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Endometriosis: Clinical Challenges and Prognosis
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Endometriosis: Clinical Challenges and Prognosis

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 November 2025 | Viewed by 3438

Special Issue Editor

Dr. Francisco Artacho-Cordon

E-Mail Website
Guest Editor
Department of Radiology and Physical Medicine, University of Granada, E-18016 Granada, Spain
Interests: women health; chronic pain; physical fitness; functional impairments; endometriosis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Endometriosis is among the most prevalent gynecologic diseases with estimated prevalence rates nearly 10% of women on reproductive age worldwide. Characterized by the presence of endome-trial-like tissue outside the uterine cavity, this complex condition causes a vast range of symptoms in suffering women, including both physical and mental problems, which in turn, ameliorates their quality of life. Conventional treatments for endometriosis usually include medical and surgical treatments, although elevated rates of treatment failure has been observed. Therefore, there is a need to optimize current treatment regimens as well as to explore new therapeutics that could improve quality of life of those women unresponsive to conventional treatments. Moreover, there is a need to develop non-invasive or minimally invasive diagnostic tools to reduce the large diagnostic delay observed in this disease.  

In this Special Issue, we invite researchers to contribute with manuscripts encompassing both clinical and preclinical studies, including but not limited to original articles, systematic reviews, meta-analyses, and study protocols. Submissions that utilize qualitative or mixed methods approaches to address unmet needs, identify barriers, or highlight research priorities are particularly encouraged.

Dr. Francisco Artacho-Cordon
Guest Editor

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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
  • therapy
  • rehabilitation
  • psychology
  • diagnostics
  • ultrasound imaging
  • metabolomics
  • prognosis

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Published Papers (4 papers)

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Research

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19 pages, 302 KiB  
Article
Quality of Life in Women with Endometriosis: The Importance of Socio-Demographic, Diagnostic-Therapeutic, and Psychological Factors
by Agnieszka Bień, Aleksandra Pokropska, Joanna Grzesik-Gąsior, Magdalena Korżyńska-Piętas, Agnieszka Pieczykolan, Marta Zarajczyk, Roya Ali Pour, Adrianna Frydrysiak-Brzozowska and Ewa Rzońca
J. Clin. Med. 2025, 14(12), 4268; https://doi.org/10.3390/jcm14124268 - 16 Jun 2025
Viewed by 607
Abstract
Background: Endometriosis is a chronic, estrogen-dependent inflammatory condition, that not only leads to significant physical symptoms but also exerts a profound psychological and social burden. This study aimed to asjsess the relationship between quality of life (QoL) in women with endometriosis and [...] Read more.
Background: Endometriosis is a chronic, estrogen-dependent inflammatory condition, that not only leads to significant physical symptoms but also exerts a profound psychological and social burden. This study aimed to asjsess the relationship between quality of life (QoL) in women with endometriosis and selected socio-demographic, diagnostic-therapeutic, and psychological factors, emphasizing self-efficacy and dispositional optimism as potential protective resources. Methods: A cross-sectional survey was conducted between 2020 and 2022 in healthcare facilities in eastern Poland. The study included 425 women diagnosed with endometriosis. The research tools were the Endometriosis Health Profile, the General Self-Efficacy Scale, and the Life Orientation Test-Revised, as well as an original socio-demographic and clinical questionnaire. Data were analyzed using descriptive statistics, linear regression, and hierarchical regression to assess the predictive role of psychological resources beyond sociodemographic and clinical variables. Results: A higher number of physicians from various specialties consulted before diagnosis was significantly associated with lower QoL in all EHP-30 domains except infertility (p < 0.05). The perceived economic burden of treatment was significantly related to lower QoL across all domains (p < 0.05). In contrast, higher levels of self-efficacy and dispositional optimism emerged as independent protective factors, positively associated with emotional well-being, social support, sexual functioning, and relationships with medical staff (p < 0.05). Psychological variables accounted for an additional 8.1% of the variance in QoL beyond socio-demographic and clinical predictors. Conclusions: The findings support the relevance of a biopsychosocial framework in managing endometriosis. Psychological resources play a critical role in coping with the disease and should be integrated into personalized care strategies. Full article
(This article belongs to the Special Issue Endometriosis: Clinical Challenges and Prognosis)
10 pages, 208 KiB  
Article
Unmet Needs of Endometriosis Patients with Respect to Health Care Services: A Qualitative Study Using a Patient Training Workshop
by María Angeles Martínez-Zamora, Georgina Feixas, Eva Palou, Eva Flo, Aida Mallorquí, Meritxell Gracia, Anne-Sophie Gresle, Joan Escarrabill and Francisco Carmona
J. Clin. Med. 2025, 14(10), 3504; https://doi.org/10.3390/jcm14103504 - 16 May 2025
Viewed by 340
Abstract
Background/Objectives: Nowadays, endometriosis is considered a chronic inflammatory disease and has a very high impact on women who suffer from it due to the symptoms of pain and infertility, as well as the delay in diagnosis. The objective of our study was to [...] Read more.
Background/Objectives: Nowadays, endometriosis is considered a chronic inflammatory disease and has a very high impact on women who suffer from it due to the symptoms of pain and infertility, as well as the delay in diagnosis. The objective of our study was to identify the unmet needs of endometriosis patients and to explore opportunities for improvement with respect to health care services for endometriosis patients using a patient training workshop. Methods: A qualitative study with a participatory action research method was performed. A two-day training workshop for patients was designed to allow them to develop the confidence and skills necessary to participate in the identification of unmet needs in their healthcare. Eighteen patients were selected by purposive sampling. After each training session, a debate on a topic of interest was also organized among all the participants. Data collection involved the nominal group technique with triangulation of data for their analysis. Results: The suggestions brought up during the sessions were divided into four areas of work: improvement of patient care, information and communication, training of professionals/patients, and encouragement of patients to participate. This study is a successful novel example of co-production with endometriosis patients and health care professionals and provides valuable information for future improvements in the care of these patients. Conclusions: Co-production between endometriosis patients and healthcare professionals allowed us to identify unmet needs in their healthcare. Full article
(This article belongs to the Special Issue Endometriosis: Clinical Challenges and Prognosis)
11 pages, 247 KiB  
Article
Multidimensional Evaluation of Myofascial Pelvic Pain and Other Comorbidities in Endometriosis Patients
by Lara Quintas-Marquès, Marta Valdés-Bango, Carla Box, Meritxell Gràcia, Mariona Rius, Francisco Carmona and Maria-Ángeles Martínez-Zamora
J. Clin. Med. 2025, 14(10), 3455; https://doi.org/10.3390/jcm14103455 - 15 May 2025
Viewed by 466
Abstract
Background/Objectives: Pain associated with endometriosis is complex and influenced by multiple factors. The presence of myofascial pelvic pain (MPP), associated comorbidities, and overlapping symptoms may play a role in endometriosis-associated pain. The aim of this study was to evaluate MPP in patients [...] Read more.
Background/Objectives: Pain associated with endometriosis is complex and influenced by multiple factors. The presence of myofascial pelvic pain (MPP), associated comorbidities, and overlapping symptoms may play a role in endometriosis-associated pain. The aim of this study was to evaluate MPP in patients with endometriosis and correlate it with other self-reported comorbidities and symptoms, health-related quality of life, and mental health. Methods: A cross-sectional study was carried out at a tertiary hospital referral center on 175 women with endometriosis. MPP was evaluated by clinical examination; if present, the patient was allocated to the MPP group (n = 84), and if absent, the patient was allocated to the non-MPP group (n = 91). Other comorbidities and symptoms frequently found in patients with chronic pain were also recorded. The Short Form 36-Item health questionnaire (SF-36) and the Hospital Anxiety and Depression Scale (HADS) were administered. Central sensitization-related symptoms were assessed using the Central Sensitization Inventory (CSI). Results: Patients with MPP showed significantly higher scores related to endometriosis-associated pain, reported lower scores in all domains of the SF-36, and higher scores in the HADS questionnaire. This group also reported more comorbid symptoms and showed higher scores in the CSI questionnaire. In the multivariate analysis, severe non-cyclic pelvic pain, abdominal bloating, and CSI ≥ 40 remained significantly associated with the presence of MPP. Conclusions: Endometriosis patients with MPP presented more pain comorbidities and general symptoms. Moreover, they reported more endometriosis-associated pain and worse health-related quality of life, and they may be at higher risk of depression and anxiety. Full article
(This article belongs to the Special Issue Endometriosis: Clinical Challenges and Prognosis)

Other

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8 pages, 21772 KiB  
Case Report
Deep Infiltrating Endometriosis of the Left Ureter Managed with Laparoscopic Ureterolysis Combined with Allium Ureteral Self-Expandable Stent: A Case Report
by Marcin Jozwik, Magdalena Miłobędzka, Joanna Wojtkiewicz, Jörg Neymeyer, Artur Jakimiuk and Maciej Jozwik
J. Clin. Med. 2024, 13(22), 6769; https://doi.org/10.3390/jcm13226769 - 11 Nov 2024
Viewed by 1547
Abstract
Introduction: In endometriosis, urinary tract involvement occurs in 1–5.5% of cases, where the ureter is affected in 9–23%. Unfortunately, endometriosis may remain asymptomatic even with significant anatomical progression. A delay in the diagnosis and treatment of ureteral endometriosis may result in hydronephrotic [...] Read more.
Introduction: In endometriosis, urinary tract involvement occurs in 1–5.5% of cases, where the ureter is affected in 9–23%. Unfortunately, endometriosis may remain asymptomatic even with significant anatomical progression. A delay in the diagnosis and treatment of ureteral endometriosis may result in hydronephrotic kidney damage and functional impairment. Methods: We present a case of a 36-year-old woman with a left ureteral stricture caused by deep infiltrating endometriosis accompanied by severe kidney-induced arterial hypertension. In March 2022, the patient underwent both laparoscopic excision/evaporation of deep infiltrating endometriosis from the left ovarian fossa and left ureterolysis, followed by an ureterorenoscopic dilatation of the left ureter via the placement of an Allium self-expandable stent. Results: This stent was successfully removed 18 months later. A computed tomography check-up confirmed normal ureteral patency with no signs of endometriosis. Elevated blood pressure also resolved. Conclusions: Deep infiltrating endometriosis can lead to asymptomatic yet serious complications. A successful treatment of ureteral endometriosis may require multidisciplinary management, including a simultaneous laparoscopic and ureterorenoscopic approach. Ureteral stent placement is a minimally invasive state-of-the-art solution for ureteral stricture(s) and should be considered the first choice in women of reproductive age suffering from ureteral deep infiltrating endometriosis. Full article
(This article belongs to the Special Issue Endometriosis: Clinical Challenges and Prognosis)
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