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Recent Advances and Clinical Outcomes of Endometriosis
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Recent Advances and Clinical Outcomes of Endometriosis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 7601

Special Issue Editors

Prof. Dr. Harald Krentel

E-Mail Website
Guest Editor
Gynecology, Obstetrics, Gynecological Oncology, Bethesda Hospital, 47053 Duisburg, Germany
Interests: deep endometriosis; adenomyosis; pelvic retroperitoneal surgery; transvaginal ultrasound; robotic surgery; laparo-scopic surgery; hysteroscopic surgery; endometrial cancer; cervical cancer; ovarian cancer
Prof. Dr. Rudy Leon De Wilde

E-Mail Website
Guest Editor
Univ Clin Gynecol, Carl Ossietzky University of Oldenburg, Pius Hosp, D-26121 Oldenburg, Germany
Interests: reproductive surgery; oncological surgery; minimal-access surgery; endometriosis surgery; gynecological surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Thanks to important advances in ultrasound and MR imaging, the diagnostic approach to endometriosis has shifted from diagnostic laparoscopy to a complete pre-therapeutical staging and classification of the extent of the disease. This allows for a more tailored medical and surgical strategy. New surgical techniques including robotics guarantee more precise and tissue-sparing resections of endometriosis lesions with improved results and less complications. New medical treatment options like GnRH antagonist combination therapies offer promising outcomes. Additionally, a targeted therapy based on molecular profiling of the disease is looking to become a reality over the next few years as different international working groups move closer to understanding the phenotypes and genetics behind endometriosis. The new pace in endometriosis science has been made possible by increased awareness and national endometriosis strategies. The coming decade will bring an increasing number of relevant advances and thus more favorable outcomes. This Special Issue aims to focus on these novel advancements in all aspects of endometriosis and adenomyosis, showing the dynamic of the recent development and giving an overview on advances and perspectives.

Prof. Dr. Harald Krentel
Prof. Dr. Rudy Leon De Wilde
Guest Editors

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Keywords

  • phenotypes
  • genetics
  • mRNA
  • robotic surgery
  • MR imaging
  • transvaginal ultrasound
  • deep endometriosis
  • GnRH antagonists
  • ICG
  • adhesions in endometriosis
  • infertility
  • adenomyosis and obstetrics
  • classification systems
  • microbiome
  • sexuality and endometriosis

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Published Papers (4 papers)

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Research

12 pages, 19706 KiB  
Article
Association between Ovarian Endometriomas and Stage of Endometriosis
by Shadi Seraji, Aliyah Ali, Esra Demirel, Meredith Akerman, Camran Nezhat and Farr R. Nezhat
J. Clin. Med. 2024, 13(15), 4530; https://doi.org/10.3390/jcm13154530 - 2 Aug 2024
Viewed by 1580
Abstract
Objectives: To determine the association between ovarian endometriomas and stage of endometriosis. Methods: A total of 222 women aged 18–55 years old, who underwent minimally invasive surgery between January 2016 and December 2021 for treatment of endometriosis were included in the study. [...] Read more.
Objectives: To determine the association between ovarian endometriomas and stage of endometriosis. Methods: A total of 222 women aged 18–55 years old, who underwent minimally invasive surgery between January 2016 and December 2021 for treatment of endometriosis were included in the study. Patients underwent laparoscopic and/or robotic treatment of endometriosis by a single surgeon (FRN) and were staged using the ASRM revised classification of endometriosis. Pre-operative imaging studies, and operative and pathology reports were reviewed for the presence of endometriomas and the final stage of endometriosis. Using univariate analyses for categorical variables and the two-sample t-test or Mann–Whitney test for continuous data, association between endometriomas, stage of endometriosis, type of endometrioma, and other patient parameters such as age, gravidity, parity, laterality of endometriomas, prior medical treatment, and indication for surgery was analyzed. Results: Of the 222 patients included in the study, 86 patients had endometrioma(s) and were found to have stage III–IV disease. All 36 patients with bilateral endometriomas and 70% of patients with unilateral endometriomas had stage IV disease. Conclusions: The presence of ovarian endometrioma(s) indicates a higher stage of disease, correlating most often with stage IV endometriosis. Understanding the association between endometriomas and anticipated stage of disease can aid in appropriate pre-operative planning and patient counseling. Full article
(This article belongs to the Special Issue Recent Advances and Clinical Outcomes of Endometriosis)
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9 pages, 452 KiB  
Article
What Is Behind? Impact of Pelvic Pain on Perceived Stress and Inflammatory Markers in Women with Deep Endometriosis
by Jordana Diniz Osaki and Marco Aurelio Pinho Oliveira
J. Clin. Med. 2024, 13(10), 2927; https://doi.org/10.3390/jcm13102927 - 16 May 2024
Viewed by 1042
Abstract
Introduction/Objectives: Endometriosis affects 10% of women worldwide. It is noteworthy that this condition is often accompanied by pelvic pain and stress. Endometriosis is a debilitating gynecological condition where tissue similar to the uterine lining grows outside the uterus, often causing significant pain and [...] Read more.
Introduction/Objectives: Endometriosis affects 10% of women worldwide. It is noteworthy that this condition is often accompanied by pelvic pain and stress. Endometriosis is a debilitating gynecological condition where tissue similar to the uterine lining grows outside the uterus, often causing significant pain and reproductive issues. We aimed to study the relationship between the intensity of pelvic pain, and stress and inflammatory markers in women with deep endometriosis. Methods: This cross-sectional study analyzed women diagnosed with deep endometriosis through imaging, surgery, and/or biopsy. We assessed pain using the Numerical Rating Scale (NRS). Stress was assessed with the Perceived Stress Scale (PSS-10) questionnaire and the serum cortisol levels. Additionally, we analyzed inflammatory markers, including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Results: Fifty-two women, with an average age of 37.8 ± 6.9 years, participated in this study. Forty-four percent of these participants demonstrated high levels of stress, as indicated by scores above 26 on the PSS-10. Those categorized with “high stress” on the PSS-10 questionnaire exhibited significantly higher pain levels compared to those with “low stress” (p < 0.05). Furthermore, patients experiencing more-severe pelvic pain (pain score > 7) had notably higher serum cortisol levels. Women with intense pelvic pain (scores above 7 on the NRS) had significantly elevated serum cortisol levels (Cohen’s d = 0.72; p = 0.018). Conclusions: A positive association was found between stress levels and the intensity of pelvic pain in women with deep endometriosis, suggesting an interconnection between emotional aspects and biological responses. Full article
(This article belongs to the Special Issue Recent Advances and Clinical Outcomes of Endometriosis)
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14 pages, 3906 KiB  
Article
MRI-Based Radiomics as a Promising Noninvasive Diagnostic Technique for Adenomyosis
by Laurin Burla, Elisabeth Sartoretti, Manoj Mannil, Stefan Seidel, Thomas Sartoretti, Harald Krentel, Rudy Leon De Wilde and Patrick Imesch
J. Clin. Med. 2024, 13(8), 2344; https://doi.org/10.3390/jcm13082344 - 18 Apr 2024
Viewed by 1292
Abstract
Background: MRI diagnostics are important for adenomyosis, especially in cases with inconclusive ultrasound. This study assessed the potential of MRI-based radiomics as a novel tool for differentiating between uteri with and without adenomyosis. Methods: This retrospective proof-of-principle single-center study included nine patients with [...] Read more.
Background: MRI diagnostics are important for adenomyosis, especially in cases with inconclusive ultrasound. This study assessed the potential of MRI-based radiomics as a novel tool for differentiating between uteri with and without adenomyosis. Methods: This retrospective proof-of-principle single-center study included nine patients with and six patients without adenomyosis. All patients had preoperative T2w MR images and histological findings served as the reference standard. The uterus of each patient was segmented in 3D using dedicated software, and 884 radiomics features were extracted. After dimension reduction and feature selection, the diagnostic yield of individual and combined features implemented in the machine learning models were assessed by means of receiver operating characteristics analyses. Results: Eleven relevant radiomics features were identified. The diagnostic performance of individual features in differentiating adenomyosis from the control group was high, with areas under the curve (AUCs) ranging from 0.78 to 0.98. The performance of ML models incorporating several features was excellent, with AUC scores of 1 and an area under the precision-recall curve of 0.4. Conclusions: The set of radiomics features derived from routine T2w MRI enabled accurate differentiation of uteri with adenomyosis. Radiomics could enhance diagnosis and furthermore serve as an imaging biomarker to aid in personalizing therapies and monitoring treatment responses. Full article
(This article belongs to the Special Issue Recent Advances and Clinical Outcomes of Endometriosis)
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9 pages, 497 KiB  
Article
Changes in Endometriosis-Associated Symptoms Following Immunization against SARS-CoV-2: A Cross-Sectional Study
by Stefan Lukac, Thomas W. P. Friedl, Tobias Gruber, Marinus Schmid, Elena Leinert, Wolfgang Janni, Katharina Hancke and Davut Dayan
J. Clin. Med. 2024, 13(5), 1459; https://doi.org/10.3390/jcm13051459 - 2 Mar 2024
Viewed by 2617
Abstract
Background: There are many reports about variations in the menstrual cycle after infection with SARS-CoV-2 or vaccination against it. However, data on SARS-CoV-2 infection or vaccination-related changes in menstruation-associated endometriosis-typical symptoms such as dysmenorrhea, dyspareunia, dyschezia, dysuria, and bloating are rare or [...] Read more.
Background: There are many reports about variations in the menstrual cycle after infection with SARS-CoV-2 or vaccination against it. However, data on SARS-CoV-2 infection or vaccination-related changes in menstruation-associated endometriosis-typical symptoms such as dysmenorrhea, dyspareunia, dyschezia, dysuria, and bloating are rare or missing. Methods: This retrospective study was performed as an online survey among employees and students at the University Hospital Ulm, Germany. Changes regarding the presence of mentioned symptoms and after immunization (vaccination and/or infection) were evaluated with the McNemar Test. Additionally, the risk factors associated with these changes and associations between a subjectively perceived general change in menstruation and changes in the symptoms were evaluated. Results: A total of 1589 respondents were included in the final analysis. Less than 4% of respondents reported the occurrence of new symptoms that they had not experienced before immunization. Overall, there was a significant reduction in the presence of dysmenorrhea, back pain, dyschezia, bloating, and dyspareunia after immunization against coronavirus (p < 0.001). Only 2.3% of all participants reported to have been diagnosed with endometriosis. Factors associated with changes in endometriosis-typical symptoms following immunization were body mass index, age, endometriosis, and thyroid disease. Conclusions: Our results provide unique data about a reduction in the incidence of endometriosis-associated symptoms as dysmenorrhea, dyschezia, and dyspareunia after immunization against COVID-19. Full article
(This article belongs to the Special Issue Recent Advances and Clinical Outcomes of Endometriosis)
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