Endometriosis: The gynecologist's opinion

Marana, Riccardo; Lecca, Antonella; Biscione, Antonella; Muzii, e Ludovico

doi:10.5301/ru.2012.9391

Cited by 11 publications

(10 citation statements)

References 31 publications

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“…Moreover, Signorile et al's data [206] showed the ectopic presence of primitive endometrium, expressing both CA125 and oestrogen receptor, in 11% of female foetuses (4/36). Focusing on this evidence, we have to consider also that endometriosis affects approximately 10% of women in reproductive age [13, 14], and moreover that retrograde menstruation could be observed in 90% of endometriosis-free women in reproductive age with pervious fallopian tubes. Taking all together, all these pieces of evidence allow us to argue that the ectopic presence of primitive endometrium in female foetuses and the presence of endometriotic implants in women of reproductive ages are quite similar.…”

Section: Discussionmentioning

confidence: 99%

“…The risk appears to decrease for personal habits that may relate to decreased estrogen levels (i.e., smoking, exercise). Approximately 10% of women in reproductive age are estimated to be affected by this disease [13, 14] and its symptoms, which include acute or chronic pelvic pain (CPP) and abnormal bleeding [12]. Pelvic pain could be expressed as dysmenorrhea, dyspareunia, dysuria, dyschezia, and nonmenstrual chronic pelvic—abdominal muscle pain [15].…”

Section: Introductionmentioning

confidence: 99%

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Interplay between Misplaced Müllerian-Derived Stem Cells and Peritoneal Immune Dysregulation in the Pathogenesis of Endometriosis

Laganà

Sturlese

Retto

et al. 2013

Obstetrics and Gynecology International

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In the genetic regulation of Müllerian structures development, a key role is played by Hoxa and Wnt clusters, because they lead the transcription of different genes according to the different phases of the organogenesis, addressing correctly cell-to-cell interactions, allowing, finally, the physiologic morphogenesis. Accumulating evidence is suggesting that dysregulation of Wnt and/or Hox genes may affect cell migration during organogenesis and differentiation of Müllerian structures of the female reproductive tract, with possible dislocation and dissemination of primordial endometrial stem cells in ectopic regions, which have high plasticity to differentiation. We hypothesize that during postpubertal age, under the influence of different stimuli, these misplaced and quiescent ectopic endometrial cells could acquire new phenotype, biological functions, and immunogenicity. So, these kinds of cells may differentiate, specializing in epithelium, glands, and stroma to form a functional ectopic endometrial tissue. This may provoke a breakdown in the peritoneal cavity homeostasis, with the consequent processes of immune alteration, documented by peripheral mononuclear cells recruitment and secretion of inflammatory cytokines in early phases and of angiogenic and fibrogenic cytokines in the late stages of the disease.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Interplay between Misplaced Müllerian-Derived Stem Cells and Peritoneal Immune Dysregulation in the Pathogenesis of Endometriosis

Laganà

Sturlese

Retto

et al. 2013

Obstetrics and Gynecology International

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“…Approximately 10% of women in reproductive age are estimated to be affected by this disease (4,5). Its symptoms and signs include acute or chronic pelvic pain, abnormal bleeding, infertility (6).…”

Section: Introductionmentioning

confidence: 99%

Different patterns of pelvic ureteral endometriosis. What is the best treatment? Results of a retrospective analysis

Butticè

Laganà

Mucciardi

et al. 2016

Arch Ital Urol Androl

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Objective. Endometriosis is an estrogendependent disease. The incidence of urinary tract endometriosis (UE) increased during the last few years and, nowadays, it ranges from 0.3 to 12% of all women affected by the disease. The ureter is the second most common site affected. The ureteral endometriosis is classified in extrinsic and intrinsic. The aim of this study is to individuate the best treatments for each subset of ureteral endometriosis. Materials and Methods. 32 patients diagnosed with surgically treated UE were retrospectively reviewed. The patients were divided into 3 subsets (intrinsic UE, extrinsic UE with and without obstruction). The patients with intrinsic UE (n = 10) were treated with laser endoureterotomy. The patients with extrinsic UE (n = 22) were divided in two subsets with (n = 16) and without (n = 6) hydronephrosis. All the patients underwent ureteral stenting, and resection and reimplantation was performed in the first group, and when the mass was > 2.5 cm (n = 3) Boari flap was performed. Laparoscopic ureterolysis (shaving) was performed in the second group. Results. In the extrinsic subset of UE, we obtained an high therapeutic success (84%). Conversely, in the intrinsic subset there was a recurrence rate of the disease in 6/10 of the patients (60%). Conclusions. Ureterolysis seems to be a good treatment in extrinsic UE without obstruction. Resection and reimplantation allows excellent results in the extrinsic UE with obstruction. In the intrinsic subset, the endoureterotomy approach is inadequate.

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“…Approximately 10% of women in reproductive age are estimated to be affected by this disease [4, 5]. Common symptoms are acute or chronic pelvic pain and abnormal bleeding [6].…”

Section: Introductionmentioning

confidence: 99%

Lumbar Ureteral Stenosis due to Endometriosis: Our Experience and Review of the Literature

Butticé

Laganà²,

Barresi³

et al. 2013

Case Reports in Urology

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Endometriosis is a chronic gynaecological disorder characterized by the presence of endometrial tissue outside the uterus. The disease most often affects the ovaries, uterine ligaments, fallopian tubes, and cervical-vaginal region. Urinary tract involvement is rare, accounting for around 1%-2% of all cases, of which 84% are in the bladder. We report a case of isolated lumbar ureteral stenosis due to endometriosis in a 37-year-old patient. The patient came to our observation complaining from lumbar back pain and presented with severe fever. The urological examination found monolateral left positive sign of Giordano. Blood tests evidenced marked lymphocytosis and increased valued of C-reactive protein. Urologic ultrasound showed hydronephrosis of first degree in the left kidney and absence of images related to stones bilaterally. Uro-CT scan evidenced ureteral stenosis at the transition between the iliac and pelvic tracts. We addressed the patient to surgery, and performed laparoscopic excision of the paraureteral bulk, endoscopic mechanical ureteral dilation, and stenting. The histological examination evidenced glandular structures lined by simple epithelium and surrounded by stroma. Immunohistochemical test of the glandular epithelium showed positivity for estrogen and progesterone receptors and moreover stromal cells were positive for CD10. The finding suggested a very rare diagnosis of isolated lumbar ureteral endometriosis.

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Endometriosis: The gynecologist's opinion

Cited by 11 publications

References 31 publications

Interplay between Misplaced Müllerian-Derived Stem Cells and Peritoneal Immune Dysregulation in the Pathogenesis of Endometriosis

Interplay between Misplaced Müllerian-Derived Stem Cells and Peritoneal Immune Dysregulation in the Pathogenesis of Endometriosis

Different patterns of pelvic ureteral endometriosis. What is the best treatment? Results of a retrospective analysis

Lumbar Ureteral Stenosis due to Endometriosis: Our Experience and Review of the Literature

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