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Sample records for wall endometriosis treated

  1. Endometriosis Abdominal wall

    International Nuclear Information System (INIS)

    Alvarez, M.; Carriquiry, L.

    2003-01-01

    Endometriosis of abdominal wall is a rare entity wi ch frequently appears after gynecological surgery. Case history includes three cases of parietal endometriosis wi ch were treated in Maciel Hospital of Montevideo. The report refers to etiological diagnostic aspects and highlights the importance of total resection in order to achieve definitive healing

  2. Post caesarean section anterior abdominal wall endometriosis ...

    African Journals Online (AJOL)

    Abdominal wall endometriosis is a likely sequelae of caesarean section as viable endometrial tissue are deposited in the peritoneal cavity or anterior abdominal wall. One such case to sensitize clinicians of this rare presentation of the disease is presented. The patient was a 48 year old woman who presented with a lesion ...

  3. 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.

  4. Radiologic findings of abdominal wall endometriosis

    International Nuclear Information System (INIS)

    Seo, Jung Wook

    2003-01-01

    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

  5. Abdominal Wall Endometriosis: An Overlooked but Possibly Preventable Complication

    Directory of Open Access Journals (Sweden)

    Chen-Chih Teng

    2008-03-01

    Conclusion: Abdominal wall endometriosis may be caused by iatrogenic inoculation of the endometrium into the surgical wound. It is strongly recommended that, at the conclusion of the surgical procedure, the abdominal wound be cleaned thoroughly, particularly at both corner sites (especially the operator's side. If an abdominal wall endometriosis is encountered after CS but the patient plans to have future pregnancy and the symptoms are mild, excision of the endometrioma may be deferred until the next indicated CS.

  6. 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.

  7. The Many Guises of Endometriosis: Giant Abdominal Wall Endometriosis Masquerading as An Incisional Hernia

    Directory of Open Access Journals (Sweden)

    Chiara Petrosellini

    2017-10-01

    Full Text Available Endometriosis is defined by the presence of ectopic endometrial tissue outside the uterine cavity. Although it is a leading cause of chronic pelvic pain and infertility, its clinical presentation can vary, resulting in diagnostic and therapeutic challenges. Extrapelvic endometriosis is particularly difficult to diagnose owing to its ability to mimic other conditions. Endometrial tissue in a surgical scar is uncommon and often misdiagnosed as a granuloma, abscess, or malignancy. Cyclical hemorrhagic ascites due to peritoneal endometriosis is exceptionally rare. We report the case of a pre-menopausal, nulliparous 44-year-old woman who presented with ascites and a large abdominal mass that arose from the site of a lower midline laparotomy scar. Five years previously, she had undergone open myomectomy for uterine fibroids. Soon after her initial operation she developed abdominal ascites, which necessitated percutaneous drainage on multiple occasions. We performed a laparotomy with excision of the abdominal wall mass through an inverted T incision. The extra-abdominal mass consisted of mixed cystic and solid components, and weighed 1.52 kg. It communicated with the abdominopelvic cavity through a 2 cm defect in the linea alba. The abdomen contained a large amount of odourless, brown fluid which drained into the mass. There was a large capsule that covered the small and large bowel, liver, gallbladder, and stomach. Final histology reported a 28×19×5 cm mass of endometrial tissue with no evidence of malignant transformation. The patient recovered well post-operatively and has remained asymptomatic. Our case illustrates that, despite being a common disease, endometriosis can masquerade as several other conditions and be missed or diagnosed late. Delay in diagnosis will not only prolong symptoms but can also compromise reproductive lifespan. It is therefore paramount that endometriosis is to be considered early in the management of premenopausal women

  8. Endometriosis

    OpenAIRE

    Garcia-Manero, M. (Manuel); Olartecoechea, B. (Begoña); Royo, P. (Pedro); Auba, M. (M.); López-García, G. (Guillermo)

    2008-01-01

    Endometriosis is a common gynaecological disease of unknown aetiology which affects an estimated 10% to 15% of all premenopausal women. It is defined as the presence of endometrial tissue, consisting of both glandular epithelium and stroma, outside the uterine cavity. Three different clinical entities of endometriosis can be distinguished: peritoneal endometriosis, ovarian endometriosis and deep invasive endometriosis. There are several theories to explain their pathogenesis: metaplasia of th...

  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. Appearance of abdominal wall endometriosis on MR imaging

    International Nuclear Information System (INIS)

    Busard, Milou P.H.; Kuijk, Cees van; Waesberghe, Jan Hein T.M. van; Mijatovic, Velja; Hompes, Peter G.A.

    2010-01-01

    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 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 -3 /mm 2 /s. MR imaging seems to be useful in determining the location and depth of infiltration in surrounding tissue preoperatively. (orig.)

  11. 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.)

  12. Endometriosis

    Science.gov (United States)

    ... can be done to relieve pain and improve fertility. During surgery, endometriosis implants can be removed. Does surgery cure endometriosis? After surgery, most women have relief from pain. However, about 40–80% of women have pain again within 2 years of surgery. The more severe the disease, the ...

  13. The burden of endometriosis: costs and quality of life of women with endometriosis and treated in referral centres.

    Science.gov (United States)

    Simoens, Steven; Dunselman, Gerard; Dirksen, Carmen; Hummelshoj, Lone; Bokor, Attila; Brandes, Iris; Brodszky, Valentin; Canis, Michel; Colombo, Giorgio Lorenzo; DeLeire, Thomas; Falcone, Tommaso; Graham, Barbara; Halis, Gülden; Horne, Andrew; Kanj, Omar; Kjer, Jens Jørgen; Kristensen, Jens; Lebovic, Dan; Mueller, Michael; Vigano, Paola; Wullschleger, Marcel; D'Hooghe, Thomas

    2012-05-01

    This study aimed to calculate costs and health-related quality of life of women with endometriosis-associated symptoms treated in referral centres. A prospective, multi-centre, questionnaire-based survey measured costs and quality of life in ambulatory care and in 12 tertiary care centres in 10 countries. The study enrolled women with a diagnosis of endometriosis and with at least one centre-specific contact related to endometriosis-associated symptoms in 2008. The main outcome measures were health care costs, costs of productivity loss, total costs and quality-adjusted life years. Predictors of costs were identified using regression analysis. Data analysis of 909 women demonstrated that the average annual total cost per woman was €9579 (95% confidence interval €8559-€10 599). Costs of productivity loss of €6298 per woman were double the health care costs of €3113 per woman. Health care costs were mainly due to surgery (29%), monitoring tests (19%) and hospitalization (18%) and physician visits (16%). Endometriosis-associated symptoms generated 0.809 quality-adjusted life years per woman. Decreased quality of life was the most important predictor of direct health care and total costs. Costs were greater with increasing severity of endometriosis, presence of pelvic pain, presence of infertility and a higher number of years since diagnosis. Our study invited women to report resource use based on endometriosis-associated symptoms only, rather than drawing on a control population of women without endometriosis. Our study showed that the economic burden associated with endometriosis treated in referral centres is high and is similar to other chronic diseases (diabetes, Crohn's disease, rheumatoid arthritis). It arises predominantly from productivity loss, and is predicted by decreased quality of life.

  14. Endometriosis

    African Journals Online (AJOL)

    Available treatment options include medical, surgical and ... with other medical treatment options. ... Gestrinone is a 19-notestosterone derivative .... There are some experimental drugs that in future might alter the treatment of endometriosis.

  15. 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

  16. Mixed endometrioid and serous carcinoma developing in abdominal wall endometriosis following Cesarean section

    International Nuclear Information System (INIS)

    Da Ines, David; Montoriol, Pierre Francois; Petitcolin, Virginie; Garcier, Jean-Marc; Bourdel, Nicolas; Canis, Michel; Charpy, Cecile

    2011-01-01

    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

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

    OpenAIRE

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

    2017-01-01

    Abstract 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 ...

  18. Ultrasound-guided high-intensity focused ultrasound treatment for abdominal wall endometriosis: Preliminary results

    International Nuclear Information System (INIS)

    Wang Yang; Wang Wei; Wang Longxia; Wang Junyan; Tang Jie

    2011-01-01

    Purpose: To evaluate the safety and therapeutic efficacy of ultrasound (US)-guided high-intensity focused ultrasound (HIFU) ablation for the treatment of abdominal wall endometriosis (AWE). Materials and methods: Twenty-one consecutive patients with AWE were treated as outpatients by US-guided HIFU ablation under conscious sedation. The median size of the AWE was 2.4 cm (range 1.0-5.3 cm). An acoustic power of 200-420 W was used, intermittent HIFU exposure of 1 s was applied. Treatment was considered complete when the entire nodule and its nearby 1 cm margin become hyperechoic on US. Pain relief after HIFU ablation was observed and the treated nodule received serial US examinations during follow-up. Results: All AWE was successfully ablated after one session of HIFU ablation, the ablation time lasted for 5-48 min (median 13 min), no major complications occurred. The cyclic pain disappeared in all patients during a mean follow-up of 18.7 months (range 3-31 months). The treated nodules gradually shank over time, 16 nodules became unnoticeable on US during follow-up. Conclusion: US-guided HIFU ablation appears to be safe and effective for the treatment of AWE.

  19. Ultrasound-guided high-intensity focused ultrasound treatment for abdominal wall endometriosis: Preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Wang Yang [Department of Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China); Wang Wei, E-mail: wangyang301301@yahoo.com.cn [Department of Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China); Wang Longxia; Wang Junyan; Tang Jie [Department of Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China)

    2011-07-15

    Purpose: To evaluate the safety and therapeutic efficacy of ultrasound (US)-guided high-intensity focused ultrasound (HIFU) ablation for the treatment of abdominal wall endometriosis (AWE). Materials and methods: Twenty-one consecutive patients with AWE were treated as outpatients by US-guided HIFU ablation under conscious sedation. The median size of the AWE was 2.4 cm (range 1.0-5.3 cm). An acoustic power of 200-420 W was used, intermittent HIFU exposure of 1 s was applied. Treatment was considered complete when the entire nodule and its nearby 1 cm margin become hyperechoic on US. Pain relief after HIFU ablation was observed and the treated nodule received serial US examinations during follow-up. Results: All AWE was successfully ablated after one session of HIFU ablation, the ablation time lasted for 5-48 min (median 13 min), no major complications occurred. The cyclic pain disappeared in all patients during a mean follow-up of 18.7 months (range 3-31 months). The treated nodules gradually shank over time, 16 nodules became unnoticeable on US during follow-up. Conclusion: US-guided HIFU ablation appears to be safe and effective for the treatment of AWE.

  20. MR imaging of bladder endometriosis and its relationship with the anterior uterine wall: Experience in a tertiary referral centre

    International Nuclear Information System (INIS)

    Busard, M.P.H.; Mijatovic, V.; Lüchinger, A.B.; Bleeker, M.C.G.; Pieters-van den Bos, I.C.; Schats, R.; Kuijk, C. van; Hompes, P.G.A.; Waesberghe, J.H.T.M. van

    2012-01-01

    Objective: Both the intraperitoneal seeding and the uterine-vesical extension theory have been proposed to explain the pathogenesis of bladder endometriosis. The aim of this study was to describe MR imaging findings of bladder endometriosis and involvement of the anterior uterine wall in a tertiary referral centre for endometriosis in a effort to improve diagnosis and help clarify the pathogenesis. Methods: In a single-centre, retrospective study (2004–2009), 463 consecutive patients analysed for deep infiltrating endometriosis (DIE) were studied independently by two experienced readers for the presence of bladder endometriosis. MR studies revealing bladder endometriosis were then analysed in consensus for: location, size, signal intensity characteristics, uterine involvement, continuity with adenomyosis and presence of cysts. There was histopathologic correlation in 9 patients who had undergone partial bladder resection. Results: Bladder endometriosis was diagnosed in 32 patients on MR imaging (k = 0.85). Most lesions showed heterogeneous isointensity compared to that of muscle on T2-weighed imaging, containing foci of high signal intensity, suggesting cystic ectopic endometrial glands. On T1-weighted imaging lesions showed heterogeneous isointensity with foci or small cysts, demonstrating high signal intensity, indicating hemorrhage, was observed. Uterine involvement was found in 94% of the lesions, with either “continuous” or “hourglass” configurations. Presence of contiguous adenomyosis was found in only 4 lesions. Conclusions: With MR imaging, uterine involvement in bladder endometriosis is frequently found and in most cases located subserosally, suggesting extensive DIE, favouring the intraperitoneal seeding theory

  1. MR imaging of bladder endometriosis and its relationship with the anterior uterine wall: Experience in a tertiary referral centre

    Energy Technology Data Exchange (ETDEWEB)

    Busard, M.P.H., E-mail: m.busard@vumc.nl [VU University Medical Centre, Department of Radiology, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Mijatovic, V., E-mail: Mijatovic@vumc.nl [VU University Medical Centre, Department of Reproductive Medicine, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Lüchinger, A.B., E-mail: ab.luchinger@vumc.nl [VU University Medical Centre, Department of Reproductive Medicine, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Bleeker, M.C.G., E-mail: MCG.Bleeker@vumc.nl [VU University Medical Centre, Department of Pathology, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Pieters-van den Bos, I.C., E-mail: i.pieters@vumc.nl [VU University Medical Centre, Department of Radiology, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Schats, R., E-mail: r.schats@vumc.nl [VU University Medical Centre, Department of Reproductive Medicine, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Kuijk, C. van, E-mail: C.vanKuijk@vumc.nl [VU University Medical Centre, Department of Radiology, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Hompes, P.G.A., E-mail: p.hompes@vumc.nl [VU University Medical Centre, Department of Reproductive Medicine, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Waesberghe, J.H.T.M. van, E-mail: JHTM.vanwaesberghe@vumc.nl [VU University Medical Centre, Department of Radiology, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands)

    2012-09-15

    Objective: Both the intraperitoneal seeding and the uterine-vesical extension theory have been proposed to explain the pathogenesis of bladder endometriosis. The aim of this study was to describe MR imaging findings of bladder endometriosis and involvement of the anterior uterine wall in a tertiary referral centre for endometriosis in a effort to improve diagnosis and help clarify the pathogenesis. Methods: In a single-centre, retrospective study (2004–2009), 463 consecutive patients analysed for deep infiltrating endometriosis (DIE) were studied independently by two experienced readers for the presence of bladder endometriosis. MR studies revealing bladder endometriosis were then analysed in consensus for: location, size, signal intensity characteristics, uterine involvement, continuity with adenomyosis and presence of cysts. There was histopathologic correlation in 9 patients who had undergone partial bladder resection. Results: Bladder endometriosis was diagnosed in 32 patients on MR imaging (k = 0.85). Most lesions showed heterogeneous isointensity compared to that of muscle on T2-weighed imaging, containing foci of high signal intensity, suggesting cystic ectopic endometrial glands. On T1-weighted imaging lesions showed heterogeneous isointensity with foci or small cysts, demonstrating high signal intensity, indicating hemorrhage, was observed. Uterine involvement was found in 94% of the lesions, with either “continuous” or “hourglass” configurations. Presence of contiguous adenomyosis was found in only 4 lesions. Conclusions: With MR imaging, uterine involvement in bladder endometriosis is frequently found and in most cases located subserosally, suggesting extensive DIE, favouring the intraperitoneal seeding theory.

  2. 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

  3. Depth of Intestinal Wall Infiltration and Clinical Presentation of Deep Infiltrating Endometriosis: Evaluation of 553 Consecutive Cases.

    Science.gov (United States)

    Rossini, Roberto; Lisi, Giorgio; Pesci, Anna; Ceccaroni, Marcello; Zamboni, Giuseppe; Gentile, Irene; Rettore, Lorenzo; Ruffo, Giacomo

    2018-02-01

    Intestinal involvement in endometriosis was first described by Sampson in 1922. The reported incidence ranges between 3% and 37% in patients diagnosed with endometriosis. In literature, there are few studies that correlate the severity of endometriosis (in terms of intestinal infiltration) and its clinical presentation. The aim of this study was to review the correlation between the severity of symptoms, the depth of intestinal wall infiltration, and lymph node involvement in our tertiary referral center. We retrospectively analyzed 553 patients who had undergone intestinal resection for deep infiltrating endometriosis at our institution (Sacro Cuore Negrar Hospital) between 2004 and 2009. Based on intestinal wall infiltration, we divided patients into three groups (Group A: intestinal infiltration that reaches the muscle layer, Group B: infiltration to the submucosa, and Group C: endometriosis reaches the mucosa). Symptoms, intestinal stenosis, and positive lymph nodes were compared in the three groups with the chi-square test. No statistical correlation was found between symptoms and the intestinal wall infiltrations. The three groups were also compared on the basis of positive visceral lymph nodes and we did find a statistical difference (P = .05) in the lymph node count in the two main groups. There seems to be no statistically significant difference in symptoms between patients with different degrees of infiltration. Although visceral lymph node involvement has been occasionally described in literature, we found that it is related to submucosal infiltration.

  4. Over one thousand patients with early stage endometriosis treated with the Helica Thermal Coagulator (HELICA): safety aspects.

    Science.gov (United States)

    Hill, Nicholas; McQueen, John; Morey, Richard; Hanna, Leila; Chandakas, Stefanos; El-Toukhy, Tarek; Erian, John

    2006-07-01

    To assess the safety of the Helica Thermal Coagulator in the laparoscopic treatment of early stage endometriosis. Retrospective, observational. The Princess Royal University Hospital, The Sloane and Chelsfield Park Hospitals, Kent, UK. One thousand and sixty patients with early stage endometriosis. All patients were treated laparoscopically with the Helica Thermal Coagulator; a new laparoscopic device that combines electrical energy with helium for the treatment of endometriosis. No major bladder, ureteric or bowel injuries occurred. The only complication was a perforated vagina from the cutting probe during dissection of the cul-de-sac in a patient with a vaginal endometriotic nodule. The Helica Thermal Coagulator is a safe device for the laparoscopic treatment of endometriosis.

  5. Uteroabdominal Wall Fistula After Cesarean Section in a Patient With Prior Colorectal Resection for Endometriosis: A Case Report and Systematic Review.

    Science.gov (United States)

    Chattot, Chloé; Aristizabal, Patrick; Bendifallah, Sofiane; Daraï, Emile

    Uteroabdominal wall fistula (UAWF) is a very rare complication of cesarean section. We report an unusual case of a UAWF occurring in a 37-year-old woman 4 years after a cesarean section and previous radical surgery for deep infiltrating endometriosis with bowel resection. The patient presented with persistent purulent discharge of the Pfannenstiel scar and noted that the discharge was blood stained during menstruation. Magnetic resonance imaging confirmed the diagnosis of UAWF. Surgery was performed by laparotomy and was complicated by a postoperative rectovaginal fistula, which was successfully treated by the placement of a biological mesh via the vagina route. The postoperative course was favorable at 6 months with disappearance of painful symptoms and good quality of the colorectal anastomosis. A systematic review was conducted, and 18 case reports were found from 1939 to 2016. This case report highlights the risk of postdelivery complications in women with deep infiltrating endometriosis and colorectal involvement, especially after cesarean section. Persistent abdominal discharge in this context should suggest a diagnosis of UAWF despite its low incidence. Finally, the vaginal route for rectovaginal fistula might be considered an option for patients with prior multiple laparotomies. Copyright © 2017 AAGL. Published by Elsevier Inc. All rights reserved.

  6. Surgical Outcomes of Urinary Tract Deep Infiltrating Endometriosis.

    Science.gov (United States)

    Darwish, Basma; Stochino-Loi, Emanuela; Pasquier, Geoffroy; Dugardin, Fabrice; Defortescu, Guillaume; Abo, Carole; Roman, Horace

    To report the outcomes of surgical management of urinary tract endometriosis. Retrospective study based on prospectively recorded data (NCT02294825) (Canadian Task Force classification II-3). University tertiary referral center. Eighty-one women treated for urinary tract endometriosis between July 2009 and December 2015 were included, including 39 with bladder endometriosis, 31 with ureteral endometriosis, and 11 with both ureteral and bladder endometriosis. Owing to bilateral ureteral localization in 8 women, 50 different ureteral procedures were recorded. Procedures performed included resection of bladder endometriosis nodules, advanced ureterolysis, ureteral resection followed by end-to-end anastomosis, and ureteroneocystostomy. The main outcome measure was the outcome of the surgical management of urinary tract endometriosis. Fifty women presented with deep infiltrating endometriosis (DIE) of the bladder and underwent either full-thickness excision of the nodule (70%) or excision of the bladder wall without opening of the bladder (30%). Ureteral lesions were treated by ureterolysis in 78% of the patients and by primary segmental resection in 22%. No patient required nephrectomy. Histological analysis revealed intrinsic ureteral endometriosis in 54.5% of cases. Clavien-Dindo grade III complications were present in 16% of the patients who underwent surgery for ureteral nodules and in 8% of those who underwent surgery for bladder endometriosis. Overall delayed postoperative outcomes were favorable regarding urinary symptoms and fertility. Patients were followed up for a minimum of 12 months and a maximum of 7 years postoperatively, with no recorded recurrences. Surgical outcomes of urinary tract endometriosis are generally satisfactory; however, the risk of postoperative complications should be taken into consideration. Therefore, all such procedures should be managed by an experienced multidisciplinary team. Copyright © 2017 AAGL. Published by Elsevier Inc

  7. Current understanding on pharmacokinetics, clinical efficacy and safety of progestins for treating pain associated to endometriosis.

    Science.gov (United States)

    Barra, Fabio; Scala, Carolina; Ferrero, Simone

    2018-04-01

    Endometriosis is a chronic estrogen and progestogen responsive inflammatory disease associated with pain symptoms and infertility. The medical therapy of endometriosis aims to induce decidualization within the hormonally dependent ectopic endometrium, and it is often administered to ameliorate women' pain symptoms or to prevent post-surgical disease recurrence. A variety of progestins have been used in monotherapy for the medical management of women with endometriosis. Areas covered: This review aims to offer the reader a complete overview of pharmacokinetic (PK) and clinical efficacy of progestins for the treatment of endometriosis. Expert opinion: Each progestin has a distinct PK parameters and pharmacodynamics affinity not only for progesterone receptor, but also for other steroid receptors, such as estrogen, androgen, and glucocorticoid. Moreover, progestins can also be delivered in different formulations. All these characteristics influence their final biological effect. Randomized, controlled, non-blinded studies support the use of oral progestin-only treatment for pelvic pain associated with endometriosis. Currently, the only two progestins approved by Food and Drug Administration (FDA) for the treatment of endometriosis are norethindrone acetate (NETA) and depot medroxyprogesterone acetate (DMPA).

  8. Left-Sided Catamenial Pneumothorax with Thoracic Endometriosis and Bullae in the Alveolar Wall.

    Science.gov (United States)

    Takahashi, Ryo; Kurihara, Masatoshi; Mizobuchi, Teruaki; Ebana, Hiroki; Yamanaka, Sumitaka

    2017-04-20

    Catamenial pneumothorax (CP) is generally caused by intraperitoneal air leaking from the uterus into the thoracic cavity via a defect in the endometrial tissue of the diaphragm and is usually detected in the right thorax. We report a case of left-sided CP caused by endometriosis in the visceral pleura and with no abnormal findings in the diaphragm. A 33-year-old female patient presented at the end of a course of low-dose contraceptive pills for pelvic endometriosis, with spontaneous pneumothorax in the left chest. Chest CT revealed a bulla in the left upper lung lobe. The patient underwent partial resection of the lung. Immunohistochemistry confirmed the presence of endometrial stromal tissue in the visceral pleura and confirmed this as the cause of pneumothorax since there were no observable abnormalities in the diaphragm. This case suggests that immunohistochemical examination of patients with spontaneous pneumothorax can detect alternative endometrial lesions.

  9. Vesical endometriosis

    International Nuclear Information System (INIS)

    Akhter, N.; Sohail, I.; Farouk, K.

    2007-01-01

    Endometriosis affecting the urinary tract is very rare and the most common site of involvement is urinary bladder. The clinical features are urgency and frequency, hypo gastric pain and hematuria. Cystoscopic examination is the most valuable diagnostic test but definitive diagnosis requires histological confirmation. A 21-year-old unmarried female presented with lower urinary tract symptoms and blood in urine, more during menstruation. She gave history of left salpingo-oophorectomy. Ultrasonography revealed a mass in the bladder 2 x 3 cm on the posterior wall. Intravenous urography showed a filling defect in the bladder. Urethrocystoscopy performed and growth was resected and sent for histopathology. Histopathology confirmed the diagnosis of vesical endometriosis. She was advised Luteinizing hormone-releasing hormone (LHRH) but she refused as she could not afford it. She was managed on Tab 17-aethinyl testosterone. (author)

  10. Scar Endometriosis Following Cesarean Section

    Directory of Open Access Journals (Sweden)

    Rüya Deveer

    2012-04-01

    CONCLUSION: Abdominal wall endometriosis frequently presents with cyclical pain during menstruation which is localised to a palpable mass in the abdominal wall especially in those who have had previous cesarean section. Complete surgical excision is curative.

  11. The expression of vascular endothelial growth factor is affected by hypoxia inducible factor-1α in peritoneum of endometriosis mice treated with genistein

    Directory of Open Access Journals (Sweden)

    Sylvi Wafda Nur Amellia

    2016-09-01

    Full Text Available This study aimed to investigate whether the genistein is able to decrease the expressions of vascular endothelial growth factor-A (VEGF-A and hypoxia inducible factor-1α (HIF-1α in mouse model of endometriosis. Forty female mice (Mus musculus were divided into eight groups (n = 5 each, including the control (untreated group, endometriosis group, and endometriosis groups treated with various doses of genistein (50; 100; 200; 300; 400; and 500 mg/day. VEGF-A and HIF-1α analyses were performed by immunohistochemistry. We found significant increases in the VEGF-A and HIF-α expressions in endometriosis group compared to the control group. The increased expressions of VEGF-A and HIF-1α were significantly (p < 0.05 attenuated by the administration of all doses of genistein. In conclusion, in mouse model of endometriosis, genistein potentially inhibits the increase in angiogenesis in peritoneal tissue. Therefore, this result may provide a novel anti-angiogenic treatment strategy for the therapy of endometriosis.

  12. Anterior abdominal Wall scar endometriosis: Case series and review of imaging modalities

    Directory of Open Access Journals (Sweden)

    Işık Üstüner

    2014-03-01

    Full Text Available Implantation of endometriosis to pelvic and abdominal scar tissue is a very rare occurrence. Most commonly observed after cesarean sections due to implantation of uterine endometrial stem cells to outside tissues. Patients are often asymptomatic but may present with cyclic pain and mass. Imaging diagnosis is possible when classical implantation site near the scar tissue, clinical history and imaging findings are combined. In ultrasound imaging the lesion is often solid, mildly hypoechoic and often isoechoic to surrounding muscle. Presence of bleeding and fluid may cause the lesion to appear more heterogeneous. On computed tomography imaging the most pronounced finding is avid contrast enhancement of the lesion whereas in magnetic resonance imaging sensitivity to blood products.

  13. Bowel Endometriosis Syndrome

    DEFF Research Database (Denmark)

    Riiskjær, M; Egekvist, A G; Hartwell, D

    2017-01-01

    STUDY QUESTION: Is it possible to develop a validated score that can identify women with Bowel Endometriosis Syndrome (BENS) and be used to monitor the effect of medical and surgical treatment? SUMMARY ANSWER: The BENS score can be used to identify women with BENS and to monitor the effect...... of medical and surgical treatment of women suffering from bowel endometriosis. WHAT IS KNOWN ALREADY: Endometriosis is a heterogeneous disease with extensive variation in anatomical and clinical presentation, and symptoms do not always correspond to the disease burden. Current endometriosis scoring systems...... are mainly based on anatomical and surgical findings. STUDY DESIGN, SIZE, DURATION: The score was developed and validated from a cohort of 525 women with medically or surgically treated bowel endometriosis from Aarhus and Copenhagen University Hospitals, Denmark. PARTICIPANTS/MATERIALS, SETTING AND METHODS...

  14. Therapeutic potential of Wenshen Xiaozheng tang, a traditional Chinese medicine prescription, for treating endometriosis.

    Science.gov (United States)

    Zhang, Zhenzhen; Hu, Chunping; Tang, Weiwei; Gui, Tao; Qian, Ruyun; Xing, Yuxia; Cao, Peng; Wan, Guiping

    2013-10-01

    The objective of this study is to investigate the effect of Wenshen Xiaozheng Tang (WXT) on the development of endometriosis in a rat model. Sprague-Dawley rats in which endometriotic implants were induced were divided randomly into 3 groups. The rats in the low-dose and high-dose WXT groups were administered WXT 8.57 and 17.14 g/kg/d, respectively. The rats in the control groups received an equal volume of dissolvent, as did the sham-operated rats. After treatment for 4 weeks, WXT significantly decreased the mean lesion size as well as the peritoneal fluid and serum levels of tumor necrosis factor α and interleukin 1β. Cyclooxygenase-2, matrix metalloproteinase 9, plasminogen activator inhibitor 1, and intercellular adhesion molecule 1 messenger RNA (mRNA) levels were downregulated, and the mRNA expression of tissue inhibitor of metalloproteinase 1 was upregulated in the endometriotic lesions of WXT versus control group. Our data suggested that WXT may suppress the development of endometriosis by inhibiting the production of proinflammatory cytokines and regulating the expression of invasion-related genes in the endometriotic lesions.

  15. Endometriosis (For Teens)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Endometriosis KidsHealth / For Teens / Endometriosis What's in this article? ... doctor thought Anne might have endometriosis. What Is Endometriosis? When a woman has endometriosis, tissue that looks ...

  16. Nodular smooth muscle metaplasia in multiple peritoneal endometriosis

    OpenAIRE

    Kim, Hyun-Soo; Yoon, Gun; Ha, Sang Yun; Song, Sang Yong

    2015-01-01

    We report here an unusual presentation of peritoneal endometriosis with smooth muscle metaplasia as multiple protruding masses on the lateral pelvic wall. Smooth muscle metaplasia is a common finding in rectovaginal endometriosis, whereas in peritoneal endometriosis, smooth muscle metaplasia is uncommon and its nodular presentation on the pelvic wall is even rarer. To the best of our knowledge, this is the first case of nodular smooth muscle metaplasia occurring in peritoneal endometriosis. A...

  17. Rectus abdominis muscle endometriosis

    International Nuclear Information System (INIS)

    Goker, A.

    2014-01-01

    Endometriosis is characterized by an abnormal existence of functional endometrial tissue outside the uterine cavity, typically occuring within the pelvis of women in reproductive age. We report two cases with endometriosis of the abdominal wall; the first one in the rectus abdominis muscle and the second one in the surgical scar of previous caesarean incision along with the rectus abdominis muscle. Pre-operative evaluation included magnetic resonance imaging. The masses were dissected free from the surrounding tissue and excised with clear margins. Diagnosis of the excised lesions were verified by histopathology. (author)

  18. 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 performed. A bias due to selection, information and negativity effects within a

  19. DEEP INFILTRATING ENDOMETRIOSIS

    Directory of Open Access Journals (Sweden)

    Martina Ribič-Pucelj

    2018-02-01

    Full Text Available Background: Endometriosis is not considered a unified disease, but a disease encompassing three differ- ent forms differentiated by aetiology and pathogenesis: peritoneal endometriosis, ovarian endometriosis and deep infiltrating endometriosis (DIE. The disease is classified as DIE when the lesions penetrate 5 mm or more into the retroperitoneal space. The estimated incidence of endometriosis in women of reproductive age ranges from 10–15 % and that of DIE from 3–10 %, the highest being in infertile women and in those with chronic pelvic pain. The leading symptoms of DIE are chronic pelvic pain which increases with age and correlates with the depth of infiltration and infertility. The most important diagnostic procedures are patient’s history and proper gynecological examination. The diagnosis is confirmed with laparoscopy. DIE can affect, beside reproductive organs, also bowel, bladder and ureters, therefore adi- tional diagnostic procedures must be performed preopertively to confirm or to exclude the involvement of the mentioned organs. Endometriosis is hormon dependent disease, there- fore several hormonal treatment regims are used to supress estrogen production but the symptoms recurr soon after caesation of the treatment. At the moment, surgical treatment with excision of all lesions, including those of bowel, bladder and ureters, is the method of choice but requires frequently interdisciplinary approach. Surgical treatment significantly reduces pain and improves fertility in inferile patients. Conclusions: DIE is not a rare form of endometriosis characterized by chronic pelvic pain and infertility. Medical treatment is not efficient. The method of choice is surgical treatment with excision of all lesions. It significantly reduces pelvic pain and enables high spontaneus and IVF preg- nacy rates.Therefore such patients should be treated at centres with experience in treatment of DIE and with possibility of interdisciplinary approach.

  20. 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) ...

  1. 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...

  2. Relevance of MRI for endometriosis diagnosis

    International Nuclear Information System (INIS)

    Krueger, Karsten; Behrendt, K.; Balzer, M.; Hoehn, S.; Ebert, A.D.

    2011-01-01

    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.)

  3. Local application of danazol-loaded hyaluronic acid hydrogel to endometriosis in a rat model.

    Science.gov (United States)

    Nomura, Kazuhito; Murakami, Koichi; Shozu, Makio; Nakama, Tsuyoshi; Yui, Nobuhiko; Inoue, Masaki

    2006-04-01

    To evaluate the efficacy of a drug delivery system composed of danazol-loaded hyaluronic acid for local application to endometriosis. Prospective, randomized study. Academic research unit of the department of obstetrics and gynecology in a university hospital. Adult female Sprague-Dawley rats. Danazol-loaded hyaluronic acid hydrogel (DZ-HA gel) was injected into the rat endometriosis model. Size and histological changes in experimental endometriosis, the concentration of danazol in the cyst wall and plasma, and estrous cycles were examined. Histologically, DZ-HA gel-treated cysts displayed marked atrophy of the endometrial epithelium. Increased numbers of apoptotic cells and decreased numbers of proliferative cells were noted with 10 mg/mL DZ-HA gel. Size of treated cysts decreased to approximately 60% at 9 weeks after injection. The estrous cycles were not disturbed during DZ-HA gel treatment. Local injection of DZ-HA gel achieved endometrial atrophy of an experimental model of endometriosis without disturbing the sexual cycle. These results suggest that local application of DZ using this drug delivery system may prove useful for treating endometriosis.

  4. What Is Endometriosis?

    Science.gov (United States)

    ... About Share Facebook Twitter Pinterest Email Print About Endometriosis Endometriosis is a disease in which tissue similar ... to get pregnant. 4 , 5 How common is endometriosis? It is difficult to know exactly how many ...

  5. Adenosarcoma arising in hepatic endometriosis

    International Nuclear Information System (INIS)

    N'Senda, P.; Dahan, H.; Tubiana, J.M.; Arrive, L.; Wendum, D.; Balladur, P.

    2000-01-01

    We report a case of adenosarcoma arising in hepatic endometriosis. Both CT and MR scans demontrated a huge heterogeneous mass containing septated, thick-walled cystic lesions. After enlarged right hepatectomy, the patient was asymptomatic with no abnormalities at liver and abdominal CT scan at 2-year follow-up. (orig.)

  6. Adenosarcoma arising in hepatic endometriosis

    Energy Technology Data Exchange (ETDEWEB)

    N' Senda, P.; Dahan, H.; Tubiana, J.M.; Arrive, L. [Service de Radiologie, Hopital Saint-Antoine, 75 - Paris (France); Wendum, D. [Service d' Anatomie Pathologie, Hopital Saint-Antoine, 75 - Paris (France); Balladur, P. [Service de Chirurgie Digestive et Generale, Hopital Saint-Antoine, 75 - Paris (France)

    2000-08-01

    We report a case of adenosarcoma arising in hepatic endometriosis. Both CT and MR scans demontrated a huge heterogeneous mass containing septated, thick-walled cystic lesions. After enlarged right hepatectomy, the patient was asymptomatic with no abnormalities at liver and abdominal CT scan at 2-year follow-up. (orig.)

  7. Pain recurrence after shaving of rectovaginal endometriosis

    DEFF Research Database (Denmark)

    Heide, Mathias Gottschalck; Forman, Axel

    Background: Surgical treatment of rectovaginal endometriosis varies from shaving of the nodule off the rectal wall without perforation, over discoid excision to routine rectal resection. Of these methods, shaving involves the lowest rate of serious complications but leaves endometriosis tissue...... 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...... OCs and gestagen IUD showed a trend towards a protective effect against menstrual pain (p=0.06). There was found no significant association between recurrence of pain and anterior rectal wall involvement. Conclusion: Shaving of rectovaginal endometriosis shows a high risk of postoperative pain...

  8. Endometriosis presenting like a psoas abscess

    International Nuclear Information System (INIS)

    Bhat, S.N.; Mohanty, S.P.; Kustagi, P.

    2007-01-01

    Endometriosis is the presence of ectopic endometrial tissue that responds to hormonal stimulation. Although endometriosis occurs most often in the pelvis, several unusual sites have been reported. We present a case of endometriosis mimicking, a psoas abscess. A 39-year-old lady presented around the right hip, of 5 years duration. Computed tomography (CT) scan showed a multi-loculated mass in the right iliopsoas muscle. On exploration, a hemorrhagic cystic mass was seen pressing on the femoral nerve. The lesion was excised and histological examination of the tissue showed features of endometriosis. The patient was treated by cyclic hormonal suppressive therapy for 3 months. Her pain and flexion deformity of the hip resolved completely. Retroperitoneal endometriosis presenting with deformity and pain in the hip may mimic a psoas abscess. If the possibility of this diagnosis is entertained, inappropriate treatment may be avoided. (author)

  9. Primary umbilical endometriosis: To scope or not to scope?

    African Journals Online (AJOL)

    only partially understood. Endometriosis usually occurs within the pelvic cavity. Common locations are the uterine wall, the fallopian tubes, the ovaries and the pelvic peritoneum.[3-5] Pelvic endometriosis presents clinically with a triad of symptoms: pain (chronic pelvic pain and dysmenorrhea), menorrhagia and infertility.

  10. Nodular smooth muscle metaplasia in multiple peritoneal endometriosis.

    Science.gov (United States)

    Kim, Hyun-Soo; Yoon, Gun; Ha, Sang Yun; Song, Sang Yong

    2015-01-01

    We report here an unusual presentation of peritoneal endometriosis with smooth muscle metaplasia as multiple protruding masses on the lateral pelvic wall. Smooth muscle metaplasia is a common finding in rectovaginal endometriosis, whereas in peritoneal endometriosis, smooth muscle metaplasia is uncommon and its nodular presentation on the pelvic wall is even rarer. To the best of our knowledge, this is the first case of nodular smooth muscle metaplasia occurring in peritoneal endometriosis. As observed in this case, when performing laparoscopic surgery in order to excise malignant tumors of intra-abdominal or pelvic organs, it can be difficult for surgeons to distinguish the metastatic tumors from benign nodular pelvic wall lesions, including endometriosis, based on the gross findings only. Therefore, an intraoperative frozen section biopsy of the pelvic wall nodules should be performed to evaluate the peritoneal involvement by malignant tumors. Moreover, this report implies that peritoneal endometriosis, as well as rectovaginal endometriosis, can clinically present as nodular lesions if obvious smooth muscle metaplasia is present. The pathological investigation of smooth muscle cells in peritoneal lesions can contribute not only to the precise diagnosis but also to the structure and function of smooth muscle cells and related cells involved in the histogenesis of peritoneal endometriosis.

  11. Diagnosic evaluation study of color doppler ultrasonic examination in abdominal wall endometriosis%彩色多普勒高频超声对腹壁子宫内膜异位症的诊断价值研究

    Institute of Scientific and Technical Information of China (English)

    史淼; 亓恒涛; 王倩; 张东东; 章阳

    2014-01-01

    Objective To explore the color doppler ultrasound manifestation of abdominal wall endometriosis,and evaluate its clinical value. Methods The manifestation of two-dimensional high frequency ultrasonography and color doppler imaging of 36 patients withabdominal wall endometriosis,which proven by surgery and pathology,were retrospectively analyzed.Results Among the 36 patients with abdominal wall endometriosis,1 6 cases located in fat layer,20 cases in muscular layer,with diameter ranging from 1 .1 to 5 .2 cm.With two-dimensionalultrasonography,there was no capsule,but with irregular morphology,blurred margins,low echoes inside and some parts of irregular no-echo areas.The size and internal echo of the mass changed respectively according to the menstruation.Color doppler ultrasound showed scattered or striped flow signals in the lesion,whose artery displayed low-speed and high resistance frequency spectrum.The accuracy and misdiagnosis rate of ultrasonography were 83.3% and 1 6.7%, respectively.Conclusions The color doppler ultrasound may directlydisplay the size,morphology,condition of internal echo and blood inflow of the abdominal wall endometriosis lesion.Therefore,it is the first choice of imaging examination for the diagnosis of abdominal wall endometriosis.%目的:探讨腹壁子宫内膜异位症的彩色多普勒高频超声表现,评价其临床应用价值。方法回顾性分析2010年2月至2013年12月,山东省聊城市人民医院经手术病理证实的腹壁子宫内膜异位症患者36例的高频超声二维图像及彩色多普勒超声表现。结果36例腹壁子宫内膜异位症患者中,位于脂肪层内16例,位于肌层内20例,直径1.1~5.2 cm。二维超声表现:无包膜,形态不规则,边缘不光滑,内部为不均质低回声,随月经的不同时期肿块大小及回声呈相应改变。彩色多普勒超声显示病灶内部可见点状或条状血流信号,其动脉均为低速高阻频谱。

  12. MR diagnosis of diaphragmatic endometriosis

    International Nuclear Information System (INIS)

    Rousset, Pascal; Gregory, Jules; Coste, Joel; Rousset-Jablonski, Christine; Hugon-Rodin, Justine; Regnard, Jean-Francois; Chapron, Charles; Golfier, Francois; Revel, Marie-Pierre

    2016-01-01

    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.)

  13. 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.)

  14. Endocannabinoids modulate apoptosis in endometriosis and adenomyosis.

    Science.gov (United States)

    Bilgic, Elif; Guzel, Elif; Kose, Sevil; Aydin, Makbule Cisel; Karaismailoglu, Eda; Akar, Irem; Usubutun, Alp; Korkusuz, Petek

    2017-06-01

    Adenomyosis that is a form of endometriosis is the growth of ectopic endometrial tissue within the muscular wall of the uterus (myometrium), which may cause dysmenorrhea and infertility. Endocannabinoid mediated apoptotic mechanisms of endometriosis and adenomyosis are not known. We hypothesized that the down regulation of endocannabinoid receptors and/or alteration in their regulatory enzymes may have a direct role in the pathogenesis of endometriosis and adenomyosis through apoptosis. Endocannabinoid receptors CB1 and CB2, their synthesizing and catabolizing enzymes (FAAH, NAPE-PLD, DAGL, MAGL) and the apoptotic indexes were immunohistochemically assessed in endometriotic and adenomyotic tissues. Findings were compared to normal endometrium and myometrium. Endometrial adenocarcinoma (Ishikawa) and ovarian endometriosis cyst wall stromal (CRL-7566) cell lines were furthermore cultured with or without cannabinoid receptor agonists. The IC50 value for CB1 and CB2 receptor agonists was quantified. Cannabinoid agonists on cell death were investigated by Annexin-V/Propidium iodide labeling with flow cytometry. CB1 and CB2 receptor levels decreased in endometriotic and adenomyotic tissues compared to the control group (p=0,001 and p=0,001). FAAH, NAPE-PLD, MAGL and DAGL enzyme levels decreased in endometriotic and adenomyotic tissues compared to control (p=0,001, p=0,001, p=0,001 and p=0,002 respectively). Apoptotic cell indexes both in endometriotic and adenomyotic tissues also decreased significantly, compared to the control group (p=0,001 and p=0,001). CB1 and CB2 receptor agonist mediated dose dependent fast anti-proliferative and pro-apoptotic effects were detected in Ishikawa and ovarian endometriosis cyst wall stromal cell lines (CRL-7566). Endocannabinoids are suggested to increase apoptosis mechanisms in endometriosis and adenomyosis. CB1 and CB2 antagonists can be considered as potential medical therapeutic agents for endometriosis and adenomyosis. Copyright

  15. Abdominal endometriosis: Ultrasonographic findings (report of two cases)

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Beum; Kim, Yong Goo; Lee, Yong Chul; Kim, Kun Sang [Chung Ang University Hospital, Seoul (Korea, Republic of)

    1993-12-15

    Endometriosis in the abdominal wall is a rare condition that most commonly occurs in the physiological scar of the umbilicus and in surgical scars of pelvic operation. The ultrasonographic findings are often non-specific, but with scrutinized physical examination and history, correct diagnosis can be made. We report ultrasonographic findings of abdominal wall endometriosis in two cases, both of which were related to previous cesarian section scar

  16. Bronchial Artery Embolization in the Management of Pulmonary Parenchymal Endometriosis with Hemoptysis

    International Nuclear Information System (INIS)

    Kervancioglu, Selim; Andic, Cagatay; Bayram, Nazan; Telli, Cumali; Sarica, Akif; Sirikci, Akif

    2008-01-01

    Pulmonary parenchymal endometriosis is extremely rare and usually manifests itself with a recurrent hemoptysis associated with the menstrual cycle. The therapies proposed for women with endometriosis consist of medical treatments and surgery. Bronchial artery embolization has become a well-established and minimally invasive treatment modality for hemoptysis, and to the best of our knowledge, it has not been reported in pulmonary endometriosis. We report a case of pulmonary parenchymal endometriosis treated with embolotheraphy for hemoptysis.

  17. Endometriosis of the rectum: CT findings

    International Nuclear Information System (INIS)

    Guo Yan; Huang Zhaomin; Liu Mingjuan; Zhong Juemin

    2004-01-01

    Objective: To investigate the CT manifestations of recto-endometriosis. Methods: Three pathologically proved cases of recto-endometriosis were reported, the CT features and clinical manifestations were investigated retrospectively with review of literatures. Results: The patients were all menstruating females (28, 34, and 45 years old, respectively), and anal pain emerged during menses in one case. Rectal examination revealed stiff immobile mass along the rectal wall in all three cases. All the cases showed solid masses on CT scan with moderate enhancement after contrast administration. Two of them confined to the rectal walls, another involved the rectum and peri-rectal aspect. One case was misdiagnosed as well-differentiated adenocarcinoma of rectum in frozen section by biopsy specimen. Conclusion: A solid mass was always found in recto-endometriosis. No characteristic CT feature was manifested. Attention should be paid to the differentiation from rectal tumors when making the diagnosis

  18. Endometriosis in the male.

    Science.gov (United States)

    Martin, J D; Hauck, A E

    1985-07-01

    An 83-year-old man with an endometrioma of the lower abdominal wall has been reported. This occurred following the administration of 25 mg of TACE for a period of about 10 years for what was thought to be carcinoma of the prostate. A second transurethral resection done by Dr. R. C. Thompson proved to be adenocarcinoma. Subsequent to this he was continued on TACE. A review of the more commonly accepted theories of the development of endometriosis in the female has been presented. It is pointed out that the separation between the male and female urogenital systems occurs in the embryo between the eighth week and the fourth month. There is always a possibility for remnants of the opposite sex to remain in individuals. No such was seen in the case which is herein reported. Normal phenotype male was demonstrated in the chromosomal evaluation. A review of the literature on endometriosis in the male reveals several cases which have occurred; the origin of which is though to be from the prostatic utricle which is a remnant of the uterus existing in the male. After a prolonged course the patient reported was followed until he died in 1979. There was no recurrence of the abdominal wall mass but persistent low grade carcinoma of the prostate remained. The terminal process was related to cardiovascular disease and not carcinoma of the prostate. There was delay in publication of this unusual case. The original plan was to await final confirmation of the exact pathologic nature of this condition; unfortunately this was never done since a postmortem examination was not performed.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Laparoscopic diagnosis of endometriosis.

    Science.gov (United States)

    Wood, Carl; Kuhn, Raphael; Tsaltas, Jim

    2002-08-01

    To consider and explain the possibility of difficulties in diagnosis of endometriosis at previous laparoscopy Retrospective patient record review. The Endometriosis Care Centre of Australia and the private practices of authors. Two hundred and fifteen patients with clinical evidence of endometriosis examined laparoscopically between March 1999 and May 2001. Confirmation of endometriosis by histological biopsy. Endometriosis was confirmed in 168 of the 215 women. Of these women 38 had a previous negative laparoscopy within 12 months of the current laparoscopy. It is possible that in some of the patients, who previously had a negative laparoscopy, endometriosis was not recognised. Possible reasons for difficulty in diagnosis have been identified and techniques to improve diagnosis suggested. This retrospective study was performed to consider and explain the possibility of difficulties in diagnosis of endometriosis at previous laparoscopy.

  20. Endometriosis: Does It Cause Infertility?

    Science.gov (United States)

    ... Website of the American Society for Reproductive Medicine Endometriosis: Does It Cause Infertility? This fact sheet was ... with The Society of Reproductive Surgeons What is endometriosis? Endometriosis is when tissue is found outside the ...

  1. A case of bifocal endometriosis involving a pfannenstiel incision.

    Science.gov (United States)

    Evsen, Mehmet Sidik; Sak, Muhammet Erdal; Yalinkaya, Ahmet; Firat, Ugur; Caca, Fatma Nur

    2011-01-01

    A 25-year-old woman was referred to our clinic for atypical cyclic pain and masses at both ends of a Pfannenstiel incision scar. Ultrasound of the anterior abdominal wall showed two masses. Both masses were hypoechoic, heterogeneous lesions located at opposite ends of the scar. The lesions were surgically excised with. Microscopic examination revealed endometrial gland structures with endometrial stroma in fibroadipose tissue in sections of both specimens indicative of endometriosis. Incisional endometriosis (IE) is a form of extrapelvic endometriosis especially in scars of obstetric or gynecologic surgery IE may be multifocal at surgical scars. We report the a case of bifocal incisional endometriosis in Pfannesteil scar. Whole scar evaluation should be done for incisional endometriosis and surgical excision should be performed for treatment.

  2. Effect of imatinib on growth of experimental endometriosis in rats.

    Science.gov (United States)

    Yildiz, Caglar; Kacan, Turgut; Akkar, Ozlem Bozoklu; Karakus, Savas; Seker, Metin; Kacan, Selen Baloglu; Ozer, Hatice; Cetin, Ali

    2016-02-01

    Currently, medical and surgical treatment options for endometriosis are limited due to suboptimal efficacy, and also safety and tolerance issues. Long-term use of gonadotrophin-releasing hormone analogs, androgenes, and the danazol, which are widely used drugs for endometriosis, is usually not possible due to their suboptimal safety and tolerance profile. The lack of an effective, tolerable and safe treatment option for endometriosis makes animal models of experimental endometriosis necessary to study candidate drugs. The aim of this study was to investigate the efficacy of imatinib on the experimental endometriosis in a rat model. Endometriosis was induced by autotransplantation of uterine tissue into the peritoneal cavity. Twenty-four rats, which had visually confirmed endometriotic implants on subsequent laparotomy, were randomized into three groups to receive imatinib (25mg/kg/day, p.o.), anastrozole (0.004 mg/day, p.o.), or normal saline (0.1 mL, i.p.) for 14 days. After removal of endometriotic tissue and H & E staining, endometriosis score was determined according to a semiquantitative histological classification. Also, immunostaining with primary antibodies including VEGF, CD117, and Bax were used for immunohistochemical (IHC) examination. Both anastrozole and imatinib suppressed the growth of endometriotic tissue and reduced the number of ovarian follicles. Although the difference was not statistically significant, imatinib was less effective than anastrozole for treatment of endometriosis. Imatinib effectively treats experimental endometriosis by its inhibitor effects on angiogenesis and cell proliferation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Differentiation of tuboovarian abscess from endometriosis: CT indicators

    International Nuclear Information System (INIS)

    Eo, Hong; Choi, Hyuck Jae; Kim, Sun Ho; Jung, Seong Il; Park, Byung Kwan; Kim, Seung Hyup

    2005-01-01

    To assess and compare CT findings of surgically confirmed cases of tuboovarian abscesses (TOA) and endometriosis in order to identify indicators which may be helpful in making correct preoperative diagnoses. Of the 35 consecutive patients with surgically confirmed TOA, CT images were available for 11 of those patients. As a comparative group, 36 patients with surgically confirmed endometriosis with CT images were selected. CT images of TOA were compared with those of endometriosis. A retrospective analysis of the CT images of both groups was performed without knowledge of the pathologic diagnosis. The analysis compared the thickness and enhancement pattern of the cyst wall, attenuation of the cyst content, size and shape of the cyst, and paraaortic lymphadenopathy. Mean thickness of the cyst wall was 6.2 ± 2.0 mm in TOA and 4.5 ± 2.4 mm in endometriosis. Multilayered appearance in both diseases was seen on enhanced CT in 91% (10/11) of TOA cases and in 25% (9/36) of endometriosis cases. Hounsefield units of the cyst contents were 20.0 ± 5.5 HU and 24.7 ± 10.0 HU for TOA and endometriosis, respectively. Mean diameter of the cysts was 7.5 ± 1.7 cm in TOA and 7.9 ± 3.1 in endometriosis. Shape of the cyst was multilocular in 82% (9/11) of TOA cases and in 75% (27/36) of endometriosis cases. Paraaortic lymphadenopathy was present in 73% (8/11) and 44% (16/36) for TOA and endometriosis, respectively. TOA should be suspected on CT when a multilocular cystic ovarian mass is observed, especially if the lesion has a thick wall and has a multilayered appearance, and is accompanied by paraaortic lymphadenopathy

  4. Differentiation of tuboovarian abscess from endometriosis: CT indicators

    Energy Technology Data Exchange (ETDEWEB)

    Eo, Hong; Choi, Hyuck Jae; Kim, Sun Ho; Jung, Seong Il; Park, Byung Kwan; Kim, Seung Hyup [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2005-10-15

    To assess and compare CT findings of surgically confirmed cases of tuboovarian abscesses (TOA) and endometriosis in order to identify indicators which may be helpful in making correct preoperative diagnoses. Of the 35 consecutive patients with surgically confirmed TOA, CT images were available for 11 of those patients. As a comparative group, 36 patients with surgically confirmed endometriosis with CT images were selected. CT images of TOA were compared with those of endometriosis. A retrospective analysis of the CT images of both groups was performed without knowledge of the pathologic diagnosis. The analysis compared the thickness and enhancement pattern of the cyst wall, attenuation of the cyst content, size and shape of the cyst, and paraaortic lymphadenopathy. Mean thickness of the cyst wall was 6.2 {+-} 2.0 mm in TOA and 4.5 {+-} 2.4 mm in endometriosis. Multilayered appearance in both diseases was seen on enhanced CT in 91% (10/11) of TOA cases and in 25% (9/36) of endometriosis cases. Hounsefield units of the cyst contents were 20.0 {+-} 5.5 HU and 24.7 {+-} 10.0 HU for TOA and endometriosis, respectively. Mean diameter of the cysts was 7.5 {+-} 1.7 cm in TOA and 7.9 {+-} 3.1 in endometriosis. Shape of the cyst was multilocular in 82% (9/11) of TOA cases and in 75% (27/36) of endometriosis cases. Paraaortic lymphadenopathy was present in 73% (8/11) and 44% (16/36) for TOA and endometriosis, respectively. TOA should be suspected on CT when a multilocular cystic ovarian mass is observed, especially if the lesion has a thick wall and has a multilayered appearance, and is accompanied by paraaortic lymphadenopathy.

  5. Interleukin-37 in endometriosis.

    Science.gov (United States)

    Kaabachi, Wajih; Kacem, Olfa; Belhaj, Rafik; Hamzaoui, Agnes; Hamzaoui, Kamel

    2017-05-01

    Interleukin-37 (IL-37) has been identified as a novel anti-inflammatory cytokine. The present study aimed to evaluate the expression of IL-37 in serum and in peritoneal fluid to determine its clinical significance in endometriosis. Enzyme-linked immunosorbent assay (ELISA) was performed to examine serum IL-37 levels in patients with endometriosis and healthy controls. Peritoneal fluid IL-37 mRNA and NFκB expression were quantified by real-time reverse transcription polymerase chain reaction assays. The association of IL-37 levels with clinical factors and prognosis of endometriosis was analysed. We found that IL-37 levels in PF and in serum were significantly higher in patients with endometriosis compared to women without endometriosis (P=0.0005). IL-37 levels were highly expressed in PF [132.38±34.62pg/mL; Pendometriosis patients. IL-37 mRNA expression contrasted with NFκB mRNA expression in PF from patients with endometriosis. A significant inverse correlation was observed between IL-37 mRNA and NFκB mRNA expression. IL-37 expression correlates with endometriosis severity. The affected NFκB mRNA expression in endometriosis contributed the to exhibited increase of IL-37. The increased levels of IL-37 may dampen NFκB activation in endometriosis patients. Copyright © 2017. Published by Elsevier B.V.

  6. Pathogenesis of deep endometriosis.

    Science.gov (United States)

    Gordts, Stephan; Koninckx, Philippe; Brosens, Ivo

    2017-12-01

    The pathophysiology of (deep) endometriosis is still unclear. As originally suggested by Cullen, change the definition "deeper than 5 mm" to "adenomyosis externa." With the discovery of the old European literature on uterine bleeding in 5%-10% of the neonates and histologic evidence that the bleeding represents decidual shedding, it is postulated/hypothesized that endometrial stem/progenitor cells, implanted in the pelvic cavity after birth, may be at the origin of adolescent and even the occasionally premenarcheal pelvic endometriosis. Endometriosis in the adolescent is characterized by angiogenic and hemorrhagic peritoneal and ovarian lesions. The development of deep endometriosis at a later age suggests that deep infiltrating endometriosis is a delayed stage of endometriosis. Another hypothesis is that the endometriotic cell has undergone genetic or epigenetic changes and those specific changes determine the development into deep endometriosis. This is compatible with the hereditary aspects, and with the clonality of deep and cystic ovarian endometriosis. It explains the predisposition and an eventual causal effect by dioxin or radiation. Specific genetic/epigenetic changes could explain the various expressions and thus typical, cystic, and deep endometriosis become three different diseases. Subtle lesions are not a disease until epi(genetic) changes occur. A classification should reflect that deep endometriosis is a specific disease. In conclusion the pathophysiology of deep endometriosis remains debated and the mechanisms of disease progression, as well as the role of genetics and epigenetics in the process, still needs to be unraveled. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  7. Ultrasound and MR-imaging in preoperative evaluation of two rare cases of scar endometriosis

    OpenAIRE

    Pados, George; Tympanidis, John; Zafrakas, Menelaos; Athanatos, Dimitrios; Bontis, John N

    2008-01-01

    Scar or incisional endometriosis is a rare, often misdiagnosed, pathologic condition of the abdominal wall. Two cases of incisional endometriosis are presented. Both patients presented with atypical cyclic pain and palpable nodules on scars of previous cesarean sections. In both cases, the mass was totally excised, after accurate preoperative evaluation with 2-D ultrasound, power Doppler and MRI. Microscopic examination confirmed the preoperatively presumed diagnosis of cutaneous endometriosi...

  8. A Novel Endometriosis Inducing Factor In Women with Endometriosis

    Directory of Open Access Journals (Sweden)

    Ramzy A,

    2010-01-01

    results from the presence of endometrial glands and stroma outside the uterus. The exact incidence of endometriosis is uncertain because the disease process exists in several stages, from microscopic lesions to macroscopic disease, some of which are not apparent during evaluation. Although, the current prevalence of endometriosis is estimated to be up to 10%1, endometriosis is found in 40–60% of women with pelvic pain2 and in 20–30% of women suffering from infertility3. Moreover, women with more advanced disease have a higher rate of infertility4. Endometriosis can be found in different sites, however, it has been estimated that endometriosis is predominately found in ovaries (44%, Pouch of Douglas (38% and vesico-uterine space (34%, uterosacral ligaments and surrounding pelvic peritoneum (22%5. Additional sites include laparotomy 6, and episiotomy scars7, Appendix8, cervix9, pleura10, abdominal wall11-12, lungs13, nose14and rarely the brain15. The consequences of endometriosis include pelvic pain, dysparunia, pelvic adhesions and infertility16.Endometriosis is a disease of theories, where the metaplasia theory suggests that under diverse influences, coelomic tissue could be transformed into endometrium17. Unfortunately, no direct evidence showing the formation of endometrial stroma has been reported at the end of the metaplastic process. Moreover, according to this theory, ectopic endometrium develops in situ from local tissues, including germinal epithelium of the ovary and remnants of the Müllerian and Wolffian ducts. In a broader context, this theory also implies that peritoneal endometriosis results from in situ metaplasia of totipotent mesothelial serosal cells18. The fact that endometriosis mostly occurs when endometrium is present, and that males are spared from this disease, weakens the power of the concept of metaplasia to explain endometriosis. Another theory proposes that the physiological phenomenon of endometrial reflux in the fallopian tubes during

  9. 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.

  10. What Are the Symptoms of Endometriosis?

    Science.gov (United States)

    ... Pinterest Email Print What are the symptoms of endometriosis? The primary symptoms of endometriosis are pain and ... symptoms, may cause these endometriosis symptoms to continue. Endometriosis-Related Pain Researchers know that pain is a ...

  11. Endometriosis, a modern syndrome

    Science.gov (United States)

    Brosens, Ivo; Benagiano, Giuseppe

    2011-01-01

    The identification of endometriosis has been a subject of intense debate over the last decade. There is, however, no doubt that Thomas Cullen was the first to describe endometriosis and adenomyosis as one disease characterized by the presence of endometrium-like tissue outside the uterine cavity. With the introduction of laparoscopy in the early 1960s three different clinical presentations of endometriosis were distinguished: peritoneal, deep adenomyotic and cystic ovarian. As soon as synthetic steroids became available, pioneer clinicians started utilizing these in an attempt to replace radical surgery by a medical treatment. While medical therapy may resort in relief, in most cases the current approach consists of a combination of medical and surgical therapy. While the pathogenesis of endometriosis is still enigmatic and complex, there is increasing evidence that endometriosis is part of a uterine reproductive dysfunction syndrome. For prevention of complications, it is very important that diagnosis is made as early as possible in a woman's life. PMID:21727656

  12. 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...... until the end of 2009. To explore changes over time, the endometriosis cohorts were followed for 15 years from the years 1980, 1986, 1992 and 1998, with the corresponding control cohorts. All pregnancy outcomes were categorized into naturally or artificially conceived pregnancies. MAIN OUTCOME MEASURES...

  13. Elevated peritoneal expression and estrogen regulation of nociceptive ion channels in endometriosis.

    Science.gov (United States)

    Greaves, Erin; Grieve, Kelsey; Horne, Andrew W; Saunders, Philippa T K

    2014-09-01

    Ovarian suppression is a common treatment for endometriosis-associated pelvic pain. Its exact mechanism of action is poorly understood, although it is assumed to reflect reduced production/action of estrogens. The objective of the study was to measure the expression of mRNAs encoded by nociceptive genes in the peritoneum of women with chronic pelvic pain (CPP) with or without endometriosis and to investigate whether estrogens alter nociceptive gene expression in human sensory neurons. The study was performed using human tissue analysis and cell culture. The study was conducted at a university research institute. Peritoneal biopsies were obtained from women with CPP and endometriosis (n = 12), CPP and no endometriosis (n = 10), and no pain or endometriosis (n = 5). Endometriosis lesions were obtained from women with endometriosis (n = 18). mRNAs encoding ion channels (P2RX3, SCN9A, SCN11A, TRPA1, TRPV1) and the neurotransmitter TAC1 were measured in human tissue samples and in human embryonic stem cell-derived sensory neurons treated with estrogens. TRPV1, TRPA1, and SCN11A mRNAs were significantly higher in the peritoneum from women with endometriosis (P endometriosis lesions (P endometriosis (P endometriosis-associated pain. Strategies directly targeting ion channels may offer an alternative option for the management of CPP.

  14. Endometriosis e infertilidad = Endometriosis and infertility

    OpenAIRE

    Restrepo Cano, Gustavo Adolfo

    2012-01-01

    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 ...

  15. The epidemiology of endometriosis.

    Science.gov (United States)

    Cramer, Daniel W; Missmer, Stacey A

    2002-03-01

    Advances in understanding the epidemiology of endometriosis have lagged behind other diseases because of methodologic problems related to disease definition and control selection. Nevertheless, a better picture of the epidemiology of endometriosis has emerged over the past few decades. Prevalence estimates of the disease in clinic populations vary from about a 4% occurrence of largely asymptomatic endometriosis found in women undergoing tubal ligation to 50% of teenagers with intractable dysmenorrhea. General population incidence during the 1970s in this country has been suggested to be 1.6 per 1000 white females aged 15-49, while a more current study based upon hospital discharges finds endometriosis as a first listed diagnosis in 1.3 per 1000 discharges in women aged 15-44. There is a clinical impression that blacks have lower rates of endometriosis and Orientals have higher rates than whites. A variety of personal risk factors for endometriosis have also been described. Women with endometriosis may be taller and thinner. Menstrual factors reported to increase risk include dysmenorrhea, early menarche, and shorter cycle lengths. There is support for the idea that lifestyle exposures that might raise or lower estrogen levels could affect risk, including a decreased risk associated with smoking and exercise and an increased risk associated with caffeine or alcohol use. These risk factors appear to be compatible with the central importance of retrograde menstruation influenced by outflow obstruction that might affect its amount, immune factors that might affect its ability to be cleared, or hormonal stimuli that might affect its growth. In this model, dysmenorrhea could be either a disease symptom or a manifestation of outflow obstruction. Nulliparity could be either a consequence of disease or a cause since nulliparous women would not have the benefit of cervical dilation associated with labor and delivery. Since there is evidence that family history is a risk

  16. SURGICAL TREATMENT OF ENDOMETRIOSIS IN INFERTILE PATIENTS

    Directory of Open Access Journals (Sweden)

    Andrej Vogler

    2003-12-01

    Full Text Available Background. Endometriosis is nowadays probably the most frequent cause of infertility or subfertility and is revealed in approximately 30–40% of infertile women. The association between fertility and minimal or mild endometriosis remains unclear and controversial. Moderate and severe forms of the disease distort anatomical relations in the minor pelvis, resulting in infertility. The goals of endometriosis treatment are relief of pain symptoms, prevention of the disease progression and fertility improvement. Treatment of stages I and II endometriosis (according to the R-AFS classification may be expectative, medical or surgical. In severely forms of the disease (stage III and IV the method of choice is surgical treatment. Combined medical and surgical treatment is justified only in cases, in which the complete endometriotic tissue removal is not possible or recurrence of pain symptoms occur. Nowadays, laparoscopic surgical treatment is the golden standard being the diagnostic and therapeutic tool during the same procedure. The aim of this study was to evaluate the fertility rate after surgical treatment of different stages of endometriosis.Patients and methods. In prospectively designed study 100 infertile women were included. The only known cause of infertility was endometriosis. In group A there were 51 patients with stage I and II endometriosis, whereas in group B there were 49 patients with stage III and IV of the disease. Endometriosis was diagnosed and treated laparoscopically. Endometriotic implants were removed either with bipolar coagulation or CO2 laser vaporisation, whereas adhesions were sharp or blunt dissected, and endometriomas stripped out of ovaries. Pregnancy rates were calculated for both groups of patients, and statistically compared between the groups.Results. Mean age of patients was 29.25 (SD ± 4.08 years and did not significantly differ between the groups of patients (29.5 years in group A and 29 years in group B. In

  17. 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.

  18. A Novel Endometriosis Inducing Factor In Women with Endometriosis

    OpenAIRE

    Ramzy A,; Bibars M; El-Sawaf A; Selim M; Sabry D; Azmy O; Taha TF; Atta H; Rasheed K; El-Garf W; Anwar M

    2010-01-01

    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 ...

  19. Endometriosis in Adolescence

    OpenAIRE

    Dessole, Margherita; Melis, Gian Benedetto; Angioni, Stefano

    2012-01-01

    Endometriosis is a common cause of pelvic pain and infertility. The majority of women report symptoms since adolescence, and there are rare cases of endometriosis in premenarchal age patients. Symptoms in adolescence are similar to those in adulthood. Treatment usually consists of oral contraceptives and nonsteroidal anti-inflammatory drugs. In cases where this treatment is not successful, laparoscopy and biopsy of the lesions are necessary for diagnosis. However, emerging new technologies pr...

  20. Endometriosis in adolescence

    OpenAIRE

    Steenberg, Christine Krohn

    2012-01-01

    Endometriosis is a chronic disease with endometrial-like tissue located outside the uterus, resulting in inflammation, pelvic pain and infertility. Laparoscopic exploration is the only accurate diagnostic aid for disease recognition, and the time between symptom onset and final diagnosis can be up to 10 years. Endometriosis can already start in adolescence, and in order to make an earlier diagnosis, researchers are beginning to look for an association between specific characteristics, or mark...

  1. [Endometriosis Update 2016].

    Science.gov (United States)

    Imesch, Patrick; Fink, Daniel

    2016-03-02

    Endometriosis is a common gynecologic benign disease, affecting 6–10% of women of reproductive age. The disease is often associated with dysmenorrhea, dyspareunia, chronic pelvic pain and infertility. The exact mechanism of the pathogenesis of endometriosis has not yet been fully elucidated, therefore, current medical therapeutic options are more symptom-oriented than causal. The aim of the present work is to summarize the current diagnostic and therapeutic options.

  2. [Combined treatment of endometriosis: radical yet gentle].

    Science.gov (United States)

    Alkatout, Ibrahim; Wedel, Thilo; Maass, Nicolai

    2018-02-01

    Endometriosis is the second most common benign female genital disease after uterine myoma. This review discusses the management of individual patients. This should take into account the severity of the disease and whether the patient desires to have children. Particular emphasis is laid on the anatomical intersections which, when injured, can lead to persistent damage of the anterior, middle or posterior compartment and are not infrequently the cause of urological and urogynaecological follow-up measures. Typical symptoms of endometriosis include chronic pelvic pain, subfertility, dysmenorrhoea, deep dyspareunia, cyclical bowel or bladder symptoms (e. g. dyschezia, bloating, constipation, rectal bleeding, diarrhoea and haematuria), abnormal menstrual bleeding, chronic fatigue and low back pain. Approx. 50 % of all female teenagers and up to 32 % of all women of reproductive age who have been operated for chronic pelvic pain or dysmenorrhoea suffer from endometriosis. The time interval between the first unspecific symptoms and the medical diagnosis of endometriosis is about 7 years. This is caused not only by the non-specific nature of the symptoms but also by the frequent lack of awareness on the part of the cooperating disciplines with which the patients have first contact. As the pathogenesis of endometriosis is not clearly understood, causal treatment is still impossible. Treatment options include expectant management, analgesia, hormonal medical therapy, surgical intervention and the combination of medical treatment before and/or after surgery. The treatment should be as radical as necessary and as minimal as possible. The recurrence rate among treated patients lies between 5 % and > 60 % and is very much dependent on integrated management and surgical skills. Consequently, to optimise the individual patient's treatment, a high degree of interdisciplinary cooperation in diagnosis and treatment is crucial and should be reserved to appropriate

  3. Potential Role of Semaphorin 3A and Its Receptors in Regulating Aberrant Sympathetic Innervation in Peritoneal and Deep Infiltrating Endometriosis.

    Science.gov (United States)

    Liang, Yanchun; Wang, Wei; Huang, Jiaming; Tan, Hao; Liu, Tianyu; Shang, Chunliang; Liu, Duo; Guo, Luyan; Yao, Shuzhong

    2015-01-01

    Previous studies have demonstrated the involvement of nerve repellent factors in regulation of the imbalanced innervation of endometriosis. This prospective study aims to explore the role of Sema 3A in regulating aberrant sympathetic innervation in peritoneal and deep infiltrating endometriosis. Ectopic endometriotic lesion were collected from patients with peritoneal endometriosis (n = 24) and deep infiltrating endometriosis of uterosacral ligament (n = 20) undergoing surgery for endometriosis. Eutopic endometrial samples were collected from patients with endometriosis (n = 22) or without endometriosis (n = 26). Healthy peritoneum (n = 13) from the lateral pelvic wall and healthy uterosacral ligament (n = 13) were obtained from patients who had no surgical and histological proof of endometriosis during hysterectomy for uterine fibroids. Firstly, we studied the immunostaining of Sema 3A, Plexin A1 and NRP-1 in all the tissues described above. Then we studied the nerve fiber density (NFD) of endometriosis-associated (sympathetic) nerve and para-endometriotic (sympathetic) nerve by double immunofluorescence staining. Finally we analyzed the relationship between expression of Sema 3A in stromal cells of endometriotic lesion and the aberrant innervation of endometriosis. Semi-quantitative immunostaining demonstrated that (1) Higher immunostaining of Sema 3A were found in the eutopic endometrial glandular epithelial cells from patients with endometriosis (p = 0.041) than those without endometriosis; (2) Sema 3A immunostaining was higher in glandular epithelial cells of peritoneal endometriosis (Pendometriosis, while its expression in ectopic stormal cells in both groups were significantly lower than that from eutopic endometrium of women without endometirosis (Pendometriosis-associated sympathetic nerve of peritoneal endometriosis (pendometriosis of uterosacral ligament (pperitoneal and deep infiltrating endometriosis.

  4. 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. © 2014 S. Karger AG, Basel.

  5. Apparatus for treating the walls and floor of the pelvic cavity with radiation

    International Nuclear Information System (INIS)

    Clayton, R.S.

    1975-01-01

    An apparatus for reaing carcinoma of the walls and floor of the pelvic cavity is described. An elongated tube has an inner end adapted to be placed in the pelvic cavity and an outer end adapted to extend through to the outside of the body. Radioactive material is placed at the inner end. An inner balloon above the radioactive material is inflated to hold a body of liquid shielding material such as mercury. A lower balloon portion beneath the inner balloon spaces areas to be treated such as the walls and floor of the pelvic cavity from the radioactive material. An upper balloon portion above the inner balloon keeps the intestines out of the pelvic cavity and away from the radioactive material. The apparatus is inserted into the pelvic cavity through an abdominal incision. When treating a woman for carcinoma in the walls and floor of the pelvic cavity the tube is moved through the vaginal passage from the inside outwardly. When treating a woman with a closed vaginal passage, as may result from surgery, or when treating a man, such as for carcinoma of the bladder, the tube will pass out of the body through a lower abdominal incision. Following treatment, all balloons are deflated so that the apparatus can be withdrawn through the vaginal passage or the lower abdominal incision, as the case may be. (auth)

  6. Endometriosis and possible inflammation markers

    Directory of Open Access Journals (Sweden)

    Meng-Hsing Wu

    2015-08-01

    Full Text Available Inflammation plays an important role in the pathogenesis of endometriosis. Infiltration of peritoneal macrophages and local proinflammatory mediators in the peritoneal microenvironment affect ovarian function and pelvic anatomy leading to the symptoms and signs of endometriosis. The identification of a noninvasive marker for endometriosis will facilitate early diagnosis and treatment of this disease. This review provides an overview of local microenvironmental inflammation and systemic inflammation biomarkers in endometriosis.

  7. 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.)

  8. Obstetrical complications of endometriosis, particularly deep endometriosis.

    Science.gov (United States)

    Leone Roberti Maggiore, Umberto; Inversetti, Annalisa; Schimberni, Matteo; Viganò, Paola; Giorgione, Veronica; Candiani, Massimo

    2017-12-01

    Over the past few years, a new topic in the field of endometriosis has emerged: the potential impact of the disease on pregnancy outcomes. This review aims to summarize in detail the available evidence on the relationship between endometriosis, particularly deep endometriosis (DE), and obstetrical outcomes. Acute complications of DE, such as spontaneous hemoperitoneum, bowel perforation, and uterine rupture, may occur during pregnancy. Although these events represent life-threatening conditions, they are rare and unpredictable. Therefore, the current literature does not support any kind of prophylactic surgery before pregnancy to prevent such complications. Results on the impact of DE on obstetrical outcomes are debatable and characterized by several limitations, including small sample size, lack of adjustment for confounders, lack of adequate control subjects, and other methodologic flaws. For these reasons, it is not possible to draw conclusions on this topic. The strongest evidence shows that DE is associated with higher rates of placenta previa; for other obstetrical outcomes, such as miscarriage, intrauterine growth restriction, preterm birth and hypertensive disorders, results are controversial. Although it is unlikely that surgery of DE may modify the impact of the disease on the course of pregnancy, no study has yet investigated this issue. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  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. Diagnosis of endometriosis with imaging: a review

    International Nuclear Information System (INIS)

    Kinkel, Karen; Frei, Kathrin A.; Balleyguier, Corinne; Chapron, Charles

    2006-01-01

    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.)

  11. 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.)

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

    International Nuclear Information System (INIS)

    Coutinho Junior, Antonio Carlos; Coutinho, Elisa Pompeu Dias; Lima, Claudio Marcio Amaral de Oliveira; Ribeiro, Erica Barreiros; Aidar, Marisa Nassar; Gasparetto, Emerson Leandro

    2008-01-01

    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)

  13. 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)

  14. Immune interactions in endometriosis

    Science.gov (United States)

    Herington, Jennifer L; Bruner-Tran, Kaylon L; Lucas, John A; Osteen, Kevin G

    2011-01-01

    Endometriosis is a common, complex gynecologic disorder characterized by the presence of endometrial glands and stroma at extrauterine (ectopic) sites. In women who develop this disease, alterations in specific biological processes involving both the endocrine and immune systems have been observed, which may explain the survival and growth of displaced endometrial tissue in affected women. In the past decade, a considerable amount of research has implicated a role for alterations in progesterone action at both eutopic and ectopic sites of endometrial growth which may contribute to the excessive inflammation associated with progression of endometriosis; however, it remains unclear whether these anomalies induce the condition or are simply a consequence of the disease process. In this article, we summarize current knowledge of alterations within the immune system of endometriosis patients and discuss how endometrial cells from women with this disease not only have the capacity to escape immunosurveillance, but also use inflammatory mechanisms to promote their growth within the peritoneal cavity. Finally, we discuss evidence that exposure to an environmental endocrine disruptor, such as 2,3,7,8-tetrachlorodibenzo-p-dioxin, can mediate the development of an endometrial phenotype that exhibits both reduced progesterone responsiveness and hypersensitivity to proinflammatory stimuli mimicking the endometriosis phenotype. Future studies in women with endometriosis should consider whether a heightened inflammatory response within the peritoneal microenvironment contributes to the development and persistence of this disease. PMID:21895474

  15. Potential Role of Semaphorin 3A and Its Receptors in Regulating Aberrant Sympathetic Innervation in Peritoneal and Deep Infiltrating Endometriosis

    Science.gov (United States)

    Liang, Yanchun; Wang, Wei; Huang, Jiaming; Tan, Hao; Liu, Tianyu; Shang, Chunliang; Liu, Duo; Guo, Luyan; Yao, Shuzhong

    2015-01-01

    Previous studies have demonstrated the involvement of nerve repellent factors in regulation of the imbalanced innervation of endometriosis. This prospective study aims to explore the role of Sema 3A in regulating aberrant sympathetic innervation in peritoneal and deep infiltrating endometriosis. Ectopic endometriotic lesion were collected from patients with peritoneal endometriosis (n = 24) and deep infiltrating endometriosis of uterosacral ligament (n = 20) undergoing surgery for endometriosis. Eutopic endometrial samples were collected from patients with endometriosis (n = 22) or without endometriosis (n = 26). Healthy peritoneum (n = 13) from the lateral pelvic wall and healthy uterosacral ligament (n = 13) were obtained from patients who had no surgical and histological proof of endometriosis during hysterectomy for uterine fibroids. Firstly, we studied the immunostaining of Sema 3A, Plexin A1 and NRP-1 in all the tissues described above. Then we studied the nerve fiber density (NFD) of endometriosis-associated (sympathetic) nerve and para-endometriotic (sympathetic) nerve by double immunofluorescence staining. Finally we analyzed the relationship between expression of Sema 3A in stromal cells of endometriotic lesion and the aberrant innervation of endometriosis. Semi-quantitative immunostaining demonstrated that (1) Higher immunostaining of Sema 3A were found in the eutopic endometrial glandular epithelial cells from patients with endometriosis (p = 0.041) than those without endometriosis; (2) Sema 3A immunostaining was higher in glandular epithelial cells of peritoneal endometriosis (Pendometriosis, while its expression in ectopic stormal cells in both groups were significantly lower than that from eutopic endometrium of women without endometirosis (Pendometriosis-associated sympathetic nerve of peritoneal endometriosis (pendometriosis of uterosacral ligament (pendometriosis. PMID:26720585

  16. Spontaneous endometriosis in a mandrill (Mandrillus sphinx).

    Science.gov (United States)

    Nakamura, S; Ochiai, K; Ochi, A; Ito, M; Kamiya, T; Yamamoto, H

    2012-01-01

    A 25-year-old female mandrill (Mandrillus sphinx) died after exhibiting weakness and recumbency with serosanguineous ascites. Gross findings included haemoperitoneum and multifocal to diffuse serosal thickening with petechiae and ecchymoses throughout the peritoneum. The uterus was covered entirely with large blood clots and was adherent to the ovaries and pelvic wall. Microscopical and immunohistochemical examination revealed extra- and intra-uterine growth of ectopic endometrial tissue with marked fibrosis. The ectopic endometrial tissues predominantly consisted of stromal cells expressing CD10 and progesterone receptor and variably-sized glands lined by the epithelium with occasional slight expression of oestrogen receptor α. A diagnosis of endometriosis was made. This is the first report of naturally occurring endometriosis in a mandrill. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Malignant transformation of superficial peritoneal endometriosis lesion.

    Science.gov (United States)

    Marchand, Eva; Hequet, Delphine; Thoury, Anne; Barranger, Emmanuel

    2013-08-26

    A 63-year-old woman with no medical history underwent an abdominal surgery with hysterectomy and bilateral salpingo-oophorectomy for a 10 cm peritoneal cyst with increased cancer antigene-125. A large suspicious tumour of the Douglas space, with contact to the uterus and the rectal wall was described. The rest of the exploration was normal, specially the rest of the peritoneum. Histopathology revealed a malignant transformation of a superficial peritoneal endometriosis. Secondary surgery was thus completed by laparoscopy with bilateral pelvic and para-aortic lymph node dissections, omentectomy and multiple peritoneal biopsies. All staging samples were free of cancer; therefore no complementary therapy was administered. After 18 months of follow-up, consisting of clinical examination and pelvis magnetic resonance imaging every 6 months, we did not observe any recurrence. Malignant transformation of superficial peritoneal endometriosis is a rare disease and surgical management seems to be the main treatment.

  18. Hardness of high-pressure high-temperature treated single-walled carbon nanotubes

    International Nuclear Information System (INIS)

    Kawasaki, S.; Nojima, Y.; Yokomae, T.; Okino, F.; Touhara, H.

    2007-01-01

    We have performed high-pressure high-temperature (HPHT) treatments of high quality single-walled carbon nanotubes (SWCNTs) over a wide pressure-temperature range up to 13 GPa-873 K and have investigated the hardness of the HPHT-treated SWCNTs using a nanoindentation technique. It was found that the hardness of the SWCNTs treated at pressures greater than 11 GPa and at temperatures higher than 773 K is about 10 times greater than that of the SWCNTs treated at low temperature. It was also found that the hardness change of the SWCNTs is related to the structural change by the HPHT treatments which was based on synchrotron X-ray diffraction measurements

  19. Progesterone resistance in endometriosis

    DEFF Research Database (Denmark)

    Patel, Bansari G; Rudnicki, Martin; Yu, Jie

    2017-01-01

    Endometriosis is a common cause of pelvic pain and affects up to 10% of women of reproductive age. Aberrant progesterone signaling in the endometrium plays a significant role in impaired decidualization and establishment of ectopic endometrial implants. Eutopic endometrial cells from women...... with endometriosis fail to downregulate genes needed for decidualization, such as those involved in cell cycle regulation, leading to unbridled proliferation. Several causes of progesterone resistance in the endometrium have been postulated, including congenital "preconditioning", whereby the in utero environment...... renders infants susceptible to neonatal uterine bleeding and endometriosis. Progesterone action is crucial to decreasing inflammation in the endometrium, and deviant progesterone signaling results in a proinflammatory phenotype. Conversely, chronic inflammation can induce a progesterone resistant state...

  20. Deep infiltrating ureteral endometriosis with catamenial hydroureteronephrosis: a case report.

    Science.gov (United States)

    Lee, Hyun Jung; Lee, Yoon Soon

    2017-12-13

    This aim of this case report is to raise awareness of ureteral endometriosis in women of reproductive age with hydronephrosis in the absence of urolithiasis to enable early diagnosis and prevent loss of renal function. A 44-year-old Asian woman presented with a 4-year history of cyclic right flank pain and right hydronephrosis during menstruation. Despite several evaluations by physicians, including gynecologists, the cause of her symptoms was not diagnosed. On transvaginal ultrasonography, the uterus was observed deviated to the right, with a nodular lesion at the right uterosacral ligament, and the right ovary was attached to the uterus with no apparent cystic lesion. Magnetic resonance imaging showed a mass in the right uterine wall and mild wall thickening with delayed enhancement of the right distal ureter. Right ureteral endometriosis was suspected. Diagnostic laparoscopy revealed narrowing of the distal right ureter between the right uterosacral ligament and the right ovary with adhesions caused by deep infiltrating endometriosis. The adhesion bands and infiltrating endometriosis around the right ureter were dissected. The nonspecific symptoms of ureteral endometriosis can result in incorrect diagnosis, with renal damage as a result of prolonged hydronephrosis. A high index of suspicion and use of imaging modalities enable earlier diagnosis and preservation of renal function.

  1. Intrinsic endometriosis of ureter: a case report

    International Nuclear Information System (INIS)

    Hong, Myung Sun; Kim, Ho Chul; Yun, Ku Sup; Choi, Chul Soon; Bae, Sang Hoon; Kim, Sung Yong; Shin, Hyung Sik

    1995-01-01

    Endometriosis is a rare cause of an ureteral obstruction. We report a case of intrinsic ureteral endometriosis resulting in severe hydroureteronephrosis. The diagnosis of ureteral endometriosis may be considered in women with flank pain and ureteric obstruction within true pelvis

  2. Intrinsic endometriosis of ureter: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Myung Sun; Kim, Ho Chul; Yun, Ku Sup; Choi, Chul Soon; Bae, Sang Hoon; Kim, Sung Yong; Shin, Hyung Sik [College of Medicine, Hallym University, Seoul (Korea, Republic of)

    1995-07-15

    Endometriosis is a rare cause of an ureteral obstruction. We report a case of intrinsic ureteral endometriosis resulting in severe hydroureteronephrosis. The diagnosis of ureteral endometriosis may be considered in women with flank pain and ureteric obstruction within true pelvis.

  3. Proton irradiation and endometriosis

    International Nuclear Information System (INIS)

    Wood, D.H.; Yochmowitz, M.G.; Salmon, Y.L.; Eason, R.L.; Boster, R.A.

    1983-01-01

    It was found that female rhesus monkeys given single total-body exposures of protons of varying energies developed endometriosis at a frequency significantly higher than that of nonirradiated animals of the same age. The minimum latency period was determined to be 7 years after the proton exposure. The doses and energies of the radiation received by the experimental animals were within the range that could be received by an aircrew member in near-earth orbit during a random solar flare event. It is concluded that endometriosis should be a consideration in assessing the risk of delayed radiation effects in female crew members. 15 references

  4. Proton irradiation and endometriosis

    International Nuclear Information System (INIS)

    Wood, D.H.; Yochmowitz, M.G.; Salmon, Y.L.; Eason, R.L.; Boster, R.A.

    1983-01-01

    Female rhesus monkeys given single total-body exposures of protons of varying energies developed endometriosis at a frequency significantly higher than that of nonirradiated animals of the same age. The minimum latency period was 7 years after exposure. The doses and energies of the radiation received were within the range that could be received by an aircrew member in near-earth orbit during a random solar flare event, leading to the conclusion that endometriosis should be a consideration in assessing the risk of delayed radiation effects in female crewmembers

  5. Endometriosis in Adolescence

    Directory of Open Access Journals (Sweden)

    Margherita Dessole

    2012-01-01

    Full Text Available Endometriosis is a common cause of pelvic pain and infertility. The majority of women report symptoms since adolescence, and there are rare cases of endometriosis in premenarchal age patients. Symptoms in adolescence are similar to those in adulthood. Treatment usually consists of oral contraceptives and nonsteroidal anti-inflammatory drugs. In cases where this treatment is not successful, laparoscopy and biopsy of the lesions are necessary for diagnosis. However, emerging new technologies provide new options, in particular the use of serological markers.

  6. Clinical outcomes of patients with clear cell and endometrioid ovarian cancer arising from endometriosis.

    Science.gov (United States)

    Paik, E Sun; Kim, Tae Joong; Choi, Chel Hun; Kim, Byoung Gie; Bae, Duk Soo; Lee, Jeong Won

    2018-03-01

    The aim of this investigation is to compare outcomes of patients according to the presence of cancer arising from endometriosis in ovarian clear cell carcinoma (CCC) and endometrioid carcinoma (EC). This study retrospectively investigated 224 CCC and EC patients treated in Samsung Medical Center from 2001 to 2015 to identify cancer arising from endometriosis according to Sampson and Scott criteria. Propensity score matching was performed to compare patients arising from endometriosis to patients without endometriosis (ratio 1:1) according to stage, age, lymph node metastasis (LNM), cancer antigen (CA)-125 level, and residual status after debulking surgery. Forty-five cases arising from endometriosis were compared with 179 cases without endometriosis. CCC and EC arising from endometriosis tended to present with early age (mean, 45.2 vs. 49.2 years; p=0.003), early-stage (stages I and II, 92.7% vs. 62.3%; p<0.001), lower CA-125 level (mean, 307.1 vs. 556.7; p=0.041), higher percentages of no gross residual disease after surgery (87.8% vs.56.8%; p=0.001), and higher percentages of negative LNM (82.9% vs. 59.0%; p=0.008) compared to cases without endometriosis. Kaplan-Meier curves for progression-free survival (PFS) and overall survival (OS) showed better outcomes for groups with cancer arising from endometriosis (p=0.014 for PFS; and p=0.010 for OS). However, the association with endometriosis was not significant in multivariate analysis. Also, after propensity score matching, survival differences between the 2 groups were not significant. CCC and EC arising from endometriosis are diagnosed at an earlier age and stage. However, cancer arising from endometriosis was not a significant prognostic factor. Copyright © 2018. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology

  7. 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.

  8. 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)

  9. Endometriosis, a disease of the macrophage

    Directory of Open Access Journals (Sweden)

    Annalisa eCapobianco

    2013-01-01

    Full Text Available Endometriosis, a common cause of pelvic pain and female infertility, depends on the growth of vascularised endometrial tissue at ectopic sites. Endometrial fragments reach the peritoneal cavity during the fertile years: local cues decide whether they yield endometriotic lesions. Macrophages are recruited at sites of hypoxia and tissue stress, where they clear cell debris and heme-iron and generate pro-life and pro-angiogenesis signals. Macrophages are abundant in endometriotic lesions, where are recruited and undergo alternative activation. In rodents macrophages are required for lesions to establish and to grow; bone-marrow derived Tie-2 expressing macrophages specifically contribute to lesions neovasculature, possibly because they concur to the recruitment of circulating endothelial progenitors, and sustain their survival and the integrity of the vessel wall. Macrophages sense cues (hypoxia, cell death, iron overload in the lesions and react delivering signals to restore the local homeostasis: their action represents a necessary, non-redundant step in the natural history of the disease. Endometriosis may be due to a misperception of macrophages about ectopic endometrial tissue. They perceive it as a wound, they activate programs leading to ectopic cell survival and tissue vascularization. Clearing this misperception is a critical area for the development of novel medical treatments of endometriosis, an urgent and unmet medical need.

  10. Endometriosis and possible inflammation markers

    OpenAIRE

    Meng-Hsing Wu; Kuei-Yang Hsiao; Shaw-Jenq Tsai

    2015-01-01

    Inflammation plays an important role in the pathogenesis of endometriosis. Infiltration of peritoneal macrophages and local proinflammatory mediators in the peritoneal microenvironment affect ovarian function and pelvic anatomy leading to the symptoms and signs of endometriosis. The identification of a noninvasive marker for endometriosis will facilitate early diagnosis and treatment of this disease. This review provides an overview of local microenvironmental inflammation and systemic inflam...

  11. PPAR–gamma: a dagger in endometriosis

    Directory of Open Access Journals (Sweden)

    Amberkar MV

    2010-12-01

    Full Text Available Endometriosis is a debilitating gynecological disorder with an enigmatic pathogenesis. Current treatment strategy mainly involves surgery and medications, which provide only temporary relief. Endometriosis is associated with an abnormal inflammatory response, one of the recent pathogenesis is RANTES (regulated upon activation normal T-cell expressed and secreted in endometriotic stromal cells, which is responsible for 70% of monocyte migration in the peritoneal fluid. This RANTES can be inhibited by the peroxisome proliferator activated receptor system. Thiazolidinediones (PPAR Gamma Agonists exhibited the ability shown to suppress existing endometriotic lesions without suppressing ovulation. In vivo studies have shown some promising results which could be incorporated in humans. These results have promised new avenues of treatment emerging from older drugs. Since the existing conventional drugs have undesirable side effects, there is always a need for highly efficacious and better tolerated drugs acting through novel mechanisms of action. Hence, in this review we have highlighted the usage of a class of drugs commonly used to treat diabetes mellitus, which could also be used to treat endometriosis.

  12. Angiogenesis and Endometriosis

    Directory of Open Access Journals (Sweden)

    Ana Luiza L. Rocha

    2013-01-01

    Full Text Available A comprehensive review was performed to survey the role of angiogenesis in the pathogenesis of endometriosis. This is a multifactorial disease in which the development and maintenance of endometriotic implants depend on their invasive capacity and angiogenic potential. The peritoneal fluid of patients with endometriosis is a complex suspension carrying inflammatory cytokines, growth factors, steroid hormones, proangiogenic factors, macrophages, and endometrial and red blood cells. These cells and their signaling products concur to promote the spreading of new blood vessels at the endometriotic lesions and surroundings, which contributes to the endometriotic implant survival. Experimental studies of several antiangiogenic agents demonstrated the regression of endometriotic lesions by reducing their blood supply. Further studies are necessary before these novel agents can be introduced into clinical practice, in particular the establishment of the safety of anti-angiogenic medications in women who are seeking to become pregnant.

  13. Emerging treatment of endometriosis

    Directory of Open Access Journals (Sweden)

    Aboubakr Elnashar

    2015-06-01

    Full Text Available Current treatment of endometriosis is mainly based on surgery and ovarian suppressive agents (oral contraceptives, progestins, GnRh agonist and androgenic agents. Hormonal treatments are often associated with unwanted effects, delayed conception and recurrence of disease and symptoms when stopped. For these reasons, new drugs that aim new targets are required to cause regression of the disease & symptoms without adverse hypo-estrogenic effects. This review aims to provide an update on the new drugs used for treatment of endometriosis. These include the levonorgestrel-releasing intrauterine device, GnRH antagonists, aromatase inhibitors, selective estrogen-receptor modulators, progesterone antagonist, selective progesterone receptor modulators, angiogenesis inhibitors, and immunomodulatory drugs.

  14. Thoracic and diaphragmatic endometriosis: Single-institution experience using a novel broadened diagnostic criteria

    Science.gov (United States)

    Larraín, Demetrio; Suárez, Francisco; Braun, Hernán; Chapochnick, Javier; Diaz, Lidia; Rojas, Iván

    2018-06-05

    To describe our experience with the multidisciplinary management of both thoracic/diaphragmatic endometriosis (TED), applying a broadened definition of the “thoracic endometriosis syndrome (TES)” to define cases. We present a retrospective series of consecutive patients affected by pathology-proven TED, treated at our institution, during a period of 7 years. Five women were included. Two cases were referred due to catamenial chest/shoulder pain, one due to recurrent catamenial pneumothorax, one due to new-onset diaphragmatic hernia. One patient had not thoracic symptoms, and diaphragmatic endometriosis was found during gynecologic laparoscopy for pelvic endometriosis. Endometriosis was histologically confirmed in all cases. After follow-up all patients remain asymptomatic. Broadened TES criteria could increase the incidence of TED and determine better knowledge of this condition. Multidisciplinary, minimally invasive surgery is effective and safe, but should be reserved to tertiary referral centers.

  15. Surgical and clinical impact of extraserosal pelvic fascia removal in segmental colorectal resection for endometriosis.

    Science.gov (United States)

    Ballester, Marcos; Belghiti, Jérémie; Zilberman, Sonia; Thomin, Anne; Bonneau, Claire; Bazot, Marc; Thomassin-Naggara, Isabelle; Daraï, Emile

    2014-01-01

    To describe the characteristics of patients with colorectal endometriosis and extraserosal pelvic fascia (EPF) involvement and to assess the effect of EPF resection. Prospective cohort study (Canadian Task Force classification II-2). University hospital. Two hundred twenty-seven patients who underwent segmental colorectal resection to treat symptomatic deep infiltrating endometriosis between 2001 and 2011, with or without EPF resection. Segmental colorectal resection with or without EPF resection. One hundred twelve patients (49.4%) required EPF resection. In these patients the total American Society for Reproductive Medicine endometriosis scores were higher (p = .004), there were more associated resected lesions of deep infiltrating endometriosis (p EPF infiltration reflects disease severity in patients with colorectal endometriosis. Its removal affects intraoperative morbidity and leads to a higher rate of voiding dysfunction. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

  16. Endometriosis | Matebese | Continuing Medical Education

    African Journals Online (AJOL)

    Endometriosis is a benign disease defined as the presence of endometrial glands and stroma outside the uterus. Its pathogenesis and optimal management remain controversial, and its true prevalence is unknown. Endometriosis can be debilitating and can affect the psychosocial functioning of women. It is estimated to ...

  17. Conservative approach to rectosigmoid endometriosis

    DEFF Research Database (Denmark)

    Egekvist, Anne G; Marinovskij, Edvard; Forman, Axel

    2017-01-01

    INTRODUCTION: The aim of the study was to assess the risk of surgery after initial conservative treatment of rectosigmoid endometriosis in relation to demographic data. MATERIAL AND METHODS: The study was conducted on the tertiary endometriosis referral unit, Aarhus University Hospital. Medical...

  18. Ovarian irradiation in recurrent endometriosis

    International Nuclear Information System (INIS)

    Kochbati, L.; Chaari, N.; Besbes, M.; Maalej, M.; Neji, K.; Ben Amara, F.; Ben Romdhane, N.K.

    2005-01-01

    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)

  19. 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.

  20. Laparoscopic excision of deep rectovaginal endometriosis in BSGE endometriosis centres: a multicentre prospective cohort study

    Science.gov (United States)

    Byrne, Dominic; Curnow, Tamara; Smith, Paul; Cutner, Alfred; Saridogan, Ertan; Clark, T Justin

    2018-01-01

    Objective To estimate the effectiveness and safety of laparoscopic surgical excision of rectovaginal endometriosis. Design A multicentre, prospective cohort study. Setting 51 hospitals accredited as specialist endometriosis centres. Participants 5162 women of reproductive age with rectovaginal endometriosis of which 4721 women had planned laparoscopic excision. Interventions Laparoscopic surgical excision of rectovaginal endometriosis requiring dissection of the pararectal space. Main outcome measures Standardised symptom questionnaires enquiring about chronic pelvic pain, bladder and bowel symptoms, analgesia use and quality of life (EuroQol) completed prior to surgery and at 6, 12 and 24 months postoperatively. Serious perioperative and postoperative complications including major haemorrhage, infection and visceral injury were recorded. Results At 6 months postsurgery, there were significant reductions in premenstrual, menstrual and non-cyclical pelvic pain, deep dyspareunia, dyschezia, low back pain and bladder pain. In addition, there were significant reductions in voiding difficulty, bowel frequency, urgency, incomplete emptying, constipation and passing blood. These reductions were maintained at 2 years, with the exception of voiding difficulty. Global quality of life significantly improved from a median pretreatment score of 55/100 to 80/100 at 6 months. There was a significant improvement in quality of life in all measured domains and in quality-adjusted life years. These improvements were sustained at 2 years. All analgesia use was reduced and, in particular, opiate use fell from 28.1% prior to surgery to 16.1% at 6 months. The overall incidence of complications was 6.8% (321/4721). Gastrointestinal complications (enterotomy, anastomotic leak or fistula) occurred in 52 (1.1%) operations and of the urinary tract (ureteric/bladder injury or leak) in 49 (1.0%) procedures. Conclusion Laparoscopic surgical excision of rectovaginal endometriosis

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

    Science.gov (United States)

    Dinsdale, Natalie L; Crespi, Bernard J

    2017-11-01

    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. Therapeutically Targeting the Inflammasome Product in a Chimeric Model of Endometriosis-Related Surgical Adhesions.

    Science.gov (United States)

    Stocks, Meredith M; Crispens, Marta A; Ding, Tianbing; Mokshagundam, Shilpa; Bruner-Tran, Kaylon L; Osteen, Kevin G

    2017-08-01

    Development of adhesions commonly occurs in association with surgery for endometriosis. Even in the absence of surgery, women with endometriosis appear to be at an enhanced risk of developing adhesions. In the current study, we utilized a chimeric mouse model of experimental endometriosis in order to examine the role of inflammasome activation in the development of postsurgical adhesions. Mice were randomized to receive peritoneal injections of human endometrial tissue fragments or endometrial tissue conditioned media (CM) from women with or without endometriosis 16 hours after ovariectomy and placement of an estradiol-releasing silastic capsule. A subset of mice receiving CM was also treated with interleukin (IL) 1 receptor antagonist (IL-1ra). Our studies demonstrate that peritoneal injection of endometrial tissue fragments near the time of surgery resulted in extensive adhesive disease regardless of tissue origin. However, adhesion scores were significantly higher in mice receiving CM from tissues acquired from patients with endometriosis compared to control tissue CM ( P = .0001). Cytokine bead array analysis of endometrial CM revealed enhanced expression of IL-1β from patients with endometriosis compared to controls ( P endometriosis as a potential causal factor in their increased susceptibility of developing postsurgical adhesions. Thus, targeting inflammasome activation may be an effective strategy for the prevention of surgical adhesions in patients with endometriosis.

  3. Spray deposition of steam treated and functionalized single-walled and multi-walled carbon nanotube films for supercapacitors

    International Nuclear Information System (INIS)

    Zhao Xin; Chu, Bryan T T; Johnston, Colin; Sykes, John M; Grant, Patrick S; Ballesteros, Belen; Wang Weiliang

    2009-01-01

    Steam purified, carboxylic and ester functionalized single-walled carbon nanotube (SWNT) and multi-walled carbon nanotube (MWNT) films with homogeneous distribution and flexible control of thickness and area were fabricated on polymeric and metallic substrates using a modified spray deposition technique. By employing a pre-sprayed polyelectrolyte, the adhesion of the carbon nanotube (CNT) films to the substrates was significantly enhanced by electrostatic interaction. Carboxylic and ester functionalization improved electrochemical performance when immersed in 0.1 M H 2 SO 4 and the specific capacitance reached 155 and 77 F g -1 for carboxylic functionalized SWNT and MWNT films respectively. Compared with existing techniques such as hot pressing, vacuum filtration and dip coating, the ambient pressure spray deposition technique is suggested as particularly well suited for preparing CNT films at large scale for applications including providing electrodes for electrochemical supercapacitors and paper batteries.

  4. Endometriosis and uterine malformations: infertility may increase severity of endometriosis.

    Science.gov (United States)

    Boujenah, Jeremy; Salakos, Eleonora; Pinto, Mélodie; Shore, Joanna; Sifer, Christophe; Poncelet, Christophe; Bricou, Alexandre

    2017-06-01

    The aim of our study was to compare the stage and severity of endometriosis in fertile and infertile women with congenital uterine malformations. We performed an observational study from September 2007 to December 2015 in a tertiary care university hospital and assisted reproductive technology center. A total of 52 patients with surgically proven uterine malformations were included. We compared 41 infertile patients with uterine malformations with 11 fertile patients with uterine malformation. The main outcome was the stage, score and type of endometriosis in regard to infertility and class of uterine malformation. The rate of endometriosis did not differ between the two groups (43.9 vs. 36.4%). The mean revised American Fertility Society score was higher in infertile patients with uterine malformations (19.02 vs. 6, p endometriosis (43.9 vs. 37.5%). Endometrioma and deep infiltrating endometriosis were associated with uterine malformations in infertile women, respectively 14.6 and 0%. No difference in the characteristics of endometriosis was found regarding the class of malformation. The association of uterine malformations and infertility may increase the severity of endometriosis and raise the issue of their diagnosis and management. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

  5. 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?...

  6. Modificações do volume e da histologia de focos de endometriose em ratas tratadas com sinvastatina Changes in the volume and histology of focus of endometriosis in rats treated with sinvastatin

    Directory of Open Access Journals (Sweden)

    João Nogueira Neto

    2007-08-01

    in female rats. METHODS: forty Wistar female rats were submitted to the technique of uterine self-transplant in mesenterium. After three weeks, 24 of them developed experimental endometriosis grade III, and were divided in two groups: one group received sinvastatin orally (20 mg/kg/day and the other (control group received 0.9% of sodium chloride orally (1 mL/100 g of body weight/day. Both groups received gavage for 14 days, followed by death. The implant volume was calculated [4pi (lenght/2 x (width/2 x (height/2/3] at the surgical intervention and after the animal’s death. The self-transplants were removed, dyed with hematoxylin-eosin and analyzed by light microscopy. The Mann-Whitney’s test was used in the independent samples and the Wilcoxon’s test for the related samples. The Fisher’s exact test was used for the histological evaluation, with a significance level of 5%. RESULTS: the difference between groups of the initial average volumes of the self-transplants was not significant (p=1.00, but became significant for the final average volumes (p=0.04. There was a significant increase (p=0.01 between the initial and final average volumes in the control group, and a no significant decrease in the sinvastatin group (p=0.95. Histologically, the sinvastatin group (n=9 presented seven cases (77.8% of moderately preserved and two cases (22.2% of well preserved epithelial wall, while the control group (n=12 presented seven cases (58.3% of moderately preserved and five cases (41.7% of well preserved epithelial wall. CONCLUSIONS: sinvastatin prevented the growth of experimental endometriosis. Studies with sinvastatin for longer periods are promising.

  7. The association between experiences with patient-centred care and health-related quality of life in women with endometriosis

    NARCIS (Netherlands)

    Apers, Silke; Dancet, Eline A. F.; Aarts, Johanna W. M.; Kluivers, Kirsten B.; D'Hooghe, Thomas M.; Nelen, Willianne L. D. M.

    2018-01-01

    In this cross-sectional study, we investigated whether patient-centred endometriosis care (PCEC) is associated with health-related quality of life (HRQOL). Dutch-speaking women with endometriosis, treated by laparoscopy in a university clinic between 2009 and 2010, were eligible (n = 194).

  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. A mixture of St. John's wort and sea buckthorn oils regresses endometriotic implants and affects the levels of inflammatory mediators in peritoneal fluid of the rat: A surgically induced endometriosis model.

    Science.gov (United States)

    İlhan, Mert; Süntar, İpek; Demirel, Mürşide Ayşe; Yeşilada, Erdem; Keleş, Hikmet; Küpeli Akkol, Esra

    2016-12-01

    Sea buckthorn (Hippophae rhamnoides L.) and St. John's wort (Hypericum perforatum L.) are used as an emmenagog and for the treatment of other gynecological disorders including uterus inflammation and endometriosis. The aim of the present study is to investigate the potential of a mixture of sea buckthorn and St. John's wort oils (HrHp oil) in the treatment of endometriosis. The activity was assessed in surgically induced endometriosis in rats. A 15-mm piece of endometrium was sutured into the abdominal wall. Twenty-eight days later, a second laparotomy was performed to calculate the endometrial foci areas and to score intra-abdominal adhesions. The rats were treated with either vehicle, HrHp oil formulation, or the reference (buserelin acetate). At the end of the experiment all rats were sacrificed and endometriotic foci areas and intra-abdominal adhesions were re-evaluated. The tissue sections were analyzed histopathologically. Peritoneal fluids of the experimental animals were collected in order to detect the levels of tumor necrosis factor-α, vascular endothelial growth factor, and interleukin-6, which might be involved in the etiology of endometriosis. In the HrHp oil-treated group, the volumes of endometriotic implants were found to be significantly decreased (from 50.8 mm 3 to 18.6 mm 3 , pnecrosis factor-α decreased from 7.02±1.33 pg/mL to 4.78±1.02 pg/mL (pvascular endothelial growth factor from 17.39±8.52 pg/mL to 9.67±5.04 pg/mL (ptreatment. HrHp oil may be a promising alternative for the treatment of endometriosis. Copyright © 2016. Published by Elsevier B.V.

  10. Effects of Bee Venom Acupuncture on Surgically Induced Endometriosis in Rats

    Directory of Open Access Journals (Sweden)

    Yong-Hyun Lee

    2006-02-01

    Full Text Available Purpose : Bee Venom Acupuncture(BVA is known to affect inflammation and immune system. This study examined the macroscopic, hormonal and immunological effects of BVA on rats with surgically induced endometriosis. Method : Endometrial tissue was implanted in the serosal wall of the small intestine in rats. The rats were divided randomly into an experimental and control group. The experimental group was treated with BVA injection on kwanwon(CV4 three times per week, and the control group was given an oral dose of normal saline every day. 6 weeks later, the size of the ectopic uterine tissue was estimated, and the serum progesterone, estradiol and cytokine(TNF-α, IL-2, IL-4, IL-6, IL-10 concentrations were analyzed. Result : The size of the ectopic uterine implants in the experimental group was much smaller than that in the control group. The estradiol, IL-2 concentrations were significantly lower and the IL-6, IL-10 concentrations were significantly higher in the serum of the experimental group than in the control group. there was no significant difference in the concentration of the other cytokine. Conclusion : These results suggest that BVA is an effective treatment for endometriosis.

  11. Pain cognition versus pain intensity in patients with endometriosis: toward personalized treatment.

    Science.gov (United States)

    van Aken, Mieke A W; Oosterman, Joukje M; van Rijn, C M; Ferdek, Magdalena A; Ruigt, Gé S F; Peeters, B W M M; Braat, Didi D M; Nap, Annemiek W

    2017-10-01

    To explore how pain intensity and pain cognition are related to health-related quality of life (HRQoL) in women with endometriosis. Cross-sectional questionnaire-based survey. Multidisciplinary referral center. Women with laparoscopically and/or magnetic resonance imaging-proven endometriosis (n = 50) and healthy control women (n = 42). For HRQoL, two questionnaires: the generic Short Form Health Survey (SF-36) and the Endometriosis Health Profile 30 (EHP-30). For pain cognition, three questionnaires: the Pain Catastrophizing Scale (PCS), the Pain Vigilance and Awareness Questionnaire (PVAQ), and the Pain Anxiety Symptoms Scale (PASS). For pain intensity, the verbal Numeric Rating Scale (NRS). Association between pain intensity and pain cognition with HRQoL in women with endometriosis, and the differences in HRQoL and pain cognition between women with endometriosis and healthy controls. Health-related quality of life was statistically significantly impaired in women with endometriosis as compared with healthy control women. The variables of pain intensity and pain cognition were independent factors influencing the HRQoL of women with endometriosis. Patients with endometriosis had statistically significantly more negative pain cognition as compared with controls. They reported more pain anxiety and catastrophizing, and they were hypervigilant toward pain. Pain cognition is independently associated with the HRQoL in endometriosis patients. Clinicians should be aware of this phenomenon and may consider treating pain symptoms in a multidimensional, individualized way in which the psychological aspects are taken into account. In international guidelines on management of women with endometriosis more attention should be paid to the psychological aspects of care. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  12. Endometriosis is the independent prognostic factor for survival in Chinese patients with epithelial ovarian carcinoma.

    Science.gov (United States)

    Ren, Tong; Wang, Shu; Sun, Jian; Qu, Ji-Min; Xiang, Yang; Shen, Keng; Lang, Jing He

    2017-10-03

    Clinico-pathological characteristics and possible prognostic factors among women with epithelial ovarian carcinoma (EOC) with or without concurrent endometriosis were explored. We retrospectively identified 304 patients with EOC treated primarily at Peking Union Medical College Hospital with median follow-up time of 60 months. Of 304 patients with EOC, concurrent endometriosis was identified in 69 (22.7%). The patients with concurrent endometriosis were younger and more probably post-menopausal at onset, were less likely to have abdominal distension, with significantly lower level of pre-surgery serum Ca125 and less possibility of having the history of tubal ligation. The women with concurrent endometriosis group were more likely to have early stage tumors (88.41% versus 52.77%), receive optimal cytoreductive surgery (92.75% versus 71.06%), and less likely to have lymph node metastasis or to develop platinum resistance disease (7.25% versus 14.89%, and 7.35% versus 20%), when compared with women without coexisting endometriosis. The univariate analysis showed that concurrent endometriosis was a prognostic factor for overall survival (OS) and disease-free survival (DFS), but this association just remained in the DFS by multivariate analysis. Besides, multivariate analysis also showed that FIGO stage, residual disease, chemotherapy cycles, chemotherapy resistance and concomitant hypertension were the independent impact factors of OS for EOC patients; whereas FIGO stage, lymphadenectomy, residual disease, coexisting endometriosis and chemoresistance were independent impact factors of DFS for those patients. EOC patients with concurrent endometriosis showed distinct characteristics and had longer overall survival and disease-free survival when compared with those without endometriosis. Endometriosis was the independent prognostic factor for DFS for patients in this series.

  13. Insights into plant cell wall structure, architecture, and integrity using glycome profiling of native and AFEXTM-pre-treated biomass

    Science.gov (United States)

    Pattathil, Sivakumar; Hahn, Michael G.; Dale, Bruce E.; Chundawat, Shishir P. S.

    2015-01-01

    Cell walls, which constitute the bulk of plant biomass, vary considerably in their structure, composition, and architecture. Studies on plant cell walls can be conducted on both native and pre-treated plant biomass samples, allowing an enhanced understanding of these structural and compositional variations. Here glycome profiling was employed to determine the relative abundance of matrix polysaccharides in several phylogenetically distinct native and pre-treated plant biomasses. Eight distinct biomass types belonging to four different subgroups (i.e. monocot grasses, woody dicots, herbaceous dicots, and softwoods) were subjected to various regimes of AFEX™ (ammonia fiber expansion) pre-treatment [AFEX is a trademark of MBI, Lansing (http://www.mbi.org]. This approach allowed detailed analysis of close to 200 cell wall glycan epitopes and their relative extractability using a high-throughput platform. In general, irrespective of the phylogenetic origin, AFEX™ pre-treatment appeared to cause loosening and improved accessibility of various xylan epitope subclasses in most plant biomass materials studied. For most biomass types analysed, such loosening was also evident for other major non-cellulosic components including subclasses of pectin and xyloglucan epitopes. The studies also demonstrate that AFEX™ pre-treatment significantly reduced cell wall recalcitrance among diverse phylogenies (except softwoods) by inducing structural modifications to polysaccharides that were not detectable by conventional gross composition analyses. It was found that monitoring changes in cell wall glycan compositions and their relative extractability for untreated and pre-treated plant biomass can provide an improved understanding of variations in structure and composition of plant cell walls and delineate the role(s) of matrix polysaccharides in cell wall recalcitrance. PMID:25911738

  14. Symptomatic endometriosis of rectus abdominis muscle in a patient with uterus didelphys

    Directory of Open Access Journals (Sweden)

    Yavuz Emre Şükür

    2012-03-01

    Full Text Available Background: Endometriosis of the rectus abdominis muscle is a very rare event and it should be kept in mind in the differential diagnosis of women with abdominal wall mass. Case: 42 year-old G2 P2 patient with uterus didelphis was referred with a painful abdominal wall mass of approximately 4x5 cm size. The mass that has contrast matter enhancement on CT was excised with median laparotomy below the umbilicus. The mass which was thought as endometriosis was excised without remaining any pieces to prevent recurrence and primarily repaired. Discussion: Along with the increasing incidence due to increased cessarean rates the endometrial wall endometriosis is an important diagnosis that should not be omitted. The treatment is surgical resection and to we should take care not to leave any pieces to prevent recurrence especially when it is located atypically.

  15. Endometriosis Leads to an Increased Trefoil Factor 3 Concentration in the Peritoneal Cavity but Does Not Alter Systemic Levels.

    Science.gov (United States)

    Henze, Diana; Doecke, Wolf-Dietrich; Hornung, Daniela; Agueusop, Inoncent; von Ahsen, Oliver; Machens, Kathrin; Schmitz, Arndt A; Gashaw, Isabella

    2017-02-01

    This study analyzed whether trefoil factor 3 (TFF3) is locally elevated and correlated with common biomarkers and inflammatory processes in endometriosis. Peritoneal fluid (PF) was obtained from 50 women and serum from 124 women with or without endometriosis. Experimental endometriosis was induced in female C57BL/6 mice by syngeneic transplantation of uterine tissue to the abdominal wall. Levels of TFF3 in PF of women with endometriosis were significantly increased ( P endometriosis: cancer antigen (CA) 125, CA-19-9, interleukin 8, monocyte chemotactic protein 1, and matrix metalloproteinase 7. Serum levels of TFF3 in women were significantly influenced by the menstrual cycle but were independent from disease state. In mice, local TFF3 levels were significantly elevated in early endometriosis (up to 4 weeks after transplantation, P peritoneal cavity in endometriosis and might play a role in disease pathogenesis and its associated inflammatory processes. Furthermore, the results show that TFF3 is regulated through the menstrual cycle. With respect to animal models, syngeneic mouse model does reflect local TFF3 upregulation in the peritoneal cavity affected by endometriosis.

  16. Retreatment Rates Among Endometriosis Patients Undergoing Hysterectomy or Laparoscopy.

    Science.gov (United States)

    Soliman, Ahmed M; Du, Ella Xiaoyan; Yang, Hongbo; Wu, Eric Q; Haley, Jane C

    2017-06-01

    Hysterectomy and laparoscopy are the two most common surgical options used to treat women with endometriosis, yet the disease may still recur. This study aimed to determine the long-term retreatment rates among endometriosis patients in the United States who received either hysterectomy or laparoscopy. Patients aged 18-49 years with endometriosis who underwent hysterectomy or laparoscopy were identified in the Truven Health MarketScan claims database (2004-2013). The retreatment rate up to 8 years after the initial surgery was estimated using Kaplan-Meier survival analysis. The relative risk of retreatment among patients with hysterectomy versus laparoscopy was assessed using a Cox proportional hazard model. A total of 24,915 patients with endometriosis who underwent hysterectomy and 37,308 patients with endometriosis who underwent laparoscopy were identified. The estimated retreatment rates were 3.3%, 4.7%, and 5.4% in the 2nd, 5th, and 8th year following hysterectomy, respectively, while the rates following laparoscopy were 15.8%, 27.5%, and 35.2%, respectively. The hazard ratio of retreatment was 0.157 (95% confidence interval [CI]: 0.146-0.169) comparing hysterectomy to laparoscopy. In the sensitivity analysis, which expanded the definition of retreatment by including medical treatments, the retreatment rate increased by a factor of 11-14 for the hysterectomy cohort and by a factor of 2-4 for the laparoscopy cohort, and the hazard ratio of retreatment rate for hysterectomy versus laparoscopy was 0.490 (95% CI: 0.477-0.502). Our study results indicated that the disease retreatment rate after laparoscopy is high among patients with endometriosis; even hysterectomy does not guarantee freedom from retreatment.

  17. Intussusception secondary to endometriosis of the cecum

    Directory of Open Access Journals (Sweden)

    Hideki Katagiri

    2014-01-01

    CONCLUSION: Intussusception in an adult is a rare cause of bowel obstruction and intussusception caused by endometriosis is also rare. Although rare, the diagnosis of endometriosis as a cause of intussusception must be considered as part of the differential diagnosis.

  18. Surgical treatment of endometriosis before gamete intrafallopian ...

    African Journals Online (AJOL)

    Abstract. Objective. To determine whether active pelvic endometriosis impairs the efficacy of GIFT (gamete intrafallopian transfer) and whether prior surgical treatment of endometriosis improves the efficacy of GIFT. Design. Matched controlled retrospective study. Setting. University-based assisted reproduction programme.

  19. Researchers Realize Major Breakthrough in Understanding Endometriosis

    Science.gov (United States)

    ... 16, 2014 Researchers Realize Major Breakthrough in Understanding Endometriosis For a disease that affects an estimated 6 ... 10% of women, surprisingly little is known about endometriosis — a disorder that causes uterine tissue to grow ...

  20. Autophagy in endometriosis: Friend or foe?

    Science.gov (United States)

    Zhan, Lei; Li, Jun; Wei, Bing

    2018-01-01

    Endometriosis is a chronic, estrogen-dependent disease and characterized by the implantation of endometrial glands and stroma deep and haphazardly into the outside the uterine cavity. It affects an estimated 10% of the female population of reproductive age and results in obvious reduction in health-related quality of life. Unfortunately, there is no a consistent theory for the etiology of endometriosis. Furthermore, the endometriosis is hard to diagnose in early stage and the treatment methods are limited. Importantly, emerging evidence has investigated that there is a close relationship between endometriosis and autophagy. However, autophagy is a friend or foe in endometriosis is puzzling, the precise mechanism underlying autophagy in endometriosis has not been fully elucidated yet. Here, we provide an integrated view on the acquired findings of the connections between endometriosis and autophagy. We also discuss which may contribute to the abnormal level of autophagy in endometriosis. Copyright © 2017 Elsevier Inc. All rights reserved.

  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. Potential involvement of the immune system in the development of endometriosis

    Directory of Open Access Journals (Sweden)

    Mwenda Jason M

    2003-12-01

    Full Text Available Abstract This article presents an overview of immunological factors and their role in the development of endometriosis, with emphasis on inflammatory cytokines, growth and adhesion factors. Although retrograde menstruation is a common phenomenon among women of reproductive age, not all women who have retrograde menstruation develop endometriosis. The development of endometriosis is hypothesised to be a complex process, which may be facilitated by several factors, including the quantity and quality of endometrial cells in peritoneal fluid (PF, increased inflammatory activity in PF, increased endometrial-peritoneal adhesion and angiogenesis, reduced immune surveillance and clearance of endometrial cells, and increased production of autoantibodies against endometrial cells. Potential biomarkers like cytokines and autoantibodies upregulated during development of endometriosis may be useful in the development of a non-surgical diagnostic tool. Although endometriosis can be treated using hormonal suppression, there is need for non-hormonal drugs, which can inhibit the development of endometriosis and alleviate pain or infertility without inhibition of ovulation. New molecules that modulate immune function in endometriosis should be the targets for future research.

  3. [Minimal and mild endometriosis: Impact of the laparoscopic surgery on pelvic pain and fertility. CNGOF-HAS Endometriosis Guidelines].

    Science.gov (United States)

    Ploteau, S; Merlot, B; Roman, H; Canis, M; Collinet, P; Fritel, X

    2018-03-01

    Minimal and mild endometriosis (stage 1 and 2 AFSR) can lead to chronic pelvic pain and infertility but can also exist in asymptomatic patients. The prevalence of asymptomatic patients with minimal and mild endometriosis is not clear but typical endometriosis lesions are found in about 5 to 10% of asymptomatic women and more than 50% of painful and/or infertile women. Laparoscopic treatment of minimal and mild endometriotic lesions is justified in case of pelvic pain because their destruction decrease significatively the pain compared with diagnostic laparoscopy alone. In this context, ablation and excision give identical results in terms of pain reduction. Moreover, literature shows no interest in uterine nerve ablation in case of dysmenorrhea due to minimal and mild endometriosis. Then, it is recommended to treat these lesions during a laparoscopy realised as part of pelvic pain. On the other hand, it is not recommended to treat asymptomatic patients. With regard to treatment of minimal and mild endometriosis in infertile patients, only two studies can be selected and both show that laparoscopy with excision or ablation and ablation of adhesions is superior to diagnostic laparoscopy alone in terms of pregnancy rate. However, it is not recommended to treat these lesions when they are asymptomatic because there is no evidence that they can progress with symptomatic disease. There is no study assessing the interest to treat these lesions when they are found fortuitously. Adhesion barrier utilisation permits to reduce post-operative adhesions, however literature failed to demonstrate the clinical profit in terms of reduction of the risk of pain or infertility. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  4. 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

  5. A young woman with endometriosis of kidney

    International Nuclear Information System (INIS)

    Dutta, P.; Bhat, M. H.; Bhansali, A.; Kumar, V.

    2006-01-01

    Endometriosis of kidney is a rare manifestation of a relatively common disease. We report a case in which ovarian and renal endometriosis were diagnosed concurrently. The disease was probably silent for a long time due to coexistent thyrotoxicosis modifying estrogen metabolism. Fine needle aspiration cytology clinched the diagnosis of endometriosis and avoided unnecessary nephrectomy. (author)

  6. Laparoscopic Management of Ureteral Endometriosis and Hydronephrosis Associated With Endometriosis.

    Science.gov (United States)

    Alves, João; Puga, Marco; Fernandes, Rodrigo; Pinton, Anne; Miranda, Ignacio; Kovoor, Elias; Wattiez, Arnaud

    STUDY OBJECTIVE: To evaluate if laparoscopic treatment of ureteral endometriosis is feasible, safe, and effective and to determine if ureteral dilatation and/or the number of incisions increases complications. An institutional review board-approved retrospective cohort study of consecutive patients who underwent surgery for deep infiltrating endometriosis involving the ureter with hydronephrosis (Canadian Task Force classification III). A university hospital. Of 658 patients who had surgery for deep infiltrating endometriosis between November 2004 and December 2013, 198 of the 658 patients had ureteral endometriosis and required ureterolysis, and 28 of the 198 patients were identified with ureteral dilatation and hydronephrosis associated with endometriosis. Of these 28 cases, 15 ureterolyses, 12 reanastomoses, and 1 reimplantation were performed. Medical, operative, and pathological data on the evolution of pain, urinary complaints, fertility, complications, and recurrences were collected from clinical records. Additionally, telephone interviews were performed for the follow-up of long-term outcomes. All 28 patients had concomitant surgical procedures because of endometriosis elsewhere in the pelvis or abdomen; 12 (42.9%) underwent surgery of the bowel, whereas 5 (17.9%) had bladder surgery. The evolution of pain after surgery showed a positive response (mean dysmenorrhea evaluation measured by the Numeric Pain Rating Scale from 0-10 preoperatively at the short-term follow-up and the long-term follow-up: 7.25-1.73 and 0.25, respectively). Three complications were noted in the group of 28 patients with ureterohydronephrosis; 1 required surgical reintervention. Logistic regression analyses found vaginal incision (odds ratio = 2.08; 95% CI 0.92-4.73), bladder incision (odds ratio = 8.77; 95% CI 3.25-23.63), number of incisions (odds ratio = 2.12; 95% CI 1.29-3.47), and number of previous surgeries (odds ratio = 1.26; 95% CI 0.93-1.71) as independent risk

  7. Comparative study of W-shaped angular plate and reconstruction plate in treating posterior wall fractures of the acetabulum.

    Directory of Open Access Journals (Sweden)

    Qi Zhang

    Full Text Available OBJECTIVE: This study aims to assess the medium-term results of the reconstruction of posterior wall fractures using a W-shaped acetabular angular plate (WAAP compared to those fixed using a reconstruction plate. METHODS: Between July 2006 and March 2009, we performed a retrospective study, which collected data for any patient treated for a posterior acetabular wall fracture. At the time of treatment, patients were either treated using a WAAP or a pelvic reconstruction plate. The intraoperative fluoroscopic images for both groups were compared. The quality of reduction and radiological grading were assessed according to the criteria developed by Matta. The clinical assessment was based on a modified Merle d'Aubigne and Postel scoring. RESULTS: 53 patients met the inclusion criteria and were followed up for an average of 38 months. 25 patients were treated with a WAAP (study group, and 28 patients were treated with a pelvic reconstruction plate (control group. The intraoperative fluoroscopic images of the study group confirmed extra-articular screw placement in all cases. In the control group, intra-articular screw placement was observed intraoperatively in 5 patients (17.86%, and the definitive location of the periarticular hardware could not be determined in 4 patients (14.29% during the operation. The differences between the two groups were statistically significant (p = 0.002. In contrast, the quality of fracture reduction, clinical outcomes, and radiological grading in the study group were not significantly different from those of the control group (p>0.05. The radiographic grade was strongly associated with the clinical outcomes in both the study and control groups (p<0.05. CONCLUSION: Reconstruction of posterior wall fractures of the acetabulum using a WAAP can help avoid screw penetration of the hip joint, provide a stable fixation of the posterior wall, and ensure good clinical outcomes.

  8. Multislice CT enteroclysis in the diagnosis of bowel endometriosis

    International Nuclear Information System (INIS)

    Biscaldi, Ennio; Rollandi, Gian A.; Ferrero, Simone; Ragni, Nicola; Remorgida, Valentino; Fulcheri, Ezio

    2007-01-01

    This prospective study aims to evaluate the efficacy of multislice computed tomography combined with colon distension by water enteroclysis (MSCTe) in determining the presence and depth of bowel endometriotic lesions. Ninety-eight women with symptoms suggestive of colorectal endometriosis underwent MSCTe; locations, number of nodule/s, size of the nodule/s and depth of bowel wall infiltration were determined. Independently from the findings of MSCTe, all women underwent laparoscopy. MSCTe findings were compared with surgical and histological results. Abnormal findings suggestive of bowel endometriotic nodules were detected by MSCTe in 75 of the 76 patients with bowel endometriosis. MSCTe identified 110 (94.8%) of the 116 bowel endometriotic nodules removed at surgery; 6 nodules missed at MSCTe were located on the rectum. MSCTe correctly determined the degree of infiltration of the bowel wall in all of the 34 serosal bowel nodules identified at MSCTe. In six nodules reaching the submucosa, the depth of infiltration was underestimated by MSCTe. MSCTe had a sensitivity of 98.7%, a specificity of 100%, a positive predictive value of 100% and a negative predictive value of 95.7% in identifying women with bowel endometriosis. MSCTe is effective in determining the presence and depth of bowel endometriotic lesions. (orig.)

  9. Multislice CT enteroclysis in the diagnosis of bowel endometriosis

    Energy Technology Data Exchange (ETDEWEB)

    Biscaldi, Ennio; Rollandi, Gian A. [' ' Duchesse of Galliera' ' -Hospital, Genoa (Italy). Dept. of Radiology; Ferrero, Simone; Ragni, Nicola; Remorgida, Valentino [San Martino Hospital and Genoa Univ. (Italy). Dept. of Obstretics and Gynaecology; Fulcheri, Ezio [San Martino Hospital and Genoa Univ. (Italy). Unit of Anatomy and Histopathology

    2007-01-15

    This prospective study aims to evaluate the efficacy of multislice computed tomography combined with colon distension by water enteroclysis (MSCTe) in determining the presence and depth of bowel endometriotic lesions. Ninety-eight women with symptoms suggestive of colorectal endometriosis underwent MSCTe; locations, number of nodule/s, size of the nodule/s and depth of bowel wall infiltration were determined. Independently from the findings of MSCTe, all women underwent laparoscopy. MSCTe findings were compared with surgical and histological results. Abnormal findings suggestive of bowel endometriotic nodules were detected by MSCTe in 75 of the 76 patients with bowel endometriosis. MSCTe identified 110 (94.8%) of the 116 bowel endometriotic nodules removed at surgery; 6 nodules missed at MSCTe were located on the rectum. MSCTe correctly determined the degree of infiltration of the bowel wall in all of the 34 serosal bowel nodules identified at MSCTe. In six nodules reaching the submucosa, the depth of infiltration was underestimated by MSCTe. MSCTe had a sensitivity of 98.7%, a specificity of 100%, a positive predictive value of 100% and a negative predictive value of 95.7% in identifying women with bowel endometriosis. MSCTe is effective in determining the presence and depth of bowel endometriotic lesions. (orig.)

  10. 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%, ppain compared to danazol.

  11. Introduction: From pathogenesis to therapy, deep endometriosis remains a source of controversy.

    Science.gov (United States)

    Donnez, Jacques

    2017-12-01

    Deep endometriosis remains a source of controversy. A number of theories may explain its pathogenesis and many arguments support the hypothesis that genetic or epigenetic changes are a prerequisite for development of lesions into deep endometriosis. Deep endometriosis is frequently responsible for pelvic pain, dysmenorrhea, and/or deep dyspareunia, but can also cause obstetrical complications. Diagnosis may be improved by high-quality imaging. Therapeutic approaches are a source of contention as well. In this issue's Views and Reviews, medical and surgical strategies are discussed, and it is emphasized that treatment should be designed according to a patient's symptoms and individual needs. It is also vital that referral centers have the knowledge and experience to treat deep endometriosis medically and/or surgically. The debate must continue because emerging trends in therapy need to be followed and investigated for optimal management. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  12. 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.

  13. Triple Pancreatic Walled-off Fluid Collections Treated Simultaneously with Endoscopic Transmural Drainage.

    Science.gov (United States)

    Khalid, Sameen; Abbass, Aamer; Nellis, Eric; Shah, Shashin; Shah, Hiral

    2018-01-09

    Pancreatic pseudocysts and walled-off pancreatic necrosis arise as a complication of pancreatitis. Multiple fluid collections are seen in 5-20% of the patients who have walled-off peripancreatic fluid collections. There is a paucity of data regarding the role of endoscopic transmural drainage in the management of multiple pancreatic fluid collections. In this case report, we present the case of a 72-year-old male with three walled-off pancreatic fluid collections in the setting of acute necrotizing pancreatitis. The patient underwent simultaneous endoscopic ultrasound-assisted cyst gastrostomy and cyst duodenostomy and aggressive irrigation without index endoscopic necrosectomy of the three peripancreatic fluid collections. Significant improvement in the size of the fluid collections was seen on the computed tomography scan, as well as a remarkable immediate clinical improvement after 24 hours of the endoscopic intervention.

  14. Bladder Involvement in Stage I Endometriosis.

    Science.gov (United States)

    Brady, Paula C; Missmer, Stacey A; Laufer, Marc R

    2017-08-01

    Endometriosis-the ectopic implantation of endometrial-like tissue-affects 10% of adolescent females and adults. Bladder involvement, causing dysuria and hematuria, occurs in a very small number of endometriosis patients. The patient presented at age 12 years with dysuria and pelvic pain. Laparoscopy revealed stage I endometriosis. Postoperatively, she reported persistent dysuria and passage of tissue in her urine. Cystoscopy showed diffuse erythema; urine cytology revealed glandular and spindle cells suggestive of endometriosis. She was transitioned from oral contraceptives to an intranasal gonadotropin-releasing hormone agonist, with symptom resolution. Intravesicular endometriosis coinciding with stage I disease supports a mechanism of endometriosis dissemination other than direct bladder infiltration. Patients with endometriosis who complain of urinary symptoms warrant assessment, because intravesicular bladder involvement cannot be excluded using pelviscopy. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  15. World Endometriosis Society consensus on the classification of endometriosis.

    Science.gov (United States)

    Johnson, Neil P; Hummelshoj, Lone; Adamson, G David; Keckstein, Jörg; Taylor, Hugh S; Abrao, Mauricio S; Bush, Deborah; Kiesel, Ludwig; Tamimi, Rulla; Sharpe-Timms, Kathy L; Rombauts, Luk; Giudice, Linda C

    2017-02-01

    What is the global consensus on the classification of endometriosis that considers the views of women with endometriosis? We have produced an international consensus statement on the classification of endometriosis through systematic appraisal of evidence and a consensus process that included representatives of national and international, medical and non-medical societies, patient organizations, and companies with an interest in endometriosis. Classification systems of endometriosis, developed by several professional organizations, traditionally have been based on lesion appearance, pelvic adhesions, and anatomic location of disease. One system predicts fertility outcome and none predicts pelvic pain, response to medications, disease recurrence, risks for associated disorders, quality of life measures, and other endpoints important to women and health care providers for guiding appropriate therapeutic options and prognosis. A consensus meeting, in conjunction with pre- and post-meeting processes, was undertaken. A consensus meeting was held on 30 April 2014 in conjunction with the World Endometriosis Society's 12th World Congress on Endometriosis. Rigorous pre- and post-meeting processes, involving 55 representatives of 29 national and international, medical and non-medical organizations from a range of disciplines, led to this consensus statement. A total of 28 consensus statements were made. Of all, 10 statements had unanimous consensus, however none of the statements was made without expression of a caveat about the strength of the statement or the statement itself. Two statements did not achieve majority consensus. The statements covered women's priorities, aspects of classification, impact of low resources, as well as all the major classification systems for endometriosis. Until better classification systems are developed, we propose a classification toolbox (that includes the revised American Society for Reproductive Medicine and, where appropriate, the

  16. 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.

  17. Reliability of visual diagnosis of endometriosis.

    Science.gov (United States)

    Fernando, Shavi; Soh, Pei Qian; Cooper, Michael; Evans, Susan; Reid, Geoffrey; Tsaltas, Jim; Rombauts, Luk

    2013-01-01

    To determine whether accuracy of visual diagnosis of endometriosis at laparoscopy is determined by stage of disease. Prospective longitudinal cohort study (Canadian Task Force classification II-2). Tertiary referral centers in three Australian states. Of 1439 biopsy specimens, endometriosis was proved in at least one specimen in 431 patients. Laparoscopy with visual diagnosis and staging of endometriosis followed by histopathologic analysis and confirmation. Operations were performed by five experienced laparoscopic gynecologists. Histopathologic confirmation of visual diagnosis of endometriosis adjusted for significant covariates. Endometriosis was accurately diagnosed in 49.7% of American Society for Reproductive Medicine (ASRM) stage I, which was significantly less accurate than for other stages of endometriosis. Deep endometriosis was more likely to be diagnosed accurately than superficial endometriosis (adjusted odds ratio, 2.51; 95% confidence interval, 1.50-4.18; p < .01). Lesion volume was also predictive, with larger lesions diagnosed more accurately than smaller lesions. In general, lesion site did not greatly influence accuracy except for superficial ovarian lesions, which were more likely to be incorrectly diagnosed visually as endometriosis (adjusted odds ratio, 0.16; 95% confidence interval, 0.06-0.41; p < .01). There was no statistically significant difference in accuracy between the gynecologic surgeons. The accuracy of visual diagnosis of endometriosis was substantially influenced by American Society of Reproductive Medicine stage, the depth and volume of the lesion, and to a lesser extent the location of the lesion. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

  18. Genistein modulates the estrogen receptor and suppresses angiogenesis and inflammation in the murine model of peritoneal endometriosis

    Directory of Open Access Journals (Sweden)

    Sutrisno Sutrisno

    2018-04-01

    Full Text Available The purpose of this study was to investigate the effect of genistein administration on the modulation of the estrogen receptor, inhibition of inflammation and angiogenesis in the murine model of peritoneal endometriosis. A total of thirty-six mice (Mus musculus were divided into six groups (n = 6, including the control group, endometriosis group, endometriosis group treated with various doses of genistein (0.78; 1.04; 1.3 mg/day, and endometriosis group treated with leuprolide acetate (0.00975 mg/day every 5 days for 15 days. Analysis of estrogen receptor-α, estrogen receptor-β, TNF-α, IL-6, VEGF, and HIF-1α were performed immunohistochemically. Expression of estrogen receptor-α, estrogen receptor-β, TNF-α, IL-6, VEGF and HIF-1α increased significantly compared with the control group (p  0.05. Genistein also decreased the expression of TNF-α and IL-6 (1.04 and 1.3 mg/day compared with the endometriosis group, reaching level comparable to that of the control group (p > 0.05. It was concluded that genistein is able to modulate estrogen receptor-α and estrogen receptor-β and inhibit the development of inflammation and angiogenesis in the murine model of peritoneal endometriosis. Thus, genistein can be a candidate in the treatment of endometriosis. Keywords: Estrogen receptor, Growth factor, Inflammation, Angiogenesis, Peritoneum

  19. [Risk factors of endometriosis associated ovarian carcinoma in women aged 45 years and older].

    Science.gov (United States)

    He, Z X; Wang, S; Li, Z F; Zhu, L; Leng, J H; Lang, J H

    2017-05-25

    Obiective: To explore the risk factors of endometriosis-associated ovarian cancer (EAOC) in women with ovarian endometriosis aged 45 years and older in China. Methods: The medical records of total 1 038 women aged 45 years and older with a surgicopathological diagnosis of ovarian endometriosis treated at Peking Union Medical College Hospital from December 1994 to December 2014 were reviewed. Histology evaluation determined ovarian endometriosis with ( n =30) or without ( n =1 008) ovarian cancer. Results: (1) There were 30 (2.9%, 30/1 018) cases confirmed as having EAOC. Clear cell carcinoma (63.3%, 17/30) and endometrioid adenocarcinoma (23.3%, 7/30) were commonly observed subtypes and 70.0% of EAOC patients were at stage Ⅰ. (2) Compared women with ovarian endometriosis in the same age group, patients with EAOC were older (50.8 vs 48.5 years, P =0.002). There were more in postmenopausal status at diagnosis of EAOC ( P 0.05). Conclusions: For women with ovarian endometriosis aged 45 years and older, the subgroup of patients characterized by postmenopausal status and ovarian endometrioma (≥8 cm) have a higher risk of EAOC. Active intervention or intensive follow-up should be considered for this population group, especially for those concurrent with endometrial disorders.

  20. Resveratrol and endometriosis: In vitro and animal studies and underlying mechanisms (Review).

    Science.gov (United States)

    Kolahdouz Mohammadi, Roya; Arablou, Tahereh

    2017-07-01

    Endometriosis is characterized by the existence of endometrial tissue and stroma exterior to the uterus. Despite the high prevalence, the etiology of endometriosis remains elusive. The search for the most promising compounds for treatment of endometriosis has led to the identification of resveratrol. Resveratrol, a plant-derived polyphenolic phytoalexin, demonstrates broad-spectrum health beneficial effects, including anti-proliferative, anti-inflammatory, antineoplastic and antioxidant. Because of these properties and its wide distribution in plants, resveratrol is proposed as a great potential to treat endometriosis. In animal models of endometriosis, resveratrol supplementation has displayed beneficial results as it decreased the number and volume of endometrial implants, suppressed proliferation, vascularization, inflammation, cell survival and increased apoptosis. On the other hand, resveratrol treatment in-vitro studies, reduced invasiveness of endometriotic stromal cells (ESCs) and suppressed their inflammatory responses. In this review, we will summarize the recent studies in in-vitro and animal studies on resveratrol and endometriosis. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  1. Evaluation of peritoneal endometriosis treatment using intralesional acetylsalicylic acid injection in rabbits.

    Science.gov (United States)

    Saad-Hossne, Rogério; Barretto, Adriana Beatriz; Siqueira, Juliana Menezes; Denadai, Rafael

    2016-04-01

    To investigate the efficacy of intralesional 20% aspirin injection for treatment of experimental peritoneal endometriosis. Peritoneal endometriosis was experimentally induced in forty adult nulligravid female rabbits. On day 30 post-endometriosis induction, rabbits were randomly divided to assess early (10 days) and late (20 days) effects of intralesional injection of physiological saline solution (control groups) in comparison to intralesional injection of 20% bicarbonate aspirin solution (experimental groups) as follows: control group 1 (10 days, n=10); control group 2 (20 days, n=10); experimental group 3 (10 days, n=10); experimental group 4 (20 days, n=10). Resected tissues, including endometriosis foci, were qualitatively (general morphology and signs of inflammatory cells infiltrate, necrosis and apoptosis) and quantitatively (remaining endometriosis area) assessed by histopathological analysis. Extensive necrosis, hemorrhage, apoptosis, and fibrosis were observed in the experimental groups 3 and 4. Groups 1 and 2 presented typical endometrial tissue cysts, respectively. Groups 3 and 4 showed sparse endometrial tissue foci and no endometrial tissue, respectively. Quantitative analysis revealed that aspirin-treated groups 3 and 4 had significantly (pendometriosis area, compared to control groups 1 and 2. Intralesional 20% aspirin injection caused total destruction of peritoneal endometriosis foci in rabbits.

  2. Treating gynaecological disorders with traditional Chinese medicine ...

    African Journals Online (AJOL)

    Traditional Chinese Medicine (TCM) has significant advantages in treating gynaecological disorders. The paper has provided a brief introduction on the current progress of treating some gynaecological disorders including endometriosis, infertility, dysmenorrhea, abnormal uterine bleeding, premenstrual syndrome, ...

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

    International Nuclear Information System (INIS)

    Di Paola, V.; Manfredi, R.; Castelli, F.; Negrelli, R.; Mehrabi, S.; Pozzi Mucelli, R.

    2015-01-01

    %, 95%, 99%, 86%, respectively. The highest accuracy was for adenomyosis (100%) and endometriosis of utero-sacral ligaments (USLs) (98%), slightly lower for vagina-rectovaginal septum an colo-rectal walls (96%), and the lowest for bladder endometriosis (92%). The concordance between histopathological and MRI ENZIAN score was excellent (k = 0.824); in particular it was 0.812 for lesions in vagina-rectovaginal space, 0.890 for lesions in USL, 0.822 for lesions in rectum–sigmoid colon, 1.000 for uterine adenomyosis, and 0.367 for lesions located in the bladder wall. Conclusion: MRI correlates with the ENZIAN score and has an accuracy of 95% in the detection and localization of deep endometriosis, allowing to minimize false negative results (4%) in patients with deep endometriosis and to obtain a correct preoperative staging

  4. 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

    %, 95%, 99%, 86%, respectively. The highest accuracy was for adenomyosis (100%) and endometriosis of utero-sacral ligaments (USLs) (98%), slightly lower for vagina-rectovaginal septum an colo-rectal walls (96%), and the lowest for bladder endometriosis (92%). The concordance between histopathological and MRI ENZIAN score was excellent (k = 0.824); in particular it was 0.812 for lesions in vagina-rectovaginal space, 0.890 for lesions in USL, 0.822 for lesions in rectum–sigmoid colon, 1.000 for uterine adenomyosis, and 0.367 for lesions located in the bladder wall. Conclusion: MRI correlates with the ENZIAN score and has an accuracy of 95% in the detection and localization of deep endometriosis, allowing to minimize false negative results (4%) in patients with deep endometriosis and to obtain a correct preoperative staging.

  5. Nitric acid treated multi-walled carbon nanotubes optimized by Taguchi method

    Energy Technology Data Exchange (ETDEWEB)

    Shamsuddin, Shahidah Arina; Hashim, Uda; Halim, Nur Hamidah Abdul [Institute of Nano Electronic Engineering, Universiti Malaysia Perlis, 01000, Kangar, Perlis (Malaysia); Derman, Mohd Nazree, E-mail: nazree@unimap.edu.my; Tahir, Muhammad Faheem Mohd [Centre of Excellence Geopolymer & Green Technology (CEGeoGTech), School of Material Engineering, Universiti Malaysia Perlis, 01000, Kangar, Perlis (Malaysia); Kashif, Muhammad [Faculty of Engineering, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Sarawak (Malaysia); Adam, Tijjani [Faculty of Engineering Technology, Universiti Malaysia Perlis, 02100, Padang Besar, Perlis (Malaysia)

    2016-07-19

    Electron transfer rate (ETR) of CNTs can be enhanced by increasing the amounts of COOH groups to their wall and opened tips. With the aim to achieve the highest production amount of COOH, Taguchi robust design has been used for the first time to optimize the surface modification of MWCNTs by nitric acid oxidation. Three main oxidation parameters which are concentration of acid, treatment temperature and treatment time have been selected as the control factors that will be optimized. The amounts of COOH produced are measured by using FTIR spectroscopy through the absorbance intensity. From the analysis, we found that acid concentration and treatment time had the most important influence on the production of COOH. Meanwhile, the treatment temperature will only give intermediate effect. The optimum amount of COOH can be achieved with the treatment by 8.0 M concentration of nitric acid at 120 °C for 2 hour.

  6. Nitric acid treated multi-walled carbon nanotubes optimized by Taguchi method

    International Nuclear Information System (INIS)

    Shamsuddin, Shahidah Arina; Hashim, Uda; Halim, Nur Hamidah Abdul; Derman, Mohd Nazree; Tahir, Muhammad Faheem Mohd; Kashif, Muhammad; Adam, Tijjani

    2016-01-01

    Electron transfer rate (ETR) of CNTs can be enhanced by increasing the amounts of COOH groups to their wall and opened tips. With the aim to achieve the highest production amount of COOH, Taguchi robust design has been used for the first time to optimize the surface modification of MWCNTs by nitric acid oxidation. Three main oxidation parameters which are concentration of acid, treatment temperature and treatment time have been selected as the control factors that will be optimized. The amounts of COOH produced are measured by using FTIR spectroscopy through the absorbance intensity. From the analysis, we found that acid concentration and treatment time had the most important influence on the production of COOH. Meanwhile, the treatment temperature will only give intermediate effect. The optimum amount of COOH can be achieved with the treatment by 8.0 M concentration of nitric acid at 120 °C for 2 hour.

  7. [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

  8. Low back pain tied to spinal endometriosis.

    Science.gov (United States)

    Dongxu, Zhao; Fei, Yin; Xing, Xiao; Bo-Yin, Zhang; Qingsan, Zhu

    2014-05-01

    Case report. We present a case of endometriosis of lumbar vertebrae. The literatures are reviewed with endometriosis of spine. Endometriosis is a common condition, which is defined as endometrial tissue lying outside the endometrial cavity. It is usually found within the peritoneal cavity, predominantly within the pelvis, commonly on the uterosacral ligaments. It can also be found in other sites such as umbilicus, abdominal scars, nasal passages and pleural cavity. But it is very rarely seen in the spine, with no report of endometriosis found in the lumbar vertebrae. A 33-year-old woman presented with severe low back pain. She had the low back pain periodically for 3 years, and the pain was associated with menstruation. Radiographs showed a lesion in the posterior L3 body. After surgery, tissue biopsy indicated the presence of endometrial tissue in the lesion and thus confirmed endometriosis. Most cases of spine endometriosis that have been reported are usually found inside spinal canal, endorachis or spinal cord. But spinal vertebrae can also be involved in endometriosis. Although endometriosis is a rare possible cause of periodical low back pain in women of childbearing age, we suggest that if a woman suffering from periodical low back pain is encountered, do not ignore the possibility of endometriosis in the spine.

  9. Full-thickness endometriosis of the bladder

    DEFF Research Database (Denmark)

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

    2014-01-01

    referral centres in Denmark for surgical treatment of stage III and IV endometriosis. POPULATION: Thirty-one women with deep infiltrating bladder endometriosis. METHODS: All women presenting in the Department of Obstetrics and Gynaecology with deep infiltrating bladder endometriosis between March 2002...... and March 2011. We included only patients with symptomatic full-thickness bladder detrusor endometriosis and mucosal involvement. All patients had had bladder symptoms for two to seven years. MAIN OUTCOME MEASURES: Symptoms after surgery and recurrence rate. RESULTS: The main preoperative symptom...

  10. Ultrasonographic features of endometriosis: with emphasis on atypical presentations and differential diagnoses

    International Nuclear Information System (INIS)

    Kim, Chan Kyo; Kim, Bo Hyun; Choi, Moon Hae

    1999-01-01

    US has been widely used for the differential diagnosis of adnexal masses. However, only a few reports have addressed its specific value in the diagnosis of endometrioma. A characteristic appearance - a round-shaped, homogeneously hypoechoic mass containing low-level echoes within the ovary - has been reported to be seen in 82% to 89% of the patients with endometriosis. Occasionally, however, endometriosis may show diverse US appearance that may mimic other ovarian pathology including ovarian cancer. The purpose of this exhibit is to demonstrate the US findings of endometriosis with emphasis on atypical presentations and to describe differential diagnoses of endometriosis on US. Pathologically proven 97 cases of endometrioma in 80 women were included in this study. US findings were retrospectively reviewed and analyzed in each patient for the following items; morphological types (I-V), internal echoes (I-IV), wall thickness, presence or absence of septation, mural nodule, solid component, echogenic foci, and daughter cyst, and blood flow patterns on color Doppler US. In addition, the US findings of 10 patients who were falsely diagnosed as endometriosis preoperatively but confirmed later to have other pathology were also analyzed.

  11. Ultrasonographic features of endometriosis: with emphasis on atypical presentations and differential diagnoses

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chan Kyo; Kim, Bo Hyun; Choi, Moon Hae [Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of)

    1999-12-15

    US has been widely used for the differential diagnosis of adnexal masses. However, only a few reports have addressed its specific value in the diagnosis of endometrioma. A characteristic appearance - a round-shaped, homogeneously hypoechoic mass containing low-level echoes within the ovary - has been reported to be seen in 82% to 89% of the patients with endometriosis. Occasionally, however, endometriosis may show diverse US appearance that may mimic other ovarian pathology including ovarian cancer. The purpose of this exhibit is to demonstrate the US findings of endometriosis with emphasis on atypical presentations and to describe differential diagnoses of endometriosis on US. Pathologically proven 97 cases of endometrioma in 80 women were included in this study. US findings were retrospectively reviewed and analyzed in each patient for the following items; morphological types (I-V), internal echoes (I-IV), wall thickness, presence or absence of septation, mural nodule, solid component, echogenic foci, and daughter cyst, and blood flow patterns on color Doppler US. In addition, the US findings of 10 patients who were falsely diagnosed as endometriosis preoperatively but confirmed later to have other pathology were also analyzed.

  12. Hydrogen storage in microwave-treated multi-walled carbon nanotubes

    Energy Technology Data Exchange (ETDEWEB)

    Geng, Hong-Zhang [BK21 Physics Division, Department of Energy Science, Center for Nanotubes and Nanostructured Composites, Sungkyunkwan Advanced Institute of Nanotechnology, Sungkyunkwan University, Suwon 440-746 (Korea); School of Materials Science and Engineering, Tianjin Polytechnic University, Tianjin 300160 (China); Kim, Tae Hyung; Lim, Seong Chu; Jeong, Hae-Kyung; Jin, Mei Hua; Jo, Young Woo; Lee, Young Hee [BK21 Physics Division, Department of Energy Science, Center for Nanotubes and Nanostructured Composites, Sungkyunkwan Advanced Institute of Nanotechnology, Sungkyunkwan University, Suwon 440-746 (Korea)

    2010-03-15

    Multiwalled carbon nanotubes (MWCNTs) treated by microwave and heat treatment were used for hydrogen storage. Their storage capacity was measured using a quadruple quartz crystal microbalance in a moisture-free chamber at room temperature and at relatively low pressure (0.5 MPa). Deuterium was also used to monitor the presence of moisture. The hydrogen storage capacity of the microwave-treated MWCNTs was increased to nearly 0.35 wt% over 0.1 wt% for the pristine sample and increased further to 0.4 wt%, with improved stability after subsequent heat-treatment. The increase in the storage capacity by the microwave treatment was mostly attributed to the introduction of micropore surfaces, while the stability improvement after the subsequent heat treatment was related to the removal of functional groups. We also propose a measurement method that eliminates the moisture effect by measuring the storage capacity with hydrogen and deuterium gas. (author)

  13. Radiologic findings of malignant tumors arising from ovarian endometriosis

    International Nuclear Information System (INIS)

    Lee, Eun Ju; Joo, Hee Jae; Kim, Bo Hyun

    1999-01-01

    To determine the radiologic characteristics of malignant tumors arising from ovarian endometriosis. The radiologic findings of eleven patients with pelvic masses histologically confirmed as malignant ovarian tumors arising from endometriosis were retrospectively reviewed. All patients underwent MR, and six underwent ultrasonography. The findings were evaluated with regard to tumor size and shape, locularity, thickness and enhancement of the wall and septa, the presence of papillary nodule or solid portion, signal intensity of the locule, the presence of mass in contralateral ovary, ascites, local invasion, distant metastases, and the Pathologic diagnosis included clear cell carcinoma in six cases, endometrioid carcinoma in three, and mucinous cystadenocarcinoma of borderline malignancy and endometrial stromal sarcoma in one case each. Tumor size ranged from 8 to 20 (mean, 12.7)cm. The tumors were mixed in four cases, entirely cystic in three, predominantly cystic in three, and predominantly solid in one. Six cases were unilocular and five were multilocular. The wall and septa varied in thickness and regularity and were well enhanced in all but one case. In all cases papillary nodules or solid portions with similar enhancement to uterine myometrium were seen. On T1WI, the signal intensity of fluid was seen to be high in eight cases, low or intermediate in two, and of differing intensity in one. Ten cases showed high signal intensity on T2WI, whereas in one case in which high signal intensity was seen on T1WI, there was low signal intensity(shading). In three cases the contralateral ovary contained an endometrioma. Other features included ascites in seven cases and peritoneal seeding in one. Malignant ovarian tumors arising from endometriosis showed radiologic features of malignancy:they were larger than 10cm, there was enhancement of the wall and septa, and a papillary nodule or solid portion was present. However, the presence of hyperintense fluid, as seen on T1WI

  14. Radiologic findings of malignant tumors arising from ovarian endometriosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Ju; Joo, Hee Jae [Ajou Univ. College of Medicine, Suwon (Korea, Republic of); Kim, Bo Hyun [SungkyunKwan Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-11-01

    To determine the radiologic characteristics of malignant tumors arising from ovarian endometriosis. The radiologic findings of eleven patients with pelvic masses histologically confirmed as malignant ovarian tumors arising from endometriosis were retrospectively reviewed. All patients underwent MR, and six underwent ultrasonography. The findings were evaluated with regard to tumor size and shape, locularity, thickness and enhancement of the wall and septa, the presence of papillary nodule or solid portion, signal intensity of the locule, the presence of mass in contralateral ovary, ascites, local invasion, distant metastases, and the Pathologic diagnosis included clear cell carcinoma in six cases, endometrioid carcinoma in three, and mucinous cystadenocarcinoma of borderline malignancy and endometrial stromal sarcoma in one case each. Tumor size ranged from 8 to 20 (mean, 12.7)cm. The tumors were mixed in four cases, entirely cystic in three, predominantly cystic in three, and predominantly solid in one. Six cases were unilocular and five were multilocular. The wall and septa varied in thickness and regularity and were well enhanced in all but one case. In all cases papillary nodules or solid portions with similar enhancement to uterine myometrium were seen. On T1WI, the signal intensity of fluid was seen to be high in eight cases, low or intermediate in two, and of differing intensity in one. Ten cases showed high signal intensity on T2WI, whereas in one case in which high signal intensity was seen on T1WI, there was low signal intensity(shading). In three cases the contralateral ovary contained an endometrioma. Other features included ascites in seven cases and peritoneal seeding in one. Malignant ovarian tumors arising from endometriosis showed radiologic features of malignancy:they were larger than 10cm, there was enhancement of the wall and septa, and a papillary nodule or solid portion was present. However, the presence of hyperintense fluid, as seen on T1WI

  15. Plasma Treated Multi-Walled Carbon Nanotubes (MWCNTs for Epoxy Nanocomposites

    Directory of Open Access Journals (Sweden)

    Jie Lian

    2011-12-01

    Full Text Available Plasma nanocoating of allylamine were deposited on the surfaces of multi-walled carbon nanotubes (MWCNTs to provide desirable functionalities and thus to tailor the surface characteristics of MWCNTs for improved dispersion and interfacial adhesion in epoxy matrices. Plasma nanocoated MWCNTs were characterized using scanning electron microscopy (SEM, high-resolution transmission electron microscopy (HR-TEM, surface contact angle, and pH change measurements. Mechanical testing results showed that epoxy reinforced with 1.0 wt % plasma coated MWCNTs increased the tensile strength by 54% as compared with the pure epoxy control, while epoxy reinforced with untreated MWCNTs have lower tensile strength than the pure epoxy control. Optical and electron microscopic images show enhanced dispersion of plasma coated MWCNTs in epoxy compared to untreated MWCNTs. Plasma nanocoatings from allylamine on MWCNTs could significantly enhance their dispersion and interfacial adhesion in epoxy matrices. Simulation results based on the shear-lag model derived from micromechanics also confirmed that plasma nanocoating on MWCNTs significantly improved the epoxy/fillers interface bonding and as a result the increased composite strength.

  16. Imaging modalities for the non-invasive diagnosis of endometriosis.

    Science.gov (United States)

    Nisenblat, Vicki; Bossuyt, Patrick M M; Farquhar, Cindy; Johnson, Neil; Hull, M Louise

    2016-02-26

    participants; sensitivity 0.95 (95% CI 0.90, 1.00), specificity 0.91 (95% CI 0.86, 0.97)) met the criteria for a replacement and SnNout triage test and approached the criteria for a SpPin test. For DIE, TVUS (nine studies, 12 data sets, 934 participants; sensitivity 0.79 (95% CI 0.69, 0.89) and specificity 0.94 (95% CI 0.88, 1.00)) approached the criteria for a SpPin triage test, and MRI (six studies, seven data sets, 266 participants; sensitivity 0.94 (95% CI 0.90, 0.97), specificity 0.77 (95% CI 0.44, 1.00)) approached the criteria for a replacement and SnNout triage test. Other imaging tests assessed in small individual studies could not be statistically evaluated.TVUS met the criteria for a SpPin triage test in mapping DIE to uterosacral ligaments, rectovaginal septum, vaginal wall, pouch of Douglas (POD) and rectosigmoid. MRI met the criteria for a SpPin triage test for POD and vaginal and rectosigmoid endometriosis. Transrectal ultrasonography (TRUS) might qualify as a SpPin triage test for rectosigmoid involvement but could not be adequately assessed for other anatomical sites because heterogeneous data were scant. Multi-detector computerised tomography enema (MDCT-e) displayed the highest diagnostic performance for rectosigmoid and other bowel endometriosis and met the criteria for both SpPin and SnNout triage tests, but studies were too few to provide meaningful results.Diagnostic accuracies were higher for TVUS with bowel preparation (TVUS-BP) and rectal water contrast (RWC-TVS) and for 3.0TMRI than for conventional methods, although the paucity of studies precluded statistical evaluation. None of the evaluated imaging modalities were able to detect overall pelvic endometriosis with enough accuracy that they would be suggested to replace surgery. Specifically for endometrioma, TVUS qualified as a SpPin triage test. MRI displayed sufficient accuracy to suggest utility as a replacement test, but the data were too scant to permit meaningful conclusions. TVUS could be

  17. 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....

  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. 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....

  20. 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....

  1. An experimental study of mechanism in treatment for endometriosis with Xiao Chai Hu Tang in rats

    International Nuclear Information System (INIS)

    Zhang Hui; Zuo Liandong; Li Hongyi

    2005-01-01

    To explore the mechanism of Xiao Chai Hu Tang in treatment for endometriosis in rats, the rat model of endometriosis was established. Using immunohistochemistry method, Fas and Caspase-3 protein expression in endometrium and endometriotic tissue of each group were observed. The results showed that in the group treated with Xiao Chai Hu Tang, the protein expressions of Fas and Caspase-3 in endometriotic tissue were higher than those in endometrium, while in the control group, the result was just opposite. The difference was not obvious in the group treated with Danazol . The higher levels of the protein expression of Fas in endometriotic tissue may related to the pathogenesis of the endometriosis. The mechanism of Xiao Chai Hu Tang treatment may be partly to increase apoptosis in endometriotic tissue. (authors)

  2. Reevaluating response and failure of medical treatment of endometriosis: a systematic review.

    Science.gov (United States)

    Becker, Christian M; Gattrell, William T; Gude, Kerstin; Singh, Sukhbir S

    2017-07-01

    To assess patient response rates to medical therapies used to treat endometriosis-associated pain. A systematic review with the use of Medline and Embase. Not applicable. Women receiving medical therapy to treat endometriosis. None. The proportions of patients who: experienced no reduction in endometriosis-associated pain symptoms; had pain symptoms remaining at the end of the treatment period; had pain recurrence after treatment cessation; experienced an increase or no change in disease score during the study; were satisfied with treatment; and discontinued therapy owing to adverse events or lack of efficacy. The change in pain symptom severity experienced during and after treatment, as measured on the visual analog scale, was also assessed. In total, 58 articles describing 125 treatment arms met the inclusion criteria. Data for the response of endometriosis-associated pain symptoms to treatment were presented in only 29 articles. The median proportions of women with no reduction in pain were 11%-19%; at the end of treatment, 5%-59% had pain remaining; and after follow-up, 17%-34% had experienced recurrence of pain symptoms after treatment cessation. After median study durations of 2-24 months, the median discontinuation rates due to adverse events or lack of efficacy were 5%-16%. Few studies of medical therapies for endometriosis report outcomes that are relevant to patients, and many women gain only limited or intermittent benefit from treatment. Copyright © 2017. Published by Elsevier Inc.

  3. Thermal characteristics of thermobrachytherapy surface applicators for treating chest wall recurrence

    International Nuclear Information System (INIS)

    Arunachalam, K; Maccarini, P F; Craciunescu, O I; Stauffer, P R; Schlorff, J L

    2010-01-01

    The aim of this study was to investigate temperature and thermal dose distributions of thermobrachytherapy surface applicators (TBSAs) developed for concurrent or sequential high dose rate (HDR) brachytherapy and microwave hyperthermia treatment of chest wall recurrence and other superficial diseases. A steady-state thermodynamics model coupled with the fluid dynamics of a water bolus and electromagnetic radiation of the hyperthermia applicator is used to characterize the temperature distributions achievable with TBSAs in an elliptical phantom model of the human torso. Power deposited by 915 MHz conformal microwave array (CMA) applicators is used to assess the specific absorption rate (SAR) distributions of rectangular (500 cm 2 ) and L-shaped (875 cm 2 ) TBSAs. The SAR distribution in tissue and fluid flow distribution inside the dual-input dual-output (DIDO) water bolus are coupled to solve the steady-state temperature and thermal dose distributions of the rectangular TBSA (R-TBSA) for superficial tumor targets extending 10-15 mm beneath the skin surface. Thermal simulations are carried out for a range of bolus inlet temperature (T b = 38-43 deg. C), water flow rate (Q b = 2-4 L min -1 ) and tumor blood perfusion (ω b = 2-5 kg m -3 s -1 ) to characterize their influence on thermal dosimetry. Steady-state SAR patterns of the R- and L-TBSA demonstrate the ability to produce conformal and localized power deposition inside the tumor target sparing surrounding normal tissues and nearby critical organs. Acceptably low variation in tissue surface cooling and surface temperature homogeneity was observed for the new DIDO bolus at a 2 L min -1 water flow rate. Temperature depth profiles and thermal dose volume histograms indicate bolus inlet temperature (T b ) to be the most influential factor on thermal dosimetry. A 42 deg. C water bolus was observed to be the optimal choice for superficial tumors extending 10-15 mm from the surface even under significant blood perfusion

  4. Effect of copaiba oil on correction of abdominal wall defect treated with the use of polypropylene/polyglecaprone mesh

    Directory of Open Access Journals (Sweden)

    Edson Yuzur Yasojima

    2013-02-01

    Full Text Available PURPOSE: To evaluate the effects of copaiba oil on the correction of abdominal defect treated with the use of polypropylene/polyglecaprone mesh in rats. METHODS: A defect in the abdominal wall was created and corrected with polypropylene/polyglecaprone mesh in 36 rats. They were randomly distributed into three groups: control, copaiba by oral administration (gavage and copaiba oil dip in the mesh. Euthanasia was performed after seven, 14 and 21 post-operative days. The healing process was analyzed regarding the meshes and macroscopic and microscopic aspects. RESULTS: All animals had abdominal adhesions, which were smaller in the copaiba (gavage group (p<0.05. In microscopy, all animals had an acute inflammation stage and the inflammatory response was best characterized by foreign body-type granulomas around the mesh fragments, which was not found in the mesh fragments within the copaiba dip group. There was a greater area of necrosis and fibrosis in the copaiba dip group compared to the control group (p<0.05. The copaiba (gavage group had a greater quantity of collagen fibers compared to the control group. CONCLUSION: Copaiba oil administered by gavage decreased the amount of abdominal adhesions, besides accelerating the process of collagen fibers formation, without damages within the early stages of healing. However, when used by dip directly on the mesh, it had corrosive effects compromising the healing process of the abdominal wall.

  5. Multi-Walled Carbon Nanotube Coating on Alkali Treated TiO2 Nanotubes Surface for Improvement of Biocompatibility

    Directory of Open Access Journals (Sweden)

    Jung-Eun Park

    2018-04-01

    Full Text Available The aim of this study is to enhance the bioactivity of pure titanium using multiple surface treatments for the application of the implant. To form the biofunctional multilayer coating on pure titanium, anodization was conducted to make titanium dioxide nanotubes, then multi-walled carbon nanotubes were coated using a dipping method after an alkali treatment. The surface characteristics at each step were analyzed using a field emission scanning electron microscope and X-ray diffractometer. The effect of the multilayer coating on the biocompatibility was identified using immersion and cytotoxicity tests. Better hydroxyapatite formation was observed on the surface of multilayer-coated pure titanium compared to non-treated pure titanium after immersion in the simulated body fluid. Improvement of biocompatibility by multiple surface treatments was identified through various cytotoxicity tests using osteoblast cells.

  6. Exceptional cause of bowel obstruction: rectal endometriosis ...

    African Journals Online (AJOL)

    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 ...

  7. Macrophages and nerve fibres in peritoneal endometriosis.

    Science.gov (United States)

    Tran, Lu Vinh Phuc; Tokushige, Natsuko; Berbic, Marina; Markham, Robert; Fraser, Ian S

    2009-04-01

    Endometriosis is considered to be an inflammatory disease, and macrophages are the most numerous immune cells in endometriotic lesions. However, the mechanisms underlying the elevation of macrophages and their role in the pathogenesis and manifestations of endometriosis still remain unclear. The number of macrophages stained for CD68 in endometriotic lesions (n = 24) and in peritoneum distant from the lesions (n = 14) from women with endometriosis was compared with the number of macrophages in normal peritoneum from women without endometriosis (n = 18). Peritoneal lesions were also double-stained for CD68 and protein gene product 9.5 to study the relationship between macrophages and nerve fibres. The densities of macrophages in peritoneal endometriotic lesions and unaffected peritoneum from women with endometriosis were both significantly higher than that in normal peritoneum from women without endometriosis (P peritoneal lesions from women with endometriosis compared with normal peritoneum from women without endometriosis. These cells may well play roles in the growth and development of endometriotic lesions and in the generation of pain through interaction with nerve fibres.

  8. Vesical endometriosis: utility of imaging techniques

    International Nuclear Information System (INIS)

    Parra, M.; Cascon, E.; Robledo, R.; Perez, M.

    1999-01-01

    We present three cases of vesical endometriosis initially studied with ultrasound. One case was also studied with intravenous urography, computed tomography and magnetic resonance imaging. We discuss on the utility of these imaging methods in the diagnosis of vesical endometriosis. (Author) 9 refs

  9. Radiologic findings of pulmonary endometriosis

    International Nuclear Information System (INIS)

    Kim, Seon Bok; Lee, Eil Seong; Jung, Hae Kyoung; Kim, Uk Jung; Yi, Jeong Geun; Kang, Ik Won; Kook, Shin Ho; Park, Jae Sung; Ryu, Dae Sik

    1998-01-01

    To describe the radiologic findings of pulmonary endometriosis. This study involved five patients with catamenial hemoptysis diagnosed as pulmonary endometriosis. All cases were diagnosed on the basis of bronchoscopic abnormalities. In one patient, endometrial glandular cells were seen on transthoracic fine needle aspiration biopsy. In three, hemoptysis ceased after Danazol treatment. The pattern, location and number of parenchymal abnormalities and the presence or absence of pleural lesion were analyzed retrospectively on plain chest radiographs (n=3D5) and CT scans(n=3D5). Follow-up study for each menstrual period was performed in two cases and changes from the initial lesion were assessed. Plain chest radiographic findings showed focal ground-glass opacity in three cases;two were in the right lung and one in the left. CT findings included ground-glass attenuation (n=3D3) and a mixed pattern of ground-glass attenuations and consolidations(n=3D2). Sites were single in four cases, and in one case, there were two; thus there were in all six lesions. Five of these were located in the right lung and subpleural region, continving to the pleura. Pleural lesion was not detected on either chest radiographs or CT scans. Follow-up CT scans (n=3D2) showed a similar lesion at the same site. In patient with repeated catamenial hemoptysis, CT may be helpful for the diagnosis of pulmonary endometriosis by exclusion of other diseases.=20

  10. Radiologic findings of pulmonary endometriosis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seon Bok; Lee, Eil Seong; Jung, Hae Kyoung; Kim, Uk Jung; Yi, Jeong Geun; Kang, Ik Won [Hallym Univ. College of Medicine, Seoul (Korea, Republic of); Kook, Shin Ho [Kangbuk Samsung Hospital, Seoul (Korea, Republic of); Park, Jae Sung [Soonchunhyang Univ. College of Medicine, Seoul (Korea, Republic of); Ryu, Dae Sik [Kangnung Hospital, Kangnung (Korea, Republic of)

    1998-12-01

    To describe the radiologic findings of pulmonary endometriosis. This study involved five patients with catamenial hemoptysis diagnosed as pulmonary endometriosis. All cases were diagnosed on the basis of bronchoscopic abnormalities. In one patient, endometrial glandular cells were seen on transthoracic fine needle aspiration biopsy. In three, hemoptysis ceased after Danazol treatment. The pattern, location and number of parenchymal abnormalities and the presence or absence of pleural lesion were analyzed retrospectively on plain chest radiographs (n=3D5) and CT scans(n=3D5). Follow-up study for each menstrual period was performed in two cases and changes from the initial lesion were assessed. Plain chest radiographic findings showed focal ground-glass opacity in three cases;two were in the right lung and one in the left. CT findings included ground-glass attenuation (n=3D3) and a mixed pattern of ground-glass attenuations and consolidations(n=3D2). Sites were single in four cases, and in one case, there were two; thus there were in all six lesions. Five of these were located in the right lung and subpleural region, continving to the pleura. Pleural lesion was not detected on either chest radiographs or CT scans. Follow-up CT scans (n=3D2) showed a similar lesion at the same site. In patient with repeated catamenial hemoptysis, CT may be helpful for the diagnosis of pulmonary endometriosis by exclusion of other diseases.=20.

  11. [Sigmoid endometriosis: a diagnostic dilemma on multidetector CT].

    Science.gov (United States)

    Telegrafo, Michele; Lorusso, Valentina; Rubini, Giuseppe; Rella, Leonarda; Pezzolla, Angela; Stabile Ianora, Amato Antonio; Moschetta, Marco

    2013-01-01

    Intestinal endometriosis represents a common condition that occurs particularly in women of reproductive age. The gastrointestinal tract is the third most common localization of endometriosis, after the ovaries and the peritoneum, and recto-sigmoid tract is involved in 70% of cases. Recto-sigmoid endometriosis has to be differentiated from other diseases of large bowel, especially in patients without a history of endometriosis. We report a case of sigmoid endometriosis which represented a diagnostic dilemma on multidetector computed tomography.

  12. Molecular aspects of development and regulation of endometriosis

    Science.gov (United States)

    2014-01-01

    Endometriosis is a common and painful condition affecting women of reproductive age. While the underlying pathophysiology is still largely unknown, much advancement has been made in understanding the progression of the disease. In recent years, a great deal of research has focused on non-invasive diagnostic tools, such as biomarkers, as well as identification of potential therapeutic targets. In this article, we will review the etiology and cellular mechanisms associated with endometriosis as well as the current diagnostic tools and therapies. We will then discuss the more recent genomic and proteomic studies and how these data may guide development of novel diagnostics and therapeutics. The current diagnostic tools are invasive and current therapies primarily treat the symptoms of endometriosis. Optimally, the advancement of “-omic” data will facilitate the development of non-invasive diagnostic biomarkers as well as therapeutics that target the pathophysiology of the disease and halt, or even reverse, progression. However, the amount of data generated by these types of studies is vast and bioinformatics analysis, such as we present here, will be critical to identification of appropriate targets for further study. PMID:24927773

  13. Suppression of annexin A2 by prostaglandin E₂ impairs phagocytic ability of peritoneal macrophages in women with endometriosis.

    Science.gov (United States)

    Wu, Meng-Hsing; Chuang, Pei-Chin; Lin, Yiu-Juian; Tsai, Shaw-Jenq

    2013-04-01

    Is annexin A2 involved in the reduced phagocytic ability of macrophages in endometriosis? Data from women with endometriosis and a murine model of the disease show that expression of annexin A2 in peritoneal macrophages is inhibited by prostaglandin E2 (PGE2) and this impairs the phagocytic ability of macrophages. Endometriosis is a chronic inflammatory disease that recruits many immune cells, especially macrophages, to the peritoneal cavity. The phagocytic ability of peritoneal macrophages isolated from women with endometriosis is reduced. A laboratory study. Thirty-five patients (20 with and 15 without endometriosis) of reproductive age with normal menstrual cycles were recruited. Peritoneal macrophages isolated from women with or without endometriosis were cultured and treated with vehicle, PGE2 and different EP receptor agonists, and the expression of annexin A2 was quantified by RT-PCR and western blotting. Annexin A2 was knocked down (by small interfering RNA) in normal macrophages or overexpressed (by treatment with recombinant protein) in endometriotic macrophages and their phagocytic ability was measured by flow cytometry. Peritoneal macrophages were isolated from a mouse model of endometriosis and treated with PGE2 or cyclo-oxygenase (COX) inhibitors, and annexin A2 mRNA was quantified. Levels of annexin A2 were markedly reduced in peritoneal macrophages from women with endometriosis versus controls (mRNA: P endometriosis versus control) via the EP2/EP4 receptor-dependent signaling pathway. Treatment with PGE2 or knockdown of annexin A2 inhibited the phagocytic ability of macrophages (P peritoneal macrophages were markedly reduced in mice treated with PGE2 (P peritoneal macrophages (P peritoneal cells from patients with endometriosis or that their endometriotic fluid contains increased amounts of PGE2 when compared with control subjects. Inhibiting PGE2 signaling, in order to restore or enhance the phagocytic capability of macrophages, may represent a new

  14. Risk of appendiceal endometriosis among women with deep-infiltrating endometriosis.

    Science.gov (United States)

    Moulder, Janelle K; Siedhoff, Matthew T; Melvin, Kathryn L; Jarvis, Elizabeth G; Hobbs, Kumari A; Garrett, Joanne

    2017-11-01

    To determine whether deep-infiltrating endometriosis (DE) carries an increased risk of appendiceal endometriosis (AppE) as compared with superficial endometriosis or no endometriosis. In a retrospective study, data were obtained by chart review of an internal database for women who underwent coincidental appendectomy during benign gynecologic surgery between July 2009 and February 2014 at a tertiary referral center in the USA. Univariate, bivariate, and regression analyses were performed. The primary exposure was surgically documented endometriosis (DE, superficial, or no endometriosis). The primary outcome was AppE. Endometriosis was diagnosed for 151 (38.2%) of 395 women; 82 (54.3%) had DE. The prevalence of AppE was 13.2% (52/395) overall; 8 (11.6%) of 69 women with superficial endometriosis and 32 (39.0%) of 82 with DE were affected. Frequency of AppE was increased among women with DE, abnormal appendix appearance, and surgical indication (all Pendometriosis, controlling for appendiceal appearance and surgical indication, and a 2.7-fold (95% CI 1.2-6.2) higher risk of AppE compared with those with superficial endometriosis. Women with DE have increased risk of AppE. Coincidental appendectomy should form part of complete endometriosis excision for these patients. © 2017 International Federation of Gynecology and Obstetrics.

  15. Endometriosis-associated hydrocele of the canal of Nuck with immunohistochemical confirmation: a case report.

    Science.gov (United States)

    Okoshi, Kae; Mizumoto, Masaki; Kinoshita, Koichi

    2017-12-21

    The canal of Nuck is an embryological vestige of the processus vaginalis, and presents a potential site for endometriosis seeding. Hydroceles in this region are a rare cause of inguinal swelling in females. In addition, endometriosis localized to the canal of Nuck is exceedingly rare. A 44-year-old Japanese woman presented with a painful mass overlying her right pubis. She underwent surgery to completely excise the mass. During surgery, division of the external oblique aponeurosis revealed a cyst that occupied the inguinal canal and it adhered to the transverse fascia, inguinal ligament, and pubic bone. The cyst was dissected from the round ligament, and the defect in the internal inguinal ring was repaired and reinforced with mesh. On macroscopic examination, the cyst had a heterogeneous fibrous aspect with dark brown inclusions. Microscopic examination revealed that the cyst was tortuous, lined by mesothelial-like cells, and accompanied by partial subcapsular hemorrhage. Endometrium-like tissue was observed in the cystic wall. Immunohistochemical staining for podoplanin confirmed the mesothelial origin of the cyst-lining cells. The epithelial cells and stromal cells were positive for estrogen receptors. In this case of an endometriosis-associated hydrocele of the canal of Nuck, the mesothelial origin of the cyst-lining cells and endometriosis were confirmed by positive immunohistochemical staining for podoplanin and estrogen receptors, respectively. We determined that hydrocele resection and reinforcement of the anterior inguinal canal wall (if necessary) are appropriate treatments for this condition.

  16. 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 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 and hypertension

  17. 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

  18. The use of JJ stent in the management of deep endometriosis lesion, affecting or potentially affecting the ureter: a review of our practice.

    Science.gov (United States)

    Weingertner, A S; Rodriguez, B; Ziane, A; Gibon, E; Thoma, V; Osario, F; Haddad, C; Wattiez, A

    2008-08-01

    With the increasing number of operative laparoscopies performed for the treatment of deep pelvic endometriosis, technical difficulties and risk of complications inevitably increase. We report our experience using JJ stents, in women treated for deep pelvic endometriosis, with regard to prevention and management of ureteral lesions. Descriptive retrospective analysis between March 2004 and March 2007. Department of Obstetrics and Gynaecology, University Hospital, Strasbourg, France. Cases of women who underwent laparoscopic surgery for severe endometriosis and who needed a JJ stent in their management were recorded. Laparoscopic surgery was performed at the Department of Obstetrics and Gynaecology at CMCO-SIHCUS and Hautepierre Hospitals, Strasbourg, which are referral centres in the treatment of deep endometriosis. To evaluate the contribution of JJ stent in the prevention and management of ureteral lesions from endometriotic origin and/or iatrogenic origin in women treated for deep pelvic endometriosis. A total of 145 women had surgery for deep pelvic endometriosis. Seventeen (11.7%) women had a JJ ureteral stent inserted. In 82.4% of women, the stent was inserted pre- or peroperatively. We noted three ureteral complications, of which only one needed management by laparotomy. Except in extreme cases, management of ureteral endometriosis should be performed laparoscopically. Ureteral lesions whether iatrogenic, or secondary to endometriotic disease, can be treated by cystoscopy, JJ stent and laparoscopy. The combination of these three elements is the optimal management and is unlikely to cause subsequent complications. Laparotomy and its associated morbidity should be avoided.

  19. 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.

  20. Development of pro-apoptotic peptides as potential therapy for peritoneal endometriosis.

    Science.gov (United States)

    Sugihara, K; Kobayashi, Y; Suzuki, A; Tamura, N; Motamedchaboki, K; Huang, C-T; Akama, T O; Pecotte, J; Frost, P; Bauer, C; Jimenez, J B; Nakayama, J; Aoki, D; Fukuda, M N

    2014-07-22

    Endometriosis is a common gynaecological disease associated with pelvic pain and infertility. Current treatments include oral contraceptives combined with nonsteroidal anti-inflammatory drugs or surgery to remove lesions, all of which provide a temporary but not complete cure. Here we identify an endometriosis-targeting peptide that is internalized by cells, designated z13, using phage display. As most endometriosis occurs on organ surfaces facing the peritoneum, we subtracted a phage display library with female mouse peritoneum tissue and selected phage clones by binding to human endometrial epithelial cells. Proteomics analysis revealed the z13 receptor as the cyclic nucleotide-gated channel β3, a sorting pathway protein. We then linked z13 with an apoptosis-inducing peptide and with an endosome-escaping peptide. When these peptides were co-administered into the peritoneum of baboons with endometriosis, cells in lesions selectively underwent apoptosis with no effect on neighbouring organs. Thus, this study presents a strategy that could be useful to treat peritoneal endometriosis in humans.

  1. Nierfunctieverlies bij diep infiltratieve endometriose: tijdige herkenning van ureterobstructie is geboden [Loss of renal function due to deep infiltrating endometriosis; a complicated consideration in women who wish to have children

    NARCIS (Netherlands)

    de Graaff, A.A.; Beets Tan, R.G.; Beets, G.L.; van de Beek, C.K.; Dunselman, G.A.

    2009-01-01

    Three nulliparous women, aged 39, 34 and 26 years, who were treated for fertility problems and who were affected by endometriosis, presented with ureteral obstruction caused by deep infiltrating endometriosis. The first two patients had complete unilateral loss of kidney function at the time of

  2. An experimental study in treatment for endometriosis with Xiao Chaihu Tang in rats

    International Nuclear Information System (INIS)

    Pan Li; Zheng Hui

    2006-01-01

    To explore the mechanism of Xiao Chaihu Tang in the treatment for endometriosis in rats,the rat model of endometriosis was established and were treated with Xiao Chaihu Tang , Danazol and Xiao Chaihu Tang plus Danazol for 4 weeks, respectively. Cyclooxygenase-2(COX- 2) expression in each group of endometrium and endometriotic tissue was observed by immuno- histochemistry method. The results showed that the expression of COX-2 in the endometriotic tissue was lower than that in endometrium in Xiao Chaihu Tang group and Xiao Chaihu Tang plus Danazol group, while Danazol group and control group were the opposite to Xiao Chaihu Tang group. The mechanism of Xiao Chaihu Tang in the treatment for endometriosis may be to decrease the COX-2 expression and reduce the formation of prostaglandins. (authors)

  3. The effect of genistein on TGF-β signal, dysregulation of apoptosis, cyclooxygenase-2 pathway, and NF-kB pathway in mice peritoneum of endometriosis model

    Directory of Open Access Journals (Sweden)

    Sutrisno Sutrisno

    2017-12-01

    Full Text Available This research aimed to investigate the effect of genistein on TGF-β, dysregulation of apoptosis, NF-κB pathway, COX-2 pathway in mice of endometriosis model. Twenty-eight female mice (Mus musculus were divided into seven groups (n = 4, involving control (normal non-treated group; endometriosis group; the endometriosis group treated with various genistein dosages (0.78; 1.04; 1.3 mg/day for 15 days, and endometriosis group treated with standard drug, namely leuprolide acetate (0.00975 mg each day for 15 days or dienogest (0.0052 mg/day for 15 days. Mice of endometriosis model were made by implanting myometrial and endometrial tissues under the condition of immunodeficiency. The TGF-β, Bcl-2, Bax, NF-κB, COX-2, and PGE-2 were analyzed immunohistochemically. The increase of Bcl-2 expression in endometriosis was decreased significantly by genistein dosage of 0.78 and 1.3 mg/day (p < 0.05. The decrease of Bax expression in endometriosis was increased significantly by genistein dosage of 1.04 and 1.3 mg/day (p < 0.05. The implantation increased the expression of NF-κB, COX-2, and PGE significantly compared with the control group (p < 0.05. This increase was reduced significantly by the administration of genistein at dosage of 0.78 and 1.3 mg/day (p < 0.05. It can be concluded that genistein potentially inhibits endometriosis development through the normalization of apoptosis dysregulation, the inhibition of NF-κB and COX-2 pathways in the peritoneal tissues. Therefore, genistein can be used as a holistic treatment strategy for endometriosis.

  4. Incisional subcutaneous endometrioma of the abdominal wall: report of two cases

    International Nuclear Information System (INIS)

    Merran, S.; Karila-Cohen, P.

    2004-01-01

    Endometriosis occurs in up to 15% of menstruating women. Abdominal wall involvement is rare and always secondary to an invasive procedure. The authors report the imaging and clinical findings of two patients with subcutaneous endometrioma following cesarean section. (author)

  5. MRI of cul-de-sac endometriosis

    International Nuclear Information System (INIS)

    Balestrini, Maria A.; Martin, Eduardo; Gomez Sanetta, Santiago; De Lucas, Federico; Bruno, Claudio; Sanchez Marull, Ricardo; Villamayor, Irene

    2000-01-01

    The endometriosis is a gynecological disorder characterized by the presence of ectopic functioning endometrial tissue. According to different studies, the incidence of endometriosis in fertile women oscillates between 10% and 15%. There are many theories (Sampson or menstrual blood transport, coelomic methaplasia, lymphatic dissemination, blood, etc.) that take part in the ethiopatogenic explanation of the disease. The findings obtained by excretory urography, computed tomography (CT), magnetic resonance imaging (MRI), cytology and histology in a 31 years old patient with cul-de-sac endometriosis is presented. MRI was the imaging method of choice for diagnosis and follow-up after treatment of this condition. (author)

  6. A case of multisystem endometriosis.

    Science.gov (United States)

    Athwal, Pardeep; Patel, Krishna; Hassani, Cameron; Bahadori, Shapour; Nardi, Peter

    2013-10-01

    Catamenial pneumothorax is a rare complication secondary to pleural endometriosis. We present a case of a 37-year-old-female with a history of recurrent pneumothoraces with an associated temporal relationship to the onset of her menses. In addition to her recurrent pneumothoraces, on further evaluation, she was found to have multiple nodular masses within the omentum. A thoracoscopic biopsy was subsequently performed, which showed endometrial implants within the pleural space and within the omental cavity. The radiological features and pathogenesis of this rare disease are reviewed and discussed with reference to relevant literature.

  7. Risk of bowel obstruction during in vitro fertilization treatment of patients with deep infiltrating endometriosis.

    Science.gov (United States)

    Seyer-Hansen, Mikkel; Egekvist, Anne; Forman, Axel; Riiskjaer, Mads

    2018-01-01

    Women with endometriosis often experience pain and infertility. Medical treatment interferes with the possibility of attaining pregnancy. For infertile women with endometriosis, surgery is a possible treatment, but with advanced disease there is an increased risk of serious complications. With only limited pain, women will often be referred for in vitro fertilization treatment instead. The disease is estrogen-dependent and during in vitro fertilization treatment the women could theoretically experience worsening of their symptoms. The study is a retrospective cohort study of 76 women with bowel endometriosis who were treated conservatively and underwent in vitro fertilization treatment. Nine (11.8%) of the women experienced severe worsening of their bowel-related symptoms, including two patients presenting with colon ileus. One additional woman had no previous diagnosis of endometriosis before she presented with subocclusion of the bowel during in vitro fertilization. In all cases the in vitro fertilization treatment was stopped. Our study revealed that bowel endometriosis increases the risk of complications during in vitro fertilization treatment. This is in contrast to several publications. However, our study population is different due to the fact that none of these women had previous operations for bowel endometriosis. In all, 88% of the women completed fertility treatment without need for surgery. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  8. 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.

  9. Functional Outcomes After Rectal Resection for Deep Infiltrating Pelvic Endometriosis: Long-term Results.

    Science.gov (United States)

    Erdem, Suna; Imboden, Sara; Papadia, Andrea; Lanz, Susanne; Mueller, Michael D; Gloor, Beat; Worni, Mathias

    2018-06-01

    Curative management of deep infiltrating endometriosis requires complete removal of all endometriotic implants. Surgical approach to rectal involvement has become a topic of debate given potential postoperative bowel dysfunction and complications. This study aims to assess long-term postoperative evacuation and incontinence outcomes after laparoscopic segmental rectal resection for deep infiltrating endometriosis involving the rectal wall. This is a retrospective study of prospectively collected data. This single-center study was conducted at the University Hospital of Bern, Switzerland. Patients with deep infiltrating endometriosis involving the rectum undergoing rectal resection from June 2002 to May 2011 with at least 24 months follow-up were included. Aside from endometriosis-related symptoms, detailed symptoms on evacuation (points: 0 (best) to 21 (worst)) and incontinence (0-24) were evaluated by using a standardized questionnaire before and at least 24 months after surgery. Of 66 women who underwent rectal resection, 51 were available for analyses with a median follow-up period of 86 months (range: 26-168). Forty-eight patients (94%) underwent laparoscopic resection (4% converted, 2% primary open), with end-to-end anastomosis in 41 patients (82%). Two patients (4%) had an anastomotic insufficiency; 1 case was complicated by rectovaginal fistula. Dysmenorrhea, nonmenstrual pain, and dyspareunia substantially improved (p endometriosis including the rectal wall is associated with good results in endometriotic-related symptoms, although patients should be informed about possible postoperative impairments in evacuation and incontinence. However, its clinical impact does not outweigh the benefit that can be achieved through this approach. See Video Abstract at http://links.lww.com/DCR/A547.

  10. Incidence of bowel wall oedema on computed tomography exams and association with diarrhoea in renal cell carcinoma patients treated with sunitinib

    Energy Technology Data Exchange (ETDEWEB)

    Cornelissen, Liesbeth; Claus, Filip; Keyzer, Frederik de [KU Leuven, Radiology, Department of Imaging and Pathology, University Hospitals Leuven, Leuven (Belgium); Wolter, Pascal; Dumez, Herlinde; Beuselinck, Benoit [KU Leuven, Department of Medical Oncology and Laboratory of Experimental Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (Belgium); Lerut, Evelyne [KU Leuven, Pathology, Department of Imaging and Pathology, University Hospitals Leuven, Leuven (Belgium); Poppel, Hendrik van [KU Leuven, Department of Urology, University Hospitals Leuven, Leuven (Belgium)

    2014-08-28

    The purpose of this study was to retrospectively assess the incidence of bowel wall oedema on computed tomography (CT) in patients with renal cell carcinoma (RCC) treated with sunitinib, and to investigate its association with diarrhoea. We conducted a retrospective analysis of all RCC patients treated with sunitinib at our hospital between December 2005 and December 2011. The presence or absence of bowel wall oedema on these CT examinations was scored. The presence of diarrhoea preceding, during, or after sunitinib treatment was identified from the patient files and retrospectively graded. For 54 of 87 patients, bowel wall oedema was present on at least one CT examination. Of these 54 patients, the right-sided colonic segment was affected in 87 %. Diarrhoea was the most common reported adverse event during treatment, with 58 patients (67 %) having grade 1/2 diarrhoea and 9 patients (10 %) having grade 3. There was a statistically significant correlation between the incidence of CT-scored bowel oedema and diarrhoea during sunitinib treatment (P = 0.004). This study shows a very high incidence of bowel wall oedema and a strong correlation between the incidence of bowel wall oedema and diarrhoea in patients treated with sunitinib. (orig.)

  11. System of multifunctional Jones matrix tomography of phase anisotropy in diagnostics of endometriosis

    Science.gov (United States)

    Ushenko, V. O.; Koval, G. D.; Ushenko, Yu. O.; Pidkamin, L. Y.; Sidor, M. I.; Vanchuliak, O.; Motrich, A. V.; Gorsky, M. P.; Meglinskiy, I.

    2017-09-01

    The paper presents the results of Jones-matrix mapping of uterine wall histological sections with second-degree and third-degree endometriosis. The technique of experimental measurement of coordinate distributions of the modulus and phase values of Jones matrix elements is suggested. Within the statistical and cross-correlation approaches the modulus and phase maps of Jones matrix images of optically thin biological layers of polycrystalline films of plasma and cerebrospinal fluid are analyzed. A set of objective parameters (statistical and generalized correlation moments), which are the most sensitive to changes in the phase of anisotropy, associated with the features of polycrystalline structure of uterine wall histological sections with second-degree and third-degree endometriosis are determined.

  12. Comprehensive study of angiogenic factors in women with endometriosis compared to women without endometriosis.

    Science.gov (United States)

    Yerlikaya, Gülen; Balendran, Sukirthini; Pröstling, Katharina; Reischer, Theresa; Birner, Peter; Wenzl, Rene; Kuessel, Lorenz; Streubel, Berthold; Husslein, Heinrich

    2016-09-01

    Endometriosis is a benign gynaecological disease, affecting women during their reproductive years. Angiogenesis represents a crucial step in the pathogenesis of endometriosis, because endometriotic lesions require neovascularization. In this study several angiogenesis-related genes have been studied in the context of endometriosis. Some of the analyzed angiogenic factors as well as their interactions were studied the first time regarding a possible association with endometriosis. This case-control study consisted of 205 biopsies of 114 patients comprising 61 endometriosis patients and 53 control patients. Among them in 29 cases paired samples were obtained. VEGFA, VEGFR2, HIF1A, HGF, NRP1, PDGFB, FGF18, TNFα, TGFB2, EPHB4, EPO and ANG mRNA expression was analyzed by qRT-PCR in ectopic tissue samples, in eutopic endometrium of women with and without endometriosis, and in unaffected peritoneum of women with and without endometriosis. VEGFR2, HIF1A, HGF, PDGFB, NRP1 and EPHB4 are overexpressed in ectopic lesions compared to eutopic tissues. VEGFR2, HGF, PDGFB, NRP1, and EPHB4 showed highest mRNA levels in peritoneal implants, in contrast HIF1A showed the highest expression in ovarian endometriomas. Correlation analyses of angiogenic factors in ectopic lesions revealed the strongest associations between VEGFR2, PDGFB, and EPHB4. We further showed a significant upregulation of VEGFR2, HIF1A and EPHB4 in eutopic endometrium of women with endometriosis compared to that of controls and a trend towards upregulation of HGF. Additionally, a significant downregulation for HIF1A, HGF and EPHB4 was observed in unaffected peritoneal tissues of women with endometriosis compared to controls. We identified new genes (EPHB4 and NRP1) that may contribute to angiogenesis in endometriosis beside known factors (VEGFA, VEGFR2, HIF1A, HGF, and PDGFB). Correlation studies revealed the putative importance of EBHB4 in association with endometriosis. Our analyses support preliminary reports

  13. Does telomerase activity have an effect on infertility in patients with endometriosis?

    Science.gov (United States)

    Sofiyeva, Nigar; Ekizoglu, Seda; Gezer, Altay; Yilmaz, Handan; Kolomuc Gayretli, Tugba; Buyru, Nur; Oral, Engin

    2017-06-01

    This study aimed to investigate the role of telomerase activity in the development of endometriosis-related infertility by evaluation of the serum telomerase in eutopic and ectopic endometrial tissue. Eutopic endometrium, cystic wall/ovarian cortex, and venous blood were assessed in forty-seven patients. The following groups of patients were identified: females with endometriosis requiring surgical intervention and healthy control females. Patients with histopathologically confirmed endometriosis were further subdivided in the infertile (n=14) and fertile (n=17) groups. Patients who underwent hysterectomy and oophorectomy for benign gynecological conditions were enrolled in the healthy control group (n=16). Telomerase activity was evaluated with three-group, endometriosis-based and fertility-based designs. Analyses were performed regardless the menstrual cycle phase (Phase G), in proliferative (Phase P) (n=22) and secretory phases (Phase S) (n=25). Telomeric Repeat Amplification Protocol PCR was applied for telomerase activity assessment. All statistical analyses were performed with STATA 14.2, GraphPad Prisma 7.01. In analyses of the eutopic endometrium, with three-group design, a significant difference was not found in Phase G and P (p=0.58 and p=0.33, respectively). However, a statistical difference was shown in Phase S (p=0.008). A significant difference was not established in Phase G, P and S of endometriosis-based design (p=0.35, p=1.0, p=0.13, respectively). No difference was detected in Phase G and P of fertility-based design (p=0.66 and p=0.14, respectively), whereas in secretory phase difference was approved (p=0,049). Telomerase activity was not established in ectopic endometrium and in serum assessment. Telomerase activity is useless as a biomarker in peripheric blood analysis. The absence of activity in cystic wall approves the high differentiation of endometriosis tissue, what is the possible reason of low malignancy risk. The high rate of telomerase

  14. Catamenial pneumothorax caused by thoracic endometriosis

    Directory of Open Access Journals (Sweden)

    Paolo Maniglio, MD

    2018-02-01

    Conclusion: The diagnosis of thoracic endometriosis is challenging. The first line of treatment is medical, whereas the surgical treatment is performed secondly. Moreover, surgical treatment can lead to a significant rate of recurrence, often reduced by a coadjutant medical treatment.

  15. What Are the Treatments for Endometriosis?

    Science.gov (United States)

    ... did not relieve pain any better than laparoscopy alone. For this reason, it is generally not recommended for treatment of endometriosis-associated pain. 2 , 6 , 8 The American College of Obstetricians and Gynecologists (ACOG) reports several clinical ...

  16. Thoracic endometriosis syndrome: CT and MRI features

    International Nuclear Information System (INIS)

    Rousset, P.; Rousset-Jablonski, C.; Alifano, M.; Mansuet-Lupo, A.; Buy, J.-N.; Revel, M.-P.

    2014-01-01

    Thoracic endometriosis is considered to be rare, but is the most frequent form of extra-abdominopelvic endometriosis. Thoracic endometriosis syndrome affects women of reproductive age. Diagnosis is mainly based on clinical findings, which can include catamenial pneumothorax and haemothorax, non-catamenial endometriosis-related pneumothorax, catamenial haemoptysis, lung nodules, and isolated catamenial chest pain. Symptoms are typically cyclical and recurrent, with a right-sided predominance. Computed tomography (CT) is the first-line imaging method, but is poorly specific; therefore, its main role is to rule out other pulmonary diseases. However, in women with a typical clinical history, some key CT findings may help to confirm this often under-diagnosed syndrome. MRI can also assist with the diagnosis, by showing signal changes typical of haemorrhage within diaphragmatic or pleural lesions

  17. Peripheral changes in endometriosis-associated pain

    Science.gov (United States)

    Morotti, Matteo; Vincent, Katy; Brawn, Jennifer; Zondervan, Krina T.; Becker, Christian M.

    2014-01-01

    BACKGROUND Pain remains the cardinal symptom of endometriosis. However, to date, the underlying mechanisms are still only poorly understood. Increasing evidence points towards a close interaction between peripheral nerves, the peritoneal environment and the central nervous system in pain generation and processing. Recently, studies demonstrating nerve fibres and neurotrophic and angiogenic factors in endometriotic lesions and their vicinity have led to increased interest in peripheral changes in endometriosis-associated pain. This review focuses on the origin and function of these nerves and factors as well as possible peripheral mechanisms that may contribute to the generation and modulation of pain in women with endometriosis. METHODS We conducted a systematic search using several databases (PubMed, MEDLINE, EMBASE and CINAHL) of publications from January 1977 to October 2013 to evaluate the possible roles of the peripheral nervous system in endometriosis pathophysiology and how it can contribute to endometriosis-associated pain. RESULTS Endometriotic lesions and peritoneal fluid from women with endometriosis had pronounced neuroangiogenic properties with increased expression of new nerve fibres, a shift in the distribution of sensory and autonomic fibres in some locations, and up-regulation of several neurotrophins. In women suffering from deep infiltrating endometriosis and bowel endometriosis, in which the anatomical distribution of lesions is generally more closely related to pelvic pain symptoms, endometriotic lesions and surrounding tissues present higher nerve fibre densities compared to peritoneal lesions and endometriomas. More data are needed to fully confirm a direct correlation between fibre density in these locations and the amount of perceived pain. A better correlation between the presence of nerve fibres and pain symptoms seems to exist for eutopic endometrium. However, this appears not to be exclusive to endometriosis. No correlation between

  18. The development of insecticide-treated durable wall lining for malaria control: insights from rural and urban populations in Angola and Nigeria

    Directory of Open Access Journals (Sweden)

    Messenger Louisa A

    2012-09-01

    Full Text Available Abstract Background Durable lining (DL is a deltamethrin-impregnated polyethylene material, which is designed to cover domestic walls that would normally be sprayed with residual insecticide. The operational success of DL as a long-lasting insecticidal substrate will be dependent on a high level of user acceptability as households must maintain correctly installed linings on their walls for several years. Preliminary trials were undertaken to identify a material to develop into a marketable wall lining and to assess its level of acceptability among rural and urban populations. Methods In Angola (n=60, prototype DL and insecticide-treated plastic sheeting (ITPS were installed on urban house walls and ceilings, respectively, and acceptability was compared to indoor residual spraying (IRS (n=20 using a knowledge, attitude and practice (KAP questionnaire. In Nigeria (n=178, three materials (prototype DL, ITPS and insecticide-treated wall netting were distributed among rural and urban households. User opinions were gathered from focus group discussions, in-depth interviews and KAP questionnaires. Results In Angola, after two weeks, the majority of participants (98% expressed satisfaction with the products and identified the killing of insects as the materials’ principal benefits (73%. After one year, despite a loss of almost 50% of households to refugee repatriation, all 32 remaining households still asserted that they had liked the DL/ITPS in their homes and given the choice of intervention preferred DL/ITPS to IRS (94% or insecticide-treated nets (78%. In Nigeria, a dichotomy between rural and urban respondents emerged. Rural participants favoured wall adornments and accepted wall linings because of their perceived decorative value and entomological efficacy. By contrast, urban households preferred minimal wall decoration and rejected the materials based upon objections to their aesthetics and installation feasibility. Conclusions The high level

  19. The development of insecticide-treated durable wall lining for malaria control: insights from rural and urban populations in Angola and Nigeria

    Science.gov (United States)

    2012-01-01

    Background Durable lining (DL) is a deltamethrin-impregnated polyethylene material, which is designed to cover domestic walls that would normally be sprayed with residual insecticide. The operational success of DL as a long-lasting insecticidal substrate will be dependent on a high level of user acceptability as households must maintain correctly installed linings on their walls for several years. Preliminary trials were undertaken to identify a material to develop into a marketable wall lining and to assess its level of acceptability among rural and urban populations. Methods In Angola (n=60), prototype DL and insecticide-treated plastic sheeting (ITPS) were installed on urban house walls and ceilings, respectively, and acceptability was compared to indoor residual spraying (IRS) (n=20) using a knowledge, attitude and practice (KAP) questionnaire. In Nigeria (n=178), three materials (prototype DL, ITPS and insecticide-treated wall netting) were distributed among rural and urban households. User opinions were gathered from focus group discussions, in-depth interviews and KAP questionnaires. Results In Angola, after two weeks, the majority of participants (98%) expressed satisfaction with the products and identified the killing of insects as the materials’ principal benefits (73%). After one year, despite a loss of almost 50% of households to refugee repatriation, all 32 remaining households still asserted that they had liked the DL/ITPS in their homes and given the choice of intervention preferred DL/ITPS to IRS (94%) or insecticide-treated nets (78%). In Nigeria, a dichotomy between rural and urban respondents emerged. Rural participants favoured wall adornments and accepted wall linings because of their perceived decorative value and entomological efficacy. By contrast, urban households preferred minimal wall decoration and rejected the materials based upon objections to their aesthetics and installation feasibility. Conclusions The high level of acceptability

  20. Exploring the impact of endometriosis on partners.

    Science.gov (United States)

    Ameratunga, Devini; Flemming, Tina; Angstetra, Donald; Ng, Shu-Kay; Sneddon, Anne

    2017-06-01

    This study aimed to determine how endometriosis affects the quality of life of partners of women who suffer from this disease and how it impacts their relationships, finances, mental states, and daily living. This was a questionnaire-based cohort study that took place at a large tertiary hospital gynecology unit, which covered two sites. Fifty-one partners of women who had surgically diagnosed endometriosis agreed to participate in the study and returned completed surveys. Ninety-two percent (n = 46) of partners reported negative feelings about the diagnosis of endometriosis. Seventy percent (n = 35) reported that endometriosis affected their day-to-day life either moderately or severely. Over half (52%) also felt that their finances were affected. Only 34% (n = 17) of partners felt that health professionals had engaged them in decision-making processes and had been supportive of them. Eighty percent (n = 40) of partners reported that they had received no information about the impact of endometriosis on couples. Partners reported a significant affect on their sex life (74%) and their relationship as a whole (56%). Participants whose relationships had been affected by endometriosis had also more likely had their day-to-day life (P = 0.027), sex life (P = 0.001), and finances (P = 0.002) affected. Overall, our findings suggest that endometriosis can have a significant impact on partners with respect to day-to-day living, finances, sex lives, and relationships. Improvements can be made to engage partners in the treatment process, and to provide better education, support, and holistic management to women and families who suffer with endometriosis. © 2017 Japan Society of Obstetrics and Gynecology.

  1. Defining Future Directions for Endometriosis Research

    Science.gov (United States)

    D’Hooghe, Thomas M.; Fazleabas, Asgerally; Giudice, Linda C.; Montgomery, Grant W.; Petraglia, Felice; Taylor, Robert N.

    2013-01-01

    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. PMID:23427182

  2. Endometriosis during adolescent’s period

    Directory of Open Access Journals (Sweden)

    Ibrahim Esinler

    2006-12-01

    Full Text Available Although endometriosis is usually diagnosed in reproductive aged women, adolescents after menarche may also effected by endometriosis. Since the diagnosis of all asymptomatic cases is impossible, the exact incidence of adolescent’s endometriosis is not known. Chronic pelvic pain, dysmenorrhea, dyspareunia, pelvic mass and rarely infertility may be associated with adolescent’s endometriosis. The exact diagnosis was performed by directly seeing endometriosis lesions. The most preferred method for this is laparoscopy (L/S. The L/S should be performed to the patients in whom chronic pelvic pain and dysmenorrhea are persistent despite medical treatment. The main goal of treatment is to decrease the severity of symptoms and to preserve the fertility. Non-steroidal antiinflammatory drugs, oral contraceptives, progestins, cyproterone acetate, danazol and gonadotrophin releasing hormone agonists are used for medical treatment. If the symptoms are resistant to the medical treatment, surgical treatment with L/S should be considered. The endometriosis lesions should be coagulated with electrocautery or laser.

  3. 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.

  4. Radiation-induced endometriosis in Macaca mulatta

    International Nuclear Information System (INIS)

    Fanton, J.W.; Golden, J.G.

    1991-01-01

    Female rhesus monkeys received whole-body doses of ionizing radiation in the form of single-energy protons, mixed-energy protons, X rays, and electrons. Endometriosis developed in 53% of the monkeys during a 17-year period after exposure. Incidence rates for endometriosis related to radiation type were: single-energy protons, 54%; mixed-energy protons, 73%; X rays, 71%; and electrons, 57%. The incidence of endometriosis in nonirradiated control monkeys was 26%. Monkeys exposed to single-energy protons, mixed-energy protons, and X rays developed endometriosis at a significantly higher rate than control monkeys (chi 2, P less than 0.05). Severity of endometriosis was staged as massive, moderate, and minimal. The incidence of these stages were 65, 16, and 19%, respectively. Observations of clinical disease included weight loss in 43% of the monkeys, anorexia in 35%, space-occupying masses detected by abdominal palpation in 55%, abnormal ovarian/uterine anatomy on rectal examination in 89%, and radiographic evidence of abdominal masses in 38%. Pathological lesions were endometrial cyst formation in 69% of the monkeys, adhesions of the colon in 66%, urinary bladder in 50%, ovaries in 86%, and ureters in 44%, focal nodules of endometrial tissue throughout the omentum in 59%, and metastasis in 9%. Clinical management of endometriosis consisted of debulking surgery and bilateral salpingo-oophorectomy combined in some cases with total abdominal hysterectomy. Postoperative survival rates at 1 and 5 years for monkeys recovering from surgery were 48 and 36%, respectively

  5. High rate of allergies among women with endometriosis.

    Science.gov (United States)

    Matalliotakis, I; Cakmak, H; Matalliotakis, M; Kappou, D; Arici, A

    2012-04-01

    Women with endometriosis frequently suffer from autoimmune inflammatory diseases, allergies and asthma. This study was conducted to examine whether the prevalence of allergies is higher in patients with endometriosis than in the control group, and to show potential correlation with endometriosis stages. We evaluated the medical files of 501 women with laparoscopically-diagnosed endometriosis and 188 women without endometriosis enrolled in Yale University Hospital. Main outcome measures used were allergy on medications, complaints of sinus or perennial allergic rhinitis, asthma, family history of allergic disease, and correlation with stages of endometriosis. Our results indicated that the overall risk of women with endometriosis and positive history of allergies was 4.28 (95% CI, 2.9-6.3) (p allergies. Overall, our study indicated a link between endometriosis and increased risk of allergic autoimmune disorders that should further be explored.

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

    DEFF Research Database (Denmark)

    Nyhøj Heidemann, Lene; 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....

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

    Directory of Open Access Journals (Sweden)

    Hong-Mei Xu

    2015-01-01

    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.

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

    African Journals Online (AJOL)

    AJRH Managing Editor

    African Journal of Reproductive Health June 2015; 19 (2): 13. COMMENTARY ... to improve awareness of endometriosis on a designated ... global movements for endometriosis provides ... subcontinent as a medical tourist destination must be ...

  9. Decreased Progesterone Receptor B/A Ratio in Endometrial Cells by Tumor Necrosis Factor-Alpha and Peritoneal Fluid from Patients with Endometriosis.

    Science.gov (United States)

    Chae, Uisoo; Min, Jin Young; Kim, Sung Hoon; Ihm, Hyo Jin; Oh, Young Sang; Park, So Yun; Chae, Hee Dong; Kim, Chung Hoon; Kang, Byung Moon

    2016-11-01

    Progesterone resistance is thought to be a major factor that contributes to progression of endometriosis. However, it is not clear what causes progesterone resistance in endometriosis. This study aimed to assess whether cytokines or peritoneal fluid can affect progesterone receptor (PR) expression in endometrial cells and to verify whether PR expression is reduced in endometriosis. The PR-B/A ratio was measured via real-time polymerase chain reaction after in vitro culture, in which endometrial cells were treated with either tumor necrosis factor-alpha (TNF-α), interleukin-1 beta, or peritoneal fluid obtained from women with advanced-stage endometriosis. Immunohistochemistry was performed to compare PR-B expression between eutopic and ectopic endometrial tissues from women with and without advanced-stage endometriosis. The PR-B/A ratio was significantly decreased by treatment with either TNF-α (p=0.011) or peritoneal fluid from women with advanced-stage endometriosis (p=0.027). Immunoreactivity of PR-B expression was significantly lower during the secretory phase than during the proliferative phase in endometrial tissues from control subjects (pendometriosis compared with eutopic endometrium tissues from control subjects. Progesterone resistance in endometriosis may be caused by proinflammatory conditions in the pelvic peritoneal microenvironment.

  10. Intestinal obstruction caused by endometriosis: Endoscopic stenting and expedited laparoscopic resection avoiding stoma. A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Pietro Calcagno

    Full Text Available Introduction: Endometriosis is the growth of endometrium outside the uterine cavity. In 5–15% of cases the disease can affect the colon and small bowel, causing complete obstruction and requiring resection in about 1% of cases. Case summary: We describe a case of sigmoid obstruction due to endometriosis in a 38 years old woman with personal history of endometriosis. She was admitted for abdominal pain and constipation. The patient was treated with endoscopic stenting and subsequent laparoscopic sigmoidectomy. Discussion: Bowel obstruction caused by endometriosis is a rare event. Its diagnosis can thus be a clinical and radiological challenge but it may be suspected in all young woman with colonic obstruction. At present, the management of endometriosis is an integrate approach of both medical and surgical therapy. In case of irreversible colonic obstruction surgery is mandatory. The treatment of choice is usually an emergency procedure (either Hartmann procedure or resection and anastomosis with stoma placement. This approach entails all the risks related to emergency procedures and can have important psychological and biological drawbacks. Conclusion: Endoscopic prosthesis placement as bridge to surgery is a feasible therapeutic strategy in colonic obstruction due to endometriosis. It brings about all the advantages of an expedited one step laparoscopic surgical procedure. Laparoscopic elective resection has a lower rate of stoma placement and has a postoperative pregnancy rate grater than open surgery. Keywords: Endometriosis, Bowel obstruction, Laparoscopy, Endoscopic stent, Stoma

  11. Incidence of Septate Uterus in Reproductive-Aged Women With and Without Endometriosis.

    Science.gov (United States)

    LaMonica, Rachel; Pinto, Judith; Luciano, Danielle; Lyapis, Anya; Luciano, Anthony

    2016-01-01

    To compare the incidence of a uterine septum in women with and without endometriosis and if such incidence correlates with the stage of endometriosis Although a correlation between obstructive Mullerian anomalies and endometriosis has been well established, its link with non-obstructive anomalies remains controversial. To elucidate whether there is a correlation between endometriosis and non-obstructive Mullerian anomalies, we conducted this prospective study on all patients admitted to our Reproductive Endocrinology and Infertility surgical service from February 1, 2010 through June 30, 2012. All patients underwent both hysteroscopy and laparoscopy. Surgical indications included: infertility, pain, and/or menorrhagia. The presence or absence of endometriosis and uterine anomalies were recorded immediately after each surgery and subsequently analyzed. Endometriosis was staged according to the r-ASRM Classification and treated by resection and ablation of deep and superficial lesions, respectively. Since uterine septum is the most common Mullerian anomaly, we considered only this anomaly to test the hypothesis that uterine septum may be associated with an increased incidence of endometriosis. Prospective Study. Evidence from a well-designed case-control study (Canadian Task Force classification II-2). University-affiliated tertiary care center. Reproductive aged women admitted to our service for treatment of pelvic pain, abnormal uterine bleeding, and/or infertility. All patients underwent both hysteroscopy and laparoscopy as part of their evaluation and treatment of pelvic pain, abnormal uterine bleeding, and/or infertility. 343 patients were included in the study. The diagnosis of each patient included infertility - 52, pain - 215, both - 30 and other - 46. The diagnosis of septate uterus was made at hysteroscopy when the endometrial cavity was separated by an avascular septum that obscured visualization of both cornua when the hysteroscope was advanced to the mid

  12. Endometriosis and fertility: women's accounts of healthcare.

    Science.gov (United States)

    Young, K; Fisher, J; Kirkman, M

    2016-03-01

    What do women with endometriosis recall being told about their fertility by their healthcare providers? Women recalled being given varied information and advice, and gave examples of empathic and individualized care from doctors but also reported opportunities for enhancing clinical practice. There is evidence of an association between endometriosis and infertility. However, the strength of this association and the mechanisms that underlie it are not yet known nor are the implications for optimum healthcare. This study used in-depth cross-sectional qualitative research methods. Women aged at least 18 years who lived in Victoria, Australia, and who had been surgically diagnosed with endometriosis were invited to participate in in-depth interviews about their experience of endometriosis. Twenty-six women of diverse backgrounds and experiences of endometriosis were interviewed from January to September 2014. Interviews were transcribed and analysed thematically using a data-driven approach. All women encountered medical professionals who were aware of the association between endometriosis and infertility, and who were proactive in ensuring fertility was addressed within endometriosis care. Women recalled being given varied, often conflicting, information about the consequences for their fertility of an endometriosis diagnosis. While some recounted positive experiences with the way their doctor communicated with them about endometriosis and fertility, all women reported adverse experiences such as receiving insufficient or inappropriate information or having their doctor prioritize their fertility over other aspects of their care, including quality of life and symptom relief, without first consulting them. The perspectives of the women's doctors were not sought. The findings may not translate to settings that differ from a predominantly Anglo-Saxon country with both universal public and private healthcare systems. Women's fertility needs and priorities differ for many

  13. Should hysterectomy be performed for the treatment of endometriosis?

    African Journals Online (AJOL)

    When there is a medical or surgical indication for a hysterectomy apart from endometriosis the following discussion is not really relevant. The question deals with the role of hysterectomy purely for the management of endometriosis. Women, who have pelvic pain due to endometriosis that is unresponsive to conventional ...

  14. Primary umbilical endometriosis: To scope or not to scope ...

    African Journals Online (AJOL)

    Background. Primary umbilical endometriosis (PUE) is a rare condition affecting 0.5 - 1% of all cases of extragenital endometriosis. The method of using routine laparoscopic inspection of the pelvis to exclude pelvic endometriosis has been applied extensively over the years. It has been demonstrated that even patients who ...

  15. Imaging modalities for the non-invasive diagnosis of endometriosis

    NARCIS (Netherlands)

    Nisenblat, Vicki; Bossuyt, Patrick M. M.; Farquhar, Cindy; Johnson, Neil; Hull, M. Louise

    2016-01-01

    About 10% of women of reproductive age suffer from endometriosis. Endometriosis is a costly chronic disease that causes pelvic pain and subfertility. Laparoscopy, the gold standard diagnostic test for endometriosis, is expensive and carries surgical risks. Currently, no non-invasive tests that can

  16. Changes in the volume and histology of endometriosis foci in rats treated with copaiba oil (Copaiferalangsdorffii Mudanças no volume e histologia do foco de endometriose em ratas tratadas com óleo de Copaíba (Copaiferalangsdorffii

    Directory of Open Access Journals (Sweden)

    João Nogueira Neto

    2011-01-01

    Full Text Available PURPOSE: The aim of this study was to analyze the changes that occur in rats with experimental endometriosis after treatment with copaiba oil. METHODS: Experimental endometriosis was induced in rats. The experimental group received copaiba oil (Copaiferalangsdorffii orally (0.63 mg/day, and the control group received a 0.9% sodium chloride solution orally (1 ml/100 g of body weight/day. Both groups were treated with gavage for 14 days. After this period, the animals were euthanized, and the implant volume was calculated. The autologous transplants were removed, dyed with hematoxylin-eosin, and analyzed by light microscopy. RESULTS: The average final volumes were significantly different between the groups (p=0.007. There was a significant increase (p=0.012 between the initial and final volumes in the control group, whereas treatment with Copaiferalangsdorffii caused a marked reduction in endometrial growth over time (p=0.016. Histologically, 6/11 (55.00% rats in the experimental group had a well-preserved epithelial layer, and 3 (45.00% had mildly preserved epithelium. The control group had seven cases (58.30% of well-preserved epithelial cells and five cases (41.70% of mildly preserved epithelial cells (p>0.05. CONCLUSION: Copaiba oil (Copaiferalangsdorffii appears to be a promising alternative treatment for endometriosis.OBJETIVO: O objetivo deste estudo foi analisar as mudanças que ocorreram em ratas com endometrioses experimental tratadas com óleo de copaíba. MÉTODOS: Foi induzida a endometriose experimental nas ratas. O grupo experimental recebeu óleo de copaíba (Copaiferalangsdorffii oralmente (0,63mg/dia e o grupo controle recebeu oralmente solução salina 0,9% (1mL/100g/dia. Ambos grupos foram tratados por gavagem por 14 dias. Depois desse período, foi realizada a eutanásia dos animais e calculado o volume do implante. Os transplantes autólogos foram removidos, corados com Hematoxilina-eosina e realizada a microscopia

  17. [Definition, description, clinicopathological features, pathogenesis and natural history of endometriosis: CNGOF-HAS Endometriosis Guidelines].

    Science.gov (United States)

    Borghese, B; Santulli, P; Marcellin, L; Chapron, C

    2018-03-01

    Endometriosis and adenomyosis are histologically defined. The frequency of endometriosis cannot be precisely estimated in the general population. Endometriosis is considered a disease when it causes pain and/or infertility. Endometriosis is a heterogeneous disease with three well-recognized subtypes that are often associated with each other: superficial endometriosis (SUP), ovarian endometrioma (OMA), and deep infiltrating endometriosis (DIE). DIE is frequently multifocal and mainly affects the following structures: the uterosacral ligaments, the posterior vaginal cul-de-sac, the bladder, the ureters, and the digestive tract (rectum, recto-sigmoid junction, appendix). The role of menstrual reflux in the pathophysiology of endometriosis is major and explains the asymmetric distribution of lesions, which predominate in the posterior compartment of the pelvis and on the left (NP3). All factors favoring menstrual reflux increase the risk of endometriosis (early menarche, short cycles, AUB, etc.). Inflammation and biosteroid hormones synthesis are the main mechanisms favoring the implantation and the growth of the lesions. Pain associated with endometriosis can be explained by nociception, hyperalgia, and central sensitization, associated to varying degrees in a single patient. Typology of pain (dysmenorrhea, deep dyspareunia, digestive or urinary symptoms) is correlated with the location of the lesions. Infertility associated with endometriosis can be explained by several non-exclusive mechanisms: a pelvic factor (inflammation), disrupting natural fertilization; an ovarian factor, related to oocyte quality and/or quantity; a uterine factor disrupting implantation. The pelvic factor can be fixed by surgical excision of the lesions that improves the chance of natural conception (NP2). The uterine factor can be corrected by an ovulation-blocking treatment that improves the chances of getting pregnant by in vitro fertilization (NP2). The impact of endometrioma exeresis on

  18. APPENDICULAR INVAGINATION DUE TO ENDOMETRIOSIS

    Directory of Open Access Journals (Sweden)

    Vasja Kruh

    2003-12-01

    Full Text Available Background. Invagination of the vermiform appendix is a very rare occurrence. We summarize epidemiologic and etiologic factors, types of classification, symtomatology, diagnostic features and treatment.Patients and treatment. The authors present 49-years old female with long-standing abdominal pains, who came in our hospital due to acute exacerbation with sever abdominal pain. Because of progressive symptoms and sensitivity in the right-lower abdominal quadrant a diagnostic laparoscopy was performed. An anomaly of cecum and the absence of appendix vermiformis have forced us to proceed with laparotomy in McBurnay point. After cecotomy an invaginated gangrenous appendix was found. The histological examination revealed endometriosis.Conclusions. By presenting this extremely rare pathology we also want to emphasize the important role of diagnostic laparoscopy in front of acute abdomen.

  19. Differentially expressed genes: OCT-4, SOX2, STAT3, CDH1 and CDH2, in cultured mesenchymal stem cells challenged with serum of women with endometriosis

    Directory of Open Access Journals (Sweden)

    Ehab Salama

    2018-06-01

    Full Text Available Endometriosis is a common chronic gynecological disorder defined as the presence of ectopic functional endometrial tissues, outside uterine cavity, primarily on the pelvic peritoneum and the ovaries. Several studies revealed a correlation between aberrant stem-cell activity in the endometrium and endometriosis. Yet the molecular and cellular behaviors of mesnchymal stem cells in development of endometriosis are hampered by lack of invitro experiments. Our aim was to explore morphological and molecular changes associated with mesenchymal stem cells (MSCs exposition to serum derived from women with severe endometriosis. Two cell cultures of MSCs isolated from endometrial tissues of two endometriosis-free women. Each cell culture was treated individually with the serum of women with endometriosis (experimental group/n = 7, and serum of women without endometriosis (control group/ n = 4 for 14 days. Quantitative Real-Time PCR was performed later to reveal expression of OCT-4, CDH1 and CDH2, STAT3 and SOX2 genes. Morphologically, cells showed no significant changes. However from molecular point of view, we found increased expression in OCT-4, CDH1 and CDH2. For STAT3 and SOX2 we did not find a significant difference. This study shows that endometriosis serum induced molecular changes in human endometrial MSCs (EnMSCs that might be related to altered cell behavior which may be a step in differentiation that may be completed invivo by other factors to complete the process of transition. Further researches are needed for optimization to reach differentiation. Keywords: Endometriosis, Mesnchymal stem cells, OCT-4, SOX2, STAT3, E-cadherin, N-cadherin

  20. Differential gene expression by 1,25(OH)2D3 in an endometriosis stromal cell line.

    Science.gov (United States)

    Ingles, Sue Ann; Wu, Liang; Liu, Benjamin T; Chen, Yibu; Wang, Chun-Yeh; Templeman, Claire; Brueggmann, Doerthe

    2017-10-01

    Endometriosis is a common female reproductive disease characterized by invasion of endometrial cells into other organs, frequently causing pelvic pain and infertility. Alterations of the vitamin D system have been linked to endometriosis incidence and severity. To shed light on the potential mechanism for these associations, we examined the effects of 1,25(OH) 2 D 3 on gene expression in endometriosis cells. Stromal cell lines derived from endometriosis tissue were treated with 1,25(OH) 2 D 3 , and RNA-seq was used to identify genes differentially expressed between treated and untreated cells. Gene ontology and pathway analyses were carried out using Partek Flow and Ingenuity software suites, respectively. We identified 1627 genes that were differentially expressed (886 down-regulated and 741 up-regulated) by 1,25(OH) 2 D 3 . Only one gene, CYP24A1, was strongly up-regulated (369-fold). Many genes were strongly down-regulated. 1,25(OH) 2 D 3 treatment down-regulated several genetic pathways related to neuroangiogenesis, cellular motility, and invasion, including pathways for axonal guidance, Rho GDP signaling, and matrix metalloprotease inhibition. These findings support a role for vitamin D in the pathophysiology of endometriosis, and provide new targets for investigation into possible causes and treatments. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. A new concept of endometriosis and adenomyosis: tissue injury and repair (TIAR).

    Science.gov (United States)

    Leyendecker, Gerhard; Wildt, Ludwig

    2011-03-01

    Pelvic endometriosis, deeply infiltrating endometriosis and uterine adenomyosis share a common pathophysiology and may be integrated into the physiological mechanism and new nosological concept of 'tissue injury and repair' (TIAR) and may, in this context, just represent the extreme of a basically physiological, estrogen-related mechanism that is pathologically exaggerated in an extremely estrogen-sensitive reproductive organ. The acronym TIAR describes a fundamental and apparently ubiquitous biological system that becomes operative in mesenchymal tissues following tissue injury and, upon activation, results in the local production of estradiol. Endometriosis and adenomyosis are caused by trauma. In the spontaneously developing disease, chronic uterine peristaltic activity or phases of hyperperistalsis induce, at the endometrial-myometrial interface near the fundo-cornual raphe, microtraumatisations, with activation of the TIAR mechanism. With ongoing traumatisations, such sites of inflammation might accumulate and the increasingly produced estrogens interfere in a paracrine fashion with ovarian control over uterine peristaltic activity, resulting in permanent hyperperistalsis and a self-perpetuation of the disease process. Overt autotraumatisation of the uterus with dislocation of fragments of basal endometrium into the peritoneal cavity and infiltration of basal endometrium into the depth of the myometrial wall ensues. In most cases of endometriosis/adenomyosis a causal event early in the reproductive period of life must be postulated, rapidly leading to archimetral hyperestrogenism and uterine hyperperistalsis. In late premenopausal adenomyosis such an event might not have occurred. However, as indicated by the high prevalence of the disease, it appears to be unavoidable that, with time, chronic normoperistalsis throughout the reproductive period of life accumulates to the same extent of microtraumatisation. With activation of the TIAR mechanism followed by

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

    Science.gov (United States)

    Vitonis, Allison F.; Vincent, Katy; Rahmioglu, Nilufer; Fassbender, Amelie; Buck Louis, Germaine M.; Hummelshoj, Lone; Giudice, Linda C.; Stratton, Pamela; Adamson, G. David; Becker, Christian M.; Zondervan, Krina T.; Missmer, Stacey A.

    2014-01-01

    Objective To harmonize the collection of nonsurgical clinical and epidemiologic data relevant to endometriosis research, allowing large-scale collaboration. Design An international collaboration involving 34 clinical/academic centers and three industry collaborators from 16 countries on five continents. Setting In 2013, two workshops followed by global consultation, bringing together 54 leaders in endometriosis research. Patients None. Intervention(s) Development of a self-administered endometriosis patient questionnaire (EPQ), based on [1] systematic comparison of questionnaires from eight centers that collect data from endometriosis cases (and controls/comparison women) on a medium to large scale (publication on >100 cases); [2] literature evidence; and [3] several global consultation rounds. Main Outcome Measure(s) Standard recommended and minimum required questionnaires to capture detailed clinical and covariate data. Result(s) The standard recommended (EPHect EPQ-S) and minimum required (EPHect EPQ-M) questionnaires contain questions on pelvic pain, subfertility and menstrual/reproductive history, hormone/medication use, medical history, and personal information. Conclusion(s) The EPQ captures the basic set of patient characteristics and exposures considered by the WERF EPHect Working Group to be most critical for the advancement of endometriosis research, but is also relevant to other female conditions with similar risk factors and/or symptomatology. The instruments will be reviewed based on feedback from investigators, and–after a first review after 1 year–triannually through systematic follow-up surveys. Updated versions will be made available through http://endometriosisfoundation.org/ephect. PMID:25256930

  3. Incisional endometriosis: A rare cause for a painful scar – A report ...

    African Journals Online (AJOL)

    Endometriosis is the presence of endometrial tissue outside the Uterus. The true incidence of endometriosis is not really known, but it is believed that 10‑15% of all women in their reproductive age will develop endometriosis and 25‑35% of all women who are infertile have endometriosis. Incisional endometriosis (IE) is a ...

  4. Phosphorylated and nucleotide sugar metabolism in relation to cell wall production in Avena coleoptiles treated with fluoride and peroxyacetyl nitrate

    International Nuclear Information System (INIS)

    Gordon, W.C.; Ordin, L.

    1972-01-01

    Coleoptile sections of Avena sativa L. were pretreated with sodium fluoride or peroxyacetyl nitrate at levels which inhibit auxin-induced growth but did not affect glucose-uptake or CO production when postincubated for 30 minutes in a 14 C-glucose medium without auxin. Labeling of metabolites involved in cell wall synthesis was measured. Peroxyacetyl nitrate decreased labeling, and it was concluded that the pool size of uridine diphosphoglucose, sucrose, and cell wall polysaccharides decreased compared to control. The changes suggest that peroxyacetyl nitrate inactivated sucrose and cell wall synthesizing enzymes including cellulose synthetase and decreased cell growth by inhibiting production of cell wall constituents. Fluoride treatment had no effect on production of cell wall polysaccharides, with or without indoleacetic acid stimulation of growth. The only change after fluoride treatment was a decrease in uridine diphosphoglucose during incubation without indoleacetic acid, a decrease that disappeared when indoleacetic acid was present. It was concluded that some other aspect of cell wall metabolism, not determined here, was involved in fluoride-induced inhibition of growth. 16 references, 3 figures, 2 tables

  5. 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.

  6. Effects of an Antagonistic Analog of Growth Hormone-Releasing Hormone on Endometriosis in a Mouse Model and In Vitro.

    Science.gov (United States)

    Köster, Frank; Jin, Li; Shen, Yuanming; Schally, Andrew V; Cai, Ren-Zhi; Block, Norman L; Hornung, Daniela; Marschner, Gabriele; Rody, Achim; Engel, Jörg B; Finas, Dominique

    2017-11-01

    Endometriosis is a benign gynecologic disorder causing dysmenorrhea, pelvic pain, and subfertility. Receptors for the growth hormone-releasing hormone (GHRH) were found in endometriotic tissues. Antagonists of GHRH have been used to inhibit the growth of endometriotic endometrial stromal cells. In this study, the GHRH receptor splice variant (SV) 1 was detected in human endometrial tissue samples by Western blots and quantitative reverse transcription polymerase chain reaction (qRT-PCR). The highest messenger RNA (mRNA) and protein levels of SV1 were found in eutopic endometrium from patients with endometriosis compared to ectopic endometriotic tissues and endometrium from normal patients. The highest expression for GHRH mRNA was found by qRT-PCR in ectopic endometriosis lesions. In an in vivo mouse model with human endometrial explants from patients with endometriosis, 10 μg MIA-602 per day resulted in significantly smaller human endometrial xenotransplants after 4 weeks compared to mice treated with vehicle. The endometrial tissues expressed SV1 before and after xenotransplantation. The proliferation of endometrial stromal cells as well as the endometriosis cell lines 12-Z and 49-Z was decreased by exposure to 1 μM MIA-602 after 72 hours. The protein levels of epithelial growth factor receptors in 12-Z and 49-Z cell lines were reduced 48 and 72 hours after the administration of 1 μM MIA-602. MIA-602 decreased the activation of the MAP-kinases ERK-1/2. Our study demonstrates the presence of SV1 receptor as a target for treatment with GHRH antagonist in endometriosis. Endometrial tissues respond to MIA-602 with inhibition of proliferation in vitro and in vivo. The use of MIA-602 could be an effective supplement to the treatment strategies in endometriosis.

  7. Pain and endometriosis: Etiology, impact, and therapeutics

    Directory of Open Access Journals (Sweden)

    Robert N. Taylor

    2012-12-01

    Full Text Available The association of pain and endometriosis was recognized with the first definitive published reports of this disorder. Unfortunately, the precise etiologies and pathways leading to nociception and pain symptoms in endometriosis remain poorly understood, and as a result, effective therapeutic interventions are lacking with consequent profound effects on affected women’s quality of life. In this opinion paper we summarize selected proceedings presented at the 28th Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE in Istanbul, Turkey, and review the clinical and translational evidence of chronic pain, neurogenesis, and the pernicious impact of dyspareunia on women with symptomatic endometriosis. The effectiveness of medical treatments is critically assessed and the findings indicate that good therapeutic options are available with extant medications effective in some sub-groups of women with endometriosis, many of which are affordable globally. Nevertheless, new management strategies and drugs need to be developed to increase the options of all afflicted women to minimize and ideally eradicate painful symptoms of endometriosis. However, only by elucidating distinctions among sub-groups with specific symptoms, suggesting different mechanisms, are we likely to derive truly successful therapeutic strategies.

  8. Spontanous Vulvar Endometriosis: Report of A Case

    Directory of Open Access Journals (Sweden)

    Coşkun Ümit

    2016-04-01

    Full Text Available Endometriosis is an ectopic occurrence of tissue morphologically and functionally resembling endometrial tissue outside the uterine cavity. Vulva is one of the rarest location of extrapelvic endometriozis. We report a case of a 44-year-old multiparous woman, referred to our clinic with the complaints of having a vulvar mass and cyclic swelling of the mass during menstruation. She had a history of 2 previous cesarean delivery and no history of previous vulvar or vaginal surgery. The mass was 3-4cm in diameter and localized on the upper-portion of the right labium minus. Complete surgical excision was performed with the suspicion of endometriosis. Final histopathology report confirmed the diagnosis of endometriosis. Three weeks after surgery there was no evidence of endometriosis. In conclusion whether or not having a history of a previous vulvar surgery, vulvar endometriosis should be considered as a part of differential diagnosis in evaluation of vulvar masses.

  9. Pathophysiology and Immune Dysfunction in Endometriosis

    Science.gov (United States)

    Ahn, Soo Hyun; Monsanto, Stephany P.; Miller, Caragh; Singh, Sukhbir S.; Thomas, Richard; Tayade, Chandrakant

    2015-01-01

    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. PMID:26247027

  10. 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.

  11. High Expression of High-Mobility Group Box 1 in Menstrual Blood: Implications for Endometriosis.

    Science.gov (United States)

    Shimizu, Keiko; Kamada, Yasuhiko; Sakamoto, Ai; Matsuda, Miwa; Nakatsuka, Mikiya; Hiramatsu, Yuji

    2017-11-01

    Endometriosis is a benign gynecologic disease characterized by the presence of ectopic endometrium and associated with inflammation and immune abnormalities. However, the molecular basis for endometriosis is not well understood. To address this issue, the present study examined the expression of high-mobility group box (HMGB) 1 in menstrual blood to investigate its role in the ectopic growth of human endometriotic stromal cells (ESCs). A total of 139 patients were enrolled in this study; 84 had endometriosis and 55 were nonendometriotic gynecological patients (control). The HMGB1 levels in various fluids were measured by enzyme-linked immunosorbent assay. Expression of receptor for advanced glycation end products (RAGE) in eutopic and ectopic endometrium was assessed by immunohistochemistry, and RAGE and vascular endothelial growth factor ( VEGF) messenger RNA expression in HMGB1- and lipopolysaccharide (LPS)-treated ESCs was evaluated by real-time polymerase chain reaction. The HMGB1 concentration was higher in menstrual blood than in serum or peritoneal fluid ( P endometriosis following retrograde menstruation when complexed with other factors such as LPS by inducing inflammation and angiogenesis.

  12. External validation of the endometriosis fertility index (EFI) staging system for predicting non-ART pregnancy after endometriosis surgery.

    Science.gov (United States)

    Tomassetti, C; Geysenbergh, B; Meuleman, C; Timmerman, D; Fieuws, S; D'Hooghe, T

    2013-05-01

    . Subjects were censored when they were lost to follow-up, had subsequent surgery for endometriosis, started ovarian suppression or underwent ART. As K-M estimates might overestimate the actual event rate, cumulative incidence estimates treating ART as competing event were also calculated. Cox regression analysis was used to assess the performance of EFI and constituting variables. Performance of the score (prediction, discrimination) was quantified with the following methods: mean squared error of prediction (Brier score), areas under the receiver-operating curve and global concordance index C(τ). There was a highly significant relationship between the EFI and the time to non-ART pregnancy (cumulative overall pregnancy rate, P = 0.0004), with the K-M estimate of cumulative overall pregnancy rate at 12 months after surgery equal to 45.5% [95% confidence interval (CI) 39.47-49.87]-ranging from 16.67% (95% CI 5.01-47.65) for EFI scores 0-3, to 62.55% (95% CI 55.18-69.94) for EFI scores 9-10. For each increase of 1 point in the EFI score, the relative risk of becoming pregnant increased by 31% (95% CI 16-47%; i.e. hazard ratio 1.31). The 'least function score'-which assesses the tubal/ovarian function at conclusion of surgery-was found to be the most important contributor to the total EFI score among all the other variables (age, duration of infertility, prior pregnancy, AFS endometriosis lesion and total score). The EFI score had a moderate performance in the prediction of the pregnancy rate. Indeed, the decrease in prediction error was rather small, as shown by the decrease in Brier score from 0.213 to 0.198, and low estimates for R² (13%) and C(τ) (0.629). As the EFI was validated externally in our own European population after initial testing by Adamson and Pasta (Endometriosis fertility index: the new, validated endometriosis staging system. Fertil Steril 2010;94:1609-1615) in an American population, it appears that the EFI can be used clinically to counsel infertile

  13. Elevated expression of CD147 in patients with endometriosis and its role in regulating apoptosis and migration of human endometrial cells.

    Science.gov (United States)

    Jin, Aihong; Chen, Hao; Wang, Chaoqun; Tsang, Lai Ling; Jiang, Xiaohua; Cai, Zhiming; Chan, Hsiao Chang; Zhou, Xiaping

    2014-06-01

    To examine the expression of CD147 in 60 human endometriosis lesions and how CD147 regulates migration and apoptosis in human uterine epithelial (HESs) cells. Experimental clinical study and laboratory-based investigation. Hospital and academic research center. Sixty women with chocolate cysts and 16 control women without endometriosis. Human uterine epithelial cells were treated with anti-CD147 antibody. Real-time polymerase chain reaction for detecting CD147 expression in 60 human endometriosis lesions; migration assay and CellTiter 96 AQueous One Solution Cell Proliferation Assay (MTS) assay for cell functional investigation; Western blot for detecting protein levels; gelatin zymography for evaluating the activity of matrix metalloproteinase-2 (MMP-2) in cultured cells. Expression of CD147 was significantly higher in ectopic endometrial tissues from patients with endometriosis than in normal endometrial tissues. Interference with CD147 function led to decreased migration and cell viability in HESs cells. Surprisingly, MMP-2 expression and activity were not changed after treating HESs cells with anti-CD147 antibody. Further examination revealed that immunodepletion of CD147 induced apoptosis in HESs cells, leading to the activation of caspase 3 and poly(ADP-ribose) polymerase. The results of the present study suggest that abnormally high expression of CD147 in ovarian endometriosis lesions with enhanced cell survival (reduced apoptosis) and migration, in an MMP-2-independent manner, may underlie the progression of endometriosis in humans. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  14. [Peritoneal fluid iron levels in women with endometriosis].

    Science.gov (United States)

    Polak, Grzegorz; Wertel, Iwona; Tarkowski, Rafał; Kotarski, Jan

    2010-01-01

    Endometriosis is characterized by a cyclic hemorrhage within the peritoneal cavity. Accumulating data suggests that iron homeostasis in the peritoneal cavity may be disrupted by endometriosis. The aim of our study was to evaluate iron levels in peritoneal fluid (PF) of women with and without endometriosis. Seventy-five women were studied: 50 women with endometriosis and, as a reference group, 25 patients with functional follicle ovarian cysts. Iron concentrations in the PF were measured using a commercially available colorimetric assay kit. Iron concentrations were significantly higher in PF from women with endometriosis as compared to the reference group. Patients with stages III/IV endometriosis had significantly higher PF iron concentrations than women with stages I/II of the disease. Disrupted iron homeostasis in the peritoneal cavity of women with endometriosis plays a role in the pathogenesis of the disease.

  15. Endometriosis

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  16. Endometriosis

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  20. Endometriosis

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    ... ibuprofen (Advil), naproxen (Aleve), and acetaminophen (Tylenol). Prescription painkillers, if needed, for more severe pain. Regular exams ... or injections -- This treatment helps shrink growths. Side effects may include weight gain and depression. Gonadotropin-agonist ...

  1. Endometriosis

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    ... bleed over the course of each menstrual cycle. Transformation of peritoneal cells. In what's known as the " ... experts propose that hormones or immune factors promote transformation of peritoneal cells — cells that line the inner ...

  3. Endometriosis

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  10. X-ray diagnosis of colorectal endometriosis

    Energy Technology Data Exchange (ETDEWEB)

    Runte, F.; Majewski, A.; Reichert, B.

    1987-05-01

    Preoperative diagnosis of symptomatic colorectal endometriosis is often difficult. Hence, the X-ray findings of eight woman patients with confirmed affection of the colon with endometriosis foci were evaluated together with the clinical, surgical and histological findings. In 50 % of the cases rectal haemorrhages were the most frequently occurring sign. In three-quarters of the cases the colon sigmoideum was involved. Radiologically it was possible to prove in 37,5 % each of the cases that there was a polypoid lesion and an irregular concentric stenosis of the intestinal lumen. In 25 % of the cases we found a complete stenosis of the intestinal lumen combined with ileus. X-ray sign pattern of colorectal endometriosis, however, is not pathognomonic.

  11. X-ray diagnosis of colorectal endometriosis

    International Nuclear Information System (INIS)

    Runte, F.; Majewski, A.; Reichert, B.

    1987-01-01

    Preoperative diagnosis of symptomatic colorectal endometriosis is often difficult. Hence, the X-ray findings of eight woman patients with confirmed affection of the colon with endometriosis foci were evaluated together with the clinical, surgical and histological findings. In 50 % of the cases rectal haemorrhages were the most frequently occurring sign. In three-quarters of the cases the colon sigmoideum was involved. Radiologically it was possible to prove in 37,5 % each of the cases that there was a polypoid lesion and an irregular concentric stenosis of the intestinal lumen. In 25 % of the cases we found a complete stenosis of the intestinal lumen combined with ileus. X-ray sign pattern of colorectal endometriosis, however, is not pathognomonic. (orig.) [de

  12. 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

  13. The cannabinoid receptor CB1 contributes to the development of ectopic lesions in a mouse model of endometriosis.

    Science.gov (United States)

    Sanchez, Ana-Maria; Quattrone, Federica; Pannese, Maria; Ulisse, Adele; Candiani, Massimo; Diaz-Alonso, Javier; Velasco, Guillermo; Panina-Bordignon, Paola

    2017-01-01

    Does signaling via the cannabinoid (CB 1 ) receptor play a role in the pathogenesis of endometriosis in a mouse model? Mice treated with a CB 1 agonist developed larger ectopic lesions, while less severe lesions developed in the absence of functional CB 1 expression. The expression of components of the endocannabinoid system has been demonstrated in both mouse and human uteri. CB 1 receptors are expressed in human epithelial and stromal cell lines derived from eutopic endometrium and deep infiltrating endometriosis nodules. This was a randomized study in a mouse model of endometriosis. In a first set of experiments, mice with endometriosis were treated with the CB 1 receptor agonist methanandamide (MET) (5 mg/kg, n = 20) on Days 1-5 and 8-12. In a second set of experiments, endometriosis development was evaluated in CB 1 -/- mice and in their wild-type (WT) littermates. Endometriosis-like lesions were induced in Balb/c and C57/Bl6 mice. Two weeks after disease induction, the lesions were counted, measured and either included for immunohistochemistry analysis or frozen for gene expression profiling by semi-quantitative real-time PCR. To limit the role of chance, the experiments were conducted under standardized laboratory conditions with appropriate controls. The lesion total volume was significantly higher in MET-treated compared with vehicle-treated mice (P endometriosis in a mouse model. However, the relative contribution of the CB 1 -mediated signaling pathways active in inflammatory, uterine and peritoneal cells remains to be ascertained. Since the study was performed in a mouse model, the significance of the findings in the human system warrants further investigation. Clarifying the function and regulation of CB 1 and its molecular interactions with endogenous ligands, and how endocannabinoids levels are regulated in women with endometriosis, represent critical areas of research for the potential development of a novel medical treatment of the disease. A

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

    Directory of Open Access Journals (Sweden)

    Hui Li

    2017-01-01

    Conclusions: Endometriosis may affect obstetric outcomes. Women with endometriosis have a higher risk of postpartum hemorrhage. Women with endometriosis who conceived by ART may have a higher risk of postpartum hemorrhage and preterm birth than those conceived naturally.

  15. Magnetic resonance imaging of pelvic endometriosis

    International Nuclear Information System (INIS)

    Vieira, G.P.; Martin, B.; Tubiana, J.M.

    1994-01-01

    Twenty-five magnetic resonance imaging (MRI) studies were performed in 18 patients with proven endometriosis. MRI findings were analyzed and compared with laparoscopic or surgical findings; MRI accurately demonstrated ovarian endometrial cysts as well as ectopic foci of endometriosis. Adhesions may be also suggested. Contrary to laparoscopy, MRI easily depicts both deep lesions and endometrial implants under the peritoneum. Consequently, MRI appears as an useful adjunct to laparoscopy for initial diagnosis before starting a medical treatment and above all as the imaging modality of choice for evaluation of the answer to treatment, avoiding iterative and often adhesions limited laparoscopies. (author). 7 refs.; 9 figs

  16. Influence of adenomyosis on pregnancy and perinatal outcomes in women with endometriosis.

    Science.gov (United States)

    Scala, Carolina; Leone Roberti Maggiore, Umberto; Racca, Annalisa; Barra, Fabio; Vellone, Valerio Gaetano; Venturini, Pier Luigi; Ferrero, Simone

    2017-12-20

    Several studies investigated the correlation between endometriosis and adverse pregnancy and perinatal outcomes. However, the role of adenomyosis as a risk factor for adverse perinatal outcomes in women with endometriosis has yet to be established. The aim of this study was to explore if fetal and maternal outcomes, in particular the incidence of small for gestational age (SGA) infants, are different in pregnant women with endometriosis (E) and the concomitant presence of diffuse (EDA) and focal ademonyosis (EFA). This is a retrospective analysis of a database collected prospectively during a three-year period. We included 206 pregnant women with endometriosis; 148 (71.8%) with E, 38 (18.4%) with EFA and 20 (9.7%) with EDA. Adenomyosis was diagnosed by ultrasonography, it was classified in focal or diffuse. The study included patients who conceived spontaneously or by assisted reproductive techniques. The three groups were similar in demographic characteristics (age, body mass index, mode of conception). Patients with diffuse adenomyosis compared with those with only endometriosis had significantly lower PAPP-A MoM (0.61 vs 0.88 MoM, p<0.001), higher mean uterine artery pulsatility index (UtA PI) in the 1st (2.23 vs 1.67, p<0.001) and 2nd (1.30 vs 0.94, p<0.001) trimester of pregnancy, and higher incidence of SGA (40% vs 10.8%, p<0.001; respectively). No statistically significant difference was found in patients with focal adenomyosis compared to those with only endometriosis. Logistic regression analysis demonstrated that diffuse adenomyosis (OR=3.744 CI 95%1.158-12.099; p=0.027) was the only independent risk factors for SGA. The presence of diffuse adenomyosis in pregnant women with endometriosis is is strongly associated with SGA infants. Women with diffuse adenomyosis should be treated as being at high risk of placental dysfunction, therefore, these pregnancies might need a closer monitoring. This article is protected by copyright. All rights reserved.

  17. Bowel Endometriosis Syndrome: a new scoring system for pelvic organ dysfunction and quality of life.

    Science.gov (United States)

    Riiskjær, M; Egekvist, A G; Hartwell, D; Forman, A; Seyer-Hansen, M; Kesmodel, U S

    2017-09-01

    Is it possible to develop a validated score that can identify women with Bowel Endometriosis Syndrome (BENS) and be used to monitor the effect of medical and surgical treatment? The BENS score can be used to identify women with BENS and to monitor the effect of medical and surgical treatment of women suffering from bowel endometriosis. Endometriosis is a heterogeneous disease with extensive variation in anatomical and clinical presentation, and symptoms do not always correspond to the disease burden. Current endometriosis scoring systems are mainly based on anatomical and surgical findings. The score was developed and validated from a cohort of 525 women with medically or surgically treated bowel endometriosis from Aarhus and Copenhagen University Hospitals, Denmark. Patients filled in questionnaires on pelvic pain, quality of life (QoL) and urinary, sexual and bowel function. Items were selected for the final score using clinical and statistical criteria. The chosen variables were included in a multivariate analysis. Individual score values were designated items to form the BENS score, which was divided into 'no BENS', 'minor BENS' and 'major BENS.' Internal and external validations were performed. The six most important items were 'pelvic pain', 'use of analgesics', 'dyschezia', 'straining to urinate', 'fecal urgency' and 'satisfaction with sexual life'. The range of the BENS score (0-28) was divided into 0-8 (no BENS), 9-16 (minor BENS) and 17-28 (major BENS). External validation showed a significant association between BENS score and QoL (P = 0.0001). The BENS scoring system is limited by the fact that it was developed from a single endometriosis unit in Denmark, making it susceptible to social, cultural and demographic bias. It is the first endometriosis classification system to be based directly on the symptomatology of the patient. Validation in other languages will promote comparison of treatments and results across borders. No external funding was either

  18. Continuous versus cyclic oral contraceptives for the treatment of endometriosis: a systematic review.

    Science.gov (United States)

    Zorbas, Konstantinos A; Economopoulos, Konstantinos P; Vlahos, Nikos F

    2015-07-01

    Recurrence of endometriosis after conservative surgery has been observed in 40-50 % of patients within the first 5 years. A variety of regimens such as combined oral contraceptives, GnRH agonists, danazol, and progestins have been used postoperatively to reduce recurrence rates. Oral contraceptives (oCP) have been used either in a cyclic or in a continuous (no pill-free interval) fashion. The purpose of this article was to summarize the existing evidence on the efficacy and patient compliance for the use of oCP in a continuous versus cyclic fashion following conservative surgery for endometriosis. A systematic search of Medline identified four eligible studies. Studies were considered eligible, if they have evaluated oCP therapy, either in a cyclic or continuous regimen, after conservative surgery for endometriosis. Specifically, studies (1) reporting on women with endometriosis who were treated postoperatively with both continuous oCP and cyclic oCP, (2) written in English, (3) with minimum 6 months duration of medical treatment, and (4) with minimum 12 months duration of follow-up were considered eligible for our systematic review. Outcome measures of these eligible studies were tabulated and then analyzed cumulatively. A purely descriptive approach was adopted concerning all variables. Postoperative use of continuous oCP was associated with a reduction in the recurrence rate of dysmenorrhea, delay in the presentation of dysmenorrhea, reduction in nonspecific pelvic pain, and reduction in the recurrence rate for endometrioma. Use of oCP in a continuous fashion following conservative surgery for endometriosis is more beneficial to cyclic use.

  19. 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.

  20. 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.

  1. Inguinal endometriosis attaching to the round ligament

    International Nuclear Information System (INIS)

    Hagiwara, Y.; Hatori, M.; Kokubun, S.; Moriya, T.; Terada, Y.; Yaegashi, N.; Ehara, S.

    2007-01-01

    We report a case of endometriosis in the right inguinal region, attached to the right round ligament in a 28-year-old woman. At the age of 20, laparoscopic left ovarian cystectomy and pelvic adhesiolysis for endometriosis was carried out. She noticed a right tender groin mass 7 months previously, and the tumour size fluctuated with the menstrual cycle. A poorly circumscribed elastic hard mass, measuring 3 cm in diameter, was palpated in her right inguinal region. Magnetic resonance imaging showed a 2.5 cm x 2.5 cm mass in the right inguinal canal and a 5.4 cm x 6.8 cm mass was seen in the left ovary. The mass enlarged during menstruation. The groin mass was removed, in addition to carrying out laparoscopic ovarian cystectomy. At operation, the groin mass was found to be in continuity with the round ligament of extraperitoneal portion. Histological diagnosis of endometriosis was made in both ovarian and inguinal tumours. After surgery, the pain disappeared completely. Worth mentioning is that MRI clearly showed the change of tumour size depending on the menstrual cycle, which aided in arriving at the correct diagnosis of endometriosis in an unusual location

  2. Thoracic endometriosis syndrome: Current concept in ...

    African Journals Online (AJOL)

    Background: Thoracic endometriosis is a rare pathology. The diagnosis is often delayed or missed, however recently, there has been significant advances in the knowledge of this condition and hence, an improvement in the diagnosis and treatment. Objective: To review the current concepts in the pathophysiology and ...

  3. Low-Density Lipoproteins Oxidation and Endometriosis

    Directory of Open Access Journals (Sweden)

    Grzegorz Polak

    2013-01-01

    Full Text Available The etiopathogenesis of endometriosis still remains unknown. Recent data provide new valuable information concerning the role of oxidative stress in the pathophysiology of the disease. It has been proved that levels of different lipid peroxidation end products are increased in both peritoneal fluid (PF and serum of endometriotic patients. We assessed the concentration of oxidized low-density lipoproteins (oxLDL in PF of 110 women with different stages of endometriosis and 119 women with serous ( or dermoid ( ovarian cysts, as the reference groups. PF oxLDL levels were evaluated by ELISA. We found that concentrations of oxLDL in PF of endometriotic women were significantly higher compared to women with serous but not dermoid ovarian cysts. Interestingly, by analyzing concentrations of oxLDL in women with different stages of the disease, it was noted that they are significantly higher only in the subgroup of patients with stage IV endometriosis as compared to women with ovarian serous cysts. In case of minimal, mild, and moderate disease, PF oxLDL levels were similar to those noted in reference groups. Our results indicate that disrupted oxidative status in the peritoneal cavity of women with endometriosis may play a role in the pathogenesis of advanced stages of the disease.

  4. 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...

  5. Incisional subcutaneous endometrioma of the abdominal wall: report of two cases; Endometriose sous cutanee sur cicatrice de la paroi abdominale anterieure. A propos de deux observations

    Energy Technology Data Exchange (ETDEWEB)

    Merran, S.; Karila-Cohen, P. [Federation Mutualiste Parisienne, Dept. d' Imagerie Medicale, 75 - Paris (France)

    2004-04-01

    Endometriosis occurs in up to 15% of menstruating women. Abdominal wall involvement is rare and always secondary to an invasive procedure. The authors report the imaging and clinical findings of two patients with subcutaneous endometrioma following cesarean section. (author)

  6. [Dinitrosyl iron complexes with glutathione recover rats with experimental endometriosis].

    Science.gov (United States)

    Adamian, L V; Burgova, E N; Tkachev, N A; Mikoian, V D; Stepanian, A A; Sonova, M M; Vanin, A F

    2013-01-01

    The effect of binuclear dinitrosyl iron complexes (DNIC) with glutathione on endometrioid tumors in rats with experimental endometriosis has been studied. The latter was induced by an autotransplantation model, where two fragments of endometrium with myometrium (2 x 2 mm) from the left uterine horn was grafted to the inner surface of the anterior abdominal wall. The test animals received intraperitoneal injections of 0.5 ml DNIC-glutathione at the dose of 12.5 micromole per kg daily for 12 days 28 days after operation. The injections resulted in more than a 2-fold decrease in the total volume of both large tumors formed from grafts and small additive tumors formed nearby grafts. The disappearance of the additive tumors was also observed in test animals. The EPR signal with g(av) = 2.03 characteristic of protein bound DNIC with thiol-containing ligands was recorded in livers, graft and additive tumors of test and control animals pointing out intensive generation of nitric oxide in rats with experimental endometriosis. Ribonucleotide reductase activation discovered by doublet the EPR signal at g = 2.0 with 2.3 mT hyperfine structure splitting was found in small tumors. The cytotoxic effect of DNIC-glutathione on endometrioid tumors was suggested to be due to DNIC degradation nearby the tumors induced by iron chelating compounds released from the tumors. The degradation resulted in release of a high amount of nitric oxide molecules and nitrosonium ions from DNICs affecting the tumors by way of the cytotoxic effect.

  7. Modeling of drug and drug-encapsulated nanoparticle transport in patient-specific coronary artery walls to treat vulnerable plaques

    KAUST Repository

    Hossain, Shaolie S.; Hossainy, Syed F A; Bazilevs, Yuri; Calo, Victor M.; Hughes, Thomas Jr R

    2010-01-01

    The main objective of this work is to develop computational tools to support the design of a catheter-based local drug delivery system that uses nanoparticles as drug carriers in order to treat vulnerable plaques and diffuse atherosclerotic disease.

  8. 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.

  9. 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.

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

    International Nuclear Information System (INIS)

    Kim, Ji Hyun; Kim, Min Jeong; Ha, Hong Il; Lee, Kwan Seop; Min, Soo Kee

    2016-01-01

    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

  11. Does surgery for deep infiltrating bowel endometriosis improve fertility? A systematic review.

    Science.gov (United States)

    Iversen, Maja L; Seyer-Hansen, Mikkel; Forman, Axel

    2017-06-01

    Reduced fertility is a major concern in women with endometriosis. The influence of surgery of deep infiltrating endometriosis (DIE) affecting the bowel wall on fertility is controversial and the literature on this field is heterogeneous. In this review we addressed whether surgery for bowel DIE improves the spontaneous pregnancy rate, and the results of in vitro fertilization (IVF), and the potential risk of such surgery. We conducted a literature search including the terms "deep", "deep infiltrating", "bowel", rectovaginal", "endometriosis", "fertility", "infertility" and "IVF" in PubMed. No randomized controlled studies were found. Other publications of relevance included four retrospective and three prospective observational studies. Moreover, one retrospective study compared results of IVF treatment with or without previous surgery for bowel DIE. All studies reported detailed data on surgical complications. The poor data quality precluded firm conclusions. The results indicate, however, the possibility that surgery for bowel DIE may improve the spontaneous pregnancy rate, and positive effects on IVF outcome cannot be excluded. Such surgery will be associated with risk of major complications. The lack of proper data precludes conclusions on the potential role for bowel DIE surgery to improve the spontaneous pregnancy rate and results of IVF treatment. Positive effects cannot be excluded, but the definite risk of major complications must be taken into account. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  12. Primary Intramural Vesical Endometriosis Mimicking Urothelial Carcinoma in a Middle Aged Female

    Directory of Open Access Journals (Sweden)

    Shirazi N

    2015-10-01

    Full Text Available Endometriosis is the presence of ectopic endometrial tissue outside the uterus. Presence of endometrial glands and/or stroma may interfere with the normal physiological process by their infiltrative nature or by forming adhesions. Endometriosis occurs in 15-20% of women of child bearing age and commonly involves the ovaries, utero-sacral ligaments, fallopian tubes, rectum, scar sites and cervico-vaginal regions. Incidence of urinary tract involvement is estimated to be 1%. We report a case of a 38 year female presenting with low back pain, single episode of haematuria and burning during micturition. Urine culture was negative. There was no past history of pelvic surgery. On cystoscopy, a growth was visualised in the posterior urinary bladder wall suspicious of neoplastic origin. Tansurethral resection of bladder nodule was done and sent for histopathology, on which it was diagnosed as endometriosis. The case merits interest due to its atypical clinical presentation and the rarity of the lesion at this site.

  13. Effects of Chinese Materia Medica-Fubao Danggui Jiao on experimental endometriosis.

    Science.gov (United States)

    Sun, Xing; Chen, Lijue; Zeng, Fanbo

    2011-01-01

    The objective of this paper was to investigate the effects of a Chinese Materia Medica variant -Fubao Danggui Jiao (FDJ)-on experimental endometriosis. An endometriosis model was created by virtue of auto-transplantation of endometrial tissue onto rats' abdominal walls. The implants were allowed to grow for 30 days until the successful completion of the model. After that, forty endometriotic rats were randomly divided into four study groups and given different treatments: (1) negative control group (water, 2ml/kg, per os); (2) FDJ-A group (FDJ, 2ml/kg, per os); (3) FDJ-B group (FDJ, 4ml/kg, per os); (4) Danazol group (70mg/kg, per os). After 30 days with treatments, the volumes of endometriotic implants in each rat were measured. The implants and normal uterine horns were removed for routine histological examination. FDJ caused significant decreases in volumes of the surviving endometriotic implants, with two different doses having statistically equivalent effects. Upon histological examination, FDJ was observed to cause regression of epithelium and stroma of endometriotic implants. FDJ had revealed promising therapeutic effects on endometriosis.

  14. The Aspergillus fumigatus Sialidase (Kdnase Contributes to Cell Wall Integrity and Virulence in Amphotericin B-Treated Mice

    Directory of Open Access Journals (Sweden)

    Jason R. Nesbitt

    2018-01-01

    Full Text Available Aspergillus fumigatus is a filamentous fungus that can cause a life-threatening invasive pulmonary aspergillosis (IPA in immunocompromised individuals. We previously characterized an exo-sialidase from A. fumigatus that prefers the sialic acid substrate, 2-keto-3-deoxy-D-glycero-D-galacto-nononic acid (Kdn; hence it is a Kdnase. Sialidases are known virulence factors in other pathogens; therefore, the goal of our study was to evaluate the importance of Kdnase in A. fumigatus. A kdnase knockout strain (Δkdnase was unable to grow on medium containing Kdn and displayed reduced growth and abnormal morphology. Δkdnase was more sensitive than wild type to hyperosmotic conditions and the antifungal agent, amphotericin B. In contrast, Δkdnase had increased resistance to nikkomycin, Congo Red and Calcofluor White indicating activation of compensatory cell wall chitin deposition. Increased cell wall thickness and chitin content in Δkdnase were confirmed by electron and immunofluorescence microscopy. In a neutropenic mouse model of invasive aspergillosis, the Δkdnase strain had attenuated virulence and a significantly lower lung fungal burden but only in animals that received liposomal amphotericin B after spore exposure. Macrophage numbers were almost twofold higher in lung sections from mice that received the Δkdnase strain, possibly related to higher survival of macrophages that internalized the Δkdnase conidia. Thus, A. fumigatus Kdnase is important for fungal cell wall integrity and virulence, and because Kdnase is not present in the host, it may represent a potential target for the development of novel antifungal agents.

  15. Hyaluronic Acid-Modified Magnetic Iron Oxide Nanoparticles for MR Imaging of Surgically Induced Endometriosis Model in Rats

    Science.gov (United States)

    Sun, Wenjie; Hu, Yong; Zhang, Guofu; Shen, Mingwu; Shi, Xiangyang

    2014-01-01

    Endometriosis is defined as the presence of endometrial tissue outside the uterine, which may affect nearly 60% of women in reproductive age. Deep infiltrating endometriosis (DIE) defined as an endometriotic lesion penetrating into the retroperitoneal space or the wall of the pelvic organs to a depth of at least 5 mm represents the most diagnostic challenge. Herein, we reported the use of hyaluronic acid (HA)-modified magnetic iron oxide nanoparticles (HA-Fe3O4 NPs) for magnetic resonance (MR) imaging of endometriotic lesions in the rodent model. Sixteen endometriotic lesions were surgically induced in eight rats by autologous transplantation. Four weeks after lesion induction, three rats were scanned via MR imaging after tail vein injection of the HA-Fe3O4 NPs. Accordingly, the remaining five mice were sacrificed in the corresponding time points. The ectopic uterine tissues (EUTs) were confirmed by histological analysis. Quantification of Fe in the EUT was also performed by inductively coupled plasma-optical emission spectroscopy. Our results showed that by using the HA-Fe3O4 NPs, the EUTs were able to be visualized via T2-weighted MR imaging at 2 hours post injection, corroborating the Prussian blue staining results. The developed HA-Fe3O4 NPs could be used as negative contrast agents for sensitively detecting endometriosis in a mouse model and may be applied for future hyperthermia treatment of endometriosis. PMID:24722347

  16. Hyaluronic acid-modified magnetic iron oxide nanoparticles for MR imaging of surgically induced endometriosis model in rats.

    Directory of Open Access Journals (Sweden)

    He Zhang

    Full Text Available Endometriosis is defined as the presence of endometrial tissue outside the uterine, which may affect nearly 60% of women in reproductive age. Deep infiltrating endometriosis (DIE defined as an endometriotic lesion penetrating into the retroperitoneal space or the wall of the pelvic organs to a depth of at least 5 mm represents the most diagnostic challenge. Herein, we reported the use of hyaluronic acid (HA-modified magnetic iron oxide nanoparticles (HA-Fe3O4 NPs for magnetic resonance (MR imaging of endometriotic lesions in the rodent model. Sixteen endometriotic lesions were surgically induced in eight rats by autologous transplantation. Four weeks after lesion induction, three rats were scanned via MR imaging after tail vein injection of the HA-Fe3O4 NPs. Accordingly, the remaining five mice were sacrificed in the corresponding time points. The ectopic uterine tissues (EUTs were confirmed by histological analysis. Quantification of Fe in the EUT was also performed by inductively coupled plasma-optical emission spectroscopy. Our results showed that by using the HA-Fe3O4 NPs, the EUTs were able to be visualized via T2-weighted MR imaging at 2 hours post injection, corroborating the Prussian blue staining results. The developed HA-Fe3O4 NPs could be used as negative contrast agents for sensitively detecting endometriosis in a mouse model and may be applied for future hyperthermia treatment of endometriosis.

  17. Role of Interleukin-6 and Its Receptor in Endometriosis

    OpenAIRE

    Li, Shihui; Fu, Xiaoxia; Wu, Tingting; Yang, Liwei; Hu, Changchang; Wu, RuiJin

    2017-01-01

    Background Studies have shown that the concentration of interleukin (IL)-6 in peritoneal fluid is increased in patients with endometriosis; however, whether the disorders involving IL-6 contribute to the development of endometriosis is still unclear. In the present study, we evaluated the potential role of IL-6 and IL-6 receptor (IL-6R) in the pathogenesis of endometriosis. Material/Methods We examined activated macrophages and the expression of membrane-binding receptor (mIL-6R) in peritonea...

  18. The role of the peritoneum in the pathogenesis of endometriosis.

    Science.gov (United States)

    Young, Vicky J; Brown, Jeremy K; Saunders, Philippa T K; Horne, Andrew W

    2013-01-01

    BACKGROUND Endometriosis affects 6-10% of women of reproductive age and is associated with chronic pelvic pain, dysmenorrhoea, dyspareunia and infertility. Endometriosis is defined by the presence of endometrial tissue outside the uterus, most commonly attached to the pelvic peritoneum. The endometrium in women with endometriosis is reported to be altered and there is increasing evidence that the phenotype of the pelvic peritoneum may also play a role in the establishment and maintenance of the disease. The aim of this review is to discuss the putative role of the pelvic peritoneum in the pathophysiology of peritoneal endometriosis. METHODS A review was undertaken of the published literature on (i) the anatomy and physiology of the peritoneum and (ii) the potential roles played by peritoneal cells in the establishment and maintenance of peritoneal endometriosis. The current understanding of the biology of peritoneal endometriosis is summarized and the potential interaction of the peritoneum with ectopic endometrial cells in endometriosis is highlighted. RESULTS Several studies indicate that differential expression of peritoneal mesothelial adhesion factors occurs in women with endometriosis, providing potential ectopic endometrial cell attachment sites for the establishment of endometriosis lesions. Changes in the peritoneal mesothelial cell phenotype, including loss of tight junctions, may allow ectopic cells to bind to, or early lesions to invade into, the extracellular matrix. Epithelial-to-mesenchymal transition of peritoneal mesothelial cells may also lead to an increase in lesion invasion and formation of fibrotic tissue in and around the lesion. There is evidence that the peritoneal mesothelium may also play a role in the invasion potential of ectopic cells by production of MMPs increasing local tissue remodelling. Peritoneal immune scavenging function may be lowered in women with endometriosis; for example there is a notable increase in macrophage

  19. 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.)

  20. Cyclic sciatica caused by infiltrative endometriosis: MRI findings

    International Nuclear Information System (INIS)

    Yekeler, Ensar; Kumbasar, Basak; Tunaci, Atadan; Barman, Ahmet; Tunaci, Mehtap; Bengisu, Ergin; Yavuz, Ekrem

    2004-01-01

    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.)

  1. 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.

  2. Urinary phthalate monoesters and endometriosis in infertile Japanese women

    International Nuclear Information System (INIS)

    Itoh, Hiroaki; Iwasaki, Motoki; Hanaoka, Tomoyuki; Sasaki, Hiroshi; Tanaka, Tadao; Tsugane, Shoichiro

    2009-01-01

    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.

  3. 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.

  4. Clear Cell Adenocarcinoma Arising from Endometriosis in the Groin: Wide Resection and Reconstruction with a Fascia Lata Tensor Muscle Skin Flap

    Directory of Open Access Journals (Sweden)

    Shozo Yoshida

    2018-01-01

    Full Text Available We herein report a case of clear cell carcinoma arising from endometriosis in the groin in a 53-year-old woman. The findings of MRI and FDG/PET-CT indicated a malignant tumor, and surgical biopsy confirmed adenocarcinoma of the female genital tract. The tumor including a part of the abdominal rectus muscle and rectus sheath, subcutaneous fat, skin, and the right inguinal ligament was resected en bloc. The defect in the abdominal wall was reconstructed with a fascia lata tensor muscle skin flap. The tumor was composed of clear cell adenocarcinoma arising from extrapelvic endometriosis. The patient received chemotherapy with gemcitabine and carboplatin for 6 cycles and had no evidence of recurrence 7 months after the treatment. We herein described the diagnosis and surgical management of endometriosis-associated carcinoma in the groin.

  5. Efficacy, Safety and Cost of Insecticide Treated Wall Lining, Insecticide Treated Bed Nets and Indoor Wall Wash with Lime for Visceral Leishmaniasis Vector Control in the Indian Sub-continent: A Multi-country Cluster Randomized Controlled Trial

    Science.gov (United States)

    Das, Pradeep; Ghosh, Debashis; Priyanka, Jyoti; Matlashewski, Greg; Kroeger, Axel; Upfill-Brown, Alexander

    2016-01-01

    Background We investigated the efficacy, safety and cost of lime wash of household walls plus treatment of sand fly breeding places with bleach (i.e. environmental management or EM), insecticide impregnated durable wall lining (DWL), and bed net impregnation with slow release insecticide (ITN) for sand fly control in the Indian sub-continent. Methods This multi-country cluster randomized controlled trial had 24 clusters in each three sites with eight clusters per high, medium or low sand fly density stratum. Every cluster included 45–50 households. Five households from each cluster were randomly selected for entomological measurements including sand fly density and mortality at one, three, nine and twelve months post intervention. Household interviews were conducted for socioeconomic information and intervention acceptability assessment. Cost for each intervention was calculated. There was a control group without intervention. Findings Sand fly mortality [mean and 95%CI] ranged from 84% (81%-87%) at one month to 74% (71%-78%) at 12 months for DWL, 75% (71%-79%) at one month to 49% (43%-55%) at twelve months for ITN, and 44% (34%-53%) at one month to 22% (14%-29%) at twelve months for EM. Adjusted intervention effect on sand fly density measured by incidence rate ratio ranged from 0.28 (0.23–0.34) at one month to 0.62 (0.51–0.75) at 12 months for DWL; 0.72 (0.62–0.85) at one month to 1.02 (0.86–1.22) at 12 months for ITN; and 0.89 (0.76–1.03) at one months to 1.49 (1.26–1.74) at 12 months for EM. Household acceptance of EM was 74% compared to 94% for both DWL and ITN. Operational cost per household in USD was about 5, 8, and 2 for EM, DWL and ITN, respectively. Minimal adverse reactions were reported for EM and ITN while 36% of households with DWL reported transient itching. Interpretation DWL is the most effective, durable and acceptable control method followed by ITN. The Visceral Leishmaniasis (VL) Elimination Program in the Indian sub

  6. Effect of GuiXiong Xiaoyi Wan in Treatment of Endometriosis on Rats

    Directory of Open Access Journals (Sweden)

    Zhixing Jin

    2015-01-01

    Full Text Available Objective. To evaluate the effect of GuiXiong Xiaoyi Wan (GXXYW on the development of endometriosis in a rat model. Methods. Sprague-Dawley rats with surgically induced endometriosis were randomly treated with low-dose GXXYW, high-dose GXXYW, or vehicle (negative control for 28 days. Immunohistochemistry was used to assess cell proliferation in the lesions. The terminal deoxynucleotidyl transferase- (TdT- mediated dUTP biotin nick end labelling (TUNEL method was performed to analyse the apoptosis induced by GuiXiong Xiaoyi Wan. The percentages of CD3+ lymphocytes, CD4+ lymphocytes, and CD8+ lymphocytes in the spleens of the rats were evaluated using flow cytometric analysis. Results. Treatment with GXXYW significantly decreased the lesion size, inhibited cell proliferation, and induced apoptosis in endometriotic tissue. The spleens of GXXYW-treated rats also demonstrated a significant increase in the percentage of CD4+ lymphocytes and a significant decrease in the percentage of CD8+ lymphocytes. Conclusions. These results suggest that, in a rat model, GXXYW may be effective in the suppression of the growth of endometriosis, possibly through the inhibition of cell proliferation, the induction of apoptosis of endometriotic cells, and the regulation of the immune system.

  7. Ultrasonically treated multi-walled carbon nanotubes (MWCNTs) as PtRu catalyst supports for methanol electrooxidation

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Chunwei; Hu, Xinguo; Wang, Dianlong; Dai, Changsong [Department of Applied Chemistry, Harbin Institute of Technology, Harbin 150001 (China); Zhang, Liang; Jin, Haibo [School of Materials Science and Engineering, Beijing Institute of Technology, Beijing 100081 (China); Agathopoulos, Simeon [Department of Materials Science and Engineering, University of Ioannina, GR-451 10 Ioannina (Greece)

    2006-09-29

    In the quest of fabricating supported catalysts, experimental results of transmission electron microscopy, Raman and infrared spectroscopy indicate that ultrasonic treatment effectively functionalizes multi-walled carbon nanotubes (MWCNTs), endowing them with groups that can act as nucleation sites which can favor well-dispersed depositions of PtRu clusters on their surface. Ultrasonic treatment seems to be superior than functionalization via regular refluxing. This is confirmed by the determination of the electrochemistry active surface area (ECA) and the CO-tolerance performance of the PtRu catalysts, measured by adsorbed CO-stripping voltammetry in 0.5M sulfuric acid solution, and the real surface area of the PtRu catalysts, evaluated by Brunauer-Emmett-Teller (BET) measurements. Finally, the effectiveness for methanol oxidation is assessed by cyclic voltammetry (CV) in a sulfuric acid and methanol electrolyte. (author)

  8. Differential expression of upstream stimulatory factor (USF 2 variants in eutopic endometria from women with endometriosis: estradiol regulation

    Directory of Open Access Journals (Sweden)

    Jazmin Castro

    2015-01-01

    Full Text Available BACKGROUND: Endometriosis, pro-inflammatory and invasive benign disease estrogen dependent, abnormally express in endometria the enzyme P450Arom, positively regulated by steroid factor-1 (SF-1. Our objective was to study the nuclear protein contents of upstream stimulating factor 2 (USF2a and USF2b, a positive regulator of SF-1, throughout the menstrual cycle in eutopic endometria from women with and without (control endometriosis and the involvement of nuclear estrogen receptors (ER and G-coupled protein estrogen receptor (GPER-1 RESULTS: Upstream stimulating factor 2 protein contents were higher in mid (USF2b and late (USF2a and USF2b secretory phase in eutopic endometria from endometriosis than control (p < 0.05. In isolated control epithelial cells incubated with E2 and PGE2, to resemble the endometriosis condition, the data showed: (a significant increase of USF2a and USF2b nuclear protein contents when treated with E2, PPT (specific agonist for ERa or G1 (specific agonist for GPER1; (b no increase in USF2 binding to SF-1 E-Box/DNA consensus sequence in E2-treated cells; (c USF2 variants protein contents were not modified by PGE2; (d SF-1 nuclear protein content was significantly higher than basal when treated with PGE2, E2 or G1, stimulation unaffected by ICI (nuclear ER antagonist; and (e increased (p < 0.05 cytosolic protein contents of P450Arom when treated with PGE2, E2, PPT or G1 compared to basal, effect that was additive with E2 + PGE2 together. Nevertheless, in endometriosis cells, the high USF2, SF-1 and P450Arom protein contents in basal condition were unmodified CONCLUSION: These data strongly suggest that USF2 variants and P450Arom are regulated by E2 through ERa and GPER1, whereas SF-1 through GPER1, visualized by the response of the cells obtained from control endometria, being unaffected the endogenously stimulated cells from endometriosis origin. The lack of E2 stimulation on USF2/SF-1 E-Box/DNA-sequence binding and the

  9. Effect of Saccharomyces Boulardii Cell Wall Extracts on Colon Cancer Prevention in Male F344 Rats Treated with 1,2-Dimethylhydrazine.

    Science.gov (United States)

    Fortin, Olivier; Aguilar-Uscanga, Blanca R; Vu, Khanh D; Salmieri, Stephane; Lacroix, Monique

    2018-01-01

    The effect of Saccharomyces boulardii cell wall extracts on colon cancer prevention in rats treated with 1,2-dimethylhydrazine was investigated. A crude insoluble glucan (0.5 and 1.0 mg/kg/day) and a crude mannoprotein extract (0.3 and 3.0 mg/kg/day) were administered in rats by gavage for 12 weeks along with a high fat low fiber diet whereupon rats were sacrificed and aberrant crypt foci (ACF) were counted in the colon. Moreover, NAD(P)H: quinone reductase (QR) and harmful fecal enzymes (β-glucosidase and β-glucuronidase) were quantified in the liver and in the caecum, respectively. Results showed a reduction in ACF counts, a decreased β-glucuronidase activity and an increased QR activity when rats were treated only with insoluble glucan. While these enzymatic modulations may be constituted one of the mechanisms that is responsible for the reduction of ACF counts observed, the reduction of ACF counts caused by insoluble glucan should be addressed, at least, as a biomarker of their cancer-prevention properties. To our knowledge, this is the first study demonstrated that crude cell wall extract obtained from S. boulardii could have a potential role in colon cancer prevention in vivo by revealing the potential implication of QR and β-glucuronidase modulation.

  10. Quantitative bias analysis of a reported association between perfluoroalkyl substances (PFAS) and endometriosis: The influence of oral contraceptive use.

    Science.gov (United States)

    Ngueta, Gerard; Longnecker, Matthew P; Yoon, Miyoung; Ruark, Christopher D; Clewell, Harvey J; Andersen, Melvin E; Verner, Marc-André

    2017-07-01

    An association between serum levels of perfluoroalkyl substances (PFAS) and endometriosis has recently been reported in an epidemiologic study. Oral contraceptive use to treat dysmenorrhea (pelvic pain associated with endometriosis) could potentially influence this association by reducing menstrual fluid loss, a route of excretion for PFAS. In this study, we aimed to evaluate the influence of differential oral contraceptive use on the association between PFAS and endometriosis. We used a published life-stage physiologically based pharmacokinetic (PBPK) model to simulate plasma levels of perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) from birth to age at study participation (range 18-44years). In the simulated population, PFAS level distributions matched those for controls in the epidemiologic study. Prevalence and geometric mean duration (standard deviation [SD]) of oral contraceptive use in the simulated women were based on data from the National Health and Nutrition Examination Survey; among the women with endometriosis the values were, respectively, 29% and 6.8 (3.1) years; among those without endometriosis these values were 18% and 5.3 (2.8) years. In simulations, menstrual fluid loss (ml/cycle) in women taking oral contraceptives was assumed to be 56% of loss in non-users. We evaluated the association between simulated plasma PFAS concentration and endometriosis in the simulated population using logistic regression. Based on the simulations, the association between PFAS levels and endometriosis attributable to differential contraceptive use had an odds ratio (95% CI) of 1.05 (1.02, 1.07) for a log e unit increase in PFOA and 1.03 (1.02, 1.05) for PFOS. In comparison, the epidemiologic study reported odds ratios of 1.62 (0.99, 2.66) for PFOA and 1.25 (0.87, 1.80) for PFOS. Our results suggest that the influence of oral contraceptive use on the association between PFAS levels and endometriosis is relatively small. Copyright © 2017 Elsevier

  11. Combination of the non-invasive tests for the diagnosis of endometriosis.

    Science.gov (United States)

    Nisenblat, Vicki; Prentice, Lucy; Bossuyt, Patrick M M; Farquhar, Cindy; Hull, M Louise; Johnson, Neil

    2016-07-13

    ) (sensitivity 0.74 (95% CI 0.60 to 0.84), specificity 0.97 (95% CI 0.86 to 1.00)) and 2. a combination of history (length of menses), serum CA-125 (cut-off >35 U/ml) and endometrial leukocytes (sensitivity 0.61 (95% CI 0.54 to 0.69), specificity 0.95 (95% CI 0.91 to 0.98)). For endometrioma, the following combinations qualified as SpIN test: 1. TVUS and either serum CA-125 (cut-off ≥25 U/ml) or CA 19.9 (cut-off ≥12 U/ml) (sensitivity 0.79 (95% CI 0.64 to 0.91), specificity 0.97 (95% CI 0.91 to 1.00)); 2. TVUS and serum CA 19.9 (cut-off ≥12 U/ml) (sensitivity 0.54 (95% CI 0.37 to 0.70), specificity 0.97 (95% CI 0.91 to 1.0)); 3-4. TVUS and serum CA-125 (cut-off ≥20 U/ml or cut-off ≥25 U/ml) (sensitivity 0.69 (95% CI 0.49 to 0.85), specificity 0.96 (95% CI 0.88 to 0.99)); 5. TVUS and serum CA-125 (cut-off ≥35 U/ml) (sensitivity 0.52 (95% CI 0.33 to 0.71), specificity 0.97 (95% CI 0.90 to 1.00)). A combination of vaginal examination and TVUS reached the threshold for a SpIN test for obliterated pouch of Douglas (sensitivity 0.87 (95% CI 0.69 to 0.96), specificity 0.98 (95% CI 0.95 to 1.00)), vaginal wall endometriosis (sensitivity 0.82 (95% CI 0.60 to 0.95), specificity 0.99 (95% CI 0.97 to 1.0)) and rectovaginal septum endometriosis (sensitivity 0.88 (95% CI 0.47 to 1.00), specificity 0.99 (95% CI 0.96 to 1.00)).All the tests were evaluated in individual studies and displayed wide CIs. Due to the heterogeneity and high risk of bias of the included studies, the clinical utility of the studied combination diagnostic tests for endometriosis remains unclear. None of the biomarkers evaluated in this review could be evaluated in a meaningful way and there was insufficient or poor-quality evidence. Laparoscopy remains the gold standard for the diagnosis of endometriosis and using any non-invasive tests should only be undertaken in a research setting.

  12. [Serum markers of oxidative stress in infertile women with endometriosis].

    Science.gov (United States)

    Andrade, Aline Zyman de; Rodrigues, Jhenifer Kliemchen; Dib, Luciana Azôr; Romão, Gustavo Salata; Ferriani, Rui Alberto; Jordão Junior, Alceu Afonso; Navarro, Paula Andrea de Albuquerque Salles

    2010-06-01

    to compare serum markers of oxidative stress between infertile patients with and without endometriosis and to assess the association of these markers with disease staging. this was a prospective study conducted on 112 consecutive infertile, non-obese patients younger than 39 years, divided into two groups: Endometriosis (n=48, 26 with minimal and mild endometriosis - Stage I/II, and 22 with moderate and severe endometriosis - Stage III/IV) and Control (n=64, with tubal and/or male factor infertility). Blood samples were collected during the early follicular phase of the menstrual cycle for the analysis of serum malondialdehyde, glutathione and total hydroxyperoxide levels by spectrophotometry and of vitamin E by high performance liquid chromatography. The results were compared between the endometriosis and control groups, stage I/II endometriosis and control, stage III/IV endometriosis and control, and between the two endometriosis subgroups. The level of significance was set at 5% (p Control Group (8.0 ± 2 µMol/g protein) and among patients with stage III/IV disease (9.7 ± 2.3 µMol/g protein) compared to patients with stage I/II disease (8.2 ± 1.0 µMol/g protein). No significant differences in serum malondialdehyde levels were observed between groups. we demonstrated a positive association between infertility related to endometriosis, advanced disease stage and increased serum hydroxyperoxide levels, suggesting an increased production of reactive species in women with endometriosis. These data, taken together with the reduction of serum vitamin E and glutathione levels, suggest the occurrence of systemic oxidative stress in women with infertility associated with endometriosis. The reproductive and metabolic implications of oxidative stress should be assessed in future studies.

  13. Endometriosis: a high-risk population for major chronic diseases?

    Science.gov (United States)

    Kvaskoff, Marina; Mu, Fan; Terry, Kathryn L.; Harris, Holly R.; Poole, Elizabeth M.; Farland, Leslie; Missmer, Stacey A.

    2015-01-01

    BACKGROUND Despite an estimated prevalence of 10% in women, the etiology of endometriosis remains poorly understood. Over recent decades, endometriosis has been associated with risk of several chronic diseases, such as cancer, autoimmune diseases, asthma/atopic diseases and cardiovascular diseases. A deeper understanding of these associations is needed as they may provide new leads into the causes or consequences of endometriosis. This review summarizes the available epidemiological findings on the associations between endometriosis and other chronic diseases and discusses hypotheses for underlying mechanisms, potential sources of bias and methodological complexities. METHODS We performed a comprehensive search of the PubMed/Medline and ISI Web of Knowledge databases for all studies reporting on the associations between endometriosis and other diseases published in English through to May 2014, using numerous search terms. We additionally examined the reference lists of all identified papers to capture any additional articles that were not identified through computer searches. RESULTS We identified 21 studies on the associations between endometriosis and ovarian cancer, 14 for breast cancer, 8 for endometrial cancer, 4 for cervical cancer, 12 for cutaneous melanoma and 3 for non-Hodgkin's lymphoma, as well as 9 on the links between endometriosis and autoimmune diseases, 6 on the links with asthma and atopic diseases, and 4 on the links with cardiovascular diseases. Endometriosis patients were reported to be at higher risk of ovarian and breast cancers, cutaneous melanoma, asthma, and some autoimmune, cardiovascular and atopic diseases, and at decreased risk of cervical cancer. CONCLUSIONS Increasing evidence suggests that endometriosis patients are at higher risk of several chronic diseases. Although the underlying mechanisms are not yet understood, the available data to date suggest that endometriosis is not harmless with respects to women's long-term health. If

  14. Theories on the Pathogenesis of Endometriosis

    Directory of Open Access Journals (Sweden)

    Samer Sourial

    2014-01-01

    Full Text Available Endometriosis is a common, chronic inflammatory disease defined by the presence of extrauterine endometrial tissue. The aetiology of endometriosis is complex and multifactorial, where several not fully confirmed theories describe its pathogenesis. This review examines existing theories on the initiation and propagation of different types of endometriotic lesions, as well as critically appraises the myriad of biologically relevant evidence that support or oppose each of the proposed theories. The current literature suggests that stem cells, dysfunctional immune response, genetic predisposition, and aberrant peritoneal environment may all be involved in the establishment and propagation of endometriotic lesions. An orchestrated scientific and clinical effort is needed to consider all factors involved in the pathogenesis of this multifaceted disease and to propose novel therapeutic targets to reach effective treatments for this distressing condition.

  15. Endometriosis-related spontaneous diaphragmatic rupture.

    Science.gov (United States)

    Triponez, Frédéric; Alifano, Marco; Bobbio, Antonio; Regnard, Jean-François

    2010-10-01

    Non-traumatic, spontaneous diaphragmatic rupture is a rare event whose pathophysiology is not known. We report the case of endometriosis-related spontaneous rupture of the right diaphragm with intrathoracic herniation of the liver, gallbladder and colon. We hypothesize that the invasiveness of endometriotic tissue caused diaphragm fragility, which finally lead to its complete rupture without traumatic event. The treatment consisted of a classical management of diaphragmatic rupture, with excision of the endometriotic nodule followed by medical ovarian suppression for six months.

  16. Urinary biomarkers for the non-invasive diagnosis of endometriosis

    NARCIS (Netherlands)

    Liu, Emily; Nisenblat, Vicki; Farquhar, Cindy; Fraser, Ian; Bossuyt, Patrick M. M.; Johnson, Neil; Hull, M. Louise

    2015-01-01

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

  17. 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

    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 invasive

  18. Involvement of immune cells in the pathogenesis of endometriosis.

    Science.gov (United States)

    Izumi, Gentaro; Koga, Kaori; Takamura, Masashi; Makabe, Tomoko; Satake, Erina; Takeuchi, Arisa; Taguchi, Ayumi; Urata, Yoko; Fujii, Tomoyuki; Osuga, Yutaka

    2018-02-01

    Endometriosis is characterized by the implantation and growth of endometriotic tissues outside the uterus. It is widely accepted the theory that endometriosis is caused by the implantation of endometrial tissue from retrograde menstruation; however, retrograde menstruation occurs in almost all women and other factors are required for the establishment of endometriosis, such as cell survival, cell invasion, angiogenesis, and cell growth. Immune factors in the local environment may, therefore, contribute to the formation and progression of endometriosis. Current evidence supports the involvement of immune cells in the pathogenesis of endometriosis. Peritoneal neutrophils and macrophages secrete biochemical factors that help endometriotic cell growth and invasion, and angiogenesis. Peritoneal macrophages and NK cells in endometriosis have limited capability of eliminating endometrial cells in the peritoneal cavity. An imbalance of T cell subsets leads to aberrant cytokine secretions and inflammation that results in the growth of endometriosis lesions. It is still uncertain whether these immune cells have a role in the initial cause and/or stimulate actions that enhance disease; however, in either case, modulating the actions of these cells may prevent initiation or disease progression. Further studies are needed to deepen the understanding of the pathology of endometriosis and to develop novel management approaches of benefit to women suffering from this disease. © 2018 Japan Society of Obstetrics and Gynecology.

  19. 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).

  20. The association between endometriosis and survival outcomes of ...

    African Journals Online (AJOL)

    Background: Although it is generally recognized that endometriosis was significantly associated with higher risk of ovarian cancer, the association between endometriosis and the cancer survival outcomes is still not clear. This meta‑analysis aims to pool previous studies and to make an update estimate. Methods: Relevant ...

  1. Primary umbilical endometriosis: a case report | Muluka | Journal of ...

    African Journals Online (AJOL)

    Umbilical endometriosis is a rare presentation especially in the absence of prior pelvic surgery. This report presents a rare case of symptomatic primary umbilical endometriosis in a 28 year old female who presented with a 2 year history of umbilical mass associated with cyclical bleeding at the time of her menses.

  2. Case Report: Endometriosis of the Appendix | Al Oulaqi | African ...

    African Journals Online (AJOL)

    Endometriosis is a well known cause of infertility. Endometriosis of the appendix is a very rare condition. To highlight this rare entity, we are reporting a case of a young lady who was admitted with recurrent attacks of lower abdominal pain associated with primary infertility. Preoperative diagnosis was acute appendicitis.

  3. Episiotomy scar endometriosis diagnosed on cytology - a case report

    African Journals Online (AJOL)

    Endometriosis, the presence of functioning endometrial tissue outside the uterus, is a common gynaecological condition. Perineal endometriosis is a rare disease characterized by the presence of ectopic endometrial stroma and glands in the perineum. Most commonly observed in the episiotomy scar after normal vaginal ...

  4. Menstruation in an unusual place: A case of thoracic endometriosis ...

    African Journals Online (AJOL)

    While pelvic endometriosis is relatively common, thoracic menstruation is rare. A report of what is believed to be the first case of thoracic endometriosis in Uganda is given. A 34 year old female was complaining of on and off chest pain mainly on the right side. Clinically she had signs of pleural effusion and 500 mls of altered ...

  5. Appendiceal Endometriosis: A case Report and Literature Review ...

    African Journals Online (AJOL)

    Appendiceal endometriosis is a very rare and usually asymptomatic condiction, but can result in severe complications such as intestinal perforation, massive gastrointestinal bleeding or intussusception. We report a case of endometriosis of the appendix presenting as acute appendicitis. The patient was a 36 year old ...

  6. What Is Endometriosis? | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... risk about six times) Periods started at an early age (before age 11) Monthly cycles are short (less than 27 days) Menstrual cycles are heavy and last more than 7 days What are the symptoms of endometriosis? While the primary symptoms of endometriosis are pain and infertility, other ...

  7. Intestinal Obstruction Due to Rectal Endometriosis: A Surgical Enigma

    Directory of Open Access Journals (Sweden)

    Razman Jarmin

    2006-07-01

    Full Text Available Obstructed rectal endometriosis is an uncommon presentation. The clinical and intraoperative presentation may present as malignant obstruction. The difficulty in making the diagnosis may delay the definitive management of the patient. We report a unique case of rectal endometriosis mimicking malignant rectal mass causing intestinal obstruction and discuss the management of the case.

  8. Endometriosis of the appendix presenting as acute appendicitis: A ...

    African Journals Online (AJOL)

    Endometriosis is a common disease generally, but appendiceal endometriosis causing acute appendicitis is a very uncommon clinical phenomenon and a few cases have been reported. The authors aim to highlight the rarity of such clinical entity in Nigeria. A 29 year old nulliparous woman presented with severe right iliac ...

  9. Spontaneous haemoperitoneum in pregnancy and endometriosis: a case series

    NARCIS (Netherlands)

    Lier, M. van; Malik, R.F.; Waesberghe, J. van; Maas, J.W.; Rumpt-van de Geest, D.A. van; Coppus, S.F.P.J.; Berger, J.P.; Rijn, B.B. van; Janssen, P.F.; Boer, M.A. de; Vries, J.I.P. de; Jansen, F.W.; Brosens, I.A.; Lambalk, C.B.; Mijatovic, V.

    2017-01-01

    OBJECTIVE: To report pregnancy outcomes of SHiP (spontaneous haemoperitoneum in pregnancy) and the association with endometriosis. DESIGN: Retrospective case note review. SETTING: Dutch referral hospitals for endometriosis. SAMPLE: Eleven women presenting with 15 events of SHiP. METHODS: In

  10. Endoglin concentration in peritoneal fluid of patients with endometriosis

    Directory of Open Access Journals (Sweden)

    Nusratuddin Abdullah

    2013-05-01

    Full Text Available Background: Endoglin is a specific angiogenic factor suspected to involve in the pathogenesis of endometriosis. The aim of this study was to evaluate the significance of endoglin concentration in the peritoneal fluid of patients with endometriosis.Methods: This pilot study was performed between March 2011 and July 2012 at Dr. Wahidin Sudirohusodo Hospital and another private hospital in Makassar, Indonesia. This was an observational, cross-sectional study. All patients undergoing laparoscopy for infertility and other cases with suitable inclusion criteria were asked to answer a questionnaire and had a 5 cc peritoneal fluid sample taken for measurement of peritoneal endoglin concentration using ELISA. Endometriosis stage was classified using ASRM criteria and divided into two groups, mild and severe. All data were analyed using Excel and Spearman correlation analysis.Results: In the endometriosis group peritoneal endoglin concentration ranged between 14.43- 15.65 ng/mL (median 15.04 ng/mL which is higher than control group 7.42-10.26 ng/mL (median 8.84 ng/mL. A peritoneal endoglin concentration equal to or higher than 11 ng/mL could be used to predict endometriosis.Conclusion: Endoglin concentrations increased proportionally with the severity of endometriosis, and many be used as predictive factor of endometriosis cases. (Med J Indones. 2013;22:88-91Keywords: Endoglin, endometriosis, peritoneum

  11. Spontaneous haemoperitoneum in pregnancy and endometriosis : a case series

    NARCIS (Netherlands)

    Lier, McI; Malik, R F; van Waesberghe, Jhtm; Maas, J W; van Rumpt-van de Geest, D A; Coppus, S F; Berger, J P; van Rijn, B B; Janssen, P F; de Boer, M. A; de Vries, Jip; Jansen, F. W.; Brosens, I A; Lambalk, C B; Mijatovic, V

    OBJECTIVE: To report pregnancy outcomes of SHiP (spontaneous haemoperitoneum in pregnancy) and the association with endometriosis. DESIGN: Retrospective case note review. SETTING: Dutch referral hospitals for endometriosis. SAMPLE: Eleven women presenting with 15 events of SHiP. METHODS: In

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

    African Journals Online (AJOL)

    AJRH Managing Editor

    . Obstet 1987; 25: 47 – 52. 8. Kyama CM, Mwenda JM, Machoki J, Mihalyi A,. Simsa P, Chai DC, D'Hoodge TM. Endometriosis in African women. Women's. Health 2007; 3(5): 629 – 635. 9. D' Hoodge TM. The challenge of Endometriosis: A.

  13. 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

  14. Role of Oxidative Stress in Epigenetic Modification in Endometriosis.

    Science.gov (United States)

    Ito, Fuminori; Yamada, Yuki; Shigemitsu, Aiko; Akinishi, Mika; Kaniwa, Hiroko; Miyake, Ryuta; Yamanaka, Shoichiro; Kobayashi, Hiroshi

    2017-11-01

    Aberrant DNA methylation and histone modification are associated with an increased risk of reproductive disorders such as endometriosis. However, a cause-effect relationship between epigenetic mechanisms and endometriosis development has not been fully determined. This review provides current information based on oxidative stress in epigenetic modification in endometriosis. This article reviews the English-language literature on epigenetics, DNA methylation, histone modification, and oxidative stress associated with endometriosis in an effort to identify epigenetic modification that causes a predisposition to endometriosis. Oxidative stress, secondary to the influx of hemoglobin, heme, and iron during retrograde menstruation, is involved in the expression of CpG demethylases, ten-eleven translocation, and jumonji (JMJ). Ten-eleven translocation and JMJ recognize a wide range of endogenous DNA methyltransferases (DNMTs). The increased expression levels of DNMTs may be involved in the subsequent downregulation of the decidualization-related genes. This review supports the hypothesis that there are at least 2 distinct phases of epigenetic modification in endometriosis: the initial wave of iron-induced oxidative stress would be followed by the second big wave of epigenetic modulation of endometriosis susceptibility genes. We summarize the recent advances in our understanding of the underlying epigenetic mechanisms focusing on oxidative stress in endometriosis.

  15. Extrapelvic endometriosis: a rare entity or an under diagnosed condition?

    Science.gov (United States)

    2013-01-01

    Endometriosis is a clinical entity characterized by the presence of normal endometrial mucosa abnormally implanted in locations other than the uterine cavity. Endometriosis can be either endopelvic or extrapelvicdepending on the location of endometrial tissue implantation. Despite the rarity of extrapelvic endometriosis, several cases of endometriosis of the gastrointestinal tract, the urinarytract, the upper and lower respiratory system, the diaphragm, the pleura and the pericardium, as well as abdominal scars loci have been reported in the literature. There are several theories about the pathogenesis and the pathophysiology of endometriosis. Depending on the place of endometrial tissue implantation, endometriosis can be expressed with a wide variety of symptoms. The diagnosis of this entity is neither easy nor routine. Many diagnostic methods clinical and laboratory have been used, but none of them is the golden standard. The multipotent localization of endometriosis in combination with the wide range of its clinical expression should raise the clinical suspicion in every woman with periodic symptoms of extrapelvic organs. Finally, the therapeutic approach of this clinical entity is also correlated with the bulk of endometriosis and the locum that it is found. It varies from simple observation, to surgical treatment and treatment with medication as well as a combination of those. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1968087883113362. PMID:24294950

  16. Clinical predictive factors for endometriosis in a Portuguese infertile population

    NARCIS (Netherlands)

    Calhaz-Jorge, C.; Mol, Ben W.; Nunes, J.; Costa, A. P.

    2004-01-01

    BACKGROUND: Endometriosis is an important clinical situation associated with subfertility. It would be very useful to identify patients at increased risk for endometriosis prior to laparoscopy. In the present study, we evaluate the demographic and clinical characteristics in a cohort of Portuguese

  17. Risk for breast cancer among women with endometriosis

    NARCIS (Netherlands)

    Bertelsen, Lisbeth; Mellemkjaer, Lene; Frederiksen, Kirsten; Kjaer, Susanne K.; Brinton, Louise A.; Sakoda, Lori C.; van Valkengoed, Irene; Olsen, Jørgen H.

    2007-01-01

    Although several risk factors are common to endometriosis and breast cancer, the results of observational studies of an association have so far been inconsistent. We evaluated the relationship between endometriosis and breast cancer on the basis of data on selected cancers and medical histories from

  18. Endometrial biomarkers for the non-invasive diagnosis of endometriosis

    NARCIS (Netherlands)

    Gupta, Devashana; Hull, M. Louise; Fraser, Ian; Miller, Laura; Bossuyt, Patrick M. M.; Johnson, Neil; Nisenblat, Vicki

    2016-01-01

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

  19. 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

  20. Dienogest in the treatment of endometriosis.

    Science.gov (United States)

    Bizzarri, Nicolò; Remorgida, Valentino; Leone Roberti Maggiore, Umberto; Scala, Carolina; Tafi, Emanuela; Ghirardi, Valentina; Salvatore, Stefano; Candiani, Massimo; Venturini, Pier Luigi; Ferrero, Simone

    2014-09-01

    Dienogest (DNG) is an oral progestin, derivative of 19-nortestosterone, that has recently been introduced for the treatment of endometriosis. This review examines the clinical efficacy, safety and tolerability of DNG in the treatment of endometriosis. The material included in the current manuscript was searched and obtained via Medline, Pubmed and EMBASE, from inception until February 2014. The term 'dienogest' was associated with the following search terms: 'endometriosis', 'pharmacokinetics', 'safety' and 'efficacy'. Several trials demonstrated the clinical efficacy, safety and tolerability of DNG. However the use of DNG is associated with some limitations. So far, no study investigated the potential of contraceptive effect of this treatment and therefore, it should be recommended with other methods of contraception (e.g., barrier methods). A further limitation of the use of DNG as daily therapy in the long term is that the cost of the therapy is higher than other progestins available on the market and combined oral contraceptives. Therefore, future studies should be designed to compare the efficacy and safety of DNG with other progestins.

  1. Enhanced human bone marrow mesenchymal stem cell functions in novel 3D cartilage scaffolds with hydrogen treated multi-walled carbon nanotubes

    Science.gov (United States)

    Holmes, Benjamin; Castro, Nathan J.; Li, Jian; Keidar, Michael; Zhang, Lijie Grace

    2013-09-01

    Cartilage tissue is a nanostructured tissue which is notoriously hard to regenerate due to its extremely poor inherent regenerative capacity and complex stratified architecture. Current treatment methods are highly invasive and may have many complications. Thus, the goal of this work is to use nanomaterials and nano/microfabrication methods to create novel biologically inspired tissue engineered cartilage scaffolds to facilitate human bone marrow mesenchymal stem cell (MSC) chondrogenesis. To this end we utilized electrospinning to design and fabricate a series of novel 3D biomimetic nanostructured scaffolds based on hydrogen (H2) treated multi-walled carbon nanotubes (MWCNTs) and biocompatible poly(L-lactic acid) (PLLA) polymers. Specifically, a series of electrospun fibrous PLLA scaffolds with controlled fiber dimension were fabricated in this study. In vitro MSC studies showed that stem cells prefer to attach in the scaffolds with smaller fiber diameter. More importantly, the MWCNT embedded scaffolds showed a drastic increase in mechanical strength and a compressive Young’s modulus matching to natural cartilage. Furthermore, our MSC differentiation results demonstrated that incorporation of the H2 treated carbon nanotubes and poly-L-lysine coating can induce more chondrogenic differentiations of MSCs than controls. After two weeks of culture, PLLA scaffolds with H2 treated MWCNTs and poly-L-lysine can achieve the highest glycosaminoglycan synthesis, making them promising for further exploration for cartilage regeneration.

  2. Enhanced human bone marrow mesenchymal stem cell functions in novel 3D cartilage scaffolds with hydrogen treated multi-walled carbon nanotubes

    International Nuclear Information System (INIS)

    Holmes, Benjamin; Castro, Nathan J; Li Jian; Keidar, Michael; Zhang, Lijie Grace

    2013-01-01

    Cartilage tissue is a nanostructured tissue which is notoriously hard to regenerate due to its extremely poor inherent regenerative capacity and complex stratified architecture. Current treatment methods are highly invasive and may have many complications. Thus, the goal of this work is to use nanomaterials and nano/microfabrication methods to create novel biologically inspired tissue engineered cartilage scaffolds to facilitate human bone marrow mesenchymal stem cell (MSC) chondrogenesis. To this end we utilized electrospinning to design and fabricate a series of novel 3D biomimetic nanostructured scaffolds based on hydrogen (H 2 ) treated multi-walled carbon nanotubes (MWCNTs) and biocompatible poly(L-lactic acid) (PLLA) polymers. Specifically, a series of electrospun fibrous PLLA scaffolds with controlled fiber dimension were fabricated in this study. In vitro MSC studies showed that stem cells prefer to attach in the scaffolds with smaller fiber diameter. More importantly, the MWCNT embedded scaffolds showed a drastic increase in mechanical strength and a compressive Young’s modulus matching to natural cartilage. Furthermore, our MSC differentiation results demonstrated that incorporation of the H 2 treated carbon nanotubes and poly-L-lysine coating can induce more chondrogenic differentiations of MSCs than controls. After two weeks of culture, PLLA scaffolds with H 2 treated MWCNTs and poly-L-lysine can achieve the highest glycosaminoglycan synthesis, making them promising for further exploration for cartilage regeneration. (paper)

  3. Protocol of randomized controlled trial of potentized estrogen in homeopathic treatment of chronic pelvic pain associated with endometriosis.

    Science.gov (United States)

    Teixeira, Marcus Zulian; Podgaec, Sérgio; Baracat, Edmund Chada

    2016-08-01

    Endometriosis is a chronic inflammatory disease that causes difficult-to-treat pelvic pain. Thus being, many patients seek help in complementary and alternative medicine, including homeopathy. The effectiveness of homeopathic treatment for endometriosis is controversial due to the lack of evidences in the literature. The aim of the present randomized controlled trial is to assess the efficacy of potentized estrogen compared to placebo in the treatment of chronic pelvic pain associated with endometriosis. The present is a randomized, double-blind, placebo-controlled trial of a homeopathic medicine individualized according to program 'New Homeopathic Medicines: use of modern drugs according to the principle of similitude' (http://newhomeopathicmedicines.com). Women with endometriosis, chronic pelvic pain and a set of signs and symptoms similar to the adverse events caused by estrogen were recruited at the Endometriosis Unit of Division of Clinical Gynecology, Clinical Hospital, School of Medicine, University of São Paulo (Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - HCFMUSP). The participants were selected based on the analysis of their medical records and the application of self-report structured questionnaires. A total of 50 women meeting the eligibility criteria will be randomly allocated to receive potentized estrogen or placebo. The primary clinical outcome measure will be severity of chronic pelvic pain. Statistical analysis will be performed on the intention-to-treat and per-protocol approaches comparing the effect of the homeopathic medicine versus placebo after 24 weeks of intervention. The present study was approved by the research ethics committee of HCFMUSP and the results are expected in 2016. ClinicalTrials.gov Identifier: https://clinicaltrials.gov/ct2/show/NCT02427386. Copyright © 2016 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.

  4. 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.

  5. Endometriosis and risks for ovarian, endometrial and breast cancers

    DEFF Research Database (Denmark)

    Mogensen, Julie Brøchner; Kjær, Susanne K.; Mellemkjær, Lene

    2016-01-01

    Objective A growing body of evidence suggests that endometriosis increases the risk for ovarian cancer, but it is less well studied whether the excess risk is confined to certain histotypes. Furthermore, it is not fully resolved if endometriosis is associated with endometrial- and breast cancer....... The aim was to study overall- and histotype-specific risks for these hormone-dependent cancers in women with endometriosis. Methods In the Danish National Patient Register, we identified 45,790 women with a clinical diagnosis of endometriosis during 1977–2012. We linked the cohort to the Danish Cancer...... Register and calculated standardized incidence ratios (SIRs) with corresponding 95% confidence intervals (CIs). Results Endometriosis was associated with increased risks for ovarian cancer (SIR 1.34; 95% CI: 1.16–1.55), due primarily to endometrioid (SIR 1.64; 95% CI: 1.09–2.37) and clear-cell types (SIR 3...

  6. Cell wall integrity, genotoxic injury and PCD dynamics in alfalfa saponin-treated white poplar cells highlight a complex link between molecule structure and activity.

    Science.gov (United States)

    Paparella, Stefania; Tava, Aldo; Avato, Pinarosa; Biazzi, Elisa; Macovei, Anca; Biggiogera, Marco; Carbonera, Daniela; Balestrazzi, Alma

    2015-03-01

    In the present work, eleven saponins and three sapogenins purified from Medicago sativa were tested for their cytotoxicity against highly proliferating white poplar (Populus alba L.) cell suspension cultures. After preliminary screening, four saponins with different structural features in terms of aglycone moieties and sugar chains (saponin 3, a bidesmoside of hederagenin; saponins 4 and 5, monodesmoside and bidesmoside of medicagenic acid respectively, and saponin 10, a bidesmoside of zanhic acid) and different cytotoxicity were selected and used for further investigation on their structure-activity relationship. Transmission Electron Microscopy (TEM) analyses provided for the first time evidence of the effects exerted by saponins on plant cell wall integrity. Exposure to saponin 3 and saponin 10 resulted into disorganization of the outer wall layer and the effect was even more pronounced in white poplar cells treated with the two medicagenic acid derivatives, saponins 4 and 5. Oxidative burst and nitric oxide accumulation were common hallmarks of the response of white poplar cells to saponins. When DNA damage accumulation and DNA repair profiles were evaluated by Single Cell Gel Electrophoresis, induction of single and double strand breaks followed by effective repair was observed within 24h. The reported data are discussed in view of the current issues dealing with saponin structure-activity relationship. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Evaluation of quality of life and sexual satisfaction in women suffering from chronic pelvic pain with or without endometriosis.

    Science.gov (United States)

    Tripoli, Tatiana M; Sato, Hélio; Sartori, Marair G; de Araujo, Fábio Fernando; Girão, Manoel J B C; Schor, Eduardo

    2011-02-01

    Chronic pelvic pain (CPP) is one of the most frequent symptoms in women of reproductive age. This is an enigmatic clinical condition that results from the complex interactions of physiological and psychological factors with direct impact on the social, marital, and professional lives of women. To evaluate the quality of life and sexual satisfaction of women who suffer from CPP with or without endometriosis. Forty-nine patients who had been diagnosed with endometriosis and 35 patients with CPP diagnosed with another gynecological condition, all 84 of whom were treated at the Chronic Pelvic Pain and Endometriosis Clinic at Universidade Federal de São Paulo (UNIFESP) from January to July of 2008. The controls were 50 healthy women from the Family Planning Clinic at UNIFESP. World Health Organization Quality of Life Assessment-Bref (WHOQOL-BREF) quality of life questionnaire and the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). No statistically significant differences were observed between the groups with CPP symptoms, in either the results from the WHOQOL-BREF or in the GRISS questionnaire. In both questionnaires, differences were observed when the two groups of symptomatic women were compared with the group of healthy women. CPP caused by endometriosis or other gynecological conditions leads to a significant reduction of quality of life and sexual satisfaction. © 2010 International Society for Sexual Medicine.

  8. 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.

  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. Morphologic Features Suggestive of Endometriosis in Nondiagnostic Peritoneal Biopsies.

    Science.gov (United States)

    Harrison, Beth T; Mittal, Khush

    2015-11-01

    Endometriosis is a common disorder that causes significant morbidity from dysmenorrhea, pelvic pain, and subfertility. Establishment of a definitive diagnosis has important therapeutic implications; however, only approximately 50% of biopsies of laparoscopically suspicious areas provide a diagnosis of endometriosis. Histologic criteria for diagnosis require the presence of endometrial glands or endometrial-type stroma. We hypothesize that other frequently present, but nondiagnostic, histologic features of endometriosis suggest its presence in patients with nondiagnostic peritoneal biopsies. We performed a retrospective clinicopathologic study of morphologic and immunohistochemical features that may improve the histologic diagnosis of endometriosis on laparoscopic peritoneal biopsies. We compared diagnostic (n=88) and nondiagnostic (n=54) peritoneal biopsies from pathologically confirmed endometriosis cases with negative peritoneal biopsies (n=84) from early-stage gynecologic cancer cases. Statistical analysis utilized the Fisher exact test. Multiple morphologic features were significantly increased in nondiagnostic biopsies from patients with endometriosis in comparison with those from negative controls, including foamy macrophages (P=0.0001) and submesothelial stromal clusters (SSCs) (P=0.0008). SSCs ranged from subtle aggregates of spindle cells to nodules of whorled spindle cells with small vessels and extravasated red blood cells resembling stromal endometriosis. Immunohistochemical studies confirmed that ER and CD10-positive SSCs were present in a greater proportion of both nondiagnostic and diagnostic peritoneal biopsies and at a greater number of lesions per biopsy. The overall histologic detection rate of peritoneal biopsies for endometriosis was 62.0%, and inclusion of SSCs with or without foamy macrophages in the diagnostic criteria appreciably increased this rate to between 72.5% and 76.8%. We describe SSCs, which appear to be an early or less developed

  11. Non-coding RNAs in endometriosis: a narrative review.

    Science.gov (United States)

    Panir, Kavita; Schjenken, John E; Robertson, Sarah A; Hull, M Louise

    2018-04-25

    Endometriosis is a benign gynaecological disorder, which affects 10% of reproductive-aged women and is characterized by endometrial cells from the lining of the uterus being found outside the uterine cavity. However, the pathophysiological mechanisms causing the development of this heterogeneous disease remain enigmatic, and a lack of effective biomarkers necessitates surgical intervention for diagnosis. There is international recognition that accurate non-invasive diagnostic tests and more effective therapies are urgently needed. Non-coding RNA (ncRNA) molecules, which are important regulators of cellular function, have been implicated in many chronic conditions. In endometriosis, transcriptome profiling of tissue samples and functional in vivo and in vitro studies demonstrate that ncRNAs are key contributors to the disease process. In this review, we outline the biogenesis of various ncRNAs relevant to endometriosis and then summarize the evidence indicating their roles in regulatory pathways that govern disease establishment and progression. Articles from 2000 to 2016 were selected for relevance, validity and quality, from results obtained in PubMed, MEDLINE and Google Scholar using the following search terms: ncRNA and reproduction; ncRNA and endometriosis; miRNA and endometriosis; lncRNA and endometriosis; siRNA and endometriosis; endometriosis; endometrial; cervical; ovary; uterus; reproductive tract. All articles were independently screened for eligibility by the authors. This review integrates extensive information from all relevant published studies focusing on microRNAs, long ncRNAs and short inhibitory RNAs in endometriosis. We outline the biological function and synthesis of microRNAs, long ncRNAs and short inhibitory RNAs and provide detailed findings from human research as well as functional studies carried out both in vitro and in vivo, including animal models. Although variability in findings between individual studies exists, collectively, the

  12. [Performances and place of sonography in the diagnostic of endometriosis: CNGOF-HAS Endometriosis Guidelines].

    Science.gov (United States)

    Philip, C-A; Dubernard, G

    2018-03-01

    Endometriosis is difficult to diagnose clinically. Transvaginal sonography (TVS) is a procedure that is known to be operator-dependent, which mean that published evidences has to be balanced with the level of the sonographer that produced the data. The objective of this publication was to assess the performances of the sonography in the diagnosis of endometriosis in order to establish the French national recommendations. We searched the MEDLINE database for publication from January 2000 to September 2017 using keywords associated with endometriosis and sonography. Eighty-four trial and reviews published in English or French were included. Ovarian endometrioma can usually be diagnosed by a non-expert sonographer, especially when its aspect is typical. In case of an ovarian cyst with atypical presentation, it is recommended to control the sonography by a referent or to perform an MRI. In menopaused women, any ovarian cyst should be considered as a cancer until proven otherwise. In the diagnosis of posterior deep invasive endometriosis (DIE), TVS with sensitivity and specificity of 96 and 99% respectively, seems at least equivalent if not superior to MRI. However, these performances are related to expert sonographers. To reach sufficient efficiency in posterior DIE, the estimated learning curve for a sonographer is 44 cases. When posterior DIE is suspected, we recommend proposing a TVS "performed by an expert" or a MRI "at least interpreted by an expert". In anterior DIE, TVS has a good specificity (100%), but its sensitivity is poor in the literature (64%). TVS is therefore not able to eliminate the diagnosis. However a renal ultrasound should be proposed each time a urinary endometriosis is confirmed, and should be considered whenever posterior DIE is diagnosed especially the lesion is superior to 3cm. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  13. Medical Therapies for Endometriosis Differentially Inhibit Stem Cell Recruitment.

    Science.gov (United States)

    Ersoy, Gulcin Sahin; Zolbin, Masoumeh Majidi; Cosar, Emine; Mamillapalli, Ramanaiah; Taylor, Hugh S

    2017-06-01

    To determine the effect of the 3 well-known endometriosis treatments on stem cell recruitment to endometriotic lesions. C57BL/6 mice (aged 8 weeks, n = 20) underwent bone marrow transplant following submyeloablation with 5-fluorouracil using 20 × 10 6 bone marrow stem cells from green fluorescent protein (GFP) mice. Two weeks after transplantation, experimental endometriosis was created in mice by suturing segments of the uterine horn into the peritoneal cavity. Mice were then randomized to receive treatment with medroxyprogesterone acetate (MPA), leuprolide acetate (Gonadotrophin-Releasing Hormone Analogue [GnRHa]), letrozole, or vehicle control (dimethyl sulfoxide). After 3 weeks of treatment, the mice were killed and the endometriosis lesions evaluated. All 3 treatments resulted in a significant reduction in lesion volume and weight. Estrogen deprivation using GnRHa or letrozole resulted in greater lesion regression than the progestin MPA. The GFP + /CD45 - bone marrow-derived stem cells (BMDSCs) engrafted the lesions of endometriosis. Estrogen deprivation using GnRHa or letrozole significantly reduced BMDSC engraftment in the endometriosis lesions. MPA failed to significantly reduce stem cell number in endometriosis. The superiority of estrogen deprivation over progestin therapy in depriving the lesions of stem cells may have implications for the long-term treatment of endometriosis. Reduced stem cell engraftment is likely to result in long-term regression of the lesions, whereas progestins may only prevent their growth acutely.

  14. Bacterial contamination hypothesis: a new concept in endometriosis.

    Science.gov (United States)

    Khan, Khaleque N; Fujishita, Akira; Hiraki, Koichi; Kitajima, Michio; Nakashima, Masahiro; Fushiki, Shinji; Kitawaki, Jo

    2018-04-01

    Endometriosis is a multifactorial disease that mainly affects women of reproductive age. The exact pathogenesis of this disease is still debatable. The role of bacterial endotoxin (lipopolysaccharide, LPS) and Toll-like receptor 4 (TLR4) in endometriosis were investigated and the possible source of endotoxin in the pelvic environment was examined. The limulus amoebocyte lysate test was used to measure the endotoxin levels in the menstrual fluid and peritoneal fluid and their potential role in the growth of endometriosis was investigated. Menstrual blood and endometrial samples were cultured for the presence of microbes. The effect of gonadotrophin-releasing hormone agonist (GnRHa) treatment on intrauterine microbial colonization (IUMC) and the occurrence of endometritis was investigated. Lipopolysaccharide regulates the pro-inflammatory response in the pelvis and growth of endometriosis via the LPS/TLR4 cascade. The menstrual blood was highly contaminated with Escherichea coli and the endometrial samples were colonized with other microbes. A cross-talk between inflammation and ovarian steroids or the stress reaction also was observed in the pelvis. Treatment with GnRHa further worsens intrauterine microbial colonization, with the consequent occurrence of endometritis in women with endometriosis. For the first time, a new concept called the "bacterial contamination hypothesis" is proposed in endometriosis. This study's findings of IUMC in women with endometriosis could hold new therapeutic potential in addition to the conventional estrogen-suppressing agent.

  15. New knowledge and insights about the malignant transformation of endometriosis.

    Science.gov (United States)

    Taniguchi, Fuminori

    2017-07-01

    Endometriosis may be a definitive risk factor for ovarian cancer, the most fatal gynecological cancer. The ability of endometriosis to transform into malignancy, first described by Dr. Sampson in 1925, is considered a rare occurrence, affecting approximately 1% of ovarian endometriomas. Recently we conducted a retrospective study regarding the malignant transformation of endometriosis in Japanese women. Many studies have reported a consistent correlation between endometriosis and ovarian cancer according to histological subtypes. However, the existing epidemiological evidence linking this association is insufficient to define the role of endometriosis as a cause of ovarian cancer and to influence changes to current clinical practice. Prospective cohort studies are therefore needed to clarify this issue. Additionally, the results of many molecular studies are conflicting, and earlier studies showing the molecular aberrations involved in genomic instability and mutation that enable malignant transformation have not been replicated in later studies. Careful long-term observation of a patient with endometrioma is required to detect possible subsequent incidence of malignant transformation. More importantly, a precise strategy should be set up for better prevention, early detection, specific diagnosis and treatment targeting molecular pathogenesis to understand the mechanisms of endometriosis-associated ovarian cancer. Clinicians need to be aware of the increased ovarian cancer risk in women with endometriosis. © 2017 Japan Society of Obstetrics and Gynecology.

  16. Endometriosis: Where are We and Where are We Going?

    Science.gov (United States)

    Greene, Alexis D.; Lang, Stephanie A.; Kendziorski, Jessica A.; Sroga-Rios, Julie M.; Herzog, Thomas J.; Burns, Katherine A.

    2016-01-01

    Endometriosis currently affects ∼5.5 million reproductive-aged women in the U.S. with symptoms such as painful periods (dysmenorrhea), chronic pelvic pain, pain with intercourse (dyspareunia), and infertility. It is defined as the presence of endometrial tissue outside the uterine cavity and is found predominately attached to sites within the peritoneal cavity. Diagnosis for endometriosis is solely made through surgery as no consistent biomarkers for disease diagnosis exist. There is no cure for endometriosis and treatments only target symptoms and not the underlying mechanism(s) of disease. The nature of individual predisposing factors or inherent defects in the endometrium, immune system, and/or peritoneal cavity of women with endometriosis remains unclear. The literature over the last 5 years (2010-2015) has advanced our critical knowledge related to hormones, hormone receptors, immune dysregulation, hormonal treatments, and the transformation of endometriosis to ovarian cancer. In this review, we cover the aforementioned topics with the goal of providing the reader an overview and related references for further study to highlight the progress made in endometriosis research, while concluding with critical areas of endometriosis research that are urgently needed. PMID:27165051

  17. 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

  18. Neuro-urological consequences of gynaecological surgery (endometriosis, simple hysterectomy, radical colpohysterectomy), colorectal surgery and pelvic radiotherapy

    International Nuclear Information System (INIS)

    Vidait, A.; Mozer, P.; Chartier-Kastler, E.; Ruffion, A.

    2007-01-01

    Apart from damage to bladder innervation, a number of local diseases and treatments such as radiotherapy can induce lower urinary tract functional disorders. Some of these disorders can be treated according to the principles used in the management of neurogenic bladder. The purpose of this review is to report the functional consequences of pelvic endometriosis, radiotherapy, colorectal surgery and urinary incontinence surgery with particular emphasis on situations in which a neurogenic mechanism is suspected. (authors)

  19. Symptomatic endometriosis of the colon - a case report

    International Nuclear Information System (INIS)

    Leutloff, U.C.; Roeren, T.; Feldmann, K.; Sillem, M.; Rabe, T.; Kauffmann, G.

    1996-01-01

    The intestinal endometriosis in need of treatment is a rare case in the surgical department. Preoperative diagnosis is very difficult and in any case must be based on histologic findings; endoscopy-guided biopsy very frequently yields negative results. Dual-contrast scanning of the colon still is a major examination method, but the findings make it difficult to rule out malignomas. Cyclic, recurrent abdominal complaints reported in the case history strongly indicate the possibility of endometriosis. Typing can be done in general only after surgery. The article reports the clinical and diagnostic parameters of a symptomatic endometriosis of the colon. (orig.) [de

  20. Rediscovering peritoneal macrophages in a murine endometriosis model.

    Science.gov (United States)

    Yuan, Ming; Li, Dong; An, Min; Li, Qiuju; Zhang, Lu; Wang, Guoyun

    2017-01-01

    What are the features of peritoneal macrophage subgroups and T helper cells in the development of murine endometriosis? During the development of endometriosis in a murine model, large peritoneal macrophages (LPMs) and small peritoneal macrophages (SPMs) are polarized into M1 and M2 cells, respectively, and the proportions of T helper (Th) 1, Th17 and T regulatory (T reg ) cells are increased. Numerous studies investigating the etiology and pathogenesis of endometriosis have focused on the polarization states of peritoneal macrophages in endometriosis models and patients, but the results are inconclusive. Further studies indicate that peritoneal macrophages are composed of two distinct subsets: LPMs and SPMs, although their roles in endometriosis are unknown. This study involves a prospective and randomized experiment. Fifty C57BL/6 female mice were randomly allocated to five control and five experimental groups (n = 5/group) according to the presence or absence of transplantation. The transplant periods are 0.25, 3, 14, 28 and 42 days. C57BL/6 mice were utilized to establish an endometriosis model by i.p. injection of allogeneic endometrial segments. Dynamic changes of peritoneal macrophage subsets and polarization profiles were evaluated by flow cytometry (FCM). Macrophage morphology and density were assessed by cell counting under a microscope. Dynamic changes of Th1, Th2, Th17 and T reg cells were estimated by FCM. Peritoneal macrophages are composed of two distinct subsets: LPMs and SPMs. The proportion of SPMs increased immediately after peritoneal injection of endometrial tissues, whereas LPMs showed an opposite trend. Peritoneal macrophages differentiated into both M1 and M2 macrophages. The bidirectional polarization of macrophages was caused by the inverse trends of polarization of LPMs and SPMs. Consistently, the proportions of Th1, Th17 and T reg cells were all increased in mice with endometriosis. N/A. In this study, detection was only performed in a

  1. APPEARANCE OF AUTOIMMUNE DISEASES IN PATIENTS WITH ENDOMETRIOSIS

    Directory of Open Access Journals (Sweden)

    Nina Slabe

    2018-02-01

    Full Text Available Background. Endometriosis is a comon, complex gynecological syndrom defined as the growth of endometrial glands and stroma in an extra-uterine location. It affects 5 – 20 % of women of reproductive age.1 Nowadays, prevailing opinion about endometriosis is based on presumption, that endometriosis is a result of changed immune system, according to autoimmune theory.2, 3 Characteristics of autoimmune disease that are also found in endometriosis are female preponderance, multiorgan involvement, family occurence, possible genetic basis, response to hormonal manipulation, tissue damage, polyclonal B lymphocite activation, immunological abnormalities in T lymphocite and B lymphocite function and associated autoimmune disease. Women with endometriosis are more frequently affected by asthma, rheumatoid arthritis, systemic lupus erythematosus, Sjögren syndrom and Hashimoto’s thyroiditis. Autoimmune disease is characterized by the production of autoantibodies against components of apoptotic cells. Anti-endometrial antibodies of IgG and IgM classes could be detected in 60 % of endometriosis patients. They show reactivity in glandular epithelium and stroma. Anti-endothelial antibodies specifically react with vascular endothelium and might be with anti-endometrial antibodies partially responsible for failure of implantation leading to infertility, wich is common in endometriosis patients. Anti-nuclear antibodies are frequent serological findings in patients with autoimmune disease, and could be detected in 29–47 % of women with endometriosis.4 Generation of anti-nuclear antibodies is a risk factor for development of other autoimmune disease in women of reproductive age. Studies have shown conflicting results on the presence of anti-ovarian antibodies in the serum of endometriosis patients and in the peritoneal fluid. Their presence is one of the possible causes of infertility. Conclusions. Ethiopathogenesis of endometriosis still remains uncelar but

  2. Progress on macrophage's proinflammatory products as markers of acute endometriosis

    Directory of Open Access Journals (Sweden)

    Alicja Ziętek

    2015-08-01

    Full Text Available 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.

  3. Endometriosis After Surgical Menopause Mimicking Pelvic Malignancy: Surgeons’ Predicament

    Directory of Open Access Journals (Sweden)

    Rani A. Bhat

    2014-05-01

    Full Text Available Prevalence of persistent endometriosis in women after menopause without any hormonal replacement therapy is very rare. This is a case of a woman with previous history of total hysterectomy and bilateral salpingo-oophorectomy for endometriosis who presented with hemoperitoneum, vaginal bleeding, pelvic mass, and pulmonary thromboembolism mimicking as rectovaginal septum carcinoma. This is the first case report with a unique mode of presentation wherein the patient presented with hemoperitoneum requiring emergency embolization of the vessel to stabilize the patient. She underwent en bloc resection of the tumor with high anterior resection of the rectum. Histopathology confirmed endometriosis.

  4. Magnetic resonance imaging in lower urinary tract endometriosis: iconographic essay

    International Nuclear Information System (INIS)

    Lima, Claudio Marcio Amaral de Oliveira; Coutinho, Elisa Pompeu Dias; Ribeiro, Erica Barreiros; Domingues, Marisa Nassar Aidar; Junqueira, Flavia Pegado; Coutinho Junior, Antonio Carlos

    2009-01-01

    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)

  5. Aromatase inhibitor treatment limits progression of peritoneal endometriosis in baboons.

    Science.gov (United States)

    Langoi, David; Pavone, Mary Ellen; Gurates, Bilgin; Chai, Daniel; Fazleabas, Asgerally; Bulun, Serdar E

    2013-03-01

    To determine the effect of inhibiting aromatase activity on endometrial lesion growth and aromatase expression in a baboon model of induced endometriosis. Prospective study. Primate research institute. Sixteen olive baboons. Sixteen olive baboons with induced endometriosis were examined with laparoscopy 10 months after disease inoculation. Animals in group 1 (n = 10) were treated with 1.25 mg/d of the aromatase inhibitor (AI) letrozole, and animals in group 2 (n = 6) were given a placebo for a total of 6 months. Total number of endometriotic lesions, morphology, and volume of lesions, as well as semiquantitative reverse transcription-polymerase chain reaction and quantitative polymerase chain reaction for levels of aromatase cytochrome messenger RNA were measured. Ovarian volumes were evaluated before treatment initiation and every 2 months during the study. Treatment of group 1 animals with an AI significantly decreased lesion volume from baseline measurements, whereas the placebo-treated animals showed an increase in lesion volume. Aromatase messenger RNA levels in lesions in the AI-treated animals were significantly lower compared with the placebo-treated animals. Ovarian volumes were significantly increased at 6 months of AI treatment compared with pretreatment volumes. These findings suggest that suppression of aromatase cytochrome P450 may inhibit the in vivo growth of endometriotic lesions in baboons. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  6. Multicentre studies of insecticide-treated durable wall lining in Africa and South-East Asia: entomological efficacy and household acceptability during one year of field use

    Directory of Open Access Journals (Sweden)

    Messenger Louisa A

    2012-10-01

    Full Text Available Abstract Background Indoor residual spraying (IRS is a primary method of malaria vector control, but its potential impact is constrained by several inherent limitations: spraying must be repeated when insecticide residues decay, householders can tire of the annual imposition and campaign costs are recurrent. Durable lining (DL can be considered an advanced form of long-lasting IRS where insecticide is gradually released from an aesthetically attractive wall lining material to provide vector control for several years. A multicentre trial was carried out in Equatorial Guinea, Ghana, Mali, South Africa and Vietnam to assess the feasibility, durability, bioefficacy and household acceptability of DL, compared to conventional IRS or insecticide-treated curtains (LLITCs, in a variety of operational settings. Methods This study was conducted in 220 households in traditional rural villages over 12-15 months. In all sites, rolls of DL were cut to fit house dimensions and fixed to interior wall surfaces (usually with nails and caps by trained teams. Acceptability was assessed using a standardized questionnaire covering such topics as installation, exposure reactions, entomology, indoor environment, aesthetics and durability. Bioefficacy of interventions was evaluated using WHO cone bioassay tests at regular intervals throughout the year. Results The deltamethrin DL demonstrated little to no decline in bioefficacy over 12-15 months, supported by minimal loss of insecticide content. By contrast, IRS displayed a significant decrease in bioactivity by 6 months and full loss after 12 months. The majority of participants in DL households perceived reductions in mosquito density (93% and biting (82%, but no changes in indoor temperature (83%. Among those households that wanted to retain the DL, 73% cited protective reasons, 20% expressed a desire to keep theirs for decoration and 7% valued both qualities equally. In Equatorial Guinea, when offered a choice of

  7. Two Young Women with Left-sided Pneumothorax Due to Thoracic Endometriosis.

    Science.gov (United States)

    Yukumi, Shungo; Suzuki, Hideaki; Morimoto, Masamitsu; Shigematsu, Hisayuki; Okazaki, Mikio; Abe, Masahiro; Kitazawa, Sohei; Nakamura, Kenji; Sano, Yoshifumi

    Pneumothorax associated with thoracic endometriosis (TE) generally occurs in women around 30 years old and it usually affects the right pleural cavity. We herein report two cases of TE associated with left-sided pneumothorax in young women. The prevalence of TE in younger patients may be underestimated if these cases are treated as spontaneous pneumothorax. Pneumothorax occurring in younger patients has not been reported to show laterality. TE-related or catamenial pneumothorax in young women must therefore represent a different clinical entity from the condition seen in older patients.

  8. Office gel sonovaginography for the prediction of posterior deep infiltrating endometriosis: a multicenter prospective observational study.

    Science.gov (United States)

    Reid, S; Lu, C; Hardy, N; Casikar, I; Reid, G; Cario, G; Chou, D; Almashat, D; Condous, G

    2014-12-01

    To use office gel sonovaginography (SVG) to predict posterior deep infiltrating endometriosis (DIE) in women undergoing laparoscopy. This was a multicenter prospective observational study carried out between January 2009 and February 2013. All women were of reproductive age, had a history of chronic pelvic pain and underwent office gel SVG assessment for the prediction of posterior compartment DIE prior to laparoscopic endometriosis surgery. Gel SVG findings were compared with laparoscopic findings to determine the diagnostic accuracy of office gel SVG for the prediction of posterior compartment DIE. In total, 189 women underwent preoperative gel SVG and laparoscopy for endometriosis. At laparoscopy, 57 (30%) women had posterior DIE and 43 (23%) had rectosigmoid/anterior rectal DIE. For the prediction of rectosigmoid/anterior rectal (i.e. bowel) DIE, gel SVG had an accuracy of 92%, sensitivity of 88%, specificity of 93%, positive predictive value (PPV) of 79%, negative predictive value (NPV) of 97%, positive likelihood ratio (LR+) of 12.9 and negative likelihood ratio (LR-) of 0.12 (P = 3.98E-25); for posterior vaginal wall and rectovaginal septum (RVS) DIE, respectively, the accuracy was 95% and 95%, sensitivity was 18% and 18%, specificity was 99% and 100%, PPV was 67% and 100%, NPV was 95% and 95%, LR+ was 32.4 and infinity and LR- was 0.82 and 0.82 (P = 0.009 and P = 0.003). Office gel SVG appears to be an effective outpatient imaging technique for the prediction of bowel DIE, with a higher accuracy for the prediction of rectosigmoid compared with anterior rectal DIE. Although the sensitivity for vaginal and RVS DIE was limited, gel SVG had a high specificity and NPV for all forms of posterior DIE, indicating that a negative gel SVG examination is highly suggestive of the absence of DIE at laparoscopy. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

  9. Efficacy of letrozole in treatment of endometriosis-related pain

    Directory of Open Access Journals (Sweden)

    Elham Hussein Madny

    2014-03-01

    Conclusion: Letrozole (aromatase inhibitor has shown to be effective in the treatment of endometriosis-related pain with substantial improvement of pain with no recurrence of pain for 6 months after completion of treatment.

  10. Genital endometriosis rate dynamics before and after Chernobyl accident

    International Nuclear Information System (INIS)

    Al-Shbul', I.; Suprun, L.Ya.

    2000-01-01

    The necessity of endometriosis dynamics evaluation is caused by worse ecological situation on the area of Belarus. Genital endometriosis frequency was studied considering the outcomes of surgeries fulfilled in hospitals of Gomel, Mogilev and Vitebsk in 1981-1995. At this time 1254 women underwent an operation and 19% of patients (235 persons) were operated before the Chernobyl accident. In the first 5 years after the accident endometriosis frequency increased nearly 2 times. The next 5 years (1991-1995) the number of operated patients was 565, i.e. 45% from the whole number. Uterus was extirpated or amputated in 898 patients, ovaries at both sides were removed in 36 ones. As the analysis showed the endometriosis frequency grew in 2,5 times for last 15 years, the most significant increase of this pathology was observed during the first five years after the accident

  11. Serum CA 125 concentrations in women with endometriosis or ...

    African Journals Online (AJOL)

    releasing hormone (GnRH) agonist analogue therapy in women with endometriosis and uterine fibroids. Serum concentrations of this cell surface antigen did not correlate with uterine volume and appeared to have no value in the assessment of ...

  12. 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.

  13. Endometriosis and the subsequent risk of epithelial ovarian cancer

    Directory of Open Access Journals (Sweden)

    Wen-Hsun Chang

    2014-12-01

    Conclusion: Taiwanese women with endometriosis really had a risk of newly developed EOC, especially those who had a surgical diagnosis, and this three-fold increase of risk was neither influenced by exposure time nor biased by surveillance.

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

    DEFF Research Database (Denmark)

    Fjerbaek, Agnete; Knudsen, Ulla B

    2007-01-01

    between diet and endometriosis/dysmenorrhea was performed. Data on diet and endometriosis were limited to four trials of which two were animal studies. The articles concerning human consumption found some relation between disease and low intake of vegetable and fruit and high intake of vegetarian...... between diet and endometriosis/dysmenorrhea was performed. Data on diet and endometriosis were limited to four trials of which two were animal studies. The articles concerning human consumption found some relation between disease and low intake of vegetable and fruit and high intake of vegetarian....... Further research is recommended on both subjects.ke of vegetarian 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...

  15. Abnormal pathways in endometriosis in relation to progesterone resistance

    DEFF Research Database (Denmark)

    Lode, Lise; Sveen, Magnhild Often; Rudnicki, Martin

    2017-01-01

    Introduction: Endometriosis is an estrogen-dependent disorder, and recent studies suggest that progesterone resistance may contribute to the development and pathophysiology of the disorder. Based on this, identification of genetic and molecular perturbations in the endometrium of women...

  16. The association between endometriosis and survival outcomes of ...

    African Journals Online (AJOL)

    2015-03-02

    Mar 2, 2015 ... Key words: Endometriosis, meta‑analysis, ovarian cancer, survival ..... Sainz de la Cuesta R, Eichhorn JH, Rice LW, Fuller AF Jr, Nikrui N, Goff BA. .... adenocarcinomas/adenosquamous carcinomas of the uterine cervix. Int J.

  17. Prevalence of Endometriosis Among Women Undergoing Laparoscopic Procedures

    Directory of Open Access Journals (Sweden)

    K. K. Chu

    1995-01-01

    Full Text Available We evaluated 752 patients for endometriosis in consecutive laparoscopic procedures over a one year period. Six hundred eighty patients underwent laparoscopy for indications unrelated to symptoms of endometriosis and 72 patients were diagnosed clinically to have endometriosis before the procedures. In the 72 patients with clinical indications of endometriosis, 59 patients had disease confirmed at surgery (82%. Out of 680 asymptomatic patients, 186 patients (24.7% were documented to have the disease of various characteristics or appearances in which the typical lesions accounted for 42%. The overall prevalence among these women undergoing laparoscopy was 32.5%. However, a prevalence of 12% was shown in a subset of asymptomatic patients indicated for sterilization. This may reflect the appropriate prevalence in reproductive age population.

  18. Update on Biomarkers for the Detection of Endometriosis

    Science.gov (United States)

    Fassbender, Amelie; Burney, Richard O.; O, Dorien F.; D'Hooghe, Thomas; Giudice, Linda

    2015-01-01

    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. PMID:26240814

  19. Endometriosis of the mesoappendix mimicking appendicitis: A case report

    Directory of Open Access Journals (Sweden)

    Suman Mewa Kinoo

    2016-09-01

    Full Text Available Although appendicitis is largely a clinical diagnosis, on occasions diagnostic modalities may be needed to aid with the diagnosis. Despite the use of adjuncts and exploratory surgery, the diagnosis may not be clear until a histological diagnosis is achieved. Endometriosis of the appendix mimicking appendicitis is one of these diagnoses described in several case reports. Endometriosis of the meso-appendix has been described in association with intussusception of the appendix in several case reports. However, to our knowledge, endometriosis of the meso-appendix mimicking appendicitis has not been reported to date. We present the case of a 33-year-old woman with classic clinical signs and symptoms of appendicitis endorsed on computed tomography imaging. The patient underwent a laparoscopic appendicectomy with the postoperative histology demonstrating a normal appendix with endometriosis of the meso-appendix.

  20. 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.

  1. Size and spatial orientation of uterine tissue transplants on the peritoneum crucially determine the growth and cyst formation of endometriosis-like lesions in mice.

    Science.gov (United States)

    Körbel, Christina; Menger, Michael D; Laschke, Matthias W

    2010-10-01

    In many studies in rodents, intraperitoneal endometriosis-like lesions are surgically induced by syngeneic or autologous transplantation of uterine tissue samples, which are sutured to the abdominal wall. However, until now the surgical techniques have not been standardized, and we address this issue here. Uterine tissue samples were transplanted to the peritoneum of C57BL/6 mice (four study groups, n = 7 each). Using non-invasive high-resolution ultrasound imaging over a period of 4 weeks, we analyzed growth characteristics and cyst formation of the endometriosis-like lesions which developed, in relation to mode of transplantation (syngeneic versus autologous), type of tissue fixed adjacent to the peritoneum (endometrium versus perimetrium), and size of tissue transplanted (2 versus 3 mm). Immunohistochemical analysis was also performed. When the perimetrium, with underlying myometrium, was sutured next to the host peritoneum the endometriosis-like lesions which developed exhibited a higher growth rate (Pendometriosis-like lesions. Our study demonstrates that size and spatial orientation of peritoneally fixed uterine tissue samples crucially determine growth and cyst formation of endometriotic lesions in mice. These findings should improve the standardization and reliability of future studies, performed in the frequently used mouse model of surgically induced endometriosis.

  2. [Pictures balance for optimal surgical management of pelvic endometriosis. Imaging and surgery of endometriosis].

    Science.gov (United States)

    Leroy, A; Garabedian, C; Fourquet, T; Azaïs, H; Merlot, B; Collinet, P; Rubod, C

    2016-03-01

    Endometriosis is a frequent benign pathology that is found in 10-15% of women and in 20% of infertile women. It has an impact on fertility, but also in everyday life. If medical treatment fails, surgical treatment can be offered to the patient. To provide adequate treatment and give clearer information to patients, it seems essential to achieve an optimal preoperative imaging assessment. Thus, the aim of this work is to define the information expected by the surgeon and the indications of each imaging test for each compartment of the pelvis, allowing an ideal surgical management of pelvic endometriosis. We will not discuss imaging techniques' principles and we will not develop the indications and surgical techniques. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  3. Intraperitoneal inflammation decreases endometriosis in a mouse model

    OpenAIRE

    Nowak, N.M.; Fischer, O.M.; Gust, T.C.; Fuhrmann, U.; Habenicht, U.-F.; Schmidt, A.

    2008-01-01

    BACKGROUND The role of the immune system in the pathogenesis of endometriosis remains elusive. It has been shown that patients have an altered peritoneal environment with increased levels of inflammatory cytokines, activated macrophages and reduced clearance of retrogradely transported endometrial fragments. However, it is not known if this unique inflammatory situation is cause or consequence of endometriosis. This study investigates the impact of a pre-existing peritoneal inflammation on en...

  4. Imbalance between sympathetic and sensory innervation in peritoneal endometriosis.

    Science.gov (United States)

    Arnold, Julia; Barcena de Arellano, Maria L; Rüster, Carola; Vercellino, Giuseppe F; Chiantera, Vito; Schneider, Achim; Mechsner, Sylvia

    2012-01-01

    To investigate possible mechanisms of pain pathophysiology in patients with peritoneal endometriosis, a clinical study on sensory and sympathetic nerve fibre sprouting in endometriosis was performed. Peritoneal lesions (n=40) and healthy peritoneum (n=12) were immunostained and analysed with anti-protein gene product 9.5 (PGP 9.5), anti-substance P (SP) and anti-tyrosine hydroxylase (TH), specific markers for intact nerve fibres, sensory nerve fibres and sympathetic nerve fibres, respectively, to identify the ratio of sympathetic and sensory nerve fibres. In addition, immune cell infiltrates in peritoneal endometriotic lesions were analysed and the nerve growth factor (NGF) and interleukin (IL)-1β expression was correlate with the nerve fibre density. Peritoneal fluids from patients with endometriosis (n=40) and without endometriosis (n=20) were used for the in vitro neuronal growth assay. Cultured chicken dorsal root ganglia (DRG) and sympathetic ganglia were stained with anti-growth associated protein 43 (anti-GAP 43), anti-SP and anti-TH. We could detect an increased sensory and decreased sympathetic nerve fibres density in peritoneal lesions compared to healthy peritoneum. Peritoneal fluids of patients with endometriosis compared to patients without endometriosis induced an increased sprouting of sensory neurites from DRG and decreased neurite outgrowth from sympathetic ganglia. In conclusion, this study demonstrates an imbalance between sympathetic and sensory nerve fibres in peritoneal endometriosis, as well as an altered modulation of peritoneal fluids from patients with endometriosis on sympathetic and sensory innervation which might directly be involved in the maintenance of inflammation and pain. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Interplay between Endometriosis and Pregnancy in a Mouse Model.

    Directory of Open Access Journals (Sweden)

    Mariela Andrea Bilotas

    Full Text Available To evaluate the effect of endometriosis on fertility and the levels of the IL-2 and IFN-γ in the peritoneal fluid in a mouse model; to evaluate the effect of pregnancy on endometriotic lesion growth, apoptosis and cell proliferation.Two month old C57BL/6 female mice underwent either a surgical procedure to induce endometriosis or a sham surgery. Four weeks after surgery mice were mated and sacrificed at day 18 of pregnancy. Number of implantation sites, fetuses and fetal weight were recorded. Endometriotic lesions were counted, measured, excised and fixed. Apoptosis and cell proliferation were evaluated in lesions by TUNEL and immunohistochemistry for PCNA respectively. Levels of IL-2 and IFN-γ were assessed by ELISA in the peritoneal fluid.Pregnancy rate (i.e. pregnant mice/N decreased in mice with endometriosis. However there were no significant differences in resorption rate, litter size and pup weight between groups. IFN-γ augmented in endometriosis mice independently of pregnancy outcome. Additionally IFN-γ increased in pregnant endometriosis mice compared to pregnant sham animals. While IFN-γ increased in non pregnant versus pregnant mice in the sham group, IL-2 was increased in non pregnant mice in the endometriosis group. The size of endometriotic lesions increased in pregnant mice while apoptosis increased in the stroma and cell proliferation decreased in the epithelium of these lesions. Additionally, leukocyte infiltration, necrosis and decidualization were increased in the same lesions.Pregnancy rate is reduced in this mouse model of endometriosis. Levels of IL-2 are increased in the peritoneal fluid of mice with endometriosis suggesting a role of this cytokine in infertility related to this disease. The size of endometriotic lesions is increased in pregnant mice; however pregnancy has a beneficial effect on lesions by decreasing cell proliferation and by increasing apoptosis, decidualization and necrosis.

  6. Interplay between Endometriosis and Pregnancy in a Mouse Model.

    Science.gov (United States)

    Bilotas, Mariela Andrea; Olivares, Carla Noemí; Ricci, Analía Gabriela; Baston, Juan Ignacio; Bengochea, Tatiana Soledad; Meresman, Gabriela Fabiana; Barañao, Rosa Inés

    2015-01-01

    To evaluate the effect of endometriosis on fertility and the levels of the IL-2 and IFN-γ in the peritoneal fluid in a mouse model; to evaluate the effect of pregnancy on endometriotic lesion growth, apoptosis and cell proliferation. Two month old C57BL/6 female mice underwent either a surgical procedure to induce endometriosis or a sham surgery. Four weeks after surgery mice were mated and sacrificed at day 18 of pregnancy. Number of implantation sites, fetuses and fetal weight were recorded. Endometriotic lesions were counted, measured, excised and fixed. Apoptosis and cell proliferation were evaluated in lesions by TUNEL and immunohistochemistry for PCNA respectively. Levels of IL-2 and IFN-γ were assessed by ELISA in the peritoneal fluid. Pregnancy rate (i.e. pregnant mice/N) decreased in mice with endometriosis. However there were no significant differences in resorption rate, litter size and pup weight between groups. IFN-γ augmented in endometriosis mice independently of pregnancy outcome. Additionally IFN-γ increased in pregnant endometriosis mice compared to pregnant sham animals. While IFN-γ increased in non pregnant versus pregnant mice in the sham group, IL-2 was increased in non pregnant mice in the endometriosis group. The size of endometriotic lesions increased in pregnant mice while apoptosis increased in the stroma and cell proliferation decreased in the epithelium of these lesions. Additionally, leukocyte infiltration, necrosis and decidualization were increased in the same lesions. Pregnancy rate is reduced in this mouse model of endometriosis. Levels of IL-2 are increased in the peritoneal fluid of mice with endometriosis suggesting a role of this cytokine in infertility related to this disease. The size of endometriotic lesions is increased in pregnant mice; however pregnancy has a beneficial effect on lesions by decreasing cell proliferation and by increasing apoptosis, decidualization and necrosis.

  7. 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.

  8. Conservative approach to rectosigmoid endometriosis: a cohort study.

    Science.gov (United States)

    Egekvist, Anne G; Marinovskij, Edvard; Forman, Axel; Kesmodel, Ulrik S; Riiskjaer, Mads; Seyer-Hansen, Mikkel

    2017-06-01

    The aim of the study was to assess the risk of surgery after initial conservative treatment of rectosigmoid endometriosis in relation to demographic data. The study was conducted on the tertiary endometriosis referral unit, Aarhus University Hospital. Medical records, from patients seen from January 2009 onwards with a diagnosis of rectosigmoid endometriosis and more than 6 months' follow up were audited. Demographic data, results of magnetic resonance imaging and time to secondary surgery for rectosigmoid endometriosis were registered. Data on 238 patients diagnosed with rectosigmoid endometriosis were included. In all, 78 (32.8%) patients had primary surgery, 27 (11.3%) had secondary surgery and 133 (55.9%) continued conservative treatment throughout the observation period. Patients who underwent primary or secondary surgery were younger than patients continuing conservative treatment. In a tertiary referral center where about half of patients with rectosigmoid endometriosis were scheduled for conservative treatment, more than 80% of these avoided surgery. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

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

    International Nuclear Information System (INIS)

    Kido, Aki; Togashi, Kaori; Koyama, Takashi; Fujimoto, Ryota; Nishino, Mizuki; Miyake, Kanae; Hayakawa, Katsumi; Iwasaku, Kazuhiro; Fujii, Shingo

    2007-01-01

    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.)

  10. Kadar TNF-α dalam Zalir Peritoneal Penderita Endometriosis

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    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.

  11. Potential involvement of iron in the pathogenesis of peritoneal endometriosis.

    Science.gov (United States)

    Defrère, S; Lousse, J C; González-Ramos, R; Colette, S; Donnez, J; Van Langendonckt, A

    2008-07-01

    The aim of this study is to review the current literature associating endometriosis with iron and to discuss the potential causes and consequences of iron overload in the pelvic cavity. Indeed, iron is essential for all living organisms. However, excess iron can result in toxicity and is associated with pathological disorders. In endometriosis patients, iron overload has been demonstrated in the different components of the peritoneal cavity (peritoneal fluid, endometriotic lesions, peritoneum and macrophages). Animal models allow us to gather essential information on the origin, metabolism and effect of iron overload in endometriosis, which may originate from erythrocytes carried into the pelvic cavity mainly by retrograde menstruation. Peritoneal macrophages play an important role in the degradation of these erythrocytes and in subsequent peritoneal iron metabolism. Iron overload could affect a wide range of mechanisms involved in endometriosis development, such as oxidative stress or lesion proliferation. In conclusion, excess iron accumulation can result in toxicity and may be one of the factors contributing to the development of endometriosis. Treatment with an iron chelator could thus be beneficial in endometriosis patients to prevent iron overload in the pelvic cavity, thereby diminishing its deleterious effect.

  12. Caesarean section greatly increases risk of scar endometriosis.

    Science.gov (United States)

    Nominato, Nilo Sérgio; Prates, Luis Felipe Victor Spyer; Lauar, Isabela; Morais, Jaqueline; Maia, Laura; Geber, Selmo

    2010-09-01

    To estimate the incidence of scar endometriosis after different surgical procedures. A retrospective study of 72 patients diagnosed with scar endometriosis between 1978 and 2003 was performed. Patient age, site of endometriosis, previous operations, time-gap between last surgery and onset of symptoms, nodule characteristics, and recurrence were evaluated. Age ranged from 16 to 48 years. Location varied according to the previous surgery: 46 caesarean section, one hysterectomy, one in abdominal surgery, 19 episiotomy, one was a relapse and two pelvic floor procedures, two women with no previous surgery. The incidence of scar endometriosis after caesarean section was significantly higher than after episiotomy (0.2 and 0.06%, respectively: p<0.00001) with a relative risk of 3.3. Pain was the most frequent symptom. The mean time between surgery and onset of symptoms was 3.7 years. Our findings confirm that scar endometriosis is a rare condition and indicate, probably for the first time, that caesarean section greatly increases the risk of developing scar endometriosis. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  13. 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.)

  14. How Many People Are Affected by or at Risk for Endometriosis?

    Science.gov (United States)

    ... Share Facebook Twitter Pinterest Email Print How many people are affected by or at risk for endometriosis? ... Gynecology, 202 , 534.e1–534.e6. How many people are affected by or at risk for endometriosis? ...

  15. Immunohistochemical Evaluation of TGF-ß Isoforms in Cases with Ovarian Endometriosis and Follicular Cyst

    Directory of Open Access Journals (Sweden)

    Abdulmuttalip Şentaş

    2007-04-01

    CONCLUSION: Ovarian tissue TGF-ß1 immunoreactivity was significantly increased in endometriosis cases when compared with follicular cyst. There are needed further studies to elucidate the importance of this finding in the pathogenesis of endometriosis.

  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...

  17. Endometriosis and Ovarian Cancer: A Review of Clinical, Pathologic, and Molecular Aspects

    Science.gov (United States)

    Wei, Jian-Jun; William, Josette; Bulun, Serdar

    2014-01-01

    Summary Endometriosis is a chronic disease that affects millions of reproductive-age women. Despite the destructive and invasive nature of endometrioses, most cases are perpetually benign or eventually regress; however, atypical endometriosis is a precursor lesion and can lead to certain types of ovarian cancer. Endometriosis induced inflammation and auto- and paracrine production of sex steroid hormones contribute to ovarian tumorigenesis. These changes provide microenvironment necessary to accumulate enough genetic alterations for endometriosis associated malignant transformation. It takes years for endometriosis to undergo the pathophysiological progression that begins with atypical epithelial proliferation (atypical endometriosis and metaplasia), and then is followed by the formation of well-defined borderline tumors, and finally culminates in fully malignant ovarian cancer. This study is a review of the natural history of endometriosis and the role of microenvironments that favor the accumulation of genetic alterations and endometriosis-associated ovarian cancer progression. PMID:21979592

  18. Leptin, its receptor and aromatase expression in deep infiltrating endometriosis.

    Science.gov (United States)

    Gonçalves, Helder F; Zendron, Carolina; Cavalcante, Fernanda S; Aiceles, Verônica; Oliveira, Marco Aurélio P; Manaia, Jorge Henrique M; Babinski, Márcio A; Ramos, Cristiane F

    2015-08-05

    The aim of this study was to evaluate the leptin levels in the serum and peritoneal fluid (PF) and the protein expression in three different peritoneal ectopic implants in patients who underwent surgery for deep infiltrating endometriosis. All patients had been treated at the Department of Gynecology of the Pedro Ernesto University Hospital, Rio de Janeiro. The study group consisted of 15 patients who underwent surgery for adnexal masses and infertility, while the control group consisted of ten women who underwent surgery for tubal ligation. Peritoneal fluid and samples tissues were collected during surgery. Serum samples were obtained before anesthesia. In this study, the leptin levels in the serum and peritoneal fluid (PF) were evaluated by ELISA. The protein expression of leptin and its receptors (ObR) and aromatase enzyme were evaluated by Western blot analysis of the intestine, uterosacral ligament and vaginal septum in the ectopic implants. The t-test and one-way ANOVA with Holm-Sìdak post-test were used, and p endometriosis = 19.2 ng/mL ± 1.84, p endometriosis = 7.71 ng/mL ± 0.59, p = 0.18). Comparing women with and without ovarian implants, the leptin levels in both the serum and PF were significantly higher in women without ovarian implants (serum: with ovarian implant = 15.85 ± 1.99; without ovarian implant = 23.14 ± 2.60; ng/mL, p = 0.04; PF: with ovarian implant = 4.28 ± 1.30; without ovarian implant = 11.18 ± 2.98;ng/mL, p = 0.048). The leptin, ObR and aromatase protein expression levels were increased in lesions in the vaginal septum and were decreased in the intestine lesions. This study reports several interesting associations between the leptin levels in serum, peritoneal fluid, and tissue samples and the localization of the ectopic endometrium. Although this study does not provide a clear picture of the role of leptin in the development and progression of peritoneal implants

  19. The effectiveness of non-pyrethroid insecticide-treated durable wall lining to control malaria in rural Tanzania: study protocol for a two-armed cluster randomized trial

    Directory of Open Access Journals (Sweden)

    George Mtove

    2016-07-01

    Full Text Available Abstract Background Despite considerable reductions in malaria achieved by scaling-up long-lasting insecticidal nets (LLINs and indoor residual spraying (IRS, maintaining sustained community protection remains operationally challenging. Increasing insecticide resistance also threatens to jeopardize the future of both strategies. Non-pyrethroid insecticide­treated wall lining (ITWL may represent an alternate or complementary control method and a potential tool to manage insecticide resistance. To date no study has demonstrated whether ITWL can reduce malaria transmission nor provide additional protection beyond the current best practice of universal coverage (UC of LLINs and prompt case management. Methods/design A two-arm cluster randomized controlled trial will be conducted in rural Tanzania to assess whether non-pyrethroid ITWL and UC of LLINs provide added protection against malaria infection in children, compared to UC of LLINs alone. Stratified randomization based on malaria prevalence will be used to select 22 village clusters per arm. All 44 clusters will receive LLINs and half will also have ITWL installed on interior house walls. Study children, aged 6 months to 11 years old, will be enrolled from each cluster and followed monthly to estimate cumulative incidence of malaria parasitaemia (primary endpoint, time to first malaria episode and prevalence of anaemia before and after intervention. Entomological inoculation rate will be estimated using indoor CDC light traps and outdoor tent traps followed by detection of Anopheles gambiae species, sporozoite infection, insecticide resistance and blood meal source. ITWL bioefficacy and durability will be monitored using WHO cone bioassays and household surveys, respectively. Social and cultural factors influencing community and household ITWL acceptability will be explored through focus-group discussions and in-depth interviews. Cost-effectiveness, compared between study arms, will be

  20. Occult microscopic endometriosis: undetectable by laparoscopy in normal peritoneum.

    Science.gov (United States)

    Khan, Khaleque Newaz; Fujishita, Akira; Kitajima, Michio; Hiraki, Koichi; Nakashima, Masahiro; Masuzaki, Hideaki

    2014-03-01

    Is there any occurrence of hidden (occult) endometriotic lesions in normal peritoneum of women with and without visible endometriosis? We detected a slightly higher occurrence of occult microscopic endometriosis (OME) in normal peritoneum of women with visible endometriosis than in control women. Based on a small number of cases, the concept of invisible microscopic endometriosis in visually normal peritoneum has been reported for more than a decade but there is controversy regarding their tissue activity and clinical significance. This case-controlled research study was conducted with prospectively collected normal peritoneal samples from 151 women with and 62 women without visible endometriosis. Normal peritoneal biopsy specimens from different pelvic sites of were collected during laparoscopy. A histological search of all peritoneal biopsy specimens for the detection of invisible endometriosis was done by immunoreaction to Ber-EP4 (epithelial cell marker), CD10 (stromal cell marker) and Calretinin (mesothelial cell marker). Tissue expression of estrogen/progesterone receptors (ER/PR) and cell proliferation marker, Ki-67, was performed by immunohistochemistry to identify tissue activity. Three different patterns of OME were detected based on (I) the presence of typical gland/stroma, (II) reactive hyperplastic change of endometrioid epithelial cells with surrounding stroma and (III) single-layered epithelium-lined cystic lesions with surrounding stroma. A higher tendency toward the occurrence of OME was found in women with visible endometriosis (15.2%, 23/151) compared with control women (6.4%, 4/62) (P = 0.06, χ(2) test). The epithelial cells and/or stromal cells of OME lesions were immunoreactive to Ber-EP4 and CD10 but not reactive to Calretinin. ER and PR expression was observed in all patterns of OME lesions. Ki-67 index was significantly higher in pattern I/II OME lesions than in pattern III OME lesions (Pendometriosis due to the presence of adhesions in

  1. 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.

  2. 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....

  3. Increased risk for ovarian cancer and borderline ovarian tumours in subfertile women with endometriosis

    NARCIS (Netherlands)

    Buis, C. C. M.; van Leeuwen, F. E.; Mooij, T. M.; Burger, C. W.; Lambalk, Cornelis B.; Kortman, Marian; Laven, Joop S. E.; Jansen, Cees A. M.; Helmerhorst, Frans M.; Cohlen, Ben J.; Willemsen, Wim N. P.; Smeenk, Jesper M. J.; Simons, Arnold H. M.; van der Veen, Fulco; Evers, Johannes L. H.; van Dop, Peter A.; Macklon, Nicholas S.

    2013-01-01

    Is ovarian or extra-ovarian endometriosis associated with an increased risk of ovarian cancer and borderline ovarian tumours (BOT)? We found a 3- to 8-fold increased risk of ovarian tumours associated with endometriosis: the magnitude of the risk increase depended on the definition of endometriosis.

  4. L1 cell adhesion molecule as a potential therapeutic target in murine models of endometriosis using a monoclonal antibody approach.

    Directory of Open Access Journals (Sweden)

    Cássia G T Silveira

    Full Text Available BACKGROUND/AIMS: The neural cell adhesion molecule L1CAM is a transmembrane glycoprotein abnormally expressed in tumors and previously associated with cell proliferation, adhesion and invasion, as well as neurite outgrowth in endometriosis. Being an attractive target molecule for antibody-based therapy, the present study assessed the ability of the monoclonal anti-L1 antibody (anti-L1 mAb to impair the development of endometriotic lesions in vivo and endometriosis-associated nerve fiber growth. METHODS AND RESULTS: Endometriosis was experimentally induced in sexually mature B6C3F1 (n=34 and CD-1 nude (n=21 mice by autologous and heterologous transplantation, respectively, of endometrial fragments into the peritoneal cavity. Transplantation was confirmed four weeks post-surgery by in vivo magnetic resonance imaging and laparotomy, respectively. Mice were then intraperitoneally injected with anti-L1 mAb or an IgG isotype control antibody twice weekly, over a period of four weeks. Upon treatment completion, mice were sacrificed and endometrial implants were excised, measured and fixed. Endometriosis was histologically confirmed and L1CAM was detected by immunohistochemistry. Endometriotic lesion size was significantly reduced in anti-L1-treated B6C3F1 and CD-1 nude mice compared to mice treated with control antibody (P<0.05. Accordingly, a decreased number of PCNA positive epithelial and stromal cells was detected in autologously and heterologously induced endometriotic lesions exposed to anti-L1 mAb treatment. Anti-L1-treated mice also presented a diminished number of intraperitoneal adhesions at implantation sites compared with controls. Furthermore, a double-blind counting of anti-neurofilament L stained nerves revealed significantly reduced nerve density within peritoneal lesions in anti-L1 treated B6C3F1 mice (P=0.0039. CONCLUSIONS: Local anti-L1 mAb treatment suppressed endometriosis growth in B6C3F1 and CD-1 nude mice and exerted a potent

  5. Rising damp in building walls: the wall base ventilation system

    Energy Technology Data Exchange (ETDEWEB)

    Guimaraes, A.S.; Delgado, J.M.P.Q.; Freitas, V.P. de [Faculdade de Engenharia da Universidade do Porto, Laboratorio de Fisica das Construcoes (LFC), Departamento de Engenharia Civil, Porto (Portugal)

    2012-12-15

    This work intends to validate a new system for treating rising damp in historic buildings walls. The results of laboratory experiments show that an efficient way of treating rising damp is by ventilating the wall base, using the HUMIVENT technique. The analytical model presented describes very well the observed features of rising damp in walls, verified by laboratory tests, who contributed for a simple sizing of the wall base ventilation system that will be implemented in historic buildings. (orig.)

  6. Endometriosis increases the risk of obstetrical and neonatal complications.

    Science.gov (United States)

    Berlac, Janne Foss; Hartwell, Dorthe; Skovlund, Charlotte Wessel; Langhoff-Roos, Jens; Lidegaard, Øjvind

    2017-06-01

    The objective of this study was to assess obstetrical complications and neonatal outcomes in women with endometriosis as compared with women without endometriosis. National cohort including all delivering women and their newborns in Denmark 1997-2014. Data were extracted from the Danish Health Register and the Medical Birth Register. Logistic regression analysis provided odds ratios (OR) with 95% confidence intervals (CI). Sub-analyses were made for primiparous women with a singleton pregnancy and for women with endometriosis who underwent gynecological surgery before pregnancy. In 19 331 deliveries, 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, 95% CI 2.0-2.5), placental abruption (OR 2.0, 95% CI 1.7-2.3), placenta previa (OR 3.9, 95% CI 3.5-4.3), premature rupture of membranes (OR 1.7, 95% CI 1.5-1.8), and retained placenta (OR 3.1, 95% CI 1.4-6.6). The neonates had increased risks of preterm birth before 28 weeks (OR 3.1, 95% CI 2.7-3.6), being small for gestational age (OR 1.5, 95% CI 1.4-1.6), being diagnosed with congenital malformations (OR 1.3, 95% CI 1.3-1.4), and neonatal death (OR 1.8, 95% CI 1.4-2.1). Results were similar in primiparous women with a singleton pregnancy. Gynecological surgery for endometriosis before pregnancy carried a further increased risk. Women with endometriosis had a significantly higher risk of several complications, such as preeclampsia and placental complications in pregnancy and at delivery. The newborns had increased risk of being delivered preterm, having congenital malformations, and having a higher neonatal death rate. Pregnant women with endometriosis require increased antenatal surveillance. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  7. Vitamin D in endometriosis: a causative or confounding factor?

    Science.gov (United States)

    Sayegh, Lamia; Fuleihan, Ghada El-Hajj; Nassar, Anwar H

    2014-01-01

    The aim of this paper is to review the evidence from studies that evaluated the relationship between vitamin D and endometriosis. Comprehensive review. Systematic literature search in Medline for relevant publications from 1946 until June 2013. Endometriosis risk may be influenced by dietary vitamin D intake and plasma hydroxyvitamin D concentration. Vitamin D receptor and vitamin D metabolizing enzymes, 24-hydroxylase and 1-α hydroxylase, are found in the normal cycling endometrium and also in the eutopic and ectopic endometrium of women with endometriosis. The endometrium is a target of 1, 25 dihydroxyvitamin D actions through regulation of specific genes and via immunomodulation. The endometrium in endometriosis expresses dysregulation of some vitamin D enzymes and receptors. If vitamin D and its metabolites are implicated in endometriosis-associated infertility, it is likely through interference with HOXA10 gene expression. The Gc2 phenotype of vitamin D binding protein is prevalent in women with endometriosis and may be implicated in its pathogenesis. In a mouse model, Elocalcitol, a VDR-agonist was shown to reduce the development of endometriotic lesions and recurrence. A biological plausibility for a role of vitamin D, as an immunomodulator and anti-inflammatory agent, in the pathogenesis and treatment of endometriosis is suggested in this article, but is difficult to illustrate due to sparse evidence from human studies limited primarily to case-control studies. A significant knowledge gap precludes the establishment of a clear cause-effect relationship. The intriguing leads presented herein need to be investigated further with placebo-controlled supplementation trials. © 2013.

  8. ZEB1 expression is a potential indicator of invasive endometriosis.

    Science.gov (United States)

    Furuya, Masataka; Masuda, Hirotaka; Hara, Kanako; Uchida, Hiroshi; Sato, Kenji; Sato, Suguru; Asada, Hironori; Maruyama, Tetsuo; Yoshimura, Yasunori; Katabuchi, Hidetaka; Tanaka, Mamoru; Saya, Hideyuki

    2017-09-01

    Although endometriosis is a benign disease, it shares some features with cancers, such as invasiveness and the potential to metastasize. This study sought to investigate the epithelial-mesenchymal transition status in human endometriotic lesions. Thirteen endometriosis patients and 10 control women without endometriosis undergoing surgery for benign indications were recruited. We examined the expression of E-cadherin, vimentin, and epithelial-mesenchymal transition-induced transcriptional factors, such as Snail and ZEB1, by immunohistochemistry. We evaluated the expression of each marker in epithelial cells of both endometriotic lesions (ovarian endometrioma, deep infiltrating endometriosis, adenomyosis) and normal endometria. The correlation between ZEB1 expression and serum level of CA125 was also investigated. Immunohistochemical analysis revealed that although E-cadherin, vimentin, and Snail were expressed in epithelia of normal endometria and endometriotic lesions, ZEB1 expression was only expressed in epithelia of endometriotic lesions. Additionally, ZEB1 was most frequently observed in epithelial cells of invasive endometriosis. The endometriosis patients with high serum CA125 level were more likely to have ZEB1-positive lesions. This is the first observation of ZEB1 expression in epithelial cells of benign disease. The preferential expression of ZEB1 in epithelial cells of endometriotic lesions suggests that these cells may have, at least in part, a higher level of mesenchymal features possibly via ZEB1-driven epithelial-mesenchymal transition than normal endometria and that ZEB1 can be a potential indicator of invasiveness or severity of endometriosis. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  9. ENDOMETRIOSIS OF APPENDIX IN WOMEN PRESENTING WITH RIGHT LOWER ABDOMINAL PAIN

    Directory of Open Access Journals (Sweden)

    Radha Bai Prabhu T, Velayudam DA, Jayalakshmi M

    2015-07-01

    Full Text Available Endometriosis is a well known gynaecological condition associated with infertility and chronic pelvic pain. Review of literature shows that endometriosis can affect any tissue in the body, including the appendix. Here we report a case of pelvic endometriosis involving the vermiform appendix in a 45 years old multiparous woman. When women of the reproductive age present with recurrent lower abdominal pain on the right side, endometriosis of the appendix should also be considered. At the time of surgery appendix should be inspected and removed; especially in the presence of pelvic endometriosis.

  10. Endometriosis fertility index predicts live births following surgical resection of moderate and severe endometriosis.

    Science.gov (United States)

    Maheux-Lacroix, S; Nesbitt-Hawes, E; Deans, R; Won, H; Budden, A; Adamson, D; Abbott, J A

    2017-11-01

    Can live birth be accurately predicted following surgical resection of moderate-severe (Stage III-IV) endometriosis? Live births can accurately be predicted with the endometriosis fertility index (EFI), with adnexal function being the most important factor to predict non-assisted reproductive technology (non-ART) fertility or the requirement for ART (www.endometriosisefi.com). Fertility prognosis is important to many women with severe endometriosis. Controversy persists regarding optimal post-operative management to achieve pregnancy and the counselling of patients regarding duration of conventional treatments before undergoing ART. The EFI is reported to correlate with expectant management pregnancy rate, although external validation has been performed without specifically addressing fertility in women with moderate and severe endometriosis. Retrospective cohort study of 279 women from September 2001 to June 2016. We included women undergoing laparoscopic resection of Stage III-IV endometriosis who attempted pregnancy post-operatively. The EFI was calculated based on detailed operative reports and surgical images. Fertility outcomes were obtained by direct patient contact. Kaplan-Meier model, log rank test and Cox regression were used for analyses. The follow-up rate was 84% with a mean duration of 4.1 years. A total of 147 women (63%) had a live birth following surgery, 94 of them (64%) without ART. The EFI was highly associated with live births (P years was 0% and steadily increased up to 91% with an EFI of 9-10, while the proportion of women who attempted ART and had a live birth, steadily increased from 38 to 71% among the same EFI strata (P = 0.1). A low least function score was the most significant predictor of failure (P = 0.003), followed by having had a previous resection (P = 0.019) or incomplete resection (P = 0.028), being older than 40 compared to years of age (P = 0.027), and having leiomyomas (P = 0.037). The main limitation of this study is its

  11. To operate or not to operate on women with deep infiltrating endometriosis (DIE) before in vitro fertilization (IVF)

    Science.gov (United States)

    Carneiro, Márcia Mendonça; Costa, Luciana Maria Pyramo; de Ávila, Ivete

    2017-01-01

    Deep infiltrating endometriosis (DIE) can cause infertility and pelvic pain. There is little evidence of a clear connection between DIE and infertility, and the absolute benefits of surgery for DIE have not been established. This paper aimed to review the current literature on the effect of surgery for DIE on fertility, pregnancy, and IVF outcomes. Clinicians should bear in mind that a comprehensive clinical history is useful to identify patients at risk for endometriosis, although many women remain asymptomatic. Imaging can be useful to plan surgery. The effect of surgery on the fertility of women with DIE remains unanswered due to the heterogeneous nature of the disease and the lack of trials with enough statistical power and adequate follow-up. Surgery is not recommended when the main goal is to treat infertility or to improve IVF results. Decisions should be tailored according to the individual needs of each woman. Patients must be provided information on the potential benefits, harm, and costs of each treatment alternative, while the medical team observes factors such as presence of pelvic pain, patient age, lesion location, and previous treatments. In this scenario, management by a multidisciplinary endometriosis team is a key step to achieving successful outcomes. PMID:28609279

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

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    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.

  13. Epithelial-to-mesenchymal transition in the development of endometriosis.

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    Yang, Yan-Meng; Yang, Wan-Xi

    2017-06-20

    Endometriosis, an estrogen-dependent chronic gynecological disease, is common in reproductive-age women and profoundly affects their life quality. Although various pathogenic theories have been proposed, the origin of endometriosis remains unclear. Epithelial to mesenchymal transition (EMT) is a process that epithelial cells lose polarized organization of the cytoskeleton and cell-to-cell contacts, acquiring the high motility of mesenchymal cells. These changes are thought to be prerequisites for the original establishment of endometriotic lesions. However, no study exactly indicates which type of EMT occurs in endometriosis. In this review, we conclude that two different types of EMT may participate in this disease. Besides, two stimulating signals, hypoxia and estrogen, can through different pathways to activate the EMT process in endometriosis. Those pathways involve many cellular factors such as TGF-beta and Wnt, ultimately leading to cell proliferation and migration. As infertility is becoming a serious and intractable issue for women, EMT, during the implantation process, is gaining attention. In this review, we will describe the known functions of EMT in endometriosis, and suggest further studies that may aid in the development of medical therapy.

  14. Medical Treatments for Endometriosis-Associated Pelvic Pain

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    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.

  15. Oxidative Stress and Endometriosis: A Systematic Review of the Literature

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    Gennaro Scutiero

    2017-01-01

    Full Text Available Endometriosis is one of the most common gynaecologic diseases in women of reproductive age. It is characterized by the presence of endometrial tissue outside the uterine cavity. The women affected suffer from pelvic pain and infertility. The complex etiology is still unclear and it is based on three main theories: retrograde menstruation, coelomic metaplasia, and induction theory. Genetics and epigenetics also play a role in the development of endometriosis. Recent studies have put the attention on the role of oxidative stress, defined as an imbalance between reactive oxygen species (ROS and antioxidants, which may be implicated in the pathophysiology of endometriosis causing a general inflammatory response in the peritoneal cavity. Reactive oxygen species are intermediaries produced by normal oxygen metabolism and are inflammatory mediators known to modulate cell proliferation and to have deleterious effects. A systematic review was performed in order to clarify the different roles of oxidative stress and its role in the development of endometriosis. Several issues have been investigated: iron metabolism, oxidative stress markers (in the serum, peritoneal fluid, follicular fluid, peritoneal environment, ovarian cortex, and eutopic and ectopic endometrial tissue, genes involved in oxidative stress, endometriosis-associated infertility, and cancer development.

  16. Endometriosis is an important cause of pelvic pain in adolescence

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    Marina de Paula Andres

    2014-12-01

    Full Text Available Objective: despite endometriosis being a common disease, where early detection is key to preventing its progression, it is a condition often overlooked in adolescents. The aim of this study was to report the clinical characteristics of adolescent patients with endometriosis monitored in a tertiary hospital. Methods: a retrospective study of 394 patients undergoing surgery with a histological diagnosis of endometriosis at the Endometriosis Division of the Gynecology Department at the Hospital das Clínicas of the University of São Paulo Medical School from 2008 to 2013. 21 adolescents were included (aged under 21 years. Results: the age ranged from 17.95 ± 1.48 years, the average time for diagnostic confirmation was 2.96 ± 2.93 years, and the age at the onset of symptoms was 15.28 ± 3.03 years on average. The sites affected were ovarian (38%, peritoneal (47.6% and retrocervical (23.8%. Dysmenorrhea was found in 80.9 % of adolescents (severe in 33.3% of cases and chronic pelvic pain in 66.6%. Conclusion: endometriosis in adolescents is an important differential diagnosis from pelvic pain and ovarian cysts, mainly among those with no response to conventional treatment. The main forms of involvement are peritoneal and ovarian. Despite the onset of symptoms in adolescence and advances in imaging methods, the diagnosis of this disease is still delayed.

  17. [IVF and endometriosis, oocyte donation and fertility preservation].

    Science.gov (United States)

    d'Argent, Emmanuelle Mathieu; Antoine, Jean-Marie

    2017-12-01

    Endometriosis is a common condition, causing pain and infertility. In infertile woman with superficial peritoneal endometriosis and patent tubes, laparoscopy is recommended, followed by ovarian stimulation alone or in combination with intrauterine inseminations. In case of ovarian or deep endometriosis, the indications of surgery and assisted reproductive technologies remain to be defined precisely. In vitro fertilization is generally proposed after the failure of up to three inseminations, directly for ovarian or deep endometriosis, or in case of an associated factor of infertility, mainly male. Before ovarian stimulation in view to in vitro fertilization, a pretreatment by GnRH agonist for 2 to 6 months or combined contraceptive for 6 to 8 weeks would improve the pregnancy rate. Egg donation is effective in patients with advanced ovarian failure or lack of ovarian response to stimulation. Fertility preservation, especially by oocytes vitrified, must be proposed preventively to women with endometriosis at risk of ovarian failure, without close wish to be pregnant. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

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

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    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

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

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    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.

  20. Endometriosis: frequency and correlation between symptomatology and disease stage

    International Nuclear Information System (INIS)

    Mehmud, G.; Akhtar, T.; Sadia, S.

    2007-01-01

    To determine the frequency of endometriosis in general gynecological and infertile women presenting to hospital and to correlate symptomatology and stage of disease. Fifty patients with diagnosis of endometriosis on laparoscopy were included in the study. The degree of pain symptoms was graded according to 1-4 point verbal rating scale designed by Biberoglu and Behrman. Endometriosis was staged according to Revised American Fertility Society (R-AFS) scoring on laparoscopy. Correlation coefficient-Spearman rank order correlation test was applied to analyze data. The frequency of endometriosis in infertile women was 24% (33) and in women with general gynecological complaints, it was 23% (17). There was a significant positive correlation between chronic pelvic pain and R-AFS scoring. Increasing severity of pelvic pain was also positively correlated with presence of endometrioma and complete obliteration of pouch of Douglas. No correlation between dysmenorrhoea and R-AFS scoring could be detected. Dysmenorrhoea was strongly and positively correlated with the presence of superficial implants. Dyspareunia was found to have positive correlation with R-AFS score and also with complete obliteration of pouch of Douglas. The frequency of endometriosis in infertile women was 24% (33) and in women with general gynecological complaints, it was 23% (17). Chronic pelvic pain and dyspareunia had strong positive correlation with R-AFS score while dysmenorrhoea had no such correlation. (author)

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

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    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.

  2. Peritoneal fluid reduces angiogenesis-related microRNA expression in cell cultures of endometrial and endometriotic tissues from women with endometriosis.

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    Aitana Braza-Boïls

    Full Text Available UNLABELLED: Endometriosis, defined as the presence of endometrium outside the uterus, is one of the most frequent gynecological diseases. It has been suggested that modifications of both endometrial and peritoneal factors could be implicated in this disease. Endometriosis is a multifactorial disease in which angiogenesis and proteolysis are dysregulated. MicroRNAs (miRNAs are small non-coding RNAs that regulate the protein expression and may be the main regulators of angiogenesis. Our hypothesis is that peritoneal fluid from women with endometriosis could modify the expression of several miRNAs that regulate angiogenesis and proteolysis in the endometriosis development. The objective of this study has been to evaluate the influence of endometriotic peritoneal fluid on the expression of six miRNAs related to angiogenesis, as well as several angiogenic and proteolytic factors in endometrial and endometriotic cell cultures from women with endometriosis compared with women without endometriosis. METHODS: Endometrial and endometriotic cells were cultured and treated with endometriotic and control peritoneal fluid pools. We have studied the expression of six miRNAs (miR-16, -17-5p, -20a, -125a, -221, and -222 by RT-PCR and protein and mRNA levels of vascular endothelial growth factor-A, thrombospondin-1, urokinase plasminogen activator and plasminogen activator inhibitor-1 by ELISA and qRT-PCR respectively. RESULTS: Control and endometriotic peritoneal fluid pools induced a significant reduction of all miRNAs levels in endometrial and endometriotic cell cultures. Moreover, both peritoneal fluids induced a significant increase in VEGF-A, uPA and PAI-1 protein levels in all cell cultures without significant increase in mRNA levels. Endometrial cell cultures from patients treated with endometriotic peritoneal fluid showed lower expression of miRNAs and higher expression of VEGF-A protein levels than cultures from controls. In conclusion , this "in vitro

  3. Molecular detection of Chlamydia Trachomatis and Mycoplasma Hominis in endometriosis lesions

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    F. Azizvakili

    2016-12-01

    Full Text Available Background: Retrograde of menstrual blood into the peritoneal cavity is one of the accepted theories for initiation of endometriosis although indicated that other factors are involved in pathogenesis. Investigation of infectious agents is important in this regard. Objective: To investigate the presence of bacterial infections; Chlamydia trachomatis and Mycoplasma Hominis as risk factors in endometriosis lesions. Methods: This case-control study was conducted in Sarem Hospital in 2014. DNA was extracted from 90 paraffin-embedded blocks included 40 endometriosis tissue samples, 23 samples of endometrial tissue from the same patients and 27 samples of endometrial tissue of the patients without endometriosis, and molecular analysis were performed using polymerase chain reaction. Results were analyzed by Fisher Exact Test and McNemar Test. Findings: Chlamydia trachomatis infection was seen in 11 (27.5% endometriosis tissue, 3 (13% normal tissue from patients and 10 (37% in patient without endometriosis. Mycoplasma hominis was diagnosed in 11 (27.5% endometriosis tissue, 7 (30.4% of normal tissue from patients and one patient without endometriosis (3.7%. These differences show significant relations between infection with Mycoplasma hominis and endometriosis. Conclusion: The findings of this study did not show significant association between Chlamydia trachomatis infections and endometriosis. However; it seems Mycoplasma hominis infection can increase the risk of endometriosis incidence.

  4. Tratamento da endometriose Treatment of endometriosis

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    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

  5. Demographic, Clinical, and Prognostic Factors of Ovarian Clear Cell Adenocarcinomas According to Endometriosis Status

    DEFF Research Database (Denmark)

    Schnack, Tine H; Høgdall, Estrid; Thomsen, Lotte Nedergaard

    2017-01-01

    OBJECTIVES: Women with endometriosis carry an increased risk for ovarian clear cell adenocarcinomas (CCCs). Clear cell adenocarcinoma may develop from endometriosis lesions. Few studies have compared clinical and prognostic factors and overall survival in patients diagnosed as having CCC according...... to endometriosis status. METHODS: Population-based prospectively collected data on CCC with coexisting pelvic (including ovarian; n = 80) and ovarian (n = 46) endometriosis or without endometriosis (n = 95) were obtained through the Danish Gynecological Cancer Database. χ Test, independent-samples t test, logistic...... regression, Kaplan-Meier test, and Cox regression were used. Statistical tests were 2 sided. P values less than 0.05 were considered statistically significant. RESULTS: Patients with CCC and pelvic or ovarian endometriosis were significantly younger than CCC patients without endometriosis, and a higher...

  6. Endometriose: modelo experimental em ratas Endometriosis: experimental model in rats

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    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

  7. Endometriosis: A Rare Cause of Large Bowel Obstruction

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    Gonçalo Alexandrino

    2017-10-01

    Full Text Available Large bowel obstruction can result in significant morbidity and mortality, especially in cases of acute complete obstruction. There are many possible causes, the most common in adults being colorectal cancer. Endometriosis is a benign disease, and the most affected extragenital location is the bowel, especially the rectosigmoid junction. However, transmural involvement and acute occlusion are very rare events. We report an exceptional case of acute large bowel obstruction as the initial presentation of endometriosis. The differential diagnosis of colorectal carcinoma may be challenging, and this case emphasizes the need to consider intestinal endometriosis in females at a fertile age presenting with gastrointestinal symptoms and an intestinal mass causing complete large bowel obstruction.

  8. Colonoscopic tattoo dye spillage mimics endometriosis on laparoscopy.

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    Stemmer, Shlomo M; Shurshalina, Anna

    2014-01-01

    Rare adverse effects of India ink injection spillage during colonoscopy have been reported. We present a case report in which prior colonoscopic India ink tattooing was found to mimic intraperitoneal endometriosis in a 48 year-old woman undergoing laparoscopic sterilization. Multiple black lesions suspicious for endometriosis involving the anterior and posterior cul-de-sac, left ovary, and omentum were found. A pathological assessment showed peritoneal tissue with focal dark pigment associated with mild chronic inflammation and deposition of tattoo pigment; there was no evidence of endometriosis in the specimens. Surgical recognition of tattoo ink spillage in the peritoneum is very important to prevent misinterpretation of peritoneal findings. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

  9. 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...

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

    DEFF Research Database (Denmark)

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

    2017-01-01

    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...... an elevated risk of epithelial ovarian cancer. However, due to the limited number and size of studies in this area we cannot draw definitive conclusions. Further research into a risk factor profile among women with endometriosis is needed before clear recommendations can be made....... of epithelial ovarian cancer among women with endometriosis were included. A quality assessment was conducted using the Newcastle-Ottawa Scale. RESULTS: Eight of 794 articles met the inclusion criteria. A lower risk of epithelial ovarian cancer was observed in women with documented complete surgical excision...

  11. RCT to evaluate the influence of adjuvant medical treatment of peritoneal endometriosis on the outcome of IVF.

    Science.gov (United States)

    Decleer, W; Osmanagaoglu, K; Verschueren, K; Comhaire, F; Devroey, P

    2016-09-01

    Does a 3-month adjuvant hormonal treatment of mild peritoneal endometriosis after laparoscopic surgery influence the outcome of IVF stimulation in terms of number of mature oocytes obtained per cycle? Complementary medical treatment of mild peritoneal endometriosis does not influence the number of oocytes per treatment cycle. Endometriosis is a disease known to be related to infertility. However, the influence of superficial endometriosis-and its treatment-is still a matter of debate. A prospective controlled, randomized, open label trial was performed between February 2012 and March 2014 and embryological and clinical outcomes were measured. Patients with laparoscopically diagnosed peritoneal endometriosis (n= 120) were treated by laser surgery after which they were sequentially randomized by computer-generated allocation to one of the two groups. The primary outcome of the trial was the number of Metaphase II (MII) oocytes. Sample size was chosen to detect a difference of two MII oocytes with a power of 80%. The control group (Group B) received the classical long protocol IVF stimulation, whereas the research group (Group A) had an additional pituitary suppression, of 3 months using a long-acting GnRH agonist, prior to IVF. A total of 120 patients were included in the study, 61 of them in the study group and 59 patients in the control group. One patient of the control group was lost to follow up leading to 58 evaluable patients. There was no difference in terms of the number of MII oocytes obtained per cycle: 8.2 in both groups (difference in MII between A and B: 0.07 [-1.89; 2.04] 95% confidence interval (CI)). Pregnancy rate did not differ, being 39.3% for Group A (24 out of 61 patients) versus 39.7% for Group B (23 out of 58 patients) (95% CI around difference in pregnancy rate between A and B: -0.31% [-17.96%; 17.86%]). However, a significantly (P = 0.025) lower dose of FSH (2561 IU for Group A and 2303 IU for Group B, 95% CI around difference in FSH between

  12. Progesterone resistance in endometriosis: origins, consequences and interventions.

    Science.gov (United States)

    Patel, Bansari G; Rudnicki, Martin; Yu, Jie; Shu, Yimin; Taylor, Robert N

    2017-06-01

    Endometriosis is a common cause of pelvic pain and affects up to 10% of women of reproductive age. Aberrant progesterone signaling in the endometrium plays a significant role in impaired decidualization and establishment of ectopic endometrial implants. Eutopic endometrial cells from women with endometriosis fail to downregulate genes needed for decidualization, such as those involved in cell cycle regulation, leading to unbridled proliferation. Several causes of progesterone resistance in the endometrium have been postulated, including congenital "preconditioning", whereby the in utero environment renders infants susceptible to neonatal uterine bleeding and endometriosis. Progesterone action is crucial to decreasing inflammation in the endometrium, and deviant progesterone signaling results in a proinflammatory phenotype. Conversely, chronic inflammation can induce a progesterone-resistant state. Repetitive retrograde endometrial shedding begets chronic peritoneal inflammation, which further exacerbates progesterone resistance. Genetic causes of progesterone resistance include progesterone receptor gene polymorphisms, altered microRNA expression, and epigenetic modifications to progesterone receptors and their targets. Environmental toxins such as dioxin play a possible role in the genesis of endometriosis by permitting an inflammatory milieu. A consequence of impaired progesterone action is that hormonal therapy is rendered ineffective for a subset of women with endometriosis. Synthetic progestins, such as dienogest, may overcome this phenomenon by increasing progesterone receptor expression and decreasing proinflammatory cytokines. Other modalities include high dose depot formulations of progestins, medicated intrauterine devices and the likely advent of oral GnRH antagonists. Unearthing root causes of progesterone inaction in endometriosis will aid in the development of novel therapeutics geared toward prevention and treatment. © 2017 Nordic Federation of

  13. Endometriosis on the uterosacral ligament: a marker of ureteral involvement.

    Science.gov (United States)

    Lima, Raquel; Abdalla-Ribeiro, Helizabet; Nicola, Ana Luisa; Eras, Aline; Lobao, Anna; Ribeiro, Paulo Ayroza

    2017-06-01

    To evaluate the association between ultrasound measurements of endometriosis nodules on the uterosacral ligament (USL) and the risk of ureteral involvement, as well as to assess whether associations with other ultrasound variables increase the sensitivity and specificity of the diagnosis of ureteral endometriosis. Cross-sectional, observational study. University hospital. Four hundred sixty-three women with deep infiltrating endometriosis (DIE). Patients diagnosed with DIE underwent transvaginal ultrasound endometriosis mapping before laparoscopic surgery for full excision of endometriotic lesions. Preoperative ultrasound evaluation, intra- and postoperative assessment, and anatomopathologic confirmation. Of the 463 patients who participated in the study, 111 (23.97%) presented with endometriosis nodules with USL involvement on ultrasound examination conducted by a single radiologist. Receiver operating characteristic curve analysis showed that the size of the USL nodule had a statistically significant association with ipsilateral ureteral involvement. After multivariate logistic regression, the variables reduction in ovarian mobility, ureteral changes on the right side, size of the USL nodule, and presence of endometrioma on the left side were significantly associated with a ureteral endometriosis nodule. However, the combined result for the variables cited was worse than the diagnostic analysis using only the size of the USL nodule. Uterosacral ligament nodules with ultrasound measurements of 1.75 cm and 1.95 cm on the right and left sides, respectively, significantly increase the risk of ureteral involvement. Even with the association of other ultrasound variables, there was no improvement in sensitivity. Therefore, USL nodule size is a key measure for therapeutic planning and consent of the patient. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  14. Expression of eicosanoid biosynthetic and catabolic enzymes in peritoneal endometriosis.

    Science.gov (United States)

    Lousse, J-C; Defrère, S; Colette, S; Van Langendonckt, A; Donnez, J

    2010-03-01

    Increased peritoneal eicosanoid concentrations have been reported in endometriosis patients and might be important in disease-associated pain and inflammation. Here, we evaluated the expression of key biosynthetic and catabolic enzymes involved in this abnormal eicosanoid production in peritoneal macrophages and endometriotic lesions. Peritoneal macrophages, endometriotic lesions and matched eutopic endometrium were collected from endometriosis patients (n = 40). Peritoneal macrophages and eutopic endometrium samples were also collected from disease-free women (n = 25). Expression of type IIA secretory phospholipase A(2) (sPLA(2)-IIA), cyclooxygenase-2 (COX-2), microsomal prostaglandin E synthase-1 (mPGES-1), 15-hydroxyprostaglandin dehydrogenase (15-PGDH) and 5-lipoxygenase (5-LO) was quantified by real-time PCR, and these five key enzymes were localized by immunohistochemistry. sPLA(2)-IIA, COX-2 and mPGES-1 mRNA was significantly increased in peritoneal macrophages of endometriosis patients compared with controls (P = 0.006, P = 0.016 and P = 0.025, respectively). In endometriosis patients, sPLA(2)-IIA, mPGES-1 and 15-PGDH mRNA was significantly enhanced in peritoneal lesions compared with matched eutopic endometrium (P endometriosis group compared with controls (P = 0.023). Finally, sPLA(2)-IIA, COX-2, mPGES-1 and 15-PGDH immunostaining was found mainly in endometrial glands, whereas 5-LO was distributed throughout the glands and stroma. Our study highlights an imbalance between eicosanoid biosynthesis and degradation in endometriosis patients. Both peritoneal macrophages and endometriotic lesions may be involved. Research into new molecules inhibiting biosynthetic enzymes (such as sPLA(2)-IIA and mPGES-1) and/or activating catabolic enzymes (such as 15-PGDH) may prove to be a major field of investigation in the development of targeted medical therapies.

  15. A life shaped by pain: women and endometriosis.

    Science.gov (United States)

    Huntington, Annette; Gilmour, Jean A

    2005-10-01

    The research aim was to explore women's perceptions of living with endometriosis, its effects on their lives and the strategies used to manage their disease. Symptomatic endometriosis significantly affects women's quality of life. Characteristically the condition causes severe pain and has a negative impact on the ability to work, on family relationships and self-esteem. There has been little discussion about women's experience of endometriosis in nursing literature. A qualitative research design informed by feminist research principles was chosen for this project. Eighteen women agreed to take part in the research. The individual, audio taped interviews were semi-structured and interactive. The interviews were analysed using a thematic analysis approach. The dominant feature of data from the interviews was the experience of severe and chronic pain impacting on all aspects of life. Analysis related to pain resulted in four themes: manifestations of pain, the pain trajectory, intractable pain and controlling pain. The diagnostic process typically took 5-10 years indicating that primary health care practitioners need higher levels of 'suspicion' for this condition. Case studies and problem-based scenarios focusing on endometriosis in health professional education programmes would enhance diagnostic skills and knowledge development. No formal pain management follow up after diagnosis and treatment meant women actively sought information from other sources as they made major lifestyle changes in the areas of activity and nutrition. Pain management services specifically for women with endometriosis would provide much needed support with this neglected aspect of the disease. This is a fertile area for the development of the Nurse Practitioner role which, also drawing on the considerable collective expertise of women with endometriosis, could provide significant information and support for women as they manage this highly complex condition.

  16. Assessment of pelvic floor muscles in women with deep endometriosis.

    Science.gov (United States)

    Dos Bispo, Ana Paula Santos; Ploger, Christine; Loureiro, Alessandra Fernandes; Sato, Hélio; Kolpeman, Alexander; Girão, Manoel João Batista Castello; Schor, Eduardo

    2016-09-01

    To assess function and prevalence of spasms and trigger points of the pelvic floor muscles in women with deep endometriosis. One hundred and four (104) patients were assessed. Group 1 (G1) was composed of 52 subjects diagnosed with deep endometriosis proven by magnetic resonance imaging (MRI); Group 2 (G2) was composed of 52 women with no signs of endometriosis. Subjects from both G1 and G2 were seen at the Division of Pelvic Pain and Endometriosis and at Center for Prevention of Sexually Transmitted Diseases, both at Federal University of São Paulo (UNIFESP), respectively. A full physical therapy evaluation was carried out, including medical history, presence of dyspareunia and physical examination, which included detailed evaluation of pelvic floor muscles and occurrence of muscle spasm, trigger point and muscle function. The average age of the subjects in the study group was 36.4 and 30.9 years in the control group (p = 0.002). A greater prevalence of deep dyspareunia was found in the subjects in the endometriosis group when compared to the control group (p = 0.010). Women in G1 had higher prevalence of muscle spasms. In this group, 53.9 % had spasms-compared to only 17.3 % of women in G2 (p < 0.001). On the other hand, no significant difference between the groups (p = 0.153) was found while searching for the presence of trigger points. Women with deep endometriosis have increased prevalence of pelvic floor muscle spasms when compared to the control group.

  17. 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

  18. Endometriosis and Type I Interferon & Characterization of a Mammalian Flippase

    DEFF Research Database (Denmark)

    Vestergaard, Anna Lindeløv

    2010-01-01

    endometriosis lesion. Human papillomavirus (HPV) is the causative agent of cervix cancer, and DNA viruses might play a role in endometriosis. DNA purified from tissue samples were subjected to highly sensitive PCR tests detecting HPV types, the herpes family viruses HSV-1 and -2, CMV, and EBV......, and ERa, when analyzed by bisulfate PCR and melting curve analysis. Also, no mutations of BRAF, HRAS, NRAS, CTNNB1, CDK4, FGFR3, PIK3CA, P53, and PTEN were detected by PCR denaturing gradient gel electrophoresis analysis. A well-known cancer-associated mutation in KRAS was detected in a single...

  19. 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.

  20. High-field-strength MR imaging of endometriosis

    International Nuclear Information System (INIS)

    Zawin, M.; McCarthy, S.M.; Comite, F.

    1987-01-01

    Twelve women with proven endometriosis were evaluated with MR imaging, utilizing a 1.5-T system. Axial and sagittal T1, proton density, and T2-weighted images were acquired. Laparoscopies were performed within a 1-month interval of the study in all cases. MR imaging accurately identified seven endometriomas but missed lesions in two cases. Areas with endometriotic implants were accurately localized five cases. The authors conclude that MR imaging is extremely useful in identifying sites of endometriosis and, therefore, promises to obviate repeated laparoscopies to monitor patients' response to therapy

  1. Correlation between matrix metalloproteinase-9 and endometriosis.

    Science.gov (United States)

    Liu, Haiping; Wang, Jianye; Wang, Haiyu; Tang, Ning; Li, Yunfei; Zhang, Yan; Hao, Tianyu

    2015-01-01

    Endometrial implantation is the major cause of endometriosis (EMS). Matrix metalloproteinase (MMPs) can degrade multiple extracellular matrix and has been postulated to be related with EMC occurrence. This study thus investigated serum and ascites levels of MMP-9 in EMS patients, in an attempt to discuss the correlation between MMP-9 and EMS. A total of 100 EMS patients, including eutopic endometrium and ectopic endometrium, were recruited in this study along with hysteromyoma patients as the control group. Peripheral blood and ascites samples were collected and tested for MMP-9 levels using gelatin zymogram and enzyme-linked immunosorbent assay (ELISA). In EMS patients, MMP-9 levels in serum and ascites were 6.24 ± 0.53 mM and 38.57 ± 4.93 mM, respectively. Both of them were significantly higher than those in control group (P<0.05). Eutopic endometrium group had higher MMP-9 levels compared to those in ectopic endometrium ones (P<0.05). With advancement of disease stage, EMS patients had progressively elevated MMP-9 levels (P<0.05). Patients at proliferative stage had higher MMP-9 secretion (P<0.05). In summary, site of endometrium, clinical stage and proliferative cycle were independent risk factors for EMS. The elevation of serum and ascites MMP-9 existed in EMS patients, of which those had ectopic endometrium, advanced stage and at proliferative stage had higher MMP-9 expression.

  2. The Peritoneum Is Both a Source and Target of TGF-β in Women with Endometriosis

    Science.gov (United States)

    Young, Vicky J.; Brown, Jeremy K.; Saunders, Philippa T. K.; Duncan, W. Colin; Horne, Andrew W.

    2014-01-01

    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 (Pendometriosis, peritoneum from sites adjacent to endometriosis lesions expressed higher levels of TGFB1 mRNA when compared to distal sites (Pendometriosis. 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. PMID:25207642

  3. Feasibility of 3.0 T pelvic MR imaging in the evaluation of endometriosis

    International Nuclear Information System (INIS)

    Manganaro, L.; Fierro, F.; Tomei, A.; Irimia, D.; Lodise, P.; Sergi, M.E.; Vinci, V.; Sollazzo, P.; Porpora, M.G.; Delfini, R.; Vittori, G.; Marini, M.

    2012-01-01

    Introduction: Endometriosis represents an important clinical problem in women of reproductive age with high impact on quality of life, work productivity and health care management. The aim of this study is to define the role of 3 T magnetom system MRI in the evaluation of endometriosis. Materials and methods: Forty-six women, with transvaginal (TV) ultrasound examination positive for endometriosis, with pelvic pain, or infertile underwent an MR 3.0 T examination with the following protocol: T2 weighted FRFSE HR sequences, T2 weighted FRFSE HR CUBE 3D sequences, T1 w FSE sequences, LAVA-flex sequences. Pelvic anatomy, macroscopic endometriosis implants, deep endometriosis implants, fallopian tube involvement, adhesions presence, fluid effusion in Douglas pouch, uterus and kidney pathologies or anomalies associated and sacral nervous routes were considered by two radiologists in consensus. Laparoscopy was considered the gold standard. Results: MRI imaging diagnosed deep endometriosis in 22/46 patients, endometriomas not associated to deep implants in 9/46 patients, 15/46 patients resulted negative for endometriosis, 11 of 22 patients with deep endometriosis reported ovarian endometriosis cyst. We obtained high percentages of sensibility (96.97%), specificity (100.00%), VPP (100.00%), VPN (92.86%). Conclusion: Pelvic MRI performed with 3 T system guarantees high spatial and contrast resolution, providing accurate information about endometriosis implants, with a good pre-surgery mapping of the lesions involving both bowels and bladder surface and recto-uterine ligaments.

  4. A higher prevalence of endometriosis among Asian women does not contribute to poorer IVF outcomes.

    Science.gov (United States)

    Yamamoto, Ayae; Johnstone, Erica B; Bloom, Michael S; Huddleston, Heather G; Fujimoto, Victor Y

    2017-06-01

    The purpose of the study was to determine whether diagnosis of endometriosis or endometriosis with endometrioma influences in vitro fertilization (IVF) outcomes in an ethnically diverse population. Women undergoing a first IVF cycle (n = 717) between January 1, 2008 and December 31, 2009, at a university-affiliated infertility clinic, were retrospectively assessed for an endometriosis diagnosis. Differences in prevalence of endometriosis by ethnicity were determined, as well as differences in IVF success by ethnicity, with a focus on country of origin for Asian women. A multivariate model was generated to assess the relative contributions of country of origin and endometriosis to chance of clinical pregnancy with IVF. Endometriosis was diagnosed in 9.5% of participants; 3.5% also received a diagnosis of endometrioma. Endometriosis prevalence in Asian women was significantly greater than in Caucasians (15.7 vs. 5.8%, p Women of Filipino (p women, although there was no difference in endometrioma presence by race/ethnicity. Oocyte quantity, embryo quality, and fertilization rates did not relate to endometriosis. Clinical pregnancy rates were significantly lower for Asian women, specifically in Indian (p women, compared to Caucasian women, even after controlling for endometriosis status. The prevalence of endometriosis appears to be higher in Filipino, Indian, Japanese, and Korean women presenting for IVF treatment than for Caucasian women; however, the discrepancy in IVF outcomes was conditionally independent of the presence of endometriosis. Future research should focus on improving pregnancy outcomes for Asian populations whether or not they are affected by endometriosis, specifically in the form of longitudinal studies where exposures can be captured prior to endometriosis diagnoses and infertility treatment.

  5. Psychotherapy With Somatosensory Stimulation for Endometriosis-Associated Pain: A Randomized Controlled Trial.

    Science.gov (United States)

    Meissner, Karin; Schweizer-Arau, Annemarie; Limmer, Anna; Preibisch, Christine; Popovici, Roxana M; Lange, Isabel; de Oriol, Barbara; Beissner, Florian

    2016-11-01

    To evaluate whether psychotherapy with somatosensory stimulation is effective for the treatment of pain and quality of life in patients with endometriosis-related pain. Patients with a history of endometriosis and chronic pelvic pain were randomized to either psychotherapy with somatosensory stimulation (ie, different techniques of acupuncture point stimulation) or wait-list control for 3 months, after which all patients were treated. The primary outcome was brain connectivity assessed by functional magnetic resonance imaging. Prespecified secondary outcomes included pain on 11-point numeric rating scales (maximal and average global pain, pelvic pain, dyschezia, and dyspareunia) and physical and mental quality of life. A sample size of 30 per group was planned to compare outcomes in the treatment group and the wait-list control group. From March 2010 through March 2012, 67 women (mean age 35.6 years) were randomly allocated to intervention (n=35) or wait-list control (n=32). In comparison with wait-list controls, treated patients showed improvements after 3 months in maximal global pain (mean group difference -2.1, 95% confidence interval [CI] -3.4 to -0.8; P=.002), average global pain (-2.5, 95% CI -3.5 to -1.4; P<.001), pelvic pain (-1.4, 95% CI -2.7 to -0.1; P=.036), dyschezia (-3.5, 95% CI -5.8 to -1.3; P=.003), physical quality of life (3.8, 95% CI 0.5-7.1, P=.026), and mental quality of life (5.9, 95% CI 0.6-11.3; P=.031); dyspareunia improved nonsignificantly (-1.8, 95% CI -4.4 to 0.7; P=.150). Improvements in the intervention group remained stable at 6 and 24 months, and control patients showed comparable symptom relief after delayed intervention. Psychotherapy with somatosensory stimulation reduced global pain, pelvic pain, and dyschezia and improved quality of life in patients with endometriosis. After 6 and 24 months, when all patients were treated, both groups showed stable improvements. ClinicalTrials.gov, https://clinicaltrials.gov, NCT01321840.

  6. Compatibility of a novel thrombospondin-1 analog with fertility and pregnancy in a xenograft mouse model of endometriosis.

    Directory of Open Access Journals (Sweden)

    Diane S Nakamura

    Full Text Available Endometriosis is a gynecological disease defined by the growth of endometrium outside of the uterus. Although endometriosis contributes to 50% of female infertility cases, medical treatments are incompatible with pregnancy. Angiogenesis, the growth of blood vessels from existing vasculature, plays a crucial role in endometriotic lesion growth and survival. Previously, we demonstrated the effectiveness of thrombospondin-1 analog, ABT-898 (Abbott Laboratories to inhibit endometriotic lesion vascularization in mice. We have now evaluated the trans-generational implications of ABT-898 treatment before and during mouse pregnancy. We hypothesized that ABT-898 would target lesion vasculature without affecting pregnancy, offspring development, or ovarian and uterine vascularity in mice. Endometriosis was induced using human endometrium in β-estradiol-primed BALB/c-Rag-2-/-Il2rγ-/- mice receiving intraperitoneal injections of ABT-898 (25 mg/kg or 5% dextrose control for 21 days. Ultrasound assessment of lesion vascularization revealed a reduction in blood flow supplying treated lesions. Excised ABT-898 treated lesions stained for CD31+ endothelial cells exhibited a decrease in microvessel density. Following confirmation of estrous cycling, mice were bred and treated with ABT-898 on gestation days 7, 9, 11, 13, 15, 17, and 19. ABT-898 did not affect estrous cycling or pregnancy parameters including litter size across generations and offspring weight gain. Quantification of angiogenic cytokine plasma levels revealed no significant differences between treatment groups. Vimentin staining of the uterus and ovary revealed no observable effects of ABT-898. Similarly, no obvious histological anomalies were observed in the kidney, liver, ovary, or uterus following ABT-898 treatment. These results suggest that ABT-898 effectively inhibit endometriotic lesion vascularization without affecting trans-generational pregnancy outcomes in mice.

  7. Chronic intestinal obstruction due to rectosigmoid endometriosis: a ...

    African Journals Online (AJOL)

    Chronic intestinal obstruction due to rectosigmoid endometriosis: a case report. AO Tade. Abstract. No Abstract. Nigerian Journal of Medicine Vol. 15(2) 2006: 165-166. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/njm.v15i2.37104.

  8. Episiotomy Scar Endometriosis Diagnosed on Cytology - A Case ...

    African Journals Online (AJOL)

    2017-06-30

    Jun 30, 2017 ... Dnyanada Kokode*, Anne Wilkinson, Sadhana Mahore and Trupti Dongre ... Endometriosis, the presence of functioning endometrial tissue outside the ... examination, a tender, irregular, raised nodule measuring .... hematoma, hypertrophic scar tissue, traumatic neuroma, ... CT and MRI seem to be useful in.

  9. Nerve fibers and menstrual cycle in peritoneal endometriosis.

    Science.gov (United States)

    Wang, Guoyun; Tokushige, Natsuko; Fraser, Ian S

    2011-06-30

    There was no difference in the density of nerve fibers across the menstrual cycle in peritoneal endometriotic lesions. These findings may explain why patients with peritoneal endometriosis often have painful symptoms throughout the menstrual cycle. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  10. untranslated region *T/C polymorphism in endometriosis

    Indian Academy of Sciences (India)

    Administrator

    3Department of Family Medicine, China Medical University Hospital, ... 5Taichung Health Care and Management University, Taichung, Taiwan ... of endometriosis, CYP17 5'-UTR gene polymorphism might not be a useful marker for ... dometriosis are difficulty to approach due to the uncertainty ... Patients and Methods.

  11. Lag time between onset of symptoms and diagnosis of endometriosis

    Directory of Open Access Journals (Sweden)

    Tânia Mara Vieira Santos

    2012-03-01

    Full Text Available Objective: To assess lag time between onset of symptoms anddiagnosis of endometriosis in patients followed up at the OutpatientsClinic of Endometriosis and Chronic Pelvic Pain, at the Hospitaldo Servidor Público Estadual de São Paulo “Francisco Moratode Oliveira”, from January 2003 to November 2009. Methods:In a retrospective analytical study, a total of 310 women withendometriosis confirmed by surgery and pathological examinationwere evaluated in the period from January 6, 2003 to November29, 2009. Data were gathered through revision of the follow-up visitforms at the specialized outpatients clinic and medical records. Thesoftware Epi-Info 3.3.2 was used for statistical analysis. Results: The mean lag time between onset of symptoms and confirming diagnosisof endometriosis was 46.16 months (3.84 years, ranging from 6 to324 months. Patients aged under 20 years had a mean time untildiagnosis of 2.8 years (33.6 months, range of 6 to 144 months. Inpatients aged 20-29 years, it was 3.51 years (42.18 months, range6-192 months. In those aged 30-40 years, the mean time was 4.14years (49.69 months, range 6-324 months. And in women age over40 years, it was 3.15 years (37.86 months, range 6-216 months.Conclusion: The lag time between onset of symptoms and diagnosisof endometriosis was shorter, as compared to other national andinternational evaluations.

  12. [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.

  13. Social isolation in women with endometriosis and chronic pelvic pain.

    Science.gov (United States)

    Mellado, Bruna H; Falcone, Ananda C M; Poli-Neto, Omero B; Rosa E Silva, Julio C; Nogueira, Antonio A; Candido-Dos-Reis, Francisco J

    2016-05-01

    To evaluate the perceptions of women with endometriosis and chronic pelvic pain regarding their social ties. A qualitative study was undertaken of women with chronic pelvic pain and endometriosis. Focus groups discussions among four to six participants were performed until saturation at the Clinics Hospital of Ribeirão Preto Medical School, Ribeirão Preto, southwest Brazil, between February 2013 and January 2014. Transcripts were analyzed according to the grounded theory approach and the emerging categories were coded using the WebQDA platform. Six focus group discussions took place, with a total of 29 patients. Social isolation was the main emerging theme. Social isolation was associated with a lack of understanding about endometriosis symptoms and with resignation in face of recurrent pain episodes. Avoiding partner intimacy and isolation from family and friends were components of social isolation. Women with endometriosis develop progressive social isolation after the onset of chronic pelvic pain. This finding is important for the multidisciplinary management of the disease. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  14. 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...

  15. Endometriosis increases the risk of obstetrical and neonatal complications

    DEFF Research Database (Denmark)

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

    2017-01-01

    Introduction: The objective of this study was to assess obstetrical complications and neonatal outcomes in women with endometriosis as compared with women without endometriosis. Material and methods: National cohort including all delivering women and their newborns in Denmark 1997–2014. Data were...... extracted from the Danish Health Register and the Medical Birth Register. Logistic regression analysis provided odds ratios (OR) with 95% confidence intervals (CI). Sub-analyses were made for primiparous women with a singleton pregnancy and for women with endometriosis who underwent gynecological surgery...... before pregnancy. Results: In 19 331 deliveries, 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, 95% CI 2.0–2.5), placental abruption (OR 2.0, 95% CI 1.7–2.3), placenta previa (OR 3.9, 95% CI 3.5–4.3), premature rupture...

  16. Characteristics and fabrication of Geiger-Mueller counters with thin walls made of treated magnesium - Note about the use of araldite

    International Nuclear Information System (INIS)

    Charbonnel, A.

    1949-03-01

    This report describes, first, the advantage of magnesium for the manufacturing of Geiger-Mueller counters: suitable for machining and polishing, but strong reactivity with the counter atmosphere in the case of magnesium-rich alloys. Thus, the inside wall of the counter (cylinder of 20 mm diameter and 6 cm length) requires a non-reactive protective coating with excellent sealing properties. The synthetic resin 'araldite' fulfills all these conditions. The second part of the report describes the different steps of the fabrication of magnesium wall counters: lathe work, machining down and chemical polishing of hulls, assembly, tight sealing, pumping, filling-up and control tests. The average service life of these counters is of about 4 months. A note about the use and properties (hardening, mechanical properties, resistance..) of araldite is given in appendix. (J.S.)

  17. The dynamics of nuclear receptors and nuclear receptor coregulators in the pathogenesis of endometriosis

    Science.gov (United States)

    Han, Sang Jun; O'Malley, Bert W.

    2014-01-01

    BACKGROUND Endometriosis is defined as the colonization and growth of endometrial tissue at anatomic sites outside the uterine cavity. Up to 15% of reproductive-aged women in the USA suffer from painful symptoms of endometriosis, such as infertility, pelvic pain, menstrual cycle abnormalities and increased risk of certain cancers. However, many of the current clinical treatments for endometriosis are not sufficiently effective and yield unacceptable side effects. There is clearly an urgent need to identify new molecular mechanisms that critically underpin the initiation and progression of endometriosis in order to develop more specific and effective therapeutics which lack the side effects of current therapies. The aim of this review is to discuss how nuclear receptors (NRs) and their coregulators promote the progression of endometriosis. Understanding the pathogenic molecular mechanisms for the genesis and maintenance of endometriosis as modulated by NRs and coregulators can reveal new therapeutic targets for alternative endometriosis treatments. METHODS This review was prepared using published gene expression microarray data sets obtained from patients with endometriosis and published literature on NRs and their coregulators that deal with endometriosis progression. Using the above observations, our current understanding of how NRs and NR coregulators are involved in the progression of endometriosis is summarized. RESULTS Aberrant levels of NRs and NR coregulators in ectopic endometriosis lesions are associated with the progression of endometriosis. As an example, endometriotic cell-specific alterations in gene expression are correlated with a differential methylation status of the genome compared with the normal endometrium. These differential epigenetic regulations can generate favorable cell-specific NR and coregulator milieus for endometriosis progression. Genetic alterations, such as single nucleotide polymorphisms and insertion/deletion polymorphisms of NR

  18. Brain ventricular wall movement assessed by a gated cine MR trueFISP sequence in patients treated with endoscopic third ventriculostomy

    International Nuclear Information System (INIS)

    Hodel, Jerome; Decq, Philippe; Rahmouni, Alain; Bastuji-Garin, Sylvie; Maraval, Anne; Combes, Catherine; Gaston, Andre; Jarraya, Bechir; Le Guerinel, Caroline

    2009-01-01

    The purpose of this study was to investigate the value of brain ventricular wall movement assessment with a gated cine trueFISP MR sequence for the diagnosis of endoscopic third ventriculostomy (ETV) patency. Sixteen healthy volunteers and ten consecutive patients with noncommunicating hydrocephalus were explored with a MR scanner (Siemens, Avanto 1.5 T) before, 1 week and 3 months after ETV. TrueFISP was evaluated qualitatively (ventricular wall movement and CSF flow through ETV) and quantitatively [distance moved (DMLT) during a cardiac cycle by the lamina terminalis]. The third ventricle volume (TVV) was assessed. Statistical analysis was performed using nonparametric tests. There was no motion of the lamina terminalis (LT) detected on preoperative data. A pulsatile motion of the LT was found for patients with a patent ETV and for controls. DMLT and TVV were correlated (r = 0.79, P = 0.006). A transient dysfunction of ETV was successfully diagnosed on the trueFISP sequence with no motion of the LT or CSF flow observed. The trueFISP sequence appears reliable for the diagnosis of ETV patency and provides non-invasive assessment of the movement of the ventricular wall related to CSF pressure changes. (orig.)

  19. Brain ventricular wall movement assessed by a gated cine MR trueFISP sequence in patients treated with endoscopic third ventriculostomy

    Energy Technology Data Exchange (ETDEWEB)

    Hodel, Jerome [Unite Analyse et Restauration du mouvement, UMR-CNRS, Paris (France); Faculte de Medecine Paris XII, Paris (France); Assistance Publique-Hopitaux de Paris, Paris (France); Hopital Henri MONDOR, Department of Neuroradiology, Creteil (France); Hopital Henri Mondor, Creteil (France); Decq, Philippe [Unite Analyse et Restauration du mouvement, UMR-CNRS, Paris (France); Faculte de Medecine Paris XII, Paris (France); Assistance Publique-Hopitaux de Paris, Paris (France); Hopital Henri MONDOR, Department of Neurosurgery, Creteil (France); Rahmouni, Alain [Faculte de Medecine Paris XII, Paris (France); Assistance Publique-Hopitaux de Paris, Paris (France); Hopital Henri MONDOR, Department of Radiology, Creteil (France); Bastuji-Garin, Sylvie [Faculte de Medecine Paris XII, Paris (France); Assistance Publique-Hopitaux de Paris, Paris (France); Hopital Henri MONDOR, Department of Public Health, Creteil (France); Maraval, Anne; Combes, Catherine; Gaston, Andre [Faculte de Medecine Paris XII, Paris (France); Assistance Publique-Hopitaux de Paris, Paris (France); Hopital Henri MONDOR, Department of Neuroradiology, Creteil (France); Jarraya, Bechir [Faculte de Medecine Paris XII, Paris (France); Assistance Publique-Hopitaux de Paris, Paris (France); Hopital Henri MONDOR, Department of Neurosurgery, Creteil (France); Le Guerinel, Caroline [Assistance Publique-Hopitaux de Paris, Paris (France); Hopital Henri MONDOR, Department of Neurosurgery, Creteil (France)

    2009-12-15

    The purpose of this study was to investigate the value of brain ventricular wall movement assessment with a gated cine trueFISP MR sequence for the diagnosis of endoscopic third ventriculostomy (ETV) patency. Sixteen healthy volunteers and ten consecutive patients with noncommunicating hydrocephalus were explored with a MR scanner (Siemens, Avanto 1.5 T) before, 1 week and 3 months after ETV. TrueFISP was evaluated qualitatively (ventricular wall movement and CSF flow through ETV) and quantitatively [distance moved (DMLT) during a cardiac cycle by the lamina terminalis]. The third ventricle volume (TVV) was assessed. Statistical analysis was performed using nonparametric tests. There was no motion of the lamina terminalis (LT) detected on preoperative data. A pulsatile motion of the LT was found for patients with a patent ETV and for controls. DMLT and TVV were correlated (r = 0.79, P = 0.006). A transient dysfunction of ETV was successfully diagnosed on the trueFISP sequence with no motion of the LT or CSF flow observed. The trueFISP sequence appears reliable for the diagnosis of ETV patency and provides non-invasive assessment of the movement of the ventricular wall related to CSF pressure changes. (orig.)

  20. Pregnancy outcome in women with endometriosis achieving pregnancy with IVF.

    Science.gov (United States)

    Benaglia, Laura; Candotti, Giorgio; Papaleo, Enrico; Pagliardini, Luca; Leonardi, Marta; Reschini, Marco; Quaranta, Lavinia; Munaretto, Maria; Viganò, Paola; Candiani, Massimo; Vercellini, Paolo; Somigliana, Edgardo

    2016-12-01

    Are women with endometriosis who conceive with IVF at increased risk of preterm birth? Women with endometriosis who conceive with IVF do not face an increased risk of preterm birth. The eutopic endometrium of women with endometriosis has been repeatedly shown to present molecular and cellular alterations. On this basis, it has been hypothesized that pregnancy outcome may be altered in affected women. However, to date, available evidence from epidemiological studies is scanty and conflicting. Data tended to be partly consistent only for an increased risk of preterm birth and placenta previa. Retrospective matched case-control study of women achieving an IVF singleton pregnancy progressing beyond 12 weeks' gestation. Women achieving IVF singleton pregnancies that progressed beyond 12 weeks' gestation at two infertility units were reviewed. Cases were women with a history of surgery for endometriosis and/or with a sonographic diagnosis of the disease at the time of the IVF cycle. Controls were women without current or past evidence of endometriosis who were matched to cases by age (± 6 months), type of cycle (fresh or frozen cycle) and study period. Male factor and unexplained infertility were the most common diagnoses in the control group. Two hundred and thirty-nine women with endometriosis and 239 controls were selected. The main outcome of the study was the rate of preterm birth (birth IVF pregnancies only, and specific data from properly designed studies are required to support any inference for natural pregnancies. The results of our study suggest that women with endometriosis conceiving with IVF can be reassured regarding the risk of preterm birth. The observed association with placenta previa requires further investigation and may open a new avenue of research. No external funding was used for this study. None of the authors have any conflict of interest to declare. © The Author 2016. Published by Oxford University Press on behalf of the European Society

  1. Endometriosis, especially mild disease: a risk factor for miscarriages.

    Science.gov (United States)

    Kohl Schwartz, Alexandra Sabrina; Wölfler, Monika Martina; Mitter, Vera; Rauchfuss, Martina; Haeberlin, Felix; Eberhard, Markus; von Orelli, Stephanie; Imthurn, Bruno; Imesch, Patrick; Fink, Daniel; Leeners, Brigitte

    2017-11-01

    To investigate the prevalence of miscarriage in women with endometriosis (WwE) compared with disease-free control women (CW). Cross-sectional analysis nested in a retrospective observational study (n = 940). Hospitals and associated private practices. Previously pregnant women (n = 268) within reproductive age in matched pairs. Retrospective analysis of surgical reports and self-administered questionnaires. Rate of miscarriage, subanalysis for fertility status (≤12 vs. >12 months' time to conception), endometriosis stages (revised American Society of Reproductive Medicine classification [rASRM] I/II vs. III/IV) and phenotypic localizations (superficial peritoneal, ovarian, and deep infiltrating endometriosis). The miscarriage rate was higher in WwE (35.8% [95% confidence interval 29.6%-42.0%]) compared with CW (22.0% [16.7%-27.0%]); adjusted incidence risk ratio of 1.97 (95% CI 1.41-2.75). This remained significant in subfertile WwE (50.0% [40.7%-59.4%]) vs. CW (25.8% [8.5%-41.2%]) but not in fertile WwE (24.5% [16.3%-31.6%]) vs. CW (21.5% [15.9%-26.8%]). The miscarriage rate was higher in women with milder forms (rASRM I/II 42.1% [32.6%-51.4%] vs. rASRM III/IV 30.8% [22.6%-38.7%], compared with 22.0% [16.7%-27.0%] in CW), and in women with superficial peritoneal endometriosis (42.0% [32.0%-53.9%]) compared with ovarian endometriosis (28.6% [17.7%-38.7%]) and deep infiltrating endometriosis (33.9% [21.2%-46.0%]) compared with CW (22.0% [16.7%-27.0%]). Mild endometriosis, as in superficial lesions, is related to a great extent of inflammatory disorder, possibly leading to defective folliculogenesis, fertilization, and/or implantation, presenting as increased risk of miscarriage. NCT02511626. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Paradisi, Roberto; Ferrini, Giulia; Matteucci, Carlotta; Facchini, Chiara; Zannoni, Letizia; Seracchioli, Renato

    2017-06-01

    At present, there is growing evidence of the existence of a genetic predisposition in both thrombophilic disorders and endometriosis. The aim of our study was to evaluate for the first time the prevalence of some thrombophilic disorders in patients with endometriosis. We conducted a retrospective study on 138 patients with endometriosis and 278 healthy control women. All women were subjected to a blood examination testing for thrombophilic screening and the variables examinated were: hyperhomocysteinemia, factor V Leiden and factor II prothrombin G20210A mutations in heterozygosis and homozigosis. A significant reduced prevalence (p endometriosis patients was found, whereas no significant differences (p = NS) for factor II and hyperhomocysteinemia were observed. 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. Copyright © 2017. Published by Elsevier B.V.

  3. Anti-Müllerian Hormone in Peritoneal Fluid and Plasma From Women With and Without Endometriosis.

    Science.gov (United States)

    Hipp, Heather; Loucks, Tammy L; Nezhat, Ceana; Sidell, Neil; Session, Donna R

    2015-09-01

    Anti-Müllerian hormone (AMH) has potential local effects on ovarian function and endometrial tissue, including endometriosis, but its presence in peritoneal fluid is not fully understood. This is a cross-sectional study evaluating AMH in peritoneal fluid and plasma from women with endometriosis (N = 61) and from control women without endometriosis (N = 36). There was a significant correlation between AMH in plasma and peritoneal fluid from both patients with endometriosis (r(2) = .767 [P peritoneal fluid in women with and without endometriosis. There were no differences in the plasma or peritoneal fluid AMH in women with endometriosis versus control women. The strong relationship between plasma and peritoneal fluid may allow plasma AMH to be a marker for peritoneal AMH in studies evaluating the local effects of AMH. © The Author(s) 2015.

  4. Endometriosis and atherosclerosis: what we already know and what we have yet to discover.

    Science.gov (United States)

    Santoro, Luca; D'Onofrio, Ferruccio; Flore, Roberto; Gasbarrini, Antonio; Santoliquido, Angelo

    2015-09-01

    The possible association between endometriosis and atherosclerosis represents an emerging topic in the field of women's health. In this Clinical Opinion paper, we analyze this theme focusing on the pathogenetic mechanisms of both diseases, deeply discussing about what is already known about this association and producing starting points about what we consider suitable to research in the near future with regard to cardiovascular involvement in women affected by endometriosis. We have identified 5 reports specifically carried out to investigate the relationship between atherosclerosis and endometriosis; these studies show the presence of subclinical atherosclerosis in women affected by endometriosis, susceptible of regression after surgical removal of endometriosis, with a possible prognostic relevance for variations of cardiovascular risk in these women. However, to date, no studies in literature have been carried out to investigate the real incidence of cardiovascular events in women with endometriosis. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Increased expression of resistin in ectopic endometrial tissue of women with endometriosis.

    Science.gov (United States)

    Oh, Yoon Kyung; Ha, Young Ran; Yi, Kyong Wook; Park, Hyun Tae; Shin, Jung-Ho; Kim, Tak; Hur, Jun-Young

    2017-11-01

    Inflammation is a key process in the establishment and progression of endometriosis. Resistin, an adipocytokine, has biological properties linked to immunologic functions, but its role in endometriosis is unclear. Resistin gene expression was examined in eutopic and ectopic endometrial tissues from women with (n=25) or without (n=25) endometriosis. Resistin mRNA and protein levels were determined in endometrial tissue using quantitative real-time reverse transcription PCR and Western blotting, following adipokine profiling arrays. Resistin protein was detected in human endometrial tissues using an adipokine array test. Resistin mRNA and protein levels were significantly higher in ectopic endometrial tissue of patients with endometriosis than in normal eutopic endometrial tissue. Our results indicate that resistin is differentially expressed in endometrial tissues from women with endometriosis and imply a role for resistin in endometriosis-associated pelvic inflammation. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. 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 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...

  7. Role of Versican in the Pathogenesis of Peritoneal Endometriosis.

    Science.gov (United States)

    Tani, Hirohiko; Sato, Yukiyasu; Ueda, Masashi; Miyazaki, Yumiko; Suginami, Koh; Horie, Akihito; Konishi, Ikuo; Shinomura, Tamayuki

    2016-11-01

    Sampson's theory cannot explain why only some cycling women develop peritoneal endometriosis. Few studies have focused on the pelvic peritoneum, which receives regurgitated endometrial tissues. We hypothesized that molecular alterations in the peritoneum are involved in the development of peritoneal endometriosis and conducted a microarray analysis to compare macroscopically normal peritoneum sampled from women with peritoneal endometriosis (endometriotic peritoneum) and those without (non-endometriotic peritoneum). Versican, a major proteoglycan component of the extracellular matrix, is one of the molecules up-regulated in endometriotic peritoneum. To investigate the role of versican in peritoneal endometriosis. Design, Patients, and Main Outcome Measure: Endometriotic peritoneum and non-endometriotic peritoneum were subjected to RT-PCR, immunostaining, and Western blotting. The versican V1 isoform was stably transfected into Chinese hamster ovary cells (CHO-V1), and the effects of CHO-V1-derived conditioned medium (V1-CM) on primary human endometrial stromal cells were investigated with attachment, invasion, and proliferation assays. The effects of peritoneal fluid collected from endometriotic women (endometriotic PF) or cytokines/growth factors, which were shown to be elevated in endometriotic PF, on versican expression in a human peritoneal cell line (HMrSV5) were also examined. Versican V1 expression levels were significantly higher in endometriotic peritoneum. In vitro, V1-CM promoted attachment to the HMrSV5 cell monolayer as well as the Matrigel invasion of endometrial stromal cells. Although versican V1 expression was up-regulated by TGF-β1 in HMrSV5 cells, it remained unchanged in endometriotic PF. Our results suggest the involvement of peritoneal versican in the development of peritoneal endometriosis.

  8. [First line management without IVF of infertility related to endometriosis: Result of medical therapy? Results of ovarian superovulation? Results of intrauterine insemination? CNGOF-HAS Endometriosis Guidelines].

    Science.gov (United States)

    Boujenah, J; Santulli, P; Mathieu-d'Argent, E; Decanter, C; Chauffour, C; Poncelet, P

    2018-03-01

    Using the structured methodology of French guidelines (HAS-CNGOF), the aim of this chapter was to formulate good practice points (GPP), in relation to optimal non-ART management of endometriosis related to infertility, based on the best available evidence in the literature. This guideline was produced by a group of experts in the field including a thorough systematic search of the literature (from January 1980 to March 2017). Were included only women with endometriosis related to infertility. For each recommendation, a grade (A-D, where A is the highest quality) was assigned based on the strength of the supporting evidence. Management of endometriosis related to infertility should be multidisciplinary and take account into the pain, the global evaluation of infertile couple and the different phenotypes of endometriotic lesions (good practice point). Hormonal treatment for suppression of ovarian function should not prescribe to improve fertility (grade A). After laproscopy for endometriosis related to infertility, the Endometriosis Fertility Index should be used to counsel patients regarding duration of conventional treatments before undergoing ART (grade C). After laparoscopy surgery for infertile women with AFS/ASRM stage I/II endometriosis or superficial peritoneal endometriosis, controlled ovarian stimulation with or without intrauterine insemination could be used to enhance non-ART pregnancy rate (grade C). Gonadotrophins should be the first line therapy for the stimulation (grade B). The number of cycles before referring ART should not exceed up to 6 cycles (good practice point). No recommendation can be performed for non-ART management of deep infiltrating endometriosis or endometrioma, as suitable evidence is lacking. Non-ART management is a possible option for the management of endometriosis related to infertility. Endometriosis Fertilty Index could be a useful tool for subsequent postoperative fertility management. Controlled ovarian stimulation can be

  9. MR findings of extrauterine muellerian adenosarcoma associated with deep pelvic endometriosis

    International Nuclear Information System (INIS)

    Oh, Dae Kun; Kim, Chan Kyo; Park, Byung Kwan; Kim, Ji Young

    2008-01-01

    Extrauterine muellerian adenosarcoma is a very rare tumor and it is characterized by a benign glandular component and a low-grade sarcomatous stromal component. These tumors have been reported to arise from ovarian or extraovarian endometriosis. However, there are scant reports on the MR findings of extrauterine muellerian adenosarcoma arising from deep pelvic endometriosis. We describe here a case of a large infiltrating extrauterine muellerian adenosarcoma arising from recurrent deep pelvic endometriosis and we discuss its MR findings

  10. Risk Profiles for Endometriosis in Japanese Women: Results From a Repeated Survey of Self-Reports

    Science.gov (United States)

    Yasui, Toshiyuki; Hayashi, Kunihiko; Nagai, Kazue; Mizunuma, Hideki; Kubota, Toshiro; Lee, Jung-Su; Suzuki, Shosuke

    2015-01-01

    Background The prevalence and risk factors for endometriosis may differ according to diagnosis methodologies, such as study populations and diagnostic accuracy. We examined risk profiles in imaging-diagnosed endometriosis with and without surgical confirmation in a large population of Japanese women, as well as the differences in risk profiles of endometriosis based on history of infertility. Methods Questionnaires that included items on sites of endometriosis determined by imaging techniques and surgical procedure were mailed to 1025 women who self-reported endometriosis in a baseline survey of the Japan Nurses’ Health Study (n = 15 019). Results Two hundred and ten women had surgically confirmed endometriosis (Group A), 120 had imaging-diagnosed endometriosis without a surgical procedure (Group B), and 264 had adenomyosis (Group C). A short menstrual cycle at 18–22 years of age and cigarette smoking at 30 years of age were associated with significantly increased risk of endometriosis (Group A plus Group B), while older age was associated with risk of adenomyosis (Group C). In women with a history of infertility, a short menstrual cycle was associated with a significantly increased risk of endometriosis in both Group A and Group B, but risk profiles of endometriosis were different between Group A and Group B in women without a history of infertility. Conclusions Women with surgically confirmed endometriosis and those with imaging-diagnosed endometriosis without surgery have basically common risk profiles, but these risk profiles are different from those with adenomyosis. The presence of a history of infertility should be taken into consideration for evaluation of risk profiles. PMID:25716280

  11. 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.

  12. CONTENTS OF CHEMOKINES AND CYTOKINES IN PERITONEAL FLUID FROM THE PATIENTS WITH ENDOMETRIOSIS OF VARIOUS SEVERITY

    Directory of Open Access Journals (Sweden)

    D. I. Sokolov

    2007-01-01

    Full Text Available Abstract. Endometriosis is a disease accompanied by development of heterotopic endometrial foci at the peritoneum, proliferation of endothelial cells, and inflammatory reaction. Aiming to specify the dynamics of inflammatory process in endometriosis of different severity, as well as significance of chemokines and cytokines in angiogenesis and inflammation, we determined concentrations of RANTES, IL-8, IP-10, MIG, MCP-1 chemokines, as well as IL-4, IL-6 and IL-10 cytokines in peritoneal fluid from patients by endometriosis. Forty women at reproductive age with an endometriosis have been observed. Among them, endometriosis grade I-II was registered in 20 cases, whereas grade III-IV has been confirmed in 20 women. Twenty-two women without evidence of endometriosis referred to diagnostic laparoscopy for pregnancy planning, comprised a control group. Diagnosis of endometriosis was based upon endoscopic findings and results of histological research. Severity grade of endometriosis was estimated according to R-AFS classification. Sampling of peritoneal fluid was carried out when performing surgical laparoscopies. Concentrations of chemokines and cytokines were determined by flow cytometry techniques, using BD Cytometric Bead Array test kits and FACStrack flow cytometer. The amounts of RANTES in peritoneal fluid were higher in grade I-II endometriosis, in comparison with grade III-IV endometriosis and control samples. Concentrations of IP-10, IL-8, МСР-1, MIG, IL-6, and IL-4 were higher than in control group and correlated with severity of the disease. IL-10 was not detectable in peritoneal fluid of the patients with endometriosis. These results suggest a significant role of the mentioned cytokines and chemokines that may promote invasion of endometrial cells, growth of heterotopic endometrioid locuses, development of vascular bed and induction of inflammatory processes, in development and progression of endometriosis.

  13. Prediction of endometriosis by transvaginal ultrasound in reproductive-age women with normal ovarian size

    OpenAIRE

    Tamer H. Said; Amal Z. Azzam

    2014-01-01

    Objective: To predict endometriosis by transvaginal ultrasound (TVS) in reproductive-age women with normal ovarian size. Design: Prospective study. Setting: El-Shatby Maternity Hospital, Alexandria University. Patients: 125 Women with symptoms suggestive of endometriosis and with normal ovarian size during TVS. Interventions: Patients were subjected to high frequency ultrasound and evaluated for the presence of ultrasound signs of endometriosis (TVS-based soft markers). All patien...

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

    Directory of Open Access Journals (Sweden)

    Takashi Harada

    Full Text Available 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.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.The effects of endometriosis on pregnancy outcome.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.This study showed that endometriosis significantly increased the incidence of preterm PROM and placenta previa after adjusting for confounding of the data by ART therapy.

  15. US or MR Imaging Features of Polypoid Endometriosis: A Case Report

    International Nuclear Information System (INIS)

    Park, Jae Il; Cho, Jae Ho; Kim, Geum Rae; Kim, Mi Jin

    2009-01-01

    Polypoid endometriosis is a rare variant of endometriosis that is pathologically similar to an endometrial polyp. This lesion is frequently mistaken for a solid neoplasm in clinical, radiological and pathological examinations. The clinical and pathological features of the lesion have been well described in the English literature. However, its imaging features have not been reported in the Korean literature. We describe ultrasound and magnetic resonance imaging features of pathologically-confirmed polypoid endometriosis

  16. MR findings of extrauterine muellerian adenosarcoma associated with deep pelvic endometriosis

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Dae Kun; Kim, Chan Kyo; Park, Byung Kwan; Kim, Ji Young [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2008-02-15

    Extrauterine muellerian adenosarcoma is a very rare tumor and it is characterized by a benign glandular component and a low-grade sarcomatous stromal component. These tumors have been reported to arise from ovarian or extraovarian endometriosis. However, there are scant reports on the MR findings of extrauterine muellerian adenosarcoma arising from deep pelvic endometriosis. We describe here a case of a large infiltrating extrauterine muellerian adenosarcoma arising from recurrent deep pelvic endometriosis and we discuss its MR findings.

  17. US or MR Imaging Features of Polypoid Endometriosis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jae Il; Cho, Jae Ho; Kim, Geum Rae; Kim, Mi Jin [Yeungnam University, Gyeongsan (Korea, Republic of)

    2009-12-15

    Polypoid endometriosis is a rare variant of endometriosis that is pathologically similar to an endometrial polyp. This lesion is frequently mistaken for a solid neoplasm in clinical, radiological and pathological examinations. The clinical and pathological features of the lesion have been well described in the English literature. However, its imaging features have not been reported in the Korean literature. We describe ultrasound and magnetic resonance imaging features of pathologically-confirmed polypoid endometriosis.

  18. 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.

  19. EFFICACY OF INTRAPERITONEAL INTERFERON-α ADMINISTRATION FOR TREATMENT OF ENDOMETRIOSIS IN RATS

    Directory of Open Access Journals (Sweden)

    R. V. Pavlov

    2006-01-01

    Full Text Available Abstract. The article presents the results of intraperitoneal administration of recombinant rat interferon-α to twenty Wistar rats with experimentally induced endometriosis. The following criteria of treatment efficiency were applied: presence of ectopic endometrium in transplanted segments of cornu uteri, proliferative activity of endometrioid cells, features of vascularization and leucocyte infiltration within endometrial foci. It was shown that local application of interferon-α caused regression of endometrioid epithelial heterotopias in 50 per cent of the cases. If endometrioid epithelium was retained, its proliferative activity did significantly drop under interferon-α application. In all transplants derived from rats treated with interferon-α, the degree of vascularization is reduced, accompanied by increased leucocytic infiltration (due to lymphocytes, along with decreased contents of macrophages within leucocytic infiltrates.

  20. Sequential imaging of intraneural sciatic nerve endometriosis provides insight into symptoms of cyclical sciatica.

    Science.gov (United States)

    Capek, Stepan; Amrami, Kimberly K; Howe, Benjamin M; Collins, Mark S; Sandroni, Paola; Cheville, John C; Spinner, Robert J

    2016-03-01

    Endometriosis of the nerve often remains an elusive diagnosis. We report the first case of intraneural lumbosacral plexus endometriosis with sequential imaging at different phases of the menstrual cycle: during the luteal phase and menstruation. Compared to the first examination, the examination performed during the patient's period revealed the lumbosacral plexus larger and hyperintense on T2-weighted imaging. The intraneural endometriosis cyst was also larger and showed recent hemorrhage. Additionally, this case represents another example of perineural spread of endometriosis from the uterus to the lumbosacral plexus along the autonomic nerves and then distally to the sciatic nerve and proximally to the spinal nerves.

  1. Prevalence of fibromyalgia and quality of life in women with and without endometriosis.

    Science.gov (United States)

    Nunes, Fabiana R; Ferreira, Jessica M; Bahamondes, Luis

    2014-04-01

    The objectives of the study were to assessed if there is any difference in the prevalence of fibromyalgia and in quality of life (QoL) between women with and without endometriosis. A cross-sectional study was conducted in 2011-2013, involving 257 women with surgically and histopathologically confirmed endometriosis and 253 women with no history of endometriosis and no endometriosis-related symptoms. Women were recruited both at the family planning and endometriosis clinic, Department of Obstetrics and Gynecology, University of Campinas, Brazil. The Short Form 36 questionnaire (SF-36) was used to assess QoL, while the 1990 and 2010 American College of Rheumatology (ACR) criteria were used to evaluate fibromyalgia. According to the 1990 ACR criteria, there were no cases of fibromyalgia in either group. Nevertheless, according to the 2010 ACR criteria, four women, two with endometriosis and two without the disease, were diagnosed with fibromyalgia. Scores were significantly lower in all the domains of the QoL questionnaire for the women with endometriosis compared to those without the disease. This study reports no difference in the prevalence of fibromyalgia between women with and without endometriosis; however QoL was poorer among women with endometriosis when compared to women without the disease.

  2. Factors Associated with Severity of Irritable Bowel Syndrome Symptoms in Patients with Endometriosis.

    Science.gov (United States)

    Lee, Caroline E; Yong, Paul J; Williams, Christina; Allaire, Catherine

    2018-02-01

    This study sought to examine factors associated with severity of irritable bowel syndrome (IBS) by using the Birmingham IBS symptom scale in patients presenting with endometriosis to a tertiary referral centre. A prospective research cohort of patients presenting to a tertiary referral centre for endometriosis was evaluated for the presence and severity of IBS between December 2013 and April 2015. Patients with endometriosis had a diagnosis of IBS by using the Rome III criteria and were evaluated for severity of IBS symptoms by using the Birmingham IBS symptom scale. Multifactorial variables, including stage of endometriosis at the time of previous surgery, clinical examination findings, mood disorder questionnaire scores, and lifestyle factors, were evaluated using the t test and Spearman rank correlation test. A total of 194 of 373 (52%) women with confirmed endometriosis had a diagnosis of IBS. Factors associated with severity of IBS symptoms in patients with endometriosis included lower-stage endometriosis (P = 0.004), presence of mood disorders (P IBS symptom scale revealed a strong association between the previously identified factors and the pain subscale. Using the Birmingham IBS symptom scale, our study revealed more severe IBS symptoms in patients with lower-stage endometriosis and identified other variables highly associated with severity of IBS. Continued research is required to characterize further the clinical importance of IBS symptoms in patients with endometriosis-associated pelvic pain. Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  3. Effect of induced peritoneal endometriosis on oocyte and embryo quality in a mouse model.

    Science.gov (United States)

    Cohen, J; Ziyyat, A; Naoura, I; Chabbert-Buffet, N; Aractingi, S; Darai, E; Lefevre, B

    2015-02-01

    To assess the impact of peritoneal endometriosis on oocyte and embryo quality in a mouse model. Peritoneal endometriosis was surgically induced in 33 B6CBA/F1 female mice (endometriosis group, N = 17) and sham-operated were used as control (sham group, N = 16). Mice were superovulated 4 weeks after surgery and mated or not, to collect E0.5-embryos or MII-oocytes. Evaluation of oocyte and zygote quality was done by immunofluorescence under spinning disk confocal microscopy. Endometriosis-like lesions were observed in all mice of endometriosis group. In both groups, a similar mean number of MII oocytes per mouse was observed in non-mated mice (30.2 vs 32.6), with a lower proportion of normal oocytes in the endometriosis group (61 vs 83 %, p endometriosis group (21 vs 35.5, p = 0.02) without difference in embryo quality. Our results support that induced peritoneal endometriosis in a mouse model is associated with a decrease in oocyte quality and embryo number. This experimental model allows further studies to understand mechanisms of endometriosis-associated infertility.

  4. 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

    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...

  5. Standard high-resolution pelvic MRI vs. low-resolution pelvic MRI in the evaluation of deep infiltrating endometriosis

    International Nuclear Information System (INIS)

    Scardapane, Arnaldo; Lorusso, Filomenamila; Ferrante, Annunziata; Stabile Ianora, Amato Antonio; Angelelli, Giuseppe; Scioscia, Marco

    2014-01-01

    To compare the capabilities of standard pelvic MRI with low-resolution pelvic MRI using fast breath-hold sequences to evaluate deep infiltrating endometriosis (DIE). Sixty-eight consecutive women with suspected DIE were studied with pelvic MRI. A double-acquisition protocol was carried out in each case. High-resolution (HR)-MRI consisted of axial, sagittal, and coronal TSE T2W images, axial TSE T1W, and axial THRIVE. Low-resolution (LR)-MRI was acquired using fast single shot (SSH) T2 and T1 images. Two radiologists with 10 and 2 years of experience reviewed HR and LR images in two separate sessions. The presence of endometriotic lesions of the uterosacral ligament (USL), rectovaginal septum (RVS), pouch of Douglas (POD), and rectal wall was noted. The accuracies of LR-MRI and HR-MRI were compared with the laparoscopic and histopathological findings. Average acquisition times were 24 minutes for HR-MRI and 7 minutes for LR-MRI. The more experienced radiologist achieved higher accuracy with both HR-MRI and LR-MRI. The values of sensitivity, specificity, PPV, NPV, and accuracy did not significantly change between HR and LR images or interobserver agreement for all of the considered anatomic sites. LR-MRI performs as well as HR-MRI and is a valuable tool for the detection of deep endometriosis extension. (orig.)

  6. Standard high-resolution pelvic MRI vs. low-resolution pelvic MRI in the evaluation of deep infiltrating endometriosis

    Energy Technology Data Exchange (ETDEWEB)

    Scardapane, Arnaldo; Lorusso, Filomenamila; Ferrante, Annunziata; Stabile Ianora, Amato Antonio; Angelelli, Giuseppe [University Hospital ' ' Policlinico' ' of Bari, Interdisciplinary Department of Medicine, Bari (Italy); Scioscia, Marco [Sacro Cuore Don Calabria General Hospital, Department of Obstetrics and Gynecology, Negrar, Verona (Italy)

    2014-10-15

    To compare the capabilities of standard pelvic MRI with low-resolution pelvic MRI using fast breath-hold sequences to evaluate deep infiltrating endometriosis (DIE). Sixty-eight consecutive women with suspected DIE were studied with pelvic MRI. A double-acquisition protocol was carried out in each case. High-resolution (HR)-MRI consisted of axial, sagittal, and coronal TSE T2W images, axial TSE T1W, and axial THRIVE. Low-resolution (LR)-MRI was acquired using fast single shot (SSH) T2 and T1 images. Two radiologists with 10 and 2 years of experience reviewed HR and LR images in two separate sessions. The presence of endometriotic lesions of the uterosacral ligament (USL), rectovaginal septum (RVS), pouch of Douglas (POD), and rectal wall was noted. The accuracies of LR-MRI and HR-MRI were compared with the laparoscopic and histopathological findings. Average acquisition times were 24 minutes for HR-MRI and 7 minutes for LR-MRI. The more experienced radiologist achieved higher accuracy with both HR-MRI and LR-MRI. The values of sensitivity, specificity, PPV, NPV, and accuracy did not significantly change between HR and LR images or interobserver agreement for all of the considered anatomic sites. LR-MRI performs as well as HR-MRI and is a valuable tool for the detection of deep endometriosis extension. (orig.)

  7. Urinary biomarkers for the non-invasive diagnosis of endometriosis.

    Science.gov (United States)

    Liu, Emily; Nisenblat, Vicki; Farquhar, Cindy; Fraser, Ian; Bossuyt, Patrick M M; Johnson, Neil; Hull, M Louise

    2015-12-23

    About 10% of reproductive-aged women suffer from endometriosis which is a costly chronic disease that causes pelvic pain and subfertility. Laparoscopy is the 'gold standard' diagnostic test for endometriosis, but it is expensive and carries surgical risks. Currently, there are no simple non-invasive or minimally-invasive tests available in clinical practice that accurately diagnoses endometriosis. 1. To provide summary estimates of the diagnostic accuracy of urinary biomarkers for the diagnosis of pelvic endometriosis compared to surgical diagnosis as a reference standard.2. To assess the diagnostic utility of biomarkers that could differentiate ovarian endometrioma from other ovarian masses.Urinary biomarkers were evaluated as replacement tests for surgical diagnosis and as triage tests to inform decisions to undertake surgery for endometriosis. The searches were not restricted to particular study design, language or publication dates. We searched the following databases to 20 April - 31 July 2015: CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, LILACS, OAIster, TRIP and ClinicalTrials.gov (trial register). MEDION, DARE, and PubMed were also searched to identify reviews and guidelines as reference sources of potentially relevant studies. Recently published papers not yet indexed in the major databases were also sought. The search strategy incorporated words in the title, abstract, text words across the record and the medical subject headings (MeSH) and was modified for each database. Published peer-reviewed, randomised controlled or cross-sectional studies of any size were considered, which included prospectively collected samples from any population of reproductive-aged women suspected of having one or more of the following target conditions: ovarian, peritoneal or deep infiltrating endometriosis (DIE). We included studies comparing the diagnostic test accuracy of one or more urinary biomarkers with surgical visualisation of endometriotic lesions. Two

  8. Chest wall desmoid tumours treated with definitive radiotherapy: a plan comparison of 3D conformal radiotherapy, intensity-modulated radiotherapy and volumetric-modulated arc radiotherapy

    International Nuclear Information System (INIS)

    Liu, Jia; Ng, Diana; Lee, James; Stalley, Paul; Hong, Angela

    2016-01-01

    Definitive radiotherapy is often used for chest wall desmoid tumours due to size or anatomical location. The delivery of radiotherapy is challenging due to the large size and constraints of normal surrounding structures. We compared the dosimetry of 3D conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc radiotherapy (VMAT) to evaluate the best treatment option. Ten consecutive patients with inoperable chest wall desmoid tumours (PTV range 416–4549 cm 3 ) were selected. For each patient, 3DCRT, IMRT and VMAT plans were generated and the Conformity Index (CI), organ at risk (OAR) doses and monitor unit (MU) were evaluated. The Wilcoxon signed-rank test was used to compare dose delivered to both target and OARs. The mean number of fields for 3DCRT and IMRT were 6.3 ± 2.1, 7.2 ± 1.8. The mean number of arcs for VMAT was 3.7 ± 1.1. The mean conformity index of VMAT (0.98 ± 0.14) was similar to that of IMRT (1.03 ± 0.13), both of which were significantly better than 3DCRT (1.35 ± 0.20; p = 0.005). The mean dose to lung was significantly higher for 3DCRT (11.9Gy ± 7.9) compared to IMRT (9.4Gy ± 5.4, p = 0.014) and VMAT (8.9Gy ± 4.5, p = 0.017). For the 3 females, the low dose regions in the ipsilateral breast for VMAT were generally less with VMAT. IMRT plans required 1427 ± 532 MU per fraction which was almost 4-fold higher than 3DCRT (313 ± 112, P = 0.005). Compared to IMRT, VMAT plans required 60 % less MU (570 ± 285, P = 0.005). For inoperable chest wall desmoid tumours, VMAT delivered equivalent target coverage when compared to IMRT but required 60 % less MU. Both VMAT and IMRT were superior to 3DCRT in terms of better PTV coverage and sparing of lung tissue

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

    Science.gov (United States)

    Hansen, Karina E; Kesmodel, Ulrik S; Baldursson, Einar B; Schultz, Rikke; Forman, Axel

    2013-07-01

    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. In a cohort study, 610 patients with diagnosed 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 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. Moreover, a higher pain level and degree of symptoms were associated with low work ability. Full regression analysis indicated that tiredness, frequent pain, a higher daily pain level, a higher number of sick days and feeling depressed at work were associated with low work ability. A long delay from symptom onset to diagnosis was associated with low work ability. These data indicate a severe impact of endometriosis on the work ability of employed women with endometriosis and add to the evidence that this disease represents a significant socio-economic burden. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  10. Expression of natural killer cell activity with CD107a on ectopic endometrium in woman with endometriosis compared with non-endometriosis

    Science.gov (United States)

    Lubis, H. P.; Aldiansyah, D.; Siregar, H. S.; Rivany, R.; Hariadi, T. S.

    2018-03-01

    Some factors have an important role in endometriosis pathogenesis; there is an immune cell that plays an important role in endometrial cells that have reflux. Woman with endometriosis experienced the cellular immune disorder. It is suspected that decrease of NK cell in the peritoneal fluid caused by its qualitative defect with CD107a expression as the best marker. The aim of this study was to compare expression of NK Cell activity with CD107a between awoman with endometriosis and non-endometriosis. A case-control study from March until July 2015 in Haji Adam Malik General Hospital. The case group was ectopic endometrial tissue block paraffin and control group was normal endometrial tissue block paraffin. This study included 23 patients in endometriosis group and control group respectively. A majority proportion of CD107a expression in endometriosis group was +1 (16 patients (69.6%)), while the control group was +3 (9 patients (39.1%)). Expression of NK cell activity with CD107a in patients with endometriosis was lower than the control group (pendometriosis.

  11. The plasma and peritoneal fluid concentrations of matrix metalloproteinase-9 are elevated in patients with endometriosis.

    Science.gov (United States)

    Liu, Haiping; Wang, Jianye; Wang, Haiyu; Tang, Ning; Li, Yunfei; Zhang, Yan; Hao, Tianyu

    2016-09-01

    Enzyme matrix metalloproteinase-9 is a member of the matrix metalloproteinase family, which is critical to normal tissue remodelling during embryogenesis and wound healing. In patients with endometriosis, increased expression and activity of matrix metalloproteinase-9 have been observed in ectopic endometrium, but the plasma and peritoneal fluid concentrations of matrix metalloproteinase-9 in patients with endometriosis and their relation to disease severity have not been clear. The aim of the study was to investigate the concentrations of matrix metalloproteinase-9 in plasma and peritoneal fluid of patients with endometriosis. A prospective case-control study was conducted in Jinan Military General Hospital between January 2010 and December 2013. Fifty patients with proven endometriosis and 26 endometriosis-free controls were enrolled in this study. Patients with endometriosis were evaluated and divided into moderate/severe endometriosis group (stage I-II, n = 26) and minimal/mild endometriosis group (stage III-IV, n = 24) according to the revised criteria of the American Society for Reproductive Medicine. Blood samples and peritoneal fluid were obtained from both patients and controls. Matrix metalloproteinase-9 was measured using enzyme-linked immunosorbent assay in plasma and peritoneal fluid. The concentration of matrix metalloproteinase-9 between different groups was compared and its correlation to disease severity was analysed. Plasma and peritoneal fluid concentrations of matrix metalloproteinase-9 in patients with endometriosis were higher than that in controls. In addition, those patients with moderate/severe endometriosis had significantly higher plasma and peritoneal fluid concentrations of matrix metalloproteinase-9 compared to those with minimal/mild endometriosis. Matrix metalloproteinase-9 concentrations in plasma and peritoneal fluid were both positively correlated with severity of endometriosis and plasma matrix metalloproteinase-9

  12. Risk factors of epithelial ovarian carcinomas among women with endometriosis: a systematic review.

    Science.gov (United States)

    Thomsen, Line H; Schnack, Tine H; Buchardi, Kristina; Hummelshoj, Lone; Missmer, Stacey A; Forman, Axel; Blaakaer, Jan

    2017-06-01

    The objective of this review was to evaluate the published literature on epidemiologic risk factors for epithelial ovarian cancer among women with a diagnosis of endometriosis. A systematic literature search was conducted in PubMed and Scopus. Studies comparing epidemiologic risk factors of epithelial ovarian cancer among women with endometriosis were included. A quality assessment was conducted using the Newcastle-Ottawa Scale. Eight of 794 articles met the inclusion criteria. A lower risk of epithelial ovarian cancer was observed in women with documented complete surgical excision of endometriotic tissue and suggested among women with unilateral oophorectomy. The use of oral contraceptives (≥10 years) may be associated with a lower risk of epithelial ovarian cancer among women with endometriosis, whereas older age at endometriosis diagnosis (≥45 years, pre- or postmenopausal), nulliparity, hyperestrogenism (endogenous or exogenous), premenopausal status at endometriosis diagnosis, solid compartments as well as larger size of endometrioma (≥9 cm in diameter at endometriosis diagnosis) were all associated with an increased risk of ovarian cancer. A subgroup of women with endometriosis characterized by endometriosis observed through surgery or imaging after the age of 45 years, nulliparity, postmenopausal status at endometriosis diagnosis, larger size of endometrioma (>9 cm) at endometriosis diagnosis, hyperestrogenism (endogenous or exogenous) and/or cysts with solid compartments may have an elevated risk of epithelial ovarian cancer. However, due to the limited number and size of studies in this area we cannot draw definitive conclusions. Further research into a risk factor profile among women with endometriosis is needed before clear recommendations can be made. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

  13. Calcium-binding protein expression in peritoneal endometriosis-associated nerve fibres.

    Science.gov (United States)

    Barcena de Arellano, M L; Münch, S; Arnold, J; Helbig, S; Schneider, A; Mechsner, S

    2013-11-01

    Recent studies demonstrated the potential involvement of nerve fibres in the chronic inflammatory process of endometriosis. We aimed to characterize nerve fibres in the proximal and distal areas of the peritoneal endometriotic lesions in order to understand the chronic inflammatory process in endometriosis. Peritoneal endometriotic lesions (proximal area) (n = 17), the matching unaffected peritoneum (distal area) and healthy peritoneum of patients without endometriosis (n = 15) were analysed with the neuronal markers PGP 9.5, calbindin, calretinin and parvalbumin. Peritoneal fluids of women with and without endometriosis were used for Western blot analysis and for the neuronal growth assay. The protein expression of neuronal PC-12 cells incubated with peritoneal fluids was analysed. The overall nerve fibre density was significantly reduced in the distal area of the lesion when compared with the proximal area or with healthy peritoneum. The density of calbindin-, calretinin- and parvalbumin-positive nerve fibres was significantly increased in the endometriosis group. Calretinin expression was elevated in the peritoneal fluid of women with symptomatic endometriosis when compared with women with asymptomatic endometriosis. Furthermore, PC-12 cells incubated with peritoneal fluid of women with endometriosis showed a higher proliferation rate and a stronger neurite outgrowth than the control group. PC-12 cells incubated in peritoneal fluids of women with endometriosis expressed less calretinin but more calbindin than the control group. Calcium-binding proteins seem to be increased in endometriosis-associated nerve fibres and might play an important role in the chronic inflammatory condition and the pain pathogenesis of endometriosis. © 2013 European Federation of International Association for the Study of Pain Chapters.

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

    Science.gov (United States)

    Young, Vicky J; Brown, Jeremy K; Saunders, Philippa T K; Duncan, W Colin; Horne, Andrew W

    2014-01-01

    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 (Pperitoneal 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 (Pendometriosis. 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.

  15. A cross-study gene set enrichment analysis identifies critical pathways in endometriosis

    Directory of Open Access Journals (Sweden)

    Bai Chunyan

    2009-09-01

    Full Text Available Abstract Background Endometriosis is an enigmatic disease. Gene expression profiling of endometriosis has been used in several studies, but few studies went further to classify subtypes of endometriosis based on expression patterns and to identify possible pathways involved in endometriosis. Some of the observed pathways are more inconsistent between the studies, and these candidate pathways presumably only represent a fraction of the pathways involved in endometriosis. Methods We applied a standardised microarray preprocessing and gene set enrichment analysis to six independent studies, and demonstrated increased concordance between these gene datasets. Results We find 16 up-regulated and 19 down-regulated pathways common in ovarian endometriosis data sets, 22 up-regulated and one down-regulated pathway common in peritoneal endometriosis data sets. Among them, 12 up-regulated and 1 down-regulated were found consistent between ovarian and peritoneal endometriosis. The main canonical pathways identified are related to immunological and inflammatory disease. Early secretory phase has the most over-represented pathways in the three uterine cycle phases. There are no overlapping significant pathways between the dataset from human endometrial endothelial cells and the datasets from ovarian endometriosis which used whole tissues. Conclusion The study of complex diseases through pathway analysis is able to highlight genes weakly connected to the phenotype which may be difficult to detect by using classical univariate statistics. By standardised microarray preprocessing and GSEA, we have increased the concordance in identifying many biological mechanisms involved in endometriosis. The identified gene pathways will shed light on the understanding of endometriosis and promote the development of novel therapies.

  16. The Association between ABO and Rh Blood Groups and Risk of Endometriosis in Iranian Women.

    Science.gov (United States)

    Malekzadeh, Farideh; Moini, Ashraf; Amirchaghmaghi, Elham; Daliri, Leila; Akhoond, Mohammad Reza; Talebi, Mehrak; Hosseini, Rihaneh

    2018-06-01

    Endometriosis is a common gynaecological disease that affects quality of life for women. Several studies have revealed that both environmental and genetic factors contribute to the development of endometriosis. The aim of this study was to investigate the distribution of ABO and Rh blood groups in Iranian women with endometriosis who presented to two referral infertility centers in Tehran, Iran. In this case-control study, women who referred to Royan Institute and Arash Women's Hospital for diagnostic laparoscopy between 2013 and 2014 were assessed. Based on the laparoscopy findings, we categorized the women into two groups: endometriosis and control (women without endometriosis and normal pelvis). Chi-square and logistic regression tests were used for data analysis. In this study, we assessed 433 women, of which 213 patients were assigned to the endometriosis group while the remaining 220 subjects comprised the control group. The most frequent ABO blood group was O (40.6%). The least frequent blood group was AB (4.8%). In terms of Rh blood group, Rh+ (90.1%) was more frequent than Rh- (9.9%). There was no significant correlation between ABO (P=0.091) and Rh (P=0.55) blood groups and risk of endometriosis. Also, there was no significant difference between the two groups with regards to the stage of endometriosis and distribution of ABO and Rh blood groups (P>0.05). Although the O blood group was less dominant in Iranian women with endometriosis, we observed no significant correlation between the risk of endometriosis and the ABO and Rh blood groups. Endometriosis severity was not correlated to any of these blood groups. Copyright© by Royan Institute. All rights reserved.

  17. Higher prevalence of chronic endometritis in women with endometriosis: a possible etiopathogenetic link.

    Science.gov (United States)

    Cicinelli, Ettore; Trojano, Giuseppe; Mastromauro, Marcella; Vimercati, Antonella; Marinaccio, Marco; Mitola, Paola Carmela; Resta, Leonardo; de Ziegler, Dominique

    2017-08-01

    To evaluate the association between endometriosis end chronic endometritis (CE) diagnosed by hysteroscopy, conventional histology, and immunohistochemistry. Case-control study. University hospital. Women with and without endometriosis who have undergone hysterectomy. Retrospective evaluation of 78 women who have undergone hysterectomy and were affected by endometriosis and 78 women without endometriosis. CE diagnosed based on conventional histology and immunohistochemistry with anti-syndecan-1 antibodies to identify CD138 cells. The prevalence of CE was statistically significantly higher in the women with endometriosis as compared with the women who did not have endometriosis (33 of 78, 42.3% vs. 12 of 78, 15.4% according to hysteroscopy; and 30 of 78, 38.5% vs. 11 of 78, 14.1% according to histology). The women were divided into two groups, 115 patients without CE and 41 patients with CE. With univariate analysis, parity was associated with a lower risk for CE, and endometriosis was associated with a statistically significantly elevated risk of CE. Using multivariate analysis, parity continued to be associated with a lower incidence of CE, whereas endometriosis was associated with a 2.7 fold higher risk. The diagnosis of CE is more frequent in women with endometriosis. Although no etiologic relationships between CE and endometriosis can be established, this study suggests that CE should be considered and if necessary ruled out in women with endometriosis, particularly if they have abnormal uterine bleeding. Identification and appropriate treatment of CE may avoid unnecessary surgery. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  18. Endometriosis in Adolescent and Young Girls: Report on a Series of 55 Cases.

    Science.gov (United States)

    Matalliotakis, Michail; Goulielmos, George N; Matalliotaki, Charoula; Trivli, Alexandra; Matalliotakis, Ioannis; Arici, Aydin

    2017-10-01

    The aim of this retrospective study was to evaluate endometriosis in adolescent and young girls and further to review the menstrual, reproductive characteristics, and risk factors. We reviewed the medical records of adolescent and young girls with endometriosis from 2 different countries. Data were collected and analyzed from charts of 900 patients with endometriosis. Fifty-five female adolescents aged between 13 and 21 years (mean age 18.3 years) participated in our series. This study was conducted in the Obstetric and Gynecology Department of Venizeleio General Hospital of Crete and involved all patients diagnosed with endometriosis between 1996 and 2016. Statistical methods included χ 2 and Mann-Whitney U test. Of 900 patients with endometriosis we found 55 female adolescents (6.1%). The mean age was 18.3 ± 2.3 years, significantly younger compared with the advanced endometriosis patients (32.7 ± 7.2; P endometriosis group. The factors associated with an increased risk for young women include age at menarche, dysmenorrhea, history of asthma, and a positive family history of endometriosis. Additionally, we report on 16 of 55 (32%) adolescent women with endometriosis and congenital malformations (P endometriosis in adolescent and young women and risk factors including early menarche, early onset of dysmenorrhea, history of asthma, previous surgical procedures, obstructive genital anomalies, and family history of endometriosis. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  19. Manual acupuncture plus usual care versus usual care alone in the treatment of endometriosis-related chronic pelvic pain: study protocol for a randomised controlled feasibility study.

    Science.gov (United States)

    Armour, Mike; Smith, Caroline A; Schabrun, Siobhan; Steiner, Genevieve Z; Zhu, Xiaoshu; Lawson, Kenny; Song, Jing

    2018-01-01

    Endometriosis is the most common cause of chronic pelvic pain worldwide. Non-surgical treatments are effective for only 30-50% of women and have a significant side effect burden that leads to high discontinuation rates. Surgery can be effective but is expensive and invasive, and symptoms tend to recur within 5 years. There is early evidence that acupuncture may be effective in treating endometriosis-related chronic pelvic pain, showing clinically significant analgesia. Both levels of inflammation and pain processing have been shown to be altered in women with chronic pelvic pain. Acupuncture has been shown to reduce inflammation and change central pain processing in other conditions, but research on women with endometriosis is currently lacking. The aim of this feasibility study is to provide data on recruitment rates, retention, appropriateness of outcome measures, minimal clinically important difference in numeric rated scales for pain and the potential effect of acupuncture on pain processing and markers of inflammation in endometriosis-related CPP. We will include women aged 18-45 years with a diagnosis of endometriosis via laparoscopy in the past 5 years. A total of 30 participants will be recruited and randomly allocated in a 1:1 ratio to receive acupuncture or usual care. Women in the acupuncture group will receive two 45-min treatment sessions per week for 8 weeks (total of 16 sessions). Women in the usual care group will continue with their current treatment regimen. The primary feasibility outcomes are recruitment rates, retention rates and the safety and acceptability of the intervention; secondary patient-centred outcomes include a change in 0-10 daily pelvic pain ratings, the Endometriosis Health Profile 30 (EHP-30) and changes in conditioned pain modulation, resting and task-related EEG activity and inflammatory markers. Analyses will be performed blind to group allocation. This is a two-armed, assessor blind, randomised controlled feasibility

  20. Malignant Transformation of Endometriosis in the Ischioanal Fossa

    Directory of Open Access Journals (Sweden)

    Jordan S. Klebanoff

    2018-01-01

    Full Text Available We present the case of a 28-year-old nulliparous female with malignant transformation of an ectopic focus of endometriosis in the right ischioanal fossa. A 28-year-old nulliparous patient with a past medical history of polycystic ovarian syndrome (PCOS was diagnosed with endometrioid adenocarcinoma in her right ischioanal fossa. Initially, patient presented to an emergency department and underwent a CT scan of the appendix to rule out appendicitis. A multiloculated cystic lesion adjacent to the right obturator internus muscle was found. She underwent surgical resection of the mass, which confirmed FIGO grade 2 endometrioid adenocarcinoma, followed by localized radiation therapy. Malignancy arising in endometriosis is rare, and the influence of PCOS on the rate of malignant transformation is not well established.