Recent Advances and Clinical Outcomes 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: 31 May 2024 | Viewed by 5254

Special Issue Editors


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Guest Editor
Gynecology, Obstetrics, Gynecological Oncology, Bethesda Hospital, 47053 Duisburg, Germany
Interests: deep endometriosis; adenomyosis; pelvic retroperitoneal surgery; transvaginal ultrasound; robotic surgery; laparo-scopic surgery; hysteroscopic surgery; endometrial cancer; cervical cancer; ovarian cancer

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Guest Editor
Univ Clin Gynecol, Carl Ossietzky University of Oldenburg, Pius Hosp, D-26121 Oldenburg, Germany
Interests: reproductive surgery; oncological surgery; minimal-access surgery; endometriosis surgery; gynecological surgery
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Special Issue Information

Dear Colleagues,

Thanks to important advances in ultrasound and MR imaging, the diagnostic approach to endometriosis has shifted from diagnostic laparoscopy to a complete pre-therapeutical staging and classification of the extent of the disease. This allows for a more tailored medical and surgical strategy. New surgical techniques including robotics guarantee more precise and tissue-sparing resections of endometriosis lesions with improved results and less complications. New medical treatment options like GnRH antagonist combination therapies offer promising outcomes. Additionally, a targeted therapy based on molecular profiling of the disease is looking to become a reality over the next few years as different international working groups move closer to understanding the phenotypes and genetics behind endometriosis. The new pace in endometriosis science has been made possible by increased awareness and national endometriosis strategies. The coming decade will bring an increasing number of relevant advances and thus more favorable outcomes. This Special Issue aims to focus on these novel advancements in all aspects of endometriosis and adenomyosis, showing the dynamic of the recent development and giving an overview on advances and perspectives.

Prof. Dr. Harald Krentel
Prof. Dr. Rudy Leon De Wilde
Guest Editors

Manuscript Submission Information

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Keywords

  • phenotypes
  • genetics
  • mRNA
  • robotic surgery
  • MR imaging
  • transvaginal ultrasound
  • deep endometriosis
  • GnRH antagonists
  • ICG
  • adhesions in endometriosis
  • infertility
  • adenomyosis and obstetrics
  • classification systems
  • microbiome
  • sexuality and endometriosis

Published Papers (3 papers)

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Research

14 pages, 3906 KiB  
Article
MRI-Based Radiomics as a Promising Noninvasive Diagnostic Technique for Adenomyosis
by Laurin Burla, Elisabeth Sartoretti, Manoj Mannil, Stefan Seidel, Thomas Sartoretti, Harald Krentel, Rudy Leon De Wilde and Patrick Imesch
J. Clin. Med. 2024, 13(8), 2344; https://doi.org/10.3390/jcm13082344 - 18 Apr 2024
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Abstract
Background: MRI diagnostics are important for adenomyosis, especially in cases with inconclusive ultrasound. This study assessed the potential of MRI-based radiomics as a novel tool for differentiating between uteri with and without adenomyosis. Methods: This retrospective proof-of-principle single-center study included nine patients with [...] Read more.
Background: MRI diagnostics are important for adenomyosis, especially in cases with inconclusive ultrasound. This study assessed the potential of MRI-based radiomics as a novel tool for differentiating between uteri with and without adenomyosis. Methods: This retrospective proof-of-principle single-center study included nine patients with and six patients without adenomyosis. All patients had preoperative T2w MR images and histological findings served as the reference standard. The uterus of each patient was segmented in 3D using dedicated software, and 884 radiomics features were extracted. After dimension reduction and feature selection, the diagnostic yield of individual and combined features implemented in the machine learning models were assessed by means of receiver operating characteristics analyses. Results: Eleven relevant radiomics features were identified. The diagnostic performance of individual features in differentiating adenomyosis from the control group was high, with areas under the curve (AUCs) ranging from 0.78 to 0.98. The performance of ML models incorporating several features was excellent, with AUC scores of 1 and an area under the precision-recall curve of 0.4. Conclusions: The set of radiomics features derived from routine T2w MRI enabled accurate differentiation of uteri with adenomyosis. Radiomics could enhance diagnosis and furthermore serve as an imaging biomarker to aid in personalizing therapies and monitoring treatment responses. Full article
(This article belongs to the Special Issue Recent Advances and Clinical Outcomes of Endometriosis)
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9 pages, 497 KiB  
Article
Changes in Endometriosis-Associated Symptoms Following Immunization against SARS-CoV-2: A Cross-Sectional Study
by Stefan Lukac, Thomas W. P. Friedl, Tobias Gruber, Marinus Schmid, Elena Leinert, Wolfgang Janni, Katharina Hancke and Davut Dayan
J. Clin. Med. 2024, 13(5), 1459; https://doi.org/10.3390/jcm13051459 - 02 Mar 2024
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Abstract
Background: There are many reports about variations in the menstrual cycle after infection with SARS-CoV-2 or vaccination against it. However, data on SARS-CoV-2 infection or vaccination-related changes in menstruation-associated endometriosis-typical symptoms such as dysmenorrhea, dyspareunia, dyschezia, dysuria, and bloating are rare or [...] Read more.
Background: There are many reports about variations in the menstrual cycle after infection with SARS-CoV-2 or vaccination against it. However, data on SARS-CoV-2 infection or vaccination-related changes in menstruation-associated endometriosis-typical symptoms such as dysmenorrhea, dyspareunia, dyschezia, dysuria, and bloating are rare or missing. Methods: This retrospective study was performed as an online survey among employees and students at the University Hospital Ulm, Germany. Changes regarding the presence of mentioned symptoms and after immunization (vaccination and/or infection) were evaluated with the McNemar Test. Additionally, the risk factors associated with these changes and associations between a subjectively perceived general change in menstruation and changes in the symptoms were evaluated. Results: A total of 1589 respondents were included in the final analysis. Less than 4% of respondents reported the occurrence of new symptoms that they had not experienced before immunization. Overall, there was a significant reduction in the presence of dysmenorrhea, back pain, dyschezia, bloating, and dyspareunia after immunization against coronavirus (p < 0.001). Only 2.3% of all participants reported to have been diagnosed with endometriosis. Factors associated with changes in endometriosis-typical symptoms following immunization were body mass index, age, endometriosis, and thyroid disease. Conclusions: Our results provide unique data about a reduction in the incidence of endometriosis-associated symptoms as dysmenorrhea, dyschezia, and dyspareunia after immunization against COVID-19. Full article
(This article belongs to the Special Issue Recent Advances and Clinical Outcomes of Endometriosis)
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16 pages, 3397 KiB  
Article
Diaphragmatic Endometriosis—A Single-Center Retrospective Analysis of the Patients’ Demographics, Symptomatology, and Long-Term Treatment Outcomes
by Antoine Naem, Argyrios Andrikos, Alin Stefan Constantin, Michael Khamou, Dimitrios Andrikos, Antonio Simone Laganà, Rudy Leon De Wilde and Harald Krentel
J. Clin. Med. 2023, 12(20), 6455; https://doi.org/10.3390/jcm12206455 - 11 Oct 2023
Cited by 2 | Viewed by 3299
Abstract
Diaphragmatic endometriosis is rare and forms 0.67–4.7% of all endometriosis cases. Evidence regarding its optimal management is lacking. In this study, we retrospectively analyzed the patient characteristics and long-term treatment outcomes of diaphragmatic endometriosis patients. Over a 4-year period, 23 patients were diagnosed [...] Read more.
Diaphragmatic endometriosis is rare and forms 0.67–4.7% of all endometriosis cases. Evidence regarding its optimal management is lacking. In this study, we retrospectively analyzed the patient characteristics and long-term treatment outcomes of diaphragmatic endometriosis patients. Over a 4-year period, 23 patients were diagnosed with diaphragmatic endometriosis. The majority of patients had coexisting deep pelvic endometriosis. Cyclic upper abdominal pain was reported by 60.9% of patients, while cyclic chest and shoulder pain were reported by 43.5% and 34.8% of patients, respectively. Most patients were treated with laparoscopic lesion ablation, while 21.1% were treated with minimally invasive excision. The mean follow-up time was 23.7 months. Long-lasting resolution of the chest, abdominal, and shoulder pain occurred in 50%, 35.7%, and 25% of patients, respectively. Nonetheless, 78.9% of patients reported major improvement in their symptoms postoperatively. Significantly higher rates of postoperative shoulder, abdominal, and chest pain were observed in patients who received postoperative hormonal therapy compared with those who did not. All patients treated expectantly remained stable. Therefore, we recommend treating diaphragmatic endometriosis only in symptomatic patients. The risk of incomplete surgery should be minimized by a multidisciplinary diagnostic and therapeutic approach with a careful assessment of the diaphragm and the thoracic cavity. Full article
(This article belongs to the Special Issue Recent Advances and Clinical Outcomes of Endometriosis)
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