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Alaoui Mhammedi W, Ouraghi A, Irzi M, El Moudane A, Mokhtari M, Barki A. Ureteral Endometriosis Presenting As Left Ureteral Obstruction: A Case Report. Cureus 2022; 14:e29288. [PMID: 36277539 PMCID: PMC9578383 DOI: 10.7759/cureus.29288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2022] [Indexed: 11/05/2022] Open
Abstract
Ureteral endometriosis is a very rare but serious form of infiltrating endometriosis since the risk of urinary tract obstruction and secondary loss of renal function exists. Although not always possible, the clinical and radiologic assessment may help in obtaining a preoperative diagnosis. We report the case of a 42-year-old woman with left ureteral endometriosis, revealed by left flank pain. Imaging revealed left obstructive uropathy with an endometriotic cyst of the left ovary and a spiculated lesion of the left parametrium. She underwent laparotomy, resection of the diseased ureter with primary re-anastomosis, resection of a left parametrial lesion and an endometriotic left ovarian cystectomy. The pathological assessment confirmed the diagnosis of ureteral endometriosis. Follow-up of the patient showed complete resolution with a stable, normal kidney function. In conclusion, ureteral endometriosis involvement is infrequent but should be included in the differential diagnosis in a premenopausal woman with ureteral obstruction of unknown cause. An early diagnosis and obstruction relief are critical to a successful outcome.
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Xie C, Yin Z, Liu Y. Analysis of characteristic genes and ceRNA regulation mechanism of endometriosis based on full transcriptional sequencing. Front Genet 2022; 13:902329. [PMID: 35938015 PMCID: PMC9353714 DOI: 10.3389/fgene.2022.902329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/01/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Endometriosis is a common gynecological disorder that usually causes infertility, pelvic pain, and ovarian masses. This study aimed to mine the characteristic genes of endometriosis, and explore the regulatory mechanism and potential therapeutic drugs based on whole transcriptome sequencing data and resources from public databases, providing a theoretical basis for the diagnosis and treatment of endometriosis. Methods: The transcriptome data of the five eutopic (EU) and ectopic (EC) endometrium samples were obtained from Beijing Obstetrics and Gynecology Hospital, Beijing, China, and dinified as the own data set. The expression and clinical data of EC and EU samples in GSE25628 and GSE7305 datasets were obtained from the GEO database (https://www.ncbi.nlm.nih.gov/gds). Differential gene expression analysis and weighted gene co-expression network analysis (WGCNA) were used to identify the endometriosis-related differentially expressed genes. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were conducted by the “clusterProfiler” R package. Then, characteristic genes for endometriosis were identified by the least absolute shrinkage and selection operator (LASSO) and support vector machine recursive feature elimination (SVM-RFE) algorithm. The expression of characteristic genes was verified by quantitative reverse transcription polymerase chain reaction (qRT-PCR) and western-blot. The receiver operating characteristic (ROC) curve was used to evaluate the discriminatory ability of characteristic genes. We assessed the abundance of infiltrating immune cells in each sample using MCP-counter and ImmuCellAI algorithms. The competitive endogenous RNA (ceRNA) regulatory network of characteristic genes was created by Cytoscape and potential targeting drugs were obtained in the CTD database. Results: 44 endometriosis-related differentially expressed genes were obtained from GSE25628 and the own dataset. Subsequently, LASSO and SVM-RFE algorithms identified four characteristic genes, namely ACLY, PTGFR, ADH1B, and MYOM1. The results of RT-PCR and western-blot were consistent with those of sequencing. The result of ROC curves indicated that the characteristic genes had powerful abilities in distinguishing EC samples from EU samples. Infiltrating immune cells analysis suggested that there was a certain difference in immune microenvironment between EC and EU samples. The characteristic genes were significantly correlated with specific differential immune cells between EC and EU samples. Then, a ceRNA regulatory network of characteristic genes was constructed and showed a total of 7, 11, 11, and 1 miRNA associated with ACLY, ADH1B, PTGFR, and MYOM1, respectively. Finally, we constructed a gene-compound network and mined 30 drugs targeting ACLY, 33 drugs targeting ADH1B, 13 drugs targeting MYOM1, and 12 drugs targeting PTGFR. Conclusion: Comprehensive bioinformatic analysis was used to identify characteristic genes, and explore ceRNA regulatory network and potential therapeutic agents for endometriosis. Altogether, these findings provide new insights into the diagnosis and treatment of endometriosis.
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Affiliation(s)
| | | | - Yong Liu
- *Correspondence: Chengmao Xie, ; Yong Liu,
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Poulos C, Soliman AM, Tekin S, Agarwal SK. Patient preferences for elagolix and leuprolide for treating endometriosis-related pain in the United States. Expert Rev Pharmacoecon Outcomes Res 2020; 21:1091-1099. [PMID: 33140977 DOI: 10.1080/14737167.2021.1832468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION We evaluated elagolix and leuprolide from the patient's perspective for the treatment of endometriosis-related pain. AREA COVERED Preference weights from a published discrete choice experiment were used to evaluate preferences for treatment profiles simulating elagolix (150 mg/day and 200 mg/twice-daily dosages) and leuprolide for the treatment of moderate to severe endometriosis-related pain. Sensitivity analyses were conducted by varying the range of risk for pregnancy-related problems, moderate to severe hot flashes, and bone fracture across scenarios. EXPERT OPINION The 200 mg twice daily dosage of elagolix is more likely to be preferred over leuprolide by patients with moderate to severe endometriosis-related pain in all scenarios explored in the evaluation and sensitivity analyses. The probability that an average respondent would select a treatment was sensitive to increases in risk of moderate to severe hot flashes for leuprolide and possible variations in the risk of pregnancy-related problems for both treatments but was not influenced by an increased risk of bone fracture. CONCLUSIONS Patients' preferences for treatment of endometriosis-related pain should be evaluated using the benefits and risks of each pharmacological option. Respondents were more likely to prefer the treatment profile similar to 200 mg twice daily elagolix over that of leuprolide in all scenarios.
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Affiliation(s)
- Christine Poulos
- Health Preference Assessment, RTI Health Solutions, Research Triangle Park, NC, USA
| | - Ahmed M Soliman
- Health Economics and Outcomes Research (HEOR), AbbVie Inc, North Chicago, IL, USA
| | - Sibel Tekin
- Health Economics and Outcomes Research (HEOR), AbbVie Inc, North Chicago, IL, USA
| | - Sanjay K Agarwal
- Center for Endometriosis Research and Treatment, University of California San Diego, La Jolla, CA, USA
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Chen P, Zhao DX, Chen L, Su CH, Ji YJ, Wang DW. Effect of melatonin for the management of endometriosis: A protocol of systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e20353. [PMID: 32481415 DOI: 10.1097/md.0000000000020353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND This study aims to explore the effect of melatonin for the management of endometriosis. METHODS We will search electronic databases (Cochrane Library, MEDLINE, EMBASE, CINAHL, Web of Science, Scopus, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure) from their inceptions to the February 29, 2020 without language and publication time limitations. The study identification, study quality assessment, and data extraction will be undertaken by two separate researchers. We will also appraise evidence quality of main outcomes by Grading of Recommendations Assessment Development and Evaluation, and statistical analysis performance by RevMan 5.3 Software. RESULTS This study will summarize up-to-date clinical evidence to investigate the effect of melatonin for the management of endometriosis. CONCLUSION This study may provide helpful evidence of melatonin for the management of endometriosis. SYSTEMATIC REVIEW REGISTRATION INPLASY202040093.
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Affiliation(s)
- Ping Chen
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Jiamusi University, Jiamusi, 154002, China
| | - Dong-Xu Zhao
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Jiamusi University, Jiamusi, 154002, China
| | - Lei Chen
- Department of Obstetrics and Gynecology, Jiamusi Central Hospital, Jiamusi, 154002, China
| | - Cui-Hong Su
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Jiamusi University, Jiamusi, 154002, China
| | - Yan-Jia Ji
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Jiamusi University, Jiamusi, 154002, China
| | - Dong-Wei Wang
- Department of Anesthesiology, First Affiliated Hospital of Jiamusi University, Jiamusi, 154002, China
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Hogg C, Horne AW, Greaves E. Endometriosis-Associated Macrophages: Origin, Phenotype, and Function. Front Endocrinol (Lausanne) 2020; 11:7. [PMID: 32038499 PMCID: PMC6989423 DOI: 10.3389/fendo.2020.00007] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 01/07/2020] [Indexed: 01/03/2023] Open
Abstract
Endometriosis is a complex, heterogeneous, chronic inflammatory condition impacting ~176 million women worldwide. It is associated with chronic pelvic pain, infertility, and fatigue, and has a substantial impact on health-related quality of life. Endometriosis is defined by the growth of endometrial-like tissue outside the uterus, typically on the lining of the pelvic cavity and ovaries (known as "lesions"). Macrophages are complex cells at the center of this enigmatic condition; they are critical for the growth, development, vascularization, and innervation of lesions as well as generation of pain symptoms. In health, tissue-resident macrophages are seeded during early embryonic life are vital for development and homeostasis of tissues. In the adult, under inflammatory challenge, monocytes are recruited from the blood and differentiate into macrophages in tissues where they fulfill functions, such as fighting infection and repairing wounds. The interplay between tissue-resident and recruited macrophages is now at the forefront of macrophage research due to their differential roles in inflammatory disorders. In some cancers, tumor-associated macrophages (TAMs) are comprised of tissue-resident macrophages and recruited inflammatory monocytes that differentiate into macrophages within the tumor. These macrophages of different origins play differential roles in disease progression. Herein, we review the complexities of macrophage dynamics in health and disease and explore the paradigm that under disease-modified conditions, macrophages that normally maintain homeostasis become modified such that they promote disease. We also interrogate the evidence to support the existence of multiple phenotypic populations and origins of macrophages in endometriosis and how this could be exploited for therapy.
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Affiliation(s)
- Chloe Hogg
- Medical Research Council Centre for Reproductive Health, The University of Edinburgh, Edinburgh, United Kingdom
| | - Andrew W. Horne
- Medical Research Council Centre for Reproductive Health, The University of Edinburgh, Edinburgh, United Kingdom
| | - Erin Greaves
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
- *Correspondence: Erin Greaves
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Sroyraya M, Songkoomkrong S, Changklungmoa N, Poljaroen J, Weerakiet S, Sophonsritsuk A, Wongkularb A, Lertvikool S, Tingthanatikul Y, Sobhon P. Differential expressions of estrogen and progesterone receptors in endometria and cyst walls of ovarian endometrioma from women with endometriosis and their responses to depo-medroxyprogesterone acetate treatment. Mol Cell Probes 2018; 40:27-36. [PMID: 30078406 DOI: 10.1016/j.mcp.2018.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Revised: 06/21/2018] [Accepted: 07/02/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Depo-medroxyprogesterone acetate (DMPA) is an injectable progestin contraceptive that provides a highly effective reduction of pelvic pain in women with endometriosis. Despite its wide use to treat pain associated with endometriosis, its precise mechanisms of action remain unclear. The aims of this study were to investigate the differential expressions of estrogen receptors (ERs), and progesterone receptors (PRs) in endometria and ovarian endometrioma cyst walls of women with endometriosis with and without DMPA treatment. METHODS Endometria and cyst walls of endometrioma were obtained from 25 to 45 year-old women who suffered from endometriosis and had ovarian endometrioma with the size ≥3 cm. The expression levels of ERs and PRs and the numbers of ER- and PR-positive cells before and after treatment with DMPA were evaluated by Western blot, real-time PCR, and immunohistochemistry. RESULTS The levels of ERα and ERβ expression, their corresponding mRNAs, and numbers of ERα- and ERβ-immunoreactive cells in stroma and glands of endometria of the DMPA group were significantly decreased when compared with those of the untreated groups (p < 0.05). In contrast, the levels of PRA/B expression and numbers of PRA/B positive cells in stroma and number of PRB positive cells in stroma and endometrial glands were significantly increased in endometria of the DMPA group when compared with those of the untreated groups. However, in cyst wall the expression levels of these proteins, their corresponding mRNAs, and immonoractive cells were low compared to those in endometria, and DMPA-treatment did not cause any significant changes in these parameters. CONCLUSION These data indicated that DMPA could upregulate the expressions of PRA/B and down-regulate ERα and ERβ in endometria but not in cyst walls from women with endometriosis.
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Affiliation(s)
- Morakot Sroyraya
- Department of Anatomy, Faculty of Science, Mahidol University, Bangkok, 10400, Thailand; Mahidol University, Nakhonsawan Campus, Nakhonsawan, 60130, Thailand
| | | | - Narin Changklungmoa
- Faculty of Allied Health Sciences, Burapha University, Chonburi, 20131, Thailand
| | - Jaruwan Poljaroen
- Department of Anatomy, Faculty of Science, Mahidol University, Bangkok, 10400, Thailand; Mahidol University, Nakhonsawan Campus, Nakhonsawan, 60130, Thailand
| | - Sawaek Weerakiet
- Department of Obstetrics and Gynecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - Areepan Sophonsritsuk
- Department of Obstetrics and Gynecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - Anna Wongkularb
- Department of Obstetrics and Gynecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - Srithean Lertvikool
- Department of Obstetrics and Gynecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - Yada Tingthanatikul
- Department of Obstetrics and Gynecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - Prasert Sobhon
- Department of Anatomy, Faculty of Science, Mahidol University, Bangkok, 10400, Thailand; Faculty of Allied Health Sciences, Burapha University, Chonburi, 20131, Thailand.
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Saccardi C, Borghero A, Cosmi E, Conte L, Caserta D, Litta P. Evaluation of the Impact of Endometriotic Lesions on Patient'S Pelvic Pain Symptoms. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/228402651000200307] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose To verify if different endometrial lesions determine the diagnostic symptom panel for a specific symptom. Methods We recruited 537 women with endometriosis who underwent laparoscopic surgery. Data on patient characteristics, severity of pelvic pain symptoms, disease stage and anatomical characteristics of endometriotic lesions were collected and analyzed by univariate analysis, followed by multiple logistic regression. Results We observed a strong inverse relationship between pain symptoms and, respectively, the age of women at surgery (OR 0.885; p<0.05) and nulliparity (OR 5.6; p<0.05). A significant association between dysmenorrhea and nulliparity (OR 10.1; p< 0.01) and dysmenorrhea and rAFS stage (OR 4.7; p<0.05) was also confirmed. Finally a strong relationship was found between the presence of a rectovaginal endometriotic nodule and pain symptoms: dyspareunia (OR 13.8, p<0.001) and dysmenorrhea (OR 2.3, p<0.05). Significant relationships were found between the presence of peri-annexial adherences and, respectively, bilateral endometrioma (p<0.01) and size of endometrioma (p<0.05); between the presence of pelvic adherential syndrome and, respectively, bilateral ovarian cyst (p<0.01), size of ovarian cyst (p<0.01) and rectovaginal nodule (p<0.01). A strong relationship was found also between a rectovaginal nodule and the presence of entero-uterine adherences (p<0.01) and Douglas obliteration (p<0.01). Conclusions: It was not possible determine a precise relationship between a specific pain symptom and the anatomic-surgical characteristics of endometriotic lesions, even though a strong association was seen between a rectovaginal endometriotic nodule and deep dyspareunia. Typical clinical features of endometriosis are probably determined by the association of different characteristics of lesions and different pathogenic mechanisms.
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Affiliation(s)
- Carlo Saccardi
- Department of Gynecological Sciences and Human Reproduction, Padua University, School of Medicine, Padua - Italy
| | - Angela Borghero
- Department of Gynecological Sciences and Human Reproduction, Padua University, School of Medicine, Padua - Italy
| | - Erich Cosmi
- Department of Gynecological Sciences and Human Reproduction, Padua University, School of Medicine, Padua - Italy
| | - Lorena Conte
- Department of Gynecological Sciences and Human Reproduction, Padua University, School of Medicine, Padua - Italy
| | - Donatella Caserta
- Gynecology Clinic, La Sapienza University of Rome, Second School of Medicine, Rome - Italy
| | - Pietro Litta
- Department of Gynecological Sciences and Human Reproduction, Padua University, School of Medicine, Padua - Italy
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Palla VV, Karaolanis G, Katafigiotis I, Anastasiou I. Ureteral endometriosis: A systematic literature review. Indian J Urol 2017; 33:276-282. [PMID: 29021650 PMCID: PMC5635667 DOI: 10.4103/iju.iju_84_17] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Introduction: Ureteral endometriosis is a rare disease affecting women of childbearing age which presents with nonspecific symptoms and it may result in severe morbidity. The aim of this study was to review evidence about incidence, pathogenesis, clinical presentation, diagnosis, and management of ureteral endometriosis. Materials and Methods: PubMed Central database was searched to identify studies reporting cases of ureteral endometriosis. “Ureter” or “Ureteral” and “Endometriosis” were used as key words. Database was searched for articles published since 1996, in English without restrictions regarding the study design. Results: From 420 studies obtained through database search, 104 articles were finally included in this review, including a total of 1384 patients with ureteral endometriosis. Data regarding age, location, pathological findings, and interventions were extracted. Mean patients' age was 38.6 years, whereas the therapeutic arsenal included hormonal, endoscopic, and/or surgical treatment. Conclusions: Ureteral endometriosis represents a diagnostic and therapeutic challenge for the clinicians and high clinical suspicion is needed to identify it.
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Affiliation(s)
- Viktoria-Varvara Palla
- Department of Obstetrics and Gynecology, Diakonie-Klinikum Schwäbisch Hall gGmbH, Schwäbisch Hall, Germany
| | - Georgios Karaolanis
- Department of Surgery, Vascular Unit, Laiko General Hospital, Medical School of Athens, Athens 11527, Greece
| | - Ioannis Katafigiotis
- Department of University Urology Clinic, Laiko Hospital, University of Athens, Athens 11527, Greece
| | - Ioannis Anastasiou
- Department of University Urology Clinic, Laiko Hospital, University of Athens, Athens 11527, Greece
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Tsui KH, Lee WL, Chen CY, Sheu BC, Yen MS, Chang TC, Wang PH. Medical treatment for adenomyosis and/or adenomyoma. Taiwan J Obstet Gynecol 2015; 53:459-65. [PMID: 25510683 DOI: 10.1016/j.tjog.2014.04.024] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2014] [Indexed: 01/12/2023] Open
Abstract
Uterine adenomyosis and/or adenomyoma is characterized by the presence of heterotopic endometrial glands and stroma within the myometrium, >2.5 mm in depth in the myometrium or more than one microscopic field at 10 times magnification from the endometrium-myometrium junction, and a variable degree of adjacent myometrial hyperplasia, causing globular and cystic enlargement of the myometrium, with some cysts filled with extravasated, hemolyzed red blood cells, and siderophages. Hysterectomy is a "gold standard" and definitive therapy for uterine adenomyosis, and many cases of adenomyosis have been diagnosed by pathological review retrospectively. As such, the diagnosis of adenomyosis is difficult, and this subsequently results in difficulty in the management of these patients, especially those who are symptomatic but have a strong desire to preserve their uterus. In our previous review, we found that the use of uterine-sparing surgery in the management of uterine adenomyosis and/or adenomyoma is still controversial, although some data support its feasibility. Conservative treatment is still needed in the group of patients that requires preservation of fertility and improvement of quality of life. However, studies focusing on the topic of medical treatment for adenomyosis are rare. In this article, current knowledge regarding the use of medical therapy for uterine adenomyosis, partly based on the understanding of endometriosis, is reviewed.
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Affiliation(s)
- Kuan-Hao Tsui
- Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan; Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Wen-Ling Lee
- Department of Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan; Department of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan
| | - Chih-Yao Chen
- Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan; Division of Gynecology, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Bor-Chin Sheu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University, Taipei, Taiwan
| | - Ming-Shyen Yen
- Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan; Division of Gynecology, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ting-Chang Chang
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
| | - Peng-Hui Wang
- Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan; Division of Gynecology, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Immunology Center, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; Infection and Immunity Research, National Yang-Ming University, Taipei, Taiwan.
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Endometriosis: Does Surgery Offer Long-Term Improvement in Quality of Life? JOURNAL OF ENDOMETRIOSIS AND PELVIC PAIN DISORDERS 2014. [DOI: 10.5301/je.5000187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction Endometriosis is a common, estrogen-dependent, benign disease that affects women of reproductive age. Endometriosis frequently presents with pain and can result in infertility. The symptoms of the disease have a negative impact on physical and mental aspects of life, contribute to reduction of social contacts and lead to a significant reduction in quality of life. In this study, we investigated quality of life of patients with endometriosis. Moreover, we examined whether surgical management could be beneficial for those patients in terms of improving quality of life. Material and methods In this prospective study, we included patients undergoing gynecological operations due to endometriosis-associated problems between 2008 and 2014. All patients were assessed preoperatively and 30 months postoperatively. The survey form chosen to achieve the aims of the study was the Greek version of SF-36. Results The results showed that both physical and mental health were highly compromised in patients affected by endometriosis, and surgical management significantly improved patients’ quality of life, as all of the SF-36 scores were higher postoperatively (p<0.05). Discussion Endometriosis represents an important medical problem in women, with a high impact on their quality of life, and surgical management can reverse the impact of endometriosis on patients’ health and restore their quality of life.
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Yu CX, Song JH, Liang L. Correlation of changes of (non)exfoliated endometrial organelles and expressions of Musashi-1 and β-catenin with endometriosis in menstrual period. Gynecol Endocrinol 2014; 30:861-7. [PMID: 25162724 DOI: 10.3109/09513590.2014.955467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
This study aims to investigate the correlation of structural changes of endometrial organelles and expressions of Musashi-1 (Msi-1) and β-catenin with the endometriosis (EMs) in the menstrual period. The structural changes of exfoliated and nonexfoliated endometrial organelles in the experimental group and the control group were observed by the transmission electron microscopy (TEM) on the first and fifth day of menstruation. (1) TEM: compared with the control group, the exfoliated endometrial organelles in the experimental group on the first day were rich, with irregular nucleus, the bi-nucleolus could be seen, with rich chromatin; while the shapes of epithelial secretory cells in the nonexfoliated endometrial gland were irregular, with abundant organelles, the basal film varied in width, with abnormal curvature, and a lot of intercellular collagen fibers could be seen. (2) The expressions of Msi-1 and β-catenin in the exfoliated and nonexfoliated endometrium of the experimental group were higher than those of the control group and exhibited positively correlation, while no correlation could be found within the control group. (1) The organelles' structural changes might cause the changes of endometrial cellular functions. (2) Msi-1 might participate in the formation of EMs through activating the Wnt/β-catenin signaling pathway.
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Affiliation(s)
- Cong-Xiang Yu
- a Department of Obstetrics and Gynecology, Affiliated Hospital of Inner Mongolia Medical University Inner Mongolia China
| | - Jing-Hui Song
- a Department of Obstetrics and Gynecology, Affiliated Hospital of Inner Mongolia Medical University Inner Mongolia China
| | - Lei Liang
- a Department of Obstetrics and Gynecology, Affiliated Hospital of Inner Mongolia Medical University Inner Mongolia China
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Maccagnano C, Pellucchi F, Rocchini L, Ghezzi M, Scattoni V, Montorsi F, Rigatti P, Colombo R. Ureteral Endometriosis: Proposal for a Diagnostic and Therapeutic Algorithm with a Review of the Literature. Urol Int 2013; 91:1-9. [DOI: 10.1159/000345140] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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13
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Maccagnano C, Pellucchi F, Rocchini L, Ghezzi M, Scattoni V, Montorsi F, Rigatti P, Colombo R. Diagnosis and treatment of bladder endometriosis: state of the art. Urol Int 2012; 89:249-58. [PMID: 22813980 DOI: 10.1159/000339519] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND The bladder is the most common affected site in urinary tract endometriosis, being diagnosed during gynecologic follow-up. The surgical urological treatment might lead to good results. STUDY OBJECTIVE To define the state of the art in the diagnosis and treatment of bladder endometriosis. METHODS We performed a literature review by searching the MEDLINE database for articles published between 1996 and 2011, limiting the searches to the words: urinary tract endometriosis, bladderendometriosis, symptoms, diagnosis and treatment. RESULTS Deep pelvic endometriosis usually involves the urinary system, with the bladder being affected in 85% of cases. The diagnosis has to be considered as a step-by-step procedure. Currently, the treatment is usually surgical, consisting of either transurethral resection or partial cystectomy, and eventually associated with hormonal therapy. The hormonal therapy alone counteracts only the stimulus of endometriotic tissue proliferation, with no effects on the scarring caused by this tissue. The overall recurrence rate is about 30% for combined therapies and about 35% for the hormonal treatment alone. CONCLUSIONS The bladder is the most common affected site in urinary tract endometriosis. Most of the time, this condition is diagnosed because of the complaint of urinary symptoms during gynecologic follow-up procedures for a deep pelvic endometriosis: a close collaboration between the gynecologist and the urologist is advisable, especially in highly specialized centers. The surgical urological treatment might lead to good results in terms of patients' compliance and prognosis.
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Affiliation(s)
- Carmen Maccagnano
- Department of Urology, San Raffaele Scientific Institute, Milan, Italy.
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14
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Affiliation(s)
- Casey A Boyd
- University of Texas Medical Branch, Galveston, Texas, USA
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Clinical Management of Ovarian Endometriotic Cyst (Chocolate Cyst): Diagnosis, Medical Treatment, and Minimally Invasive Surgery. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2012. [DOI: 10.1007/s13669-011-0002-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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16
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Setälä M, Kössi J, Silventoinen S, Mäkinen J. The impact of deep disease on surgical treatment of endometriosis. Eur J Obstet Gynecol Reprod Biol 2011; 158:289-93. [DOI: 10.1016/j.ejogrb.2011.04.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Revised: 04/09/2011] [Accepted: 04/30/2011] [Indexed: 10/18/2022]
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17
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Current world literature. Curr Opin Support Palliat Care 2011; 5:174-83. [PMID: 21521986 DOI: 10.1097/spc.0b013e3283473351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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