Identification of predictive factors in endometriosis for improvement in patient quality of life

Publication date: Available online 27 May 2019Source: Journal of Minimally Invasive GynecologyAuthor(s): Aurélie Comptour, Bruno Pereira, Céline Lambert, Pauline Chauvet, Anne-Sophie Gremeau, Jean-Luc Pouly, Michel Canis, Nicolas BourdelABSTRACTStudy objectiveTo investigate predictive factors for change in quality of life (QoL) between pre and post-operative periods in patients with endometriosisDesignProspective and multicenter cohort studySetting5 districts including a tertiary referral center, private and general public hospitalsPatient981 patients, aged 15-50 years, underwent laparoscopic treatment (preferred approach) for endometriosis between January 2004 and December 2012InterventionLaparoscopic treatment for endometriosis. All rAFS stages were included.Measurements and main resultsQoL was evaluated using the SF-36 questionnaire. Factors influencing changes for each SF-36 domain score between t0 (prior to surgery) and 1 year after surgery were predicted on the basis of univariate and multivariable analyses. The effect size method (ES) was used to measure changes in QoL. Univariate analysis revealed that 47% of stage IV endometriosis patients presented an improvement in post-operative PCS (Physical Component Score) score (ES≥0.8) versus 26%, 31.3% and 27.5% of patients with stage I, II and III respectively (p0.8) versus 23% and 24% of patients without CPP respectively (p0.8 versus ES
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research

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AbstractIntroductionOvarian endometriosis is the most common type of endometriosis (EM), affecting more than 40% of women with EM. Currently, surgical intervention is still controversial in infertile patients with ovarian endometriosis, especially in those with stage  III–IV EM. Very few studies have been done to analyze long-term pregnancy results in patients with endometrioma more than 5 years after surgery. Therefore, the aim of this study was to explore the pregnancy outcomes and the related factors in patients with endometrioma and stage III–IV endom etriosis during a long-term follow-up pos...
Source: Advances in Therapy - Category: Drugs & Pharmacology Source Type: research
AbstractEndometriosis is a common entity causing chronic pain and infertility in women. The gold standard method for diagnosis is diagnostic laparoscopy, which is invasive and costly. MRI has shown promise in its ability to diagnose endometriosis and its efficacy for preoperative planning. The Society of Abdominal Radiology established a Disease-Focused Panel (DFP) to improve patient care for patients with endometriosis. In this article, the DFP performs a literature review and uses its own experience to provide technical recommendations on optimizing MRI Pelvis for the evaluation of endometriosis.
Source: Abdominal Imaging - Category: Radiology Source Type: research
AbstractDeeply infiltrative endometriosis (DIE) is a common gynecologic disease affecting women of reproductive age and often causing chronic pelvic pain and infertility. Clinical treatment options and preventive actions are ineffective due to the lack of knowledge about the etiology of DIE. Surgical treatment is currently the only alternative to eradicate the disease. Diagnostic imaging plays a crucial role for surgical planning and postoperative evaluation. Transvaginal sonography (TVS) with a dedicated protocol and magnetic resonance imaging (MRI) can be used to evaluate recurrent disease. Extensive pelvic surgery may c...
Source: Abdominal Imaging - Category: Radiology Source Type: research
Endometriosis is a common cause of chronic pelvic pain, dysmenorrhea and infertility. Although 6 –10% of women of child bearing age are affected by the disease, and even more in the group of patients with fertility problems, diagnosis is often delayed and treatment can be challenging. Depending on the complaints, extent of disease and the goals of treatment (fertility treatment, pain reducti on, …), both medical and surgical options are available for the management of this pathology and often a  multidisciplinary approach will be necessary. Although diagnostic laparoscopy with histologic confirmation...
Source: Journal of the Belgian Society of Radiology - Category: Radiology Source Type: research
ConclusionTraditionally only pathologies of the uterus and ovaries are assessed during a routine pelvic ultrasound. Here we demonstrate that the routine ultrasound examination can easily be extended beyond the uterus and ovaries into the posterior and anterior pelvic compartments to evaluate structural mobility and to look for deep infiltrating endometriotic nodules, so women suffering from deep infiltrating endometriosis can benefit from a pre-operative diagnosis and subsequently a single, well-planned procedure in the hands of a well-prepared team.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
ConclusionsWe have identified menstrual cycle- and endometriosis-associated protein changes linked to various cellular processes that are potential biomarkers and that provide insight into the biology of endometriosis. Our data indicate that the markers tested, whilst not useful alone, have improved diagnostic accuracy when used in combination and demonstrate menstrual cycle specificity. Tissue heterogeneity and blood contamination is likely to have hindered biomarker discovery, whilst a small sample size precludes accurate determination of performance by cycle phase. Independent validation of these biomarker panels in a l...
Source: Clinical Proteomics - Category: Biochemistry Source Type: research
We present an interesting case of a nulliparous patient that underwent laparoscopic surgery for pelvic endometriosis and 2 years after a laparoscopic excision of an intraligamentous fibroid.
Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology - Category: OBGYN Authors: Tags: Movies Technique 1 – Surgical techniques in Gynaecology Source Type: research
Endometriosis is an estrogen-dependent, chronic gynecological disorder associated with pelvic pain and infertility, with a prevalence of 6 to 10% in the general population.6,7,12 Affected women experience dysmenorrhea, deep dyspareunia, dyschezia, and dysuria12,35 associated with low quality of life.8 The disorder is underdiagnosed or there is a delay in diagnosis in many cases leading to chronic pelvic pain (CPP).7,26 Diagnosis is made using laparoscopy or laparotomy, where endometrial lesions are found in extrauterine locations, mainly the peritoneum and ovaries.
Source: The Journal of Pain - Category: Materials Science Authors: Tags: Original Report Source Type: research
ConclusionOwing to the possibility to perform a complete assessment of all pelvic compartments at one time, MRI represents the best imaging technique for preoperative staging of endometriosis, in order to choose the more appropriate surgical approach and to plan a multidisciplinary team work.Teaching Points• Endometriosis includes ovarian endometriomas, peritoneal implants and deep pelvic endometriosis.• MRI is a second-line imaging technique after US.• Deep pelvic endometriosis is associated with chronic pelvic pain and infertility.• Endometriosis is characterized by considerable diagnostic delay.&bull...
Source: Insights into Imaging - Category: Radiology Source Type: research
AbstractSTUDY QUESTIONWhat is the role of SFRP2 in endometriosis?SUMMARY ANSWERSFRP2 acts as a canonical WNT/CTNNB1 signaling agonist in endometriosis, regulating endometriosis lesion growth and indicating endometriosis lesion borders together with CTNNB1 (also known as beta catenin).WHAT IS KNOWN ALREADYEndometriosis is a common, chronic disease that affects women of reproductive age, causing pain and infertility, and has significant economic impact on national health systems. Despite extensive research, the pathogenesis of endometriosis is poorly understood, and targeted medical treatments are lacking. WNT signaling is d...
Source: Human Reproduction - Category: Reproduction Medicine Source Type: research
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