1
|
Kaneko M, Fujihara A, Iwata T, Ramacciotti LS, Palmer SL, Oishi M, Aron M, Cacciamani GE, Duddalwar V, Horiguchi G, Teramukai S, Ukimura O, Gill IS, Abreu AL. A nomogram to predict the absence of clinically significant prostate cancer in males with negative MRI. Int Braz J Urol 2024; 50:319-334. [PMID: 37450770 PMCID: PMC11152327 DOI: 10.1590/s1677-5538.ibju.2024.0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 02/16/2024] [Indexed: 04/12/2024] Open
Abstract
PURPOSE To create a nomogram to predict the absence of clinically significant prostate cancer (CSPCa) in males with non-suspicion multiparametric magnetic resonance imaging (mpMRI) undergoing prostate biopsy (PBx). MATERIALS AND METHODS We identified consecutive patients who underwent 3T mpMRI followed by PBx for suspicion of PCa or surveillance follow-up. All patients had Prostate Imaging Reporting and Data System score 1-2 (negative mpMRI). CSPCa was defined as Grade Group ≥2. Multivariate logistic regression analysis was performed via backward elimination. Discrimination was evaluated with area under the receiver operating characteristic (AUROC). Internal validation with 1,000x bootstrapping for estimating the optimism corrected AUROC. RESULTS Total 327 patients met inclusion criteria. The median (IQR) age and PSA density (PSAD) were 64 years (58-70) and 0.10 ng/mL2 (0.07-0.15), respectively. Biopsy history was as follows: 117 (36%) males were PBx-naive, 130 (40%) had previous negative PBx and 80 (24%) had previous positive PBx. The majority were White (65%); 6% of males self-reported Black. Overall, 44 (13%) patients were diagnosed with CSPCa on PBx. Black race, history of previous negative PBx and PSAD ≥0.15ng/mL2 were independent predictors for CSPCa on PBx and were included in the nomogram. The AUROC of the nomogram was 0.78 and the optimism corrected AUROC was 0.75. CONCLUSIONS Our nomogram facilitates evaluating individual probability of CSPCa on PBx in males with PIRADS 1-2 mpMRI and may be used to identify those in whom PBx may be safely avoided. Black males have increased risk of CSPCa on PBx, even in the setting of PIRADS 1-2 mpMRI.
Collapse
Affiliation(s)
- Masatomo Kaneko
- University of Southern CaliforniaUSC Institute of Urology and Catherine & Joseph ArestyCenter for Image-Guided SurgeryLos AngelesCaliforniaUSAUSC Institute of Urology and Catherine & Joseph Aresty, Center for Image-Guided Surgery, Focal Therapy, and Artificial Intelligence for Prostate Cancer, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Kyoto Prefectural University of MedicineGraduate School of Medical ScienceDepartment of UrologyKyotoJapanDepartment of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Atsuko Fujihara
- University of Southern CaliforniaUSC Institute of Urology and Catherine & Joseph ArestyCenter for Image-Guided SurgeryLos AngelesCaliforniaUSAUSC Institute of Urology and Catherine & Joseph Aresty, Center for Image-Guided Surgery, Focal Therapy, and Artificial Intelligence for Prostate Cancer, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Kyoto Prefectural University of MedicineGraduate School of Medical ScienceDepartment of UrologyKyotoJapanDepartment of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tsuyoshi Iwata
- University of Southern CaliforniaUSC Institute of Urology and Catherine & Joseph ArestyCenter for Image-Guided SurgeryLos AngelesCaliforniaUSAUSC Institute of Urology and Catherine & Joseph Aresty, Center for Image-Guided Surgery, Focal Therapy, and Artificial Intelligence for Prostate Cancer, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Kyoto Prefectural University of MedicineGraduate School of Medical ScienceDepartment of UrologyKyotoJapanDepartment of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Lorenzo Storino Ramacciotti
- University of Southern CaliforniaUSC Institute of Urology and Catherine & Joseph ArestyCenter for Image-Guided SurgeryLos AngelesCaliforniaUSAUSC Institute of Urology and Catherine & Joseph Aresty, Center for Image-Guided Surgery, Focal Therapy, and Artificial Intelligence for Prostate Cancer, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Suzanne L. Palmer
- University of Southern CaliforniaKeck School of MedicineDepartment of RadiologyLos AngelesCaliforniaUSADepartment of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Masakatsu Oishi
- University of Southern CaliforniaUSC Institute of Urology and Catherine & Joseph ArestyCenter for Image-Guided SurgeryLos AngelesCaliforniaUSAUSC Institute of Urology and Catherine & Joseph Aresty, Center for Image-Guided Surgery, Focal Therapy, and Artificial Intelligence for Prostate Cancer, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Kyoto Prefectural University of MedicineGraduate School of Medical ScienceDepartment of UrologyKyotoJapanDepartment of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Manju Aron
- University of Southern CaliforniaUSC Institute of Urology and Catherine & Joseph ArestyCenter for Image-Guided SurgeryLos AngelesCaliforniaUSAUSC Institute of Urology and Catherine & Joseph Aresty, Center for Image-Guided Surgery, Focal Therapy, and Artificial Intelligence for Prostate Cancer, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- University of Southern CaliforniaKeck School of MedicineDepartment of PathologyLos AngelesCaliforniaUSADepartment of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Giovanni E. Cacciamani
- University of Southern CaliforniaUSC Institute of Urology and Catherine & Joseph ArestyCenter for Image-Guided SurgeryLos AngelesCaliforniaUSAUSC Institute of Urology and Catherine & Joseph Aresty, Center for Image-Guided Surgery, Focal Therapy, and Artificial Intelligence for Prostate Cancer, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- University of Southern CaliforniaKeck School of MedicineDepartment of RadiologyLos AngelesCaliforniaUSADepartment of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Vinay Duddalwar
- University of Southern CaliforniaUSC Institute of Urology and Catherine & Joseph ArestyCenter for Image-Guided SurgeryLos AngelesCaliforniaUSAUSC Institute of Urology and Catherine & Joseph Aresty, Center for Image-Guided Surgery, Focal Therapy, and Artificial Intelligence for Prostate Cancer, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- University of Southern CaliforniaKeck School of MedicineDepartment of RadiologyLos AngelesCaliforniaUSADepartment of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Go Horiguchi
- University HospitalThe Clinical and Translational Research CenterDivision of Data ScienceKyotoJapanDivision of Data Science, The Clinical and Translational Research Center, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Satoshi Teramukai
- Kyoto Prefectural University of MedicineGraduate School of Medical ScienceDepartment of BiostatisticsKyotoJapanDepartment of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Osamu Ukimura
- Kyoto Prefectural University of MedicineGraduate School of Medical ScienceDepartment of UrologyKyotoJapanDepartment of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Inderbir S. Gill
- University of Southern CaliforniaUSC Institute of Urology and Catherine & Joseph ArestyCenter for Image-Guided SurgeryLos AngelesCaliforniaUSAUSC Institute of Urology and Catherine & Joseph Aresty, Center for Image-Guided Surgery, Focal Therapy, and Artificial Intelligence for Prostate Cancer, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Andre Luis Abreu
- University of Southern CaliforniaUSC Institute of Urology and Catherine & Joseph ArestyCenter for Image-Guided SurgeryLos AngelesCaliforniaUSAUSC Institute of Urology and Catherine & Joseph Aresty, Center for Image-Guided Surgery, Focal Therapy, and Artificial Intelligence for Prostate Cancer, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- University of Southern CaliforniaKeck School of MedicineDepartment of RadiologyLos AngelesCaliforniaUSADepartment of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| |
Collapse
|
2
|
Chatzigrigoriadis C, Goulioumis A, Sperdouli D, Gyftopoulos K. Embryological, anatomical and clinical considerations on pleuroperitoneal communication. Pleura Peritoneum 2023; 8:101-111. [PMID: 37662602 PMCID: PMC10469182 DOI: 10.1515/pp-2023-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/26/2023] [Indexed: 09/05/2023] Open
Abstract
The pleural and peritoneal cavity share many related features due to their common celomic origin. Normally these two spaces are completely separated with the development of the diaphragm. Defects in diaphragm morphogenesis may result in congenital diaphragmatic hernias, which is the most known form of communication between the pleural and peritoneal cavity. However, in several cases, findings of pleuroperitoneal communication (PPC) have been described in adults through an apparently intact diaphragm. In this comprehensive review we systematically evaluate clinical scenarios of this form of "unexpected" PPC as reported in the literature and focus on the possible mechanisms involved.
Collapse
Affiliation(s)
| | | | | | - Kostis Gyftopoulos
- Department of Anatomy, School of Medicine, University of Patras, Patras, Greece
| |
Collapse
|
3
|
Diniz ALL, Resende JAD, de Andrade CM, Brandão AC, Gasparoni MP, Favorito LA. Urological knowledge and tools applied to diagnosis and surgery in deep infiltrating endometriosis - a narrative review. Int Braz J Urol 2023; 49:564-579. [PMID: 37450770 PMCID: PMC10482465 DOI: 10.1590/s1677-5538.ibju.2023.9907] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 05/19/2023] [Indexed: 07/18/2023] Open
Abstract
OBJECTIVES This review discusses deep infiltrating endometriosis (DIE) diagnosis and surgery using current urological knowledge and technologies. MATERIALS AND METHODS Narrative review of deep infiltrating endometriosis that result in urological issues. We examined manuscripts from Pubmed, Embase, and Scielo's database using the following MeSH terms: ('endometriosis') AND ('urology' OR 'urological' OR 'urologist') AND ('bladder' OR'vesical') AND ('ureteral' OR 'ureter').Selection followed PRISMA guidelines. Sample images from our records were brought to endorse the findings. RESULTS Thirty four related articles were chosen from 105. DIE may affect the urinary system in 52.6% of patients. Lower urinary tract symptoms may require urodynamic examination. Ultrasonography offers strong statistical yields for detecting urinary tract lesions or distortions, but magnetic resonance will confirm the diagnosis. Cystoscopy can detect active lesions, although any macroscopic visual appeal is pathognomonic. Endourology is utilized intraoperatively for bladder and ureteral assessment, however transurethral endoscopic excision of bladder lesions had higher recurrence rates. Laparoscopy is the route of choice for treatment; partial cystectomy, and bladder shaving were the most prevalent surgical treatments for bladder endometriosis. Regarding the ureteral treatment, the simple ureterolysis and complex reconstructive techniques were described in most papers. Using anatomical landmarks or neuronavigation, pelvic surgical systematization allows intraoperative neural structure identification. CONCLUSIONS DIE in the urinary system is common, however the number of publications with high level of evidence is limited. The initial tools for diagnosis are ultrasonography and cystoscopy, but magnetic resonance is the most reliable tool. When the patient has voiding symptoms, the urodynamic examination is crucial. Laparoscopy improves lesion detection and anatomical understanding. This approach must be carried out by professionals with high expertise, since the surgery goes beyond the resection of lesions and includes the preservation of nerve structures and urinary tract reconstruction techniques.
Collapse
Affiliation(s)
- André L. Lima Diniz
- Universidade do Estado do Rio de JaneiroUnidade de Pesquisa UrogenitalRio de JaneiroRJBrasilUnidade de Pesquisa Urogenital - Universidade do Estado do Rio de Janeiro - Uerj, Rio de Janeiro, RJ, Brasil
| | - José Anacleto D. Resende
- Universidade do Estado do Rio de JaneiroUnidade de Pesquisa UrogenitalRio de JaneiroRJBrasilUnidade de Pesquisa Urogenital - Universidade do Estado do Rio de Janeiro - Uerj, Rio de Janeiro, RJ, Brasil
| | - Cláudio M. de Andrade
- Universidade do Estado do Rio de JaneiroUnidade de Pesquisa UrogenitalRio de JaneiroRJBrasilUnidade de Pesquisa Urogenital - Universidade do Estado do Rio de Janeiro - Uerj, Rio de Janeiro, RJ, Brasil
| | - Alice C. Brandão
- Universidade do Estado do Rio de JaneiroUnidade de Pesquisa UrogenitalRio de JaneiroRJBrasilUnidade de Pesquisa Urogenital - Universidade do Estado do Rio de Janeiro - Uerj, Rio de Janeiro, RJ, Brasil
| | - Mauro P. Gasparoni
- Universidade do Estado do Rio de JaneiroUnidade de Pesquisa UrogenitalRio de JaneiroRJBrasilUnidade de Pesquisa Urogenital - Universidade do Estado do Rio de Janeiro - Uerj, Rio de Janeiro, RJ, Brasil
| | - Luciano A. Favorito
- Universidade do Estado do Rio de JaneiroUnidade de Pesquisa UrogenitalRio de JaneiroRJBrasilUnidade de Pesquisa Urogenital - Universidade do Estado do Rio de Janeiro - Uerj, Rio de Janeiro, RJ, Brasil
| |
Collapse
|
4
|
Frankel LR. A 10-Year Journey to Diagnosis With Endometriosis: An Autobiographical Case Report. Cureus 2022; 14:e21329. [PMID: 35186587 PMCID: PMC8849430 DOI: 10.7759/cureus.21329] [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: 01/17/2022] [Indexed: 11/29/2022] Open
Abstract
Endometriosis is a multifocal, chronic disease defined by extrauterine endometrial glands and stroma. This case report describes the author’s experience of living with stage IV endometriosis, including a 10-year diagnostic delay, the impact on daily life, management, and treatment. The diagnostic delay for endometriosis averages between seven to nine years globally, which imparts significant physical, psychological, and financial effects on the lives of patients.
Collapse
|
5
|
Topbas Selcuki NF, Yilmaz S, Kaya C, Usta T, Kale A, Oral E. Thoracic Endometriosis: A Review Comparing 480 Patients Based on Catamenial and Noncatamenial Symptoms. J Minim Invasive Gynecol 2021; 29:41-55. [PMID: 34375738 DOI: 10.1016/j.jmig.2021.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 07/15/2021] [Accepted: 08/01/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This review aimed to categorize thoracic endometriosis syndrome (TES) according to whether the presenting symptoms were catamenial and to evaluate whether such a categorization enables a better management strategy. DATA SOURCES An electronic search was conducted using the PubMed/Medline database. METHODS OF STUDY SELECTION The following keywords were used in combination with the Boolean operators AND OR: "thoracic endometriosis syndrome," "thoracic endometriosis," "diaphragm endometriosis," and "catamenial pneumothorax." TABULATION, INTEGRATION, AND RESULTS The initial search yielded 445 articles. Articles in non-English languages, those whose full texts were unavailable, and those that did not present the symptomatology clearly were further excluded. After these exclusions, the review included 240 articles and 480 patients: 61 patients in the noncatamenial group and 419 patients in the catamenial group. The groups differed significantly in presenting symptoms, surgical treatment techniques, and observed localization of endometriotic loci (p <.05). CONCLUSION This review points out the significant differences between patients with TES with catamenial and noncatamenial symptoms. Such categorization and awareness by clinicians of these differences among patients with TES can be helpful in designing a management strategy. When constructing management guidelines, these differences between patients with catamenial and noncatamenial symptoms should be taken into consideration.
Collapse
Affiliation(s)
- Nura Fitnat Topbas Selcuki
- Department of Obstetrics and Gynecology, University of Health Sciences Turkey, Istanbul Sisli Hamidiye Etfal Training and Research Hospital (Dr. Topbas Selcuki)
| | - Salih Yilmaz
- Department of Obstetrics and Gynecology, Acibadem Altunizade Hospital (Dr. Yilmaz)
| | - Cihan Kaya
- Department of Obstetrics and Gynecology, Acibadem Mehmet Ali Aydinlar University, Acibadem Bakirkoy Hospital (Dr. Kaya)
| | - Taner Usta
- Department of Obstetrics and Gynecology, Acibadem Mehmet Ali Aydinlar University, Acibadem Altunizade Hospital (Dr. Usta).
| | - Ahmet Kale
- Department of Obstetrics and Gynecology, University of Health Sciences Turkey, Istanbul Kartal Dr. Lutfi Kirdar City Hospital (Dr. Kale)
| | - Engin Oral
- Department of Obstetrics and Gynecology, Bezmialem Vakif University (Dr. Oral), Istanbul, Turkey
| |
Collapse
|
6
|
Singh A, Das CJ, Das BK, Gupta AK. Utility of diffusion weighted imaging in diagnosing subdiaphragmatic endometriosis presenting as shoulder pain. Indian J Radiol Imaging 2021; 27:314-317. [PMID: 29089681 PMCID: PMC5644326 DOI: 10.4103/ijri.ijri_86_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Extrapelvic endometriosis (EPE) is a rare entity which may potentially occur at any site. Symptomatic EPE is now increasingly being managed laparoscopically. Imaging is imperative in diagnosis as well as extent delineation prior to surgery. In addition to increasing the success rate of diagnostic laparoscopy, prior knowledge of EPE at certain sites may modify the standard surgical technique. We present here an unusual case of chronic pain in the right shoulder in a 26-year-old female caused by subdiaphragmatic endometriosis (SDE). It was noticed on conventional magnetic resonance imaging (MRI) sequences; however, due to the lack of the characteristic signal intensity, imaging findings were noncontributory. Diffusion-weighted imaging (DWI) facilitated its characterization and precisely mapped the extent of involvement. SDE should be suspected in young females presenting with cyclical shoulder pain. Due to nonspecific clinical features, it may remain undiagnosed. MRI is the imaging modality of choice in evaluation of EPE. Including DWI sequence in the MR protocol increases the diagnostic precision besides delineating the extent of involvement noninvasively.
Collapse
Affiliation(s)
| | | | - Bimal K Das
- Department of Microbiology, AIIMS, New Delhi, India
| | - A K Gupta
- Department of Radiology, AIIMS, New Delhi, India
| |
Collapse
|
7
|
Ribeiro MD, Freire T, Leite F, Werebe E, Cabrera Carranco R, Kondo William W. The importance of early diagnosis and treatment of incidental tension pneumothorax during robotic assisted laparoscopy for diaphragmatic endometriosis: a report of two cases. Facts Views Vis Obgyn 2021; 13:95-98. [PMID: 33889865 PMCID: PMC8051199 DOI: 10.52054/fvvo.13.1.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We describe two cases of diaphragmatic endometriosis treated using the robotic assisted laparoscopic approach, in which an incidental tension pneumothorax occurred during the initial inspection and assessment of diaphragmatic lesions. We demonstrate the importance of early diagnosis of this complication and report successful resolution using the thoracic drainage technique. In case one, after the pneumoperitoneum was installed, during the cavity assessment and inspection, small endometriotic lesions were observed in the tendon portion of the diaphragmatic surface. We observed a sudden increase in maximum airway pressures and a reduction in tidal volume, associated with arterial hypotension and hemodynamic instability and bulging of the diaphragm, which led to the diagnosis of a tension pneumothorax. In case two, diaphragmatic endometriotic lesions were also observed after hepatic mobilisation and following visualisation of the endometriotic lesions, an abrupt decrease in the capnography values was observed, consistent with hypertensive pneumothorax. In both cases, even after deflation of the abdominal cavity, hemodynamic instability persisted. We treated both cases with thoracic drainage, which immediately normalised respiratory parameters and resulted in hemodynamic stabilisation, and the surgical procedures were continued. During laparoscopic procedures for the treatment of diaphragmatic endometriosis, the endometriotic lesions can behave as communication hole in the tendon portion of the diaphragmatic surface and the changes in ventilatory patterns and haemodynamic instability should alert the medical team to the development of an incidental tension pneumothorax. The early identification of this complication in both cases allowed rapid intervention for chest drainage and allowed the surgical procedure to continue.
Collapse
Affiliation(s)
- M D Ribeiro
- Department of Gynaecological Surgery, Hospital São Luiz Morumbi Rede Dor, São Paulo, Brasil
| | - T Freire
- Department of Gynaecological Surgery, Hospital São Luiz Morumbi Rede Dor, São Paulo, Brasil
| | - F Leite
- Department of Gynaecological Surgery, Hospital Israelita Albert Einstein, São Paulo, Brasil
| | - E Werebe
- Department of Gynaecological Surgery, Hospital Israelita Albert Einstein, São Paulo, Brasil
| | - R Cabrera Carranco
- Department of Gynaecological Surgery, Vita Batel Hospital, Curitiba, Brazil
| | - W Kondo William
- Department of Gynaecological Surgery, Vita Batel Hospital, Curitiba, Brazil
| |
Collapse
|
8
|
Esfandyari S, Elkafas H, Chugh RM, Park HS, Navarro A, Al-Hendy A. Exosomes as Biomarkers for Female Reproductive Diseases Diagnosis and Therapy. Int J Mol Sci 2021; 22:ijms22042165. [PMID: 33671587 PMCID: PMC7926632 DOI: 10.3390/ijms22042165] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/14/2021] [Accepted: 02/18/2021] [Indexed: 12/12/2022] Open
Abstract
Cell-cell communication is an essential mechanism for the maintenance and development of various organs, including the female reproductive system. Today, it is well-known that the function of the female reproductive system and successful pregnancy are related to appropriate follicular growth, oogenesis, implantation, embryo development, and proper fertilization, dependent on the main regulators of cellular crosstalk, exosomes. During exosome synthesis, selective packaging of different factors into these vesicles happens within the originating cells. Therefore, exosomes contain both genetic and proteomic data that could be applied as biomarkers or therapeutic targets in pregnancy-associated disorders or placental functions. In this context, the present review aims to compile information about the potential exosomes with key molecular cargos that are dysregulated in female reproductive diseases which lead to infertility, including polycystic ovary syndrome (PCOS), premature ovarian failure (POF), Asherman syndrome, endometriosis, endometrial cancer, cervical cancer, ovarian cancer, and preeclampsia, as well as signaling pathways related to the regulation of the reproductive system and pregnancy outcome during these pathological conditions. This review might help us realize the etiology of reproductive dysfunction and improve the early diagnosis and treatment of the related complications.
Collapse
Affiliation(s)
- Sahar Esfandyari
- Department of Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.E.); (H.E.); (R.M.C.)
- Department of Physiology and Biophysics, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Hoda Elkafas
- Department of Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.E.); (H.E.); (R.M.C.)
- Department of Pharmacology and Toxicology, Egyptian Drug Authority (EDA) Formally, (NODCAR), Cairo 35521, Egypt
| | - Rishi Man Chugh
- Department of Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.E.); (H.E.); (R.M.C.)
- Department of Radiation Oncology, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Hang-soo Park
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA; (H.-s.P.); (A.N.)
| | - Antonia Navarro
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA; (H.-s.P.); (A.N.)
| | - Ayman Al-Hendy
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA; (H.-s.P.); (A.N.)
- Correspondence: ; Tel.: +1-773-832-0742
| |
Collapse
|
9
|
Hirata T, Koga K, Kai K, Katabuchi H, Kitade M, Kitawaki J, Kurihara M, Takazawa N, Tanaka T, Taniguchi F, Nakajima J, Narahara H, Harada T, Horie S, Honda R, Murono K, Yoshimura K, Osuga Y. Clinical practice guidelines for the treatment of extragenital endometriosis in Japan, 2018. J Obstet Gynaecol Res 2020; 46:2474-2487. [PMID: 33078482 PMCID: PMC7756675 DOI: 10.1111/jog.14522] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/28/2020] [Indexed: 01/31/2023]
Abstract
The aim of this publication is to disseminate the clinical practice guidelines for the treatment of intestinal, bladder/ureteral, thoracic and umbilical endometriosis, already published in Japanese, to non-Japanese speakers. For developing the original Japanese guidelines, the clinical practice guideline committee was formed by the research team for extragenital endometriosis, which is part of the research program of intractable disease of the Japanese Ministry of Health, Labor and Welfare. The clinical practice guideline committee formulated eight clinical questions for the treatment of extragenital endometriosis, which were intestinal, bladder/ureteral, thoracic and umbilical endometriosis. The committee performed a systematic review of the literature to provide responses to clinical questions and developed clinical guidelines for extragenital endometriosis, according to the process proposed by the Medical Information Network Distribution Service. The recommendation level was determined using modified Delphi methods. The clinical practice guidelines were officially approved by the Japan Society of Obstetrics and Gynecology and the Japan Society of Endometriosis. This English version was translated from the Japanese version.
Collapse
Affiliation(s)
- Tetsuya Hirata
- Department of Obstetrics and GynecologyDoai Kinen HospitalTokyoJapan
- Department of Obstetrics and GynecologyUniversity of TokyoTokyoJapan
| | - Kaori Koga
- Department of Obstetrics and GynecologyUniversity of TokyoTokyoJapan
| | - Kentaro Kai
- Department of Obstetrics and GynecologyOita UniversityOitaJapan
| | | | - Mari Kitade
- Department of Obstetrics and GynecologyJuntendo UniversityTokyoJapan
| | - Jo Kitawaki
- Department of Obstetrics and GynecologyKyoto Prefectural UniversityKyotoJapan
| | - Masatoshi Kurihara
- Pneumothorax Research Center and Division of Thoracic SurgeryNissan Tamagawa HospitalTokyoJapan
| | | | - Toshiaki Tanaka
- Department of Surgical OncologyUniversity of TokyoTokyoJapan
- Department of SurgeryInternational Catholic HospitalTokyoJapan
| | | | - Jun Nakajima
- Department of Thoracic SurgeryUniversity of TokyoTokyoJapan
| | | | - Tasuku Harada
- Department of Obstetrics and GynecologyTottori UniversityTottoriJapan
| | - Shigeo Horie
- Department of UrologyJuntendo UniversityTokyoJapan
| | - Ritsuo Honda
- Department of Obstetrics and GynecologyKumamoto UniversityKumamotoJapan
| | - Koji Murono
- Department of Surgical OncologyUniversity of TokyoTokyoJapan
| | - Kotaro Yoshimura
- Department of Plastic SurgeryJichi Medical UniversityShimotsukeJapan
| | - Yutaka Osuga
- Department of Obstetrics and GynecologyUniversity of TokyoTokyoJapan
| |
Collapse
|
10
|
Esfandyari S, Chugh RM, Park HS, Hobeika E, Ulin M, Al-Hendy A. Mesenchymal Stem Cells as a Bio Organ for Treatment of Female Infertility. Cells 2020; 9:E2253. [PMID: 33050021 PMCID: PMC7599919 DOI: 10.3390/cells9102253] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/01/2020] [Accepted: 10/03/2020] [Indexed: 12/14/2022] Open
Abstract
Female infertility is a global medical condition that can be caused by various disorders of the reproductive system, including premature ovarian failure (POF), polycystic ovary syndrome (PCOS), endometriosis, Asherman syndrome, and preeclampsia. It affects the quality of life of both patients and couples. Mesenchymal stem cells (MSCs) have received increasing attention as a potential cell-based therapy, with several advantages over other cell sources, including greater abundance, fewer ethical considerations, and high capacity for self-renewal and differentiation. Clinical researchers have examined the therapeutic use of MSCs in female infertility. In this review, we discuss recent studies on the use of MSCs in various reproductive disorders that lead to infertility. We also describe the role of microRNAs (miRNAs) and exosomal miRNAs in controlling MSC gene expression and driving MSC therapeutic outcomes. The clinical application of MSCs holds great promise for the treatment of infertility or ovarian insufficiency, and to improve reproductive health for a significant number of women worldwide.
Collapse
Affiliation(s)
- Sahar Esfandyari
- Department of Surgery, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL 60612, USA; (S.E.); (R.M.C.); (H.-s.P.); (M.U.)
| | - Rishi Man Chugh
- Department of Surgery, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL 60612, USA; (S.E.); (R.M.C.); (H.-s.P.); (M.U.)
| | - Hang-soo Park
- Department of Surgery, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL 60612, USA; (S.E.); (R.M.C.); (H.-s.P.); (M.U.)
| | - Elie Hobeika
- Fertility Centers of Illinois, Glenview, IL 60026, USA;
| | - Mara Ulin
- Department of Surgery, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL 60612, USA; (S.E.); (R.M.C.); (H.-s.P.); (M.U.)
| | - Ayman Al-Hendy
- Department of Surgery, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL 60612, USA; (S.E.); (R.M.C.); (H.-s.P.); (M.U.)
- Department of Obstetrics and Gynecology, University of Chicago, 5841 South Maryland Ave, Chicago, IL 60637, USA
| |
Collapse
|
11
|
Charpentier E, Petit E, Beranger S, Azarine A. Presumption of pericardial endometriosis using MRI: Case report and review of the literature. J Gynecol Obstet Hum Reprod 2019; 48:71-73. [DOI: 10.1016/j.jogoh.2018.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 06/23/2018] [Accepted: 06/28/2018] [Indexed: 10/28/2022]
|
12
|
Hufnagel D, Goetz TG, Hu Z, Nyachieo A, D'Hooghe T, Fazleabas A, Duleba A, Krikun G, Taylor HS, Lockwood CJ. Icon immunoconjugate treatment results in regression of red lesions in a non-human primate (Papio anubis) model of endometriosis. Reprod Biol 2018; 18:109-114. [PMID: 29422377 DOI: 10.1016/j.repbio.2018.01.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 01/20/2018] [Accepted: 01/26/2018] [Indexed: 12/24/2022]
Abstract
Endometriosis is a common condition in reproductive-aged women characterized by ectopic endometrial lesions of varied appearance, including red, white, blue, black or powder burn coloration, which contribute to chronic pain and infertility. The immunoconjugate molecule (Icon) targets Tissue Factor, a transmembrane receptor for Factor VII/VIIa that is aberrantly expressed in the endothelium supporting ectopic endometrial tissue. Icon has been shown to cause regression of endometriosis in a murine model of disease but prior to this study had not been tested in non-human primates. This study evaluated Icon as a novel treatment for endometriosis in non-human primates (Papio anubis) using an adenoviral vector (AdIcon) delivery system. Female baboons (n = 15) underwent surgical induction of endometriosis. After laparoscopic confirmation of endometriosis lesions 6-weeks post-surgery, the treatment group (n = 7) received weekly intraperitoneal injections of viral particles carrying the sequence for Icon, resulting in expression of the protein, while the control group (n = 8) received no treatment. Icon preferentially reduced the number and volume of red vascularized lesions. Icon may present a novel treatment for endometriosis by degrading red vascularized lesions, likely by targeting tissue factor aberrantly expressed in the lesion vasculature.
Collapse
Affiliation(s)
- Demetra Hufnagel
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, United States
| | - Teddy G Goetz
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, United States
| | - Zhiwei Hu
- Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Atunga Nyachieo
- Department of Reproductive Health and Non-Communicable Diseases, Institute of Primate Research, Nairobi, Kenya
| | - Thomas D'Hooghe
- Department of Development and Regeneration, Group Biomedical Sciences, KU Leuven (University of Leuven), Campus Gasthuisberg, Leuven, Belgium
| | - Asgerally Fazleabas
- Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, Grand Rapids, MI, United States
| | - Antoni Duleba
- Department of Reproductive Medicine, University of California San Diego, San Diego, CA, United States
| | - Graciela Krikun
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, United States.
| | - Hugh S Taylor
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, United States
| | - Charles J Lockwood
- Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| |
Collapse
|
13
|
Cosma S, Ceccaroni M, Benedetto C. A pseudoneoplastic finding of deep endometriosis: laparoscopic triple segmental bowel resection. Wideochir Inne Tech Maloinwazyjne 2014; 9:463-7. [PMID: 25337175 PMCID: PMC4198630 DOI: 10.5114/wiitm.2014.41617] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 10/05/2013] [Accepted: 11/05/2013] [Indexed: 11/17/2022] Open
Abstract
Bowel endometriosis affects 3-37% of patients with endometriosis, involving more frequently the rectum and the rectosigmoid junction. Severe endometriosis with bowel involvement is often refractory to standard medical therapy. For these reasons, surgery for bowel treatment is frequently needed. We report the case of a 36-year-old woman with deep endometriosis of the pelvis, triple segmental bowel involvement (recto-sigma, ileum-cecum, transverse colon) and massive endometriotic ascites with secondary Glisson's capsule inflammation, refractory to medical therapy. A laparoscopic triple segmental bowel resection and complete fertility sparing excision of pelvic endometriotic lesions was performed. At 48 months of follow-up, the woman was asymptomatic, with no evidence of recurrence of disease or ascites. Laparoscopic segmental bowel resection, including multiple section, is feasible in selected symptomatic patients with consequent improved quality of life, morbidity rates similar to those achieved by laparotomy and with a less detrimental effect on fertility.
Collapse
Affiliation(s)
- Stefano Cosma
- Department of Gynecology and Obstetrics, Sant'Anna Hospital, University of Turin, Turin, Italy
| | - Marcello Ceccaroni
- Department of Gynecology and Obstetrics, Gynecologic Oncology Division, International School of Surgical Anatomy, European Gynecology Endoscopy School, Sacred Heart Hospital, Negrar, Verona, Italy
| | - Chiara Benedetto
- Department of Gynecology and Obstetrics, Sant'Anna Hospital, University of Turin, Turin, Italy
| |
Collapse
|
14
|
Paramythiotis D, Stavrou G, Panidis S, Panagiotou D, Chatzopoulos K, Papadopoulos VN, Michalopoulos A. Concurrent appendiceal and umbilical endometriosis: a case report and review of the literature. J Med Case Rep 2014; 8:258. [PMID: 25052818 PMCID: PMC4131801 DOI: 10.1186/1752-1947-8-258] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Accepted: 06/02/2014] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Endometriosis affects 3 to 10 percent of women of reproductive age. Most of the time it involves the pelvis; however, sites of endometriosis have been reported almost anywhere in the body. Appendiceal and primary umbilical endometriosis are considered rare loci, making accurate diagnosis elusive. Here we present the case of a 46-year-old woman with concurrent appendiceal and umbilical endometriosis. CASE PRESENTATION A 46-year-old Greek woman presented with a large mass in the lower abdomen adhering to the surrounding organs. She reported recurrent lower abdominal and pelvic pain and the presence of a dark-blue hard nodule at the umbilicus. She had no previous medical, surgical or gynecological history. Her physical examination and laboratory test results were without any significant findings. The laparotomy revealed a fibromatose uterus adhering to the rectum and a urinary cyst and a palpable mass in the vermiform appendix. A hysterectomy and an appendectomy were performed. The umbilical mass was also excised. Pathology revealed endometriosis of the umbilicus and the appendix. The postoperative period was uneventful and she was discharged. CONCLUSIONS Endometriosis, although rare, should always be considered in women of reproductive age, presenting with cyclic pain. The diagnosis is, most of the time, difficult and requires a high degree of clinical suspicion. The clinical doctor should be aware that endometriosis can sometimes be multifocal, thus a thorough investigation is required in all cases.
Collapse
Affiliation(s)
| | | | - Stavros Panidis
- First Propedeutic Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, St Kyriakidi 1, 54636 Thessaloniki, Greece.
| | | | | | | | | |
Collapse
|