scholarly journals Menstruation Dysregulation and Endometriosis Development

2021 ◽  
Vol 3 ◽  
Author(s):  
Kevin K. W. Kuan ◽  
Douglas A. Gibson ◽  
Lucy H. R. Whitaker ◽  
Andrew W. Horne
Keyword(s):  
Chronic Pelvic Pain ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Endometrial Tissue ◽  
Hypoxic Stress ◽  
Retrograde Menstruation ◽  
Disease Staging ◽  
New Treatment ◽  
Underlying Mechanisms ◽  
Menstrual Fluid

Endometriosis is a common gynecological condition characterized by the growth of endometrial-like tissue outside of the uterus which may cause symptoms such as chronic pelvic pain or subfertility. Several surgical and medical therapies are available to manage symptoms, but a cure has yet to be determined which can be attributed to the incomplete understanding of disease pathogenesis. Sampson's theory of retrograde menstruation is a widely accepted theory describing how shed endometrial tissue can enter the peritoneal cavity, but other factors are likely at play to facilitate the establishment of endometriosis lesions. This review summarizes literature that has explored how dysregulation of menstruation can contribute to the pathogenesis of endometriosis such as dysregulation of inflammatory mediators, aberrant endometrial matrix metalloproteinase expression, hypoxic stress, and reduced apoptosis. Overall, many of these factors have overlapping pathways which can prolong the survival of shed endometrial debris, increase tissue migration, and facilitate implantation of endometrial tissue at ectopic sites. Moreover, some of these changes are also implicated in abnormal uterine bleeding and endometrial diseases. More research is needed to better understand the underlying mechanisms driving dysregulation of menstruation in endometriosis specifically and identifying specific pathways could introduce new treatment targets. Analyzing menstrual fluid from women with endometriosis for inflammatory markers and other biomarkers may also be beneficial for earlier diagnosis and disease staging.

scholarly journals Abnormal uterine bleeding in perimenopausal age group women: a study on clinicopathological evaluation and management

2017 ◽  
Vol 7 (1) ◽  
pp. 192
Author(s):  
Sreelakshmi U. ◽  
Tushara Bindu V. ◽  
Subhashini T.
Keyword(s):  
Age Groups ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Endometrial Tissue ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Age Group ◽  
Histopathological Findings ◽  
Number Of Patients ◽  
Perimenopausal Women

Background: Abnormal uterine bleeding is the most common and frequent presenting complaint in Gynaecology Outpatient Department in all age groups, especially in perimenopausal women. Objective of present study was clinicopathological evaluation and management of abnormal uterine bleeding in perimenopausal age group women.Methods: The present study was prospective analytical study conducted at Mallareddy Narayana Multi-speciality Hospital, reputed teaching hospital, in Obstetrics and gynaecology department in association with department of pathology from January 2015 to December 2016. Perimenopausal women in age group 45-55 years included in this study. Other age groups with abnormal uterine bleeding, isolated cervical or vaginal pathology, bleeding diathesis, and pregnancy related causes of bleeding excluded from this study. Endometrial tissue collected by sampling procedure such as dilatation and curettage. Proper counselling about management was given to all women related to medical and surgical interventional approaches.Results: A total of 135 women with abnormal uterine bleeding in perimenopausal age were examined after fulfilling criteria during study period of 2 years. The age of participants in mean±SD was 46.68±2.03 years (min 45 years and max 55 years). Maximum number of patients with abnormal uterine bleeding presented in age group of 45-50 years. The most common symptoms were heavy menstrual bleeding (83.7%), followed by frequent menstrual bleeding (26.6%). Proliferative endometrium was the most common histopathological (30.3%) study followed by secretory endometrium (27.4%). Surgical management was given to 94 patients.Conclusions: Heavy menstrual bleeding and frequent menstrual bleeding were mostly correlated with abnormal endometrial histopathological findings in this study. Gynaecologists should pay attention towards these abnormal bleeding patterns along with the evaluation of endometrial tissue for histopathological findings, which will help us to plan for successful management. 

scholarly journals Treatment of C-section diverticula with hysteroscopic resection in women without childbearing intention: a retrospective cohort study

2019 ◽  
Author(s):  
Hui Shi ◽  
Jingyan He ◽  
Yunhe Gao ◽  
Shuang Qin ◽  
Jiaying Fan ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cesarean Section ◽  
Pelvic Pain ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Chronic Pelvic Pain ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Timing Of Surgery ◽  
Hysteroscopic Resection

Abstract Background: Diverticulum, one of the long-term squelae of cesarean section, can cause abnormal uterine bleeding, dysmenorrhea and chronic pelvic pain. Hysteroscopic resection of diverticula is thought to reduce abnormal uterine bleeding and chronic pelvic pain. In this study, we aim to describe the improvement after hysteroscopic resection of cesarean section diverticula hysteroscopic resection of cesarean section diverticula (CSD) in women without childbearing intention, and to explore the variables associated with poor prognosis.Methods: A retrospective cohort study of women aged 25-48 with CSD diagnosis by transvaginal ultrasonography (TVS) and hysteroscopy that were enrolled at Guangzhou Women and Children’s Medical Center between June 2017 and December 2018. A total of 124 women met the inclusion criteria and all patients had undergone hysteroscopic resection and accepted a follow-up interview at the 3rd and 6th months postoperatively to record symptom improvement.Result: The mean of intraoperative blood loss and operative time of hysteroscopic resection were (12.94±12.63) ml and (33.63±6.87) min in 124 patients. Overall observed improvement rates of CSD symptom were 47.2% and 65.6% in the first 3 and 6 months, respectively. Multivariable logistic regression models revealed that timing of surgery <14 days was a good prognostic factor associated with both 3-month improvement (OR, 16.59; 95% CI, 2.62-104.90; P=0.003) and 6-month improvement (OR, 15.51; 95%CI, 1.63-148.00; P=0.02); Patients with numbers of cesarean section(CS) ≥2 had a lower rate of improvement after 6 months of CSD repair surgery compared with patients who underwent one CS(OR, 8.29; 95%CI, 1.05-65.75; P=0.04).Conclusions: A hysteroscopic repair might be an appropriate method for CSD in women who no childbearing intentions. The timing of surgery and the number of CS seems to be factors influencing the postoperative improvement of CSD.

Success of uterus-preserving treatments for abnormal uterine bleeding, chronic pelvic pain, and symptomatic fibroids: age and bridges to menopause

2011 ◽  
Vol 204 (3) ◽  
pp. 272.e1-272.e7 ◽  
Author(s):  
Lee A. Learman ◽  
Sanae Nakagawa ◽  
Steven E. Gregorich ◽  
Rebecca A. Jackson ◽  
Alison Jacoby ◽  
...  
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding

scholarly journals Adolescence endometriosis with abnormal uterine bleeding: A challenging case report

2020 ◽  
Vol 28 (1) ◽  
pp. 32
Author(s):  
Fita Maulina ◽  
Botefilia Botefilia
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Bleeding Disorder ◽  
Uterine Bleeding ◽  
Von Willebrand Disease ◽  
Reproductive Age ◽  
Adult Women ◽  
Retrograde Menstruation ◽  
True Incidence ◽  
Pelvic Symptoms ◽  
Von Willebrand

Endometriosis is the presence of endometrial tissue outside the Uterus. The true incidence of endometriosis is not really known, but it is believed that 10-15% of all women in their reproductive age will develop endometriosis and 25-35% of all women who are infertile have endometriosis. The true incidence of endometriosis in adolescents is difficult to quantify and estimates vary among different studies. Although in the past it was assumed that endometriosis presented only after many years of menstruation, studies have shown endometriosis to occur prior to menarche and between 1-6 months after the onset of menarche. A 66% of adult women with endometriosis report the onset of pelvic symptoms prior to age 20. Although etiology and pathophysiology of endometriosis is not well‐understood, but increased rate of retrograde menstruation in patients with heavier menses as with bleeding disorder, is a possible mechanism of disease. Here, we report an early adolescent admitted with dysmenorrhea with bleeding disorder, suspected Von Willebrand disease, presenting abnormal uterine bleeding.

scholarly journals Histopathological evaluation of endometrial tissue in patients of abnormal uterine bleeding

2021 ◽  
Vol 11 (1) ◽  
pp. 69
Author(s):  
Zothansangi . ◽  
Vanremmawii . ◽  
Naveen P.
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Endometrial Tissue ◽  
Histopathological Study ◽  
Age Group ◽  
North East ◽  
The North ◽  
Resource Setting ◽  
A Prospective Study

Background: Abnormal uterine bleeding (AUB) is one of the commonest complaints in the gynecology OPD. It is also one of the most common reason for hysterectomy among Mizo women. Endometrial biopsy is a gold standard and first step for diagnosis of AUB in a low resource setting like the North-east states of India. The aim of the study was to evaluate the histopathology of endometrium for proper management of AUB cases.Methods: This was a prospective study done to evaluate the histopathology of all the cases of AUB who attended gynaecology OPD, from the year 2018 to 2020. This study comprised of 668 AUB cases and material of the study was endometrial tissue of the cases of Abnormal uterine bleeding collected by dilatation and curettage, and sent for histopathological study to the department of pathology.Results: Most of the abnormal uterine bleeding patients was in the age group of 40 to 49 years, and the most common histopathological finding was proliferative endometrium, 35.5% followed by disordered proliferation, 21%. 14 cases of carcinoma endometrium were found among the age group above 40 years.Conclusions: The research evident that all the women above 40 years old need to undergo screening, keeping in mind the higher risk of carcinoma in the older age group of women.

Hysteroscopic management of a juvenile cystic adenomyosis

2018 ◽  
Vol 10 (2) ◽  
pp. 123-123
Author(s):  
Taner A Usta ◽  
Tolga Karacan ◽  
Ulviye Hanli ◽  
Elif Cansu ◽  
Engin Oral
Keyword(s):  
Adolescent Girls ◽  
Chronic Pelvic Pain ◽  
Abnormal Uterine Bleeding ◽  
Posterior Wall ◽  
Uterine Bleeding ◽  
Transrectal Ultrasonography ◽  
Cyst Size ◽  
Postoperative Course ◽  
Outer Sheath ◽  
Effective Option

Introduction: Hysteroscopic management of juvenile cystic adenomyosis on a virgin patient with non-touch technique. Description: Juvenile cystic adenomyosis of uterus is a cyst which is surrounded by myometrium and inside of this cyst is filled with hemorrhagic fluid. A 23-year-old virgin patient admitted to endometriosis outpatient clinic. The patient complained of dysmenorrhea, chronic pelvic pain, and abnormal uterine bleeding. A submucosal adenomyotic cyst was, sized 40 mm approximately, determined at posterior wall of uterus by transrectal ultrasonography. She received daily 2 mg dienogest (Visanne®) for 6 months. At the end of 6 months of treatment, the cyst size was still 35 mm. Hysteroscopy was performed with the use of the non-touch technique (vaginoscopic approach). A rigid 2.9-mm hysteroscope with a 12° oblique lens and an outer sheath diameter of 4 mm was used. When the cystic wall was ruptured by bipolar instrument, a chocolate-colored fluid was drained. The operation lasted 10 min. Her postoperative course was uncomplicated. Postoperatively, two dose of leuprolide acetate 11.25 mg (Lucrin depot®—3M; Abbot, Istanbul, Turkey) was prescribed (6 months total). On her sixth month, there was no cyst on transrectal ultrasonography examination. The patient did not exhibit any symptoms. Conclusions: Because the disease affects adolescent girls, fertility issues should be kept in mind during the workup and when operating on these patients. Hysteroscopy is a mini-invasive, safe, and effective option for the treatment of juvenile cystic adenomyosis.

Treatment of Uterine Pathology

2021 ◽  
pp. 305-320
Author(s):  
Dimitrios Tsolakidis ◽  
Maria Lantzanaki
Keyword(s):  
Chronic Pelvic Pain ◽  
Negative Impact ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Laparoscopic Hysterectomy ◽  
Gestational Trophoblastic Disease ◽  
Uterine Bleeding ◽  
Trophoblastic Disease ◽  
Life Threatening

Hysterectomy is the most common gynecological operation after cesarean section. The majority of hysterectomies are performed for the treatment of benign diseases, which, although not life-threatening, may have a negative impact on the quality of patient's life. Abnormal uterine bleeding is the most common indication for hysterectomy in premenopausal women and is usually a result of myomas and adenomyosis. Another indication is chronic pelvic pain that is usually caused by endometriosis and/or adenomyosis. A simple hysterectomy can be the treatment of choice in early stages of endometrial, cervical cancer, sarcomas, or gestational trophoblastic disease. Laparoscopic hysterectomy is superior to laparotomy when a vaginal hysterectomy is contraindicated.

Clinical and morphometric characteristics of endometrial polyps and underlying mechanisms of abnormal uterine bleeding

2019 ◽  
Vol 7_2019 ◽  
pp. 64-70
Author(s):  
Asaturova A.V. Asaturova ◽  
Chernukha G.E. Chernukha ◽  
Ivanov I.A. Ivanov ◽  
Kuzemin A.A. Kuzemin ◽  
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Morphometric Characteristics ◽  
Endometrial Polyps ◽  
Underlying Mechanisms
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