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This book presents an overview of the diagnostic performance of non- or semi-invasive tests for endometriosis in peripheral blood, endometrium, saliva, peritoneal fluid and urine. The value of existing and emerging systems biology technologies for biomarker development is addressed in several chapters on genetics, microarrays, proteomics and metabolomics. Although tests with high sensitivity and acceptable specificity have been developed, sometimes validated in independent populations and seem promising, more research is needed to translate these data into clinical benefit for patients and coordinate efforts internationally to standarize analysis, reports and operating procedures. The gold standard to diagnose endometriosis is currently through laparoscopic inspection with histological confirmation, a surgical procedure with rare but significant potential risks for the patients. A non-invasive test for endometriosis would be critical for the early detection of endometriosis of symptomatic women with pelvic pain and/or subfertility with normal ultrasound. This would include nearly all cases of minimal-mild endometriosis, some cases of moderate-severe endometriosis without a clearly visible ovarian endometrioma and cases with pelvic adhesions and/or other pelvic pathology, who might benefit from surgery to improve pelvic pain and/or subfertility. Such a test would also be useful in symptomatic women with ultrasound imaging suspicious for endometriosis, since it may be difficult to differentiate an ovarian endometrioma from other ovarian cysts and since the quality of ultrasound imaging is highly variable worldwide.
Endometriosis is defined as the presence of endometrial-like endometrial cells, glands, and stroma outside the uterus, causing a wide range of symptoms and signs, including acute and chronic pelvic pain and infertility. Endometriosis affects approximately 10% of women of reproductive age, and up to 50% of infertile women. The etiopathogenesis of endometriosis still remains controversial: immune, hormonal, genetic, and epigenetic factors may be all involved, and several theories have been proposed to explain it. One of the main problems for the management of endometriosis is the significant diagnostic delay: to date, several biomarkers are currently being tested in order to provide a reliable non-invasive diagnosis in case of symptoms and signs suspicious for endometriosis. In addition, ultrasound techniques and magnetic resonance imaging are evolving rapidly, allowing for better accuracy, even with the use of artificial intelligence. Finally, new potential histological makers are helping to correlate the occurrence of endometriosis in different anatomical landmarks, supporting specific pathways to clarify the etiology of the disease.
Endometriosis is defined as the presence of endometrial-like endometrial cells, glands, and stroma outside the uterus, causing a wide range of symptoms and signs, including acute and chronic pelvic pain and infertility. Endometriosis affects approximately 10% of women of reproductive age, and up to 50% of infertile women. The etiopathogenesis of endometriosis still remains controversial: immune, hormonal, genetic, and epigenetic factors may be all involved, and several theories have been proposed to explain it.One of the main problems for the management of endometriosis is the significant diagnostic delay: to date, several biomarkers are currently being tested in order to provide a reliable non-invasive diagnosis in case of symptoms and signs suspicious for endometriosis.In addition, ultrasound techniques and magnetic resonance imaging are evolving rapidly, allowing for better accuracy, even with the use of artificial intelligence. Finally, new potential histological makers are helping to correlate the occurrence of endometriosis in different anatomical landmarks, supporting specific pathways to clarify the etiology of the disease.
Endometriosis is one of the most common gynecological diseases, causing pelvic pain, infertility, and cancer. The condition reduces the quality of life for the estimated 10% of menstruating women who are affected by it. This book provides a clear insight into the pathogenesis and pathophysiology of endometriosis—essential information for clinicians intending to successfully treat the condition. The first part covers a range of topics including stem cells, NK cells, macrophages, inflammation, cytokines, epigenetics, prostaglandin, sex steroids, aromatase, apoptosis, nerve fibers, and malignant transformation to aid in understanding the pathogenesis and pathophysiology of the disease. The second part provides useful tools for therapy, specifically, notable recent techniques in prevention, imaging, biomarkers, medical treatments, surgical treatments, prevention of recurrence, and infertility treatments. Each chapter was written by an expert in the field, with nearly 40 researchers and clinicians contributing to the work. This book will be highly useful to clinicians as well as to research scientists who are interested in this enigmatic disease.
Addresses new concepts and theories in disease control and provides the latest treatment modalities. Dedicated to new developments in the medical and surgical treatment of endometriosis, this reference delves into current management controversies, examines emerging therapeutic strategies, and assists specialists in the design of new investigations and research paths for the study of this common condition.
Endometriosis is an oestrogen-dependent disease and is usually not encountered after menopause. Endometriosis-associated pain is treated with drugs that suppress oestrogen secretion in the ovaries. Hormonal products used to reduce pain also prevent pregnancy and are not recommended for infertility patients.Surgery relieves pain and may improve infertility.
Clinical Reproductive Medicine and Surgery is the new, definitive resource in reproductive medicine. This unique text offers detailed discussion on both the medical and surgical management of reproductive disorders, as well as coverage of associated imaging modalities. Included are chapters on Reproductive Genetics, Management of Endometriosis (including interventional radiology), Ultrasonography and Sonohysterography, Preservation of Fertility, and Recurrent Pregnancy Loss. The book also features an accompanying DVD with additional images and video loops. A resource every practitioner interested in Reproductive Endocrinology and Infertility needs! Offers detailed discussion of medical and surgical management of reproductive disorders ... No other text offers coverage of both medical and surgical management in one resource. Covers gynecologic disorders that impact fertility--an important aspect of identifying fertility issues, not included in major competition Section on basic reproductive biology ... Not overly detailed -- Written for a clinician to understand how to practice reproductive medicine Section on reproductive imaging ... Unique to this text - includes US and MRI of the reproductive organs Algorithm in each chapter ... 4-color throughout ... Demonstrates the appropriate clinical investigation and management ... Offers attractive layout and best views of surgical procedures Perform reproductive surgery procedures with step-by-step guidance on intrauterine device insertion and laparoscopic surgery with detailed images and videos on the accompanying dvd
Adolescent endometriosis is a previously overlooked disease in children, the true prevalence of which is still unknown but has been estimated between 19-73%. There are numerous initial challenges faced by adolescents suffering from delayed or undiagnosed endometriosis apart from experiencing chronic pain, such as: school/work absenteeism, false diagnoses/treatments, erroneous physician referrals, unnecessary radiological studies, radiation exposure, and emergency room visits as well as early exposure to narcotic pain medications and subsequent drug tolerance, resistance or even addiction. This text presents a clear history of physician and patient understanding and awareness of endometriosis in adolescents. It lays the groundwork for this condition with background information on endometriosis in general followed by a more focused look at endometriosis in adolescents. Leading experts in the field provide chapters on the different locations where endometriotic lesions can present in adolescents as well as identified risk factors and concomitant diseases of which it is important to be aware. In addition to the clinical presentation, this book also provides information on breaking down existing barriers, such as stigma, and current activism and awareness of this condition. Adolescent Endometriosis is a first-of-its-kind text that focuses exclusively on endometriosis in the adolescent population. Written by experts in the field, this book is a comprehensive resource for clinicians in all medical disciplines that treat adolescent age girls.
Written with the busy practice in mind, this book delivers clinically focused, evidence-based gynecology guidance in a quick-reference format. It explores etiology, screening, tests, diagnosis, and treatment for a full range of gynecologic health issues. The coverage includes the full range of gynecologic malignancies, reproductive endocrinology and infertility, infectious diseases, urogynecologic problems, gynecologic concerns in children and adolescents, and surgical interventions including minimally invasive surgical procedures. Information is easy to find and absorb owing to the extensive use of full-color diagrams, algorithms, and illustrations. The new edition has been expanded to include aspects of gynecology important in international and resource-poor settings.