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Dzatic-Smiljkovic O, Vasiljevic M, Djukic M, Vugdelic R, Vugdelic J. Frequency of ovarian endometriosis in epithelial ovarian cancer patients. CLIN EXP OBSTET GYN 2011; 38:394-398. [PMID: 22268283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE The aim of this study was to determine the frequency of endometriosis in epithelial ovarian cancer patients. METHODS Patients who had undergone epithelial ovarian cancer surgery between 2000 and 2004 were subjected to a retrospective analysis. The analysis focused on the presence of ovarian endometriosis, histological types and stages of ovarian cancer, treatment types and five-year survival rate. RESULTS Out of the 210 operated ovarian cancer patients, 23 had coexisting ovarian endometriosis. Ovarian endometriosis was detected in 3.5% (4 of 113 patients) of cases with serous ovarian cancer, in 31.6% (12 of 38 patients) of cases with endometrioid, and in 36.8% (7 of 19 patients) of cases with clear cell ovarian cancer. The treatment of ovarian cancer patients was a combination of surgery and chemotherapy. CONCLUSION Endometriosis was most frequently present in patients with clear cell (36.8%) and endometrioid ovarian cancers (31.6%). The five-year survival rate for ovarian cancer patients in all stages was 39.1%.
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MESH Headings
- Adenocarcinoma, Clear Cell/complications
- Adenocarcinoma, Clear Cell/epidemiology
- Adenocarcinoma, Clear Cell/therapy
- Adult
- Aged
- Carcinoma, Endometrioid/complications
- Carcinoma, Endometrioid/epidemiology
- Carcinoma, Endometrioid/therapy
- Carcinoma, Ovarian Epithelial
- Combined Modality Therapy
- Endometriosis/complications
- Endometriosis/epidemiology
- Endometriosis/therapy
- Female
- Humans
- Middle Aged
- Neoplasm Staging
- Neoplasms, Glandular and Epithelial/complications
- Neoplasms, Glandular and Epithelial/epidemiology
- Neoplasms, Glandular and Epithelial/therapy
- Ovarian Neoplasms/complications
- Ovarian Neoplasms/epidemiology
- Ovarian Neoplasms/therapy
- Retrospective Studies
- Serbia/epidemiology
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302
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Melin A, Lundholm C, Malki N, Swahn ML, Sparen P, Bergqvist A. Endometriosis as a prognostic factor for cancer survival. Int J Cancer 2010; 129:948-55. [PMID: 20949560 DOI: 10.1002/ijc.25718] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Accepted: 09/21/2010] [Indexed: 12/24/2022]
Abstract
Studies have shown an increased risk of malignancies in women with endometriosis. Little is known about the impact of endometriosis on cancer survival. We investigated whether the survival after a diagnosis of a malignancy differs in women with a previously diagnosed endometriosis compared to other women. Women with a first time diagnosis of a malignancy in 1969-2005, were identified using the National Swedish Cancer Register (NSCR). By use of the National Swedish Patient Register (NSPR) we identified all women with a diagnosis of endometriosis during the same period and linked these patients with the data from the NSCR. The cohort comprised 4,278 women with endometriosis and a malignancy, and 41,831 randomly selected matched women without endometriosis. Cox regression was used for all calculations to obtain crude and adjusted cause specific mortality rates, measured as hazard ratios (HR) with 95% confidence intervals (CI). A total of 46,109 women entered the study. There was a statistically significant better survival for women with endometriosis for all malignancies combined (HR=0.92) and for breast cancer (HR=0.86) and ovarian cancer (HR=0.81) specifically. For breast cancer the survival enhancing effect in women with endometriosis decreased with increasing parity. There was poorer survival in malignant melanoma for women with endometriosis (HR=1.52). The survival in a malignancy is better in women with a previously diagnosed endometriosis compared to women without endometriosis especially for breast and ovarian cancers. The prognosis of malignant melanoma is poorer in women with endometriosis.
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303
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Paris K, Aris A. Endometriosis-associated infertility: a decade's trend study of women from the Estrie region of Quebec, Canada. Gynecol Endocrinol 2010; 26:838-42. [PMID: 20486880 DOI: 10.3109/09513590.2010.487590] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Endometriosis (ENDO) has been believed to increase during the last years, but recent data supporting this trend are lacking. The aim of this study was to verify whether the incidence of ENDO, infertility (INF) and the both increased during the last 10 years among women living in the Estrie region of Quebec. This retrospective cross-sectional study was realised using data from the CIRESS (Centre Informatisé de Recherche Evaluative en Services et Soins de Santé) system, the database of the CHUS (Centre Hospitalier Universitaire de Sherbrooke), Sherbrooke, Canada. Among the 6845 studied patients, 2564 had ENDO, 4537 were infertile and 256 suffered from both. According to the last 10 years, a significant increase in the number of cases with ENDO (r2 = 0.717, p = 0.001) and endometriosis-associated infertility (r2 = 0.601, p = 0.003) was noted, while INF remained stable (r2 = 2813 e-005, p = 0.987). We showed a prevalence of ENDO of 10.91%. Women with ENDO were at increased risk for being infertile (OR = 2.30; 95% CI = 2.014-2.626, p <0.0001). An increase of ENDO in women 18-24 years of age has been shown (r2 = 0.418, p = 0.023), suggesting an earlier onset of the disease.
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304
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Gemmill JAL, Stratton P, Cleary SD, Ballweg ML, Sinaii N. Cancers, infections, and endocrine diseases in women with endometriosis. Fertil Steril 2010; 94:1627-31. [PMID: 19945097 PMCID: PMC2946463 DOI: 10.1016/j.fertnstert.2009.07.1698] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Revised: 07/14/2009] [Accepted: 07/29/2009] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess the prevalence of patient-reported, physician-diagnosed comorbid conditions in women with endometriosis. DESIGN Cross-sectional study of self-reported survey data. SETTING Academic research. PATIENT(S) Four thousand three hundred thirty-one Endometriosis Association (EA) members reporting surgically diagnosed endometriosis. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Self-reported, physician-diagnosed infectious diseases, cancers, and endocrine diseases. RESULT(S) Nearly two-thirds of women reported one or more of the assessed conditions. Recurrent upper respiratory infections and recurrent vaginal infections were common and more likely in women responding to the EA survey. Melanoma was reported by 0.7% (n=29), breast cancer by 0.4% (n=16), and ovarian cancer by 0.2% (n=10). While ovarian cancer and melanoma were significantly more common than in the general population, breast cancer was surprisingly less common. Addison's disease and Cushing's syndrome were rare (0.2% and 0.1%, respectively). CONCLUSION(S) Respondents reported a higher prevalence of recurrent upper respiratory or vaginal infections, melanoma, and ovarian cancer than the general population. These findings document other potential associations related to the immune system, which may help focus future research into this disease.
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305
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Larosa M, Facchini F, Pozzoli G, Leone M, Grande M, Monica B. [Endometriosis: aetiopathogenetic basis]. Urologia 2010; 77 Suppl 17:1-11. [PMID: 21308668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2010] [Indexed: 05/30/2023]
Abstract
Endometriosis, defined by the presence of endometrial tissue outside the uterine cavity, is a common condition affecting 10% of women in the reproductive age. Menstrual factors reported to increase risk include dysmenorrhea, early menarche, and shorter cycle lengths. The theory of retrograde menstruation with implantation of endometrial fragments, in conjunction with peritoneal factors to stimulate cell growth is the most widely accepted. There is a growing body of evidence that immunological factors and angiogenesis play a key role in the pathogenesis of endometriosis. In women with endometriosis, there appears to be an alteration in the function of peritoneal macrophages, natural killer cells and lymphocytes, with production of growth factors and inflammatory mediators in the peritoneal fluid. Survival, adhesion, proliferation, invasion and vascularization of endometrial tissue in abdominal cavity may be the consequence of retrograde menstruation and referred to as implantation theory.
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306
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Marino G, Piras D, Pedalino M, Di Primio OG, Vella R, Vercesi E. [Indications and limits to endourologic procedures for endometriosis of the urinary tract]. Urologia 2010; 77 Suppl 17:16-19. [PMID: 21308670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2010] [Indexed: 05/30/2023]
Abstract
INTRODUCTION The incidence of Urinary tract endometriosis (UTE) ranges from 1% to 3%; bladder is the most affected organ (85% of UTE), followed by ureter (12 - 14% of UTE), for which we distinguish an intrinsic very rare form and an extrinsic variety most frequently occurring in advanced pelvic endometriosis. MATERIALS AND METHODS From 1997 to 2010, 33 surgical procedures for urologic endometriosis were performed, involving the urinary tract, in 28 patients with mean age of 31 years (25-43). The localization of endometriosis were: 7 cases in the bladder, 2 cases in the vesicoureteral tract, and 19 cases of ureteral tract only. Of these, two cases were diagnosed with an intrinsic localization. RESULTS Overall, we performed 3 TURB, 5 partial cystectomies (2 with open surgical approach and 3 by laparoscopy procedure), 12 laparoscopic ureterolysis and simultaneous protection of the upper urinary tract with stent, 9 cases of ureterocystoneostomy (UCNS) according to Lich-Gregoire procedure, and 3 according to Boari-Kuess procedure. Of the 12 patients who underwent ureterolysis with laparoscopic and stenting procedure, five cases required a UCNS according to Lich-Gregoire technique for persistent ureteral obstruction. CONCLUSIONS The limits of endoscopic procedures in endometriosis of the urinary tract are correlated both to the degree of extension and the localization of the disease. It is mandatory to achieve an interdisciplinary consensus in order to ensure the disease removal and the simultaneous functional results of the upper urinary tract.
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307
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Romanek K, Bartuzi A, Bogusiewicz M, Rechberger T. Risk factors for adenomyosis in patients with symptomatic uterine leiomyomas. Ginekol Pol 2010; 81:678-680. [PMID: 20968175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
OBJECTIVE The aim of the study was to evaluate the potential risk factors for adenomyosis in patients with symptomatic uterine leiomyomas. MATERIAL AND METHODS The medical charts and histopathology reports of 1499 women who underwent hysterectomy between 2003-2007 were retrospectively reviewed. The study group was composed of 135 patients with coexisting uterine leiomyoma and adenomyosis. The control group comprised 176 patients with uterine leiomyoma without adenomyosis. RESULTS Among 233 patients with adenomyosis 135 (57.9%) had associated uterine fibroids. Women who delivered twice or more were at increased risk for adenomyosis in relation to nulliparuos women: RR (95% CI) 2.44 (1.04-5.72), p = 0.040. No relationship was found between adenomyosis and cesarean section rate, abortions, menorrhagia or dysmenorrhea. CONCLUSION Results of our study indicate that multiparity is a risk factor for adenomyosis in women with symptomatic leiomyomas.
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308
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Bulletti C, Coccia ME, Battistoni S, Borini A. Endometriosis and infertility. J Assist Reprod Genet 2010; 27:441-7. [PMID: 20574791 PMCID: PMC2941592 DOI: 10.1007/s10815-010-9436-1] [Citation(s) in RCA: 359] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Accepted: 05/06/2010] [Indexed: 11/30/2022] Open
Abstract
Endometriosis is a debilitating condition characterized by high recurrence rates. The etiology and pathogenesis remain unclear. Typically, endometriosis causes pain and infertility, although 20-25% of patients are asymptomatic. The principal aims of therapy include relief of symptoms, resolution of existing endometriotic implants, and prevention of new foci of ectopic endometrial tissue. Current therapeutic approaches are far from being curative; they focus on managing the clinical symptoms of the disease rather than fighting the disease. Specific combinations of medical, surgical, and psychological treatments can ameliorate the quality of life of women with endometriosis. The benefits of these treatments have not been entirely demonstrated, particularly in terms of expectations that women hold for their own lives. Although theoretically advantageous, there is no evidence that a combination medical-surgical treatment significantly enhances fertility, and it may unnecessarily delay further fertility therapy. Randomized controlled trials are required to demonstrate the efficacy of different treatments.
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309
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Gylfason JT, Kristjansson KA, Sverrisdottir G, Jonsdottir K, Rafnsson V, Geirsson RT. Pelvic endometriosis diagnosed in an entire nation over 20 years. Am J Epidemiol 2010; 172:237-43. [PMID: 20616202 DOI: 10.1093/aje/kwq143] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The annual incidence of pelvic endometriosis among women aged 15-49 years and up to age 69 years was ascertained for the Icelandic population between 1981 and 2000 by using Iceland's extensive record linkage systems. Comprehensive, state-financed health care and unique personal identification numbers enabled care to be tracked from first diagnosis. To identify cases, a centralized discharge-code registry was searched, as well as all hospital databases and, for individual patients, all hospital records. Each case of visually diagnosed and histologically verified endometriosis was cross-checked against the nationwide pathology registry. The revised American Society for Reproductive Medicine classification system was used for staging. Recorded was type of operation at diagnosis and presence of disease at 5 sites: deep pelvis, appendages, central pelvis, vesicouterine pouch, and ovaries. A total of 1,383 women were diagnosed surgically, with histologic verification of 811 (58.6%). All but 6 cases could be staged; 297 (36.9%) had minimal/mild and 508 (63.1%) had moderate/severe disease. The estimates of crude annual incidence were 0.1% for visually confirmed and 0.06% for histologically verified endometriosis, and respective age-standardized annual incidence was 0.1% and 0.05% for women aged 15-49 years. The most common site was the ovary, followed by deep pelvis, central pelvis, appendages, and vesicouterine pouch.
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310
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Nouri K, Ott J, Krupitz B, Huber JC, Wenzl R. Family incidence of endometriosis in first-, second-, and third-degree relatives: case-control study. Reprod Biol Endocrinol 2010; 8:85. [PMID: 20618992 PMCID: PMC2911462 DOI: 10.1186/1477-7827-8-85] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2010] [Accepted: 07/11/2010] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Initial publications examining the hereditary aspects of endometriosis appeared in the early seventies and demonstrated an up to seven-fold risk for endometriosis in first-degree relatives of endometriosis patients. The aim was to evaluate the influence of hereditary aspects on the endometriosis risk in our patient collective. METHODS In a retrospective cohort study we evaluated the incidence of endometriosis among first-, second-, and third-degree relatives of endometriosis patients and compare it with its incidence among first-, second-, and third-degree relatives of patients without endometriosis. RESULT(S) Eighty patients in whom endometriosis had been confirmed laparoscopically and histologically by biopsy and 60 patients in whom no endometriosis had been found during laparoscopy were given a questionnaire about the presence of symptoms associated with endometriosis and its family incidence. Patients of both the endometriosis and the control group were 37.7 +/- 6.2 and 45.9 +/- 12.0 years of age at the time of the interview, respectively (p < 0.05). Information about the presence of endometriosis was more readily available for relatives of those in the endometriosis group than for those in the control group (325/749 [43.4%] vs. 239/425 [56.2%], p < 0.05). In 5/136 (3.7%) and 8/134 (6.0%) first-degree relatives of endometriosis patients and the control group, respectively, information about the presence of endometriosis was not available (p = 0.554). Endometriosis was found in 8/136 (5.9%) first-degree relatives of patients and in 4/134 (3.0%) first-degree relatives of controls in the real-case analysis (p = 0.248). When comparing endometriosis characteristics between endometriosis patients with and without a history of familial endometriosis, no significant differences were found. CONCLUSION(S) There is a trend toward an increased familial incidence of endometriosis. In contrast to the literature, we found a less dramatic increase in familial risk for the development of endometriosis.
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311
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Leyland N, Casper R, Laberge P, Singh SS. Endometriosis: diagnosis and management. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2010; 32:S1-S32. [PMID: 21545757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To improve the understanding of endometriosis and to provide evidence-based guidelines for the diagnosis and management of endometriosis. OUTCOMES OUTCOMES evaluated include the impact of the medical and surgical management of endometriosis on women's experience of morbidity and infertility. METHODS Members of the guideline committee were selected on the basis of individual expertise to represent a range of practical and academic experience in terms of both location in Canada and type of practice, as well as subspecialty expertise along with general gynaecology background. The committee reviewed all available evidence in the English and French medical literature and available data from a survey of Canadian women. Recommendations were established as consensus statements. The final document was reviewed and approved by the Executive and Council of the SOGC. RESULTS This document provides a summary of up-to-date evidence regarding diagnosis, investigations, and medical and surgical management of endometriosis. The resulting recommendations may be adapted by individual health care workers when serving women with this condition. CONCLUSIONS Endometriosis is a common and sometimes debilitating condition for women of reproductive age. A multidisciplinary approach involving a combination of lifestyle modifications, medications, and allied health services should be used to limit the impact of this condition on activities of daily living and fertility. In some circumstances surgery is required to confirm the diagnosis and provide therapy to achieve the desired goal of pain relief or improved fecundity. Women who find an acceptable management strategy for this condition may have an improved quality of life or attain their goal of successful pregnancy. EVIDENCE Medline and Cochrane databases were searched for articles in English and French on subjects related to endometriosis, pelvic pain, and infertility from January 1999 to October 2009 in order to prepare a Canadian consensus guideline on the management of endometriosis. VALUES The quality of evidence was rated with use of the criteria described by the Canadian Task Force on Preventive Health Care. Recommendations for practice were ranked according to the method described by the Task Force. See Table 1. BENEFITS, HARMS, AND COSTS Implementation of the guideline recommendations will improve the care of women with pain and infertility associated with endometriosis.
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312
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Weuve J, Hauser R, Calafat AM, Missmer SA, Wise LA. Association of exposure to phthalates with endometriosis and uterine leiomyomata: findings from NHANES, 1999-2004. ENVIRONMENTAL HEALTH PERSPECTIVES 2010; 118:825-32. [PMID: 20185384 PMCID: PMC2898860 DOI: 10.1289/ehp.0901543] [Citation(s) in RCA: 126] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Accepted: 02/25/2010] [Indexed: 05/17/2023]
Abstract
BACKGROUND Phthalates are ubiquitous chemicals used in consumer products. Some phthalates are reproductive toxicants in experimental animals, but human data are limited. OBJECTIVE We conducted a cross-sectional study of urinary phthalate metabolite concentrations in relation to self-reported history of endometriosis and uterine leiomyomata among 1,227 women 20-54 years of age from three cycles of the National Health and Nutrition Examination Survey (NHANES), 1999-2004. METHODS We examined four phthalate metabolites: mono(2-ethylhexyl) phthalate (MEHP), monobutyl phthalate (MBP), monoethyl phthalate (MEP), and monobenzyl phthalate (MBzP). From the last two NHANES cycles, we also examined mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and mono(2-ethyl-5-oxohexyl) phthalate (MEOHP). We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for potential confounders. RESULTS Eighty-seven (7%) and 151 (12%) women reported diagnoses of endometriosis and leiomyomata, respectively. The ORs comparing the highest versus lowest three quartiles of urinary MBP were 1.36 (95% CI, 0.77-2.41) for endometriosis, 1.56 (95% CI, 0.93-2.61) for leiomyomata, and 1.71 (95% CI, 1.07-2.75) for both conditions combined. The corresponding ORs for MEHP were 0.44 (95% CI, 0.19-1.02) for endometriosis, 0.63 (95% CI, 0.35-1.12) for leiomyomata, and 0.59 (95% CI, 0.37-0.95) for both conditions combined. Findings for MEHHP and MEOHP agreed with findings for MEHP with respect to endometriosis only. We observed null associations for MEP and MBzP. Associations were similar when we excluded women diagnosed > 7 years before their NHANES evaluation. CONCLUSION The positive associations for MBP and inverse associations for MEHP in relation to endometriosis and leiomyomata warrant investigation in prospective studies.
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313
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Attar R, Agachan B, Kuran SB, Toptas B, Eraltan IY, Attar E, Isbir T. Genetic variants of vascular endothelial growth factor and risk for the development of endometriosis. In Vivo 2010; 24:297-301. [PMID: 20555002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND/AIMS Endometriosis is regarded as a complex disese, in which genetic and environmental factors contribute to the disease phenotype. Whether vascular endothelial growth factor (VEGF) -460 C/T and +405 G/C polymorphisms are associated with susceptibility to endometriosis was investigated. PATIENTS AND METHODS Diagnosis of endometriosis was made on the basis of laparoscopic findings. Stage of endometriosis was determined according to the Revised American Fertility Society classification. Sixty out of the 112 women enrolled had no endometriosis, 11 had mild or early-stage endometriosis and 41 had severe endometriosis. Polymerase chain reaction (PCR), restriction fragment length polymorphism and agarose gel electrophoresis techniques were used to determine the -460 C/T and +405 G/C genotypes. RESULTS The VEGF +405 G/C genotype frequencies among the cases and controls were CC 55.8% and 35%; GC 30.8% and 50.0%; GG 13.5% and 15.0%, respectively. The allelic frequencies were C 71.15% (cases) and 60.0% (controls) and G 28.8% (cases) and 40% (controls). Patients with endometriosis had a higher incidence of the VEGF +405 CC genotype compared with the controls (p=0.027). Women with VEGF +405 CC genotype had 2.3-fold higher risk for endometriosis. VEGF +405 GC genotype and G allele in the control group was higher than the endometriosis group (p=0.039, p=0.027 respectively). The VEGF -460 C/T genotype frequencies among the cases were CC 21.2%, CT 26.9% and TT 51.9%; the C and T allelic frequencies were 34.6% and 65.3%, respectively. The VEGF -460 genotype frequencies among the controls were CC 31.70%, CT 18.3% and TT 50.0%; the C and T allelic frequencies were 40.8% and 59.1%, respectively (p>0.05). There was linkage disequilibrium between VEGF -460 C/T and +405 G/C polymorphisms (D': 0.197, r(2)=0.013). We observed that the VEGF 460T/405C haplotype frequency was significantly higher in patients compared to controls (p=0.011). CONCLUSION Our data suggest that the CC genotype of VEGF +405 and 460T/405C haplotypes of VEGF may be associated with the risk of endometriosis, but the G allele of VEGF +405 appears to be protective against endometriosis.
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314
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Vitonis AF, Baer HJ, Hankinson SE, Laufer MR, Missmer SA. A prospective study of body size during childhood and early adulthood and the incidence of endometriosis. Hum Reprod 2010; 25:1325-34. [PMID: 20172865 PMCID: PMC2854045 DOI: 10.1093/humrep/deq039] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2008] [Revised: 11/06/2009] [Accepted: 01/25/2010] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND An inverse association between adult body mass index (BMI) and risk of endometriosis has frequently been reported. However, the association between body size during childhood and early adulthood and endometriosis is not as well documented. METHODS Using data collected from the Nurses' Health Study II, a prospective cohort study of premenopausal US nurses, that began in 1989, we have attempted to clarify this relationship. Data are updated every 2 years with follow-up for these analyses through 2001. In 1989 women recalled their body size at ages 5, 10 and 20 years using a validated 9-level figure drawing. RESULTS During 831 910 person-years of follow-up, 1817 cases of self-reported laparoscopically-confirmed endometriosis were observed among women with no past infertility. After adjusting for age, birthweight, age at menarche, parity, oral contraceptive use and adult BMI, we observed a significant reduction in the incidence of endometriosis with increasing body size for all time periods. The relative risks (RRs) comparing the smallest and largest figure sizes to the middle category during childhood (ages 5-10) were 1.18 (95% confidence interval 1.02-1.36) and 0.82 (0.66-1.02), P-trend = 0.0002. At age 20, the RRs for the same comparisons were 1.32 (1.06-1.65) and 0.87 (0.74-1.03), P-trend = 0.04. Additional adjustment by menstrual cycle length and regularity yielded similar associations. The associations were stronger among nulliparous women than among parous women, although not all differences were statistically significant. CONCLUSION In this large cohort of premenopausal women, there was evidence of a persistent inverse association between childhood and early adulthood body size and incidence of laparoscopically confirmed endometriosis, independent of adult BMI and menstrual cycle characteristics.
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Abstract
OBJECTIVES To describe the relationship between endometriosis and ovarian cancer. SEARCH STRATEGY Review of the relevant clinical, epidemiologic, and molecular biology literature. SELECTION CRITERIA Studies published in the English language using the MEDLINE database. DATA COLLECTION AND ANALYSIS Relevant studies were reviewed by the three authors and those that seem to be of significant scientific value, based on the methodology and statistical power, were included. MAIN RESULTS Endometriosis and ovarian cancer share many common predisposing factors. Both conditions demonstrate similar patterns regarding local invasion and distal spread they respond similarly to estrogen-induced growth signaling, they express resistance to apoptotic mechanisms and they are characterized by genomic instability. Endometrioid and clear-cell are the most frequent types of ovarian cancer associated with endometriosis. Tubal ligation, in women with endometriosis, seems to prevent retrograde menstruation but it has also been shown to be protective from these types of ovarian cancer. CONCLUSION There is evidence to support that endometriosis (by definition a benign process), could simultaneously have the potential for malignant transformation. More studies are needed to establish risk factors that may lead to malignant transformation of this condition and to identify predisposed individuals who may require closer surveillance.
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316
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Larkin M. CEM outbreak took its toll on U.S. J Am Vet Med Assoc 2010; 236:270-271. [PMID: 20131494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Knight J. A deeper insight. Nurs Stand 2010; 24:64. [PMID: 20191749 DOI: 10.7748/ns2010.01.24.20.64.p4315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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318
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El Nahas M. Editorial comment. NEPHRON. CLINICAL PRACTICE 2010; 114:c94. [PMID: 20191693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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319
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Sun ZJ, Zhu L, Lang JH. A rare extrapelvic endometriosis: inguinal endometriosis. THE JOURNAL OF REPRODUCTIVE MEDICINE 2010; 55:62-66. [PMID: 20337210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To study the diagnosis and treatment of inguinal endometriosis. STUDY DESIGN A retrospective study was made of 9 patients presenting with inguinal endometriosis between January 1986 and November 2008. RESULTS The incidence of inguinal endometriosis was 0.07% among a total of 13,352 patients with endometriosis treated. Eight of 9 patients (88.9%) had lesions on the right side. The symptoms in 6 patients fluctuated with menses. Only in 3 of them with cyclic symptoms was inguinal endometriosis suspected preoperatively. Symptomatic complaints ranged from 3 months to 10 years, with an average interval of 3 years. Eight patients received complete excision of inguinal lumps. One patient with a lump of 5 cm in diameter underwent a wide excision including the extraperitoneal portion of the round ligament. Four cases underwent pelvic exploration at the same time, and it revealed the coexistence of ovarian endometriomas. No one showed recurrence in the groin on follow-up of 19-96 months. CONCLUSION Inguinal endometriosis is rare and often diagnosed accidentally. It is mostly right-sided and concomitant with pelvic endometriosis. The surgical procedure is complete excision of the mass. Pelvic exploration should be performed if necessary.
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Abstract
BACKGROUND Regular exercise has been associated with a 40%-80% reduction in risk for endometriosis in several case-control studies. However, women experiencing symptoms prior to their diagnosis may be less likely to exercise than healthy controls, thus biasing the observed association. METHODS Using data collected from the Nurses' Health Study II, a prospective cohort study of premenopausal US nurses that began in 1989, we have attempted to clarify this relation. Data are updated every 2 years with follow-up for these analyses through 2001. In 1989, 1991, and 1997 women reported average amount of time per week engaging in various physical activities. A metabolic equivalent (MET) score was assigned to each activity, and these were summed to estimate total activity. RESULTS A total of 102,197 premenopausal women contributed 996,422 person-years of follow-up with 2703 cases of laparoscopically confirmed endometriosis. After adjusting for BMI at age 18, current BMI, smoking, parity, infertility status, oral contraceptive use, age at menarche, and menstrual cycle length and pattern in college, we observed only a slight reduction in the incidence of endometriosis, comparing the highest level of activity (>or=42 MET hours/week) to the lowest (<3 MET hours/week) (rate ratio = 0.89 [95% confidence interval = 0.77-1.03]). The association was limited to participants with no past or concurrent infertility (P = 0.002, test for heterogeneity). No associations were seen with inactivity. CONCLUSIONS In this first prospective assessment, we did not find evidence of the strong inverse association previously reported, although we cannot rule out a modest inverse association.
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Szendei GA. Endometriosis in Hungary. Gynecol Endocrinol 2009; 25:694-700. [PMID: 19903047 DOI: 10.3109/09513590903230234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Endometriosis is a growing healthcare problem all around the world. I discuss in this article how the hungarian healthcare system is working and helping patients suffering from endometriosis. I discuss all diagnostic and therapeutic possibilities which are available for the patients. I discuss also some data from my own practice, 181 patients suffering from chronic pelvic pain caused by endometriosis.
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Steinkasserer M, Engl B. Endometriosis in the north Italian province of South Tyrol. Gynecol Endocrinol 2009; 25:748-50. [PMID: 19903053 DOI: 10.3109/09513590903230408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Here, we report regarding the health status and medical support for patients suffering from endometrioisis in South Tyrol, which is a politically autonomous province in the north of Italy containing three different ethnic groups. The health service is administered largely by the autonomous regional government. Because of the establishment of a centre for reproductive medicine and the introduction of laparoscopy as a prime surgery method, the gynaecological department of the hospital in Bruneck developed into a reference centre for diagnosis and surgical treatment for endometriosis. The planned future social, health care and insurance developments on local and national level regarding this illness will be discussed.
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Camanni M, Bonino L, Delpiano EM, Berchialla P, Migliaretti G, Revelli A, Deltetto F. Laparoscopic conservative management of ureteral endometriosis: a survey of eighty patients submitted to ureterolysis. Reprod Biol Endocrinol 2009; 7:109. [PMID: 19818156 PMCID: PMC2770480 DOI: 10.1186/1477-7827-7-109] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2009] [Accepted: 10/12/2009] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND this study aims to evaluate the effectiveness and safety of laparoscopic conservative management of ureteral endometriosis. METHODS Eighty cases of histologically confirmed endometriosis affecting the ureter, 10 of which with bladder involvement were prospectively studied. In detail, patients were 13 women with ureteral stenosis (7 with hydronephrosis), 32 with circular lesions totally encasing the ureter, and 35 with endometriotic foci on the ureteral wall, but not completely encasing it. They were submitted to laparoscopic ureterolysis with or without partial cystectomy, ureteroneocistostomy. The rate of surgical complications, the recurrence rate, the patients' satisfaction rate was assessed during 22 months (median) follow-up. RESULTS Laparoscopic ureterolysis was employed for all patients and set free the ureter from the disease in 95% of cases, whereas ureteroneocystostomy was necessary for 4 patients showing severe stenosis with hydronephrosis, among which 2 had intrinsic endometriosis of the ureteral muscularis. Three post-surgery ureteral fistulae occurred in cases with ureteral involvement longer than 4 cm: two cases were successfully treated placing double J catheter, the third needed ureteroneocistostomy. During follow-up, ureteral endometriosis recurred in 2 patients who consequently underwent ureteroneocystostomy. Most patients expressed high satisfaction rate throughout the whole follow-up period. CONCLUSION laparoscopic ureterolysis is effective and well tolerated in most cases of ureteral endometriosis. Ureteroneocystostomy is a better strategy for patients with extended (more than 4 cm) ureteral involvement or with severe stenosis with or without hydronephrosis.
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Lim MC, Lee DO, Kang S, Seo SS, Lee BY, Park SY. Clinical manifestations in patients with ovarian clear cell carcinoma with or without co-existing endometriosis. Gynecol Endocrinol 2009; 25:435-40. [PMID: 19499405 DOI: 10.1080/09513590902770131] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVES The symptoms associated with ovarian cancer are vague. Endometriosis, which causes dysmenorrhea and dyspareunia, is frequently detected along with ovarian clear cell carcinoma (OCCC). We have therefore evaluated the clinical manifestations of OCCC based on the co-existence of endometriosis. METHODS A retrospective analysis was conducted on 43 patients who had been treated for OCCC at the National Cancer Center between June 2000 and July 2007. Using medical records and the cancer registry, the clinical features and laboratory findings were analysed. RESULTS Endometriosis was identified in 16 (37.2%) of the 43 patients with OCCC. The main presenting symptoms included a hard, palpable mass (32.6%), and newly developed or an exacerbation of dysmenorrhea (32.6%) and dyspareunia (25.6%). Gastrointestinal symptoms, pelvic pain, and abdominal distension existed in nine (20.9%), eight (18.6%) and one (2.3%) of the patients, respectively. The symptoms did not differ statistically in patients with or without endometriosis. Thirty-seven percent (11/30) of the patients had a normal CA-125 level (<35 U/ml); 18.8% (3/16) of the patients without endometriosis and 57% (8/14) of the patients with endometriosis had normal levels of CA-125 (<35 U/ml). Nine of 16 (56.3%) patients with early stage OCCC had a normal CA-125 level. CONCLUSIONS The main presenting symptoms in patients with OCCC include a hard, palpable mass, dysmenorrhea and dyspareunia, irrespective of co-existing endometriosis. A normal CA-125 level has limited value in excluding OCCC, especially in the early stages.
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Bulletti C, Montini A, Setti PL, Palagiano A, Ubaldi F, Borini A. Vaginal parturition decreases recurrence of endometriosis. Fertil Steril 2009; 94:850-5. [PMID: 19524893 DOI: 10.1016/j.fertnstert.2009.04.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2007] [Revised: 02/23/2009] [Accepted: 04/03/2009] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To evaluate the role of parturition in the recurrence of endometriosis. DESIGN Retrospectively analyzed, prospectively obtained data. SETTING Unit of Physiopathology of Reproduction, Health Care Unit of Rimini, and University of Bologna Cervesi General Hospital, Cattolica, Italy. PATIENT(S) Three hundred forty-five patients with stage II-IV endometriosis, dysmenorrhea, and infertility were treated for endometriosis and divided into four groups according to parity and mode of parturition. INTERVENTION(S) The patients were laparoscopically treated for endometriosis upon the occurrence and recurrence of the disease. Ultrasound measurements of the uterine internal ostium (IOS) were performed at each study interval. MAIN OUTCOME MEASURE(S) Degree of dysmenorrhea, occurrence and recurrence of endometriosis, and uterine IOS measurements were established and related to parity and mode of parturition. RESULT(S) After parturition, dysmenorrhea recurrence was significantly higher in nulliparous women than in women with vaginal parturition. The endometriosis recurrence rate was higher in women who did not have vaginal parturition. The IOS significantly enlarged after vaginal delivery but not after cesarean delivery. There were significant negative correlations between IOS and the recurrence of endometriosis and dysmenorrhea. Odds ratios indicated that as the IOS enlarged, the risk of recurrence decreased. CONCLUSION(S) Vaginal parturition plays a protective role in the recurrence of endometriosis.
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