Effectiveness of ovarian suspension in preventing postoperative ovarian adhesions in patients with severe pelvic endometriosis —a case-control study

AbstractBackgroundEndometriosis can exert obvious negative effects on women ’s quality of life.Excisional surgery is among the most effective treatments for severe pelvic endometriosis. The prevalence of severe pelvic adhesions following a laparoscopic examination of severe endometriosis varies between 50 and 100%. Temporary intraoperative ovarian suspension is a method for the reduction of adhesions is in the treatment of severe pelvic endometriosis. Given the importance and the prevalence of endometriosis and its complications, we conducted the present study to determine more effective adhesion-reducing methods with a view to improving the quality of the treatments provided.MethodsThe present prospective double-blind randomized clinical trial was conducted on 50 women of reproductive age ( ≥ 19 years) diagnosed with severe pelvic endometriosis on transvaginal ultrasound scans and vaginal examinations at Yas Hospital between 2014 and 2017. Women with severe endometriosis (stage III, stage IV, and deep infiltrating endometriosis) requiring an extensive bilateral dissection of the pe lvic walls and the rectovaginal space, with preserved uterus and ovaries, were included in the study.The preoperative severity of ovarian adhesions was assessed in terms of ovarian motility, measured through a combination of gentle pressures applied with the vaginal probe and abdominal pressures applied with the examiner ’s free hand. A table of random numbers was used to cho...
Source: Gynecological Surgery - Category: OBGYN Source Type: research

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Authors: Mabrouk M, Borghese G, Esposti ED, Raimondo D, Remorgida V, Arena A, Zupi E, Mattioli G, Ambrosio M, Seracchioli R Abstract Endometriosis, defined as the presence of functional endometrial tissue outside the uterine cavity, presents mainly with pelvic pain and infertility. Acute abdominal pain in non-pregnant patients with endometriosis might be minimised as a typical feature of the disease, while endometriosis is rarely considered in the differential diagnosis of acute abdominal pain. Our objective was to conduct a systematic review of the current literature of cases of acute abdomen/acute abdominal pain ...
Source: Journal of Obstetrics and Gynaecology - Category: OBGYN Tags: J Obstet Gynaecol Source Type: research
A 36-year-old patient was admitted to the emergency room with low abdominal pain and suspected right adnexal mass, and showing a recent positive pregnancy test. She was affected by non-symptomatic pelvic endometriosis and she had three years of infertility. Trans-vaginal ultrasound showed an adenomyotic uterus with a decidualized endometrium without any intrauterine gestational sac. A tubal ring sign on the right adnexa was identified, suggesting an ectopic tubal pregnancy. A 3 cm endometrioma has been identified on the left ovary.
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Tags: IMAGES IN Gynecological Surgery Source Type: research
CONCLUSIONS: Using robust consensus science methods, healthcare professionals, researchers, and women with endometriosis have developed a core outcome set to standardise outcome selection, collection, and reporting across future randomised controlled trials and systematic reviews evaluating potential treatments for endometriosis. TWEETABLE ABSTRACT: @coreoutcomes for future #endometriosis research have been developed @jamesmnduffy. PMID: 32227676 [PubMed - as supplied by publisher]
Source: BJOG : An International Journal of Obstetrics and Gynaecology - Category: OBGYN Authors: Tags: BJOG Source Type: research
CONCLUSIONS: We found no evidence on the effects of barrier agents used during pelvic surgery on pelvic pain or live birth rate in women of reproductive age because no trial reported these outcomes. It is difficult to draw credible conclusions due to lack of evidence and the low quality of included studies. Given this caveat, low-quality evidence suggests that collagen membrane with polyethylene glycol plus glycerol may be more effective than no treatment in reducing the incidence of adhesion formation following pelvic surgery. Low-quality evidence also shows that oxidised regenerated cellulose may reduce the incidence of ...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
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
Publication date: February 2020Source: Journal of Minimally Invasive Gynecology, Volume 27, Issue 2Author(s): Mathew Leonardi, Tatjana Gibbons, Mike Armour, Rui Wang, Elizabeth Glanville, Ruth Hodgson, Adele E. Cave, Jozarino Ong, Yui Yee Felice Tong, Tal Z. Jacobson, Ben W. Mol, Neil P. Johnson, George CondousABSTRACTObjectiveWe performed a systematic review and meta-analysis with the aim to answer whether operative laparoscopy is an effective treatment in a woman with demonstrated endometriosis compared with alternative treatments. Moreover, we aimed to assess the risks of operative laparoscopy compared with those of alt...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
This article offers advanced acupuncture techniques clinically used to build, preserve, and protect the Blood-derived from a synthesis of basic Energetic concepts mentioned throughout the ancient medical texts-that can be applied in clinics and research in reproductive medicine today. Acupuncture points with reasons for using them are reviewed with examples in application and treatment to support the infertile, pregnant, and postpartum patient. The acupuncture treatment methods offered in this article have been used throughout the world by medical acupuncturists trained by Drs. Viet Dzung and Van Nghi with positive clinica...
Source: Acupuncture in Medicine - Category: Complementary Medicine Authors: Tags: Med Acupunct Source Type: research
We present the case of a pregnant woman admitted for sudden and severe abdominal pain at 34 weeks gestation. Her previous medical history included endometriosis suspected by clinical symptoms and ultrasound. During cesarean section, performed by sustained fetal bradycardia, a large volume hemoperitoneum and multiple hemorrhagic foci in the posterior uterine wall were detected. Although rare, spontaneous hemoperitoneum may occur in pregnancy, especially in women with endometriosis. Thus, a prompt suspicion and expedite intervention are needed to improve maternal and fetal outcomes. PMID: 31703187 [PubMed - in process]
Source: Acta Medica Portuguesa - Category: General Medicine Tags: Acta Med Port Source Type: research
Purpose of review To investigate the JZE alterations in gynecological and obstetrical disorders and impact on diagnosis, prognosis and treatment. Recent findings JZE was found to be significantly extended in patients with endometriosis, leading to the conclusion that endometriosis is a primary disease of the uterus, much like adenomyosis. Statistical correlation was then demonstrated between the severity of endometriosis and the depth of the adenomyosis infiltrates, hence the thickening of the JZE. Stem cells, predominantly found in the JZE were also found in histological sections of leiomyoma, suggested to be the ori...
Source: Current Opinion in Obstetrics and Gynecology - Category: OBGYN Tags: WOMEN'S HEALTH: Edited by Joseph Aquilina Source Type: research
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...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
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