Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ENDOMETRIOSIS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources
PubMed1997

Long-term follow-up on the treatment of endometriosis with the GnRH-agonist buserelinacetate. Long-term follow-up data (up to 98 months) of 42 patients with endometriosis who were treated with GnRH-agonist buserelinacetate (Suprecur), were evaluated in respect of recurrence of pain symptoms and pregnancy outcome.

OBJECTIVE: In our previous study, 119 patients with histologically confirmed endometriosis underwent a 'three-step' therapy between 1987 and 1989, where surgical removal of endometriosis was followed by a 6 month treatment with 3 x 300 microgram buserelinacetate daily intranasally and a second look laparoscopy or laparotomy with removal of residuals. Long-term follow-up data in respect of recurrence of symptoms and pregnancy outcome were investigated. STUDY-DESIGN: Long-term follow-up data of 42 out of 119 treated patients on the post-treatment effect were obtained using a special questionnaire. Recurrence of dysmenorrhea, dyspareunia and pelvic pain was defined as recurrence of disease. The follow-up period was up to 98 months with a median time of 82.5 months. RESULTS: Out of the 42 patients, 23 complained of infertility. Fourteen out of these 23 patients became pregnant during the follow-up period, resulting in 23 pregnancies with 18 newborns, 4 miscarriages and one ectopic pregnancy. Ten patients conceived spontaneously, stimulation program became necessary in the rest of patients. Twenty-eight of the 42 patients complained recurrence of symptoms with median first onset at 10.7 months. Improvement on quality of life and subjective conditions were reported by 30 patients. CONCLUSIONS: Our study suggests that the 'three-step' therapy of endometriosis with GnRH-agonist buserelinacetate leads to a significant improvement on the quality of life and well being in the majority of the patients and to a high pregnancy rate. This treatment represents a favourable approach in the management of endometriosis.

Adult↗
PubMed1990

Stromal endometriosis of the uterine cervix. A variant of endometriosis that may simulate a sarcoma.

Six cases of endometriosis of the uterine cervix characterized by the exclusive or almost exclusive presence of endometriotic stroma are reported. These cases of "stromal endometriosis" were encountered in women 29 to 64 (mean, 43) years of age. Three of them presented with abnormal bleeding, one presented with weight loss and abdominal swelling due to an ovarian clear cell adenocarcinoma, and two were asymptomatic. None of the patients had a history of pelvic endometriosis. In three cases, red lesions of the ectocervical mucosa were recognized on pelvic examination. Histological examination of the lesions showed well circumscribed foci within the superficial stroma of the cervix that were composed of an admixture of closely packed cells resembling endometrial stromal cells, small blood vessels, and extravasated erythrocytes. Endometrial-type glands were absent in the initial sections in all of the cases, but rare glands were found in deeper sections in one case. Apart from the absence or paucity of endometrial glands, the clinical and pathological features of the lesions were similar to those of previously described cases of superficial endometriosis of the cervix. Because of the pure or almost pure stromal composition of the lesion, however, it can be confused histologically with benign and malignant neoplasms, particularly low-grade endometrial stromal sarcoma and Kaposi's sarcoma.

Adult↗
PubMed1999

Recurrent pain after hysterectomy and bilateral salpingo-oophorectomy for endometriosis: evaluation of laparoscopic excision of residual endometriosis.

Endometriosis can represent with a variety of symptoms including pelvic pain, dyspareunia and pain with defaecation, up to several years after hysterectomy and bilateral salpingo-oophorectomy. This may occur when all endometriotic tissue is not excised at the time of the initial procedure. Although excision of endometriosis at this time would be preferable, we have found laparoscopic excision of residual endometriosis to be effective in relieving endometriosis associated pain.

Adult↗
PubMedDate not supplied

Whole endometrial fragments form characteristics of in vivo endometriosis in a mesothelial cell co-culture system: an in vitro model for the study of the histogenesis of endometriosis.

OBJECTIVE: We have previously reported on the effects of tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 (IL-1) on the adhesion of human endometrial stromal cells to peritoneal mesothelial cells in vitro. The relevance of this co-culture system to in vivo endometriosis remains to be established. We contrasted endometrial fragments with endometrial stromal cells to determine their relevance. METHODS: Human mesothelial cells were isolated from peritoneal fluid from four normal women via Ficoll-Paque gradient centrifugation at 400 x g for 30 minutes and grown in M199 medium containing epidermal growth factor (10 ng/mL) and 10% fetal calf serum. The homogeneous cells were cultured on collagen-coated plates until a monolayer formed. Endometrial stromal cells or whole endometrial fragments, isolated from endometrial tissue of four normal women, were put on the mesothelial monolayer and cultured at 37 degrees C for 24 days. After fixation, the samples were incubated with monoclonal antibody to epithelial membrane antigen, cytokeratin, and vimentin, and processed with standard immunohistochemical techniques. RESULTS: Observation under phase contrast microscopy revealed that, in this co-culture system, whole endometrial fragments demonstrated characteristic morphology of in vivo endometriosis, whereas isolated endometrial stromal cells did not. CONCLUSION: Whole endometrial fragments, but not isolated endometrial stromal cells, form morphologically characteristic structures similar to in vivo endometriosis in this co-culture system. It is hoped that this system might be useful for studying certain aspects of the histogenesis of endometriosis.

Adult↗
PubMed1999

Estrogen production in endometriosis and use of aromatase inhibitors to treat endometriosis.

Estrogen is the most important known factor that stimulates the growth of endometriosis. Estrogen delivery to endometriotic implants was classically viewed to be only via the circulating blood in an endocrine fashion. We recently uncovered an autocrine positive feedback mechanism, which favored the continuous production of estrogen and prostaglandin (PG)E2 in the endometriotic stromal cells. The enzyme, aromatase, is aberrantly expressed in endometriotic stromal cells and catalyzes the conversion of C19 steroids to estrogens, which then stimulate cyclooxygenase-2 to increase the levels of PGE2. PGE2, in turn, is a potent inducer of aromatase activity in endometriotic stromal cells. Aromatase is not expressed in the eutopic endometrium. Aromatase expression in endometriosis and its inhibition in eutopic endometrium are controlled by the competitive binding of a stimulatory transcription factor, steroidogenic factor-1, and an inhibitory factor, chicken ovalbumin upstream promoter-transcription factor to a regulatory element in the aromatase P450 gene promoter. In addition, we find that endometriotic tissue is deficient in 17beta-hydroxysteroid dehydrogenase type 2, which is normally expressed in eutopic endometrial glandular cells and inactivates estradiol-17beta to estrone. This deficiency is another aberration that favors higher levels of estradiol-17beta in endometriotic tissues in comparison with the eutopic endometrium. The clinical relevance of local aromatase expression in endometriosis was exemplified by the successful treatment of an unusually aggressive form of recurrent endometriosis in a postmenopausal woman using an aromatase inhibitor.

Aromatase↗
PubMed1992

Nafarelin for endometriosis: a large-scale, danazol-controlled trial of efficacy and safety, with 1-year follow-up. The Nafarelin European Endometriosis Trial Group (NEET).

OBJECTIVE: To compare the efficacy and safety of nafarelin and danazol for endometriosis. DESIGN: Randomized, double-blind, double-dummy. SETTING: Multiple European institutions. PATIENTS: In total, 307 patients with laparoscopically diagnosed endometriosis received nafarelin (n = 206) or danazol (n = 101); 263 (171 nafarelin, 92 danazol) were analyzed for efficacy. INTERVENTIONS: Intranasal nafarelin 200 micrograms two times a day or oral danazol 200 mg three times a day were administered for 6 months. MAIN OUTCOME MEASURES: Efficacy assessments were based on preadmission and end-of-treatment laparoscopic scores and subjective symptom scores at admission, end of treatment, 1, 3, 6, and 12 months after treatment. Safety was evaluated by adverse events and clinical laboratory tests. RESULTS: In each group, endometriosis growth and symptoms significantly improved during treatment (P less than 0.001). After treatment, symptoms returned in each group, but severity was less than at admission at all time points (P less than or equal to 0.016). Mean body weight increased in the danazol-treated group (P less than 0.001), serum glutamic oxaloacetic transaminase increased in both groups (P less than 0.001 for both) but significantly more in danazol users (P less than 0.002), and more nafarelin recipients had hot flushes (P less than 0.001). CONCLUSIONS: Nafarelin and danazol were equally effective in reducing endometriosis growth and symptoms during treatment and in preventing the return of symptoms during 12-month follow-up.

Administration, Intranasal↗
PubMedDate not supplied

A new translaparoscopic approach in endometriosis treatment: a. CO2 laser endometriosis excision and/or vaporization. b. CO2 laser uterine nerve ablation. c. Uterine suspension with Falope Rings. d. Intraperitoneally 32% Dextran-70 installation.

During a period of 18 months with a history of chronic pelvic pain symptomatology (severe dysmenorrhea, severe dyspareunia, extramenstrual pain) retroverted or retroflexed uterus, and infertility were subjected to laparoscopy for diagnostic and therapeutic purposes as well. These women were able to follow up this protocol. After informed consent had been presented patient decided, in a case of endometriosis being verified by the tissue pathology intraoperatively, which one mode of therapy (Group I or Group II) would be administered in her case. All women failed to respond to non-steroidal, antiinflammatory medication, as well as to oral contraceptive treatment. Proposed intraoperative staging of pelvic endometriosis that has not yet been published, was utilized by the author. Group I twenty women were subjected to a translaparoscopic CO2 laser excision and (or vaporization of endometriosis implants, CO2 laser uterine nerve ablation, uterine suspension with Falope Rings and intraperitoneally 32% Dextran was installed. Group II twenty women were subjected only to a translaparoscopic CO2 laser endometriosis excision and/or vaporization and intraperitoneally 32% Dextran-70 was installed. In Group I extramenstrually pain was 90%, severe dysmenorrhea 85%, and infertility 90% were cured. Ten per cent of extramenstrual pain, 5% of severe dysmenorrhea, and 15% of severe dyspareunia were improved. Infertility in this group was unchanged in 10%. Patients' symptoms were not worsened during the 18 months of observation. In Group II only 60% infertility was curred. In 60% extramenstrual pain, in 35% severe dysmenorrhea, in 5% severe dyspareunia were improved. Symptoms were noted to worsen in 5% extramenstrual pain, in 5% severe dysmenorrhea, in 10% severe dyspareunia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2000

Estroprogestin vs. gonadotrophin agonists plus estroprogestin in the treatment of endometriosis-related pelvic pain: a randomized trial. Gruppo Italiano per lo Studio dell'Endometriosi.

OBJECTIVE: This is a randomized clinical trial comparing estroprogestin (E/P) pill given for 12 months vs. gonadotrophin releasing hormone agonist (GNRHa) given for 4 months followed by E/P pill treatment for 8 months in the relief of endometriosis-related pelvic pain. METHODS: Eligible for the study were women with laparoscopically confirmed endometriosis and pelvic pain lasting 3-12 months after diagnosis. Eligible women were randomly assigned to treatment with E/P pill (gestroden 0.75 mg and ethynlestradiol 0.03 mg) for 12 months (47 patients) vs. tryptorelin 3.75 mg slow release every 28 days for 4 months followed by E/P pill for 8 months (55 patients). RESULTS: At baseline, dysmenorrhea was reported in 46 women allocated to E/P pill only (97.9%), and in all the 55 women allocated to GNRHa+E/P pill. The corresponding value at the 12 months follow-up visit was 14 subjects (35.9%) and 16 subjects (34.8%). The baseline median values of the multidimensional and analog scale were for dysmenorrhea 4 and 6 in the EP only and 3 and 6 in the GNRHa+E/P group. The corresponding value at the 12 months follow-up visit were 2 and 6 and 0 and 5. Non-menstrual pain was reported, respectively, at baseline and 12 month visit by 46 (97.9%) and 15 (38.5%) subjects in the E/P pill group and 49 (89.1%) and 17 (37.0%) of the GNRHa+E/P pill one. The baseline median values of the multidimensional and analog scale were for non-menstrual pain 3 and 5 in the E/P only and 2 and 6 in the GNRHa+E/P group. The corresponding values at the 12 month follow-up visit were 0 and 4 and 0 and 4. These differences between the two groups were not statistically significant. CONCLUSIONS: 1 year after randomization, the two treatment schedules show similar relief of pelvic pain in women with endometriosis.

Adult↗
PubMed1992

Goserelin (Zoladex) depot in the treatment of endometriosis. Zoladex Endometriosis Study Group.

STUDY OBJECTIVE: To evaluate the safety and efficacy of Goserelin (Zoladex depot; ICI Pharmaceuticals, Macclesfield, Cheshire, United Kingdom) in the treatment of endometriosis. DESIGN: Open study. SETTING: Eleven centers in Germany and 1 center in Austria. PATIENTS: One hundred forty-six patients with pelvic endometriosis. INTERVENTION: Goserelin (Zoladex depot) therapy, one depot (3.6 mg) subcutaneously every 4 weeks for 6 months. RESULTS: Total subjective score and total pelvic symptom score showed a reduction by 86% and 93%, respectively, at the end of the treatment and did not exceed one fifth of the pretreatment value throughout the follow-up period of 48 weeks. One hundred seven women underwent a second laparoscopy at the end of the therapy for determination of objective efficacy: 54% of the patients showed a reduction of implants and adhesions by at least 50% or more, and 31.5% had a complete resolution of visible deposits. The mean reduction of implants and adhesions was 50%, and the mean reduction of implants 72%. Twenty of 64 (31.3%) previously infertile patients successfully conceived within 12 months after discontinuation of the therapy. Goserelin led to a down regulation of the pituitary ovarian axis and as a pharmacological effect of this hypoestrogenism most patients had hot flushes and vaginal dryness. CONCLUSIONS: Zoladex depot therapy proved to be safe and effective in the medical treatment of endometriosis.

Adult↗
PubMed1980

Heritage aspects of endometriosis. II. Clinical characteristics of familial endometriosis.

Clinical characteristics of patients with histologically confirmed pelvic endometriosis who had an affected first-degree relative (N = 18) were compared to those who had no such affected relative (N = 105). The only significant difference was that 61% of individuals in the former group had severe endometriosis, compared to only 24% in the latter group. This observation is most consistent with a polygenic/multifactorial etiology, although other genetic mechanisms cannot be excluded. Our observations carry several important practical implications. First, an apparently unaffected patient with an affected first-degree relative should be counseled that her risk of developing endometriosis is 7%. This might influence the choice of contraception, the timing of pregnancy, and the extent to which aggressive diagnostic approaches (e.g., laparoscopy and curettage) would be appropriate.

Adolescent↗
PubMed2026

Integrative analysis and experiment validation of SLC12A8 as a biomarker for the malignant transition from endometriosis to endometriosis associated ovarian cancer.

Endometriosis (EM) is a chronic inflammatory, estrogen‑dependent benign gynecological disorder. A subset of patients with EM may subsequently develop endometriosis‑associated ovarian cancer (EAOC), implying a biological continuum between these two conditions. Nevertheless, the molecular events underlying the progression from benign endometriotic lesions toward EAOC remain incompletely characterized. In this study, transcriptomic datasets retrieved from the GEO database were interrogated through differentially expressed gene screening, functional enrichment analysis, and weighted gene co‑expression network analysis (WGCNA) to identify key genes and pathways relevant to EM and EAOC. Candidate genes were further prioritized by integrating survival analysis via the Kaplan‑Meier Plotter, LASSO regression, random‑forest modeling, and CIBERSORT immune‑infiltration profiling. Loss and gain‑of‑function cellular models were established using siRNA and overexpression plasmids, and in‑vitro functional assays were performed to characterize the phenotypic effects of target genes.We identified several candidate genes associated with EM and EAOC and evaluated their discriminatory performance. Among them, SLC12A8 elevated expression across EM and EAOC tissues and exhibited moderate diagnostic capacity. Higher SLC12A8 expression was also associated with poorer prognosis in EAOC patients. In‑vitro experiments further demonstrated that SLC12A8 modulates proliferation, invasion, and migration in both EM and EAOC cell lines. Collectively, our exploratory research findings support SLC12A8 as a candidate functional mediator and potential biomarker linked to EM‑EAOC pathological progression, thereby extending the mechanistic understanding of these disorders.

Female↗
PubMed2003

Primary umbilical endometriosis--a rare variant of cutaneous endometriosis.

A case of primary umbilical endometriosis is being reported here, who presented with a dark brown nodule on the umbilicus with black pigmentation around it for the last seven months, associated with cyclical pain and bleeding from the nodule. Wide local excision of the nodule, laparoscopic tubal ligation and visualization of pelvic cavity was performed, revealing no sign of pelvic endometriosis. Histopathology report showed endometrial glands with stroma in the excised nodule.

Adult↗
PubMed1999

Ablation of lesions or no treatment in minimal-mild endometriosis in infertile women: a randomized trial. Gruppo Italiano per lo Studio dell'Endometriosi.

In order to analyse the efficacy of resection/ablation of minimal/mild endometriotic lesions for improving fertility, we conducted a randomized clinical trial. Eligible patients were women aged </=36 years who were trying to conceive and had a laparoscopically confirmed diagnosis of minimal/mild endometriosis (stage I or II of the revised American Fertility Society classification) and otherwise unexplained infertility for >/=2 years. Eligible women were randomly assigned to resection or ablation of visible endometriosis (54 patients) or diagnostic laparoscopy only (47 patients). After laparoscopy women tried to conceive spontaneously for 1 year (follow-up period). A total of five women withdrew from the study: three for personal reasons, and two were lost to follow-up. Considering 51 women in the resection/ablation and 45 in the no-treatment group who ended the follow-up period, 12 (24%) in the resection/ablation group and 13 (29%) in the no treatment group conceived; the difference was not significant. Two spontaneous abortions were observed in the resection/ablation group and three in the no-treatment one. Thus the 1 year birth rate was 10 out of 51 women (19.6%) in the resection/ablation group and 10 out of 45 women (22.2%) in the no-treatment group. In conclusion, the results of this study do not support the hypothesis that ablation of endometriotic lesions markedly improves fertility rates.

Adult↗
PubMed1999

[Endometriosis. Potential mechanism of sterility. Management of patients with endometriosis. Review and reflections].

Endometriosis is an ailment which has no exact etiology due to its uncertain genesis, its inception can develop unnoticed, its silent evolution makes it difficult to identify it until a cardinal symptom appears and its semeiology provides us facts to integrate a diagnosis, it is an entity that does not have relation while and/or with the reproductive stage, neither with the parity, but we are aware it occurs in its different stages, varying from 9% to 33% in the reproductive cycle, it can be recurring after being medically or surgically treated, appearing endometriomas in it or in the infundibulum stump in the latter case. It is characterized by a collagenosis, endometrio abnormal implant out of the uterus cavity, thereby generating and inflammatory process in the zone of implant, increasing the cytokines production (polypeptide secreted by the lymphocytes and macrophages playing an important role in the immunological response), involving a dysfunction in the hypothalamus-pituitary-ovarian, altering the endocrinos physiology; regarding the genetic aspect, alterations in the chromosomes 4.9 in the Endometriosis frames have been found. The human semen preparation with half Ham F 10 enriched with ascorbic acid is described. In cases of permeable tubes or FIVTE.

Endometriosis↗
PubMed1991

Immunomodulation in the treatment of endometriosis-associated subfertility: use of pentoxifylline to reverse the inhibition of fertilization by surgically induced endometriosis in a rodent model.

OBJECTIVE: To determine the effect of pentoxifylline on early reproductive performance in an animal model for endometriosis. DESIGN: Preclinical blinded study in a rodent model. SETTING: Animal research laboratory. PARTICIPANTS: Sexually mature female golden hamsters. INTERVENTIONS: At laparotomy, groups of hamsters were subjected to: (1) excision of the right uterine horn and (2) excision of the right uterine horn with explantation of four 2-cm2 uterine fragments onto the left uterine mesentery. Six weeks later, surgically treated hamsters and nonsurgically treated controls were subjected to ovulation induction with pregnant mare serum gonadotropin and human chorionic gonadotropin; subsequently, hamsters were divided into groups for periovulatory treatment with either pentoxifylline (2.5 mg/kg) or vehicle given subcutaneously every 8 hours. All hamsters were mated with proven males and killed after 48 hours. MAIN OUTCOME MEASURES: Numbers of unfertilized oocytes and embryos recovered from the left uterine horn at 48 hours after mating. RESULTS: Fertilization rates in surgical and nonsurgical control groups exceeded 90%. Fertilization was significantly impaired in saline-treated animals bearing uterine explants (mean of 2.3% +/- 1.9%). Administration of pentoxifylline dramatically reversed this effect (99.0% +/- 0.7% mean fertilization rate). CONCLUSION: These data suggest that periovulatory treatment with pentoxifylline abrogated the adverse influence of endometrial explants on fertilization in the rodent model. Periovulatory administration of nonteratogenic immunomodulatory agents may provide an alternative to conventional treatment for endometriosis.

Adjuvants, Immunologic↗
PubMed1993

Depot leuprolide acetate versus danazol in the treatment of women with symptomatic endometriosis: a multicenter, double-blind randomized clinical trial. II. Assessment of safety. The Lupron Endometriosis Study Group.

OBJECTIVES: This is the first multicenter, double-blind randomized clinical trial that compares a depot gonadotropin-releasing hormone agonist with danazol in the treatment of endometriosis. Efficacy results have been previously reported; this report focuses on safety data. STUDY DESIGN: A total of 270 patients from 22 centers were randomly selected to receive either leuprolide acetate depot (3.75 mg injected monthly) or danazol (800 mg administered orally daily). Safety outcomes included adverse effects, clinical laboratory changes, and bone mineral density changes. RESULTS: Most patients receiving either drug reported side effects, most of which were related to the hypoestrogenism of leuprolide (e.g., vasodilatation) and relative hyperandrogenism of danazol (e.g., weight gain). Similarly small numbers of patients dropped out of the two treatment groups because of the side effects encountered. Leuprolide depot caused a greater decrease in bone density; preliminary data suggest a return to baseline on cessation of the drug. Danazol was associated with alteration of serum lipids, specifically a significant decrease in high-density lipoprotein. CONCLUSIONS: Although side effects were commonly reported in both groups, the drugs were similarly safe in terms of the absence of serious complications and the results of cessation of therapy. Side effects were largely reversible on discontinuation of medication. More longitudinal data are necessary before the possibility of long-term risks can be excluded, especially as they pertain to bone mineral density and lipids.

Adolescent↗
PubMed1997

Peritoneal endometriosis, ovarian endometriosis, and adenomyotic nodules of the rectovaginal septum are three different entities.

OBJECTIVE: To review the histogenesis of peritoneal, ovarian, and rectovaginal endometriotic lesions. DESIGN: The comparison of morphologic, morphometric, and histochemical data observed in each type of lesion. SETTING: A university hospital department of gynecology. PATIENT(S): Patients complaining of infertility or pelvic pain with laparoscopically proved endometriosis. INTERVENTION(S): Laparoscopy was performed, and biopsy specimens from the endometriotic lesions were histologically studied. RESULT(S): Three types of endometriotic lesions must be considered: peritoneal, ovarian, and rectovaginal. Morphologic and morphometric data show similarities between eutopic endometrium and red peritoneal lesions, suggesting that these lesions are the first stage of early implantation of endometrial glands and stroma. After partial shedding, the red lesions regrow constantly. The shedding induces an inflammatory reaction, provoking scarification, and the lesions become black. The subsequent fibrosis leads to areas of white opacification that are inactive. The pathogenesis of ovarian endometriomas is a source of controversy. Although there seems to be a consensus concerning the invagination theory, there is still a contradiction between the implantation theory and the metaplasia theory. We recently showed that the mesothelium covering the ovary can invaginate into the ovarian cortex, pushing back the primordial follicles. The presence of mesothelial invagination in continuum with endometriotic tissue suggests that metaplastic histogenesis of ovarian endometriotic lesions occurs. Rectovaginal endometriotic nodules must be considered adenomyomas, consisting of smooth muscle with active glandular epithelium and scanty stroma. Immunocytochemical results show poor differentiation and hormonal independence of these lesions and indicate a close relation with their mesodermal müllerian origin. CONCLUSION(S): Peritoneal, ovarian and rectovaginal endometriotic lesions must be considered as three separate entities with different pathogeneses.

Endometriosis↗