Endometriosis: From Diagnosis to Treatment

$230.00

Simone Ferrero, MD, PhD (Editor)
Associate Professor of Obstetrics and Gynaecology, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genova, Italy
Unit of Obstetrics and Gynaecology, IRCCS AOU San Martino – IST, Genova, Italy

Fabio Barra (Editor)
Academic Unit of Obstetrics and Gynecology University of Genoa Genoa, Italy

Endometriosis is a chronic benign estrogen-dependent disease which is characterized by the presence of endometriotic glands and stroma outside the uterine cavity. It affects women during reproductive age, but it may also be diagnosed in menopausal women.

Endometriosis can be asymptomatic; but most frequently it can be responsible for pain symptoms and/or infertility, severely impacting women’ quality of life. Overall, clinical presentation depends on the location of endometriotic lesions: intestinal symptoms can occur in case of bowel nodules whereas urinary symptoms can occur in case of urinary tract endometriosis.

At the moment, the exact prevalence of endometriosis is unknown because its definitive diagnosis requires surgery and histological evaluation. It has been estimated that this benign chronic disease affects at least 3.6% of reproductive age women; however, its prevalence could significantly increase considering women suffering from dysmenorrhea, chronic pelvic pain and/or infertility.

The etiology of endometriosis is unclear: various factors, such as multiple abnormalities of the immune system, genetic factors and environmental factors may influence women’ susceptibility to develop this chronic disease.

Although the gold standard for the diagnosis of endometriosis is the pathological evaluation of surgical biopsies or specimens, today transvaginal ultrasonography is largely employed to reliably identify the presence of deep infiltrating endometriosis or ovarian endometriomas.

The aim of the surgery for endometriosis is to restore the normal anatomy by removing endometriotic lesions and by performing adequate removal of abdominal adhesions. However, surgery, in case of deep infiltrating implants, can be rather challenging for gynecologists due to the complexity of pelvic adhesions involving several structures and it may be characterized by rare but not negligible urological, intestinal, neurological and vascular complications. Furthermore, pain may recur after conservative surgery for endometriosis. Although surgery is obviously required in cases of ureteral stenosis, bowel occlusion or ovarian cysts with doubtful characteristics of malignancy, medical therapy, and, particularly, hormonal therapies, are the initial therapeutic approach today for most patients with endometriosis-related pain. Long-term medical therapy for endometriosis aims to minimize the production and action of estradiol, inhibiting the production of cyclic hormones from the ovaries. Numerous medical options (such as estroprogestins, progestins, gonadotropin- releasing hormones analogs and antagonists) are available for treating women with endometriosis: the choice of the most suitable compound is based on several factors, such as intensity of pain, age, desire to conceive, costs, route of administration and impact of the endometriosis on work capacity, sexual function and quality of life of each women. Currently, research is focused on finding new innovative targets to treat this benign chronic disease; in fact, it is well known that development, maintenance and progression of endometriosis depend on a variety of aberrant mechanisms including cell proliferation, immune function, apoptosis, invasion capacity and angiogenesis.

The aim of this book is to give an accurate overview on pathogenesis, diagnosis and therapy of endometriosis.
(Imprint: Nova Medicine and Health)

 

 

Series: Obstetrics and Gynecology Advances
BISAC: MED033000

Table of Contents

Table of Contents

Preface

Chapter 1. Environmental Factors and Endometriosis: Is There a Need or Possibility for a Change?
(Melanie Norton, MD, Sanja Terzic, MD, Gauri Bapayeva, MD PhD, Gulzhanat Aimagambetova, MD, Michele Fichera, MD, Gaetano Riemma, MD, and Milan Terzic, MD PhD, Department of Urogynaecology, Whittington Hospital, London, England, and others)

Chapter 2. Pathogenesis of Endometriosis
(Diletta Marcolin, MD, Fabio Barra, MD, Umberto Leone Roberti Maggiore, MD, PhD, Simone Ferrero, MD, PhD, Department of Obstetrics and Gynecology, University of Genoa, Genoa, Liguria, Italy, and others)

Chapter 3. Is Macrophage Polarization Important in Pathogenesis of Endometriosis?
(Justina Sikora, MD, and Simone Ferrero, MD, PhD, Department of Immunology and Serology, School of Pharmacy with the Division of Medical Analytics in Sosnowiec, Medical University of Silesia, Kato, Katowice, Poland, and others)

Chapter 4. Advances in Endometriosis Diagnosis: How Far Can Molecular Biology Help Us?
(Luana Grupioni Lourenço Antônio, Juliana Meola MD, PhD, Ana Carolina Japur de Sá Rosa e Silva, MD, Omero Benedicto Poli Neto, MD, and Julio César Rosa e Silva, MD, Department of Gynecology and Obstetrics, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil)

Chapter 5. Quality of Life, Sexual Function and Couple Relationship in Women with Endometriosis and Chronic Pelvic Pain
(Valentina Lucia La Rosa, PsyD, Gaetano Riemma, MD, and Agnese Maria Chiara Rapisarda, MD, Unit of Psychodiagnostics and Clinical Psychology, University of Catania, Catania, Italy, and others)

Chapter 6. Endometriosis: Comprehensive Overview on Diagnostic and Therapeutic Options
(Giuseppe Gullo, MD, PhD, Department of Gynecology and Obstetrics, AOOR Villa Sofia Cervello, IVF Public Center, Palermo, Italy)

Chapter 7. First-Line Medical Therapies for the Treatment of Endometriosis
(Giulio Evangelisti, MD, Matteo Tantari, MD, Fabio Barra, MD, Carolina Scala, MD, PhD, and Simone Ferrero, MD, PhD, Department of Obstetrics and Gynecology, University of Genoa, Genoa, Liguria, Italy, and others)

Chapter 8. Second-Line Medical Therapies for the Treatment of Endometriosis
(Giulio Evangelisti, MD, Fabio Barra, MD, and Simone Ferrero, MD, PhD, Department of Obstetrics and Gynecology, University of Genoa, Genoa, Liguria, Italy, and others)

Chapter 9. Experimental Drugs in Endometriosis Therapy
(Matteo Tantari, MD, Fabio Barra, MD, Giulio Evangelisti, MD, Umberto Leone Roberti Maggiore, MD, PhD, and Simone Ferrero, MD, PhD, Department of Obstetrics and Gynecology, University of Genoa, Genoa, Liguria, Italy, and others)

Chapter 10. Hormonal Therapies before In vitro Fertilization in Patients with Endometriosis
(Simone Ferrero, MD, PhD, Carolina Scala, MD, PhD, and Fabio Barra, MD, Department of Obstetrics and Gynecology, University of Genoa, Genoa, Liguria, Italy, and others)

Chapter 11. Bowel Endometriosis: Epidemiology of a Challenging Disease
(Giovanni Noberasco, MD, Andrea Orsi, MD, PhD, Giulio Evangelisti, MD, Fabio Barra, MD, Simone Ferrero, MD, PhD, and Giancarlo Icardi, MD, PhD, Department of Health Sciences, University of Genoa, Genoa, Liguria, Italy, and others)

Chapter 12. Surgical Treatment of Bowel Endometriosis
(Simone Ferrero, MD, PhD, Umberto Leone Roberti Maggiore, MD, PhD, Cesare Stabilini, MD, and Fabio Barra, MD, Department of Obstetrics and Gynecology, University of Genoa, Genoa, Liguria, Italy, and others)

Chapter 13. Rectovaginal Deep Endometriosis: Planning the Right Surgical Approach
(Marco Mitidieri, MD, Domenico Ferraioli, MD, PhD, Emanuele Manti, MD, Vanessa Nirde, MD, and Stefano Cosma, MD, PhD, Department of Gynecology and Obstetrics, City of Health and Science, Turin, Italy, and others)

Chapter 14. Urinary Tract Endometriosis: Clinical Presentation and Diagnosis
(Brunella Gravina, MD, Fabio Barra, MD, Giulio Evangelisti, MD, Domenico Ferraioli, MD, Umberto Leone Roberti Maggiore, MD, PhD, and Simone Ferrero, MD, PhD, Department of Obstetrics and Gynecology, University of Genoa, Genoa, Liguria, Italy, and others)

Chapter 15. Cesarean Scar Endometriosis
(Sara Guzzetti, MD, Fabio Barra, MD, and Simone Ferrero, MD, PhD, Department of Obstetrics and Gynecology, University of Genoa, Genoa, Liguria, Italy, and others)

Chapter 16. Impact of Endometriosis on Pregnancy
(Carolina Scala, MD, PhD, Fabio Barra, MD, and Simone Ferrero, MD, PhD, Department of Obstetrics and Gynecology, Gaslini Institute, Genoa, Liguria, Italy, and others)

Appendix I

Index

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