Mol Hum Reprod. 2006 Jan;12(1):35-9. Epub 2006 Feb 2.
Polymorphisms in the promoter regions of the matrix metalloproteinases-7, -9 and the risk of endometriosis and adenomyosis in China.
Shan K, Lian-Fu Z, Hui D, Wei G, Na W, Xia J, Yan L.
Department of Obstetrics and Gynaecology, Hebei Medical University, Fourth Hospital and Department of Molecular Biology, Hebei Cancer Institute, Shijiazhuang, China.
Matrix metalloproteinases (MMPs) may contribute to the development of endometriosis. The aim of this study was to assess the effects of the polymorphisms in the promoters of MMP-7 (181A/G) and MMP-9 (1562C/T) on the risk of occurrence of endometriosis and adenomyosis. We genotyped 219 patients (143 women with endometriosis, 76 women with adenomyosis) and 160 control women in North China. There was a significant difference in frequency of the MMP-7 genotype between endometriosis and controls (P = 0.01) and also between adenomyosis and controls (P = 0.01). The frequency of the G allele in two groups of patients (7.3 and 7.9%) was significantly higher than in the controls (2.8%) (P = 0.01 and 0.01, respectively). Compared to the A/A genotype, the genotype with the -181G allele showed a significantly increased susceptibility to both diseases, with adjusted odds ratio of 2.62 [95% confidence interval (CI) = 1.17-5.87] for endometriosis and 3.14 (95% CI = 1.26-7.81) for adenomyosis. However, the overall genotype and allelotype distribution of the MMP-9 in the two case groups were not different from that of controls. We conclude that MMP-7-181A/G polymorphism has a potential to be a susceptibility factor for endometriosis and adenomyosis while MMP-9-1562C/T polymorphism may not provide a useful marker to predict susceptibility to endometriosis and adenomyosis, at least in women from North China.
PMID: 16455621 [PubMed – in process]

Int J Clin Pract. 2006 Feb;60(2):232-3.
What we see is not what we get in catamenial haemoptysis.
Lu MS, Liu YH, Wu YC, Hsieh MJ, Liu HP.
Division of Thoracic Surgery, Chang Gung Memorial Hospital, Chang Gung University, Kweishan, Taoyuan, Taiwan.
Catamenial haemoptysis is rare entity, a part of thoracic endometriosis syndrome. We present a young woman who was timely diagnosed, successfully treated using video-assisted thoracoscopic surgery and pathologically confirmed the case. The change in lung parenchyma over time in the computed tomography is highlighted.
PMID: 16451299 [PubMed – in process]
Heart. 2006 Jan 31; [Epub ahead of print] Pregnancy and delivery in women after Fontan palliation.
Drenthen W, Pieper PG, Roos-Hesselink JW, van Lottum WA, Voors AA, Mulder BJ, van Dijk AP, Vliegen HW, Sollie KM, Moons P, Ebels T, van Veldhuisen DJ.
University Medical Center Groningen, Netherlands.
OBJECTIVES: A contemporary evaluation of outcome of pregnancy in women after Fontan palliation. To assess occurrence of infertility and menstrual cycle disorders. Design and PATIENTS: Using two CHD registries, 38 female patients who had undergone Fontan palliation (aged 18-45 years) were investigated: atrio-pulmonary anastomosis (n=23), atrio-ventricular connection (n=5) and total cavo-pulmonary connection (n=10). RESULTS: Only 10 pregnancies in 6 different women were observed, including 5 miscarriages (50%) and 1 aborted ectopic pregnancy. During the remaining 4 live- birth pregnancies clinically significant complications were encountered: e.g. NYHA deterioration; atrial fibrillation; gestational hypertension; premature rupture of membranes; premature delivery; foetal growth retardation and neonatal demise. Four of seven women who had attempted to become pregnant reported female infertility e.g. non-specified secondary infertility (n=2), uterus bicornis (n=1) and related to endometriosis (n=1). Moreover, several important menstrual cycle disorders were documented. In particular, the incidence of primary amenorrhoea was high (n=15, 40%), which resulted in a significant increase in age at menarche (14.6 +/- 2.1 years, p<0.0001, in comparison with general population). CONCLUSION: Successful completion of pregnancy is possible in women after adequate Fontan palliation without important long-term sequelae, though often complicated by clinically significant (non-) cardiac events. In addition, sub-/infertility and menstrual disorders were frequently documented.
PMID: 16449503 [PubMed – as supplied by publisher]

Hum Reprod. 2006 Mar;21(3):774-81. Epub 2006 Jan 31.
Laparoscopic nerve-sparing complete excision of deep endometriosis: is it feasible?
Landi S, Ceccaroni M, Perutelli A, Allodi C, Barbieri F, Fiaccavento A, Ruffo G, McVeigh E, Zanolla L, Minelli L.
Department of Obstetrics and Gynecology, Ospedale Sacro Cuore, Via Don A.Sempreboni 5, 37024 Negrar (Verona), School of Medicine, University of Bologna, Italy.
BACKGROUND: Little is known about the morbidity associated with laparoscopic complete excision of endometriosis in terms of urinary, digestive and sexual function. METHODS: We performed a prospective non-randomized study in 45 patients with laparoscopic complete excision of all detectable foci of endometriosis with segmental bowel resection using a non nerve-sparing technique (control group-group A n=20) and a nerve-sparing technique (case group-group B n=25). At initial gynaecological evaluation, and at follow-up details on dysmenorrhoea, pelvic pain, dyspareunia and dyschezia were evaluated using an interview-based questionnaire (10-point analogue rating scale: 0=absent, 10=unbearable). RESULTS: The mean (+/-SD) follow-up period was 15.3+/-10 months (range, 8.8-23 months) for group A and 3.5+/-2.1 months (range, 0.3-5.2 months) for group B. In the immediate postoperative course, in group A three women required blood transfusion vs seven women in group B (P=0.003). The median time to resume the voiding function was significantly shorter in group B (12.5 vs 3.0 days; P<0.01). At the time of follow-up a higher proportion of patients in group B were ‘very satisfied’ than those in group A (87.7% vs 59.0%, P=0.013). CONCLUSIONS: Laparoscopic nerve-sparing complete excision of endometriosis seems to be feasible and offers good results in terms of bladder morbidity reduction with apparently higher satisfaction than classical technique. Larger series with longer follow-up are needed to confirm our results.
PMID: 16449312 [PubMed – in process]
Obstet Gynecol. 2006 Feb;107(2 Pt 2):523-4.
A rare case of precoccygeal endometriosis.
Micha JP, Goldstein BH, Rettenmaier MA, Brown JV 3rd.
Gynecologic Oncology Associates, Hoag Memorial Hospital Cancer Center, Newport Beach, California 92663, USA. bram@gynocology.com
BACKGROUND: Endometriosis is commonly identified in the abdomen, specifically the ovaries, adnexa, and fallopian tubes, and sometimes in more distant areas; precoccygeal endometriosis is an extremely rare phenomenon. CASE: We present a case involving a 44-year-old woman diagnosed and treated for precoccygeal endometriosis. She underwent laparotomy, extensive lysis of pelvic adhesions, and resection of a 2.5-cm midline precoccygeal mass. After surgical excision of the precoccygeal endometriosis, the patient recovered without incident. CONCLUSION: Precoccygeal endometriosis is a very rare diagnosis.
PMID: 16449173 [PubMed – in process]
Obstet Gynecol. 2006 Feb;107(2 Pt 2):451-3.
Colouterine fistula secondary to endometriosis with associated chorioamnionitis.
Sriganeshan V, Willis IH, Zarate LA, Howard L, Robinson MJ.
Arkadi M. Rywlin Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, Miami Beach, Florida 33140, USA. vathanysri@yahoo.com
BACKGROUND: Intestinal endometriosis may be complicated by bowel obstruction, colonic rupture, sepsis, and rarely, malignant transformation. Fistula formation is extremely rare. CASE: A 26-year-old woman presented at 16 weeks of gestation with an acute abdomen suggestive of ruptured appendicitis. Blood cultures were positive for Bacteroides fragilis. At laparotomy, she was found to have a colouterine fistula with pelvic sepsis. The resected specimens demonstrated extensive uterine adenomyosis and endometriosis of the cecum, with a fistulous tract lined by endometriosis and suppurative inflammation extending from the cecum to the uterine endometrial cavity associated with severe chorioamnionitis and endomyometritis. CONCLUSION: This case illustrates a rare complication of colouterine fistula secondary to intestinal endometriosis.
PMID: 16449145 [PubMed – in process]
J Chin Med Assoc. 2006 Jan;69(1):47-50.
Extrapelvic endometriosis complicated with colonic obstruction.
Lin YH, Kuo LJ, Chuang AY, Cheng TI, Hung CF.
Department of Surgery, Taipei Veterans General Hospital, Taiwan, ROC.
Endometriosis is often seen in gynecology practice and is treated medically. However, intestinal involvement of endometriosis causing obstruction is relatively uncommon and is hard to differentiate from malignancy before surgery. Herein, we present a case of acute colonic obstruction caused by rectal endometriosis. Repeat colonoscopic biopsy and imaging studies could not differentiate the lesion from malignancy. Segmental resection with anastomosis was performed to relieve the symptom and confirm the diagnosis. We present this unusual disease in general surgical practice and also review the literature. The incidence, symptoms, diagnosis, treatment, and risk of malignancy of intestinal endometriosis are discussed.
Publication Types: ? Case Reports
PMID: 16447927 [PubMed – indexed for MEDLINE]

J Chin Med Assoc. 2006 Jan;69(1):42-6.
Endometriosis associated with hemothorax.
Lee HT, Wang HC, Huang IaT, Chang HC, Lu JY.
Division of Chest Medicine, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
Bloody pleural effusion is rarely associated with endometriosis. To effectively treat this condition, it is important to differentiate the malady from other common diseases such as malignancy or tuberculosis. We describe the case of a 40-year-old multiparous female featuring right-sided hemothorax presenting with right shoulder pain and progressive shortness of breath for the preceding 2 months. Thoracoscopy disclosed grossly negative findings apart from multiple small pores in the right hemi-diaphragm with blood clots within them. Examination of the thoracoscopic biopsy specimens showed chronic pleuritis without evidence of malignancy or tuberculosis. Pelvic endometriosis was considered a possible diagnosis according to the results of abdominal computed tomography (CT) scan, transvaginal sonography, and the results of dilatation and curettage. Periodic episodes of symptoms concurrent with menstruation led to the suspicion of a relationship between these conditions in our patient. Despite the patient undergoing an abdominal total hysterectomy and adhesiolysis without salpingo-oophorectomy, recurrent right-sided bloody pleural effusion developed 1.5 months subsequent to surgery. As a consequence, danazol (400 mg/day) was maintained because of the endometriosis associated with pleural effusion. One year of regular follow-up later, there was no evidence of recurrent pleural effusion. We considered that the bloody pleural fluid arose via seepage from the pelvic endometriosis through the pores of the right hemi-diaphragm during menstruation.
Publication Types: ? Case Reports
PMID: 16447926 [PubMed – indexed for MEDLINE]
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2005 Dec;27(6):753-5.
[Repairment of the large wound of endometriosis in the abdominal wall] [Article in Chinese] Song KX, Liu ZF, Zhao R, Wang XJ, Qiao Q.
Department of Plastic Surgery, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.
OBJECTIVE: To explore the plastic surgical repairment of the large wound of endometriosis in the abdominal wall. METHOD: Since March 2003 to December 2004, 6 patients were treated with abdominoplasty and V-Y plasty for the wounds of the endometriosis in the abdominal wall. RESULTS: The endometriotic foci were removed thoroughly with pretty abdominal contour. No complications were observed. CONCLUSION: Abdominoplasty and V-Y plasty are good methods to repair the wounds of the endometriosis in the abdominal wall.
PMID: 16447652 [PubMed – in process]
Int J Gynecol Cancer. 2006 Jan-Feb;16(1):432-5.
Carcinosarcoma arising from atypical endometriosis in a cesarean section scar.
Leng J, Lang J, Guo L, Li H, Liu Z.
Department of Gynecology and Obstetrics, Peking Union Medical College Hospital, CAM&PUMC, #1 Shuaifuyuan, Wangfujing, Beijing 100730, China. lengjenny@vip.sina.com
Malignant change of endometriosis in a cesarean scar (CS) is rare. We report a case of carcinosarcoma arising from atypical endometriosis in a CS scar, which was successfully treated with complete excision of the lesion and repair of the abdominal wall defect with autologous skin-muscle flap graft. A 41-year-old woman presented with a recurrent endometriosis in a CS scar. Within 16 years it changed from benign to atypical endometriosis and finally to carcinosarcoma after three operations. Complete excision of the tumor was performed, with a big defect of abdominal wall successfully repaired by autologous pedicle skin-muscle graft. The diagnosis of carcinosarcoma arising from atypical endometriosis was confirmed histologically. The lesion recurred 6 months after the fourth operation. She died of disease 15 months after the fourth operation. This case demonstrated that long-standing recurrent scar endometriosis could undergo malignant changes and should be made aware. The primary treatment is complete surgical excision.
PMID: 16445672 [PubMed – in process]
J Obstet Gynaecol Res. 2006 Feb;32(1):86-9.
Bilateral pleural endometriosis.
Dhanaworavibul K, Hanprasertpong J, Cheewadhanaraks S, Buhachat R.
Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, Thailand.
The patient was a 40-year-old woman with a 1-year history of catamenial chest pain and a recent bilateral hemothorax. She underwent a left thoracotomy for surgical pleurodesis, and a pleural biopsy. Subsequently, she had a hysterectomy in conjunction with an oophorectomy. The pathologic investigation of the pleura revealed an endometrial implant. The postoperative course was uneventful with no recurrence of hemothorax and chest pain during the first 6 months and at the patient’s follow-up. This is a very rare case of a patient with thoracic endometriosis presenting with bilateral hemothorax.
PMID: 16445531 [PubMed – in process]

Pharmacoeconomics. 2006;24(1):55-65.
Interstitial Cystitis: Cost, Treatment and Co-morbidities in an Employed Population.
Wu EQ, Birnbaum H, Mareva M, Parece A, Huang Z, Mallett D, Taitel H.
Analysis Group Inc., Boston, Massachusetts, USA.
INTRODUCTION: Recent literature indicates that interstitial cystitis (IC) may affect 20% of women and a smaller proportion of men, although many individuals with IC may be misdiagnosed or remain undiagnosed. Factors that can contribute to the cost of IC include medical and drug utilisation related to treatment and diagnosis of IC and associated conditions (e.g. depression), as well as employee work loss. This study assesses the direct medical cost and indirect cost of work loss for IC patients in the first year after diagnosis, and evaluates IC treatment patterns and prevalence of co-morbidities. METHODS: Data for patients under the age of 65 years with at least one diagnosis of IC (n = 749) were drawn from a de-identified, administrative database of approximately 2 million beneficiaries that included medical, drug and disability claims for 1999-2002. A 2 : 1 matched control sample of patients without an IC diagnosis (non-IC sample) was randomly selected based on patient characteristics. Indirect costs were calculated from a subgroup of 152 IC patients (plus their matched controls) who had disability information available.Costs incurred in the first year after IC diagnosis and co-morbidities were compared between IC patients and the non-IC sample, with the difference in costs defined as ‘excess costs’ of IC patients. Treatment patterns were profiled in the 2 months following initial diagnosis of IC. Descriptive statistics are presented. A multivariate two-part model was applied to estimate the IC direct medical cost, indirect cost and total cost to adjust for observed patient demographics and co-morbidities. Statistical significance was evaluated by the bootstrap method. RESULTS: The average IC patient had 130% higher direct costs (p < 0.05) and the average IC employee patient had 84% higher indirect costs than the average non-IC control individual. IC patients also had a higher diagnostic prevalence of prostatitis (relative risk [RR] = 40.0), endometriosis (RR = 7.4), vulvodynia (RR = 6.9), chronic pelvic pain (RR = 5.8) and urinary tract infections (RR = 5.1) [all p < 0.05]. IC patients were also more likely to report depression (RR = 2.8) and anxiety (RR = 4.5 ) than non-IC controls (all p < 0.05).Seventeen percent of IC patients received pentosan polysulfate therapy, the only US FDA-approved oral drug therapy indicated for treating IC, within the first 2 months after diagnosis. Of these patients, 69% received at least one ‘other’ drug from the non-approved oral medications studied. Approximately one-third of IC patients received only ‘other’ drug therapies, and almost half of IC patients received no drug treatment within the first 2 months after the initial diagnosis. CONCLUSIONS: IC is a costly disease associated with co-morbidities. Following diagnosis, patients with IC are commonly untreated or treated with non-approved drug therapies. It is possible that more accurate diagnosis and earlier and more appropriate treatment of IC would lead to better management (or even prevention) of co-morbidities and reduce healthcare costs, and this should be investigated in future studies.
PMID: 16445303 [PubMed – in process]

Arq Gastroenterol. 2005 Oct-Dec;42(4):226-32. Epub 2006 Jan 19.
[Importance of the tridimensional ultrasound in the anorectal evaluation] [Article in Portuguese] Regadas SM, Regadas FS, Rodrigues LV, Silva FR, Lima DM, Regadas-Filho FS.
Centro de Coloproctologia e Gastroenterologia, Hospital Sao Carlos, Fortaleza, CE. smregadas@hospitalsaocarlos.com.br
BACKGROUND: Anorectal endosonography is actually the main image exam to evaluate some anorectal diseases. AIM: To show the three-dimensional endosonography importance in the anal canal anatomic evaluation and the anorectal diseases diagnosis. METHODS: Seventy four anorectal ultrasound were performed, 23 normal individuals (13 women) and 51 patients (33 women) with benign and malignant diseases. All the patients were examined with a 3-D equipment with 360 degrees transducer. Normal individuals were evaluated in midline sagittal plane concerning to the length of the anal canal, the internal anal sphincter, the external anal sphincter and the anatomic defect in the anterior quadrant. RESULTS: There were no differences in the anal canal and the internal anal sphincter length between men and women. Otherwise, the external anal sphincter length is longer in men and the anatomic defect is longer in women. In those with anorectal diseases, 11 sphincter injuries, 8 anal fistulas, 7 abscess, 1 perirectal endometriosis, 1 pre-sacral cyst, 3 anal canal and 10 rectal malignant neoplasias were diagnosed. The surgical findings confirmed the ultrasound diagnosis in all the patients. CONCLUSION: Three-dimensional endosonography demonstrated the anatomic differences between male and female anal canal, justifying the larger incidence of pelvic floor disorders in female patients. It was possible to diagnose the anorectal diseases, in multi-plane, with high spatial resolution, adding also important informations about the therapeutic decision. Such characteristics become it similar to nuclear magnetic resonance with intra-rectal coil, with the advantages to be easier, quicker, low cost and better tolerated.
PMID: 16444377 [PubMed – in process]
Eur J Obstet Gynecol Reprod Biol. 2006 Jan 25; [Epub ahead of print] Proliferative activity of early ovarian clear cell adenocarcinoma depends on association with endometriosis.
Komiyama SI, Aoki D, Katsuki Y, Nozawa S.
Department of Obstetrics and Gynecology, School of Medicine, Keio University, Tokyo, Japan; Department of Obstetrics and Gynecology, National Saitama Hospital, 2-1 Suwa, Wako-shi, Saitama 351-0102, Japan.
OBJECTIVE: To investigate differences in the biological characteristics of ovarian clear cell adenocarcinoma based on the presence/absence of endometriosis and tumor proliferative activity. METHODS: Stage I ovarian clear cell adenocarcinoma patients were divided into groups with and without endometriosis, and immunohistochemical expression of proliferating cell nuclear antigen was determined in surgical specimens. Then xenograft models of human ovarian clear cell adenocarcinoma with or without human ectopic endometrium were created in severe combined immunodeficiency mice, and tumor growth was assessed from the wet weight and the bromodeoxyuridine uptake. Furthermore, a xenograft model of human endometriosis was made with or without ovarian clear cell adenocarcinoma and cytokine production was investigated. RESULTS: The proliferating cell nuclear antigen labeling index was significantly lower in the tumors of patients with endometriosis compared to the tumors of patients without endometriosis. In tumor-bearing mice, the tumor weight and bromodeoxyuridine uptake were both significantly lower when ovarian clear cell adenocarcinoma was associated with endometriosis than in its absence. Release of transforming growth factor-beta1 and interleukin-6 from the ectopic human endometrium was greater in the presence of clear cell adenocarcinoma than without it, and transforming growth factor-beta1 levels showed a significant difference. CONCLUSION: The proliferative activity of early ovarian clear cell adenocarcinoma seems to depend on the association of this cancer with endometriosis. When endometriosis is associated with ovarian clear cell adenocarcinoma, there is a change of its cytokine production that may inhibit tumor growth.
PMID: 16442693 [PubMed – as supplied by publisher]
Aust N Z J Obstet Gynaecol. 2006 Feb;46(1):38-41.
Effect of BCG vaccine on peritoneal endometriotic implants in a rat model of endometriosis.
Itil IM, Cirpan T, Akercan F, Gamaa A, Kazandi M, Kazandi AC, Yildiz PS, Askar N.
Department of Obstetrics and Gynecology, Ege University Faculty of Medicine, Izmir, Turkey.
OBJECTIVE: To investigate the effect of Bacillus Calmette-Guerin (BCG) vaccine on peritoneal implantation of endometrial tissue in rats. METHODS: Forty sexually mature virgin Wistar albino rats weighing 190-200 g were randomly assigned (double blind) to two groups. The rats in the first group were vaccinated with 0.1 mL BCG and those in the second group were injected with 0.1 mL saline into the tail, intracutaneously. All the rats underwent median laparotomy after 4 weeks of vaccination or injection. The right uterine horn was excised, and the two samples of endometrial tissue dissected from myometrium were implanted on each side of peritoneum at the 2 cm lateral line of the median laparotomy incision. The implanted peritoneal segments were excised after 8 weeks of laparotomy. The tissue samples were accepted, histologically, as endometriosis when both glands and stroma of endometrial tissue were seen in sections. RESULTS: Thirty-six implants from the study group and 34 implants from the control group were obtained. Ten and 23 implants were accepted as endometriosis in the study and control group, respectively. The number of endometriotic foci were significantly lower in the study group than in the control group (P = 0.01). CONCLUSIONS: Stimulation of the cellular immune response with BCG vaccine could exert an inhibitory effect on ectopic endometriotic implants.
PMID: 16441691 [PubMed – in process]

Nurs Times. 2006 Jan 17-23;102(3):41.
Goserelin.
[No authors listed] PMID: 16440976 [PubMed – indexed for MEDLINE]
Hum Reprod. 2006 Jan 26; [Epub ahead of print] Quality of life after laparoscopic colorectal resection for endometriosis.
Dubernard G, Piketty M, Rouzier R, Houry S, Bazot M, Darai E.
Service de Gynecologie, Obstetrique et Medecine de la Reproduction, Hopital Tenon, Universite Saint-Antoine Paris VI, Assistance Publique des Hopitaux de Paris, France.
BACKGROUND: Indications of colorectal resection for endometriosis remain controversial because of the risk of major complications. Therefore, the aims of the current study were to evaluate the efficacy of laparoscopic segmental colorectal resection for endometriosis on quality of life and gynaecologic and digestive symptoms, and its complications. METHODS: After magnetic resonance imaging and rectal endoscopic sonographic evaluation of symptomatic colorectal endometriosis, 58 consecutive women requiring colorectal resection were included in this study. Symptom questionnaires and the short-form (SF)-36 Health Status and the quality of life score were completed. Linear intensity scores for several gynaecologic and digestive symptoms and perioperative complications were also recorded. RESULTS: Fifty-one women (88%) underwent laparoscopic segmental colorectal resection and seven required laparoconversion. Major complications occurred in nine cases (15.5%), including six rectovaginal fistulae (10.3%), and the three remaining complications corresponded to a haemoperitoneum, a uroperitoneum and a pelvic abscess. Median follow-up after colorectal resection was 22.5 months (2-55 months). A significant improvement in dysmenorrhoea (P < 0.0001), dysparaeunia (P < 0.0001), bowel movement pain or cramping (P < 0.0001), pain on defecation (P < 0.0001), diarrhoea (P < 0.016), lower back pain (P < 0.0001) and asthaenia (P < 0.0002) was observed. Tenesmus, rectorrhagia and constipation were not improved. All the items of the SF-36 Health Status and the quality of life score were improved after colorectal resection for endometriosis. CONCLUSION: Laparoscopic segmental colorectal resection for endometriosis significantly improves quality of life and gynaecologic and digestive symptoms. However, women have to be informed on the risk of complications including rectovaginal fistula.
PMID: 16439504 [PubMed – as supplied by publisher]
Fertil Steril. 2006 Mar;85(3):758-60.
Excision of endometriotic cyst wall may cause loss of functional ovarian tissue.
Dilek U, Pata O, Tataroglu C, Aban M, Dilek S.
Department of Obstetrics and Gynecology, Mersin University School of Medicine, Mersin, Turkey. umutkutludilek@yahoo.com
Management of ovarian cysts is still controversial especially when dealing with endometriomas. Cyst excision was accepted surgical method by many centers; however, relationship between the excision and the loss of functional ovarian tissue is still uncertain.
PMID: 16500357 [PubMed – indexed for MEDLINE]
Fertil Steril. 2006 Mar;85(3):748-9.
Images in reproductive medicine. A case of giant cystic adenomyosis.
Koga K, Osuga Y, Hiroi H, Oishi H, Kugu K, Yano T, Taketani Y.
Department of Obstetrics and Gynecology, University of Tokyo, Tokyo, Japan.
We describe a 37-year-old woman with giant cystic adenomyosis who underwent a hysterectomy, providing magnetic resonance imaging and gross and microscopic images.
Publication Types: ? Case Reports
PMID: 16500348 [PubMed – indexed for MEDLINE]
Fertil Steril. 2006 Mar;85(3):735-40.
Comparison of fallopian tube sperm perfusion and intrauterine tuboperitoneal insemination: a prospective randomized study.
Mamas L.
Neogenesis IVF Center, Athens, Greece. leonidasmamas@neogenesis.gr
OBJECTIVE: To evaluate the results of two different methods of insemination: fallopian tube sperm perfusion (FSP) with 4 mL of inseminate and intrauterine tuboperitoneal insemination (IUTPI) with 10 mL of inseminate. DESIGN: Prospective randomized clinical study. SETTING: Private infertility center. PATIENT(S): Two hundred seventy-six couples, undergoing 403 cycles, with unexplained infertility, mild or moderate male infertility, or mild or moderate endometriosis. INTERVENTION(S): Patients were assigned randomly to either FSP (group A, n = 138) or IUTPI (group B, n = 138) treatment. Both groups followed the same mild ovarian stimulation protocol. MAIN OUTCOME MEASURE(S): Ninety-five overall pregnancies: 35 in group A (FSP) and 60 in group B (IUTPI). RESULT(S): The pregnancy rate per cycle (presence of gestational sac with heart beats) was 17.6% in group A (n = 199) and 29.4% in group B (n = 204). These differences were statistically significant (P < .007). The odds ratio of getting pregnant, per patient, in group B was 2.26 (95% confidence interval 1.36-3.77) compared with group A. CONCLUSION(S): The results of this study indicate that IUTPI may prove to be a useful technique in the treatment of unexplained infertility, mild or moderate male infertility, and mild or moderate endometriosis. Three attempts of IUTPI may be beneficial before moving on to more invasive and expensive methods of assisted reproduction techniques.
Publication Types: ? Randomized Controlled Trial
PMID: 16500346 [PubMed – indexed for MEDLINE]
Fertil Steril. 2006 Mar;85(3):714-20.
Expression of interleukin-8 receptors in patients with adenomyosis.
Ulukus M, Ulukus EC, Seval Y, Cinar O, Zheng W, Arici A.
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut 06520-8063, USA.
OBJECTIVE: To investigate the expression of interleukin-8 (IL-8) receptors CXCR1 and CXCR2 in adenomyosis. DESIGN: Comparative immunohistochemical study. SETTING: Academic medical center. PATIENT(S): Thirty women who had undergone hysterectomy and were proved histopathologically to have adenomyosis, and 27 women without adenomyosis who had a hysterectomy for nonendometrial pathology such as leiomyomata or benign ovarian cysts. INTERVENTION(S): Tissue sections were immunostained with murine monoclonal anti-human CXCR1 and CXCR2 antibodies. MAIN OUTCOME MEASURE(S): Microscopic evaluation to assess the presence and localization of CXCR1 and CXCR2 throughout the menstrual cycle in both eutopic endometrial and adenomyotic tissues of women with adenomyosis and compare it with normal endometrium. RESULT(S): In eutopic endometrium of women with adenomyosis, proliferative phase samples showed higher epithelial CXCR1 and CXCR2 staining intensity compared with proliferative phase samples of normal endometrium. Adenomyosis foci expressed higher epithelial CXCR1 compared with the homologous eutopic endometrium and normal endometrium. On the other hand, adenomyosis foci and the homologous eutopic endometrium showed similar epithelial CXCR2 staining intensity, and this expression was higher than the normal controls. CONCLUSION(S): Intrinsic abnormalities concerning IL-8 and its receptor system may be present in the eutopic endometrium of women affected by adenomyosis. These findings suggest that IL-8 receptors may be involved in the pathogenesis and/or pathophysiology of adenomyosis.
PMID: 16500343 [PubMed – indexed for MEDLINE]
Fertil Steril. 2006 Mar;85(3):700-5.
Complete septate uterus with longitudinal vaginal septum.
Heinonen PK.
Tampere University Hospital and Medical School, Tampere, Finland. pentti.heinonen@uta.fi
OBJECTIVE: To review clinical implications, reproductive outcome, and long-term consequences in women with complete septate uterus and longitudinal vaginal septum. DESIGN: A retrospective study. SETTING: A university hospital. PATIENT(S): Sixty-seven patients who had a complete septate uterus including the cervix and a longitudinal vaginal septum. INTERVENTION(S): The longitudinal vaginal septum was incised in 36 cases and metroplasty for uterine septum was undertaken in 4 patients. MAIN OUTCOME MEASURE(S): Fertility, outcome of pregnancies, possible late consequences, and presence of other anomalies. RESULT(S): Eight (15.7%) of 51 women attempting pregnancy had primary infertility of nonuterine causes. Forty-nine women not undergoing metroplasty produced 115 pregnancies, abortion rate 27%, preterm delivery 12%, and live birth rate 72%. Only five women with no metroplasty had only miscarriages and 44 women at least one delivery. One of four women undergoing metroplasty delivered preoperatively and three after metroplasty. During the follow-up period endometriosis was observed in two (3%) of 61 cases and two patients had borderline ovarian tumors. Kidney abnormalities were found in 11 (20%) of 55 patients studied, double ureter being the most common. CONCLUSION(S): Complete septate uterus with longitudinal vaginal septum is not associated with primary infertility, and pregnancy may progress successfully without surgical treatment. The results do not support elective hysteroscopic incision of the septum in asymptomatic patients or before first pregnancy.
PMID: 16500341 [PubMed – indexed for MEDLINE]
Fertil Steril. 2006 Mar;85(3):694-9.
Laparoscopic excision of recurrent endometriomas: long-term outcome and comparison with primary surgery.
Fedele L, Bianchi S, Zanconato G, Berlanda N, Raffaelli R, Fontana E.
Department of Obstetrics, Gynecology, and Neonatology, Fondazione Policlinico-Mangiagalli-Regina Elena, University of Milan, Milan, Italy. luigi.fedele@unimi.it
OBJECTIVE: To compare the laparoscopic excision of primary versus recurrent ovarian endometriomas. DESIGN: Descriptive study. SETTING: Tertiary referral center for the treatment of endometriosis. PATIENT(S): Between 1993 and 2002, 359 consecutive patients: 305 primary surgeries (group A) and 54 reoperations for a recurrent endometrioma in the same ovary of the primary cyst (group B). INTERVENTION(S): Laparoscopic stripping of the cyst wall. Follow-up evaluations every 6 months, including clinical and ultrasonographic evaluations and a questionnaire for pain symptoms (mean follow-up time, +/- standard deviation: 35.4 +/- 27.6 months). MAIN OUTCOME MEASURE(S): Recurrence of pain symptoms, sonographic recurrence of endometriomas, need for a new medical or surgical treatment, and reproductive outcome. RESULT(S): In groups A and B, respectively, the 5-year cumulative rates were not statistically significantly different: pain recurrence 20.5% versus 17.4%; ultrasonographic recurrence 18.9% versus 15.1%; retreatment requirement 19.4% versus 17.3%; and pregnancy 40.8% versus 32.4%. Although the difference was not statistically significant, compared with patients of group A, the women of group B underwent assisted reproduction techniques more frequently (50% vs. 32.2%) and had more irregular menstrual cycles associated with follicle-stimulating hormone levels > or = 14 IU/mL in the early follicular phase (5.5% vs. 1.3%). CONCLUSION(S): After laparoscopic excision of recurrent ovarian endometriomas, the recurrence of pain and the reproductive outcome are comparable with those found after primary surgery.
PMID: 16500340 [PubMed – indexed for MEDLINE]
Fertil Steril. 2006 Mar;85(3):564-72.
Stromal cells from endometriotic lesions and endometrium from women with endometriosis have reduced decidualization capacity.
Klemmt PA, Carver JG, Kennedy SH, Koninckx PR, Mardon HJ.
Nuffield Department of Obstetrics and Gynaecology, The Women’s Centre, John Radcliffe Hospital, Oxford, United Kingdom.
OBJECTIVE: To evaluate the phenotype, proliferative, and differentiation capacities in vitro of stromal cells derived from peritoneal, ovarian, and deeply infiltrating endometriosis. DESIGN: Experimental study using phase contrast microscopy, immunocytochemistry, and functional bioassays. SETTING: University-based laboratory. PATIENT(S): Women with and without endometriosis undergoing surgery for benign indications. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): The stability in vitro of stromal cells derived from peritoneal (n = 18), ovarian (n = 29), and deeply infiltrating (n = 14) endometriotic lesions, as well as endometrium from women with (n = 5) and without endometriosis (n = 5) was evaluated by detection of endometrial markers. The proliferative and differentiation capacity of the cells was assessed by the use of cell doubling estimation and in vitro decidualization assays. RESULT(S): The expression of the progesterone receptor and CD10 in stromal cells derived from the three types of endometriotic lesions is retained in culture up to passage 10. The doubling time of stromal cells from deeply infiltrating lesions is lower than that of endometrial stromal cells. Levels of prolactin and insulin-like growth factor binding protein-1 (IGFBP-1) are reduced in supernatants from stromal cells derived from the three types of lesions and from the endometrium of women with endometriosis. CONCLUSION(S): The peritoneal, ovarian, and deeply infiltrating endometriotic stromal cell lines we describe retain in vivo tissue markers. Loss of differentiation capacity of the endometriotic cell lines and endometrial cells from women with endometriosis may influence the capacity for proliferation and survival of these cells in the ectopic environment.
PMID: 16500320 [PubMed – indexed for MEDLINE]

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