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Maharajaa SPK, Asally R, Markham R, Manconi F. Endometriotic lesions. JOURNAL OF ENDOMETRIOSIS AND PELVIC PAIN DISORDERS 2019. [DOI: 10.1177/2284026519838748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Endometriosis is a complex gynaecological condition affecting women of reproductive age. It is characterised by the presence of lesions containing endometrial glands and stroma outside the uterus. The disease is typically associated with pelvic pain (including dysmenorrhoea and dyspareunia), infertility and bowel-related symptoms. Endometriotic lesions have a highly variable presentation and most commonly occur in the abdominal cavity. These lesions are broadly classified into peritoneal, ovarian and deep infiltrating endometriosis. There have been observations of increased density of nerve fibres and neurological molecules in the endometriotic lesions compared to the uninvolved peritoneum of women without endometriosis and the presence of unmyelinated nerve fibres were higher near the glands. The lesion sites are characterised by a range of immunological alterations, and specific immune cell populations have also been known to synthesise and secrete neurogenic factors. Endometriotic lesions are capable of producing prostaglandins which are direct generators of pain and are capable of inducing inflammation. Diagnosing the disease involves direct visualisation of the lesions through a laparoscopic or laparotomy, which is followed by histopathological examination of biopsied or excised lesions. The staging of endometriosis due to its complexity is highly variable as presentation and gaps in knowledge pose a great challenge in the classification of the disease. The medical management of endometriosis aims at providing adequate analgesia and suppression of the activity of the lesion. A better understanding of endometriotic lesion relationships between innervations and specific clinical characteristics may elucidate aspects of pain mechanisms and infertility in endometriosis and facilitate the development of novel therapeutic approaches.
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Affiliation(s)
- Sri PK Maharajaa
- Discipline of Obstetrics, Gynaecology and Neonatology, The University of Sydney, Camperdown, NSW, Australia
| | - Razan Asally
- Discipline of Obstetrics, Gynaecology and Neonatology, The University of Sydney, Camperdown, NSW, Australia
| | - Robert Markham
- Discipline of Obstetrics, Gynaecology and Neonatology, The University of Sydney, Camperdown, NSW, Australia
| | - Frank Manconi
- Discipline of Obstetrics, Gynaecology and Neonatology, The University of Sydney, Camperdown, NSW, Australia
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Khashper A, Addley HC, Abourokbah N, Nougaret S, Sala E, Reinhold C. T2-Hypointense Adnexal Lesions: An Imaging Algorithm. Radiographics 2012; 32:1047-64. [DOI: 10.1148/rg.324115180] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Lima CMADO, Coutinho EPD, Ribeiro ÉB, Domingues MNA, Junqueira FP, Coutinho Junior AC. Ressonância magnética na endometriose do trato urinário baixo: ensaio iconográfico. Radiol Bras 2009. [DOI: 10.1590/s0100-39842009000300013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Endometriose é definida como a presença de tecido endometrial funcionante fora da cavidade endometrial e do miométrio. É uma doença comum, de causas multifatoriais, porém o envolvimento do trato urinário baixo é raro. A ressonância magnética tem elevada sensibilidade, especificidade e acurácia no diagnóstico da endometriose do trato geniturinário baixo, principalmente por permitir a identificação das lesões de permeio a aderências e a avaliação da extensão das lesões subperitoneais. Neste estudo são ilustrados, sob a forma de ensaio iconográfico, os principais achados à ressonância magnética do envolvimento por endometriose do trato urinário baixo.
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Affiliation(s)
| | - Elisa Pompeu Dias Coutinho
- Clínicas de Diagnóstico Por Imagem (CDPI) e Multi-Imagem; Centro de Diagnóstico por Imagem Fátima Digittal, Brasil
| | - Érica Barreiros Ribeiro
- Clínicas de Diagnóstico Por Imagem (CDPI) e Multi-Imagem; Centro de Diagnóstico por Imagem Fátima Digittal, Brasil
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