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Latest & greatest articles for endometriosis
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Non-steroidal anti-inflammatory drugs for pain in women with endometriosis. Endometriosis is a common gynaecological condition that affects women and can lead to painful symptoms and infertility. It affects women's quality of life greatly, impacting on their careers, everyday activities, sexual and non-sexual relationships, and fertility. Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly used first-line treatment for endometriosis.To assess the effects of NSAIDs (...) for the management of pain in women with endometriosis compared to placebo, other NSAIDs, other pain management drugs, or no treatment.We searched the Cochrane Menstrual Disorders and Subfertility Group Specialised Trials Register (May 2005) published in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966 to May 2005), EMBASE (1980 to May 2005) and the reference lists from relevant publications. Experts in the field were also contacted for information about possible studies.We included
Is helium thermal coagulator therapy for the treatment of women with minimal to moderate endometriosis cost-effective: a prospective randomised controlled trial Is helium thermal coagulator therapy for the treatment of women with minimal to moderate endometriosis cost-effective: a prospective randomised controlled trial Is helium thermal coagulator therapy for the treatment of women with minimal to moderate endometriosis cost-effective: a prospective randomised controlled trial Lalchandani S (...) an ionised plasma beam or corona-type flame, the energy from which is delivered to the patient's target tissue via a probe. Type of intervention Treatment for endometriosis. Economic study type Cost-effectiveness analysis. Study population The study population comprised women presenting to a gynaecology outpatient clinic with a history of pelvic pain, dysmenorrhoea, dyspareunia, and dyschesia suggestive of endometriosis, or who had previously been diagnosed with the disease. Patients were excluded
Laparoscopic helium plasma coagulation of endometriosis Laparoscopic helium plasma coagulation of endometriosis Laparoscopic helium plasma coagulation of endometriosis National Institute for Clinical Excellence Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation National Institute for Clinical Excellence. Laparoscopic helium plasma coagulation of endometriosis (...) . London: National Institute for Clinical Excellence (NICE) 2004: 2 Authors' objectives This study aims to assess the current evidence on the safety and efficacy of laparoscopic helium plasma coagulation of endometriosis. Authors' conclusions 1.1 Current evidence on the safety and efficacy of laparoscopic helium plasma coagulation of endometriosis does not appear adequate for this procedure to be used without special arrangements for consent and for audit or research. 1.2 Clinicians wishing
Endometriosis. Endometriosis is an oestrogen-dependent disorder that can result in substantial morbidity, including pelvic pain, multiple operations, and infertility. New findings on the genetics, the possible roles of the environment and the immune system, and intrinsic abnormalities in the endometrium of affected women and secreted products of endometriotic lesions have given insight into the pathogenesis of this disorder and serve as the background for new treatments for disease-associated
that further studies are required to evaluate the effect of alternative surgical treatments on lesion recurrence and post-operative pregnancy rates. Bibliographic details Vercellini P, Chapron C, De Giorgi O, Consonni D, Frontino G, Crosignani P G. Coagulation or excision of ovarian endometriomas? American Journal of Obstetrics and Gynecology 2003; 188(3): 606-610 PubMedID Indexing Status Subject indexing assigned by NLM MeSH Endometriosis /surgery; Female; Gynecologic Surgical Procedures /adverse effects (...) Coagulation or excision of ovarian endometriomas? Coagulation or excision of ovarian endometriomas? Coagulation or excision of ovarian endometriomas? Vercellini P, Chapron C, De Giorgi O, Consonni D, Frontino G, Crosignani P G CRD summary This review compared coagulation or vapourisation with excision or cystectomy for the treatment of ovarian endometriomas. The authors concluded that coagulation appears to be associated with a significant increase in cyst recurrence. The studies were generally
Peritoneal fluid, endometriosis, and ciliary beat frequency in the human fallopian tube. Endometriosis and infertility are known to be associated, but it is unclear whether endometriosis causes infertility. We used contrast analogue enhancement to study the effect of peritoneal fluid from women with early stage endometriosis on the ciliary beat frequency of human fallopian tube epithelium. We obtained peritoneal fluid from six women with early stage endometriosis and from six fertile women (...) with no evidence of endometriosis to use as controls. Fallopian tubes from hysterectomy specimens were collected from 17 women. The difference in ciliary beat frequency between fallopian tubes exposed to peritoneal fluids of women with and without endometriosis increased with the duration of incubation (mean difference at 24 h 1.35 Hz, 95% CI 0.94-1.75, p=0.01). At 24 h, ciliary beat frequency was significantly lower in the incubations with peritoneal fluid from women with endometriosis than controls (4.29
A systematic review of the accuracy of ultrasound in the diagnosis of endometriosis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Laparoscopic surgery for pelvic pain associated with endometriosis. To assess the efficacy of laparoscopic surgery in the treatment of pelvic pain associated with endometriosis. The review aims to compare the effectiveness of any laparoscopic procedure versus any other treatment modality, including expectant management.The search strategy of the Menstrual Disorders and Subfertility Review Group was used to identify all publications that described or might have described randomised trials (...) of laparoscopic surgery in the treatment of symptomatic endometriosis. For a full description of the Review Group strategy see the Review Group details.Trials were selected if they were randomised and compared the effectiveness of laparoscopic surgery in the treatment of pelvic pain associated with endometriosis, with other treatment modalities or placebo.One study had data appropriate for inclusion within the review. This study compared laparoscopic laser surgery with diagnostic laparoscopy. Pain relief
of endometriomas reduces pain; the most important factor is complete removal of endometrial tissue. Mere evacuation of an endometrioma always results in rapid recurrence. The removal of deep tissue colonies relieves pain and the effect may last for years. Surgical interruption of pelvic nerve pathways does not increase the effectiveness of surgery. The effect of hysterectomy or ovarectomy on endometriosis with pain has been studied little. The surgical treatment of endometriosis requires much experience (...) . Little data exist on the optimal dosage of GnRH-agonists. Although the NSAIDs and hormonal drugs suppress the pain caused by endometriosis, they have little effect on the progression of the disease. After discontinuing medication, the pain often returns rapidly. The surgical treatment of endometriosis removes pain, producing more lasting effects than drugs do. Laparoscopic removal of endometrial tissue is an effective treatment for pain related to stage I-II endometriosis. The surgical removal
Laparoscopic ablation or resection of endometriosis deposits for moderate and severe endometriosis Laparoscopic ablation or resection of endometriosis deposits for moderate and severe endometriosis Laparoscopic ablation or resection of endometriosis deposits for moderate and severe endometriosis Ball C M Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation Ball C M (...) . Laparoscopic ablation or resection of endometriosis deposits for moderate and severe endometriosis. London: Bazian Ltd (Editors), Wessex Institute for Health Research and Development, University of Southampton 2001: 9 Authors' objectives This study aims to assess the effects of laparoscopic ablation or resection of endometriosis deposits in women with moderate and severe endometriosis. Authors' conclusions Further studies are required to assess the role of laparoscopic surgery for managing stage III-IV
Modern combined oral contraceptives for pain associated with endometriosis. Endometriosis is a major women's health-care problem. It causes pain and/or infertility, and affects millions of women worldwide. Endometriosis is defined according to histological criteria by the presence of tissue resembling endometrium in sites outside the uterus, most commonly the ovaries and peritoneum. The aim of treatment has been to remove the deposits of ectopic endometrium that are thought to be responsible (...) for the symptoms of endometriosis. This can be achieved surgically by destroying or removing the implants; medical therapies induce atrophy within the hormonally-dependent ectopic endometrium. The duration of hormonal treatment may be limited by unwanted side effects. There is some evidence, however, from epidemiological research that current use of the combined oral contraceptive pill (OCP) is associated with a reduced incidence of endometriosis. The combined pill has the great advantage over other hormonal
Ovulation suppression for endometriosis. Although the etiology of endometriosis is unknown, several theories exist, the most popular of which is retrograde menstruation. As endometriosis can only be diagnosed by laparoscopy, neither the incidence (annual occurrence) nor the prevalence (proportion of the population affected) of endometriosis is known. The association between endometriosis and infertility isn't clear in Stage I (minimal) and Stage II (mild) endometriosis. Endometriosis appears (...) to be an estrogen dependent condition. At the time of menopause, most endometriosis becomes quiescent. This hormonal dependency prompted researchers to seek agents which would suppress ovarian activity.To determine effectiveness of a) ovulation suppression with danazol, medroxy progesterone acetate, gestrinone, combined oral contraceptive pills and GnRH analogues versus placebo or no treatment and b) any of the above agents versus danazol, for the treatment of endometriosis explained infertility in terms
Progestagens and anti-progestagens for pain associated with endometriosis. Endometriosis is a gynaecological condition that presents either with the problem of infertility or with painful symptoms. The clinical observation of an apparent resolution of symptoms during pregnancy gave rise to the concept of treating patients with a pseudo-pregnancy regime. Initially combinations of high dose oestrogens and progestagens were used but this was subsequently replaced by progestogens alone. More (...) therapies.Progestagens appear to be an effective therapy for the painful symptoms associated with endometriosis. Gestrinone is as effective as other established medical therapies (danazol and GnRH analogues).The limited available data suggests that both continuous progestagens and anti-progestagens are effective therapies in the treatment of painful symptoms associated with endometriosis. Progestagens given in the luteal phase are not effective. These conclusions should be accepted cautiously due to a lack of data.
Danazol for pelvic pain associated with endometriosis. Endometriosis is defined as the presence of endometrial tissue (stromal and glandular) outside the normal uterine cavity. Conventional medical and surgical treatments for endometriosis aim to remove or decrease deposits of ectopic endometrium. The observation that hyperandrogenic states (an excess of male hormone) induce atrophy of the endometrium has led to the use of androgens in the treatment of endometriosis. Danazol is one (...) of these treatments used. The efficacy of danazol is based on its ability to produce a high androgen/low estrogen environment (a pseudo menopause) which results in the atrophy of endometriotic implants and thus an improvement in painful symptoms.To determine the effectiveness of danazol compared to placebo or no treatment in the treatment of the symptoms and signs, other than infertility, of endometriosis in women of reproductive age.The Menstrual Disorders Group search strategy was used to identify randomised
Gonadotrophin-releasing hormone analogues for pain associated with endometriosis. Endometriosis is a common gynaecological condition that frequently presents with the symptom of pain. The precise pathogenesis (mode of development) of endometriosis is unclear but it is evident that endometriosis arises by the dissemination of endometrium to ectopic sites and the subsequent establishment of deposits of ectopic endometrium. The observation that endometriosis is rarely seen in the hypo-oestrogenic (...) stimulation of the ovary).To determine the effectiveness of Gonadotrophin Releasing Hormone analogues (GnRHas) in the treatment of the painful symptoms of endometriosis by comparing them with no treatment, placebo, other recognised medical treatments, and surgical interventions.The search strategy of the Menstrual Disorders and Subfertility review group (please see Review Group details) was used to identify all randomised trials of the use of GnRHas for the treatment of the painful symptoms
Is minimal or mild endometriosis associated with infertility? Is minimal or mild endometriosis associated with infertility? Is minimal or mild endometriosis associated with infertility? Burrows E Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation Burrows E. Is minimal or mild endometriosis associated with infertility? Clayton, Victoria: Centre for Clinical (...) Effectiveness (CCE) 2000: 16 Authors' objectives This aim of this report was to assess whether minimal or mild endometriosis is associated with infertility. Authors' conclusions - Six studies met the inclusion/exclusion criteria - The best evidence available does not confirm an association between minimal and mild endometriosis and infertility. However, a consistent trend in results suggests a negative impact of minimal and mild endometriosis on fertility. - Four of the six identified studies were conducted
Surgical management of endometriosis Surgical management of endometriosis Surgical management of endometriosis Vercellini P, De Giorgi O, Pisacreta A, Pesole A P, Vicentini S, Crosignani P G Authors' objectives To evaluate the effects of pelvic denervations in addition to conservative surgery on dysmenorrhoea and deep dyspareunia associated with endometriosis. Searching Articles published in the English language were sought in MEDLINE (1977 to 1998) and EMBASE (1980 to 1998) using the following (...) MeSH terms: 'endometriosis', 'pelvic pain', 'presacral neurectomy', 'uterosacral ligament resection' and 'surgical therapy'. Handsearches were conducted of the main specialty journals (American Journal of Obstetrics and Gynaecology, British Journal of Obstetrics and Gynaecology, Fertility and Sterility, and Obstetrics and Gynaecology). Additional reports were identified by reviewing all references from retrieved articles and by consulting books and monographs on endometriosis published in the last
An evidence-based medicine approach to the treatment of endometriosis-associated chronic pelvic pain: placebo-controlled studies An evidence-based medicine approach to the treatment of endometriosis-associated chronic pelvic pain: placebo-controlled studies An evidence-based medicine approach to the treatment of endometriosis-associated chronic pelvic pain: placebo-controlled studies Howard F M Authors' objectives To assess the efficacy of treatment of endometriosis-associated chronic pelvic (...) pain. Searching MEDLINE was searched from 1976 to 1998 for articles published in the English language, using a combination of the following MeSH and textwords: 'endometriosis', 'pelvic pain', 'treatment'. Additional studies were located by examining the references from the identified studies, and by contacting the authors of selected studies. Study selection Study designs of evaluations included in the review Placebo-controlled randomised clinical trials (RCTs) were eligible if they scored at least
The evidence for the management of endometriosis The evidence for the management of endometriosis The evidence for the management of endometriosis Farquhar C, Sutton C Authors' objectives To summarise the effectiveness and safety of medical and surgical management of endometriosis. Searching The search strategy of the Cochrane Menstrual Disorders and Subfertility Group was used to identify trials on MEDLINE and EMBASE (years not stated). The database of the Cochrane Menstrual Disorders (...) and Subfertility Group was also available to the authors. Thirty key journals were handsearched and the reference lists of other RCTs were also searched. Unpublished studies were identified from abstracts and conference proceedings, and from pharmaceutical companies. Study selection Study designs of evaluations included in the review Randomised controlled trials (RCTs) which compared an ovulatory suppressive agent in the treatment of endometriosis-associated pain with placebo; compared other ovulatory
Human issues and medical economics of endometriosis: three- vs. six-month GnRH-agonist therapy Human issues and medical economics of endometriosis: three- vs. six-month GnRH-agonist therapy Human issues and medical economics of endometriosis: three- vs. six-month GnRH-agonist therapy Heinrichs W L, Henzl M R Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results (...) and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The use of a short-term course of intranasal gonadotropin-releasing hormone agonist (GnRH-a) as both a diagnostic tool and a treatment in women with symptoms of endometriosis. Type of intervention Diagnosis and treatment. Economic study type Cost-effectiveness analysis. Study population Women with the symptoms of endometriosis, in particular chronic pelvic pain. Setting