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Oliveira FG, Rosa-e-Silva JC, Gomes AG, Grzesiuk JD, Vidotto T, Squire JA, Panepucci RA, Meola J, Martelli L. Identification of a rare copy number polymorphic gain at 3q12.2 with candidate genes for familial endometriosis. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2024; 46:e-rbgo12. [PMID: 38765507 PMCID: PMC11075382 DOI: 10.61622/rbgo/2024cr12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 10/10/2023] [Indexed: 05/22/2024] Open
Abstract
Endometriosis is a complex disease that affects 10-15% of women of reproductive age. Familial studies show that relatives of affected patients have a higher risk of developing the disease, implicating a genetic role for this disorder. Little is known about the impact of germline genomic copy number variant (CNV) polymorphisms on the heredity of the disease. In this study, we describe a rare CNV identified in two sisters with familial endometriosis, which contain genes that may increase the susceptibility and progression of this disease. We investigated the presence of CNVs from the endometrium and blood of the sisters with endometriosis and normal endometrium of five women as controls without the disease using array-CGH through the Agilent 2x400K platform. We excluded common CNVs that were present in the database of genomic variation. We identified, in both sisters, a rare CNV gain affecting 113kb at band 3q12.2 involving two candidate genes: ADGRG7 and TFG. The CNV gain was validated by qPCR. ADGRG7 is located at 3q12.2 and encodes a G protein-coupled receptor influencing the NF-kappaβ pathway. TFG participates in chromosomal translocations associated with hematologic tumor and soft tissue sarcomas, and is also involved in the NF-kappa B pathway. The CNV gain in this family provides a new candidate genetic marker for future familial endometriosis studies. Additional longitudinal studies of affected families must confirm any associations between this rare CNV gain and genes involved in the NF-kappaβ pathway in predisposition to endometriosis.
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Affiliation(s)
- Flávia Gaona Oliveira
- Universidade de São PauloRibeirão Preto Medical SchoolDepartment of GeneticsRibeirão PretoSPBrazilDepartment of Genetics, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | - Júlio Cesar Rosa-e-Silva
- Universidade de São PauloRibeirão Preto Medical SchoolDepartment of Gynecology and ObstetricsRibeirão PretoSPBrazilDepartment of Gynecology and Obstetrics, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | - Alexandra Galvão Gomes
- Universidade de São PauloRibeirão Preto Medical SchoolDepartment of GeneticsRibeirão PretoSPBrazilDepartment of Genetics, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | - Juliana Dourado Grzesiuk
- Universidade de São PauloRibeirão Preto Medical SchoolDepartment of GeneticsRibeirão PretoSPBrazilDepartment of Genetics, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | - Thiago Vidotto
- Universidade de São PauloRibeirão Preto Medical SchoolDepartment of GeneticsRibeirão PretoSPBrazilDepartment of Genetics, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | - Jeremy Andrew Squire
- Universidade de São PauloRibeirão Preto Medical SchoolDepartment of GeneticsRibeirão PretoSPBrazilDepartment of Genetics, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | - Rodrigo Alexandre Panepucci
- Universidade de São PauloRibeirão Preto Medical SchoolDepartment of GeneticsRibeirão PretoSPBrazilDepartment of Genetics, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
- Universidade de São PauloBlood CenterCenter for Cell TherapyRibeirão PretoSPBrazilCenter for Cell Therapy, Blood Center, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | - Juliana Meola
- Universidade de São PauloRibeirão Preto Medical SchoolDepartment of Gynecology and ObstetricsRibeirão PretoSPBrazilDepartment of Gynecology and Obstetrics, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | - Lúcia Martelli
- Universidade de São PauloRibeirão Preto Medical SchoolDepartment of GeneticsRibeirão PretoSPBrazilDepartment of Genetics, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
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Endometrium as Control of Endometriosis in Experimental Research: Assessment of Sample Suitability. Diagnostics (Basel) 2022; 12:diagnostics12040970. [PMID: 35454018 PMCID: PMC9032605 DOI: 10.3390/diagnostics12040970] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 11/29/2022] Open
Abstract
Endometriosis is a chronic gynecological disease that causes numerous severe symptoms in affected women. Revealing alterations of the molecular processes in ectopic endometrial tissue is the current policy for understanding the pathomechanisms and discovering potential novel therapeutic targets. Examining molecular processes of eutopic endometrium is likely to be a convenient method to compare it with the molecular alterations observed in ectopic tissues. The aim of the present study was to determine what proportion of the surgically resected eutopic endometrial samples is suitable for further experiments so that these can be comparable with endometriosis. Final hospital reports and histopathology reports of a 3-year-long period (1162 cases) were analysed. The application of a retrospective screening method promoted the categorization of these cases, and quantification of the categorized cases was accomplished. In addition, results obtained from cultured endometrium samples were also detailed. Only a small number of the harvested endometrial samples was suitable for further molecular analysis, while preoperative screening protocol could enlarge this fraction. Applying clinical and histopathological selection and exclusion criteria for tissue screening and histopathological examination of samples could ensure the comparability of healthy endometrium with endometriosis. The present study could be useful for researchers who intend to perform molecular experiments to compare endometriosis with the physiological processes of the endometrium.
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Varga J, Reviczká A, Háková H, Švajdler P, Rabajdová M, Ostró A. Predictive factors of endometriosis progression into ovarian cancer. J Ovarian Res 2022; 15:5. [PMID: 35012617 PMCID: PMC8751310 DOI: 10.1186/s13048-021-00940-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 12/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In recent years, the endometriosis has overcome a noteworthy renaissance in the recognition of its potential. In certain patients, a demonstrable malignant progression of ectopic foci leading to development of ovarian cancer is seen. The knowledge of endometriosis overthrow background into endometriosis associated ovarian cancer is of paramount importance for selection of patients at risk. The goal of the presented study was to review a malignant potential of the endometriosis and to specify predictive factors of endometriosis progression into ovarian cancer. Altogether 189 patients were included in the study. Conventional cytogenetics as well as measurement of transcriptional activity of CTNNB1 (β-catenin) and HIF1A (HIF1-α) genes were prospectively studied in 60 endometriosis patients and 50 control group patients. The retrospective histopathological analysis was performed in 19 endometriosis associated ovarian cancer patients and 60 patients with histologically confirmed endometriosis. RESULTS Five endometriosis patients showed a deviation from normal cytogenetics finding without affecting of their phenotype. In 6 cases of endometriosis associated ovarian cancer ectopic endometrium was not confirmed. The remaining 13 cases demonstrated either benign or atypical endometriosis or even structures of borderline carcinoma. Atypical endometriosis was histologically confirmed in 20% of 60 endometriosis patients. Determination of gene expression (CTNNB1, HIF1A) formed two subgroups. Transcriptionally incipient endometriosis subgroup with insignificant genes expression compared to control group. In transcriptionally evident endometriosis subgroup were genes expressions significantly higher compared to control group (p < 0.01) as well as transcriptionally incipient endometriosis subgroup (p < 0.05). CONCLUSIONS Significant structural abnormalities of chromosomes are not included in genetic rigging of endometriosis patients. Atypical endometriosis represents a histopathologically detectable intermediate of endometriosis progression. Determination of genes expression CTNNB1 and HIF1A helps to allocate risk patients with endometriosis where more precise management is needed.
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Affiliation(s)
- Ján Varga
- Department of Gynaecology and Obstetrics, Faculty of Medicine, P.J. Šafárik University and L. Pasteur University Hospital, Rastislavova 43 Street, 041 90, Košice, Slovakia.
| | - Alžbeta Reviczká
- Frauenklinik, DONAUISAR Klinikum Deggendorf, Deggendorf, Germany
| | - Hedviga Háková
- Department of Laboratory Medicine, subdivision of Medical Genetics L. Pasteur University Hospital, Košice, Slovakia
| | | | - Miroslava Rabajdová
- Department of Medical and Clinical Biochemistry, Faculty of Medicine, P. J. Šafárik University, Košice, Slovakia
| | - Alexander Ostró
- Department of Gynaecology and Obstetrics, Faculty of Medicine, P.J. Šafárik University and L. Pasteur University Hospital, Rastislavova 43 Street, 041 90, Košice, Slovakia
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Hung SW, Zhang R, Tan Z, Chung JPW, Zhang T, Wang CC. Pharmaceuticals targeting signaling pathways of endometriosis as potential new medical treatment: A review. Med Res Rev 2021; 41:2489-2564. [PMID: 33948974 PMCID: PMC8252000 DOI: 10.1002/med.21802] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 12/23/2020] [Accepted: 03/19/2021] [Indexed: 12/13/2022]
Abstract
Endometriosis (EM) is defined as endometrial tissues found outside the uterus. Growth and development of endometriotic cells in ectopic sites can be promoted via multiple pathways, including MAPK/MEK/ERK, PI3K/Akt/mTOR, NF-κB, Rho/ROCK, reactive oxidative stress, tumor necrosis factor, transforming growth factor-β, Wnt/β-catenin, vascular endothelial growth factor, estrogen, and cytokines. The underlying pathophysiological mechanisms include proliferation, apoptosis, autophagy, migration, invasion, fibrosis, angiogenesis, oxidative stress, inflammation, and immune escape. Current medical treatments for EM are mainly hormonal and symptomatic, and thus the development of new, effective, and safe pharmaceuticals targeting specific molecular and signaling pathways is needed. Here, we systematically reviewed the literature focused on pharmaceuticals that specifically target the molecular and signaling pathways involved in the pathophysiology of EM. Potential drug targets, their upstream and downstream molecules with key aberrant signaling, and the regulatory mechanisms promoting the growth and development of endometriotic cells and tissues were discussed. Hormonal pharmaceuticals, including melatonin, exerts proapoptotic via regulating matrix metallopeptidase activity while nonhormonal pharmaceutical sorafenib exerts antiproliferative effect via MAPK/ERK pathway and antiangiogenesis activity via VEGF/VEGFR pathway. N-acetyl cysteine, curcumin, and ginsenoside exert antioxidant and anti-inflammatory effects via radical scavenging activity. Natural products have high efficacy with minimal side effects; for example, resveratrol and epigallocatechin gallate have multiple targets and provide synergistic efficacy to resolve the complexity of the pathophysiology of EM, showing promising efficacy in treating EM. Although new medical treatments are currently being developed, more detailed pharmacological studies and large sample size clinical trials are needed to confirm the efficacy and safety of these treatments in the near future.
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Affiliation(s)
- Sze Wan Hung
- Department of Obstetrics and GynaecologyThe Chinese University of Hong KongHong Kong
| | - Ruizhe Zhang
- Department of Obstetrics and GynaecologyThe Chinese University of Hong KongHong Kong
- Center for Reproductive Medicine, Henan Key Laboratory of Reproduction and GeneticsThe First Affiliated Hospital of Zhengzhou UniversityZhengzhou
| | - Zhouyurong Tan
- Department of Obstetrics and GynaecologyThe Chinese University of Hong KongHong Kong
| | | | - Tao Zhang
- Department of Obstetrics and GynaecologyThe Chinese University of Hong KongHong Kong
| | - Chi Chiu Wang
- Department of Obstetrics and GynaecologyThe Chinese University of Hong KongHong Kong
- Reproduction and Development, Li Ka Shing Institute of Health SciencesThe Chinese University of Hong KongHong Kong
- School of Biomedical SciencesThe Chinese University of Hong KongHong Kong
- Chinese University of Hong Kong‐Sichuan University Joint Laboratory in Reproductive MedicineThe Chinese University of Hong KongHong Kong
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Bouquet de Joliniere J, Major A, Ayoubi JM, Cabry R, Khomsi F, Lesec G, Frydman R, Feki A. It Is Necessary to Purpose an Add-on to the American Classification of Endometriosis? This Disease Can Be Compared to a Malignant Proliferation While Remaining Benign in Most Cases. EndoGram® Is a New Profile Witness of Its Evolutionary Potential. Front Surg 2019; 6:27. [PMID: 31231658 PMCID: PMC6566301 DOI: 10.3389/fsurg.2019.00027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 04/29/2019] [Indexed: 12/22/2022] Open
Abstract
Endometriosis is a curious pathology that has been the topic of many international publications. Its etiology remains mysterious but seems to have multiple causes. It is a complex disease whose lesions are very heterogeneous in where they can occur (deep endometriosis, superficial, ovarian cyst), extent, associated symptoms, evolution or aggressiveness of the disease, and response to treatments. Furthermore, it evolves in pushes, remains autonomous, and is responsible for both superficial and deep lesions that explain its two most well know challenges: pain and infertility. It has always been classified by the size of its anatomical lesions—Acosta classification (1), revised by the American fertility society (AFS) (2), and the American society of reproductive medicine (ASRM) classification with a description of the disease at different stages: minimal (score of 1 to 5), mild (3–12), moderate (16 to 40), and severe (>40) (13). If this classification provides a complete repertoire of implants (anatomic) (10), the attribution of points is arbitrary. In fact, the size of the lesions is not synonymous with the difficulty to treat them surgically. Their location, if deep, is larger than the size of ovarian endometriomas. In addition, small anatomical but evaluative lesions will have a larger impact than big fibrous and stable lesions (Figure 1). Thus, attempts to explain their inflammatory side effects have been proposed (14, 15). The French classification nodule, ovaries, adhesions, tube, and inflammation (FOATI) (10) has had the merit of taking this phenomenon into account. In our opinion, we must go much further and propose an amendment in this classification, taking into account the evolution of the lesions and their deep molecular biology because in reality, the lesions are not at the same stage.
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Affiliation(s)
| | - Attila Major
- Department of Gynecology and Obstetrics, HFR, Fribourg Cantonal Hospital, Friborg, Switzerland
| | - Jean Marc Ayoubi
- Department of Gynecology and Obstetrics, Foch Hospital, Suresnes, France
| | - Rosalie Cabry
- Department of Gynecology and Obstetrics, HFR, Fribourg Cantonal Hospital, Friborg, Switzerland
| | - Fathi Khomsi
- Department of Gynecology and Obstetrics, HFR, Fribourg Cantonal Hospital, Friborg, Switzerland
| | - Guy Lesec
- Department of Anatomopathology, Unilabs, Lausanne, Switzerland
| | - René Frydman
- Department of Gynecology and Obstetrics, Foch Hospital, Suresnes, France
| | - Anis Feki
- Department of Gynecology and Obstetrics, HFR, Fribourg Cantonal Hospital, Friborg, Switzerland
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Klemmt PA, Starzinski-Powitz A. Molecular and Cellular Pathogenesis of Endometriosis. CURRENT WOMEN'S HEALTH REVIEWS 2018; 14:106-116. [PMID: 29861704 PMCID: PMC5925869 DOI: 10.2174/1573404813666170306163448] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 02/06/2017] [Accepted: 02/15/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND A substantial body of studies supports the view that molecular and cellular features of endometriotic lesions differ from those of eutopic endometrium. Apart from that, evidence exists that the eutopic endometrium from pa-tients with endometriosis differs from that of females without endometriosis. OBJECTIVE Aberrant expression profiles include a number of non-steroid signaling pathways that exert their putative influ-ence on the pathogenesis of endometriosis at least in part via crosstalk(s) with estrogen-mediated mechanisms. A rational to focus research on non-steroid signal pathways is that they might be remunerative targets for the development and selection of novel therapeutics to treat endometriosis possibly without affecting estrogen levels. RESULTS AND CONCLUSION In this article, we describe molecular and cellular features of endometriotic lesions and focus on the canonical WNT/β-signaling pathway, a key regulatory system in biology (including stem cell homeostasis) and often in pathophysiological conditions such as endometriosis. Recently emerged novel biological concepts in signal transduction and gene regulation like exosomes and microRNAs are discussed in their putative role in the pathogenesis of endometriosis.
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Affiliation(s)
- Petra A.B. Klemmt
- Department of Molecular Cell Biology and Human Genetics, Institute of Cell Biology and Neuroscience, Johann Wolfgang Goethe University of Frankfurt, Max-von-Laue-Str. 13, D-60438Frankfurt am Main, Germany
| | - Anna Starzinski-Powitz
- Department of Molecular Cell Biology and Human Genetics, Institute of Cell Biology and Neuroscience, Johann Wolfgang Goethe University of Frankfurt, Max-von-Laue-Str. 13, D-60438Frankfurt am Main, Germany
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Mafra F, Mazzotti D, Pellegrino R, Bianco B, Barbosa CP, Hakonarson H, Christofolini D. Copy number variation analysis reveals additional variants contributing to endometriosis development. J Assist Reprod Genet 2016; 34:117-124. [PMID: 27817035 DOI: 10.1007/s10815-016-0822-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 09/22/2016] [Indexed: 01/21/2023] Open
Abstract
PURPOSE Endometriosis is a gynecological disease influenced by multiple genetic and environmental factors. The aim of the current study was to use SNP-array technology to identify genomic aberrations that may possibly contribute to the development of endometriosis. METHODS We performed an SNP-array genotyping of pooled DNA samples from both patients (n = 100) and controls (n = 50). Copy number variation (CNV) calling and association analyses were performed using PennCNV software. MLPA and TaqMan Copy-Number assays were used for validation of CNVs discovered. RESULTS We detected 49 CNV loci that were present in patients with endometriosis and absent in the control group. After validation procedures, we confirmed six CNV loci in the subtelomeric regions, including 1p36.33, 16p13.3, 19p13.3, and 20p13, representing gains, while 17q25.3 and 20q13.33 showed losses. Among the intrachromosomal regions, our results revealed duplication at 19q13.1 within the FCGBP gene (p = 0.007). CONCLUSIONS We identified CNVs previously associated with endometriosis, together with six suggestive novel loci possibly involved in this disease. The intergenic locus on chromosome 19q13.1 shows strong association with endometriosis and is under further functional investigation.
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Affiliation(s)
- Fernanda Mafra
- Collective Health Department, Division of Sexual and Reproductive Health Care and Population Genetics, Faculdade de Medicina do ABC, Santo André, SP, Brazil.
- Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Diego Mazzotti
- Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Renata Pellegrino
- Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Bianca Bianco
- Collective Health Department, Division of Sexual and Reproductive Health Care and Population Genetics, Faculdade de Medicina do ABC, Santo André, SP, Brazil
| | - Caio Parente Barbosa
- Collective Health Department, Division of Sexual and Reproductive Health Care and Population Genetics, Faculdade de Medicina do ABC, Santo André, SP, Brazil
| | - Hakon Hakonarson
- Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Denise Christofolini
- Collective Health Department, Division of Sexual and Reproductive Health Care and Population Genetics, Faculdade de Medicina do ABC, Santo André, SP, Brazil
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Kuntai Capsule Inhibited Endometriosis via Inducing Apoptosis in a Rat Model. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:5649169. [PMID: 27597876 PMCID: PMC4997064 DOI: 10.1155/2016/5649169] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 06/27/2016] [Accepted: 07/10/2016] [Indexed: 01/11/2023]
Abstract
We evaluated the effectiveness of Kuntai Capsule (KTC) for treating endometriosis using rat model and investigated its preliminary mechanism of action involved. SD rats were implanted with endometrial tissues and treated with KTC for three weeks. Then, laparotomy was performed to examine volume changes of the autografts. The serum levels of TNF-α, IL-6, COX-2, E2, and P4 were measured through ELISA. TUNEL was performed to analyze the apoptosis on ectopic endometrium. Protein levels of caspases 8, 9, and 3 and cytochrome c in the ectopic and eutopic endometrium were measured by western blotting. Results showed that KTC significantly decreased the volumes of ectopic endometrium. The level of TNF-α increased and E2 decreased in the KTC treatment groups. TUNEL and western blot assay showed that KTC could induce apoptosis of endometriotic tissues, accompanied with the increased protein expression of caspases 8 and 9, activated caspase-3, and cytochrome c in a dose-dependent manner. However, these protein expression profiles were not affected in eutopic endometrium. Our findings suggest that KTC could inhibit the growth of ectopic endometrial tissue through upregulating the level of TNF-α and its downstream signaling, including caspases and cytochrome c.
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Fadhlaoui A, Gillon T, Lebbi I, Bouquet de Jolinière J, Feki A. Endometriosis and Vesico-Sphincteral Disorders. Front Surg 2015; 2:23. [PMID: 26157800 PMCID: PMC4476201 DOI: 10.3389/fsurg.2015.00023] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 05/29/2015] [Indexed: 11/13/2022] Open
Abstract
Objectives The aim of this mini review is to determine the relationship between endometriosis and urinary tract symptoms and to investigate the consequences of surgical treatment of mild to severe endometriosis, especially deep lesions, on the vesico-sphincteral function (lower urinary tract function). Materials and methods We performed a literature review by searching the MEDLINE database for articles published between 2000 and 2014, limiting the searches to the words: urinary tract, vesico-sphincteral, dysfunction, endometriosis, symptoms, and surgery. Results The incidence of vesico-sphincteral symptoms in endometriosis varies from 3.4 up to 15.4%. The frequency of such symptoms seems to be under estimated because of a lack of specific questionnaire including urinary symptoms. Urodynamic evaluation could help to detect unsuspected abnormalities. It seems that endometriosis surgery (particularly deep infiltrating lesions) is a purveyor of de novo urinary dysfunction, with an incidence varying from 6.8 up to 17.5%. Nerve sparing processes such as neuro-navigators or neuro-stimulators seem to be promising techniques to avoid postoperative urinary tract dysfunction. Conclusion A precise anamnesis and the use of specific validated questionnaires (IPSS and BFLUTS) improve the screening of vesico-sphincteral symptoms in case of endometriosis. No recommendation can be found in the literature about the place of urodynamic evaluation. Most publications lack of proof and therefore do not allow making recommendations about optimal treatment of endometriotic lesions to avoid urinary tract disorders.
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Affiliation(s)
- Anis Fadhlaoui
- Service de Gynécologie Obstétrique, HFR Fribourg - Hôpital Cantonal , Fribourg , Switzerland ; Service de Gynécologie Obstetrique et de Médecine de la reproduction de l'Hôpital Aziza Othmana , Tunis , Tunisia ; Faculté de Médecine de Tunis , Tunis , Tunisia
| | - Tessa Gillon
- Service de Gynécologie Obstétrique, HFR Fribourg - Hôpital Cantonal , Fribourg , Switzerland
| | - Issam Lebbi
- Obstetric Gynecology and Fertility Private Clinic, Dream Center , Tunis , Tunisia
| | | | - Anis Feki
- Service de Gynécologie Obstétrique, HFR Fribourg - Hôpital Cantonal , Fribourg , Switzerland
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