Pub Date : 2021-02-07DOI: 10.1177/2284026521990465
A. Haghgoo, A. Shervin, S. Chaichian, M. Ghahremani, A. Mehdizadeh Kashi, F. Akhbari
Background: Endometriosis is a chronic disease mostly affecting women at reproductive age. Some evidence suggests that surgery of ovarian endometrioma may have a detrimental effect on ovarian reserve. The aim of this study was to evaluate the changes of serum antimullerian hormone (AMH) levels in patients with endometrioma after cystectomy. Methods: A prospective study was performed at Nikan hospital on 58 patients with endometrioma who underwent laparoscopic cystectomy. Of them, 30 had unilateral endometrioma and 28 had bilateral endometrioma. Complete excision was done, pelvic endometriosis implants as well as deep infiltrative endometriosis was resected. Sutures were made for the closure of ovarian parenchyma and bleeding control. We did not use any hot energy devices such as cautery on ovaries for ablation, coagulation or resection of endometrioma. Serum AMH levels were measured preoperatively, 3, 9, and 15 months postoperatively. Results: Serum AMH levels decreased significantly from the preoperative sample (2.98 ± 2.47 ng/ml) to 3 months after laparoscopy (1.07 ± 1.06 ng/ml), then gradually increased 9 months (1.47 ± 1.16 ng/ml) and 15 months (1.95 ± 1.85 ng/ml) after surgery, without returning to the preoperative levels during the follow-up time of study. Conclusion: There is a fluctuation pattern in AMH levels from preoperative to 15-month follow-up after endometrioma surgery using only suture for ovarian hemostasis. Firstly, there is decline in AMH level 3 months after surgery, then an increasing trend was observed gradually up to 15 months after surgery. Controlled studies are needed to compare the effects of various cystectomy methods on the ovarian reserve after endometrioma surgery
{"title":"Increasing trend of serum antimullerian hormone level after long term follow up of endometrioma resection","authors":"A. Haghgoo, A. Shervin, S. Chaichian, M. Ghahremani, A. Mehdizadeh Kashi, F. Akhbari","doi":"10.1177/2284026521990465","DOIUrl":"https://doi.org/10.1177/2284026521990465","url":null,"abstract":"Background: Endometriosis is a chronic disease mostly affecting women at reproductive age. Some evidence suggests that surgery of ovarian endometrioma may have a detrimental effect on ovarian reserve. The aim of this study was to evaluate the changes of serum antimullerian hormone (AMH) levels in patients with endometrioma after cystectomy. Methods: A prospective study was performed at Nikan hospital on 58 patients with endometrioma who underwent laparoscopic cystectomy. Of them, 30 had unilateral endometrioma and 28 had bilateral endometrioma. Complete excision was done, pelvic endometriosis implants as well as deep infiltrative endometriosis was resected. Sutures were made for the closure of ovarian parenchyma and bleeding control. We did not use any hot energy devices such as cautery on ovaries for ablation, coagulation or resection of endometrioma. Serum AMH levels were measured preoperatively, 3, 9, and 15 months postoperatively. Results: Serum AMH levels decreased significantly from the preoperative sample (2.98 ± 2.47 ng/ml) to 3 months after laparoscopy (1.07 ± 1.06 ng/ml), then gradually increased 9 months (1.47 ± 1.16 ng/ml) and 15 months (1.95 ± 1.85 ng/ml) after surgery, without returning to the preoperative levels during the follow-up time of study. Conclusion: There is a fluctuation pattern in AMH levels from preoperative to 15-month follow-up after endometrioma surgery using only suture for ovarian hemostasis. Firstly, there is decline in AMH level 3 months after surgery, then an increasing trend was observed gradually up to 15 months after surgery. Controlled studies are needed to compare the effects of various cystectomy methods on the ovarian reserve after endometrioma surgery","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"13 1","pages":"98 - 103"},"PeriodicalIF":0.5,"publicationDate":"2021-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2284026521990465","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41826725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-19DOI: 10.1177/2284026520987915
A. Hismiogullari, Gurhan Guney, Mine İSLİMYE TAŞKIN, Berna Güngörmus
Objectives: ADAMTS (A Disintegrin And Metalloproteinase with ThromboSpondin repeats) proteinases, which are released outside the cell (soluble) have very critical roles in damage and repair of extracellular matrix (ECM) processes. Our aim was to analyse the ADAMTS-1 and ADAMTS-9 which were the member of the ADAMTS gene family of metalloproteinases that might had been involved in the cytokines-mediated etiopathogenesis of endometriosis. Methods: A case-control study was performed in an university hospital. Thirty-four patient with endometriosis which was defined via laparoscopy and thirty-three healthy female volunteers were recruited in the present study. Serum ADAMTS-1 and ADAMTS-9 and IL-beta (IL-1 β) and vascular endothelial growth factor (VEGF) levels were determined by a human enzyme-linked immunoassay (ELISA) in all subjects. Results: The demographic characteristics of the patients were significantly higher than healthy control group. The IL-1 β and VEGF levels were significantly higher; ADAMTS-1 and ADAMTS-9 levels were significantly lower in the endometriosis patients compared to the controls. We also found a negative correlation between ADAMTS-1, ADAMTS-9, and IL-1 β, VEGF. Conclusion: The results of the study might suggest that ADAMS-1 and ADAMTS-9 have a role in the pathogenesis of the endometriosis.
{"title":"ADAMS-1 and ADAMS-9, novel markers in endometriosis","authors":"A. Hismiogullari, Gurhan Guney, Mine İSLİMYE TAŞKIN, Berna Güngörmus","doi":"10.1177/2284026520987915","DOIUrl":"https://doi.org/10.1177/2284026520987915","url":null,"abstract":"Objectives: ADAMTS (A Disintegrin And Metalloproteinase with ThromboSpondin repeats) proteinases, which are released outside the cell (soluble) have very critical roles in damage and repair of extracellular matrix (ECM) processes. Our aim was to analyse the ADAMTS-1 and ADAMTS-9 which were the member of the ADAMTS gene family of metalloproteinases that might had been involved in the cytokines-mediated etiopathogenesis of endometriosis. Methods: A case-control study was performed in an university hospital. Thirty-four patient with endometriosis which was defined via laparoscopy and thirty-three healthy female volunteers were recruited in the present study. Serum ADAMTS-1 and ADAMTS-9 and IL-beta (IL-1 β) and vascular endothelial growth factor (VEGF) levels were determined by a human enzyme-linked immunoassay (ELISA) in all subjects. Results: The demographic characteristics of the patients were significantly higher than healthy control group. The IL-1 β and VEGF levels were significantly higher; ADAMTS-1 and ADAMTS-9 levels were significantly lower in the endometriosis patients compared to the controls. We also found a negative correlation between ADAMTS-1, ADAMTS-9, and IL-1 β, VEGF. Conclusion: The results of the study might suggest that ADAMS-1 and ADAMTS-9 have a role in the pathogenesis of the endometriosis.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"13 1","pages":"122 - 126"},"PeriodicalIF":0.5,"publicationDate":"2021-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2284026520987915","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46353257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-18DOI: 10.1177/2284026520984412
L. McAlarnen, Jean Ricci Goodman, A. Sarwark, A. Winder, R. Potkul, M. Liotta
Objective: Here we present a pilot study investigating the prevalence of pelvic floor myofascial pain in patients presenting to an academic tertiary care gynecologic oncology clinic. We describe patients’ responses to a pain survey including the pain disability index. Methods: An IRB approved prospective survey and chart review was conducted. Patients underwent standard physical exam maneuvers for detection of pelvic floor myofascial pain. Consented patients completed a pain survey and pain disability index on presentation to clinic. Statistical analysis included Chi square test and Mann Whitney test. Results: Twenty-nine percent (45/155) of patients exhibited pelvic floor myofascial pain, while 71% (110/155) did not. Of those with malignancy, 28% (16/57) had pelvic floor myofascial pain and 72% (41/57) did not. Patients with pelvic floor myofascial pain had a significantly higher rating of “pain right now” (p = 0.001) and “usual level of pain during the past week” (p = 0.003) than those without such pain. Patients with pelvic floor myofascial pain had significantly greater disability in family/home responsibilities (p = 0.01), recreation (p = 0.001), social activity (p = 0.008), occupation (p = 0.015), sexual behavior (p = 0.025), and life support activities (p = 0.007) compared to those without pelvic floor myofascial pain. Conclusion: Pelvic floor myofascial pain affects 28% of patients with malignancy. Routine incorporation of a myofascial exam can identity those with such pain, which can lead to improved quality of life in gynecologic oncology patients with pelvic floor disorders.
{"title":"Pelvic floor myofascial pain in gynecology oncology patients: A pilot study","authors":"L. McAlarnen, Jean Ricci Goodman, A. Sarwark, A. Winder, R. Potkul, M. Liotta","doi":"10.1177/2284026520984412","DOIUrl":"https://doi.org/10.1177/2284026520984412","url":null,"abstract":"Objective: Here we present a pilot study investigating the prevalence of pelvic floor myofascial pain in patients presenting to an academic tertiary care gynecologic oncology clinic. We describe patients’ responses to a pain survey including the pain disability index. Methods: An IRB approved prospective survey and chart review was conducted. Patients underwent standard physical exam maneuvers for detection of pelvic floor myofascial pain. Consented patients completed a pain survey and pain disability index on presentation to clinic. Statistical analysis included Chi square test and Mann Whitney test. Results: Twenty-nine percent (45/155) of patients exhibited pelvic floor myofascial pain, while 71% (110/155) did not. Of those with malignancy, 28% (16/57) had pelvic floor myofascial pain and 72% (41/57) did not. Patients with pelvic floor myofascial pain had a significantly higher rating of “pain right now” (p = 0.001) and “usual level of pain during the past week” (p = 0.003) than those without such pain. Patients with pelvic floor myofascial pain had significantly greater disability in family/home responsibilities (p = 0.01), recreation (p = 0.001), social activity (p = 0.008), occupation (p = 0.015), sexual behavior (p = 0.025), and life support activities (p = 0.007) compared to those without pelvic floor myofascial pain. Conclusion: Pelvic floor myofascial pain affects 28% of patients with malignancy. Routine incorporation of a myofascial exam can identity those with such pain, which can lead to improved quality of life in gynecologic oncology patients with pelvic floor disorders.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"13 1","pages":"142 - 148"},"PeriodicalIF":0.5,"publicationDate":"2021-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2284026520984412","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48624035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-10DOI: 10.1177/2284026520985715
O. Mutter, S. Ackroyd, G. A. Taylor, Juan Díaz
Introduction: We aimed to evaluate surgical outcomes of hysterectomy for endometriosis performed by general obstetricians and gynecologists (OB/GYNs) based on surgical approach. Methods: Using the 2016–2018 National Surgical Quality Improvement Program (NSQIP) database, we examined surgical outcomes including 30-day complication rates based on surgical approach in patients who underwent a hysterectomy for endometriosis by OB/GYNs. Results: From 2016 to 2018, 3641 hysterectomies were performed by OB/GYNs for endometriosis. 86.0% were performed via a minimally invasive (MIS) approach, with 2882 (79.2%) via a laparoscopic and 247 (6.8%) via a vaginal approach. Compared to MIS hysterectomies, those who underwent an abdominal hysterectomy included a higher proportion of African American and a lower proportion of non-Hispanic white patients, had heavier uteri, lower parity, and were more likely obese (all p < 0.05). There were no differences in age, American Society of Anesthesiologists class, comorbidities other than obesity, or a history of prior abdominal or pelvic surgery (all p > 0.05). Women undergoing hysterectomy for endometriosis experienced an overall 9.8% complication rate. Compared to abdominal approaches, MIS had a lower rate of overall complications (8.5% vs 17.8%) including wound (2.7% vs 7.2%) and major (4.4% vs 8.8%) complications (all p < 0.001). MIS had shorter operative time (129.2 ± 60.9 vs 143.8 ± 71.9), shorter length of stay (0.9 ± 1.6 vs 2.4 ± 1.8), and fewer readmissions (2.8% vs 5.5%) (all p < 0.001). Conclusion: While hysterectomy for endometriosis is a challenging procedure to perform, OB/GYNs are performing this procedure predominantly via a minimally invasive approach with fewer complications and more favorable surgical outcomes than an abdominal approach.
简介:我们的目的是评估普通妇产科医生(OB/GYNs)基于手术入路的子宫切除术治疗子宫内膜异位症的手术效果。方法:使用2016-2018年国家手术质量改进计划(NSQIP)数据库，我们检查了由OB/GYNs接受子宫切除术治疗子宫内膜异位症患者的手术结果，包括基于手术入路的30天并发症发生率。结果:2016年至2018年，共有3641例子宫内膜异位症患者接受了子宫切除术。86.0%采用微创入路，其中2882例(79.2%)采用腹腔镜入路，247例(6.8%)采用阴道入路。与MIS子宫切除术相比，接受腹部子宫切除术的非裔美国人比例更高，非西班牙裔白人比例更低，子宫更重，胎次更低，更容易肥胖(均p < 0.05)。因子宫内膜异位症而接受子宫切除术的妇女的并发症发生率为9.8%。与腹部入路相比，MIS的总并发症发生率(8.5%比17.8%)较低，包括伤口(2.7%比7.2%)和主要并发症(4.4%比8.8%)(均p < 0.001)。MIS的手术时间较短(129.2±60.9 vs 143.8±71.9)，住院时间较短(0.9±1.6 vs 2.4±1.8)，再入院率较低(2.8% vs 5.5%)(均p < 0.001)。结论:虽然子宫内膜异位症的子宫切除术是一项具有挑战性的手术，但OB/ gyn主要通过微创入路进行该手术，其并发症更少，手术效果比腹部入路更好。
{"title":"Surgical outcomes of hysterectomy for endometriosis: Benefits of a minimally invasive approach","authors":"O. Mutter, S. Ackroyd, G. A. Taylor, Juan Díaz","doi":"10.1177/2284026520985715","DOIUrl":"https://doi.org/10.1177/2284026520985715","url":null,"abstract":"Introduction: We aimed to evaluate surgical outcomes of hysterectomy for endometriosis performed by general obstetricians and gynecologists (OB/GYNs) based on surgical approach. Methods: Using the 2016–2018 National Surgical Quality Improvement Program (NSQIP) database, we examined surgical outcomes including 30-day complication rates based on surgical approach in patients who underwent a hysterectomy for endometriosis by OB/GYNs. Results: From 2016 to 2018, 3641 hysterectomies were performed by OB/GYNs for endometriosis. 86.0% were performed via a minimally invasive (MIS) approach, with 2882 (79.2%) via a laparoscopic and 247 (6.8%) via a vaginal approach. Compared to MIS hysterectomies, those who underwent an abdominal hysterectomy included a higher proportion of African American and a lower proportion of non-Hispanic white patients, had heavier uteri, lower parity, and were more likely obese (all p < 0.05). There were no differences in age, American Society of Anesthesiologists class, comorbidities other than obesity, or a history of prior abdominal or pelvic surgery (all p > 0.05). Women undergoing hysterectomy for endometriosis experienced an overall 9.8% complication rate. Compared to abdominal approaches, MIS had a lower rate of overall complications (8.5% vs 17.8%) including wound (2.7% vs 7.2%) and major (4.4% vs 8.8%) complications (all p < 0.001). MIS had shorter operative time (129.2 ± 60.9 vs 143.8 ± 71.9), shorter length of stay (0.9 ± 1.6 vs 2.4 ± 1.8), and fewer readmissions (2.8% vs 5.5%) (all p < 0.001). Conclusion: While hysterectomy for endometriosis is a challenging procedure to perform, OB/GYNs are performing this procedure predominantly via a minimally invasive approach with fewer complications and more favorable surgical outcomes than an abdominal approach.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"13 1","pages":"83 - 88"},"PeriodicalIF":0.5,"publicationDate":"2021-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2284026520985715","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46565916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-03DOI: 10.1177/2284026520984364
M. Bazot, M. Delaveau, E. Daraï, S. Bendifallah
Objectives: The aims of the study were to evaluate ultrasound (US) in the diagnosis of parametrial endometriosis compared with surgical-pathological findings, and to define an optimal cut-off of lesion size for correlation between torus/uterosacral ligaments (USL) or rectosigmoid and parametrial involvement by deep endometriosis. Methods: Longitudinal study of 60 patients referred for surgical management of pelvic endometriosis, who underwent sonography performed by an experienced sonographer. The presence of parametrial endometriosis shown by US was compared with surgical and histologic findings. The presence of endometrial cysts, deep endometriotic locations, and their potential association with parametrial endometriosis was assessed by US. The sensitivity, specificity, predictive values (PV), accuracy, and positive and negative likelihood ratios (LR) of US for predicting parametrial endometriosis and other pelvic endometriotic locations were assessed. Descriptive analysis, optimal cut-off analysis, categorical (Fisher’s exact test) and non-categorical variables (Mann—Whitney) were calculated. Results: Parametrial, ovarian, and deep endometriosis were found by surgery in respectively 30 (50%), 21 (35%), and 59 (98.63%) of the 60 patients. The sensitivity, specificity, PPV, NPV, accuracy, PLR, and NLR of US for the sonographic diagnosis of parametrial endometriosis were 40%, 96.7%, 92.3%, 61.7%, 68.3%, 12, and 0.62 respectively. In patients with parametrial involvement, a relation with rectosigmoid (p = 0.005) and USL (p = 0.0074) endometriosis was noted. For isolated torus/USL and rectosigmoid endometriosis, optimal cut-offs suggesting parametrial involvement by DE were 11 mm and 30 mm, respectively. Conclusions: US has low sensitivity but high specificity to diagnose parametrial endometriosis and could be used to rule in diagnosis before surgery.
{"title":"Value of sonography in assessing parametrial endometriotic involvement: Preliminary results","authors":"M. Bazot, M. Delaveau, E. Daraï, S. Bendifallah","doi":"10.1177/2284026520984364","DOIUrl":"https://doi.org/10.1177/2284026520984364","url":null,"abstract":"Objectives: The aims of the study were to evaluate ultrasound (US) in the diagnosis of parametrial endometriosis compared with surgical-pathological findings, and to define an optimal cut-off of lesion size for correlation between torus/uterosacral ligaments (USL) or rectosigmoid and parametrial involvement by deep endometriosis. Methods: Longitudinal study of 60 patients referred for surgical management of pelvic endometriosis, who underwent sonography performed by an experienced sonographer. The presence of parametrial endometriosis shown by US was compared with surgical and histologic findings. The presence of endometrial cysts, deep endometriotic locations, and their potential association with parametrial endometriosis was assessed by US. The sensitivity, specificity, predictive values (PV), accuracy, and positive and negative likelihood ratios (LR) of US for predicting parametrial endometriosis and other pelvic endometriotic locations were assessed. Descriptive analysis, optimal cut-off analysis, categorical (Fisher’s exact test) and non-categorical variables (Mann—Whitney) were calculated. Results: Parametrial, ovarian, and deep endometriosis were found by surgery in respectively 30 (50%), 21 (35%), and 59 (98.63%) of the 60 patients. The sensitivity, specificity, PPV, NPV, accuracy, PLR, and NLR of US for the sonographic diagnosis of parametrial endometriosis were 40%, 96.7%, 92.3%, 61.7%, 68.3%, 12, and 0.62 respectively. In patients with parametrial involvement, a relation with rectosigmoid (p = 0.005) and USL (p = 0.0074) endometriosis was noted. For isolated torus/USL and rectosigmoid endometriosis, optimal cut-offs suggesting parametrial involvement by DE were 11 mm and 30 mm, respectively. Conclusions: US has low sensitivity but high specificity to diagnose parametrial endometriosis and could be used to rule in diagnosis before surgery.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"13 1","pages":"58 - 65"},"PeriodicalIF":0.5,"publicationDate":"2021-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2284026520984364","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43271482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-03DOI: 10.1177/2284026520984415
Samaneh Youseflu, S. J. Sadatmahalleh, A. Mottaghi, M. Nasiri
Background: Endometriosis is defined as the presence of functioning endometrial tissue in extra uterine structures that causes pain, infertility and reduced quality of life. Diet plays an important role in the modulation of endometriosis. Aim: This study aimed to evaluate the association between the dietary inflammatory index (DII) score and the endometriosis compared to healthy people in a case-control study in Iran. Methods: This study included 78 women with laparoscopically confirmed endometriosis and 78 women with normal pelvis. The DII was calculated from dietary intake assessed using a validated food frequency questionnaire. The association between DII scores (divided in tertiles) and endometriosis risk was investigated using logistic regression analysis and reported as odds ratios (ORs) and 95% confidence intervals (CI) adjusted for age, energy, BMI, education, para, smoking, pelvic pain, menorrhagia, stage of endometriosis, physical activity, and income. Results: In the age-adjusted models, subjects who consumed more pro-inflammatory diets (the upper tertile of DII) had an OR of 2.24 (95% CI = 2.03, 3.91) as compared to subjects in the lowest tertile. Also after multivariable adjustment, women in the highest tertile of DII (versus lowest tertile) were more likely to have endometriosis (OR 2.63; 95% CI 1.88–2.91, p = 0.004). Conclusion: Our results suggest that women with more consumption of pro-inflammatory diet were at increased endometriosis risk.
背景:子宫内膜异位症被定义为子宫外结构中存在功能性子宫内膜组织，导致疼痛、不孕和生活质量下降。饮食在子宫内膜异位症的调节中起重要作用。目的:本研究旨在评估饮食炎症指数(DII)评分与子宫内膜异位症之间的关系，并与伊朗的一项病例对照研究中的健康人进行比较。方法:本研究包括78名经腹腔镜确认的子宫内膜异位症妇女和78名骨盆正常的妇女。DII是根据膳食摄入量计算的，使用有效的食物频率问卷进行评估。使用logistic回归分析调查DII评分(以位数划分)与子宫内膜异位症风险之间的关系，并以比值比(ORs)和95%置信区间(CI)报告，调整了年龄、能量、BMI、教育程度、para、吸烟、盆腔疼痛、月经过多、子宫内膜异位症分期、体育活动和收入。结果:在年龄调整模型中，与最低五分之一的受试者相比，食用更多促炎饮食的受试者(DII的上五分之一)的OR为2.24 (95% CI = 2.03, 3.91)。同样，在多变量调整后，DII最高分位数的女性(与最低分位数的女性相比)更容易患子宫内膜异位症(OR 2.63;95% CI 1.88-2.91, p = 0.004)。结论:我们的研究结果表明，食用促炎饮食的女性患子宫内膜异位症的风险增加。
{"title":"Association between dietary inflammatory index and endometriosis risk in a case-control study","authors":"Samaneh Youseflu, S. J. Sadatmahalleh, A. Mottaghi, M. Nasiri","doi":"10.1177/2284026520984415","DOIUrl":"https://doi.org/10.1177/2284026520984415","url":null,"abstract":"Background: Endometriosis is defined as the presence of functioning endometrial tissue in extra uterine structures that causes pain, infertility and reduced quality of life. Diet plays an important role in the modulation of endometriosis. Aim: This study aimed to evaluate the association between the dietary inflammatory index (DII) score and the endometriosis compared to healthy people in a case-control study in Iran. Methods: This study included 78 women with laparoscopically confirmed endometriosis and 78 women with normal pelvis. The DII was calculated from dietary intake assessed using a validated food frequency questionnaire. The association between DII scores (divided in tertiles) and endometriosis risk was investigated using logistic regression analysis and reported as odds ratios (ORs) and 95% confidence intervals (CI) adjusted for age, energy, BMI, education, para, smoking, pelvic pain, menorrhagia, stage of endometriosis, physical activity, and income. Results: In the age-adjusted models, subjects who consumed more pro-inflammatory diets (the upper tertile of DII) had an OR of 2.24 (95% CI = 2.03, 3.91) as compared to subjects in the lowest tertile. Also after multivariable adjustment, women in the highest tertile of DII (versus lowest tertile) were more likely to have endometriosis (OR 2.63; 95% CI 1.88–2.91, p = 0.004). Conclusion: Our results suggest that women with more consumption of pro-inflammatory diet were at increased endometriosis risk.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"13 1","pages":"77 - 82"},"PeriodicalIF":0.5,"publicationDate":"2021-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2284026520984415","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46843913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1007/978-3-030-56387-5
A. Biroli
{"title":"Chronic Pelvic Pain and Pelvic Dysfunctions: Assessment and Multidisciplinary Approach","authors":"A. Biroli","doi":"10.1007/978-3-030-56387-5","DOIUrl":"https://doi.org/10.1007/978-3-030-56387-5","url":null,"abstract":"","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"7 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87647836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-07DOI: 10.1177/2284026520977996
H. S. Abdalla Ribeiro, Beatriz Taliberti da Costa Porto, L. Bassoi, Graziela Y Ninomiya, M. Tomasi, Graziele V Cervantes, P. Ribeiro
Introduction: In this study, we evaluated the relationships between symptoms of bladder endometriosis (EDT), lesion size, and the subsequent surgical technique used to excise the lesion. Methods: This is retrospective observational study of patients who underwent surgery in the Gynecological Endoscopy and Endometriosis Section at Hospital da Santa Casa of São Paulo, Brazil. A sample population of 39 women diagnosed with bladder EDT was included from 463 women presenting with deep pelvic EDT between January 2010 and March 2017. Clinical evaluations and surgical treatments for each EDT were performed. Results: Of the 39 women, 43.58% had dysmenorrhea or dyspareunia and 2.56% had hematuria. Furthermore, 21.10% presented with dysuria and endometriotic nodules on the bladder (p < 0.04). The nodules had reached the muscle layer in 97.30% of patients, and a further 2.60% had reached the mucosal layer. In addition to bladder involvement, other pelvic regions were affected, including the left (15.8%) and right (13.2%) round ligament, left (68.4%) and right (65.8%) uterosacral ligament, retrocervical region (84.20%), and ureter (45.71%). Conclusion: The patients’ pain symptoms were found to be associated with bladder endometriosis and nodule size. Partial cystectomy with complete lesion excision might be an effective treatment option to relieve these symptoms. A study with a larger sample population is needed to confirm these findings.
{"title":"Effect of nodule size on symptoms and the choice of surgical technique in patients with bladder endometriosis","authors":"H. S. Abdalla Ribeiro, Beatriz Taliberti da Costa Porto, L. Bassoi, Graziela Y Ninomiya, M. Tomasi, Graziele V Cervantes, P. Ribeiro","doi":"10.1177/2284026520977996","DOIUrl":"https://doi.org/10.1177/2284026520977996","url":null,"abstract":"Introduction: In this study, we evaluated the relationships between symptoms of bladder endometriosis (EDT), lesion size, and the subsequent surgical technique used to excise the lesion. Methods: This is retrospective observational study of patients who underwent surgery in the Gynecological Endoscopy and Endometriosis Section at Hospital da Santa Casa of São Paulo, Brazil. A sample population of 39 women diagnosed with bladder EDT was included from 463 women presenting with deep pelvic EDT between January 2010 and March 2017. Clinical evaluations and surgical treatments for each EDT were performed. Results: Of the 39 women, 43.58% had dysmenorrhea or dyspareunia and 2.56% had hematuria. Furthermore, 21.10% presented with dysuria and endometriotic nodules on the bladder (p < 0.04). The nodules had reached the muscle layer in 97.30% of patients, and a further 2.60% had reached the mucosal layer. In addition to bladder involvement, other pelvic regions were affected, including the left (15.8%) and right (13.2%) round ligament, left (68.4%) and right (65.8%) uterosacral ligament, retrocervical region (84.20%), and ureter (45.71%). Conclusion: The patients’ pain symptoms were found to be associated with bladder endometriosis and nodule size. Partial cystectomy with complete lesion excision might be an effective treatment option to relieve these symptoms. A study with a larger sample population is needed to confirm these findings.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"13 1","pages":"53 - 57"},"PeriodicalIF":0.5,"publicationDate":"2020-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2284026520977996","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49656438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-11DOI: 10.1177/2284026520970813
Jason Gandhi, Anthony L. Wilson, Raymond Liang, Steven J Weissbart, S. Khan
Endometriosis is a condition in which there is an ectopic growth of endometrial tissue. Sciatic endometriosis, otherwise known as catamenial sciatica, is a rare but exceedingly significant presentation of endometriosis. Symptoms include cyclic sciatic pain that peaks during the menstrual period; additionally, paresthesia, paresis, and areflexia may occur with this condition. Sciatic endometriosis can be presumptively diagnosed in response to empiric treatment (e.g. gonadotropin-releasing hormone analogs) or imaging studies, but a definitive diagnosis of sciatic endometriosis may occur from examining tissue obtained during surgery. Surgical removal of endometriosis from the sciatic nerve root can potentially eliminate symptoms while maintaining normal reproductive function, though poses particular surgical risks. Familiarity with this rare condition is paramount to making this diagnosis and the initiation of earlier treatment.
{"title":"Sciatic endometriosis: A narrative review of an unusual neurogynecologic condition","authors":"Jason Gandhi, Anthony L. Wilson, Raymond Liang, Steven J Weissbart, S. Khan","doi":"10.1177/2284026520970813","DOIUrl":"https://doi.org/10.1177/2284026520970813","url":null,"abstract":"Endometriosis is a condition in which there is an ectopic growth of endometrial tissue. Sciatic endometriosis, otherwise known as catamenial sciatica, is a rare but exceedingly significant presentation of endometriosis. Symptoms include cyclic sciatic pain that peaks during the menstrual period; additionally, paresthesia, paresis, and areflexia may occur with this condition. Sciatic endometriosis can be presumptively diagnosed in response to empiric treatment (e.g. gonadotropin-releasing hormone analogs) or imaging studies, but a definitive diagnosis of sciatic endometriosis may occur from examining tissue obtained during surgery. Surgical removal of endometriosis from the sciatic nerve root can potentially eliminate symptoms while maintaining normal reproductive function, though poses particular surgical risks. Familiarity with this rare condition is paramount to making this diagnosis and the initiation of earlier treatment.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"13 1","pages":"3 - 9"},"PeriodicalIF":0.5,"publicationDate":"2020-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2284026520970813","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42305644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-03DOI: 10.1177/2284026520967599
Clarissa Viana Demézio da Silva, Valéria Lauriana Felipe, N. Shivappa, J. Hébert, J. Perini, Patricia Dias de Brito, J. V. Cardoso, Renato Ferrari, G. L. de Almeida Filho
The possible relationship between chronic inflammation from dietary exposure and endometriosis has not been investigated. Thus, the aim of this study was to investigate the association between the Dietary Inflammatory Index (DII®) and endometriosis. Women with endometriotic lesions were defined as cases (n = 59), and controls (n = 59) had no visible ectopic endometrium sites. Body mass index (BMI=weight(kg)/height(m)2) was calculated from measured height and weight and waist circumference was measured. A validated semi-quantitative food frequency questionnaire was used to calculate the DII score. Women with endometriosis were younger, thinner; and had a more pro-inflammatory diet and more pain (dysmenorrhea, chronic pelvic pain, deep dyspareunia), than controls. Women with higher DII scores (>0.86) were more likely to have endometriosis and to present with dyspareunia. Results obtained from modeling DII as a categorical variable in relation to risk of endometriosis showed a near tripling of risk (OR = 2.77; 95% CI = 1.13–6.77) for women with DII >0.86 versus those with DII ⩽ 0.86, after adjusting for age and BMI. After multivariable adjustment, women with DII > 0.86 were four times more likely to have endometriosis compared to women with DII ⩽ 0.86 (OR = 4.14; 95% CI= 1.50–11.4). In conclusion, a pro-inflammatory diet was significantly associated with endometriosis.
膳食暴露引起的慢性炎症与子宫内膜异位症之间可能存在的关系尚未得到调查。因此，本研究的目的是探讨饮食炎症指数(DII®)与子宫内膜异位症之间的关系。有子宫内膜异位病变的女性被定义为病例(n = 59)，对照组(n = 59)没有可见的子宫内膜异位。体重指数(BMI=体重(kg)/身高(m)2)由测量的身高和体重计算，并测量腰围。采用经过验证的半定量食物频率问卷来计算DII评分。患有子宫内膜异位症的女性更年轻、更瘦;与对照组相比，他们有更多的促炎饮食和更多的疼痛(痛经、慢性盆腔疼痛、深度性交困难)。DII评分较高的女性(>.86)更容易出现子宫内膜异位症和性交困难。将DII作为与子宫内膜异位症风险相关的分类变量建模的结果显示，风险增加了近三倍(OR = 2.77;95% CI = 1.13-6.77)，在调整年龄和BMI后，DII≥0.86的女性与DII≥0.86的女性的差异。多变量调整后，与DII≥0.86的女性相比，DII≥0.86的女性发生子宫内膜异位症的可能性高4倍(OR = 4.14;95% ci = 1.50-11.4)。总之，促炎饮食与子宫内膜异位症显著相关。
{"title":"Dietary Inflammatory Index score and risk of developing endometriosis: A case–control study","authors":"Clarissa Viana Demézio da Silva, Valéria Lauriana Felipe, N. Shivappa, J. Hébert, J. Perini, Patricia Dias de Brito, J. V. Cardoso, Renato Ferrari, G. L. de Almeida Filho","doi":"10.1177/2284026520967599","DOIUrl":"https://doi.org/10.1177/2284026520967599","url":null,"abstract":"The possible relationship between chronic inflammation from dietary exposure and endometriosis has not been investigated. Thus, the aim of this study was to investigate the association between the Dietary Inflammatory Index (DII®) and endometriosis. Women with endometriotic lesions were defined as cases (n = 59), and controls (n = 59) had no visible ectopic endometrium sites. Body mass index (BMI=weight(kg)/height(m)2) was calculated from measured height and weight and waist circumference was measured. A validated semi-quantitative food frequency questionnaire was used to calculate the DII score. Women with endometriosis were younger, thinner; and had a more pro-inflammatory diet and more pain (dysmenorrhea, chronic pelvic pain, deep dyspareunia), than controls. Women with higher DII scores (>0.86) were more likely to have endometriosis and to present with dyspareunia. Results obtained from modeling DII as a categorical variable in relation to risk of endometriosis showed a near tripling of risk (OR = 2.77; 95% CI = 1.13–6.77) for women with DII >0.86 versus those with DII ⩽ 0.86, after adjusting for age and BMI. After multivariable adjustment, women with DII > 0.86 were four times more likely to have endometriosis compared to women with DII ⩽ 0.86 (OR = 4.14; 95% CI= 1.50–11.4). In conclusion, a pro-inflammatory diet was significantly associated with endometriosis.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"13 1","pages":"32 - 39"},"PeriodicalIF":0.5,"publicationDate":"2020-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2284026520967599","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43511436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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