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Latest & greatest articles for endometriosis
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value of markers retrieved from endometrial tissue, menstrual fluid or uterine fluid to diagnose endometriosis in a non-invasive way. All 182 studies had visual and/or histological confirmation of endometriosis after laparoscopy or laparotomy, defined as the presence of peritoneal endometriotic lesions, endometrioma and/or rectovaginal endometriotic nodules (May, et al., 2011). The overall conclusions of the authors were: 1) nine studies of high quality were identified, 2) in 32 studies sensitivity (...) versus excision of endometriosis 40 2.4.3 Surgical interruption of pelvic nerve pathways 41 2.4.4 Surgery for treatment of pain associated with ovarian endometrioma 42 2.4.5 Surgery for treatment of pain associated with deep endometriosis 43 2.4.6 Hysterectomy for endometriosis-associated pain 45 2.4.7 Adhesion prevention after endometriosis surgery 46 2.5 Preoperative hormonal therapies for treatment of endometriosis-associated pain 48 2.6 Postoperative hormonal therapies for treatment
for endometriosis in adolescents is conservative surgical therapy for diagnosis and treatment combined with ongoing suppressive medical therapies to prevent endometrial proliferation. Patients with endometriosis who have pain refractory to conservative surgical therapy and suppressive hormonal therapy often benefit from at least 6 months of gonadotropin-releasing hormone (GnRH) agonist therapy with add-back medicine. Nonsteroidal antiinflammatory drugs should be the mainstay of pain relief for adolescents (...) in adolescents requiring the presence of endometrial glands and stroma in the biopsy specimen from a location outside of the endometrial cavity. Patients with persistent dysmenorrhea despite treatment and no other identified etiologies should be counseled about the high likelihood of endometriosis and the risks and benefits of diagnostic laparoscopy. The benefits of laparoscopy include confirmation of the presence or absence of endometriosis or other causes of chronic pain such as adhesive disease
EndometriosisEndometriosis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Endometriosis Last reviewed: February 2019 Last updated: March 2019 Summary Chronic inflammatory condition defined by endometrial stroma and glands found outside of the uterine cavity. The most common sites affected are the pelvic peritoneum and ovaries. May present incidentally in asymptomatic patients, or more commonly in women (...) of lesions. Controlled ovarian hyper-stimulation and IVF may be considered for patients with sub-fertility. Individualised care for patients with pelvic pain should incorporate a multi-disciplinary evaluation and treatment plan that focuses on limiting the risk of recurrence and improving quality of life. Definition Endometriosis is defined as the presence of endometrial glands and stroma outside the endometrial cavity and uterine musculature. Surgical appearance varies significantly from superficial
and/or abdominal examination is normal To identify endometriomas and deep endometriosis involving the bowel, bladder or ureter. If a transvaginal scan is not appropriate, consider a transabdominal ultrasound scan of the pelvis. Serum Cancer Antigen 125 (CA125) Do not use serum CA125 to diagnose endometriosis. If a coincidentally reported serum CA125 level is available, be aware that: A raised serum CA125 (that is, 35 IU/ml or more) may be consistent with having endometriosisEndometriosis may be present (...) , consider taking a biopsy of suspected endometriosis: To confirm the diagnosis of endometriosis (be aware that a negative histological result does not exclude endometriosis) To exclude malignancy if an endometrioma is treated but not excised. If a full, systematic laparoscopy is performed and is normal, explain to the woman that she does not have endometriosis, and offer alternative management. Staging Systems Offer endometriosis treatment according to the woman's symptoms, preferences and priorities
HormonalContraceptives Combinedhormonalcontraceptiveshavebeenusedinbotha cyclicandacontinuousfashioninthetreatmentofsymptoms associated with endometriosis. Decidualization followed by atrophy of the endometrial tissue is the proposed mechanism of action (60). Whereas combined OCs containing the more androgenic progestogens (19-nortestosterone derivatives) traditionally have been used to treat endometriosis symp- toms,combinedOCscontainingthenewgenerationprogesto- gen, desogestrel, also have proven effective (61 (...) surgical treatment for endometriosis (63). Progestogens Progestogensmostcommonlyusedforthetreatmentofendo- metriosis include medroxyprogesterone acetate (MPA) and 19-nortestosteronederivatives(e.g.,levonorgestrel,norethin- drone acetate, and dienogest). As with OCs, their proposed mechanism of action involves decidualization and subse- quent atrophy of endometrial tissue. Another more recently proposedmechanisminvolvesprogestogen-inducedsuppres- sion of matrix metalloproteinases, a class of enzymes
Acupuncture for pain in endometriosis. Endometriosis is a prevalent gynaecological condition, significantly affecting women's lives. Clinical presentations may vary from absence of symptoms to complaints of chronic pelvic pain, most notably dysmenorrhoea. The management of pain in endometriosis is currently inadequate. Acupuncture has been studied in gynaecological disorders but its effectiveness for pain in endometriosis is uncertain.To determine the effectiveness and safety of acupuncture (...) for pain in endometriosis. We searched the Cochrane Menstrual Disorders and Subfertility Group (MSDG) Specialised Register of controlled trials, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE, EMBASE, CINAHL, AMED, PsycINFO, CNKI and TCMDS (from inception to 2010) and reference lists of retrieved articles.Randomised single or double-blind controlled trials enrolling women of reproductive age with a laparoscopically confirmed diagnosis of endometriosis
Endometriosis: an overview of Cochrane Reviews. This overview reports on interventions for pain relief and for subfertility in pre-menopausal women with clinically diagnosed endometriosis.The objective of this overview was to summarise the evidence from Cochrane systematic reviews on treatment options for women with pain or subfertility associated with endometriosis.Published Cochrane systematic reviews reporting pain or fertility outcomes in women with clinically diagnosed endometriosis were (...) cases the evidence was of low or very low quality. Anti-TNF-α drugs One review found no evidence of a difference in effectiveness between anti-TNF-α drugs and placebo. However, the evidence was of low quality. Reviews reporting fertility outcomes (8 reviews) Medical interventions Four reviews reported on medical interventions for improving fertility in women with endometriosis. One compared three months of GnRH agonists with a control in women undergoing assisted reproduction and found very low
Efficacy of acupuncture on pelvic pain in patients with endometriosis: study protocol for a randomized, single-blind, multi-center, placebo-controlled trial Endometriosis is a chronic gynecological disease that is characterized by the presence of endometrial tissue outside the uterine cavity. The main symptoms include dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. These symptoms impair the lives of most of the women suffering from the disease. Surgical resection (...) of endometriotic lesions is an effective means of treating dysmenorrhea, but the risk of recurrence is high. Western medicine has limited use for treating it due to side effects and ineffectiveness. The purpose of this study is to verify the effectiveness and safety of acupuncture.This trial will be carried out in four parts. A total of 106 eligible patients with pelvic pain related to endometriosis will be randomly assigned into two groups, in a 1:1 ratio, as the treatment group or the control group
2018TrialsControlled trial quality: predicted high
Elagolix (Orilissa) - for the treatment of moderate to severe pain associated with endometriosis Search Page - Drug and Health Product Register Language selection Search and menus Search Search website Search Topics menu You are here: Summary Basis of Decision - - Health Canada Expand all Summary Basis of Decision (SBD) for Contact: Summary Basis of Decision (SBD) documents provide information related to the original authorization of a product. The for is located below. Recent Activity for SBDs
[Efficacy observation on the combination of acupuncture and Chinese medication in prevention of the recurrence of endometriosis after laparoscopic surgery]. To evaluate the efficacy and safety of acupuncture-moxibustion combined with modified Mojie tablet (see text) in the prevention of the recurrence of endometriosis (EMS) after laparoscopic surgery.After laparoscopic surgery, 120 cases of EMS were randomized into an acupuncture-moxibustion group, a western medication group, a Chinese (...) , the self-prepared Mojie tablet were prescribed for oral administration. In the combined therapy group, acupuncture, moxibustion and modified Mojie tablet for oral administration were used in combination. The therapeutic methods were same as the acupuncture-moxibustion group and the Chinese medication group. Totally, the treatment of 3 months was required. Separately, before treatment, after treatment, in 3 months after treatment and in 6 months after treatment, EHP-5 score (endometriosis health profile
EndometriosisEndometriosis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Search Select language Endometriosis Last reviewed: December 2019 Last updated: March 2019 Summary Chronic inflammatory condition defined by endometrial stroma and glands found outside of the uterine cavity. The most common sites affected are the pelvic peritoneum and ovaries. May present incidentally in asymptomatic patients, or more (...) ), and surgical destruction of lesions. Controlled ovarian hyper-stimulation and IVF may be considered for patients with sub-fertility. Individualised care for patients with pelvic pain should incorporate a multi-disciplinary evaluation and treatment plan that focuses on limiting the risk of recurrence and improving quality of life. Definition Endometriosis is defined as the presence of endometrial glands and stroma outside the endometrial cavity and uterine musculature. Surgical appearance varies
Nonsteroidal anti-inflammatory drugs for pain in women with endometriosis. 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 their careers, everyday activities, sexual and nonsexual relationships and fertility. Nonsteroidal anti-inflammatory drugs (NSAIDs) are most commonly used as first-line treatment for women with pain associated with endometriosis.To assess effects (...) of NSAIDs used for management of pain in women with endometriosis compared with placebo, other NSAIDs, other pain management drugs or no treatment.We searched the Cochrane Gynaecology and Fertility Group Specialised Register of Controlled Trials (October 2016), published in the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, as well as MEDLINE (January 2008 to October 2016), Embase (date limited from 1 January 2016 to 19 October 2016, as all earlier references
that further studies are required to evaluate the effect of alternative surgical treatments on lesion recurrence and post-operative pregnancy rates. Bibliographic details Vercellini P, Chapron C, De Giorgi O, Consonni D, Frontino G, Crosignani P G. Coagulation or excision of ovarian endometriomas? American Journal of Obstetrics and Gynecology 2003; 188(3): 606-610 PubMedID Indexing Status Subject indexing assigned by NLM MeSH Endometriosis /surgery; Female; Gynecologic Surgical Procedures /adverse effects (...) Coagulation or excision of ovarian endometriomas? Coagulation or excision of ovarian endometriomas? Coagulation or excision of ovarian endometriomas? Vercellini P, Chapron C, De Giorgi O, Consonni D, Frontino G, Crosignani P G CRD summary This review compared coagulation or vapourisation with excision or cystectomy for the treatment of ovarian endometriomas. The authors concluded that coagulation appears to be associated with a significant increase in cyst recurrence. The studies were generally
with endometriosis and are often associated with the severe form of the disease. , While the pathognomonic mechanisms of endometriosis per se remain elusive, it is widely believed that most endometriotic lesions develop from retrograde menstruation and are possibly associated with immune dysfunction, which can interfere with endometrial implant clearance. Endometriotic ovarian cysts (known as ‘endometriomas’) are mostly thought to occur through invagination of endometriotic tissue/cells through the ovarian (...) distortion and reduced endometrial receptivity, leading to compromised oocyte and embryo quality, and ovarian reserve, but the precise mechanism has yet to be determined. 3 Potential mechanisms for endometrioma‐associated infertility 3.1 Chronic inflammation Endometriosis is associated with dysregulation of the immune system. Peritoneal fluid from women with endometriosis has been found to contain increased numbers of immune cells, including macrophages, and mast, natural killer and T cells, as well
diagnosed. Endometriosis can often be confused with or misdiagnosed as IBS (irritable bowel syndrome). It is important that women receive a early diagnosis, or working diagnosis, of endometriosis even if hormonal treatments appear to be working, as women need to understand that they have a long term, chronic condition and the impact this might have on their future and their fertility. What is endometriosis? Endometriosis is defined as the presence of endometrial-like tissue outside the uterus, which (...) arrangements and seek advice from an endometriosis clinical nurse specialist: • if there is uncertainty over the diagnosis • if a women requests referral • if the woman has fertility problems • if surgical and medical management of endometriosis is required6 • if complex/severe endometriosis is suspected – for example, endometriomas or where endometriosis is affecting the bowel (Quality Standard 2018) • if initial hormonal treatment for endometriosis is not effective, not tolerated or contraindicated (NICE
Manual acupuncture plus usual care versus usual care alone in the treatment of endometriosis-related chronic pelvic pain: study protocol for a randomised controlled feasibility study Endometriosis is the most common cause of chronic pelvic pain worldwide. Non-surgical treatments are effective for only 30-50% of women and have a significant side effect burden that leads to high discontinuation rates. Surgery can be effective but is expensive and invasive, and symptoms tend to recur within 5 (...) years. There is early evidence that acupuncture may be effective in treating endometriosis-related chronic pelvic pain, showing clinically significant analgesia. Both levels of inflammation and pain processing have been shown to be altered in women with chronic pelvic pain. Acupuncture has been shown to reduce inflammation and change central pain processing in other conditions, but research on women with endometriosis is currently lacking. The aim of this feasibility study is to provide data