In deep endometriosis (DE), clusters of endometrium-like cells penetrate more than 5 mm below the peritoneum: The affected organs and tissue structures can eventuate in an alteration of the anatomy with eliminated organ boundaries, which in some cases can pose a real surgical challenge, even for experienced surgeons. A comprehensive description of the different manifestations of the disease can be found in the #Enzian classification. Since the operation is usually the foundation for the successful treatment of DE, what is important are conclusive indications, appropriate preoperative preparation and, above all, appropriate experience on the part of the surgical team. This article aims to provide a review of the surgical options that are currently available.
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http://dx.doi.org/10.1055/a-1799-2658 | DOI Listing |
Hum Reprod
December 2024
Department of Medical BioSciences, Radboudumc, Nijmegen, The Netherlands.
Study Question: How can we best achieve tissue segmentation and cell counting of multichannel-stained endometriosis sections to understand tissue composition?
Summary Answer: A combination of a machine learning-based tissue analysis software for tissue segmentation and a deep learning-based algorithm for segmentation-independent cell identification shows strong performance on the automated histological analysis of endometriosis sections.
What Is Known Already: Endometriosis is characterized by the complex interplay of various cell types and exhibits great variation between patients and endometriosis subtypes.
Study Design, Size, Duration: Endometriosis tissue samples of eight patients of different subtypes were obtained during surgery.
Microb Pathog
December 2024
Hospital Israelita Albert Einstein, Av. Albert Einstein 627, Morumbi, São Paulo, 05651-901, Brazil; Departamento de Obstetricia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Endometriosis is a chronic gynecological disease that affects 10 % of reproductive-aged women and characterized by the presence of endometrial tissue outside the uterus. The disease is linked to a pro-inflammatory environment in the peritoneal fluid of patients, with high levels of cytokines, growth factors, and reactive oxygen species. Changes in the peritoneal fluid, such as altered immune cells and cytokines, can be linked to the immune balance in endometriosis.
View Article and Find Full Text PDFHum Reprod
December 2024
Department of Family and Preventative Medicine, University of Utah, Salt Lake City, UT, USA.
Study Question: How do endometriosis diagnoses and subtypes reported in administrative health data compare with surgically confirmed disease?
Summary Answer: For endometriosis diagnosis, we observed substantial agreement and high sensitivity and specificity between administrative health data-International Classification of Diseases (ICD) 9 codes-and surgically confirmed diagnoses among participants who underwent gynecologic laparoscopy or laparotomy.
What Is Known Already: Several studies have assessed the validity of self-reported endometriosis in comparison to medical record reporting, finding strong confirmation. We previously reported high inter- and intra-surgeon agreement for endometriosis diagnosis in the Endometriosis, Natural History, Diagnosis, and Outcomes (ENDO) Study.
Cureus
November 2024
Obstetrics and Gynecology, Hung Vuong Hospital, Ho Chi Minh, VNM.
Endometriosis is a common condition among women of reproductive age worldwide, with the urinary tract being the second most frequently affected extragenital organ system, particularly the bladder and ureters. Ureteral endometriosis (UE) is relatively rare, often asymptomatic, and can lead to progressive renal function loss if not addressed promptly. Early diagnosis and intervention are essential, requiring a high index of suspicion.
View Article and Find Full Text PDFHum Reprod
December 2024
Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada.
Study Question: Is there an association between the somatic loss of PTEN (phosphatase and tensin homolog) and ARID1A (AT-rich interaction domain 1A) and endometriosis disease severity and worse clinical outcomes?
Summary Answer: Somatic PTEN loss in endometriosis epithelium was associated with greater disease burden and subsequent surgical complexity.
What Is Known Already: Somatic cancer-driver mutations including those involving the PTEN and ARID1A genes exist in endometriosis without cancer; however, their clinical impact remains unclear.
Study Design, Size, Duration: This prospective longitudinal study involved endometriosis tissue and clinical data from 126 participants who underwent surgery at a tertiary center for endometriosis (2013-2017), with a follow-up period of 5-9 years.
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