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Biomedical subjects

Lan Zhu

Publications and source records attributed to Lan Zhu.

At least 19 recordsLinked to original sources
PubMed2006

[Repair of abdominal wall defect after resection of abdominal wall endometriosis].

OBJECTIVE: To study the techniques to repair the fascia layer of abdominal wall after the resection of abdominal wall endometriosis (AWE). METHODS: Fifty-five AWE patients aged 28 approximately 38 underwent resection of the lesion. After the resection a defect fascia in abdominal wall larger than 2 cm(2) was seen in 29 patients (large fascia defect group), and in the other 26 patients the fascia defect was less than 2 cm(2) (small fascia defect group). In the large fascia defect group, 11 cases underwent routine closure of the abdominal wall, 2 underwent abdominal wall reconstruction by applying tension suture, 1 case underwent fascia layer/skin tension-relieving suture, 4 cases abdominal wall reconstruction by PDS-II suture, 4 cases underwent fascia patch grafting, and 7 cases underwent abdominal wall plastic repair plus fascia patch grafting, the different techniques being selected according to the size of the defect. Routine abdominal wall closure was performed on all the 26 patients in the small fascia detect group. The features of the lesion and operation, and the outcomes were compared. RESULTS: Primary healing was achieved in all the patients. In comparison with the small fascia defect group, the mean size of the masses measured by pre-operational ultrasonography of the large fascia defect group was significantly bigger [(3.8 +/- 1.4) cm vs. (2.5 +/- 1.1 cm)], the mean size of the masses resected in operation was significantly larger [(5, 5 +/- 2.0) cm vs. (3.7 +/- 1.9) cm, P = 0.004], the operation time was significantly longer [(66 +/- 42) min vs. (35 +/- 24) min, P = 0.002], and the intra-operational blood loss was significantly more [(52 +/- 50) ml vs. (23 +/- 19) ml, P = 0.006]. Relapse occurred in 1 case in the large fascia defect group. CONCLUSION: Ultrasonography helps estimate the extension of AWE before operation. Fascia layer/skin tension-relieving suture can be used in the fascia defect of abdominal wall larger than 2 cm(2). Abdominal wall plastic repair plus fascia patch grafting is capable of repairing larger fascia layer and skin defects of abdominal wall.

Abdominal Wall↗
PubMed2006

[The study on the prevalence and associated risk factors of female urinary incontinence in Beijing women].

OBJECTIVES: To evaluate the prevalence, the clinical characteristics and associated risk factors of urinary incontinence in Beijing women. METHODS: In the cross-sectional study, 5300 Beijing women aged over 20 years were interviewed through a questionnaire including International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Module (ICIQ-FLUTS). Aged from 20 to 99 years old (mean 46 +/- 17). Divided into 8 groups every 10 years. 4812 cases are married. RESULTS: The overall prevalence of UI was 38.5% (2008/5221), among theses women, 22.9% (1197/5221), had stress incontinence, 2.8% (147/5221) urge incontinence and 12.4% (649/5221) mixed incontinence. In multiple logistic models, age, delivery mode, smoking, hypertension, constipation, body mass index, chronic pelvic pain (CPP) were relation factors for stress incontinence. CONCLUSIONS: The prevalence of urinary incontinence is high (38.5%). Urinary incontinence is major disease that affects female quality of life. 22.9% (1197/5221) of the incontinence women had stress urinary incontinence, 2.8% (147/5221) urge urinary incontinence and 12.4% (649/5221) mixed urinary incontinence. Old, vaginal delivery, smoking, hypertension, constipation, CPP and higher BMI are potential risk factors for stress urinary incontinence. Cesarean section are protective factors for stress urinary incontinence.

Adult↗
PubMed2006

Role of laparoscopy in the diagnosis and treatment of adnexal masses.

BACKGROUND: Laparoscopy has been accepted for years as a management of benign ovarian tumors. The aim of this study was to estimate the feasibility and safety of laparoscopy in diagnosis and management of adnexal masses. METHODS: A total of 2083 patients with benign adnexal mass were treated by laparoscopy at Peking Union Medical College Hospital from January 2000 to December 2003. Their clinical data were reviewed retrospectively. All the adnexal masses suspicious of malignancy at the time of laparoscopy were sent for frozen section evaluation intraoperatively. The rates of unexpected intracystic vegetation and low malignant potential (LMP) tumor or malignancy were investigated. The sensitivity, specificity, positive predictive value, and negative predictive value of laparoscopic diagnosis for LMP or ovarian malignancies were calculated. The ratios were compared by Chi-square test and the continuous variables were tested using two-tailed t test. RESULTS: Of the 2083 patients, 16 had LMP or invasive tumors (0.77%), among which 14 were diagnosed histologically intraoperatively and 2 postoperatively. Fifty-five (2.6%) of the 2083 patients had unexpected intracystic vegetations. Their frozen sections showed benign tumors in 41 (74.5%), LMP tumors in 8 (14.5%), and focal invasive ovarian cancers (stage Ic) in 6 (10.9%). The final pathological diagnosis were benign tumors in 41 (74.5%), LMP tumors 7 (12.7%), and focal invasive ovarian cancers (stage Ic) in 7 (12.7%). Laparoscopy achieved a sensitivity of 87.5%, specificity of 98%, positive predictive value of 25.5%, and negative predictive value of 99.9% in the diagnosis of ovarian malignancies. 2067 cases with benign adnexal masses underwent laparoscopy successfully. No conversion to laparotomy, or intra- and postoperative complications in this series. Of the 16 patients with LMP or invasive ovarian cancer, seven underwent laparoscopic surgery including immediate staging laparoscopy in 3. The mean follow-up was 17.3 months for the 16 patients. Among them, 1 developed a recurrent LMP tumor in the contralateral ovary 36 months after laparoscopic salpingo-oophorectomy, and received subsequent laparoscopic cystectomy and pelvic lymph node sampling; the others had no evidence of recurrent tumor during the follow-up. CONCLUSION: Laparoscopy is feasible for diagnosis of adnexal masses, and the surgery is safe for patients with benign ovarian tumors.

Adolescent↗
PubMed2006

Chronic inhibition of dipeptidyl peptidase-4 with a sitagliptin analog preserves pancreatic beta-cell mass and function in a rodent model of type 2 diabetes.

Inhibitors of dipeptidyl peptidase-4 (DPP-4), a key regulator of the actions of incretin hormones, exert antihyperglycemic effects in type 2 diabetic patients. A major unanswered question concerns the potential ability of DPP-4 inhibition to have beneficial disease-modifying effects, specifically to attenuate loss of pancreatic beta-cell mass and function. Here, we investigated the effects of a potent and selective DPP-4 inhibitor, an analog of sitagliptin (des-fluoro-sitagliptin), on glycemic control and pancreatic beta-cell mass and function in a mouse model with defects in insulin sensitivity and secretion, namely high-fat diet (HFD) streptozotocin (STZ)-induced diabetic mice. Significant and dose-dependent correction of postprandial and fasting hyperglycemia, HbA(1c), and plasma triglyceride and free fatty acid levels were observed in HFD/STZ mice following 2-3 months of chronic therapy. Treatment with des-fluoro-sitagliptin dose dependently increased the number of insulin-positive beta-cells in islets, leading to the normalization of beta-cell mass and beta-cell-to-alpha-cell ratio. In addition, treatment of mice with des-fluoro-sitagliptin, but not glipizide, significantly increased islet insulin content and improved glucose-stimulated insulin secretion in isolated islets. These findings suggest that DPP-4 inhibitors may offer long-lasting efficacy in the treatment of type 2 diabetes by modifying the courses of the disease.

Animals↗
PubMed2006

[Protective effect of rosiglitazone on myocardium in diabetic cardiomyopathy of rats].

OBJECTIVE: To investigate the protective effect of PPARgamma ligands rosiglitazone on myocardium in diabetic cardiomyopathy of rats. METHODS: The rat model of diabetes was induced by administration of streptozotocin (STZ) for 6 or 10 weeks. In the treatment group the STZ-induced diabetic rats were treated with rosiglitazone. The left ventricular muscle specimens were taken from treatment and control group; then were examined under transmission electron microscope. RESULT: Cardiac myofibrils of diabetic rats in control group were obviously fewer and broken. There were fewer and smaller dissolved mitochondria with incomplete membrane and mixed cristae and karyopyknosis. Myocardium of diabetic rats treated with rosiglitazone was markedly improved although their blood glucose levels were still high. CONCLUSION: Hyperglycemia can cause destruction of myocardial cell structure. Rosiglitazone has protective effect on myocardial cells of diabetic rats, which seems to be independent of blood glucose levels.

Animals↗
PubMed2006

Fallopian tube prolapse following hysterectomy.

OBJECTIVE: To investigate the clinical diagnosis, treatment, and prevention of fallopian tube prolapse (FTP) after hysterectomy. METHODS: A total of 7949 patients received hysterectomy from January 1983 to August 2005 in Peking Union Medical College Hospital, and 9 cases (including 1 case from other hospital) of FTP after hysterectomy were involved during this period. All of them were diagnosed according to pathological results and were followed up. The symptoms, diagnosis, and treatment of the FTP patients were analyzed retrospectively. RESULTS: The incidence of FTP after hysterectomy was 0.1% (8/7949), with the incidence of FTP after transabdominal hysterectomy being 0.06% (4/6229), after trans-vaginal hysterectomy being 0.5% (4/780), after laparoscopic assistant vaginal hysterectomy being 0 (0/940). There was no symptom in 3 cases. The pelvic examination revealed the typical prolapsed fimbrial end of a fallopian tube in 3 cases and the other 6 cases revealed red granulation tissue. All of them were excised vaginally and cauterized. The results were proved by pathological examination. No recurrence was reported during follow-up. CONCLUSIONS: FTP is a rare complication after hysterectomy. The prognosis is well after proper diagnosis and treatment Fixation of accessories onto the pelvic wall and complete peritonealization at the time of hysterectomy are the most important methods to prevent FTP after hysterectomy.

Adult↗
PubMed2006

[Study of sexual function in women after surgery for stress urinary incontinence].

OBJECTIVE: To investigate the change of the patients' sexual function after the surgeries for stress urinary incontinence (SUI). METHODS: Pelvic organ prolapse-urinary incontinence sexual function questionnaire (PISQ) was sent to 62 sexually active patients who underwent laparoscopic Burch colposuspension or had a tension free vaginal tape (TVT) inserted at least 6 months after the operation, to a maximum of 3 years. The patient was divided into two groups according to different operations, different follow-up intervals and whether there was concomitant coital incontinence before the operations respectively. The changes of PISQ scores before and after the operation were compared between two groups. For the groups not having significant difference in PISQ score, we compared the rate of PISQ score improvement and the rate of satisfaction postoperatively. Multivariate logistic regression analyses were performed to determine whether age, parity, body mass index, menstrual status, surgical history, medical illness, severity of SUI, concomitant hysterectomy and intraoperative or postoperative complications affected the change of sexual function. RESULTS: Fifty-six patients answered the questionnaire giving a follow-up rate of 90%. The average score of PISQ was 85.2 +/- 10.7 and 82.4 +/- 17.7 before and after the surgery, and there was no significant difference (P > 0.05); however behavioral emotional domain scores worsened (30.5 +/- 6.6 vs 26.8 +/- 10.7, P < 0.05). The PISQ scores of the patients who underwent the operation within a year declined significantly (86.0 +/- 10.7 vs 77.7 +/- 18.6, P < 0.05), especially in behavioral emotional domain (31.0 +/- 7.2 vs 23.7 +/- 11.3, P < 0.01); however after a year, there was no significant change (84.4 +/- 10.8 vs 86.5 +/- 16.1, P > 0.05) and even an improvement in the physical domain (34.5 +/- 5.6 vs 36.9 +/- 4.3, P < 0.05). Regarding the sexual function improvement ratio, the patients who had the TVT operations (54% vs 12%) or had concomitant coital incontinence before the operations (62% vs 23%) were better (P < 0.01). The change of PISQ scores was independent of clinical features. CONCLUSIONS: The operations of SUI have an adverse effect on the patients' sexual life within a year, which may recover after that period. TVT operation has a better effect on the patients sexual function compared with laparoscopic Burch colposuspension; the patients who have concomitant coital incontinence before the operations have a better sexual function improvement.

Adult↗
PubMed2006

[Clinical analysis of fallopian tube prolapse after hysterectomy].

OBJECTIVE: To investigate the clinical diagnosis, treatment and prevention of fallopian tube prolapse (FTP) after hysterectomy. METHODS: A total of 7949 patients received hysterectomy from 1983 to Aug 2005 in Peking Union Medical College Hospital, including 6229 cases of trans-abdominal hysterectomy (TAH), 780 cases of transvaginal hysterectomy (TVH), and 940 cases of laparoscopic assisted vaginal hysterectomy (LAVH). Nine cases (including 1 case from other hospital) of FTP after hysterectomy were analyzed retrospectively for their symptoms, diagnosis and treatment. All of them were diagnosed according to the results of histology and follow-up. RESULTS: The overall incidence of FTP after hysterectomy was 0.11% (9/7949). Incidence of FTP after trans-abdominal hysterectomy was 0.08% (5/6229), after vaginal hysterectomy 0.51% (4/780), and after laparoscopic assisted vaginal hysterectomy 0 (0/940). There were no symptoms in 3 cases, but the other 6 cases had symptoms. The pelvic examination revealed the typical prolapsed fimbrial end of a fallopian tube in 3 cases and red granulation tissue in the other 6 cases. All of them were excised vaginally and cauterized. The results were confirmed by histological examination. No recurrent cases were reported in follow up. CONCLUSIONS: FTP is a rare complication after hysterectomy. The prognosis is well after proper diagnosis and treatment. Salpingectomy or fixation of accessories into the pelvic wall and complete peritonealisation at the time of hysterectomy are important methods to prevent FTP after hysterectomy.

Adult↗
PubMed2006

[A prospective control study on treatment of stress urinary incontinence with alpha-adrenoceptor agonists and pelvic floor muscle exercises].

OBJECTIVE: To evaluate the therapeutic results of alpha-adrenoceptor agonists and pelvic floor muscle exercises (PFME) for stress urinary incontinence. METHODS: A prospective, single-center, random control study was carried out in 46 patients with stress urinary incontinence (SUI). The patients were divided into two groups, 22 in alpha-adrenoceptor agonists group vs 24 in PFME group. Clinical outcomes and the scores of quality of life were evaluated and compared between the two groups. RESULTS: Two patients in alpha-adrenoceptor agonists group and four patients in PFME group were failed to complete the study. According to patient's subjective scores, excellent effective rate was 15% (3/20) and effective rate was 85% (17/20) in alpha-adrenoceptor agonists group versus effective rate of 55% (11/20) and no-effective rate of 45% (9/20) in PFME group. According to objective 1 h pad test criteria, the efficacy was significantly better in alpha-adrenoceptor agonists group (P < 0.01). The scores of quality of life were improved in all patients of two groups after treatment, and were significantly better in alpha-adrenoceptor agonists group (P < 0.05). There was no difference in sexual life score in PFME group and alpha-adrenoceptor agonists group. CONCLUSIONS: Both alpha-adrenoceptor agonists and PFME are effective non-surgical treatments for stress urinary incontinence. However, alpha-adrenoceptor agonists have better effect than PFME.

Adrenergic alpha-Agonists↗
PubMed2006

[Clinical features and treatment options for aggressive angiomyxoma].

OBJECTIVE: To discuss the clinical features and treatment options for aggressive angiomyxoma (AAM). METHODS: We retrospectively analyzed the clinical data of 4 patients with AAM treated at PUMC Hospital from January 1990 to December 2004. RESULTS: There were 1 man and 3 women with an average age of 34 years. The average age of the female patients were 27 years. Two patients (50%) had urinary or enteric compressive complaints, while another 2 patients had no clinical symptoms. Two patients underwent transvaginal surgeries, 1 patient underwent transabdomenal surgery, and 1 patient underwent subcurtaneouly local excision. Three patients (75%) experienced recurrences after operation and the median relapse time was 2.5 years. CONCLUSIONS: AAM usually occurs in female pelvic cavity and the soft tissues of female perineum. AAM is huge in capacity, and easy to infiltrate or recur locally.

Adolescent↗
PubMed2006

[Effects of levonorgestrel-releasing intrauterine system on pain and recurrence associated with endometriosis and adenomyosis].

OBJECTIVE: To observe the effects of levonorgestrel-releasing intrauterine system (LNG-IUS) in treatment of pain associated with endometriosis (EM) and adenomyosis (AM), and in prevention of disease recurrence. METHODS: Thirty-three cases of moderate to severe EM or AM patients received insertion of LNG-IUS immediately after conservative operation, or after recurrence of simple pain, and were self controlled respectively before and after insertion of LNG-IUS. The visual analogue scale (VAS) was compared, and the change of the lesion and the uterine size, as well as the serum steroid and CA(125) were observed. The side-effects, such as bleeding pattern were recorded. The bleeding period was compared between the cases injected with or without gonadotropin-releasing hormone agonist (GnRHa) before insertion of LNG-IUS. RESULTS: Baseline and follow-up VASs of EM were 8.09 +/- 0.21 and 1.64 +/- 1.12 (P = 0.042), of AM were 8.41 +/- 1.59 and 3.99 +/- 3.87 (P = 0.068), respectively. During nearly 2 years' follow-up, moderate dysmenorrhea recurred in only 1 case who was hyper-estrogenism at that time. Generally, irregular bleeding and spotting period were longer in this LNG-IUS treated group than those reported in literatures in which LNG-IUS was used for contraception. Persistent prolonged spotting was seen in most of the patients during 1 year follow-up. Average bleeding days in one month during the first 6 months after insertion of LNG-IUS were both around 18 days, whether using GnRHa or not. CONCLUSIONS: LNG-IUS greatly reduces pain associated with EM and AM, and delays disease recurrence. Irregular bleeding and spotting is the main side effects. Administration of GnRHa in advance does not improve the bleeding symptoms.

Adult↗
PubMed2005

Morphologic study on levator ani muscle in patients with pelvic organ prolapse and stress urinary incontinence.

The objective of this study was to determine the morphologic changes of the levator ani muscle of patients with pelvic organ prolapse and stress urinary incontinence. Histological and histochemical analyses of the biopsy specimens of the levator ani muscle obtained from patients with stress urinary incontinence (SUI), pelvic organ prolapse (POP), and a control group were performed. The striated muscle-positive biopsy rate was 26.7% in the SUI group, 15.8% in the POP group, whereas it was 100% in the control group. The diameters of types I and II fibers decreased significantly with age and menopausal time in the control group. Splitting or fragmentation of fibers with red granules, which are called ragged-red fibers, were found in the SUI group. The diameters of levator ani muscle fibers in the control group were significantly larger than those in the SUI group (p=0.034<0.05). The degenerative change in histology and decrease in relative number of levator ani muscle might be associated with women suffering from SUI.

Adult↗
PubMed2005

[Expression of vascular endothelial growth factor receptors in the ectopic and eutopic endometrium of women with endometriosis].

OBJECTIVE: To study the localization and expression of the vascular endothelial growth factor receptors (VEGFR) Fms-like tyrosine kinase (Flt-1) and kinase insert domain-containing receptor (KDR) in human ectopic and eutopic endometrium of patients with endometriosis. METHODS: Specimens of endometriosis patients, aged (38 +/- 8) years, including 37 specimens of entopic endometrium, 34 specimens of ovarian chocolate cyst, 34 specimens of ovarian chocolate cyst, 15 specimens of red peritoneal endometriosis lesions, and 4 abdominal wall endometriosis lesions were collected. Specimens of endometrium of 33 patients with other gynecological diseases, aged (36 +/- 8) years, were collected during operation and used as controls. Immunohistochemistry was used to detect the location and expression of Flt-1 and KDR protein in different tissues. Western blotting was used to detect the protein expression of Flt-1 and KDR protein in different tissues. The mRNA expressions of Flt-1 and KDR were detected by RT-PCR. RESULTS: Flt-1 and KDR were expressed in the endometrial glandular epithelium and stromal cells besides the endometrial blood vessels. The positive expression rate of Flt-1 and KDR in the ectopic endometrium of endometriosis patients were 94.3% and 91.4% respectively, both significantly higher than those in the ovarian endometrial cyst (74.3% and 77.1% respectively, both P < 0.05), and similar to those in the eutopic endometrium of the endometriosis patients (93.8% and 90.6% respectively, both P > 0.05). In the eutopic endometrium of the endometriosis patients, the Flt-1 mRNA expression level was 2.4 +/- 1.2 and the Flt-1 protein expression level was 31 +/- 17, and the KDR mRNA expression level was 3.0 +/- 1.4 and the KDR protein expression level was 36 +/- 24, all significantly higher than those in the ovarian endometrial cyst (1.5 +/- 0.9 and 1.8 +/- 1.0 for the Flt-1 and KDR mRNA expressions, and 17 +/- 6 and 20 +/- 11 for the Flt-1 and KDR protein expressions, all P < 0.05), and similar to those in the eutopic endometrium of the non-endometriosis patients (1.9 +/- 0.8 and 2.3 +/- 1.3 for the Flt-1 and KDR mRNA expressions, and 24 +/- 18 and 25 +/- 16 for the Flt-1 and KDR protein expressions, all P > 0.05) CONCLUSION: VEGF may play certain biological role in the development of endometriosis through VEGFR (Flt-1 and KDR). The expression of Flt-1 and KDR in the endometriotic lesion appears to be associated with neovascualization.

Adult↗
PubMed2005

Simultaneous inference of selection and population growth from patterns of variation in the human genome.

Natural selection and demographic forces can have similar effects on patterns of DNA polymorphism. Therefore, to infer selection from samples of DNA sequences, one must simultaneously account for demographic effects. Here we take a model-based approach to this problem by developing predictions for patterns of polymorphism in the presence of both population size change and natural selection. If data are available from different functional classes of variation, and a priori information suggests that mutations in one of those classes are selectively neutral, then the putatively neutral class can be used to infer demographic parameters, and inferences regarding selection on other classes can be performed given demographic parameter estimates. This procedure is more robust to assumptions regarding the true underlying demography than previous approaches to detecting and analyzing selection. We apply this method to a large polymorphism data set from 301 human genes and find (i) widespread negative selection acting on standing nonsynonymous variation, (ii) that the fitness effects of nonsynonymous mutations are well predicted by several measures of amino acid exchangeability, especially site-specific methods, and (iii) strong evidence for very recent population growth.

Computational Biology↗
PubMed2005

A composite-likelihood approach for detecting directional selection from DNA sequence data.

We present a novel composite-likelihood-ratio test (CLRT) for detecting genes and genomic regions that are subject to recurrent natural selection (either positive or negative). The method uses the likelihood functions of Hartl et al. (1994) for inference in a Wright-Fisher genic selection model and corrects for nonindependence among sites by application of coalescent simulations with recombination. Here, we (1) characterize the distribution of the CLRT statistic (Lambda) as a function of the population recombination rate (R=4Ner); (2) explore the effects of bias in estimation of R on the size (type I error) of the CLRT; (3) explore the robustness of the model to population growth, bottlenecks, and migration; (4) explore the power of the CLRT under varying levels of mutation, selection, and recombination; (5) explore the discriminatory power of the test in distinguishing negative selection from population growth; and (6) evaluate the performance of maximum composite-likelihood estimation (MCLE) of the selection coefficient. We find that the test has excellent power to detect weak negative selection and moderate power to detect positive selection. Moreover, the test is quite robust to bias in the estimate of local recombination rate, but not to certain demographic scenarios such as population growth or a recent bottleneck. Last, we demonstrate that the MCLE of the selection parameter has little bias for weak negative selection and has downward bias for positively selected mutations.

Base Sequence↗
PubMed2005

(2R)-4-oxo-4-[3-(trifluoromethyl)-5,6-dihydro[1,2,4]triazolo[4,3-a]pyrazin-7(8H)-yl]-1-(2,4,5-trifluorophenyl)butan-2-amine: a potent, orally active dipeptidyl peptidase IV inhibitor for the treatment of type 2 diabetes.

A novel series of beta-amino amides incorporating fused heterocycles, i.e., triazolopiperazines, were synthesized and evaluated as inhibitors of dipeptidyl peptidase IV (DPP-IV) for the treatment of type 2 diabetes. (2R)-4-Oxo-4-[3-(trifluoromethyl)-5,6-dihydro[1,2,4]triazolo[4,3-a]pyrazin-7(8H)-yl]-1-(2,4,5-trifluorophenyl)butan-2-amine (1) is a potent, orally active DPP-IV inhibitor (IC(50) = 18 nM) with excellent selectivity over other proline-selective peptidases, oral bioavailability in preclinical species, and in vivo efficacy in animal models. MK-0431, the phosphate salt of compound 1, was selected for development as a potential new treatment for type 2 diabetes.

Administration, Oral↗
PubMed2005

Abdominal wall endometriomas.

OBJECTIVE: To investigate the clinical characteristics, treatment, and factors of recurrence of abdominal wall endometriomas (AWE). METHOD: Sixty-four cases of AWE diagnosed at Peking Union Medical College Hospital (PUMCH) from 1983 to 2003 were reviewed retrospectively. RESULT: There was an AWE incidence of 0.044% among the parturients undergoing cesarean section at PUMCH, of whom 87.5% had the typical complaint of an enlarging mass and pain during menstruation. Among these women, 62 underwent low abdominal surgery for endometrioma (2 for primary umbilicus endometrioma); 2 women with small endometriomas opted for a temporary medical solution and had relief after menopause. The latent period of AWE positively correlated to the women's age at onset of symptoms (P<0.001). Of the 62 women who underwent local excision, 19 had an unsatisfactory experience with medical management. There were 5 recurrences and 1 evolution to malignancy during a mean follow-up of 83.7 months. Recurrence was closely related to the size and depth of lesions. CONCLUSION: Because of its typical clinical manifestations, abdominal wall endometriomas could be diagnosed before pregnancy. Surgical excision is the only effective treatment and wide local excision with clear margins is the key point to prevent recurrence.

Abdominal Wall↗