and five-year recurrent rate.Conclusion GnRHa treatment after operative laparoscopy for ovarian endometriosis does not appear to be superior to expectant in terms of prevention of symptoms recurrence and has no significant improvement on pregnancy rate.%目的:分析卵巢子宫内膜异位囊肿接受腹腔镜保守治疗,术后辅助使用与不用促性腺激素释放激素激动剂(gonadotropin-releasing-hormone agonist,GnRHa)的近期、远期复发率和妊娠率。方法收集2008年1月~2011年7月在我院妇科行腹腔镜保守手术

  15. ENDOMETRIOSIS IN ADOLESCENTS-ANALYSIS OF 6 CASES

    Institute of Scientific and Technical Information of China (English)

    杨佳欣; 沈铿; 冷金花; 郎景和

    2003-01-01

    Objective.To study the characteristics, diagnosis and treatment of endometriosis in adolescent patients. Method.Six cases of adolescent endometriosis in our hospital were reviewed retrospectively. Result. Endometriosis is the most common cause of chronic pelvic pain in adolescents. There may be a natural progression of endometriosis from atypical lesions in adolescents to classic lesions in adults. Congenital abnormalities of the reproductive tract are the main reasons for the adolescent endometriosis. Conclusion. Endometriosis should be strongly suspected in adolescent girls with chronic pelvic pain,especially unresponsive to oral contraceptives and nonsteroidal anti-inflammatory drugs. The treatment involves the operations and medicines.

  16. Integrated Bioinformatics, Environmental Epidemiologic and Genomic Approaches to Identify Environmental and Molecular Links between Endometriosis and Breast Cancer

    Directory of Open Access Journals (Sweden)

    Deodutta Roy

    2015-10-01

    Full Text Available We present a combined environmental epidemiologic, genomic, and bioinformatics approach to identify: exposure of environmental chemicals with estrogenic activity; epidemiologic association between endocrine disrupting chemical (EDC and health effects, such as, breast cancer or endometriosis; and gene-EDC interactions and disease associations. Human exposure measurement and modeling confirmed estrogenic activity of three selected class of environmental chemicals, polychlorinated biphenyls (PCBs, bisphenols (BPs, and phthalates. Meta-analysis showed that PCBs exposure, not Bisphenol A (BPA and phthalates, increased the summary odds ratio for breast cancer and endometriosis. Bioinformatics analysis of gene-EDC interactions and disease associations identified several hundred genes that were altered by exposure to PCBs, phthalate or BPA. EDCs-modified genes in breast neoplasms and endometriosis are part of steroid hormone signaling and inflammation pathways. All three EDCs–PCB 153, phthalates, and BPA influenced five common genes—CYP19A1, EGFR, ESR2, FOS, and IGF1—in breast cancer as well as in endometriosis. These genes are environmentally and estrogen responsive, altered in human breast and uterine tumors and endometriosis lesions, and part of Mitogen Activated Protein Kinase (MAPK signaling pathways in cancer. Our findings suggest that breast cancer and endometriosis share some common environmental and molecular risk factors.

  17. Integrated Bioinformatics, Environmental Epidemiologic and Genomic Approaches to Identify Environmental and Molecular Links between Endometriosis and Breast Cancer

    Science.gov (United States)

    Roy, Deodutta; Morgan, Marisa; Yoo, Changwon; Deoraj, Alok; Roy, Sandhya; Yadav, Vijay Kumar; Garoub, Mohannad; Assaggaf, Hamza; Doke, Mayur

    2015-01-01

    We present a combined environmental epidemiologic, genomic, and bioinformatics approach to identify: exposure of environmental chemicals with estrogenic activity; epidemiologic association between endocrine disrupting chemical (EDC) and health effects, such as, breast cancer or endometriosis; and gene-EDC interactions and disease associations. Human exposure measurement and modeling confirmed estrogenic activity of three selected class of environmental chemicals, polychlorinated biphenyls (PCBs), bisphenols (BPs), and phthalates. Meta-analysis showed that PCBs exposure, not Bisphenol A (BPA) and phthalates, increased the summary odds ratio for breast cancer and endometriosis. Bioinformatics analysis of gene-EDC interactions and disease associations identified several hundred genes that were altered by exposure to PCBs, phthalate or BPA. EDCs-modified genes in breast neoplasms and endometriosis are part of steroid hormone signaling and inflammation pathways. All three EDCs–PCB 153, phthalates, and BPA influenced five common genes—CYP19A1, EGFR, ESR2, FOS, and IGF1—in breast cancer as well as in endometriosis. These genes are environmentally and estrogen responsive, altered in human breast and uterine tumors and endometriosis lesions, and part of Mitogen Activated Protein Kinase (MAPK) signaling pathways in cancer. Our findings suggest that breast cancer and endometriosis share some common environmental and molecular risk factors. PMID:26512648

  18. A case of endometriosis presenting as an inguinal hernia.

    Science.gov (United States)

    Husain, Fahd; Siddiqui, Zain Ahmed; Siddiqui, Midhat

    2015-03-11

    Endometriosis is a common clinical presentation for gynaecologists. Occasionally it can present to general surgeons as a swelling in the groin or abdominal wall. This condition should be included in the differential diagnosis in female patients. A 32-year-old woman with a 2-year history of a painful persistent lump in her right groin was referred to the general surgeons by her general practitioner. She was referred with a diagnosis of a suspected inguinal hernia. MRI excluded a hernia and exploration of the groin and subsequent histology confirmed the lesion to be an endometrial deposit.

  19. Gallbladder endometriosis as a cause of occult bleeding

    Institute of Scientific and Technical Information of China (English)

    K Saadat-Gilani; L Bechmann; A Frilling; G Gerken; A Canbay

    2007-01-01

    A 17-year-old girl with colicky abdominal pain and chronic anemia presented to the gastrointestinal service of the University Hospital of Essen. In the routine workup, there were no pathological findings despite the anemia. Because of the fluctuation of symptoms with a climax at the time of menstruation, consecutive ultrasound studies were performed revealing a visible mass inside the gallbladder. This finding was confirmed by a magnetic resonance imaging (MRI) study performed at the same time. Because of the severe anemia by that time, a cholecystectomy was performed, and histology reconfirmed the diagnosis of isolated gallbladder endometriosis. The patient recovered well and has had no recurrence of the disease to date.

  20. Use of aromatase inhibitors to treat endometriosis-related pain symptoms: a systematic review

    Directory of Open Access Journals (Sweden)

    Venturini Pier L

    2011-06-01

    Full Text Available Abstract This systematic review aims to assess the efficacy of aromatase inhibitors (AIs in treating pain symptoms caused by endometriosis. A comprehensive literature search was conducted to identify all the published studies evaluating the efficacy of type II nonsteroidal aromatase inhibitors (anastrozole and letrozole in treating endometriosis-related pain symptoms. The MEDLINE, EMBASE, PubMed, and SCOPUS databases and the Cochrane System Reviews were searched up to October 2010. This review comprises of the results of 10 publications fitting the inclusion criteria; these studies included a total of 251 women. Five studies were prospective non-comparative, four were randomized controlled trials (RCTs and one was a prospective patient preference trial. Seven studies examined the efficacy of AIs in improving endometriosis-related pain symptoms, whilst three RCTs investigated the use of AIs as post-operative therapy in preventing the recurrence of pain symptoms after surgery for endometriosis. All the observational studies demonstrated that AIs combined with either progestogens or oral contraceptive pill reduce the severity of pain symptoms and improve quality of life. One patient preference study demonstrated that letrozole combined with norethisterone acetate is more effective in reducing pain and deep dyspareunia than norethisterone acetate alone. However, letrozole causes a higher incidence of adverse effects and does not improve patients' satisfaction or influence recurrence of symptoms after discontinuation of treatment. A RCT showed that combining letrozole with norethisterone acetate causes a lower incidence of adverse effects and lower discontinuation rate than combining letrozole with triptorelin. Two RCTs demonstrated that, after surgical treatment of endometriosis, the administration of AIs combined with gonadotropin releasing hormone analogue for 6 months reduces the risk of endometriosis recurrence when compared with gonadotropin

  1. Associations among body size across the life course, adult height and endometriosis.

    Science.gov (United States)

    Farland, L V; Missmer, S A; Bijon, A; Gusto, G; Gelot, A; Clavel-Chapelon, F; Mesrine, S; Boutron-Ruault, M C; Kvaskoff, M

    2017-08-01

    Are body size across the life course and adult height associated with endometriosis? Endometriosis is associated with lean body size during childhood, adolescence and adulthood; tall total adult height; and tall sitting height. The literature suggests that both adult body size and height are associated with endometriosis risk, but few studies have investigated the role of body size across the life course. Additionally, no study has investigated the relationships between components of height and endometriosis. We used a nested case-control design within E3N (Etude Epidémiologique auprès de femmes de l'Education Nationale), a prospective cohort of French women. Data were updated every 2-3 years through self-administered questionnaires. Odds ratios (ORs) and 95% CIs were computed using logistic regression models adjusted for a priori confounding factors. A total of 2416 endometriosis cases were reported as surgically ascertained among the 61 208 included women. The odds of endometriosis were lower among women who reported having a large versus lean body size at 8 years (P for trend = 0.003), at menarche (P for trend size is based on retrospective self-report, which may be subject to recall bias. The results of this study suggest that endometriosis is positively associated with lean body size across the life course and total adult height. They also suggest that components of height are associated with endometriosis, which should be investigated further. The Mutuelle Générale de l'Education Nationale (MGEN); the European Community; the French League against Cancer (LNCC); Gustave Roussy; the French Institute of Health and Medical Research (Inserm). L.V.F. was supported by a T32 grant (#HD060454) in reproductive, perinatal and pediatric epidemiology from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Cancer Institute (3R25CA057711) National Institutes of Health. M.K. was supported by a Marie Curie Fellowship

  2. What Are the Treatments for Endometriosis?

    Science.gov (United States)

    ... endometriosis: Translational evidence of the relationship and implications. Human Reproduction Update, 17 (3), 327-346. [top] American College ... F. J. (1996). GnRH agonists and uterine leiomyomas. Human Reproduction, 11 (Suppl 3):3-25. [top] Practice Committee ...

  3. A Survey of TCM Treatment for Endometriosis

    Institute of Scientific and Technical Information of China (English)

    HAN Yu-fen; HOU Li-hui; ZHOU Ya-jie; WU Xiao-ke

    2009-01-01

    @@ Endometriosis (EM) refers to the disorders caused by the endometrial tissues growing out. of the uterine cavity but in other parts of the body,which may include the progressive dysmenorrhea,dyspareunia,sterility,and abnormal menstruation.

  4. Pelvic Gliomatosis within Foci of Endometriosis

    OpenAIRE

    Killeen, Vincent B.; Reich, Harry; McGlynn, Fran; Virgilio, Lawrence A.; Krawitz, Michael A.; Sekel, Lisa

    1997-01-01

    The third reported case of pelvic gliomatosis found within foci of endometriosis is documented 16 years after the removal of a benign cystic teratoma. Grossly at laparoscopy the lesions appear as typical deep fibrotic endometriotic implants.

  5. Pathophysiology of cyclic hemorrhagic ascites and endometriosis.

    Science.gov (United States)

    Ussia, Anastasia; Betsas, George; Corona, Roberta; De Cicco, Carlo; Koninckx, Philippe R

    2008-01-01

    Massive hemorrhagic ascites (4470 mL, range 1-10 L) in women with endometriosis is a rare condition occurring predominantly in black women. Of the 43 case reports published, 42 are compatible with the hypothesis that the hemorrhagic ascites is predominantly a consequence of excessive ovarian transudation similar to a Meigs syndrome. Indeed, bilateral ovariectomy cures the condition without recurrences, whereas after unilateral ovariectomy or cystectomy recurrence rate is more than 50%; during ovarian suppression by luteinizing hormone-releasing hormone agonist ascites disappears, but reappears after treatment. Superficial pelvic endometriosis also contributes to the ascites because after superficial endometriosis destruction the recurrence rate is only 4 in 14. Based on these data, it is suggested, to scrutinize the ovaries for tumors given the analogy with Meigs syndrome. In women desiring fertility, conservative treatment with destruction of endometriosis only can be attempted given the cure rate of some 20%. It is unknown what the effect of ovulation induction would be.

  6. Urinary tract endometriosis: Review of 19 cases

    Directory of Open Access Journals (Sweden)

    Suresh Kumar

    2012-01-01

    Conclusion: One should have a high index of suspicion with irritative voiding symptoms with or without hematuria, with negative urine culture, in all premenopausal women to diagnose urinary tract endometriosis. Partial cystectomy is a better alternative to transurethral resection followed by GnRh analogue in vesical endometriosis. Approach to the ureter must be individualised depending upon the severity of disease and dilatation of the upper tract to maximise the preservation of renal function.

  7. Vesicoovarian Fistula on an Endometriosis Abscessed Cyst

    OpenAIRE

    2014-01-01

    We report the case of a patient who developed a vesicoovarian fistula on an endometriosis abscessed cyst. The patient presented with an advanced endometriosis stage IV complicated with a right ovarian abscessed cyst of 10 cm. A first coelioscopy with cystectomy was realized. After surgery, a voiding cystography highlighted a fistula between the ovarian abscess and the bladder. A second surgery by median laparotomy was realized with the resection of the right ovarian abscess and the resection ...

  8. The relation between endometriosis and ovarian cancer - a review

    DEFF Research Database (Denmark)

    Heidemann, Lene Nyhøj; Hartwell, Dorthe; Heidemann, Christian Hamilton;

    2014-01-01

    Endometriosis is known to harbor characteristics substantiating that it is a possible precursor of ovarian cancer.......Endometriosis is known to harbor characteristics substantiating that it is a possible precursor of ovarian cancer....

  9. Diagnosis and Management of Abdominal Wall Endometriosis: A Systematic Review and Clinical Recommendations.

    Science.gov (United States)

    Rindos, Noah B; Mansuria, Suketu

    2017-02-01

    Abdominal wall endometriosis (AWE) is a rare but easily treated cause of pain in women, especially those who have undergone cesarean deliveries. This article reviews the diagnosis and management of AWE, a condition that generally develops after surgery but may arise spontaneously. We present a systematic review of the existing literature on AWE, as well as our clinical recommendations for medical and surgical management. We searched PubMed and other databases using the search criteria "abdominal wall endometriosis," "abdominal wall endometriomas," and "abdominal wall mass." The references of those articles were then reviewed, and additional publications were evaluated. Many case reports and case series have been published describing AWE. The overall quality of evidence is poor due to the lack of prospective studies and heterogeneous descriptions of AWE lesions and treatment options. Based on the available literature, it appears that AWE may arise spontaneously but is generally associated with prior pelvic surgery. Abdominal wall endometriosis can be diagnosed with a careful history and physical examination. Imaging including ultrasound and magnetic resonance imaging can assist with localization of the lesions, and aid in surgical excision and management. Lesions that have been removed in their entirety are unlikely to reoccur. Although limited, the body of literature describing management of AWE suggests that it can be successfully treated in most patients with careful surgical planning.

  10. Endometriosis and chronic pelvic pain%子宫内膜异位症与慢性盆腔痛

    Institute of Scientific and Technical Information of China (English)

    陈正云; 林俊

    2013-01-01

    Chronic pelvic pain is the manifestation of endometriosis The pathophysiology and causes of endometriosis-associated pain are complex. Management can be medical (first-line treatment is oral contraceptive pills combined with along with NSAIDs), surgical, or and the two combined (surgery combined with suppression of ovarian function). It is recommended that long-term treatment combined with multiple modes of therapies for the pain associated with endometriosis individually.%慢性盆腔痛是子宫内膜异位症(内异症)的常见症状.内异症相关疼痛的机制复杂,可采取药物(首选口服避孕药联合非甾体类抗炎药)、手术以及手术联合药物抑制卵巢功能的治疗,现多主张采取长期综合个体化治疗.

  11. Clinical analysis of abdominal wall endometriosis in 101 cases

    Institute of Scientific and Technical Information of China (English)

    Cheng Ning-hai; Zhu Lan; Lang Jing-he; Liu Zhu-feng; Sun Da-wei; Leng Jin-hua

    2006-01-01

    Objective: To review the clinical characteristics, treatment and prognoses of abdominal wall endometriosis(AWE).Methods: A retrospective study of 101 cases of AWE from 1992 to 2005 at Obstetric and Gynecologic Department of Peking Union Medical College Hospital was performed. Ninety-eight patients had a history of caesarean section. The mean age of the patients was (33.3±4.8) years and the average size of the mass was 1.5 cm. Abdominal wall mass associated pain during the menstrual cycle was noticed in 89.8% of the patients. The occurrence of AWE after caesarean section was 0.05% at our hospital. In patients without pelvic endometriosis or adenomyosis, 20.5% were presented with high CA125 >35 U/ml and the highest one was 93.4 U/ml. 92.1% of patients were diagnosed before surgery. 4 patients were administrated first in General Surgical Department with painless abdominal mass. Medication was adopted in 16 cases pre-operatively and 14 cases post-operatively.Results: The mean size of the resected mass was 4.2 cm, significantly larger than the estimation with palpation or ultrasonography, which was 0.8-1.2 cm (P=0.006, P<0.001). Pelvic endometriosis or adenomyosis was detected during the operation in 13 patients. One patient was diagnosed as atypical endometriosis by pathological examination in the beginning but transformed to be sarcoma finally. Ten patients recurred after surgery. 2 of them received medication and 5 of them received second operation.Conclusions: Ultrasonography can be used to evaluate the size of the mass and the infiltrative scope pre-operation. The serum CA125 is not specific for diagnosis of AWE. Complete eradication of the lesion with at least 1 cm beyond the edge of the mass is recommended as the primary treatment. Eradication should be considered also in recurrent cases. It may transform to malignant lesions after multiple recurrence.

  12. Expressão de mediadores neurotróficos e pró-inflamatórios na endometriose de reto e sigmoide Expression of neurotrophic and inflammatory mediators in rectosigmoid endometriosis

    Directory of Open Access Journals (Sweden)

    Fábio Sakae Kuteken

    2012-12-01

    -to-end anastomosis with a circular stapler from January 2005 to December 2007. The study included premenopausal women who underwent surgical treatment for deep endometriosis infiltrating the rectum with involvement of the rectum and sigmoid, reaching the level of the muscle layer, submucosa or mucosa. Twenty-four rectum and sigmoid fragments with histologically confirmed endometriosis, one from each of the 24 selected patients, were used for the study group. For the control group, we used a fragment of the distal resection margin called anastomosis ring from each of the 24 patients enrolled in the study. Samples were grouped into Tissue Micro Array (TMA blocks and subjected to immunohistochemistry to evaluate the expression of tumor necrosis factor alpha (TNF-α, nerve growth factor (NGF, neuropeptide Y (NPY and P vasoactive intestinal peptide (VIP, followed by semiquantitative analysis of immunostaining by reading the relative optical density (OD. RESULTS: There was higher optical density relative to TNF-α immunostaining and NGF in the study group (samples with intestinal endometriosis, DO=0.01, for the two proteins, respectively (p<0.05, compared to controls without endometriosis. There was no statistically significant difference in the optical density of immunostaining of NPY and VIP. CONCLUSION: We identified increased immunostaining of TNF-α antibodies and fragments of NGF in the rectum and sigmoid compromised by endometriosis compared to disease-free controls. We did not identify any statistical difference in immunostaining of NPY and VIP proteins.

  13. Anginogenesis of Eutopic and Ectopic Endometria in Endometriosis

    Institute of Scientific and Technical Information of China (English)

    刘义; 吕立群; 朱桂金

    2003-01-01

    Summary: In order to study the angiogenesis in endometriosis, the samples of eutopic and ectopic en-dometria from patients with endometriosis were quantitatively analyzed by color morphometric imagesystem (CMIS) for vascular surface area, and by examining endometrial blood vessel for microvesseldensity (MVD). The results showed that within each menstrual phase the vascular surface area andMVD were significantly higher in ectopic endometria with endometriosis than those in eutopic en-dometria with endometriosis or normal endometrium (P<0. 05). It is concluded that angiogenesismight be involved in the development of endometriosis.

  14. Impact of superovulation for women with endometriosis.

    Science.gov (United States)

    Kavoussi, Shahryar K

    2013-03-01

    Superovulation (SO)/Intrauterine insemination (IUI) has been used as a treatment approach for endometriosis-associated infertility. The existing medical literature regarding SO in endometriosis patients is composed of heterogeneous studies that differ in terms of study design, SO protocols, the addition of IUI, and comparison groups. There is a need for more well-designed studies to further investigate the efficacy of SO in women with endometriosis-associated infertility. Although in vitro fertilization (IVF) is most effective and is significantly superior to other treatments in endometriosis patients, most of the existing studies suggest some benefit of SO/IUI in infertility patients with early-stage disease. Therefore, SO/IUI is a reasonable early fertility treatment option for women with endometriosis who desire a short trial of potentially more cost-effective treatment options prior to pursuing an IVF cycle and those for whom IVF is not a feasible or desirable option. It appears that gonadotropins are most effective for SO in this patient population even though more head-to-head comparisons are needed. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  15. Activated glucocorticoid and eicosanoid pathways in endometriosis.

    Science.gov (United States)

    Monsivais, Diana; Bray, Jeffrey D; Su, Emily; Pavone, Mary Ellen; Dyson, Matthew T; Navarro, Antonia; Kakinuma, Toshiyuki; Bulun, Serdar E

    2012-07-01

    To define altered gene expression networks in endometriosis. Experiments using endometriotic tissues and primary cells. Division of Reproductive Biology Research, Northwestern University. Premenopausal women. Matched samples of eutopic endometrium and ovarian endometriosis (n = 8 patients) were analyzed by microarray and verified in a separate set of tissues (n = 6 patients). Experiments to define signaling pathways were performed in primary endometriotic stromal cells (n = 12 patients). Using a genome-wide in vivo approach, we identified 1,366 differentially expressed genes and a new gene network favoring increased glucocorticoid levels and action in endometriosis. Transcript and protein levels of 11β-hydroxysteroid dehydrogenase (HSD11B1), which produces cortisol, the biologically active glucocorticoid, were strikingly higher, whereas messenger RNA (mRNA) levels of the cortisol-degrading HSD11B2 enzyme were significantly lower in endometriotic tissue. Glucocorticoid receptor mRNA and protein levels were significantly higher in endometriosis. The inflammatory cytokine tumor necrosis factor robustly induced mRNA and protein levels of HSD11B1 and glucocorticoid receptor but suppressed HSD11B2 mRNA in primary endometriotic stromal cells, suggesting that tumor necrosis factor stimulates cortisol production and action. We also uncovered a subset of genes critical for prostaglandin synthesis and degradation, which favor high eicosanoid levels and activity in endometriosis. The proinflammatory milieu of the endometriotic lesion stimulates cortisol synthesis and action in endometriotic lesions. Published by Elsevier Inc.

  16. Pathophysiology and Immune Dysfunction in Endometriosis

    Directory of Open Access Journals (Sweden)

    Soo Hyun Ahn

    2015-01-01

    Full Text Available Endometriosis is an estrogen-dependent, chronic, proinflammatory disease prevalent in 10% of women of reproductive age worldwide. Characterized by the growth of endometrium-like tissue in aberrant locations outside of the uterus, it is responsible for symptoms including chronic pelvic pain, dysmenorrhea, and subfertility that degrade quality of life of women significantly. In Canada, direct and indirect economic cost of endometriosis amounts to 1.8 billion dollars, and this is elevated to 20 billion dollars in the United States. Despite decades of research, the etiology and pathophysiology of endometriosis still remain to be elucidated. This review aims to bring together the current understanding regarding the pathogenesis of endometriosis with specific focus on mechanisms behind vascularization of the lesions and the contribution of immune factors in facilitating lesion establishment and development. The role of hormones, immune cells, and cytokine signaling is highlighted, in addition to discussing the current pharmaceutical options available for management of pain symptoms in women with endometriosis.

  17. Non-invasive neurosensory testing used to diagnose and confirm successful surgical management of lower extremity deep distal posterior compartment syndrome

    Directory of Open Access Journals (Sweden)

    Guyton Gregory P

    2009-05-01

    Full Text Available Abstract Background Chronic exertional compartment syndrome (CECS is characterized by elevated pressures within a closed space of an extremity muscular compartment, causing pain and/or disability by impairing the neuromuscular function of the involved compartment. The diagnosis of CECS is primarily made on careful history and physical exam. The gold standard test to confirm the diagnosis of CECS is invasive intra-compartmental pressure measurements. Sensory nerve function is often diminished during symptomatic periods of CECS. Sensory nerve function can be documented with the use of non-painful, non-invasive neurosensory testing. Methods Non-painful neurosensory testing of the myelinated large sensory nerve fibers of the lower extremity were obtained with the Pressure Specified Sensory Device™ in a 25 year old male with history and invasive compartment pressures consistent with CECS both before and after running on a tread mill. After the patient's first operation to release the deep distal posterior compartment, the patient failed to improve. Repeat sensory testing revealed continued change in his function with exercise. He was returned to the operating room where a repeat procedure revealed that the deep posterior compartment was not completely released due to an unusual anatomic variant, and therefore complete release was accomplished. Results The patient's symptoms numbness in the plantar foot and pain in the distal calf improved after this procedure and his repeat sensory testing performed before and after running on the treadmill documented this improvement. Conclusion This case report illustrates the principal that non-invasive neurosensory testing can detect reversible changes in sensory nerve function after a provocative test and may be a helpful non-invasive technique to managing difficult cases of persistent lower extremity symptoms after failed decompressive fasciotomies for CECS. It can easily be performed before and after

  18. Incisional endometriosis: Diagnosed by fine needle aspiration cytology

    Directory of Open Access Journals (Sweden)

    P Veda

    2010-01-01

    Full Text Available Incisional endometriosis (IE is a rare entity reported in 0.03-1.08% of women following obstetric or gynecologic surgeries. Most cases reported in literature have appeared after cesarean sections and were often clinically mistaken for hernia, abscess, suture granuloma or lipoma. We hereby report a case of IE following a second trimester hysterotomy, which was diagnosed by fine needle aspiration cytology (FNAC. Our patient was 26 years old, presenting with a mass over anterior abdominal wall, associated with incapacitating pain during each menstrual cycle. FNAC showed epithelial cells, stromal cells and hemosiderin laden macrophages. Based on the typical history, clinical and cytological features, the diagnosis of IE was established. Wide surgical excision was done and the resulting rectus sheath defect was repaired. Patient was followed for 6 months during which time she was symptom free. This article also reviews the spectrum of cytological features and the rare possibility of malignant transformation that can occur in IE.

  19. Incisional endometriosis: diagnosed by fine needle aspiration cytology.

    Science.gov (United States)

    Veda, P; Srinivasaiah, M

    2010-07-01

    Incisional endometriosis (IE) is a rare entity reported in 0.03-1.08% of women following obstetric or gynecologic surgeries. Most cases reported in literature have appeared after cesarean sections and were often clinically mistaken for hernia, abscess, suture granuloma or lipoma. We hereby report a case of IE following a second trimester hysterotomy, which was diagnosed by fine needle aspiration cytology (FNAC). Our patient was 26 years old, presenting with a mass over anterior abdominal wall, associated with incapacitating pain during each menstrual cycle. FNAC showed epithelial cells, stromal cells and hemosiderin laden macrophages. Based on the typical history, clinical and cytological features, the diagnosis of IE was established. Wide surgical excision was done and the resulting rectus sheath defect was repaired. Patient was followed for 6 months during which time she was symptom free. This article also reviews the spectrum of cytological features and the rare possibility of malignant transformation that can occur in IE.

  20. Postmenopausal intestinal obstructive endometriosis: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Pedro Popoutchi

    Full Text Available CONTEXT: Endometriosis is characterized by the presence of endometrial tissue outside the uterine cavity, which is commonly detected in gynecological practice but rarely reported as a coloproctological disorder. The objective of the present report was to discuss a rare case of postmenopausal intestinal endometriosis simulating a malignant lesion, following a review of the literature. CASE REPORT: A 74-year-old woman with complaints of hematochezia and tenesmus of two months' duration accompanied by liquid feces and pelvic pain, but with no other gastrointestinal or gynecological complaints, was referred to our service. She had been menopausal for 22 years, with no hormone replacement treatment, and had undergone panhysterectomy three years before the referral to us, due to endometrial thickening and a right adnexal cyst. Five months before this referral, she had undergone laparotomy due to acute obstructive abdomen, which revealed a tumor mass involving the small bowel. Anatomopathological examination of the enterectomy suggested a hypothesis of intestinal endometriosis. A proctological examination was normal. Computed tomography of the pelvis revealed thickening of the rectosigmoid transition and colonoscopy revealed friable tumor formation in the rectum. A biopsy of the lesion revealed mucosal fragments of endometrial type, which led to a review of the previous anatomopathological examination. The patient underwent rectosigmoidectomy with protective transversotomy, with a good postoperative course, and anatomical examination confirmed the intestinal endometriosis. The patient subsequently suffered a stenosing recurrence of the lesion and has undergone colostomy since then.

  1. Endometriosis

    Science.gov (United States)

    ... women who do not want to become pregnant. Birth control pills work by decreasing the thickness of the endometrial lining and the amount of menstrual flow. Most birth control pills contain two hormones, estrogen and progestin. Progestin-only ...

  2. Endometriosis

    Science.gov (United States)

    ... including birth control pills, progestin -only medications, and gonadotropin-releasing hormone agonists . Hormonal medications help slow the growth of ... egg travels from the ovary to the uterus. Gonadotropin-Releasing Hormone Agonists: Medical therapy used to block the effects ...

  3. Endometriosis

    Medline Plus

    Full Text Available ... Home FAQs Frequently Asked Questions Quick Facts About Infertility FAQs About Infertility FAQs About the Psychological Component of Infertility FAQs About Cloning and Stem Cell Research SART's ...

  4. Endometriosis

    Science.gov (United States)

    ... has already occurred. Progesterone pills or injections. This treatment helps shrink growths. However, side effects can include weight gain and depression. Gonadotropin-agonist medicines. These medicines stop your ovaries from producing the ...

  5. Indomethacin and fertility in experimental endometriosis.

    Science.gov (United States)

    Dargenio, R; Corbucci, M G; Lamanna, M A; Garcea, N

    1992-01-01

    Clinical and experimental evidence showed an increased concentration of prostaglandins in peritoneal fluid in cases of endometriosis. The aim of this study was to verify whether an antiprostaglandin drug can restore fertility in cases of endometriosis. For this reason endometriosis was induced in 4 groups of 10 rats. Group A was treated with indomethacin both in the pre-ovulatory and in the post-ovulatory phase. Group B was treated in the pre-ovulatory phase. Group C was treated in the post-ovulatory phase. Group D was not treated. Ten other rats (group E) underwent a sham operation and were used as a control. Twelve days after mating, gestational sacs and corpora lutea were counted and the nidation index was calculated. Only indomethacin administered during the pre-ovulatory phase completely restored fertility in these rats.

  6. Obstrucción intestinal debido a endometriosis ileal: reporte de un caso y revisión bibliográfica

    Directory of Open Access Journals (Sweden)

    Hermann Barquero Melchor

    2003-09-01

    Full Text Available La obstrucción del intestino delgado es uno de los padecimientos abdominales más frecuentemente atendidos en el servicio de urgencias. Es un síndrome con múltiple s causas, una particularmente interesante es la endometriosis intestinal, la cual ocurre hasta en el 37% de 1 as pacientes con endometriosis. La vasta mayoría de pacientes no experimenta síntomas relacionados con el tracto gastrointestinal. Presentamos aquí el caso de una mujer de 34 años con obstrucción intestinal secundaria a endometriosis. Requirió resección quirúrgica con anastomosis primaria. La evaluación patológica demostró endometriosis extensa del intestino delgado, que producía obstrucción completa. Tuvo una lento postoperatorio y requirió una laparotomía e ileostomía, debido a dehiscencia de la anastomosis. Este informe ilumina las raras, aunque significativas complicaciones de la endometriosis intestinal, incluyendo la obstrucción intestinal. La endometriosis intestinal debe considerarse en el diagnóstico diferencial de aquellas pacientes con obstrucción intestinal en edad reproductiva.Small bowel obstruction is one of the most common abdominal urgencias seen in the emergency room. lt is a syndrome due to many causes, a particularly rare one is intestinal envolvement by endometriotic tissue which occurs in up to 37% of patients with endometriosis. The vast majority of patients do not experience symptoms related to the gastrointestinal tract. We present here the case of a 34-year-old woman with intestinal obstruction secondary to endometriosis. She underwent surgical resection with primary anastomosis. Pathologic evaluation showed extensive endometriosis of the small bowel which resulted in complete obstruction of the lumen. Postoperatively, the patient recovered slowly and required an ileostomy due to dehiscence of the anastomosis. This report illuminates the rare, yet significant, complications of intestinal endometriosis, including small bowel

  7. Umbilical endometriosis associated with umbilical hernia. Management of a rare occurrence.

    Science.gov (United States)

    Iovino, Francesco; Ruggiero, Roberto; Irlandese, Eduardo; Gili, Simona; Lo Schiavo, Francesco

    2007-01-01

    We report a rare case of primitive umbilical endometriosis associated with umbilical hernia, which required wide umbilical resection and immediate reconstruction performed according to a recently described technique. A wide resection of the peritoneal sac was performed because of the possible presence of endometrial tissue inside. The hernia was repaired according to Mayo's technique. Umbilical reconstruction was performed using two semicircular skin flaps shaped into in an ellipse preoperatively drawn on the skin with a vertical orientation. The surgical approach described in this report allowed easy hernia repair and umbilical reconstruction. No prosthesis was used because of the small size of the hernia and lack of literature data on prosthesis use in endometriosis. The aesthetic result was considered satisfactory 6 months after the operation because of absence of hypertrophic scars and in view of the anatomical aspect of the new umbilicus. No recurrence was observed within this time frame.

  8. Relating Chronic Pelvic Pain and Endometriosis to Signs of Sensitization and Myofascial Pain and Dysfunction.

    Science.gov (United States)

    Aredo, Jacqueline V; Heyrana, Katrina J; Karp, Barbara I; Shah, Jay P; Stratton, Pamela

    2017-01-01

    Chronic pelvic pain is a frustrating symptom for patients with endometriosis and is frequently refractory to hormonal and surgical management. While these therapies target ectopic endometrial lesions, they do not directly address pain due to central sensitization of the nervous system and myofascial dysfunction, which can continue to generate pain from myofascial trigger points even after traditional treatments are optimized. This article provides a background for understanding how endometriosis facilitates remodeling of neural networks, contributing to sensitization and generation of myofascial trigger points. A framework for evaluating such sensitization and myofascial trigger points in a clinical setting is presented. Treatments that specifically address myofascial pain secondary to spontaneously painful myofascial trigger points and their putative mechanisms of action are also reviewed, including physical therapy, dry needling, anesthetic injections, and botulinum toxin injections.

  9. Relating Chronic Pelvic Pain and Endometriosis to Signs of Sensitization and Myofascial Pain and Dysfunction

    Science.gov (United States)

    Aredo, Jacqueline V.; Heyrana, Katrina J.; Karp, Barbara I.; Shah, Jay P.; Stratton, Pamela

    2017-01-01

    Chronic pelvic pain is a frustrating symptom for patients with endometriosis and is frequently refractory to hormonal and surgical management. While these therapies target ectopic endometrial lesions, they do not directly address pain due to central sensitization of the nervous system and myofascial dysfunction, which can continue to generate pain from myofascial trigger points even after traditional treatments are optimized. This article provides a background for understanding how endometriosis facilitates remodeling of neural networks, contributing to sensitization and generation of myofascial trigger points. A framework for evaluating such sensitization and myofascial trigger points in a clinical setting is presented. Treatments that specifically address myofascial pain secondary to spontaneously painful myofascial trigger points and their putative mechanisms of action are also reviewed, including physical therapy, dry needling, anesthetic injections, and botulinum toxin injections. PMID:28049214

  10. Effectiveness of laparoscopic treatment for deep infiltrating type endometriosis

    Directory of Open Access Journals (Sweden)

    Jie ZOU

    2011-10-01

    Full Text Available Objective To analyze the effect of laparoscopic excision on deep infiltrating type endometriosis(DIE in posterior pelvis.Methods Data of 35 cases of posterior pelvic DIE admitted to General Hospital of PLA from Jan.2006 to Jan.2009 were retrospectively analyzed.All the cases were pathologically confirmed and treated with laparoscopic surgery.10-point linear visual analog scale(VAS was used to estimate the degree of pre-and post-operative pain.Results Thirty-four patients were treated successfully by laparoscopic surgery,in one case it was shifted to open laparotomy because of malignant transformation of endometriosis.No complication occurred.There was an obvious decline of VAS score for dysmenorrhoea after operation compared with that before operation(5.8±1.7 vs 1.2±1.3,P < 0.001.Thirteen cases with dysmenorrhoea(39.3% showed significant improvement of symptoms,and satisfactory improvement was found in 20 cases(60.7%.Conclusion Laparoscopic excision for posterior type of DIE is effective and safe,it can ameliorate dysmenorrhoea and improve patient’s quality of life.

  11. Hormonal treatment for endometriosis associated pelvic pain

    Directory of Open Access Journals (Sweden)

    Wu Shun Felix Wong

    2011-01-01

    Full Text Available AbstractBackground: Endometriosis is a common gynecological problem associated with chronic pelvic pain. Objective: To evaluate the effectiveness of current hormonal treatments of endometriosis associated pain.Materials and Methods: Randomized Controlled studies identified from databases of Medline and Cochrane Systemic Review groups were pooled. 7 RCTs were recruited for evaluation in this review. Data from these studies were pooled and meta-analysis was performed in three comparison groups: 1 Progestogen versus GnRHa; 2 Implanon versus Progestogen (injection; 3 Combined oral contraceptive pills versus placebo and progestogen. Response to treatment was measured as a reduction in pain score. Pain improvement was defined as improvement ≥1 at the end of treatment. Results: There was no significant difference between treatment groups of progestogen and GnRHa (RR: 0.036; CI:-0.030-0.102 for relieving endometriosis associated pelvic pain. Long acting progestogen (Implanon and Mirena are not inferior to GnRHa and depot medroxy progesterone acetate (DMPA (RR: 0.006; CI:-0.142-0.162. Combined oral contraceptive pills demonstrated effective treatment of relieving endometriosis associated pelvic pain when compared with placebo groups (RR:0.321CI-0.066-0.707. Progestogen was more effective than combined oral contraceptive pills in controlling dysmenorrhea (RR:-0.160; CI:-0.386-0.066, however, progestogen is associated with more side effects like spotting and bloating than the combined contraceptive pills. Conclusion: Combined oral contraceptive pills (COCP, GnRHa and progestogens are equally effective in relieving endometriosis associated pelvic pain. COCP and progestogens are relatively cheap and more suitable for long-term use as compared to GnRHa. Long-term RCT of medicated contraceptive devices like Mirena and Implanon are required to evaluate their long-term effects on relieving the endometriosis associated pelvic pain

  12. Glutathione-S-transferases M1/T1 gene polymorphisms and endometriosis: a meta-analysis in Chinese populations.

    Science.gov (United States)

    Chen, Xin-Ping; Xu, Da-Feng; Xu, Wei-Hua; Yao, Jia; Fu, Sheng-Miao

    2015-01-01

    In view of the controversies surrounding the glutathione-S-transferases (GST) M1/T1-endometriosis association, a meta-analysis of the GSTM1/GSTT1 genetic association studies of endometriosis was performed in Chinese populations. PubMed, Springer Link, OvidSP, and Chinese databases were searched for related studies. A total of nine studies on GSTM1-endometriosis involved 874 cases and 997 controls, and five studies on GSTT1 involved 404 cases and 513 controls were included in this meta-analysis. Overall, the null genotype of GSTM1/GSTT1 was significantly related to endometriosis risk in Chinese populations (GSTM1, OR = 2.21, 95% CI: 1.22-4.01; GSTT1, OR = 2.31, 95% CI: 1.34-3.99). In subgroup analyses stratified by ethnicity and source of controls, the same results were observed in Chinese Han and population-based studies. The sensitivity analysis confirmed the reliability and stability of the meta-analysis. No publication bias was found among studies by Egger's test. In conclusion, our meta-analysis supports that the GSTM1/GSTT1 null genotype might contribute to individual susceptibility to endometriosis in Chinese populations, especially in Chinese Han.

  13. A Promise in the Treatment of Endometriosis: An Observational Cohort Study on Ovarian Endometrioma Reduction by N-Acetylcysteine

    Directory of Open Access Journals (Sweden)

    Maria Grazia Porpora

    2013-01-01

    Full Text Available Urged by the unmet medical needs in endometriosis treatment, often with undesirable side effects, and encouraged by N-acetylcysteine (NAC efficacy in an animal model of endometriosis and by the virtual absence of toxicity of this natural compound, we performed an observational cohort study on ovarian endometriosis. NAC treatment or no treatment was offered to 92 consecutive Italian women referred to our university hospital with ultrasound confirmed diagnosis of ovarian endometriosis and scheduled to undergo laparoscopy 3 months later. According to patients acceptance or refusal, NAC-treated and untreated groups finally comprised 73 and 72 endometriomas, respectively. After 3 months, within NAC-treated patients cyst mean diameter was slightly reduced (-1.5 mm versus a significant increase (+6.6 mm in untreated patients (P=0.001. Particularly, during NAC treatment, more cysts reduced and fewer cysts increased their size. Our results are better than those reported after hormonal treatments. Twenty-four NAC-treated patients—versus 1 within controls—cancelled scheduled laparoscopy due to cysts decrease/disappearance and/or relevant pain reduction (21 cases or pregnancy (1 case. Eight pregnancies occurred in NAC-treated patients and 6 in untreated patients. We can conclude that NAC actually represents a simple effective treatment for endometriosis, without side effects, and a suitable approach for women desiring a pregnancy.

  14. Perianal Endometriosis Mimicking Recurrent Perianal Abscess

    Directory of Open Access Journals (Sweden)

    Mohd Iqbal

    2009-11-01

    Full Text Available Endometriosis of the perianal region is an extremely rare condition usually seen in episiotomy scars and can involve the septum separating vagina and anal canal. The clinician is unlikely to suspect it if there is no scar in the perineum and patient the does not give a history of episiotomy. Moreover it is difficult to suspect when the patient does not report cyclical pain and therefore it is likely to be treated as perianal sepsis. We report the rare case of a 35-year-old woman who presented with recurrent painful nodule of endometriosis of the perianal area without previous episiotomy.

  15. Vesicoovarian Fistula on an Endometriosis Abscessed Cyst

    Directory of Open Access Journals (Sweden)

    C. Tran

    2014-01-01

    Full Text Available We report the case of a patient who developed a vesicoovarian fistula on an endometriosis abscessed cyst. The patient presented with an advanced endometriosis stage IV complicated with a right ovarian abscessed cyst of 10 cm. A first coelioscopy with cystectomy was realized. After surgery, a voiding cystography highlighted a fistula between the ovarian abscess and the bladder. A second surgery by median laparotomy was realized with the resection of the right ovarian abscess and the resection of vesical fistula.

  16. Cystoscopy-assisted laparoscopy for bladder endometriosis: modified light-to-light technique for bladder preservation

    Science.gov (United States)

    Stopiglia, Rafael Mamprin; Ferreira, Ubirajara; Faundes, Daniel Gustavo; Petta, Carlos Alberto

    2017-01-01

    ABSTRACT Introduction Endometriosis is a disease with causes still unclear, affecting approximately 15% of women of reproductive age, and in 1%-2% of whom it may involve the urinary tract. The bladder is the organ most frequently affected by endometriosis, observed around 85% of the cases. In such cases, the most effective treatment is partial cystectomy, especially via videolaparoscopy. Study Objective, Design, Size and Duration In order to identify and delimit the extent of the intravesical endometriosis lesion, to determine the resection limits, as well as to perform an optimal reconstruction of the organ aiming for its maximum preservation, we performed a cystoscopy simultaneously with the surgery, employing a modified light-to-light technique in 25 consecutive patients, from September 2006 to May 2012. Setting Study performed at Campinas Medical Center – Campinas – Sao Paulo – Brazil.Participants/materials, setting and methods: Patients aged 27 to 47 (average age: 33.4 years) with deep endometriosis with total bladder involvement were selected for the study. The technique used was conventional laparoscopy with a transvaginal uterine manipulator and simultaneous cystoscopy (the light-to-light technique). A partial videolaparoscopic cystectomy was performed with cystoscopy-assisted vesical reconstruction throughout the entire surgical time. The lesions had an average size of 2.75cm (ranging from 1.5 to 5.5cm). The average surgical time was 137.7 minutes, ranging from 110 to 180 minutes. Main Results Postoperative follow-up time was 32.4 months (12-78 months), with clinical evaluation and a control cystoscopy performed every six months. No relapse was observed during the follow-up period. Conclusions A cystoscopy-assisted partial laparoscopic cystectomy with a modified light-to-light technique is a method that provides adequate identification of the lesion limits, intra or extravesically. It also allows a safe reconstruction of the organ aiming for its

  17. Cystoscopy-assisted laparoscopy for bladder endometriosis: modified light-to-light technique for bladder preservation

    Directory of Open Access Journals (Sweden)

    Rafael Mamprin Stopiglia

    Full Text Available ABSTRACT Introduction Endometriosis is a disease with causes still unclear, affecting approximately 15% of women of reproductive age, and in 1%-2% of whom it may involve the urinary tract. The bladder is the organ most frequently affected by endometriosis, observed around 85% of the cases. In such cases, the most effective treatment is partial cystectomy, especially via videolaparoscopy. Study Objective, Design, Size and Duration In order to identify and delimit the extent of the intravesical endometriosis lesion, to determine the resection limits, as well as to perform an optimal reconstruction of the organ aiming for its maximum preservation, we performed a cystoscopy simultaneously with the surgery, employing a modified light-to-light technique in 25 consecutive patients, from September 2006 to May 2012. Setting Study performed at Campinas Medical Center – Campinas – Sao Paulo – Brazil.Participants/materials, setting and methods: Patients aged 27 to 47 (average age: 33.4 years with deep endometriosis with total bladder involvement were selected for the study. The technique used was conventional laparoscopy with a transvaginal uterine manipulator and simultaneous cystoscopy (the light-to-light technique. A partial videolaparoscopic cystectomy was performed with cystoscopy-assisted vesical reconstruction throughout the entire surgical time. The lesions had an average size of 2.75cm (ranging from 1.5 to 5.5cm. The average surgical time was 137.7 minutes, ranging from 110 to 180 minutes. Main Results Postoperative follow-up time was 32.4 months (12-78 months, with clinical evaluation and a control cystoscopy performed every six months. No relapse was observed during the follow-up period. Conclusions A cystoscopy-assisted partial laparoscopic cystectomy with a modified light-to-light technique is a method that provides adequate identification of the lesion limits, intra or extravesically. It also allows a safe reconstruction of the organ

  18. A novel role of the Sp/KLF transcription factor KLF11 in arresting progression of endometriosis.

    Directory of Open Access Journals (Sweden)

    Gaurang S Daftary

    Full Text Available Endometriosis affects approximately 10% of young, reproductive-aged women. Disease associated pelvic pain; infertility and sexual dysfunction have a significant adverse clinical, social and financial impact. As precise disease etiology has remained elusive, current therapeutic strategies are empiric, unfocused and often unsatisfactory. Lack of a suitable genetic model has impaired further translational research in the field. In this study, we evaluated the role of the Sp/KLF transcription factor KLF11/Klf11 in the pathogenesis of endometriosis. KLF11, a human disease-associated gene is etiologically implicated in diabetes, uterine fibroids and cancer. We found that KLF11 expression was diminished in human endometriosis implants and further investigated its pathogenic role in Klf11-/- knockout mice with surgically induced endometriotic lesions. Lesions in Klf11-/- animals were large and associated with prolific fibrotic adhesions resembling advanced human disease in contrast to wildtype controls. To determine phenotype-specificity, endometriosis was also generated in Klf9-/- animals. Unlike in Klf11-/- mice, lesions in Klf9-/- animals were neither large, nor associated with a significant fibrotic response. KLF11 also bound to specific elements located in the promoter regions of key fibrosis-related genes from the Collagen, MMP and TGF-β families in endometrial stromal cells. KLF11 binding resulted in transcriptional repression of these genes. In summary, we identify a novel pathogenic role for KLF11 in preventing de novo disease-associated fibrosis in endometriosis. Our model validates in vivo the phenotypic consequences of dysregulated Klf11 signaling. Additionally, it provides a robust means not only for further detailed mechanistic investigation but also the ability to test any emergent translational ramifications thereof, so as to expand the scope and capability for treatment of endometriosis.

  19. Efficacy of guided ovarian hyperstimulation in patients with mild type endometriosis

    Directory of Open Access Journals (Sweden)

    Jašović-Siveska Emilija

    2008-01-01

    Full Text Available Background/Aim. Endometriosis befalls in one of the most frequent gynecologic diseases. It manifests itself by the presence and growth of focus of endometrium out of the uterus cavum that reacts to hormonal stimulations as the normal uterus endometrium does. Hyperstimulation and induction of ovulation together with intrauterine insemination (IUI are the most frequently used treatments of unexplained infertility in patients with mild type endometriosis. The aim of this study was to compare the effects of stimulation using human menopausal gonadotrophine (hMG in the patients with mild type endometriosis to the patients with infertility of unknown ethiology. Methods. The study included 50 patients with unexplained infertility (group N, as well as 50 patients with mild type endometriosis (group E confirmed by laparoscopy. Within the same therapeutic protocole hMG stimulation and horionic gonadotrophine induction (hCG were used. Results. In the group E ovulation occurred in 74% of the patients during the first stimulation, in 77.78% during the second cycle, and in 75% of the patients during the third one. Regarding the group N, ovulation appeared in 82% of the patients during the first stimulation. Stimulation was performed two times more in 38 patients with unknown couse of infertility, and ovulation appeared in 84.21% of them. In the group N stimulation was performed three times in 28 women resulting in ovulation in 85.71% of them. Conclusion. Considering the obtained results it can be concluded that hMG stimulation and hCG induction are efficient in the treatment of infertility, particularly in mild type endometriosis.

  20. Expression of Annexin-1 in patients with endometriosis

    Institute of Scientific and Technical Information of China (English)

    LI Chun-yan; LANG Jing-he; LIU Hai-yuan; ZHOU Hui-mei

    2008-01-01

    Background Annexin-1 was identified as an endometriosis-related protein by comparative proteomics in previous study. As an endogeneous anti-inflammatory mediator, Annexin-1 has been shown to regulate the immune response, cell proliferation and apoptosis. To investigate whether Annexin-1 is involved in the pathogenesis of endometdosis, we examined the expression of Annexin-1 in eutopic endometrium of women with or without endometriosis, and detected its expression in peritoneal fluids of those with endometriosis.Methods Eutopic endometrium samples from twenty-five women with endometriosis and those from sixteen age-matched women without endometriosis were collected. Peritoneal fluids were obtained from ten patients with endometriosis. The expression of Annexin-1 protein in eutopic endometrium was detected by immunohistochemistry and Western blotting, and mRNA detected by real-time PCR. Annexin-1 protein in the peritoneal fluids was detected by Western blotting.Results Annexin-1 mRNA and protein were overexpressed in eutopic endometrium of endometriosis without significant differences between the proliferative and secretory phase. Immunohistochemistry showed that Annexin-1 protein was expressed mainly in endometrial glandular cells throughout the menstrual cycle. Annexin-1 protein was detected in the peritoneal fluids of all the ten patients with endometriosis.Conclusions Annexin-1 is overexpressed in eutopic endometrium and presents in the peritoneal fluids of patients with endometriosis, and may play a role in the pathogenesis of endometriosis.

  1. Laser capture microdissection and cDNA array analysis of endometrium identify CCL16 and CCL21 as epithelial-derived inflammatory mediators associated with endometriosis

    Directory of Open Access Journals (Sweden)

    Jones Rebecca L

    2007-05-01

    Full Text Available Abstract Background Understanding the pathophysiology of chemokine secretion in endometriosis may offer a novel area of therapeutic intervention. This study aimed to identify chemokines differentially expressed in epithelial glands in eutopic endometrium from normal women and those with endometriosis, and to establish the expression profiles of key chemokines in endometriotic lesions. Methods Laser capture microdissection isolated epithelial glands from endometrial eutopic tissue from women with and without endometriosis in the mid-secretory phase of their menstrual cycles. Gene profiling of the excised glands used a human chemokine and receptor cDNA array. Selected chemokines were further examined using real-time PCR and immunohistochemistry. Results 22 chemokine/receptor genes were upregulated and two downregulated in pooled endometrial epithelium of women with endometriosis compared with controls. CCL16 and CCL21 mRNA was confirmed as elevated in some women with endometriosis compared to controls on individual samples. Immunoreactive CCL16 and CCL21 were predominantly confined to glands in eutopic and ectopic endometrium: leukocytes also stained. Immunoreactive CCL16 was overall higher in glands in ectopic vs. eutopic endometrium from the same woman (P Conclusion This study provides novel candidate molecules and suggests a potential local role for CCL16 and CCL21 as mediators contributing to the inflammatory events associated with endometriosis.

  2. Bladder Endometriosis Mimicking TCC - A Case Report.

    Science.gov (United States)

    Gupta, Asish; Bhatnagar, Atul; Seth, B N; Dang, Arbinder; Gupta, Vineeta

    2016-02-01

    Endometriosis is the ectopic presence of endometrial tissue outside the uterus. Though on its own endometriosis is not a rare lesion, the involvement of the urinary tract is rare but with the bladder being the most commonly affected organ. Endometriosis is usually seen in females between the ages of 30-40 years and may occur due to fluctuating levels of oestrogen and progesterone. Clinically the patient maybe asymptomatic or show symptoms of dysmenorrhea, irregular or heavy periods, pain in the pelvic area, lower abdomen or in the back. It has been suggested that ultrasonography should be done either before or during menstruation as the lesion becomes more evident and a biopsy taken during this period is a strong aid in reaching a final diagnosis. We report here an unusual case of bladder endometriosis where the patient came with severe pelvic pain and an endoluminal mass seen on the ultrasonographic report. Based on these findings a differential of transitional cell carcinoma was given which was ruled out based on the cystoscopic findings.

  3. DIOXINS AND ENDOMETRIOSIS: A PLAUSIBLE HYPOTHESIS

    Science.gov (United States)

    A potential connection exists between the increasing prevalence of endometriosis and exposure to organochlorine chemicals. There is evidence that dioxin (2,3,7,8-TCDD) can increase the incidence and severity of the disease in monkeys and can promote the growth or survival of end...

  4. ESHRE guideline: management of women with endometriosis

    NARCIS (Netherlands)

    Dunselman, G.A.; Vermeulen, N.; Becker, C.; Calhaz-Jorge, C.; D'Hooghe, T.; Bie, B. De; Heikinheimo, O.; Horne, A.W.; Kiesel, L.; Nap, A.; Prentice, A.; Saridogan, E.; Soriano, D.; Nelen, W.L.D.M.

    2014-01-01

    STUDY QUESTION: What is the optimal management of women with endometriosis based on the best available evidence in the literature? SUMMARY ANSWER: Using the structured methodology of the Manual for ESHRE Guideline Development, 83 recommendations were formulated that answered the 22 key questions on

  5. Hormonal Treatment for Severe Hydronephrosis Caused by Bladder Endometriosis

    Directory of Open Access Journals (Sweden)

    Erkan Efe

    2014-01-01

    Full Text Available The incidence of endometriosis cases involving the urinary system has recently increased, and the bladder is a specific zone where endometriosis is most commonly seen in the urinary system. In the case presented here, a patient presented to the emergency department with the complaint of side pain and was examined and diagnosed with severe hydronephrosis and bladder endometriosis was determined in the etiology. After the patient was pathologically diagnosed, Levonorgestrel-Releasing Intrauterine System (LNG-IUS was administered to the uterine cavity. At the 12-month follow-up, endometriosis was not observed in the cystoscopy and symptoms had completely regressed. Hydronephrosis may be observed after exposure of the ureter, and silent renal function loss may develop in patients suffering from endometriosis with bladder involvement. For patients with moderate or severe hydronephrosis associated with bladder endometriosis, LNG-IUS application may be separately and successfully used after conservative surgery.

  6. Descending colon endometriosis misdiagnosis as diverticulitis: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Hyun; Kim, Min Jeong; Ha, Hong Il; Lee, Kwan Seop; Min, Soo Kee [Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang (Korea, Republic of)

    2016-09-15

    Endometriosis is defined as the presence of ectopic endometrial tissue outside the uterus. It is a common disease in menstruating females and intestinal involvement is not uncommon. Intestinal endometriosis most commonly involves the sigmoid colon, rectum, ileum, appendix, and cecum. However, the descending colon is a rare site of intestinal endometriosis. Although computed tomography (CT) findings of bowel endometriosis have been presented in several articles, there has been no report describing the CT findings of descending colon endometriosis above the pelvic cavity. Here, we report a rare case of descending colon endometriosis located in the retroperitoneal space, in which the initial impression was acute colonic diverticulitis with a small abscess on preoperative multidetector CT.

  7. Clinical diagnosis and treatment for urinary tract endometriosis%泌尿系子宫内膜异位症临床诊治特点分析

    Institute of Scientific and Technical Information of China (English)

    张继伟; 王海涛; 白焱; 王建军; 夏溟

    2010-01-01

    Objective To evaluate the diagnosis and treatment of urinary tract endometriosis.Methods Retrospective review of 10 female cases of urinary tract endometriosis was carried out. All cases age was from 28-49, and the average age was 39-year-old. The course of this disease was from 6 months to 3 years. Four of 10 cases were bladder endometriosis. The clinical presentations included the urgency, frequency, pain at micturition and lower abdomen pain during menstruation, gross hematuria coinciding with menstruation 1 case. B-ultrasound and CT showed the mass of bladder from 2. 0 -3.5 cm but were not specific. Four of 6 cases ureteral endometriosis were the left side and 2 cases were the right side. This clinical presentation included non-specific flank or abdomenal discomfort in 4 cases, intermittent gross hematuria in 1 case and 1 case renal hydronephrosis was found incidentally by B-ultrasound. B-ultrasound indicated unilateral upper urinary tract dilation and hydrops in all cases,with pyelic separation from 2.0-4.5 cm and ureteral separation from 1-2 cm. CT indicated stenosis of the lower ureter in 5 cases, ureter tumor in 1 case. Results All cases were treated surgically.Partial cystectomy were performed in 4 cases of bladder endometriosis, of which, 1 case bilateral oophorectomy and hysterectomy. Five cases were performed ureteral segmental resection, of which, 3 ureterocystostomy and 2 terminoterminal anastomosis. 1 case was performed radical nephrectomy and ureterectomy. Postoperative pathological findings confirmed the diagnosis of endometriosis. Postoperative oral hormone therapy was given to 9 cases for 6-12 months. All cases were followed for 12-60months. 2 cases ureteral endometriosis had recurrent hydronephrosis in 18-24 months. The 2 cases received ureteral stent and cured by oral hormone therapy or goserelin subcutaneous injection for 3 months. Conclusions Urinary tract endometriosis usually shows non-specific symptoms. The diagnosis can be missed on both

  8. Systems genetics view of endometriosis: a common complex disorder.

    Science.gov (United States)

    Baranov, Vladislav S; Ivaschenko, Tatyana E; Liehr, Thomas; Yarmolinskaya, Maria I

    2015-02-01

    Endometriosis is a condition in which cells derived from the endometrium grow outside the uterus, e.g. in the peritoneum (external genital endometriosis). As these cells are under the influence of female hormones, major symptoms of endometriosis are pain, especially during the cycle, and infertility. Numerous hypotheses for the formation of endometriosis can be found in the literature, but there is growing evidence of serious genetic contributions to endometriosis susceptibility. The involvement of genes, steroid hormone metabolism, immunological reactions, receptor formation, inflammation, proliferation, apoptosis, intercellular adhesion, cell invasion and angiogenesis as well as genes regulating the activity of aforementioned enzymes have been suggested. Some more recently suggested candidate genes picked up in genome-wide association studies are involved in oncogenesis, metaplasia of endometrium cells and pathways of embryonic development of the female reproductive system. However, gene mutations proven to be causative for endometriosis have not been identified so far, even though the abnormal expression of candidate genes for endometriosis could be provoked by different epigenetic modifications including DNA methylation, heterochromatization or introduction of regulatory miRNA. We hypothesize that endometriosis is induced by a combination of abnormal genetic and/or epigenetic mutations: the latter pave the way for pathological changes which become irreversible, and according to the "epigenetic landscape" theory, this proceeds to the typical clinical manifestations. Two stages in the endometriosis pathway are suggested: (1) induction of primary endometrial cells toward endometriosis, and (2) implantation and progression of these cells into endometriosis lesions. The model favors endometriosis as an outgrowth of primary cells different in their origin, canalization of pathological processes, manifestation diversity provoked by unique genetic background and

  9. COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM THERAPIES FOR MANAGEMENT OF PAIN RELATED TO ENDOMETRIOSIS

    Directory of Open Access Journals (Sweden)

    Panda Roshni

    2012-03-01

    Full Text Available Endometriosis is a gynaecological disease with a complex etiology. It is associated with severe pelvic pain, sub fertility and reduced quality of life. Endometriosis has a multifactorial etiology and therefore its management is also multidimensional. The main targets of therapy are controlling of the pain symptoms and increasing fertility where it is desired. Hormonal and surgical therapies are the two major treatment modalities available currently. But they are not without their side effects. Therefore many women explore Complementary and Alternative Medicine (CAM forms of treatment for symptomatic relief from pain. These CAM therapies have been used as an adjuvant to conventional therapy or as an independent form of treatment. CAM therapies are purported to have lesser side effects as compared to conventional medical formulations. Ancient Chinese and Indian medicine system have laid the foundation of several of the prevalent Cam practices. The following CAM practices have been discussed in the article-Acupuncture, Herbal therapy, Meditation and Hypnotherapy, Yoga, Exercise, Dietary therapy Aromatherapy and Massage, Reiki, Magnet therapy and Chiropractice. Randomized Clinical Trials (RCT have been conducted for some of the CAM therapies in Endometriosis and Acupuncture and Herbal and Dietary therapies have been found to have some positive effect on the patients. The efficacy of CAM therapies still needs substantial evidence to be integrated into general healthcare practices.

  10. Mechanisms regulating invasiveness and growth of endometriosis lesions in rat experimental model and in humans.

    Science.gov (United States)

    Sotnikova, Natalia Yu; Antsiferova, Yulia S; Posiseeva, Lyubov V; Shishkov, Dmitrii N; Posiseev, Denis V; Filippova, Ekaterina S

    2010-05-15

    To compare the expression of MMP-2, TIMP-2, and TGFbeta2 mRNA in experimental and human endometriotic lesions and to assess the possibility of its cytokine regulation. Experimental laboratory study. Medical center. ANIMALS AND PATIENT(S): Thirty female Wistar rats, 17 women with endometriosis, 11 healthy women. Uterine transplants were attached to rat peritoneum via the surgical autotransplantation technique. The collection of endometriotic implants at 7, 14, and 21 days postsurgery and laparoscopic collection of peritoneal fluid, ectopic, and matched eutopic endometrium from women with endometriosis were performed. MMP-2, TIMP-2, TGFbeta2 mRNA expression in endometrium was assessed by real-time reverse-transcription polymerase chain reaction. In rats, the increase of MMP-2 and decrease of TIMP-2 mRNA expression was noted at the 7th day, and an increase of TGFbeta2 mRNA expression was seen at the 14th day postsurgery. In humans, elevation of TIMP-2 mRNA expression in eutopic endometrium and of MMP-2, TGFbeta2 mRNA expression in ectopic endometrium was observed. Autologous peritoneal fluid stimulated MMP-2 mRNA expression in eutopic endometrium of women with endometriosis. Cytokines derived from ectopic lesions mononuclear cells increased TGFbeta2 mRNA expression in endometrium of healthy women. Supposedly MMP-TIMP balance is important in promoting endometriotic tissue invasion and TGFbeta2 in regulating ectopic endometrium growth. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  11. The role of the Hoxa10/HOXA10 gene in the etiology of endometriosis and its related infertility: a review

    Science.gov (United States)

    Rocha, André M.; Carvalho, Filomena M.; Pereira, Ricardo M. A.; Taylor, Hugh S.; Motta, Eduardo L. A.; Baracat, Edmund C.; Serafini, Paulo C.

    2010-01-01

    Purpose Endometriosis and its associated infertility have been the object of continuous research for over a century. To understand the molecular mechanisms underlying the disease, it has become necessary to determine the aspects of its etiology that are not explained by the retrograde menstruation theory. This could in turn elucidate how various clinical and surgical treatments might affect the evolution and remission of the disease. Methods This review is focused on the most recent clinical and laboratory findings regarding the association of HOXA10 with endometriosis and infertility. Result The homebox (Hox/HOX) proteins are highly conserved transcription factors that determine segmental body identities in multiple species, including humans. Hoxa10/HOXA10 is directly involved in the embryogenesis of the uterus and embryo implantation via regulation of downstream genes. Cyclical endometrial expression of Hoxa10/HOXA10, with a peak of expression occurring during the window of implantation, is observed in the adult in response to estrogen and progesterone. Women with endometriosis do not demonstrate the expected mid-luteal rise of HOXA10 expression, which might partially explain the infertility observed in many of these patients. Recent studies also demonstrated HOXA10 expression in endometriotic foci outside the Müllerian tract. Conclusions Multiple lines of evidence suggest that the actions of the homeobox A10 (Hoxa10/HOXA10) gene could account for some aspects of endometriosis. PMID:20821045

  12. Cyclic sciatica caused by infiltrative endometriosis: MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Yekeler, Ensar; Kumbasar, Basak; Tunaci, Atadan; Barman, Ahmet; Tunaci, Mehtap [Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, 34390, Capa, Istanbul (Turkey); Bengisu, Ergin [Department of Obstetrics and Gynecology, Istanbul Faculty of Medicine, Istanbul University, Istanbul (Turkey); Yavuz, Ekrem [Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, 34390, Capa, Istanbul (Turkey)

    2004-03-01

    Endometriosis, an important gynecological disorder of reproductive women, affects most commonly the ovaries and less frequently the gastrointestinal tract, chest, urinary tract, and soft tissues. Endometriosis classically appears on MRI as a mass with a large cystic component and variable signal intensities on T1- and T2-weighted images due to the presence of variable degradation of hemorrhagic products. Endometriosis in an atypical location, an infiltrative appearance and without cystic-hemorrhagic components has rarely been described. We report on a 33-year-old woman with cyclic sciatica due to histologically documented infiltrative endometriosis involving the area of the left sciatic notch. (orig.)

  13. Communicating endometriosis with young women to decrease diagnosis time.

    Science.gov (United States)

    Shadbolt, Naomi A; Parker, Melissa A; Orthia, Lindy A

    2013-08-01

    Endometriosis is estimated to affect approximately 10% of women. Although early detection may enhance health outcomes and fertility, there is a recognised diagnostic delay of 6.7 years. There are limited data on ways to discuss endometriosis with young women. The aims of the present study were to determine what young women know about endometriosis, what young women want to know about endometriosis and how this is best communicated to promote early detection. Women aged 16-25 years were invited to complete an online survey that was advertised via Facebook, email, Twitter and flyers at high schools and a university. In all, 131 women responded to the survey. Fifty-two percent of participants had heard of endometriosis, 89% thought teenagers should be educated about endometriosis and 78% thought that young men should also be educated about the condition. Favoured sources for obtaining information were schools (40%), the Internet (22%) and magazines (13%). Participants were most comfortable talking to a doctor (75%), parent (59%) or friend (51%). Participants primarily wanted to know about the disease, its symptoms, risk factors and treatment. Many participants' descriptions of endometriosis were vague or inaccurate. The results of the present study indicate that young women are keen to learn about endometriosis, particularly its symptoms. Preferential sources of information appear to be schools or the Internet, and young women appear more comfortable talking to doctors. SO WHAT? To promote early detection of endometriosis, health promotion activities should direct their information towards sources that young women prefer.

  14. Urinary phthalate monoesters and endometriosis in infertile Japanese women

    Energy Technology Data Exchange (ETDEWEB)

    Itoh, Hiroaki [Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 (Japan); Iwasaki, Motoki, E-mail: moiwasak@ncc.go.jp [Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 (Japan); Hanaoka, Tomoyuki [Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 (Japan); Sasaki, Hiroshi; Tanaka, Tadao [Department of Obstetrics and Gynecology, Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo 105-8461 (Japan); Tsugane, Shoichiro [Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 (Japan)

    2009-12-15

    Phthalates may act as an estrogen and are a potential risk factor for estrogen-related diseases such as endometriosis. We assessed the association between phthalate exposure and endometriosis in 166 consecutive women who presented at a university hospital for consultation regarding infertility. The subjects were interviewed and provided a urine specimen prior to a laparoscopic diagnosis of endometriosis. They were then categorized by the severity of endometriosis as controls (stages 0-I) and cases (stages II-IV). Urinary concentrations of the phthalate metabolites monoethyl phthalate, mono-n-butyl phthalate, monobenzyl phthalate, mono(2-ethylhexyl) phthalate (MEHP), mono(2-ethyl-5-oxohexyl) phthalate, and mono(2-ethyl-5-hydroxyhexyl) phthalate were measured in 57 cases and 80 controls using high-performance liquid chromatography isotope-dilution tandem mass spectrometry. Adjusted odds ratios for endometriosis in relation to dichotomized individual phthalate metabolites (standardized for creatinine) were calculated. No significant association between endometriosis and any urinary creatinine-adjusted phthalate monoester was seen. Adjusted odds ratio (95% confidence interval) for higher dichotomized MEHP by endometriosis was 1.57 (0.74-3.30). No monotonic trend was seen in urinary creatinine-adjusted concentration of phthalate metabolites by endometriosis stage (p = 0.23-0.90). Our results do not support the hypothesis that higher urinary concentrations of phthalate metabolites are associated with the risk of endometriosis in infertile Japanese women.

  15. Endometriosis-Associated Ovarian Cancer: A Review of Pathogenesis

    Directory of Open Access Journals (Sweden)

    Shu-Wing Ng

    2013-03-01

    Full Text Available Endometriosis is classically defined as the presence of endometrial glands and stroma outside of the endometrial lining and uterine musculature. With an estimated frequency of 5%–10% among women of reproductive age, endometriosis is a common gynecologic disorder. While in itself a benign lesion, endometriosis shares several characteristics with invasive cancer, has been shown to undergo malignant transformation, and has been associated with an increased risk of epithelial ovarian carcinoma (EOC. Numerous epidemiologic studies have shown an increased risk of EOC among women with endometriosis. This is particularly true for women with endometrioid and clear cell ovarian carcinoma. However, the carcinogenic pathways by which endometriosis associated ovarian carcinoma (EAOC develops remain poorly understood. Current molecular studies have sought to link endometriosis with EAOC through pathways related to oxidative stress, inflammation and hyperestrogenism. In addition, numerous studies have sought to identify an intermediary lesion between endometriosis and EAOC that may allow for the identification of endometriosis at greatest risk for malignant transformation or for the prevention of malignant transformation of this common gynecologic disorder. The objective of the current article is to review the current data regarding the molecular events associated with EAOC development from endometriosis, with a primary focus on malignancies of the endometrioid and clear cell histologic sub-types.

  16. Experimental endometriosis reduction in rats treated with Uncaria tomentosa (cat's claw) extract.

    Science.gov (United States)

    Nogueira Neto, João; Coelho, Tarcísio Mota; Aguiar, Guilherme Carneiro; Carvalho, Laura Rosa; de Araújo, Ana Gisélia Portela; Girão, Manuel João B C; Schor, Eduardo

    2011-02-01

    The aim of this study was to analyze the macroscopic and histological changes that occur in experimental endometriosis after treatment with Uncaria tomentosa. Experimental endometriosis was induced in twenty-five female Wistar rats. After three weeks, 24 animals developed grade III experimental endometriosis and were divided into two groups. Group "U" received U. tomentosa extract orally (32 mg/day), and group "C" (control group) received a 0.9% sodium chloride solution orally (1 ml/100g of body weight/day). Both groups were treated with gavage for 14 days. At the surgical intervention and after the animal was euthanized, the implant volume was calculated with the following formula: [4π (length/2)×(width/2)×(height/2)/3]. The autotransplants were removed, dyed with hematoxylin-eosin, and analyzed by light microscopy. The Mann-Whitney test was used for the independent samples, and the Wilcoxon test analyzed the related samples, with a significance level of 5%. The difference between the initial average volumes of the autotransplants was not significant between the groups (p = 0.18). However, the final average volumes were significantly different between the groups (p = 0.001). There was a significant increase (p = 0.01) between the initial and final average volumes in the control group, and treatment with the U. tomentosa caused a marked reduction in the growth over time (p = 0.009). Histologically, in the experimental group (n = 10) six rats had a well-preserved epithelial layer, three had mildly preserved epithelium, and one had poorly preserved epithelium. The epithelial layer occasionally presented sporadic epithelial cells. The control group (n = 12) presented seven cases (58.3%) of well-preserved epithelial cells and five cases (41.7%) of mildly preserved epithelial cells. Cat's claw extract appears to be a promising alternative for treating endometriosis. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  17. The double-edged experience of healthcare encounters among women with endometriosis: A qualitative study.

    Science.gov (United States)

    Grundström, Hanna; Alehagen, Siw; Kjølhede, Preben; Berterö, Carina

    2017-05-11

    To identify and describe the experience of healthcare encounters among women with endometriosis. Endometriosis is a "hidden" chronic gynaecological disease appearing in every 10th woman of fertile age. Different manifestations of pain are the main symptoms, often leading to impaired physical and mental health, and lower quality of life. Previous research on healthcare experiences among women with endometriosis has focused on diagnostic delay and experiences of encountering general practitioners. A qualitative, interpretive, phenomenological approach was used. We interviewed nine women aged 23-55, with a laparoscopy-confirmed diagnosis of endometriosis. The interviews were recorded and transcribed verbatim. The data were analysed following the steps of the interpretive phenomenological approach. Two themes were identified in the interview transcripts: being treated with ignorance and being acknowledged. The essence: "the double-edged experience of healthcare encounters" emerged from the themes. The women's experience was double-edged as it involved contradictory feelings: the encounters were experienced as both destructive or constructive. On the one hand, the destructive side was characterised by ignorance, exposure and disbelief. On the other hand, the constructive side made the women feel acknowledged and confirmed, boosting their self-esteem. The new and important aspects of the findings are that the experience of healthcare encounters is for the first time expressed as double-edged: both destructive and constructive. The experience was of specific importance as it affected the women's perceptions of themselves and of their bodies. The information about the constructive side of the experience is of clinical valuable for all healthcare professionals (nurses, midwives and doctors) encountering these women, as it provides a new level of understanding of the experiences. The findings demonstrate both psychological and practical aspects that can help professionals to

  18. Tension Hydrothorax Related to Disseminated Endometriosis

    Directory of Open Access Journals (Sweden)

    AnnaKate Deal, MD

    2016-01-01

    Full Text Available We present the case of a 34-year-old woman presenting to the emergency department (ED with dyspnea, cough, and fever. She was found to have a tension hydrothorax and was treated with ultrasound-guided thoracentesis in the ED. Subsequent inpatient evaluation showed the patient had disseminated endometriosis. Tension hydrothorax has not been previously described in the literature as a complication of this disease.

  19. Laparoscopic surgery for intestinal and urinary endometriosis.

    Science.gov (United States)

    Redwine, D B; Sharpe, D R

    1995-12-01

    Intestinal and urinary tract involvement by endometriosis may be symptomatic, particularly when invasive disease is present. Even in expert hands, complete excision of all invasive disease cannot be accomplished laparoscopically in every case. The practitioner must balance enthusiasm for the advantages of a laparoscopic approach with limitations of time and skill. Laparoscopy should be abandoned in a particular case if a better job can be performed by laparotomy. Hysterectomy with castration may not relieve symptoms due to invasive disease.

  20. Anti-laminin-1 Autoantibodies, Pregnancy Loss and Endometriosis

    Directory of Open Access Journals (Sweden)

    Junko Inagaki

    2004-01-01

    Full Text Available Laminin-1 is a major component and multifunctional glycoprotein of basement membranes that consists of three different subunits, α1, β1 and γ1 chains. It is the earliest synthesized network-forming protein during embryogenesis and plays an important role in embryonic development, embryonic implantation and placentation. We have recently shown that IgG anti-laminin-1 antibodies were significantly associated with recurrent first-trimester miscarriages and with subsequent pregnancy outcome. Interestingly, these antibodies were also observed in patients with endometriosis-associated infertility but not in patients with other causes of infertility, including tubal factors, hormonal and uterine abnormalities. Laminin-α1, -β1 and -γ1 mRNAs have been detected in 90% of endometriotic lesions and all laminin-α1, -β1 and -γ1 chains were localized in the basement membranes of glandular epithelium in endometriotic peritoneal lesions. Western blot analysis showed that anti-laminin-1 antibodies from those patients reacted with all laminin-1's chains. ELISA also confirmed that one of the target epitopes for these antibodies was located in a particular region of the laminin-1 molecule, i.e. the carboxyl-terminal globular G domain of α1 chain. IgM monoclonal anti-laminin-1 autoantibody, that we recently established, also recognized the G domain. Anti-laminin-1 antibodies from mice immunized with –mouse— laminin-1, caused a higher fetal resorption rate with lower embryonic and placental weights. Thus, anti-laminin-1 antibodies may be important in development of autoimmune-mediated reproductive failures and the assessment of the antibodies may provide a novel non-invasive diagnosis of endometriosis.

  1. Diagnosis of endometriosis with imaging: a review

    Energy Technology Data Exchange (ETDEWEB)

    Kinkel, Karen [Clinique et fondation des Grangettes, Institut de Radiologie, Chene-Bougeries/Geneva (Switzerland); Frei, Kathrin A. [University Hospital Bern, Department of Obstetrics and Gynaecology, Bern (Switzerland); Balleyguier, Corinne [Institut Gustave Roussy, Radiology Department, Villejuif (France); Chapron, Charles [Hopitaux de Paris, Service de Gynecologie Obstetrique II, Unite de Chirurgie, Paris (France)

    2006-02-01

    Endometriosis corresponds to ectopic endometrial glands and stroma outside the uterine cavity. Clinical symptoms include dysmenorrhoea, dyspareunia, infertility, painful defecation or cyclic urinary symptoms. Pelvic ultrasound is the primary imaging modality to identify and differentiate locations to the ovary (endometriomas) and the bladder wall. Characteristic sonographic features of endometriomas are diffuse low-level internal echos, multilocularity and hyperchoic foci in the wall. Differential diagnoses include corpus luteum, teratoma, cystadenoma, fibroma, tubo-ovarian abscess and carcinoma. Repeated ultrasound is highly recommended for unilocular cysts with low-level internal echoes to differentiate functional corpus luteum from endometriomas. Posterior locations of endometriosis include utero-sacral ligaments, torus uterinus, vagina and recto-sigmoid. Sonographic and MRI features are discussed for each location. Although ultrasound is able to diagnose most locations, its limited sensitivity for posterior lesions does not allow management decision in all patients. MRI has shown high accuracies for both anterior and posterior endometriosis and enables complete lesion mapping before surgery. Posterior locations demonstrate abnormal T2-hypointense, nodules with occasional T1-hyperintense spots and are easier to identify when peristaltic inhibitors and intravenous contrast media are used. Anterior locations benefit from the possibility of MRI urography sequences within the same examination. Rare locations and possible transformation into malignancy are discussed. (orig.)

  2. Spontaneous External Endometriosis in a Gorilla (Gorilla gorilla)

    OpenAIRE

    Doré, Monique; Lagacé, Andre

    1985-01-01

    The present report describes a case of external endometriosis in a 28 year old female gorilla (Gorilla gorilla). Microscopical examination of a pelvic mass observed at necropsy revealed ovarian tissue together with uterine glands and stroma, fibrous tissue and many siderophages. Theories of pathogenesis of external endometriosis are briefly reviewed.

  3. Characteristics, expectations and needs of the dutch endometriosis society members

    NARCIS (Netherlands)

    Roos-Eysbouts, Y.K.; Bie-Rocks, B. De; Dijk, J. van; Nap, A.W.

    2015-01-01

    Background/Aim Study Question: Endometriosis is associated with a significant reduction in the quality of life and higher depression and anxiety rates. The Dutch Endometriosis Society (ES) was founded to increase the recognition and knowledge in patients and health care professionals, stimulate rese

  4. Signal intensity change of the labyrinth in patients with surgically confirmed or radiologically diagnosed vestibular schwannoma on isotropic 3D fluid-attenuated inversion recovery MR imaging at 3 T

    Energy Technology Data Exchange (ETDEWEB)

    Lee, In Ho; Kim, Hyung-Jin; Kim, Eunhee; Moon, Jung Won; Kim, Sung Tae; Kim, Keon Ha; Jeon, Pyoung; Byun, Hong Sik [Sungkyunkwan University School of Medicine, Department of Radiology, Samsung Medical Center, Seoul (Korea); Chung, Won Ho [Sungkyunkwan University School of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Seoul (Korea)

    2010-04-15

    The purpose of this study was to evaluate the signal intensity (SI) change of the labyrinth in patients with vestibular schwannoma on isotropic 3D fluid-attenuated inversion recovery (FLAIR) imaging at 3 T. Thirty-four patients with surgically confirmed or radiologically diagnosed vestibular schwannoma were included in this study. Retrospectively, we visually and quantitatively compared the SIs of the cochlea and vestibule on the affected side with those on the unaffected side. We also investigated whether there was correlation between the SI ratios (SIRs) of the labyrinth and the audiometric findings. On 3D FLAIR images, the SI of the cochlea and vestibule on the affected side was significantly increased in 97% (33/34) and 91% (31/34), respectively. While the SI of the cochlea was diffusely increased, that of the vestibule was only partially increased. Quantitative study also revealed statistically significantly higher SIRs of the cochlea (0.99 {+-} 0.29) and vestibule (0.73 {+-} 0.31) on the affected side, compared with the cochlea (0.47 {+-} 0.20) and vestibule (0.19 {+-} 0.10) on the unaffected side. There was no significant correlation of the SIRs of the labyrinth with the degree of hearing loss. In patients with vestibular schwannoma, isotropic 3D FLAIR imaging is a useful method for the evaluation of the SI changes of the labyrinth. (orig.)

  5. [Treatment of endometriosis by aromatase inhibitors: efficacy and side effects].

    Science.gov (United States)

    Racine, A-C; Legrand, E; Lefebvre-Lacoeuille, C; Hoppe, E; Catala, L; Sentilhes, L; Descamps, P

    2010-05-01

    The recent demonstration that aromatase is expressed at higher levels in endometriosis implants than in normal endometrium has led to pilot studies using inhibitor aromatasis in patients with endometriosis. We conducted a systematic review of the literature and studied the efficacy of aromatase inhibitors on endometriosis. There were seventeen studies (case reports/series) evaluating outcomes of aromatase inhibitors. Studies suggest that aromatase inhibitors alone or co-administered with progestins, oral contraceptives or gonadotrophin releasing hormone (GnRH) agonist could reduce pain and endometriosis. There is only one randomized controlled trial comparing aromatase inhibitor+GnRH agonist and GnRH agonist and one study with eighty patients. Side-effects profiles of aromatase inhibitor regimens are favorable; it does not appear a significant bone loss. Aromatase inhibitors seem to have a promising effect on endometriosis but randomized controlled trials are needed to prove their effects and their safety.

  6. Implications of immune dysfunction on endometriosis associated infertility.

    Science.gov (United States)

    Miller, Jessica E; Ahn, Soo Hyun; Monsanto, Stephany P; Khalaj, Kasra; Koti, Madhuri; Tayade, Chandrakant

    2017-01-24

    Endometriosis is a complex, inflammatory disease that affects 6-10% of reproductive-aged women. Almost half of the women with endometriosis experience infertility. Despite the excessive prevalence, the pathogenesis of endometriosis and its associated infertility is unknown and a cure is not available. While many theories have been suggested to link endometriosis and infertility, a consensus among investigators has not emerged. In this extensive review of the literature as well as research from our laboratory, we provide potential insights into the role of immune dysfunction in endometriosis associated infertility. We discuss the implication of the peritoneal inflammatory microenvironment on various factors that contribute to infertility such as hormonal imbalance, oxidative stress and how these could further lead to poor oocyte, sperm and embryo quality, impaired receptivity of the endometrium and implantation failure.

  7. SERUM SOLUBLE E CADHERIN LEVEL IN PATIENTS WITH ENDOMETRIOSIS

    Institute of Scientific and Technical Information of China (English)

    傅晨薇; 郎景和

    2002-01-01

    Objective.To investigate the serum sE cadherin level in patients with endometriosis and the alterations of that level in healthy control during the menstrual cycle.Methods.Thirty two patients with endometriosis and 30 healthy women were tested for serum sE cadherin levels by enzyme linked immunosorbent assay.Results.The serum sE cadherin levels in healthy control did not vary throughout the menstrual cycle,which were lower than those in patients with endometriosis.Conclusions.E cadherin might be involved in endometrial shedding during menstruation in endometriosis patients.The serum sE cadherin assay might be helpful as a serum marker for the diagnosis and management of endometriosis.

  8. Minimally invasive surgery when treating endometriosis has a positive effect on health and on quality of work life of affected women.

    Science.gov (United States)

    Wullschleger, M F; Imboden, S; Wanner, J; Mueller, M D

    2015-03-01

    What is the effect of the minimally invasive surgical treatment of endometriosis on health and on quality of work life (e.g. working performance) of affected women? Absence from work, performance loss and the general negative impact of endometriosis on the job are reduced significantly by the laparoscopic surgery. The benefits of surgery overall and of the laparoscopic method in particular for treating endometriosis have been described before. However, previous studies focus on medical benchmarks without including the patient's perspective in a quantitative manner. A retrospective questionnaire-based survey covering 211 women with endometriosis and a history of specific laparoscopic surgery in a Swiss university hospital, tertiary care center. Data were returned anonymously and were collected from the beginning of 2012 until March 2013. Women diagnosed with endometriosis and with at least one specific laparoscopic surgery in the past were enrolled in the study. The study investigated the effect of the minimally invasive surgery on health and on quality of work life of affected women. Questions used were obtained from the World Endometriosis Research Foundation (WERF) Global Study on Women's Health (GSWH) instrument. The questionnaire was shortened and adapted for the purpose of the present study. Of the 587 women invited to participate in the study, 232 (232/587 = 40%) returned the questionnaires. Twenty-one questionnaires were excluded due to incomplete data and 211 sets (211/587 = 36%) were included in the study. Our data show that 62% (n = 130) of the study population declared endometriosis as influencing the job during the period prior to surgery, compared with 28% after surgery (P work due to endometriosis was reduced from 2.0 (4.9) to 0.5 (1.4) hours per week (P working performance after the surgery averaged out at 5.7% (12.6%) compared with 17.5% (30.5%) before this treatment (P working performance of women suffering from moderate to severe endometriosis

  9. Prolactin and cortisol levels in women with endometriosis

    Directory of Open Access Journals (Sweden)

    A.P. Lima

    2006-08-01

    Full Text Available Endometriosis is a progressive estrogen-dependent disease affecting women during their reproductive years. The objective of the present study was to investigate whether endometriosis is associated with stress parameters. We determined cortisol and prolactin levels in serum, peritoneal and follicular fluid from infertile women with endometriosis and fertile women without the disease. The extent of the disease was staged according to the revised American Fertility Society classification (1997. Serum and peritoneal fluid were collected from 49 women aged 19 to 39 years undergoing laparoscopy. Eighteen women had stage I-II endometriosis and 10 had stage III-IV. Controls were 21 women undergoing laparoscopy for tubal sterilization. Follicular fluid was obtained from 39 women aged 25-39 years undergoing in vitro fertilization (21 infertile women with endometriosis and 18 infertile women without endometriosis. Serum prolactin levels were significantly higher in infertile women with stage III-IV endometriosis (28.9 ± 2.1 ng/mL than in healthy controls (13.2 ± 2.1 ng/mL. Serum cortisol levels were significantly higher in infertile women with stage III-IV endometriosis (20.1 ± 1.3 ng/mL than in controls (10.5 ± 1.4 ng/mL. Cortisol and prolactin levels in follicular fluid and peritoneal fluid did not differ significantly between groups. The high levels of cortisol and prolactin in the serum from women with endometriosis might contribute to the subfertility frequently associated with the disease. Moreover, since higher levels of cortisol and prolactin are often associated with stress, it is probable that stress might contribute to the development of endometriosis and its progression to advanced stages of the disease.

  10. Prolactin and cortisol levels in women with endometriosis.

    Science.gov (United States)

    Lima, A P; Moura, M D; Rosa e Silva, A A M

    2006-08-01

    Endometriosis is a progressive estrogen-dependent disease affecting women during their reproductive years. The objective of the present study was to investigate whether endometriosis is associated with stress parameters. We determined cortisol and prolactin levels in serum, peritoneal and follicular fluid from infertile women with endometriosis and fertile women without the disease. The extent of the disease was staged according to the revised American Fertility Society classification (1997). Serum and peritoneal fluid were collected from 49 women aged 19 to 39 years undergoing laparoscopy. Eighteen women had stage I-II endometriosis and 10 had stage III-IV. Controls were 21 women undergoing laparoscopy for tubal sterilization. Follicular fluid was obtained from 39 women aged 25-39 years undergoing in vitro fertilization (21 infertile women with endometriosis and 18 infertile women without endometriosis). Serum prolactin levels were significantly higher in infertile women with stage III-IV endometriosis (28.9 +/- 2.1 ng/mL) than in healthy controls (13.2 +/- 2.1 ng/mL). Serum cortisol levels were significantly higher in infertile women with stage III-IV endometriosis (20.1 +/- 1.3 ng/mL) than in controls (10.5 +/- 1.4 ng/mL). Cortisol and prolactin levels in follicular fluid and peritoneal fluid did not differ significantly between groups. The high levels of cortisol and prolactin in the serum from women with endometriosis might contribute to the subfertility frequently associated with the disease. Moreover, since higher levels of cortisol and prolactin are often associated with stress, it is probable that stress might contribute to the development of endometriosis and its progression to advanced stages of the disease.

  11. Inhibition of Adhesion, Proliferation, and Invasion of Primary Endometriosis and Endometrial Stromal and Ovarian Carcinoma Cells by a Nonhyaluronan Adhesion Barrier Gel

    Directory of Open Access Journals (Sweden)

    Stefan P. Renner

    2015-01-01

    Full Text Available Endometriosis is a chronic disease of women in the reproductive age, defined as endometrial cells growing outside of the uterine cavity and associated with relapses. Relapses are hypothesized to correlate with incomplete surgical excision or result from nonrandom implantation of new endometrial implants in adjacent peritoneum. Thus, surgical excision could lead to free endometriotic cells or tissue residues, which readhere, grow, and invade into recurrent lesions. Barrier agents are frequently used to prevent postoperative adhesions. We tested if the absorbable cell adhesion barrier gel Intercoat consisting of polyethylene oxide and sodium carboxymethyl cellulose could inhibit cellular adhesion, proliferation, and invasion of primary endometriosis and endometrial cells. Due to an association of endometriosis with ovarian carcinoma, we tested two ovarian carcinoma cell lines. Prior to cell seeding, a drop of the barrier gel was placed in cell culture wells in order to test inhibition of adherence and proliferation or coated over a polymerized collagen gel to assay for prevention of invasion. Results showed that the barrier gel significantly inhibited cell adherence, proliferation, and invasion of endometriosis and endometrial stromal cells as well as ovarian carcinoma cells in culture. Our findings could help to prevent local cell growth/invasion and possible consequent recurrences.

  12. Evaluation of Cases of Abdominal Wall Endometriosis at Universidade Estadual de Campinas in a period of 10 Years.

    Science.gov (United States)

    Yela, Daniela Angerame; Trigo, Lucas; Benetti-Pinto, Cristina Laguna

    2017-08-01

    Purpose To determine the clinical and epidemiological characteristics of abdominal wall endometriosis (AWE), as well as the rate and recurrence factors for the disease. Methods A retrospective study of 52 women with AWE was performed at Universidade Estadual de Campinas from 2004 to 2014. Of the 231 surgeries performed for the diagnosis of endometriosis, 52 women were found to have abdominal wall endometriosis (AWE). The frequencies, means and standard deviations of the clinical characteristics of these women were calculated, as well as the recurrence rate of AWE. To determine the risk factors for disease recurrence, Fisher's exact test was used. Results The mean age of the patients was 30.71 ± 5.91 years. The main clinical manifestations were pain (98%) and sensation of a mass (36.5%). We observed that 94% of these women had undergone at least 1 cesarean section, and 73% had used medication for the postoperative control of endometriosis. The lesion was most commonly located in the cesarean section scar (65%). The recurrence rate of the disease was of 26.9%. All 14 women who had relapsed had surgical margins compromised in the previous surgery. There was no correlation between recurrent AWE and a previous cesarean section (p = 0.18), previous laparotomy (p = 0.11), previous laparoscopy (p = 0.12) and postoperative hormone therapy (p = 0.51). Conclusion Women with previous cesarean sections with local pain or lumps should be investigated for AWE. The recurrence of AWE is high, especially when the first surgery is not appropriate and leaves compromised surgical margins. Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.

  13. Innervation of ectopic endometrium in a rat model of endometriosis.

    Science.gov (United States)

    Berkley, Karen J; Dmitrieva, Natalia; Curtis, Kathleen S; Papka, Raymond E

    2004-07-27

    Endometriosis (ENDO) is a disorder in which vascularized growths of endometrial tissue occur outside the uterus. Its symptoms include reduced fertility and severe pelvic pain. Mechanisms that maintain the ectopic growths and evoke symptoms are poorly understood. One factor not yet considered is that the ectopic growths develop their own innervation. Here, we tested the hypothesis that the growths develop both an autonomic and a sensory innervation. We used a rat model of surgically induced ENDO whose growths mimic those in women. Furthermore, similar to women with ENDO, such rats exhibit reduced fertility and increased pelvic nociception. The ENDO was induced by autotransplanting, on mesenteric cascade arteries, small pieces of uterus that formed vascularized cysts. The cysts and healthy uterus were harvested from proestrous rats and immunostained using the pan-neuronal marker PGP9.5 and specific markers for calcitonin gene-related peptide (CGRP) (sensory C and A delta fibers), substance P (SP) (sensory C and A delta fibers) and vesicular monoamine transporter (sympathetic fibers). Cysts (like the uterus) were robustly innervated, with many PGP9.5-stained neurites accompanying blood vessels and extending into nearby luminal epithelial layers. CGRP-, SP-, and vesicular monoamine transporter-immunostained neurites also were observed, with CGRP and SP neurites extending the furthest into the cyst lining. These results demonstrate that ectopic endometrial growths develop an autonomic and sensory innervation. This innervation could contribute not only to symptoms associated with ENDO but also to maintenance of the ectopic growths.

  14. Unremitting Cell Proliferation in the Secretory Phase of Eutopic Endometriosis

    Science.gov (United States)

    Franco-Murillo, Yanira; Miranda-Rodríguez, José Antonio; Rendón-Huerta, Erika; Montaño, Luis F.; Cornejo, Gerardo Velázquez; Gómez, Lucila Poblano; Valdez-Morales, Francisco Javier; Gonzalez-Sanchez, Ignacio

    2014-01-01

    Objective: Endometriosis is linked to altered cell proliferation and stem cell markers c-kit/stem cell factor (SCF) in ectopic endometrium. Our aim was to investigate whether c-kit/SCF also plays a role in eutopic endometrium. Design: Eutopic endometrium obtained from 35 women with endometriosis and 25 fertile eumenorrheic women was analyzed for in situ expression of SCF/c-kit, Ki67, RAC-alpha serine/threonine-protein kinase (Akt), phosphorylated RAC-alpha serine/threonin-protein kinase (pAkt), Glycogen synthase kinase 3 beta (GSK3β), and phosphorylated glycogen synthase kinase 3 beta (pGSK3β), throughout the menstrual cycle. Results: Expression of Ki67 and SCF was higher in endometriosis than in control tissue (P < .05) and greater in secretory rather than proliferative (P < .01) endometrium in endometriosis. Expression of c-kit was also higher in endometriosis although similar in both phases. Expression of Akt and GSK3β was identical in all samples and cycle phases, whereas pAkt and pGSK3β, opposed to control tissue, remained overexpressed in the secretory phase in endometriosis. Conclusion: Unceasing cell proliferation in the secretory phase of eutopic endometriosis is linked to deregulation of c-kit/SCF-associated signaling pathways. PMID:25194152

  15. Phosphoproteomics Analysis of Endometrium in Women with or without Endometriosis

    Institute of Scientific and Technical Information of China (English)

    Hong-Mei Xu; Hai-Teng Deng; Chong-Dong Liu; Yu-Ling Chen; Zhen-Yu Zhang

    2015-01-01

    Background:The molecular mechanisms underlying the endometriosis are still not completely understood.In order to test the hypothesis that the approaches in phosphoproteomics might contribute to the identification of key biomarkers to assess disease pathogenesis and drug targets,we carried out a phosphoproteomics analysis of human endometrium.Methods:A large-scale differential phosphoproteome analysis,using peptide enrichment of titanium dioxide purify and sequential elution from immobilized metal affinity chromatography with linear trap quadrupole-tandem mass spectrometry,was performed in endometrium tissues from 8 women with or without endometriosis.Results:The phosphorylation profiling of endometrium from endometriosis patients had been obtained,and found that identified 516 proteins were modified at phosphorylation level during endometriosis.Gene ontology annotation analysis showed that these proteins were enriched in cellular processes of binding and catalytic activity.Further pathway analysis showed that ribosome pathway and focal adhesion pathway were the top two pathways,which might be deregulated during the development of endometriosis.Conclusions:That large-scale phosphoproteome quantification has been successfully identified in endometrium tissues of women with or without endometriosis will provide new insights to understand the molecular mechanisms of the development of endometriosis.

  16. Pain recurrence after shaving of rectovaginal endometriosis

    DEFF Research Database (Denmark)

    Heide, Mathias Gottschalck; Forman, Axel

    on the bowel with risk of recurrence. This could motivate a change into more radical surgery. In the present study we therefore assessed recurrence of pain after shaving of rectovaginal endometriosis performed 2001-2009. Methods: Retrospective follow-up study. Questionnaires were sent to 212 women of whom 174...... women (82%) responded. Outcomes were correlated to the involvement of the anterior rectal wall and postoperative hormonal treatment. Results: Recurrence (pain unchanged or worse) of menstrual pain was found in 26 %, intermenstrual pain in 29 %, dyspareunia in 42 % and dyschezia in 41 %. Postoperative...

  17. Endometriose Simulando Neoplasia Vesical Endometriosis Simulating Bladder Cancer

    Directory of Open Access Journals (Sweden)

    Marcos Tobias-Machado

    2000-04-01

    . Methods: retrospective analysis of urinary endometriosis slides of the Department of Pathology files was made. Medical charts and follow-up were reviewed in detail and interviews were performed during or after treatment. Results: we describe four cases with cyclic disuria, abdominal mass, pelvic pain and imaging diagnosis of bladder tumor. Pathological specimens were obtained by endoscopic resection (3 cases and laparoscopic biopsy (1 case. Therapeutic options were exclusive medical treatment or surgical removal with transurethral resection or partial cystectomy supplemented with adjuvant medication. Conclusions: we review the clinical and therapeutic aspects of urinary tract endometriosis stressing that this is an important differential diagnosis of bladder cancer in reproductive women.

  18. Laparoscopically Assisted Low Anterior Resection for Lower Rectal Endometriosis: Usefulness of Laparoscopic Surgery

    Directory of Open Access Journals (Sweden)

    Hiroki Sugishita

    2009-11-01

    Full Text Available A 34-year-old woman presented with pain during menstruation and was diagnosed with endometriosis of the lower rectum. Despite treatment with an LH-RH agonist, she was unable to become pregnant and surgical removal of her endometriosis was recommended. Preoperative magnetic resonance imaging revealed endometriosis localized between the neck of the uterus and rectum with indentation and scuffing. Laparoscopically assisted low anterior resection was performed. Exfoliation was started from the right side of the rectum to the presacral and retrorectal space, and the rectococcygeus ligament was transected. Exfoliation of the retrorectal space was continued to the levator ani muscle and mobilization of the right side of the rectum was performed. In front of the rectum, exfoliation was started posterior to the wall of the vagina, but layers became unclear near the tumor as the tissue was solid in this region. The left hypogastric nerve close to the tumor was inflamed and it was cut. The layer of the exfoliation was connected to the right side of the rectum, the tumor was isolated from the vagina, and the lower rectum was transected at a point 1 cm distal to the tumor with a 60-mm linear stapler. Reconstruction with a 31-mm circular stapler was performed using the double stapling technique. Operative time was 520 min with a blood loss of 320 ml. On the 9th post operative day, a rectovaginal fistula occurred, and ileostomy was performed. The patient was discharged from the hospital on the 25th postoperative day, and 4 months later, stoma closure was performed.

  19. Endometriosis presenting as carcinoma colon in a perimenopausal woman

    Directory of Open Access Journals (Sweden)

    Tanuja Muthyala

    2015-01-01

    Full Text Available Endometriosis is a common benign disease of reproductive age women, and can involve the intestinal tract. Inconsistent clinical presentation, similar features on radiological imaging and colonoscopy with other inflammatory and malignant lesions of the bowel makes the preoperative diagnosis of bowel endometriosis difficult. We present a case of a 42-year-old perimenopausal female clinically presented, investigated and managed in the lines of carcinoma of sigmoid colon. She underwent terminal ileac resection with end to end anastomoses, Hartmann′s procedure and total hysterectomy with bilateral salpingoophorectomy. The histopathological report revealed endometriosis of small intestine, large intestine, mesentery, right ovary and adenomyoma of uterus. Thus, bowel endometriosis should also be considered as differential diagnosis in reproductive age women with gastrointestinal symptoms or intestinal mass of uncertain diagnosis.

  20. Managing Endometriosis in sub-Saharan Africa: Emerging Concepts ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    Capital Territory 26171; JUNIC Specialist Imaging and Women's Center, 20 Cartwright street Charnwood ... some of the few published studies, .... scientific conference on endometriosis in .... Galukande M, Jambwe J.Feasibility of laparocopic.

  1. Update on Biomarkers for the Detection of Endometriosis

    Directory of Open Access Journals (Sweden)

    Amelie Fassbender

    2015-01-01

    Full Text Available Endometriosis is histologically characterized by the displacement of endometrial tissue to extrauterine locations including the pelvic peritoneum, ovaries, and bowel. An important cause of infertility and pelvic pain, the individual and global socioeconomic burden of endometriosis is significant. Laparoscopy remains the gold standard for the diagnosis of the condition. However, the invasive nature of surgery, coupled with the lack of a laboratory biomarker for the disease, results in a mean latency of 7–11 years from onset of symptoms to definitive diagnosis. Unfortunately, the delay in diagnosis may have significant consequences in terms of disease progression. The discovery of a sufficiently sensitive and specific biomarker for the nonsurgical detection of endometriosis promises earlier diagnosis and prevention of deleterious sequelae and represents a clear research priority. In this review, we describe and discuss the current status of biomarkers of endometriosis in plasma, urine, and endometrium.

  2. Clear Cell Adenocarcinoma Arising from Abdominal Wall Endometriosis

    Directory of Open Access Journals (Sweden)

    Thouraya Achach

    2008-01-01

    Full Text Available Endometriosis is a frequent benign disorder. Malignancy arising in extraovarian endometriosis is a rare event. A 49-year-old woman is presented with a large painful abdominal wall mass. She underwent a myomectomy, 20 years before, for uterus leiomyoma. Computed tomography suggested that this was a desmoid tumor and she underwent surgery. Histological examination showed a clear cell adenocarcinoma associated with endometriosis foci. Pelvic ultrasound, computed tomography, and endometrial curettage did not show any malignancy or endometriosis in the uterus and ovaries. Adjuvant chemotherapy was recommended, but the patient was lost to follow up. Six months later, she returned with a recurrence of the abdominal wall mass. She was given chemotherapy and then she was reoperated.

  3. Catamenial pneumothorax due to solitary localization of diaphragmatic endometriosis

    Directory of Open Access Journals (Sweden)

    Stefano Elia

    2015-01-01

    Conclusion: Catamenial pneumothorax is the most common presentation of thoracic endometriosis syndrome and should always be suspected in women in childbearing age. Treatment option are still debated but best results are achieved by videothoracoscopic pleurodesis combined with hormonal therapy.

  4. Medical Treatments for Endometriosis-Associated Pelvic Pain

    OpenAIRE

    2014-01-01

    The main sequelae of endometriosis are represented by infertility and chronic pelvic pain. Chronic pelvic pain causes disability and distress with a very high economic impact. In the last decades, an impressive amount of pharmacological agents have been tested for the treatment of endometriosis-associated pelvic pain. However, only a few of these have been introduced into clinical practice. Following the results of the controlled studies available, to date, the first-line treatment for endome...

  5. Oxidation-sensitive nociception involved in endometriosis-associated pain.

    Science.gov (United States)

    Ray, Kristeena; Fahrmann, Johannes; Mitchell, Brenda; Paul, Dennis; King, Holly; Crain, Courtney; Cook, Carla; Golovko, Mikhail; Brose, Stephen; Golovko, Svetlana; Santanam, Nalini

    2015-03-01

    Endometriosis is a disease characterized by the growth of endometrial tissue outside the uterus and is associated with chronic pelvic pain. Peritoneal fluid (PF) of women with endometriosis is a dynamic milieu and is rich in inflammatory markers, pain-inducing prostaglandins prostaglandin E2 and prostaglandin F2α, and lipid peroxides; and the endometriotic tissue is innervated with nociceptors. Our clinical study showed that the abundance of oxidatively modified lipoproteins in the PF of women with endometriosis and the ability of antioxidant supplementation to alleviate endometriosis-associated pain. We hypothesized that oxidatively modified lipoproteins present in the PF are the major source of nociceptive molecules that play a key role in endometriosis-associated pain. In this study, PF obtained from women with endometriosis or control women were used for (1) the detection of lipoprotein-derived oxidation-sensitive pain molecules, (2) the ability of such molecules to induce nociception, and (3) the ability of antioxidants to suppress this nociception. LC-MS/MS showed the generation of eicosanoids by oxidized-lipoproteins to be similar to that seen in the PF. Oxidatively modified lipoproteins induced hypothermia (intracerebroventricular) in CD-1 mice and nociception in the Hargreaves paw withdrawal latency assay in Sprague-Dawley rats. Antioxidants, vitamin E and N-acetylcysteine, and the nonsteroidal anti-inflammatory drug indomethacin suppressed the pain-inducing ability of oxidatively modified lipoproteins. Treatment of human endometrial cells with oxidatively modified lipoproteins or PF from women with endometriosis showed upregulation of similar genes belonging to opioid and inflammatory pathways. Our finding that oxidatively modified lipoproteins can induce nociception has a broader impact not only on the treatment of endometriosis-associated pain but also on other diseases associated with chronic pain.

  6. The role of NF-kappaB in endometriosis.

    Science.gov (United States)

    Kaponis, Apostolos; Iwabe, Tomio; Taniguchi, Fuminori; Ito, Masayuki; Deura, Imari; Decavalas, George; Terakawa, Naoki; Harada, Tasuku

    2012-06-01

    The nuclear factor kappaB (NF-kappaB) is a ubiquitously expressed transcription factor playing vital roles in innate immunity and other processes involving cellular survival, proliferation, and differentiation. This review highlights the importance of NF-kappaB in the pathophysiology of endometriosis. Constitutive activation of NF-kappaB has been shown in endometriotic lesions. Complex interactions of NF-kappaB with steroid receptors and apoptotic molecules in endometriosis resulting in opposing roles of NF-kappaB are discussed. NF-kappaB regulates the expression of cytokines mediating autocrine self-amplifying cycles of cytokine release and NF-kappaB activation, leading to maintenance of inflammatory reactions in endometriosis. NF-kappaB can contribute to the increased ability of endometriotic cells to invade and adhere to the peritoneal surface by regulating the expression of matrix metaloproteinases. We are presenting the role of NF-kappaB to regulate vascularization and oxidative stress in endometriotic cells. Effects of drugs used for the treatment of endometriosis on NF-kappaB pathway are presented and we show how drugs that inhibit the NF-kappaB can mediate the progression of endometriosis. Novel therapeutic strategies involving the NF-kappaB and applied in endometriosis are also discussed.

  7. Cine MR imaging of uterine peristalsis in patients with endometriosis

    Energy Technology Data Exchange (ETDEWEB)

    Kido, Aki; Togashi, Kaori; Koyama, Takashi; Fujimoto, Ryota [Kyoto University, Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto (Japan); Nishino, Mizuki [Beth Israel Deaconess Medical Center, Department of Radiology, Kyoto (Japan); Miyake, Kanae; Hayakawa, Katsumi [Kyoto City Hospital, Department of Radiology, Kyoto (Japan); Iwasaku, Kazuhiro [Kyoto City Hospital, Department of Obstetrics and Gynecology, Kyoto (Japan); Fujii, Shingo [Kyoto University, Department of Gynecology and Obstetrics, Kyoto (Japan)

    2007-07-15

    Endometriosis is one of the most important causes of infertility; however the precise mechanism by which it affects female fertility is unclear. The objective of this study was to study the functional aspects of the uterus by evaluating uterine contractility in patients with endometrial cysts of the ovary. The study population was recruited from two institutes and consisted of 26 women (periovulatory (10), luteal (13), and menstrual phase (3); age range: 19-51 years) with untreated endometriosis; the control group consisted of 12 healthy women (age range: 22-41 years). Cine MR imaging obtained by a 1.5T magnet was visually evaluated at 12 x faster than real speed, focusing on the presence of uterine peristalsis, the direction and frequency of peristalsis, and the presence of sustained uterine contractions. Uterine peristalsis was identifiable in 3/10, 3/13, and 3/3 of the endometriosis patients in each menstrual cycle, respectively, and in 11/12, 3/12, and 5/12 of their control subjects. Peristaltic detection rate and frequency were significantly less for the endometriosis group than for the controls in the periovulatory phase only (p<0.05). Sustained contractions were recognized in 19/36 control subjects and in 13/26 endometriosis patients, but the difference was not significant. Uterine peristalsis appears to be suppressed during the periovulatory phase in patients with endometriosis, which may have an adverse effect on sperm transport. (orig.)

  8. Kadar TNF-α dalam Zalir Peritoneal Penderita Endometriosis

    Directory of Open Access Journals (Sweden)

    TEDJA DANUDJA OEPOMO

    2005-11-01

    Full Text Available The aim of this research was to expose the role of tumor necrotic factor alpha (TNF-α in the pathogenetic endometriosis. This research had been done in dr. Muwardi Hospital Surakarta. Twenty patients undergoing laparoscopic operation because of endometriosis indication (Group I, 20 women (aged 23 to 40 who undergo interval sterilization by means of laparoscopic technique (Group II. During laparoscopic operation, peritoneal fluid is taken to examine TNF-α by ELISA technique. The results indicated that by independent t-test, a significant difference of concentration of TNF-α in the peritoneal fluid is found between endometriosis patients and normal women (who are sterilized (P=0.00. By chi-square test, the Ratio Odds value 171 shows that the high concentration of TNF-α will increase the possibility of endometriosis 171 times rather than the low TNF-α. It could be concluded the high concentration of TNF-α is the risk factor of endometriosis in comparison with the low TNF-α. It shows that quite possibly TNF-α has a role in the pathogenic endometriosis.

  9. An Investigation of the Potential Malignant Characteristics of Endometriosis

    Institute of Scientific and Technical Information of China (English)

    Chengxin Wang; Hongyan Zhou; Xiaonan You; Xiji Shu; Yan Li; Xiaoling Zhao

    2005-01-01

    OBJECTIVE To investigate the potential malignant characteristics and pathogenesis of endometriosis as well as the role of human growth hormone and epidermal growth factor receptor in the pathogenesis of malignant transformation of endometriosis.METHODS The immunohistochemical S-P method was used to examine the expression of human growth hormone and epidermal growth factor receptor in the eutopic and ectopic endometrium of 84 cases of endometriosis.RESULTS The percentage of positive cases of human growth hormone in eutopic and ectopic endometrium was 90.77% (59/65) and 85.71% (72/84) respectively. The percentage of positive cases of epidermal growth factor receptor in eutopic and ectopic endometrium was 81.54% (53/65)and 89.29% (75/84) respectively. The positive rate of epidermal growth factor receptor in ectopic endometrium was higher than that in the eutopic endometrium but without a statistically significant difference (P>0.05).CONCLUSION Endometriosis is caused by multiple factors, which possesses some biologic features of neoplastic tissue such as invasion and metastasis. Both human growth hormone and epidermal growth factor receptor are highly expressed in eutopic and ectopic endometrium, which lead directly or indirectly to the pathogenesis of endometriosis and promote the initiation and malignant transformation of endometriosis.

  10. Clinical analysis on 43 cases with abdominal wall and perineal endometriosis%43例腹壁会阴子宫内膜异位症的临床分析

    Institute of Scientific and Technical Information of China (English)

    任黔川; 伍宗惠; 李晓斌

    2011-01-01

    目的:探讨腹壁、会阴子宫内膜异位症的诊断和治疗.方法:对1993~2008年收治的43例腹壁、会阴内异症病例进行同顾性分析.结果:根据临床表现和病理检查,43例均诊断正确.29例腹壁切口内异症均有剖宫产史,14例会阴内异症均有会阴撕裂或侧切史.腹壁内异症完整切除29例,会阴内异症完整切除13例,随访2~5年无复发.结论:根据典型的病史和体检,可以对腹壁、会阴内异症做出正确诊断;手术切除为主要治疗方法.%Objective; To explore the diagnosis and treatment of abdominal wall and perinea] endometriosis. Methods: 43 patients with abdominal wall and perineal endometriosis treated in the hospital from 1993 to 2008 were analyzed retrospectively. Results: 43 cases were diagnosed correctly according to clinical manifestations and pathological evidences. 29 cases with abdominal wall endometriosis had history of cesarean section, 14 cases with perineal endometriosis had history of perineal tear and episiotomy. 29 cases with abdominal wall endometriosis and 13 cases with perineal endometriosis were excised totally. All the cases were followed up for 2 ~5 years, no recurrence occurred. Conclusion; The patients with abdominal wall and perineal endometriosis can be diagnosed correctly according to typical medical history and physical examination. Surgical excision is the first choice for treatment

  11. Does exist a correlation between endometriosis and thrombophilic disorders? A pilot study

    Directory of Open Access Journals (Sweden)

    Roberto Paradisi

    2017-06-01

    Conclusion: Our preliminary data do not show any association between thrombophilic condition and endometriosis. Before assuming hormonal therapies, a thrombophilic plasmatic screening seems to be unnecessary in patients affected by endometriosis.

  12. Responsiveness of the Dutch Endometriosis Health Profile-30 (EHP-30) questionnaire

    NARCIS (Netherlands)

    Burgt, T.J. van de; Kluivers, K.B.; Hendriks, J.C.M.

    2013-01-01

    OBJECTIVE: To evaluate the responsiveness to change and the minimal clinical important difference (MCID) of the Dutch Endometriosis Health Profile-30 (EHP-30) questionnaire. STUDY DESIGN: Prospective cohort study among endometriosis patients attending the Radboud University Nijmegen Medical Centre a

  13. A potential novel treatment strategy: inhibition of angiogenesis and inflammation by resveratrol for regression of endometriosis in an experimental rat model.

    Science.gov (United States)

    Ozcan Cenksoy, Pinar; Oktem, Mesut; Erdem, Ozlem; Karakaya, Cengiz; Cenksoy, Cahit; Erdem, Ahmet; Guner, Haldun; Karabacak, Onur

    2015-03-01

    The aim of our study was to evaluate the effectiveness of resveratrol in experimentally induced endometrial implants in rats through inhibiting angiogenesis and inflammation. Endometrial implants were surgically induced in 24 female Wistar-Albino rats in the first surgery. After confirmation of endometriotic foci in the second surgery, the rats were divided into resveratrol (seven rats), leuprolide acetate (eight rats), and control (seven rats) groups and medicated for 21 d. In the third surgery, the measurements of mean areas and histopathological analysis of endometriotic lesions, VEGF, and MCP-1 measurements in blood and peritoneal fluid samples, and immunohistochemical staining were evaluated. After treatment, significant reductions in mean areas of implants (p treatment were also significantly lower in the resveratrol and leuprolide acetate groups. Resveratrol appears to be a potential novel therapeutic agent in the treatment of endometriosis through inhibiting angiogenesis and inflammation. Further studies are needed to determine the optimum effective dose in humans and to evaluate other effects on reproductive physiology.

  14. Overtreatment and undertreatment of endometriosis%子宫内膜异位症治疗中的过度与不足

    Institute of Scientific and Technical Information of China (English)

    周应芳

    2011-01-01

    Endometriosis is a frustrating disease. The main treatment includes medical and surgical approaches with an unsatisfied efficacies and a high relapse. For both medical and surgical therapies, there are some degrees of undertreatment or overtreatment. For example, deep infiltrating endometriosis is often underestimated, resulting in incomplete surgery. Theundertreatment and overtreatment of endometriosis based on medical and surgical therapies are discussed.%子宫内膜异位症是妇科常见病,主要采用手术和药物治疗,但疗效并不满意,而且容易复发.无论手术治疗还是药物治疗都存在不同程度的不足之处或过度治疗.常见由于对深部浸润型内异症经常认识不足,导致治疗不足.文章主要从手术和药物治疗两大方面对此进行探讨.

  15. Stages of endometriosis: Does it affect in vitro fertilization outcome

    Directory of Open Access Journals (Sweden)

    Sonja Pop-Trajkovic

    2014-06-01

    Conclusion: The American Society for Reproductive Medicine classification of endometriosis is useful in predicting IVF outcome. Advanced endometriosis means a worse prognosis for IVF treatment compared to milder stages or tubal factor infertility. The decreased fertilization rate in Stage I/II endometriosis might be a cause of subfertility in these women, as a result of a hostile environment caused by the disease.

  16. Mannan-binding lectin polymorphisms and serum levels in patients with endometriosis

    DEFF Research Database (Denmark)

    Kruse, Christina; Steffensen, Rudi; Nielsen, Hans J;

    2014-01-01

    OBJECTIVE: To investigate a possible association between endometriosis and low levels of mannan-binding lectin (MBL). STUDY DESIGN: Case-control study of blood samples from 100 patients with endometriosis compared with results from a group of 350 blood donors. RESULT: The frequency of MBL levels...... endometriosis and low levels of MBL....

  17. Parietal wall endometriosis: a rare case report

    Directory of Open Access Journals (Sweden)

    Mahija Sahu

    2015-04-01

    Full Text Available A 28 year old P2L1 with one previous cesarean presented with cyclical pain in periumblical area just below umbilicus for 1 year with USG finding suggestive of parietal wall endometriosis planned for surgery on her 2nd day of menstruation. She underwent diagnostic laparoscopy with complete excision of endometrioma. Diagnostic laparoscopy showed no evidence of endometrioma in the pelvic cavity except for omental adhesion at parietal wall endometrioma site, adhesiolysis of omentum, mesh repair of rectus sheath defect done. She is followed up for last 3 cycles post-operative and has no cyclical pain further. [Int J Reprod Contracept Obstet Gynecol 2015; 4(2.000: 524-526

  18. Pathophysiology of Endometriosis: Role of High Mobility Group Box-1 and Toll-Like Receptor 4 Developing Inflammation in Endometrium

    Science.gov (United States)

    Yun, Bo Hyon; Chon, Seung Joo; Choi, Young Sik; Cho, SiHyun; Lee, Byung Seok; Seo, Seok Kyo

    2016-01-01

    Oxidative stress has been proposed as a potential factor associated with the establishment and progression of endometriosis. Although a few studies have shown possible mechanisms which may play roles in development, progression of endometriosis, few are known in regards of initiation of the disease, especially in the relationship with endometrium. The aim of our study was to investigate whether normal endometrium may be changed by Damage-associated molecular patterns (DAMPs), which may contribute developing pathologic endometrium to induce endometriosis. Endometrial tissues were obtained from 10 patients with fibroids undergoing hysterectomy at a university hospital. High mobility group box-1 (HMGB-1), which is a representative DAMP, has been chosen that may induce alteration in endometrium. In preceding immunohistochemistry experiments using paraffin-block sections from endometriosis (N = 33) and control (N = 27) group, retrospectively, HMGB-1 expression was shown in both epithelial and stromal cell. HMGB-1 expression was significantly increased in secretory phase of endometriosis group, comparing to the controls. To examine the alteration of endometrial stromal cell (HESC) by oxidative stress in terms of HMGB-1, cell proliferation and expression of its receptor, TLR4 was measured according to recombinant HMGB-1 use. Cell proliferation was assessed by CCK-8 assay; real-time PCR and western blotting were used to quantify Toll like receptor 4 (TLR4) mRNA and protein expression respectively. A TLR4 antagonist (LPS-RS) and an inhibitor of the NF-κB pathway (TPCA-1, an IKK-2 inhibitor) were used to confirm the relationships between HMGB-1, TLR4, and the NF-κB pathway. Passive release of HMGB-1 was significantly proportional to the increase in cell death (P<0.05). HESCs showed significant proliferation following treatment with rHMGB-1 (P<0.05), and increased TLR4 expression was observed following rHMGB-1 treatment (P<0.05) in a concentration-dependent manner

  19. Safety and tolerability of dienogest in endometriosis: pooled analysis from the European clinical study program

    Directory of Open Access Journals (Sweden)

    Strowitzki T

    2015-04-01

    Full Text Available Thomas Strowitzki,1 Thomas Faustmann,2 Christoph Gerlinger,3,4 Ulrike Schumacher,5,6 Christiane Ahlers,7 Christian Seitz8 1Department of Gynecological Endocrinology and Reproductive Medicine, University of Heidelberg, Heidelberg, Germany; 2Bayer Pharma AG, Global Medical Affairs Women’s Healthcare, Berlin, Germany; 3Bayer Pharma AG, Global Research and Development Statistics, Berlin, Germany; 4Department of Gynecology, Obstetrics, and Reproductive Medicine, University Medical School of Saarland, Homburg/Saar, Germany; 5Jenapharm GmbH & Co KG, Medical Affairs Support, Jena, Germany; 6Center for Clinical Studies, Universitätsklinikum Jena, Jena, Germany; 7Bayer Pharma AG, Global Integrated Analysis and Lifecycle Management Statistics, Wuppertal, Germany; 8Bayer Pharma AG, Global Clinical Development Therapeutic Area Primary Care and Women’s Healthcare, Berlin, Germany Background: In four randomized, controlled, European trials, dienogest 2 mg once daily demonstrated significant efficacy for lesion reduction and reduction in pain intensity in endometriosis. We describe a pooled analysis of the safety and tolerability data from these trials to confirm and further characterize the safety profile of dienogest in the treatment of endometriosis.Methods: All 332 women treated with dienogest 2 mg who participated in the four clinical trials were included in the pooled analyses for safety assessments, including adverse events, laboratory tests, vital signs, body weight, and bleeding patterns. Safety variables were analyzed using descriptive statistics.Results: Pooled analyses of this large patient population confirmed that dienogest 2 mg is well tolerated, with a favorable safety profile extending over a period up to 65 weeks in women with endometriosis. The most common adverse drug reactions were headache, breast discomfort, depressed mood, and acne, each occurring in <10% of women. All these adverse events were generally of mild

  20. The role of DJ-1 in the pathogenesis of endometriosis.

    Directory of Open Access Journals (Sweden)

    Priyanka Rai

    Full Text Available BACKGROUND: Endometriosis is an estrogen-dependent disease causing pelvic pain and infertility in 10% of reproductive-aged women. Despite a long history of the disease the pathogenesis of endometriosis is poorly understood. It is known that the expression of several proteins is either up or down regulated during endometriosis, but their precise role remains to be determined. DJ-1 is one such protein that is upregulated in eutopic endometrium of women having endometriosis suggesting that DJ-1 may be involved in the pathogenesis of endometriosis. METHODOLOGY AND PRINCIPAL FINDINGS: The role of DJ-1 in the pathogenesis of endometriosis was investigated. For this purpose the influence of DJ-1 on endometrial cell survival, attachment, proliferation, migration, and invasion either by overexpressing DJ-1 in normal endometrial cells or by knocking down DJ-1 expression in endometriotic cells using siRNA was investigated. The results indicated that DJ-1 protects endometrial cells from oxidative stress mediated apoptosis. Overexpression of DJ-1 in normal endometrial epithelial cells increases the adhesion on collagen type IV. However, no significant difference was observed incase of stromal cells. It was further demonstrated that DJ-1 regulates cell proliferation, migration, and invasion in normal endometrial and endometriotic epithelial cells whereas in the case of normal endometrial and endometriotic stromal cells, it regulates cell proliferation and invasion but not migration. Furthermore, the present study also indicated that DJ-1 regulates these cellular processes by modulating PI3K/Akt pathway by interacting and negatively regulating PTEN. CONCLUSIONS: Abnormally high levels of DJ-1 expression may be involved in endometriosis, possibly by stimulating endometrial cell survival, proliferation, migration, and invasion.

  1. Revisiting the wandering womb: Oxytocin in endometriosis and bipolar disorder.

    Science.gov (United States)

    Dinsdale, Natalie L; Crespi, Bernard J

    2017-09-19

    Hippocrates attributed women's high emotionality - hysteria - to a 'wandering womb'. Although hysteria diagnoses were abandoned along with the notion that displaced wombs cause emotional disturbance, recent research suggests that elevated levels of oxytocin occur in both bipolar disorder and endometriosis, a gynecological condition involving migration of endometrial tissue beyond the uterus. We propose and evaluate the hypothesis that elevated oxytocinergic system activity jointly contributes to bipolar disorder and endometriosis. First, we provide relevant background on endometriosis and bipolar disorder, and then we examine evidence for comorbidity between these conditions. We next: (1) review oxytocin's associations with personality traits, especially extraversion and openness, and how they overlap with bipolar spectrum traits; (2) describe evidence for higher oxytocinergic activity in both endometriosis and bipolar disorder; (3) examine altered hypothalamic-pituitary-gonadal axis functioning in both conditions; (4) describe data showing that medications that treat one condition can improve symptoms of the other; (5) discuss fitness-related impacts of endometriosis and bipolar disorder; and (6) review a pair of conditions, polycystic ovary syndrome and autism, that show evidence of involving reduced oxytocinergic activity, in direct contrast to endometriosis and bipolar disorder. Considered together, the bipolar spectrum and endometriosis appear to involve dysregulated high extremes of normally adaptive pleiotropy in the female oxytocin system, whereby elevated levels of oxytocinergic activity coordinate outgoing sociality with heightened fertility, apparently characterizing, overall, a faster life history. These findings should prompt a re-examination of how mind-body interactions, and the pleiotropic endocrine systems that underlie them, contribute to health and disease. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Medical treatments for endometriosis-associated pelvic pain.

    Science.gov (United States)

    Zito, Gabriella; Luppi, Stefania; Giolo, Elena; Martinelli, Monica; Venturin, Irene; Di Lorenzo, Giovanni; Ricci, Giuseppe

    2014-01-01

    The main sequelae of endometriosis are represented by infertility and chronic pelvic pain. Chronic pelvic pain causes disability and distress with a very high economic impact. In the last decades, an impressive amount of pharmacological agents have been tested for the treatment of endometriosis-associated pelvic pain. However, only a few of these have been introduced into clinical practice. Following the results of the controlled studies available, to date, the first-line treatment for endometriosis associated pain is still represented by oral contraceptives used continuously. Progestins represent an acceptable alternative. In women with rectovaginal lesions or colorectal endometriosis, norethisterone acetate at low dosage should be preferred. GnRH analogues may be used as second-line treatment, but significant side effects should be taken into account. Nonsteroidal anti-inflammatory drugs are widely used, but there is inconclusive evidence for their efficacy in relieving endometriosis-associated pelvic pain. Other agents such as GnRH antagonist, aromatase inhibitors, immunomodulators, selective progesterone receptor modulators, and histone deacetylase inhibitors seem to be very promising, but there is not enough evidence to support their introduction into routine clinical practice. Some other agents, such as peroxisome proliferator activated receptors-γ ligands, antiangiogenic agents, and melatonin have been proven to be efficacious in animal studies, but they have not yet been tested in clinical studies.

  3. Medical Treatments for Endometriosis-Associated Pelvic Pain

    Directory of Open Access Journals (Sweden)

    Gabriella Zito

    2014-01-01

    Full Text Available The main sequelae of endometriosis are represented by infertility and chronic pelvic pain. Chronic pelvic pain causes disability and distress with a very high economic impact. In the last decades, an impressive amount of pharmacological agents have been tested for the treatment of endometriosis-associated pelvic pain. However, only a few of these have been introduced into clinical practice. Following the results of the controlled studies available, to date, the first-line treatment for endometriosis associated pain is still represented by oral contraceptives used continuously. Progestins represent an acceptable alternative. In women with rectovaginal lesions or colorectal endometriosis, norethisterone acetate at low dosage should be preferred. GnRH analogues may be used as second-line treatment, but significant side effects should be taken into account. Nonsteroidal anti-inflammatory drugs are widely used, but there is inconclusive evidence for their efficacy in relieving endometriosis-associated pelvic pain. Other agents such as GnRH antagonist, aromatase inhibitors, immunomodulators, selective progesterone receptor modulators, and histone deacetylase inhibitors seem to be very promising, but there is not enough evidence to support their introduction into routine clinical practice. Some other agents, such as peroxisome proliferator activated receptors-γ ligands, antiangiogenic agents, and melatonin have been proven to be efficacious in animal studies, but they have not yet been tested in clinical studies.

  4. The influence of endometriosis-related symptoms on work life and work ability - a study of Danish endometriosis patients in employment

    DEFF Research Database (Denmark)

    Hansen, Karina Ejgaard; Kesmodel, Ulrik Schiøler; Baldursson, Einar B

    2013-01-01

    Abstract Objective Little is known about the implications of endometriosis on women's work life. This study aimed at examining the relation between endometriosis-related symptoms and work ability in employed women with endometriosis. Study design In a cohort study, 610 patients with diagnosed...... ability. The level of statistical significance was set at pResults In binary analyses a diagnosis of endometriosis was associated with more sick days, work disturbances due to symptoms, lower work ability and a wide number of other implications on work life in employed women...... endometriosis and 751 reference women completed an electronic survey based on the Endometriosis Health Profile 30-questionnaire and the Work Ability Index (short form). Percentages were reported for all data. Binary and multivariate logistic regression analyses were used to assess risk factors for low work...

  5. Desmoid Tumor of the Anterior Abdominal Wall in Female Patients: Comparison with Endometriosis

    Directory of Open Access Journals (Sweden)

    H. Krentel

    2012-01-01

    Full Text Available In female patients presenting a tumor of the lower abdominal wall especially after cesarian section, an endometriotic tumor as well as an aggressive desmoid tumor should be considered. Symptoms in correlation with the monthly period can facilitate the presurgical differentiation between endometriosis and fibromatosis. Ultrasound reveals the typical location of both tumors and its remarkable sonographic appearance. In the clinical practice, the desmoid fibromatosis of the lower abdominal wall is a very rare disease. We present a case of a 25-year-old pregnant and discuss diagnostic and therapeutic options by a PubMed literature review. With the knowledge of the prognosis of the desmoid fibromatosis and the respective treatment options including wait and see, complete surgical resection with macroscopically free margins and adjuvant approaches is essential to avoid further interventions and progression of the locally destructive tumor.

  6. The selective vitamin D receptor agonist, elocalcitol, reduces endometriosis development in a mouse model by inhibiting peritoneal inflammation.

    Science.gov (United States)

    Mariani, Margherita; Viganò, Paola; Gentilini, Davide; Camisa, Barbara; Caporizzo, Elvira; Di Lucia, Pietro; Monno, Antonella; Candiani, Massimo; Somigliana, Edgardo; Panina-Bordignon, Paola

    2012-07-01

    Endometriosis, which is characterized by the growth of endometrial tissue at ectopic locations as well as vascular development and inflammation, is still an unmet clinical need since an optimal drug that allows for both pain and infertility management does not exist. Since both the eutopic and the ectopic endometrium express the vitamin D receptor (VDR), and VDR agonists are endowed with anti-proliferative and anti-inflammatory properties, we evaluated the effect of elocalcitol, a VDR agonist with low calcaemic liability, in a mouse model of experimentally induced endometriosis. Endometriosis was induced by injection of syngeneic endometrial tissue fragments into adult Balb/c female mice. After having confirmed by immunohistochemistry that endometriotic lesions developing in mice expressed VDR, the mice were administered with elocalcitol (100 μg/kg) or vehicle orally, once a day, for various durations of time. In this model, elocalcitol was able to reduce total lesion weight up to 70% upon treatment for 1 week before and 2 weeks after disease induction. Interestingly, a therapeutic effect was also observed on already established lesions. Elocalcitol was shown to reduce the capacity of mouse endometrial cells to adhere to collagen. In addition in treated mice, a decreased state of peritoneal inflammation was demonstrated by the inhibition of macrophage recruitment and inflammatory cytokine secretion. The VDR agonist elocalcitol inhibits lesion development in a validated mouse model of endometriosis, and exerts a protective effect on both the implantation and organization of transferred endometrial tissue. These preliminary data in mice provide a sound rationale for further testing in primate models and eventually in humans.

  7. The Traditional Chinese Medicine Prescription Pattern of Endometriosis Patients in Taiwan: A Population-Based Study

    Directory of Open Access Journals (Sweden)

    Ruei-Chi Fang

    2012-01-01

    Full Text Available Background. Traditional Chinese medicine (TCM, when given for symptom relief, has gained widespread popularity among women with endometriosis. The aim of this study was to analyze the utilization of TCM among women with endometriosis in Taiwan. Methods. The usage, frequency of service, and the Chinese herbal products prescribed for endometriosis, among endometriosis patients, were evaluated using a randomly sampled cohort of 1,000,000 beneficiaries recruited from the National Health Insurance Research Database. Results. Overall, 90.8% (N=12,788 of reproductive age women with endometriosis utilized TCM and 25.2% of them sought TCM with the intention of treating their endometriosis-related symptoms. Apart from the usage of either analgesics or more than one type of medical treatment, the odds of using TCM and Western medicine were similar in all types of conventional endometriosis treatment. However, endometriosis patients suffering from symptoms associated with endometriosis were more likely to seek TCM treatment than those with no symptoms. There were 21,056 TCM visits due to endometriosis and its related symptoms, of which more than 98% were treated with Chinese herbal products (CHPs. Conclusion. Gui-Zhi-Fu-Ling-Wan (Cinnamon Twig and Poria Pill containing sedative and anti-inflammatory agents is the most commonly prescribed Chinese herbal formula mainly for the treatment of endometriosis-related symptomatic discomfort and the effects of these TCMs should be taken into account by healthcare providers.

  8. An evaluation of quality of life in women with endometriosis who underwent primary surgery: a 6-month follow up in Sabah Women & Children Hospital, Sabah, Malaysia.

    Science.gov (United States)

    M F, Ahmad; Narwani, Hussin; Shuhaila, Ahmad

    2017-10-01

    Endometriosis is a complex disease primarily affecting women of reproductive age worldwide. The management goals are to improve the quality of life (QoL), alleviate the symptoms and prevent severe disease. This prospective cohort study was to assess the QoL in women with endometriosis that underwent primary surgery. A pre- and post-operative questionnaire via ED-5Q and general VAS score used for the evaluation for endometrial-like pain such as dysmenorrhoea and dyspareunia. A total of 280 patients underwent intervention; 224 laparoscopically and 56 via laparotomy mostly with stage II disease with ovarian endometriomas. Improvements in dysmenorrhoea pain scores from 5.7 to 4.15 and dyspareunia from 4.05 to 2.17 (p improved; 6.66-4.68 post-operatively (p intervention. There was no correlation between the stage of disease and endometrial pain; (p = .289), method of intervention (p = .290) and usage of post-operative hormonal therapy (p = .632). This study concluded that surgical treatment improved the QoL with added hormonal therapy post-intervention, despite not reaching statistical significance, showed a promising result. Impact statement Surgical intervention does improve the QoL for women with endometriosis however post interventional hormonal therapy is remain inconclusive.

  9. Endometriosis-induced vaginal hyperalgesia in the rat: role of the ectopic growths and their innervation.

    Science.gov (United States)

    McAllister, Stacy L; McGinty, Kristina A; Resuehr, David; Berkley, Karen J

    2009-12-15

    Endometriosis is a painful disorder defined by extrauteral endometrial growths whose contribution to pain symptoms is poorly understood. Endometriosis is created in rats by autotransplanting on abdominal arteries pieces of either uterus (ENDO), which form cysts, or fat (shamENDO), which do not form cysts. ENDO, but not shamENDO induces vaginal hyperalgesia. We tested the hypothesis that the cysts are necessary to maintain vaginal hyperalgesia by assessing the effect of surgically removing them. Complete-cyst-removal eliminated ENDO-induced vaginal hyperalgesia up to 4 months post-operatively. Sham-cyst-removal in ENDO rats, in which cysts were not removed, or partial cyst-removal increased the ENDO-induced hyperalgesia. The decreases and increases both took 3-6 weeks to develop. Changes in ENDO-induced hyperalgesia did not occur in a control group of ENDO rats who had no surgery after ENDO. In a double-surgery control group, neither shamENDO surgery nor a subsequent sham surgery that mimicked "removal" of non-existent cysts influenced vaginal nociception. In a no-surgery control group, vaginal nociception remained stable for >6 months. The increases in ENDO-induced hyperalgesia produced by the sham-cyst-removal surgery were smaller in proestrus than in other estrous stages. During the other stages (but not during proestrus), sympathetic innervation of the cysts increased. These results suggest that maintenance of ENDO-induced vaginal hyperalgesia requires continued presence of at least some ectopic endometrial tissue, and that surgical treatment that fails to remove ectopic endometrial tissue can exacerbate the hyperalgesia, possibly due in part to an increase in the cysts' sympathetic innervation.

  10. Somatic Stem Cells and Their Dysfunction in Endometriosis

    Science.gov (United States)

    Djokovic, Dusan; Calhaz-Jorge, Carlos

    2015-01-01

    Emerging evidence indicates that somatic stem cells (SSCs) of different types prominently contribute to endometrium-associated disorders such as endometriosis. We reviewed the pertinent studies available on PubMed, published in English language until December 2014 and focused on the involvement of SSCs in the pathogenesis of this common gynecological disease. A concise summary of the data obtained from in vitro experiments, animal models, and human tissue analyses provides insights into the SSC dysregulation in endometriotic lesions. In addition, a set of research results is presented supporting that SSC-targeting, in combination with hormonal therapy, may result in improved control of the disease, while a more in-depth characterization of endometriosis SSCs may contribute to the development of early-disease diagnostic tests with increased sensitivity and specificity. Key message: Seemingly essential for the establishment and progression of endometriotic lesions, dysregulated SSCs, and associated molecular alterations hold a promise as potential endometriosis markers and therapeutic targets. PMID:25593975

  11. Osteopathy for Endometriosis and Chronic Pelvic Pain – a Pilot Study

    Science.gov (United States)

    Sillem, M.; Juhasz-Böss, I.; Klausmeier, I.; Mechsner, S.; Siedentopf, F.; Solomayer, E.

    2016-01-01

    Introduction: Pelvic pain is a common problem in gynaecological practice. It is often unclear whether definite causality exists between reported symptoms and objective clinical findings of the female genital tract, and medical or operative treatments do not always achieve long-term resolution of symptoms. Methods: This pilot study investigated 28 patients (age 20–65, median 36.5 years) from a gynaecology practice whose only clinical finding was painful pelvic floor muscle tightness. Following standardised gynaecological and physiotherapist examination, all patients received osteopathic treatment. Pain had been present for a median of 3 years (range 1 month to 20 years). 14 patients had previously confirmed endometriosis. Treatment success was evaluated on consultation with patients in person or in writing. Results: 22 of the 28 participants completed the treatment according to plan. Overall, 17 reported symptom improvement, while 10 of the 14 patients with endometriosis did. Conclusion: Osteopathy is well received by women with painful pelvic floor muscle tightness and appears to be an effective treatment option. PMID:27681520

  12. Demographic and Clinical Features of Endometrial Polyps in Patients with Endometriosis

    Directory of Open Access Journals (Sweden)

    Ningning Wang

    2016-01-01

    Full Text Available Aims. To compare the clinical features of endometrial polyps (EPs between patients with endometriosis (EM (EM group and without EM (non-EM group. Methods and Results. Seventy-six cases in the EM group and 133 cases in the non-EM group underwent laparotomy or hysteroscopy and laparoscopy; later, it was confirmed that the results by pathology from July 2002 to April 2008 in the Department of Gynecology and Obstetrics at the First Affiliated Hospital of Sun Yat-sen University. The recurrence of EPs was followed up after the surgery until 2013. The following parameters were assessed: age, gravidity, parity, infertility, and menstrual cycle changes, as well as polyps diameters, locations, number, association with the revised American Fertility Society (r-AFS classification, and their recurrence. On review, 76 EPs cases of EM group histologically resembled EPs but the majority of EPs with EM occurred in primary infertility cases and in fewer pregnancy rate women who had stable and smaller EPs without association with the AFS stage. The recurrence rate of EPs in EM group was higher than that in non-EM group. Conclusion. It is important to identify whether infertile patients with EM are also having EPs. Removing any coexisting EPs via hysteroscopy would be clinically helpful in treating endometriosis-related infertility in these patients.

  13. Effect of recombinant human endostatin on endometriosis in mice

    Institute of Scientific and Technical Information of China (English)

    JIANG Hong-qing; LI Ya-li; ZOU Jie

    2007-01-01

    Background Direct and indirect evidences have suggested that angiogenesis is a prerequisite for the development of endometriosis. Aiming at offering experimental evidences for anti-angiogenesis therapy, we transplanted the eutopic endometrium from patient with endometriosis into the severe combined immunodeficiency disease (SCID) mice, to evaluate the effect of the endostatin on the growth and angiogenesis of the established endometriosis lesions in SCID mice model.Methods Eutopic endometrium of women with endometriosis was transplanted into the SCID mice. The mice were randomized into treatment (n=10) and control groups (n=10). Two weeks after the implantation of endometrium fragment,whereas the control group received equivalent volume of PBS (200 μl/d). The volume of endometriotic lesions in SCID mice was measured every three days, and all the treatment lasted for 14 days. Immunohistochemistry was used to determine microvessel density (MVD) and the expression of VEGF. The results were analyzed by t test and X2 test to value the treating effect.Results Compared with the control group, growth of endometriosis lesion was reduced in the mice treated with YH-16.Statistically significant differences in the volume and weight of the ectopic lesions were observed between the treatment and the control groups (P<0.05). Microscopical examination showed that after being treated with YH-16, the volume of the endometrial tissues decreased, the glands depauperated, and the glandular epithelium partially degenerated.Necrotic debris was observed in the endometrial stroma. MVD and expression of VEGF in the treatment group were significantly lower than those in the control group (P<0.05).Conclusions Recombinant human endostatin affects the maintenance and growth of endometriotic tissues by inhibiting angiogenesis and reducing the expression of VEGF in ectopic lesion. The angiostatic agent may be promising as a therapy for endometriosis.

  14. Thoracoscopic Video-Assisted Pulmonary Vein Antrum Isolation, Ganglionated Plexus Ablation and Periprocedural Confirmation of Ablation Lesions. First Results of a Hybrid Surgical-Electrophysiological Approach for Atrial Fibrillation

    NARCIS (Netherlands)

    S.P.J. Krul; A.H.G. Driessen; W.J. van Boven; A.C. Linnenbank; G.S.C. Geuzebroek; W.M. Jackman; A.A.M. Wilde; J.M.T. de Bakker; J.R. de Groot

    2011-01-01

    BACKGROUND: -Thoracoscopic pulmonary vein isolation (PVI) and ganglionated plexus (GP) ablation is a novel approach in the treatment of atrial fibrillation (AF). We hypothesize that meticulous electrophysiological confirmation of PVI results in fewer recurrences of AF during follow-up. METHODS AND R

  15. Endometriosis mimicking the perianal fistula tract: Case report

    Directory of Open Access Journals (Sweden)

    Gül Türkcü

    2014-09-01

    Full Text Available Endometriosis is the presence of endometrial glands and stroma outside the uterine cavity. Nowadays, in many cases, although routine use of episiotomy perineal endo metriosis is extremely rare. A 36 year old female patient was referred to our hospital with complaints of pain in the perianal region for five months. On physical examination, stiffness was palpated and then magnetic resonance im aging (MRI was performed. MRI is compatible with fistula tract. The lesion was excised and the histopathological appearance correspond to endometriosis. Perianal endo metriosis is rare in the perianal region and in the clinic mimicking perianal fistulas and malignancy should be kept in mind in the differential diagnosis

  16. Estrogen signaling in the proliferative endometrium: implications in endometriosis

    Directory of Open Access Journals (Sweden)

    Rita de Cássia Pereira da Costa e Silva

    2016-02-01

    Full Text Available SUMMARY Even though the physiological role of estrogen in the female reproductive cycle and endometrial proliferative phase is well established, the signaling pathways by which estrogen exerts its action in the endometrial tissue are still little known. In this regard, advancements in cell culture techniques and maintenance of endometrial cells in cultures enabled the discovery of new signaling mechanisms activated by estrogen in the normal endometrium and in endometriosis. This review aims to present the recent findings in the genomic and non-genomic estrogen signaling pathways in the proliferative human endometrium specifically associated with the pathogenesis and development of endometriosis.

  17. Endometriosis impairs bone marrow-derived stem cell recruitment to the uterus whereas bazedoxifene treatment leads to endometriosis regression and improved uterine stem cell engraftment.

    Science.gov (United States)

    Sakr, Sharif; Naqvi, Hanyia; Komm, Barry; Taylor, Hugh S

    2014-04-01

    Endometriosis is a disease defined by the ectopic growth of uterine endometrium. Stem cells contribute to the generation of endometriosis as well as to repair and regeneration of normal endometrium. Here we demonstrate that the selective estrogen receptor modulator bazedoxifene (BZA), administered with conjugated estrogens (CEs), leads to regression of endometriosis lesions as well as reduction in stem cell recruitment to the lesions. Female mice underwent transplantation of male bone marrow. Endometrium was transplanted in the peritoneal cavity of half to create experimental endometriosis. Mice with or without experimental endometriosis were randomized to BZA/CE or vehicle treatment. Endometriosis lesions, bone marrow-derived mesenchymal stem cell engraftment of the lesions, and eutopic endometrium as well as ovarian stimulation were assessed. BZA treatment significantly reduced lesion size, gland number, and expression of proliferation marker proliferating cell nuclear antigen. Ovarian weight was not affected. Stem cells were recruited to the endometriosis lesions, and this recruitment was dramatically reduced by BZA/CE treatment. Stem cell engraftment was reduced in the uterus of animals with endometriosis; however the number of stem cells engrafting the uterus was completely restored by treatment with BZA/CE. Competition between endometriosis and the eutopic endometrium for a limited supply of stem cells and depletion of normal stem cells flux to the uterus is a novel mechanism by which endometriosis interferes with endometrial function and fertility. BZA/CE not only treats lesions of endometriosis, it also dramatically reduces stem cell recruitment to the lesions and restores stem cell engraftment of the uterine endometrium.

  18. Beyond Body Mass Index: Using Anthropometric Measures and Body Composition Indicators to Assess Odds of an Endometriosis Diagnosis.

    Science.gov (United States)

    Backonja, Uba; Hediger, Mary L; Chen, Zhen; Lauver, Diane R; Sun, Liping; Peterson, C Matthew; Buck Louis, Germaine M

    2017-05-24

    upper arm and upper arm muscle areas (aOR = 0.76, 95% CI 0.61-0.94 and aOR = 0.74, 95% CI 0.59-0.93, respectively); and BMI (aOR = 0.75, 95% CI 0.60-0.93), despite similar heights. Women in the highest versus lowest quartile had lower adjusted odds of an endometriosis diagnosis for: weight; mid-upper arm, hip, and waist circumferences; total upper arm and upper arm muscle areas; BMI; and centripetal fat ratio. There was no evidence of a main effect or moderation of physical activity or sedentariness. In a surgical cohort, endometriosis was inversely associated with anthropometric measures and body composition indicators.

  19. Tratamento laparoscópico de 98 pacientes com endometriose intestinal Laparoscopic treatment of 98 women with bowel endometriosis

    Directory of Open Access Journals (Sweden)

    Luciana Maria Pyramo Costa

    2010-03-01

    Full Text Available OBJETIVO: Identificar os tipos de tratamento cirúrgico e a morbidade operatória na endometriose intestinal. MÉTODOS: Estudo retrospectivo de pacientes operadas no Biocor Instituto (Belo Horizonte, MG por uma equipe multidisciplinar para tratamento de endometriose no período de janeiro de 2002 a junho de 2009. RESULTADO: Noventa e oito pacientes foram submetidas aos seguintes procedimentos para tratamento da endometriose intestinal: ressecção segmentar do reto (n 46; 45,5%, ressecção em disco (n 25; 24,7%, "shaving" (n 18; 17,8%, apendicectomia (n 5; 5%, liberação de aderências sem ressecção (n 5; 5%, ressecção segmentar do sigmóide (n 1; 1% e ressecção segmentar do colo direito (n 1, 1%. A cirurgia concomitante mais freqüente foi a ressecção de endometriomas ovarianos (n 45. A morbidade operatória foi de 9,2%, sendo as complicações maiores uma fístula retovaginal (1% e uma deiscência de anastomose (1%. Quarenta e duas pacientes tiveram seguimento médio de 14 meses com recidiva clínica em 8 casos (dor pélvica e dispareunia e 4 recidivas de imagem à ultrassonografia em parede intestinal, assintomáticas. CONCLUSÃO: O tratamento da endometriose por laparoscopia é factível e seguro, com baixos índices de recidiva.OBJECTIVE: The purpose of this study was to identify the types of surgical procedures performed and the operative morbidity in women with bowel endometriosis. METHODS: Retrospective evaluation of surgical records of women who underwent surgical treatment of endometriosis by a mutidisciplinar team at Biocor Instituto (Belo Horizonte, MG from January 2002 to June 2009. RESULTS: Ninety-eight women underwent surgical treatment of bowel endometriosis during the study period. The following surgical procedures were performed: segmetnal rectal resection (n 46; 45,5%, intestinal disc excision (n 25; 24,7%, "shaving" (n 18; 17,8%, appendectomy (n 5; 5%, adhesiolysis without intestinal resection (n 5; 5%, segmental

  20. Surgical treatment of catamenial pneumothorax: Report of three cases.

    Science.gov (United States)

    Ichiki, Yoshinobu; Nagashima, Akira; Yasuda, Manabu; Takenoyama, Mitsuhiro; Toyoshima, Satoshi

    2015-07-01

    Catamenial pneumothorax (CP) is a rare entity of spontaneous, recurring pneumothorax in females. Although it has been known to be associated with thoracic endometriosis, varying clinical course and the lack of consistent intraoperative findings have led to conflicting etiological theories. We herein discuss the etiology, clinical course, and surgical treatment of three patients with CP. Three females (aged 40 years, 28 years, and 34 years) had recurrent right-sided spontaneous pneumothoraces that coincided with their menses. They had undergone video-assisted thoracoscopic surgery (VATS) previously. Blueberry spots in the right diaphragm were detected in all three cases. Two patients had recurrence, postoperatively. The other patient, who received luteinizing hormone-releasing hormone analog therapy for an abdominal endometriosis in the perioperative period and postoperative chemical pleurodesis to prevent recurrence, has been free of recurrence for 15 months, postoperatively. However, pelvic endometriosis was detected in this patient only. Therefore, CP should be suspected in ovulating females with spontaneous pneumothorax, even in the absence of any symptoms associated with pelvic endometriosis. In addition, while performing VATS, careful inspection of the diaphragmatic surface is important. In complicated cases, hormonal suppression therapy and chemical pleurodesis might also be helpful adjunct modalities.

  1. Surgical treatment of catamenial pneumothorax: Report of three cases

    Directory of Open Access Journals (Sweden)

    Yoshinobu Ichiki

    2015-07-01

    Full Text Available Catamenial pneumothorax (CP is a rare entity of spontaneous, recurring pneumothorax in females. Although it has been known to be associated with thoracic endometriosis, varying clinical course and the lack of consistent intraoperative findings have led to conflicting etiological theories. We herein discuss the etiology, clinical course, and surgical treatment of three patients with CP. Three females (aged 40 years, 28 years, and 34 years had recurrent right-sided spontaneous pneumothoraces that coincided with their menses. They had undergone video-assisted thoracoscopic surgery (VATS previously. Blueberry spots in the right diaphragm were detected in all three cases. Two patients had recurrence, postoperatively. The other patient, who received luteinizing hormone-releasing hormone analog therapy for an abdominal endometriosis in the perioperative period and postoperative chemical pleurodesis to prevent recurrence, has been free of recurrence for 15 months, postoperatively. However, pelvic endometriosis was detected in this patient only. Therefore, CP should be suspected in ovulating females with spontaneous pneumothorax, even in the absence of any symptoms associated with pelvic endometriosis. In addition, while performing VATS, careful inspection of the diaphragmatic surface is important. In complicated cases, hormonal suppression therapy and chemical pleurodesis might also be helpful adjunct modalities.

  2. Risk factors of epithelial ovarian carcinomas among women with endometriosis

    DEFF Research Database (Denmark)

    Thomsen, Line Holdgaard; Schnack, Tine H; Buchardi, Kristina

    2016-01-01

    INTRODUCTION: To evaluate the published literature on epidemiologic risk factors for epithelial ovarian cancer among women with a diagnosis of endometriosis. MATERIAL AND METHODS: A systematic literature search was conducted in PubMed and Scopus. Studies comparing epidemiologic risk factors...

  3. Intestinal endometriosis-A rare cause of colonic perforation

    Institute of Scientific and Technical Information of China (English)

    Neeraj Kumar Garg; Nitin Babulal Bagul; Sam Doughan; Paul Harold Rowe

    2009-01-01

    Endomet r iosis is the ectopic growth of viable endometrium outside the uterus, affecting approximately 7% of females. It commonly affects pelvic structures including the bowel. Perforation of the colon by endometriosis is very rare and the patients generally present with an asymptomatic or painful pelvic mass, often in the left iliac fossa. Our patient presented acutely unwell and her symptoms were more suggestive of pyelonephritis or diverticulitis. We therefore report an unusual cause of acute abdomen. The purpose of the following case report is to elucidate certain diagnostic and therapeutic problems of the disease, concerning both surgeons and gynaecologists. In summary, intestinal endometriosis should be considered in the differential diagnosis of all post-menarche women with episodic gastrointestinal symptoms. A past history of endometriosis or co-existent gynaecological symptoms should increase the index of suspicion, and laparoscopy prior to formal laparotomy should be considered.Our patient, in retrospect, had a history of mild endometriosis, but we feel that this case serves as a reminder of a rare, but important, differential diagnosis of acute abdomen in females.

  4. Molecular biology of endometriosis: from aromatase to genomic abnormalities.

    Science.gov (United States)

    Bulun, Serdar E; Monsivais, Diana; Kakinuma, Toshiyuki; Furukawa, Yuichi; Bernardi, Lia; Pavone, Mary Ellen; Dyson, Matthew

    2015-05-01

    Endometriosis has been initially described as the presence of ectopic endometrial tissue on pelvic organs or in extrapelvic sites; and this has been used as its key pathologic feature ever since. Endometriosis responds to fluctuations in estrogen and progesterone by growth and inflammation, leading to pain aggravated by menses. It was proposed that pelvic endometriosis primarily originate from retrograde menstruation of a critical number of eutopic endometrial cells with stem characteristics. This postulate is supported by the molecular defects found in ectopic endometriotic tissue. Genome-wide differences in CpG methylation between eutopic endometrial and endometriotic stromal cells are present. Defective CpG methylation affecting several genes that encode key transcription factors such as GATA6, steroidogenic factor-1, and estrogen receptor-β in endometriosis gives rise to overproduction of local estrogen and prostaglandins and suppression of progesterone receptor. Progesterone receptor deficiency leads to progesterone resistance, resulting in decreased retinol uptake and retinoic acid production and altered retinoic acid action. These molecular defects collectively give rise to poor cellular differentiation, enhanced survival, and increased inflammation, which are the biological hallmarks of endometriotic tissue. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  5. ENVIRONMENTAL PCB AND PESTICIDE EXPOSURE AND RISK OF ENDOMETRIOSIS

    Science.gov (United States)

    Environmental PCB and Pesticide Exposure and Risk of EndometriosisGermaine M. Buck1, John M. Weiner2, Hebe Greizerstein3, Brian Whitcomb1, Enrique Schisterman1, Paul Kostyniak3, Danelle Lobdell4, Kent Crickard5, and Ralph Sperrazza51Epidemiology Branch, Division o...

  6. Diagnostic Accuracy of Urinary Cytokeratin 19 Fragment for Endometriosis

    Science.gov (United States)

    Savaris, R. F.; Ali, S.; Brophy, S.; Tomazic-Allen, S.; Chwalisz, K.

    2015-01-01

    Endometriosis affects up to 10% of women of reproductive age and 176 million women worldwide. The prevalence in women with infertility is between 30% and 50% but may be higher in women with pelvic pain, interstitial cystitis, or irritable bowel syndrome. Cytokeratin 19 has been suggested as a potential biomarker in urine for the diagnosis of this condition. The objective of this study was to prospectively determine the accuracy and the performance of a urinary cytokeratin 19 (uCYFRA 21-1) test for diagnosing endometriosis. Ninety-eight consecutive women who underwent laparoscopy had a urinary sample obtained before surgery and were included in the study. Endometriosis was diagnosed by laparoscopy and pathology in 64.3% (63 of 98 women). The estimates and 95% confidence intervals for sensitivity, specificity, positive and negative predictive values, and likelihood ratios were 11.1% (4.5%-21.5%), 94.3% (80.8%-99.3%), 77.7% (39.9-97.1), 37% (27-47.9), 1.94 (0.43-8.86), and 0.94 (0.84-1.06), respectively. Despite the high specificity, the uCYFRA 21-1 test has limited value for clinical practice to discriminate between women with and without endometriosis. PMID:25296695

  7. The relevance of menstrual timing for surgery of thoracic endometriosis

    Directory of Open Access Journals (Sweden)

    David Perez

    2017-06-01

    This is a report of an unusual case of pleuropulmonary and endotracheal endometriosis that presented with recurrent hemothorax. Minimally invasive surgery scheduled for the days of menstruation played a major role in its diagnosis and management. [Arch Clin Exp Surg 2017; 6(2.000: 96-99

  8. Estrogen is essential but not sufficient to induce endometriosis

    Indian Academy of Sciences (India)

    MOSAMI GALVANKAR; NEHA SINGH; MODI DEEPAK

    2017-06-01

    Endometriosis is a common gynaecological disorder of unknown aetiology. Among the several factors, estrogen hasbeen implicated as a causative factor in endometriosis. In the present study using mouse model, we assessed the role ofestrogen in the initial implantation and growth of endometrium in ectopic locations. Uterine tissues from greenfluorescent protein (GFP) mice were transplanted in to the peritoneum of wild type mice in presence and absence ofestrogen. As compared to untreated controls, the implantation of uterine tissue at ectopic locations was higher whenestrogen was administered to both host and donor animals. However, this effect was not sustained as lesions regressedwithin 14 days of treatment. Irrespective of the treatment, peritoneal adipose was the most preferred site of lesionestablishment. The lesions did not have typical features of the endometriosis (presence of glands and stroma) even afterestrogen treatment and the ectopic tissue underwent regression by apoptosis irrespective of treatment. Since estrogenpromotes implantation of endometrial tissue to ectopic locations but failure of these ectopic lesions to grow and sustaineven in high estrogenic environment we propose that estrogen is necessary but not sufficient to sustain endometriosis.

  9. (CYP19) gene in Iranian women with endometriosis

    African Journals Online (AJOL)

    Hajar Saber

    2012-11-09

    Nov 9, 2012 ... This study involved 110 patients with endometriosis and 200 healthy ... overall cancer risk, with particular elevation of ovarian cancer risk [3]. Two principal ... for the terminal step of estrogen biosynthesis by converting. 19-carbon steroids ... breast and lung cancers and osteoporosis [14–18]. However,.

  10. EP2 receptor antagonism reduces peripheral and central hyperalgesia in a preclinical mouse model of endometriosis

    Science.gov (United States)

    Greaves, Erin; Horne, Andrew W.; Jerina, Helen; Mikolajczak, Marta; Hilferty, Lisa; Mitchell, Rory; Fleetwood-Walker, Sue M.; Saunders, Philippa T. K.

    2017-01-01

    Endometriosis is an incurable gynecological disorder characterized by debilitating pain and the establishment of innervated endometriosis lesions outside the uterus. In a preclinical mouse model of endometriosis we demonstrated overexpression of the PGE2-signaling pathway (including COX-2, EP2, EP4) in endometriosis lesions, dorsal root ganglia (DRG), spinal cord, thalamus and forebrain. TRPV1, a PGE2-regulated channel in nociceptive neurons was also increased in the DRG. These findings support the concept that an amplification process occurs along the pain neuroaxis in endometriosis. We then tested TRPV1, EP2, and EP4 receptor antagonists: The EP2 antagonist was the most efficient analgesic, reducing primary hyperalgesia by 80% and secondary hyperalgesia by 40%. In this study we demonstrate reversible peripheral and central hyperalgesia in mice with induced endometriosis. PMID:28281561

  11. CERN confirms LHC schedule

    CERN Multimedia

    2003-01-01

    The CERN Council held its 125th session on 20 June. Highlights of the meeting included confirmation that the LHC is on schedule for a 2007 start-up, and the announcement of a new organizational structure in 2004.

  12. [Evaluation of endometriosis fertility index in follow-up treatment of endometriosis combined with infertility patients after laparoscopic surgery].

    Science.gov (United States)

    Qian, R Y; Wu, X; Sheng, J; Zheng, P; Zhou, Q; Duan, A H; Zhang, J P; Zhang, Y L; Lu, D

    2017-04-25

    Objective: To explore the application of endometriosis fertility index (EFI) in guidance after laparoscopic surgery of endometriosis patients combined with infertility and to explore methods to improve pregnancy rate in different EFI groups. Methods: A prospective research was done in endometriosis patients combined with infertility in Beijing Obstetrics and Gynecology Hospital from January 2010 to June 2011, after laparoscopic surgery, these 146 patients were divided into 3 groups by EFI score. Using different pregnancy guidance, these patients had 5 years follow-up. Results: (1) The 5 years overall pregnancy rate was 89.0% (130/146). The pregnancy rate was 95.7% (45/47) in EFI≥9 group, 92.8% (77/83) in EFI 5-8 group and 8/16 in EFI≤4 group, three groups were all reach satisfactory pregnancy rate; the rate of the first two groups had no statistically significance (P=0.498), but had significant difference with the last group (Pinfertility after laparoscopic surgery. EFI score guidance, strict post-operation management and positive pregnancy scheme could significantly improve the pregnancy rate of endometriosis patients with infertility.

  13. Quality of life in endometriosis: evaluation of the Dutch-version Endometriosis Health Profile-30 (EHP-30)

    NARCIS (Netherlands)

    Burgt, T.J. van de; Hendriks, J.C.M.; Kluivers, K.B.

    2011-01-01

    The Dutch version of the Endometriosis Health Profile-30 (EHP-30) showed a high return rate and data completeness, low floor and ceiling effects, as well as good internal consistency, test-retest reliability and construct validity. The questionnaire is a reliable and valid instrument for the measure

  14. A rare case of pancreatic endometriosis in a postmenopausal woman and review of the literature

    Science.gov (United States)

    Sommer, Ulrich; Baretton, Gustavo B; Aust, Daniela E; Laniado, Michael; Hoffmann, Ralf-Thorsten; Platzek, Ivan

    2016-01-01

    Pancreatic endometriosis is very rare with only a few cases reported in the literature. The imaging features are non-specific and the definitive diagnosis is usually only established after surgery. We report on a 68-year-old woman with left upper quadrant pain who demonstrated a mass in the pancreatic tail on imaging. Laboratory results showed only mildly elevated liver enzymes, tumor markers were within the normal range. A left pancreatectomy was performed, frozen section suggesting a benign lesion, and final histopathology confirmed endometriotic cysts. A research of the literature found only eight reported cases of endometriotic cysts of the pancreas, with the majority affecting premenopausal women. Preoperative diagnosis is challenging and most patients undergo resection because of suspected neoplasm. Thorough diagnostic workup may help in avoiding extensive surgery and reduce postoperative complications. PMID:27733937

  15. A rare case of pancreatic endometriosis in a postmenopausal woman and review of the literature

    Directory of Open Access Journals (Sweden)

    Verena Plodeck

    2016-09-01

    Full Text Available Pancreatic endometriosis is very rare with only a few cases reported in the literature. The imaging features are non-specific and the definitive diagnosis is usually only established after surgery. We report on a 68-year-old woman with left upper quadrant pain who demonstrated a mass in the pancreatic tail on imaging. Laboratory results showed only mildly elevated liver enzymes, tumor markers were within the normal range. A left pancreatectomy was performed, frozen section suggesting a benign lesion, and final histopathology confirmed endometriotic cysts. A research of the literature found only eight reported cases of endometriotic cysts of the pancreas, with the majority affecting premenopausal women. Preoperative diagnosis is challenging and most patients undergo resection because of suspected neoplasm. Thorough diagnostic workup may help in avoiding extensive surgery and reduce postoperative complications.

  16. Exceptional cause of bowel obstruction: rectal endometriosis mimicking carcinoma of Rectum - a case report

    OpenAIRE

    Selim Sassi; Mahdi Bouassida; Hassen Touinsi; Mohamed Mongi Mighri; Sonia Baccari; Fathi Chebbi; Khaled Bouzeidi; Sadok Sassi

    2011-01-01

    Endometriosis with intestinal serosal involvement is not uncommon in women of childbearing age. However, endometriosis presenting as colon obstruction is rare and occurs in less than 1% of cases. The Lack of pathognomonic signs makes the diagnosis difficult, mostly because the main differential diagnosis is with neoplasm, even during the intervention. Reported here is a case of a 35-year –old woman presenting with bowel obstruction due to rectal endometriosis. The patient presented signs and ...

  17. The peritoneum is both a source and target of TGF-β in women with endometriosis.

    Directory of Open Access Journals (Sweden)

    Vicky J Young

    Full Text Available Transforming growth factor-β (TGF-β is believed to play a major role in the aetiology of peritoneal endometriosis. We aimed to determine if the peritoneum is a source of TGF-β and if peritoneal TGF-β expression, reception or target genes are altered in women with endometriosis. Peritoneal fluid, peritoneal bushings and peritoneal biopsies were collected from women with and without endometriosis. TGF-β1, 2 and 3 protein concentrations were measured in the peritoneal fluid. TGF-β1 was measured in mesothelial cell conditioned media. Control peritoneum and peritoneum prone to endometriosis (within Pouch of Douglas from women without disease (n = 16 and peritoneum distal and adjacent to endometriosis lesions in women with endometriosis (n = 15 and were analysed for TGF-β expression, reception and signalling by immunohistochemistry, qRT-PCR and a TGF-β signalling PCR array. TGF-β1 was increased in the peritoneal fluid of women with endometriosis compared to those without disease (P<0.05 and peritoneal mesothelial cells secrete TGF-β1 in-vitro. In women with endometriosis, peritoneum from sites adjacent to endometriosis lesions expressed higher levels of TGFB1 mRNA when compared to distal sites (P<0.05. The TGF-β-stimulated Smad 2/3 signalling pathway was active in the peritoneum and there were significant increases (P<0.05 in expression of genes associated with tumorigenesis (MAPK8, CDC6, epithelial-mesenchymal transition (NOTCH1, angiogenesis (ID1, ID3 and neurogenesis (CREB1 in the peritoneum of women with endometriosis. In conclusion, the peritoneum, and in particular, the peritoneal mesothelium, is a source of TGF-β1 and this is enhanced around endometriosis lesions. The expression of TGF-β-regulated genes is altered in the peritoneum of women with endometriosis and this may promote an environment favorable to lesion formation.

  18. Ileocecal endometriosis and a diagnosis dilemma: A case report and literature review

    OpenAIRE

    Tong, Yu-Ling; Chen, Yan; Zhu, Shen-Yi

    2013-01-01

    Bowel endometriosis affects between 3.8% and 37% of women with endometriosis. The evaluation of symptoms and clinical examination are inadequate for an accurate diagnosis of intestinal endometriosis. We describe the case of a 41-year-old woman who presented to our hospital because of six months of recurrent abdominal pain, vomiting and diarrhea, without previous history of bowel disease. Physical examination revealed a palpable 3 cm × 5 cm mass in the right lower quadrant abdomen. Laboratory ...

  19. Traditional Chinese medical herbs staged therapy in infertile women with endometriosis: a clinical study

    OpenAIRE

    Ding, Zhaorong; Lian, Fang

    2015-01-01

    Background: Endometriosis is a common gynecological disease defined as the presence of endometrioid tissue (glands and stroma) outside the uterus. About 30 to 40% patients with endometriosis are infertile. In traditional Chinese medical system, endometriosis associated infertility is mostly caused by kidney deficiency and blood stasis. The herb of reinforcing kidney and removing blood stasis is designed to treat the disease. Material and methods: All the 80 up-to-standard patients were divide...

  20. Obstetrical Complications in Women with Endometriosis: A Cohort Study in Japan

    Science.gov (United States)

    Harada, Takashi; Taniguchi, Fuminori; Onishi, Kazunari; Kurozawa, Youichi; Hayashi, Kunihiko; Harada, Tasuku

    2016-01-01

    Background Endometriosis, which occurs in approximately 10% of women of reproductive age, is defined as the presence of endometrial tissue outside the uterus. Women with endometriosis are more likely to have difficulty conceiving and tend to receive infertility treatment, including assisted reproductive technology (ART) therapy. There has not yet been a prospective cohort study examining the effects of endometriosis on pregnancy outcome in pregnant Japanese women. Methodology This was a prospective cohort study of the incidence of obstetrical complications in women with endometriosis using data of the Japan Environment & Children’s Study (JECS). Included in this study were 9,186 pregnant women in the JECS with or without a history of endometriosis who gave birth or stillbirth or whose pregnancy was terminated with abortion between February and December 2011. Main Outcome Measures The effects of endometriosis on pregnancy outcome. Results Of the 9,186 pregnant women in the JECS, 4,119 (44.8%) had obstetrical complications; 330 participants reported a diagnosis of endometriosis before pregnancy, and these women were at higher risk for complications of pregnancy than those without a history of endometriosis (odds ratio (OR) = 1.50; 95% confidence interval (CI) 1.20 to 1.87). Logistic regression analyses showed that the adjusted OR for obstetrical complications of pregnant women who conceived naturally and had a history of endometriosis was 1.45 (CI 1.11 to 1.90). Among pregnant women with endometriosis, the ORs of preterm premature rupture of the membranes (PROM) and placenta previa were significantly higher compared with women never diagnosed with endometriosis who conceived naturally or conceived after infertility treatment, except for ART therapy (OR 2.14, CI 1.03–4.45 and OR 3.37, CI 1.32–8.65). Conclusions This study showed that endometriosis significantly increased the incidence of preterm PROM and placenta previa after adjusting for confounding of the

  1. Abortion - surgical

    Science.gov (United States)

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

  2. Repository performance confirmation.

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, Francis D.

    2011-09-01

    Repository performance confirmation links the technical bases of repository science and societal acceptance. This paper explores the myriad aspects of what has been labeled performance confirmation in U.S. programs, which involves monitoring as a collection of distinct activities combining technical and social significance in radioactive waste management. This paper is divided into four parts: (1) A distinction is drawn between performance confirmation monitoring and other testing and monitoring objectives; (2) A case study illustrates confirmation activities integrated within a long-term testing and monitoring strategy for Yucca Mountain; (3) A case study reviews compliance monitoring developed and implemented for the Waste Isolation Pilot Plant; and (4) An approach for developing, evaluating and implementing the next generation of performance confirmation monitoring is presented. International interest in repository monitoring is exhibited by the European Commission Seventh Framework Programme 'Monitoring Developments for Safe Repository Operation and Staged Closure' (MoDeRn) Project. The MoDeRn partners are considering the role of monitoring in a phased approach to the geological disposal of radioactive waste. As repository plans advance in different countries, the need to consider monitoring strategies within a controlled framework has become more apparent. The MoDeRn project pulls together technical and societal experts to assimilate a common understanding of a process that could be followed to develop a monitoring program. A fundamental consideration is the differentiation of confirmation monitoring from the many other testing and monitoring activities. Recently, the license application for Yucca Mountain provided a case study including a technical process for meeting regulatory requirements to confirm repository performance as well as considerations related to the preservation of retrievability. The performance confirmation plan developed as part

  3. Levels of Lipid Perioxides and Superoxide Dismutase in Peritoneal Fluid of Patients with Endometriosis

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    In order to evaluate the changes of lipid perioxides (LPO) and superoxide dismutase (SOD) levels in peritoneal fluid in patients with endometriosis, the levels of LPO and SOD in peritoneal fluids from infertile women with endometriosis and with normal pelvis were measured. The result showed that the levels of LPO but SOD was elevated significantly in peritoneal fluid from women with endometriosis than in women with normal pelvis (P<0.01). It is suggested that free oxygen radicals may be involved in the pathogenesis of endometriosis associated infertility.

  4. Immunohistochemical Study of HLA-DR Antigen in Endometrial Tissue of Patients with Endometriosis

    Institute of Scientific and Technical Information of China (English)

    刘义; 罗丽兰; 赵海波

    2002-01-01

    In order to evaluate the expression of HLA-DR antigen in glandular cells in eutopic and ectopic endometrium in patients with endometriosis, 19 infertile patients with endometriosis were analyzed immunohistochemically by labelled streptavidin biotin (LSAB) method. Nineteen infertile patients without endometriosis were studied as controls. The results showed that the expression of HLA-DR antigen in the glandular cells in both eutopic and ectopic endometrium was increased significantly as compared with that in the controls (P<0.01). It is likely that aberrant expression of HLADR antigen in endometriotic tissue is involved in abormal immunogenesis of endometriosis.

  5. Antiangiogenesis Therapy of Endometriosis Using PAMAM as a Gene Vector in a Noninvasive Animal Model

    Directory of Open Access Journals (Sweden)

    Ningning Wang

    2014-01-01

    Full Text Available Objective. To evaluate the characteristics and antiangiogenic effects of endostatin-loaded PAMAM on endometriosis in a noninvasive animal model. Materials and Methods. A noninvasive animal model was established by injecting adenovirus-GFP transfected endometrial stromal and glandular epithelial cells subcutaneously into nude mice. Endostatin-loaded PAMAM was prepared and identified by transmission electron microscopy. For in vitro studies, the DNA protection and cytotoxicity of PAMAM were investigated and compared with Lipofectamine 2000. For in vivo study, endostatin-loaded PAMAM was injected into the noninvasive model and evaluated by continuously observing the fluorescent lesion, lesion weight, microvessel density and VEGF immunostaining. Results. Compared with Lipofectamine 2000, PAMAM and HC PAMAM-ES group, MC PAMAM-ES group and LC PAMAM-ES group demonstrated a better stromal cells protective such that MC PAMAM-ES group of CCK8 was 0.617 ± 0.122 at 24 hr and 0.668 ± 0.143 at 48 hr and LC PAMAM-ES group of CCK8 was 0.499 ± 0.103 at 24 hr and 0.610 ± 0.080 at 48 hr in stromal cells (P<0.05 but similar cytotoxicity in glandular epithelial cells in vitro. After 16 hrs of digestion, DNA decreased slightly under the protection of PAMAM. Endostatin-loaded PAMAM of HD PAMAM-ES group and LD PAMAM-ES group inhibited the growth of the endometriotic lesion in vivo at days 15, 20, 25 and 30 detected by noninvasive observation after injecting one dose endostatin of various medicines into the endometrial lesion in each mouse on day 10 (P<0.05 and confirmed by lesion weight at day 30 with HD PAMAM-ES group being 0.0104 ± 0.0077 g and LD PAMAM-ES group being 0.0140 ± 0.0097 g (P<0.05. Immunohistochemistry results showed that endostatin-loaded PAMAM reduced the microvessel density 3.8 ± 2.4 especially in HD PAMAM-ES group in the lesion (P<0.05. Conclusion. Endostatin-loaded PAMAM inhibits the development of

  6. Negotiating science and experience in medical knowledge: gynaecologists on endometriosis.

    Science.gov (United States)

    Whelan, Emma

    2009-04-01

    This paper analyses the gynaecological literature on endometriosis, particularly endometriosis classification, to evaluate the epistemological concepts it uses. A qualitative content analysis was conducted on a sample of gynaecological literature published between 1985 and 2000, a period that witnessed the explosion of both evidence-based and patient-centred models of medicine, with their dwelling emphases on science and experience. It was found that the discourse of science is used strategically in this literature as a formal epistemology to lend weight to authors' claims and to guide medical thinking and research. However, gynaecologists also use the notion of experience to assert their own credibility and to question the credibility of other experts. In fact, accounts of their own experience and the experiential accounts of their patients are foundational to gynaecologists' claims-making activities, including their engagement with scientific research.

  7. Endometriosis, dysmenorrhea and diet--what is the evidence?

    DEFF Research Database (Denmark)

    Fjerbaek, Agnete; Knudsen, Ulla Breth

    2007-01-01

    polyunsaturated fat, ham, beef and other red meat. Results concerning fish intake were not consistent. Eight trials of different design, with a total of 1097 women, investigated the relationship between diet and dysmenorrhea. Intake of fish oil seemed to have a positive effect on pain symptoms. This study...... concludes that literature on diet and endometriosis is sparse, whereas eight studies have looked at diet and dysmenorrhea. No clear recommendations on what diet to eat or refrain from to reduce the symptoms of endometriosis can be given, while a few studies indicate that fish oil can reduce dysmenorrhea...... polyunsaturated fat, ham, beef and other red meat. Results concerning fish intake were not consistent. Eight trials of different design, with a total of 1097 women, investigated the relationship between diet and dysmenorrhea. Intake of fish oil seemed to have a positive effect on pain symptoms. This study...

  8. [The implantation of bipolar coagulation to remove endometriosis foci].

    Science.gov (United States)

    Sobkiewicz, S; Palatyński, A; Salata, I

    2001-05-01

    The paper compares the results of bipolar coagulation bey means of ERBE ICC 300 diatermy coagulator and WISAP endocoagulator. The results of both types of coagulation were assessed with reference to the changes occurring on peritoneum ligamenti sacro-uterini, Douglas pouch and ovary. The best results of endometriosis foci coagulation were obtained with bipolar ball at 20-30 W; no side effects or feelings of malaise were observed in patients just after the operation or over a longer period of convalescence.

  9. Potential role of aromatase inhibitors in the treatment of endometriosis

    OpenAIRE

    2014-01-01

    Hatem Abu HashimDepartment of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura, EgyptAbstract: Endometriosis is an estrogen-dependent chronic inflammatory disease affecting 5%–10% of reproductive-age women, with a prevalence of 5%–50% in infertile women and >33% of women with chronic pelvic pain. Third-generation aromatase inhibitors (AIs) are approved adjuvants for the treatment of estrogen receptor-positive breast cancer. Molecular stu...

  10. A novel homologous model for noninvasive monitoring of endometriosis progression.

    Science.gov (United States)

    Ferrero, Hortensia; Buigues, Anna; Martínez, Jessica; Simón, Carlos; Pellicer, Antonio; Gómez, Raúl

    2017-02-01

    To date, several groups have generated homologous models of endometriosis through the implantation of endometrial tissue fluorescently labeled by green fluorescent protein (GFP) or tissue from luciferase-expressing transgenic mice into recipient animals, enabling noninvasive monitoring of lesion signal. These models present an advantage over endpoint models, but some limitations persist; use of transgenic mice is laborious and expensive, and GFP presents poor tissue penetration due to the relatively short emission wavelength. For this reason, a homologous mouse model of endometriosis that allows in vivo monitoring of generated lesions over time and mimics human lesions in recipient mice would be most desirable. In this regard, using C57BL/6 and B6N-Tyrc-Brd/BrdCrCrl mice, we optimized a decidualization protocol to obtain large volumes of decidual endometrium and mimic human lesions. Subsequently, to obtain a more robust and reliable noninvasive monitoring of lesions, we used the fluorescent reporter mCherry, which presents deeper tissue penetration and higher photostability, showing that endometrial tissue was properly labeled with 1 × 108 PFU/mL mCherry adenoviral vectors. mCherry-labeled endometriotic tissue was implanted in recipient mice, generating lesions that displayed characteristics typical of human endometriotic lesions, such as epithelial cells forming glands, local inflammation, collagen deposits, and new vessel formation. In vivo monitoring demonstrated that subcutaneous implantation on ventral abdomen of recipient mice provided the most intense and reliable signal for noninvasive lesion monitoring over a period of at least 20 days. This homologous model improves upon previously reported models of endometriosis and provides opportunities to study mechanism underlying endometriotic lesion growth and progression. We created a cost-effective but accurate homologous mouse model of endometriosis that allows the study of growth and progression of

  11. A nude mouse model of endometriosis and its biological behaviors

    Institute of Scientific and Technical Information of China (English)

    WANG Dan-bo; ZHANG Shu-lan; NIU Hui-yan; LU Jing-ming

    2005-01-01

    @@ Endometriosis (EM) as a common and intractable gynecological disease is characterized by unknown etiology and complex pathologic changes. Many factors of the disease are uncertain at the molecular level and it is difficult to study clinically. In this study, we attempted to establish a nude mice model of EM for dynamical observation of the genesis and development of the disease, morphological changes in tissue, and biological behaviors.

  12. Endometriosis increases the risk of obstetrical and neonatal complications

    DEFF Research Database (Denmark)

    Berlac, Janne Foss; Hartwell, Dorthe; Skovlund, Charlotte Wessel

    2017-01-01

    . RESULTS: The 19 331 women with endometriosis had a higher risk of severe preeclampsia (OR 1.7 95% CI, 1.5-2.0), hemorrhage in pregnancy (OR 2.3, 2.0-2.5), placental abruption (OR 2.0, 1.7-2.3), placenta previa (OR 3.9, 3.5-4.3), premature rupture of membranes (OR 1.7, 1.5-1.8), and retained placenta (OR 3...

  13. Targeting galectin-1-induced angiogenesis mitigates the severity of endometriosis.

    Science.gov (United States)

    Bastón, Juan I; Barañao, Rosa I; Ricci, Analía G; Bilotas, Mariela A; Olivares, Carla N; Singla, José J; Gonzalez, Alejandro M; Stupirski, Juan C; Croci, Diego O; Rabinovich, Gabriel A; Meresman, Gabriela F

    2014-11-01

    Endometriosis is characterized by the presence of endometrial tissue outside the uterus that causes severe pelvic pain and infertility in women of reproductive age. Although not completely understood, the pathophysiology of the disease involves chronic dysregulation of inflammatory and vascular signalling. In the quest for novel therapeutic targets, we investigated the involvement of galectin-1 (Gal-1), an endogenous glycan-binding protein endowed with both immunosuppressive and pro-angiogenic activities, in the pathophysiology of endometriotic lesions. Here we show that Gal-1 is selectively expressed in stromal and endothelial cells of human endometriotic lesions. Using an experimental endometriosis model induced in wild-type and Gal-1-deficient (Lgals1(-/-) ) mice, we showed that this lectin orchestrates the formation of vascular networks in endometriotic lesions in vivo, facilitating their ectopic growth independently of vascular endothelial growth factor (VEGF) and the keratinocyte-derived CXC-motif (CXC-KC) chemokine. Targeting Gal-1 using a specific neutralizing mAb reduced the size and vascularized area of endometriotic lesions within the peritoneal compartment. These results underline the essential role of Gal-1 during endometriosis and validate this lectin as a possible target for the treatment of disease. Copyright © 2014 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

  14. Common variation of the CYP17 gene in Iraqi women with endometriosis disease.

    Science.gov (United States)

    Al-Rubae'i, Salwa H N; Naji, Tamara Sami; Turki, Kisma M

    2017-03-01

    Common variants among genes coding for enzymes in sex steroid biosynthetic pathways may influence the risk of endometriosis in Iraqi women patients in the last years. Cytochrome P450c17a1 (CYP17), a gene that codes for a key enzyme (cytochrome P450c17a1) in a rate-limiting step of estrogen biosynthesis has attracted considerable attention as an important gene for endometriosis. To evaluate the relationship between common genetic variations in CYP17 and endometriosis risk and determine the main effects of those variations on the gene expression. A women-based case control study of Iraqi women aged range (23-46), the associations between selected single-nucleotide polymorphisms (SNPs) in the CYP17 gene and endometriosis diagnosis in fifty women and thirty disease-free controls were evaluated. The study found a significant association (P ≤ 0.01)between endometriosis and selected SNPs of CYP17 gene, with the homozygous genotype conferring decreased risk. A highly significant difference (P ≤ 0.01) in CYP17 gene expression from women with versus without endometriosis and increased by 1.56-fold in women with endometriosis. These findings suggest that variation in or around CYP17 may be associated with endometriosis development in the Iraqi women.

  15. Common variation of the CYP17 gene in Iraqi women with endometriosis disease

    Directory of Open Access Journals (Sweden)

    Salwa H.N. Al-Rubae'i

    2017-03-01

    Full Text Available Common variants among genes coding for enzymes in sex steroid biosynthetic pathways may influence the risk of endometriosis in Iraqi women patients in the last years. Cytochrome P450c17a1 (CYP17, a gene that codes for a key enzyme (cytochrome P450c17a1 in a rate-limiting step of estrogen biosynthesis has attracted considerable attention as an important gene for endometriosis. To evaluate the relationship between common genetic variations in CYP17 and endometriosis risk and determine the main effects of those variations on the gene expression. A women-based case control study of Iraqi women aged range (23–46, the associations between selected single-nucleotide polymorphisms (SNPs in the CYP17 gene and endometriosis diagnosis in fifty women and thirty disease-free controls were evaluated. The study found a significant association (P ≤ 0.01between endometriosis and selected SNPs of CYP17 gene, with the homozygous genotype conferring decreased risk. A highly significant difference (P ≤ 0.01 in CYP17 gene expression from women with versus without endometriosis and increased by 1.56-fold in women with endometriosis. These findings suggest that variation in or around CYP17 may be associated with endometriosis development in the Iraqi women.

  16. Association between endometriosis and risk of histological subtypes of ovarian cancer

    DEFF Research Database (Denmark)

    Pearce, Celeste Leigh; Templeman, Claire; Rossing, Mary Anne

    2012-01-01

    Endometriosis is a risk factor for epithelial ovarian cancer; however, whether this risk extends to all invasive histological subtypes or borderline tumours is not clear. We undertook an international collaborative study to assess the association between endometriosis and histological subtypes of...

  17. The involvement of T lymphocytes in the pathogenesis of endometriotic tissues overgrowth in women with endometriosis

    Directory of Open Access Journals (Sweden)

    Krzysztof Szyllo

    2003-01-01

    Full Text Available Background: Endometriosis, uncontrolled proliferation of ectopic and eutopic endometriotic tissues, is common in women at reproductive age, and may affect fertility. The role of macrophages in the pathogenesis is well proved, but engagement of T cells in the pathogenesis of endometriosis is a matter of controversy

  18. The significant effect of endometriosis on physical, mental and social wellbeing

    DEFF Research Database (Denmark)

    De Graaff, A A; D'Hooghe, T M; Dunselman, G A J;

    2013-01-01

    To what extent do the management of endometriosis and the symptoms that remain after treatment affect the quality of life in women with the disease?......To what extent do the management of endometriosis and the symptoms that remain after treatment affect the quality of life in women with the disease?...

  19. Progesterone receptor gene polymorphisms and risk of endometriosis: results from an international collaborative effort

    DEFF Research Database (Denmark)

    Near, Aimee M; Wu, Anna H; Templeman, Claire;

    2011-01-01

    To investigate the association between self-reported endometriosis and the putative functional promoter +331C/T single nucleotide polymorphism and the PROGINS allele.......To investigate the association between self-reported endometriosis and the putative functional promoter +331C/T single nucleotide polymorphism and the PROGINS allele....

  20. The patient-centeredness of endometriosis care and targets for improvement: a systematic review

    NARCIS (Netherlands)

    Dancet, E.A.; Apers, S.; Kremer, J.A.; Nelen, W.L.; Sermeus, W.; D'Hooghe, T.M.

    2014-01-01

    BACKGROUND: Endometriosis is a prevalent condition compromising physical and psychosocial health and thus requiring patient-centered care, which is guided by patients' values. This study aimed to find out what the patient's perspective on endometriosis care is and how the patient-centeredness of end

  1. Induction of Endometriosis in Mice: A New Model Sensitive to Estrogen

    Science.gov (United States)

    Endometriosis consists of the growth of endometrial tissue outside the uterus. A rat model of endometriosis is available to evaluate the potential for environmental chemicals to promote the disease but may he relatively insensitive for the evaluation of the hazard of certain comp...

  2. Intron 1 and exon 1 alpha estrogen receptor gene polymorphisms in women with endometriosis.

    Science.gov (United States)

    Sato, Hélio; Nogueira-de-Souza, Naiara C; D'Amora, Paulo; Silva, Ismael D C G; Girão, Manoel J B C; Schor, Eduardo

    2008-12-01

    To evaluate the association of intron 1 and exon 1 polymorphisms in the estrogen receptor alpha gene (ER-alpha) with endometriosis in women. Association study. Endometriosis Unit, Federal University of São Paulo. The control group consisted of volunteers older than 45 years who had no evidence of endometriosis antecedents. Two groups with the disease were evaluated: the first group had stage I or II endometriosis and the second group stage III or IV. Polymerase chain reaction (PCR) followed by digestion with HaeIII and MspI endonucleases (RFLP) were applied to detect intron 1 and exon 1 polymorphisms, respectively, in a total of 125 controls and 105 affected women. Frequency and distribution of HaeIII and MspI polymorphisms in ER-alpha. No significant differences in the frequency of polymorphisms either in intron 1 or exon 1 of ER-alpha were found when endometriosis patients were compared with control subjects. Furthermore, the frequency of ER-alpha polymorphisms within the two different groups of patients with disease was statistically similar. The odds ratio between presence of intron 1 single-nucleotide polymorphisms (SNP) and endometriosis was 0.904, and the odds ratio between exon 1 SNP and endometriosis was 0.976. The evaluated polymorphisms were not associated with endometriosis.

  3. Women with endometriosis are more likely to suffer from migraines: a population-based study.

    Directory of Open Access Journals (Sweden)

    Meng-Han Yang

    Full Text Available Previous research suggests that a co-morbid relationship exists between migraine and endometriosis; however, results have been inconsistent. In addition, female hormones, which are important in the pathogenesis and management of endometriosis, have been reported to precipitate migraine attacks and may confound the results. The aim of this population-based cohort study was to explore the relationship between migraine and endometriosis in women of reproductive age (18-51 years. Data were derived from the National Health Insurance Research Database of Taiwan, which contains outpatient and inpatient records from 2000 to 2007. Our study cohort included 20,220 endometriosis patients and 263,767 controls without endometriosis. We analyzed the prevalence of migraine in these women as recorded during the eight years of the database. Our results found that patients with endometriosis were more likely to suffer migraine headaches compared to controls (odds ratio [OR], 1.70; 95% confidence interval [CI] [1.59, 1.82]; p<0.001. In addition, the co-morbid association between migraine and endometriosis remained significant after the data were controlled for age and frequently utilized hormone therapies (OR, 1.37; 95% CI, [1.27, 1.47]; p<0.001. The results of this cohort study support the existence of a co-morbid relationship between migraine and endometriosis, even after adjusting for the possible effects of female hormone therapies on migraine attacks.

  4. [The so-called "chocolate cyst"--frequently misinterpreted as ovarian endometriosis?].

    Science.gov (United States)

    Christensen, B; Schindler, A E

    1996-09-01

    Limitation of morphological diagnostic and possible misinterpretations are shown in a patient with anamnestic ovarian endometriosis. In cases of "chocolate cysts" it is necessary to differentiate between ovarian endometriosis and functional cysts. Hints for the existence of a functional cyst are an atypical past history or perioperative findings. Biochemical analysis of the cyst fluid may lead to a correct diagnosis.

  5. Possible Role of α1-Antitrypsin in Endometriosis-Like Grafts From a Mouse Model of Endometriosis.

    Science.gov (United States)

    Tamura, Kazuhiro; Takashima, Haruka; Fumoto, Keiko; Kajihara, Takeshi; Uchino, Satomi; Ishihara, Osamu; Yoshie, Mikihiro; Kusama, Kazuya; Tachikawa, Eiichi

    2015-09-01

    Previous study indicated that bleeding into the peritoneum may accelerate inflammatory response in endometriosis-like grafts in mice. To identify changes in protein levels in the grafts from mice that underwent unilateral ovariectomy (uOVX), which causes bleeding from ovarian arteries and vein, the grafts were generated by injecting a suspension of human endometrial cells in BALB/c nude female mice, and protein profile changes were compared with non-uOVX control mice. The level of α1-antitrypsin (α1-AT) decreased in grafts from nude mice that underwent uOVX. The levels of phosphorylated Akt, mammalian target of rapamycin, S6K, regulatory factors for cell survival, and of phosphorylated nuclear factor κB, an inflammatory mediator, were higher in endometriosis-like grafts from the uOVX group than from the control. The grafts were mostly comprised of stromal cells. The bioactivity of α1-AT was assessed by investigating cytokine expression in protease-activated receptor (PAR) 1/2 agonists-stimulated stromal cells. The PARs promoted the expression of interleukin 8 (IL-8), but treatment with α1-AT blocked IL-8 expression dose dependently. Knocking down α1-AT expression increased the constitutive IL-6, IL-8, and cyclooxygenase 2 expression as well as PAR1 agonist-stimulated IL-6 expression. These findings support the notion that decreased α1-AT protein in the grafts constituted with human endometrial cells in mice may have exacerbated inflammation in endometriosis-like grafts, suggesting the possible involvement of α1-AT in the pathophysiology of endometriosis.

  6. Exceptional cause of bowel obstruction: rectal endometriosis mimicking carcinoma of Rectum - a case report

    Directory of Open Access Journals (Sweden)

    Selim Sassi

    2011-11-01

    Full Text Available Endometriosis with intestinal serosal involvement is not uncommon in women of childbearing age. However, endometriosis presenting as colon obstruction is rare and occurs in less than 1% of cases. The Lack of pathognomonic signs makes the diagnosis difficult, mostly because the main differential diagnosis is with neoplasm, even during the intervention. Reported here is a case of a 35-year �old woman presenting with bowel obstruction due to rectal endometriosis. The patient presented signs and symptoms of bowel obstruction. Colonoscopy and radiological findings were suggestive of rectal carcinoma. Surgeons performed an anterior resection with right salpingectomy. Histopathology diagnosed bowel endometriosis. This case demonstrates the difficulty of establishing an accurate pre- and intra- operative diagnosis and the ability of intestinal endometriosis to mimic colon cancer.

  7. The influence of endometriosis-related symptoms on work life and work ability

    DEFF Research Database (Denmark)

    Hansen, Karina E; Kesmodel, Ulrik S; Baldursson, Einar Baldvin

    2013-01-01

    Abstract Objective Little is known about the implications of endometriosis on women's work life. This study aimed at examining the relation between endometriosis-related symptoms and work ability in employed women with endometriosis. Study design In a cohort study, 610 patients with diagnosed...... ability. The level of statistical significance was set at pwork disturbances due to symptoms, lower work ability and a wide number of other implications on work life in employed women...... endometriosis and 751 reference women completed an electronic survey based on the Endometriosis Health Profile 30-questionnaire and the Work Ability Index (short form). Percentages were reported for all data. Binary and multivariate logistic regression analyses were used to assess risk factors for low work...

  8. Insulin-like growth factor II gene Apa I polymorphism is not associated with endometriosis susceptibility

    Directory of Open Access Journals (Sweden)

    Yao-Yuan Hsieh

    2004-01-01

    Full Text Available Insulin-like growth factor II (IGF2 has been shown to play a role in abnormal cell growth and carcinogenesis. We investigated if the IGF2 gene Apa I polymorphism at exon 9 was associated with the susceptibility to endometriosis, analyzing 120 women with moderate/severe endometriosis and 103 controls. The genotype frequencies did not differ statistically between the endometriosis (aa = 25.4, ab = 57.4, bb = 17.2% and control (aa = 20.8 ab = 52.8, bb = 26.4% groups. The allele frequencies did not differ either: a = 54.1, b = 45.9% among women with endometriosis and a = 47.2, b = 52.8% in the control group. Therefore, no indication was found for an association of this polymorphism with endometriosis susceptibility.

  9. Endometriose de cicatriz cirúrgica: estudo retrospectivo de 72 casos Scar endometriosis: a retrospective study of 72 patients

    Directory of Open Access Journals (Sweden)

    Nilo Sérgio Nominato

    2007-08-01

    Full Text Available OBJETIVO: avaliar a freqüência e fatores associados à endometriose de cicatriz cirúrgica. MÉTODOS: foi realizado estudo observacional, tipo coorte retrospectivo, a partir da revisão de prontuários de pacientes do Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG com diagnóstico anatomopatológico de endometriose de cicatriz cirúrgica, no período de maio de 1978 a dezembro de 2003. RESULTADOS: foram encontrados 72 pacientes com diagnóstico de endometriose de cicatriz. A incidência de endometriose de cicatriz após cesariana foi significativamente maior do que após parto normal (0,2 e 0,06%, respectivamente; pPURPOSE: to identify the incidence and associated factors of surgical scar endometriosis. METHODS: a retrospective cohort observational study performed from the medical records of female patients attended at the Clinical Hospital of Univesidade Federal de Minas Gerais (UFMG with histopathological diagnosis of scar endometriosis from May 1978 to December 2003. RESULTS: a total of 72 patients were included in the study. The incidence of scar endometriosis after cesarean section was significantly higher than after episiotomy (0.2% and 0.06%, respectively; p<0.00001 with relative risk of 3.3. The women’s age, when diagnosed, ranged from 16 to 48 years old, (mean=30.8 years old. The scar location varied according to the previous surgery: 46 scars after cesarean sections, one after hysterectomy and one after abdominal surgery (48 lesions in the abdominal wall; 19 scars after episiotomy, one because of relapse and two after pelvic floor surgeries (22 pelvic wounds; two women had not been submitted to previous gynecological surgery (one umbilical endometrioma and one lesion in the posterior vaginal wall. Pain was the most frequent symptom (80%, followed by a node (79% and, in more than 40%, the pain and the node suffered modification with menstruation. Other less frequent complaints were: dyspareunia, secondary

  10. Correlation between aromatase expression in the eutopic endometrium of symptomatic patients and the presence of endometriosis

    Directory of Open Access Journals (Sweden)

    Maia Jr H

    2012-02-01

    Full Text Available Hugo Maia Jr1,2, Clarice Haddad1,2, Julio Casoy11CEPARH, 2Itaigara Memorial Day Hospital, Salvador, Bahia, BrazilObjective: To investigate whether aromatase expression in the eutopic endometrium correlates with the presence and severity of endometriosis in patients with infertility and/or dysmenorrhea undergoing laparoscopy and hysteroscopy.Patients: The study involved 106 patients of reproductive age with symptoms of dysmenorrhea and infertility. Sixteen endometriosis-free asymptomatic patients were used as a control group.Methods: Concomitant laparoscopy and hysteroscopy was carried out in all cases. An endometrial biopsy was taken to determine aromatase p450 expression by immunohistochemistry. Endometriosis was staged according to the American Society of Reproductive Medicine classification.Results: Endometriosis was diagnosed by laparoscopy in 92/106 symptomatic patients. In this group, aromatase expression was detected in the eutopic endometrium of 66/92 patients with endometriosis (72% and in 13/14 (95% patients in the symptomatic, endometriosis-free group (P = 0.09. Aromatase expression was not detected in any patients from the control group. In the endometriosis group, aromatase expression was detected in the eutopic endometrium of 28/45 patients (62% with American Society of Reproductive Medicine classification stage 1 of the disease, in 11/14 patients (78% with stage II, 14/20 patients (70% with stage III, and in 12/13 patients (92% with stage IV; however, the difference was only statistically significant between stages I and IV (P = 0.04.Conclusion: Aromatase expression in the endometrium was associated with the presence of dysmenorrhea and infertility irrespective of the presence of endometriosis. When endometriosis was present, however, there was a tendency for aromatase expression to be positively correlated with dysmenorrhea severity.Keywords: aromatase, endometrium, endometriosis, Cox-2, dysmenorrhea

  11. Glutathione S-transferase M1 and T1 genotypes and endometriosis risk: a case-controlled study

    Institute of Scientific and Technical Information of China (English)

    林俊; 张信美; 钱羽力; 叶英辉; 石一复; 徐开红; 徐键云

    2003-01-01

    Objective To investigate the correlation between glutathione S-transferase (GST) M1 and T1 genotypes and endometriosis risk (EM). Methods Polymerase chain reaction (PCR) technique was used to detect the presence or absence of the GSTM1 and GSTT1 genes in genomic DNA isolated from the blood samples of 68 Han Chinese women with endometriosis and 28 without endometriosis. Results The frequencies of GSTM1 and GSTT1 null genotypes in women with endometriosis were 0.721 (49/68) and 0.779 (53/68), respectively, and in women without endometriosis were 0.429 (12/28) and 0.321 (9/28), respectively. There was a significant difference with regard to the frequencies of GSTM1 and GSTT1 null genotypes between the women with and without endometriosis (P0.05). Conclusion GSTM1 and GSTT1 null genotypes may be risk factors for the development of endometriosis.

  12. CONFIRMATION OF CIRCUMSTELLAR PHOSPHINE

    Energy Technology Data Exchange (ETDEWEB)

    Agúndez, M.; Cernicharo, J. [Instituto de Ciencia de Materiales de Madrid, CSIC, C/ Sor Juana Inés de la Cruz 3, E-28049 Cantoblanco (Spain); Decin, L. [Sterrenkundig Instituut Anton Pannekoek, University of Amsterdam, Science Park 904, NL-1098 Amsterdam (Netherlands); Encrenaz, P. [LERMA, Observatoire de Paris, 61 Av. de l' Observatoire, F-75014 Paris (France); Teyssier, D. [European Space Astronomy Centre, Urb. Villafranca del Castillo, P.O. Box 50727, E-28080 Madrid (Spain)

    2014-08-01

    Phosphine (PH{sub 3}) was tentatively identified a few years ago in the carbon star envelopes IRC +10216 and CRL 2688 from observations of an emission line at 266.9 GHz attributable to the J = 1-0 rotational transition. We report the detection of the J = 2-1 rotational transition of PH{sub 3} in IRC +10216 using the HIFI instrument on board Herschel, which definitively confirms the identification of PH{sub 3}. Radiative transfer calculations indicate that infrared pumping in excited vibrational states plays an important role in the excitation of PH{sub 3} in the envelope of IRC +10216, and that the observed lines are consistent with phosphine being formed anywhere between the star and 100 R {sub *} from the star, with an abundance of 10{sup –8} relative to H{sub 2}. The detection of PH{sub 3} challenges chemical models, none of which offer a satisfactory formation scenario. Although PH{sub 3} holds just 2% of the total available phosphorus in IRC +10216, it is, together with HCP, one of the major gas phase carriers of phosphorus in the inner circumstellar layers, suggesting that it could also be an important phosphorus species in other astronomical environments. This is the first unambiguous detection of PH{sub 3} outside the solar system, and is a further step toward a better understanding of the chemistry of phosphorus in space.

  13. Confirmation of circumstellar phosphine

    CERN Document Server

    Agundez, M; Decin, L; Encrenaz, P; Teyssier, D

    2014-01-01

    Phosphine (PH3) was tentatively identified a few years ago in the carbon star envelopes IRC+10216 and CRL2688 from observations of an emission line at 266.9 GHz attributable to the J=1-0 rotational transition. We report the detection of the J=2-1 rotational transition of PH3 in IRC+10216 using the HIFI instrument on board Herschel, which definitively confirms the identification of PH3. Radiative transfer calculations indicate that infrared pumping to excited vibrational states plays an important role in the excitation of PH3 in the envelope of IRC+10216, and that the observed lines are consistent with phosphine being formed anywhere between the star and 100 R* from the star, with an abundance of 1e-8 relative to H2. The detection of PH3 challenges chemical models, none of which offers a satisfactory formation scenario. Although PH3 locks just 2 % of the total available phosphorus in IRC+10216, it is together with HCP, one of the major gas phase carriers of phosphorus in the inner circumstellar layers, suggest...

  14. Endometriose de septo retovaginal: doença de diagnóstico e tratamento específicos Rectovaginal septum endometriosis: a disease with specific diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Mauricio Simões Abrão

    2003-09-01

    Full Text Available RACIONAL: O envolvimento do septo retovaginal, reto e sigmóide pela endometriose pode causar sintomas intensos como dismenorréia, dor pélvica, dispareunia de profundidade, tenesmo e proctorragia cíclicos, em mulheres em idade reprodutiva. O diagnóstico pode ser suspeitado diante da história clínica típica e exame ginecológico adequado, ou ainda através de exame retal, enema opaco ou colonoscopia, entre outros. As indicações cirúrgicas, em geral, estão relacionadas à intensidade dos sintomas e falha no tratamento conservador. No entanto, o tratamento de escolha, para este tipo de endometriose, é a ressecção cirúrgica do tecido acometido, a fim de aliviar os sintomas e evitar progressão da doença. A localização correta assim como a avaliação da presença de extensão do processo em direção ao reto, ligamentos uterossacros ou septo retovaginal é extremamente importante para se garantir um tratamento cirúrgico eficaz. OBJETIVO: Descrever os principais aspectos relacionados à endometriose de septo retovaginal e fornecer aos cirurgiões gerais algumas informações específicas sobre esta enigmática doença. CONCLUSÃO: A endometriose de septo retovaginal é doença freqüente, de diagnóstico e tratamento específicos.BACKGROUND: The involvement of the rectovaginal septum, of rectum and sigmoid by endometriosis leads to intense symptoms as dysmenorrhea, pelvic pain, deep dyspareunia, tenesmus and hematochezia in young and middle aged women during periods. The diagnosis can be made by tipycal history and vaginal examination, rectal examination, barium enema, proctoscopy and so on. The indications of operation include severe clinic symptoms and failed conservative therapy. The treatment of choice for this type of endometriosis is the surgical resection of affected tissue, in order to relieve patient symptoms, and avoid disease progression. The correct assessment as to the presence and extension of the endometriosis

  15. Clinical Effectiveness of Modified Laparoscopic Fimbrioplasty for the Treatment of Minimal Endometriosis and Unexplained Infertility

    Directory of Open Access Journals (Sweden)

    Sarah E. Franjoine

    2015-01-01

    Full Text Available Objective. To study the reproductive outcomes of modified laparoscopic fimbrioplasty (MLF, a surgical technique designed to increase the working surface area of the fimbriated end of the fallopian tube. We postulated that an improvement in fimbrial function through MLF will improve reproductive outcomes. Design. Retrospective cohort study. Setting. Academic tertiary-care medical center. Patients. Women with minimal endometriosis or unexplained infertility, who underwent MLF during diagnostic laparoscopy (n=50 or diagnostic laparoscopy alone (n=87. Intervention. MLF involved gentle, circumferential dilatation of the fimbria and lysis of fimbrial adhesions bridging the fimbrial folds. Main Outcome Measures. The primary outcome was pregnancy rate and the secondary outcome was time to pregnancy. Results. The pregnancy rate for the MLF group was 40.0%, compared to 28.7% for the control group. The average time to pregnancy for the MLF group was 13 weeks, compared to 18 weeks for the control group. The pregnancy rate in the MLF group was significantly higher for patients ≤35 ys (51.5% versus 28.8%, but not for those >35 ys (17.6% versus 28.6%. Conclusion. MLF was associated with a significant increase in pregnancy rate for patients ≤35 ys.

  16. Endometriosis-associated infertility: GDF-9, AMH, and AMHR2 genes polymorphisms.

    Science.gov (United States)

    De Conto, Emily; Matte, Úrsula; Bilibio, João Paolo; Genro, Vanessa Krebs; Souza, Carlos Augusto; Leão, Delva Pereira; Cunha-Filho, João Sabino

    2017-08-22

    The purpose of this paper is to determine whether there is a correlation between polymorphisms in the growth differentiation factor-9 (GDF-9) gene and anti-Müllerian hormone (AMH) gene and its receptor, AMHR2, and endometriosis-associated infertility. This is a case-control study to evaluate whether there is a correlation between polymorphisms in the GDF-9 gene (SNPs determined by direct sequencing), AMH gene, AMHR2 (both SNPs determined by genotyping using TaqMan Allelic Discrimination), and endometriosis-associated infertility. The study included 74 infertile women with endometriosis and 70 fertile women (tubal ligation) as a control group. Patient age and the mean FSH levels were similar between the infertile with endometriosis and fertile without endometriosis groups. The frequency of genotypes between the groups for GDF-9 gene polymorphisms did not show statistical significance, nor did the AMHR2 gene polymorphism. However, the AMH gene polymorphism did show statistical significance, relating the polymorphic allele with infertility in endometriosis. We demonstrate that an SNP in the AMH gene is associated with infertility in endometriosis, whereas several SNPs in the GDF-9 gene and the - 482A G SNP in the AMHR2 gene were found to be unrelated.

  17. Mechanism of Elevated Vascular Endothelial Growth Factor Levels in Peritoneal Fluids from Patients with Endometriosis

    Institute of Scientific and Technical Information of China (English)

    刘义; 吕立群

    2004-01-01

    In order to investigate the mechanism of elevated vascular endothelial growth factor (VEGF) in peritoneal fluids from patients with endometriosis, macrophages were recovered from peritoneal fluids obtained at the time of diagnostic laparoscopy from infertile women with endometriosis (EMT group, n = 20) and without endometriosis (control group, n = 20). Macrophages were cultured in vitro. The VEGF levels of peritoneal fluid and the supernatant of macrophages culture were determined by enzyme linked immunoassay (ELISA). Meanwhile, the eutopic (n = 20) and ectopic endometrium (n=20) from endometriosis patients, and normal edometrium (n=20) from non-endometriosis patients were obtained for the analysis of VEGF expression by labeled Streptavidin Biotin (LSAB). It was found that VEGF levels in peritoneal fluid and macrophages culture supernatant were significantly higher in EMT group than in control group (P<0.01). In normal endometrium, VEGF showed a cyclic changes and similar in eutopic and ectopic endometrium from patients with endometriosis. There was no difference in the intensity of VEGF in endometrium between two groups within each menstrual phase. It is suggested that altered VEGF production by peritoneal macrophages and ectopic endometrium secretion may contribute to the elevated VEGF levels in the peritoneal fluid of patients with endometriosis.

  18. Perfluoroalkyl substances and endometriosis in US women in NHANES 2003-2006.

    Science.gov (United States)

    Campbell, Stephanie; Raza, Masooma; Pollack, Anna Z

    2016-10-01

    Exposure to endocrine-active perfluoroalkyl substances (PFASs), is nearly ubiquitous, but data on the association between PFASs and endometriosis diagnosis are limited. We aimed to examine the relationship between PFASs and endometriosis. Women aged 20-50 years from the National Health and Nutrition Examination Survey (2003-2006) were selected (n=753). Serum PFAS levels were measured and endometriosis status was determined by self-report of doctor diagnosis. Weighted survey sampling logistic regression was used. Women reporting endometriosis were older (39.4 vs. 33.7 years), and more likely to be non-Hispanic white. Geometric mean levels of perfluorononanoic acid (PFNA), perfluorooctanoic acid (PFOA), and perfluorooctane sulfonate (PFOS) were significantly higher among women reporting endometriosis. Endometriosis was associated with select quartiles of PFOA, PFNA, and PFOS. Sensitivity analyses had similar results but wider confidence intervals. These findings suggest that PFOA, PFNA, and PFOS may be of interest in future studies with improved endometriosis diagnostic criteria and prospectively measured exposure.

  19. Expression of TWEAK on the Ectopic and Eutopic Endometrium from Women with Endometriosis

    Institute of Scientific and Technical Information of China (English)

    Qian PENG; Jin ZHU

    2008-01-01

    Objective To investigate the relationship between Tumor necrosis factor (TNF)-like weak inducer of apoptosis(TWEAK) and endometriosis. Methods TWEAK mRNA and protein concentrations in paired samples of eutopic endometrial tissue from women with and without endometriosis,and also of ectopic endometrial tissue from women with endometriosis were measured by Real time PCR,immunohistochemistry and Western blotting,respectively. Results Compared with control endometrium from women without endometriosis and eutopic endometrium from women with endometriosis.TWEAK expressions were reduced on the ectopic endometrium f P<0.05).Moreover,the expressions of TWEAK mRNA on eutopic endometrium and control endometrium in proliferative phase were much lower than those in secretory phase.TWEAK protein was expressed in the cytoplasm of glandular cells and stromal cells of endometrium. Conclusion TWEAK is expressed on the endometrium of reproductive women,and its concentration rises in secretory phase,compared with that in proliferative phase.Patients with endometriosis had a lower expression of TWEAK on ectopic endometrium,which may lead to a decreased level of apoptosis on endometrial cells.Consequently,endometrial cells were able to survive outside uterus helping the development of endometriosis.

  20. Women with endometriosis have higher comorbidities: Analysis of domestic data in Taiwan

    Directory of Open Access Journals (Sweden)

    Sen-Wen Teng

    2016-11-01

    Full Text Available Endometriosis, defined by the presence of viable extrauterine endometrial glands and stroma, can grow or bleed cyclically, and possesses characteristics including a destructive, invasive, and metastatic nature. Since endometriosis may result in pelvic inflammation, adhesion, chronic pain, and infertility, and can progress to biologically malignant tumors, it is a long-term major health issue in women of reproductive age. In this review, we analyze the Taiwan domestic research addressing associations between endometriosis and other diseases. Concerning malignant tumors, we identified four studies on the links between endometriosis and ovarian cancer, one on breast cancer, two on endometrial cancer, one on colorectal cancer, and one on other malignancies, as well as one on associations between endometriosis and irritable bowel syndrome, one on links with migraine headache, three on links with pelvic inflammatory diseases, four on links with infertility, four on links with obesity, four on links with chronic liver disease, four on links with rheumatoid arthritis, four on links with chronic renal disease, five on links with diabetes mellitus, and five on links with cardiovascular diseases (hypertension, hyperlipidemia, etc.. The data available to date support that women with endometriosis might be at risk of some chronic illnesses and certain malignancies, although we consider the evidence for some comorbidities to be of low quality, for example, the association between colon cancer and adenomyosis/endometriosis. We still believe that the risk of comorbidity might be higher in women with endometriosis than that we supposed before. More research is needed to determine whether women with endometriosis are really at risk of these comorbidities.

  1. The follicular and endocrine environment in women with endometriosis: local and systemic cytokine production.

    Science.gov (United States)

    Pellicer, A; Albert, C; Mercader, A; Bonilla-Musoles, F; Remohí, J; Simón, C

    1998-09-01

    To assess the endocrine, paracrine, and autocrine milieu in patients with endometriosis on the basis of the measurement of several cytokines in serum and follicular fluid (FF) and in vitro culture of granulosa luteal cells. Case-control study. In vitro fertilization program at the Instituto Valenciano de Infertilidad. Twenty patients with laparoscopically documented endometriosis and 18 controls. Fifteen subjects were studied in a natural cycle and 23 were investigated in a stimulated cycle while undergoing IVF. Individual follicle aspiration, oocyte isolation, FF storage, and preparation of luteinized granulosa cell cultures. Diagnostic laparoscopy in natural cycles. Serum (day of ovum pick-up or laparoscopy) and FF measurement of interleukin (IL)-1beta, IL-6, and vascular endothelial growth factor (VEGF). Secretion of IL-1beta, IL-6, and VEGF in the cell-conditioned medium. Results were compared between patients with endometriosis and controls. Interleukin-6 levels in serum were increased in the natural cycles of patients with endometriosis and modulated by ovarian stimulation, showing a significant decrease in hMG- and FSH-stimulated cycles and a significant increase after hCG administration. In addition, IL-6 levels were increased in the FF of patients with endometriosis and released in higher amounts by their granulosa luteal cells. Vascular endothelial growth factor was accumulated in lesser concentrations in the FF of patients with endometriosis. Interleukin-1beta levels did not show significant changes. Implantation rates were decreased significantly in patients with endometriosis who were undergoing IVF. The data demonstrate that cytokines are regulated differently in patients with endometriosis, who have increased IL-6 production, and suggest that fine hormonal modulation of this cytokine occurs at the systemic and local (ovarian) levels. These changes show that the endocrine, paracrine, and autocrine milieu is different in patients with endometriosis and

  2. Women with endometriosis have higher comorbidities: Analysis of domestic data in Taiwan.

    Science.gov (United States)

    Teng, Sen-Wen; Horng, Huann-Cheng; Ho, Chi-Hong; Yen, Ming-Shyen; Chao, Hsiang-Tai; Wang, Peng-Hui

    2016-11-01

    Endometriosis, defined by the presence of viable extrauterine endometrial glands and stroma, can grow or bleed cyclically, and possesses characteristics including a destructive, invasive, and metastatic nature. Since endometriosis may result in pelvic inflammation, adhesion, chronic pain, and infertility, and can progress to biologically malignant tumors, it is a long-term major health issue in women of reproductive age. In this review, we analyze the Taiwan domestic research addressing associations between endometriosis and other diseases. Concerning malignant tumors, we identified four studies on the links between endometriosis and ovarian cancer, one on breast cancer, two on endometrial cancer, one on colorectal cancer, and one on other malignancies, as well as one on associations between endometriosis and irritable bowel syndrome, one on links with migraine headache, three on links with pelvic inflammatory diseases, four on links with infertility, four on links with obesity, four on links with chronic liver disease, four on links with rheumatoid arthritis, four on links with chronic renal disease, five on links with diabetes mellitus, and five on links with cardiovascular diseases (hypertension, hyperlipidemia, etc.). The data available to date support that women with endometriosis might be at risk of some chronic illnesses and certain malignancies, although we consider the evidence for some comorbidities to be of low quality, for example, the association between colon cancer and adenomyosis/endometriosis. We still believe that the risk of comorbidity might be higher in women with endometriosis than that we supposed before. More research is needed to determine whether women with endometriosis are really at risk of these comorbidities.

  3. Disrupted cell cycle control in cultured endometrial cells from patients with endometriosis harboring the progesterone receptor polymorphism PROGINS.

    Science.gov (United States)

    D'Amora, Paulo; Maciel, Thiago Trovati; Tambellini, Rodrigo; Mori, Marcelo A; Pesquero, João Bosco; Sato, Helio; Girão, Manoel João Batista Castello; Guerreiro da Silva, Ismael Dale Cotrim; Schor, Eduardo

    2009-07-01

    Presently, little is understood about how endometriosis is established or maintained, or how genetic factors can predispose women to the disease. Because of the crucial role that the progesterone receptor polymorphism PROGINS plays in predisposing women to the development of endometriosis, we hypothesized that this variant may influence critical steps during endometrial cell metabolism that are involved in the pathogenesis of endometriosis. Eutopic endometria were collected from three sources: women with endometriosis who had a single PROGINS allele (from the progesterone receptor gene); women with endometriosis who had the wild-type progesterone receptor allele; and women without endometriosis who had the wild-type allele. Cells prepared from the eutopic endometria of these women were stimulated with both estradiol and progesterone, and then examined for cell proliferation, viability, and apoptosis. The cells from women with endometriosis that carried the PROGINS allele demonstrated increased proliferation, greater viability, and decreased apoptosis following progesterone treatment. In general, these parameters were very different as compared with those of women with endometriosis but without the PROGINS allele and women in the control group. This result indicates there is a reduced level of progesterone responsiveness in women who carry the PROGINS polymorphism. Because progesterone responsiveness is known to be an important characteristic of women with endometriosis, these data support the contention that the PROGINS polymorphism enhances the endometriosis phenotype.

  4. Current Status of Integral Medical Study on Endometriosis

    Institute of Scientific and Technical Information of China (English)

    YU Chao-qin (俞超芹); YU Jin (俞瑾)

    2003-01-01

    @@ Endometriosis (EM), an estrogen dependent disease that comes from the planting of endometrial gland and stroma outside the uterine cavity, is characterized by invasiveness, wide planting and liability to relapse. It has been proved by recent studies that the pathogenesis of EM has its genetic background and is closely related with neuro-, endocrino- and immuno-factors. There has been great progress in the treatment of EM, but the clinical effect is not yet satisfactory. Traditional Chinese medicine (TCM) has definitely played its role in EM treatment. In this article, the current status of integral medical study on EM is reviewed.

  5. Umbilical endometriosis mimicking as papilloma to general surgeons: A case report

    Directory of Open Access Journals (Sweden)

    A Singh

    2012-05-01

    Full Text Available IntroductionCutaneous or umbilical endometriosis is a rare entity that isoften overlooked because of chronic abdominal pain. Wepresent a case of umbilical hernia that presented to thegeneral surgeons due to chronic abdominal pain and nodulein the umbilicus, which was clinically diagnosed as umbilicalpapilloma.Case presentationA 48-year old multiparous Caucasian woman presented withpainful nodule in the umbilicus for two and half years. Thenodule was excised and the histopathological diagnosis wasumbilicus endometriosis.ConclusionUmbilical endometriosis is a very rare disease but should beconsidered as a differential diagnosis in women presentingwith umbilical swelling.

  6. The Impact of Endometriosis across the Lifespan of Women: Foreseeable Research and Therapeutic Prospects

    Directory of Open Access Journals (Sweden)

    C. L. Hughes

    2015-01-01

    Full Text Available In addition to estrogen dependence, endometriosis is characterized by chronic pelvic inflammation. The impact of the chronic pelvic inflammatory state on other organ systems and women’s health is unclear. Endometriosis associated chronic inflammation and potential adverse health effects across the lifespan render it imperative for renewed research vigor into the identification of novel biomarkers of disease and therapeutic options. Herein we propose a number of opportunities for research and development of new therapeutics to address the unmet needs in the treatment of endometriosis per se and its ancillary risks for other diseases in women across the lifespan.

  7. Endometrial Stromal Sarcoma Arising in Colorectal Endometriosis: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Qiao Wang

    2015-01-01

    Full Text Available Extrauterine endometrial stromal sarcoma (ESS arising in endometriosis is extremely rare, particularly in the colorectum. It should always be included in the differential diagnosis of primary tumors originating from gastrointestinal tract in females, given that preoperative endoscopical biopsy may reveal no specific changes. We reported a case of ESS arising in colorectal endometriosis and reviewed the previous 7 cases reported in the English literature. Our patient, who was unavailable for tumor resection and refused further adjuvant therapy, played a role in representing the natural history of low-grade extragenital ESS. This case was the only death from ESS arising in colorectal endometriosis.

  8. Progress on macrophage’s proinflammatory products as markers of acute endometriosis

    Institute of Scientific and Technical Information of China (English)

    Alicja Ziętek; Konrad Futyma; Łukasz Nowakowski; Marek Gogacz; Tomasz Rechberger

    2015-01-01

    To provide the review of the macrophage activity products as pathophysiological markers of endometriosis by literature survey (PubMed, Cochrane). Immunoreactive cells and several of their synthesis products concentrations are elevated in the serum and peritoneal fluid in patients with endometriosis.The enhanced reactive proteins contributed to local inflammation and aggregation of endometriotic lesions. Immune response and immune surveillance of tissue play an important role in pathogenesis of endometriosis. Activated macrophages in peritoneal environment secrete immunoreactive cytokines which are responsible for inflammatory cascade of reactions. The immunoreactive cytokines should be a target not only as a disease marker but also as a part of therapeutic protocol.

  9. Relevance of MRI for endometriosis diagnosis; Stellenwert der Magnetresonanztomografie in der Diagnostik der Endometriose

    Energy Technology Data Exchange (ETDEWEB)

    Krueger, Karsten; Behrendt, K.; Balzer, M.; Hoehn, S. [Vivantes Humboldt-Klinikum, Berlin (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Ebert, A.D. [Vivantes Humboldt-Klinikum, Berlin (Germany). Klinik fuer Gynaekologie und Geburtsmedizin

    2011-05-15

    Endometriosis is a disease of the uterus with displacement of endometrium-like tissue outside the endometrium. Endometriosis is a common benign chronic often debilitating disease that primarily affects young woman. The estimated prevalence is about 10 %. In addition to the uterus and ovaries, clinically important localisations are the rectovaginal space, rectum, sigmoid colon, urinary bladder, ureter and peritoneum. The most common localisation outside the pelvis is the abdominal wall. Today, MRI is one of the most important tools in the diagnosis of endometriosis. The detection of peritoneal manifestations and the exact definition of the depth of infiltration in the rectum, sigmoid colon and bladder walls are limitations of MRI. (orig.)

  10. Appearance of abdominal wall endometriosis on MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Busard, Milou P.H.; Kuijk, Cees van; Waesberghe, Jan Hein T.M. van [VU Medical Center, Department of Radiology, Endometriosis Center VUMC, Amsterdam (Netherlands); Mijatovic, Velja; Hompes, Peter G.A. [VU Medical Center, Department of Gynecology, Endometriosis Center, Amsterdam (Netherlands)

    2010-05-15

    Abdominal wall endometriosis (AWE) is defined as endometrial tissue that is superficial to the peritoneum. AWE is often difficult to diagnose, mimicking a broad spectrum of diseases. The aim of this study was to describe the appearance of AWE on magnetic resonance (MR) imaging. We present ten patients with AWE (12 lesions) in which MR imaging was used for diagnosis. MR imaging included T2-weighted imaging and T1-weighted imaging with fat suppression. To assess the value of diffusion-weighted imaging (DWI) in endometriosis, four patients underwent additional DWI. The apparent diffusion coefficient (ADC) was calculated using b values of 50, 400, 800 and 1,200 s/mm{sup 2}. In most cases, the lesion was located ventral or dorsal to the aponeurosis of the rectus oblique muscle (n=6) or in the rectus abdominis (n = 5). MR of AWE lesions showed isointense or slightly hyperintense signal compared with muscle on T2-weighted images and showed isointense or slightly hyperintense signal compared with muscle on T1-weighted images with foci of high signal intensity, indicative of haemorrhage. The mean ADC value of AWE was 0.93 x 10{sup -3}/mm{sup 2}/s. MR imaging seems to be useful in determining the location and depth of infiltration in surrounding tissue preoperatively. (orig.)

  11. Clinical Analysis of 144 Cases of Endometriosis%子宫内膜异位症144例临床预后分析

    Institute of Scientific and Technical Information of China (English)

    苏明兰; 杨法

    2014-01-01

    Objective To investigate the clinical characteristics of patients with endometriosis,treatment and prevention. Methods The clinical data of 144 patients with endometriosis were analyzed,and pelvic pain,dysmenorrhea and infertility patients were fol owed up for 2 to 3 years Phone . Results 144 patients underwent surgery,endometriosis,pelvic pain in patients with the defense team representing 54.5%,34.5%dysmenorrhea,infertility 37.5%,postoperative pelvic pain remission rate of 75.2%,50.5%response rate dysmenorrhea pregnancy rate of 63.5%. Conclusions Clinical features master EM timely surgical treatment after diagnosis is to relieve pelvic pain,dysmenorrhea,infertility effective means to improve the pregnancy rate.%目的:探讨子宫内膜异位症患者的临床特点、治疗方法及预防。方法对144例子宫内膜异位症患者的临床资料进行分析,并对盆腔痛、痛经和不孕患者进行电话随访2~3年。结果144例患者行手术治疗,子宫内膜异位症联防队员患者中盆腔痛占54.5%,痛经占34.5%,不孕占37.5%,术后盆腔痛症状缓解率75.2%,痛经症状缓解率50.5%,妊娠率63.5%。结论掌握EM的临床特点,确诊后及时进行手术治疗是缓解盆腔痛、痛经,提高不孕者妊娠率的有效手段。

  12. [Psychology and sexology are essential, from diagnosis to comprehensive care of endometriosis].

    Science.gov (United States)

    Leroy, A; Azaïs, H; Garabedian, C; Bregegere, S; Rubod, C; Collier, F

    2016-06-01

    Endometriosis, defined by the presence of endometrial tissue outside the uterine cavity, is a common but often under diagnosed pathology. The clinical manifestations are varied (chronic pelvic pain, urinary or gastrointestinal symptoms) and can sometimes be very frustrated, delaying the diagnosis. This delay in diagnosis can be a high source of stress responsible for an important psychological impact in these patients, having a sense of misunderstanding and neglect of the medical profession. This climate of stress and anxiety can cause alteration of behavior including sexual disorders. In addition, endometriosis can be revealed as part of an infertility evaluation, and the patient and the couple can already be affected by this situation. The clinical and psychological impact of endometriosis inevitably leads to an impairment of patient's quality of life and sexuality. The objective of this article is to show the psychological consequences of endometriosis and its impact on sexuality, in order to highlight this essential aspect for a comprehensive care of patients.

  13. Sigmoid colon endometriosis treated with laparoscopy-assisted sigmoidectomy: Significance of preoperative diagnosis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    We present a female patient with sigmoid colon endometriosis who was diagnosed correctly preoperatively and underwent minimally invasive surgery. She was admitted to our hospital with rectal bleeding and constipation. We performed several workups. Colonoscopy and endoscopic ultrasonography showed sigmoid colon stenosis caused by submucosal tumor, and magnetic resonance imaging revealed a sigmoid colon tumor displaying signal hypointensity on both T1- and T2-weighted imaging. However, colonoscopic ultrasonography-assisted needle aspiration biopsy could not specify tumor characteristics. From these examinations, the lesion was diagnosed as sigmoid colon endometriosis and laparoscopy-assisted sigmoidectomy was performed. Pathological diagnosis from the resected specimen was identical to preoperative diagnosis, i.e., colonic endometriosis. Since differential diagnosis of intestinal endometriosis seems difficult, a cautious preoperative diagnosis is required to select treatments including minimally invasive surgery.

  14. The V109G polymorphism in the p27 gene is associated with endometriosis.

    Science.gov (United States)

    Camargo-Kosugi, Cíntia M; da Silva, Ismael D C G; Sato, Hélio; D'Amora, Paulo; Carvalho, Cristina V; Nogueira-de-Souza, Naiara C; Girão, Manoel J C B; Schor, Eduardo

    2009-08-01

    To investigate the prevalence of the p27 gene polymorphism in women with endometriosis. Transversal case-control study. Genomic DNA was extracted from cells collected from buccal swabs. The p27 V109G polymorphism was investigated using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method in a hospital-based Brazilian population. We analysed the 104 patients and 109 control subjects. The distribution of genotype and allele frequencies of p27 V109G polymorphism was significantly different between the endometriosis cases and healthy women (p=0.016 and 0.002). Women who had at least one mutated allele presented twofold chances for endometriosis development (OR=1.9; 95% CI, 1.120-3.343). The polymorphic variant at codon 109 of the p27 gene seems to be associated with higher risk of endometriosis development.

  15. Low prevalence of DNA virus in the human endometrium og endometriosis

    DEFF Research Database (Denmark)

    Vestergaard, Anna Lindeløv; Knudsen, Ulla Breth; Munk, Torben

    2010-01-01

    biopsies and subjected to highly sensitive PCR tests detecting human papillomavirus (HPV) types, the herpes family viruses HSV-1 and -2, CMV, and EBV, and the polyomaviruses SV40, JCV, BKV, KIV, WUV, and MCV. The prevalence of pathogenic DNA viruses in the human endometrium was generally low (0......The chronic female disease endometriosis causes debilitating pain and lowered fertility. The aetiology is unknown, but indications of an infectious agent are present. This study investigates the possible involvement of a pathogenic virus in endometriosis patients and controls. DNA was purified from......–10%). The virus prevalence was found to vary slightly when comparing the endometrium of healthy women and women with endometriosis. However, these were not significant differences, and no viruses were identified in endometriotic lesions. These results do not point towards any evidence that endometriosis is caused...

  16. MR imaging findings of extraovarian endocervical mucinous borderline tumors arising from pelvic endometriosis

    Energy Technology Data Exchange (ETDEWEB)

    Yeo, Dong Myung; Rha, Sung Eun; Byun, Jae Young; Lee, Ahwon; Kim, Mee Ran [Seoul St. Mary' s Hospital, The Catholic University of Korea, Seoul (Korea, Republic of)

    2013-12-15

    We report MR imaging findings of a rare case of endocervical mucinous borderline tumor (MBT) involving the cul-de-sac and left fallopian tube arising from extensive pelvic endometriosis with pathologic correlation in a 35-year-old woman presented with vague pelvic pain. Endocervical MBT is a type of endometriosis-associated carcinoma. Imaging findings of endocervical MBT are unilocular or oligolocular cystic lesions with enhancing mural nodules, which are different from those of the more common intestinal type MBT.

  17. Plasminogen activator inhibitor-1 4G/5G polymorphism in infertile women with and without endometriosis.

    Science.gov (United States)

    Gonçalves-Filho, Rubens P; Brandes, Ariel; Christofolini, Denise M; Lerner, Tatiana G; Bianco, Bianca; Barbosa, Caio P

    2011-05-01

    To evaluate PAI-1 genotypes in a group of infertile women with or without endometriosis and control subjects. Case-control study. Human Reproduction Center of Medicina do ABC Faculty. One hundred and forty infertile women with endometriosis, 64 women with idiopathic infertility and 148 fertile women as control subjects. The PAI-1 4G/5G polymorphism was identified by restriction fragment length polymorphism-polymerase chain reaction. Genotype distribution and allele frequency of the 4G/5G polymorphism of the PAI-1 gene. The frequencies of genotypes 4G/4G, 4G/5G and 5G/5G of the PAI-1 gene in the infertile women with endometriosis were 38.6, 37.1 and 24.3%, respectively, and in the control group 24.3, 33.8 and 41.9%, respectively (p=0.003). When the infertile women with endometriosis were divided according to their endometriosis stage, genotypes 4G/4G, 4G/5G and 5G/5G were identified, respectively, in 36.7, 32.9 and 30.4% of the patients with minimal/mild endometriosis (p=0.102) and in 41.0, 42.6 and 16.4% of the patients with moderate/severe endometriosis (p=0.001); in the women with idiopathic infertility, these genotypes were found at a frequency of 29.7, 34.3 and 36%, respectively (p=0.637). The data suggest that, in Brazilian women, the PAI-1 4G/5G polymorphism may be associated with a risk of endometriosis-associated infertility. © 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.

  18. Magnetic resonance imaging of endometriosis of the piriform muscle causing sciatica: case report

    Energy Technology Data Exchange (ETDEWEB)

    Hickey, N.A.J.; Murphy, J.P.; Bloom, C.; Hamilton, P. [Sunnybrook and Women' s College Health Sciences Centre, Dept. of Medical Imaging, Toronto, Ontario (Canada)

    1999-02-01

    Endometriosis is the presence of functioning endometrial tissue in a location outside the uterus and is a rare cause of sciatica. The superior soft-tissue contrast and sensitivity of magnetic resonance imaging (MRI) in detecting blood products make it a valuable imaging modality in patients with pelvic endometriosis. In the case described below, it allowed a presumptive diagnosis to be made and the response to medical therapy to be monitored. (author)

  19. Mixed endometrioid and serous carcinoma developing in abdominal wall endometriosis following Cesarean section

    Energy Technology Data Exchange (ETDEWEB)

    Da Ines, David; Montoriol, Pierre Francois; Petitcolin, Virginie; Garcier, Jean-Marc (Dept. of Radiology and Medical Imaging, CHU Clermont-Ferrand, CHU Estaing, Clermont-Ferrand (France)), email: ddaines@chu-clermontferrand.fr; Bourdel, Nicolas; Canis, Michel (Dept. of Obstetrics and Gynecology, CHU Clermont-Ferrand, CHU Estaing, Clermont-Ferrand (France)); Charpy, Cecile (Dept. of Pathology, CHU Clermont-Ferrand, CHU Estaing, Clermont-Ferrand (France))

    2011-06-15

    Abdominal wall endometriosis is unusual and mostly occurs in scars following Cesarean section. Although malignant transformation is rare, it must be recognized in order to benefit from radical resection. We report a very rare case of mixed endometrioid and serous carcinoma developing in a Cesarean section endometriosis scar and the way we managed it using surgery and chemotherapy. 18-FDG PET-CT imaging was performed to correctly stage the disease

  20. Decidualized Endometriosis Causing Inversion of the Appendix, Massive Hemorrhage and Fetal Death

    Directory of Open Access Journals (Sweden)

    Anthony M Magliocco

    1991-01-01

    Full Text Available An extraordinary case of inversion of the appendix due to decidualized endometriosis is reported. A 35-year-old woman presented at 3 7 weeks of pregnancy with acute massive rectal hemorrhage and fetal death. A limited right hemicolectomy was performed. The cecum contained an inverted appendix with an ulcerated tip. Histologically there was decidualized endometriosis in the ulcer bed and in all layers of the appendiceal wall.

  1. Tumor necrosis factor gene polymorphisms and endometriosis in Asians: a systematic review and meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Lyu Jiangtao; Yang Hua; Lang Jinghe; Tan Xianjie

    2014-01-01

    Background Numerous studies have described the association between polymorphisms in the tumor necrosis factor (TNF) gene and risk of endometriosis.However,the results remain controversial.Here we reviewed studies reporting the association between TNF gene polymorphisms and endometriosis risk in Asians.Methods PubMed and Embase were searched.Twelve case-control studies assessing the role of multiple TNF gene polymorphisms in endometriosis were included.If no less than two articles evaluated one variant,meta-analysis was conducted; otherwise,narrative analysis was chosen.A fixed-or random-effects model was employed according to the heterogeneity among studies.The strength of the association between TNF gene polymorphisms and endometriosis risk was assessed by odds ratios and 95% confidence intervals.Results For TNF-α-238G>A,-308G>A,-857C>T,and-863C>A,no significant associations were identified from all genetic models.For TNF-α-850T>C,results from one study showed that patients harboring the heterozygote TC were less susceptible to endometriosis than patients harboring the homozygote TT.For TNF-α-1031T>C,a mild increase in endometriosis risk was found in the Asian population.Meta-analysis from two studies found that the TNF-β +252>G polymorphism had a protective effect in Chinese individuals.Due to the limitations of the included studies,it is necessitated to perform more studies to elucidate the possible roles of TNF gene polymorphisms in the pathogenesis of endometriosis.Conclusions TNF-α-1031T>C and TNF-β +252A>G were significantly associated with the risk of endometriosis in Asian and Chinese populations,respectively.To further evaluate these associations,more large-scale,rigorously designed studies are needed.

  2. Endometriosis and its global research architecture: an in-depth density-equalizing mapping analysis.

    Science.gov (United States)

    Brüggmann, Dörthe; Elizabeth-Martinez, Alexandra; Klingelhöfer, Doris; Quarcoo, David; Jaque, Jenny M; Groneberg, David A

    2016-09-21

    Endometriosis is one of the most common gynecological diseases. It is still a chameleon in many aspects and urges intense research activities in the fields of diagnosis, therapy and prevention. Despite the need to foster research in this area, no in-depth analysis of the global architecture of endometriosis research exists yet. We here used the NewQIS platform to conduct a density equalizing mapping study, using the Web of Science as database with endometriosis related entries between 1900 and 2009. Density equalizing maps of global endometriosis research encompassing country-specific publication activities, and semi-qualitative indices such as country specific citations, citation rates, h-Indices were created. In total, 11,056 entries related to endometriosis were found. The USA was leading the field with 3705 publications followed by the United Kingdom (952) and Japan (846). Concerning overall citations and country-specific h-Indices, the USA again was the leading nation with 74,592 citations and a modified h-Index of 103, followed by the UK with 15,175 citations (h-Index 57). Regarding the citation rate, Sweden and Belgium were at top positions with rates of 22.46 and 22.26, respectively. Concerning collaborative studies, there was a steep increase in numbers present; analysis of the chronological evolution indicated a strong increase in international collaborations in the past 10 years. This study is the first analysis that illustrates the global endometriosis research architecture. It shows that endometriosis research is constantly gaining importance but also underlines the need for further efforts and investments to foster research and ultimately improve endometriosis management on a global scale.

  3. Diffuse panbronchiolitis with histopathological confirmation among Chinese

    Institute of Scientific and Technical Information of China (English)

    谢广顺; 李龙芸; 刘鸿瑞; 张伟宏; 朱元珏

    2004-01-01

    Background Diffuse panbronchiolitis (DPB) was originally and is still primarily reported in Japan, rarely in other countries. As macrolide therapy is effective for this disease with once dismal prognosis, familiarity with its clinical features is urgently needed, especially for clinicians outside Japan. The objectives of this study were to investigate the clinical features of DPB in a Chinese population and propose diagnostic procedures that will lead to increased awareness of this treatable disease among clinicians, ultimately allowing for more rapid diagnosis. Methods After a literature review, the clinical features of DPB were histopathologically confirmed in a series of 9 cases either by open lung biopsy or video-assisted thoracic surgical biopsy, resulting in the largest series of confirmed DPB cases in a non-Japanese population. Here, the cases are retrospectively described and diagnostic procedures are discussed.Conclusions Although its clinical features may vary with disease course and ethnic populations, most cases of DPB can be diagnosed or suggested according to clinical diagnostic criteria. However, underdiagnosis as a result of unfamiliarity with its clinical features and diagnostic criteria prevails. If difficulty in diagnosis arises, the diagnosis should be based on clinicopathological features and the exclusion of other diseases. Few cases can be confirmed by transbronchial biopsies; in these cases, either an open-lung biopsy or a video-assisted thoracic surgical lung biopsy should be recommended.

  4. 'Money for nothing'. The role of robotic-assisted laparoscopy for the treatment of endometriosis.

    Science.gov (United States)

    Berlanda, Nicola; Frattaruolo, Maria Pina; Aimi, Giorgio; Farella, Marilena; Barbara, Giussy; Buggio, Laura; Vercellini, Paolo

    2017-10-01

    Despite higher costs for robotic-assisted laparoscopy (RAL) than standard laparoscopy (SL), RAL treatment of endometriosis is performed without established indications. PubMed/MEDLINE was searched for 'robotic surgery' and 'endometriosis' or 'gynaecological benign disease' from January 2000 to December 2016. Full-length studies in English reporting original data were considered. Among 178 articles retrieved, 17 were eligible: 11 non-comparative (RAL only) and six comparative (RAL versus SL). Non-comparative studies included 445 patients. Mean operating time, blood loss and hospital stay were 226 min, 168 ml and 4 days. Major complications and laparotomy conversions were 3.1% and 1.3%. Eight studies reported pain improvement at 15-month follow-up. Comparative studies were all retrospective; 749 women underwent RAL and 705 SL. Operating time was longer for RAL in five studies. Major complications and laparotomy conversions for RAL and SL were 1.5% versus 0.3% and 0.3% versus 0.5%. One study reported pain reduction for RAL at 6-month follow-up. RAL treatment of endometriosis did not provide benefits over SL, overall and among subgroups of women with severe endometriosis, peritoneal endometriosis and obesity. Available evidence is low-quality, and data regarding long-term pain relief and pregnancy rates are lacking. RAL treatment of endometriosis should be performed only within controlled studies. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  5. Treatment of infertility associated with deep endometriosis: definition of therapeutic balances.

    Science.gov (United States)

    Somigliana, Edgardo; Garcia-Velasco, Juan Antonio

    2015-10-01

    Deep endometriosis is a demanding condition that is associated with infertility. However, evidence supporting a direct link between deep endometriosis and infertility is weak. In fact, infertility in affected patients is more likely to be explained by the strong association between deep endometriosis and adhesions, superficial endometriotic implants, ovarian endometriomas, and adenomyosis. The purported beneficial effects of surgery on infertility are mainly based on the 40%-42% pregnancy rate (PR) after surgery observed in published case series. However, this level of evidence is questionable and overestimates the benefits of the intervention. Even if comparative studies are lacking, IVF may be a valid alternative. The procedure may be less effective in affected women compared with other indications and it is not without additional deep endometriosis-related risks. Some case reports suggest that lesions might progress during IVF causing ureteral or intestinal complications or can decidualize during pregnancy causing intestinal perforation, pneumothorax, and pelvic vessels rupture. Finally, in the decision-making process, physicians should also consider that women with a history of deep endometriosis may face an increased risk of pregnancy complications. In conclusion, clear recommendation for the management of infertile women with deep endometriosis cannot be extrapolated from the literature. The therapeutic decision should be based on a comprehensive evaluation that includes clinical history, instrumental findings, pain symptoms, risks of pregnancy complications, and the woman's wishes. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  6. Multicystic mesothelioma caused by endometriosis: 2 case reports and review of the literature.

    Science.gov (United States)

    Kurisu, Yoshitaka; Tsuji, Motomu; Shibayama, Yuro; Yamada, Takashi; Ohmichi, Masahide

    2011-03-01

    Multicystic mesothelioma was described as a benign neoplasm in most reports. But, whether it is neoplastic or reactive is still controversial. Although multicystic mesothelioma is often accompanied by endometriosis, histologic findings of the lesion with endometriosis have not been well documented. In this report, 2 cases of multicystic mesothelioma with endometriosis were studied histologically. The first lesion consisted of multiple cysts having thin walls lined with single-layered cuboidal mesothelia, and in the cystic walls, small foci of endometriosis were found. The second lesion was next to the endometriotic cysts in the pelvic space. These histologic findings suggest that endometriosis greatly contributes to the origin of the lesions. In addition, from the review of the literature, cystic mesothelioma was divided into 2 categories, that is, neoplastic or non-neoplastic lesions. Differentiation of both disorders might be possible by the following: size of the lesion, macroscopic and microscopic solid proliferation, features of adenomatoid tumor, and common mesothelioma-like histology. In conclusion, multicystic mesothelioma accompanied by endometriosis is thought to be a secondary non-neoplastic lesion induced by adhesion or inflammation rather than a neoplasm.

  7. Protocol for developing, disseminating and implementing a core outcome set for endometriosis

    Science.gov (United States)

    Hirsch, Martin; Duffy, James M N; Barker, Claire; Hummelshoj, Lone; Johnson, Neil P; Mol, Ben; Khan, Khalid S; Farquhar, Cindy

    2016-01-01

    Introduction Endometriosis is a common gynaecological disease characterised by pain and subfertility. Randomised controlled trials evaluating treatments for endometriosis have reported many different outcomes and outcome measures. This variation restricts effective data synthesis limiting the usefulness of research to inform clinical practice. To address these methodological concerns, we aim to develop, disseminate and implement a core outcome set for endometriosis engaging with key stakeholders, including healthcare professionals, researchers and women with endometriosis. Methods and analysis An international steering group has been established, including healthcare professionals, researchers and patient representatives. Potential outcomes identified from a systematic review of the literature will be entered into a modified Delphi method. Key stakeholders will be invited to participate including healthcare professionals, researchers and women with endometriosis. Participants will be invited to score individual outcomes on a nine-point Likert scale anchored between 1 (not important) and 9 (critical). Repeated reflection and rescoring should promote whole and individual stakeholder group converge towards consensus, ‘core’, outcomes. High-quality outcome measures will be associated with core outcomes. Ethics and dissemination The implementation of a core outcome set for endometriosis within future clinical trials, systematic reviews and clinical guidelines will enhance the availability of comparable data to facilitate evidence-based patient care. This study was prospectively registered with Core Outcome Measures in Effectiveness Trials Initiative; number: 691. PMID:28003300

  8. Association of the neutrophil-to-lymphocyte ratio and CA 125 with the endometriosis score.

    Science.gov (United States)

    Kim, Seul Ki; Park, Jung Yeon; Jee, Byung Chul; Suh, Chang Suk; Kim, Seok Hyun

    2014-12-01

    To evaluate the association between the severity of endometriosis and the preoperative neutrophil-to-lymphocyte ratio (NLR) and serum level of cancer antigen 125 (CA 125). Data were obtained from the medical records of 419 patients who underwent laparoscopic conservative surgery for ovarian endometrioma between April 2005 and March 2013. Each patient's preoperative complete blood count was recorded and the endometriosis score was assessed. The endometriosis score was not associated with either the NLR or the serum level of CA 125. The endometriosis score was negatively related to preoperative hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration. The only positive association was between NLR and the patients' age. NLR and preoperative serum anti-Müllerian hormone level were found to be negatively related. The severity of endometriosis was not associated with the serum level of CA 125 or the NLR. The presence of a negative correlation between the severity of endometriosis and red blood cell dynamics needs further investigation.

  9. Endometriosis-induced alterations in mouse metaphase II oocyte microtubules and chromosomal alignment: a possible cause of infertility.

    Science.gov (United States)

    Mansour, Gihan; Sharma, Rakesh K; Agarwal, Ashok; Falcone, Tommaso

    2010-10-01

    To examine the effect of peritoneal fluid (PF) of patients with endometriosis on the cytoskeleton of metaphase II oocytes and correlate the results with the stage of endometriosis and the duration of infertility. Prospective-controlled study. Center for reproductive medicine at a tertiary-care hospital. Women with endometriosis (n=23) and tubal ligation/reversal (n=15). Peritoneal fluid obtained from 38 women (23 with endometriosis and 15 tubal ligation/reversal) after laparoscopy. Four hundred metaphase II oocytes were used: 165 frozen metaphase II oocytes were incubated in the PF of patients with endometriosis, 135 oocytes incubated in the PF of nonendometriosis patients (control subjects) and 100 oocytes incubated in human tubal fluid (HTF) media. Spindle abnormalities (microtubule and chromosomal) were evaluated by confocal imaging. In the endometriosis group, the cytoskeleton had a higher frequency of abnormal meiotic spindle and chromosomal misalignment (score ≥3), indicating severe damage compared with the control groups. The proportions of abnormalities in microtubule and chromosome alterations in endometriosis (67.9% and 63.6%, respectively) were significantly higher than for oocytes incubated with PF of the nonendometriosis group (24.4% and 14.8%) as well as the HTF group (13% and 13%). Oocyte cytoskeleton damage positively correlated with the duration of infertility and the stage of endometriosis. Alteration of oocyte cytoskeleton might be one of the causes of poor oocyte quality in patients with endometriosis. Copyright © 2010. Published by Elsevier Inc.

  10. [Morphologic characteristics of the endometrium in women with endometriosis].

    Science.gov (United States)

    Skopichev, V G; Savitkiĭ, G A; Gorbushin, S M

    1998-01-01

    It was established that in accordance with certain phases of sexual cycle (menstrual cycle in women and estral cycle in rats) on the background of hormone action at follicular and luteal phase the surface of epitheliocytes acquires specific relief (formation and degradation of microvilli appropriately in first and second halves of the cycle, accordingly). Disturbance of cyclic change of the relief of apical surface of epitheliocytes of the endometrium, persistence of high binding activity of the cationic dye and formation of intercellular clefts were demonstrated in developing endometriosis, which significantly interferes with the reproductive function. This was suggested to be an unfavourable result of cytotoxic effect of autoimmune processes that develop due to implantation of cells of endometrium in abdominal cavity and initiation of cooperative cellular response, which seems to be morphologically demonstrated by significant increase in number of macrophages in tissues of the uterus and in menstrual discharge.

  11. [Essential data set's archetypes for nursing care of endometriosis patients].

    Science.gov (United States)

    Spigolon, Dandara Novakowski; Moro, Claudia Maria Cabral

    2012-12-01

    This study aimed to develop an Essential Data Set for Nursing Care of Patients with Endometriosis (CDEEPE), represented by archetypes. An exploratory applied research with specialists' participation that was carried out at Heath Informatics Laboratory of PUCPR, between February and November of 2010. It was divided in two stages: CDEEPE construction and evaluation including Nursing Process phases and Basic Human Needs, and archetypes development based on this data set. CDEEPE was evaluated by doctors and nurses with 95.9% of consensus and containing 51 data items. The archetype "Perception of Organs and Senses" was created to represents this data set. This study allowed identifying important information for nursing practices contributing to computerization and application of nursing process during care. The CDEEPE was the basis for archetype creation, that will make possible structured, organized, efficient, interoperable, and semantics records.

  12. Atypical Endometriosis: a Clinicopathologic Study of 163 Cases

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    OBJECTIVE To investigate the clinicopathologic features of atypical endometriosis (AEM), and to discuss the relations between AEMs and tumors.METHODS A retrospective analysis was performed on 163 cases of AEMs. The changes in the glandular epithelium, stroma, and their background and the relationship with coexisting tumors were observed.RESULTS The AEMs account of for 4.4% (163/3,724) of the endometriosis (EM) cases. Of 172 AEM foci of 163 patients, 168 were in the ovary, and the other 4 were in the fallopian tube, cervix and uterine serosa. Of the cases of ovarian EM, 6.8% were AEM. All of the 27 cases (15.7%) of the AEMs associated with a tumor were found in the ovaries, of which 15 were malignant,9 borderline, and 3 benign. Of the ovary AEMs, 14.9% were associated with a borderline or malignant tumor. The AEM epithelia were mainly arranged in the form of surface epithelia, with only a few glands. Present were characteristic features of moderate to marked pleomorphism, epithelial tufting, bud or firework-like structures on microscopy. Epithelial metaplastic changes were observed in 86 cases (50%) of the 172 AEM foci. Epithelium, endometrioid stroma, and fibrotic-collagen formed a three-layer structure in the wall of the AEM cysts. The endometrioid stroma were usually thin compared to the fibro-collagen tissue. The transformation from an AEM to a tumor was found in most of the malignant tumors.CONCLUSION AEM lesions have some features which are similar and also differ from both of the tumor and EM. AEMs have a relative higher potential for tumorigenesis and canceration, especially for ovarian cancer.The process of damage, repair, and scarring in EM foci over a long period may play a role in the development of EM into AEM and eventally into tumor formation.

  13. P53 codon 11, 72, and 248 gene polymorphisms in endometriosis

    Directory of Open Access Journals (Sweden)

    Yao-Yuan Hsieh , Chich-Sheng Lin

    2006-01-01

    Full Text Available Objective: Mutated p53 gene is related to the instability of cell growth and cell cycle progression. We aimed to evaluate the association between endometriosis and p53 codon 11, 72 and 248 gene polymorphisms. Patients and methods: Women were divided into two groups: (1 moderate/severe endometriosis (n=148, and (2 non-endometriosis groups (n=150. P53 gene polymorphisms include codon11 Glu/Gln or Lys (GAG->CAG or AAG, codon 72 Arg/Pro (CGC->CCC, and codon 248 Arg/Thr (CGG->TCG. These gene polymorphisms were amplified by polymerase chain reaction and detected by electrophoresis after restriction enzyme (Taq I, BstU I, Hap II digestions. Associations between the endometriosis and p53 polymorphisms were evaluated. Results: The distributions of p53 codon 72 polymorphisms in both groups were significantly different. The proportions of Arg homozygotes/heterozygotes/Pro homozygotes in both groups were 9.5/66.2/24.3% and 30.7/50/19.3%. The proportions of Arg/Pro alleles were 42.6/57.4% and 56/44%. The distributions of p53 codon 11 and 248 polymorphisms in both groups were non-significantly different. All individuals appeared the wild genotypes (Glu11 and Arg248 homozygotes. Conclusion: Association between endometriosis and p53 codon 72 polymorphism exists. P53 codon 72*Pro-related genotype and allele are related with higher susceptibility of endometriosis. P53 codon 11 and 248 polymorphisms are not related with endometriosis susceptibility.

  14. Physical activity and endometriosis risk in women with infertility or pain

    Science.gov (United States)

    Ricci, Elena; Viganò, Paola; Cipriani, Sonia; Chiaffarino, Francesca; Bianchi, Stefano; Rebonato, Giorgia; Parazzini, Fabio

    2016-01-01

    Abstract Background: The potential association between endometriosis and physical activity (PA) has been suggested in several epidemiological studies. We aimed to establish whether PA influences endometriosis risk. Methods: MEDLINE and EMBASE were searched using “physical activity” OR “exercise” combined with “endometriosis,” in Medical Subject Headings and free text. We selected original articles in English, published up to April 2016, evaluating the association between endometriosis and recent or past PA (case–control or cohort studies). References of retrieved papers were reviewed. We computed summary odds ratios (ORs) of endometriosis for recent and past PA. Results: Six case–control and 3 cohort studies included 3355 cases for recent PA and 4600 cases for past PA. The summary OR for endometriosis according to PA level, calculated by the random-effect model, was 0.85 [95% confidence interval (CI) 0.67–1.07] for any recent versus no PA. As compared to no recent PA, ORs for low and moderate/high PA were 1.00 (95% CI: 0.68–1.28) and 0.75 (95% CI: 0.53–1.07), respectively. Conclusions: Though it suggests that PA may reduce the risk of endometriosis, this meta-analysis does not conclusively support the hypothesis. Whether our findings are really explained by the benefit of exercise at molecular and endocrine level, or related to confounding mechanisms, such as study design, choice of controls, and PA potentially improving pain, needs to be further investigated. PMID:27749551

  15. Slit2 overexpression results in increased microvessel density and lesion size in mice with induced endometriosis.

    Science.gov (United States)

    Guo, Sun-Wei; Zheng, Yu; Lu, Yuan; Liu, Xishi; Geng, Jian-Guo

    2013-03-01

    We recently reported that Slit/Roundabout (ROBO) 1 pathway may be a constituent biomarker for recurrence of endometriosis, likely through promoting angiogenesis. In this study, we sought to determine as whether Slit2 overexpression can facilitate angiogenesis, increase lesion size, and induce hyperalgesia in mice with induced endometriosis. We used 30 Slit2 transgenic (S) and 29 wild-type (W) mice and cross-transplanted endometrial fragments from S to W (group SW) and vice versa (group WS), and also within the S and W (groups SS and WW, respectively), into the peritoneal cavity, inducing endometriosis. We also performed a sham surgery within both S and W mice (groups Sm and Wm, respectively). The size of the ectopic implants, microvessel density (MVD) and immunoreactivity to ROBO1, and vascular endothelial cell growth factor (VEGF) in ectopic and eutopic endometrium, along with hotplate and tail-flick tests in all mice, were then evaluated. We found that the induction of endometriosis resulted in generalized hyperalgesia, which was unaffected by Slit2 overexpression. Slit2 overexpression did increase the lesion size significantly and correlated positively with the MVD in ectopic and eutopic endometrium. Slit2 expression levels appear to correlate with the MVD, but not with VEGF immunoreactivity, in ectopic endometrium. Consequently, we conclude that Slit2 may play an important role in angiogenesis in endometriosis. The increased angiogenesis, as measured by MVD, but not VEGF immunoreactivity, likely resulted in increased lesion size in induced endometriosis. Thus, SLIT2/ROBO1 pathway may be a potential therapeutic target for treating endometriosis.

  16. Effect of Surgical Removal of Endometriomas on Cyclic and Non-cyclic Pelvic Pain

    Directory of Open Access Journals (Sweden)

    Murat Api

    2015-07-01

    Full Text Available Background: Endometriosis is a complex disease with a spectrum of pain symptoms from mild dysmenorrhea to debilitating pelvic pain. There is no concrete evidence in the literature whether endometriotic cyst per se, causes pain spectrum related to the disease. The aim of the present study was to evaluate the effect of surgical removal of endometriomas on pain symptoms. Materials and Methods: In this prospective, observational, before-after study, which was conducted between March 2012 and January 2013 in Training and Research Hospital,Adana, Turkey, a total of 23 patients including 16 sexually active and 7 virgin symptomatic women were questioned for non-cyclic pelvic pain (NCPP, intensity of the NCPP, presence of cyclic dysmenorrhea, and dyspareunia before and after the endometrioma operation. Participants who were sonographically diagnosed and later pathologically confirmed as having endometrioma without sign and symptoms of deep infiltrative endometriosis (DIE were also questioned for pain symptoms before and after the laparoscopic removal of cyst wall. Patients with intraabdominal adhesions, history of pelvic inflammatory disease, and pathological diagnosis other than endometrioma were excluded. No ancillary procedures were applied for pain management, but if pain was present, pelvic peritoneal endometriotic lesions were ablated beside the removal of ovarian endometriotic cysts. Results: Out of 23 cases with endometrioma, 91 and 78% reported to have NCPP and dysmenorrhea, respectively, before the operation, while 60 and 48%, respectively, after the operation (McNemar’s test, P=0.016 for both figures. Among the sexually active cases, 31% (5/16 had dyspareunia before the operation and only 1 case reported the pain relief after the operation (McNemar’s test, P=1. Intensity of NCPP were reported to be none (8.7%, moderate (21.7%, severe (56.5% and unbearable (13% before the operation and decreased to none (43.5%, mild (43.5%, moderate (4

  17. The effect of peritoneal fluid from patients with endometriosis on mitochondrial function and development of early mouse embryos.

    Directory of Open Access Journals (Sweden)

    Jing Shu

    Full Text Available BACKGROUND: Peritoneal fluid (PF from patients with endometriosis can inhibit early embryo development via probable functional changes of embryo mitochondria in the early stage of embryo development. The purpose of this study was to determine the effect of PF from patients with endometriosis on mitochondrial function and development of early mouse embryos. METHODOLOGY/PRINCIPAL FINDINGS: PF was collected from patients with infertility and endometriosis, infertility due to tubal factors, and normal control subjects, and the level of NO was measured. Early murine embryos were then cultured with PF from normal control subjects, those with endometriosis, and with human tubal fluid (HTF, respectively. Cleavage and blastulation rates, mitochondrial DNA (mtDNA copy numbers, adenosine triphosphate (ATP level, and mitochondrial membrane potential (ΔΨm of the different groups were compared. The NO level in the PF of patients with endometriosis was significantly greater than in those without endometriosis and control patients. The embryos cultures with PF from patients with endometriosis had a lower cleavage rate and blastulation rate, and higher ATP and ΔΨm level at the 2- and 4-cell stages. No significant difference was found in mtDNA copies among the 3 groups. CONCLUSIONS/SIGNIFICANCE: PF from patients with endometriosis can inhibit early embryo development via probable functional changes of embryo mitochondria in the early stage of embryo development. Understanding the effects of PF on embryo development may assist in developing new methods of treatment for infertility.

  18. Genetic variation of the E-cadherin gene is associated with primary infertility in patients with ovarian endometriosis.

    Science.gov (United States)

    Kang, Shan; Li, Yan; Li, Bin; Wang, Na; Zhou, Rong-Miao; Zhao, Xi-Wa

    2014-10-01

    To explore the association between the genetic variant of E-cadherin gene and endometriosis-related infertility. Case-control study. University hospital. Five hundred eighty-nine women with ovarian endometriosis including 127 patients with primary infertility and 589 female controls in northern China. None. Single nucleotide polymorphisms (SNPs) in the promoter region, exons, and the 3' untranslated region of the E-cadherin gene were identified by direct sequencing in patients with ovarian endometriosis and with polymerase chain reaction (PCR). Six candidate SNPs (rs16260, rs28372783, rs1801552, rs1801026, rs8049282, and rs13689) were genotyped by PCR and ligase detection reaction. The results revealed a significant association of rs8049282 SNP on E-cadherin gene with endometriosis-related infertility. When compared with control women or endometriosis patients who had a history of successful fertility, the CC genotype of rs8049282 may significantly increase the risk of primary infertility in patients with ovarian endometriosis (adjusted odds ratio [OR] = 2.70, 95% confidence interval [CI] 1.45-5.00; OR = 2.54, 95% CI 1.45-4.44, respectively). Our results suggested that genetic variants on the E-cadherin gene may be involved in endometriosis-related infertility. The rs8049282 SNP of the E-cadherin gene may be a potential molecular marker for the development of primary infertility in northern Chinese women with ovarian endometriosis. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  19. The management of menopause in women with a history of endometriosis: a systematic review.

    Science.gov (United States)

    Gemmell, L C; Webster, K E; Kirtley, S; Vincent, K; Zondervan, K T; Becker, C M

    2017-07-01

    Endometriosis is typically regarded as a premenopausal disease, resolving after natural or iatrogenic menopause due to declining oestrogen levels. Nonetheless, case reports over the years have highlighted the incidence of recurrent postmenopausal endometriosis. It is now clear that both recurrence and malignant transformation of endometriotic foci can occur in the postmenopausal period. Postmenopausal women are commonly treated with hormone replacement therapy (HRT) to treat climacteric symptoms and prevent bone loss; however, HRT may reactivate endometriosis and stimulate malignant transformation in women with a history of endometriosis. Given the uncertain risks of initiating HRT, it is difficult to determine the best menopausal management for this group of women. The aim of this study was to systematically review the existing literature on management of menopausal symptoms in women with a history of endometriosis. We also aimed to evaluate the published literature on the risks associated with HRT in these women, and details regarding optimal formulations and timing (i.e. initiation and duration) of HRT. Four electronic databases (MEDLINE via OVID, Embase via OVID, PsycINFO via OVID and CINAHL via EbscoHost) were searched from database inception until June 2016, using a combination of relevant controlled vocabulary terms and free-text terms related to 'menopause' and 'endometriosis'. Inclusion criteria were: menopausal women with a history of endometriosis and menopausal treatment including HRT or other preparations. Case reports/series, observational studies and clinical trials were included. Narrative review articles, organizational guidelines and conference abstracts were excluded, as were studies that did not report on any form of menopausal management. Articles were assessed for risk of bias and quality using GRADE criteria. We present a synthesis of the existing case reports of endometriosis recurrence or malignant transformation in women undergoing

  20. Outcome of in vitro fertilization in endometriosis-associated infertility: a 5-year database cohort study

    Institute of Scientific and Technical Information of China (English)

    LIN Xiao-na; WEI Min-ling; TONG Xiao-mei; XU Wei-hai; ZHOU Feng; HUANG Qiong-xiao; WEN Guo-feng; ZHANG Song-ying

    2012-01-01

    Background Endometriosis affects natural fertility through various approaches,and in vitro fertilization (IVF) is a good treatment.But the IVF result of endometriosis patients is still under debate.We investigated the effect of endometriosis on IVF by analyzing the data from a single reproductive center.Methods A retrospective,database-searched cohort study was performed.Relevant information was collected from the electronic records of women who underwent IVF/intracytoplasmic sperm injection between January 2006 and December 2010 in the Assisted Reproductive Unit of Sir Run Run Shaw Hospital.Patients with endometriosis were enrolled the study group.The rest of the women formed the control group.The main outcome was the clinical pregnancy rate.Secondary outcomes were oocytes retrieved number,fertilization rate,high-quality embryo rate,number of high-quality embryo for embryo transplantation,and implantation embryo/high-quality embryo ratio (IE/HQE ratio).Comparisons were performed by the x2-test and independent t-test.Results The endometriosis group (n=177) had a markedly lower oocytes retrieved number,fertilization rate,implantation rate,and clinical pregnancy rate (7.6±5.1,63.6%,27.7%,and 45.2%,respectively) compared with the non-endometriosis group (n=4267; 11.8±7.3,68.4%,36.2%,and 55.2%,respectively).Stratified analysis showed that this difference was found in the subgroup younger than 35-years old,while only fertilization rate and implantation rate were different in the elder subgroup.The ratio of high-quality embryos transferred is lower in endometriosis group (53.7% vs.71.8%,P <0.05),but there is no difference in IE/HQE ratio between two groups.There is no significant difference in fertilization rate,implantation rate,and clinical pregnancy rate between mild and severe endometriosis patients.Conclusions Endometriosis patients suffer a decreasing IVF pregnancy rates mainly caused by reducing oocytes number and fertilization rate

  1. Endometrial receptivity in terms of pinopode expression is not impaired in women with endometriosis in artificially prepared cycles.

    Science.gov (United States)

    Garcia-Velasco, J A; Nikas, G; Remohí, J; Pellicer, A; Simón, C

    2001-06-01

    To assess endometrial receptivity in terms of pinopode expression in women with endometriosis. Prospective, observational study. Oocyte donation program at the Instituto Valenciano de Infertilidad. Twelve women with endometriosis as the only cause of infertility. Pinopode expression pattern analysis by scanning electron microscopy in two sequential endometrial biopsies obtained in the same cycle of each patient. Pinopode pattern and pregnancy rates. Pinopode expression in women with endometriosis did not differ from that of patients without endometriosis undergoing artificial cycles. Similarly, the clinical outcome in these women was comparable to that of the general population included in the oocyte donation program. The pregnancy rate per transfer was 46.7%. These results show that in women with endometriosis undergoing oocyte donation under hormone replacement therapy, pinopode expression is not altered, suggesting that endometrial receptivity in women with this disease remains unaltered.

  2. Ultrastructural Study of the Epithelium of Endometrial Glands in Women with Endometriosis :a Comparison with the Normal

    Institute of Scientific and Technical Information of China (English)

    金海燕; 王自能; 郭祖文

    2001-01-01

    Objective The ultrastructure of endometrium women suffering from endometriosis was compared with those from women of normal reproductive age.Materials & Methods Six specimens of eutopic endometrium were taken from women diagnosed with endometriosis. Three specimens were taken from women at normal reproductive-age. The specimens, all at early proliferative phase, were processed for ultrastructural study.Results Compared with the normal, the secretory cells of the epithelium of endometrium from women with endometriosis had more numerous and longer microvil li. In the cytoplasm, there were more secretory granules and mitochondria. The RER was more prominent and with dilated cisternae. Lipid droplets and electron dense particles were frequently seen. The cilia ciliated cells were increased and elongated remarkably. The basement membrane became markedly tortouas.Conclusion The endometrium from women with endometriosis showed a number of features which are abnormal. This might be the origin of endometriosis and a cause o f sterility.

  3. Apigenin induces ROS-dependent apoptosis and ER stress in human endometriosis cells.

    Science.gov (United States)

    Park, Sunwoo; Lim, Whasun; Bazer, Fuller W; Song, Gwonhwa

    2017-06-15

    Apigenin is a plant-derived flavonoid having antiproliferative, anti-inflammatory, and anti-angiogenic properties in chronic and metabolic diseases, and cancers. However, the functional role of apigenin remains to be identified in human endometriosis that is a benign inflammatory disease causing infertility, dysmenorrhea, dyspareunia, and chronic abdominal or pelvic pain. In the present study, we determined the effects of apigenin on two well-established human endometriosis cell lines (VK2/E6E7 and End1/E6E7). Apigenin reduced proliferation and induced cell cycle arrest and apoptosis in the both endometriosis cell lines. In addition, it disrupted mitochondrial membrane potential (MMP) which was accompanied by an increase in concentration of calcium ions in the cytosol and in pro-apoptotic proteins including Bax and cytochrome c in the VK2/E6E7 and End1/E6E7 cells. Moreover, apigenin treated cells accumulated excessive reactive oxygen species (ROS), and experienced lipid peroxidation and endoplasmic reticulum (ER) stress with activation of the unfolded protein response (UPR) regulatory proteins. Furthermore, the apigenin-induced apoptosis in endometriosis cells was regulated via the ERK1/2, JNK, and AKT cell signaling pathways. Taken together, apigenin is a potential novel therapeutic agent to overcome current limitations in the treatment to endometriosis. © 2017 Wiley Periodicals, Inc.

  4. Coffee and caffeine intake and risk of endometriosis: a meta-analysis.

    Science.gov (United States)

    Chiaffarino, Francesca; Bravi, Francesca; Cipriani, Sonia; Parazzini, Fabio; Ricci, Elena; Viganò, Paola; La Vecchia, Carlo

    2014-10-01

    The potential association between endometriosis and coffee/caffeine consumption has been analysed in several epidemiological studies. In order to establish whether caffeine influences the risk of endometriosis, we provide to summarize the evidence from published studies on this issue. We performed a meta-analysis of epidemiological studies published up to January 2013. We computed summary relative risks (RR) of endometriosis for any, high and low versus no coffee/caffeine consumption. We identified a total eight studies, six case-control and two cohort studies, including a total of 1,407 women with endometriosis. The summary RR for any versus non-consumption were 1.26 [95% confidence interval (CI) 0.95-1.66] for caffeine and 1.13 (95% CI 0.46-2.76) for coffee consumption; the overall estimate was 1.18 (95% CI 0.92-1.49). The summary RR were 1.09 (95% CI 0.84-1.42) and 1.09 (95% CI 0.89-1.33) for high and low caffeine consumption as compared to no consumption, respectively. The present meta-analysis provided no evidence for an association between coffee/caffeine consumption and the risk of endometriosis. Coffee/caffeine consumption, as currently used in diet, does not carry a health risk.

  5. Endometriosis of the Vermiform Appendix within a Hernia Sac Infiltrating the Pubic Bone

    Directory of Open Access Journals (Sweden)

    Damian Ziaja

    2015-01-01

    Full Text Available Purpose. Appendicular endometriosis mimicking appendicitis is a rare finding. Inguinal tumor in the course of appendicular endometriosis located within an inguinal hernia sac and infiltrating the periosteum of the pubic bone has not yet been described. Case Report. This paper describes a case of a rapidly enlarging, solid, unmovable, very painful upon palpation inguinal tumor, in a 36-year-old nulliparous woman. During surgery, a hard (approximately 4 cm in diameter tumor infiltrating the periosteum of the right pubic bone and continuous with the inguinal hernia sac was dissected. The distal segment of the vermiform appendix was an element of the dissected tumor. Histological examination revealed endometriosis of the distal vermiform appendix. After 6 months of hormone treatment, she was referred for reoperation due to tumor recurrence. Once again histological examination of the resected tissue revealed endometriosis. There was no further recurrence of the disease with goserelin therapy. In addition to the case report, we present a review of the literature about endometriosis involving the vermiform appendix and the inguinal canal (Amyand’s hernia. Conclusion. This case expands the list of differential diagnoses of nodules found in the inguinal region of women.

  6. Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

    Institute of Scientific and Technical Information of China (English)

    Rong Liu; Demin Pu; Dan Yang

    2007-01-01

    Objective: To explore the role of matrix metalloproteinase-1,2 (MMP-1, MMP-2) and tissue inhibitor of matrix metalloproteinases-1 (TIMP-1) in endometriosis. Methods: The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects (excluding endometriosis) were collected and examined by in situ hybridization technology and western blot assay. Results: Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant (P < 0.01). Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion: The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.

  7. [Hypothetical link between endometriosis and xenobiotics-associated genetically modified food].

    Science.gov (United States)

    Aris, A; Paris, K

    2010-12-01

    Endometriosis is an oestrogen-dependent inflammatory disease affecting 10 % of reproductive-aged women. Often accompanied by chronic pelvic pain and infertility, endometriosis rigorously interferes with women's quality of life. Although the pathophysiology of endometriosis remains unclear, a growing body of evidence points to the implication of environmental toxicants. Over the last decade, an increase in the incidence of endometriosis has been reported and coincides with the introduction of genetically modified foods in our diet. Even though assessments of genetically modified food risk have not indicated any hazard on human health, xenobiotics-associated genetically modified food, such as pesticides residues and xenoproteins, could be harmful in the long-term. The "low-dose hypothesis", accumulation and biotransformation of pesticides-associated genetically modified food and the multiplied toxicity of pesticides-formulation adjuvants support this hypothesis. This review summarizes toxic effects (in vitro and on animal models) of some xenobiotics-associated genetically modified food, such as glyphosate and Cry1Ab protein, and extrapolates on their potential role in the pathophysiology of endometriosis. Their roles as immune toxicants, pro-oxidants, endocrine disruptors and epigenetic modulators are discussed. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  8. Ubiquitin is associated with the survival of ectopic stromal cells in endometriosis

    Directory of Open Access Journals (Sweden)

    Bebington Catherine R

    2004-09-01

    Full Text Available Abstract Background Endometriosis is a condition that affects women of reproductive age, where the glandular and/or stromal tissues from the eutopic endometrium implant in ectopic locations. It is well established that the survival of ectopic implants is due to lower levels of apoptosis, but no consensus exists as to which pathway/s this is mediated by. The ubiquitin protein shares a similar sequence homology to an anti-apoptotic protein called BAG-1 and is expressed in the normal endometrium. Currently, no studies have been conducted to determine ubiquitin expression and its possible anti-apoptotic effects in endometriosis. Methods Archived endometrial tissues from endometriosis patients and women undergoing laparoscopic diagnosis (controls from January 2000 to July 2003 at Westmead Hospital were examined, where 14 cases of endometriosis and 55 controls were included in the study. Results Both the ubiquitin protein and apoptosis were expressed in both glandular and stromal cells throughout the menstrual cycle of the eutopic endometrium, in which ubiquitin exhibited a cyclic expression, reaching a peak in late proliferative phase. In contrast, ubiquitin was predominantly expressed in cells of stromal origin in endometriosis, was no longer regulated by a cyclic pattern and was associated with an aberrant level of cell survival. Conclusions For the first time, this study shows that ubiquitin is expressed in endometriotic cells and may contribute to a reduced sensitivity of ectopic endometrial tissue to apoptosis. These findings also suggest that stromal cells contribute differentially to the development of ectopic endometrial tissue.

  9. PTGS2 down-regulation in cumulus cells of infertile women with endometriosis.

    Science.gov (United States)

    da Luz, Caroline M; da Broi, Michele G; Donabela, Flávia Cappello; Paro de Paz, Cláudia Cristina; Meola, Juliana; Navarro, Paula A

    2017-07-10

    A deleterious effect of endometriosis on oocyte quality has been proposed. Evidence suggests that cumulus cells could be used as indirect biomarkers of oocyte quality. The PTGS2 gene, which encodes cyclooxygenase 2 (COX-2), is deregulated in endometriotic lesions and plays a crucial role in the acquisition of oocyte competence. To date, research evaluating PTGS2 expression in cumulus cells of infertile patients with endometriosis has not been conducted. The aim this study was to compare the expression levels of PTGS2 in cumulus cells of infertile women, with and without endometriosis, undergoing ovarian stimulation for intracytoplasmic sperm injection (ICSI). Therefore, a case-control study compared PTGS2 gene expression in the cumulus cells of 38 infertile patients with endometriosis and 40 without, using real-time polymerase chain reaction. For the first time, decreased expression of PTGS2 was found in cumulus cells of infertile women with endometriosis compared with controls (7.2 ± 10.5 versus 12.4 ± 15.7), which might be related to reduced levels of COX-2 in the cumulus cells of women with the disease. Consequently, we hypothesize that lower transcript levels of PTGS2 in cumulus cells may be involved in the impairment of oocyte quality, suggesting a possible mechanism involved in disease-related infertility. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  10. Peripheral blood proinflammatory response in women during menstrual cycle and endometriosis.

    Science.gov (United States)

    Sikora, Justyna; Mielczarek-Palacz, Aleksandra; Kondera-Anasz, Zdzisława; Strzelczyk, Jarosław

    2015-12-01

    The aim of this study was to evaluate differences in levels of serum and monocyte derived interleukin (IL)-1, IL-6 and neopterin (NPT) in women with normal or abnormal menstrual cycles and women with endometriosis. The women participating in this study were divided into 4 groups: 25 women with normal menstrual cycle; 25 women taking oral contraception (OC); 20 postmenopausal women and 25 endometriosis patients. IL-1beta, IL-6 and NPT levels in serum and monocyte culture media were measured with ELISA methods. The data collected showed the lowest serum NPT levels in women with follicular menstrual cycles. The levels of both types of interleukins in serum were the lowest in women using OC. In contrast, the highest concentrations of all cytokines were found in the serum of women with endometriosis. The lowest monocyte activity was observed in women with a follicular menstrual cycle phase and the highest in endometriosis. Monocytes from women using OC secreted similar amounts of cytokines to the cells during the follicular menstrual cycle phase. Changes occurring at the time of contraception, after menopause and during endometriosis, are followed by changed proinflammatory monocyte activity, which is associated with different secretion of cytokines. OC can inhibit inflammatory monocyte properties. Lower serum concentration of cytokines compared to cell secretion may suggest some control mechanisms of monocyte activity.

  11. Expression and clinical significance of MMP-2, MVD, MEK-2 in endometriosis

    Institute of Scientific and Technical Information of China (English)

    Wei Zhang; Qian-Qian Hu; Lu Wang; Meng Shen; Sheng Li

    2016-01-01

    Objective:To investigate the expression and clinical significance of MMP-2, MVD, MEK-2in the endometriosis.Methods:A total of 42 endometrial endometriosis patients with surgery were selected in our hospital obstetrics and gynecology from September 1, 2008 to December 18, 2014. Endometriosis were removed during surgery and served as ectopic group. A total of 42 examples of the above-described patients with endometriosis eutopic were taken out as the eutopic group. Another 34 patients with uterine fibroids were selected in our hospital obstetrics and gynecology during the same period. Normal endometrium were taken as the normal endometrium group. Clinical expression of MMP-2, MVD, MEK-2 of three groups were analyzed.Results:MVD in ectopic endometrium group were significantly higher than those in eutopic and normal endometrium (P<0.05). MEK-2 expression in normal endometrial tissue mainly was negative and weakly positive. The expression was positive in ectopic endometrium and eutopic. The expression of ectopic endometrium MEK-2and MMP-2 were the highest, followed by the reign of endometrium, and the expression of normal endometrium were the lowest.Conclusions: MMP-2, MVD, MEK-2 in ectopic endometrium show high expression, detection of MMP-2, MVD, MEK-2-clinical expression in endometriosis can help in pathogenesis, clinical diagnosis and treatment.

  12. Uterine Leukocyte Function and Dysfunction: A Hypothesis on the Impact of Endometriosis.

    Science.gov (United States)

    Parkin, Kirstin L; Fazleabas, Asgerally T

    2016-03-01

    Endometriosis is a chronic inflammatory disease characterized by the growth of endometrial glands and stroma outside of the uterus. The disease affects approximately 10-15% of women of reproductive age and presents with clinical symptoms of pelvic pain and infertility. Changes in the leukocyte populations within the ectopic tissue and eutopic endometrium have been reported, and data suggest these alterations contribute to the pathology and symptoms of the disease. In this review, we discussed differences when comparing uterine NK cells and regulatory T cells within the eutopic endometrium between patients with endometriosis and healthy patients, and how these differences relate to implantation failure and/or decreased clearance of menstrual tissue in patients with the disease. The data demonstrate a critical need to examine endometrium and menstrual tissue in patients with endometriosis excluded from studies examining unknown causes of infertility and heavy menstrual bleeding. The information gathered from excluded patients will further enhance our understanding of how the immune system contributes to the pathophysiology of endometriosis and help to identify biomarkers for patients at higher risk for developing endometriosis-associated infertility.

  13. Association study of Glutathione S-Transferase polymorphisms and risk of endometriosis in an Iranian population

    Science.gov (United States)

    Hassani, Mina; Saliminejad, Kioomars; Heidarizadeh, Masood; Kamali, Koorosh; Memariani, Toktam; Khorram Khorshid, Hamid Reza

    2016-01-01

    Background: Endometriosis influenced by both genetic and environmental factors. Associations of glutathione S-transferases (GSTs) genes polymorphisms in endometriosis have been investigated by various researchers; however, the results are not consistent. Objective: We examined the associations of GSTM1 and GSTT1 null genotypes and GSTP1 313 A/G polymorphisms with endometriosis in an Iranian population. Materials and Methods: In this case-control study, 151 women with diagnosis of endometriosis and 156 normal healthy women as control group were included. The genotyping was determined using multiplex PCR and PCR- RFLP methods. Results: The GSTM1 null genotype was significantly higher (p=0.027) in the cases (7.3%) than the control group (1.3%). There was no significant difference between the frequency of GSTT1 genotypes between the cases and controls. The GSTP1 313 AG genotype was significantly lower (p=0.048) in the case (33.1%) than the control group (44.4%). Conclusion: Our results showed that GSTM1 and GSTP1 polymorphisms may be associated with susceptibility of endometriosis in Iranian women. PMID:27351025

  14. Histological and Immunohistochemical Characterization of a Case of Endometriosis in a Guinea Pig (Cavia tschudii

    Directory of Open Access Journals (Sweden)

    Alfonso Baldi

    2017-01-01

    Full Text Available Endometriosis is a chronic gynecological disease characterized by the ectopic proliferation of endometrial tissue outside of the uterine cavity. The pathogenesis of this disease is still obscure, and Sampson’s theory of retrograde menstruation is still the most widely accepted explanation. Endometriosis in animals has been so far described not only in baboons and a rhesus macaque but also in dogs and horses that are nonmenstruating animals. In this article, we report the histological and immunohistochemical characterization of the first case of ovarian cystic endometriosis and adenomyosis in a guinea pig. The case presented supports the hypothesis that endometriosis is a disease not at all related to the phenomenon of retrograde menstruation but is a consequence of some alterations in the morphogenesis of the female genital system and therefore it could be found in any mammal. We suggest considering endometriosis among the other pathological phenotypes in animals displaying ovarian and uterine alterations and having a history of difficulties in conceiving.

  15. 子宫内膜异位症患者发病的影响因素研究%Study of the related risk factors associated with endometriosis

    Institute of Scientific and Technical Information of China (English)

    王美娥

    2015-01-01

    目的:探讨子宫内膜异位症发病的影响因素。方法采用病例-对照研究,收集214例子宫内膜异位症患者(观察组)和214例非子宫内膜异位症患者(对照组)的相关资料,采用单因素和多因素非条件Logistic回归进行分析。结果多因素分析结果表明,初潮年龄早、月经周期短、经期长、人工流产次数多是子宫内膜异位症的危险因素;孕次增多、产次增多使发生子宫内膜异位症的危险性减少,是子宫内膜异位症的保护因素。结论子宫内膜异位症发病的影响因素同经期长、初潮年龄早、人工流产次数多和月经周期短相关。%Objective To investigate the risk factors associated with endometriosis. Methods A case control study was carried out including 214 endometriosis patients and 214 healthy people.The data were collected and analyzed with single factor analysis and multivariate unconditional logistic regression analysis among individual aspects, menstrual characteristics and reproductive activity. Results Multi factor analysis confirmed that the risk factors associated with endometriosis included early menarche, short cycles,long menstrual lengths and more abortions numbers.Pregnancy number and labor number were proved to be the protective factors. Conclusion Endometriosis seemed to be related to early menarche,short cycles,long menstrual lengths,and more abortions numbers.

  16. Regulation of Matrix Metalloproteinase-2 Activity by COX-2-PGE2-pAKT Axis Promotes Angiogenesis in Endometriosis

    Science.gov (United States)

    Ray, Amlan K.; DasMahapatra, Pramathes; Swarnakar, Snehasikta

    2016-01-01

    Endometriosis is characterized by the ectopic development of the endometrium which relies on angiogenesis. Although studies have identified the involvement of different matrix metalloproteinases (MMPs) in endometriosis, no study has yet investigated the role of MMP-2 in endometriosis-associated angiogenesis. The present study aims to understand the regulation of MMP-2 activity in endothelial cells and on angiogenesis during progression of ovarian endometriosis. Histological and biochemical data showed increased expressions of vascular endothelial growth factor (VEGF), VEGF receptor-2, cycloxygenase (COX)-2, von Willebrand factor along with angiogenesis during endometriosis progression. Women with endometriosis showed decreased MMP-2 activity in eutopic endometrium as compared to women without endometriosis. However, ectopic ovarian endometrioma showed significantly elevated MMP-2 activity with disease severity. In addition, increased MT1MMP and decreased tissue inhibitors of metalloproteinases (TIMP)-2 expressions were found in the late stages of endometriosis indicating more MMP-2 activation with disease progression. In vitro study using human endothelial cells showed that prostaglandin E2 (PGE2) significantly increased MMP-2 activity as well as tube formation. Inhibition of COX-2 and/or phosphorylated AKT suppressed MMP-2 activity and endothelial tube formation suggesting involvement of PGE2 in regulation of MMP-2 activity during angiogenesis. Moreover, specific inhibition of MMP-2 by chemical inhibitor significantly reduced cellular migration, invasion and tube formation. In ovo assay showed decreased angiogenic branching upon MMP-2 inhibition. Furthermore, a significant reduction of lesion numbers was observed upon inhibition of MMP-2 and COX-2 in mouse model of endometriosis. In conclusion, our study establishes the involvement of MMP-2 activity via COX-2-PGE2-pAKT axis in promoting angiogenesis during endometriosis progression. PMID:27695098

  17. Fatores ambientais e endometriose Environmental factors and endometriosis

    Directory of Open Access Journals (Sweden)

    Patrick Bellelis

    2011-08-01

    Full Text Available A endometriose representa uma afecção ginecológica comum, atingindo de 5%-15% das mulheres no período reprodutivo e até 3%-5% na fase pós-menopausa. Essa doença é definida pelo implante de estroma e/ou epitélio glandular endometrial em localização extrauterina, podendo comprometer diversos locais. Humanos e animais são expostos diariamente a poluentes químicos que têm a capacidade de influenciar negativamente processos fisiológicos e, potencialmente, causar doenças, dentre elas a endometriose. Com esta revisão tivemos por objetivo relacionar a influência dos fatores ambientais e dietéticos na gênese da endometriose. O mecanismo pelo qual a dioxina e seus símiles (TCDD/PCBs atuam na alteração da fisiologia endometrial permanence incerta e é especulativa devido à dificuldade em se avaliar a exposição na vida intraútero, infância e vida adulta e suas reais consequências, além das limitações de sua reprodução in vitro. Devemos entender melhor o mecanismo de ação desses poluentes amibentais não só na saúde reprodutiva, mas na saúde em geral do indivíduo, para se promover estratégias de prevenção que devem incluir não só a educação populacional, mas o estabelecimento de limites de exposição, técnicas menos poluentes e melhor aproveitamento dos nossos recursos naturais.Endometriosis represents a common gynecological condition affecting 5%-15% of childbearing age women and up to 3% 5% of post-menopausal women. This disease is defined by the presence of stromal and/or endometrial glandular epithelium implants in extra-uterine locations possibly compromising several sites. Humans and animals are daily exposed to chemical pollutants that could adversely influence physiological processes and potentially cause diseases, including endometriosis. In this review, the authors aimed at settling the influence of environmental and dietary factors on endometriosis pathogenesis. The mechanism by which dioxin and its

  18. Surgical Navigation

    DEFF Research Database (Denmark)

    Azarmehr, Iman; Stokbro, Kasper; Bell, R. Bryan

    2017-01-01

    were identified in the field of traumatology. Treatment of complex orbital fractures was considerably improved by the use of SN compared with traditionally treated control groups. Conclusions: SN seems to be a very promising addition to the surgical toolkit. Planning details of the surgical procedure...... in a 3-dimensional virtual environment and execution with real-time guidance can significantly improve precision. Among factors to be considered are the financial investments necessary and the learning curve....

  19. Ear Acupuncture Therapy for 37 Cases of Dysmenorrhea Due to Endometriosis

    Institute of Scientific and Technical Information of China (English)

    向东方; 司徒仪; 梁雪芳; 程兰; 章国来

    2002-01-01

    @@ Endometriosis (EMT) is one of the difficult and complicated cases in gynecology, and its incidence shows a tendency to go up year by year. It is mainly manifested in clinic as dysmenorrhea, acyesis, irregular menstruation and pelvic lumps. Dysmenorrhea is the most characteristic symptom of endometriosis and its relief has important significance in the treatment of the disease. Certain hormonal drugs, such as danazol and gestrinone, exhibit convincing therapeutic effects but with obvious adverse actions. Operative therapy has also some limitations. Since 1997, the disorder has been treated by our special department for endometriosis with ear acupuncture therapy. Meanwhile, a group of patients were treated as controls with the decoction of traditional Chinese drugs for activating blood circulation and removing stasis. The results are reported as follows.

  20. Acute small bowel obstruction caused by endometriosis: A case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Antonella De Ceglie; Claudio Bilardi; Sabrina Blanchi; Massimo Picasso; Marcello Di Muzio; Alberto Trimarchi; Massimo Conio

    2008-01-01

    Gastrointestinal involvement of endometriosis has been found in 3%-37% of menstruating women and exclusive localization on the ileum is very rare (1%-7%).Endometriosis of the distal ileum is an infrequent cause of intestinal obstruction,ranging from 7% to 23% of all cases with intestinal involvement.We report a case in which endometrial infiltration of the small bowel caused acute obstruction requiring emergency surgery,in a woman whose symptoms were not related to menses.Histology of the resected specimen showed that endometriosis was mainly prevalent in the muscularis propria and submucosa and that the mucosa was not ulcerated but had inflammation and glandular alteration. Endometrial lymph node involvement,with a cystic glandular pattern was also deted.

  1. Mucocele of the appendix due to endometriosis: a rare case report.

    Science.gov (United States)

    Tsuda, Motoyuki; Yamashita, Yukitaka; Azuma, Shunjiro; Akamatsu, Takuji; Seta, Takeshi; Urai, Shunji; Uenoyama, Yoshito; Deguchi, Yasunori; Ono, Kazuo; Chiba, Tsutomu

    2013-08-14

    Mucocele of the appendix due to endometriosis is extremely rare, and there are only 10 previously reported cases in the English literature. We report a case of mucocele of the appendix due to endometriosis and provide the first review of the literature. A 43-year-old woman was admitted to the hospital because of recurrent right lower abdominal pain during her menstrual periods. Colonoscopy revealed submucosal tumor-like elevations of the appendiceal orifice. Computed tomography and magnetic resonance imaging of the abdomen suggested cystic lesions near the appendix. Consequently, mucocele of the appendix was suspected preoperatively. An open ileocecal resection was performed. Multiple cystic lesions were observed around the appendix. The cystic lesions contained mucus. Histopathological examination was consistent with a mucocele of the appendix due to endometriosis. The postoperative course was uneventful. We present the first review of the literature to clarify the clinical features.

  2. Development and pharmacological evaluation of in vitro nanocarriers composed of lamellar silicates containing copaiba oil-resin for treatment of endometriosis

    Energy Technology Data Exchange (ETDEWEB)

    Almeida Borges, Vinícius Raphael de [Department of Drugs and Pharmaceutics, Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro (Brazil); Henriques da Silva, Julianna [Programa de Pesquisa em Biologia Celular e do Desenvolvimento, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro (Brazil); Soares Barbosa, Samantha [Department of Drugs and Pharmaceutics, Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro (Brazil); Nasciutti, Luiz Eurico [Programa de Pesquisa em Biologia Celular e do Desenvolvimento, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro (Brazil); Cabral, Lúcio Mendes [Department of Drugs and Pharmaceutics, Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro (Brazil); Pereira de Sousa, Valeria, E-mail: valeria@pharma.ufrj.br [Department of Drugs and Pharmaceutics, Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro (Brazil)

    2016-07-01

    In this work, newly developed nanocomposites based upon lamellar silicates are evaluated to determine their potential in controlling endometriosis. The preparation of the new nanocarriers is detailed, properties characterized and in vitro pharmacological evaluation performed. The nanocomposites in this study were obtained from the reaction of copaiba oil-resin (COPA) with the polymer polyvinylpyrrolidone (PVP K-30). COPA was selected due to its antiinflammatory and anticancer activities along with the organophilic derivatives of sodium montmorillonite, Viscogel B8, S7 and S4. The results indicated that it was feasible to obtain a good yield of a COPA nanocomposite using a simple process. Intercalation was confirmed by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC). In vitro release experiments demonstrated that COPA was released from the nanocomposite in a delayed fashion. Whereas, in vitro pharmacological studies showed a reduction in viability and proliferation of endometriotic cell cultures upon COPA nanocomposite treatment, suggesting that the system developed here can be a promising alternative therapy for the oral treatment of endometriosis. - Highlights: • Nanocomposite containing copaiba oil-resin can be obtained with good yield by intercalation in solution method. • The copaiba oil-resin is released from the nanocomposite following Higuchi's model in a delayed release. • The nanocomposites containing copaiba reduced the viability and proliferative capacity of the endometriotic cell cultures.

  3. In Vitro and In Vivo Effects of Tumor Suppressor Gene PTEN on Endometriosis: An Experimental Study

    Science.gov (United States)

    Lv, Juan; Zhu, Qiaoying; Jia, Xuemei; Yu, Ningzhu; Li, Qian

    2016-01-01

    Background Endometriosis can cause dysmenorrhea and infertility. Its pathogenesis has not yet been clarified and its treatment continues to pose enormous challenges. The protein tyrosine phosphatase (PTEN) gene is a tumor suppressor gene. The aim of this study was to investigate the role and significance of PTEN protein in the occurrence, development, and treatment of endometriosis through changes in apoptosis rate, cell cycle, and angiogenesis. Material/Methods PTEN was overexpressed and silenced in lentiviral vectors and inserted into primary endometrial cells. The changes in cell cycle and apoptosis in the different PTEN expression groups were evaluated using flow cytometry. Vessel growth mimicry was observed using 3-dimensional culture. A human-mouse chimeric endometriosis model was constructed using SCID mice. Hematoxylin and eosin staining and immunohistochemistry were used to detect pathological changes in ectopic endometrial tissues and the expression of VEGF protein in a human-mouse chimeric endometriosis mouse model. Results PTEN overexpression significantly increased apoptosis and inhibited the cell cycle compared with the silenced and control groups. Furthermore, cells expressing low PTEN levels were better able to undergo vasculogenic mimicry, and exhibited significantly increased angiogenesis compared to cells overexpressing PTEN. We found that ectopic foci were more easily formed in the endometrial tissue of SCID mice with low PTEN expression, and the VEGF expression in this group was relatively high. Conclusions PTEN inhibits the occurrence and development of endometriosis by regulating angiogenesis and the apoptosis and cell cycle of endometrial cells; therefore, we propose that the PTEN gene can be used to treat endometriosis. PMID:27744455

  4. Serum anti-inflammatory cytokines for the evaluation of inflammatory status in endometriosis

    Science.gov (United States)

    Măluţan, Andrei Mihai; Drugan, Tudor; Ciortea, Răzvan; Mocan-Hognogi, Radu Florin; Bucuri, Carmen; Rada, Maria Patricia; Mihu, Dan

    2015-01-01

    Background: Endometriosis is a frequent gynecologic disease with a severe impact on the quality of life in the affected women; its pathogenesis is yet to be fully understood, with an altered immunity as a possible key factor. The present study aimed to investigate the serum anti-inflammatory cytokine profile in the patients with endometriosis compared with the healthy controls. Materials and Methods: One hundred and sixty women were included, divided into two study groups (Group I — endometriosis; Group 2 — healthy women). We evaluated the serum levels of interleukin-1 receptor antagonist (IL-1Ra), IL-2, IL-2R, IL-4, IL-10, IL-13, and IL-15 with the use of Human multiplex cytokine panels. Statistical analyses (normality distribution analysis, independent t-test, Mann–Whitney U-test) were performed using IBM SPSS software (version 22.0) and GraphPad Prism (version 5.00); receiver operating characteristic curve were used to demonstrate the diagnostic performance of the studied markers. Results: The mean serum level of IL-1Ra, IL-4, and IL-10 were significantly higher in women with endometriosis compared to women free of disease from the control group (30.155, 138.459, and 1.489, respectively, compared to 14.109, 84.710, and 0.688, respectively; P < 0.001, P < 0.001, and P = 0.002, respectively.). No significant differences in the mean serum levels of IL-2, IL-13, and IL-15 were observed between the studied groups and IL-2R had a very low detection rate. Conclusion: Endometriosis is associated with elevated levels of anti-inflammatory cytokines, IL-1Ra, IL-4, and IL-10, markers that have a potential role as a prognostic factor for endometriosis. PMID:26622256

  5. Serum anti-inflammatory cytokines for the evaluation of inflammatory status in endometriosis

    Directory of Open Access Journals (Sweden)

    Andrei Mihai Malutan

    2015-01-01

    Full Text Available Background: Endometriosis is a frequent gynecologic disease with a severe impact on the quality of life in the affected women; its pathogenesis is yet to be fully understood, with an altered immunity as a possible key factor. The present study aimed to investigate the serum anti-inflammatory cytokine profile in the patients with endometriosis compared with the healthy controls. Materials and Methods: One hundred and sixty women were included, divided into two study groups (Group I - endometriosis; Group 2 - healthy women. We evaluated the serum levels of interleukin-1 receptor antagonist (IL-1Ra, IL-2, IL-2R, IL-4, IL-10, IL-13, and IL-15 with the use of Human multiplex cytokine panels. Statistical analyses (normality distribution analysis, independent t-test, Mann-Whitney U-test were performed using IBM SPSS software (version 22.0 and GraphPad Prism (version 5.00; receiver operating characteristic curve were used to demonstrate the diagnostic performance of the studied markers. Results: The mean serum level of IL-1Ra, IL-4, and IL-10 were significantly higher in women with endometriosis compared to women free of disease from the control group (30.155, 138.459, and 1.489, respectively, compared to 14.109, 84.710, and 0.688, respectively; P < 0.001, P < 0.001, and P = 0.002, respectively.. No significant differences in the mean serum levels of IL-2, IL-13, and IL-15 were observed between the studied groups and IL-2R had a very low detection rate. Conclusion: Endometriosis is associated with elevated levels of anti-inflammatory cytokines, IL-1Ra, IL-4, and IL-10, markers that have a potential role as a prognostic factor for endometriosis.

  6. Prevalence of high-risk human papillomavirus infection in women with ovarian endometriosis.

    Science.gov (United States)

    Heidarpour, Mitra; Derakhshan, Maryam; Derakhshan-Horeh, Marzieh; Kheirollahi, Majid; Dashti, Sepideh

    2017-01-01

    In this study, we aimed to determine the prevalence of human papillomavirus (HPV) in ovarian endometriosis and ovarian tissue from women without endometriosis. Understanding the pathogenesis of the disease could help us design preventative strategies as well as novel and appropriate treatment approaches in this regard. In this cross-sectional study, formalin-fixed and paraffin-embedded tissue sections from 50 and 49 ovaries with and without endometriosis, respectively, were evaluated for the presence of high-risk HPV using the polymerase chain reaction technique. Prevalence of HPV infection and other related characteristics of the studied population were compared. High-risk HPV infection was detected in 13 (26%) and five (10.2%) of the samples with and without endometriosis, respectively (P = 0.041, χ(2)  = 3.16). Mean age and parity were not significantly different in subjects with and without HPV infection in the two studied groups (P = 0.7 and P = 0.06 for age in case and control groups, respectively; and P = 0.32 and P = 0.09 for parity in case and control groups, respectively). The results of our study indicated a higher rate of high-risk HPV infection among patients with endometriosis. The findings could provide us baseline information for future studies regarding the pathogenesis of endometriosis and the role of viral infection and their possible impact on future cancer development in this group of patients. © 2016 Japan Society of Obstetrics and Gynecology.

  7. [Relationship among anthropometric and gluco-metabolic parameters, bone mineral density and endometriosis].

    Science.gov (United States)

    Nava-González, Edna J; de la Garza-Casas, Yolanda E; Salazar-Montalvo, Raúl G; Gallegos-Cabriales, Esther C

    2013-01-01

    Introducción: las mujeres con endometriosis cursan con una densidad mineral ósea (DMO) disminuida. Varios estudios han demostrado que la acumulación del tejido adiposo afecta profundamente la DMO. También se ha documentado que un exceso de grasa corporal se asocia con el desarrollo de endometriosis. Nuestro objetivo fue analizar la relación entre la DMO, la masa grasa corporal y el eje insulina-glucosa en mujeres con endometriosis. Métodos: treinta mujeres con diagnóstico laparoscópico de endometriosis aceptaron participar en este estudio. Se les efectuó antropometría y densitometría dual de rayos X para determinar su índice de masa corporal, su composición corporal y su DMO. Se les determinaron mediciones de insulina y glucosa en ayuno y posprandiales. Resultados: para el análisis de los resultados, se utilizaron metodologías de estadística descriptiva y prueba de Pearson. Existió un patrón entre cada fenotipo caracterizado y el T-score de la DMO en nuestras participantes con endometriosis.Conclusiones: la importancia de encontrar correlaciones clínico-observacionales entre enfermedades prevalentes que afectan la composición corporal en la población femenina (endometriosis, osteoporosis, diabetes y obesidad) podría dar lugar a hipótesis sobre una génesis causal común entre estas condiciones patológicas.

  8. The impact of endometriosis on the outcome of Assisted Reproductive Technology.

    Science.gov (United States)

    González-Comadran, Mireia; Schwarze, Juan Enrique; Zegers-Hochschild, Fernando; Souza, Maria do Carmo B; Carreras, Ramon; Checa, Miguel Ángel

    2017-01-24

    Endometriosis has been described to impair fertility through various mechanisms. However, studies evaluating the reproductive outcomes of women undergoing assisted reproductive technologies show controversial results. The aim of this study is to assess whether the reproductive outcome is impaired among women with endometriosis-associated infertility undergoing IVF. A retrospective cohort study was performed, including women undergoing IVF reported by the Red Latinoamericana de Reproduccion Asistida (Redlara) registry, between January 2010 and December 2012. The study group included women with endometriosis-associated infertility, and the control group women with tubal factor, endocrine disorders or unexplained infertility. Women above 40 years, severe male factor and premature ovarian failure were excluded. The reproductive outcomes of between both groups were compared. The primary outcome was live birth. Secondary outcomes included clinical pregnancy, miscarriage, number of oocytes retrieved and number of fertilized oocytes. Outcomes were assessed after the first fresh IVF cycle, and were adjusted for age and number of embryos transferred. A total of 22.416 women were included (3.583 with endometriosis and 18.833 in the control group). Mean age of patients in the endometriosis group and control group was 34.86 (3.47) and 34.61 (3.91) respectively, p = 0.000. The mean number of oocytes retrieved were 8.89 (6.23) and 9.86 (7.02) respectively, p = 0.000. No significant differences were observed between groups in terms of live birth (odds ratio (OR) 1.032, p = 0.556), clinical pregnancy (OR 1.044, p = 0.428) and miscarriage rates (OR 1.049, p = 0.623). Women with endometriosis had significantly lower number of oocytes retrieved (incidence risk ratio (IRR) 0.917, 95% CI 0.895-0.940), however, the number of fertilized oocytes did not differ among the two groups when adjusting for the number of oocytes retrieved (IRR 1.003, p = 0.794). An age

  9. Change Profiles in Matrix Metalloproteinase-2 and-9 in Induced Endometriosis in Mice

    Institute of Scientific and Technical Information of China (English)

    陈琼华; 邱娜璇; 濮德敏; 周玉明; 李天; 杨宏毅

    2010-01-01

    To examine the changes in matrix metalloproteinase-2(MMP-2) and-9(MMP-9) in the development and progression of endometriosis,real time quantitative polymerase chain reaction,enzyme-linked immunoabsorbent assay and gelatin zymography were employed to determine the mRNA and protein levels and activities of MMP-2 and MMP-9 from the first day to the 21st day after the induction in mice with induced endometriosis(experimental group) and sham-operated animals(controls).The results showed that the mRNA and protein...

  10. Identification of Biomarkers for Endometriosis Using Clinical Proteomics

    Directory of Open Access Journals (Sweden)

    Yang Zhao

    2015-01-01

    Full Text Available Background: We investigated possible biomarkers for endometriosis (EM using the ClinProt technique and proteomics methods. Methods: We enrolled 50 patients with EM, 34 with benign ovarian neoplasms and 40 healthy volunteers in this study. Serum proteomic spectra were generated by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MS combined with weak cationic exchange (WCX magnetic beads. Possible biomarkers were analyzed by a random and repeat pattern model-validation method that we designed, and ClinProtools software, results were refined using online liquid chromatography-tandem MS. Results: We found a cluster of 5 peptides (4210, 5264, 2660, 5635, and 5904 Da, using 3 peptides (4210, 5904, 2660 Da to discriminate EM patients from healthy volunteers, with 96.67% sensitivity and 100% specificity. We selected 4210 and 5904 m/z, which differed most between patients with EM and controls, and identified them as fragments of ATP1B4, and the fibrinogen alpha (FGA isoform 1/2 of the FGA chain precursor, respectively. Conclusions: ClinProt can identify EM biomarkers, which - most notably - distinguish even early-stage or minimal disease. We found 5 stable peaks at 4210, 5264, 2660, 5635, and 5904 Da as potential EM biomarkers, the strongest of which were associated with ATP1B4 (4210 Da and FGA (5904 Da; this indicates that ATP1B4 and FGA are associated with EM pathogenesis.

  11. Whole-exome sequencing of endometriosis identifies frequent alterations in genes involved in cell adhesion and chromatin-remodeling complexes.

    Science.gov (United States)

    Li, Xiaolei; Zhang, Yan; Zhao, Luyang; Wang, Lingxiong; Wu, Zhiqiang; Mei, Qian; Nie, Jing; Li, Xiang; Li, Yali; Fu, Xiaobing; Wang, Xiaoning; Meng, Yuanguang; Han, Weidong

    2014-11-15

    Endometriosis is a complex and enigmatic disease that arises from the interplay among multiple genetic and environmental factors. The defining feature of endometriosis is the deposition and growth of endometrial tissues at sites outside of the uterine cavity. Studies to date have established that endometriosis is heritable but have not addressed the causal genetic variants for this disease. Here, we conducted whole-exome sequencing to comprehensively search for somatic mutations in both eutopic and ectopic endometrium from 16 endometriosis patients and five normal control patients using laser capture microdissection. We compared the mutational landscape of ectopic endometrium with the corresponding eutopic sample from endometriosis patients compared with endometrium from normal women and identified previously unreported mutated genes and pathway alternations. Statistical analysis of exome data identified that most genes were specifically mutated in both eutopic and ectopic endometrium cells. In particular, genes that are involved in biological adhesion, cell-cell junctions, and chromatin-remodeling complex(es) were identified, which partially supports the retrograde menstruation theory that proposes that endometrial cells are refluxed through the fallopian tubes during menstruation and implanted onto the peritoneum or pelvic organs. Conspicuously, when we compared exomic mutation data for paired eutopic and ectopic endometrium, we identified a mutational signature in both endometrial types for which no overlap in somatic single nucleotide variants were observed. These mutations occurred in a mutually exclusive manner, likely because of the discrepancy in endometriosis pathology and physiology, as eutopic endometrium rapidly regrows, and ectopic endometrial growth is inert. Our findings provide, to our knowledge, an unbiased view of the landscape of genetic alterations in endometriosis and vital information for indicating that genetic alterations in cytoskeletal and

  12. [The use of restorative medicine technologies for the rehabilitation of the patients presenting with endometriosis of external genitalia].

    Science.gov (United States)

    Makarenko, L V; Krutova, V A; Gordon, K V

    2012-01-01

    This paper reports the results of analysis of the psycho-emotional status and pain syndrome in the women presenting with endometriosis of external genitalia treated with a combination of hormonal preparations and balneotherapy. A total of 216 infertile patients were involved in the study. The duration of the infertility period varied from 1.5 to 19 years. All the patients underwent surgical intervention. The influence of rehabilitative therapy on the quantitative vital indices (psycho-emotional adaptation to the social environment and pain intensity) was estimated before and after the treatment. The patients were divided into 3 groups. Those of group 1 received an oral contraceptive (30 mcg of ethinylestradiol plus 2 mg dienogest) as a continuous three-cycle course (63 tablets) followed by its discontinuation for the 7 day menstrual period and the final three-cycle course (total duration of therapy 6 months). The patients of group 2 were treated with injections of agonists of gonadotropin releasing hormone (GnRH) at a dose of 3.75 mg once every 4 weeks (total duration 6 months). In group 3, the injections of GnRH agonists (3.75 mg once every 4 weeks, total duration 6 months) were combined with a course of balneotherapy using radon. All the three rehabilitative modalities produced a well-apparent positive effect. Chronic pelvic pain before treatment was reported by 90,3% of the patients. After the treatment, the number of such women in groups 1, 2, and 3 decreased to 20,8%, 12,5%, and 30,6% respectively Dyspareunia in the pre-treatment period was diagnosed in 66,7% of the patients. After treatment, this pathology persisted only in 23,6%, 18,1%, and 31,9% of the patients in groups 1, 2, and 3 respectively. Psycho-emotional disorders before treatment were documented in 90,3% of the patients compared with 27,8%, 25%, and 30,6% after therapy. It is concluded that all the three therapeutic modalities markedly improved health conditions of the patients presenting with

  13. Magnetic resonance imaging in lower urinary tract endometriosis: iconographic essay; Ressonancia magnetica na endometriose do trato urinario baixo: ensaio iconografico

    Energy Technology Data Exchange (ETDEWEB)

    Lima, Claudio Marcio Amaral de Oliveira; Coutinho, Elisa Pompeu Dias; Ribeiro, Erica Barreiros; Domingues, Marisa Nassar Aidar; Junqueira, Flavia Pegado; Coutinho Junior, Antonio Carlos [Clinicas de Diagnostico Por Imagem (CDPI) e Multi-Imagem, Rio de Janeiro, RJ (Brazil)], e-mail: cmaol@br.inter.net, e-mail: cmaolima@gmail.com

    2009-05-15

    Endometriosis is defined as the presence of functional endometrial tissue outside the endometrial cavity and myometrium. Although this is a frequent disease with multifactorial causes, involvement of the lower urinary tract is rare. Magnetic resonance imaging is highly sensitive, specific and accurate in the diagnosis of endometriosis in the lower urinary tract, especially for allowing the identification of lesions obscured by adhesions or with subperitoneal extension. The present iconographic essay presents the main magnetic resonance imaging findings of the lower urinary tract involvement by endometriosis. (author)

  14. Opinion Dynamics with Confirmation Bias

    CERN Document Server

    Allahverdyan, A E

    2014-01-01

    Background: Confirmation bias is the tendency to acquire or evaluate new information in a way that is consistent with one's preexisting beliefs. It is omnipresent in psychology, economics, and even scientific practices. Prior theoretical research of this phenomenon has mainly focused on its economic implications possibly missing its potential connections with broader notions of cognitive science. Methodology/Principal Findings: We formulate a (non-Bayesian) model for revising subjective probabilistic opinion of a confirmationally-biased agent in the light of a persuasive opinion. The revision rule ensures that the agent does not react to persuasion that is either far from his current opinion or coincides with it. We demonstrate that the model accounts for the basic phenomenology of the social judgment theory, and allows to study various phenomena such as cognitive dissonance and boomerang effect. The model also displays the order of presentation effect|when consecutively exposed to two opinions, the preferenc...

  15. Performance Confirmation Data Aquisition System

    Energy Technology Data Exchange (ETDEWEB)

    D.W. Markman

    2000-10-27

    The purpose of this analysis is to identify and analyze concepts for the acquisition of data in support of the Performance Confirmation (PC) program at the potential subsurface nuclear waste repository at Yucca Mountain. The scope and primary objectives of this analysis are to: (1) Review the criteria for design as presented in the Performance Confirmation Data Acquisition/Monitoring System Description Document, by way of the Input Transmittal, Performance Confirmation Input Criteria (CRWMS M&O 1999c). (2) Identify and describe existing and potential new trends in data acquisition system software and hardware that would support the PC plan. The data acquisition software and hardware will support the field instruments and equipment that will be installed for the observation and perimeter drift borehole monitoring, and in-situ monitoring within the emplacement drifts. The exhaust air monitoring requirements will be supported by a data communication network interface with the ventilation monitoring system database. (3) Identify the concepts and features that a data acquisition system should have in order to support the PC process and its activities. (4) Based on PC monitoring needs and available technologies, further develop concepts of a potential data acquisition system network in support of the PC program and the Site Recommendation and License Application.

  16. Opinion dynamics with confirmation bias.

    Science.gov (United States)

    Allahverdyan, Armen E; Galstyan, Aram

    2014-01-01

    Confirmation bias is the tendency to acquire or evaluate new information in a way that is consistent with one's preexisting beliefs. It is omnipresent in psychology, economics, and even scientific practices. Prior theoretical research of this phenomenon has mainly focused on its economic implications possibly missing its potential connections with broader notions of cognitive science. We formulate a (non-Bayesian) model for revising subjective probabilistic opinion of a confirmationally-biased agent in the light of a persuasive opinion. The revision rule ensures that the agent does not react to persuasion that is either far from his current opinion or coincides with it. We demonstrate that the model accounts for the basic phenomenology of the social judgment theory, and allows to study various phenomena such as cognitive dissonance and boomerang effect. The model also displays the order of presentation effect-when consecutively exposed to two opinions, the preference is given to the last opinion (recency) or the first opinion (primacy) -and relates recency to confirmation bias. Finally, we study the model in the case of repeated persuasion and analyze its convergence properties. The standard Bayesian approach to probabilistic opinion revision is inadequate for describing the observed phenomenology of persuasion process. The simple non-Bayesian model proposed here does agree with this phenomenology and is capable of reproducing a spectrum of effects observed in psychology: primacy-recency phenomenon, boomerang effect and cognitive dissonance. We point out several limitations of the model that should motivate its future development.

  17. Opinion dynamics with confirmation bias.

    Directory of Open Access Journals (Sweden)

    Armen E Allahverdyan

    Full Text Available Confirmation bias is the tendency to acquire or evaluate new information in a way that is consistent with one's preexisting beliefs. It is omnipresent in psychology, economics, and even scientific practices. Prior theoretical research of this phenomenon has mainly focused on its economic implications possibly missing its potential connections with broader notions of cognitive science.We formulate a (non-Bayesian model for revising subjective probabilistic opinion of a confirmationally-biased agent in the light of a persuasive opinion. The revision rule ensures that the agent does not react to persuasion that is either far from his current opinion or coincides with it. We demonstrate that the model accounts for the basic phenomenology of the social judgment theory, and allows to study various phenomena such as cognitive dissonance and boomerang effect. The model also displays the order of presentation effect-when consecutively exposed to two opinions, the preference is given to the last opinion (recency or the first opinion (primacy -and relates recency to confirmation bias. Finally, we study the model in the case of repeated persuasion and analyze its convergence properties.The standard Bayesian approach to probabilistic opinion revision is inadequate for describing the observed phenomenology of persuasion process. The simple non-Bayesian model proposed here does agree with this phenomenology and is capable of reproducing a spectrum of effects observed in psychology: primacy-recency phenomenon, boomerang effect and cognitive dissonance. We point out several limitations of the model that should motivate its future development.

  18. Evaluating the Efficacy of Levonorgestrel Intrauterine System and Danazol for Relief of Postoperative Pain in Endometriosis.

    Science.gov (United States)

    Taneja, Ashima; Kaur, Satinder; Soni, R K; Bhanupriya; Kaur, Jaspreet; Singla, Laveen

    2017-07-01

    Endometriosis is an oestrogen-dependent disorder, manifests during reproductive years and is associated with pain and infertility. There is considerable debate about the effectiveness of various interventions for pain relief. To evaluate the efficacy of Levonorgestrel Intrauterine System (LNG-IUS) and Danazol in postoperative pain relief for patients with endometriosis. Hundred patients with diagnosis of endometriosis, who were treated laparoscopically, entered the study to receive either danazol (600 mg once daily) or LNG-IUS (inserted during immediate post operative period) postsurgery, for pain relief. Patients were analysed for pain relief according to VAS score and recurrence of disease using ultrasonography at third and sixth months of follow up. There were 50% patients in stage IV of endometriosis. Majority of them presented with complaint of infertility (49%) and pelvic pain (43%). It was observed that LNG-IUS was significantly more effective in relieving pain compared to danazol (65.2% vs 38.0%, p<0.05). Recurrence rate was significantly lower in LNG-IUS users compared to other group. LNG-IUS was found to be more effective in relieving pain compared to danazol.

  19. The ENDOCARE questionnaire guides European endometriosis clinics to improve the patient-centeredness of their care

    NARCIS (Netherlands)

    Dancet, E.A.; Apers, S.; Kluivers, K.B.; Kremer, J.A.M.; Sermeus, W.; Devriendt, C.; Nelen, W.L.D.M.; D'Hooghe, T.M.

    2012-01-01

    STUDY QUESTION: How patient-centered are two included specialized endometriosis clinics relative to each other and how can they improve the patient-centeredness of their care? SUMMARY ANSWER: The validated ENDOCARE questionnaire (ECQ) reliably concluded that the adjusted overall patient-centeredness

  20. Oral and depot progestin therapy for endometriosis: towards a personalized medicine.

    Science.gov (United States)

    Buggio, Laura; Somigliana, Edgardo; Barbara, Giussy; Frattaruolo, Maria Pina; Vercellini, Paolo

    2017-09-24

    Endometriosis is an estrogen-dependent chronic inflammatory disorder that requires a life-long management plan. Long-term adherence to treatment is pivotal to ensure an effective clinical management. In this optic, one of the cornerstone of endometriosis medical treatment is represented by progestins. Areas covered: This narrative review examines the clinical efficacy, safety and tolerability of oral and depot progestins used in the treatment of endometriosis. The material included in the current manuscript was obtained with a MEDLINE search through PubMed from inception until February 2017. Expert opinion: Progestins are effective in controlling pain symptoms in the majority of women with endometriosis, and their effect seems not inferior to that achieved with other compounds used to treat the disease, such as gonadotropin-releasing hormone agonist. Available progestins include a broad range of both oral and depot compounds, and represent, in most cases, an inexpensive treatment option. In addition, progestins do not increase significantly thrombotic risk and could be adopted in those women with metabolic or cardiovascular contraindication to estrogen-progestins. The choice between the different available compounds should be tailored for every woman with preference to the most cost-effective treatment, depending on the most complained symptom and disease location.

  1. Pregnancy Rate after Controlled Ovarian Hyperstimulation and Intrauterine Insemination for the Treatment of Endometriosis following Surgery

    Directory of Open Access Journals (Sweden)

    Attila Keresztúri

    2015-01-01

    Full Text Available Objective. To compare pregnancy rate after controlled ovarian hyperstimulation and intrauterine insemination (COH-IUI with no treatment in patients with endometriosis-associated infertility treated with laparoscopy. Design. A clinical cohort study. Setting. University-level tertiary care center. Patients. 238 women with various stages of endometriosis after laparoscopic treatment. Interventions. Either COH-IUI or follow-up for 12 months. Main Outcome Measures. The primary outcome measures were clinical pregnancy and live birth rate. Predictive factors evaluated were female age, maternal BMI, and duration of infertility. Results. The pregnancy rate attained after the integrated laparoscopy–COH-IUI approach was 53.4%, while it was significantly lower (38.5% in the control group. Similarly, a significant difference was observed in live births (48.3% versus 34.2%. Patients with severe endometriosis were less likely to achieve pregnancy (38% and live birth (35% than their counterparts with milder forms (57% and 53%. Conclusions. In patients with endometriosis-based infertility, surgery followed by COH-IUI is more effective than surgery alone.

  2. Mindfulness-based psychological intervention for coping with pain in endometriosis

    DEFF Research Database (Denmark)

    Jensen, Mette Kold; Hansen, Tia G. B.; Vedsted-Hansen, Hanne

    2012-01-01

    after optimal medical treatment. We suggest a psychological intervention based on mindfulness techniques for dealing with pain, and report results from a pilot study with 10 endometriosis patients with chronic pain problems. Participants’ level of distress was measured with self-report questionnaires...

  3. The follicular endocrine environment in stimulated cycles of women with endometriosis: steroid levels and embryo quality.

    Science.gov (United States)

    Pellicer, A; Valbuena, D; Bauset, C; Albert, C; Bonilla-Musoles, F; Remohí, J; Simón, C

    1998-06-01

    To assess the endocrine milieu in follicles of stimulated cycles comparing women with and without endometriosis. Steroids were measured in follicular fluid (FF) and in in vitro culture of granulosa-luteal cells, and this status was related to the quality of the embryos obtained after IVF. Case-control study. IVF program at the Instituto Valenciano de Infertilidad. Twenty-four women with laparoscopically documented endometriosis and 26 controls undergoing IVF. Individual follicular aspiration, oocyte isolation, FF storage, and preparation of luteinized granulosa cells for culture; oocyte insemination and embryo cleavage in standard IVF. Serum (day of ovum pickup) and FF measurements of estradiol, progesterone, testosterone, and androstenedione. Secretion of progesterone was measured in the cell-conditioned medium. Results were compared between patients with endometriosis and controls, as well as between oocytes that yielded embryos of different quality. Levels of progesterone in the FF increased with the severity of the disease, whereas testosterone accumulation in the FF decreased with the severity of the disease. An increase in progesterone accumulation in vitro was observed in basal and hCG-induced granulosa cell cultures. No difference was observed in terms of embryo quality, and no steroid marker was able to identify follicles with oocytes that displayed embryos of good or bad quality under the inverted microscope. The data show differences in the steroidogenesis of follicles from stimulated women with and without endometriosis. These changes indicate good endocrine health but are not predictive of embryo quality.

  4. Analysis of biomarker expression in severe endometriosis and determination of possibilities for targeted intraoperative imaging

    NARCIS (Netherlands)

    van den Berg, Liseth L.; Crane, Lucia M. A.; van Oosten, Marleen; van Dam, Gooitzen M.; Simons, Arnold H. M.; Hofker, H. Sijbrand; Bart, Joost

    2013-01-01

    Objective: To evaluate the expression of biomarkers in endometriotic tissue in order to determine the most promising molecules for targeted intraoperative imaging. Methods: Tissue samples were obtained from 18 patients with endometriosis. The intensity and pattern of expression of the following biom

  5. [Pelvic inflammatory disease and an abscessed endometriosis cyst: a diagnostic problem and a therapeutic dilemma

    NARCIS (Netherlands)

    Weering, H.G.I. van; Mijatovic, V.; Groot, J. de; Hompes, P.G.; Brolmann, H.A.M.

    2007-01-01

    A 52-year-old woman with known endometriosis was treated with a levonorgestrel-containing IUD for irregular vaginal blood loss. Two weeks later she was admitted with signs ofpelvic inflammatory disease (PID) and was treated with antibiotics. As no clinical improvement ensued, laparoscopy was

  6. [Pelvic inflammatory disease and an abscessed endometriosis cyst: a diagnostic problem and a therapeutic dilemma

    NARCIS (Netherlands)

    Weering, H.G.I. van; Mijatovic, V.; Groot, J. de; Hompes, P.G.; Brolmann, H.A.M.

    2007-01-01

    A 52-year-old woman with known endometriosis was treated with a levonorgestrel-containing IUD for irregular vaginal blood loss. Two weeks later she was admitted with signs ofpelvic inflammatory disease (PID) and was treated with antibiotics. As no clinical improvement ensued, laparoscopy was perform

  7. Women with endometriosis improved their peripheral antioxidant markers after the application of a high antioxidant diet

    Directory of Open Access Journals (Sweden)

    Casanueva Esther

    2009-05-01

    Full Text Available Abstract Background Oxidative stress has been identified in the peritoneal fluid and peripheral blood of women with endometriosis. However, there is little information on the antioxidant intake for this group of women. The objectives of this work were 1 to compare the antioxidant intake among women with and without endometriosis and 2 to design and apply a high antioxidant diet to evaluate its capacity to reduce oxidative stress markers and improve antioxidant markers in the peripheral blood of women with endometriosis. Methods Women with (WEN, n = 83 and without endometriosis (WWE, n = 80 were interviewed using a Food Frequency Questionnaire to compare their antioxidant intake (of vitamins and minerals. Then, the WEN participated in the application of a control (n = 35 and high antioxidant diet (n = 37 for four months. The high antioxidant diet (HAD guaranteed the intake of 150% of the suggested daily intake of vitamin A (1050 μg retinol equivalents, 660% of the recommended daily intake (RDI of vitamin C (500 mg and 133% of the RDI of vitamin E (20 mg. Oxidative stress and antioxidant markers (vitamins and antioxidant enzymatic activity were determined in plasma every month. Results Comparison of antioxidant intake between WWE and WEN showed a lower intake of vitamins A, C, E, zinc, and copper by WEN (p Conclusion WEN had a lower intake of antioxidants in comparison to WWE. Peripheral oxidative stress markers diminished, and antioxidant markers were enhanced, in WEN after the application of the HAD.

  8. Dioxin-like compounds and endometriosis: a study on Italian and Belgian women of reproductive age.

    Science.gov (United States)

    De Felip, Elena; Porpora, Maria Grazia; di Domenico, Alessandro; Ingelido, Anna Maria; Cardelli, Massimo; Cosmi, Ermelando V; Donnez, Jacques

    2004-04-21

    Compounds with dioxin-like toxicity are suspected to adversely affect human reproduction even at current background exposures. Endometriosis, a gynecological disorder often associated with infertility, has been hypothesized to be linked to dioxins and similar chemicals, a hypothesis supported by the outcome of experimental studies on animal models. Endometriosis severity and incidence in Belgium is one of the highest of the world: in this country, the general population exposure to dioxin-like compounds has been, on average, higher than in most industrialized countries. Here we show the results of a pilot case-control study carried out on 22 Italian and 18 Belgian women of reproductive age, with and without endometriosis. No significant differences were found in dioxin-like compound body burdens between cases and controls on a country basis, whereas the body burdens of the Italian women resulted to be significantly lower than that of the Belgian. In particular, total TEQs in Italian and Belgian women without endometriosis were respectively 18 and 45 pg WHO-TE/g lb.

  9. ANTIOXIDANT DEFENSE SYSTEM CORRECTION IN TREATMENT OF PAYIENTS WITH INFERTILITY AND PERITONEAL ENDOMETRIOSIS

    Directory of Open Access Journals (Sweden)

    Dubinskaya, E.D.

    2016-09-01

    The findings suggest that the efficiency of the proposed comprehensive treatment techniques (laparoscopy and subsequent course of therapeutic plasmapheresis of patients with peritoneal endometriosis and infertility and with point mutations in the gene NAT2. The use of plasmapheresis  is pathogenetically justified in patients of the studied group.

  10. Metformin as a new therapy for endometriosis, its effects on both clinical picture and cytokines profile

    Directory of Open Access Journals (Sweden)

    Ashraf Ahmed Foda

    2012-12-01

    Conclusion: Metformin therapy in patients with endometriosis resulted in a significant reduction in the symptomatic cases, increased chance of pregnancy, and a decrease in the levels of serum cytokines, suggesting that it may have a therapeutic potential as an anti-endometriotic drug.

  11. Role of some biomarkers in chronic pelvic pain for early detection of endometriosis in infertile women

    Directory of Open Access Journals (Sweden)

    Ashraf Ahmed Foda

    2012-09-01

    Conclusion: Serum IL-6 and TNF-α levels are reliable non-invasive biomarkers for the diagnosis of early stages of endometriosis because they increased significantly in early cases than in late cases. CA125, Hs-CRP & VEGF are significantly increased in late cases, so they cannot be used for early diagnosis.

  12. Effect of genistein on proinflammatory cytokines and estrogen receptor-β in mice model of endometriosis

    Institute of Scientific and Technical Information of China (English)

    Sutrisno Sutrisno; RR Catur Leny Wulandari; Dwi Wahyu Wulan Sulistyowati; Ratna Feti Wulandari; Endang Sri Wahyuni; Yuyun Yueniwati; Sanarto Santoso

    2015-01-01

    Objective: To investigate the effect of genistein on proinflammatory cytokines, NF-κB activation, and estrogen receptor-β expression in a mice model of endometriosis. Methods:Forty female mice (Mus musculus) were divided into eight groups (n=5 each), including the control (untreated) group, endometriosis group, and the endometriosis groups were given various doses of genistein (at doses of 50; 100; 200; 300; 400; 500 mg/day). Analysis of TNF-α, IL-1β, IL-6, and IL-8 level were done by ELISA technically. Analysis of estrogen receptor-β and NF-κB were done by immunohistochemistry. Results: The level of TNF-α, IL-1β, IL-6, and IL-8 were significantly higher in the EM group compared to the untreated control group (P0.05). These increased levels of IL-1β,IL-6, adn IL-8 in the EM group were significantly reduced by all doses of genistein. There were significantly (P0.05). All doses genistein significantly prevented EM-induced increase in NF-κB activation (P<0.05), to reach the expression on control group. Conclusion: In conclusion, genistein prohibits the increase in proinflammatory cytokines, NF-κB, and estrogen receptor-β expression in a mice model of endometriosis.

  13. Treatment of endometriosis with local acetylsalicylic acid injection: experimental study in rabbits.

    Science.gov (United States)

    Siqueira, Juliana Menezes; Barreto, Adriana Beatriz; Saad-Hossne, Rogério

    2011-01-01

    The objective of the present study was to estimate the effects of introduction of acetylsalicylic acid solution into peritoneal implants in autologous endometrium as a method for treating endometriosis. Forty adult female rabbits were subdivided into 4 groups of 10 rabbits each, and endometriosis was induced via autotransplantation of endometrial fragments into the peritoneal cavity. At 30 days after induction of endometriosis, all animals were randomly assigned to 1 of 2 protocols. In protocol 1, animals were evaluated at 24 hours after treatment; group 1 (control) received physiologic solution, and group 2 received acetylsalicylic acid. In protocol 2, animals were evaluated at 10 days after treatment, group 3 (control) and group 4 received acetylsalicylic acid. After measuring the lesion, the endometriotic focus was removed and prepared for mounting on slides for histologic analysis. Imaging software was used for analysis of the total remaining area of endometrial tissue. The affected area in acetylsalicylic acid-treated animals was smaller than that in control animals at 24 hours and 10 days after treatment; a significant difference was found between control and treated groups (p acetylsalicylic acid groups (p = .30), and no differences between times (p = .75). Acetylsalicylic acid solution led to less growth (or higher involution) of endometrial implants. Acetylsalicylic acid injected directly into endometriotic foci was effective in their destruction. This presents new perspectives for treatment of endometriosis and for clinical applications based on further clinical studies.

  14. How Many People Are Affected by or at Risk for Endometriosis?

    Science.gov (United States)

    ... with subsequent diagnosis of endometriosis. American Journal of Obstetrics & Gynecology, 202 , 534.e1-534.e6. [top] « What causes it? What are common symptoms? » Related A-Z Topics Infertility and Fertility NICHD News and Spotlights Selected NICHD ...

  15. Endometriose: modelo experimental em ratas Endometriosis: experimental model in rats

    Directory of Open Access Journals (Sweden)

    Eduardo Schor

    1999-06-01

    Full Text Available Objetivo: divulgar a metodologia da indução de endometriose experimental em animais de laboratório. Método: utilizamos ratas albinas, virgens, adultas de aproximadamente três meses de idade, que foram inicialmente anestesiadas pelo éter etílico. Aberta a cavidade abdominal, identificamos os cornos uterinos e retiramos um fragmento de aproximadamente 4 cm do corno uterino direito. Esse fragmento foi mergulhado em solução fisiológica e sob lupa estereoscópica foi separado o endométrio do miométrio e feitos retângulos de aproximadamente 4 por 5 mm. Esses foram fixados por meio de fio de sutura, sobre vasos sangüíneos visíveis a olho nu, na parede lateral do abdômen, tomando-se sempre o cuidado de manter a porção do endométrio livre voltada para a luz da cavidade abdominal. Após 21 dias os animais foram novamente operados para verificarmos o tamanho dos implantes e para retirada do endométrio ectópico para análise histológica. Resultados: macroscopicamente observamos crescimento significativo dos implantes endometriais. Ao exame microscópico pudemos observar a presença de epitélio glandular e estroma semelhantes ao do endométrio tópico. Conclusões: o modelo utilizado reproduz a doença, em ratas, sendo método auxiliar de valia para estudar esta afecção, principalmente a ação de medicamentos sobre esses implantes.Purpose: to demonstrate the experimental endometriosis induction in animals. Method: we used adult female Wistar rats weighing 200 - 250 g anesthetized with ethyl ether to open the abdominal cavity. After identifying the uterine horns, we removed an approximately 4 cm fragment from the right uterine horn. This fragment was placed in physiological saline and, with the aid of a stereoscopic magnifying glass, the endometrium was separated from the myometrium and cut into rectangles of approximately 4 x 5 mm. These rectangles were fastened to the lateral abdominal wall near great blood vessels, taking care

  16. Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group.

    Science.gov (United States)

    Guerriero, S; Condous, G; van den Bosch, T; Valentin, L; Leone, F P G; Van Schoubroeck, D; Exacoustos, C; Installé, A J F; Martins, W P; Abrao, M S; Hudelist, G; Bazot, M; Alcazar, J L; Gonçalves, M O; Pascual, M A; Ajossa, S; Savelli, L; Dunham, R; Reid, S; Menakaya, U; Bourne, T; Ferrero, S; Leon, M; Bignardi, T; Holland, T; Jurkovic, D; Benacerraf, B; Osuga, Y; Somigliana, E; Timmerman, D

    2016-09-01

    The IDEA (International Deep Endometriosis Analysis group) statement is a consensus opinion on terms, definitions and measurements that may be used to describe the sonographic features of the different phenotypes of endometriosis. Currently, it is difficult to compare results between published studies because authors use different terms when describing the same structures and anatomical locations. We hope that the terms and definitions suggested herein will be adopted in centers around the world. This would result in consistent use of nomenclature when describing the ultrasound location and extent of endometriosis. We believe that the standardization of terminology will allow meaningful comparisons between future studies in women with an ultrasound diagnosis of endometriosis and should facilitate multicenter research. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

  17. Opinion Dynamics with Confirmation Bias

    Science.gov (United States)

    Allahverdyan, Armen E.; Galstyan, Aram

    2014-01-01

    Background Confirmation bias is the tendency to acquire or evaluate new information in a way that is consistent with one's preexisting beliefs. It is omnipresent in psychology, economics, and even scientific practices. Prior theoretical research of this phenomenon has mainly focused on its economic implications possibly missing its potential connections with broader notions of cognitive science. Methodology/Principal Findings We formulate a (non-Bayesian) model for revising subjective probabilistic opinion of a confirmationally-biased agent in the light of a persuasive opinion. The revision rule ensures that the agent does not react to persuasion that is either far from his current opinion or coincides with it. We demonstrate that the model accounts for the basic phenomenology of the social judgment theory, and allows to study various phenomena such as cognitive dissonance and boomerang effect. The model also displays the order of presentation effect–when consecutively exposed to two opinions, the preference is given to the last opinion (recency) or the first opinion (primacy) –and relates recency to confirmation bias. Finally, we study the model in the case of repeated persuasion and analyze its convergence properties. Conclusions The standard Bayesian approach to probabilistic opinion revision is inadequate for describing the observed phenomenology of persuasion process. The simple non-Bayesian model proposed here does agree with this phenomenology and is capable of reproducing a spectrum of effects observed in psychology: primacy-recency phenomenon, boomerang effect and cognitive dissonance. We point out several limitations of the model that should motivate its future development. PMID:25007078

  18. Model confirmation in climate economics.

    Science.gov (United States)

    Millner, Antony; McDermott, Thomas K J

    2016-08-01

    Benefit-cost integrated assessment models (BC-IAMs) inform climate policy debates by quantifying the trade-offs between alternative greenhouse gas abatement options. They achieve this by coupling simplified models of the climate system to models of the global economy and the costs and benefits of climate policy. Although these models have provided valuable qualitative insights into the sensitivity of policy trade-offs to different ethical and empirical assumptions, they are increasingly being used to inform the selection of policies in the real world. To the extent that BC-IAMs are used as inputs to policy selection, our confidence in their quantitative outputs must depend on the empirical validity of their modeling assumptions. We have a degree of confidence in climate models both because they have been tested on historical data in hindcasting experiments and because the physical principles they are based on have been empirically confirmed in closely related applications. By contrast, the economic components of BC-IAMs often rely on untestable scenarios, or on structural models that are comparatively untested on relevant time scales. Where possible, an approach to model confirmation similar to that used in climate science could help to build confidence in the economic components of BC-IAMs, or focus attention on which components might need refinement for policy applications. We illustrate the potential benefits of model confirmation exercises by performing a long-run hindcasting experiment with one of the leading BC-IAMs. We show that its model of long-run economic growth-one of its most important economic components-had questionable predictive power over the 20th century.

  19. Identification of Biomarkers for Endometriosis Using Clinical Proteomics

    Institute of Scientific and Technical Information of China (English)

    Yang Zhao; Ya-Nan Liu; Yi Li; Li Tian; Xue Ye; Heng Cui; Xiao-Hong Chang

    2015-01-01

    Background:We investigated possible biomarkers for endometriosis (EM) using the ClinProt technique and proteomics methods.Methods:We enrolled 50 patients with EM,34 with benign ovarian neoplasms and 40 healthy volunteers in this study.Serum proteomic spectra were generated by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MS) combined with weak cationic exchange (WCX) magnetic beads.Possible biomarkers were analyzed by a random and repeat pattern model-validation method that we designed,and ClinProtools software,results were refined using online liquid chromatography-tandem MS.Results:We found a cluster of 5 peptides (4210,5264,2660,5635,and 5904 Da),using 3 peptides (4210,5904,2660 Da) to discriminate EM patients from healthy volunteers,with 96.67% sensitivity and 100% specificity.We selected 4210 and 5904 m/z,which differed most between patients with EM and controls,and identified them as fragments of ATP1B4,and the fibrinogen alpha (FGA) isoform 1/2 of the FGA chain precursor,respectively.Conclusions:ClinProt can identify EM biomarkers,which-most notably-distinguish even early-stage or minimal disease.We found 5 stable peaks at 4210,5264,2660,5635,and 5904 Da as potential EM biomarkers,the strongest of which were associated with ATP1B4 (4210 Da) and FGA (5904 Da); this indicates that ATP1B4 and FGA are associated with EM pathogenesis.

  20. Confirmation of shutdown cooling effects

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Kotaro, E-mail: ksato@nelted.co.jp; Tabuchi, Masato; Sugimura, Naoki; Tatsumi, Masahiro [Nuclear Engineering, Limited, 1-3-7 Tosabori Nishi-ku, Osaka-shi, Osaka 550-0001 (Japan)

    2015-12-31

    After the Fukushima accidents, all nuclear power plants in Japan have gradually stopped their operations and have long periods of shutdown. During those periods, reactivity of fuels continues to change significantly especially for high-burnup UO{sub 2} fuels and MOX fuels due to radioactive decays. It is necessary to consider these isotopic changes precisely, to predict neutronics characteristics accurately. In this paper, shutdown cooling (SDC) effects of UO{sub 2} and MOX fuels that have unusual operation histories are confirmed by the advanced lattice code, AEGIS. The calculation results show that the effects need to be considered even after nuclear power plants come back to normal operation.

  1. Improving accuracy of intraoperative diagnosis of endometriosis: Role of firefly in minimal access robotic surgery

    Directory of Open Access Journals (Sweden)

    John R Lue

    2016-01-01

    Full Text Available Endometriosis continues to be a major primary gynecologic etiology of chronic pelvic pain. The symptom profile, which includes cyclic pelvic pain, dysmenorrhea, and dyspareunia or dyschezia, is nonspecific and does not correlate with the extent or severity of disease. Trans-vaginal or trans-rectal ultrasound, as well as magnetic resonance imaging, can help visualize endometriomas and deeply infiltrating endometriosis. Additionally, there have been no serum marker tests available so far. However, even intraoperatively, the diagnosis may be missed, leading to under diagnosis and delayed or noninitiation of treatment. There are thought to be three distinct endometriotic lesions of the pelvis that are seen laparoscopically. The first is that which is visible on the pelvic peritoneal surface or the surface of the ovary, which is commonly termed peritoneal endometriosis. Second, endometriotic lesions that occur within the ovary and form cysts that are often lined with endometrioid mucosa are termed endometriomas. Lastly, rectovaginal endometriomas are endometriotic lesions that contain a mixture of adipose and fibrous tissue located between the rectum and vagina. All of these lesions can be singular or multiple and the pelvis may contain one or all three types of lesions. The shared histologic feature with all three lesions is the presence of endometrial epithelial cells or endometrial stroma. During a diagnostic procedure, the da-Vinci robot and its firefly mode allow for three dimensional visualization and seven degrees of instrument articulation for meticulous dissection of fibrotic areas of peritoneum that may contain deep infiltrating lesions of endometriosis. This case report describes a relatively new and innovative technique for effectively diagnosing and successfully treating endometriosis when other less invasive methods have failed.

  2. Genome-wide DNA methylation analysis predicts an epigenetic switch for GATA factor expression in endometriosis.

    Directory of Open Access Journals (Sweden)

    Matthew T Dyson

    2014-03-01

    Full Text Available Endometriosis is a gynecological disease defined by the extrauterine growth of endometrial-like cells that cause chronic pain and infertility. The disease is limited to primates that exhibit spontaneous decidualization, and diseased cells are characterized by significant defects in the steroid-dependent genetic pathways that typify this process. Altered DNA methylation may underlie these defects, but few regions with differential methylation have been implicated in the disease. We mapped genome-wide differences in DNA methylation between healthy human endometrial and endometriotic stromal cells and correlated this with gene expression using an interaction analysis strategy. We identified 42,248 differentially methylated CpGs in endometriosis compared to healthy cells. These extensive differences were not unidirectional, but were focused intragenically and at sites distal to classic CpG islands where methylation status was typically negatively correlated with gene expression. Significant differences in methylation were mapped to 403 genes, which included a disproportionally large number of transcription factors. Furthermore, many of these genes are implicated in the pathology of endometriosis and decidualization. Our results tremendously improve the scope and resolution of differential methylation affecting the HOX gene clusters, nuclear receptor genes, and intriguingly the GATA family of transcription factors. Functional analysis of the GATA family revealed that GATA2 regulates key genes necessary for the hormone-driven differentiation of healthy stromal cells, but is hypermethylated and repressed in endometriotic cells. GATA6, which is hypomethylated and abundant in endometriotic cells, potently blocked hormone sensitivity, repressed GATA2, and induced markers of endometriosis when expressed in healthy endometrial cells. The unique epigenetic fingerprint in endometriosis suggests DNA methylation is an integral component of the disease, and

  3. Aromatase Inhibitors for Endometriosis-Associated Infertility; Do We Have Sufficient Evidence?

    Directory of Open Access Journals (Sweden)

    Hatem Abu Hashim

    2016-09-01

    Full Text Available Orally active aromatase inhibitors (AIs have gained attention for treatment of infertile women with endometriosis in whom aromatase p450 is aberrantly expressed. This review aimed to critically appraise and summarize the available evidence concerning the use of AIs for management of endometriosis-associated infertility. PubMed was searched to May 2015 with the following key words: endometriosis, infertility and aromatase. Priority was given for randomized controlled trials (RCTs followed by other study designs. Main outcome measures were as follows: rates of clinical pregnancy, miscarriage and live birth as well as endocrine outcomes. Eighty-two abstracts were screened and six original articles were included. A RCT demonstrated that post-operative letrozole treatment did not improve spontaneous pregnancy rate. Another RCT reported no superiority of letrozole superovulation over clomiphene citrate (each combined with intrauterine insemination in minimal– mild endometriosis and previous laparoscopic treatment. Anastrozole significantly inhibited the growth of endometriotic cells and their estrogen production in culture. In assisted reproductive technology (ART cycles, dual suppression (Agonist/anastrozole was tested in a pilot study with a pregnancy rate of 45% however, high pregnancy loss (30% occurred. A retrospective study showed that letrozole may improve endometrial receptivity in endometriotic patients undergoing in vitro fertilization (IVF. An opposite view from an in vitro study showed lower estradiol production and aromatase expression in cultured granulosa cells from endometriotic women undergoing IVF and marked reduction under letrozole. In conclusion, current evidence is limited. More trials are warranted to enhance our knowledge and provide a clear and unequivocal evidence to guide our clinical management of infertile women with endometriosis using AIs.

  4. Study on the role of Interleukine-8 in the pathogenesis of endometriosis

    Institute of Scientific and Technical Information of China (English)

    Wang Lijie; Leng Jinhua; Lang Jinghe

    2004-01-01

    Objective:To determine the role of Interleukine-8 in the pathogenesis of endometriosis(EM).Methods:36 patients with endometriosis were selected as study group.20 patients without endometriosis served as control group. IL-8 concentration in peritoneal fluid(PF) and serum of both groups were detected by ELISA.The correlation between IL-8 concentration and the severity of EM were performed.The differences of IL-8 mRNA expression in eutopic endometrium of patients between with and without endometriosis, and the differences among different endometriotic lesions were further studied by Northern Blot;Cultured endometrial stromal cells(CESC) were divided into groups. IL-8 and anti-IL-8 were used to treat these cells.Results:(1)The PF and serum from patients with EM contained significantly greater amounts of IL-8 than those in controls. A significant correlation between PF IL-8 content and the severity of disease was noted but there were no evidences of a relationship between concentrations of serum IL-8 and PF IL-8.(2) It was showed that the expression density of IL-8 mRNA of Eu were significantly higher than that of En. Among the three different endometriotic lesions, the highest IL-8 mRNA expression density was found in RPL(red peritoneal lesion), while the lowest IL-8mRNA expression density was detected in ULN(uterosacral ligament module).(3) There was a dose-dependent stimulatory effect of IL-8 on the survival of ESC. At 1ng/ml, anti-IL-8 significantly inhibited the survival of endometrial cells.Conclusion:IL-8 may be one of the essential factors for the pathogenesis of endometriosis.

  5. Aromatase Inhibitors for Endometriosis-Associated Infertility; Do We Have Sufficient Evidence?

    Science.gov (United States)

    Abu Hashim, Hatem

    2016-01-01

    Orally active aromatase inhibitors (AIs) have gained attention for treatment of infertile women with endometriosis in whom aromatase p450 is aberrantly expressed. This review aimed to critically appraise and summarize the available evidence concerning the use of AIs for management of endometriosis-associated infertility. PubMed was searched to May 2015 with the following key words: endometriosis, infertility and aromatase. Priority was given for randomized controlled trials (RCTs) followed by other study designs. Main outcome measures were as follows: rates of clinical pregnancy, miscarriage and live birth as well as endocrine outcomes. Eighty-two abstracts were screened and six original articles were included. A RCT demonstrated that post-operative letrozole treatment did not improve spontaneous pregnancy rate. Another RCT reported no superiority of letrozole superovulation over clomiphene citrate (each combined with intrauterine insemination) in minimalmild endometriosis and previous laparoscopic treatment. Anastrozole significantly inhibited the growth of endometriotic cells and their estrogen production in culture. In assisted reproductive technology (ART) cycles, dual suppression (Agonist/anastrozole) was tested in a pilot study with a pregnancy rate of 45% however, high pregnancy loss (30%) occurred. A retrospective study showed that letrozole may improve endometrial receptivity in endometriotic patients undergoing in vitro fertilization (IVF). An opposite view from an in vitro study showed lower estradiol production and aromatase expression in cultured granulosa cells from endometriotic women undergoing IVF and marked reduction under letrozole. In conclusion, current evidence is limited. More trials are warranted to enhance our knowledge and provide a clear and unequivocal evidence to guide our clinical management of infertile women with endometriosis using AIs. PMID:27695608

  6. Endometriosis, Ovarian Reserve and Live Birth Rate Following In Vitro Fertilization/Intracytoplasmic Sperm Injection.

    Science.gov (United States)

    Coelho Neto, Marcela Alencar; Martins, Wellington de Paula; Luz, Caroline Mantovani da; Jianini, Bruna Talita Gazeto Melo; Ferriani, Rui Alberto; Navarro, Paula Andrea

    2016-05-01

    Purpose To evaluate whether women with endometriosis have different ovarian reserves and reproductive outcomes when compared with women without this diagnosis undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI), and to compare the reproductive outcomes between women with and without the diagnosis considering the ovarian reserve assessed by antral follicle count (AFC). Methods This retrospective cohort study evaluated all women who underwent IVF/ICSI in a university hospital in Brazil between January 2011 and December 2012. All patients were followed up until a negative pregnancy test or until the end of the pregnancy. The primary outcomes assessed were number of retrieved oocytes and live birth. Women were divided into two groups according to the diagnosis of endometriosis, and each group was divided again into a group that had AFC ≤ 6 (poor ovarian reserve) and another that had AFC ≥ 7 (normal ovarian reserve). Continuous variables with normal distribution were compared using unpaired t-test, and those without normal distribution, using Mann-Whitney test. Binary data were compared using either Fisher's exact test or Chi-square (χ(2)) test. The significance level was set as p live birth was similar between women with the diagnosis of endometriosis and those without it (19.1 versus 22.5%), and also when considering only women with a poor ovarian reserve (9.4 versus 8.9%) and only those with a normal ovarian reserve (25.5 versus 26.5%). Conclusions Women diagnosed with endometriosis are more likely to have a poor ovarian reserve; however, their chance of conceiving by IVF/ICSI is similar to the one observed in patients without endometriosis and with a comparable ovarian reserve. Thieme Publicações Ltda Rio de Janeiro, Brazil.

  7. Performance of Circulating Placental Growth Factor as A Screening Marker for Diagnosis of Ovarian Endometriosis: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Cinzia Zucchini

    2016-12-01

    Full Text Available Background: The aim of this study is to compare the circulating placental growth factor (PlGF concentration in women with and without endometrioma to verify the performance of this marker to diagnose the disease. Materials and Methods: In this case-control study, thirteen women with histological diagnosis of ovarian endometriosis were compared with women without endometriosis disease. PlGF plasma levels of endometriotic patients and controls were investigated using a fluorescence immunoassay technique. Results: PlGF showed a direct correlation with body mass index (BMI only in the control group (P=0.013. After adjustment for BMI values, PlGF median value in endometriosis group (14.7 pg/mL resulted higher than in control group (13.8 pg/ mL, P=0.004. Conclusion: PlGF is a promising peripheral blood marker that can discriminate between patients with and without ovarian endometriosis.

  8. Progesterone Alleviates Endometriosis via Inhibition of Uterine Cell Proliferation, Inflammation and Angiogenesis in an Immunocompetent Mouse Model

    National Research Council Canada - National Science Library

    Li, Yanfen; Adur, Malavika K; Kannan, Athilakshmi; Davila, Juanmahel; Zhao, Yuechao; Nowak, Romana A; Bagchi, Milan K; Bagchi, Indrani C; Li, Quanxi

    2016-01-01

      Endometriosis, defined as growth of the endometrial cells outside the uterus, is an inflammatory disorder that is associated with chronic pelvic pain and infertility in women of childbearing age...

  9. Deep Dyspareunia in Endometriosis: A Proposed Framework Based on Pain Mechanisms and Genito-Pelvic Pain Penetration Disorder.

    Science.gov (United States)

    Yong, Paul J

    2017-10-01

    Endometriosis is a common chronic disease affecting 1 in 10 women of reproductive age, with half of women with endometriosis experiencing deep dyspareunia. A review of research studies on endometriosis indicates a need for a validated question or questionnaire for deep dyspareunia. Moreover, placebo-controlled randomized trials have yet to demonstrate a clear benefit for traditional treatments of endometriosis for the outcome of deep dyspareunia. The reason some patients might not respond to traditional treatments is the multifactorial nature of deep dyspareunia in endometriosis, which can include comorbid conditions (eg, interstitial cystitis and bladder pain syndrome) and central sensitization underlying genito-pelvic pain penetration disorder. In general, there is a lack of a framework that integrates these multifactorial causes to provide a standardized approach to deep dyspareunia in endometriosis. To propose a clinical framework for deep dyspareunia based on a synthesis of pain mechanisms with genito-pelvic pain penetration disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Narrative review after literature search with the terms (endometriosis AND dyspareunia) OR (dyspareunia AND deep) and after analysis of placebo-controlled randomized trials. Deep dyspareunia presence or absence or deep dyspareunia severity on a numeric rating scale or visual analog scale. Four types of deep dyspareunia are proposed in women with endometriosis: type I that is directly due to endometriosis; type II that is related to a comorbid condition; type III in which genito-pelvic pain penetration disorder is primary; and type IV that is secondary to a combination of types I to III. Four types of deep dyspareunia in endometriosis are proposed, which can be used as a framework in research studies and in clinical practice. Research trials could phenotype or stratify patients by each type. The framework also could give rise to more personalized

  10. Modeling confirmation bias and polarization

    CERN Document Server

    Del Vicario, Michela; Caldarelli, Guido; Stanley, H Eugene; Quattrociocchi, Walter

    2016-01-01

    Online users tend to select claims that adhere to their system of beliefs and to ignore dissenting information. Confirmation bias, indeed, plays a pivotal role in viral phenomena. Furthermore, the wide availability of content on the web fosters the aggregation of likeminded people where debates tend to enforce group polarization. Such a configuration might alter the public debate and thus the formation of the public opinion. In this paper we provide a mathematical model to study online social debates and the related polarization dynamics. We assume the basic updating rule of the Bounded Confidence Model (BCM) and we develop two variations a) the Rewire with Bounded Confidence Model (RBCM), in which discordant links are broken until convergence is reached; and b) the Unbounded Confidence Model, under which the interaction among discordant pairs of users is allowed even with a negative feedback, either with the rewiring step (RUCM) or without it (UCM). From numerical simulations we find that the new models (UCM...

  11. Clinical signs, symptoms and serum level of interleukin-6 and tumor necrosis factor in women with or without endometriosis

    Institute of Scientific and Technical Information of China (English)

    Wachyu Hadisaputra

    2013-01-01

    Objective: To evaluate clinical signs and symptoms and serum levels of interleukin-6 ( IL-6), tumor necrosis factor-α (TNF-α), matrix metalloproteinase-2 (MMP-2), and vascular endothelial growth factor (VEGF) as non-invasive methods to diagnose endometriosis. Methods: Eighty women scheduled to laparoscopy underwent blood sampling for measurement of IL-6, TNF-α, MMP-2, and VEGF. The diagnosis of endometriosis was established by laparoscopy using The American Fertility Society visual diagnosis. The presence or absence of endometriosis was correlated with clinical signs and symptoms and with serum levels of those substances. Results:The sensitivity and specificity to detect endometriosis of infertility (OR 134.3) were 78 % and 98%, dysmenorrhoea (OR 11.7) were 63 % and 88 %, and chronic pelvic pain (OR 13.0) were 28 % and 100 %. The presence of rectovaginal nodules had a sensitivity 25 % and specificity 100 %. (OR 11.3, 95 %). The sensitivity and specificity of biologic markers IL-6 (OR 2.5) were 68 % and 53%, and TNF-α (OR 28.1) were 68% and 60 %. Conclusions: History of infertility, dysmenorrhea, chronic pelvic pain, dyspareunia, cervical tenderness and rectovaginal nodule are clinical signs and symptoms suggesting endometriosis. IL-6 and TNF-α appears to be best serum markers for endometriosis.

  12. N-acetyltransferase 2 (NAT2 Gene Polymorphisms and the Effectiveness of Infertility Treatment in Patients with Peritoneal Endometriosis

    Directory of Open Access Journals (Sweden)

    Ekaterina D. Dubinskaya

    2014-03-01

    Full Text Available Today, infertility has become a global issue. WHO ranks it the fifth among the major diseases of those below 60 years, after alcoholism, depression, injuries and eyesight disorders. Numerous studies conducted on the problems of infertility in endometriosis still do not offer clear answers regarding the pathogenesis and mechanisms of this disease and its influences on fertility. According to the survey results, point mutations of the NAT2 gene (NAT2*5 and NAT2*6 have been identified in 75.6% of the patients with infertility problems and the peritoneal form of endometriosis, that create “slow” allelic variants, which exceed the average index in the population. The peculiarities of the NAT2 gene polymorphisms have been proven to be associated with the effectiveness of the infertility treatment of female patients with peritoneal endometriosis. In the group of non-pregnant patients, the presence of с.341Т>C, c.481C>T, c.590G>A and c.803A>G heterozygous point mutations are 73.2, 73.2, 5.4, and 62.5%, respectively. The significant difference in the comparison of the allelic polymorphism during the various stages of the endometriosis was not identified. At stage III-IV endometriosis the frequency of three and more point substitutions was significantly higher. NAT2 gene polymorphisms can find use as an additional criterion for predicting the effectiveness of the infertility treatment of patients with peritoneal endometriosis.

  13. The 763C>G Polymorphism of The Secretory PLA2IIa Gene Is Associated with Endometriosis in Iranian Women

    Directory of Open Access Journals (Sweden)

    Mehdi Sahmani

    2015-02-01

    Full Text Available Background: Endometriosis is a chronic gynecological disease resulting from complex interactions between genetic, hormonal, environmental and oxidative stress and intrinsic inflammatory components. The aim of this study was to investigate the potential association of the 763C>G polymorphism in the secretory phospholipase A2 group IIa gene (PLA2G2A with the risk of endometriosis in Iranian women. Materials and Methods: Ninety seven patients with endometriosis along with 107 women who were negative for endometriosis after laparoscopy and laparatomy, and served as the control group, were enrolled for this cross-sectional study. Samples were genotyped using the polymerase chain reaction-restriction fragment length polymorphism method. Results: Multivariate analysis was used to examine the association between the risk of endometriosis and the 763C>G polymorphism of PLA2G2A. Genotype distributions of PLA- 2G2A were significantly different between patients and the controls (pG polymorphism of PLA2G2A plays an important role as an independent factor in the risk of endometriosis in Iranian women.

  14. Reduction of blood nitric oxide levels is associated with clinical improvement of the chronic pelvic pain related to endometriosis

    Directory of Open Access Journals (Sweden)

    M.G. Rocha

    2015-04-01

    Full Text Available The objective of this prospective study was to determine the plasma levels of nitric oxide (NO in women with chronic pelvic pain secondary to endometriosis (n=24 and abdominal myofascial pain syndrome (n=16. NO levels were measured in plasma collected before and 1 month after treatment. Pretreatment NO levels (μM were lower in healthy volunteers (47.0±12.7 than in women with myofascial pain (64.2±5.0, P=0.01 or endometriosis (99.5±12.9, P<0.0001. After treatment, plasma NO levels were reduced only in the endometriosis group (99.5±12.9 vs 61.6±5.9, P=0.002. A correlation between reduction of pain intensity and reduction of NO level was observed in the endometriosis group [correlation = 0.67 (95%CI = 0.35 to 0.85, P<0.0001]. Reduction of NO levels was associated with an increase of pain threshold in this group [correlation = -0.53 (-0.78 to -0.14, P<0.0001]. NO levels appeared elevated in women with chronic pelvic pain diagnosed as secondary to endometriosis, and were directly associated with reduction in pain intensity and increase in pain threshold after treatment. Further studies are needed to investigate the role of NO in the pathophysiology of pain in women with endometriosis and its eventual association with central sensitization.

  15. Expression patterns of progesterone receptor membrane components 1 and 2 in endometria from women with and without endometriosis.

    Science.gov (United States)

    Bunch, Kristen; Tinnemore, Deborah; Huff, Seth; Hoffer, Zachary S; Burney, Richard O; Stallings, Jonathan D

    2014-02-01

    Endometriosis is a hormone-dependent inflammatory condition associated with pain and infertility. A growing body of evidence supports attenuated secretory-phase progesterone responsiveness in women with this disease. Herein, we compare the expression of progesterone receptor membrane components (PGRMC) 1 and 2 in eutopic endometrium from 11 women with laparoscopically and/or histologically proven stage III/IV endometriosis and 23 disease-free women. Menstrual cycle phase was determined using a combination of reported cycle day, serum hormone profile, and endometrial histologic dating. The PGRMC-1 (fold change -3.3; P phase, eutopic endometrium from women with endometriosis. Immunohistochemistry demonstrated decreased PGRMC-1 and PGRMC-2 protein expression in the secretory phase endometrial stroma cells of women with endometriosis. Consistent with the preclinical work of others, our results reflect downregulation of endometrial PGRMC-1 and PGRMC-2 expression in secretory phase endometrium from women with advanced stage endometriosis. Understanding the molecular mechanisms of attenuated progesterone action in endometriosis has important diagnostic and therapeutic implications.

  16. Impact of stage III-IV endometriosis on recipients of sibling oocytes: matched case-control study.

    Science.gov (United States)

    Díaz, I; Navarro, J; Blasco, L; Simón, C; Pellicer, A; Remohí, J

    2000-07-01

    To evaluate the impact of severe endometriosis on IVF-ET outcome in women receiving oocytes from the-same donor. A matched case-control study. Oocyte donation program at the Instituto Valenciano de Infertilidad. Fifty-eight recipients were included in a matched case-control study of IVF-ET in our oocyte donation program. Twenty-five patients were diagnosed by laparoscopy with stage III-IV endometriosis (group I), while the remaining 33 were free of the disease (group II). On the day of retrieval, oocytes from a single donor were donated to recipients from both groups. Some of the donors supplied oocytes for more than 2 patients. Recipients received steroid replacement therapy for endometrial preparation. Ovarian stimulation and oocyte retrieval in donors. Uterine embryo transfer (ET) in recipients after appropriate exogenous hormone replacement therapy (HRT). Pregnancy, implantation, miscarriage, and live birth rates. The number of oocytes donated and fertilized, as well as the number of available and transferred embryos, was not statistically different between the two groups. Pregnancy, implantation, and miscarriage rates were not affected by stage III-IV endometriosis when compared with the control group. The live birth rate was 28.0% in the group with endometriosis and 27.2% in the control group. These results show that implantation is not affected by stage III-IV endometriosis. Given the contemporary methods of endometrial preparation for transfer of embryos derived from donor oocytes, any potential negative effect of severe endometriosis on the uterine environment is