What’s the delay? A qualitative study of women’s experiences of reaching a diagnosis of endometriosis

Ballard, Karen; Lowton, Karen; Wright, Jeremy

doi:10.1016/j.fertnstert.2006.04.054

Cited by 481 publications

(465 citation statements)

References 22 publications

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“…The initiation of endometriosis in women is difficult to investigate, as there is a considerable delay from onset of lesion development to clinical diagnosis. [35][36][37] Furthermore, it is ethically difficult to address these questions in humans, and thus studies of animals with induced disease are beneficial in allowing us to characterize and better understand early immunological reactions associated with the pathophysiology of endometriosis. We have demonstrated significantly increased presence of CD10þ endometrial stromal cells in femoral LNs of baboons with induced endometriosis compared to control animals.…”

Section: Discussionmentioning

confidence: 99%

Endometrial Stromal Cells and Immune Cell Populations Within Lymph Nodes in a Nonhuman Primate Model of Endometriosis

et al. 2011

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Mounting evidence suggests that immunological responses may be altered in endometriosis. The baboon (Papio anubis) is generally considered the best model of endometriosis pathogenesis. The objective of the current study was to investigate for the first time immunological changes within uterine and peritoneal draining lymph nodes in a nonhuman primate baboon model of endometriosis. Paraffin-embedded femoral lymph nodes were obtained from 22 normally cycling female baboons (induced endometriosis n ¼ 11; control n ¼ 11). Immunohistochemical staining was performed with antibodies for endometrial stromal cells, T cells, immature and mature dendritic cells, and B cells. Lymph nodes were evaluated using an automated cellular imaging system. Endometrial stromal cells were significantly increased in lymph nodes from animals with induced endometriosis, compared to control animals (P ¼ .033). In animals with induced endometriosis, some lymph node immune cell populations including T cells, dendritic cells and B cells were increased, suggesting an efficient early response or peritoneal drainage.

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Section: Discussionmentioning

confidence: 99%

Endometrial Stromal Cells and Immune Cell Populations Within Lymph Nodes in a Nonhuman Primate Model of Endometriosis

et al. 2011

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“…, 5 This delay is not only due to suboptimal clinical assessment of patients 6 and the consideration of other differential diagnosis of chronic pelvic pain but also because of the surgico‐pathologic requirement for a definitive diagnosis of endometriosis 7 . Such delay pervades several aspects of a woman's quality of life and may lead to long‐term impairment of organ function, particularly in cases of DIE of the bowel or ureter 6 …”

Section: Introductionmentioning

confidence: 99%

The ‘sliding sign’ in conjunction with sonovaginography: is this the optimal approach for the diagnosis of Pouch of Douglas obliteration and posterior compartment deep infiltrating endometriosis?

Menakaya

Reid

Infante

et al. 2013

Australas J Ultrason Med

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Introduction: Endometriosis is a chronic peritoneal disease that may progress as a deep infiltrating lesion involving the posterior compartment of the pelvis. Efforts to improve pre‐operative knowledge of the location and extent of these lesions have resulted in the development of Transvaginal ultrasound (TVS) as the first‐line imaging modality for extra‐ovarian endometriosis. However, various techniques of TVS have been described in the literature for this purpose. Methods: In this review we will detail the evolution of TVS as the primary imaging modality in the pre‐operative diagnosis of posterior compartment deep infiltrating endometriosis (DIE). We will also discuss the potential of an emerging new real‐time diagnostic ultrasound‐based technique known as the ‘sliding sign’ in combination with office gel sonovaginography for the pre‐operative diagnosis of Pouch of Douglas obliteration and posterior compartment DIE. Conclusion: Implementation of the new real‐time dynamic, reproducible and simple ‘sliding sign’ in conjunction with SVG has the potential to challenge the current concept that traditional laparoscopy is the ‘gold standard’ modality for the diagnosis of women with posterior compartment DIE.

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“…There appears to be a genetic link, with many women reporting a firstdegree relative with the disease. 1 Cardinal symptoms are dysmenorrhoea, dyspareunia, and chronic (non-menstrual) pelvic pain. Bowel symptoms (painful defaecation or irritable bowel-type dysfunction) are common, even in the absence of overt bowel involvement.…”

Section: Recognising Endometriosismentioning

confidence: 99%

“…Women with endometriosis typically face a diagnostic delay of 7-10 years, despite more frequent GP and accident and emergency attendances than women without the disease. 1,2 Endometriosis has a relatively high prevalence (up to 10% of women in the general UK population and up to 50% of infertile women) and causes high morbidity in terms of both pain and infertility. 2 Despite this, the condition remains poorly recognised in practice, meaning that patients must often navigate misdiagnosis and suboptimal care.…”

Section: Introductionmentioning

confidence: 99%

Diagnosing endometriosis in primary care: clinical update

2015

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What’s the delay? A qualitative study of women’s experiences of reaching a diagnosis of endometriosis

Cited by 481 publications

References 22 publications

Endometrial Stromal Cells and Immune Cell Populations Within Lymph Nodes in a Nonhuman Primate Model of Endometriosis

Endometrial Stromal Cells and Immune Cell Populations Within Lymph Nodes in a Nonhuman Primate Model of Endometriosis

The ‘sliding sign’ in conjunction with sonovaginography: is this the optimal approach for the diagnosis of Pouch of Douglas obliteration and posterior compartment deep infiltrating endometriosis?

Diagnosing endometriosis in primary care: clinical update

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