Deeply Infiltrating Endometriosis Is a Disease Whereas Mild Endometriosis Could Be Considered a Non‐Disease

Koninckx, Philippe; Oosterlynck, Didier J.; D’Hooghe, Thomas; Meuleman, Christel

doi:10.1111/j.1749-6632.1994.tb21763.x

Cited by 115 publications

(60 citation statements)

References 17 publications

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“…In those who are symptomatic, the events of pain tend to be more intense in the premenstrual period, improving after cessation of menstruation. Pelvic pain as dysmenorrhea is the most common symptom, and does not correlate with the visually assessed degree of endometriosis 16 nor with the depth of tissue infiltration 17,18 . Other symptoms that may be present are lumbar pain, dyschezia, pain during micturition and dyspareunia.…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

Desenvolvimento de modelo experimental de endometriose em ratas

Amaral

Lago

Kondo

et al. 2009

Rev. Col. Bras. Cir.

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OBJETIVO: Desenvolver um modelo de endometriose experimental em ratas. MÉTODOS: Foram utilizadas 30 ratas adultas da linhagem Wistar. A técnica cirúrgica consistiu em laparotomia mediana com identificação do útero bicorno e ressecção de um segmento de 2 cm do corno uterino direito. Um retalho de 0,25 cm² foi retirado dessa estrutura e suturado na parede abdominal com a face endometrial voltada para a cavidade peritoneal. As ratas foram divididas aleatoriamente em dois grupos de acordo com o tempo para a reoperação: grupo 1 (n=15), reoperado em 30 dias, e grupo 2 (n=15), em 60 dias. No momento da segunda laparotomia os implantes foram avaliados macroscopicamente, ressecados e encaminhados para análise microscópica com coloração hematoxilina-eosina e imunohistoquímica (HEMA, AE1 e AE2). RESULTADOS: Os implantes se desenvolveram em 83,3 % do Grupo 1 e 71,4% no Grupo 2. Não houve diferença estatisticamente significativa entre o peso dos animals dos dois grupos. Também não houve diferença estatisticamente significativa no tamanho da área das lesões induzidas: no Grupo 1 a média foi 0,37 cm² e no Grupo 2, de 0,25 cm². Segundo a classificação histológica semi-quantitativa de Keenan (de acordo com a preservação da camada epitelial de endométrio), o Grupo 1 teve média de 1,9 e o Grupo 2, de 2,4. CONCLUSÃO: A técnica utilizada para o desenvolvimento de endometriose em ratas foi satisfatória.

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Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

Desenvolvimento de modelo experimental de endometriose em ratas

Amaral

Lago

Kondo

et al. 2009

Rev. Col. Bras. Cir.

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“…Researchers have found either no association between pain symptoms and disease stage (1)(2)(3) or observed a degree of association between pain and the presence of adnexal adhesions, rectal and vaginal infiltration, ovarian involvement, or endometriomas (2,4,5). The failure of many women with minimal endometriosis to respond to surgical treatment has led some investigators to question whether this is even a cause of pain (6), especially as it may be an incidental finding in asymptomatic women (7,8).…”

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confidence: 99%

Differences in characteristics among 1,000 women with endometriosis based on extent of disease

Sinaii

Plumb

Cotton

et al. 2008

Fertility and Sterility

197

127

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Objective-To determine the relationship between disease severity and patient characteristics in endometriosis.Design-Cross-sectional study of self-reported survey data. Setting-Academic research setting. Patient(s)-One thousand women in the Oxford Endometriosis Gene (OXEGENE) study. Intervention(s)-None.Main Outcome Measure(s)-Participants were assigned to one of two groups with predominantly revised AFS stage I-II (group I, n = 423) or III-IV disease (group II, n = 517). Their characteristics were compared by disease extent.Result(s)-Most participants were white (96%) and of reproductive age (81%). Women in group I were significantly younger on entering the study (39.9 ± 0.5 vs. 44.5 ± 0.4 years). Overall time to diagnosis did not differ between groups. The most common symptoms leading to a diagnosis were dysmenorrhea (79%) and pelvic pain (69%). In group II, subfertility (21.5% vs. 30.0%) and an ovarian mass (7.3% vs. 29.4%) more commonly led to a diagnosis, whereas dyspareunia (51.1% vs. 39.5%) was significantly more common in group I. Subfertility (41.5% vs. 53.4%) remained more common in group II throughout reproductive life, although birth and miscarriage rates were similar. Conclusion(s)-Pelvicpain is common to all with endometriosis and those with more extensive disease report higher rates of subfertility. Remarkably, the time to diagnosis was similar among women. KeywordsEndometriosis; patient characteristics; extent of disease; pelvic pain; subfertility Chronic pelvic pain, defined as persistent pain in the pelvis, is the most common symptom associated with endometriosis, yet there is no clear relationship between the severity of the Reprint requests: Ninet Sinaii, Ph.D., 10 Center Drive, Building 10, Room 2N-228, Bethesda, MD 20892-1871 (FAX: 301-496-0457; sinaiin@mail.nih.gov NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript pain experienced and the extent of disease, irrespective of which classification system is used.Researchers have found either no association between pain symptoms and disease stage (1-3) or observed a degree of association between pain and the presence of adnexal adhesions, rectal and vaginal infiltration, ovarian involvement, or endometriomas (2,4,5). The failure of many women with minimal endometriosis to respond to surgical treatment has led some investigators to question whether this is even a cause of pain (6), especially as it may be an incidental finding in asymptomatic women (7,8).The relationship between subfertility and disease stage is similarly uncertain. Some researchers have found no association between stage and subfertility (1), whereas others report that fertility decreases with increasing disease severity (9).Although studies have reported an increased risk of other diseases among women with endometriosis (10-12), evidence is lacking as to how these other conditions are influenced by stage of disease. Women with endometriosis, regardless of stage, appear to have similar ages at menarche and menstrual patterns (13). Health and li...

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“…This theory is supported by the presence of viable endometrial tissue in the peritoneal fluid and anatomical arrangement of endometrial implants. All women of reproductive age have some degree of retrograde menstruation, thus it suggests that all women also exhibit a certain degree of endometriosis (Koninckx et al, 1994). This explanation is controversial because ectopic implants do not progress in normal women, being eliminated by immune cells or apoptosis; although these processes generally occur at the end of a menstrual cycle, they are altered in patients with endometriosis.…”

Section: Introductionmentioning

confidence: 99%

Genetic polymorphisms in patients with endometriosis: an analytical study in Goiânia (Central West of Brazil)

Silva

Moura

2016

Genet. Mol. Res.

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ABSTRACT. In healthy women, intra-and extracellular controls prevent the attachment and proliferation of ectopic endometrial cells. During endometriosis, abnormalities in these control mechanisms permit the survival of endometrial cells, their subsequent attachment to the peritoneal cavity, and disease progression. These abnormal cells cause invasion of tissues and induce an inflammatory response. Several genetic, immunological, and environmental factors contribute to this complex process. In this study we examined 6 polymorphisms for 6 different genes (p53; estrogen receptor β; progesterone receptor; GSTM1; GSTT1; CYP1A1). We obtained polymorphic genotype frequencies of all genes for 50 patients and analyzed them using the Fisher exact test or G test. Initially, we analyzed the genes in groups of 2, followed by 3. We found a significant association between polymorphisms in 6 pairs of genes (p53-ERβ showed 5.9-times higher frequency in the experimental group, p53-GSTM1 showed 2.39 times higher, 65.5% patients showed p53-CYP1A1 polymorphism, ERβ-PROGINS showed 3.0-times higher frequency, while 31.25% patients showed GSTM1-PROGINS and GSTT1-CYP1A1 polymorphism). Positive results were found in 15 situations when genes were analyzed in groups of 3; the most significant result corresponded to polymorphisms of p53, ERβ and GSTM1 seen in 20%; PROGINS, ERβ and GSTM1 in 18%; and p53, ERβ and PROGINS in 12% patients. The results indicate that the presence of polymorphisms in more than one endometriosis-related gene is associated with onset of disease and progression. Future studies should focus on these genes to understand their inter-relationships and explore the possibility of developing new diagnostic techniques based on molecular markers.

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Deeply Infiltrating Endometriosis Is a Disease Whereas Mild Endometriosis Could Be Considered a Non‐Disease

Cited by 115 publications

References 17 publications

Desenvolvimento de modelo experimental de endometriose em ratas

Desenvolvimento de modelo experimental de endometriose em ratas

Differences in characteristics among 1,000 women with endometriosis based on extent of disease

Genetic polymorphisms in patients with endometriosis: an analytical study in Goiânia (Central West of Brazil)

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