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Pelvic nerves endometriosis

B Rabischong, R Botchorishvili, N Bourdel, S Curinier, S Campagne-Loiseau, J L Pouly, M Canis
OBJECTIVES: To evaluate the feasibility and functional urinary and digestive results of nerve sparing techniques in endometriosis surgery. METHODS: A research on the medline/pubmed database using specific keywords (nerve sparing, endometriosis, pelvic nerves) identified 7 publications among about 50 whose purpose was to describe the feasibility, the techniques and the functional results of nerve preservation in this indication. Among them there are: 2 uncontrolled retrospective studies, 3 prospective non-randomized studies, a meta-analysis and a review of the literature...
March 15, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Lydia Coxon, Andrew W Horne, Katy Vincent
Although pain is one of the main symptoms women with endometriosis present with, there is poor correlation between symptom severity and disease burden and the underlying biological mechanisms by which pain arises are still only poorly understood. We briefly review the neurobiology of pain before considering mechanisms that may be specifically relevant in the context of endometriosis. The role of pelvic factors such as new nerve fibre growth, peritoneal fluid and inflammation is explored with a particular focus on studies where these factors have been associated with pain symptoms rather than just being compared between women with endometriosis and disease-free controls...
February 15, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
S Ploteau, B Merlot, H Roman, M Canis, P Collinet, X Fritel
Minimal and mild endometriosis (stage 1 and 2 AFSR) can lead to chronic pelvic pain and infertility but can also exist in asymptomatic patients. The prevalence of asymptomatic patients with minimal and mild endometriosis is not clear but typical endometriosis lesions are found in about 5 to 10% of asymptomatic women and more than 50% of painful and/or infertile women. Laparoscopic treatment of minimal and mild endometriotic lesions is justified in case of pelvic pain because their destruction decrease significatively the pain compared with diagnostic laparoscopy alone...
March 3, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Vito Chiantera, Marco Petrillo, Elene Abesadze, Giulio Sozzi, Margherita Dessole, Mariano Catello Di Donna, Giovanni Scambia, Jalid Sehouli, Sylvia Mechsner
OBJECTIVE: Evaluation of clinical presentation and surgical outcome in patients with deep lateral pelvic endometriosis (dLPE). DESIGN: Retrospective multicentric study (Canadian Task Force Classification II-2). SETTING: University tertiary referral centres. PATIENTS: 148 women with deep infiltrating endometriosis (DIE). INTERVENTION: Laparoscopic excision of DIE. Disease Distribution was classified as: Central Pelvic Endometriosis (CPE) when DIE involved one of these anatomic sites: cervix, vagina, uterosacral ligaments, rectum, bladder and pelvic peritoneum; superficial Lateral Pelvic Endometriosis (sLPE) when parametria, ureters or hypogastric plexus were involved; deep Lateral Pelvic Endometriosis (dLPE) in presence of sacral plexus and/or sciatic nerve infiltration...
March 1, 2018: Journal of Minimally Invasive Gynecology
Luciana P Chamié, Duarte Miguel Ferreira Rodrigues Ribeiro, Dario A Tiferes, Augusto Cesar de Macedo Neto, Paulo C Serafini
Endometriosis is defined as the presence of endometrial tissue that is located outside the uterine cavity and associated with fibrosis and inflammatory reaction. It is a polymorphic and multifocal disease with no known cure or preventive mechanisms. Patients may be asymptomatic or may experience chronic pelvic pain, dysmenorrhea, dyspareunia, or infertility. The pelvic cavity is the most common location for endometriotic implants, which usually affect the retrocervical space, ovaries, vagina, rectosigmoid colon, bladder dome, and round ligaments...
January 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
A Grouin, A Florian, A C Sans Mischel, O Toullalan
CONTEXT: Detrusor sphincter disorders impact quality of life in case of deep endometriosis. Surgery, which is one of the main treatments, is responsible of detrusor sphincter disorders. Since then, it is essential to look for those disorders and find the right medical care. OBJECTIVE: To specify the detrusor sphincter disorders, its links with anatomical localisation of deep endometriosis and its prognosis after surgery. METHODS: A literature review was carried out via PubMed® with the followings keywords: "deep endometriosis", "urinary disorders", "voiding dysfunction" and "urinary dysfunction"...
January 2018: Progrès en Urologie
Maria Grazia Porpora, Valeria Vinci, Corrado De Vito, Giuseppe Migliara, Emanuela Anastasi, Adele Ticino, Serena Resta, Carlo Catalano, Pierluigi Benedetti Panici, Lucia Manganaro
OBJECTIVES: To evaluate the sacral nerve root features by the means of magnetic resonance imaging-diffusion tensor imaging (MRI-DTI) tractography in women with endometriosis and/or adenomyosis, and to analyze the correlations among DTI abnormalities, pain symptoms, and endometriotic lesions found at surgery. DESIGN: A cross-sectional, observational study (Canadian Task Force classification II-2). SETTING: University hospital. PATIENTS: Women (n = 76) with clinical suspicion of endometriosis...
November 8, 2017: Journal of Minimally Invasive Gynecology
Stewart F Cramer, Debra S Heller
When hysterectomy is performed for chronic pelvic pain, routine pathology examination often provides no explanation. However, analysis of small uterine nerves using immunostains may help to address this deficiency. Small uterine nerves tend to be sparse or absent in wide areas of normal myometrium. Some studies of uterine nerves have suggested that endometriosis, adenomyosis, and fibroids are not inherently painful, with increased small nerves in the inner uterine wall associated with the history of pelvic pain...
September 2017: Human Pathology
Benedetta Gui, Anna Lia Valentini, Valeria Ninivaggi, Maura Miccò, Viola Zecchi, Pier Paolo Grimaldi, Francesco Cambi, Maurizio Guido, Lorenzo Bonomo
Endometriosis is a disease distinguished by the presence of endometrial tissue outside the uterine cavity with intralesional recurrent bleeding and resulting fibrosis. The most common locations for endometriosis are the ovaries, pelvic peritoneum, uterosacral ligaments, and torus uterinus. Typical symptoms are secondary dysmenorrhea and cyclic or chronic pelvic pain. Unusual sites of endometriosis may be associated with specific symptoms depending on the localization. Atypical pelvic endometriosis localizations can occur in the cervix, vagina, round ligaments, ureter, and nerves...
July 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
Christina Ramirez, Nicole Donnellan
PURPOSE OF REVIEW: Chronic pelvic pain and dysmenorrhea are common conditions affecting reproductive-age women. Surgical pelvic denervation procedures may be a treatment option for women with midline dysmenorrhea, in which medical management is declined by the patient, ineffective at managing symptoms, or medically contraindicated. This review describes the surgical techniques and complications associated with pelvic denervation procedures as well as the current evidence for these procedures in women with primary dysmenorrhea and dysmenorrhea secondary to endometriosis...
August 2017: Current Opinion in Obstetrics & Gynecology
Bo Peng, Hong Zhan, Fahad Alotaibi, Ghadeer M Alkusayer, Mohamed A Bedaiwy, Paul J Yong
Endometriosis is present in 1 in 10 reproductive-age women, and half experience deep dyspareunia (pelvic pain with sexual intercourse). Our objective was to investigate nerve growth factor (NGF) and its receptors (TrkA/p75NTR) in endometriosis-associated deep dyspareunia. A total of 32 women with endometriosis in the posterior pelvic compartment (cul-de-sac/uterosacrals) were included, either with (n = 17) or without (n = 15) deep dyspareunia symptoms confirmed by endovaginal ultrasound-assisted palpation on examination...
January 1, 2017: Reproductive Sciences
Camran Nezhat, Rebecca Falik, Sara McKinney, Louise P King
Endometriosis predominantly affects the pelvic reproductive organs but can also affect the urinary tract. A number of theories for the pathogenesis of endometriosis have been suggested, but the exact mechanisms remain elusive. Endometriotic lesions can be found on both the ureter and bladder, and the optimal therapeutic approach depends on the extent, depth, and location of these lesions. Medical approaches, including hormonal therapies such as GnRH agonists and oral contraceptives, tend to be a temporary measure, but can be useful in a preoperative setting or if the patient is unsuitable for surgery, and are also useful as a postoperative treatment...
June 2017: Nature Reviews. Urology
Vadim Petrov-Kondratov, Avneesh Chhabra, Stephanie Jones
Pudendal neuralgia (PN) is a result of pudendal nerve entrapment or injury, also called "Alcock syndrome." Pain that develops is often chronic, and at times debilitating. If conservative measures fail, invasive treatment modalities can be considered. The goal of this case report is to add to a small body of literature that a pulsed radiofrequency (PRF) ablation can be effectively used to treat PN and to show that high resolution MR neurography imaging can be used to detect pudendal neuropathy. CASE PRESENTATION: We present a case of a 51-year-old woman with 5 years of worsening right groin and vulva pain...
March 2017: Pain Physician
Alfredo Ercoli, Emma Bassi, Stefania Ferrari, Daniela Surico, Anna Fagotti, Francesco Fanfani, Fiorenzo De Cicco, Nicola Surico, Giovanni Scambia
Deep infiltrating endometriosis (DIE) is a complex disease that impairs the quality of life and the fertility of women. Colorectal DIE accounts for 70% to 93% of all the intestinal endometriotic sites and frequently needs a surgical approach. However, the indications for the surgical management of this condition are still controversial. From March 2010 to June 2014, we scheduled 33 consecutive patients presenting with retrocervical-rectal DIE of any diameter not involving the mucosa nor producing rectal stenosis > 50% for laparoscopic robotic assisted nerve-sparing rectal nodulectomy (LRN)...
March 18, 2017: Journal of Minimally Invasive Gynecology
Basma Darwish, Horace Roman
Nerve-sparing surgery is an emerging technique for surgery-related dysfunction. Within the past 15 years, an essential progress in recognition and understanding of the anatomy of the pelvic autonomous nervous system has been made. Surgical preservation of vegetative nerves has become well known in many cancer centers. The technique has led to improvement of the quality of life following oncologic radical procedures. Positive results have led to the adoption of such techniques in the surgical treatment of deep infiltrating endometriosis in an aim to prevent urinary, rectal, and sexual dysfunction...
January 2017: Seminars in Reproductive Medicine
S Aksu, S Misirlioglu, C Taskiran, B Urman
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
Xiaoling Zhang, Meizhi Li, Jian Guan, Huanjun Wang, Shurong Li, Yan Guo, Mingjuan Liu
PURPOSE: To investigate the feasibility of three-dimensional MR neurography (3D MRN) for the sacral plexus using sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) sequences, and to demonstrate structural abnormalities in the pelvic nerve of women with pelvic endometriosis. MATERIALS AND METHODS: Twenty patients with pelvic endometriosis and 20 healthy controls were examined by contrast-enhanced 3D short time inversion recovery T2-weighted imaging (CE 3D STIR T2WI) SPACE sequences on 3 Tesla MRI...
September 26, 2016: Journal of Magnetic Resonance Imaging: JMRI
Claudia Scheerer, Sergio Frangini, Vito Chiantera, Sylvia Mechsner
Endometriosis is a chronic inflammatory disease and one of the most common causes of pelvic pain. The mechanisms underlying pain emergence or chronic inflammation during endometriosis remain unknown. Several chronic inflammatory diseases including endometriosis show reduced amounts of noradrenergic nerve fibers. The source of the affected innervation is still unclear. Semaphorins represent potential elicitors, due to their known role as axonal guidance cues, and are suggested as nerve repellent factors in different chronic inflammatory diseases...
September 2017: Molecular Neurobiology
Amy V Jones, James R F Hockley, Craig Hyde, Donal Gorman, Ana Sredic-Rhodes, James Bilsland, Gordon McMurray, Nicholas A Furlotte, Youna Hu, David A Hinds, Peter J Cox, Serena Scollen
Dysmenorrhea is a common chronic pelvic pain syndrome affecting women of childbearing potential. Family studies suggest that genetic background influences the severity of dysmenorrhea, but genetic predisposition and molecular mechanisms underlying dysmenorrhea are not understood. In this study, we conduct the first genome-wide association study to identify genetic factors associated with dysmenorrhea pain severity. A cohort of females of European descent (n = 11,891) aged 18 to 45 years rated their average dysmenorrhea pain severity...
November 2016: Pain
E A Kogan, A S Ovakimyan, N B Paramonova, N M Faizullina, I F Kazachenko, L V Adamyan
UNLABELLED: Endometriosis (EM) is morphologically characterized by the development of extrauterine endometrioid heterotopies, the major clinical symptoms of which is chronic pelvic pain, which is a serious problem not only in modern gynecology, but also in public health as a whole. AIM: to investigate neurogenic markers in the foci of EM of various sites and histological structure in women with and without pain syndrome. MATERIAL AND METHODS: The investigation was performed using the operative material (resected segments of the intestine, bladder, rectovaginal septum, and small pelvic peritoneum) obtained from 52 women with an intraoperative and morphologically verified diagnosis of EM and (Group 1) and without (Group 2) pain syndrome...
May 2016: Arkhiv Patologii
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