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Endometriosis: Diagnosis and Treatment

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

Deadline for manuscript submissions: 20 January 2026 | Viewed by 1985

Special Issue Editors


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Guest Editor
Camran Nezhat Institute, Center for Special Minimally Invasive and Robotic Surgery, Woodside, CA 94061, USA
Interests: endometriosis; infertility; fibroids; adenomyosis; MIS; reproductive surgery; robotic surgery
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Guest Editor
Nezhat Medical Center, Atlanta Center for Special Minimally Invasive Surgery and Reproductive Medicine, Atlanta, GA 30342, USA
Interests: minimally invasive surgeon; endometriosis; laparoscopy; robotic techniques
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Endometriosis is a chronic, often debilitating condition that affects an estimated 400 million–1 billion individuals globally. Despite its high prevalence and significant impact on quality of life, diagnosis and treatment remain complex and frequently delayed. This Special Issue aims to bring together leading research and clinical insights concerning the diagnosis and treatment of endometriosis, with a focus on advancing timely, accurate diagnostic methods, evidence-based therapeutic strategies, and multidisciplinary approaches to care.

We invite original research articles, reviews, clinical studies, and case reports that explore innovative diagnostic tools (including imaging and biomarker development), medical and surgical treatment modalities, long-term management strategies, fertility preservation, and the role of artificial intelligence and omics in personalized care. Submissions addressing disparities in access to care and quality of life outcomes are also encouraged.

By assembling a comprehensive body of work on endometriosis, this Special Issue seeks to foster collaboration across specialties, promote standardization of care, and ultimately improve outcomes for individuals affected by this complex disease.

Prof. Dr. Camran R. Nezhat
Dr. Ceana Nezhat
Guest Editors

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Keywords

  • endometriosis
  • diagnosis
  • video laparoscopy with and without robotic assistance
  • chronic pelvic pain
  • fertility preservation
  • minimally invasive surgery
  • biomarkers
  • artificial intelligence in endometriosis, adenomyosis, and adenomyoma care
  • multidisciplinary care
  • personalized medicine

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Published Papers (2 papers)

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Research

16 pages, 15554 KB  
Article
Selective Appendectomy in Patients Undergoing Minimally Invasive Surgery for Endometriosis: A Retrospective Cohort Study
by Camran Nezhat, Zahra Najmi, Maryam Mirzaie, Quincy Harding, Zoë Pennington, Nikki Amirlatifi, Rana Khaloghli, Dahnia Zarroug and Eric R. Sokol
J. Clin. Med. 2025, 14(20), 7277; https://doi.org/10.3390/jcm14207277 - 15 Oct 2025
Viewed by 711
Abstract
Background/Objectives: Endometriosis is a chronic inflammatory systemic disease that commonly affects bowel structures, including the appendix, where it may mimic or coexist with chronic appendicitis. Visual inspection alone often fails to detect appendiceal involvement, leading to underdiagnosis and suboptimal management. This study investigates [...] Read more.
Background/Objectives: Endometriosis is a chronic inflammatory systemic disease that commonly affects bowel structures, including the appendix, where it may mimic or coexist with chronic appendicitis. Visual inspection alone often fails to detect appendiceal involvement, leading to underdiagnosis and suboptimal management. This study investigates the prevalence and histopathologic spectrum of appendiceal abnormalities in patients undergoing minimally invasive laparoscopic surgery for endometriosis and evaluates the safety and postoperative outcomes of selective appendectomy. Methods: We conducted a retrospective cohort study of 236 patients who underwent a selective appendectomy concurrent with laparoscopic surgery for endometriosis with and without robotic assistance from January 2024 to April 2025. Preoperative evaluation included clinical assessment, imaging, and risk stratification using the Nezhat Endometriosis Risk Advisor tool, with some patients referred after positive ReceptivaDx testing. Intraoperatively, the appendix was examined for endometriosis, adhesions, or obliteration, and abnormal findings warranted removal using a vascular stapler. Postoperative outcomes and histopathologic results were assessed over six months, with appendiceal involvement analyzed in relation to endometriosis stage. Results: Of 236 patients who underwent selective laparoscopic appendectomy during surgical treatment for endometriosis, abnormal appendiceal pathology was identified in 216 (91.53%) patients. Histopathology revealed appendiceal endometriosis in 34 patients (14.41%), adhesions in 140 (59.32%), fibrous obliteration in 82 (34.75%), inflammation in 20 (8.47%), and neuroendocrine tumors in 3 (1.27%), one of which was malignant. Endometriotic lesions of the appendix showed a significant association with advanced-stage (III–IV) disease (p = 0.05), while other pathologies were not stage-dependent. No intraoperative complications occurred, and postoperative outcomes were favorable, with only one readmission unrelated to the appendectomy. Conclusions: Selective appendectomy during laparoscopic surgery for endometriosis revealed a high prevalence (91.5%) of appendiceal pathology. Even without visible implants, the appendix may contribute to symptoms, underscoring the importance of thorough intraoperative evaluation. Selective appendectomy based on surgical findings may aid symptom relief, prevent missed diagnoses, and enhance comprehensive management of endometriosis, but these potential benefits must be weighed against the small risks of concurrent appendectomy. Full article
(This article belongs to the Special Issue Endometriosis: Diagnosis and Treatment)
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8 pages, 565 KB  
Article
Diagnostic Tools for Endometriosis in Poland: A Comparative Assessment of Reliability and Out-of-Pocket Costs
by Anna Rogalska and Katarzyna Brukało
J. Clin. Med. 2025, 14(14), 4935; https://doi.org/10.3390/jcm14144935 - 11 Jul 2025
Viewed by 1001
Abstract
Objectives: This study aimed to assess the availability, diagnostic reliability, and out-of-pocket costs of endometriosis diagnostic tools available on the private healthcare market in Poland. Methods: A desk-based analysis was conducted from a patient perspective to identify commercially available diagnostic tests for endometriosis [...] Read more.
Objectives: This study aimed to assess the availability, diagnostic reliability, and out-of-pocket costs of endometriosis diagnostic tools available on the private healthcare market in Poland. Methods: A desk-based analysis was conducted from a patient perspective to identify commercially available diagnostic tests for endometriosis in Poland. Data were collected in September 2024 using relevant keywords to simulate a patient search process. Identified tests were evaluated for their compliance with the 2022 European Society of Human Reproduction and Embryology (ESHRE) guidelines. Key parameters, including sensitivity, specificity, and associated costs, were assessed based on the available literature. Out-of-pocket costs were compared between the private and public healthcare sectors. Results: Five diagnostic methods were identified in the private healthcare market: two imaging techniques (transvaginal ultrasound, magnetic resonance imaging) and three blood-based tests. None of the blood-based tests demonstrated sensitivity or specificity above 90%. Imaging techniques met this criterion. The cost of blood tests ranged from EUR 21.1 to EUR 467.77. The average private-sector cost for transvaginal ultrasound was EUR 111.64, representing a 482.6% increase compared to the public sector. Magnetic resonance imaging cost EUR 122.89 in the private sector, a 148.64% increase. Conclusions: The private Polish healthcare market lacks non-invasive diagnostic tests for endometriosis that achieve high reliability based on large study samples. Imaging tests, while reliable, pose significant financial barriers when accessed privately. Enhanced public access and clearer patient guidance are required to ensure timely and effective diagnosis. Full article
(This article belongs to the Special Issue Endometriosis: Diagnosis and Treatment)
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