A Pilot Feasibility Multicenter Study of Patients After Excision of Endometriosis

Yeung, Patrick; Tu, Frank F.; Bajzak, Krisztina; Lamvu, Georgine; Guzovsky, Olga; Agnelli, Rob; Peavey, Mary; Winer, Wendy K.; Albee, R.; Sinervo, K

doi:10.4293/108680812x13517013317833

Cited by 8 publications

(3 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The prevalence of endometriosis was much higher in this patient population (with chronic pelvic pain failing medical therapy – as defined in “Methods”) – than that found in previous screening tool development (with prevalence ranging from 41% to 58.2%) (11, 25, 26). However, this figure for the SLU-CE of around 80% endometriosis patients was in agreement with a previous publication from the surgeon at a previous tertiary referral center (16). This prevalence of over 4 in 5 patients with chronic pelvic pain having endometriosis points to the importance of recognition of the disease (including atypical and subtle forms in early-stage endometriosis), systematic observation (with near-contact laparoscopy) (27) and histological confirmation of disease.…”

Section: Discussionsupporting

confidence: 93%

“…Patients eligible for participation in the study were women of reproductive age (defined as 13-55 years of age – the upper limit allowing for a range of ages for menopause occurring) reporting endometriosis-associated chronic pelvic pain defined as (i) 3 months of pelvic pain (average pain intensity >5/10), localized predominantly to the pelvic region (between the umbilicus and thighs) (15, 16); (ii) pain that persisted despite having tried one class of medical treatments (e.g., over-the-counter antiinflammatories or hormonal suppression with oral contraceptives); and (iii) pain that included at least one pelvic visceral pain component (dysmenorrhea, dyspareunia, dyschezia or dysuria).…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Development of a Symptom-Based, Screening Tool for Early-Stage Endometriosis in Patients with Chronic Pelvic Pain

Yeung

Bazinet

Gavard

2014

Journal of Endometriosis and Pelvic Pain Disorders

Self Cite

View full text Add to dashboard Cite

Purpose The aim of this study was to develop a noninvasive screening tool for patients with chronic pelvic pain, for early-stage endometriosis, with a discriminatory ability of the area under the curve (AUC) for the receiver operator characteristic (ROC) curve of over 0.8. Methods Participants were women aged 13-55 years, with chronic pelvic pain (for more than 6 months despite medical therapy), seen at the Saint Louis University Center for Endometriosis, from January 2012 to June 2013, who were found to have early-stage endometriosis or not, based on histology. All patients received the same surgical approach and goal of surgery, which was excision of all visible abnormal peritoneum. Potential variables used for generating the screening tool came from the pre-operative questionnaire with standard pain symptoms and quality-of-life questions. Individual categorical variables were tested. In addition, new binary variables were created to test specific combinations of answers to 2 individual questions. A backwards-stepping multiple logistic regression model was used to develop the screening tool. Results Ninety patients found to have early-stage disease completed pre-operative surveys. Of these, 70 (77.8%) had histologically confirmed endometriosis and 20 (22.2%) were confirmed not to be affected. Combinations of 2 variables made it possible to create a predictive model for early-stage endometriosis with excellent discriminatory ability (AUC = 0.822, p<0.001). This model was generated using a multi-staged, backwards stepping logistic regression analysis with all variables that were univariately significant included in the initial model (p<0.025). The final model had 80.5% sensitivity and 57.7% specificity. The model allows for an individual probability of disease to be calculated for each patient. Conclusions A clinically useful, symptom-based screening tool was developed for early-stage endometriosis in patients with chronic pelvic pain seen at a referral center. This approach to developing a screening tool for endometriosis should be tested further.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Methodsmentioning

confidence: 99%

Development of a Symptom-Based, Screening Tool for Early-Stage Endometriosis in Patients with Chronic Pelvic Pain

Yeung

Bazinet

Gavard

2014

Journal of Endometriosis and Pelvic Pain Disorders

Self Cite

View full text Add to dashboard Cite

show abstract

“…In addition, the follow-up interviews were performed mainly face-to-face, reducing the risk of recall bias. Our follow-up rate was high compared to other studies (61.61% in Yeung et al, 60.3% in Riley et al [ 70 , 71 ]).…”

Section: Discussioncontrasting

confidence: 57%

When and how should peritoneal endometriosis be operated on in order to improve fertility rates and symptoms? The experience and outcomes of nearly 100 cases

Dückelmann

Taube

Abesadze

et al. 2021

Arch Gynecol Obstet

View full text Add to dashboard Cite

Purpose To analyze the follow-up results of patients suffering from symptomatic early-stage endometriosis after a consistent laparoscopic peritoneal stripping of the altered peritoneum (peritoneal endometriosis and surrounding inflamed tissue) was performed. This type of endometriosis is resistant to medical therapy and/or impairs fertility. Methods Using our prospectively maintained database, we were able to identify all symptomatic women with the suspicion of only peritoneal endometriosis who underwent laparoscopy at our endometriosis center over a period of 5 years. All procedures were carried out in a standardized fashion by one single surgeon, who is highly experienced in minimal invasive surgery, and included a suspended hormonal pretreatment for 2 months. Postoperative outcomes including complications, fertility and recurrence rates were analysed. Results Laparoscopic peritonectomy was performed on 94 women. Follow-up data were available in 87% of these cases. At the time of surgery, almost all patients tested showed signs of stage I or II endometriosis (44.7 and 48.9%, respectively). More than three-quarters of the women reported pain relief, inter alia, due to the post-surgical hormonal therapy. About one-third of the patients wanted to have children after the procedure. 62% of them became pregnant and the majority did so without the need for assisted reproductive therapy. In seven women a re-operation was performed. Conclusion According to our data, a consistent excision of altered peritoneum followed by adjuvant hormonal therapy and multimodal concepts results in better outcomes for the patient, particularly in regards to pregnancy and recurrence rates.

show abstract

The effect of acupuncture on pain, dyspareunia, and quality of life in Brazilian women with endometriosis: A randomized clinical trial

Sousa

Souza

Zomkowisk

et al. 2016

Complementary Therapies in Clinical Practice

View full text Add to dashboard Cite

A Pilot Feasibility Multicenter Study of Patients After Excision of Endometriosis

Abstract: A multicenter prospective study evaluating the management of endometriosis comparing excision versus ablation is needed using primary outcomes other than chronic pelvic pain.

Cited by 8 publications

References 12 publications

Development of a Symptom-Based, Screening Tool for Early-Stage Endometriosis in Patients with Chronic Pelvic Pain

Development of a Symptom-Based, Screening Tool for Early-Stage Endometriosis in Patients with Chronic Pelvic Pain

When and how should peritoneal endometriosis be operated on in order to improve fertility rates and symptoms? The experience and outcomes of nearly 100 cases

The effect of acupuncture on pain, dyspareunia, and quality of life in Brazilian women with endometriosis: A randomized clinical trial

Contact Info

Product

Resources

About