Associated ovarian endometrioma is a marker for greater severity of deeply infiltrating endometriosis

Chapron, Charles; Piétin-Vialle, Claire; Borghese, Bruno; Davy, Céline; Foulot, H.; Chopin, Nicolás

doi:10.1016/j.fertnstert.2008.06.003

Cited by 166 publications

(126 citation statements)

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“…Um outro estudo 11 , que incluiu 500 mulheres com diagnóstico de EPI, observou que, na presença de endometrioma ovariano associado, o número médio de lesões de endometriose profunda foi superior. Para as mulheres com endometrioma ovariano associado, as lesões profundas de endometriose foram mais severas, com maior taxa de lesões em vagina, intestino e ureter.…”

Section: Discussionunclassified

“…Existe uma forte associação entre o endometrioma ovariano e a presença de doença pélvica extensa, EPI e comprometimento intestinal [9][10][11] . Dada a complexidade do tratamento cirúrgico da EPI 12-14 e a taxa considerável de potenciais complicações pós-operatórias 2,15 , é sensato e necessário que se identifiquem na investigação pré-operatória marcadores de severidade da doença para o aconselhamento adequado da paciente e para o planejamento cirúrgico apropriado 10 .…”

Section: Introductionunclassified

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Associação entre endometrioma ovariano e endometriose profunda infiltrativa

Kondo¹,

Ribeiro²,

Trippia³

et al. 2012

Rev. Bras. Ginecol. Obstet.

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ResumoOBJETIVO: Avaliar a associação do endometrioma ovariano e a presença de lesões de endometriose profunda infiltrativa (EPI) em uma amostra de mulheres do Sul do Brasil. MÉTODOS: Foi conduzida uma análise retrospectiva com informações dos prontuários de mulheres submetidas a tratamento cirúrgico de endometriose durante o período de janeiro de 2010 e junho de 2012. As pacientes foram divididas em dois grupos de acordo com a presença ou não de endometrioma ovariano. As pacientes portadoras de endometrioma ovariano foram subdivididas em dois grupos de acordo com o diâmetro do endometrioma (<40 e ≥40 mm). Os parâmetros comparados entre os grupos incluíram: dosagem sérica de cancer antigen (CA) 125, tamanho do endometrioma, presença e número de lesões profundas. A análise estatística foi conduzida com o programa Statistica versão 8.0, utilizando-se o teste exato de Fisher, o teste t de Student e o teste de Mann-Whitney, quando necessário. Os valores p<0,05 foram considerados estatisticamente significativos. RESULTADOS: Durante o período de estudo, um total de 201 mulheres foram submetidas a tratamento cirúrgico laparoscópico de endometriose. Cinquenta e seis pacientes (27,9%) eram portadoras de endometrioma ovariano e 180 pacientes (89,5%) apresentaram EPI confirmada histologicamente. As mulheres com endometrioma ovariano apresentaram um CA 125 sérico mais alto (39,5 versus 24,1 U/mL; p<0,01) e uma maior associação com a presença de lesões de EPI (98,2 versus 86,2%; p=0,01) e de EPI intestinal (57,1 versus 37,9%; p=0,01). Não houve diferença significativa quando se comparou os grupos com endometriomas <40 e ≥40 mm. CONCLUSÕES: O endometrioma ovariano é um marcador para a presença de lesões de EPI, incluindo EPI com comprometimento intestinal. Abstract PURPOSE:To evaluate the association between ovarian endometrioma and the presence of deep infiltrating endometriosis (DIE) lesions in a sample of women of the South of Brazil. METHODS: A retrospective study was conducted in all women undergoing surgical treatment of endometriosis from January 2010 to June 2012. Patients were divided into 2 groups according to the presence or not of ovarian endometrioma. Patients presenting an ovarian endometrioma were subsequently divided into 2 groups according to the diameter of the endometrioma (<40 and ≥40 mm). The following parameters were compared between the groups: cancer antigen (CA) 125 level, size of the endometrioma, presence and number of deep lesions. The statistical analysis was performed with Statistica version 8.0 using Fisher's exact test, Student's t-test and Mann-Whitney test, when needed. The p values of <0.05 were considered statistically significant. RESULTS: During the study period, a total of 201 women underwent laparoscopic surgical treatment of endometriosis. Fifty-five patients (27.9%) presented ovarian endometrioma and 180 patients (89.5%) presented DIE confirmed by pathologic examination. Women presenting an ovarian endometrioma had higher CA 125 levels (39.5 versus 24.1 U/mL; p<0.01) and stronger assoc...

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Section: Discussionunclassified

Section: Introductionunclassified

Associação entre endometrioma ovariano e endometriose profunda infiltrativa

Kondo¹,

Ribeiro²,

Trippia³

et al. 2012

Rev. Bras. Ginecol. Obstet.

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“…In these cases, patients usually refer to symptoms related to the site affected by the disease, such as intestinal and urinary cyclic alterations and deep dyspareunia, respectively 22 . Further, Chapron et al (2009) evaluated 500 patients with deep endometriosis and observed that presence of ovarian endometrioma can be a marker for severity of deeply infiltrating endometriosis and when the patient has severe dysmenorrhea, pain is probably due to deep lesions, mainly rectal infiltration, and not to the ovarian cyst 23,24 .…”

Section: Discussionmentioning

confidence: 99%

Th1 and Th2 immune responses related to pelvic endometriosis

Podgaec¹,

Dias²,

Chapron³

et al. 2010

Rev. Assoc. Med. Bras.

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“…Ovarian endometriomas are frequently associated with other endometriotic lesions [28], such as adhesions and DIE, which are not easy to diagnose. Underestimation of extensive adhesions in women with endometriomas before surgery is one of the main reasons why surgery is often incomplete [28], leading to repeat operations.…”

Section: Diagnostic Imaging and Implications For Treatmentmentioning

confidence: 99%

“…Underestimation of extensive adhesions in women with endometriomas before surgery is one of the main reasons why surgery is often incomplete [28], leading to repeat operations.…”

Section: Diagnostic Imaging and Implications For Treatmentmentioning

confidence: 99%

Imaging for the evaluation of endometriosis and adenomyosis

Exacoustòs

Manganaro

Zupi

2014

Best Practice & Research Clinical Obstetrics & Gynaecol

211

143

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Endometriosis affects between 5 and 45% of women in reproductive age, is associated with significant morbidity, and constitutes a major public health concern. The correct diagnosis is fundamental in defining the best treatment strategy for endometriosis. Therefore, non-invasive methods are required to obtain accurate diagnoses of the location and extent of endometriotic lesions. Transvaginal sonography and magnetic resonance imaging are used most frequently to identify and characterise lesions in endometriosis. Subjective impression by an experienced sonologist for identifying endometriomas by ultrasound showed a high accuracy. Adhesions can be evaluated by real-time dynamic transvaginal sonography, using the sliding sign technique, to determine whether the uterus and ovaries glide freely over the posterior and anterior organs and tissues. Diagnosis is difficult when ovarian endometriomas are absent and endometriosis causes adhesions and deep infiltrating nodules in the pelvic organs. Magnetic resonance imaging seems to be useful in diagnosing all locations of endometriosis, and its diagnostic accuracy is similar to those obtained using ultrasound. Transvaginal ultrasound has been proposed as first line-line imaging technique because it is well accepted and widely available. The main limitation of ultrasound concerns lesions located above the rectosigmoid junction owing to the limited field-of-view of the transvaginal approach and low accuracy in detecting upper bowel lesions by transabdominal ultrasound. A detailed non-invasive diagnosis of the extension in the pelvis of endometriosis can facilitate the choice of a safe and adequate surgical or medical treatment

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Associated ovarian endometrioma is a marker for greater severity of deeply infiltrating endometriosis

Cited by 166 publications

References 30 publications

Associação entre endometrioma ovariano e endometriose profunda infiltrativa

Associação entre endometrioma ovariano e endometriose profunda infiltrativa

Th1 and Th2 immune responses related to pelvic endometriosis

Imaging for the evaluation of endometriosis and adenomyosis

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