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Adenomyosis 子宫腺肌症
Pub Date : 2021-01-14 DOI: 10.5772/intechopen.90942
Wei Zheng, B. Deng
Adenomyosis is a benign uterus disease in which the invasion of the endometrial glands and/or stroma within myometrium is found and usually appears between the ages of 40 and 50 years in women. There are several differences in their pathogenesis. The secondary dysmenorrhea and menorrhagia are the common symptoms. Ultrasound sonography, MRI, CA125, and histological examination can be helpful for the diagnosis of adenomyosis. The treatment of adenomyosis depends on the patient’s age, symptoms, and desire for future fertility, including medical treatment and surgical treatment.
子宫腺肌病是一种良性子宫疾病,主要表现为子宫内膜腺体和/或子宫肌层间质的浸润,通常发生在40至50岁的女性中。它们的发病机制有几个不同之处。继发性痛经、月经过多是常见症状。超声、MRI、CA125、组织学检查对子宫腺肌病的诊断有一定的帮助。子宫腺肌病的治疗取决于患者的年龄、症状和对未来生育的愿望,包括药物治疗和手术治疗。
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引用次数: 0
Endocrine Disrupting Chemicals in Cosmetics and Personal Care Products and Risk of Endometriosis 化妆品和个人护理产品中的内分泌干扰物质与子宫内膜异位症的风险
Pub Date : 2020-06-29 DOI: 10.5772/intechopen.93091
Francisco M. Peinado, Luz M. Iribarne-Durán, O. Ocón-Hernández, N. Olea, F. Artacho-Cordón
In the last years, the variety and consumption of cosmetics and personal care products (PCPs) have greatly increased, although the long-term adverse effects to low doses of chemicals used in their production and with proven hormone-mimicking properties have been still poorly addressed. Among these endocrine disrupting chemicals (EDCs), parabens, benzophenones, bisphenols, and phthalates are the most widely found in these products. Given the estrogenic-dependent nature of the endometrium, it has been hypothesized the potential contribution of these EDCs contained in cosmetics and PCPs in the risk of endometriosis. In this book chapter, we have summarized the current evidence supporting this hypothesis, highlighting epidemiological, in vivo, and in vitro studies that have addressed the potential influence of parabens, benzophenones, bisphenols, and phthalates in the origin and progression of this chronic feminine disease.
在过去几年中,化妆品和个人护理产品(pcp)的种类和消费量大大增加,尽管在生产过程中使用的低剂量化学品和已证实的激素模拟特性的长期不利影响仍然没有得到充分解决。在这些内分泌干扰化学物质(EDCs)中,对羟基苯甲酸酯、二苯甲酮、双酚和邻苯二甲酸酯是这些产品中最广泛发现的。考虑到子宫内膜的雌激素依赖性,人们假设化妆品和pcp中含有的EDCs可能会增加子宫内膜异位症的风险。在本书的这一章中,我们总结了支持这一假说的现有证据,强调了流行病学、体内和体外研究,这些研究解决了对羟基苯甲酸酯、二苯甲酮类、双酚类和邻苯二甲酸酯在这种慢性女性疾病的起源和发展中的潜在影响。
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引用次数: 2
Benefits of Surgical Intervention in Women with Endometriosis-Related Infertility 子宫内膜异位症相关性不孕症手术治疗的益处
Pub Date : 2020-03-29 DOI: 10.5772/intechopen.91820
P. Alexander, Koval Alexey, F. Antón, Tyurina Svetlana, Fedotova Irina, Khabibullakh Tamana
Endometriosis is one of the most common gynecological diseases in the world with a great variety of symptoms and clinical features. The true prevalence rates in the general population are not known, but according to different authors, endometriosis is to be found in 10% in women of reproductive age. According to different publications, around half of the patients with infertility were diagnosed with endometriosis which change the significance of this disease from the only female to a socio-economical problem. In this chapter, we will focus on the current view on endometriosis-associated infertility, from superficial to adenomyosis, with a closer view of surgical treatment, as it is still the standard of care for diagnosis and in severe cases—treatment of the disease.
子宫内膜异位症是世界上最常见的妇科疾病之一,具有多种症状和临床特征。一般人群的真实患病率尚不清楚,但根据不同作者的研究,子宫内膜异位症在育龄妇女中占10%。根据不同的出版物,大约一半的不孕症患者被诊断患有子宫内膜异位症,这使得这种疾病的重要性从唯一的女性转变为一个社会经济问题。在本章中,我们将重点关注目前对子宫内膜异位症相关不孕症的看法,从浅表到子宫腺肌症,并更密切地观察手术治疗,因为它仍然是诊断和严重情况下治疗该病的标准护理。
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引用次数: 0
Adenomyosis and endometriosis 子宫腺肌病和子宫内膜异位症
Pub Date : 2020-03-02 DOI: 10.1201/9780429448980-12
M. Rohilla
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引用次数: 0
Diagnostic evaluation 诊断性评价
Pub Date : 2020-03-02 DOI: 10.1201/9780429448980-5
Neha Agarwal, S. Chopra, A. Syal
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引用次数: 0
Conclusion 结论
Pub Date : 2020-03-02 DOI: 10.1201/9780429448980-22
S. Chopra
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引用次数: 0
Medical management of endometriosis 子宫内膜异位症的医学处理
Pub Date : 2020-03-02 DOI: 10.1201/9780429448980-8
Bharti Joshi, N. Aggarwal
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引用次数: 1
microRNA and Overcoming the Challenges of Their Use in the Diagnosis of Endometriosis microRNA及其在子宫内膜异位症诊断中的应用
Pub Date : 2020-02-19 DOI: 10.5772/intechopen.91324
Victoria Turpin, A. Leonova, Sanjay Agarwal, W. Foster
Endometriosis is a common estrogen dependent and inflammatory disease affecting approximately 176 million women worldwide. Currently, the time between onset of symptoms and a definitive diagnosis has been reported by several international studies to range from 6 to 12 years. Presently, laparoscopic surgery followed by histopathological confirmation of lesions remains the gold standard for diagnosis. In part because of cost and invasiveness, current trends favor reduced laparoscopic surgeries in preference of the non-surgical diagnosis of endometriosis. However, the search for a clinical marker or markers of endometriosis that provide equal or similar sensitivity and specificity to laparoscopy has remained elusive. Thus, the search for a diagnostic test for the diagnosis of endometriosis continues to be a high priority research and clinical issue. Recent studies have reported favorable results with microRNA; however, lack of replication and absence of validation suggest that circulating miRNA may not be reliable for clinical use. Use of different screening platforms together with divergent methods may account for some of the lack or reproducibility in the literature. Herein we critically assess the recent literature and explore sources for discrepant findings. We suggest that prospective studies using validated reference miRNA to normalize results together with improved study design may yet reveal a suitable diagnostic marker or panel of markers for the diagnosis of endometriosis.
子宫内膜异位症是一种常见的雌激素依赖性炎症性疾病,影响全球约1.76亿女性。目前,几项国际研究报告,从出现症状到最终诊断之间的时间为6至12年。目前,腹腔镜手术后的组织病理学确认病变仍然是诊断的金标准。部分由于成本和侵入性,目前的趋势倾向于减少腹腔镜手术,而不是非手术诊断子宫内膜异位症。然而,寻找一种或多种子宫内膜异位症的临床标志物,提供与腹腔镜检查相同或相似的敏感性和特异性,仍然难以捉摸。因此,寻找诊断子宫内膜异位症的诊断测试仍然是一个高度优先的研究和临床问题。最近的研究报道了microRNA的有利结果;然而,缺乏复制和验证表明循环miRNA可能不可靠用于临床。使用不同的筛选平台和不同的方法可以解释文献中的一些缺乏或可重复性。在此,我们批判性地评估了最近的文献,并探讨了差异发现的来源。我们建议,使用经过验证的参考miRNA来标准化结果的前瞻性研究,以及改进的研究设计,可能还会发现一个合适的诊断标记或一组标记物来诊断子宫内膜异位症。
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引用次数: 1
A prospective cohort study of Vitamins B, C, E, and multivitamin intake and endometriosis. 维生素B、C、E和多种维生素摄入与子宫内膜异位症的前瞻性队列研究。
Pub Date : 2013-01-01 DOI: 10.5301/je.5000151
Anne Marie Darling, Jorge E Chavarro, Susan Malspeis, Holly R Harris, Stacey A Missmer

Purpose: Diet is a potentially modifiable risk factor for endometriosis. It has been hypothesized that vitamins C, E, and the B vitamins may influence factors involved in the pathogenesis of endometriosis, such as oxidative stress and steroid hormone metabolism. In this large, prospective cohort study, we examined the relation between intake of vitamins C, E, the B vitamins, and the use of multivitamin supplements and diagnosis of endometriosis.

Methods: Data were collected from women in the Nurses' Health Study II between 1991 and 2005. Diet was assessed via food frequency questionnaire. Incidence rate ratios (RR) and 95% confidence intervals (CI) were estimated using time-varying Cox proportional hazards models.

Results: A total of 1383 incident cases of laparoscopically-confirmed endometriosis were observed among 70,617 women during 735,286 person years of follow-up. Intakes of thiamine (B1) (RR = 0.84, CI = 0.72-0.99; P-value, test for linear trend [P] = 0.04), folate (B9) (RR = 0.79, CI = 0.66-0.93; P = 0.003), vitamin C (RR = 0.81, CI = 0.68-0.95; P = 0.02), and vitamin E (RR = 0.70, CI = 0.59-0.83; P<0.0001) solely from food sources were inversely related to endometriosis diagnosis. However, intakes of these nutrients from supplements alone were unrelated to endometriosis.

Conclusion: Thiamine, folate, vitamin C, and vitamin E from food sources are inversely related to endometriosis risk. Our results suggest that the protective mechanism may not be related to the nutrients themselves but rather other components of foods rich in these micronutrients or factors correlated with diets high in these vitamin-rich foods.

目的:饮食是子宫内膜异位症的一个潜在可改变的危险因素。有假说认为维生素C、E和B族维生素可能影响子宫内膜异位症发病的相关因素,如氧化应激和类固醇激素代谢。在这项大型的前瞻性队列研究中,我们研究了维生素C、E、B族维生素的摄入量、复合维生素补充剂的使用和子宫内膜异位症诊断之间的关系。方法:收集1991年至2005年护士健康研究II中妇女的数据。通过食物频率问卷对饮食进行评估。使用时变Cox比例风险模型估计发病率比(RR)和95%置信区间(CI)。结果:在735,286人年的随访中,70,617名女性共观察到1383例腹腔镜确诊子宫内膜异位症。硫胺素(B1)摄入量(RR = 0.84, CI = 0.72-0.99;P值,线性趋势检验[P] = 0.04),叶酸(B9) (RR = 0.79, CI = 0.66-0.93;P = 0.003),维生素C (RR = 0.81, CI = 0.68-0.95;P = 0.02),维生素E (RR = 0.70, CI = 0.59-0.83;结论:食物来源的硫胺素、叶酸、维生素C和维生素E与子宫内膜异位症风险呈负相关。我们的研究结果表明,这种保护机制可能与营养素本身无关,而是与富含这些微量营养素的食物的其他成分或与富含这些维生素的食物的饮食相关的因素有关。
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引用次数: 46
Decreasing Dyspareunia and Dysmenorrhea in Women with Endometriosis via a Manual Physical Therapy*: Results from Two Independent Studies 通过手工物理治疗减少子宫内膜异位症女性的性交困难和痛经*:来自两项独立研究的结果
Pub Date : 2012-02-28 DOI: 10.5301/JE.2012.9088
Belinda F. Wurn, Lawrence J. Wurn, Kimberley Patterson, C. R. King, E. S. Scharf
® - Patent pending AbstrAct Purpose: To assess the efficacy of a non-invasive, site-specific manual physiotherapeutic technique in ameliorating dyspareunia and dysmenorrhea, commonly associated with endometriosis, by perform- ing a retrospective and prospective analysis, respectively. Methods: Human female subjects, all surgically diagnosed with endometriosis, were enrolled in each of the studies post informed consent. Each subject underwent 20 hours of site-specific manual physi- cal therapy (Wurn Technique) designed to address adhesions and restrictions in soft tissue mobility in the abdomen and the pelvic floor. Post-test was completed 6 weeks after treatment. Evaluation incorporated outcome prediction based on Female Sexual Function Index (FSFI) for analyzing the ef- fect on dyspareunia and sexual function (n=14) and quantitative differences in ratings of average pain during menstrual cycle and intercourse based on the Mankoski Pain Scale for analyzing the effect on dysmenorrhea and dyspareunia (n=18), respectively. Data was analyzed by the Wilcoxon signed-rank test (two-sided). results: FSFI Full Scale score showed overall statistically significant improvements (P=.001) for all domains of sexual function, inclusive of dyspareunia (P<.001) in the retrospective analyses. Mankoski Pain Scale exhibited statistically significant improvements in menstrual cycle (P<.014), dysmenorrhea (P=.008) and dyspareunia (P=.001) in the prospective analyses. conclusion: Site-specific manual physiotherapy might offer a non-pharmacologic and non-surgical alternative in the treatment of dyspareunia and dysmenorrhea in endometriosis patients. Further ran- domized, blinded, and multi-center assessment of the technique is warranted to validate the results and gauge any potential pitfalls.
目的:分别通过回顾性和前瞻性分析,评估一种非侵入性、部位特异性手动物理治疗技术在改善性交困难和痛经(通常与子宫内膜异位症相关)方面的疗效。方法:所有手术诊断为子宫内膜异位症的女性受试者在知情同意后被纳入每项研究。每个受试者都接受了20小时的特定部位的手工物理治疗(Wurn技术),旨在解决腹部和骨盆底软组织活动的粘连和限制。治疗后6周完成后测。评估纳入了基于女性性功能指数(FSFI)的结局预测,用于分析痛经和性功能的影响(n=14),以及基于Mankoski疼痛量表的月经周期和性交平均疼痛评分的定量差异,用于分析痛经和性交困难的影响(n=18)。数据采用双侧Wilcoxon sign -rank检验进行分析。结果:FSFI全量表评分显示,在回顾性分析中,性功能的所有领域,包括性交困难(P< 0.001),总体上有统计学意义上的显著改善(P= 0.001)。在前瞻性分析中,Mankoski疼痛量表在月经周期(P< 0.014)、痛经(P= 0.008)和性交困难(P= 0.001)方面显示有统计学意义的改善。结论:子宫内膜异位症患者的阴道痛和痛经可采用部位特异性手工物理治疗,这是一种非药物和非手术的治疗方法。进一步的随机、盲法和多中心评估技术是必要的,以验证结果和衡量任何潜在的缺陷。
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引用次数: 18
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Journal of endometriosis
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