Pain in endometriosis: effectiveness of medical and surgical management

Davis, Colin J.; McMillan, Lindsay

doi:10.1097/00001703-200312000-00009

Cited by 28 publications

(17 citation statements)

References 37 publications

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“…The symptoms of endometriosis are complex [22] and varied [23], although common symptoms are pelvic pain, menstrual disturbances, painful sexual intercourse, and fertility problems [16, 24]. Diagnosis of endometriosis is now usually made by laparoscopic surgery.…”

Section: Introductionmentioning

confidence: 99%

Why Do They Do It?

Treloar

Morley

Taylor

et al. 2007

Public Health Genomics

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Objective:This exploratory, pilot study aimed to investigate motivations and reflections of participants who had provided epidemiological information, blood samples and access to clinical records and data in a large genetic epidemiological study of endometriosis, a common multifactorial disorder affecting women. We also aimed to explore understanding of complex genetic or multifactorial conditions in general. Methods:In-depth interviews were conducted with 16 endometriosis study participants with diverse characteristics. Results:Interviewees generally described their participation in the genetic study using altruistic frameworks of reference. Themes that emerged included unquestioning willingness and consent to participate, little concern about privacy issues, desire for more information from the researchers about the condition rather than scientific progress, the benefits of research participation to family communication, and differing ideas about genetic influences on endometriosis. Specific features of endometriosis also influenced reflections on research participation experience. Conclusions:As increasing numbers of individuals and families in the community become involved in genetic epidemiological studies of common diseases, more extensive research will be needed to better understand their expectations with a view to improving researchers’ communications with study participants.

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Section: Introductionmentioning

confidence: 99%

Why Do They Do It?

Treloar

Morley

Taylor

et al. 2007

Public Health Genomics

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“…Four pregnancies were conceived using Intra-Uterine Insemination after ovarian induction in 4 women. The time to conception was 6.5 months (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Thirteen women in total tried IUI.…”

Section: Resultsmentioning

confidence: 99%

Outcome of Fertility after Radical Conservative Surgery in Grade III-IV Endometriosis Lesions: A Retrospective Analysis

Baekelandt¹,

Arne²,

Aelvoet³

et al. 2016

Int J Gynecol Clin Pract

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Purpose: Researching reproductive outcome after laparoscopic radical resection of grade III and IV endometrial lesions. Methods and Materials: A retrospective analysis of 54 women was carried out. The patients underwent laparoscopic radical resection in the Gynecology Department of a secondary health care center between January 2009 and December 2013. Diagnostic investigation, with histological confirmation of moderate to severe endometriosis, preceded surgical intervention in a multidisciplinary setting. Thirty seven of the 54 patients had an active desire for pregnancy. The outcome measure was the number of pregnancies in the subgroup of 37 women with an active desire for pregnancy. Results: Within the subgroup of 37 patients, 28 women became pregnant within the study period. Twelve patients became pregnant spontaneously and 16 had medically assisted pregnancies. Within the medically assisted group, 4 patients conceived after Intra-Uterine Insemination (IUI) and 12 after InVitro Fertilization (IVF). The pregnancy rate was 76%, a result similar to findings of earlier studies. Conclusion:The results of this retrospective analysis suggest that extensive laparoscopic surgery for moderate to severe endometriosis has a beneficial effect on fertility in both spontaneous and medically assisted pregnancies.

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“…[129][130][131] In some patients surgical removal of ectopic growths or the uterus as well as denervation are tried. 132 Apart from the above interventions, opioids and opioid analogues as well as antidepressants and anticonvulsants have been used with some success. Also, in some women, sensory stimulation techniques (acupuncture or TENS) as well as cognitive therapy may be tried as adjunctive treatments.…”

Section: Discussionmentioning

confidence: 99%

Is There a Role for Acupuncture in Endometriosis Pain, Or ‘endometrialgia’?

Lundeberg

Lund

2008

Acupunct Med

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Endometriosis is a common cause of pelvic pain in women, many of whom suffer a progression of symptoms over their menstrual life. Symptoms may include combinations of abnormal visceral sensations and emotional distress. Endometriosis pain, or ‘endometrialgia’ often has a negative influence on the ability to work, on family relationships and sense of worth. Endometrialgia is often considered to be a homogeneous sensory entity, mediated by a specialised high threshold sensory system, which extends from the periphery through the spinal cord, brain stem and thalamus to the cerebral cortex. However, multiple mechanisms have been detected in the nervous system responsible for the pain including peripheral sensitisation, phenotypic switches, central sensitisation, ectopic excitability, structural reorganisation, decreased inhibition and increased facilitation, all of which may contribute to the pain. Although the causes of endometrialgia can differ (eg inflammatory, neuropathic and functional), they share some characteristics. Endometrialgia may be evoked by a low intensity, normally innocuous stimulus (allodynia), or it may be an exaggerated and prolonged response to a noxious stimulus (hyperalgesia). The pain may also be spontaneous in the absence of any apparent peripheral stimulus. Oestrogens and prostaglandins probably play key modulatory roles in endometriosis and endometrialgia. Consequently many of the current medical treatments for the condition include oral drugs, like non-steroid anti-inflammatory drugs, contraceptives, progestogens, androgenic agents, gonadotrophin releasing hormone analogues, as well as laparoscopic surgical excision of the endometriosis lesions. However, management of pain in women with endometriosis is currently inadequate for many. Possibly acupuncture and cognitive therapy may be used as an adjunct.

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Pain in endometriosis: effectiveness of medical and surgical management

Abstract: Review of the current literature demonstrates that a combined medical and conservative surgical approach is beneficial for most women with endometriosis associated pelvic pain.

Cited by 28 publications

References 37 publications

Why Do They Do It?

Why Do They Do It?

Outcome of Fertility after Radical Conservative Surgery in Grade III-IV Endometriosis Lesions: A Retrospective Analysis

Is There a Role for Acupuncture in Endometriosis Pain, Or ‘endometrialgia’?

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