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Qing Li, Yan Ding, Xu-Yin Zhang, Wei-Wei Feng, Ke-Qin Hua
Objective To provide novel insights into the clinical treatment of adenomyosis. Methods Two hundred patients with adenomyosis were enrolled in this prospective, nonrandomized, parallel-controlled study with a 1-year follow-up in our hospital. Group 1 was treated with 3.75 mg leuprorelin acetate (LA) (n = 40), Group 2 was treated with 1.88 mg LA (n = 40), Group 3 underwent Mirena implantation (n = 40), Group 4 underwent Mirena implantation after treatment with 3.75 mg LA (n = 40), Group 5 underwent Mirena implantation after treatment with 1...
January 1, 2018: Journal of International Medical Research
B Borghese, P Santulli, L Marcellin, C Chapron
Endometriosis and adenomyosis are histologically defined. The frequency of endometriosis cannot be precisely estimated in the general population. Endometriosis is considered a disease when it causes pain and/or infertility. Endometriosis is a heterogeneous disease with three well-recognized subtypes that are often associated with each other: superficial endometriosis (SUP), ovarian endometrioma (OMA), and deep infiltrating endometriosis (DIE). DIE is frequently multifocal and mainly affects the following structures: the uterosacral ligaments, the posterior vaginal cul-de-sac, the bladder, the ureters, and the digestive tract (rectum, recto-sigmoid junction, appendix)...
March 11, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
C Huchon, G Aubry, S Ploteau, A Fauconnier
In case of consultation for chronic pelvic pain or suspicion of endometriosis, it is recommended to evaluate the pain (intensity, resonance) and to search out the evocative and localizing symptoms of endometriosis (Grade B). The main symptoms suggestive of endometriosis are: severe dysmenorrhea (NP2), deep dyspareunia (NP2), painful defecation during menstruation (NP2), urinary tract symptoms during menstruation (NP2) and infertility (NP2). In patients with chronic pelvic pain, it is recommended to search deep infiltrating endometriosis in patients with painful defecation during menstruation or severe deep dyspareunia (Grade B)...
March 9, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
John Jarrell
Historically, the evolutionary origins of menstruation have been based on two theories: the ability to eliminate infectious agents carried to the uterus with spermatozoa and the comparative conservation of energy with menstruation compared to its absence. In the menstruating species, more recent theories have identified spontaneous decidualization as the key adaptive mechanism. Spontaneous decidualization is seen as a mechanism to provide the mother with protection from the invasive characteristics of the embryo...
February 8, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
Jacques Donnez, Olivier Donnez, Marie-Madeleine Dolmans
Like endometriosis, uterine adenomyosis is another enigmatic disease and remains a source of controversy. Uterine adenomyosis is characterized by the presence of endometrial glands in the myometrium. Two main theories may explain its pathogenesis: adenomyosis may arise from invagination of the myometrial basalis into the myometrium; or an alternative theory maintains that it may result from metaplasia of displaced embryonic pluripotent müllerian remants or differentiation of adult stem cells. Uterine adenomyosis is responsible for pelvic pain, abnormal bleeding, and infertility...
March 8, 2018: Fertility and Sterility
Chih-Ching Yeh, Fu-Hsiung Su, Chii-Ruey Tzeng, Chih-Hsin Muo, Wen-Chang Wang
OBJECTIVE: Both adenomyosis and endometriosis are characterized by the presence of ectopic endometrial glands and stroma and have been suggested to share some characteristics with malignant tumors. Although accumulating evidence indicates that endometriosis is associated with some cancer types, the cancer risks in patients with adenomyosis have been rarely examined. In this study, we investigated the relationship between adenomyosis and risks of common cancers. METHODS: This study included a cohort of 12,447 women with adenomyosis but not endometriosis, born in 1951-1984, and a cohort of 124,470 adenomyosis-free women matched by birth year...
2018: PloS One
Andrew J Gall, June E Olds, Arno Wünschmann, Laura E Selmic, James Rasmussen, Anne D Lewis
Reproductive lesions have been described in various nonhuman primate species, including rhesus macaques ( Macaca mulatta), cynomolgus macaques ( Macaca fascicularis), baboons ( Papio spp.), squirrel monkeys ( Saimiri sciureus), and chimpanzees ( Pan spp.); however, there are few publications describing reproductive disease and pathology in Japanese macaques ( Macaca fuscata). A retrospective evaluation of postmortem reports for two captive M. fuscata populations housed within zoos from 1982 through 2015 was completed, comparing reproductive diseases diagnosed by gross pathology and histopathology...
March 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Tamara N Kruse, Michelle R Bowman, Jan C Ramer, Melissa A Fayette, Leah L Greer, Cynthia K Stadler, Michael M Garner, Jeffry S Proudfoot
Uterine lesions in two orangutans were effectively managed with surgical intervention. A 26-year-old hybrid orangutan ( Pongo spp.) was diagnosed with uterine adenomyosis based on advanced imaging. Histologic evaluation identified multifocal myometrial endometriosis, a variant of adenomyosis. A 27-year-old Bornean orangutan ( Pongo pygmaeus) was diagnosed with a focal uterine fibroid based on histologic examination. The animals were housed at separate institutions and initially presented with dysmenorrhea and menorrhagia...
March 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Hiroto Hirashima, Akihide Ohkuchi, Rie Usui, Shigeyoshi Kijima, Shigeki Matsubara
Degeneration of adenomyosis during pregnancy and the post-partum period is very rare. A 42-year-old Japanese parous woman with four normal-term deliveries, who presented with abdominal pain and fever at 22 weeks of gestation with transient increases of the white blood cell count and C-reactive protein, demonstrated sustained inflammation after cesarean section at 29 weeks of gestation due to the occurrence of gestational hypertension with late deceleration. The noncontrast-enhanced magnetic resonance imaging (MRI) at 22 weeks demonstrated a poorly demarcated hypointense area at the posterior uterine wall on T1- and T2-weighted imaging...
March 8, 2018: Journal of Obstetrics and Gynaecology Research
J Knez, E Saridogan, T Van Den Bosch, D Mavrelos, G Ambler, D Jurkovic
STUDY QUESTION: What would be a potential impact of implementing the new ESHRE/European Society of Gynaecological Endoscopy (ESGE) female genital anomalies classification system on the management of women with previous diagnosis of arcuate uteri based on the modified American Society for Reproductive Medicine (ASRM) criteria? SUMMARY ANSWER: A significant number of women with previous diagnosis of arcuate uteri are reclassified as having partial septate uteri according to the new ESHRE/ESGE classification system which may increase the number of remedial surgical procedures...
March 5, 2018: Human Reproduction
Thierry Van den Bosch, Dominique Van Schoubroeck
Transvaginal ultrasonography has become the primary test in the diagnosis of pelvic endometriosis and adenomyosis. A review of the literature on the diagnostic accuracy of ultrasonography in pelvic endometriosis and adenomyosis, as well as a comparison with magnetic resonance imaging, will be presented. Criteria for diagnosis of an endometrioma according to robust prospective data together with guidelines as to adequate reporting of the location of deep infiltrating endometriosis will be given. The sonographic features of adenomyosis including the differential diagnosis between focal adenomyosis and a uterine fibroid are reviewed...
February 14, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
Ying-Yuan Chen, Ching-Lan Wu, Shu-Huei Shen
BACKGROUND: The diffusion-weighted imaging (DWI) signals of the female pelvic bone marrow show great variability and are usually high in female patients with fibroid-associated symptoms and anemia. PURPOSE: To ascertain clinical factors contributing to high signal intensity in the bone marrow of the female pelvis on DWI. STUDY TYPE: Retrospective case-control study. SUBJECTS: A single-institution review of 221 female patients underwent a pelvic magnetic resonance study from December 2012 to July 2014...
March 5, 2018: Journal of Magnetic Resonance Imaging: JMRI
Ekaterina Perminov, Sara Mangosing, Alexandra Confer, Olga Gonzalez, Jason R Crawford, Natalia Schlabritz-Loutsevitch, Shyamesh Kumar, Edward Dick
Disorders of sexual development are rare in non-human primates. We report a case of true hermaphroditism in a 19-year-old, nulliparous, female baboon (Papio spp.). At necropsy, the animal was obese with adequate muscle mass and hydration. Reproductive organs appeared normal with the exception of 2 firm nodular structures in the myometrium (1-1.5 cm diameter) and a thickened, dark endocervical mucosa. Histologically, both gonads were ovotestes and contained discrete areas of ovarian and testicular tissue. There were follicles in various stages of development surrounded by ovarian stroma...
March 5, 2018: Journal of Medical Primatology
Yu Chang, Nari Kay, Minpheus R Huang, S Joseph Huang, Eing Mei Tsai
STUDY OBJECTIVE: To evaluate the feasibility, efficiency, and safety of manual morcellation in laparoendoscopic single-site (LESS) supracervical hysterectomy. DESIGN: A retrospective study (Canadian Task Force classification II-2). SETTING: A teaching hospital. PATIENTS: One hundred and ninety patients with symptomatic uterine leiomyomas and/or adenomyosis underwent LESS supracervical hysterectomy. INTERVENTIONS: Manual morcellation through the umbilical wound...
March 1, 2018: Journal of Minimally Invasive Gynecology
Annefleur Machteld de Bruijn, Paul Nm Lohle, Judith Af Huirne, Jolanda de Vries, Moniek Twisk, Wouter Jk Hehenkamp
BACKGROUND: Adenomyosis is a benign uterine disease characterized by invasion of endometrium into the myometrium resulting in heavy menstrual bleeding and pain (dysmenorrhea). Hysterectomy is established as the final treatment option when conservative treatment fails. Uterine artery embolization (UAE) in patients with symptomatic adenomyosis has demonstrated to reduce symptoms and improve quality of life. However, randomized controlled trials are lacking. OBJECTIVE: With this study, we aim to evaluate the impact of UAE on Health-Related Quality of Life (HRQOL) in a randomized comparison to hysterectomy in patients with symptomatic adenomyosis...
March 1, 2018: JMIR Research Protocols
Andrzej Woźniak, Sławomir Woźniak
Uterine leiomyomas or uterine fibroids are the most common gynaecological tumours and occur in about 20-50% of women around the world. Ultrasonography (USG) is the first-line imaging examination in suspected fibroids and shows high sensitivity and specificity in diagnosing this condition. Ultrasound scans can be performed transvaginally (transvaginal scan - TVS) or transabdominally (transabdominal scan - TAS); both scans have advantages and limitations, but, in general, transvaginal sonography is superior to transabdominal sonography in most cases of pelvic pathology...
December 2017: Przeglad Menopauzalny, Menopause Review
Yong Seek Kim, Kichang Han, Man-Deuk Kim, Gyoung Min Kim, Joon Ho Kwon, Junhyung Lee, Woosun Choi, Jong Yun Won, Do Yun Lee
PURPOSE: To evaluate safety and efficacy of uterine artery embolization (UAE) for pedunculated subserosal (PS) leiomyomas. MATERIALS AND METHODS: Of 1,069 patients who underwent UAE for symptomatic leiomyomas or adenomyosis from 2007 to 2016, 55 patients (mean age 40.3 y ± 4.8) with 66 PS leiomyomas (mean diameter 6.61 cm ± 2.04) were enrolled. Each PS leiomyoma was categorized into 1 of 2 groups: high-risk PS leiomyoma (stalk diameter < 25% of diameter of leiomyoma) and low-risk PS leiomyoma (stalk diameter 25%-50% of diameter of leiomyoma)...
February 22, 2018: Journal of Vascular and Interventional Radiology: JVIR
Ching-Jung Lin, Teh-Fu Hsu, Yen-Hou Chang, Ben-Shian Huang, Ling-Yu Jiang, Peng-Hui Wang, Yi-Jen Chen
OBJECTIVE: To evaluate whether a maintenance levonorgestrel-releasing intrauterine system is effective for preventing the recurrence of postoperative adenomyosis-related symptoms. MATERIALS AND METHODS: From January 2005 through December 2014, a retrospective study including 133 patients with symptomatic adenomyosis undergoing conservative uterine-sparing surgery followed by gonadotropin-releasing hormone agonist treatment was conducted. We excluded the 18 patients who did not meet the inclusion criteria...
February 2018: Taiwanese Journal of Obstetrics & Gynecology
Shih-Shien Weng, Yi-Chun Chou, Fang-Ju Sun
OBJECTIVE: To describe the surgical outcomes of single port access laparoscopic subtotal hysterectomy (LSH) using in-bag manual morcellation and evaluate the feasibility of this procedure. MATERIALS AND METHODS: Thirty patients with symptomatic leiomyoma or adenomyosis were enrolled. A 2-cm transverse incision was made at the umbilicus and single port apparatus (LagiPort) was applied. After dissection of vesicouterine peritoneum from the uterus, the uterine ligaments and vessels were secured and transected by Gyrus PK cutting forceps...
February 2018: Taiwanese Journal of Obstetrics & Gynecology
Xiao-Ying Zhang, Ying-Shu Guo, Jiu-Mei Chen, Jin-Juan Wang, Hong Ye, Chun-Yi Zang, Hua Duan
OBJECTIVES: To evaluate the efficacy and safety of GnRH-α pretreatment with HIFU ablation for diffuse adenomyosis. METHODS: From January 2014 to December 2016, 61 patients were divided into two groups. Twenty-three patients with larger uteri received pretreatment with GnRH-αand were then subjected to HIFU, and 38 patients underwent HIFU alone. The technical parameters included treatment time, sonication time, average sonication power, treatment intensity, total energy, non-perfusion volume (NPV) and NPV ratio...
February 15, 2018: International Journal of Hyperthermia
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