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Colorectal Surgery for Deep Endometriosis Infiltrating the Bowel
Published in Nazar N. Amso, Saikat Banerjee, Endometriosis, 2022
Hanan Alsalem, Jean-Jacques Tuech, Damien Forestier, Benjamin Merlot, Myriam Noailles, Horace Roman
Fertility is a major concern of women with endometriosis. The data on the impact of surgery for deep infiltrating endometriosis on fertility are controversial. In a patient preference trial comparing women with rectovaginal endometriosis opting for surgery (n = 44) with those choosing expectant management (n = 61), the 24-month cumulative pregnancy rate was 44.9% in the former group and 46.8% in the latter group (33).
Surgical treatment of endometriosis
Published in Caroline Overton, Colin Davis, Lindsay McMillan, Robert W Shaw, Charles Koh, An Atlas of ENDOMETRIOSIS, 2020
Caroline Overton, Colin Davis, Lindsay McMillan, Robert W Shaw, Charles Koh
Laparoscopy allows a diagnosis of endometriosis to be made along with an assessment of the extent of disease. With the advent of improved laparoscopic equipment and enhanced surgical techniques, complex conservative surgery can now be performed safely. In severe cases where bowel, bladder and ureter are involved, laparotomy may be required, and sometimes the assistance of surgical colleagues. The aim of surgery is to remove or destroy visible and/or palpable endometriosis with the specific aim of improving pelvic pain and enhancing fertility.
Regulation of Reproduction by Dopamine
Published in Nira Ben-Jonathan, Dopamine, 2020
Endometriosis is a growth of endometrial tissue outside the uterine cavity, affecting 6%–10% of women [72]. It is most common in women in their 30s and 40s and it is located primarily in the ovaries, oviducts, and their vicinity, and in rare cases in other parts of the body. Endometriosis is an estrogen-dependent disease, associated with chronic pelvic pain, dysmenorrhea, dyspareunia, and infertility. Treatment of endometriosis includes surgery, hormonal therapies, or their combination. Adverse effects of hormonal treatments limit their long-term use, and recurrence rates are high after cessation of therapy.
Excision of subcutaneous endometriosis lesions in obese patients by marking them with methylene blue with ultrasound guidance: a novel technique
Published in Journal of Obstetrics and Gynaecology, 2023
Çağlar Çetin, Mehmet Serdar Kütük, Fatma Başak Tanoğlu, Seda Ateş, Pınar Özcan, Rabia Zehra Bakar
Subcutaneous endometriosis is a dynamic but not fully understood issue that needs a multidisciplinary approach. Its incidence has increased due to increased obstetric and gynecological procedures. The clinical presentation is a palpable mass and local cyclic pain in the abdominal wall or cesarean scar. Imaging techniques such as ultrasound or magnetic resonance may be helpful in diagnosis, but a definitive diagnosis is based on the postoperative histopathological report. In a 2017 meta-analysis including 11 studies, the combined relative risk of endometriosis was reported as 0.67 (95% CI: 0.53, 0.84) for each 5 kg/m2 increase in current body mass index, with statistically significant heterogeneity in studies (p < .001). This study suggested that higher body mass index may be associated with lower risk of endometriosis (Liu and Zhang 2017). Treatment of endometriosis can be medical, surgical, or combined therapy. Oral contraceptives and progestins combined with various routes of administration are generally safe, effective and well-tolerated methods in treating endometriosis and should constitute the first-line treatment in symptomatic women who do not want to have children (Vercellini et al.2009). It is known that distant lesions usually lose their hormonal receptors and do not respond to medical treatment (Ueki 1991). Hormonal therapy has been shown to provide reasonable symptom control in some case reports (Mignemi et al.2012). Surgical removal of the implant is currently considered the most effective method known (Carsote et al.2020).
The therapeutic effects of coenzyme Q10 on surgically induced endometriosis in Sprague Dawley rats
Published in Journal of Obstetrics and Gynaecology, 2022
Saadet Özen Akarca-Dizakar, Mürşide Ayşe Demirel, Neslihan Coşkun Akçay, Mehmet Sipahi, Lale Karakoç Sökmensüer, Hakan Boyunaga, Ayse Köylü, Suna Ömeroğlu
Endometriosis treatments include medical, surgical, or a combination of these approaches. Even though these options are available to help reduce symptoms and manage any complications, they purely provide temporary relief (Bulletti et al. 2010). The most common medical treatment for endometriosis is gonadotropin-releasing hormone (GnRH) agonists and estrogen/progestin oral contraceptive combinations (Rafique and Decherney 2017). Nowadays, a lot of research is being done to create new treatment options. Ideal treatment should eliminate endometriotic lesions, prevent their recurrence, and not inhibit ovulation and fertility (Lebovic et al. 2004; Bulletti et al. 2010). It is important that the preferred treatment method should maintain the balance between immune response, neoangiogenesis, and OS. In recent years, vitamins and trace elements, which are key cofactors of antioxidant enzymes, are preferred for the prevention and treatment of diseases associated with the reproductive system, because they are powerful free radical scavengers (Bakacak et al. 2015).
The effect of carbamazepine, which increases oestrogen destruction, on the endometriotic implants; an experimental rat model
Published in Journal of Obstetrics and Gynaecology, 2022
Mehmet Bulbul, Mehmet Can Nacar, Bilge Aydin Turk, Talip Karacor, Muhittin Onderci, Ali Parlar, Pınar Kirici, Cihat Ucar
Surgical and medical treatment options are available for the treatment of endometriosis. The main goal in medical treatment is to eliminate the high oestrogenic environment in the endometriotic implants, to prevent neovascularisation, or to try and destroy the lesion by immune modulation. However, due to relapses of the disease, drug side effects, and negative effects on fertility, a fully effective drug has not been found yet. Therefore, new studies are needed for the treatment of endometriosis (Bedaiwy et al. 2017; Maduro 2018). In this experimental study, which we planned according to this need, we aimed to investigate the effects of CMZ on the endometriotic implants in physiological and supraphysiological oestrogenic environments (oestrogenic environment unopposed by progesterone).