Endometriosis: An Enigma

Description

Endometriosis is a complex gynecological disorder with multifactorial etiology. An estrogen-dependent condition, it affects 6% to 10% of women in the general population, and in 35% to 50% of these women often experience pain, and sometimes infertility. Exploring this benign but chronic disease, the book covers the different aspects of endometriosis from basic to advanced levels, including diagnoses, management, treatment modalities, complications, and fertility. Features Provides an overview of the guidelines, expert opinions, and ethical dilemmas involved with endometriosis. Covers the various complications that these women can experience Presents informative illustrations that complement the text discussion An overview of surgery, hormone therapy, and other options is provided In-depth coverage of novel treatments, including alternative medicine, diet, nutrition, and lifestyle modifications Cover Half Title Title Page Copyright Page Contents Preface Acknowledgments Editor Contributors 1. Natural history: Basics of endometriosis Ancient descriptions suggesting the diagnosis of endometriosis Ovarian endometriosis Identification of adenomyoma Adenomyosis and endometriosis—The differentiation References 2. Epidemiology Introduction Epidemiology References 3. Etiopathogenesis of endometriosis What is endometriosis? What is the pathology? What is adenomyosis? Etiology Risk factors Genital tract (MÜllerian anomalies) Suggested reading 4. Molecular basis and biomarkers of disease activity Biomarkers in peripheral blood Endometrial biomarkers Biomarkers in urine Biomarkers in saliva Biomarkers in peritoneal fluid Proteomic biomarkers Genetic biomarkers Conclusion References 5. Diagnostic evaluation Pain Infertility Symptoms from specific sites Diagnostic evaluation References 6. Adolescents and endometriosis Prevalence Clinical presentation Diagnosis Management Postoperative treatment Conclusion References 7. Infertility attributed to endometriosis Introduction Epidemiology Biological mechanisms in endometriosis-associated infertility Immunobiology and molecular mechanisms Distortion of pelvic anatomy Endocrine and ovulatory abnormalities in endometriosis Fertilization and implantation defects Early pregnancy loss Other factors Conclusion References 8. Medical management of endometriosis Background Mechanisms of pain Treatment of endometriosis Medical treatment Treatment in current practice Critical appraisal of current treatment modalities Future directions Conclusion References 9. Surgical exploration as the primary modality of treatment Surgery as the primary modality When to shift from medical to surgical management Counseling and consent for surgery Surgery for acute pain Surgery for chronic pain Adenomyomectomy Hysterectomy with bilateral salpingo-oophorectomy LUNA and presacral neurectomy Scar endometriosis Surgery for suspected malignancy in ovarian endometrioma Surgery for women with infertility Before ART Hydrosalpinx removal Mode of surgery Surgical techniques Cystectomy Adhesion prevention How much resection is not too much? Role of preoperative/postoperative medical management References 10. Management of deep infiltrative endometriosis (DIE) causing gynecological morbidity: A urologist’s perspective Introduction and epidemiology Etiopathogenesis History and examination Evaluation Imaging Cystoscopy and ureteroscopy Urodynamics Treatment Conclusion References 11. Management of deep infiltrative endometriosis (DIE) causing gynecological morbidity: A colorectal surgeon’s perspective Introduction, definition, and scope of the problem Morphology and patterns of involvement Clinical features Investigations Scoring systems for bowel endometriosis Treatment Treatment of endometriosis at other sites Outcomes of treatment Conclusion References 12. Adenomyosis and endometriosis Introduction Etiopathogenesis Histopathology Symptoms and signs Classification Diagnosis Treatment Endometriosis and adenomyosis Conclusion References 13. Helping a woman afflicted with endometriosis to conceive Stage-wise probable mechanism of infertility in endometriosis Treatment modalities Pregnancy and endometriosis Complications during pregnancy due to endometriosis Operative delivery Fetal Effects Conclusion References 14. Alternative medicine for endometriosis: Diet and nutrition Introduction Dietary nutrients and their role in endometriosis Functional foods help in tackling endometriosis when incorporated daily in diet Special diets for endometriosis Diet summary Conclusion References 15. Novel treatment modalities Treatment modalities GnRH antagonists GnRH agonist Selective progesterone receptor modulators selective estrogen receptor modulators Nonhormonal treatments Hormonal therapy versus diet Other investigational hormonal therapies Investigational nonhormonal therapies: Anti-angiogenic drugs Danazol Implants Future therapies Conclusion References 16. Long-term complications associated with endometriosis Deep infiltrating endometriosis Bowel endometriosis Abdominal wall endometriosis Urinary tract endometriosis Bladder endometriosis Ureteral endometriosis Renal endometriosis Liver endometriosis Pancreatic endometriosis Omental endometriosis Nervous system endometriosis Massive ascites in endometriosis Spontaneous hemoperitoneum in pregnancy and endometriosis Malignancy Conclusion References 17. Recurrence of endometriosis Risk factors for recurrence Biomarkers Glycoproteins Immunological and inflammatory cytokines Oxidative stress Cell adhesion and invasion Angiogenesis Hormones Autoantibodies Metabolomics Circulating cell-free DNA Cell populations Urine biomarkers Endometrial biomarkers Endometrial transcriptome Endometrial proteomes Neuronal marker Treatment Conclusion References 18. Quality of life affected by endometriosis: Lifestyle modification for symptom alleviation References 19. Literature review: Guidelines for the management of endometriosis Introduction Methodological quality of the guidelines ESHRE guidelines Recent systematic reviews and meta-analyses Role of support groups, lay organizations, and online portals Conclusion References 20. Hormone therapy after total surgery for endometriosis Total surgery for endometriosis Natural menopause versus surgical (sudden) menopause Endometriosis and estrogen dependence HRT for surgical menopause following endometriosis Options for HRT Concerns of HRT in endometriosis Conclusion References 21. Ethical dilemmas in the management of endometriosis References 22. Conclusion References Index