Endometriosis classification

Adamson, G. David

doi:10.1097/gco.0b013e328348a3ba

Cited by 106 publications

(71 citation statements)

References 42 publications

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“…64 For infertility patients diagnosed with endometriosis, the Endometriosis Fertility Index that has recently been emerged as a staging system superior to the rASRM in predicting pregnancy rates following surgical diagnosis and treatment of endometriosis. 65 For endometriosis-related pain, unfortunately, there is no better staging system yet.…”

Section: Discussionmentioning

confidence: 99%

Dating Endometriotic Ovarian Cysts Based on the Content of Cyst Fluid and its Potential Clinical Implications

et al. 2015

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This study was undertaken to test the hypotheses that, due to gradual accumulation of dead erythrocytes and their ingested products resulting from repeated hemorrhage, older endometriomas (whitish in color) contain chocolate fluid with higher iron content than younger (brownish/blackish in color) ones with concomitant higher collagen content and more adhesions. We recruited 30 premenopausal women with histologically confirmed ovarian endometriomas and collected samples of their endometriotic lesions and chocolate fluid and measured the viscosity, density, and the concentration of total bilirubin, ferritin, and free iron of the chocolate fluid. We also evaluated the lesion color and adhesion scores. In addition, we performed Masson trichrome and Picro-Sirius red staining on all endometriotic cysts and evaluated the extent of fibrosis in the lesions. We found that fluids taken from white-colored endometriomas had significantly higher concentration of total bilirubin, ferritin, and free iron, respectively, than black/brown-colored ones. In addition, older cysts had fluids that had significantly higher density and viscosity. Fluid density correlated positively with the concentrations of total bilirubin, ferritin, and free iron. Older lesions had significantly more collagen content and higher adhesion scores. Taken together, these data supports the notion that older cysts, having experienced more bleeding episodes, contain chocolate fluid that is higher in viscosity, density, and iron content and higher fibrotic content than younger ones. This provides another piece of evidence that endometriotic lesions are wounds that undergo repeated injury and repair, resulting ultimately fibrotic lesions that are resistant to hormonal treatment.

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Section: Discussionmentioning

confidence: 99%

Dating Endometriotic Ovarian Cysts Based on the Content of Cyst Fluid and its Potential Clinical Implications

et al. 2015

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“…This information might be useful in patients, especially those with severe endometriosis undergoing controlled ovarian stimulation (1). Putative serum markers (monocyte chemoattractant protein 1, migration inhibitory factor, leptin, and CA-125) improved their diagnostic capability to 73% of patients, with 94% overall accuracy (2). A new marker, HE4 (human epididymis secretory protein-4), could be used in the differential diagnosis of endometriosis cyst.…”

Section: Diagnosismentioning

confidence: 99%

Ovarian cystectomy in endometriomas: Combined approach

Ünlü

Yıldırım

2014

J Turkish German Gynecol Assoc

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Endometrioma is one of the most frequent adnexal masses in the premenopausal population, but the recommended treatment is still a subject of debate. Medical therapy is inefficient and can not be recommended in the management of ovarian endometriomas. The general consensus is that ovarian endometriomas larger than 4 cm should be removed, both to reduce pain and to improve spontaneous conception rates. The removal of ovarian endometriomas can be difficult, as the capsule is often densely adherent. While the surgical treatment of choice is surgical laparoscopy, for conservative treatment, the preferred method is modified combined cystectomy. Cystectomy can be destructive for the ovary, whereas ablation may be incomplete, with a greater risk of recurrence. To the best of our knowledge, the modified combined technique seems to be more efficient in the treatment of endometriomas. (J Turk Ger Gynecol Assoc 2014; 15: 177-89) Key words: Endometrioma, laparoscopy, cystectomy, combined technique Received: 25 August, 2014 Accepted: 29 August, 2014 Ovarian cystectomy in endometriomas: Combined approach This article will be credited by TMA within the scope of CME/CPD.

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“…Currently, The American Association of Gynecologic Laparoscopists is developing a categorization system that will be more focused on pain. 26 There has been recent progress in the development of a prognostic algorithm for fertility following surgery for endometriosis. The endometriosis fertility index (EFI) is a clinical tool that predicts pregnancy rates in patients with surgically documented endometriosis who attempt non-in vitro fertilization conception.…”

Section: Classification and Prognosismentioning

confidence: 99%

Defining Future Directions for Endometriosis Research: Workshop Report From the 2011 World Congress of Endometriosis in Montpellier, France

D’Hooghe²,

et al. 2013

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Endometriosis, defined as estrogen-dependent lesions containing endometrial glands and stroma outside the uterus, is a chronic and often painful gynecological condition that affects 6% to 10% of reproductive age women. Endometriosis has estimated annual costs of US $12 419 per woman (approximately €9579), comprising one-third of the direct health care costs with two-thirds attributed to loss of productivity. Decreased quality of life is the most important predictor of direct health care and total costs. It has been estimated that there is a mean delay of 6.7 years between onset of symptoms and a surgical diagnosis of endometriosis, and each affected woman loses on average 10.8 hours of work weekly, mainly owing to reduced effectiveness while working. To encourage and facilitate research into this debilitating disease, a consensus workshop to define future directions for endometriosis research was held as part of the 11th World Congress on Endometriosis in September 2011 in Montpellier, France. The objective of this workshop was to review and update the endometriosis research priorities consensus statement developed following the 10th World Congress on Endometriosis in 2008. 1 A total of 56 recommendations for research have been developed, grouped under 6 subheadings: (1) diagnosis, (2) classification and prognosis, (3) clinical trials, treatment, and outcomes, (4) epidemiology, (5) pathophysiology, and (6) research policy. By producing this consensus international research priorities statement, it is the hope of the workshop participants that researchers will be encouraged to develop new interdisciplinary research proposals that will attract increased funding support for work on endometriosis.

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Endometriosis classification

Abstract: The only validated endometriosis classification system that predicts a clinical outcome is the EFI. It is to be hoped that renewed interest in the importance and utility of classification systems will result in novel classification systems that are clinically useful.

Cited by 106 publications

References 42 publications

Dating Endometriotic Ovarian Cysts Based on the Content of Cyst Fluid and its Potential Clinical Implications

Dating Endometriotic Ovarian Cysts Based on the Content of Cyst Fluid and its Potential Clinical Implications

Ovarian cystectomy in endometriomas: Combined approach

Defining Future Directions for Endometriosis Research: Workshop Report From the 2011 World Congress of Endometriosis in Montpellier, France

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