Obstetrics and Gynecology
fatemeh davari tanha; Mojgan Asadi; Faeze Mirbagheri; Elham Feizabad; Zahra kaveh; Kazem Mousavizadeh
Articles in Press, Accepted Manuscript, Available Online from 01 August 2023
Abstract
Background and Objective: Endometriosis is a chronic gynecological condition that affects approximately 10% of women of reproductive age. Chronic pelvic pain is a common symptom of endometriosis and can have a significant impact on a woman's quality of life, including sexual satisfaction. Botulinum toxin ...
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Background and Objective: Endometriosis is a chronic gynecological condition that affects approximately 10% of women of reproductive age. Chronic pelvic pain is a common symptom of endometriosis and can have a significant impact on a woman's quality of life, including sexual satisfaction. Botulinum toxin injection has been used as a treatment for chronic pelvic pain in endometriosis, but its effect on sexual satisfaction is not well understood.Methods: A randomized controlled trial was conducted to evaluate the effect of botulinum toxin injection on chronic pelvic pain and sexual satisfaction in women with endometriosis. The study included 32 women with endometriosis who were randomly assigned to receive either botulinum toxin injection or placebo. The primary outcome measure was change in chronic pelvic pain assessed using the visual analog scale (VAS) at one month after treatment. Secondary outcome measures included changes in sexual satisfaction assessed using the Female Sexual Function Index (FSFI) at one month after treatment.Results: The results showed that botulinum toxin injection significantly reduced chronic pelvic pain compared to placebo at one month after treatment (p<0.001). There was also a significant improvement in sexual satisfaction in the botulinum toxin group compared to placebo at one month after treatment (p=0.001). Conclusion: Botulinum toxin injection may be an effective treatment option for women with endometriosis, chronic pelvic pain and sexual dysfunction.This research was also registered with the code IRCT20091012002576N20 in the Clinical Trial Registration Center of Iran. Date of registration performed between July2021and July 2022
Gynecology Oncology
Zahra Shiravani; Fatemehsadat Najib; Mahvash Alirahimi; Elham Askary; Tahereh Poordast; Nader Tanideh; Shohreh Roozmeh; Golsa Shekarkhar; Sana Atbaei; danilo porro; Soudabeh Sabetian; Claudia Cava
Articles in Press, Accepted Manuscript, Available Online from 03 September 2023
Abstract
The endometriosis treatment was critical issue due to complications associated with current drug delivery system. Present investigation compared the curative effect of Vitamin D3 (VTD3) and Omega–3 (OG3) with Diphereline during the treatment of endometriosis. Endometriosis was induced in different ...
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The endometriosis treatment was critical issue due to complications associated with current drug delivery system. Present investigation compared the curative effect of Vitamin D3 (VTD3) and Omega–3 (OG3) with Diphereline during the treatment of endometriosis. Endometriosis was induced in different groups containing 60 adult female rats. The rat model is categorized into 6 groups untreated and treated (Olive Oil (solvent), VTD3 (42 mcg/kg/day), OG3 (450 mg/kg/day), VTD3+OG3, Diphereline (3 mg/kg/day)). The suspension containing combination of Diphereline and supplements was injected and treated for 4 weeks to analyses the effect of supplements. The interleukin -6 (IL-6) and Tumor necrosis factor – alpha (TNFα) inflammatory responses were measured from the serum samples while endometrial implants was dissected and histopathological investigation was done. At the end of four weeks pathologic score was decreases significantly with simultaneous measurement of inflammation score of endometriotic lesion, size of implant area, IL-6, TNFα response and compared with untreated female rat. No significant different was observed in groups undergoing treatment of VTD3, OG3 and Diphereline. The combined effect of VTD3+OG3 has similar responses with Diphereline treated endometrial implants. In conclusion, treatment of VTD3 deficiency and making a change in dietary habits of high-risk population for endometriosis from adolescence may also play a preventative role in adulthood.
Reproductive Medicine
Achmad Kemal Harzif; Mila Maidarti; Costan Tryono Parulian Rumapea; Sarah Miriam Ratna Pratamasari; Heidi Dewi Mutia; Nafi’atul Ummah; Aisyah Retno Puspawardani; Putri Nurbaeti; Budi Wiweko
Articles in Press, Accepted Manuscript, Available Online from 06 April 2024
Abstract
Abstract:
Background and Objective: Endometriosis is one of the primary etiology of subfertility in women; in severe cases, endometriosis surgery could result in infertility due to oophorectomy. Ovarian tissue cryopreservation is a method by which the ovarian cortex is frozen and retransplanted in patients. ...
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Abstract:
Background and Objective: Endometriosis is one of the primary etiology of subfertility in women; in severe cases, endometriosis surgery could result in infertility due to oophorectomy. Ovarian tissue cryopreservation is a method by which the ovarian cortex is frozen and retransplanted in patients. This method is unaffected by the menstrual cycle, can restore ovarian hormonal function, and does not require sperm donor or ovulation induction. This systematic review aims to review the utility of ovarian tissue cryopreservation in endometriosis patients.
Methods: We searched the literature using keywords such as “fertility preservation,” “cryopreservation,” “endometriosis,” and “ovarian tissue cryopreservation” for relevant articles in Pubmed and Embase. We included all relevant articles, including case reports, cohort studies, and clinical trials.
Results: A total of 6 articles were included in this systematic review, including three retrospective studies and three case reports. In screening for candidates of ovarian tissue cryopreservation, serum antimullerian hormone (AMH) is a good marker for primordial follicle count. Patients undergoing ovarian tissue implantation after cryopreservation demonstrated an excellent pregnancy rate (41.2%) in one study. Follicle viability and hormonal function were preserved post-transplantation.
Conclusion: The current evidence shows that endocrine function and fertility in patients grafted with cryopreserved ovarian tissue are good. However, the evidence on the long-term outcome of ovarian tissue cryopreservation in endometriosis patients is lacking.
Obstetrics and Gynecology
Behnaz Nouri; Maliheh Arab; Mohammad Nasiri
Volume 8, Issue 5 , September and October 2023, , Pages 481-487
Abstract
Background & Objective: Endometriosis is one of the most common diseases in the female population. The range of diagnostic delays in this disease is long and leads to adverse health-related consequences. The aim of this study was to evaluate diagnostic experiences in patients with endometriosis ...
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Background & Objective: Endometriosis is one of the most common diseases in the female population. The range of diagnostic delays in this disease is long and leads to adverse health-related consequences. The aim of this study was to evaluate diagnostic experiences in patients with endometriosis who are candidates for laparoscopic surgery.Materials & Methods: This cross-sectional study was performed on 433 patients with endometriosis who were candidates for laparoscopic surgery referred to Shohada-Tajrish Hospital in Tehran, Iran, between January 2016 and December 2021. A questionnaire including demographic and clinical information, MRI, and pathology reports were collected from participants. The MRI lesions were segmented and the results were compared with pathology and clinical examination. For statistical analysis SPSS software, version 22 was used.Results: A total of 433 participated in this study with a mean age of 34.18±7.99. The average estimated duration of disease symptoms (months) was 40.58±42.33. The predictive value of clinical symptoms is weak compared to MRI. However, the probability that the disease is not present when the clinical signs are negative is acceptable in most of the endometriosis sites. MRI considerably shows the true negative rate, but its sensitivity is only relatively acceptable for the diagnosis of ascites (67.66%). Calculating the accuracy of MRI reports probably shows the overall classification of the patients via MRI test.Conclusion: despite extensive research, there are no suitable and accurate non-invasive methods for diagnosing endometriosis. MRI and clinical examination alone are not useful for definitive diagnosis and it is better to examine biomarkers and artificial intelligence for non-invasive and accurate diagnosis of this disease.
Gynecology Oncology
Behnaz Nouri; Malihe Arab; Nazli Najeddin Choukan
Volume 8, Issue 5 , September and October 2023, , Pages 494-500
Abstract
Background & Objective: Endometriosis is a common and benign disease of the female genital system, which is often seen in reproductive age and leads to infertility, dysmenorrhea, and dyspareunia. The aim of this study is to investigate the anatomical location and characteristics of endometriosis ...
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Background & Objective: Endometriosis is a common and benign disease of the female genital system, which is often seen in reproductive age and leads to infertility, dysmenorrhea, and dyspareunia. The aim of this study is to investigate the anatomical location and characteristics of endometriosis lesions in laparoscopic surgery.Materials & Methods: In this cross-sectional study, 557 endometriosis patients who referred to the gynecology department of Shohadaye-Tajrish Hospital and underwent laparoscopic surgery during 2016-2021 were evaluated. Statistical analysis of data was done using SPSS software version 24.P-value less than 0.05 was considered statistically significant level.Results: The results of this study show that the highest anatomical distribution of endometriosis lesions was ovarian endometriosis, and the lowest was vagina. Also, the highest rate of surface lesions is uterus and bladder, and the lowest is superficial lesions of the cul-de-sac cyst.Conclusion: Our results demonstrate that the distribution of endometriosis lesions is asymmetric.
Obstetrics and Gynecology
Poorya Davoodi; Delaram J. Ghadimi; Malihe Rezaei; Mohammad Amin Khazei Tabari; Aryan Shirani; Behnaz Nouri; Noosha Samieefar; Meisam Akhlaghdoust
Volume 8, Issue 4 , July and August 2023, , Pages 315-326
Abstract
Background & Objective: Endometriosis, a common disease of the female reproductive system, could affect many aspects of women’s lives. Along with many other diseases, COVID-19 has affected the diagnostic or treatment approaches towards endometriosis. This systematic review aims to investigate ...
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Background & Objective: Endometriosis, a common disease of the female reproductive system, could affect many aspects of women’s lives. Along with many other diseases, COVID-19 has affected the diagnostic or treatment approaches towards endometriosis. This systematic review aims to investigate COVID-19 in endometriosis patients in terms of prognosis, diagnosis, treatment, and quality of life during the pandemic.Materials & Methods: Relevant studies were identified through searching for endometriosis and COVID-19 in different databases, including PubMed, Medline, Scopus, and Web of Science, on 17 January 2022. Peer-reviewed published articles evaluating COVID-19 and endometriosis written in English were included.Results: Out of 115 articles, 9 manuscripts met our criteria. Endometriosis does not intensify the risk of COVID-19 infection. However, COVID-19 has changed the health care of endometriosis patients.Conclusion: COVID-19 has affected endometriosis patients’ life in many aspects, including their job, lifestyle, and health care. Further studies are recommended to evaluate how the pandemic has affected endometriosis patients.
Obstetrics and Gynecology
Maryam Moradi; Azin Niazi; Melissa Parker; Anne Sneddon; Violeta Lopez; David Ellwood
Volume 7, Issue 6 , September and October 2022, , Pages 479-488
Abstract
Background & Objective: The aim of this study was to determine the endometriosis-associated symptoms and diagnostic delay through an online survey.Materials & Methods: A cross-sectional study was conducted in Australia using an online web-based survey. All data were entered into and analyzed ...
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Background & Objective: The aim of this study was to determine the endometriosis-associated symptoms and diagnostic delay through an online survey.Materials & Methods: A cross-sectional study was conducted in Australia using an online web-based survey. All data were entered into and analyzed using the STATA software (version 14.1). A total of 903 respondents completed an online survey from September 2013 to October 2015.Results: Out of 903, 71.10% were Australians and 28.90% were Non-Australian, with a self-reported diagnosis of endometriosis confirmed by surgery. Out of the participants, 86.5% completed the online survey. Delay in diagnosis was 8.1±6.2 years. There was no difference in the age range (P < /i> = 0.35), mean age of onset of the first symptoms (P < /i> = 0.93), and delay in diagnosis (P < /i> = 0.11) between both groups. Most common endometriosis-related symptoms that all respondents had experienced in their lifetime were period pain (98.1%), fatigue (94%), bloating (90.7%), ovulation pain (88.7%), pelvic pain (87.3%), pain during and before/after sexual activity (82.7%), and heavy bleeding (82.2%). Treatments used by affected women included: pain killers (96%), hormonal medication (84.7%), surgical treatments (84.5%), and delayed fertility (37.1%). Conclusion: Vast similarities in demographics and endometriosis-associated symptoms among the Australian and non-Australian women with endometriosis support the universality of the disease characteristics. Delay in diagnosis of endometriosis is a problem and the reasons for delayed diagnosis must be understood to try to shorten this delay. Besides pain, patients with endometriosis suffer from a variety of other symptoms; hence, any treatment must take into account the most prominent symptoms.
Gynecology Oncology
Behnaz Nouri; Mohadese Alemi; Ahmad Reza Baghestani
Volume 7, Issue 5 , July and August 2022, , Pages 429-436
Abstract
Background & Objective: Endometriosis is associated with the increased risk of coronary heart disease and immune alterations, which may be attributed to the altered lipid profile and decreased serum level of 25–hydroxyl vitamin D (25(OH)D). The present study aimed to evaluate the effect of ...
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Background & Objective: Endometriosis is associated with the increased risk of coronary heart disease and immune alterations, which may be attributed to the altered lipid profile and decreased serum level of 25–hydroxyl vitamin D (25(OH)D). The present study aimed to evaluate the effect of radical laparoscopic surgery of endometriosis on serum lipid profile and 25(OH)D.Materials & Methods: This cross-sectional study was performed on 47 women aged 15 to 45, with body mass index <30kg/m2, who were referred to Shohaday-eTajrish Hospital, from May 2018 until Jan 2020, for surgical treatment of endometriosis and did not have a systemic disease and did not use oral contraceptives and/or other hormonal therapies three months before surgery were enrolled into the study. The serum lipid profile and 25(OH)D levels of patients two months after surgery were compared with presurgical levels. The results were analyzed by using paired t-test.Results: A total of 47 patients completed the study (mean age: 32.8±7.5years). About half had no pregnancies (49.1%). Comparing the serum lipid profile of patients before and two months after surgery showed a significant decrease in triglyceride from 108.4±46.2 to 86.4±51.1 mg/dL (P < /i>=0.001), ], total cholesterol from 172.5±26.5 to 160.0±28.3mg/dl (P < /i>=0.002), and low-density lipoprotein levels from 97±28.3 to 89.8±26.1 mg/dL (P < /i>=.003); however, high-density lipoprotein and 25(OH)D levels did not show a significant difference (P < /i>>0.05). Conclusion: the results of the current study showed that laparoscopic resection of endometriotic lesions resulted in a significant reduction of the unfavorable lipid profile after two months, but not 25(OH)D levels.
Radiology
Behnaz Moradi; Masoumeh Gity; Fatemeh Davari Tanha; Masoumeh Golestani Jahromi; Shahrzad Fayyazi
Volume 7, Issue 4 , March and April 2022, , Pages 272-278
Abstract
Diagnosis of endometriosis according to TVS may be an appropriate alternative method for laparoscopy. Hence in this study, the role of TVS was investigated compared with laparoscopic assessment in cases with pelvic endometriosis attending to imaging center of Imam-Khomeini and Yas Hospital in Tehran ...
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Diagnosis of endometriosis according to TVS may be an appropriate alternative method for laparoscopy. Hence in this study, the role of TVS was investigated compared with laparoscopic assessment in cases with pelvic endometriosis attending to imaging center of Imam-Khomeini and Yas Hospital in Tehran in 2018. In this diagnostic study, 69 patients with pelvic endometriosis were assessed. The results of TVS were compared with laparoscopic assessment, and the sensitivity, specificity, and congruence rate were determined. According to the obtained results, it may be concluded that most sensitivity of TVS is related to the torus uterinus and dome of the bladder. Also, the most specificity is related to bladder, sigmoid colon, and peritoneal cyst. The most congruence rate between U/S and laparoscopy is at bladder trigon and sigmoid colon. However, in the end, multicenter studies with more cases and comparisons with the results of other diagnostic methods are recommended to achieve more accurate results.
Atieh Mirfendereski; Khadigeh Abadian
Volume 3, Issue 4 , November and December 2018, , Pages 177-180
Abstract
Background & Objective: Given the impact of endometriosis on patients’ social lives, marital relationships, and fertility and on reducing these people’s quality of life, its proper diagnosis and treatment seem vital. This study aimed to report a case of rectus muscle endometriosis and ...
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Background & Objective: Given the impact of endometriosis on patients’ social lives, marital relationships, and fertility and on reducing these people’s quality of life, its proper diagnosis and treatment seem vital. This study aimed to report a case of rectus muscle endometriosis and the way it was managed.
Case Report: The patient was a 30-year-old woman who had a history of dysmenorrhea and chronic pain for 2 years after her first delivery which was performed by cesarean section. During ultrasonography conducted on the anterior abdominal wall of the midline, a mass indicating endometriosis was observed in the abdominal wall at the site of the cesarean section incision scar and in the thickness of the rectus muscle. After the termination of pregnancy and during the cesarean section, the mass was removed and the patient’s symptoms subsided.
Conclusion: To manage endometriosis a patient’s complete records and imaging techniques can be effective.
