Diagnosis Of Peritoneal Endometriosis Research Articles

Indicators of quality of life, anxiety-depressive symptoms and severity of dysmenorrhea in adolescent girls with peritoneal endometriosis during conservative therapy for a year

Introduction. Delayed diagnosis and treatment of endometriosis lead to impaired quality of life and pain chronification in young female patients.Aim. To study indicators of quality of life, anxiety, depression and pain syndrome in adolescents with peritoneal endometriosis (PE) over a one-year period of conservative therapy.Materials and methods. A total of 45 girls aged 13 to 17 years with a confirmed diagnosis of PE were enrolled in a prospective longitudinal study. Pain syndrome (VAS, McGill Pain Questionnaire), anxiety-depressive symptoms (Beck Depression Inventory (BDI), Hospital Anxiety and Depression Scale (HADS), Spielberger State-Trait Anxiety Inventory (STAI)), quality of life indicators (SF-36) were assessed before and after one year of treatment in female patients (dienogest administered continuously, NSAIDs and drotaverine for immediate pain relief only).Results. One year of therapy resulted in a significant decrease in the severity of dysmenorrhea and chronic pelvic pain, gastrointestinal symptoms and dysuria, daily activity and productivity impairment (p < 0.001) in girls with PE. In addition, the study demonstrated decreased indicators of anxiety and depressive disorders (BDI depression, HADS anxiety and depression, STAI reactive and personal anxiety (p < 0.001)) and an improvement in quality-of-life indicators (physical and psychological component, average index (p < 0.001)). There was a declining trend in blood hormone and inflammation test results within the reference range during treatment. The estradiol level has been shown to be a risk factor for high levels of affective disorder symptoms in adolescents with PE: STAI reactive anxiety (p = 0.046), HADS anxiety and depression (p = 0.044 and 0.033, respectively).Conclusion. The one-year therapy of PE in adolescents (dienogest administered continuously, a combination of NSAIDs and drotaverine in pain syndrome only) was associated with significantly improved quality of life, decreased severity of anxietydepressive disorders and pain, which confirms the need to start therapy when symptoms of the disease begin to show them-selves in adolescence.

Antibody Arrays Identified Cycle-Dependent Plasma Biomarker Candidates of Peritoneal Endometriosis.

Endometriosis is an estrogen-dependent inflammatory disease affecting women in their reproductive age. Due to non-specific symptoms, women with endometriosis are often misdiagnosed or are accurately diagnosed only after several years. Diagnosis of peritoneal endometriosis is especially challenging and relies only on laparoscopic surgery. To date, different molecules have been proposed as potential non-invasive biomarkers of endometriosis; however, none have been confirmed as clinically useful. Therefore, this study aimed to discover novel plasma biomarker candidates for peritoneal endometriosis using an antibody array platform. This study included patients with endometriosis-like symptoms characterized by the absence (controls) or presence of peritoneal endometriosis (cases) after laparoscopic surgery and histological evaluation. Patients were further divided into secretory and proliferative groups, according to the phase of their menstrual cycle. Their plasma samples were collected and analyzed on an antibody array platform targeting more than 1350 proteins with over 1820 antibodies. In the proliferative group, the analysis revealed three differential proteins between cases and controls: ITB3, ITA2B2, and ACVL-1. In the secretory group, none of the examined proteins reached the log-fold change (logFC) and significance thresholds simultaneously. The potential of the identified differential proteins as plasma biomarker candidates for peritoneal endometriosis should be evaluated on a larger cohort, and their role in endometriosis should be investigated in further studies.

Reliability of Visual Diagnosis of Peritoneal Endometriosis

Reliability of Visual Diagnosis of Peritoneal Endometriosis

Diverse applications for near infra-red intraoperative imaging.

Near infra-red angiography using Indocyanine Green (ICG) has increasingly used as a tool for intraoperative diagnostics. The aim of this review is to explore the applications of ICG fluorescence angiography with particular emphasis on general surgical applications. A literature review was conducted to identify and summarise the diverse range of applications of ICG fluorescence. ICG fluorescence angiography is increasingly used in a number of general surgical applications, including identification of colorectal liver metastases, assessment of skin flap perfusion, diagnosis of peritoneal endometriosis, ureteric identification, and localisation of colonic pathology. ICG fluorescence angiography has clinical application in many areas as a tool for guiding surgical resection. With the technological developments in near infra-red imaging it is likely that ICG fluorescence will play an increasing role in many routine surgical procedures.

Does the Size of Biopsy Correlate with Accuracy in the Diagnosis of Peritoneal Endometriosis?

Background: Accurate diagnosis of endometriosis at the time of laparoscopy is important in differentiating causes of pelvic pain and infertility. Rate of concordance between visual and pathology diagnosis is dependent on a variety of factors; however, there is little data available to recommend the optimal size of a peritoneal biopsy.

Massive Haemorrhagic Ascites and Pleural effusion: An Unusual Presentation of Endometriosis. A Case report and Literature Review

The association between endometriosis and haemorrhagic (bloody) ascites is rare.Since its first description by Brews in 1954,only a few sporadic cases have been reported in the literature. We report a case of massive haemorrhagic ascites associated with right-sided pleural effussion.Therapeutic paracentesis of eight litres of brownish haemorrhagic fluid and transfusion of blood and colloids led to short-term symptomatic relief.A histological diagnosis of peritoneal endometriosis was made by tissue obtained at percutaneous peritoneal biopsy.Conservative hormonal treatment using Danazole therapy led to a remission of disease activity. This case illustrates the uncommon presentation of a relatively common disorder,and represents one of the few potentially curable causes of haemorrhagic ascites .It also serves to emphasize the utility of a percutaneous peritoneal biopsy in the investi gation of exudative and bloody ascites of obscure origin. Key Words: Haemorrhagic ascites,pleural effusion,endometriosis,peritoneal biopsy Nigerian Medical Practitioner Vol.44(1) 2003: 22-24

Assessment of 5-aminolevulinic acid–induced porphyrin fluorescence in patients with peritoneal endometriosis

Objective: The purpose of this study was to examine the diagnostic potential for patients with endometriosis of porphyrin fluorescence after oral administration of 5-aminolevulinic acid. Study Design: Fifteen women referred for laparoscopy because of suspected endometriosis received 1 or 10 mg/kg 5-aminolevulinic acid orally. After 1.5 to 6 hours endoscopic fluorescence spectral analysis and video inspection were performed. Results: With 10 mg/kg 5-aminolevulinic acid and application intervals of >3 hours we observed a significantly higher porphyrin fluorescence in active peritoneal endometriosis than in adjacent normal peritoneum. Pigmented and nodular endometriosis showed weak to negative fluorescence. A strong fluorescence of the fimbrial mucosa was seen. A 1-mg/kg dose of 5-aminolevulinic acid was insufficient for fluorescence diagnosis. No side effects were recorded. Conclusion: Porphyrin fluorescence after oral administration of 5-aminolevulinic acid may be beneficial in diagnosis of peritoneal endometriosis. The strong fluorescence of fimbrial mucosa may limit the applicability of this technique in young women, however, because phototoxic damage cannot be excluded at present. (Am J Obstet Gynecol 2000;183:52-7.)

Peritoneal endometriosis: two-dimensional and three-dimensional evaluation of typical and subtle lesions.

Endometriosis most commonly affects the pelvic peritoneum close to the ovaries, including the uterosacral ligaments, the ovarian fossa peritoneum, and the peritoneum of the cul-de-sac. The increased diagnosis of endometriosis at laparoscopy can be explained by the increased experience and ability of the surgeon to detect such subtle lesions. The greatest change has been in the case of “subtle” lesions, which increased from 15% in 1986 to 65% in 1988. The diagnosis of peritoneal endometriosis at the time of laparoscopy is often made by the observation of typically puckered black or bluish lesions. There are, in addition, numerous subtle appearances of peritoneal endometriosis. These lesions, frequently nonpigmented, were diagnosed as endometriosis following confirmation by biopsy by Jansen and Russell in 1986.