Treatment Of Genital Endometriosis Research Articles

Ведение пациенток с генитальным эндометриозом: новые стратегии

Aim: To analyze modern approaches to the diagnosis and treatment of genital endometriosis. Key points. Endometriosis is one of the most common gynecological diseases, affecting mainly women of reproductive age, the main manifestations of which are chronic pelvic pain and infertility. Constant pelvic pain, which reduces the quality of life, leads to the fact that patients are in a state of prolonged stress, and they have behavioral disorders. According to the latest world recommendations, drug treatment is the first line of therapy for endometriosis, if pregnancy is not a priority at this stage. There are many imaging methods for diagnosing this disease, but the search for non-invasive markers of endometriosis that can reliably confirm the diagnosis is still ongoing. Conclusion. An interdisciplinary approach and the choice of adequate treatment for endometriosis at each stage of a woman's life can limit unnecessary surgery and better meet the needs of patients. Keywords: endometriosis, adenomyosis, chronic pelvic pain, progestins, dienogest, endometriosis markers.

Role of genes involved in the regulation of apoptosis in the pathogenesis of genital endometriosis. A literature review

BACKGROUND: The high prevalence, the lack of reliable data on the etiology, as well as the complexity of diagnosis and treatment of genital endometriosis indicate the urgency of the problem.
 AIM: The aim of this study was to analyze and summarize scientific publications devoted to the study of single-nucleotide polymorphisms involved in apoptosis and their association with endometriosis.
 MATERIALS AND METHODS: Based on keyword searches for gene, SNP, apoptosis, and endometriosis, a selection of papers published in open sources (PubMed and Google Scholar) in the period from 2010 to 2020 was performed.
 RESULTS AND CONCLUSIONS: An analysis of the main and auxiliary apoptotic pathways was performed, with the protein regulators and their genes detailed in accordance with the implementation of the programmed cell death cascade in genital endometriosis. The review identified the significance of a number of proteins (TNF-, FADD, CASP3, CASP7, CASP10) in the pathogenesis of hyperproliferative diseases. However, many apoptotic regulators (BCL2, BIK, BMF, HRK, BAD, Survivin) in genital endometriosis were found to have been understudied, which makes future research in this direction promising.

MODERN APPROACHES TO THE TREATMENT OF ENDOMETRIOID CYSTS BEFORE CONTROLLED OVARIAN STIMULATION PROTOCOLS

The article is devoted to the current problem of endometriosis-associated infertility. In recent years, a great deal of information has been accumulated on the etiology, diagnosis and treatment of genital endometriosis and endometriosis-associated infertility. According to world studies, endometriosis remains one of the most pressing problems in modern gynecology. This is evidenced by statistics showing that the disease occurs in every 10 women of fertile age, and a total of 176 million women worldwide. Approximately 20–50 % of women included in this number have a problem of infertility. Hence, the problem of this disease is not only a medical but also a social problem.
 Conclusions. The tactics of treatment of patients with endometriosis who are planning a pregnancy and are included in the ART protocols are significantly different from the tactics of treatment of patients who believe that they have performed reproductive function.

Клиническая эффективность агонистов дофамина в лечении генитального эндометриоза

Клиническая эффективность агонистов дофамина в лечении генитального эндометриоза

The efficacy of selective cyclooxygenase 2 inhibitors in the treatment of genital endometriosis

External genital endometriosis is characterized by the processes of angiogenesis, neurogenesis, impaired apoptosis, local inflammation of the tissues, secretion of estradiol, and cell proliferation. In a similar manner, prostaglandin E2 affects tissues. The safest drugs that overwhelm COX-2 activity and inhibit the expression of prostaglandin E2 are selective COX-2 inhibitors. As a mediator of inflammation, prostaglandin E2 is involved in all inflammatory processes. It induces the expression of local P450 aromatase and the anti-apoptotic gene Bcl-2. E2 also possesses immunosuppressive-mediated activity and inhibits the synthesis of cytokines IFNγ, TNFα, and IL-12, IL-1β-mediated expression of chemokines, the proliferation of T- and B-cells and reduces the cytotoxic activity of NK cells, creating a background of the immunosuppressive characteristic of endometriosis [1–3].
 This study included 100 patients of reproductive age (aged 22-35 years) with a confirmed diagnosis of external genital endometriosis of degree II–IV. Fifty patients received 100 mg of celecoxib in monotherapy and in combination with 2 mg of dienoguest. The control group included 50 people receiving monotherapy with 2 mg of dienogest. The effectiveness of therapy was assessed using the visual analog scale (VAS) and on the basis of the dynamics of algodismenorrhea, pain during coitus, clinical examination, and the patient’s subjective assessment of the degree of irritability and severity of depressive syndrome. The effectiveness of the treatment was evaluated according to MRI and ultrasound of the pelvic organs throughout the study. To control for possible complications of the therapy, the patients performed a comprehensive dynamic survey assessing the indicators of general blood analysis and the blood coagulation system. In the group with the combined application of celecoxib and dienoguest, a clinically significant reduction in pain syndrome and a decrease in the degree of irritability and depressive syndrome were noted relative to the control group. No side effects of celecoxib on the body systems were identified throughout the study. Thus, celecoxib can be recommended as a safe and effective combination therapy for endometriosis.

Генітальний ендометріоз у жінок з гіпотиреозом: патогенез, тактика лікування та профілактика рецидивів

The objective: rising of efficiency of treatment of genital endometriosis in combination with hypothyrosis and depression of frequency of recurrence on the basis of improvement and introduction of algorithm diagnostic, medical prophylactical and rehabilitational actions with use of modern endoscopic technologies and medicamental correction. Patients and methods. Аt first was carried out the analysis of frequency of extragenital pathology at 789 patients with an internal genital endometriosis, then we surveyed 110 patients who received conservative and 100 patients – expeditious treatment. Research methods: clinical, laboratory, tool, functional, morphological and statistical. Results. Аt women with various forms of genital endometriosis obligatory inspection of funcshionale condition of thyroid gland, the endocrinologic and immunologic status is necessary; at vibor of a method of expeditious treatment of women with genital endometriosis and hypothyrosis the preference should be given to endoscopic and vaginal techniques, and also organ-preserving volume; for postoperative aftertreatment of women with genital endometriosis and hypothyrosis the preference should be given to hormonal therapy, courses not less 6 months. Conclusion. Introduction of the received results will allow to increase efficiency of treatment of genital endometriosis as is conservative, and operative that increases quality of life of women. Key words: genital endometriosis, hypothyrosis, pathogenesis, treatment.

Melatonin and genital endometriosis - new possibilities of therapy

Presented literature review describes anti-estrogenic, anti-inflammatory, antioxidant, antiangiogenic, proapoptotic, antiproliferative and analgesic effects of melatonin, that allow to consider it as pathogenetically proved medication for treatment of genital endometriosis.

Treatment of genital endometriosis in women of late reproductive and premenopausal age

Treatment of genital endometriosis in women of late reproductive and premenopausal age

Medicosurgical Treatment of Genital Endometriosis Focusing on Gestagens and Antigestagens Together with Surgical Pelviscopy

Medicosurgical Treatment of Genital Endometriosis Focusing on Gestagens and Antigestagens Together with Surgical Pelviscopy

Non-ovlon treatment of patients with genital endometriosis

In the last decade, hormonal drugs, including synthetic progestins, have been widely used for the treatment of genital endometriosis.