Pag. 19

ILAR J.

J Reprod Med. 2011 Jan-Feb;56(1-2):71-4.

Acute inflammatory reaction following placement of sodium hyaluronate-carboxymethylcellulose barrier in a young woman undergoing gynecologic surgery: a case report.

Temkin SM, Turner JR, Lengyel ER.

Source

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Maryland Women’s Health, Stapa Building, 3rd Floor, 11 South Paca Street, Baltimore, MD 21201, USA. stemkin@upi.umaryland.edu

Abstract

BACKGROUND:

Hyaluronate-carboxymethylcellulose (HA-CMC) is commonly used to inhibit adhesion formation in women undergoing gynecologic surgery.

CASE:

A 38-year old woman underwent a bilateral salpingo-oophorectomy for the indication of persistent pelvic pain following a hysterectomy, an ovarian cyst and endometriosis. HA-CMC was placed at the time of surgery. The patient returned to the operating room on postoperative day 3 with an acute inflammatory reaction and small bowel obstruction. A mast cell infiltrate and acute serosal damage was observed on final histopathology of the resection portion of small bowel.

CONCLUSION:

Few case reports describing adverse events with the use of HA-CMC have been published. This patient appears to have had a paradoxical inflammatory reaction to this adhesion barrier.

J Reprod Med. 2011 Jan-Feb;56(1-2):44-6.

Endometrioma occurring in abdominal wall incisions after cesarean section.

Lipscomb GH, Givens VM, Smith WE.

Source

Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, Tennessee, USA. garyhlipscomb@gmail.com

Abstract

OBJECTIVE:

To investigate outcomes following incisional endometrioma after cesarean section and correlate the role of predisposing factors.

STUDY DESIGN:

Chart review of patients from a 7-year period noting surgical history, previous incisions, uterine exteriorization, and wound irrigation at cesarean section, preoperative and final endometrioma size, mass location, fascial involvement, and mesh placement.

RESULTS:

All 16 patients had cesarean section as their last surgery and 15 of 16 had transverse incisions. Patients averaged 29.2 years of age, had two prior surgeries with time to symptoms of 25.9 months. Endometriomas were primarily left of midline, extrafascial in 10 patients and intrafascial 3 patients, and involved fascia and muscle in 3 patients. Estimated and actual sizes were similar (p = 0.54) and not correlated with mesh placement (p = 0.21). No patient had concomitant pelvic endometriosis.

CONCLUSION:

Incisional endometriomas developing after cesarean section occur primarily on the left of transverse incisions. Endometrioma size estimates correlate well with surgical findings but not with the need for mesh placement.

Chin Med J (Engl). 2011 Jan;124(1):148-51.

Morphological analysis on adhesion and invasion involved in endometriosis with tissue culture.

Shi JH, Yang YJ, Dong Z, Lang JH, Leng JH.

Source

Department of Obstetrics & Gynaecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.

Abstract

BACKGROUND:

Endometriosis (EM) is a benign gynecologic disease predominantly found in women of reproductive age. However, its pathogenesis is still poorly understood. Our experiment was designed to establish a stable and reliable cultural environment for coculture of endometrium and peritoneum, so as to observe the adhesion/invasion ability of endometrium from patients with or without EM.

METHODS:

Endometria of secretory phase and peritoneum were sampled from 6 women with endometriois during laparoscopy. Six with ovarian teratoma or simple ovarian cyst were taken as control. We cocultured endometrium and peritoneum into four groups (endometrium from EM cultured with peritoneum from EM, endometrium from control cultured with peritoneum from control, endometrium from EM cultured with peritoneum from non-EM and the endometrium from control cultured with peritoneum from EM) to observe the adhesion/invasion process in gas-liquid surface culture and in-medium culture. Specimens were collected at 1 hour, 6 hours, 12 hours, 24 hours, 2 days, 3 days, 4 days, 5 days, 6 days and 7 days for histology, immunofluorescence and immunohistochemical analysis on cytokeratin 8 (CK8) and CD10.

RESULTS:

The gas-liquid surface culture was superior to in-medium culture for the maintenance of tissue morphology and survival of endometrium. CK8 immunoflurescence demonstrated no remarkable difference in adhesion process between patients with and without EM. CD10 immunochemistry manifested frequent invasion of endometrial stromal cells from EM patients into peritoneum of up to 3 days culture, while the endometriotic cells from non-EM patients did not invade into peritoneum.

CONCLUSIONS:

Gas-liquid surface culture is a suitable model for observing the early events in EM lesion formation. Endometrium from patients with EM showed increased invasion capacity during coculture, which might help to explain the etiology of endometriosis.

Chin Med J (Engl). 2011 Feb;124(4):627-30.

Endometriosis coexisting with dermoid cyst in a single ovary: a case report.

Chen TC, Kuo HT, Shyu SK, Chu CP, Chang TC.

Source

Department of Obstetrics and Gynecology, Lin-Shin Medical Corporation/Lin-Shin Hospital, Taichung 408, Taiwan, China.

Abstract

Endometriosis coexisting with a dermoid cyst of the ovary is extraordinarily rare, although both these benign conditions are said to be common in women in the reproductive age group. There are only two previous case reports,which is evident from our literature review from January 1960 through January 2010. Acute abdomen is one of the greatest diagnostic challenges and easily ignored by the clinicians to exclude the possibility of gynecologic illness. A 35-year-old woman was referred by the doctor in Family clinic. She experienced a three-day period of severe right lower abdominal pain and intermittent vomiting. Ultrasonography identified a bilocular, cystic, hypoechoic, and hyperechoic tumor, 7 cm × 6 cm × 6 cm in the right adnexal region. Laparoscopic cystectomy was performed under the impression of ovarian cyst with torsion or hemorrhage. The frozen section was benign and appendiceal status was adequate. Histopathologic examination described an ovarian cyst composed of endometrial-type lining with stromacells (endometriosis) and benign teratoma tissue with plenty of skin appendages and sebaceous glands. We report this unusual and interesting ovarian mass to remind physicians that the usage of the Endobag after cystectomy, the benefits on minimizing operative time, spilled opportunity, and postoperative complications. Laparoscopic techniques for large ovarian masses might be considered. The experience of the surgeon is also very important to prevent misdiagnosis or complication. Further follow up is mandatory for this simultaneous finding of ovarian endometriosis with coincidental dermoid cyst as a separate pathology in single ovary of such a nature. It also presents a challenge to the clinicians and to the pathologists.

Can J Plast Surg. 2010 Spring;18(1):19-20.

Scar endometriosis – a rare cause for a painful scar: A case report and review of the literature.

Danielpour PJ, Layke JC, Durie N, Glickman LT.

Source

Division of Plastic Surgery, Nassau University Medical Center, East Meadow;

Abstract

Endometriosis is described as the presence of functioning endometrial tissue outside the uterine cavity. Scar endometriosis is a rare disease, and is difficult to diagnose. The symptoms are nonspecific, typically involving abdominal wall pain at the incision site at the time of menstruation. It commonly follows obstetrical and gynecological surgeries. The diagnosis is frequently made only after excision of the diseased tissue. A case report of a patient with a troublesome scar after a caesarian section is presented. Surgical excision led to the diagnosis of scar endometriosis. The pathogenesis, diagnosis and treatment of this somewhat rare condition are discussed.

J Cancer Res Ther. 2010 Oct-Dec;6(4):578-80.

Endometrioid carcinoma of the upper urinary tract.

Kulkarni JN, Gorasia TK, Choudhary JP, Mahajan PP.

Source

Department of Urology, Bombay Hospital Institute of Medical Sciences, New Marine Lines, Mumbai – 400 020, India. jnkulkarni@gmail.com

Abstract

Herein, we report a second case of endometrioid carcinoma of the upper urinary tract presenting 17 years after hysterectomy for high grade adenocarcinoma of ovary. A 51-year-old nullipara presented to us with a complaint of hematuria. After complete work up, she underwent right radical nephro-ureterectomy with bladder cuff excision. The histology showed endometrioid carcinoma of upper urinary tract without any evidence of endometriosis.

J Ultrasound Med. 2011 Mar;30(3):391-5.

Echogenic foci in the ovary: are they predictive of endometriosis?

Wall DJ, Brown DL, Dudiak KM, Mandrekar J.

Source

Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 USA. wall.darci@mayo.edu.

Abstract

Objectives- The purpose of this study was to determine whether sonographically depicted echogenic foci are more common in the ovaries of women with endometriosis when compared to the ovaries of women who do not have endometriosis. Methods- Two radiologists blinded to the pathologic results reviewed the preoperative pelvic sonograms of consecutive women with a surgical diagnosis of endometriosis between June 2006 and October 2007. Results were compared with the preoperative sonograms of a control group of women without surgical evidence of endometriosis. The presence of echogenic foci in the ovaries and ovarian masses was recorded. Results- Echogenic foci were present in the ovaries of 33 of 70 women (47%) with endometriosis and in the ovaries of 21 of 76 women (28%) without endometriosis (P = 0.015). When only patients with sonographically normal ovaries were evaluated by excluding endometriomas and other ovarian masses, echogenic foci were present in 8 of 23 women (35%) with endometriosis and in 10 of 42 women (24%) without endometriosis (P = .344). Conclusions- Echogenic foci are more commonly seen on sonography in the ovaries of women with endometriosis than in those without endometriosis, but this result seems largely due to ovarian endometriomas with echogenic foci in the walls. Echogenic foci are not predictive of endometriosis in women with otherwise sonographically normal ovaries.

Climacteric. 2011 Aug;14(4):409-17. Epub 2011 Feb 28.

HRT in difficult circumstances: are there any absolute contraindications?

Maclennan AH.

Source

The Discipline of Obstetrics and Gynaecology, School of Paediatrics and Reproductive Medicine, The University of Adelaide, South Australia, Australia.

Abstract

Many traditional contraindications to hormone replacement therapy (HRT) are based on the theoretical potential for these hormones to worsen a disease process and are rarely based on supporting data. This review addresses the available data and lack of data that make the prescription of HRT difficult in a variety of common morbidities. In each circumstance, it is assumed that conservative evidence-based therapies have been tried and that menopausal symptoms remain debilitating and are reducing quality of life. Tailoring of the product, dose, route and regimen may avoid some of the theoretical risks of HRT in particular women or conditions and guidelines are given for each co-morbidity. Specifically, it is discussed that tailored HRT may be used without strong evidence of a deleterious effect after ovarian cancer, endometrial cancer, most other gynecological cancers, bowel cancer, melanoma, a family history of breast cancer, benign breast disease, in carriers of BRACA mutations, after breast cancer if adjuvant therapy is not being used, past thromboembolism, varicose veins, fibroids and past endometriosis. Relative contraindications are existing cardiovascular and cerebrovascular disease and breast cancer being treated with adjuvant therapies. Consultation with other carers and written consent are recommended in all these difficult circumstances, but no condition is an absolute contraindication to HRT if potential risk is understood, if HRT is effective in symptom control and if quality of remaining life is paramount.

Fertil Steril. 2011 Jun;95(7):2429.e9-13. Epub 2011 Feb 26.

Endometriosis in para-aortic lymph nodes during pregnancy: case report and review of literature.

Beavis AL, Matsuo K, Grubbs BH, Srivastava SA, Truong CM, Moffitt MN, Maliglig AM, Lin YG.

Source

Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California 90033, USA.

Abstract

OBJECTIVE:

To report a case of endometriosis in para-aortic lymph nodes during pregnancy.

DESIGN:

Case report.

SETTING:

Tertiary care center.

PATIENT(S):

A 25-year-old multipara pregnant woman with a history of chronic pelvic pain and ovarian cystectomies for bilateral endometriomas.

INTERVENTION(S):

The patient was admitted with a placenta previa and a subchorionic hemorrhage at 24 weeks 5 days’ gestation, and subsequently developed uterine contractions. Magnetic resonance imaging revealed a large complex adnexal mass adherent to the uterus and pelvic and para-aortic lymphadenopathy. Tocolysis could not be achieved and the patient underwent cesarean delivery at 26 weeks 3 days. An implant on the uterus and an enlarged para-aortic lymph node were removed surgically at that time.

MAIN OUTCOME MEASURE(S):

Involvement of lymph node by endometriosis and presence of a recurrent endometrioma.

RESULT(S):

Endometriosis was confirmed pathologically in para-aortic lymph nodes. Uterine serosal biopsy demonstrated endometriosis, and the large adnexal cyst was grossly consistent with endometrioma. The patient delivered a viable male infant at 26 weeks 3 days.

CONCLUSION(S):

To our knowledge, this is the first reported case of endometriosis in para-aortic lymph nodes. Its presence supports the hypothesis that endometriosis travels lymphatically, and not simply via locoregional spread. Lymphatic spread also further supports the theory that endometriosis is an aggressive chronic systemic disease.

J Chin Med Assoc. 2011 Feb;74(2):75-80. Epub 2011 Feb 12.

Mean grey value is lower in endometriomas: differentiating a hypoechogenic adnexal cyst by 3-dimensional power Doppler ultrasound–a preliminary study.

Huang CY, Wang HI, Wang PH, Wu YC, Yang MJ, Chen LH, Chao KC, Chen CY.

Source

Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Sec. 2 Shih-Pai Road, Taipei, Taiwan, ROC.

Abstract

BACKGROUND:

To assess parameters of 3-dimensional power Doppler ultrasound in differentiating an endometrioma from other hypoechogenic adnexal cysts.

METHODS:

We collected 58 patients with classic-appearing endometriomas (homogeneous hypoechogenic adnexal cysts with round shapes) on a 2-dimensional conventional sonography. The serum level of CA-125, parameters of 3-dimensional pelvic ultrasound including the volume of the cyst, the mean grey value (MGV), and three vascular indices: vascularization index, flow index, and vascularization flow index, were measured and then, after surgical intervention, were compared between the group with histologically proven endometriomas and the group with other histological diagnoses.

RESULTS:

In the chocolate cyst group, the parity was significantly lower (0.68±0.17, p=0.012). The MGV and lesion volume of histologically proven endometriomas were significantly lower (14.78±0.7; 118.34±15.5) than those of other hypoechogenic benign adnexal cysts (17.17±0.74; 227.18±47.46), and the p values were 0.038 and 0.041, respectively. No differences in vascularization index (VI), flow index (FI), and vascularization flow index (VFI) were found between the two groups. No relationship between lesion volume and MGV in the two groups, either (p=0.127 and 0.353). We also found little correlation between CA-125 and the volume of a histologically proven endometrioma as well as between CA-125 and its MGV.

CONCLUSION:

MGV might be useful to differentiate an endometrioma from other homogeneous hypoechogenic adnexal cysts.

J Minim Invasive Gynecol. 2011 Mar-Apr;18(2):257-61.

Laparoscopically resected uterine adenomatoid tumor with coexisting endometriosis: case report.

Sakurai N, Yamamoto Y, Asakawa Y, Taoka H, Takahashi K, Kubushiro K.

Source

Department of Obstetrics and Gynecology, Toho University School of Medicine, Ohashi Medical Center, Ohashi, Meguro-ku, Tokyo, Japan.

Abstract

Adenomatoid tumors are rare benign mesothelial tumors of the genital tract, and only a few cases of uterine adenomatoid tumors treated at laparoscopic surgery have been reported. Herein is reported the case of a laparoscopically resected uterine adenomatoid tumor with coexisting endometriosis. A 34-year-old nulliparous woman with suspected uterine fibroma and endometrial cysts underwent laparoscopic surgery in which both the uterine tumor and the endometrial cysts were enucleated. Enucleation of the uterine tumor was difficult, and, therefore, the border between the tumor and normal myometrium was divided using a harmonic scalpel for tumor resection. Microscopic examination of the tumor showed irregularly proliferating smooth muscle cells and many round hiatuses lined by epithelial-like cells. These epithelial-like cells were immunohistochemically positive for mesothelin and podoplanin, and negative for CD34, which suggests that the tumor was an adenomatoid tumor. This may be the fourth reported case of an adenomatoid tumor resected using the laparoscopic approach.

J Minim Invasive Gynecol. 2011 Mar-Apr;18(2):211-7.

Use of the Short-Form McGill Pain Questionnaire as a diagnostic tool in women with chronic pelvic pain.

Droz J, Howard FM.

Source

Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York.

Abstract

STUDY OBJECTIVE:

To estimate the usefulness of the Short-Form McGill Pain Questionnaire (MPQ) pain descriptors in the diagnostic evaluation of chronic pelvic pain.

DESIGN:

Retrospective cohort study (Canadian Task Force classification II-2).

SETTING:

University-based center specializing in chronic pelvic pain.

PATIENTS:

Three hundred thirty-one consecutively evaluated women with chronic pelvic pain who had data sufficient for evaluation.

INTERVENTIONS:

The relationships between MPQ pain descriptors and subsequent diagnoses were evaluated using odds ratios, sensitivity, specificity, and positive and negative predictive values.

MEASUREMENTS AND MAIN RESULTS:

The most common diagnoses were endometriosis, interstitial cystitis and painful bladder syndrome, and irritable bowel syndrome. Seventy-one percent of the patients had more than one diagnosis. Relative risks for pain descriptors as diagnostic tools for specific diagnoses were most significant, with “cramping” for endometriosis (4.0), “cramping” for interstitial cystitis and painful bladder syndrome (2.0), “sickening” for irritable bowel syndrome (1.5), and “aching” for abdominal myofascial pain syndrome (4.27).

CONCLUSION:

Several of the MPQ descriptors had high negative predictive values but not high positive predictive values, which suggests that they have diagnostic usefulness in excluding but not predicting pelvic pain-related diagnoses. This was especially the case with cramping as an MPQ descriptor in women with endometriosis. However, overall the MPQ descriptors were not robust as diagnostic tools, which suggests that inclusion of the MPQ descriptors in the evaluation of women with chronic pelvic pain is of limited diagnostic value.

Eur J Obstet Gynecol Reprod Biol. 2011 Jun;156(2):177-80. Epub 2011 Feb 25.

Live birth rate in fresh and frozen embryo transfer cycles in women with endometriosis.

Mohamed AM, Chouliaras S, Jones CJ, Nardo LG.

Source

IVF Unit, Reproductive Medicine Department, Saint Mary’s Hospital, Manchester, UK. a_mostafa_f@hotmail.com

Abstract

OBJECTIVES:

To test the hypothesise that the treatment protocol used for preparation of the endometrium for frozen embryo transfer (ET) has a beneficial effect on the disorganised endometrium in women with endometriosis and leads to a higher pregnancy rate.

STUDY DESIGN:

We performed a retrospective, database-searched cohort study. Relevant information was collected from the electronic records of women who underwent IVF/ICSI between 1/1/2000 and 31/12/2008 in our unit. Endometriosis patients formed the study group. The rest of the women formed the control group. The two groups were subdivided, depending on whether they had fresh or frozen ET. The main outcome was live birth rate (LBR). Secondary outcomes were clinical pregnancy rate (CPR) and miscarriage rate (MR). Comparisons were performed by Chi-square and Mann-Whitney tests (SPSS 16.0).

RESULTS:

A total of 3763 fresh and 3523 frozen ET IVF cycles were included in our study, of which 415 (5.7%) were due to endometriosis related subfertility. In the non-endometriosis group, fresh ET had significantly higher LBR, CBR and MR than frozen ET. In women with endometriosis, down-regulated frozen ET cycles had a markedly high LBR and CPR (16.9%, 18.2%), comparable to the LBR and CPR of fresh ET cycles in the same group (19.5%, 20.2%). No significant differences were found in the LBR and CPR in fresh ET cycles between the study and the control group. In frozen ET, however, the CPR was significantly higher in the endometriosis group (18.2% versus 12.7%, P=0.048).

CONCLUSION:

Unlike the general IVF population, in women with endometriosis undergoing IVF, the preparation of the endometrium for frozen ET with GnRH agonists compared to fresh cycles is associated with higher LBR (16.9% versus 11.9%) and a significantly higher CPR (18.2% versus 12.7%, P=0.048). These results suggest that, in cases of endometriosis, the combined effect of GnRHa on the endometrium and the low level of ovarian steroids may simultaneously offer a better endometrial environment for implantation which may lead to better outcomes.

Fertil Steril. 2011 May;95(6):1970-4. Epub 2011 Feb 26.

Associations between free fatty acids, cumulus oocyte complex morphology and ovarian function during in vitro fertilization.

Jungheim ES, Macones GA, Odem RR, Patterson BW, Lanzendorf SE, Ratts VS, Moley KH.

Source

Department of Obstetrics and Gynecology, Washington University, St. Louis, Missouri 63108, USA. jungheime@wudosis.wustl.edu

Abstract

OBJECTIVE:

To determine if follicular free fatty acid (FFA) levels are associated with cumulus oocyte complex (COC) morphology.

DESIGN:

Prospective cohort study.

SETTING:

University in vitro fertilization (IVF) practice.

PATIENT(S):

A total of 102 women undergoing IVF.

INTERVENTION(S):

Measurement of FFAs in serum and ovarian follicular fluid.

MAIN OUTCOME MEASURE(S):

Total and specific follicular and serum FFA levels, correlations between follicular and serum FFAs, and associations between follicular FFA levels and markers of oocyte quality, including COC morphology.

RESULT(S):

Predominant follicular fluid and serum FFAs were oleic, palmitic, linoleic, and stearic acids. Correlations between follicular and serum FFA concentrations were weak (r=0.252, 0.288, 0.236, 0.309, respectively for specific FFAs; r=0.212 for total FFAs). A receiver operating characteristic curve determined total follicular FFAs≥0.232 μmol/mL distinguished women with a lower versus higher percentage of COCs with favorable morphology. Women with elevated follicular FFAs (n=31) were more likely to have COCs with poor morphology than others (n=71; OR 3.3, 95% CI1.2-9.2). This relationship held after adjusting for potential confounders, including age, body mass index, endometriosis, and amount of gonadotropin administered (β=1.2; OR 3.4, 95% CI 1.1-10.4).

CONCLUSION(S):

Elevated follicular FFA levels are associated with poor COC morphology. Further work is needed to determine what factors influence follicular FFA levels and if these factors impact fertility.

Cir Esp. 2011 Feb 24. [Epub ahead of print]

Extrapelvic endometriosis: a diagnosis to consider in the patient with a perianal tumour.

[Article in English, Spanish]

Maturana Ibáñez V, Ferrer Márquez M, Moreno Serrano A, Reina Duarte A, Belda Lozano R.

Source

Servicio de Cirugía General y del Aparato Digestivo, CH Torrecárdenas, Almería, España.

J Cutan Pathol. 2011 Jun;38(6):525-8. doi: 10.1111/j.1600-0560.2011.01681.x. Epub 2011 Feb 24.

Cutaneous endometriosis: diagnostic immunohistochemistry and clinicopathologic correlation.

Farooq U, Laureano AC, Miteva M, Elgart GW.

Source

Kendall Medical Laboratory, Coral Gables, FL, USA. Farooq.uz@gmail.com

Abstract

Endometriosis is a condition where endometrial glands and stroma are ectopically located in sites other than the uterine cavity. Cutaneous endometriosis is very rare, representing approximately 1.1% of cases of extrapelvic endometriosis. We report a case of a 44-year-old female with no prior surgical history who presented with multiple tan brown periumbilical nodules. Histopathological examination revealed multiple glandular structures in the dermis with surrounding stroma. Immunohistochemistry cinches the diagnosis, as CD10, estrogen receptor and progesterone receptor are strongly positive in our case. The mainstay of treatment of cutaneous endometriosis is surgical excision of the lesion.

Ultrasound Obstet Gynecol. 2011 May;37(5):603-13. doi: 10.1002/uog.8971. Epub 2011 Apr 5.

Multidetector computerized tomography enteroclysis vs. rectal water contrast transvaginal ultrasonography in determining the presence and extent of bowel endometriosis.

Ferrero S, Biscaldi E, Morotti M, Venturini PL, Remorgida V, Rollandi GA, Valenzano Menada M.

Source

Department of Obstetrics and Gynecology, San Martino Hospital and University of Genoa, Genoa, Italy. dr@simoneferrero.com

Abstract

OBJECTIVES:

To compare the accuracy of multidetector computerized tomography enteroclysis (MDCT-e) and rectal water contrast transvaginal ultrasonography (RWC-TVS) in determining the presence and extent of bowel endometriosis.

METHODS:

This prospective study included 96 patients of reproductive age with suspicion of bowel endometriosis. Patients underwent MDCT-e and RWC-TVS before operative laparoscopy. Findings of MDCT-e and RWC-TVS were compared with histological results. The severity of pain experienced during MDCT-e and RWC-TVS was measured by a 10-cm visual analog scale.

RESULTS:

Fifty-one patients had bowel endometriotic nodules at surgery. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy for the diagnosis of rectosigmoid endometriosis were 95.8% (46/48), 100.0% (48/48), 100.0% (46/46), 96.0% (48/50) and 97.9% (94/96) for MDCT-e and 93.8% (45/48), 97.9% (47/48), 97.8% (45/46), 94.0% (47/50) and 95.8% (92/96) for RWC-TVS. MDCT-e was associated with more intense pain than was RWC-TVS.

CONCLUSIONS:

MDCT-e and RWC-TVS have similar accuracy in the diagnosis of rectosigmoid endometriosis, but patients tolerate RWC-TVS better than they do MDCT-e.

BMC Med. 2011 Feb 24;9:19.

MUC4 gene polymorphisms associate with endometriosis development and endometriosis-related infertility.

Chang CY, Chang HW, Chen CM, Lin CY, Chen CP, Lai CH, Lin WY, Liu HP, Sheu JJ, Tsai FJ.

Source

Human Genetic Center, China Medical University Hospital, Taichung, Taiwan.

Abstract

BACKGROUND:

Mucin 4 (MUC4) plays an important role in protecting and lubricating the epithelial surface of reproductive tracts, but its role in the pathogenesis of endometriosis is largely unknown.

METHODS:

To correlate MUC4 polymorphism with the risk of endometriosis and endometriosis-related infertility, we performed a case-control study of 140 patients and 150 healthy women. Six unique single-nucleotide polymorphisms (SNPs) (rs882605, rs1104760, rs2688513, rs2246901, rs2258447 and rs2291652) were selected for this study. DNA fragments containing the target SNP sites were amplified by polymerase chain reaction using the TaqMan SNP Genotyping Assay System to evaluate allele frequency and distribution of genotype in MUC4 polymorphisms.

RESULTS:

Both the T/G genotype of rs882605 and the frequency of haplotype T-T (rs882605 and rs1104760) were higher in patients than in controls and were statistically significant. The frequency of the C allele at rs1104760, the C allele at rs2688513, the G allele at rs2246901 and the A allele at rs2258447 were associated with advanced stage of endometriosis. Moreover, the G allele at rs882605 was verified as a key genetic factor for infertility in patients. Protein sequence analysis indicated that amino acid substitutions by genetic variations at rs882605, rs2688513 and rs2246901 occur in the putative functional loops and the type D von Willebrand factor (VWFD) domain in the MUC4 sequence.

CONCLUSIONS:

MUC4 polymorphisms are associated with endometriosis development and endometriosis-related infertility in the Taiwanese population.

 

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