Eur J Obstet Gynecol Reprod Biol. 2006 Feb 1;124(2):216-21. Epub 2005 Nov 22.
COX-2 overexpression in peritoneal lesions is correlated with nonmenstrual chronic pelvic pain.
Buchweitz O, Staebler A, Wulfing P, Hauzman E, Greb R, Kiesel L.
Department of Obstetrics and Gynecology, University of Munster, Albert Schweitzer Str. 33, D-48149 Munster, Germany. buchweo@mednet.uni-muenster.de
OBJECTIVE: To investigate cyclooxygenase (COX-2) expression within different endometriotic lesions and to assess whether these expression patterns correlate with clinical characteristics. DESIGN: Retrospective cross-sectional study. SETTING: University Hospital. PATIENTS: Seventy patients with histologically confirmed exclusively peritoneal (n=20), ovarian (n=19) or deep-infiltrating (n=31) endometriosis and a detailed medical history. INTERVENTION: Immunohistochemical analysis for COX-2 was performed on 108 endometriotic lesions. MEASUREMENTS AND MAIN RESULTS: COX-2 intensity, percentage of stained glandular endometriotic cells, and correlation of COX-2 expression with clinicopathological parameters. Semiquantitative COX-2 expression did not differ between distinct morphological types of endometriosis and showed no association with the menstrual cycle. Patients with peritoneal-only endometriosis suffering from moderate or severe chronic pelvic pain showed significantly more frequent COX-2 overexpression than asymptomatic patients or patients with minimal symptoms. In patients with exclusively ovarian or deep-infiltrating endometriosis no association between COX-2 expression and clinical parameters, such as chronic pelvic pain, dysmenorrhoea, dyspareunia, sterility, lower urinary tract symptoms or gastrointestinal symptoms was observed. CONCLUSION: Peritoneal endometriotic lesions with increased COX-2 expression have a special relevance for the development of chronic, nonmenstruation-associated, pelvic pain in endometriotic patients. These patients may benefit from therapy with COX-2 inhibitors.
PMID: 16309818 [PubMed – in process]
Anticancer Res. 2005 Nov-Dec;25(6B):4313-8.
Endothelial cell survivin is involved in the growth of ovarian endometriotic cysts.
Goteri G, Lucarini G, Pieramici T, Filosa A, Pugnaloni A, Montik N, Biagini G, Tranquilli AL, Fabris G, Ciavattini A, Lo Muzio L.
Institutes of Pathology, University of Ancona, Ancona, Italy.
BACKGROUND: The aim of the present study was to evaluate microvessel density (MVD) in the cellular layers of ovarian endometriomata, with particular interest in the relationship with VEGF and survivin expressions by endothelial cells and with the diameter of the cysts. MATERIALS AND METHODS: MVD and VEGF and survivin endothelial cell expressions were evaluated in 26 ovarian endometriotic cysts and correlated with the cyst diameter. RESULTS: The mean MVD was higher in the inner specialized stroma of ectopic endometrium than in the outer fibrous capsule, but only in the fibrous capsule was MVD correlated with endothelial cell VEGF and survivin expressions as well as with the cyst diameter. CONCLUSION: The diameter of ovarian endometriotic cysts seems to be related to the angiogenic process involving the outer fibrous capsule, and not the inner specialized stroma of ectopic endometrium, since only in the capsule are vessels stimulated to proliferate by VEGF and protected from apoptosis by survivin, and their density is correlated to cyst diameter.
PMID: 16309234 [PubMed – indexed for MEDLINE]
Skeletal Radiol. 2005 Nov 25;:1-4 [Epub ahead of print] Endometriosis of the vastus lateralis muscle.
Basu PA, Kesani AK, Stacy GS, Peabody TD.
Radiology, The University of Chicago, Chicago, IL, USA, patbasu@yahoo.com.
We report an unusual case of a woman who sought medical attention for a painful mass within her anterolateral left thigh. The patient’s symptoms waxed and waned with her menses. Magnetic resonance imaging revealed a 3 cm mass isointense to muscle and surrounded by a rim of decreased signal intensity on T1-weighted images. T2-weighted images with fat saturation revealed a low signal intensity mass with a surrounding rind of high signal intensity edema. Based on its magnetic resonance imaging characteristics, the lesion was initially thought to represent the sequela of prior trauma or perhaps a small fibrous tumor. An excisional biopsy of the mass, however, revealed endometrial tissue, and a pathologic diagnosis of intramuscular endometriosis was rendered.
PMID: 16308716 [PubMed – as supplied by publisher]
Georgian Med News. 2005 Oct;(127):19-22.
[Comparative assessment of the quality of life of reproductive age patients with endometriosis depending on the method of treatment] [Article in Russian] Koridze LT, Dzangidze MA.
The purpose of the study was to investigate the influence of endometriosis as well as certain widely-spread methods of its conservative hormonal and surgical treatment on the quality of life of the patients in reproductive age. 546 twenty to forty years old women have been examined: 371 patients with the first time diagnosed endometriosis (I group), 64 — after conservative hormonal therapy (II group), 111 — after radical surgery (III group) and 30 healthy women (control group). All women operated for endometriosis were assessed to determine the quality of life by the following scores: "unsatisfactory" — 0 point, "satisfactory" — 1 point, excellent — 2 points. The average index of quality of life among all subjects was equal to 0,5+/-0,62 points (from 1,0+/-0,69 in the group of patients after one-sided ovariectomy or adnexectomy to 0,3+/-0,45 — in patients after double adnexectomy with hysterectomy) that was 7,8 times (p<0,001) and 2,6 times less than the given indices in the control group and in the untreated patients correspondingly. So, endometriosis in reproductive age significantly deteriorates the quality of life of the patients in comparison with healthy women. This quality can’t be fully restored by any of the analyzed methods of conservative hormonal treatment, radical surgery leads to its further significant deterioration requiring thus to continue searching for the most optimal approaches to the treatment and rehabilitation of patients with endometriosis in the reproductive age.
PMID: 16308434 [PubMed – indexed for MEDLINE]
Contraception. 2005 Dec;72(6):443-6. Epub 2005 Aug 22.
Effect on insulin sensitivity of Implanon vs. GnRH agonist in women with endometriosis.
Cagnacci A, Tirelli A, Cannoletta M, Pirillo D, Volpe A.
Department of Obstetrics, Gynaecology and Pediatrics Sciences, University of Modena, 41100 Modena, Italy. cagnacci@unimore.it
OBJECTIVES: To evaluate the influence of two medical treatments for endometriosis on insulin sensitivity. STUDY DESIGN: After surgery, 26 women with endometriosis were randomly allocated to a 6-month treatment with a GnRH agonist (Leuprorelin 3.75 mg/28 days) or a subdermal progestin implant (etonogestrel 68 mg). Insulin sensitivity (SI) and glucose utilization independent of insulin (Sg) were investigated at baseline and after 6 months by a frequently sampled intravenous glucose tolerance test (FSIGT) associated with the minimal model method. RESULTS: Both therapies tended to decrease SI, but the effect did not reach statistical significance in the GnRH agonist group (5.43+/-1.29 vs. 3.99+/-0.8) and was significant in the etonogestrel group (5.74+/-1.12 vs. 3.95+/-0,78; p=.046). Sg, fasting glucose, insulin, C-peptide and C-peptide/insulin were not modified by either treatment. CONCLUSIONS: The modifications of glucose-insulin metabolism induced by the GnRH agonist are of no relevance for the short-term use of this molecule. Even if the modification induced by the etonogestrel implant is subtle and of no major impact, it should be taken into consideration for the long-term treatment of individuals with abnormalities of glucose-insulin metabolism.
PMID: 16307968 [PubMed – in process]
Endocrinology. 2006 Mar;147(3):1278-86. Epub 2005 Nov 23.
Neutrophils and macrophages promote angiogenesis in the early stage of endometriosis in a mouse model.
Lin YJ, Lai MD, Lei HY, Wing LY.
Graduate Institute of Basic Medical Sciences, National Cheng Kung University, Tainan, Taiwan.
Substantial evidence suggests that inflammatory cytokines, immune cells, and angiogenesis are important for endometriosis. In this study, we investigated the role of the sequential events in the development of endometriosis in a mouse model. Uterine tissue was transplanted into the peritoneum of ovariectomized mice and then supplemented with estrogen or vehicle. On different days after transplantation, cell proliferation, angiogenesis, and infiltrated immune cells in ectopic tissue were examined using immunochemical staining. Many disintegrated blood vessels but no bromodeoxyuridine-positive cells in ectopic tissue were observed in the estrogen-treated group on posttransplantation d 1 and 2. On d 4-7, bromodeoxyuridine-positive cells were detected in the blood vessels of ectopic tissue, indicating that angiogenesis was initiated in this stage. Angiogenesis also occurred in ectopic tissue in the vehicle-treated group. Profound infiltration of neutrophils in ectopic tissue occurred on d 1-4, when the number of neutrophils and levels of macrophage inflammatory protein (MIP)-1alpha and MIP-2 chemokines in peritoneal fluids also reached their peak. Peritoneal macrophage numbers did not change, but secretions of TNFalpha, IL-6, MIP-1alpha, and MIP-2 from macrophages isolated on d 2 were higher than on d 0. In vitro studies showed that peritoneal neutrophils and macrophages secreted vascular endothelial growth factor, which was up-regulated by TNFalpha and IL-6. Our results suggest that neutrophils and macrophages may promote angiogenesis in the early stage of endometriosis and that chemokines and cytokines amplify the angiogenic signal for the growth of endometriotic tissue.
PMID: 16306083 [PubMed – in process]
Acta Obstet Gynecol Scand. 2005 Dec;84(12):1141-4.
Increased granulocyte chemotactic protein-2 concentrations in peritoneal fluid of women with endometriosis.
Suzumori N, Zhao XX, Suzumori K.
Department of Obstetrics & Gynecology, Nagoya City University Graduate School of Medicine, 1-Kawasumi, Mizuho-ku, Mizuho-cho, Nagoya 467-8601, Japan. og.n.suz@med.nagoya-cu.ac.jp
BACKGROUND: To evaluate the release of granulocyte chemotactic protein-2 (GCP-2) into peritoneal fluid in women with endometriosis, we measured its concentration with reference to the disease stage and the phase of the menstrual cycle. METHODS: Surgery was scheduled in the proliferative or secretory phase of the menstrual cycle for 64 women with endometriosis (n = 38) or cystadenomas (n = 26). GCP-2 concentrations in the peritoneal fluid were measured using an enzyme-linked immunosorbent assay. RESULT: Our findings indicated elevated concentrations of GCP-2 in peritoneal fluid from women with endometriosis during the proliferative phase, which were positively correlated with the stage of endometriosis. CONCLUSION: Inflammation associated with endometriosis may be involved in the pathogenesis of the disease through increasing levels of peritoneal fluid GCP-2.
PMID: 16305697 [PubMed – indexed for MEDLINE]
Eur J Obstet Gynecol Reprod Biol. 2005 Nov 19; [Epub ahead of print] Intestinal endometriosis without evident pelvic foci treated with gonadotropin-releasing hormone agonist.
Porpora MG, Pallante D, Ferro A, Crobu M, Cerenzia P, Panici PL.
Department of Gynecological Sciences, Perinatology and Child Health, University of Rome " La Sapienza", Italy.
Publication Types: ? LETTER
PMID: 16303229 [PubMed – as supplied by publisher]
Eur J Obstet Gynecol Reprod Biol. 2005 Dec 13; [Epub ahead of print] Pituitary desensitization for eight weeks after the administration of two distinct gonadotrophin-releasing hormone agonists.
Matteo M, Caroppo E, Gliozheni O, Carone D, Schonauer LM, Vizziello G, Greco P, D’Amato G.
Operative Unit of Obstetric and Gynecology, Department of Surgical Sciences, University of Foggia, Foggia, Italy.
OBJECTIVE(S): The objective was to evaluate the duration of pituitary desensitization after the administration of 3.5mg of triptorelin (T) and leuprolin (L) depot preparations in patients with endometriosis. STUDY DESIGN: Two groups of 30 patients received, on 21st day of the cycle, 3.75mg i.m. of triptorelin (T group), and of leuprolin acetate (L group). From the first to the eighth week following gonadotrophin-releasing hormone agonists (GnRH-a) administration both groups underwent pelvic ultrasound and serum follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) evaluation. Statistical analysis was performed using the ANOVA test and the median test. A p-value<0.05 was considered significant. RESULTS: Pituitary suppression was achieved from two to six and from two to seven weeks after the administration of 3.75mg of leuprolin and triptorelin, respectively. FSH and LH serum levels were significantly higher in the L group than in the T group after the fourth week. CONCLUSIONS: Leuprolin and triptorelin depots (3.75mg) promote satisfactory ovarian suppression lasting for six and seven weeks, respectively, after administration, with significantly different ambient levels of endogenous LH.
PMID: 16359772 [PubMed – as supplied by publisher]
Obstet Gynecol Surv. 2005 Dec;60(12):817-26.
Future perspectives in the medical treatment of endometriosis.
Ferrero S, Abbamonte LH, Anserini P, Remorgida V, Ragni N.
Department of Obstetrics and Gynaecology, San Martino Hospital, University of Genoa, Genoa, Italy. simone.ferrero@fastwebnet.it
In the last few years, our understanding of the pathogenesis of endometriosis at the cellular and molecular levels has improved significantly. This may give us the opportunity to use new, specific agents for the treatment of this disorder. Despite the effectiveness of the available treatments, novel therapeutic strategies may improve our ability to eliminate endometriotic lesions when present and to prevent the recurrence of endometriosis after surgical treatment. This review focuses on the new, experimental approaches to the medical treatment of endometriosis and its symptoms. The blockage of aromatase activity in endometriotic lesions with an aromatase inhibitor may represent a new step in the medical treatment of endometriosis. Preliminary clinical studies have demonstrated the efficacy of third-generation nonsteroidal aromatase inhibitors (ie, anastrozole and letrozole) in reducing the intensity of pain symptoms associated with the presence of endometriosis. The new selective progesterone receptor modulators may represent a valid hormonal treatment option. Therapeutic manipulation of the immune system through TNFalpha inhibitors may be beneficial in women with endometriosis. New pharmaceutical agents affecting inflammation, angiogenesis, and matrix metalloproteinase activity may prevent or inhibit the development of endometriosis. Further clinical trials may determine if these new therapies are superior to current medical treatment strategies for endometriosis. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians Learning. OBJECTIVES: After completion of this article, the reader should be able to describe the new experimental medical treatments of endometriosis, state that the clinical use of nonsteroidal aromatase inhibitors for endometriosis appears to be efficacious but is based on preliminary clinical data, and recall that the drugs used for endometriosis in the future may include manipulation of the immune system.
Publication Types: ? Review
PMID: 16359564 [PubMed – indexed for MEDLINE]
J Endourol. 2005 Dec;19(10):1177-9.
Endoscopic diagnosis and management of ureteral endometriosis.
Generao SE, Keene KD, Das S.
Department of Urology, University of California, Davis Medical Center, Sacramento, California 95816, USA. generas@sutterhealth.org
It is estimated that 1% of patients with endometriosis have involvement of the urinary tract, with the bladder being the most common location. Ureteral endometriosis is a rare entity, and the majority of cases are found at exploratory laparotomy for extensive involvement of the pelvic organs. Obstruction of the ureter may be caused by extrinsic or intrinsic disease, with the extrinsic form occurring four times as often. Progressive ureteral obstruction can be insidious in onset and ultimately lead to renal failure. Hormone therapy has had variable success, and open surgery has been the mainstay of treatment. Only one case of ureteral endometriosis, both intrinsic and extrinsic, diagnosed at ureteroscopy has been reported previously. We present a case of ureteral obstruction secondary to isolated intrinsic endometriosis diagnosed at ureteroscopy and treated endoscopically with holmium laser ablation and leuprolide therapy.
Publication Types: ? Case Reports
PMID: 16359209 [PubMed – indexed for MEDLINE]
Mt Sinai J Med. 2005 Nov;72(6):405-8.
Intestinal obstruction due to rectal endometriosis.
Paksoy M, Karabicak I, Ayan F, Aydogan F.
Department of General Surgery, Cerrahpasa Medical Facility, Istanbul University, Istanbul, Turkey.
We report a case of a premenopausal woman with severe constipation causing intermittent obstruction. Colonoscopy revealed a tight rectal stricture; however, mucosal biopsies were normal. Exploratory surgery revealed an intense fibrotic reaction involving the rectum and uterus, necessitating a simultaneous low anterior resection and hysterectomy. Pathology established a diagnosis of endometriosis. Preoperative diagnosis of rectal endometriosis can be difficult to establish. Endometrial deposits do not invade the mucosa; therefore, colonoscopy with biopsies are frequently non-diagnostic. Surgery may be the only definitive way to obtain a certain diagnosis. In cases involving rectal strictures of unknown etiology in premenopausal women, rectal endometriosis must be included in the differential diagnosis.
Publication Types: ? Case Reports
PMID: 16358167 [PubMed – indexed for MEDLINE]
AJR Am J Roentgenol. 2006 Jan;186(1):56-7.
Radiologic-pathologic conference of Brooke Army Medical Center: endometriosis of the canal of Nuck.
Kirkpatrick A, Reed CM, Bui-Mansfield LT, Russell MJ, Whitford W.
Department of Radiology, Brooke Army Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234, USA.
Publication Types: ? Case Reports
PMID: 16357379 [PubMed – indexed for MEDLINE]
Int J Gynecol Cancer. 2005 Nov-Dec;15(6):1206-9.
Parametrial and rectovaginal adenocarcinoma arising from endometriosis.
Ulrich U, Rhiem K, Kaminski M, Wardelmann E, Trog D, Valter M, Richter ON.
Department of Obstetrics and Gynecology, University of Bonn School of Medicine, Bonn, Germany. uweaulrich@aol.com
Malignant extragonadal tumors arising from endometriosis are rare. We report on two cases. A 41-year-old gravida 1, para 1 (G1P1), with adenocarcinoma of the right parametrium arising from endometriosis and a 51-year-old G1P1 with endometriosis-associated rectovaginal adenocarcinoma were treated. Treatment included radical surgery plus radiation therapy. While the former patient was doing well 2 years after the primary diagnosis, the latter suffered a local pelvic recurrence 2 years later. Although there are no randomized controlled studies, radical surgery followed by radiation therapy seems generally to be the treatment of choice. The analysis of PTEN in various forms of endometriosis and its malignant transformation may help in understanding the early steps of tumorigenesis.
Publication Types: ? Case Reports
PMID: 16343215 [PubMed – indexed for MEDLINE]
Int J Gynecol Cancer. 2005 Nov-Dec;15(6):1203-5.
Primary adenocarcinoma arising from endometriosis of the rectovaginal septum: a case report.
Yazbeck C, Poncelet C, Chosidow D, Madelenat P.
Department of Obstetrics and Gynecology, Bichat University Hospital, Paris, France. chayazmd@hotmail.com
Adenocarcinomas developing in endometriotic lesions have been reported, most commonly in the ovary. The rectovaginal septum is a rare location of this neoplastic transformation. We report a case of primary adenocarcinoma arising from endometriosis of the rectovaginal septum in a 25-year-old woman presenting with lower abdominal pain and dyspareunia. Diagnostic and treatment modalities were discussed. Immunohistochemical studies of different keratin subtypes and CA125 expression of the tumor cells are of interest for the diagnosis. Preoperative radiation therapy promotes clinical symptoms relief, tumor volume reduction, and better radical surgical approach.
PMID: 16343214 [PubMed – indexed for MEDLINE]
Indian J Med Sci. 2005 Nov;59(11):495-8.
Cesarean scar endometriosis–report of two cases.
Goel P, Sood SS, Dalal A; Romilla.
Department of Obstetrics,Government Medical College and Hospital, Chandigarh, India. poonam1302@yahoo.com
Endometriosis is presence of functioning endometrial tissue outside the uterine cavity. Endometriosis can sometimes occur in a previous surgical scar. Scar endometriosis is rare and difficult to diagnose. It mostly follows obstetrical and gynecological surgeries. This condition is often confused with other surgical conditions. We are reporting two cases of scar endometriosis following cesarean section, which were misdiagnosed as stitch granuloma initially. Medical treatment was not helpful. Both the patients required wide surgical excision of the lesion. The pathogenesis, diagnosis and treatment of this condition are being discussed.
Publication Types: ? Case Reports
PMID: 16340149 [PubMed – indexed for MEDLINE]
J Minim Invasive Gynecol. 2005 Nov-Dec;12(6):525-7.
Laparoscopic neurolysis of the pelvic sciatic nerve in a case of catamenial footdrop.
Volpi E, Seinera P, Ferrero A, Dompe D.
Department of Gynecologic Oncology, University of Turin, Italy.
Isolated cases of cyclic sciatica associated with endometriosis have been reported since the 1940s. Surgical intervention, either by laparoscopy for lesions within the pelvis or by open procedures for extrapelvic lesions, has usually been performed. A 37-year-old woman with catamenial footdrop and pain of the right thigh came to our observation. Previously, she underwent laparoscopy for bilateral ovarian endometriomas. In a second laparoscopy, we removed her uterosacral right ligament and recto-vaginal endometriotic nodules. After a temporary improvement, a third surgical procedure was necessary: laparoscopic neurolysis to free the sciatic nerve from fibrotic tissue. Then the patient was treated with gonadotropin-releasing hormone analogs for 6 months, and she is free of symptoms 2 years after last surgery. This is the first described case of laparoscopic neurolysis of the proximal sciatic nerve. The procedure has been successful in treating a patient with endometriosis in whom the cause of the syndrome was probably due to entrapment of the nerve in fibrous tissue.
Publication Types: ? Case Reports
PMID: 16337582 [PubMed – indexed for MEDLINE]
J Minim Invasive Gynecol. 2005 Nov-Dec;12(6):508-13.
Surgical treatment of deep endometriosis and risk of recurrence.
Vignali M, Bianchi S, Candiani M, Spadaccini G, Oggioni G, Busacca M.
Department of Obstetrics and Gynaecology, University of Milano, Macedonio Melloni Hospital, Milano, Italy. michele.vignali@unimi.it
STUDY OBJECTIVE: To evaluate the risk of recurrence of deep endometriosis after conservative surgery. DESIGN: Retrospective analysis (Canadian Task Force classification II-3). SETTING: Tertiary care university hospital. PATIENTS: One hundred fifteen symptomatic patients operated on in our department from 1996 through 2002 with postoperative follow-up of at least 12 months. INTERVENTION: All patients underwent conservative surgery for deep infiltrating endometriosis. MEASUREMENT AND MAIN RESULTS: Risk factors for recurrence of symptoms and clinical findings and for repeated surgery were evaluated by univariate and multivariate analysis. During follow-up, we observed 28 patients with pain recurrence and 15 patients with recurrent clinical findings, and 12 patients required reoperation for deep endometriosis. Recurrence rates of pain and clinical findings during 36 months were 20.5% and 9%, respectively. Multivariate analysis showed that only age was a significant predictor of pain recurrence (OR 0.9, 95% CI 0.81-0.99, p<.05), enhancing the risk in younger patients. Recurrence of clinical signs of deep endometriosis was predicted by obliteration of the pouch of Douglas (OR 1.46, 95% CI 1.16-16.2, p<.05). Reoperation for deep endometriosis was predicted only by the incompleteness of first operation (OR 21.9, 95% CI 3.2-146.5, p<.001). CONCLUSION: Our study indicates that age, obliteration of the pouch of Douglas, and surgical completeness may have a significant influence on the recurrence of the disease.
Publication Types: ? Evaluation Studies
PMID: 16337578 [PubMed – indexed for MEDLINE]
J Minim Invasive Gynecol. 2005 Nov-Dec;12(6):486-93.
Endometriosis: what is the risk of hospital admission, readmission, and major surgical intervention?
Weir E, Mustard C, Cohen M, Kung R.
Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. eweir@sympatico.ca
STUDY OBJECTIVE: To describe trends in hospital utilization and surgical rates for endometriosis and to estimate the probability of hospital readmission over 4 years among women with early-stage disease. DESIGN: Population-based, retrospective cross-sectional and longitudinal analysis of 53,385 hospital admissions for same-day surgery or inpatient treatment of endometriosis from fiscal years 1994/95 through 2001/02 (Canadian Task Force classification III). SETTING: All hospital discharge records that listed endometriosis as the most-responsible diagnosis in the province of Ontario, Canada, from fiscal years 1994-1995 through 2001-2002. PATIENTS: Ontario female patients 15 years of age or older admitted to the hospital for treatment of endometriosis. INTERVENTIONS: Surgical treatments were classified as minor, intermediate, or major depending on the extent of the surgery. MEASUREMENTS AND MAIN RESULTS: Age-standardized annual discharge rates were calculated and trends in surgical treatment described. The records of 7993 women who received minor or intermediate surgery on their index hospital visit were linked, and the likelihood and predictors of readmission were calculated using survival analysis and logistic regression. During the observation period, the standardized discharge rates fell significantly from 172.9 per 100,000 women aged 15 to 70 to 137.1 per 100,000 (p<.05). Age-specific rates were highest for women aged 15 to 39 (approximately 200 per 100,000). The proportion of hospitalizations involving minor surgeries dropped (from 27% to 17%), and the proportion involving intermediate surgeries increased (from 40% to 53%). The likelihood of hospital readmission within 4 years for additional surgical treatment was 27% and of having a hysterectomy was 12%. CONCLUSION: Fewer women are being hospitalized for minor surgical procedures for endometriosis with hospital-based care being reserved for more extensive procedures. Nonetheless, about a quarter of women hospitalized for initial surgical treatment for endometriosis will undergo additional surgical treatment within 4 years, and one in 10 will have a hysterectomy.
PMID: 16337575 [PubMed – indexed for MEDLINE]
J Minim Invasive Gynecol. 2005 Nov-Dec;12(6):480-5.
Minimizing ancillary ports size in gynecologic laparoscopy: a randomized trial.
Ghezzi F, Cromi A, Colombo G, Uccella S, Bergamini V, Serati M, Bolis P.
Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy. fabio.ghezzi@uninsubria.it
STUDY OBJECTIVE: To evaluate the feasibility, safety, and effect on postoperative pain of laparoscopy for the management of adnexal masses by downsizing ancillary trocars from 5- to 3-mm. DESIGN: Randomized, controlled trial (Canadian Task Force classification I). SETTING: Gynecologic department of a university hospital PATIENTS: A total of 102 women with an adnexal mass scheduled for gynecologic laparoscopic procedures were randomized to undergo laparoscopy using either conventional 5-mm ancillary trocars (n=52) or 3-mm instruments (n=50). Preoperative suspicion of malignancy, deep infiltrating endometriosis, and indications for hysterectomy or myomectomy were considered as exclusion criteria. INTERVENTIONS: Laparoscopic procedures for the treatment of benign adnexal masses. MEASUREMENTS AND MAIN RESULTS: Both groups were similar in patient age, body mass index, history of abdominal surgery, and type of procedures. Intraoperative complications occurred in no patient (0%) in the 3-mm group and in two patients (3.8%) in the 5-mm group (p=.49). Conversion from 3- to 5-mm instrumentation was necessary in one procedure. No difference was found in the operative time between the 3-mm and the 5-mm groups (54 min [range 15-175 min] vs 50 min [range 20-150 min], p=.89). The severity of incisional pain was evaluated with a 100-mm visual analog scale at 1, 3, and 24 hours after surgery. Postoperative pain was significantly lower in the 3-mm than in the 5-mm group 1 hour after laparoscopy (20 [range 0-60] vs 32.5 [range 0-80], p=.04). The proportion of women requiring analgesia before discharge, the timing of analgesic requirement, and the total amount of medication in the first 24 hours after surgery were similar in the two groups. CONCLUSION: Three-millimeter ancillary trocars can safely replace traditional-size equipment for the management of adnexal masses without a negative impact on the surgeon’s ability to perform gynecologic laparoscopy and are associated with less immediate postoperative pain.
Publication Types: ? Randomized Controlled Trial
PMID: 16337574 [PubMed – indexed for MEDLINE]
J Assist Reprod Genet. 2005 Dec;22(11-12):415-7.
Effect of pentoxifylline in reducing oxidative stress-induced embryotoxicity.
Zhang X, Sharma RK, Agarwal A, Falcone T.
Center for Advanced Research in Human Reproduction, Infertility and Sexual Function, Department of Obstetrics-Gynecology and Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
PURPOSE: To 1) evaluate the embryotoxic effects of hydrogen peroxide on mouse embryo development and 2) examine if pentoxifylline can reverse hydrogen peroxide induced embryotoxicity. METHODS: Prospective in vitro study examining the effects of varying concentrations of hydrogen peroxide and pentoxifylline on the blastocyst development rate alone as well as in combination. RESULTS: A dose-dependent decrease in % BDR was seen with increasing concentrations of H2O2. High concentrations of hydrogen peroxide (> 60 microM) were embryotoxic. Pentoxifylline (500 microM) was able to reduce the embryotoxic effect of hydrogen peroxide. Percent blastocyst development rate increased from 44% in hydrogen peroxide alone to 85% in hydrogen peroxide and pentoxifylline coincubation. CONCLUSIONS: Pentoxifylline may be beneficial in reducing hydrogen peroxide induced embryo damage and improve IVF outcome. Patients with endometriosis-associated infertility may benefit from the use of pentoxifylline without significantly affecting embryo development.
PMID: 16331539 [PubMed – in process]
Arch Pathol Lab Med. 2005 Dec;129(12):e218-21.
A 42-year-old woman with a 7-month history of abdominal pain. A, endometriosis involving ileocecal junction and 2 pericolonic lymph nodes; B, intranodal benign glandular inclusions.
Sheikh HA, Krishnamurti U, Bhat Y, Rajendiran S.
Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA. cheikhha@msx.upmc.edu
Publication Types: ? Case Reports
PMID: 16329741 [PubMed – indexed for MEDLINE]

Int J Oncol. 2006 Jan;28(1):43-51.
Activation of telomerase in BeWo cells by estrogen and 2,3,7,8-tetrachlorodibenzo-p-dioxin in co-operation with c-Myc.
Sarkar P, Shiizaki K, Yonemoto J, Sone H.
Endocrine Disruptors and Dioxin Research Project, National Institute for Environmental Studies, Tsukuba 305-8506, Japan.
Telomerase activation, known to be stimulated by estrogen, is essential for cellular immortalization and trans-formation, both of which play a role in tumorigenesis. Dioxin and dioxin-like compounds have been shown to induce endometriosis and promote estrogen-dependent tumors. In this study, we show that either 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) or a combination of TCDD and 17-beta estradiol (E2) increase telomerase activity and the expression of the human telomerase catalytic subunit (hTERT) in human choriocarcinoma (BeWo) cells. Compared with estrogen or TCDD alone, the combination treatment did not show an additive effect. Likewise, treatment with either E2 or TCDD increased DNA synthesis and the cell population in S-phase, as detected by FACS analysis. However, following treatment with the E2 and TCDD combination, the proportion of cells in S-phase was actually lower than in cells treated with TCDD alone. These results suggest that TCDD alone mimics estrogenic action in telomerase activation and cell proliferation but, in the presence of estrogen, TCDD-induced actions were partially counteracted. E2 and TCDD also induced c-Myc, which is a transcriptional activator of hTERT in Bewo, but neither of these agents induced telomerase activity in HO15.19 c-myc-null cells. In contrast, only TCDD upregulated telomerase in TGR-1 cells, which are c-Myc expressing but lacking ER expression. The findings suggest that TCDD induces telomerase activity mediated through AhR signaling and/or ER-independent c-Myc signaling. The present study provides insight into the mechanism of promoter activity of TCDD in estrogen-related tumors.
PMID: 16327978 [PubMed – indexed for MEDLINE]
Eur J Obstet Gynecol Reprod Biol. 2006 Mar 1;125(1):9-28. Epub 2005 Dec 1.
Non-contraceptive uses of levonorgestrel-releasing hormone system (LNG-IUS)-A systematic enquiry and overview.
Varma R, Sinha D, Gupta JK.
Academic Department of Obstetrics and Gynaecology, Birmingham Women’s Hospital, Birmingham B15 2TG, UK.
Levonorgestrel releasing-intrauterine systems (LNG-IUS) were originally developed as a method of contraception in the mid 1970s. The only LNG-IUS approved for general public use is the Mirena((R)) LNG-IUS, which releases 20mcg of levonorgestrel per day directly in to the uterine cavity. However, new lower dose (10 and 14mcg per day) and smaller sized LNG-IUS (MLS, FibroPlant-LNG) are currently under clinical development and investigation. Research into the non-contraceptive uses of LNG-IUS is rapidly expanding. In the UK, LNG-IUS is licensed for use in menorrhagia and to provide endometrial protection to perimenopausal and postmenopausal women on estrogen replacement therapy. There is limited evidence to suggest that LNG-IUS may also be beneficial in women with endometriosis, adenomyosis, fibroids, endometrial hyperplasia and early stage endometrial cancer (where the patient is deemed unfit for primary surgical therapy). This systematic enquiry and overview evaluates the quality of evidence relating to the non-contraceptive therapeutic uses of LNG-IUS in gynaecology.
PMID: 16325993 [PubMed – in process]
Am J Obstet Gynecol. 2005 Dec;193(6):2133-7.
Chronic urinary retention and pelvic floor hypertonicity after surgery for endometriosis: a case series.
Gehrich AP, Aseff JN, Iglesia CB, Fischer JR, Buller JL.
Washington Continence Center/Institute for Pelvic Floor Disorders, Washington Hospital Center, Washington, DC, USA. ABRGehrich@aol.com
OBJECTIVE: The purpose of this study was to evaluate 4 cases of chronic urinary retention and pelvic floor muscle spasms after surgery for endometriosis. STUDY DESIGN: These patients underwent a complete history, physical exam, and diagnostic work- up. The results were analyzed with regards to type and extent of inciting surgery, diagnostic findings, postoperative recovery, and treatment success. RESULTS: The patients’ mean age was 39.5 years and all had undergone various surgical interventions for endometriosis. In addition to urinary retention, all developed debilitating pelvic floor muscle spasm postoperatively. Physical exam revealed pelvic floor hypertonicity and urodynamics indicated hypoactive detrusor contractility. Neurodiagnostic testing gave evidence of neuropathy in all subjects. CONCLUSION: Extensive endometriosis surgery may pose a risk for postoperative bladder dysfunction and pelvic floor muscle spasm.
PMID: 16325629 [PubMed – indexed for MEDLINE]
Am J Obstet Gynecol. 2005 Dec;193(6):2062-6.
Ovarian remnant syndrome.
Magtibay PM, Nyholm JL, Hernandez JL, Podratz KC.
Division of Gynecologic Surgery, Mayo Clinic, Scottsdale, AZ 85259, USA. magtibay.paul@mayo.edu
OBJECTIVE: This study was undertaken to examine surgical management of patients with ovarian remnant syndrome. STUDY DESIGN: Data were abstracted from records of patients with a history of bilateral salpingo-oophorectomy who were treated surgically at Mayo Clinic between 1985 and 2003 for pathologically confirmed residual ovarian tissue. A follow-up questionnaire was also mailed. RESULTS: Records review identified 186 patients (mean age, 37.6 years; mean follow-up, 1.2 years). Of 180 patients with available data, 153 (85%) underwent oophorectomy by laparotomy, 13 (7%) by laparoscopy, and 14 (8%) by transvaginal approach, mostly for endometriosis (56.8%). Of 186 patients, 105 (57%) presented with pelvic masses and 89 (48%) with pelvic pain. Remnant ovarian tissue was associated with a corpus luteum in 78 (42%) and endometriosis in 54 (29%). The intraoperative complication rate was 9.6%. Of 142 patients, 12 (9%) required subsequent re-exploration (1 ovarian remnant identified). CONCLUSION: This heavily pretreated population has modest risk of bowel, bladder, or ureteral trauma with definitive pelvic sidewall stripping and apical vaginal excision. However, subsequent recurrence is minimal (<1%). More than 90% of patients reported resolution or marked improvement of symptoms.
PMID: 16325616 [PubMed – indexed for MEDLINE]
Am J Obstet Gynecol. 2005 Dec;193(6):1908-14.
Damage to ovarian reserve associated with laparoscopic excision of endometriomas: a quantitative rather than a qualitative injury.
Ragni G, Somigliana E, Benedetti F, Paffoni A, Vegetti W, Restelli L, Crosignani PG.
Infertility Unit, Policlinico, Mangiagalli and Regina Elena Hospital, Universita Degli Studi di Milano, Milan, Italy.
OBJECTIVE: Retrospective studies suggest that laparoscopic excision of endometriomas is associated with a reduced responsiveness to ovarian hyperstimulation. In this study, we prospectively evaluated ovarian response to hyperstimulation in women selected for in vitro fertilization and intracytoplasmic sperm injection cycles who previously underwent laparoscopic enucleation of a monolateral endometrioma. STUDY DESIGN: Operated and contralateral intact ovaries of the same patient were compared in terms of number of follicles, number of oocytes retrieved, fertilization rate, and rate of high-quality embryos. RESULTS: Thirty-eight subjects were included. A reduced number of dominant follicles, oocytes, embryos, and high-quality embryos was observed in the operated gonad. The mean percentage of reduction was 60% (95% confidence interval 38-81%), 53% (95% confidence interval 30-75%), 55% (95% confidence interval 28-81%), and 52% (95% confidence interval 17-87%), respectively. Fertilization rate and rate of good-quality embryos were similar. CONCLUSION: Laparoscopic excision of endometriomas is associated with a quantitative but not a qualitative damage to ovarian reserve.
PMID: 16325591 [PubMed – indexed for MEDLINE]
J Med Food. 2005 Winter;8(4):550-1.
The effect of soybeans on the anovulatory cycle.
Kohama T, Kobayashi H, Inoue M.
Department of Obstetrics and Gynecology, Keiju Medical Center, Nanao, Japan. kohama@yu.incl.ne.jp
We treated 36 outpatients, suffering from secondary amenorrhea, who had no menstruation or no ovulation for more than 6 months before consulting our clinic. After polycystic ovary syndrome, hyperprolactinemia, and other ovarian disorders that require medical treatment had been ruled out through smear test examinations of the uterine cervix and uterine myoma, ovarian tumor, and endometriosis had been checked for with ultrasonography and serum CA-125, the subjects began to take 6 g/day of black soybean in micropowder form for 6 months (S group). We estimated the ovular improvement of theses patients, observing basal body temperature (BBT) and follicular development with ultrasonography during the menstrual cycle as the indexes for ovulation and compared them with 34 patients with no treatment (C group). In the S group, improved ovulation was seen in 12 patients, four patients became pregnant, and three patients had anovular menstruation within 3 months after starting to take soybean powder. The periods of first ovulation were 66 +/- 12 days. After ovulation started, all subjects had regular menstruations and ovulation, with more than a 7-day high phase in BBT. On the other hand, in the C group, improved ovulation was seen in two patients, and two patients had anovular menstruation. In conclusion, black soybean has the potential to improve the anovular menstrual cycle.
PMID: 16379571 [PubMed – in process]
J Soc Gynecol Investig. 2006 Jan;13(1):58-62.
Effect of peroxisome proliferator-activated receptor-gamma agonist rosiglitazone on the induction of endometriosis in an experimental rat model.
Demirturk F, Aytan H, Caliskan AC, Aytan P, Koseoglu DR.
Department of Obstetrics and Gynecology, Gaziosmanpasa University, Tokat, Turkey.
OBJECTIVE: To assess the effect of the peroxisome proliferator-activated receptor (PPAR)-gamma agonist rosiglitazone on the induction of endometriosis in a rat model. METHODS: Endometriosis was surgically induced in 28 rats by transplanting an autologous fragment of endometrial tissue onto the inner surface of the abdominal wall. Group I was assigned as control and no medication was administered. Starting 3 days before the operation and continuing for 4 weeks, 0.2 mg/kg/d rosiglitazone was administered to the study group orally. Four weeks later rats were killed and ectopic uterine tissues were evaluated morphologically and histologically. Scoring systems were used to evaluate preservation of epithelia. RESULTS: Four rats in the study group and one rat in the control group died of complications related to surgery. There was a significant difference in post-treatment spherical volumes (64.00 mm3 [interquartile range (IQR): 354.42] vs 41.60 mm3 [IQR: 37.87], P = .018) and explant weights (77.97 mg [IQR: 431.27] vs 47.24 mg [IQR: 43.01], P = .005) between control and rosiglitazone-treated groups. The epithelia were found to be preserved significantly better in the control group when compared with the roziglitazone-treated group (2.00 [IQR:2.00] vs 0.00 [IQR:2.25], P = .014). CONCLUSIONS: Rosiglitazone was found to affect the induction of endometriosis negatively in this experimental rat model and seemed to interfere with the growth and maintenance of the uterine explant.
PMID: 16378914 [PubMed – in process]
J Reprod Immunol. 2005 Dec 22; [Epub ahead of print] Expression of apoptosis-related proteins in peritoneal, ovarian and colorectal endometriosis.
Dufournet C, Uzan C, Fauvet R, Cortez A, Siffroi JP, Darai E.
Service d’Anatomie Pathologie, Hopital Tenon, AP-HP, UFR Saint Antoine, Paris VI, France; UPRESS UFR Saint Antoine, France.
Endometriosis is defined as the presence of endometrial glands and stroma outside the uterus. Apoptosis, a physiological process by which multicellular organisms eliminate superfluous cells, is altered in tumor tissue. Here we studied the expression of the apoptosis-related proteins p53, bcl-2, bax, p21 and fas in proliferative (n=9) and secretory (n=9) endometrium, and in peritoneal (n=11), ovarian (n=20) and colorectal (n=20) endometriosis, by qualitative and semi-quantitative immunohistochemical methods using the percentage of positive cells and HSCORE analysis. In endometrium, p53, p21 and fas expression was low, whereas bax and bcl-2 expression was elevated. Using HSCORE analysis, only bcl-2 expression varied during the menstrual cycle (48.9+/-34.2% in the proliferative phase, 11.5+/-24.7% in the secretory phase, p=0.01). Using HSCORE analysis, p53 expression was higher in ovarian endometriosis than in peritoneal (p<0.0001) and colorectal endometriosis (p=0.03). P21 expression was higher in ovarian endometriosis than in peritoneal (p=0.01) and colorectal endometriosis (p=0.01). Bcl-2 expression was lower in ovarian endometriosis than in peritoneal (p=0.0002) and colorectal endometriosis (p<0.0001). Fas expression was higher in peritoneal endometriosis than in ovarian (p=0.02) and colorectal endometriosis (p=0.008). In conclusion, these results confirm the involvement of apoptosis in the pathogenesis of endometriosis. Moreover, expression of apoptosis-related proteins varies according to the location of endometriosis suggesting the involvement of different apoptotic pathways.
PMID: 16378643 [PubMed – as supplied by publisher]
Eur J Obstet Gynecol Reprod Biol. 2005 Dec 22; [Epub ahead of print] Reproductive outcome after laparoscopic treatment of minimal and mild endometriosis using Helica Thermal Coagulator.
Nardo LG, Moustafa M, Beynon DW.
Department of Obstetrics and Gynaecology, Frimley Park Hospital, Surrey, United Kingdom.
OBJECTIVE: To investigate the reproductive outcome following Helica Thermal Coagulator (Helica TC) in an infertile population with early-stage endometriosis. DESIGN: A clinical observational trial conducted in a NHS tertiary referral centre for treatment of endometriosis. Forty-four healthy infertile women (mean age 21 years, range 18-34 years) with laparoscopically confirmed diagnosis of minimal (stage I) or mild (stage II) endometriosis were included. All visible endometriotic lesions and adhesions were treated using Helica TC at the same time of diagnostic laparoscopy. Following laparoscopy, women attempted to conceive spontaneously and were followed for 12 months or until delivery. No hormonal therapy for endometriosis was given whatsoever. RESULTS: One woman was lost to follow-up and the remaining 43 women were considered in the final analysis. The cumulative pregnancy rate was 23.2% (10/43). All pregnancies occurred spontaneously and neither miscarriages nor ectopic pregnancies were observed. Pregnancy rate did not differ between women with stage I and those with stage II endometriosis. The time-to-pregnancy was similar in women with different stage endometriosis. No surgical complications were encountered. CONCLUSIONS: These findings suggest that Helica TC is a simple and safe conservative laparoscopic surgery for early-stage endometriosis. Helica TC appears to improve reproductive outcome in women with otherwise unexplained infertility. Large RCTs are needed to define these preliminary data.
PMID: 16377064 [PubMed – as supplied by publisher]
Mol Hum Reprod. 2005 Oct;11(10):745-9. Epub 2005 Dec 22.
Variants of the CTLA4 gene that segregate with autoimmune diseases are not associated with endometriosis.
Vigano P, Lattuada D, Somigliana E, Abbiati A, Candiani M, Di Blasio AM.
Department of Obstetrics, Gynaecology and Neonatology, Fondazione Policlinico-Mangiagalli-Regina Elena Hospital, University of Milano, Italy.
An autoimmune etiology has been suggested for endometriosis mostly on the basis of an increased prevalence of autoimmune diseases in affected women. Cytotoxic T lymphocyte antigen (CTLA) 4 gene is recognized as a primary determinant for autoimmunity since specific polymorphisms have been associated with predisposition to most autoimmune disorders. This study was aimed to evaluate whether two variants of CTLA4 gene might be associated with endometriosis in an Italian population. We examined the +49A/G polymorphism and the CT60A/G dimorphism in n = 146 endometriosis subjects classified according to Holt and Weiss criteria. Controls were represented by n = 165 women without laparoscopic evidence of the disease. We found no statistically significant difference in the genotype frequencies between women with and without endometriosis. The proportion of the mutant G allele of the +49A/G polymorphism in the former and in the latter group resulted 34 and 30%, respectively. The proportion of the susceptible G allele of the CT60 A/G dimorphism resulted 51% in both groups. No association was demonstrated between the polymorphisms and the clinical forms of the disease and no susceptibility haplotypes were found. These findings suggest that endometriosis aetiology is not primarily associated with the development of CTLA4-linked autoimmunity.
PMID: 16373368 [PubMed – in process]
Handb Exp Pharmacol. 2006;(174):53-71.
Embryonic stem cells: a novel tool for the study of antiangiogenesis and tumor-induced angiogenesis.
Wartenberg M, Donmez F, Budde P, Sauer H.
Department of Cell Biology, GKSS Research Center Teltow, Teltow, Germany.
Major research initiatives in antiangiogenesis research have been undertaken to control angiogenic diseases such as polyarthritis, psoriasis, endometriosis, and diabetic retinopathy, and inhibition of tumor-induced angiogenesis has emerged as one of the most promising anti-cancer therapies currently available. Although several quantitative in vivo (i.e., animal models) as well as in vitro (i.e., pure endothelial cell cultures) angiogenesis assays have been described, the development of novel angiogenesis assays with organotypic culture systems that take into account oxygen and nutrient gradients, depth-dependent changes in intracellular pH and a redox state similar to that found in a natural tissue microenvironment are necessary to investigate blood vessel growth. Embryonic stem cells of mouse and human origin have the capacity to develop into three-dimensional tissues with functional capillaries, and this model system represents an excellent in vitro model for antiangiogenesis research. Upon confrontation of stem cells by co-culture with multicellular tumor spheroids, tumor-induced angiogenesis, i.e., the invasion of endothelial host-derived cells into a tumor tissue, can also be monitored. The current review provides an overview of embryonic stem cells as novel tools for antiangiogenesis research and outlines the use of confrontation cultures for the study of tumor-induced angiogenesis.
Publication Types: ? Review
PMID: 16370324 [PubMed – indexed for MEDLINE]
MedGenMed. 2005 Apr 7;7(2):64.
Cervical endometriosis, a case presenting with intractable spotting.
Ata B, Ates U, Usta T, Attar E.
Department of Obstetrics and Gynecology, Vakif Gureba Hospital, Istanbul, Turkey.
Cervix uteri is regarded as an infrequent localization for endometriosis. With widespread use of invasive cervical procedures, however, an increased incidence can be expected. Limited awareness of the clinical appearance of the disease may account for its apparent rarity. This presentation aims to refocus attention to the disease by reviewing the case of a woman who presented to us with minimal metrorrhagia, which is a rare symptom of cervical endometriosis.
PMID: 16369442 [PubMed – in process]
Georgian Med News. 2005 Nov;(128):21-4.
[Combined usage of dufaston and reaferon for infertility treatment in patients with endometriosis] [Article in Russian] [No authors listed] A new method of treatment of endometriosis includes combination of surgical and hormonal therapy. Surgical method included excision of tissue with endometriosis, while the hormonal therapy involved the combination of dufaston and reaferon-EC (recombinant interferon alpha 2b). The aim of this study was to develop effective method of treatment of infertility caused by endometriosis using combination of dufaston and reaferon. There were 114 patients under observation who suffered from endometriosis and infertility. At the first stage of treatment thermokouterisation of area with endometrosis has been used. At the second stage of treatment all patients were divided into different clinical groups. To 34 patients from the study group reaferom-EC has been administered on the 5th, 8th, 10th, 12th, 14th days of menstrual cycle. The control group was represented by 80 patients, which was divided into two subgroups, 40 patients in each group. The patients from the first subgroup got hormonal therapy 20 mg dufaston from the 5th to 25th days of menstrual cycle, while the patients from the second subgroup got 20 mg dufaston from the 15th-20th to 25th days. The treatment was successful among the patients who got the combination of reaferon and dufaston, the frequency of pregnancy in the study group reached 52% vs. 27.3% in the control group (p>0.05). Those patients who had so called "small form" of endometriosis became pregnant in 34% cases in the study group and in 22.7% cases in the control group. Patients who had endometriosal cystoma became pregnant in 18.7% in the study group, but only in 9.4% in the test group, which shows that the treatment is less effective among these categories of patients. As a result of our study it is proved that the method of combination of reaferon and dufaston gives a chance to increase therapeutic effect and the number of pregnancy among the patients with endometriosis.
PMID: 16369056 [PubMed – in process]
J Obstet Gynaecol. 2005 Nov;25(8):829-32.
The laparoscopic appearances of pelvic splenosis: a case of mistaken identity.
Olah KS.
Warwick Hospital, Warwick, UK. karl.olah@btinternet.com
Publication Types: ? Case Reports
PMID: 16368605 [PubMed – indexed for MEDLINE]
Ann Thorac Surg. 2006 Jan;81(1):373.
Magnetic resonance images of diaphragmatic endometriosis treated by polyglactin mesh.
Bagan P, Le Pimpec-Barthes F, Martinod E, Brauner M, Azorin JF, Riquet M.
Department of Thoracic and Vascular Surgery, Avicenne Hospital, Paris XIII University, Bobigny, France. pbagan@mageos.com
PMID: 16368414 [PubMed – in process]
Cancer Epidemiol Biomarkers Prev. 2005 Dec;14(12):2929-35.
Relationship of benign gynecologic diseases to subsequent risk of ovarian and uterine tumors.

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