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1.
Reprod Biol Endocrinol ; 20(1): 57, 2022 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-35337338

RESUMO

INTRODUCTION: To evaluate whether the incidence of hypertensive disorders of pregnancy (HDP) in pregnant women was related to endometriosis (EM), ovulation and embryo vitrification technology. METHODS: A retrospective cohort study was conducted on the clinical data of 3674 women who were treated with IVF / ICSI in the Reproductive Medicine Center of the First Affiliated Hospital of Sun Yat-sen University and maintained clinical pregnancy for more than 20 weeks. All pregnancies were followed up until the end of pregnancy. The follow-up consisted of recording the course of pregnancy, pregnancy complications, and basic situation of newborns. RESULTS: Compared with NC-FET without EM, HRT-FET without EM was found to have a higher incidence of HDP during pregnancy (2.7% V.S. 6.1%, P<0.001); however, no significant difference was found in the incidence of HDP between NC-FET and HRT-FET combined with EM (4.0% V.S. 5.7%, P>0.05). In total frozen-thawed embryo transfer (total-FET), the incidence of HDP in the HRT cycle without ovulation (HRT-FET) was observed to be higher than that in the NC cycle with ovulation (NC-FET) (2.8% V.S. 6.1%, P<0.001). In patients with EM, no significant difference was found in the incidence of HDP between fresh ET and NC-FET (1.2% V.S. 4.0%, P>0.05). CONCLUSION: EM does not seem to have an effect on the occurrence of HDP in assisted reproductive technology. During the FET cycle, the formation of the corpus luteum may play a protective role in the occurrence and development of HDP. Potential damage to the embryo caused by cryopreservation seems to have no effect on the occurrence of HDP.


Assuntos
Endometriose , Hipertensão Induzida pela Gravidez , Endometriose/epidemiologia , Feminino , Humanos , Hipertensão Induzida pela Gravidez/epidemiologia , Recém-Nascido , Gravidez , Técnicas de Reprodução Assistida , Estudos Retrospectivos , Injeções de Esperma Intracitoplásmicas
2.
Pan Afr Med J ; 42: 54, 2022.
Artigo em Francês | MEDLINE | ID: mdl-35949478

RESUMO

Abdominal wall endometriosis is a rare disease that usually develops in association with a cesarean section scar. Although frequently identified in the skin and subcutaneous adipose tissue adjacent to the cesarean scar, intramuscular localization is possible but rare. Treatment is based on surgical excision of the lesion associated with or without hormone therapy. Wide surgical excision is the treatment of choice, but it exposes to the risk of abdominal wall hernia. We here report two cases of parietal endometriosis occurring after Pfannstiel scar for cesarean section whose data were collected at the Department of surgery in the Zaghouan Regional Hospital.


Assuntos
Parede Abdominal , Endometriose , Parede Abdominal/patologia , Parede Abdominal/cirurgia , Cesárea , Cicatriz/patologia , Endometriose/complicações , Endometriose/diagnóstico , Endometriose/cirurgia , Feminino , Humanos , Gravidez
3.
J Med Life ; 15(6): 742-746, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35928366

RESUMO

For the last decades, endometriosis has been a major gynecological problem and a significant cause of infertility for women worldwide. It is estimated that the disease affects about 10-15% of all women of reproductive age and 70% of women suffering from chronic pelvic pain. At the same time, the incidence is about 40-60% in women with dysmenorrhea and 20-30% in women with subfertility. Despite the high percentage of affected women, endometriosis is still characterized by insufficient knowledge of the pathogenic processes, leading to the development and continuity of the disease. For this reason, there is a significant need for insight and understanding of the pathogenesis of endometriosis. This systematic review aims to present the latest data on the use of rats in endometriosis research and to explore how fertility is affected in rats with endometriosis. The methodology included a review of the available publications retrieved by a search in various scientific databases, such as PubMed, Scopus, Medline, and Google Scholar. The initial search generated 30 titles, with 10 articles fulfilling the inclusion criteria. In conclusion, several surgical techniques have been proposed to induce endometriosis, mainly using rats as the appropriate animal model. Studies in rats showed that endometriosis causes infertility and that pregnancy rates are lower for rats with endometriosis than those without endometriosis. In addition, rats with endometriosis have significant abnormalities in the structure of their oocytes as well as in the development of their embryos (genetic abnormalities).


Assuntos
Endometriose , Infertilidade , Animais , Endometriose/complicações , Endometriose/patologia , Feminino , Fertilidade , Humanos , Dor Pélvica/etiologia , Gravidez , Taxa de Gravidez , Ratos
4.
Rev Med Liege ; 77(7-8): 421-425, 2022 Jul.
Artigo em Francês | MEDLINE | ID: mdl-35924495

RESUMO

A 31-year-old patient is admitted to the emergency room because of an acute right thoracic pain associated with a dyspnea. The patient reports the stopping of Decapeptyl®, a treatment taken in regards to an endometriosis, but interrupted to get pregnant. An x-ray highlights a pneumothorax of 15 mm at the right apical level. It is a second episode for this patient. Catamenial pneumothorax is one of the most frequent manifestation in terms of a thoracic endometriosis syndrome (TES). It concerns a rare pathology, unrecognized and underdiagnosed. The diagnosis should be invoked on all patients having the childbearing age who are presenting themselves at the emergencies with a right thoracic pain. The medical care is multidisciplinary, the association of a hormonal therapy and then a surgical treatment being the best therapeutical approach. This case report describes the recurrence of a catamenial pneumotorax induced by the stopping of the endometriosis treatment and reviews the physiopathology, the diagnosis and its multidisciplinary management.


Une patiente de 31 ans est admise aux urgences pour douleur thoracique droite apparue brutalement et associée à une dyspnée. La patiente rapporte l'arrêt du Decapeptyl®, traitement pris dans le cadre d'une endométriose, mais interrompu pour un désir de grossesse. Une radiographie mettra en évidence un pneumothorax de 15 mm au niveau apical droit. Il s'agit du deuxième épisode chez cette patiente. Le pneumothorax cataménial (PC) est l'une des manifestations les plus fréquentes dans le cadre d'un syndrome d'endométriose thoracique (SET). Il s'agit d'une pathologie rare, méconnue et sous-diagnostiquée. Il est à évoquer chez toutes patientes en âge de procréer se présentant aux urgences avec une douleur thoracique droite. La prise en charge est multidisciplinaire, l'association d'un traitement hormonal, puis chirurgical, semble être la meilleure approche thérapeutique. Cet article rapporte la récidive d'un PC, récidive induite par l'arrêt du traitement de l'endométriose, et revoit la physiopathologie, le diagnostic et la prise en charge de celui-ci.


Assuntos
Endometriose , Pneumotórax , Adulto , Dor no Peito/diagnóstico , Dor no Peito/etiologia , Endometriose/complicações , Endometriose/diagnóstico , Endometriose/cirurgia , Feminino , Humanos , Menstruação , Pneumotórax/diagnóstico , Pneumotórax/etiologia , Pneumotórax/terapia
5.
PLoS One ; 17(8): e0271173, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35921357

RESUMO

The management of endometriosis-related infertility is still a challenging issue. Women can be managed with either surgery or in vitro fertilization (IVF). The decision is tailored to the patients considering pros and cons of both approaches. Surgery might increase the chances of natural conception and relieve symptoms. IVF may be more effective, but costs are higher and unoperated women face some peculiar additional risks during the procedure and pregnancy. The unavailability of randomized trials comparing the two strategies hampers the possibility to provide precise estimates. This Randomized Controlled Trial (RCT) aims at filling this gap. This is a multicenter, non-blinded, randomized controlled trial with parallel groups and allocation 1:1. Three Italian Academic Infertility Units will be involved. Main inclusion criteria are infertility for more than one year, age less than 40 years and a sonographic diagnosis of endometriosis (ovarian endometriomas or deep peritoneal lesions). Previous IVF and previous surgery for endometriosis are exclusion criteria. Women will be randomized to either surgery and then natural pregnancy seeking or a standard program of three IVF cycles. The primary aim is the comparison of live birth rate between the two groups (IVF versus surgery) within one year of randomization. The secondary aim is the evaluation of cost-effective profile of the two interventions. The present study can influence the clinical practice of infertility treatment in women with endometriosis. From a public health perspective, information on the more cost-effective clinical management strategy would consent a wiser allocation of resources. Trial registration: NCT04743167, registered on 8 February 2021.


Assuntos
Endometriose , Infertilidade Feminina , Infertilidade , Adulto , Protocolos Clínicos , Endometriose/complicações , Endometriose/cirurgia , Feminino , Fertilização In Vitro/métodos , Humanos , Infertilidade Feminina/etiologia , Infertilidade Feminina/cirurgia , Estudos Multicêntricos como Assunto , Indução da Ovulação/métodos , Gravidez , Taxa de Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto
6.
Sci Rep ; 12(1): 13336, 2022 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-35922461

RESUMO

Epidemiological study shows inconsistent results in the association between endometriosis and Systemic lupus erythematosus (SLE). We conducted a nationwide retrospective cohort study and analyzed data from the Taiwan Longitudinal Health Insurance Research Database 2000 (n = 958,349) over a 13-year follow-up period (2000-2013). After matching 1930 SLE women with 7720 non-SLE women in a 1:4 ratio by age, we used Cox proportional hazard regression to calculate the adjusted hazard ratio (aHR) for endometriosis diagnosed after SLE. We also used a diagnosis of endometriosis with previous gynecologic surgery codes as secondary outcomes and performed sensitivity analyses using a landmark analysis. After adjustment for age, urbanization, income, length of hospital stay, and comorbidities in the age-matched group, women with SLE had a higher risk of endometriosis than women without SLE (aHR 1.32, 95% CI 1.02-1.70). When we defined endometriosis as patients with an ICD-9 endometriosis code after undergoing gynecologic surgery, the increased risk of endometriosis in patients with SLE was not significant. Our findings suggest that the risk of endometriosis was significantly elevated in the cohort of women with SLE compared with the age-matched general cohort of women. The burden of endometriosis in SLE patients requires special attention.


Assuntos
Endometriose , Lúpus Eritematoso Sistêmico , Estudos de Coortes , Endometriose/complicações , Endometriose/epidemiologia , Feminino , Humanos , Incidência , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Taiwan/epidemiologia
7.
JSLS ; 26(3)2022.
Artigo em Inglês | MEDLINE | ID: mdl-35967961

RESUMO

BACKGROUND AND OBJECTIVES: To identify intraoperative factors during laparoscopic hysterectomy associated with postoperative opioid use and increased pain scores during the acute postoperative period. METHODS: This is a prospective survey-based cohort study at two teaching hospitals in the Boston metropolitan area. A total of 125 patients undergoing laparoscopic hysterectomy were enrolled. Surveys were administered by telephone at one-week postoperatively and in-person at their two-week postoperative visit to elicit opioid consumption converted to morphine milligram equivalents (MMEs) and pain scores. RESULTS: The median total opioid consumption was 37.5 MME (range 0-960 MMEs). Intraoperative factors associated with increased total MME consumption were lower uterine weight and resection of endometriosis at the time of surgery. Patients with uteri less than 250 grams used twice as much opioid compared to participants with uteri greater than 250 grams (median of 49.8 MME (interquartile range [IQR] 7.5-120.5) vs. 22.5 MME (IQR 7.5-61.0). The median opioid consumption by patients with resection or ablation of endometriosis was three times that of those who did not undergo surgical treatment of endometriosis (97.0 MME (IQR 53.1-281.3) vs. 30.0 MMEs (IQR 7.5-81.3 MME)). Maximum pain scores and reported pain score at one and two-week interviews were also significantly higher in patients with these characteristics. CONCLUSION: Several easily identified intraoperative factors may be correlated with opioid requirements during the acute postoperative period. This can allow surgeons to set expectations and dispense patient-specific opioid prescriptions. Individualizing prescriptions may lower the amount of excess circulating opioids and help combat the opioid epidemic.


Assuntos
Endometriose , Laparoscopia , Analgésicos Opioides/uso terapêutico , Estudos de Coortes , Feminino , Humanos , Histerectomia , Dor Pós-Operatória/tratamento farmacológico , Período Pós-Operatório , Padrões de Prática Médica , Estudos Prospectivos
8.
Int J Mol Sci ; 23(15)2022 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-35955568

RESUMO

There is evidence for increased angiogenesis in the (ectopic) endometrium of adenomyosis patients under the influence of vascular endothelial growth factor (VEGF). VEGF stimulates both angiogenesis and lymph-angiogenesis. However, information on lymph vessels in the (ectopic) endometrium of adenomyosis patients is lacking. In this retrospective matched case-control study, multiplex immunohistochemistry was performed on thirty-eight paraffin embedded specimens from premenopausal women who had undergone a hysterectomy at the Amsterdam UMC between 2001 and 2018 to investigate the evidence for (lymph) angiogenesis in the (ectopic) endometrium or myometrium of patients with adenomyosis versus controls with unrelated pathologies. Baseline characteristics of both groups were comparable. In the proliferative phase, the blood and lymph vessel densities were, respectively, higher in the ectopic and eutopic endometrium of patients with adenomyosis than in the endometrium of controls. The relative number of blood vessels without α-smooth muscle actinin (α SMA) was higher in the eutopic and ectopic endometrium of adenomyosis patients versus controls. The level of VEGF staining intensity was highest in the myometrium but did not differ between patients with adenomyosis or controls. The results indicate increased angiogenesis and lymphangiogenesis in the (ectopic) endometrium affected by adenomyosis. The clinical relevance of our findings should be confirmed in prospective clinical studies.


Assuntos
Adenomiose , Endometriose , Adenomiose/metabolismo , Adenomiose/patologia , Estudos de Casos e Controles , Endometriose/patologia , Endométrio/metabolismo , Feminino , Humanos , Imuno-Histoquímica , Linfangiogênese , Neovascularização Patológica/metabolismo , Estudos Prospectivos , Estudos Retrospectivos , Fator A de Crescimento do Endotélio Vascular/metabolismo , Fatores de Crescimento do Endotélio Vascular/metabolismo
9.
BMC Mol Cell Biol ; 23(1): 37, 2022 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-35933378

RESUMO

BACKGROUND: Endometriosis is one of the most common gynecological diseases, and seriously reduces the quality of life of patients. However, the pathogenesis of this disease is unclear. Therefore, more studies are needed to elucidate its pathogenesis. Our previous publication found that the Sonic Hedgehog (SHH) signaling pathway was activated in endometriosis. This study tested whether SHH signaling in endometrial stromal cells (ESCs) was critical for the pathogenesis of endometriosis. METHODS: To examine the effect of inhibiting the SHH signaling pathway on endometriosis, we first isolated ESCs from eutopic endometrial tissues of patients with or without endometriosis and identified the extracted cells by morphological observation and immunofluorescence. Then, we treated ESCs with the GLI inhibitor GANT61 and used CCK-8, wound healing and invasion assays to detect cell activities, such as proliferation, invasion and metastasis. Furthermore, we detected the expression of key proteins and proliferation markers of the SHH signaling pathway in the lesions of nude mice using immunochemistry. RESULTS: We demonstrated that higher concentrations of GANT61 decreased the proliferation rate and migration distance of ESCs. We observed that GANT61 inhibited the invasion of ESCs. In addition, blockage of the SHH signaling pathway significantly reduced cell proliferation in vitro. CONCLUSIONS: Our study suggested that inhibition of the SHH pathway is involved in cell proliferation and invasive growth in the pathogenesis of endometriosis.


Assuntos
Endometriose , Animais , Endometriose/metabolismo , Endometriose/patologia , Feminino , Proteínas Hedgehog , Humanos , Camundongos , Camundongos Nus , Qualidade de Vida , Transdução de Sinais
10.
Front Immunol ; 13: 943839, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35935991

RESUMO

Endometriosis is defined as the presence of endometrial-like glands and stroma located outside the uterine cavity. This common, estrogen dependent, inflammatory condition affects up to 15% of reproductive-aged women and is a well-recognized cause of chronic pelvic pain and infertility. Despite the still unknown etiology of endometriosis, much evidence suggests the participation of epigenetic mechanisms in the disease etiopathogenesis. The main rationale is based on the fact that heritable phenotype changes that do not involve alterations in the DNA sequence are common triggers for hormonal, immunological, and inflammatory disorders, which play a key role in the formation of endometriotic foci. Epigenetic mechanisms regulating T-cell responses, including DNA methylation and posttranslational histone modifications, deserve attention because tissue-resident T lymphocytes work in concert with organ structural cells to generate appropriate immune responses and are functionally shaped by organ-specific environmental conditions. Thus, a failure to precisely regulate immune cell transcription may result in compromised immunological integrity of the organ with an increased risk of inflammatory disorders. The coexistence of endometriosis and autoimmunity is a well-known occurrence. Recent research results indicate regulatory T-cell (Treg) alterations in endometriosis, and an increased number of highly active Tregs and macrophages have been found in peritoneal fluid from women with endometriosis. Elimination of the regulatory function of T cells and an imbalance between T helper cells of the Th1 and Th2 types have been reported in the endometria of women with endometriosis-associated infertility. This review aims to present the state of the art in recognition epigenetic reprogramming of T cells as the key factor in the pathophysiology of endometriosis in the context of T-cell-related autoimmunity. The new potential therapeutic approaches based on epigenetic modulation and/or adoptive transfer of T cells will also be outlined.


Assuntos
Endometriose , Infertilidade , Autoimunidade , Endometriose/patologia , Endométrio , Epigênese Genética , Feminino , Humanos , Infertilidade/genética
12.
BMC Womens Health ; 22(1): 332, 2022 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-35932070

RESUMO

BACKGROUND: Endometriosis is assumed to be involved in ovarian cancer development, which is called endometriosis-associated ovarian cancer (EAOC). Uterine endometrial cells may be the cell of origin of EAOC. Accumulated carcinogenic changes in the uterine endometrial cells may increase the risk of developing EAOC. To further understand the pathogenesis of EAOCs, we focused on the clinicopathological characteristics of EAOCs in endometrial cancer patients with concomitant endometriosis. METHODS: We retrospectively reviewed 376 patients who were surgically treated for stage I-III endometrial cancer. Clinicopathological characteristics were compared between patients with and without endometriosis. Furthermore, the incidence of simultaneous endometrial and ovarian cancer (SEOC) and the histological characteristics of SEOC were compared between the two groups. RESULTS: Among 376 patients with endometrial cancer, 51 had concomitant endometriosis. Patients with endometriosis were significantly younger and more frequently had endometrioid G1/G2 tumors than those without endometriosis. The incidence of SEOCs was significantly higher in endometrial cancer patients with endometriosis than those without it (p < 0.0001); notably, 12 of 51 endometrial cancer patients with endometriosis (24%) had SEOCs. All of the ovarian cancers in endometrial cancer patients with endometriosis were endometrioid carcinomas. Moreover, even in those without endometriosis, endometrioid carcinoma was the most common histological type of SEOC. CONCLUSION: We revealed that endometrial cancer patients with endometriosis had a high probability of SEOC and that endometrioid carcinoma was the most common histological subtype of SEOC regardless of the presence of endometriosis. For patients with endometrial cancer and endometriosis, careful examination of ovarian endometriotic lesions may be important to detect EAOCs.


Assuntos
Carcinoma Endometrioide , Neoplasias do Endométrio , Endometriose , Neoplasias Ovarianas , Carcinoma Endometrioide/complicações , Carcinoma Endometrioide/diagnóstico , Carcinoma Endometrioide/epidemiologia , Carcinoma Epitelial do Ovário , Neoplasias do Endométrio/complicações , Neoplasias do Endométrio/epidemiologia , Neoplasias do Endométrio/patologia , Endometriose/complicações , Endometriose/patologia , Feminino , Humanos , Neoplasias Ovarianas/complicações , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/epidemiologia , Estudos Retrospectivos
13.
BMJ Open ; 12(7): e059280, 2022 07 18.
Artigo em Inglês | MEDLINE | ID: mdl-35851021

RESUMO

OBJECTIVES: This study investigates the association of daily physical exercise with pain symptoms in endometriosis. We also examined whether an individual's typical weekly (ie, habitual) exercise frequency influences (ie, moderates) the relationship between their pain symptoms on a given day (day t) and previous-day (day t-1) exercise. PARTICIPANTS: The sample included 90 382 days of data from 1009 participants (~85% non-Hispanic white) living with endometriosis across 38 countries. STUDY DESIGN: This was an observational, retrospective study conducted using data from a research mobile app (Phendo) designed for collecting self-reported data on symptoms and self-management of endometriosis. PRIMARY OUTCOME MEASURES: The two primary outcomes were the composite day-level pain score that includes pain intensity and location, and the change in this score from previous day (Δ-score). We applied generalised linear mixed-level models to examine the effect of previous-day exercise and habitual exercise frequency on these outcomes. We included an interaction term between the two predictors to assess the moderation effect, and adjusted for previous-day pain, menstrual status, education level and body mass index. RESULTS: The association of previous-day (day t-1) exercise with pain symptoms on day t was moderated by habitual exercise frequency, independent of covariates (rate ratio=0.96, 95% CI=0.95 to 0.98, p=0.0007 for day-level pain score, B=-0.14, 95% CI=-0.26 to -0.016, p=0.026 for Δ-score). Those who regularly engaged in exercise at least three times per week were more likely to experience favourable pain outcomes after having a bout of exercise on the previous day. CONCLUSIONS: Regular exercise might influence the day-level (ie, short-term) association of pain symptoms with exercise. These findings can inform exercise recommendations for endometriosis pain management, especially for those who are at greater risk of lack of regular exercise due to acute exacerbation in their pain after exercise.


Assuntos
Endometriose , Telemedicina , Estudos Transversais , Endometriose/complicações , Endometriose/terapia , Exercício Físico , Feminino , Humanos , Dor/etiologia , Qualidade de Vida , Estudos Retrospectivos
14.
J Int Med Res ; 50(7): 3000605221109373, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35836383

RESUMO

Although high-grade serous cancer (HGSC) accounts for >70% of ovarian epithelial cancers, it is rarely associated with endometriosis. No previous study has reported an association between the malignant transformation of uterine ligament endometriosis and HGSC. Here, we reported two cases of Chinese female patients with HGSC arising from endometriosis in the uterosacral ligament. They had a long-term history of endometriosis and dysmenorrhea. Both were diagnosed with HGSC at stage IIB. They underwent operations and six cycles of chemotherapy with paclitaxel and carboplatin and have remained disease-free to date. Genomic analysis showed no known/suspected pathogenic variations or somatic homologous recombination deficiency in the two cases. In conclusion, these rare cases of HGSC from endometriosis might indicate a new origin of ovarian type II carcinoma. Patients with a long-term history of endometriosis and sudden aggravation of dysmenorrhea or vaginal bleeding should be aware of the possibility of endometriotic malignant transformation.


Assuntos
Carcinoma Epitelial do Ovário , Endometriose , Neoplasias Ovarianas , Doenças Uterinas , Carcinoma Epitelial do Ovário/patologia , Endometriose/complicações , Feminino , Humanos , Ligamentos/patologia , Gradação de Tumores , Neoplasias Ovarianas/patologia , Doenças Uterinas/complicações
15.
J Korean Med Sci ; 37(26): e207, 2022 07 04.
Artigo em Inglês | MEDLINE | ID: mdl-35790209

RESUMO

BACKGROUND: There are several medical treatment options for endometrioma. Progestin, especially dienogest, is an effective drug for preventing recurrence of endometrioma after surgery. Additionally, oral contraceptive (OC) use after conservative surgery has been reported to reduce significantly the risk of endometrioma recurrence. The aim of this study was to compare the long-term effects of gonadotropin-releasing hormone (GnRH) agonist followed by OC to those of dienogest alone to prevent recurrence of endometrioma after laparoscopic surgery. METHODS: A retrospective cohort study was performed on patients who underwent conservative laparoscopic surgery for endometrioma between January 2000 and December 2020, in the Endometriosis Clinic, Department of Gynecology, Samsung Medical Center. A total of 624 patients who received medical treatment at least six months after laparoscopic conservative surgery for endometrioma was included. Among them, 372 patients used OC after GnRH agonist therapy, and 252 patients used dienogest. Within the OC group, 148 used a 21/7 regiment and 224 used a 24/4 regimen. A cumulative endometrioma recurrence curve was presented using the Kaplan-Meier method to compare the recurrence of those groups. RESULTS: The cumulative recurrence rate of endometrioma for 60 months was 2.08% (n = 4) in the OC after GnRH agonist group and 0.40% (n = 1) in the dienogest group. There was no statistical difference in cumulative recurrence of endometrioma between the two groups. In subgroup analysis, the cumulative recurrence rate of endometrioma over 60 months was 4.21% (n = 2) in the 21/7 OC group and 1.09% (n = 2) in the 24/4 OC group and showed no significant difference. CONCLUSION: Long-term use of OC after GnRH agonist as well as that of dienogest treatment are effective postoperative medical therapies for preventing endometrioma recurrence. Thus, the choice of regimen can be individualized or used interchangeably depending on patient condition, need for contraception, and compliance with drug therapy.


Assuntos
Endometriose , Anticoncepção , Anticoncepcionais Orais/uso terapêutico , Endometriose/tratamento farmacológico , Endometriose/prevenção & controle , Endometriose/cirurgia , Feminino , Hormônio Liberador de Gonadotropina/uso terapêutico , Humanos , Nandrolona/análogos & derivados , Estudos Retrospectivos , Prevenção Secundária/métodos
16.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 49(3): 100753, Jul - Sep 2022. graf
Artigo em Espanhol | IBECS | ID: ibc-205914

RESUMO

Los pólipos endometriales representan un trastorno común en la práctica habitual en ginecología. Si bien se han identificado factores de riesgo asociados a su proliferación, se desconoce la causa exacta de su aparición. En ocasiones su manejo es controvertido, siendo difícil para el clínico optar en muchos casos por una actitud expectante con seguimientos periódicos dado que el riesgo de malignidad de esta entidad no es despreciable. El objetivo del presente artículo es la realización de una revisión exhaustiva de la literatura, a partir de las principales bases de datos, sobre el diagnóstico y manejo de pólipos endometriales, así como de la fisiopatología y epidemiología, con el fin de conocer la última evidencia científica sobre esta entidad.(AU)


Endometrial polyps are a common disorder in routine gynaecological practice. Although risk factors associated with their proliferation have been identified, the exact cause of their onset is unknown. Sometimes their management is controversial, in many cases it being difficult for the clinician to opt for a wait-and-see approach with periodic follow-ups, given that the risk of malignancy with this entity is not negligible. The objective of this article was to carry out an exhaustive review of the literature, based on the main databases, on the diagnosis and management of endometrial polyps, and their pathophysiology and epidemiology, to determine the latest evidence and scientific information regarding this entity.(AU)


Assuntos
Pré-Menopausa , Neoplasias do Endométrio , Endométrio/lesões , Endometriose/diagnóstico , Tamoxifeno , Hemorragia Uterina , Ginecologia , Obstetrícia
17.
J Ovarian Res ; 15(1): 84, 2022 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-35836288

RESUMO

BACKGROUND: Ovarian clear cell carcinoma (OCCC) is the most common endometriosis-associated ovarian cancer. Ovarian endometriosis may present with atypical or malignant sonographic features and interfere with clinical judgment about whether definitive surgical intervention is required. OBJECTIVE: To compare the characteristics of endometrioma with atypical features and OCCC. METHODS: This study enrolled patients with pathologic diagnoses of either endometrioma or OCCC. For patients with endometrioma, only those with atypical features, defined as the presence of at least one of the following sonographic characteristics: cyst diameter of 10 ± 1 cm, multi-cystic lesions, any solid component or papillary structure, and blood flow of any degree, were included. RESULTS: Sixty-three patients had endometriomas with atypical features, while 57 patients had OCCC. Patients with endometriomas were younger (39.33 ± 7.04 years vs. 53.11 ± 9.28 years, P < 0.01), had smaller cysts (7.81 ± 2.81 cm vs. 12.68 ± 4.60 cm, P < 0.01), and had smaller solid components (0.93 ± 1.74 cm vs. 4.82 ± 3.53 cm, P < 0.01). In contrast, OCCCs were associated with loss of ground-glass echogenicity (6.3% vs 68.4%, P < 0.01). In multivariate analysis, advanced age (> 47.5 years), large cysts (> 11.55 cm), large solid components (size > 1.37 cm), and loss of ground-glass echogenicity were independent factors suggestive of malignancy. CONCLUSION: Advanced age, larger cyst sizes, larger solid component sizes, and loss of ground-glass echogenicity are major factors differentiating endometriomas from malignancies. For women in menopausal transition who have finished childbearing who present with endometrioma with atypical features, removal of the adnexa intact could be considered.


Assuntos
Adenocarcinoma de Células Claras , Cistos , Endometriose , Cistos Ovarianos , Doenças Ovarianas , Neoplasias Ovarianas , Adenocarcinoma de Células Claras/diagnóstico por imagem , Adenocarcinoma de Células Claras/cirurgia , Cistos/complicações , Endometriose/complicações , Feminino , Humanos , Pessoa de Meia-Idade , Cistos Ovarianos/patologia , Doenças Ovarianas/cirurgia , Neoplasias Ovarianas/patologia , Ultrassonografia
18.
Cells ; 11(13)2022 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-35805112

RESUMO

Endometriosis is a chronic disease that affects about 10% of women of reproductive age. It can contribute to pelvic pain, infertility or other conditions such as asthma, cardiovascular disease, breast or ovarian cancer. Research has shown that one of the conditions for the development of endometrial lesions is the dysfunction of the immune system. It appears that immune cells, such as neutrophils, macrophages, NK cells and dendritic cells, may play a specific role in the angiogenesis, growth and invasion of endometriosis cells. Immune cells secrete cytokines and defensins that also affect the endometriosis environment. This review discusses the various components of the immune system that are involved in the formation of endometrial lesions in women.


Assuntos
Endometriose , Citocinas , Endometriose/patologia , Feminino , Humanos , Células Matadoras Naturais , Macrófagos , Neutrófilos/patologia
19.
Molecules ; 27(13)2022 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-35807280

RESUMO

Endometriosis is a gynecological condition characterized by the growth of endometrium-like tissues inside and outside the pelvic cavity. The evolution of the disease can lead to infertility in addition to high treatment costs. Currently, available medications are only effective in treating endometriosis-related pain; however, it is not a targeted treatment. The objective of this work is to review the characteristics of the disease, the diagnostic means and treatments available, as well as to discuss new therapeutic options.


Assuntos
Endometriose , Osteopatia , Endometriose/diagnóstico , Endometriose/tratamento farmacológico , Endométrio , Feminino , Humanos , Dor
20.
J Med Case Rep ; 16(1): 256, 2022 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-35780175

RESUMO

BACKGROUND: Umbilical endometriosis is a rare entity accounting for 0.5-4% of cases with endometriosis. CASE PRESENTATION: Here we report a rare case of umbilical endometriosis with concurrent ovarian endometriomas in a 37-year old primiparous Iranian woman. CONCLUSION: This interesting coexistence reflects the importance of thorough gynecological assessment in patients with cutaneous endometriosis to enable appropriate management.


Assuntos
Endometriose , Dermatopatias , Adulto , Endometriose/complicações , Endometriose/diagnóstico , Endometriose/cirurgia , Feminino , Humanos , Irã (Geográfico)
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