Laparoscopic Uterine Biopsy for Diagnosing Diffuse Adenomyosis

Vercillini, Paolo; Trespìdi, Laura; Panazza, Stefania; Bramante, Tiziana; Mauro, Fabio; Crosignani, Pier Giorgio

doi:10.1097/00006254-199608000-00012

Cited by 11 publications

(16 citation statements)

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“…The presence of pelvic pain, especially dysmenorrhea, plus infertility and dyspareunia, are the trio that characterizes the disease. 9 In the present study, 16.25% of the patients had mild endometriosis, and the serum CA125 levels showed no difference between fertile asymptomatic women with and without endometriosis, although the number of cases investigated was small. Moreover, endometriosis was observed in healthy peritoneum of fertile women, 27 in the same way as reported by Nezhat et al, 28 Nisolle et al 29 and Balasch et al 30 among women with infertility and pelvic pain.…”

Section: Discussioncontrasting

confidence: 47%

“…3,25 On the other hand, some authors consider superficial endometriosis to be a physiological and intermittent condition in women during their reproductive years, whereas its progression, characterized as deep infiltrative endometriosis and/or endometrial ovarian cysts, is considered to be the true disease. 9,13,19,26 Divergences persist regarding the natural history of endometriosis, its symptoms, extent, location and staging. The presence of pelvic pain, especially dysmenorrhea, plus infertility and dyspareunia, are the trio that characterizes the disease.…”

Section: Discussionmentioning

confidence: 99%

“…7 Some authors have described superficial endometriosis as a cyclical and normal phenomenon in women's lives, and have indicated that development and progression of this disease would only occur in some women as a result of immunological changes. 8,9 Thus, the low specificity of the diagnostic methods available, along with the severity of the disease, has motivated new studies to search for noninvasive diagnostic methods to detection endometriosis. 6 Serological testing for CA125 has been widely used to detect endometriosis and to monitor its progression.…”

Section: Introductionmentioning

confidence: 99%

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Frequency of endometriotic lesions in peritoneum samples from asymptomatic fertile women and correlation with CA125 values

et al. 2009

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CONTEXT AND OBJECTIVE: Serological testing for CA125 has been widely used to detect endometriosis and to monitor its progression. However, controversy still exists regarding the usefulness of the plasma CA125 assay for diagnosing endometriosis. Furthermore, some authors have described superficial endometriosis as a cyclical and normal phenomenon in women's lives, and have indicated that development and progression of this disease would only occur in some women as a result of immunological changes. This study aimed to determine the frequency of endometriosis and the correlation between serum CA125 levels and the presence of endometriotic lesions in the peritoneum of asymptomatic fertile patients. DESIGN AND SETTING:Cross-sectional study at the Family Planning outpatient clinic of Faculdade de Medicina do ABC. METHODS:Eighty asymptomatic fertile patients who underwent tubal sterilization surgery were studied. Blood and peritoneum samples were collected. CA125 levels were measured from blood samples, and peritoneum biopsies were studied using histopathological tests. RESULTS:Histopathological evaluation of the peritoneum revealed that 16.25% of the patients had minimal or mild endometriosis. There was no statistically significant difference in CA125 levels between patients with and without endometriosis. CONCLUSION:The presence of endometriotic lesions in the peritoneum of fertile patients supports the hypothesis that incidental findings of minimal or mild endometriosis may not be of clinical significance, and that the progression of the disease probably occurs as a result of immunological and genetic abnormalities. Serum CA125 levels did not show any diagnostic significance with regard to detecting the disease.RESUMO CONTEXTO E OBJETIVO: O teste sorológico para CA125 tem sido largamente usado para detectar e monitorar a progressão da endometriose, entretanto, a utilidade do ensaio do CA125 plasmático para o diagnóstico da endometriose ainda é controversa. Além disso, alguns autores descreveram a endometriose superficial como sendo um fenômeno cíclico e normal na vida de uma mulher, e que o desenvolvimento e progressão desta doença ocorreriam apenas em algumas mulheres como resultado de alterações imunológicas. Este estudo teve como objetivo determinar a freqüência de endometriose e a correlação entre os níveis séricos de CA125 e a presença de lesões endometrióticas em peritônio de pacientes férteis assintomáticas. TIPO DE ESTUDO E LOCAL: Estudo transversal realizado no Ambulatório de Planejamento Familiar da Faculdade de Medicina do ABC.MÉTODOS: Foram estudadas 80 pacientes férteis assintomáticas submetidas à cirurgia de esterilização tubária. Amostras de sangue e peritônio foram coletadas. Os níveis de CA125 foram medidos a partir das amostras de sangue e as biópsias de peritônio foram estudadas por ensaio histopatológico. RESULTADOS:O estudo histopatológico do peritônio revelou que 16,25% das pacientes apresentavam endometriose mínima e leve. Os níveis de CA125 não demonstraram diferença estatística sign...

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Section: Discussioncontrasting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Frequency of endometriotic lesions in peritoneum samples from asymptomatic fertile women and correlation with CA125 values

et al. 2009

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“…Vercellini [42] konnte durch laparoskopisch gesteuerte Nadelbiopsien eine Korrelation zwischen Schmerzen und dem Vorliegen einer Adenomyosis herstellen, die jedoch nicht signifikant war.…”

Section: Verstärkte Echogenität Des Myometriumsunclassified

“…Bei fokaler Adenomyosis ist dieses Verfahren nur bedingt anwendbar,außer der sonographisch nachgewiesene Befund wird unter Ultraschallsichtkontrolle gezielt punktiert [42,46].…”

Section: Verstärkte Echogenität Des Myometriumsunclassified

Endokrine operative Therapie der Adenomyosis

Keckstein

Ulrich

2004

Gyn�kologische Endokrinologie

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Als Adenomyosis wird das Vorhandensein von Stroma-und Epithelzellen imMyometrium bezeichnet (⊡ Abb. 1, 2). Dieses Phänomen, auch Endometriosis genitalis interna genannt, wurde in der Vergangenheit oft gar nicht oder zu spät diagnostiziert. Dabei wurde die Diagnose postoperativ erst durch den Pathologen am Präparat nachgewiesen. Eine Adenomyosis wird mit Myomen oder einer Myohyperplasie verwechselt, woraus eine falsche Therapie resultieren kann. Das Auftreten von Epithel-, Stroma-und glatten Muskelzellen außer-halb des Uterus wird als extrauterine Adenomyosis beschrieben [8, 25]).Veränderungen dieser Art finden sich insbesondere im Septum rectovaginale und in der Darm-bzw. Blasenwand. In 20-35% der wegen einer anderen benignen Erkrankungen entfernten Uteri findet sich eine Adenomyosis. Klinik ▃ Das häufigste Symptom der Adenomyosis ist die abnorme Menstruationsblutung (⊡ Tabelle 1). Ausgeprägte, krampfartige Schmerzen begleiten diese Blutungspathologie in über 60% der Fälle. Meist findet sich eine deutliche Vergrößerung des Uterus, eine Veränderung seiner Konsistenz und seiner Lage. Eine Retroflexio des Uterus kann durch eine Adenomyose verursacht sein, insbe-

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Classifications of Adenomyosis and Correlation of Phenotypes in Imaging and Histopathology to Clinical Outcomes: a Review

Tellum

Munro

2022

Curr Obstet Gynecol Rep

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Purpose of Review To provide an update on published classification and reporting systems for adenomyosis. There is an urgent need to standardize reporting of various phenotypes of adenomyosis into a validated and globally recognized system. This can be used to examine the nature and severity of adenomyosis symptoms and inform the design, evaluation, and implementation of appropriate treatment options. Recent Findings In recent years, several new proposals for adenomyosis classification have emerged. Most are MRI-based and include features such as uterine size, junctional zone thickness, size and location of the lesions, and distribution patterns. To date, none of those proposals has been validated. Only one recent classification based on transvaginal ultrasound was validated for interobserver congruence and correlated to clinical findings. However, the differentiation of diffuse and focal adenomyosis still lacks consensus. In addition, only a few authors advocated imaging-based definitions. Summary There is a need for one or a combination of a classification and reporting system for adenomyosis. To date, there is no widely accepted and validated system.

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Laparoscopic Uterine Biopsy for Diagnosing Diffuse Adenomyosis

Cited by 11 publications

References 0 publications

Frequency of endometriotic lesions in peritoneum samples from asymptomatic fertile women and correlation with CA125 values

Frequency of endometriotic lesions in peritoneum samples from asymptomatic fertile women and correlation with CA125 values

Endokrine operative Therapie der Adenomyosis

Classifications of Adenomyosis and Correlation of Phenotypes in Imaging and Histopathology to Clinical Outcomes: a Review

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