Chronic Pelvic Pain due to Postmenopausal Endometriosis
Publication date: Available online 20 August 2019Source: Journal of Minimally Invasive GynecologyAuthor(s): Megan N. Wasson
Conditions: Endometriosis; Pelvic Pain Intervention: Procedure: surgical removal of superficial peritoneal endometriosis Sponsors: University of Edinburgh; NHS Grampian; University of Nottingham Not yet recruiting
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.
I remember hearing this story many years ago and it has become a powerful teaching tool for my clients who I see in my therapy practice and in classes/presentations I offer. “I’ll never forget the day Marilyn and I were walking around New York City, just having a stroll on a nice day. She loved New York because no one bothered her there like they did in Hollywood, she could put on her plain-Jane clothes and no one would notice her. She loved that. So, as we we’re walking down Broadway, she turns to me and says, ‘Do you want to see me become her?’ I didn’t know what she meant but I just s...
ConclusionThe laparoscopic reverse technique is an alternative approach to face retrocervical or rectovaginal nodules infiltrating the anterior rectal wall. In this technique, the separation of the nodule from the rectal wall is performed at the end of the surgery and not at the beginning as performed within the traditional technique. This enables the surgeon to perform a more precise dissection of the endometriotic nodule from the rectal wall because of the increased mobility of the bowel. The wider range of movements serves as an ergonomic advantage for the subsequent dissection of the lesion from the rectum, allowi...
Endometriosis is an estrogen-dependent disease with symptoms of dysmenorrhea, chronic pain, and infertility that affects 6% to 10% of women of reproductive age. Medical or surgical therapy, such as administration of an anti-gonadotropin or ovarian cystectomy, provide effective pain relief. However, neither therapy can be used for patients wishing to become pregnant. Despite the high morbidity, the pathogenesis of endometriosis has not been well elucidated. Several inflammatory cytokines are reported to participate in the onset of endometriosis. Here, we examined the role of interleukin (IL)-1/IL-33 signaling in the develop...
A 38-year-old woman presented with chronic pelvic pain. She reported an extensive surgical history focused primarily on treatment of endometriosis of unknown stage and her pelvic pain. This included total hysterectomy and bilateral salpingectomy subsequently followed by bilateral-oophorectomy 3 years prior. Following her surgical menopause, she underwent six additional robotically assisted procedures during a 3 year period of time which involved fulguration of endometriosis. She denied having had any prior excisional procedures performed.
ConclusionQualitative research has the potential to reveal and explain several aspects of CPP in women. The medical community may better accept knowledge gained from these studies if the methods are described more transparently in published articles.
Conditions: Pain, Chronic; Pain, Pelvic; Pain, Abdominal; Depression; Sex Disorder; Endometriosis Intervention: Behavioral: Learning of Coping Strategies Sponsor: Swiss Paraplegic Centre Nottwil Not yet recruiting