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1.
Artigo em Inglês | MEDLINE | ID: mdl-34360152

RESUMO

A retrospective population-based study aimed to assess the incidence of endometriosis in the general population in Spain and in each of its autonomous communities. The authors used the incidence of diagnosed endometriosis in the minimum basic dataset at discharge in the national hospital discharge registry of Spain. This analysis was carried out with hospital data with a diagnosis of endometriosis (International Classification of Diseases (ICD)-9 code 617.xx and ICD-10 code N80.xx) and covered the period from 1 January 2014 to 31 December 2017 and a population of 12,775,911 women of reproductive age (15-54 years). The data were then analyzed at the national level and separately for each autonomous community. This nationwide Spanish study estimated the overall incidence of endometriosis among autonomous communities in Spain to be 16.1 per 10,000 women (range, 6.8 to 24). The mean age of the 20,547 women diagnosed with endometriosis during the study period was 36.8 ± 5.4 years. The types (proportions) of endometriosis were uterine (28.4%), tubo-ovarian (35.2%), peritoneal (8.1%), vesical (6.8%) and intestinal (3.2%) endometriosis. Further studies are needed to assess the reasons for the decrease in the observed incidence and for the significant differences in the regional incidence rates of this disease.


Assuntos
Endometriose , Adolescente , Adulto , Endometriose/epidemiologia , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Sistema de Registros , Estudos Retrospectivos , Espanha/epidemiologia , Adulto Jovem
2.
Artigo em Inglês | MEDLINE | ID: mdl-34360470

RESUMO

Endometriosis is a chronic disease of unclear aetiology that affects millions of women around the world. It causes chronic pain, dysmenorrhea, and infertility, which significantly reduces the quality of daily life. The aim of the following study was a multivariate analysis of the functioning of women diagnosed with endometriosis, and the identification of the relationship between the level of physical activity and sexual functioning, ability to cope with stress, and the degree of anxiety and mood disorders. The prospective survey was conducted of 957 women. The research was carried out using standardised IPAQ, FSFI, HADS, and Mini-Cope questionnaires. The study showed that patients with endometriosis exhibit a higher level of depression and anxiety disorders (p = 0.01) and a lower level of sexual functions (p < 0.001). The influence of physical activity on the functioning of patients with endometriosis was demonstrated. Depending on the clinical stage of endometriosis, the influence of physical activity on individual aspects of life differed. Physical activity was shown, inter alia, to reduce anxiety (p = 0.015), and influence stress-coping strategies. Endometriosis affects the mental and physical health of women. Physical activity can reduce the severity of endometriosis symptoms and improve the daily functioning of patients.


Assuntos
Endometriose , Depressão/epidemiologia , Endometriose/epidemiologia , Feminino , Humanos , Dor Pélvica , Estudos Prospectivos , Qualidade de Vida , Inquéritos e Questionários
3.
Artigo em Inglês | MEDLINE | ID: mdl-34360501

RESUMO

Endometriosis is a chronic gynecological disease that affects approximately 1 in 10 women of reproductive age. Symptoms of severe pelvic pain, infertility, fatigue, and abnormal menstruation can cause significant negative effects on an individual's physical and mental health, including interactions with their family, friends, and health care providers. Stigma associated with endometriosis has been under-studied and is rarely discussed in current literature. Herein, this paper aims to provide a brief overview of published literature to explore and establish the plausibility of stigma as a driver of suboptimal psychosocial well-being and diagnostic delay among individuals living with endometriosis. We present the clinical characteristics and physical and mental health consequences associated with endometriosis, highlight several theoretical constructs of stigma, and review the limited studies documenting women's lived experiences of endometriosis-related stigma. To mitigate harmful effects of this phenomenon, we recommend increasing efforts to assess the prevalence of and to characterize endometriosis-related stigma, implementing awareness campaigns, and developing interventions that combat the multidimensional negative effects of stigma on timely care, treatment, and quality of life for individuals living with endometriosis.


Assuntos
Diagnóstico Tardio , Endometriose , Endometriose/diagnóstico , Endometriose/epidemiologia , Feminino , Humanos , Saúde Mental , Qualidade de Vida , Estigma Social
4.
Eur J Obstet Gynecol Reprod Biol ; 264: 363-367, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34391052

RESUMO

Malignant transformation of abdominal wall endometriosis (AWE) is rare. The clinical characteristics and treatment of malignant transformation of AWE are not well known. Therefore, in this review, we performed a thorough search for malignant transformation of AWE on MEDLINE and Web of Science from their inception to May 2021. In total, the data of 46 patients with malignant transformation of AWE were retrieved, and all the data on these patients were collected. After reviewing and analyzing the clinical parameters, we found that cesarean scar was the most common site of malignant transformation of AWE, and the most common pathological type of malignant transformation of AWE was clear cell cancer, followed by endometrioid adenocarcinoma. The main symptoms of malignant transformation of AWE included an abdominal nodule or mass, and ultrasonography was the first choice for diagnosis. The most widely accepted treatment was surgical resection of local lesions with adjunctive chemotherapy and/or radiotherapy, and the overall survival of patients with malignant transformation of AWE was poor. In conclusion, malignant transformation of AWE is rare, and the prognosis is poor. Thus, improving abdominal surgical technology and avoiding iatrogenic ectopia and implantation of the endometrium are necessary to prevent malignant transformation of AWE.


Assuntos
Parede Abdominal , Carcinoma Endometrioide , Endometriose , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/cirurgia , Carcinoma Endometrioide/patologia , Cesárea/efeitos adversos , Cicatriz/patologia , Endometriose/diagnóstico , Endometriose/epidemiologia , Endometriose/terapia , Feminino , Humanos , Gravidez
5.
Environ Int ; 157: 106819, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34391986

RESUMO

BACKGROUND: Perfluorinated substances (PFAS) are chemicals with endocrine disruptive properties that may interfere with the female reproductive system. However, few studies have explored the association between benign gynecological diseases and high PFAS exposure. OBJECTIVES: The aim of this study was to investigate the possible associations between PFAS exposure and subsequent diagnosis of polycystic ovarian syndrome (PCOS), uterine leiomyoma (fibroids), and endometriosis in a cohort exposed to PFAS through drinking water. MATERIAL AND METHODS: In 2013, high levels (with sum of PFAS above 10,000 ng/L), dominated by perfluorooctanesulfonic acid (PFOS) and perfluorohexane sulfonic acid (PFHxS), were found in the drinking water from one of the two waterworks in Ronneby, Sweden. The contamination came from firefighting foams used at a nearby airfield. Females of all ages (n = 29,106) who had ever resided in the municipality between 1985 and 2013 formed a cohort. Individual exposure was assessed based on municipality waterworks distribution data linked to annual residential address data; 27% of the females had ever lived at an address with PFAS-contaminated water. Gynecological health outcomes were retrieved from the Swedish National Patient Register. The Cox proportional hazards model was used to estimate the association between exposure and each diagnosis. RESULTS: There were in all 161 cases of PCOS, 1,122 cases of uterine leiomyoma, and 373 cases of endometriosis. In women aged 20-50 years (n = 18,503), those with the highest estimated PFAS exposure had increased hazard ratios (HR) for PCOS (HR = 2.18; 95% confidence interval (CI) 1.43, 3.34) and uterine leiomyoma (HR = 1.28; 95% CI 0.95, 1.74). No increased HR for endometriosis was found (HR = 0.74; 95% CI 0.42, 1.29). CONCLUSIONS: Exposure to high levels of PFAS in drinking water was associated with increased risk of PCOS and possibly uterine leiomyoma, but not endometriosis. The findings for PCOS are consistent with prior studies reporting positive associations between PCOS and PFAS exposure at background levels.


Assuntos
Ácidos Alcanossulfônicos , Água Potável , Endometriose , Poluentes Ambientais , Fluorcarbonetos , Leiomioma , Síndrome do Ovário Policístico , Poluentes Químicos da Água , Ácidos Alcanossulfônicos/análise , Estudos de Coortes , Água Potável/efeitos adversos , Água Potável/análise , Endometriose/induzido quimicamente , Endometriose/epidemiologia , Feminino , Fluorcarbonetos/análise , Fluorcarbonetos/toxicidade , Humanos , Leiomioma/induzido quimicamente , Leiomioma/epidemiologia , Síndrome do Ovário Policístico/induzido quimicamente , Síndrome do Ovário Policístico/epidemiologia , Suécia/epidemiologia , Poluentes Químicos da Água/análise , Poluentes Químicos da Água/toxicidade
6.
BMJ Open ; 11(8): e050844, 2021 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-34373312

RESUMO

INTRODUCTION: Endometriosis is one of the common, gynaecological disorders associated with chronic pelvic pain and subfertility affecting ~10% of reproductive age women. The clinical presentation, etiopathogenesis of endometriosis subtypes and associated risk factors are largely unknown. Genome-Wide Association (GWA) Studies (GWAS) provide strong evidence for the role of genetic risk factors contributing to endometriosis. However, no studies have investigated the association of the GWAS-identified single-nucleotide polymorphism (SNPs) with endometriosis risk in the Indian population; therefore, one-sixth of the world's population is not represented in the global genome consortiums on endometriosis. The Endometriosis Clinical and Genetic Research in India (ECGRI) study aims to broaden our understanding of the clinical phenotypes and genetic risks associated with endometriosis. METHODS AND ANALYSIS: ECGRI is a large-scale, multisite, case-control study of 2000 endometriosis cases and 2000 hospital controls to be recruited over 4 years at 15 collaborating study sites across India covering representative Indian population from east,north-east, north, central, west and southern geographical zones of India. We will use the World Endometriosis Research Foundation Endometriosis Phenome and Biobanking Harmonisation Project (WERF-EPHect) data collection instruments for capturing information on clinical, epidemiological, lifestyle, environmental and surgical factors. WERF-EPHect standard operating procedures will be followed for the collection, processing and storage of biological samples. The principal analyses will be for main outcome measures of the incidence of endometriosis, disease subtypes and disease severity determined from the clinical data. This will be followed by GWAS within and across ethnic groups. ETHICS AND DISSEMINATION: The study is approved by the Institutional Ethics Committee of Indian Council of Medical Research-National Institute for Research in Reproductive Health and all participating study sites. The study is also approved by the Health Ministry Screening Committee of the Government of India. The results from this study will be actively disseminated through discussions with endometriosis patient groups, conference presentations and published manuscripts.


Assuntos
Endometriose , Bancos de Espécimes Biológicos , Estudos de Casos e Controles , Endometriose/epidemiologia , Endometriose/genética , Feminino , Pesquisa em Genética , Estudo de Associação Genômica Ampla , Humanos , Fenótipo
7.
Artigo em Inglês | MEDLINE | ID: mdl-34444500

RESUMO

To compare the rate and risk of ovarian cancer in patients with endometriosis or pelvic inflammatory disease (PID). A nationwide population cohort research compared the risk of ovarian cancer in 135,236 age-matched comparison females, 114,726 PID patients, and 20,510 endometriosis patients out of 982,495 females between 1 January 2002 and 31 December 2014 and ended on the date of confirmation of ovarian cancer, death, or 31 December 2014. In order to reduce the unbalanced characteristics, propensity score matching (PSM) was performed for 20,478 females in each subgroup. The incidence rate (per 100,000 person-years) of ovarian cancer was 8.74 (95% CI, 7.16-10.66) in comparison, 9.26 (7.54-11.39) in PID, and 28.73 (21.07-39.16) in endometriosis cohorts. The adjusted hazard ratio (aHR) of ovarian cancer was 1.17 (p = 0.296) in PID and 3.12 (p < 0.001) in endometriosis cohorts, compared with the comparison cohort in full cohort, using the multiple Cox regression model. The aHR of ovarian cancer was 0.83 (p = 0.650) in PID and 3.03 (p = 0.001) in endometriosis cohorts, compared with the comparison cohort after performing PSM. In the full cohort and PSM population, the cumulative incidence rate of ovarian cancer was significantly higher in patients with endometriosis than in those with PID or in the comparison cohort (p < 0.001 and p < 0.001). In conclusion, after considering the differences in the impacts of exposure to endometriosis or PID, patients with endometriosis were more likely to develop ovarian cancer.


Assuntos
Endometriose , Neoplasias Ovarianas , Doença Inflamatória Pélvica , Carcinoma Epitelial do Ovário , Endometriose/epidemiologia , Feminino , Humanos , Neoplasias Ovarianas/epidemiologia , Doença Inflamatória Pélvica/epidemiologia , Fatores de Risco
8.
Eur J Obstet Gynecol Reprod Biol ; 264: 155-161, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34303076

RESUMO

OBJECTIVE: To review prospectively the clinical characteristics of patients suffering from urinary tract endometriosis (UTE) in France, in 2017. STUDY DESIGN: We conducted a prospective observational multicenter study including women managed surgically for UTE in 31 French endometriosis expert centers (FRIENDS group) from January 1, 2017 to December 31, 2017. We distinguished patient with isolated bladder endometriosis ("IBE") or isolated ureteral endometriosis ("IUE") and patients associating both locations (mixed locations "ML"). Surgeons belonging to FRIENDS group enrolled patients by filling a 24 items questionnaire the day of the surgery and 6 weeks later. Data on the locations of UTE, preoperative assessment, urinary symptoms and associated pelvic locations were collected in a single anonymized database. RESULTS: A total of 232 patients from 31 centers were included. IBE concerned 82 patients (35.3%), IUE 126 patients (54.4%) ML 24 patients (10.3%). 111 patients reported urinary symptoms (47.8%). IUE was more often asymptomatic than the rest of the locations (59.5% versus 43.3%, OR 1,92, p = 0.017). Associated deep infiltrating endometriosis (DIE) lesions were found in 193 patients (83.1%). IUE was significantly associated with other DIE lesions (82.5% versus 66%, OR2.4, p = 0.006), particularly with rectum or sigmoid nodules (57.1% versus 36.8%, OR 2.3, p = 0.002) and retrocervical space nodules (31.7% versus 19.8%, OR 1.9, p = 0.05). CONCLUSION: Our study reports the second largest series of patients operated from a UTE and shows that ureteral location seems more frequent, less symptomatic and more frequently associated to other DIE locations than bladder endometriosis.


Assuntos
Endometriose , Laparoscopia , Ureter , Doenças da Bexiga Urinária , Endometriose/epidemiologia , Endometriose/cirurgia , Feminino , Humanos , Doenças da Bexiga Urinária/epidemiologia , Doenças da Bexiga Urinária/cirurgia
9.
Artigo em Inglês | MEDLINE | ID: mdl-34205332

RESUMO

BACKGROUND: Chronic pelvic pain affects approximately 15% of reproductive age women. It is mainly caused by adhesions (20-40%). Despite CPP being the main symptom of endometriosis, the disease is confirmed by laparoscopy only in 12-18% of cases. The aim of this study was to evaluate the results of laparoscopy in women with CCP and to assess the sensitivity and specificity of elements of an interview and clinical examination. MATERIALS AND METHODS: The study included 148 women with CPP. Each patient underwent laparoscopy. In laparoscopy, the presence of endometriosis and/or peritoneal adhesions was confirmed. Then, the sensitivity and specificity and the positive and negative predictive value of endometriosis symptoms or abnormalities in the gynecological examination were statistically calculated. RESULTS: After previous surgery, adhesions were found in almost half (47%) of patients. In patients without a history of surgery, adhesions were diagnosed in 6.34% of patients. Endometriosis without coexisting adhesions was more often diagnosed in women without previous surgery (34.9%), compared to 10.58% in the group with a history of surgery (p < 0.05). CONCLUSIONS: Intraperitoneal adhesions are most common in women after pelvic surgery and with chronic ailments. The best results for sensitivity, specificity, positive predictive value, and negative predictive value in the diagnosis of endometriosis are found in women with irregular menstruations during which the pain increases. Laparoscopy still remains the primary diagnostic and therapeutic method for these women.


Assuntos
Endometriose , Laparoscopia , Endometriose/complicações , Endometriose/diagnóstico , Endometriose/epidemiologia , Feminino , Humanos , Dor Pélvica/diagnóstico , Dor Pélvica/epidemiologia , Dor Pélvica/etiologia , Exame Físico , Aderências Teciduais/diagnóstico , Aderências Teciduais/epidemiologia
10.
Int J Mol Sci ; 22(11)2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34199930

RESUMO

Endometriosis is a common gynecological disorder that has been associated with endometrial, breast and epithelial ovarian cancers in epidemiological studies. Since complex diseases are a result of multiple environmental and genetic factors, we hypothesized that the biological mechanism underlying their comorbidity might be explained, at least in part, by shared genetics. To assess their potential genetic relationship, we performed a two-sample mendelian randomization (2SMR) analysis on results from public genome-wide association studies (GWAS). This analysis confirmed previously reported genetic pleiotropy between endometriosis and endometrial cancer. We present robust evidence supporting a causal genetic association between endometriosis and ovarian cancer, particularly with the clear cell and endometrioid subtypes. Our study also identified genetic variants that could explain those associations, opening the door to further functional experiments. Overall, this work demonstrates the value of genomic analyses to support epidemiological data, and to identify targets of relevance in multiple disorders.


Assuntos
Neoplasias do Endométrio/epidemiologia , Endometriose/epidemiologia , Endométrio/patologia , Predisposição Genética para Doença , Neoplasias Hormônio-Dependentes/epidemiologia , Neoplasias Ovarianas/epidemiologia , Polimorfismo de Nucleotídeo Único , Neoplasias do Endométrio/genética , Neoplasias do Endométrio/patologia , Endometriose/genética , Endometriose/patologia , Feminino , Estudo de Associação Genômica Ampla , Humanos , Neoplasias Hormônio-Dependentes/genética , Neoplasias Hormônio-Dependentes/patologia , Neoplasias Ovarianas/genética , Neoplasias Ovarianas/patologia , Fatores de Risco , Espanha/epidemiologia
11.
Artigo em Inglês | MEDLINE | ID: mdl-34281113

RESUMO

BACKGROUND: Diagnosis of endometriosis and evaluation of incidence data are complex tasks because the disease is identified laparoscopically and confirmed histologically. Incidence estimates reported in literature are widely inconsistent, presumably reflecting geographical variability of risk and the difficulty of obtaining reliable data. METHODS: We retrieved incident cases of endometriosis in women aged 15-50 years using hospital discharge records and pathology databases of the Friuli Venezia Giulia region in the calendar period 2004-2017. We studied the spatial pattern of endometriosis incidence applying Bayesian approaches to Disease Mapping, and profiled municipalities at higher risk controlling for multiple comparisons using both q-values and a fully Bayesian approach. RESULTS: 4125 new cases of endometriosis were identified in the age range 15 to 50 years in the period 2004-2017. The incidence rate (x100 000) is 111 (95% CI 110-112), with a maximum of 160 in the age group 31-35 years. The geographical distribution of endometriosis incidence showed a very strong north-south spatial gradient. We consistently identified a group of five neighboring municipalities at higher risk (RR 1.31 95% CI 1.13; 1.52), even accounting for ascertainment bias. CONCLUSIONS: The cluster of 5 municipalities in the industrialized and polluted south-east part of the region is suggestive. However, due to the ecologic nature of the present study, information on the patients' characteristics and exposure histories are limited. Individual studies, including biomonitoring, and life-course studies are necessary to better evaluate our findings.


Assuntos
Endometriose , Adolescente , Adulto , Teorema de Bayes , Bases de Dados Factuais , Endometriose/epidemiologia , Feminino , Humanos , Incidência , Itália/epidemiologia , Pessoa de Meia-Idade , Adulto Jovem
12.
Hum Reprod ; 36(8): 2170-2180, 2021 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-34166496

RESUMO

STUDY QUESTION: What is the relationship between specific quality of life domains and depression, anxiety and stress in the endometriosis population? SUMMARY ANSWER: Psychosocial domains of quality of life, such as a perception of social support and self-image, are more strongly associated with depression, anxiety and stress than pain and medical factors. WHAT IS KNOWN ALREADY: Prior research indicates a high prevalence of anxiety and depression in individuals with endometriosis. Pain is thought to be critical in the development of psychological distress, however prior research has investigated this association without consideration of psychosocial quality of life domains such as social functioning, perceived social support and self-image. STUDY DESIGN, SIZE, DURATION: This study is a cross-sectional analysis of baseline data collected in a longitudinal study exploring psychological distress in endometriosis (n = 584). PARTICIPANTS/MATERIALS, SETTING, METHODS: Individuals living with endometriosis participated in this study and were recruited via online platforms of community organizations and support groups. Demographic and medical information concerning endometriosis treatment and diagnosis was self-reported. Psychological distress and quality of life was measured using the Depression, Anxiety and Stress Scale (DASS-21), Endometriosis Health Profile-30 (EHP-30) and the Short Form Survey (SF-36v2). A series of linear regression analyses explored the relationship between specific quality of life domains and the primary outcomes of depression, anxiety and stress. MAIN RESULTS AND THE ROLE OF CHANCE: Approximately half of the participants in this sample reported moderate to severe anxiety, depression and stress. Quality of life domains, particularly perceived social support, social functioning and self-image, were more strongly associated with psychological distress than medical or demographic factors. Pain was associated with anxiety, but not depression or stress. A greater number of endometriosis symptoms was only associated with depression. LIMITATIONS, REASONS FOR CAUTION: These data are cross-sectional and, therefore, causality cannot be inferred from this analysis. Information about endometriosis diagnosis and treatment was self-reported, and not verified against medical records. WIDER IMPLICATIONS OF THE FINDINGS: This study indicates that psychosocial factors may be more salient factors underlying depression, anxiety and stress in the endometriosis population than pain and medical factors. There is a need for interventions that target psychological distress in this population with a focus on the broader impact of endometriosis beyond pain and physical symptomatology. STUDY FUNDING/COMPETING INTEREST(S): This research was supported by the Research Training Program (RTP) Scholarship awarded to C.S.M. by Macquarie University. The remaining authors have nothing to declare. TRIAL REGISTRATION NUMBER: ACTRN12619001508167.


Assuntos
Endometriose , Angústia Psicológica , Ansiedade/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Depressão/etiologia , Endometriose/complicações , Endometriose/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Qualidade de Vida , Estresse Psicológico/epidemiologia
13.
Fertil Steril ; 116(3): 855-861, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34120737

RESUMO

OBJECTIVE: To develop diagnostic criteria for chronic endometritis and compare the prevalence of chronic endometritis between women with recurrent pregnancy loss (RPL) and controls. DESIGN: Cohort study. SETTING: Single academic fertility center. PATIENTS: Women with unexplained RPL (two or more pregnancy losses) and prospectively recruited controls without a history of RPL or infertility. INTERVENTIONS: Endometrial samples were stained with hematoxylin and eosin and CD138. A pathologist blinded to patient history recorded the number of plasma cells per 10 high-power fields (HPFs). In addition, the presence or absence of endometrial stromal changes was documented. MAIN OUTCOME MEASURE: Prevalence of chronic endometritis. RESULTS: Endometrial samples from 50 women with unexplained RPL and 26 controls were evaluated. When chronic endometritis was defined as the presence of one or more plasma cells per 10 HPFs, 31% of controls and 56% of women with RPL met the criterion. When both endometrial stromal changes and plasma cells were required for a diagnosis of chronic endometritis, no controls and 30% of women with RPL met the criteria. CONCLUSIONS: Although rare plasma cells were found in biopsy samples from controls, the presence of both plasma cells and endometrial stromal changes was limited to the RPL cohort. We propose that chronic endometritis be defined as the presence of one or more plasma cells per 10 HPFs in the setting of endometrial stromal changes. With the use of these strict diagnostic criteria, women with RPL have a significantly higher rate of chronic endometritis, supporting an association between chronic endometritis and RPL.


Assuntos
Aborto Habitual/epidemiologia , Endometriose/epidemiologia , Endometriose/patologia , Endométrio/patologia , Células Estromais/patologia , Adulto , Estudos de Casos e Controles , Doença Crônica , Feminino , Humanos , Plasmócitos/patologia , Prevalência , Estudos Prospectivos , Medição de Risco , Fatores de Risco
14.
Medicina (Kaunas) ; 57(5)2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-34066945

RESUMO

Objective: To highlight the most frequent localization of ovarian endometriosis, the presence of atypical endometriosis, and recurrences. Retrospective review of 259 patients diagnosed with ovarian endometriosis treated at Tîrgu-Mures Emergency County Hospital, Obstetric Gynecology Clinic, between January 2014 and December 2018. Methods: Data were collected and analyzed for demographics, size of ovarian endometriotic cyst, and recurrences. Results: Out of 259 patients, 51 patients presented atypia, 20 on the right, 24 on the left, and seven patients were diagnosed with endometriosis with bilateral atypia. Higher susceptibility for left localization was noted. Thirty-nine patients (15.1%) presented recurrence. A statistically significant correlation (p = 0.006) was noted between patients with recurrence and atypia compared with those without atypia and endometriotic cysts larger than 7 cm. Patients with relapse under the age of 40 were noted to have mainly atypia with localization on the right (p = 0.025, OD = 4.107). Conclusions: The presence of endometrioma was not statistically significant correlated with left or right sided localization; recurrent endometriomas larger than 7 cm represents a risk for atypical endometriosis development. Recurrence and atypia appear more often in patients under the age of 40 and are right-sided. The total removal of the endometriomas can prevent the recurrence and subsequently the appearance of atypia and secondary neoplastic conditions.


Assuntos
Endometriose , Endometriose/epidemiologia , Feminino , Humanos , Recidiva Local de Neoplasia , Gravidez , Estudos Retrospectivos
15.
Artigo em Inglês | MEDLINE | ID: mdl-34073723

RESUMO

Endometriosis is a disabling disease that may significantly compromise a woman's social relationships, sexuality, and mental health. Considering the impact of endometriomas and deep infiltrating endometriosis (DIE) on quality of life and the limited number of papers on this topic, the objective of this study was to assess health-related quality of life (HRQoL) in adult Spanish women with the condition. A case-control study was conducted on a group of 99 patients with ovarian endometriomas or DIE and 157 controls. Women underwent physical and gynecological examinations, and they completed health questionnaires including the Short Form-12v2 (SF-12v2), a survey for HRQoL. Eight scales and two component summary scores (Physical (PCS) and Mental (MCS), respectively) were calculated. Women with endometriomas or DIE had significantly worse PCS: 47.7 ± 9.7 vs. 56.1 ± 5.9, respectively (p < 0.001) compared to controls, as well as lower scores on seven out of the eight scales (p < 0.01). No significant differences were found for the MCS. Conclusions: HRQoL was significantly lower in patients with endometriomas or DIE compared to controls. If confirmed, these results may have important implications for prevention, clinical practice, and intervention.


Assuntos
Endometriose , Qualidade de Vida , Adulto , Estudos de Casos e Controles , Endometriose/epidemiologia , Feminino , Humanos , Saúde Mental , Inquéritos e Questionários
16.
J Pak Med Assoc ; 71(4): 1118-1122, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34125754

RESUMO

OBJECTIVE: The study aimed to explore the association of endometriosis risk factors with single nucleotide polymorphisms rs6166 and rs6165 (Asn680Ser and Ala307Thr) of follicle stimulating hormone receptor (FSHR) gene in Pakistani women. METHODS: This study was conducted from 2013 to 2016. The sampling and extraction of DNA was done in Department of Zoology GC University, Lahore, while the sequencing was performed at Yale University, USA. This case control study consisted of 364 subjects including 156 women diagnosed with endometriosis and 208 conveniently recruited controls. Subjects diagnosed at stage II-IV endometriosis with infertility were pooled for study. The women with adenomyosis, ovarian cancer and leiomyoma were excluded. The whole blood leukocytes were used for DNA extraction. Two important polymorphisms of exon 10 of FSHR gene were analyzed by direct DNA sequencing both in endometriosis and controls. Results: Genetic variant SNP rs6166 in the affected endometriosis subjects exhibited high incidence of allele "A" (Asn/Asn) 68.3% as compared to controls 33.7% (OR= 4.240; P =0.001). Similarly, the allele "A" of SNP rs6165 (Thr/Thr) was more frequent in endometriosis 67.3% than in control subjects 37.5% (OR =3.430, P =0.001). The occurrence of haplotype AA (Asn/Thr) was 45.5% in endometriosis and 11 % in control subjects (P= 0.001). Remarkably, the incidence of haplotype GG (Ser/Ala) was contrary to previous observations, since only 9.9% occurred in endometriosis as opposed to 45.2% in controls (P= 0.001). CONCLUSIONS: Investigation of FSHR gene polymorphisms rs6165and rs6166 (Ala307Thr and Asn680Ser) in the current study showed that haplotype AA (680Asn/307Thr) was associated with endometriosis in Pakistani women.


Assuntos
Endometriose , Receptores do FSH , Estudos de Casos e Controles , Endometriose/epidemiologia , Endometriose/genética , Feminino , Genótipo , Humanos , Paquistão/epidemiologia , Polimorfismo de Nucleotídeo Único , Receptores do FSH/genética , Centros de Atenção Terciária
17.
J Obstet Gynaecol Can ; 43(8): 935-942, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33984522

RESUMO

OBJECTIVE: To evaluate the prevalence of endometriosis and peritoneal pockets and to analyze whether these pockets are associated with pain. METHODS: Analysis of prospectively registered data of all women undergoing laparoscopy for infertility or pelvic pain between 1988 and 2011 at KU Leuven University Hospital. RESULTS: Of 4497 women, 191 had 238 pockets, with a prevalence of 4.7% in women with infertility only, 4.9% in women with infertility and pelvic pain, and 3.5% in women with pelvic pain only (P = 0.045 for all infertility vs. pelvic pain only). Prevalence did not vary by age. Pockets were associated with endometriosis (P < 0.0001), which was found in 77% of women with pockets. Among women with infertility only, the prevalence of endometriosis was higher in women with pockets (P = 0.0001) than in women without. The prevalence of endometriosis was similar in women with infertility and pelvic pain or pelvic pain only. Pelvic pain as an indication for surgery was associated simultaneously (through logistic regression) with endometriosis (P < 0.0001) and pockets (P = 0.040). Pelvic pain severity was associated simultaneously with pockets (P = 0.0026) and the severity of subtle (P = 0.001), typical (P = 0.030), cystic ovarian (P = 0.051), and deep endometriosis (P < 0.0001). Pelvic pain severity was not associated with endometriosis in the pockets or the diameter or location of pockets. CONCLUSIONS: The prevalence of pockets was low, at between 3.5% and 5%. Women with infertility only and pockets had more endometriosis than women without. Severe pelvic pain and pelvic pain as an indication for surgery were associated with the presence of pockets as well as the presence and severity of endometriosis.


Assuntos
Endometriose , Infertilidade Feminina , Laparoscopia , Endometriose/complicações , Endometriose/epidemiologia , Endometriose/cirurgia , Feminino , Humanos , Infertilidade Feminina/epidemiologia , Dor Pélvica/epidemiologia , Dor Pélvica/cirurgia , Peritônio , Prevalência
18.
J Psychosom Res ; 146: 110508, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33993063

RESUMO

OBJECTIVE: The COVID-19 pandemic has resulted in restrictions and social isolation measures, which carry mental health risks. Cancellation of surgery and appointments, medication shortages and fear of the virus itself may have further challenged wellbeing. We aimed to understand how COVID-19 has affected people with endometriosis. METHODS: Using a mixed methods design, we examined; 1) the impact of COVID-19 on endometriosis related healthcare, symptoms and functioning; and 2) the relationship between a measure of fear of COVID-19 and qualitative impact in 162 women with endometriosis. RESULTS: We found that 60% of women reported impact of the pandemic upon healthcare, with sub-themes documenting the difficulty of cancelled and delayed treatment, specific COVID-19 barriers, and the advantages and disadvantages of telehealth. Only 23% reported negative impact on symptoms, specifically stress; 76% reported impact on daily functioning, with sub-themes related to compromised work, social life and healthy living. A 'hidden benefits' theme revealed ways that COVID-19 had improved some women's lives, including working from home, and the opportunity for healthy lifestyle choices. Logistic regressions revealed that fear of COVID-19 significantly predicted impact themes (healthcare odds ratio = 0.93, 95% confidence interval: 0.87-0.98; symptoms odds ratio = 0.88, 95% confidence interval: 0.82-0.95; functioning odds ratio = 0.92, 95% confidence interval: 0.85-0.99). CONCLUSION: Our findings indicate the need to provide patients with supportive care during pandemic restrictions that leverage self-management strategies.


Assuntos
COVID-19/prevenção & controle , COVID-19/psicologia , Endometriose/epidemiologia , Endometriose/terapia , Adolescente , Adulto , COVID-19/epidemiologia , Medo/psicologia , Feminino , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Pesquisa Qualitativa , Isolamento Social/psicologia , Inquéritos e Questionários , Turquia/epidemiologia , Adulto Jovem
19.
J Obstet Gynaecol Res ; 47(8): 2713-2719, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33998109

RESUMO

AIM: To evaluate the frequency of complications and factors associated with the recurrence of endometriosis in women with deep infiltrating endometriosis (DIE) undergoing surgical treatment. METHODS: A retrospective observational cohort study with 72 women who underwent surgery and followed up by DIE at the University of Campinas from 2007 to 2017. The variables analyzed were clinical characteristics, use and type of drug treatment before and after surgery, operative time and complications inherent to the procedure, as well as the recurrence of lesions on imaging. RESULTS: The mean age of women was 39.7 ± 6.3 years and the mean follow-up was 4.56 ± 2.60 years. Complications were reported in 16.6% of surgeries and recurrence of lesions in 34.7%. The risk of intraoperative complications was higher in the presence of lesions of the bowel and in those who used intramuscular progestin before surgery. A higher risk of recurrence was observed among those who did not use hormonal treatment or used a levonorgestrel-releasing intrauterine device (LNG-IUD) in the postoperative period. CONCLUSION: Women with DIE have a high rate of complications during surgical treatment and a higher risk of recurrence when they did not receive hormonal treatment or when treated with LNG-IUD after surgery.


Assuntos
Endometriose , Dispositivos Intrauterinos Medicados , Adulto , Endometriose/epidemiologia , Endometriose/cirurgia , Feminino , Humanos , Levanogestrel , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
20.
Artigo em Inglês | MEDLINE | ID: mdl-33810403

RESUMO

While large numbers of women report high levels of psychological distress associated with endometriosis, others report levels of distress that are comparable to those of healthy women. Thus, the aim of the current study was to develop an explanatory model for the effect of endometriosis on women's psychological distress. Furthermore, it sought to further investigate the role of body image, self-criticism, and pain intensity on the psychological distress associated with endometriosis and establish the effect of chronic illness load on the development of this distress. This study comprised a total of 247 women aged 20-49 (M = 31.3, SD = 6.4)-73 suffering from endometriosis only, 62 suffering from endometriosis and an additional chronical illness (ACI), and 112 healthy peers (HP)-who completed the Patient Health Questionnaire, the Generalized Anxiety Disorder-Item Scale, the Body Appreciation Scale-2, and the Self-Criticism Sub-Scale. When comparing each endometriosis group to their HP's, we found that the differences between HP and endometriosis ACI in depression and anxiety were mediated by body image (Betas = 0.17 and 0.09, respectively, p's < 0.05) and self-criticism (Betas = 0.23 and 0.26, respectively, p's < 0.05). When comparing endometriosis participants to endometriosis ACI participants, differences in depression were mediated by body image, self-criticism, and pain intensity (Betas = 0.12, 0.13, 0.13 respectively, p's < 0.05), and the differences in anxiety were mediated by self-criticism and pain intensity (Betas = 0.19, 0.08, respectively, p's < 0.05). Physicians and other health professionals are advised to detect women with endometriosis ACI who are distressed, and to offer them appropriate intervention.


Assuntos
Endometriose , Angústia Psicológica , Adulto , Ansiedade/epidemiologia , Imagem Corporal , Depressão/epidemiologia , Endometriose/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Multimorbidade , Autoavaliação (Psicologia) , Estresse Psicológico/epidemiologia , Inquéritos e Questionários , Adulto Jovem
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