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Latest & greatest articles for endometriosis
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on endometriosis or other clinical topics then use Trip today.
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Hormonal treatment for endometriosis associated pelvic pain Hormonal treatment for endometriosis associated pelvic pain Hormonal treatment for endometriosis associated pelvic pain Wong WS, Lim CE CRD summary The review concluded that it appeared that combined oral contraceptive pills, gonadotrophin-releasing hormone analogues and progestogens were all effective and well tolerated by patients in treating endometriosis-associated pain, but side effects had to be considered. The review had some (...) methodological problems and data limitations that limit the reliability of the authors’ conclusions. Authors' objectives To evaluate the effectiveness of hormonal treatments of endometriosis associated pain in women of reproductive age. Searching MEDLINE and Cochrane Database of systematic reviews were searched from 1995 to 2009 for articles in English. Search terms were reported. Study selection Randomised controlled trials (RCTs) of medical treatments aimed at improving symptomatic endometriosis-associated
Oral contraceptives and risk of endometriosis: a systematic review and meta-analysis Oral contraceptives and risk of endometriosis: a systematic review and meta-analysis Oral contraceptives and risk of endometriosis: a systematic review and meta-analysis Vercellini P, Eskenazi B, Consonni D, Somigliana E, Parazzini F, Abbiati A, Fedele L CRD summary This review concluded that oral contraceptive exposure could decrease the risk of endometriosis in current users, but increase the risk in previous (...) users. The evidence was insufficient to recommend oral contraceptives to prevent endometriosis. The methodological limitations in the included studies and in the review mean that these conclusions may not be reliable. Authors' objectives To determine whether combined oral contraceptives change the risk of endometriosis. Searching MEDLINE was searched for publications, in English, from 1970 to January, 2010. Search terms were reported. Reference lists of included articles were handsearched to locate
ARID1A mutations in endometriosis-associated ovarian carcinomas. BACKGROUND: Ovarian clear-cell and endometrioid carcinomas may arise from endometriosis, but the molecular events involved in this transformation have not been described. METHODS: We sequenced the whole transcriptomes of 18 ovarian clear-cell carcinomas and 1 ovarian clear-cell carcinoma cell line and found somatic mutations in ARID1A (the AT-rich interactive domain 1A [SWI-like] gene) in 6 of the samples. ARID1A encodes BAF250a (...) somatic mutations each. Loss of the BAF250a protein correlated strongly with the ovarian clear-cell carcinoma and endometrioid carcinoma subtypes and the presence of ARID1A mutations. In two patients, ARID1A mutations and loss of BAF250a expression were evident in the tumor and contiguous atypical endometriosis but not in distant endometriotic lesions. CONCLUSIONS: These data implicate ARID1A as a tumor-suppressor gene frequently disrupted in ovarian clear-cell and endometrioid carcinomas. Since
Endometriosis and infertility: pathophysiology and management. Endometriosis and infertility are associated clinically. Medical and surgical treatments for endometriosis have different effects on a woman's chances of conception, either spontaneously or via assisted reproductive technologies (ART). Medical treatments for endometriosis are contraceptive. Data, mostly uncontrolled, indicate that surgery at any stage of endometriosis enhances the chances of natural conception. Criteria for non (...) for a global approach to infertility associated with endometriosis. Copyright 2010 Elsevier Ltd. All rights reserved.
Anti-TNF-alpha treatment for pelvic pain associated with endometriosis. BACKGROUND: Endometriosis is a chronic, recurring condition that can develop during the reproductive years. It is characterized by the development of endometrial tissue outside the uterine cavity. It is the most common cause of pelvic pain in women. This endometrial tissue development is dependent on estrogen produced primarily by the ovaries and, therefore, traditional management has focused on suppression of ovarian (...) function. The mounting evidence shows that altered immune function plays a crucial role in the genesis and development of endometriosis. In this review we considered modulating the inflammation as an alternative approach. OBJECTIVES: To determine the effectiveness and safety of anti-tumour necrosis factor-alpha (anti-TNF-alpha) drugs in the management of pelvic pain associated with endometriosis. SEARCH STRATEGY: We searched for trials in the following databases (from their inception to August 2009
Nonsteroidal anti-inflammatory drugs for pain in women with endometriosis. BACKGROUND: Endometriosis is a common gynaecological condition that affects women and can lead to painful symptoms and infertility. It greatly affects women's quality of life, impacting on their careers, everyday activities, sexual and non-sexual relationships, and fertility. Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly used first-line treatment for endometriosis. OBJECTIVES: To assess the effects (...) of NSAIDs used for the management of pain in women with endometriosis compared to placebo, other NSAIDs, other pain management drugs, or no treatment. SEARCH STRATEGY: We searched the Cochrane Menstrual Disorders and Subfertility Group Trials Register (April 2008) published in the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE (1966 to April 2008), EMBASE (1980 to April 2008), and the reference lists from relevant publications. Experts in the field were also
Hormone therapy for endometriosis and surgical menopause. BACKGROUND: Endometriosis is characterized by the presence of ectopic endometrial tissue that might lead to many distressing and debilitating symptoms. Despite available studies supporting standard hormone therapy for women with endometriosis and post-surgical menopause, there is still a concern that estrogens may induce a recurrence of the disease and its symptoms. OBJECTIVES: This review aimed to look at pain and disease recurrence (...) in women with endometriosis who used hormone therapy for post-surgical menopause. SEARCH STRATEGY: We searched the Cochrane Menstrual Disorders and Subfertility Group Specialized Register (March 2008), Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2008, Issue 3), MEDLINE (1966 to March 2008), EMBASE (1980 to March 2008), and references lists of articles. Relevant journals and conference proceedings were handsearched. SELECTION CRITERIA: Randomized controlled trials
The effect of second-line surgery on reproductive performance of women with recurrent endometriosis: a systematic review The effect of second-line surgery on reproductive performance of women with recurrent endometriosis: a systematic review The effect of second-line surgery on reproductive performance of women with recurrent endometriosis: a systematic review Vercellini P, Somigliana E, Vigano P, De Matteis S, Barbara G, Fedele L CRD summary This review evaluated the effect of repetitive (...) surgery for endometriosis on conception. It found that repetitive surgery was associated with lower pregnancy rates compared with primary surgery, and that the results of in-vitro fertilisation were not inferior to those of re-operation. Given potential limitations in the quality of the data and review process, the reliability of these conclusions is uncertain. Authors' objectives The primary objective was to define the effects of repetitive surgery for recurrent endometriosis on postoperative
Medical treatment for rectovaginal endometriosis: what is the evidence? Medical treatment for rectovaginal endometriosis: what is the evidence? Medical treatment for rectovaginal endometriosis: what is the evidence? Vercellini P, Crosignani PG, Somigliana E, Berlanda N, Barbara G, Fedele L CRD summary The authors concluded that medical treatments of women with rectovaginal endometriosis were effective for pain relief. Given that the studies were limited by size, quality and were heterogeneous (...) with regard to drug and dosage, this conclusion should be treated with caution. Authors' objectives To evaluate the efficacy of medical treatments for pain associated with rectovaginal endometriosis. Searching PubMed and EMBASE were searched for English-Language articles from January 1989 to March 2009. Search terms were reported. Bibliographies of retrieved articles and review articles, books and monographs published on endometriosis were handsearched for additional material. No attempt was made
Laparoscopic management of endometriosis: comprehensive review of best evidence Laparoscopic management of endometriosis: comprehensive review of best evidence Laparoscopic management of endometriosis: comprehensive review of best evidence Yeung PP, Shwayder J, Pasic RP CRD summary The authors found that laparoscopic treatment of endometriosis reduced pain and improved fertility. Co-interventions that may help (in appropriate circumstances) included laparoscopic presacral neurectomy, pre (...) -operative and/or postoperative hormonal suppression, excisional cystectomy with mesna and/or initial circular excision and anti-adhesive barriers. Due to methodological problems in the review, particularly the failure to assess study quality, the conclusions should be regarded cautiously. Authors' objectives To assess the effectiveness of laparoscopic techniques for pain and/or fertility problems associated with endometriosis. Searching The Cochrane Library and MEDLINE were searched from 1966. Search
Systematic review of the effects of aromatase inhibitors on pain associated with endometriosis Systematic review of the effects of aromatase inhibitors on pain associated with endometriosis Systematic review of the effects of aromatase inhibitors on pain associated with endometriosis Patwardhan S, Nawathe A, Yates D, Harrison GR, Khan KS CRD summary This review found that although aromatase inhibitors appeared to have a promising effect on pain associated with endometriosis, but due (...) to the paucity of good quality evidence, the strength of the inference was limited. The review was well conducted and the authors' conclusions are likely to be reliable. Authors' objectives To evaluate the effects of aromatase inhibitors in women with symptoms of pain with endometriosis. Searching MEDLINE, EMBASE, CINAHL and the Cochrane Library were searched from inception to 2007 for relevant published studies, using a combination of keywords (not reported). Reference lists from the review and primary
[Evaluation of pain and depression in women with endometriosis after a multi- professional group intervention]. 17952353 2007 10 22 2008 07 31 2016 08 15 0104-4230 53 5 2007 Sep-Oct Revista da Associacao Medica Brasileira (1992) Rev Assoc Med Bras (1992) [Evaluation of pain and depression in women with endometriosis after a multi- professional group intervention]. 433-8 Evaluate pain and depression scores before and after multi-professional group intervention in women with endometriosis as (...) compared to those who did not participate in this activity. A total of 128 women attended at the Endometriosis Outpatient Facility CAISM/UNICAMP, was assessed and distributed equally into two groups: women who received group intervention and those who did not. All women completed the Beck Depression Inventory and the Analogical Visual Scale. There was a significant decrease in pain and depression scores at the end of group intervention. Women who had not participated in the intervention had higher
Danazol for pelvic pain associated with endometriosis. BACKGROUND: Endometriosis is defined as the presence of endometrial tissue (stromal and glandular) outside the normal uterine cavity. Conventional medical and surgical treatments for endometriosis aim to remove or decrease the deposits of ectopic endometrium. The observation that hyper androgenic states (an excess of male hormone) induce atrophy of the endometrium has led to the use of androgens in the treatment of endometriosis. Danazol (...) is one of these treatments. The efficacy of danazol is based on its ability to produce a high androgen and low oestrogen environment (a pseudo menopause) which results in atrophy of the endometriotic implants and thus an improvement in painful symptoms. OBJECTIVES: To determine the effectiveness of danazol compared to placebo or no treatment in the treatment of the symptoms and signs, other than infertility, of endometriosis in women of reproductive age. SEARCH STRATEGY: We searched the Cochrane
Oral contraceptives for pain associated with endometriosis. BACKGROUND: Endometriosis is a common gynaecological condition which affects many women of reproductive age worldwide and is a major cause of pain and infertility. The modern oral contraceptive pill is widely used to treat pain occurring as a result of endometriosis, although the evidence for its efficacy is limited. OBJECTIVES: To assess the effects of the oral contraceptive pill (OCP) in comparison to other treatments for painful (...) symptoms of endometriosis in women of reproductive age. SEARCH STRATEGY: We searched the Menstrual Disorders and Subfertility Group Specialised Register of controlled trials; Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2006); MEDLINE (January 1966 to September 2006); EMBASE (1980 to September 2006); National Research Register; and reference lists of articles. SELECTION CRITERIA: All truly randomised controlled trials of the use of oral contraceptive pills
Ovulation suppression for endometriosis. BACKGROUND: Endometriosis is the finding of endometrial glands or stroma in sites other than the uterine cavity. Endometriosis appears to be an oestrogen dependent condition. This hormonal dependency has prompted the therapeutic use of ovulation suppression agents, in an effort to improve subsequent fertility. OBJECTIVES: To assess the effectiveness of ovulation suppression agents, including danazol, progestins and oral contraceptives, in the treatment (...) of endometriosis-associated subfertility in improving pregnancy outcomes including live birth. SEARCH STRATEGY: We searched the Cochrane Menstrual Disorders and Sub-fertility Group's specialised register of trials (searched October 5th, 2007) the Cochrane Register of Controlled Trials (The Cochrane Library, Issue 3, 2007), MEDLINE (1966-October 2007), EMBASE (1980 - October 2007) and reference lists of articles. SELECTION CRITERIA: Randomised trials comparing an ovulation suppression agent with placebo
WITHDRAWN: Gonadotrophin-releasing hormone analogues for pain associated with endometriosis. BACKGROUND: Endometriosis is a common gynaecological condition that frequently presents with the symptom of pain. The precise pathogenesis (mode of development) of endometriosis is unclear but it is evident that endometriosis arises by the dissemination of endometrium to ectopic sites and the subsequent establishment of deposits of ectopic endometrium. The observation that endometriosis is rarely seen (...) hormones due to non stimulation of the ovary). OBJECTIVES: To determine the effectiveness of Gonadotrophin Releasing Hormone analogues (GnRHas) in the treatment of the painful symptoms of endometriosis by comparing them with no treatment, placebo, other recognised medical treatments, and surgical interventions. SEARCH STRATEGY: The search strategy of the Menstrual Disorders and Subfertility review group (please see Review Group details) was used to identify all randomised trials of the use of GnRHas
Levonorgestrel-releasing intrauterine device (LNG-IUD) for symptomatic endometriosis following surgery. BACKGROUND: Various options exist for treating endometriosis, including ovarian suppression therapy, surgical treatment or a combination of these strategies. Surgical treatment of endometriosis sets out to remove visible areas of endometriosis and restore anatomy by division of adhesions. The aim of medical therapy is to inhibit growth of endometriotic implants by suppression of ovarian (...) steroids and induction of a hypo-estrogenic state. Postoperative treatment with a hormone-releasing intrauterine system, using levonorgestrel (LNG-IUS), has been suggested. OBJECTIVES: To determine if postoperative use of an LNG-IUS in women with endometriosis improves pain symptoms associated with menstruation and reduces recurrence compared with treatment with surgery only, placebo or systemic hormones. SEARCH STRATEGY: The following databases were searched: (1) Cochrane Menstrual Disorders
Laparoscopic helium plasma coagulation for the treatment of endometriosis Laparoscopic helium plasma coagulation for the treatment of endometriosis Laparoscopic helium plasma coagulation for the treatment of endometriosis National Institute for Health and Clinical Excellence Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation National Institute for Health (...) and Clinical Excellence. Laparoscopic helium plasma coagulation for the treatment of endometriosis. London: National Institute for Health and Clinical Excellence (NICE). Interventional Procedure Guidance 171. 2006 Authors' objectives This study aims to assess the current evidence on laparoscopic helium plasma coagulation for the treatment of endometriosis. This document replaces previous guidance on laparoscopic helium plasma coagulation of endometriosis (NICE interventional procedure guidance no. 54