Journal articles: 'Digestive endometriosis'

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Petrushkova, N. I. "Dysregulatory visceropathies in patients with uterine endometriosis and recurrent endometrial hyperplasia." Kazan medical journal 67, no. 5 (September 15, 1986): 347–49. http://dx.doi.org/10.17816/kazmj70697.

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The study of neurohormonal-visceral relationships in patients with uterine endometriosis is of practical significance in the development of rational therapy and prevention of this complex and rather frequent pathology. This study was aimed to investigate the functional state of the digestive glands of the stomach, intestines, liver and pancreas in 152 patients with uterine internal endometriosis (Group 1) and in 50 patients with recurrent endometrial hyperplasia (Group 2). Twenty healthy women were the control group. Patients with no history of diseases of the digestive system were selected for the examination.

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Shah, Monica. "Intestinal Endometriosis Masquerading as Common Digestive Disorders." Archives of Internal Medicine 155, no. 9 (May 8, 1995): 977. http://dx.doi.org/10.1001/archinte.1995.00430090127013.

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Shah, M. "Intestinal endometriosis masquerading as common digestive disorders." Archives of Internal Medicine 155, no. 9 (May 8, 1995): 977–80. http://dx.doi.org/10.1001/archinte.155.9.977.

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Aupetit, Alexandra, Sébastien Grigioni, Horace Roman, Moïse Coëffier, Amélie Bréant, Clotilde Hennetier, and Najate Achamrah. "Association between Endometriosis, Irritable Bowel Syndrome and Eating Disorders: ENDONUT Pilot Study." Journal of Clinical Medicine 11, no. 19 (September 29, 2022): 5773. http://dx.doi.org/10.3390/jcm11195773.

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Background and aim: Irritable bowel syndrome (IBS), eating disorders (ED) and endometriosis share common pathophysiological mechanisms, involving alterations of the gut–brain axis. The aim of the ENDONUT pilot study was to investigate an association between these three diseases by screening for IBS and ED in patients with endometriosis. Method: We included patients from the CIRENDO cohort (Inter-Regional North-West Cohort of women with ENDOmetriosis) with a recent documented diagnosis of endometriosis of less than 4 years, regardless of age, date of onset of symptoms, type of endometriosis (digestive or not), with or without endometriosis-related digestive surgery. Validated questionnaires were used to screen for IBS (Rome IV, Francis score), ED (SCOFF-F, EAT-26), and anxiety/depression (HAD). Anthropometric data and lifestyle habits were also collected. The primary composite endpoint was SCOFF-F and ROME-IV scores. Results: Among 100 patients meeting inclusion criteria, 54 patients completed all the questionnaires. Of these, 19 had a positive SCOFF-F score (35.2%), 26 had a positive ROME-IV score (48.1%), and 14 patients (25.9%) had both a positive SCOFF-F score and a positive ROME-IV score (p = 0.006). Patients with positive SCOFF-F and ROME-IV scores had significantly higher HAD-anxiety and depression scores (p < 0.05). Conclusion: These results suggest a significant association between IBS, ED and endometriosis. The prevalence of IBS and ED in our population is higher than in the general population. Larger studies are needed to confirm these results, to better understand this triad, and to improve the diagnostic and multidisciplinary therapeutic management of these patients.

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Roy, Chhandika, and Nitish Mondal. "Global risks of endometriosis in women – an appraisal." European Journal of Clinical and Experimental Medicine 21, no. 2 (June 2023): 405–15. http://dx.doi.org/10.15584/ejcem.2023.2.27.

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Introduction and aim. Endometriosis is a complex condition in which endometrium, tissue that resembles the uterine lining, develops outside the uterus. It is considered to be a chronic, estrogen-dependent, inflammatory gynecological disorder having multi-factorial origins. This review paper aims to consolidate recent information on ethnic differences, endometriosis risks, and the disease’s etiology in the global context. Material and methods. A systematic search was performed using a variety of international electronic databases, including “PubMed” and “DOAJ”, using the terms endometriosis, endometriosis and infertility, endometriosis and cancer, and treatment of endometriosis. Analysis of the literature. Endometriosis can appear anywhere in the body, including the umbilicus, the cecum and ileum of the digestive tract, the breast, the lungs, and the genitourinary organs. It is typically clinically asymptomatic with no obvious clinical manifestation and expensive treatment, which makes the diagnosis late. There is a complex interplay between socioeconomic status, family history, societal beliefs and laws, personal habits, reproductive and gynaecological conditions, and environmental influences in the development of endometriosis. Conclusion. Women with endometriosis should be given more attention, and specific resources in the healthcare system should be utilized to provide more efficient multidisciplinary healthcare and treatment.

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Zhang, Shiting, Xuelu Jiang, and Peiyu Mao. "Laparoscopic treatment of colonic endometriosis causing periodic abdominal pain and hematochezia: A case report." Medicine 102, no. 47 (November 24, 2023): e36229. http://dx.doi.org/10.1097/md.0000000000036229.

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Rationale: Endometriosis, a benign disease, has a malignant biological behavior and is highly prone to recurrence. Although gastrointestinal involvement is the most common site for extra-genital endometriosis, deep infiltrative endometriosis, which affects the mucosal layer, is very rare. Patient concerns: A 44-year-old woman with a 6-month history of recurring abdominal pain and Hematochezia. The patient visited several hospitals over the past six months and was suspected to have been diagnosed with a digestive disease, for which medication was ineffective, leading to a great deal of anxiety. Diagnoses: Colonic endometriosis. Interventions: After a thorough imaging evaluation and preoperative discussion, laparoscopic colonic endometriosis resection under indocyanine green indication was performed by gynecologists and gastroenterologists. Outcomes: After laparoscopic treatment, the patient's symptoms improved significantly, with occasional pain felt and no blood in the stool. Lessons: This case provides a rare example of sigmoid endometriosis causing periodic abdominal pain and Hematochezia. We report a clinical case to investigate the feasibility of an indocyanine green fluorescent contrast technique to guide the scope of surgery in laparoscopic deep infiltrative endometriosis surgery. In intestinal endometriosis surgery, indocyanine green fluoroscopy may indicate the lesion's precise localization.

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Ferrero, S., N. Ragni, and V. Remorgida. "Post-operative digestive symptoms after colorectal resection for endometriosis." Human Reproduction 21, no. 7 (July 2006): 1941–42. http://dx.doi.org/10.1093/humrep/del101.

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Podgaec, Sergio, Manoel Orlando Gonçalves, Sidney Klajner, and Mauricio Simões Abrão. "Epigastric pain relating to menses can be a symptom of bowel endometriosis." Sao Paulo Medical Journal 126, no. 4 (July 2008): 242–44. http://dx.doi.org/10.1590/s1516-31802008000400012.

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CONTEXT AND OBJECTIVE: Endometriosis is a common affliction that may affect the intestinal tract. The objective of this case report was to describe an unusual clinical presentation of this form of the disease. CASE REPORT: The patient was a 35-year-old woman with epigastric pain that only occurred during menstruation, who had a history of bladder endometriosis. Endoscopy of the upper digestive tract showed normal results. Transvaginal ultrasound and nuclear magnetic resonance of the pelvis showed a lesion involving the ileocecal junction and appendix, measuring 30 x 22/x/13/mm, that was suggestive of endometriosis. The patient underwent laparoscopic resection of the bowel segment affected by the disease, followed by anastomosis of the ileum and ascending colon for immediate restoration of intestinal transit. Histological analysis confirmed the diagnosis of endometriosis. CONCLUSIONS: In young women, recurrent epigastric pain should be evaluated with regard to its relationship to menstruation, particularly if there is a history of endometriosis, since this may be a clinical sign that the disease is affecting the intestinal transit.

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Santoro, Luca, Sebastiano Campo, Ferruccio D’Onofrio, Antonella Gallo, Marcello Covino, Vincenzo Campo, Guglielmo Palombini, Angelo Santoliquido, Giovanni Gasbarrini, and Massimo Montalto. "Looking for Celiac Disease in Italian Women with Endometriosis: A Case Control Study." BioMed Research International 2014 (2014): 1–5. http://dx.doi.org/10.1155/2014/236821.

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In the last years, a potential link between endometriosis and celiac disease has been hypothesized since these disorders share some similarities, specifically concerning a potential role of oxidative stress, inflammation, and immunological dysfunctions. We investigated the prevalence of celiac disease among Italian women with endometriosis with respect to general population. Consecutive women with a laparoscopic and histological confirmed diagnosis of endometriosis were enrolled; female nurses of our institution, without a known history of endometriosis, were enrolled as controls. IgA endomysial and tissue transglutaminase antibodies measurement and serum total IgA dosage were performed in both groups. An upper digestive endoscopy with an intestinal biopsy was performed in case of antibodies positivity. Presence of infertility, miscarriage, coexistence of other autoimmune diseases, and family history of autoimmune diseases was also investigated in all subjects. Celiac disease was diagnosed in 5 of 223 women with endometriosis and in 2 of 246 controls (2.2% versus 0.8%;P=0.265). Patients with endometriosis showed a largely higher rate of infertility compared to control group (27.4% versus 2.4%;P<0.001). Our results confirm that also in Italian population an increased prevalence of celiac disease among patients with endometriosis is found, although this trend does not reach the statistical significance.

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Dubernard, Gil, and Emile Darai. "Reply: Post-operative digestive symptoms after colorectal resection for endometriosis." Human Reproduction 21, no. 7 (July 2006): 1942–43. http://dx.doi.org/10.1093/humrep/del102.

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Istrate Ofiteru, Anca Maria, Sabina Berceanu, Stefan Paitici, Gabriela Camelia Rosu, Larisa Iovan, Nicoleta Loredana Voicu, Daniel Pirici, et al. "Endometriosis of the Abdominal Wall - Clinical, Histopathological and Immunohistochemical Aspects." Revista de Chimie 70, no. 8 (September 15, 2019): 2860–65. http://dx.doi.org/10.37358/rc.19.8.7444.

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Endometriosis is a benign gynecological pathology that mostly affects the organs of the pelvis,but also organs located at a distance maybe affected. Tissue immunohistochemically identified as ectopic endometrium may undergo certain structural and functional changes that may lead to preneoplastic alterations (hyperplasia, dysplasia) in normal cellswhich can evolve to neoplasia. Clinical, genetic, metabolic conditions and local factors may influence degenerationof a benign pathology into a malignant pathology. Endometriosis of the abdominal wall is more frequently encountered, as the number of casarean section has increased. Endometriomas surrounding tissue has a direct impact on the structure of the cells that form the mass. By remodeling cellular morphology, corroborated with the hormonal factors action and the inflammatory response ( via lymphocyte cell secretion), the cell cycle is altered and antiapoptotic activity may be promoted. Immune system via lymphocyte cell secretion, the pressure exerted on the tumor area by surrounding tissueswith its size change, conditioned by the fluctuation of hormonal factors, act directly on the cellular structure and can increase anti-apoptotic action and decrease cell cycle regulation. The presence of endometriomas is identified by the positivity of immunohistochemical reactions for estrogen receptors (ER), progesteron receptors (PR), Cytokeratin 7 (CK7) for endometrial tissue. Negative reaction at Cytokeratin 20 (CK20) shows that the studied area is not a metastasis of a digestive tumor. The presence of abundant inflammatory, peritumoral cells markedwith anti-CD68 / Tryptase for macrophages / mast cells demonstrates the involvement of the inflammatory system in the structural and functional modification of endometrial cells.The pronounced cell division was demonstrated by intense reaction with the anti-Ki67 antibody.The signigicant anti-apoptotic action of the endometrial tissue is shown by the positivity of anti-B cell Lymphoma 2 (BCL2) / anti-Phosphatase and tensin homolog (PTEN) / anti-p53 antibodies.

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Mehedintu, Claudia, Francesca Frincu, Lacramioara Aurelia Brinduse, Andreea Carp-Veliscu, Elvira Bratila, Clotilde Hennetier, and Horace Roman. "Postoperative Assessment of the Quality of Life in Patients with Colorectal Endometriosis." Journal of Clinical Medicine 10, no. 21 (November 8, 2021): 5211. http://dx.doi.org/10.3390/jcm10215211.

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Morbidity and mortality alone are not comprehensive measures of evaluating the benefits of surgical interventions in endometriosis patients, thus, subjective patient-reported instruments are required. The 36-tem Short Form Survey (SF-36) is a Health-Related Quality of Life (HRQoL) instrument that has not been validated yet for women with endometriosis. The aims of this study are to evaluate the validity and reliability of the SF-36 in patients with colorectal endometriosis and to compare the HRQoL before and after surgery, using different Quality of Life (QoL) instruments: the Gastrointestinal QoL Index (GIQLI) and Knowles–Eccersley–Scott Symptom Questionnaire (KESS). We conducted a retrospective study using prospectively recorded data in the North-West Inter-Regional Female Cohort for Patients with Endometriosis (CIRENDO) database. The assessment was performed on four hundred and eighty-eight patients before and 12 months after the surgery. Preoperative and postoperative item-internal consistency and Cronbach’s α proved evidence for good reliability showing that SF-36 is a useful instrument for endometriosis patients’ QoL. The domains of Role (limitation) physical, Bodily pain and Role (limitation) emotional showed the most remarkable improvements (difference before vs. one year after surgery) with p < 0.001. Our data show that SF-36 has validity and reliability and can be used in patients with endometriosis. Surgery improved the QoL and digestive function.

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Donnez, Olivier. "Conservative Management of Rectovaginal Deep Endometriosis: Shaving Should Be Considered as the Primary Surgical Approach in a High Majority of Cases." Journal of Clinical Medicine 10, no. 21 (November 5, 2021): 5183. http://dx.doi.org/10.3390/jcm10215183.

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Deep endometriosis infiltrating the rectum remains a challenging situation to manage, and it is even more important when ureters and pelvic nerves are also infiltrated. Removal of deep rectovaginal endometriosis is mandatory in case of symptoms strongly impairing quality of life, alteration of digestive, urinary, sexual and reproductive functions, or in case of growing. Extensive preoperative imaging is required to choose the right technique between laparoscopic shaving, disc excision, or rectal resection. When performed by skilled surgeons and well-trained teams, a very high majority of cases of deep endometriosis nodule (>95%) is feasible by the shaving technique, and this is associated with lower complication rates regarding rectal resection. In most cases, removing a part of the rectum is questionable according to the risk of complications, and the rectum should be preserved as far as possible. Shaving and rectal resection are comparable in terms of recurrence rates. As shaving is manageable whatever the size of the lesions, surgeons should consider rectal shaving as first-line surgery to remove rectal deep endometriosis. Rectal stenosis of more than 80% of the lumen, multiple bowel deep endometriosis nodules, and stenotic sigmoid colon lesions should be considered as indication for rectal resection, but this represents a minority of cases.

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Rault, Emmanuel, Charles-André Philip, Marion Cortet, and Gil Dubernard. "Virtual cystoscopy and colonoscopy to assess deep infiltrating endometriosis." Journal of Endometriosis and Pelvic Pain Disorders 11, no. 1 (January 8, 2019): 3–6. http://dx.doi.org/10.1177/2284026518818976.

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Introduction: Faced with a suspicion of endometriosis, transvaginal sonography is the first-line procedure to diagnose deep infiltrating endometriosis. Methods: We recently introduced the FlyThru® mode from TOSHIBA aplio 500. With the 3D acquisition (Multiplanar Reconstruction), we can assess the deep invasion of the endometriosis nodule into the digestive and bladder wall and provide a virtual colonoscopy or cystoscopy. The entire wall of the organ can be explored either by starting the animation or by rotating the arrow. The detection threshold can be adjusted manually from 45 to 100 in order to remove any artifacts. Results: We reported two deep infiltrating endometriosis nodules explored with FlyThru mode: the first one in the rectum and the second in the bladder. Similar to a colonoscopy, the virtual animation of the FlyThru mode showed the progression into the intestine lumen until the visualization of the bulge of the nodule. Operators can appreciate precisely the location, the degree of stenosis, and the circumferential involvement of the bowel wall. The bulges of the two nodules were also visible into the bladder. The size of the lesions was assessed and related to bladder volume, which represents important preoperative data. Conclusion: Three dimensional-transvaginal sonography combined with the FlyThru mode allows the enhanced practitioner to diagnose and assess the invasion of an endometriosis nodule in a single procedure.

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Poujois, Julie, Cécile Mézan De Malartic, Ronan Callec, Laurent Bresler, Nicolas Hubert, Philippe Judlin, and Oliver Morel. "Deep infiltrating endometriosis: Interest of the robotic approach for a fledgling team." Journal of Endometriosis and Pelvic Pain Disorders 11, no. 3 (May 27, 2019): 152–57. http://dx.doi.org/10.1177/2284026519850369.

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Introduction: Mini-invasive surgery of deep endometriosis is challenging. Surgical difficulties related to the technical limitations of classical laparoscopic approach might be overcome with the use of robotic assistance. The aim of this study was to evaluate the safety and feasibility of robotic surgery for deep infiltrating endometriosis in the learning phase of our team. Methods: The 20 first cases of robotic-assisted laparoscopies for endometriosis were included over a 2-year period. Baseline characteristics of patients and surgical data were reviewed. Surgical outcomes and follow-up information of the patients were analyzed. Results: Twenty women were included. The mean age was 31.9 years (range: 25–44) and mean body mass index was 23 kg/m2 (range: 16–35). Ten patients had rectovaginal or uterosacral location only (50%) and nine women had deep infiltrating endometriosis with digestive or urinary tract lesions (45%). In addition to the gynecologic surgeon, urologic or visceral surgeons were required in 10 cases, and there were 3 cases where the three specialties were needed. The mean operative time was 183.9 min (range: 85–398) and no difference was observed between the first five cases and the last five cases. There was one laparoconversion, and only two urologic postoperative complications occurred. Conclusion: Thanks to the use of robotic surgical assistance and a multidisciplinary approach, and despite the start of the team for deep endometriosis care, no learning curve effect was observed regarding surgical procedures’ success, safety, or duration. The use of robotic assistance might improve the quality of care for women facing deep endometriosis.

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Yilmaz, Bulent, Selma Cukur, and Rula Sahin. "A case of rectal bleeding caused by digestive endometriosis resembling colon cancer." Endoscopy 46, S 01 (September 8, 2014): E357—E358. http://dx.doi.org/10.1055/s-0034-1377378.

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Fucili, A., R. Cogliandro, V. Gabusi, C. Frisoni, M. Dolci, and V. Stanghellini. "P.12.5 DOES DEEP INFILTRATING ENDOMETRIOSIS ALTER ANORECTAL MOTILITY AND DIGESTIVE SYMPTOMS?" Digestive and Liver Disease 46 (March 2014): S99—S100. http://dx.doi.org/10.1016/s1590-8658(14)60294-2.

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Merzouki, Wissem, Saida Khouni, Ali Benazza, Omar Bafdel, Aissa Hadj Brahim, Sihem Guerfi, and Hachani Khadraoui. "Colic endometriosis: report of 2 cases." Batna Journal of Medical Sciences (BJMS) 2, no. 1 (June 30, 2015): 85–88. http://dx.doi.org/10.48087/bjmscr.2015.2120.

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L'endométriose est une affection gynécologique touchant 5 à 10 % des femmes en activité génitale. La localisation intestinale est la forme extra pelvienne la plus fréquente de l’endométriose ; son diagnostic reste difficile et peut même simuler, dans certains cas, un cancer du colon. Nous rapportons 2 observations cliniques d’endométriose colique, la première à localisation rare caecoappendiculaire suspecte de malignité et la deuxième de siège rectal, chez 2 jeunes femmes mariées en pleine activité génitale dont une est nullipare. Dans les 2 cas, la découverte de la masse endométriotique a été radiologique (TDM abdomino-pelvienne, IRM pelvienne) réalisée à la suite de manifestations cliniques assez variables (douleurs pelviennes chroniques, dyschésie rectale). L’atteinte digestive est dans les 2 cas associée à une atteinte gynécologique ; la coloscopie a été normale chez la première patiente ; par contre elle a mis en évidence chez la deuxième patiente au 5ème jour du cycle, une rectite congestive avec un aspect bombé correspondant à la compression de l’endométriose de la cloison recto-vaginale. Les 2 patientes ont reçu un traitement hormonal (contraceptif) pendant une durée de 3 à 6 mois avec un contrôle gynécologique ; par contre la patiente chez qui on a découvert une masse cœco-appendiculaire suspecte, a bénéficié d’un traitement chirurgical radical. L’évolution sous traitement a été favorable chez les 2 patientes.

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Istrate-Ofiţeru, Anca-Maria, Elena-Iuliana-Anamaria Berbecaru, George-Lucian Zorilă, Gabriela-Camelia Roşu, Laurențiu Mihai Dîră, Cristina Maria Comănescu, Roxana Cristina Drăguşin, et al. "Specific Local Predictors That Reflect the Tropism of Endometriosis—A Multiple Immunohistochemistry Technique." International Journal of Molecular Sciences 23, no. 10 (May 17, 2022): 5614. http://dx.doi.org/10.3390/ijms23105614.

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Ectopic endometrial epithelium associates a wide spectrum of symptomatology. Their evolution can be influenced by inflammatory and vascular changes, that affect not only the structure and cell proliferation rate, but also symptoms. This prospective study involved tissue samples from surgically treated patients, stained using classical histotechniques and immunohistochemistry. We assessed ectopic endometrial glands (CK7+, CK20−), adjacent blood vessels (CD34+), estrogen/progesterone hormone receptors (ER+, PR+), inflammatory cells (CD3+, CD20+, CD68+, Tryptase+), rate of inflammatory cells (Ki67+) and oncoproteins (BCL2+, PTEN+, p53+) involved in the development of endometriosis/adenomyosis. A CK7+/CK20− expression profile was present in the ectopic epithelium and differentiated it from digestive metastases. ER+/PR+ were present in all cases analyzed. We found an increased vascularity (CD34+) in the areas with abdominal endometriosis and CD3+−:T-lymphocytes, CD20+−:B-lymphocytes, CD68+:macrophages, and Tryptase+: mastocytes were abundant, especially in cases with adenomyosis as a marker of proinflammatory microenvironment. In addition, we found a significantly higher division index-(Ki67+) in the areas with adenomyosis, and inactivation of tumor suppressor genes-p53+ in areas with neoplastic changes. The inflammatory/vascular/hormonal mechanisms trigger endometriosis progression and neoplastic changes increasing local pain. Furthermore, they may represent future therapeutic targets. Simultaneous-multiple immunohistochemical labelling represents a valuable technique for rapidly detecting cellular features that facilitate comparative analysis of the studied predictors.

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Saavalainen, L., A. But, A. Tiitinen, P. Härkki, M. Gissler, J. Haukka, and O. Heikinheimo. "Mortality of midlife women with surgically verified endometriosis—a cohort study including 2.5 million person-years of observation." Human Reproduction 34, no. 8 (July 2, 2019): 1576–86. http://dx.doi.org/10.1093/humrep/dez074.

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Abstract STUDY QUESTION Is all-cause and cause-specific mortality increased among women with surgically verified endometriosis? SUMMARY ANSWER The all-cause and cause-specific mortality in midlife was lower throughout the follow-up among women with surgically verified endometriosis compared to the reference cohort. WHAT IS KNOWN ALREADY Endometriosis has been associated with an increased risk of comorbidities such as certain cancers and cardiovascular diseases. These diseases are also common causes of death; however, little is known about the mortality of women with endometriosis. STUDY DESIGN, SIZE, DURATION A nationwide retrospective cohort study of women with surgically verified diagnosis of endometriosis was compared to the reference cohort in Finland (1987–2012). Follow-up ended at death or 31 December 2014. During the median follow-up of 17 years, 2.5 million person-years accumulated. PARTICIPANTS/MATERIALS, SETTING, METHODS Forty-nine thousand nine hundred and fifty-six women with at least one record of surgically verified diagnosis of endometriosis in the Finnish Hospital Discharge Register between 1987 and 2012 were compared to a reference cohort of 98 824 age- and municipality-matched women. The age (mean ± standard deviation) of the endometriosis cohort was 36.4 ± 9.0 and 53.6 ± 12.1 years at the beginning and at the end of the follow-up, respectively. By using the Poisson regression models the crude and adjusted all-cause and cause-specific mortality rate ratios (MRR) and 95% confidence intervals (CI) were assessed. Calendar time, age, time since the start of follow-up, educational level, and parity adjusted were considered in the multivariate analyses. MAIN RESULTS AND THE ROLE OF CHANCE A total of 1656 and 4291 deaths occurred in the endometriosis and reference cohorts, respectively. A lower all-cause mortality was observed for the endometriosis cohort (adjusted MRR, 0.73 [95% CI 0.69 to 0.77])—there were four deaths less per 1000 women over 10 years. A lower cause-specific mortality contributed to this: the adjusted MRR was 0.88 (95% CI 0.81 to 0.96) for any cancer and 0.55 (95% CI 0.47 to 0.65) for cardiovascular diseases, including 0.52 (95% CI 0.42 to 0.64) for ischemic heart disease and 0.60 (95% CI 0.47 to 0.76) for cerebrovascular disease. Mortality due to alcohol, accidents and violence, respiratory, and digestive disease-related causes was also decreased. LIMITATIONS, REASONS FOR CAUSATION These results are limited to women with endometriosis diagnosed by surgery. In addition, the study does not extend into the oldest age groups. The results might be explained by the characteristics and factors related to women’s lifestyle, and/or increased medical attention and care received, rather than the disease itself. WIDER IMPLICATIONS OF THE FINDINGS These reassuring data are valuable to women with endometriosis and to their health care providers. Nonetheless, more studies are needed to address the causality. STUDY FUNDING/COMPETING INTEREST This research was funded by the Hospital District of Helsinki and Uusimaa and The Finnish Medical Foundation. None of the authors report any competing interest in relation to the present work; all the authors have completed the disclosure form.

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Roman, Horace, Maud Vassilieff, Jean Jacques Tuech, Emmanuel Huet, Guillaume Savoye, Loïc Marpeau, and Lucian Puscasiu. "Postoperative digestive function after radical versus conservative surgical philosophy for deep endometriosis infiltrating the rectum." Fertility and Sterility 99, no. 6 (May 2013): 1695–704. http://dx.doi.org/10.1016/j.fertnstert.2013.01.131.

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Pacchetti, A., F. Dotta, A. Olivero, G. Mantica, A. Caviglia, F. Alessandri, G. Camerini, and C. Terrone. "Deep infiltrative endometriosis with urogenital and digestive tract involvement: A challenge for the urologist in laparoscopy." European Urology Supplements 17, no. 8 (September 2018): 185. http://dx.doi.org/10.1016/s1569-9056(18)33077-x.

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Vallée, Aurélie, Stéphane Ploteau, Carole Abo, Emanuela Stochino-Loi, Salwa Moatassim-Drissa, Noémie Marty, Benjamin Merlot, and Horace Roman. "Surgery for deep endometriosis without involvement of digestive or urinary tracts: do not worry the patients!" Fertility and Sterility 109, no. 6 (June 2018): 1079–85. http://dx.doi.org/10.1016/j.fertnstert.2018.02.124.

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Roman, H., J. Ness, N. Suciu, V. Bridoux, G. Gourcerol, A. M. Leroi, J. J. Tuech, P. Ducrotte, C. Savoye-Collet, and G. Savoye. "Are digestive symptoms in women presenting with pelvic endometriosis specific to lesion localizations? A preliminary prospective study." Human Reproduction 27, no. 12 (September 7, 2012): 3440–49. http://dx.doi.org/10.1093/humrep/des322.

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Roman, H., J. Ness, G. Savoye, V. Bridoux, and J.-J. Tuech. "Digestive Symptoms in Women Presenting with Pelvic Endometriosis and Their Relationship with the Localisation of the Lesions." Journal of Minimally Invasive Gynecology 18, no. 6 (November 2011): S103. http://dx.doi.org/10.1016/j.jmig.2011.08.359.

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Mortlock, Sally, Raden I. Kendarsari, Jenny N. Fung, Greg Gibson, Fei Yang, Restuadi Restuadi, Jane E. Girling, et al. "Tissue specific regulation of transcription in endometrium and association with disease." Human Reproduction 35, no. 2 (February 2020): 377–93. http://dx.doi.org/10.1093/humrep/dez279.

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Abstract STUDY QUESTION Are genetic effects on endometrial gene expression tissue specific and/or associated with reproductive traits and diseases? SUMMARY ANSWER Analyses of RNA-sequence data and individual genotype data from the endometrium identified novel and disease associated, genetic mechanisms regulating gene expression in the endometrium and showed evidence that these mechanisms are shared across biologically similar tissues. WHAT IS KNOWN ALREADY The endometrium is a complex tissue vital for female reproduction and is a hypothesized source of cells initiating endometriosis. Understanding genetic regulation specific to, and shared between, tissue types can aid the identification of genes involved in complex genetic diseases. STUDY DESIGN, SIZE, DURATION RNA-sequence and genotype data from 206 individuals was analysed and results were compared with large publicly available datasets. PARTICIPANTS/MATERIALS, SETTING, METHODS RNA-sequencing and genotype data from 206 endometrial samples was used to identify the influence of genetic variants on gene expression, via expression quantitative trait loci (eQTL) analysis and to compare these endometrial eQTLs with those in other tissues. To investigate the association between endometrial gene expression regulation and reproductive traits and diseases, we conducted a tissue enrichment analysis, transcriptome-wide association study (TWAS) and summary data-based Mendelian randomisation (SMR) analyses. Transcriptomic data was used to test differential gene expression between women with and without endometriosis. MAIN RESULTS AND THE ROLE OF CHANCE A tissue enrichment analysis with endometriosis genome-wide association study summary statistics showed that genes surrounding endometriosis risk loci were significantly enriched in reproductive tissues. A total of 444 sentinel cis-eQTLs (P < 2.57 × 10−9) and 30 trans-eQTLs (P < 4.65 × 10−13) were detected, including 327 novel cis-eQTLs in endometrium. A large proportion (85%) of endometrial eQTLs are present in other tissues. Genetic effects on endometrial gene expression were highly correlated with the genetic effects on reproductive (e.g. uterus, ovary) and digestive tissues (e.g. salivary gland, stomach), supporting a shared genetic regulation of gene expression in biologically similar tissues. The TWAS analysis indicated that gene expression at 39 loci is associated with endometriosis, including five known endometriosis risk loci. SMR analyses identified potential target genes pleiotropically or causally associated with reproductive traits and diseases including endometriosis. However, without taking account of genetic variants, a direct comparison between women with and without endometriosis showed no significant difference in endometrial gene expression. LARGE SCALE DATA The eQTL dataset generated in this study is available at http://reproductivegenomics.com.au/shiny/endo_eqtl_rna/. Additional datasets supporting the conclusions of this article are included within the article and the supplementary information files, or are available on reasonable request. LIMITATIONS, REASONS FOR CAUTION Data are derived from fresh tissue samples and expression levels are an average of expression from different cell types within the endometrium. Subtle cell-specifc expression changes may not be detected and differences in cell composition between samples and across the menstrual cycle will contribute to sample variability. Power to detect tissue specific eQTLs and differences between women with and without endometriosis was limited by the sample size in this study. The statistical approaches used in this study identify the likely gene targets for specific genetic risk factors, but not the functional mechanism by which changes in gene expression may influence disease risk. WIDER IMPLICATIONS OF THE FINDINGS Our results identify novel genetic variants that regulate gene expression in endometrium and the majority of these are shared across tissues. This allows analysis with large publicly available datasets to identify targets for female reproductive traits and diseases. Much larger studies will be required to identify genetic regulation of gene expression that will be specific to endometrium. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the National Health and Medical Research Council (NHMRC) under project grants GNT1026033, GNT1049472, GNT1046880, GNT1050208, GNT1105321, GNT1083405 and GNT1107258. G.W.M is supported by a NHMRC Fellowship (GNT1078399). J.Y is supported by an ARC Fellowship (FT180100186). There are no competing interests.

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Istrate-Ofiţeru, Anca-Maria, Carmen Aurelia Mogoantă, George-Lucian Zorilă, Gabriela-Camelia Roşu, Roxana Cristina Drăguşin, Elena-Iuliana-Anamaria Berbecaru, Marian Valentin Zorilă, et al. "Clinical Characteristics and Local Histopathological Modulators of Endometriosis and Its Progression." International Journal of Molecular Sciences 25, no. 3 (February 1, 2024): 1789. http://dx.doi.org/10.3390/ijms25031789.

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Endometriosis (E) and adenomyosis (A) are associated with a wide spectrum of symptoms and may present various histopathological transformations, such as the presence of hyperplasia, atypia, and malignant transformation occurring under the influence of local inflammatory, vascular and hormonal factors and by the alteration of tumor suppressor proteins and the inhibition of cell apoptosis, with an increased degree of lesion proliferation. Material and methods: This retrospective study included 243 patients from whom tissue with E/A or normal control uterine tissue was harvested and stained by histochemical and classical immunohistochemical staining. We assessed the symptomatology of the patients, the structure of the ectopic epithelium and the presence of neovascularization, hormone receptors, inflammatory cells and oncoproteins involved in lesion development. Atypical areas were analyzed using multiple immunolabeling techniques. Results: The cytokeratin (CK) CK7+/CK20− expression profile was present in E foci and differentiated them from digestive metastases. The neovascularization marker cluster of differentiation (CD) 34+ was increased, especially in areas with malignant transformation of E or A foci. T:CD3+ lymphocytes, B:CD20+ lymphocytes, CD68+ macrophages and tryptase+ mast cells were abundant, especially in cases associated with malignant transformation, being markers of the proinflammatory microenvironment. In addition, we found a significantly increased cell division index (Ki67+), with transformation and inactivation of tumor suppressor genes p53, B-cell lymphoma 2 (BCL-2) and Phosphatase and tensin homolog (PTEN) in areas with E/A-transformed malignancy. Conclusions: Proinflammatory/vascular/hormonal changes trigger E/A progression and the onset of cellular atypia and malignant transformation, exacerbating symptoms, especially local pain and vaginal bleeding. These triggers may represent future therapeutic targets.

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Roman, H. "Digestive Functional Outcomes Following Conservative or Radical Surgery in Large Deep Endometriosis Infiltrating the Rectum: ENDORE Randomized Trial." Journal of Minimally Invasive Gynecology 23, no. 7 (November 2016): S107—S108. http://dx.doi.org/10.1016/j.jmig.2016.08.264.

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Roman, H., M. Saint Ghislain, M. Milles, N. Marty, C. Hennetier, S. Moatassim, E. Desnyder, and C. Abo. "Improvement of digestive complaints in women with severe colorectal endometriosis benefiting from continuous amenorrhoea triggered by triptorelin. A prospective pilot study." Gynécologie Obstétrique & Fertilité 43, no. 9 (September 2015): 575–81. http://dx.doi.org/10.1016/j.gyobfe.2015.07.001.

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Sun, Xutao, Caiyun Mao, Ying Xie, Qing Zhong, Rong Zhang, Deyou Jiang, and Yunjia Song. "Therapeutic Potential of Hydrogen Sulfide in Reproductive System Disorders." Biomolecules 14, no. 5 (April 30, 2024): 540. http://dx.doi.org/10.3390/biom14050540.

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Hydrogen sulfide (H2S), previously regarded as a toxic exhaust and atmospheric pollutant, has emerged as the third gaseous signaling molecule following nitric oxide (NO) and carbon monoxide (CO). Recent research has revealed significant biological effects of H2S in a variety of systems, such as the nervous, cardiovascular, and digestive systems. Additionally, H2S has been found to impact reproductive system function and may have therapeutic implications for reproductive disorders. This paper explores the relationship between H2S and male reproductive disorders, specifically erectile dysfunction, prostate cancer, male infertility, and testicular damage. Additionally, it examines the impact of H2S regulation on the pathophysiology of the female reproductive system, including improvements in preterm birth, endometriosis, pre-eclampsia, fetal growth restriction, unexplained recurrent spontaneous abortion, placental oxidative damage, embryo implantation, recovery of myometrium post-delivery, and ovulation. The study delves into the regulatory functions of H2S within the reproductive systems of both genders, including its impact on the NO/cGMP pathway, the activation of K+ channels, and the relaxation mechanism of the spongy smooth muscle through the ROCK pathway, aiming to broaden the scope of potential therapeutic strategies for treating reproductive system disorders in clinical settings.

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Roman, Horace, Jean-Jacques Tuech, Emmanuel Huet, Valérie Bridoux, Haitham Khalil, Clotilde Hennetier, Michael Bubenheim, and Lacramioara Aurelia Brinduse. "Excision versus colorectal resection in deep endometriosis infiltrating the rectum: 5-year follow-up of patients enrolled in a randomized controlled trial." Human Reproduction 34, no. 12 (December 1, 2019): 2362–71. http://dx.doi.org/10.1093/humrep/dez217.

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Abstract STUDY QUESTION Is there a difference in functional outcomes and recurrence rate between conservative versus radical rectal surgery in patients with large deep endometriosis infiltrating the rectum 5 years postoperatively? SUMMARY ANSWER No evidence was found that long-term outcomes differed when nodule excision was compared to rectal resection for deeply invasive endometriosis involving the bowel. WHAT IS KNOWN ALREADY Functional outcomes of nodule excision and rectal resection for deeply invasive endometriosis involving the bowel are comparable 2 years after surgery. Despite numerous previously reported case series enrolling patients managed for colorectal endometriosis, long-term data remain scarce in the literature. STUDY DESIGN, SIZE, DURATION From March 2011 to August 2013, we performed a two-arm randomized trial, enrolling 60 patients with deep endometriosis infiltrating the rectum up to 15 cm from the anus, measuring >20 mm in length, involving at least the muscular layer in depth, and up to 50% of rectal circumference. Among them, 55 women were enrolled at one tertial referral centre in endometriosis, using a randomization list drawn up separately for this centre. Institute review board approval was obtained to continue follow-up to 10 years postoperatively. One patient requested to stop the follow-up 2 years after surgery. PARTICIPANTS/MATERIALS, SETTING, METHODS Patients underwent either nodule excision by shaving or disc excision, or segmental resection. Randomization was performed preoperatively using sequentially numbered, opaque, sealed envelopes, and patients were informed of randomization results. The primary endpoint was the proportion of patients experiencing one of the following symptoms: constipation (1 stool/>5 consecutive days), frequent bowel movements (≥3 stools/day), anal incontinence, dysuria or bladder atony requiring self-catheterization 24 months postoperatively. Secondary endpoints were values taken from the Knowles–Eccersley–Scott-symptom questionnaire (KESS), the gastrointestinal quality of life index (GIQLI), the Wexner scale, the urinary symptom profile (USP) and the Short Form 36 Health Survey (SF36). MAIN RESULTS AND THE ROLE OF CHANCE Fifty-five patients were enrolled. Among the 27 patients in the excision arm, two were converted to segmental resection (7.4%). One patient managed by segmental resection withdrew from the study 2 years postoperatively, presuming that associated pain of other aetiologies may have jeopardized the outcomes. The 5 year-recurrence rate for excision and resection was 3.7% versus 0% (P = 1), respectively. For excision and resection, the primary endpoint was present in 44.4% versus 60.7% of patients (P = 0.29), respectively, while 55.6% versus 53.6% of patients subjectively reported normal bowel movements (P = 1). An intention-to-treat comparison of overall KESS, GIQLI, Wexner, USP and SF36 scores did not reveal significant differences between the two arms 5 years postoperatively. Statistically significant improvement was observed shortly after surgery with no further improvement or impairment recorded 1–5 years postoperatively. During the 5-year follow-up, additional surgical procedures were performed in 25.9% versus 28.6% of patients who had undergone excision or resection (P = 0.80), respectively. LIMITATIONS, REASONS FOR CAUTION The presumption of a 40% difference concerning postoperative functional outcomes in favour of nodule excision resulted in a lack of power for demonstration of the primary endpoint difference. WIDER IMPLICATIONS OF THE FINDINGS Five-year follow-up data do not show statistically significant differences between conservative and radical rectal surgery for long-term functional digestive and urinary outcomes in this specific population of women with large involvement of the rectum. STUDY FUNDING/COMPETING INTEREST(S) No specific funding was received. Patient enrolment and follow-up until 2 years postoperatively was supported by a grant from the clinical research programme for hospitals in France. The authors declare no competing interests related to this study. TRIAL REGISTRATION NUMBER This randomized study is registered with ClinicalTrials.gov, number NCT 01291576. TRIAL REGISTRATION DATE 31 January 2011. DATE OF FIRST PATIENT’S ENROLMENT 7 March 2011.

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Roman, Horace, Valérie Bridoux, Benjamin Merlot, Benoit Resch, Rachid Chati, Julien Coget, Damien Forestier, and Jean-Jacques Tuech. "Risk of bowel fistula following surgical management of deep endometriosis of the rectosigmoid: a series of 1102 cases." Human Reproduction 35, no. 7 (July 1, 2020): 1601–11. http://dx.doi.org/10.1093/humrep/deaa131.

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Abstract STUDY QUESTION What are the risk factors and prevalence of bowel fistula following surgical management of deep endometriosis infiltrating the rectosigmoid and how can it be managed? SUMMARY ANSWER In patients managed for deep endometriosis of the rectosigmoid, risk of fistula is increased by bowel opening during both segmental colorectal resection and disc excision and rectovaginal fistula repair is more challenging than for bowel leakage. WHAT IS KNOWN ALREADY Bowel fistula is known to be a severe complication of colorectal endometriosis surgery; however, there is little available data on its prevalence in large series or on specific management. STUDY DESIGN, SIZE, DURATION A retrospective study employing data prospectively recorded in the North-West Inter Regional Female Cohort for Patients with Endometriosis (CIRENDO) from June 2009 to May 2019, in three tertiary referral centres. PARTICIPANTS/MATERIALS, SETTING, METHODS One thousand one hundred and two patients presenting with deep endometriosis infiltrating the rectosigmoid, who were managed by shaving, disc excision or colorectal resection. The prevalence of bowel fistula was assessed, and factors related to the complication and its surgical management. MAIN RESULTS AND THE ROLE OF CHANCE Of 1102 patients enrolled in the study, 52.5% had a past history of gynaecological surgery and 52.7% had unsuccessfully attempted to conceive for over 12 months. Digestive tract subocclusion/occlusion was recorded in 12.7%, hydronephrosis in 4.5% and baseline severe bladder dysfunction in 1.5%. An exclusive laparoscopic approach was carried out in 96.8% of patients. Rectal shaving was performed in 31.9%, disc excision in 23.1%, colorectal resection in 35.8% and combined disc excision and sigmoid colon resection in 2.9%. For various reasons, the nodule was not completely removed in 6.4%, while in 7.2% of cases complementary procedures on the ileum, caecum and right colon were required. Parametrium excision was performed in 7.8%, dissection and excision of sacral roots in 4%, and surgery for ureteral endometriosis in 11.9%. Diverting stoma was performed in 21.8%. Thirty-seven patients presented with bowel fistulae (3.4%) of whom 23 (62.2%) were found to have rectovaginal fistulae and 14 (37.8%) leakage. Logistic regression model showed rectal lumen opening to increase risk of fistula when compared with shaving, regardless of nodule size: adjusted odds ratio (95% CI) for disc excision, colorectal resection and association of disc excision + segmental resection was 6.8 (1.9–23.8), 4.8 (1.4–16.9) and 11 (2.1–58.6), respectively. Repair of 23 rectovaginal fistulae required 1, 2, 3 or 4 additional surgical procedures in 12 (52.2%), 8 (34.8%), 2 (8.7%) and 1 patient (4.3%), respectively. Repair of leakage in 14 patients required 1 procedure (stoma) in 12 cases (85.7%) and a second procedure (colorectal resection) in 2 cases (14.3%). All patients, excepted five women managed by delayed coloanal anastomosis, underwent a supplementary surgical procedure for stoma repair. The period of time required for diverting stoma following repair of rectovaginal fistulae was significantly longer than for repair of leakages (median values 10 and 5 months, respectively, P = 0.008) LIMITATIONS, REASONS FOR CAUTION The main limits relate to the heterogeneity of techniques used in removal of rectosigmoid nodules and repairing fistulae, the lack of accurate information about the level of nodules, the small number of centres and that a majority of patients were managed by one surgeon. WIDER IMPLICATIONS OF THE FINDINGS Deep endometriosis infiltrating the rectosigmoid can be managed laparoscopically with a relatively low risk of bowel fistula. When the type of bowel procedure can be chosen, performance of shaving instead of disc excision or colorectal resection is suggested considering the lower risk of bowel fistula. Rectovaginal fistula repair is more challenging than for bowel leakage and may require up to four additional surgical procedures. STUDY FUNDING/COMPETING INTEREST(S) CIRENDO is financed by the G4 Group (The University Hospitals of Rouen, Lille, Amiens and Caen) and the ROUENDOMETRIOSE Association. No financial support was received for this study. H.R. reports personal fees from ETHICON, Plasma Surgical, Olympus and Nordic Pharma outside the submitted work. The other authors declare no conflict of interests related to this topic.

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d’Avout-Fourdinier, Perrine, Marta Lempicka, André Gilibert, Céline Savoye-Collet, Loïc Marpeau, Clotilde Hennetier, Jean-Jacques Tuech, and Horace Roman. "Posterior rectal pouch after large full-thickness disc excision of deep endometriosis infiltrating the low/mid rectum and relationship with digestive functional outcome." Journal of Gynecology Obstetrics and Human Reproduction 49, no. 7 (September 2020): 101792. http://dx.doi.org/10.1016/j.jogoh.2020.101792.

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Roman, H., M. Vassilieff, V. Bridoux, B. Resch, J.-J. Tuech, and L. Marpeau. "Digestive Functional Outcomes of the Surgical Management of Deep Endometriosis Infiltrating the Rectum: Radical Versus Symptom Guided Approach? Results of a Comparative Study." Journal of Minimally Invasive Gynecology 18, no. 6 (November 2011): S15. http://dx.doi.org/10.1016/j.jmig.2011.08.062.

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Ojezele, Matthew Obaineh, Anthony Taghogho Eduviere, Emmanuel Adesola Adedapo, and Treasure Kurakughan Wool. "Mood swing during menstruation: Confounding factors and drug use." Ethiopian Journal of Health Sciences 32, no. 4 (September 18, 2022): 681–88. http://dx.doi.org/10.4314/ejhs.v32i4.3.

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BACKGROUND: Premenstrual syndrome (PMS) is a physiologic process in women where mood swing is one of the symptoms influencing the psycho-emotional, physical, and behavioral reactions exhibited by women during menstruation. This study elucidates the effect of mood swing, confounding factors and healthcare-seeking behaviors of women in an educational environment.METHODS: Exactly 328 women who were within reproductive ages 16 and 35 years participated in this study. A survey method was adopted; validated and standardized questionnaires were administered to confidentially assess the effect of mood swing via PMS. All data were analyzed with SPSS 25.0; descriptive method was adopted and results were expressed in percentages.RESULTS: Mood swing was discovered as a symptom overlapping with psycho-emotional, physical, and behavioral symptoms during menstruation. The overall PMS prevalence was 67.4% while PMDD prevalence was 25.6%. Psycho-emotional symptoms: anger, irritability, depression. Physical symptoms: coldness, paleness, food craving, breast tenderness, digestive changes. Behavioral symptoms: social withdrawal, nocturnal social activity, absenteeism, poor work or academic performance, increased libido. Confounding factors include stress, gynecological conditions such as endometriosis, uterine fibroid, ovarian cyst, pelvic adhesion, and polycystic ovarian syndrome. Also, 22.9% had a family history of bipolar disorder (BD) while 30.2% had previous diagnosis. Severe pain was a major factor for seeking treatment; Paracetamol, and Piroxicam were frequently used drugs.CONCLUSIONS: Severe PMS triggers mood swing and can badly affect academic or work activities; victims either endure the pain due to socio-cultural and financial factors or take unsuitable medications where abuse is inevitable.

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Roman, H., M. Vassilieff, Da Costa C, C. Collet-Savoye, and J.-J. Tuech. "Computed Tomography-Based Virtual Colonoscopy and Conservative Surgery of the Deep Endometriosis Infiltrating the Rectum and the Sigmoid Colon: Effects of Shaving and Disc Excision on the Digestive Tract Stenosis." Journal of Minimally Invasive Gynecology 18, no. 6 (November 2011): S124—S125. http://dx.doi.org/10.1016/j.jmig.2011.08.511.

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Merlot, B., D. Forestier, M. Ballester, P. Collinet, M. Noailles, Q. Denost, J. J. Tuech, and H. Roman. "Endometriosis digestiva: técnicas quirúrgicas de tratamiento." EMC - Ginecología-Obstetricia 57, no. 4 (October 2021): 1–9. http://dx.doi.org/10.1016/s1283-081x(21)45717-6.

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Zouari, L., M. Aurélie, M. Abitbol, M. Boudiaf, Y. Fargeaudou, J. Nemeth, P. Soyer, and R. Rymer. "DIG45 Endometriose digestive : aspects en imagerie." Journal de Radiologie 86, no. 10 (October 2005): 1488. http://dx.doi.org/10.1016/s0221-0363(05)76001-7.

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Bal, Onon, Yanzganbuuvei Chadraa, Narmandakh Tsagaan, Altanchimeg Nyamgarav, Bilguun Ganbold, Sanchin Urjin, Ankhbayar Enkhbold, et al. "Gastric Endometriosis." Central Asian Journal of Medical Sciences 3, no. 1 (February 25, 2017): 95–99. http://dx.doi.org/10.24079/cajms.2017.01.014.

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Objectives: First reported in 1950, endometriosis is characterized by the presence of endometrial glands and stroma outside the endometrial cavity. Methods: A forty year old Mongolian woman had symptoms of epigastric and right upper quadrant pain, slow digestion, early satiety, and occasional diarrhea when diagnosed with gastroptosis in 2014. In December 2016, her symptoms became more severe and, at times, dry food would become stuck in her throat. Results: The patient was successfully treated by surgery and has not shown evidence of recurrence, although prolonged observation is necessary. Conclusion: The treatment of choice for extrapelvic endometriosis is surgical resection.

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Wang, Ningning, Bin Liu, Lili Liang, Yanxin Wu, Hongzhe Xie, Jiaming Huang, Xu Guo, et al. "Antiangiogenesis Therapy of Endometriosis Using PAMAM as a Gene Vector in a Noninvasive Animal Model." BioMed Research International 2014 (2014): 1–11. http://dx.doi.org/10.1155/2014/546479.

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Objective. To evaluate the characteristics and antiangiogenic effects of endostatin-loaded PAMAM on endometriosis in a noninvasive animal model.Materials and Methods. A noninvasive animal model was established by injecting adenovirus-GFP transfected endometrial stromal and glandular epithelial cells subcutaneously into nude mice. Endostatin-loaded PAMAM was prepared and identified by transmission electron microscopy. Forin vitrostudies, the DNA protection and cytotoxicity of PAMAM were investigated and compared with Lipofectamine 2000. Forin vivostudy, endostatin-loaded PAMAM was injected into the noninvasive model and evaluated by continuously observing the fluorescent lesion, lesion weight, microvessel density and VEGF immunostaining.Results. Compared with Lipofectamine 2000, PAMAM and HC PAMAM-ES group, MC PAMAM-ES group and LC PAMAM-ES group demonstrated a better stromal cells protective such that MC PAMAM-ES group of CCK8 was 0.617 ± 0.122 at 24 hr and 0.668 ± 0.143 at 48 hr and LC PAMAM-ES group of CCK8 was 0.499 ± 0.103 at 24 hr and 0.610 ± 0.080 at 48 hr in stromal cells (P<0.05) but similar cytotoxicity in glandular epithelial cellsin vitro. After 16 hrs of digestion, DNA decreased slightly under the protection of PAMAM. Endostatin-loaded PAMAM of HD PAMAM-ES group and LD PAMAM-ES group inhibited the growth of the endometriotic lesionin vivoat days 15, 20, 25 and 30 detected by noninvasive observation after injecting one dose endostatin of various medicines into the endometrial lesion in each mouse on day 10 (P<0.05) and confirmed by lesion weight at day 30 with HD PAMAM-ES group being 0.0104 ± 0.0077 g and LD PAMAM-ES group being 0.0140 ± 0.0097 g (P<0.05). Immunohistochemistry results showed that endostatin-loaded PAMAM reduced the microvessel density 3.8 ± 2.4 especially in HD PAMAM-ES group in the lesion (P<0.05).Conclusion. Endostatin-loaded PAMAM inhibits the development of endometriosis through an antiangiogenic mechanism and can be observed through the noninvasive endometriosis model.

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Aubert, E., N. Ragu, S. Aufort, E. Delhom, H. Dechaud, and B. Gallix. "Endometriose digestive : interet du couple IRM-echographie." Journal de Radiologie 90, no. 10 (October 2009): 1426. http://dx.doi.org/10.1016/s0221-0363(09)75621-5.

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Horban, N. Ye, N. P. Dzys, O. V. Lynchak, and T. M. Pokanevych. "Features of gynecological pathology in women of reproductive age from Kyiv region." Biomedical and Biosocial Anthropology, no. 34 (February 28, 2019): 62–67. http://dx.doi.org/10.31393/bba34-2019-09.

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One of the main conditions for the birth of a healthy baby is the gynecological health of the mother. For this reason, the purpose of the work was to assess the state of gynecological health of women in the Kyiv region. In this work, we used the data of departmental statistical reporting of the Ministry of Health of Ukraine about the number of cases of gynecological pathology from 2010-2017. The number of women of the corresponding age was determined according to the State Statistics Service of Ukraine. The relative risk of pathology (taking into account the 95 % confidence interval) from 2010-2013, 2014-2017 in the Kyiv region was evaluated in comparison with the general indicators in Ukraine as well as from 2014-2017 compared to 2010-2013 in the Kyiv region and general data in Ukraine. Separately for the Kyiv region, the frequency of gynecological pathology was determined among women of reproductive age (707 women), who visited Municipal Institution of Kyiv Regional Council “Kyiv Regional Centre for the Mother and Child Health Defense” from 2014 to 2017. The average age of women was 31.66±0.37. In most cases, the residents of the Kyiv region were diagnosed with chronic inflammatory diseases of the pelvic organs (salpingitis, 21.6 ‰). The relative risks of the occurrence of such diseases were determined in the region, compared with Ukraine, and over time. Those, who had menstrual disorders, hyperproliferative processes of the endometrium were more often recorded (10.8% versus 3.1%, p<0.01), and those with inflammatory processes of the pelvic organs more often had cervical dysplasia (19.8 % versus 4.7 %, p<0.001), chronic diseases of the genitourinary system (7.1 % versus 3.2 %, p<0.05) and digestive organs (17.3 % versus 9.6 %, p<0.01), which indicates a possible pathogenetic role of the inflammatory factor in the development of gynecological pathology. The relative risk of gynecological diseases among the women in the Kyiv region showed that the greatest attention is needed to improving the diagnostics of infertility and endometriosis, as well as the prevention and treatment of salpingitis and uterine cancer. Women with menstrual disorder during their visit to a gynecologist should be checked for the presence of hyperproliferative pathology and, in case a woman is diagnosed with other chronic diseases, they should be offered treatment of these areas of inflammation, which can further positively affect their reproductive health.

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Govindan, Sujatha, Noor Ahmad Shaik, Bhavani Vedicherla, Vijayalakshmi Kodati, Kaipa Prabhakar Rao, and Qurratulain Hasan. "Estrogen Receptor-αgene (T/C) Pvu II Polymorphism in Endometriosis and Uterine Fibroids." Disease Markers 26, no. 4 (2009): 149–54. http://dx.doi.org/10.1155/2009/580260.

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Endometriosis and fibroids are estrogen-dependent benign pathologies of the uterus, which account for infertility and pelvic pain along with dysmenorrhea in women. Suppression of the disease and recurrence after discontinuing hormone therapy strongly suggests that these are responsive to hormones, especially estrogen, which acts via its receptor. A T/C SNP in intron 1 and exon 2 boundary of estrogen receptor (ER)αgene recognized by PvuII enzyme has been associated with several female pathologies like breast cancer, osteoporosis, endometriosis and fibroids in various ethnic groups. The aim of the present study was to assess this ERαT/C polymorphism in endometriosis and fibroid patients from Asian Indian population. Genomic DNA was isolated from 367 women, who included 110 cases of endometriosis, 142 cases of uterine fibroids and 115 healthy age matched women volunteers. PCR was carried out to amplify ERαgene followed by restriction digestion with Pvu II. Results indicate a significant association of C allele with both endometriosis [OR = 2.6667, 95% CI = 1.4166 to 5.0199;p< 0.05] and fibroids [2.0833, 95% CI = 1.1327 to 3.8319;p< 0.05]. Further studies are needed in larger population to establish ERαC allele as a risk marker for endometriosis and fibroids in Asian Indian women. Ethnicity, race, diet etc may play a role in susceptibility to endometriosis and fibroids and further studies are warranted in this area.

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Mordefroid, M., J. de Laveaucoupet, P. Goussault, A. Resten, F. Petit, A. Dumas de La Roque, H. Fernandez, and D. Musset. "AGF3 Endometriose et envahissement digestif : quels signes IRM." Journal de Radiologie 86, no. 10 (October 2005): 1457. http://dx.doi.org/10.1016/s0221-0363(05)75876-5.

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Гутикова, Л. В. "Clinical Effects of Alpha-Lipoic Acid for Women’s Health." Репродуктивное здоровье. Восточная Европа, no. 3 (November 4, 2021): 371–81. http://dx.doi.org/10.34883/pi.2021.11.3.009.

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Проведенный анализ источников литературы, содержащих актуальную доказательную базу по эффективности альфа-липоевой кислоты (АЛК) в лечении и профилактике заболеваний у женщин, свидетельствует об универсальности антиоксидантного действия АЛК. Возможность с помощью применения АЛК влиять на воспаление, апоптоз, кровоток, эндотелиальную дисфункцию, активацию нейротрансмиттеров, метаболические процессы позволяет рассматривать ее препараты как потенциальное лекарственное средство в различных областях медицины. АЛК значимо снижает гликемию натощак, уровень инсулина, значения индекса оценки гомеостатической модели, гликированного гемоглобина у пациентов с метаболическими нарушениями, массу тела и индекс массы тела у лиц с ожирением. АЛК оказывает влияние на противовоспалительные и антитромботические механизмы, что ведет к уменьшению эндотелиальной дисфункции для лечения и профилактики заболеваний сердечно-сосудистой системы. Использование АЛК способствует профилактике прогрессирования болезни Альцгеймера, а при инсульте к регрессу клинических симптомов. АЛК подавляет окислительный стресс и снижает инсулинорезистентность у женщин, имеющих диагностированный синдром поликистозных яичников. Комбинация N-ацетилцистеина, АЛК ибромелаина эффективна для лечения и профилактики эндометриоза. Применение АЛК у пациенток с угрозой невынашивания беременности улучшает резорбцию субхорионической гематомы. У беременных с риском выкидыша прием АЛК стабилизирует течение беременности, после кесарева сечения и ушивания послеродовых разрывов способствует более быстрому заживлению. АЛК может быть использована для профилактики диабетической эмбриопатии и преждевременного разрыва плодных оболочек, вызванного воспалением. АЛК можно безопасно использовать для прегравидарной подготовки на этапе планирования беременности обоим партнерам. У мужчин АЛК улучшает качество спермы, а у женщин способность к зачатию. Имеются благоприятные эффекты АЛК в отношении уменьшения выраженности болевого синдрома при первичной дисменорее, а также для нормализации менструального цикла и облегчения симптомов климакса. Прием АЛК также способствует увеличению минеральной плотности костной ткани. АЛК способна препятствовать инициации и развитию канцерогенеза, в связи с чем выдвинуто предположение о наличии у нее онкопревентивного потенциала. Таким образом, для женщин всех возрастов применение АЛК показано для устранения причин окислительного стресса, активации иммунной системы, оптимизации работы эндокринной, сердечно-сосудистой и пищеварительной систем, улучшения мозговой активности, лечения заболеваний печени, профилактики старения, а также при менопаузальных расстройствах, СПКЯ, дисменорее, при планировании беременности. The analysis of literature sources containing the current evidence based on the effectiveness of alpha-lipoic acid (ALA) in the treatment and prevention of diseases in women indicates the universality of the antioxidant effect of ALA. The possibility of using ALA is the influence on inflammation, apoptosis, blood flow, endothelial dysfunction, activation of neurotransmitters, metabolic processes, that allows to use it in various fields of medicine. ALA significantly reduces fasting glycemia, insulin levels, values of the homeostatic model score index, glycated hemoglobin in patients with metabolic disorders, body weight and body mass index in obese individuals. ALA has an effect on anti-inflammatory and antithrombotic mechanisms, which leads to a reduction in endothelial dysfunction for the treatment and prevention of diseases of the cardiovascular system. The use of ALA contributes to the prevention of the progression of Alzheimer’s disease, and in stroke to the regression of clinical symptoms. ALA suppresses oxidative stress and reduces insulin resistance in women diagnosed with polycystic ovary syndrome. The combination of N-acetylcysteine, ALA, and bromelain is effective for the treatment and prevention of endometriosis. The use of ALA in patients with the threat of miscarriage improves the resorption of subchorionic hematoma. In pregnant women at risk of miscarriage, taking ALA stabilizes the course of pregnancy, after cesarean section and suturing postpartum ruptures promotes faster healing. ALA can be used to prevent diabetic embryopathy and premature rupture of the fetal membranes caused by inflammation. ALA can be safely used for pre-pregnancy preparation during pregnancy planning for both partners. In men, ALA improves the quality of sperm, and in women, the ability to conceive. There are favorable effects of ALA in terms of reducing the severity of pain in primary dysmenorrhea, as well as for the normalization of the menstrual cycle and relief of menopausal symptoms. Taking ALA also contributes to an increase in bone mineral density. ALA is able to prevent the initiation and development of carcinogenesis, and therefore it is suggested that it has an oncopreventive potential. Summing up, for women of all ages, using of ALA is indicated to eliminate the causes of oxidative stress, activate the immune system, optimize the work of the endocrine, cardiovascular and digestive systems, improve brain activity, treat liver diseases, prevent aging, as well as for menopausal disorders, PCOS, dysmenorrhea and planning pregnancy.

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Boșoteanu, Mădălina, Raluca Ioana Vodă, Gabriela Izabela Balţǎtescu, Mariana Aşchie, Luana-Andreea Nurla, and Cristian Ionuţ Orǎşanu. "Clinico-Morphological Features and Immunohistochemical Profile of a Rare Case of Three Synchronous Primary Malignancies in the Female Genital Tract." Reports 7, no. 1 (February 17, 2024): 14. http://dx.doi.org/10.3390/reports7010014.

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(1) Background: Synchronous tumors are defined as tumors that occur at the same time, appearing within 2 months, according to the Surveillance Epidemiology and End Results Program, with a frequency of tertiary tumors of 0.5%. The purpose of this presentation is to report a case of three synchronous tumors of the female genital tract, given the fact that it represents a challenge both therapeutically and in demonstrating that the malignant lesions are completely different from each other. (2) Methods: We report the case of a 45 year-old patient diagnosed with three synchronous tumors developed in the genital tract: clear-cell ovarian carcinoma, uterine endometrioid adenocarcinoma, and cervical adenosquamous carcinoma. (3) Results: Total hysterectomy with bilateral anexectomy was performed and accompanied by a biopsy of the greater omentum. The evolution of the patient was favorable during chemotherapy, but she died two weeks after the completion of this treatment, from a cause secondary to the adverse effects determined by it, namely, severe thrombopenia which caused a massive lower digestive hemorrhage. (4) Conclusions: This case demonstrates the maximum importance of the involvement of adjuvant diagnostic techniques, especially when it comes to a diagnostic challenge with direct implications in the subsequent therapy of the patient.

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Kocherova, Ievgeniia, Maciej Brązert, Patrycja Sujka-Kordowska, Aneta Konwerska, Magdalena Kulus, Błażej Chermuła, Piotr Celichowski, et al. "Genes regulating biochemical pathways of oxygen metabolism in porcine oviductal epithelial cells during long-term IVC." Medical Journal of Cell Biology 7, no. 2 (October 12, 2019): 39–47. http://dx.doi.org/10.2478/acb-2019-0006.

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AbstractOxygen metabolism has an important role in the normal functioning of reproductive system, as well as the pathogenesis of female infertility. Oxidative stress seems to be responsible for the initiation or development of reproductive organ diseases, including polycystic ovary syndrome, endometriosis, preeclampsia, etc. Given the important role of maintaining balance between the production of ROS and antioxidant defence in the proper functioning of reproductive system, in the present study we aimed to analyse the expression of genes related to oxygen metabolism in porcine oviductal epithelial cells during long-term in vitro culture. The oviducts were collected from 45 crossbred gilts at the age of approximately nine months that displayed at least two regular oestrous cycles. The oviductal endothelial cells were isolated by enzymatic digestion to establish long-term primary cultures. Gene expression changes between 7, 15 and 30 daysof culturewere analysed with the use ofwhole transcriptome profiling by Affymetrix microarrays. The most of the “cellular response to oxidative stress” genes were upregulated. However, we did not observe any main trend in changes within the “cellular response to oxygen-containing compound” ontology group, where the gene expression levels were changed in various manner.Running title: Oxygen metabolism in porcine oviductal epithelial cells

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Yin, Wenze, Xiaoqing Li, Peng Liu, Yingjie Li, Jin Liu, Shan Yu, and Sheng Tai. "Digestive system deep infiltrating endometriosis: What do we know." Journal of Cellular and Molecular Medicine, August 25, 2023. http://dx.doi.org/10.1111/jcmm.17921.

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AbstractDigestive system infiltrating endometriosis (DSIE) is an uncommon form of endometriosis in the digestive system. DSIE often occurs in the intestines (especially the sigmoid rectum), liver, gallbladder and pancreas. Clinically, DSIE presents with the same symptoms as endometriosis, including cyclic pain, bleeding and infertility, in addition to specific biliary/intestinal obstruction and gastrointestinal bleeding. Compared to general endometriosis, DSIE has unique biological behaviour and pathophysiological mechanisms. Most DSIEs are deep invasive endometrioses, characterized by metastasis to the lymph nodes and lymphatic vessels, angiogenesis, peripheral nerve recruitment, fibrosis and invasion of surrounding tissues. DSIE‐related peripheral angiogenesis is divided into three patterns: angiogenesis, vasculogenesis and inosculation. These patterns are regulated by interactions between multiple hypoxia‐hormone cytokines. The nerve growth factors regulate the extensive neurofibril recruitment in DSIE lesions, which accounts for severe symptoms of deep pain. They are also associated with fibrosis and the aggressiveness of DSIE. Cyclic changes in DSIE lesions, recurrent inflammation and oxidative stress promote repeated tissue injury and repair (ReTIAR) mechanisms in the lesions, accelerating fibril formation and cancer‐related mutations. Similar to malignant tumours, DSIE can also exhibit aggressiveness derived from collective cell migration mediated by E‐cadherin and N‐cadherin. This often makes DSIE misdiagnosed as a malignant tumour of the digestive system in clinical practice. In addition to surgery, novel treatments are urgently required to effectively eradicate this lesion.

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Maragliano, Roberta, Laura Libera, Ileana Carnevali, Valeria Pensotti, Giovanna De Vecchi, Margherita Testa, Cristina Amaglio, et al. "Mixed Neuroendocrine/Non-neuroendocrine Neoplasm (MiNEN) of the Ovary Arising from Endometriosis: Molecular Pathology Analysis in Support of a Pathogenetic Paradigm." Endocrine Pathology, August 3, 2021. http://dx.doi.org/10.1007/s12022-021-09689-8.

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AbstractPrimary ovarian neuroendocrine neoplasms (Ov-NENs) are infrequent and mainly represented by well-differentiated forms (neuroendocrine tumors — NETs — or carcinoids). Poorly differentiated neuroendocrine carcinomas (Ov-NECs) are exceedingly rare and only few cases have been reported in the literature. A subset of Ov-NECs are admixed with non-neuroendocrine carcinomas, as it occurs in other female genital organs, as well (mostly endometrium and uterine cervix), and may be assimilated to mixed neuroendocrine/non-neuroendocrine neoplasms (MiNENs) described in digestive and extra-digestive sites. Here, we present a case of large cell Ov-NEC admixed with an endometrioid carcinoma of the ovary, arising in the context of ovarian endometriosis, associated with a uterine endometrial atypical hyperplasia (EAH). We performed targeted next-generation sequencing analysis, along with a comprehensive immunohistochemical study and FISH analysis for TP53 locus, separately on the four morphologically distinct lesions (Ov-NEC, endometrioid carcinoma, endometriosis, and EAH). The results of our study identified molecular alterations of cancer-related genes (PIK3CA, CTNNB1, TP53, RB1, ARID1A, and p16), which were present with an increasing gradient from preneoplastic lesions to malignant proliferations, both neuroendocrine and non-neuroendocrine components. In conclusion, our findings underscored that the two neoplastic components of this Ov-MiNEN share a substantially identical molecular profile and they progress from a preexisting ovarian endometriotic lesion, in a patient with a coexisting preneoplastic proliferation of the endometrium, genotypically and phenotypically related to the ovarian neoplasm. Moreover, this study supports the inclusion of MiNEN in the spectrum ovarian and, possibly, of all gynecological NENs, among which they are currently not classified.

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Slama, Loubna, Amal El Filali, Reda Rhazi, Hafsa Taheri, Hanane Saadi, Mohammed Bouziane, and Ahmed Mimouni. "Deep endometriosis of ileocecum complicated by acute intestinal obstruction: a case report." Journal of International Medical Research 51, no. 12 (December 2023). http://dx.doi.org/10.1177/03000605231191584.

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Endometriosis is a frequent gynecological pathology. Digestive localization complicated by acute intestinal obstruction is exceptionally rare. We herein report a case involving a 48-year-old woman who had a long-term history of endometriosis symptoms. She was diagnosed with endometriosis by ultrasound 1 month before her admission to the emergency room with acute intestinal obstruction. The diagnosis was confirmed by histopathological examination following surgical resection. Further medical management resulted in a satisfactory outcome.

Journal articles on the topic 'Digestive endometriosis'

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