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Endometriosis and Adenomyosis: Modern Concepts on Clinical Outcomes, Treatment and Management

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: 10 October 2024 | Viewed by 2997

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Special Issue Editor

Prof. Dr. Errico Zupi

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Guest Editor

Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic, University of Siena, 53100 Siena, Italy
Interests: endometriosis; adenomyosis; laparoscopic surgery; transvaginal ultrasound; hysteroscopy; pelvic anatomy

Special Issue Information

Dear Colleagues,

Endometriosis is a chronic benign disease which affects 10% of women worldwide. Adenomyosis affects 5–70% of women and is frequently associated with endometriosis. Both reduce the quality of life of patients by causing painful symptoms, abnormal uterine bleeding, and subfertility.

Nowadays, treatment includes several medical and surgical options. The choice of the most appropriate therapy is tailored to the patient according to age, painful symptoms, and desire of pregnancy.

In the last 10 years, researchers have investigated new medical therapies and experimented with new surgical techniques to achieve the best outcome in terms of control of symptoms, fertility, and quality of life.

Research is proceeding quickly. New findings and modern concepts in the near future can aid specialized and dedicated physicians in the management of endometriosis and adenomyosis.

The topics of this Special Issue will include (but are not limited to):

New medical treatments for endometriosis and adenomyosis;
Novel surgical approaches to endometriosis and adenomyosis;
Investigation of accepted treatments which could modify the outcome and the clinical management of endometriosis and adenomyosis patients.

Therefore, researchers in the field of endometriosis and adenomyosis are encouraged to submit original articles and reviews related to this Special Issue. Communications, systematic reviews, and meta-analyses are also welcome.

Prof. Dr. Errico Zupi
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

endometriosis
adenomyosis
management
outcome
surgical treatment
medical treatment
modern concepts

Published Papers (3 papers)

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Research

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11 pages, 665 KiB

Open AccessArticle

Women with Endometriosis—Who Is at Risk for Complications Associated with Pregnancy and Childbirth? A Retrospective Case–Control Study

by Teresa Mira Gruber, Laura Ortlieb, Wolfgang Henrich and Sylvia Mechsner

J. Clin. Med. 2024, 13(2), 414; https://doi.org/10.3390/jcm13020414 - 11 Jan 2024

Viewed by 878

Abstract

Women with endometriosis (EM), particularly the manifestations of adenomyosis (AM) and deep infiltrating endometriosis (DIE), suffer from pain and sterility. DIE also appears with several specific obstetric complications. To determine the risk profile, we designed a retrospective case–control study. Primary outcomes were defined as the risk of preterm birth and caesarean delivery (CD). Primiparous singleton pregnancies in women with DIE were compared with controls without EM. We matched for mode of conception and maternal age. A total of 41 women diagnosed with DIE and 164 controls were recruited. A total of 92.7% of the cases were also diagnosed with AM. Preterm birth occurred in 12.2% of cases and in 6.7% of controls. The difference was not statistically significant (OR: 1.932; 95% CI: 0.632–5.907). The rate of CD was similar in both groups. Remarkably, placental implantation disorders in the form of placenta praevia were eight times more frequent in women with DIE (9.8%) than in controls (1.2%, OR: 8.757; 95% CI: 1.545–49.614). Neonatal outcome was similar in both groups. Four out of fourteen cases reported abdominal wall endometriosis after CD. Women with DIE/AM and with placenta praevia are at risk of bleeding complications. After CD, they can develop abdominal wall EM. We therefore suggest evaluating the birth mode in each woman with DIE/AM. Full article

(This article belongs to the Special Issue Endometriosis and Adenomyosis: Modern Concepts on Clinical Outcomes, Treatment and Management)

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Review

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15 pages, 305 KiB

Open AccessReview

Artificial Intelligence in the Management of Women with Endometriosis and Adenomyosis: Can Machines Ever Be Worse Than Humans?

by Giulia Emily Cetera, Alberto Eugenio Tozzi, Valentina Chiappa, Isabella Castiglioni, Camilla Erminia Maria Merli and Paolo Vercellini

J. Clin. Med. 2024, 13(10), 2950; https://doi.org/10.3390/jcm13102950 - 16 May 2024

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Abstract

Artificial intelligence (AI) is experiencing advances and integration in all medical specializations, and this creates excitement but also concerns. This narrative review aims to critically assess the state of the art of AI in the field of endometriosis and adenomyosis. By enabling automation, AI may speed up some routine tasks, decreasing gynecologists’ risk of burnout, as well as enabling them to spend more time interacting with their patients, increasing their efficiency and patients’ perception of being taken care of. Surgery may also benefit from AI, especially through its integration with robotic surgery systems. This may improve the detection of anatomical structures and enhance surgical outcomes by combining intra-operative findings with pre-operative imaging. Not only that, but AI promises to improve the quality of care by facilitating clinical research. Through the introduction of decision-support tools, it can enhance diagnostic assessment; it can also predict treatment effectiveness and side effects, as well as reproductive prognosis and cancer risk. However, concerns exist regarding the fact that good quality data used in tool development and compliance with data sharing guidelines are crucial. Also, professionals are worried AI may render certain specialists obsolete. This said, AI is more likely to become a well-liked team member rather than a usurper. Full article

(This article belongs to the Special Issue Endometriosis and Adenomyosis: Modern Concepts on Clinical Outcomes, Treatment and Management)

18 pages, 3287 KiB

Open AccessReview

Deep Infiltrating Endometriosis in Adolescence: Early Diagnosis and Possible Prevention of Disease Progression

by Francesco Giuseppe Martire, Matteo Giorgi, Claudia D’Abate, Irene Colombi, Alessandro Ginetti, Alberto Cannoni, Francesco Fedele, Caterina Exacoustos, Gabriele Centini, Errico Zupi and Lucia Lazzeri

J. Clin. Med. 2024, 13(2), 550; https://doi.org/10.3390/jcm13020550 - 18 Jan 2024

Cited by 1 | Viewed by 1445

Abstract

Endometriosis has a prevalence of 10% worldwide in premenopausal women. Probably, endometriosis begins early in the life of young girls, and it is commonly diagnosed later in life. The prevalence of deep infiltrating endometriosis (DIE) in adolescence is currently unknown due to diagnostic limits and underestimation of clinical symptoms. Dysmenorrhea is a common symptom in adolescents affected by DIE, often accompanied by dyspareunia and chronic acyclic pelvic pain. Ultrasonography—either performed transabdominal, transvaginal or transrectal—should be considered the first-line imaging technique despite the potential for missed diagnosis due to early-stage disease. Magnetic resonance imaging should be preferred in the case of virgo patients or when ultrasonographic exam is not accepted. Diagnostic laparoscopy is deemed acceptable in the case of suspected DIE not responding to conventional hormonal therapy. An early medical and/or surgical treatment may reduce disease progression with an immediate improvement in quality of life and fertility, but at the same time, painful symptoms may persist or even recur due to the surgery itself. The aim of this narrative review is to report the prevalence of DIE in adolescents, describe the pathogenetic theories and discuss the management in adolescent women, including the challenging road to diagnosis and the treatment alternatives. Full article

(This article belongs to the Special Issue Endometriosis and Adenomyosis: Modern Concepts on Clinical Outcomes, Treatment and Management)

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