Endometriosis

Background: Endometriosis, a non-lethal cancer-like inflammatory condition, and cancer share common features, with the major being the inability of the organism to confront the cause of disease initiation due to an incompetent immune and homeostatic surveillance, respectively.  In addition, and to a degree, both diseases can be detected by identical diagnostic tools and treatment can be successfully achieved by a number of common substances found in nature that can fortify the organism’s defense mechanisms to combat disease. Thus, this commentary focuses on and discusses the remedial action pine bark extracts (Pycnogenol®), almond skins, Agaricus Blazei murrill, oleuropein and oleocanthal may have on a destabilized organism that fails to combat illness by its own. Such a similarity in diagnosis and treatment may become as an alternative approach to create models of investigation for both diseases.

Since the electrosurgical instruments are commonly used in a wide variety of surgical specialties, understanding of the properties of these instruments is very important to prevent the potential complications. We report the case of a patient who sustained a third-degree dermal burn caused by contact with the ground plate of the electrosurgical system. This burn healed with surgical treatment. Since electrosurgery causes serious complications, surgeon and operating suite personnel should pay attention to the electrosurgical system during the operation. Additionally, patients must be informed about these complications.

... The role of major histocompatibility complex class I antigens in tumorigenesis: future applications in cancer therapy. Auteur(s) / Author(s). NAPOLITANO L. (1) ; VOGEL J. ; JAY G. ; Affiliation(s) du ou des auteurs / Author(s) Affiliation(s). ... Tumor. ; Antígeno histocompatibilidad clase ...

Objective: Our aim was to investigate the clinical efficacy and safety of gonadotropin-releasing hormone agonist (GnRH-a) following laparoscopic surgery in the treatment of endometriosis. Methods: A total of 100 patients with endometriosis were randomly divided into a control group (laparoscopic resection only, n=50) and treatment group (laparoscopic resection combined with GnRH-a treatment, n=50). In addition to laparoscopic resection that was performed in the control group, the treatment group also received an additional 3-6 courses of GnRH-a therapy postoperatively (3.75 mg per time, every 28 days). The effective rates, recurrence rates, dysmenorrhea relief rates, dyspareunia relief rates, chronic pelvic pain relief rates, and the total pain relief rates as well as the adverse events were recorded and analyzed. Results: Total effective rates of the treatment and control groups were 86.0% (43/50) and 62.0% (31/50), respectively, with significant inter-group difference (P<0.05)....

The aim of the study was to investigate the reproductive outcomes of patients after surgical treatment of endometriosis. The study included 100 infertile women, aged 21 to 41 years, who underwent surgical treatment of endometriosis. From January 2007 to January 2012, excision of endometriosis was performed by operative laparoscopy or laparotomy Demographic, clinical, surgical and reproductive outcomes of 52 patients were retrospectively analyzed. Twenty-three pregnancies (44%) were obtained in 52 patients, resulting in 16 term pregnancies, 4 spontaneous abortions under 16 weeks gestation, 2 spontaneous abortions at 20 gestational weeks and 1 ectopic pregnancy Twenty nine patients did not achieve pregnancy and 68.9% (20/29) of them were treated with IVF-ICSI. Spontaneous pregnancies were obtained within 7 months after the surgery whereas IVF-ICSI pregnancies were obtained within the period of 11 months. Seven patients were stage 1, 14 patients stage II, 19 patients stage III, and 12 ...

Curcumin, a polyphenol derived from turmeric (Curcuma longa) possesses diverse pharmacological properties including antioxidant, anti-inflammatory and antiproliferative activities. Endometriosis is a gyneocological disorder characterized by growth of endometrial tissues outside uterus that involves aberrant matrix remodeling. In this study the effect of curcumin was studied on surgically developed endometriosis in mice. Endometriosis with varying severity was developed in mice by peritoneal implantation of uterine fragments. The changes in matrix metalloproteinase (MMP)-9 and tissue inhibitor of metalloprotease (TIMP)-1 were investigated in endometriotic tissues following curcumin pre- and posttreatment. Results showed that MMP-9 activity increased gradually in endometriotic tissues with severity and curcumin treatment reversed the MMP-9 activity near to control value. Curcumin administered either post- or pre-endometriosis arrested endometriosis in a dose-dependent manner. It inhib...

Deep infiltrating endometriosis (DIE) is the most aggressive of the three phenotypes that constitute endometriosis.
It can affect the whole pelvis, subverting the anatomy and functionality of vital organs, with an important negative
impact on the patient’s quality of life. The diagnosis of DIE is based on clinical and physical examination, instrumental
examination, and, if surgery is needed, the identification and biopsy of lesions. The choice of the best therapeutic
approach for women with DIE is often challenging. Therapeutic options include medical and surgical treatment, and
the decision should be dictated by the patient’s medical history, disease stage, symptom severity, and personal choice.
Medical therapy can control the symptoms and stop the development of pathology, keeping in mind the side effects
derived from a long-term treatment and the risk of recurrence once suspended. Surgical treatment should be proposed
only when it is strictly necessary (failed hormone therapy, contraindications to hormone treatment, severity of symptoms,
infertility), preferring, whenever possible, a conservative approach performed by a multidisciplinary team. All
therapeutic possibilities have to be explained by the physicians in order to help the patients to make the right choice
and minimize the impact of the disease on their lives.

Background: Endometriosis is considered the most common cause of pelvic adhesions in women. Endometriosis-associated adhesions could result in the formation of fibrous bands, which contain endometriotic glands, stroma and scarring. The aim of this study was to identify the impact of endometriosis-related adhesions on quality of life among infertile women.

To present a case of an acute hemoperitoneum caused by a ruptured ovarian cyst in a late twin pregnancy. Case report study. Department of Obstetrics and Gynecology, Medical University of Graz, Austria. A woman with a history of surgery for endometriosis and currently pregnant with dichorionic twins after IVF presented with acute abdominal pain. Serial ultrasound assessment revealed a massive hemoperitoneum that was caused by a ruptured endometriotic ovarian cyst. Emergency laparotomy was performed. Hemostasis. Laparotomy led to operative hemostasis and preterm cesarean section of healthy twins at 27 weeks of gestation. Endometriosis occurs in about 10% of women of reproductive age and carries an infertility rate of up to 50%. Severe endometriosis used to be a rare event in patients with spontaneously conceived pregnancies. However, during the last decade, the increased use of assisted reproductive technologies has led to higher fertility rates in patients with endometriosis and to a higher incidence of multiple gestations. Therefore, the number of pregnant women with endometriosis and associated complications may rise.

Research aim: to determine the clinical efficacy and safety of bioavailable curcumin Longimin® in the complex anti-relapse therapy of patients with extragenital endometriosis after surgery.
Materials and methods. Study involved 45 women with a mean age of 29.3 ± 3.6 years with a diagnosis of extragenital endometriosis. After surgical treatment of this disease all patients were prescribed dienogest 2 mg/day for 6 months with anti-relapse purpose. After that, 22 patients did not receive drug treatment (group 1) and other 23 women started a six-month course of 400 mg bioavailable curcumin (group 2).
Results. After 12 months of observation 3 cases (13.6%) of newly formed foci of endometriosis were found among patients of group 1, two of which were multi-endometriomas, and the third was retrocervical heterotopia. There were no signs of recurrence in the group of sequential use of dienogest and bioavailable curcumin. In addition, 6 months after completion of hormonal treatment the number of women with chronic pelvic pain in group 1 was increased and average score on a visual analogue scale (VAS) was increased by 80% (p ≤0.05). It was accompanied by a stable moderately high level of anxiety throughout the observation period. At the same time the number of women who complained of intermenstrual pain in group 2 decreased from 15 to 13, and the average VAS score decreased by 13% (p ≥0.05) during the treatment period. Patients in group 2 noted an improvement in emotional control during treatment, which resulted in the average score decrease on the scale of personal and situational anxiety of the Spielberg-Hanin's questionnaire (25% and 30% respectively, p ≤0.05).
Conclusions. The nature of the endometriosis development and progression is multipathogenetic. Blocking only its hormonal link, especially in cases of extragenital forms, may not be sufficient to stop the pathological process and prevent recurrence
in the long term. Оbtained results of sequential course of dienogest and bioavailable curcumin Longimin® with anti-relapse purpose showed the wider clinical effectiveness of this therapy, which is probably based on additional inhibition of systemic inflammation, proliferation, stroma and psychogenic component of disease.

Endometriosis infiltrating the sacral nerve roots is a rarely reported manifestation of the disease. The objectives of this article are to report such a case and to describe the surgical technique for laparoscopic decompression of sacral nerve roots and treatment of endometriosis at this site. The patient as a 38-year-old woman who had undergone 2 previous laparoscopic procedures for electrocoagulation of peritoneal endometriosis and self-reported perimenstrual right-sided sciatica and urinary retention. Clinical examination revealed allodynia (pain from a stimulus that does not normally cause pain) on the S2 to S4 dermatomes and hypoesthesia on part of the S3 dermatome. Magnetic resonance imaging showed an endometriotic nodule infiltrating the anterior rectal wall. Laparoscopic exploration of the sacral nerve roots demonstrated vascular compression of the lumbosacral trunk and endometriosis entrapping the S2 to S4 sacral nerve roots, with an endometrioma inside S3. The endometriosi...

Introduction: Endometriosis is a prevalent gynecological disorder among women which is
diagnosed by the growth of endometrial tissue outside of uterus and is mainly accompanied
by severe pelvic pain and infertility. P53 also known as cellular tumor antigen P53 inside
codons 11, 72 and 248 are contained with single nucleotide changes in which tends to be nearly
rampant.This will probably be increasing the chances of endometriosis infection to some great
extent.
Our aim was to evaluate the connection between endometriosis and polymorphism inside the
codons 11, 72 and 248 of P53 gene.
Methods: In this study, single nucleotide changes in codons 11, 72 and 284 of TP53 gene
among 44 persons infected with endometriosis and the same studying population for noninfected
group have been examined. After primer design and amplification of polymorphic
sequences by PCR, the polymorphisms of related codons have been evaluated by the digestion
method (RFLP).
Results: In this study on the codon 72, there were seen differences in the distribution of genotype
frequencies of normal polymorphic subjects and control subjects with endometriosis. At codons
11 and 248, there were observed no significant correlations between polymorphic and normal
genotypes of endometriosis and non-endometriosis groups.
Conclusion: According to the results, we can say that probably polymorphism of codon 72 of
p53 gene is one of the predisposing factors of endometriosis.

Endometriosis is a complex, chronic condition with known psychological and social implications for women. Little is known about clinicians' perceptions of the psychosocial aspects of endometriosis and associated care. To describe clinicians' perceptions of women's experiences of living with endometriosis and of the provision of psychosocial care for endometriosis. A qualitative approach was taken using semi-structured interviews with eight gynaecologists and four general practitioners who provide care to women with endometriosis in Victoria, conducted by telephone and in person from June to December 2014. Clinicians' perceptions of women's experiences of endometriosis were consistent with those reported by women, particularly when discussing potential infertility. However, less comprehensive descriptions of the effects of endometriosis on women's work and social life and intimate relationships were observed. Some clinicians asserted that endometriosis is caus...

The revised American Society for Reproductive Medicine (rASRM) score is currently the best-known classification of endometriosis and is the one most widely used throughout the world. It is relatively easy to use, but it does not take into account the involvement of retroperitoneal structures with deeply infiltrating endometriosis. For this reason, the Enzian classification was developed as a supplement to the rASRM score, in order to provide a morphologically descriptive classification of deeply infiltrating endometriosis. The Enzian classification currently has a poor level of international acceptance and is mainly used in the German-speaking countries. It was revised in 2011 and is now also easier to use. This article describes the strengths and weaknesses of the rASRM score and the Enzian classification and their common potential for classifying endometriosis.