Transvaginal ultrasound in deep endometriosis: pictorial essay

Oliveira, Jorge Gilmar Amaral de; Bonfada, Vanessa; Zanella, Janice de Fátima Pavan; Coser, Janaina

doi:10.1590/0100-3984.2018.0019

Cited by 7 publications

(11 citation statements)

References 12 publications

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“…A number of recent studies conducted in Brazil have highlighted the importance of imaging methods in the evaluation of the female reproductive system (22)(23)(24)(25)(26)(27) . The use of microCT was pivotal to observing the vasculariza tion in detail.…”

Section: Discussionmentioning

confidence: 99%

Proportional vascularization along the fallopian tubes and ovarian fimbria: assessment by confocal microtomography

et al. 2020

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Abstract Objective: To evaluate and reconstruct three-dimensional images of vascularization along the fallopian tube (FT), as well as to determine its relationship with the ovary and ovarian fimbria, and to quantify the blood vessels along the FT according to its anatomical segments, using confocal microtomography (micro-CT). Materials and Methods: Nine specimens (six FTs and three FTs with ovaries) were fixed in a solution of 10% formalin for > 24 h at room temperature. Iodine staining was performed by soaking the specimens in 10% Lugol’s solution for 24 h. All specimens were evaluated using micro-CT. A morphometric analysis was performed on the reconstructed images to quantify the vascular distribution along the FT. Results: In the FTs evaluated, the density of blood vessels was significantly greater in the fimbrial segments than in the isthmic segments (p < 0.05). The ovarian fimbria was clearly identified, demonstrating the important relationship between these vessels and the FT fimbriae. Conclusion: We believe that the vascularization in the fimbriae is greater than and disproportional that in the other segments of FT, and that the ovarian fimbria plays an important role in the development of that difference.

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Section: Discussionmentioning

confidence: 99%

Proportional vascularization along the fallopian tubes and ovarian fimbria: assessment by confocal microtomography

et al. 2020

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“…Due to the high cost of check, time consuming, and restricted clinical usage, in general, ultrasonic has more application value in diagnosis of DIE. Ultrasound generally fall into the abdominal ultrasound, transvaginal ultrasound by transrectal ultrasound and endoscopic ultrasonography examination (9)(10)(11)(12)(13)(14). Transvaginal ultrasound is considered as a kind of convenient safe noninvasive way to check.…”

Section: Original Articlementioning

confidence: 99%

A systematic review and meta-analysis on transvaginal ultrasonography in the diagnosis of deep invasive endometriosis

Xiang¹,

Wang²,

Zhou³

et al. 2022

Ann Palliat Med

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Background:The uterus is prone to many diseases, including endometriosis. Transvaginal ultrasonography (TVS) has become a frequently used detection method for deep invasive endometriosis (DIE). Methods:The combinations of relevant keywords and medical topic title terms were searched in the databases of PubMed, Medline, and Embase, and the Cochrane Central Register of Controlled Trials (endometriosis) from their inception to June 2021. Based on the descriptive terms of endometriosis, deep infiltrating endometrium, heterotopia, deep endometriosis, ultrasound, and TVS, the full texts of the target articles were obtained and subjected to a manual search. Meta-analysis was performed using RevMan 5.3 software provided by the Cochrane collaboration.Results: A total of 12 articles were included in this study, involving 1,707 patients overall. The sensitivity range was 0.57 to 0.98, and the specificity range was 0.87 to 1.00. The positive likelihood ratio (PLR) was 6.2282 [95% confidence interval (CI): 3.774 to 8.932]; the negative likelihood ratio (NLR) was 0.0664 (95% CI: 0.03 to 0.09); and the duration of remission was 1,174.7 (95% CI: 683.8 to 1,793.4). The sensitivity, specificity, PLR, NLR, and diagnostic odds ratio (DOR) of χ 2 were 36.10 (P=0.021), 27.00 (P=0.035), 53.11 (P=0.001), 55.22 (P=0.001), and 63.89 (P=0.001), respectively, and the differences were statistically significant.Discussion: A total of 12 articles were included in this meta-analysis, and the results were basically stable.Diagnosis with TVS showed high sensitivity (98%) and specificity (nearly 100%), indicating that it is a reasonable detection method for DIE, improving the disease status of patients.

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“…Progestins Progestins inhibit the hypothalamic-pituitary-ovarian axis, reducing serum estrogen levels and leading to anovulation and atrophy of the eutopic endome-trium and endometrial lesions. They modulate the immune response involved in the pathogenesis of endometriosis, decreasing peritoneal inflammatory mediators, inhibiting angiogenesis and suppressing matrix metalloproteinases, factors that facilitate the growth and implantation of the ectopic endometrium [5]. Of this class, the main drugs and/or methods reported were: dienogest [5], medroxyprogesterone acetate [7] and norethisterone acetate [6] [7], as well as the levonorgestrel-releasing system (LGN-IUS) and the etonogestrel-releasing implant [25].…”

Section: Hormonal Pharmacological Therapiesmentioning

confidence: 99%

“…It was found that dienogest, a 4th generation selective progesterone, composed of 19-nortestosterone and progesterone derivatives, has low androgenic, estrogenic, glucocorticoid and/or mineralocorticoid activities. In addition, it has anovulatory, antiproliferative effects and inhibits the secretion of cytokines in the stroma of endometrial cells [5]. Dienogest (2 mg/day) suppressed pain about 24 weeks after starting treatment, in addition to reducing bone mineral loss observed with the use of leuprolide acetate [7].…”

Section: Hormonal Pharmacological Therapiesmentioning

confidence: 99%

“…Subdermal etonogestrel-releasing implant (68 mg) lasting up to 3 years has been shown to reduce pelvic pain as well menstrual flow [25]. Furthermore, the most common side effects associated with these drugs were acne, bone mineral loss, weight gain, and mood change [5], seborrhea, oily hair, pimples, headache, breast tenderness, and vaginal irritation [25].…”

Section: Hormonal Pharmacological Therapiesmentioning

confidence: 99%

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Approach to Pain in Endometriosis Patients: Systematic Literature Review

Costa¹,

Gonçalves²,

Leite³

et al. 2022

JBM

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Background: Endometriosis is a gynecological, multifactorial condition that affects women's life quality, especially due to the pain inherent to it. Pain is caused by physical and psychological aspects; therefore, several factors must be analyzed, aiming to treat the whole. Conventional, drug or surgical treatments are the most used; however, the search for alternative therapeutic methods is growing. Objective: To analyze the approach to pain in women with endometriosis, seeking a better understanding of the pathophysiological mechanisms of this disease, its impact on life quality, as well as the means of treatments in use and innovations in this field. Methods: Systematic literature review, conducted in the Virtual Health Library databases between 2010 and 2021, restricted to articles in English and Portuguese with the descriptors: Endometriosis, Pain, and Treatment. After reading the abstracts, 197 articles were found, and, after reading them, 59 articles were selected. Results: This review analyzed 59 scientific studies that rigorously met the previously established characteristics in the sample selection. The synthesis included the following aspects: author/year of publication, article title, objective, type of study and database. Related factors such as acute or chronic pain, late diagnosis, discrediting symptomatic complaints and trivialization by health professionals have a profound impact on the physical and mental health of women with endometriosis. On the other hand, there are several classes of drugs, surgical procedures, and alternative therapies available for pain management. Conclusion: Given the context addressed, a certain need is suggested for health professionals to better understand the disease and adopt new behaviors or improve existing ones, such as reception, active listening, early diagnosis and comprehensive and individualized treatment. In addition, further studies are needed regarding alternative therapies, seeking to expand the scientific evidence of their benefits.

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Transvaginal ultrasound in deep endometriosis: pictorial essay

Cited by 7 publications

References 12 publications

Proportional vascularization along the fallopian tubes and ovarian fimbria: assessment by confocal microtomography

Proportional vascularization along the fallopian tubes and ovarian fimbria: assessment by confocal microtomography

A systematic review and meta-analysis on transvaginal ultrasonography in the diagnosis of deep invasive endometriosis

Approach to Pain in Endometriosis Patients: Systematic Literature Review

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