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Zhao H, Zhang J, Bao ZL, Kong J, Wei W, Gu JQ. A preoperative predictive model for stage IV endometriosis. J OBSTET GYNAECOL 2023; 43:2188072. [PMID: 36988228 DOI: 10.1080/01443615.2023.2188072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
This was a retrospective study that evaluated a total of 280 patients who underwent surgery for complete removal of endometriosis to develop and validate the predictive model for stage IV endometriosis. The differences between stage I-III and stage IV endometriosis were performed by logistic regression. A model for the prediction of stage IV endometriosis was constructed, which was subsequently validated. The independent variables were visual analogue scale (VAS)≥4 [3.855, 95% confidence interval (CI): 1.675-8.871, p = 0.002], painful nodularity on uterosacral ligaments (13.954, 95% CI: 1.658-117.423, p = 0.015), and bilateral endometriosis (5.933, 95% CI: 1.931-18.225, p = 0.002). The AUC of the model was 0.777, with a sensitivity of 71.9% and specificity of 76.3% for stage IV endometriosis. Therefore, a complete collection of patient information prior to surgery, asking about pain and VAS scores, careful completion of pelvic examinations, and application of imaging techniques are conducive to better diagnosis and prediction of advanced endometriosis.IMPACT STATEMENTWhat is already known on this subject? Endometriosis, a chronic disease causing pain and infertility, is characterised by endometrial-like tissue outside the uterine cavity, which is often treated via surgery at present. Considering the risks of surgery, it is necessary to identify patients with stage IV endometriosis through non-invasive predictive models for adequate preparation for surgery. However, there is no reliable non-invasive predictive model now, despite utilisation of patient medical history, symptoms especially pain-related ones, pelvic examinations, laboratory examinations, and images in the preoperative diagnosis of endometriosis in the clinic.What do the results of this study add? A model developed based on three simple, accessible and non-invasive indicators displays good performance in predicting stage IV endometriosis.What are the implications of these findings for clinical practice and/or further research? It is conducive to diagnosing and predicting advanced endometriosis before surgery, so as to reduce the difficulty and improve the safety of surgery.
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Affiliation(s)
- He Zhao
- Department of Obstetrics and Gynecology, Beijing Anzhen Hospital affiliated to Capital Medical University, Beijing, P.R. China
| | - Jun Zhang
- Department of Obstetrics and Gynecology, Beijing Anzhen Hospital affiliated to Capital Medical University, Beijing, P.R. China
| | - Zhao-Liang Bao
- Department of Obstetrics and Gynecology, Beijing Anzhen Hospital affiliated to Capital Medical University, Beijing, P.R. China
| | - Jia Kong
- Department of Obstetrics and Gynecology, Beijing Anzhen Hospital affiliated to Capital Medical University, Beijing, P.R. China
| | - Wei Wei
- Department of Obstetrics and Gynecology, Beijing Anzhen Hospital affiliated to Capital Medical University, Beijing, P.R. China
| | - Jia-Qi Gu
- Department of Obstetrics and Gynecology, Beijing Anzhen Hospital affiliated to Capital Medical University, Beijing, P.R. China
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Sun S, Li H, Liu M, Shang Q, Tan Q, Yin W. An Evaluation of the Effects of Gestational Weight Gain on the Early Postpartum Pelvic Floor Using Transperineal Ultrasound. J Ultrasound Med 2023; 42:2331-2338. [PMID: 37255035 DOI: 10.1002/jum.16257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/11/2023] [Accepted: 04/29/2023] [Indexed: 06/01/2023]
Abstract
OBJECTIVES We herein evaluated the effects of gestational weight gain (GWG) on postpartum pelvic floor function using transperineal ultrasound (TPUS). METHODS We analyzed retrospectively the data from 228 primiparous women with singleton pregnancies who were evaluated for postpartum pelvic floor function between February 2022 and October 2022. According to the 2009 Institute of Medicine guidelines regarding GWG, subjects were separated into three groups: inadequate GWG, recommended GWG, and excessive GWG. All underwent TPUS 6-10 weeks postpartum to assess bladder neck descent between rest and Valsalva (BND), retrovesical angle at Valsalva (RVA), urethral rotation angle between rest and Valsalva (URA), the area of levator hiatus at Valsalva (LHA), and abnormal pelvic floor function. Univariate and multivariate regression analyses were applied to explore the association measures between GWG and the pelvic floor. A P-value <.05 was considered statistically significant. RESULTS Of the 228 primiparous women, 113 (49.6%) showed excessive GWG. Univariate analysis revealed that there were no statistical differences in ultrasonic parameters of the pelvic floor among the three groups (P > .05). After adjusting for potential confounders and using the recommended GWG group as a reference group, inadequate GWG was significantly associated with BND ≥25 mm (OR = 0.36, 95% CI = 0.14-0.93), and excessive GWG was significantly associated with uterine prolapse (OR = 2.79, 95% CI = 1.13-6.92). CONCLUSIONS GWG was associated with the ultrasonic parameters of the female pelvic floor in the early postpartum period.
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Affiliation(s)
- Shitian Sun
- School of Medical Imaging, Bin Zhou Medical University, Yan Tai, People's Republic of China
| | - Hua Li
- Department of Ultrasonography, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, People's Republic of China
| | - Meiyan Liu
- Department of Ultrasonography, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, People's Republic of China
| | - Qingmei Shang
- Department of Ultrasonography, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, People's Republic of China
| | - Qi Tan
- School of Medical Imaging, Bin Zhou Medical University, Yan Tai, People's Republic of China
| | - Weihong Yin
- Department of Ultrasonography, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, People's Republic of China
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Gremillet L, Netter A, Sari-Minodier I, Miquel L, Lacan A, Courbiere B. Endometriosis, infertility and occupational life: women's plea for recognition. BMC Womens Health 2023; 23:29. [PMID: 36670397 PMCID: PMC9853480 DOI: 10.1186/s12905-023-02183-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/17/2023] [Indexed: 01/21/2023] Open
Abstract
The objective of this study was to explore and describe the specificities of the occupational life of infertile endometriotic women treated by in vitro fertilization. We conducted a qualitative monocentric study between December 2020 and June 2021. Twelve semi-structured in-depth interviews using a theme-based interview guide with open questions were undertaken with infertile women with deep infiltrating endometriosis. Data analysis was conducted using an inductive approach according to the grounded theory method. Three main themes emerged from the interviews: (i) barriers to reconciling illness and work life, (ii) facilitating factors for well-being at work, and (iii) consequences and outlooks. It appeared that the time of infertility treatment represents a particular period of change in the working lives of women with endometriosis. For most women, these changes are experienced negatively, often with a renunciation of goals. For others, this is the time to communicate the difficulties linked to their illness to their professional entourage. There is a long path ahead to finally achieving recognition of endometriosis in the context of professional life.
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Affiliation(s)
- Letizia Gremillet
- grid.411535.70000 0004 0638 9491Department of Gynecology-Obstetrics and Reproductive Medicine, AP-HM, La Conception Hospital, 147 Boulevard Baille, Marseille, France
| | - Antoine Netter
- grid.411535.70000 0004 0638 9491Department of Gynecology-Obstetrics and Reproductive Medicine, AP-HM, La Conception Hospital, 147 Boulevard Baille, Marseille, France ,grid.7310.50000 0001 2190 2394CNRS, IRD, IMBE UMR 7263 FR, AP-HM, Aix Marseille Univ, Avignon University, Marseille, France
| | - Irène Sari-Minodier
- grid.7310.50000 0001 2190 2394CNRS, IRD, IMBE UMR 7263 FR, AP-HM, Aix Marseille Univ, Avignon University, Marseille, France ,grid.414336.70000 0001 0407 1584Faculty of Medical and Paramedical Sciences, AP-HM La Timone, University Hospital Service of Medicine and Occupational Health, Aix Marseille Univ 27, Boulevard Jean Moulin, 13385 Marseille Cedex 5, France
| | - Laura Miquel
- grid.411535.70000 0004 0638 9491Department of Gynecology-Obstetrics and Reproductive Medicine, AP-HM, La Conception Hospital, 147 Boulevard Baille, Marseille, France
| | - Arnaud Lacan
- grid.17673.340000 0001 2325 5880AMSE, CNRS, UMR 7316, Kedge Business School, EHESS, Marseille, France
| | - Blandine Courbiere
- grid.411535.70000 0004 0638 9491Department of Gynecology-Obstetrics and Reproductive Medicine, AP-HM, La Conception Hospital, 147 Boulevard Baille, Marseille, France ,grid.7310.50000 0001 2190 2394CNRS, IRD, IMBE UMR 7263 FR, AP-HM, Aix Marseille Univ, Avignon University, Marseille, France
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Svensson A, Garcia-Etxebarria K, Åkesson A, Borgfeldt C, Roth B, Ek M, D'Amato M, Ohlsson B. Applicability of polygenic risk scores in endometriosis clinical presentation. BMC Womens Health 2022; 22:208. [PMID: 35659226 PMCID: PMC9166598 DOI: 10.1186/s12905-022-01788-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 05/24/2022] [Indexed: 11/18/2022] Open
Abstract
Background Risk prediction is an essential part of preventative medicine and in recent years genomic information has become an interesting factor in risk models. Polygenic risk scores (PRS) combine the effect of many genetic variations into a single score which has been shown to have predictive value for many diseases. This study aimed to investigate the association between PRS for endometriosis and the clinical presentation of the disease. Methods Women with endometriosis (N = 172) were identified at the Department of Gynecology. All participants answered questionnaires regarding sociodemographic factors, lifestyle habits and medical history, registered bowel symptoms on the Visual Analog Scale for Irritable Bowel Syndrome and passed blood samples. DNA was extracted and samples were genotyped, and a PRS was calculated based on previous genome-wide association studies of endometriosis. Inflammatory proteins and TSH receptor antibodies (TRAb) in serum were analyzed. Results Inverse associations were identified between PRS and spread of endometriosis, involvement of the gastrointestinal tract and hormone treatment. However, significance was lost when calculated as p for trend and the specificity and sensitivity were low. There were no correlations between PRS and TRAb or inflammatory proteins. Conclusion The findings indicate that specific PRS should be developed to predict clinical presentations in patient with endometriosis. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01788-w.
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Affiliation(s)
- Agnes Svensson
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden.
| | - Koldo Garcia-Etxebarria
- Biodonostia, Gastrointestinal Genetics Group, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas Y Digestivas (CIBERehd), 20014, San Sebastian, Spain
| | - Anna Åkesson
- Clinical Studies Sweden - Forum South, Skåne University Hospital, Lund, Sweden
| | - Christer Borgfeldt
- Department of Obstetrics and Gynecology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Bodil Roth
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Malin Ek
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Mauro D'Amato
- Gastrointestinal Genetics Lab, CIC bioGUNE - BRTA, Derio, Spain.,Ikerbasque, Basque Foundation for Science, Bilbao, Spain.,Department of Medicine and Surgery, LUM University, Casamassima, Italy
| | - Bodil Ohlsson
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
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de Pedro Negri AM, Ruiz Prieto MJ, Díaz-Mohedo E, Martín-Valero R. Efficacy of Magnetic Therapy in Pain Reduction in Patients with Chronic Pelvic Pain: A Systematic Review. Int J Environ Res Public Health 2022; 19. [PMID: 35627359 DOI: 10.3390/ijerph19105824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/30/2022] [Accepted: 05/06/2022] [Indexed: 12/03/2022]
Abstract
Chronic pelvic pain (CPP), also known as chronic pelvic pain syndrome (CPPS), is a common and painful condition. However, its treatment is still a challenge. The findings about the beneficial effects of electromagnetic therapy provide a new, potentially valid, therapeutic alternative for the management of patients with CPP. Objectives: to analyze the efficacy of magnetic field therapy in pain reduction in patients with CPP and for other variables, such as urinary symptoms and quality of life, as well as to review the evidence, in order to establish an action protocol. A qualitative systematic review was carried out, based on the PRISMA protocol and registered in PROSPERO (CRD42022285428). A search was performed in the PubMed, Medline, Scopus, Cochrane, PEDro, BVS, and WOS databases, including those articles in which the patients suffered from CPP; the study variable was pain, and the intervention was based on the application of magnetic fields. Results: Among the 81 articles found, five clinical trials were considered (with an average score of 7.2 in the PEDro scale), with a total of 278 participants, most of whom presented improvements in perceived pain (p ≤ 0.05), as well as in quality of life (p < 0.05) and urinary symptoms (p = 0.05), evaluated through the NIH-CPSI and VAS scales. The therapy was conducted as a monotherapy or in combination with a pharmacological treatment. There was no common protocol among the different articles. Conclusions: Intervention programs through electromagnetic therapy, on their own or with other therapies, can be effective in patients with CPP.
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