Endometriotic Lesions (endometriotic + lesion)

Distribution by Scientific Domains


Selected Abstracts


Magnetic resonance imaging in the evaluation of (deep infiltrating) endometriosis: The value of diffusion-weighted imaging

JOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 5 2010
M.P.H. Busard MD
Abstract Purpose To assess the value of magnetic resonance (MR) diffusion-weighted imaging (DWI) in the evaluation of deep infiltrating endometriosis (DIE). Materials and Methods In a prospective single-center study, DWI was added to the standard MRI protocol in 56 consecutive patients with known or suspected endometriosis. Endometriotic lesions as well as (functional) ovarian cysts were analyzed for location, size, and signal intensity on T1, T2, and DWI. Apparent diffusion coefficient (ADC) values were calculated using b-values of 50, 400, 800, and 1200 s/mm2. Statistical analysis included the Spearman correlation coefficient, Mann,Whitney U, and Kruskal,Wallis tests. Results A total of 112 lesions (62 endometrial cysts and 48 DIE) were detected, 60 of which were large enough to analyze. Mean ADC values of endometrial cysts and functional ovarian cysts were 1.11 × 10,3/mm2/s and 2.14 × 10,3/mm2/s, respectively. Mean ADC values of DIE retrocervical, infiltrating the colon, and bladder were 0.70 × 10,3/mm2/s, 0.79 × 10,3/mm2/s, and 0.76 × 10,3/mm2/s, respectively. ADC values of DIE did not show a significant difference between varying pelvic locations (P = 0.63). Conclusion Results of our study suggest that ADC values of DIE are consistently low, without significant difference between pelvic locations. J. Magn. Reson. Imaging 2010;31:1117,1123. © 2010 Wiley-Liss, Inc. [source]


Adolescent endometriosis in the Waikato region of New Zealand , A comparative cohort study with a mean follow-up time of 2.6 years

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 2 2010
Jose D ROMAN
Study objective:, To describe our experience with laparoscopic excision of endometriosis on an adolescent population and to compare it with a non-adolescent population treated during the same period. Design:, Comparative cohort study of patients with endometriosis treated consecutively between July 2003 and January 2009 with a follow-up between six months and six years. Setting:, Braemar Hospital, Hamilton, New Zealand. Results:, We treated 20 adolescents. Ninety-five per cent (19/20) of adolescents were using pain relief other than Paracetamol, in contrast to only 59% (84/143) of non-adolescents. Thirty per cent (6/20) of adolescents had a first-degree relative with endometriosis, in contrast to 8% (11/143) of non-adolescents. Endometriosis was found to be stage I in 40% (8/20) of patients, stage II in 45% (9/20) of patients, stage III in 5% (1/20) of patients and stage IV in 10% (2/20) of patients. The main type of endometriotic lesion in the adolescent was an atypical red vascular lesion, which was present in 60% (12/20) of adolescents; but it was present in only 20% (29/143) of non-adolescents. There were no intra-operative complications. Minor postoperative complications included one case of urinary tract infection and one case of port infection. The operative complications that developed when treating the non-adolescent group are presented for comparison. Pain scores recorded at follow-up revealed a significant reduction in dysmenorrhoea and pelvic pain and there was a positive effect on the quality of life of adolescents as measured by the EQ-5D questionnaire tool. Conclusion:, Adolescents with endometriosis use significantly more pain relief than non-adolescents to control symptoms. They have a higher rate of a first degree relative with the disease and they present with more atypical endometriotic lesions when compared with an adult population with endometriosis. All the stages of disease are present in the adolescent, including stages III and IV. The laparoscopic excision of endometriosis has a positive effect on the relief of pain symptoms and on the improvement in quality of life in the adolescent. [source]


McGill Pain Questionnaire: A multi-dimensional verbal scale assessing postoperative changes in pain symptoms associated with severe endometriosis

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 4 2009
Elena Fabbri
Abstract Background:, Objective evaluation of pelvic pain symptoms using a standard pain questionnaire is essential to assessing the treatment of endometriosis and related pain. Aim:, To evaluate the McGill Pain Questionnaire (MPQ) as a multi-dimensional verbal scale in providing information about chronic pelvic pain associated with endometriosis, before and after laparoscopic surgery. Methods:, Fifty-five women undergoing laparoscopy for severe endometriosis were asked to complete the MPQ before surgery and at the 6-month follow up. All patients presented with preoperative pain symptoms of variable severity. We obtained the pain indexes and studied their relation with: patients' characteristics (age, body mass index, parity, qualification, occupation); operative findings (number, site and size of endometriotic lesions and presence of pelvic adhesions); and postoperative evolution of variable MPQ pain indexes at the 6-month follow up. Results:, Median present pain index (PPI) (index of pain intensity), before surgical treatment was 3 (2,4): preoperative PPI was <2 in 25% of patients while 25% of patients had PPI > 4. Overall median PPI after surgical treatment was 1 (0,2): postoperative index of pain intensity was <1 in 50% of patients, >2 in 25% of patients while 25% of patients did not experience postoperative pain. Overall pain intensity significantly decreased after laparoscopic treatment of endometriosis (Wilcoxon test P < 0.0005). None of the patients' characteristics were found to be significantly correlated with the severity or improvement of preoperative pain at postoperative follow up (P > 0.05), and the intensity of preoperative pain was not correlated to any of the operative variables. There was a significant reduction in all individual MPQ pain indexes; however 18.2% of women did not show improvement of pain symptoms after laparoscopic surgery. An increasing endometrioma diameter was associated with a significant decrease in the difference in evaluative rank score of pain rating index between pain indexes at the 6-month follow up and preoperatively (P = 0.04, Spearman's rank correlation Rho = ,0.277). Conclusions:, MPQ appears to be useful as a multi-dimensional scale in describing patients' pain semiology and evaluating pain evolution after surgical treatment. However, due to the extreme variability of pain experience, MPQ results don't clarify the relationship between pain intensity and the severity of endometriosis. [source]


Adolescent endometriosis in the Waikato region of New Zealand , A comparative cohort study with a mean follow-up time of 2.6 years

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 2 2010
Jose D ROMAN
Study objective:, To describe our experience with laparoscopic excision of endometriosis on an adolescent population and to compare it with a non-adolescent population treated during the same period. Design:, Comparative cohort study of patients with endometriosis treated consecutively between July 2003 and January 2009 with a follow-up between six months and six years. Setting:, Braemar Hospital, Hamilton, New Zealand. Results:, We treated 20 adolescents. Ninety-five per cent (19/20) of adolescents were using pain relief other than Paracetamol, in contrast to only 59% (84/143) of non-adolescents. Thirty per cent (6/20) of adolescents had a first-degree relative with endometriosis, in contrast to 8% (11/143) of non-adolescents. Endometriosis was found to be stage I in 40% (8/20) of patients, stage II in 45% (9/20) of patients, stage III in 5% (1/20) of patients and stage IV in 10% (2/20) of patients. The main type of endometriotic lesion in the adolescent was an atypical red vascular lesion, which was present in 60% (12/20) of adolescents; but it was present in only 20% (29/143) of non-adolescents. There were no intra-operative complications. Minor postoperative complications included one case of urinary tract infection and one case of port infection. The operative complications that developed when treating the non-adolescent group are presented for comparison. Pain scores recorded at follow-up revealed a significant reduction in dysmenorrhoea and pelvic pain and there was a positive effect on the quality of life of adolescents as measured by the EQ-5D questionnaire tool. Conclusion:, Adolescents with endometriosis use significantly more pain relief than non-adolescents to control symptoms. They have a higher rate of a first degree relative with the disease and they present with more atypical endometriotic lesions when compared with an adult population with endometriosis. All the stages of disease are present in the adolescent, including stages III and IV. The laparoscopic excision of endometriosis has a positive effect on the relief of pain symptoms and on the improvement in quality of life in the adolescent. [source]