Endometriosis

Debski R, Kotarski J, Paszkowski T, Pawelczyk L, Skrzypulec V, Tomaszewski J, Anonymous00190. · No affiliation provided · Ginekol Pol. · Pubmed #19323063 No free full text.

Abstract: Recent epidemiologic studies indicate that use of combined oral contraception is associated with a increase in the incidence of cardiovascular disease (venous thromboembolism, pulmonary embolism, myocardial infarction and stroke). The risk of cardiovascular disease is strongly related to estrogen dose, progestogen type and other factors for example thrombogenic mutations and cigarette smoking among female over age 35. The progestogen only contraception is safe alternative to combined hormonal contraception. Progestogen only pill (POP) has different levels of action (local and/or central) which may vary from one drug to another. As for the cardiovascular disease risk, progestogens are not considered to be risk factors. Desogestrel containing POP is advised in the following cases: bad tolerance of exogenous oestrogens; in order to counteract an endogenous hyperoestrogenosis; medical, metabolic or cardiovascular contraindications to estroprogestogen contraception. Lastly, POP should be used as a prime contraception in some particular situations (breast feeding, endometriosis, adenomyosis, cigarette smoking, contraception for older women). These recommendations present the actual system of care in that population of women in Poland.

Hori Y, Anonymous00015. · Society of American Gastrointestinal and Endoscopic Surgeons, 11300 West Olympic Blvd, Suite 600, Los Angeles, CA 90064, USA. · Surg Endosc. · Pubmed #18389320 No free full text.

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Anonymous00253. · No affiliation provided · Fertil Steril. · Pubmed #17055818 No free full text.

Abstract: Pain associated with endometriosis requires careful evaluation to exclude other potential causes and may involve a number of different mechanisms. Both medical and surgical treatments for pain related to endometriosis are effective and choice of treatment must be individualized.

Anonymous00248. · No affiliation provided · Fertil Steril. · Pubmed #17055813 No free full text.

Abstract: Women with endometriosis typically present with pelvic pain, infertility or an adnexal mass. Surgery for persistent adnexal masses may be indicated to remove an endometrioma or other pelvic pathology. Surgical or medical therapy is efficacious for pelvic pain due to endometriosis, but treatment of endometriosis in the female partner of an infertile couple raises a number of complex clinical questions that do not have simple answers.

Anonymous00080. · No affiliation provided · Obstet Gynecol. · Pubmed #15802438 No free full text.

Abstract: Historically thought of as a disease that affects adult women, endometriosis increasingly is being diagnosed in the adolescent population. This disorder, which was originally described more than a century ago, still represents a vague and perplexing entity that frequently results in chronic pelvic pain, adhesive disease, and infertility. The purpose of this Committee Opinion is to highlight the differences in adolescent and adult types of endometriosis. Early diagnosis and treatment during adolescence may decrease disease progression and prevent subsequent infertility.

Anonymous00117. · No affiliation provided · Fertil Steril. · Pubmed #15363692 No free full text.

Abstract: Women with endometriosis typically present with pelvic pain, infertility or an adnexal mass. Surgery for persistent adnexal masses may be indicated to remove an endometrioma or other pelvic pathology. Surgical or medical therapy is efficacious for pelvic pain due to endometriosis, but treatment of endometriosis in the female partner of an infertile couple raises a number of complex clinical questions that do not have simple answers.

Lefebvre G, Allaire C, Jeffrey J, Vilos G, Arneja J, Birch C, Fortier M, Anonymous00163. · No affiliation provided · J Obstet Gynaecol Can. · Pubmed #12196887 No free full text.

Abstract: OBJECTIVE: To identify the indications for hysterectomy, preoperative assessment, and available alternatives required prior to hysterectomy. Patient self-reported outcomes of hysterectomy have revealed high levels of patient satisfaction. These may be maximized by careful preoperative assessment and discussion of other treatment choices. In most cases hysterectomy is performed to relieve symptoms and improve quality of life. The patient's preference regarding treatment alternatives must be considered carefully. OPTIONS: The areas of clinical practice considered in formulating this guideline are preoperative assessment including alternative treatments, choice of method for hysterectomy, and evaluation of risks and benefits. The risk-to-benefit ratio must be examined individually by the woman and her health practitioners. OUTCOMES: Optimizing the decision-making process of women and their caregivers in proceeding with a hysterectomy having considered the disease process, and available alternative treatments and options, and having reviewed the risks and anticipated benefits. EVIDENCE: Using Medline, PubMed, and the Cochrane Database, English language articles were reviewed from 1996 to 2001 as well as the review published in the 1996 SOGC guidelines. The level of evidence has been determined using the criteria described by the Canadian Task Force on the Periodic Health Examination. BENEFITS, HARMS, AND COSTS: Hysterectomy is the treatment of choice for certain gynaecologic conditions. The predicted advantages must be carefully weighed against the possible risks of the surgery and other treatment alternatives. In the properly selected patient, the result from the surgery should be an improvement in the quality of life. The cost of the surgery to the health care system and to the patient must be interpreted in the context of the cost of untreated conditions. The approach selected for the hysterectomy will impact on the cost of the surgery. RECOMMENDATIONS: Benign Disease 1. Leiomyomas: For symptomatic fibroids, hysterectomy provides a permanent solution to menorrhagia and the pressure symptoms related to an enlarged uterus. (I-A) 2. Abnormal uterine bleeding: Endometrial lesions must be excluded and medical alternatives should be considered as a first line of therapy. (III-B) 3. Endometriosis: Hysterectomy is often indicated in the presence of severe symptoms with failure of other treatments and when fertility is no longer desired. (1-B) 4. Pelvic relaxation: A surgical solution usually includes vaginal hysterectomy, but must include pelvic supporting procedures. (II-B) 5. Pelvic pain: A multidisciplinary approach is recommended, as there is little evidence that hysterectomy will cure chronic pelvic pain. When the pain is confined to dysmenorrhea or associated with significant pelvic disease, hysterectomy may offer relief. (II-C) Preinvasive Disease 1. Hysterectomy is usually indicated for endometrial hyperplasia with atypia. (I-A) 2. Cervical intraepithelial neoplasia in itself is not an indication for hysterectomy. (I-B) 3. Simple hysterectomy is an option for treatment of adenocarcinoma in situ of the cervix when invasive disease has been excluded. (I-B) Invasive Disease 1. Hysterectomy is an accepted treatment or staging procedure for endometrial carcinoma. It may play a role in the staging or treatment of cervical, epithelial ovarian, and fallopian tube carcinoma. (I-A) Acute Conditions 1. Hysterectomy is indicated for intractable postpartum hemorrhage when conservative therapy has failed to control bleeding. (II-B) 2. Tubo-ovarian abscesses that are ruptured or do not respond to antibiotics may be treated with hysterectomy and bilateral salpingo-oophorectomy in selected cases. (I-C) 3. Hysterectomy may be required for cases of acute menorrhagia refractory to medical or conservative surgical treatment. (II-C) Other Indications 1. Consultation with an oncologist or geneticist is recommended when considering hysterectomy and prophylactic oophorectomy for a familial history of ovarian cancer. (III-C) Surgical Approach 1. The vaginal route shoe should be considered as a first choice for all benign indications. The laparoscopic approach should be considered when it reduces the need for a laparotomy. (III-B) VALIDATION: Medline searches were performed in preparing this guideline with input from experts in their field across Canada. The guideline was reviewed and accepted by SOGC Council and Executive. SPONSOR: The Society of Obstetricians and Gynaecologists of Canada.

Anonymous00028. · No affiliation provided · Int J Gynaecol Obstet. · Pubmed #11186465 No free full text.

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Lapp T. · No affiliation provided · Am Fam Physician. · Pubmed #11011865 links to  free full text

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Anonymous54326. · No affiliation provided · BJU Int. · Pubmed #10383236 No free full text.

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Van Steirteghem A. · No affiliation provided · Hum Reprod. · Pubmed #19451131 No free full text.

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Savelli L. · No affiliation provided · Ultrasound Obstet Gynecol. · Pubmed #19402098 No free full text.

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Lang JH. · No affiliation provided · Chin Med J (Engl). · Pubmed #19302735 links to  free full text

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Van Steirteghem A. · No affiliation provided · Hum Reprod. · Pubmed #19147505 No free full text.

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Bazot M, Daraï E. · No affiliation provided · J Radiol. · Pubmed #19106824 No free full text.

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Szamatowicz M. · No affiliation provided · Gynecol Endocrinol. · Pubmed #19012093 No free full text.

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Lamar CA, DeCherney AH. · No affiliation provided · Fertil Steril. · Pubmed #18976748 No free full text.

Abstract: OBJECTIVE: To identify issues related to fertility preservation, discuss the state of the science, and make specific recommendations to guide future research supported by the U.S. National Institutes of Health in the field of fertility preservation. DESIGN: A 1-day meeting of an expert advisory panel convened by the Eunice Kennedy Shriver National Institute of Child Health and Human Development on January 23, 2007, at the National Institutes of Health in Bethesda, Maryland. The panelists represented the disciplines of reproductive endocrinology and infertility, urology, neurobiology, physiology, radiation oncology, pediatrics, genetics, behavioral science, surgery, and occupational health. CONCLUSION(S): The panel members recognized the emerging focus on fertility preservation to help women and men have biological children. Among those who might benefit from research in this area are those at risk for impaired fertility or infertility, including not only cancer survivors but also others with genetic predispositions to infertility, environmental occupational exposure to hazardous substances or conditions, or reproductive diseases such as endometriosis. The panelists highlighted the need for education and awareness among health-care providers to help people understand options for preserving fertility, the need for technologic advances, the lack of data on long-term consequences of fertility preservation, and emerging ethical and social questions. This report describes the process for developing a multidisciplinary, collaborative approach for research in this area, summarizes the discussions of the panelists, and outlines the recommendations for future research.

Rohmer V, Dewailly D. · No affiliation provided · Ann Endocrinol (Paris). · Pubmed #18954852 No free full text.

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Parker CM. · No affiliation provided · South Med J. · Pubmed #18791541 No free full text.

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Farquhar CM. · No affiliation provided · Med J Aust. · Pubmed #18673095 links to  free full text

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Wagstaff D, Becker CM. · No affiliation provided · Br J Hosp Med (Lond). · Pubmed #18646409 No free full text.

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Schindler AE. · No affiliation provided · Gynecol Endocrinol. · Pubmed #18569025 No free full text.

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Petraglia F, Luisi S. · No affiliation provided · Gynecol Endocrinol. · Pubmed #17999278 No free full text.

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Bianconi L, Hummelshoj L, Coccia ME, Vigano P, Vittori G, Veit J, Music R, Tomassini A, D'Hooghe T. · XII Committee on Hygiene and Health in the XIV Parliament of the Italian Senate, Rome, Italy. · Fertil Steril. · Pubmed #17991515 No free full text.

Abstract: Started at the grassroot level, increased awareness and investment in research has resulted in unprecedented recognition of endometriosis by the European Parliament, taken up by the Italian Senate in a 5-year action plan. This offers welcome assurance to the scientific community.

Fink D, Lang U, Kimmig R. · No affiliation provided · Gynakol Geburtshilfliche Rundsch. · Pubmed #17641472 No free full text.

Abstract: Endometriosis is one of the most frequent gynecological disorders. The diagnosis is usually confirmed by laparoscopy. As the etiology and pathogenesis of endometriosis are still mostly obscure, a causal therapy has not been found yet. As for the medicinal treatment of endometriosis, all modern therapeutic approaches aim at ovarian downregulation or at antagonizing the estrogen effects in the endometriosis focus. Surgery aims at a preferably complete resection of all endometriosis focuses. In addition to individual distress, the economic aspect must not be neglected because of its high morbidity, loss of workforce and the repeated therapeutic interventions. As treatment strongly depends on the specific complaints and the personal life circumstances of the patient, an individual therapy concept should always be considered.