Current and Prospective Treatment of Adenomyosis

Sharara, Fady I.; Kheil, Mira; Féki, Anis; Rahman, Sara; Klebanoff, Jordan S.; Ayoubi, Jean Marc; Moawad, Gaby

doi:10.3390/jcm10153410

Cited by 31 publications

(43 citation statements)

References 91 publications

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“…Since the IIA provides the main blood supply to the uterus, it is also crucial in the development of a range of uterine pathologies such as adenomyosis [15] and uterine broids [16]. Both those conditions are exacerbated by an excessive blood supply from the uterine artery, which is why uterine artery embolization (UAE) provides effective treatment.…”

Section: Discussionmentioning

confidence: 99%

Branching Pattern of the Internal Iliac Artery Accompanied by a Venous Anastomosis: Rare Vascular Variations

Kula

Olewnik

Ruzik

et al. 2022

Preprint

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The ability to navigate the complex and often deceptive branching patterns of the internal iliac artery can be decisive in planning and performing surgeries within the lesser pelvis. The following case report presents a peculiar quadruple division of the internal iliac artery, accompanied by a venous anastomotic structure. Apart from the posterior and anterior trunks, the superior vesicle and iliolumbar arteries arose independently from the internal iliac artery. The division was surrounded by a venous oval, compressing certain branches and potentially complicating surgical access. Clinical significance of the case is discussed. Knowledge of this anatomical variation is significant for both diagnosis and surgery.Level of Evidence – II Basic Science Research

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Section: Discussionmentioning

confidence: 99%

Branching Pattern of the Internal Iliac Artery Accompanied by a Venous Anastomosis: Rare Vascular Variations

Kula

Olewnik

Ruzik

et al. 2022

Preprint

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“…Current therapeutic options mostly rely on conservative hormonal therapies. Hereby, combined hormonal therapy and, especially, progestins seems to represent the cornerstone of medications, being also able to inhibit cell proliferation, inflammation, neurogenesis and neovascularization in endometriosis ( 12 , 13 ). However, for yet unclear mechanisms, some forms seem to be characterized by progesterone resistance, being thus refractory to conventional medical therapy ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

Antiangiogenic Therapy as a New Strategy in the Treatment of Endometriosis? The First Case Report

et al. 2021

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Angiogenesis plays a pivotal role in implantation and development of ectopic endometrial lesions. Thus, the potential usefulness of anti-angiogenic therapies has been speculated. Several reports describe their usefulness in animal models. Nonetheless this therapy has not been tested on humans yet. Here we report the outcome of a patient treated for a severe endometriosis with Bevacizumab (Avastin®), a monoclonal antibody directed against the vascular endothelial growth (VEGF). After a first-look laparoscopy with confirmatory biopsies was performed, three doses of Bevacizumab at 2-week intervals were administered. The therapy showed a well-tolerated profile and the prompt disappearance of the therapy-refractory chronic dysmenorrhea. A suppression of metabolic activity at the PET-scan compared to the basal one performed at diagnosis was also recorded. Furthermore, compared to the diagnostic biopsies prior the treatment, we documented a shift in the hormonal receptors profile toward a higher expression of progesterone and estrogen receptors in the endometriotic lesions.

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“…The progression of adenomyosis lesions with hypertrophic myometrium is enhanced by estrogen and abrogated by progesterone [ 136 ]. For those reasons, hormonal treatments such as GnRH agonists, progestins, and oral contraceptives have been used to suppress pain symptoms and abnormal heavy menorrhagia [ 132 , 151 , 152 ]. GnRH agonists are effective in causing systemic hypoestrogenism to reduce the size of adenomyosis and improve adenomyosis-associated symptoms [ 153 , 154 , 155 ], whereas the side effects of GnRH agonists (menopausal symptoms) limit their use.…”

Section: Adenomyosismentioning

confidence: 99%

“…LNG-IUD has been considered most effective and successfully used to treat adenomyosis because it is efficient in suppressing menstrual bleeding [ 156 , 157 , 158 , 159 , 160 ]. The efficacy of LNG-IUD is generally higher than other progestin-based treatments [ 151 , 152 ]. This is because LNG-IUD consistently suppresses the menstrual cycle.…”

Section: Adenomyosismentioning

confidence: 99%

Progesterone Actions and Resistance in Gynecological Disorders

MacLean

Hayashi

2022

Cells

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Estrogen and progesterone and their signaling mechanisms are tightly regulated to maintain a normal menstrual cycle and to support a successful pregnancy. The imbalance of estrogen and progesterone disrupts their complex regulatory mechanisms, leading to estrogen dominance and progesterone resistance. Gynecological diseases are heavily associated with dysregulated steroid hormones and can induce chronic pelvic pain, dysmenorrhea, dyspareunia, heavy bleeding, and infertility, which substantially impact the quality of women’s lives. Because the menstrual cycle repeatably occurs during reproductive ages with dynamic changes and remodeling of reproductive-related tissues, these alterations can accumulate and induce chronic and recurrent conditions. This review focuses on faulty progesterone signaling mechanisms and cellular responses to progesterone in endometriosis, adenomyosis, leiomyoma (uterine fibroids), polycystic ovary syndrome (PCOS), and endometrial hyperplasia. We also summarize the association with gene mutations and steroid hormone regulation in disease progression as well as current hormonal therapies and the clinical consequences of progesterone resistance.

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Current and Prospective Treatment of Adenomyosis

Cited by 31 publications

References 91 publications

Branching Pattern of the Internal Iliac Artery Accompanied by a Venous Anastomosis: Rare Vascular Variations

Branching Pattern of the Internal Iliac Artery Accompanied by a Venous Anastomosis: Rare Vascular Variations

Antiangiogenic Therapy as a New Strategy in the Treatment of Endometriosis? The First Case Report

Progesterone Actions and Resistance in Gynecological Disorders

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