Deeply infiltrating pelvic endometriosis: histology and clinical significance

Cornillie, Freddy; Oosterlynck, Didier J.; Lauweryns, Joseph M.; Koninckx, Philippe

doi:10.1016/s0015-0282(16)53570-5

Cited by 525 publications

(158 citation statements)

References 10 publications

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“…Endometriosis was diagnosed laparoscopically and confirmed histologically. Lesions of deepinfiltrating endometriosis were defined as those deeper than 5 mm beneath the peritoneal surface according to the previous study by Cornillie et al 22 Forty women (aged 35.8 Ϯ 6.2 years; mean Ϯ SD) were diagnosed with endometriosis, and 40 women (aged 37.2 Ϯ 6.5 years) had no endometriosis. Severity of endometriosis was determined according to the revised American Society for Reproductive Medicine classification.…”

Section: Human Tissuementioning

confidence: 99%

Deficiency of Immunophilin FKBP52 Promotes Endometriosis

Hirota

Tranguch

Daikoku

et al. 2008

The American Journal of Pathology

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Endometriosis is a common gynecological disease that affects approximately 10% of women of childbearing age. It is characterized by endometrial growth outside the uterus and often results in inflamed lesions, pain, and reduced fertility. Although heightened estrogenic activity and/or reduced progesterone responsiveness are considered to be involved in the etiology of endometriosis, neither the extent of their participation nor the underlying mechanisms are clearly understood. Heterogeneous uterine cell types differentially respond to estrogen and progesterone (P 4 ). P 4 , primarily acting via its nuclear receptor (PR), activates gene transcription and impacts many reproductive processes. Deletion of Fkbp52, an immunophilin cochaperone for PR, results in uterine-specific P 4 resistance in mice, creating an opportunity to study the unique aspects of P 4 signaling in endometriosis. Here we explored the roles of FKBP52 in this disease using Fkbp52 ؊/؊ mice. We found that the loss of FKBP52 encourages the growth of endometriotic lesions with increased inflammation , cell proliferation , and angiogenesis. We also found remarkable down-regulation of FKBP52 in cases of human endometriosis. Our results provide the first evidence corroborated by genetic studies in mice for a potential role of an immunophilin cochaperone in the etiology of human endometriosis. This investigation is highly relevant for clinical application , particularly because P 4 resistance is favorably indicated in endometriosis and other gynecological diseases.

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Section: Human Tissuementioning

confidence: 99%

Deficiency of Immunophilin FKBP52 Promotes Endometriosis

Hirota

Tranguch

Daikoku

et al. 2008

The American Journal of Pathology

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“…Endometriosis can be classified as peritoneal, ovarian, or deep infiltrating endometriosis (DIE) (4). DIE, characterized by the infiltration of anatomic structures within the pelvis, is defined as a lesion that infiltrates 5 mm or more into the peritoneum (5)(6)(7). DIE typically involves the pouch of Douglas, the uterosacral ligaments, and the recto-vaginal septum; however, it can affect the urinary tract as well.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic ureteroneocystostomy and vesicopsoas hitch for infiltrative ureteral endometriosis

Azioni

Bracale²,

Scala

et al. 2010

Minimally Invasive Therapy & Allied Technologies

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The aim of the study was to assess the safety and efficacy of laparoscopic treatment of distal infiltrative ureteral endometriosis with segmental ureteral resection, ureteroneocystostomy, and vesicopsoas hitch. We performed a retrospective analysis of perioperative data and looked at follow-up outcomes of patients with deep endometriosis with ureteral involvement treated by laparoscopic vesicopsoas hitch. Six patients were treated for left ureteral endometriosis in the study period. Four of those were diagnosed during previous laparoscopies. A ureteroneocystostomy (Lich-Gregoir reimplantation procedure) with vesicopsoas hitch was fashioned laparoscopically in all cases, and a double-J stent was applied intraoperatively. There were no intraoperative or postoperative complications and no cases of extravasation of contrast at cystogram one week after surgery. The median follow-up time was 38 months (range 12-56). All patients had normal renal ultrasound or intravenous pyelogram results at one year follow-up. This study confirmed that laparoscopic ureteroneocystostomy and vesicopsoas hitch is a safe and effective option in the management of distal ureteral endometriosis. In view of the small size of this series, multicenter studies are needed to confirm these conclusions.

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“…Előfordulási gyakorisága a reproduktív korú női populációban 6-10% közötti [1]. Legsúlyosabb megjelenési formája a mélyen infi ltráló endometriosis (deep infi ltrating endometriosis -DIE), amely esetén a laesio a peritoneum szintjétől 5 mm-es vagy azt meghaladó mélységbe terjed [2,3].…”

Section: Eredeti Közleményunclassified

“…A DIE érintheti a kismedence elülső régióját is, jelentkezhet a plica vesicouterinán és infi ltrálhatja a húgyhólyag izomzatát. Érintheti a kismedence lateralis falát, ezáltal veszélyeztetheti az ott elhelyezkedő szomatikus idegek lefutását [3,4,8,9].…”

Section: Eredeti Közleményunclassified

Az idegkímélő műtéti technika jelentősége a mélyen infiltráló endometriosis sebészetében

et al. 2015

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Bevezetés: A mélyen infi ltráló endometriosis kezelésében az elváltozások hagyományos sebészi eltávolítása súlyos szö-vődményekkel járhat. Célkitűzés: Idegkímélő, illetve hagyományos technikával végzett műtétek összehasonlítása, az egyes szövődmények előfordulási gyakoriságának ismertetése mélyen infi ltráló endometriosissal foglalkozó munkacsoportok műtéti eredményeinek összefoglalásával. Módszer: A szerzők retrospektív elemzést végeztek a 2004. már-cius 31. és 2015. március 31. között megjelent tudományos közlemények felhasználásával. A keresést a http://www. pubmed.org adatbázisban végezték az "endometriosis", "deep infi ltrating," "nerve-sparing, surgery" (endometriosis, mélyen infi ltráló, idegkímélő, sebészet) keresőszavak kombinációjának alkalmazásával. Eredmények: Mélyen infi ltráló endometriosis kapcsán végzett, nem idegkímélő beavatkozásokat követően 19,1-38,5%-ban jelentkezhet átmeneti húgyhólyag-diszfunkció, míg idegkímélő műtéti technika alkalmazását követően a betegek 0,61-33,3%-ában fordulhat elő. Nem idegkímélő technika alkalmazását követően a betegek átlagosan 121,1 napig, idegkímélő műtéteket követően 7-39,8 napig szorultak önkatéterezésre. Krónikus húgyhólyag-diszfunkció mélyen infi ltráló endometriosis miatt végzett idegkímélő műtéteket követően nem fordult elő. Következtetések: Az idegkímélő technikák alkalmazása a betegek életminőségének jelentős javulását eredményezi, mivel panaszaik kezelése mellett alacsonyabb poszt operatív szövődményrátával társul. Orv. Hetil., 2015Hetil., , 156(48), 1960Hetil., -1965. Kulcsszavak: nőgyógyászat, műtét, endometriosis, neurogén húgyhólyag-diszfunkció Importance of nerve-sparing surgical technique in the treatment of deep infi ltrating endometriosisIntroduction: Traditional surgeries performed in cases of deep infi ltrating endometriosis lead to impaired quality of life. Aim: To summarize the postoperative outcome and to compare the rate of postoperative complications after different therapeutic approaches applied in deep infi ltrating endometriosis. Method: The authors analized the articles published between March 31, 2004 and March 31, 2015, in the database www.pubmed.org using the following keywords: endometriosis, deep infi ltrating, nerve sparing, surgery. Results: Non-nerve sparing surgery resulted in temporary urinary dysfunction in 19.1-38.5% of patients, while it occurred in 0.61-33.3% of patients after nervesparing surgery. Non-nerve sparing surgical technique resulted in an avarage of 121 days of need for self-catheretisation. When nerve-sparing surgeries were performed the duration of self-catheterisation varied between 7 to 39.8 days. After nerve sparing surgeries, permanent bladder dysfunction was not detected in any case. Conclusions: Because of the successful treatment of the patients symptoms and the lower postoperative complication rate, nerve-sparing surgical technique leads to a signifi cant improvement of the quality of life.

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Deeply infiltrating pelvic endometriosis: histology and clinical significance

Cited by 525 publications

References 10 publications

Deficiency of Immunophilin FKBP52 Promotes Endometriosis

Deficiency of Immunophilin FKBP52 Promotes Endometriosis

Laparoscopic ureteroneocystostomy and vesicopsoas hitch for infiltrative ureteral endometriosis

Az idegkímélő műtéti technika jelentősége a mélyen infiltráló endometriosis sebészetében

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