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Clinical Aspects of Diagnosis and Treatment of Endometriosis
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Clinical Aspects of Diagnosis and Treatment of Endometriosis

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

Deadline for manuscript submissions: 25 October 2024 | Viewed by 1770

Special Issue Editor

Dr. Cornelia Bachmann

E-Mail Website
Guest Editor
Department of Women’s Health Tübingen, Eberhard Karls University Tübingen, 72076 Tübingen, Germany
Interests: gynecologic oncology; endometriosis; surgery; basic and clinical research
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Endometriosis is a chronic gynecological disease affecting about 10% of women of childbearing age. It can affect various pelvic and abdominal organs and leads to a wide spectrum of symptoms including pain and infertility. Potential organ infiltration, e.g., into the ovaries, bowel, and bladder, can also lead to disfunction of affected organs. There are various hypotheses regarding the etiology, but this is still unclear. Endometriosis is characterized by the presence of endometrial-like tissue outside the uterus; these lesions are spread out in the abdominal cavity and differ in size. Superficial and deep infiltrating endometriosis is possible according to the type of organ or peritoneal infiltration.

The lesions can grow especially while pregnancy and relapses are possible. Medical or surgical therapy could be administered, while laparoscopy staging of endometriosis could be performed and the removal of endometriosis is possible to improve rate of fertility. Enzian classification is a tool for staging deep infiltrating endometriosis.

In recent years, the importance of economic, clinical and even diagnostic and therapeutic aspects is realized.

The aim of this Special Issue, entitled “Clinical Aspects of Diagnosis and Treatment of Endometriosis”, is to collect and publish original articles as well as reviews demonstrating advances in the diagnostic and therapeutic research field of endometriosis. In summary, better understanding in this field could also help clinicians better guide their patient toward suitable treatment decisions.

Dr. Cornelia Bachmann
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
  • surgery
  • ultrasound-guided surgery
  • diagnosis
  • treatment
  • complications

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Published Papers (2 papers)

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11 pages, 221 KiB  
Article
Pregnancy and Neonatal Outcomes in Women Treated for Bowel Endometriosis: A Seven-Year Single-Centre Retrospective Matched Cohort Study
by Vesna Šalamun, Gaetano Riemma, Tina Sirc, Eda Vrtacnik Bokal and Helena Ban Frangež
J. Clin. Med. 2024, 13(19), 5956; https://doi.org/10.3390/jcm13195956 - 7 Oct 2024
Viewed by 383
Abstract
Background/Objectives: Deep infiltrating endometriosis has been linked to worsened maternal and neonatal outcomes. However, reports regarding bowel endometriosis are still scanty. We aimed to evaluate pregnancy, delivery, and newborn adverse outcomes in women after laparoscopic-assisted surgery for bowel endometriosis. Methods: A single-center [...] Read more.
Background/Objectives: Deep infiltrating endometriosis has been linked to worsened maternal and neonatal outcomes. However, reports regarding bowel endometriosis are still scanty. We aimed to evaluate pregnancy, delivery, and newborn adverse outcomes in women after laparoscopic-assisted surgery for bowel endometriosis. Methods: A single-center retrospective cohort study was conducted at a tertiary-care university hospital. From January 2015 to December 2021, pregnant women who were diagnosed and treated for bowel endometriosis were matched using a 1:3 ratio with pregnant women with no history of endometriosis. Patients were matched using the Cox proportional hazards model to determine parity, age, BMI and gestational age-adjusted relative risk (aRR) with a 95% confidence interval (CI). Co-primary outcomes were the incidence of labor abnormalities and cesarean section (CS) rate. Co-secondary outcomes were incidence of complications related to pregnancy, delivery, and newborn. Results: A total of 71 pregnancies among women treated for bowel endometriosis and 213 from healthy controls were included. Patients requiring IVF/ET for getting pregnant were in the bowel endometriosis group relative to controls (43.7% vs. 11.7%; p < 0.001). Increased risk of labor abnormalities was present for bowel endometriosis relative to controls (21.1% vs. 17.4%; p = 0.040; aRR 1.39 [95% CI 1.06–2.05]). Risk of non-cephalic fetal presentation (14.1% vs. 6.1%; p = 0.016; aRR 3.08 [95% CI 2.03–4.68]), CS rate (43.7% vs. 24.9%; p = 0.003; aRR 1.75 [95% CI 1.23–2.49]), and emergent CS rate (19.7% vs. 8.5%; p = 0.009; aRR 2.21 [95% CI 1.55–3.16]) were significantly higher in women treated for colorectal endometriosis compared with controls. Moreover, placenta previa (9.9% vs. 0.0%; p < 0.001; aRR 21.82 [95% CI 2.19–116.40]), second-trimester hemorrhage (5.6% vs. 0.9%; p = 0.017; aRR 6.00 [95% CI 1.12–32.06]), postpartum hemorrhage (15.5% vs. 3.3%; p < 0.001; aRR 4.71 [95% CI 1.90–11.70]), and the need for transfusion during labor (5.6% vs. 0.5%; p = 0.004; aRR 12.00 [95% CI 1.36–105.60]) were increased in treatments vs. controls. Concerning neonatal outcomes, an increased risk for neonatal intensive care unit admission was seen in postsurgical endometriotic women relative to healthy controls (26.0% vs. 6.9%; p < 0.001; aRR 3.75 [2.04–3.86]). Conclusions: Women treated for bowel endometriosis seem more exposed to adverse pregnancy and neonatal outcomes relative to healthy controls. However, additional prospective and comparative studies are needed to validate the available evidence. Full article
(This article belongs to the Special Issue Clinical Aspects of Diagnosis and Treatment of Endometriosis)
10 pages, 439 KiB  
Article
Can Laparoscopic Surgery Reduce Fatigue in Women with Endometriosis?—A Pilot Study
by Theresa Reischer, Catherine Sklenar, Alexandra Perricos-Hess, Heinrich Husslein, Lorenz Kuessel, René Wenzl and Christine Bekos
J. Clin. Med. 2024, 13(11), 3150; https://doi.org/10.3390/jcm13113150 - 28 May 2024
Viewed by 978
Abstract
Background: Fatigue is mentioned as one of the most significant symptoms of endometriosis. The impact of laparoscopic endometriosis surgeries on fatigue remains unknown. The aim of this study was to investigate, for the first time, the effect of laparoscopic surgery in endometriosis patients, [...] Read more.
Background: Fatigue is mentioned as one of the most significant symptoms of endometriosis. The impact of laparoscopic endometriosis surgeries on fatigue remains unknown. The aim of this study was to investigate, for the first time, the effect of laparoscopic surgery in endometriosis patients, with the complete removal of endometriotic lesions, on the severity of fatigue. Methods: This is a single-center prospective pilot study including 58 participants. Participants were recruited at the Tertiary Endometriosis Referral Center of the Medical University of Vienna between February 2020 and November 2021. Thirty patients with histologically proven endometriosis were compared to a control group of 28 patients who underwent a laparoscopy for benign gynecologic conditions other than endometriosis. All participants were interviewed using the Fatigue Severity Scale before their surgery and 6 months afterward. Relationships between variables were established using regression analysis and associations were quantified as odds ratios. Results: Fatigue was significantly more severe preoperatively in patients with endometriosis when compared to controls ((odds ratio (OR): 1.82; 95% confidence interval (CI): 1.24–2.67, p < 0.01). Six months postoperatively, the fatigue severity score of endometriosis patients decreased significantly (p < 0.01). In multivariate analysis, fatigue was significantly associated with endometriosis (OR: 4.50, CI: 1.14–17.8, p < 0.05), when adjusted for abdominal pain and menstrual bleeding. Fatigue in patients with endometriosis was not associated with disease stage or the presence of deep endometriosis. Conclusions: Fatigue is a frequent and bothersome symptom in patients with endometriosis. Within our study, we demonstrated for the first time that fatigue responds to surgical treatment. The management of fatigue is crucial to improving patients’ quality of life. Full article
(This article belongs to the Special Issue Clinical Aspects of Diagnosis and Treatment of Endometriosis)
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