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Diagnosis and Therapeutic Advances in Endometriosis
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Diagnosis and Therapeutic Advances in Endometriosis

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Women’s and Children’s Health".

Deadline for manuscript submissions: 5 May 2027 | Viewed by 5293

Special Issue Editors

Dr. Carmen Bianca Crivii

E-Mail Website
Guest Editor
Morpho-Functional Sciences Department, Iuliu Hațieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
Interests: morphology and embryology; oncology; artificial intelligence; machine learning algorithms; textural analysis; mpMRI
Special Issues, Collections and Topics in MDPI journals
Dr. Roxana-Denisa Capraș

E-Mail Website
Guest Editor Assistant
Department of Anatomy and Embryology, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
Interests: anatomy; infectious diseases; medical ethics; medical informatics; surgery; obstetrics and gynecology; nutrition and dietetics

Special Issue Information

Dear Colleagues,

Endometriosis is a chronic, often debilitating gynecological disorder that affects millions of women worldwide. Despite significant progress, clinical management of the disorder remains challenging, and optimal strategies for diagnosis and management continue to evolve. Given the multifaceted nature of this disease, which impacts not only reproductive health but also general well-being, advancing our understanding is crucial for improving patient outcomes.

We are pleased to invite you to contribute to this Special Issue, which aims to explore current advances in the causation, diagnosis, and management of endometriosis. This topic aligns closely with the interdisciplinary scope of Healthcare, promoting innovative, patient-centered approaches in medicine and public health.

In this Special Issue, original research articles and comprehensive reviews are welcome. Research areas may include (but are not limited to) endometriosis causation, novel diagnostic tools, advances in surgical and medical therapies, reproductive outcomes, quality of life assessments, and interdisciplinary models of care.

We look forward to receiving your contributions.

Dr. Carmen Bianca Crivii
Guest Editor

Dr. Roxana-Denisa Capraș
Guest Editor Assistant

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 250 words) can be sent to the Editorial Office for assessment.

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. Healthcare 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 2700 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

  • pathophysiology
  • diagnosis
  • therapeutic strategies
  • reproductive health
  • chronic pelvic pain
  • minimally invasive surgery
  • fertility preservation
  • quality of life
  • women’s health

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Review

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18 pages, 869 KB  
Review
Non-Invasive Methods for Early Diagnosis of Endometriosis—A Comprehensive Narrative Literature Review
by Adriana Ioana Gaia-Oltean, Dan Boitor, Laura-Ancuta Pop, Geanina Galea, Teodora Telecan and Romeo Micu
Healthcare 2025, 13(24), 3276; https://doi.org/10.3390/healthcare13243276 - 13 Dec 2025
Cited by 2 | Viewed by 1386
Abstract
Endometriosis is a common gynecological pathology, with an incidence of nearly 10% in patients of reproductive age, and is still underdiagnosed. A thorough and well-spread diagnostic study of endometriosis based on epigenetic factor dysregulation can highlight potential areas for improvement. To quantify the [...] Read more.
Endometriosis is a common gynecological pathology, with an incidence of nearly 10% in patients of reproductive age, and is still underdiagnosed. A thorough and well-spread diagnostic study of endometriosis based on epigenetic factor dysregulation can highlight potential areas for improvement. To quantify the potential and utility of non-invasive tools in the early diagnosis of endometriosis, an overview of current knowledge on epigenetic factors, based on DNA and RNA, is presented. Among these tools, it is important to highlight the role of miRNAs (microRNAs), cfDNA (cell-free DNA), and rRNAs (ribosomal RNAs), which are small molecules involved in endometriosis and numerous other pathologies. To evaluate their potential and utility in endometriosis, a salivary miRNA diagnostic test was conducted, the cfDNA methylation patterns of fragmented DNA circulating in bodily fluids (e.g., plasma) were analyzed, and cervical and uterine microbiomes were profiled for bacterial rRNA in patients with clinical suspicion of incipient endometriosis. Specific molecular profiles associated with endometriosis were analyzed. The first profile, a 109-miRNA saliva signature, was validated as a product of miRNA biomarkers and artificial intelligence modeling. In addition, peripheral blood cfDNA methylation biomarkers were identified by investigating nine genes in a molecular signature that requires validation. A profile was also obtained from cervical swabs and uterine washes, including molecular analysis of 16S rRNA amplicon sequencing to evaluate alterations in the cervical bacterial community. This review aims to optimize the integration of a non-invasive diagnostic tool for early endometriosis diagnosis. Genetic biomarkers can be correlated with clinical factors to improve diagnostic accuracy. Of the assessed diagnostic tools, salivary miRNA tests, a peripheral blood cfDNA methylation biomarker, and a microbiome rRNA signature may be useful for early diagnosis of endometriosis, as well as, implicitly, therapeutic attitude and follow-up. Full article
(This article belongs to the Special Issue Diagnosis and Therapeutic Advances in Endometriosis)
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Other

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20 pages, 2127 KB  
Systematic Review
The Diagnostic Performance of Transvaginal Ultrasound for Posterior Compartment Endometriosis Compared to Laparoscopic and Histopathological Findings: A Systematic Review
by Roxana-Denisa Capraș, Iulia Clara Badea, Mădălina Moldovan, Adriana Ioana Gaia-Oltean, Alexandru-Florin Badea and Teodora Telecan
Healthcare 2025, 13(20), 2548; https://doi.org/10.3390/healthcare13202548 - 10 Oct 2025
Viewed by 3086
Abstract
Background: Deep infiltrating endometriosis (DIE) frequently affects the posterior pelvic compartment, where accurate non-invasive imaging is essential for diagnosis and surgical planning. Aim: This systematic review evaluates the diagnostic performance of transvaginal ultrasound (TVUS) in detecting posterior compartment DIE, specifically rectosigmoid lesions, uterosacral [...] Read more.
Background: Deep infiltrating endometriosis (DIE) frequently affects the posterior pelvic compartment, where accurate non-invasive imaging is essential for diagnosis and surgical planning. Aim: This systematic review evaluates the diagnostic performance of transvaginal ultrasound (TVUS) in detecting posterior compartment DIE, specifically rectosigmoid lesions, uterosacral ligament involvement, and pouch of Douglas obliteration. Material and Methods: A comprehensive literature search of PubMed, Scopus, and Web of Science was performed for studies published between 2015 and 2025. Eligible studies assessed the accuracy of TVUS for posterior compartment DIE using laparoscopy and histology as reference standards. Data on sensitivity, specificity, and overall diagnostic accuracy were extracted or derived. The study’s quality was evaluated using the QUADAS-2 tool. Results: Thirty eligible studies were included. The mean sensitivities and specificities reported in the included studies reached 83.05% and 90.53% for rectosigmoid disease, 78.07% and 90.49% for uterosacral ligament involvement, and 79.58% and 89.75% for pouch of Douglas obliteration, respectively. Adjunctive techniques such as gel sonovaginography, rectal water contrast, or saline instillation into the pouch of Douglas were described, but their use was inconsistent. Marked heterogeneity in patient preparation, scanning protocols, and reporting limited comparability across studies. Despite this, TVUS demonstrated diagnostic performance within a similar range to that reported for MRI in prior systematic reviews, with the advantages of lower cost, accessibility, and integration into routine gynecological practice. Conclusions: TVUS is consistently reported as a reliable and cost-effective imaging modality and, in line with international guidelines, should be considered the first-line option for posterior compartment DIE, though further standardization of scanning and reporting protocols is needed to optimize reproducibility and clinical utility. Full article
(This article belongs to the Special Issue Diagnosis and Therapeutic Advances in Endometriosis)
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