Endometriosis: Classification, Risk factors, Diagnosis and management - Review of Literature
DOI:
https://doi.org/10.12775/QS.2024.22.54531Keywords
endometriosis, endometriosis treatment, endometriosis diagnosis, infertility in endometriosis, pelvic pain.Abstract
Endometriosis is an oestrogen-dependent disease characterised by the presence of the endometrial tissue outside its normal location. Three types of endometriosis are distinguished: ovarian, peritoneal, and deeply infiltrating [1,2].
The literature reports that 6-15% of the general female population suffers from endometriosis. This disease occurs mainly in women of reproductive age, but also in young women and postmenopausal women [3]. Symptoms of endometriosis include periodic pain that becomes constant, very painful menstruation, painful intercourse, as well as painful micturition or defecation. Endometriosis is present in up to 35-50% of women diagnosed with infertility. In diagnosing endometriosis, laparoscopy is of utmost importance, as it allows for simultaneous treatment of the condition. Laparoscopy should be preceded by a thorough medical history and imaging diagnostics such as ultrasound or magnetic resonance imaging (MRI).
The treatment of endometriosis is divided into pharmacological and surgical methods, which can be either conservative or radical. The type of treatment used depends on the patient's age and reproductive desires, the symptoms present, and the form of the disease. A proper diet and lifestyle play a significant role in the treatment of endometriosis.
References
Rolla E. Endometriosis: advances and controversies in classification, pathogenesis, diagnosis, and treatment. F1000Res. 2019 Apr 23;8:F1000 Faculty Rev-529. https://doi:10.12688/f1000research.14817.1.
Mechsner S. Endometriosis, an Ongoing Pain—Step-by-Step Treatment. J Clin Med. 2022;11(2): 467. https://doi: 10.3390/jcm11020467.
Taylor H, Kotlyar A, Flores V. Endometriosis is a chronic systemic disease: clinical challenges and novel innovations. Lancet. 2021;397(10276):839–852. https://doi: 10.1016/S0140-6736(21)00389-5.
Hudelist G, Ballard K, English J, Wright J, Banerjee S, Mastoroudes H, Thomas A, Singer CF, Keckstein J. Transvaginal sonography vs. clinical examination in the preoperative diagnosis of deep infiltrating endometriosis. Ultrasound Obstet. Gynecol. 2011; 37:p:480–487. https://doi.org/10.1002/uog.8935.
Vercellini P, Viganò P, Somigliana E, Fedele L. Endometriosis: Pathogenesis and treatment. Nat. Rev. Endocrinol. 2014; 10:p: 261–275.
Dunselman GAJ, Vermeulen N, Becker C, Calhaz-Jorge C, D’Hooghe T, De Bie B, Heikinheimo O, Horne AW, Kiesel L, Nap A, et al. ESHRE guideline: Management of women with endometriosis. Hum. Reprod. 2014; 29:p: 400–412. https://doi.org/10.1093/humrep/det457.
Menni K, Facchetti L, Cabassa P. Extragenital endometriosis: assessment with MR imaging. A pictorial review. Br J Radiol. 2016; 89(1060). https://doi: 10.1259/bjr.20150672.
Zhai J, Vannuccini S, Petraglia F, Giudice LC. Adenomyosis: Mechanisms and Pathogenesis. Semin Reprod Med . 2020 May;38(2-03):129-143. https://doi: 10.1055/s-0040-1716687.
Zervou MI, Tarlatzis BC, Grimbizis GF, Spandidos DA, Niewold TB, Goulielmos GNs. Association of endometriosis with Sjögren's syndrome: Genetic insights (Review). International Journal of Molecular Medicine. 2024 Feb; 53(2): 20. https://doi: 10.3892/ijmm.2024.5344.
Jess T, Frisch M, Jørgensen KT. Increased risk of inflammatory bowel disease in women with endometriosis: a nationwide Danish cohort study. Gut. 2012;61(9):p:1279-83. https://doi:10.1136/gutjnl-2011-301095.
Aguiar FM, Castanheira Melo SB, Carvalho Galvão L, Rosa-e-Silva JC, dos Reis RM, Ferriani RA. Serological testing for celiac disease in women with endometriosis. A pilot study. Clin Exp Obstet Gynecol. 2009;36(1):p:23-5.
Smolarz B, Szyłło K, Romanowicz H. Endometriosis: Epidemiology, Classification, Pathogenesis, Treatment and Genetics (Review of Literature). Int. J. Mol. Sci. 2021, 22(19), 10554; https://doi.org/10.3390/ijms221910554.
Pan G, Zhang P, Li S, Cao L, Yang C. Association of endometriosis with asthma: a study of the NHANES database in 1999–2006. J Health Popul Nutr. 2024; 43: 50. https://doi: 10.1186/s41043-024-00541-3.
Williams C, Long AJ, Noga H, Allaire C, Bedaiwy MA, Lisonkova S, Yong PJs. East and South East Asian ethnicity and moderate-to-severe endometriosis. J Minim Invasive Gynecol. 2019;26:507–515. https://doi:10.1016/j.jmig.2018.06.009.
Shafrir A, Farland L, Shah D, Harris H, Kvaskoff M, Zondervan K, Missmer S. Risk for and consequences of endometriosis: Acritical epidemiologic review. Best Pract Res Clin Obstet Gynaecol. 2018;51:1–15. https://doi: 10.1016/j.bpobgyn.2018.06.001.
Santanam N, Kavtaradze N, Murphy A, Dominguez C, Parthasarathy Ss. Antioxidant supplementation reduces endometriosis-related pelvic pain in humans. Transl Res. (2013) 161:p:189–95. https://doi.org/10.1016/j.trsl.2012.05.00110.
Collinet P, Fritel X, Revel-Delhom C, et al. Management of endometriosis: CNGOF/HAS clinical practice guidelines – Short version. Journal of Gynecology Obstetrics and Human Reproduction. 2018; 46: p:265-274 https://doi.org/10.1016/j.jogoh.2018.06.003.
P Viganò P, Somigliana E, Panina P, Rabellotti E, Vercellini P, Candiani MS. Principles of phenomics in endometriosis. Hum Reprod Update. 2012; 18(3): P:248-59. https:// doi:10.1093/humupd/dms001.
Bahat PY, Ayhan I, Ozdemir EU, Inceboz Ü, Oral E. Dietary supplements for treatment of endometriosis: A review. Acta Biomed. 2022; 93(1): e2022159. https://doi:10.23750/abm.v93i1.11237.
Qiu Y, Yuan S, Wang H. Vitamin D status in endometriosis: a systematic review and meta-analysis. Arch Gynecol Obstet. 2020; 302:p:141–52. https://:10.1007/s00404-020-05576-5.
Missmer SA, Hankinson SE, Spiegelman D, Barbieri RL, Marshall LM, Hunter DJ. Incidence of laparoscopically confirmed endometriosis by demographic, anthropometric,
and lifestyle factors.
Am J Epidemiol. 2004;160(8):78p:4-96. https:// doi:10.1093/aje/kwh275.
Moen MH, Magnus P. The familial risk of endometriosis. Acta Obstet Gynecol Scand. 1993;72(7):p:560-4. https://doi: 10.3109/00016349309058164.
Stefansson H, Geirsson RT, Steinthorsdottir V, Jonsson H, Manolescu A, Kong A, Ingadottir G, Gulcher J, Stefansson K. Genetic factors contribute to the risk of developing endometriosis. Hum Reprod. 2002 Mar;17(3):p:555-9. https://doi: 10.1093/humrep/17.3.555.
Wójcik M, Szczepaniak R, Placek K. Physiotherapy Management in Endometriosis. International Journal of Environmental Researchand Public Health. 2022;19. https://doi.org/10.3390/ijerph192316148.
Nicolas-Boluda A, Oppenheimer A, Bouaziz J, Fauconnier A. Patient-Reported Outcome Measures in Endometriosis. J Clin Med. 2021; 10(21): p: 5106. https://doi:10.3390/jcm10215106.
Ballard KD, Seaman HE, de Vries SC, Wright JT. Can symptomatology help in the diagnosis of endometriosis? Findings from a national case-control study--Part 1. BJOG. 2008;115(11):p:1382-91. https:// doi: 10.1111/j.1471-0528.2008.01878.
Wang Y, Nicholes K, Shih IM. The Origin and Pathogenesis of Endometriosis. Annu Rev Pathol. 2020;15:71-95.:doi: 10.1146/annurev-pathmechdis-012419-032654.
Vannuccini S, Lazzeri L, Orlandini C, Tosti C, Clifton VL, Petraglia F. Potential influence of in utero and early neonatal exposures on the later development of endometriosis. Fertil Steril. 2016;105(4):p:997-1002. https //doi: 10.1016/j.fertnstert.2015.12.127.
Borghese B, Sibiude J, Santulli P, Pillet MCL, Marcellin L, Brosens I, Chapron C. Low birth weight is strongly associated with the risk of deep infiltrating endometriosis: results of a 743 case-control study. PLoS One. 2015;10(2):e0117387. https://doi:10.1371/journal.pone.0117387.
Amro B, Ramirez Aristondo ME, Alsuwaidi S, et al. New Understanding of Diagnosis, Treatment and Prevention of Endometriosis. Int J Environ Res Public Health. 2022 May;19(11):6725. https //doi: 10.3390/ijerph19116725.
Amro B, Ramirez Aristondo ME. New Understanding of Diagnosis, Treatment and Prevention of Endometriosis. Int J Environ Res Public Health. 2022 May;19(11):6725. https://doi:10.3390/ijerph19116725.
Shigesi N, Kvaskoff M, Kirtley S. The association between endometriosis and autoimmune diseases: a systematic review and meta-analysis. Hum Reprod Update. 2019 Jul 1;25(4):486-503. https://doi: 10.1093/humupd/dmz014.
Aguiar FM, Melo SBC, Galvão LC. Serological testing for celiac disease in women with endometriosis. A pilot study. Clin Exp Obstet Gynecol. 2009;36(1):p:23-5.
Lamb K, Nichols TR. Endometriosis: a comparison of associated disease histories. Am J Prev Med. 1986;2(6):p:324-9.
Nichols TR, Lamb K, Arkins JA. The association of atopic diseases with endometriosis. Ann Allergy. 1987;59(5):p:360-3.
Ferrero S, Petrera P, Colombo BM, Navaratnarajah R, Parisi M, Anserini P, Remorgida V, Ragni N. Asthma in women with endometriosis. Hum Reprod. 2005 Dec;20(12):3514-7. https:// doi: 10.1093/humrep/dei263. Epub 2005 Sep 9.
Matalliotakis I, Cakmak H, Matalliotakis M, Kappou D, Arici A.
High rate of allergies among women with endometriosis. J Obstet Gynaecol. 2012;32(3):p:291-3. https://doi: 10.3109/01443615.2011.644358.
Ammendola M, Pietropolli A, Saccucci P, Piccione E, Bottini E, Gloria-Bottini F. Acid phosphatase locus 1 genetic polymorphism, endometriosis, and allergy. Fertil Steril. 2008;90(4):p:1203-5. https://doi: 10.1016/j.fertnstert.2007.10.014.
Hurd WW. Criteria that indicate endometriosis is the cause of chronic pelvic pain. Obstet Gynecol. 1998 Dec;92(6):1029-32. https:// doi: 10.1016/s0029-7844(98)00283-x.
Abramiuk M, Grywalska E, Małkowska P, Sierawska O, Hrynkiewicz R, Niedźwiedzka-Rystwej P. The Role of the Immune System in the Development of Endometriosis. Cells. 2022 ;25;11(13):2028. https://doi: 10.3390/cells11132028.
Chapron C, Dubuisson JB, Pansini V, Vieira M, Fauconnier A, Barakat H, Dousset B. Routine clinical examination is not sufficient for diagnosing and locating deeply infiltrating endometriosis. J Am Assoc Gynecol Laparosc. 2002;9(2):p:115-9. https://doi: 10.1016/s1074-3804(05)60117-x.
National Institute for Health and Care Excellence. Endometriosis: diagnosis and management [NG73]. London, United Kingdom; 2017. Available at: https://www.nice.org.uk/guidance/ng73.
Becker CM, Bokor A, Heikinheimo O, et al. ESHRE guideline: endometriosis. Hum Reprod Open.2022;2:1-26. https://doi: 10.1093/hropen/hoac009.
Koninckx PR, Meuleman C, Oosterlynck D, Cornillie FJ. Diagnosis of deep endometriosis by clinical examination during menstruation and plasma CA-125 concentration. Fertil Steril. 1996;65(2):p:280-7.
Guerriero S, Condous G, van den Bosch T, et al. Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group. Ultrasound Obstet Gynecol .2016;48(3):p:318-32. https://doi: 10.1002/uog.15955.
Van den Bosch T, Van Schoubroeck D. Ultrasound diagnosis of endometriosis and adenomyosis: State of the art .Best Pract Res Clin Obstet Gynaecol . 2018:51:p:16-24. https://doi: 10.1016/j.bpobgyn.2018.01.013.
Guerriero S, Alcázar JL, Pascual MA, el al. Deep Infiltrating Endometriosis: Comparison Between 2-Dimensional Ultrasonography (US), 3-Dimensional US, and Magnetic Resonance Imaging. J Ultrasound Med. 2018 Jun;37(6):1511-1521. https://doi: 10.1002/jum.14496.
Guerriero S, Saba L , Pascual MA, Ajossa S, Rodriguez I, Mais V, Alcazar JL. Transvaginal ultrasound vs magnetic resonance imaging for diagnosing deep infiltrating endometriosis: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2018;51(5):p:586-595. https://doi: 10.1002/uog.18961.
Wykes CB, Clark TJ, Khan KS. Accuracy of laparoscopy in the diagnosis of endometriosis: a systematic quantitative review. BJOG. 2004;111(11):p:1204-12. https://doi: 10.1111/j.1471-0528.2004.00433.x.
Piketty M , Chopin N, Dousset B, et al. Preoperative work-up for patients with deeply infiltrating endometriosis: transvaginal ultrasonography must definitely be the first-line imaging examination. Hum Reprod . 2009 Mar;24(3):602-7. https://doi: 10.1093/humrep/den405.
Moore J, Copley S, Morris J, Lindsell D, Golding S, Kennedy S. A systematic review of the accuracy of ultrasound in the diagnosis of endometriosis. Ultrasound Obstet Gynecol. 2002;20(6):p:630-4. https://doi: 10.1046/j.1469-0705.2002.00862.x.
Goncalves MO, Neto JS, Andres MP, et al. Systematic evaluation of endometriosis by transvaginal ultrasound can accurately replace diagnostic laparoscopy, mainly for deep and ovarian endometriosis. Hum Reprod. 2021;36(6):p:1492-1500. https://doi: 10.1093/humrep/deab085.
Dessole S, Farina M, Rubattu G, Cosmi E, Ambrosini G, Nardelli GB. Sonovaginography is a new technique for assessing rectovaginal endometriosis. Fertil Steril.2003 Apr;79(4):1023-7. https://doi: 10.1016/s0015-0282(02)04952-x.
Grasso RF, Di Giacomo V, Sedati P, et al. Diagnosis of deep infiltrating endometriosis: accuracy of magnetic resonance imaging and transvaginal 3D ultrasonography Abdom Imaging. 2010;35(6):p:716-25. https://doi: 10.1007/s00261-009-9587-7.
Manti F, Battaglia C, Bruno I, et al. The Role of Magnetic Resonance Imaging in the Planning of Surgical Treatment of Deep Pelvic Endometriosis. Front Surg. 2022; 9: 944399. https://doi: 10.3389/fsurg.2022.944399:PMC9273906 PMID: 35836610
Saba L, Sulcis R, Melis GB. Endometriosis: the role of magnetic resonance imaging. Acta Radiol. 2015 Mar;56(3):355-67. https://doi: 10.1177/0284185114526086.
Hottat N, Larrousse C, Anaf V, et al. Endometriosis: contribution of 3.0-T pelvic MR imaging in preoperative assessment--initial results. Radiology. 2009;253(1):p:126-34. https://doi: 10.1148/radiol.2531082113.
Anastasiu CV, Moga MA, Neculau AE, Bălan A, Scârneciu J, Dragomir RM, Dull AM, Chicea LM. Biomarkers for the Noninvasive Diagnosis of Endometriosis: State of the Art and Future Perspectives. Int J Mol Sci. 2020;4;21(5):1750. https:// doi: 10.3390/ijms21051750.
Gupta D, Hull ML, Fraser I, Miller L, Bossuyt PMM, Johnson N, Nisenblat V. Endometrial biomarkers for the non-invasive diagnosis of endometriosis. Cochrane Database Syst Rev. 2016;4(4):CD012165. https://doi: 10.1002/14651858.CD012165.
Hirsch M, Duffy J, Davis CJ, et al. International Collaboration to Harmonise Outcomes and Measures for Endometriosis. Diagnostic accuracy of cancer antigen 125 for endometriosis: a systematic review and meta-analysis.
BJOG. 2016;123(11):p:1761-8. https://doi: 10.1111/1471-0528.14055.
Herranz-Blanco B, Daoud E, Viganò P, García-Velasco JA, Colli E. Development and Validation of an Endometriosis Diagnostic Method Based on Serum Biomarkers and Clinical Variables. Biomolecules. 2023;13(7):1052. https://doi: 10.3390/biom13071052.
Żeberkiewicz M, Hyc A, Iwan A, Zwierzchowska A, Ścieżyńska A, Kalaszczyńska I, Barcz E, Malejczyk J. Expression of Fucosyltransferase 4 (FUT4) mRNA Is Increased in Endometrium from Women with Endometriosis . J. Clin. Med. 2022, 11(19), 5606; https://doi.org/10.3390/jcm11195606.
Grandi G, Barra F, Ferrero S, Sileo FG, Bertucci E, Napolitano A, Facchinetti F. Hormonal contraception in women with endometriosis: a systematic review. Eur J
Contracept Reprod Health Care
. 2019;24(1):p:61-70. https://doi: 10.1080/13625187.2018.1550576.
Schenken RS. Endometriosis: Treatment of pelvic – UpToDate. Retrieved July 18, 2022, from https://www.uptodate.com/contents/endometriosis-treatment-of-pelvic-pain.
Hughes E, Brown J, Collins JJ, Farquhar C, Fedorkow DM, Vandekerckhove P. Ovulation suppression for endometriosis. Cochrane Database Syst Rev.2007(3):CD000155. https://doi: 10.1002/14651858.CD000155.pub2.
Duffy DM, VandeVoort CA. Maturation and Fertilization of Non-Human Primate Oocytes are Compromised by Oral Administration of a COX2 Inhibitor. Fertil Steril. 2011; 95(4): p:1256–1260. https://doi: 10.1016/j.fertnstert.2010.12.048.
Chen I, Veth VB, Choudhry AJ, Murji A, Zakhari A, Black AY, Agarpao C, Maas JWM. Pre‐ and postsurgical medical therapy for endometriosis surgery. Cochrane Database of Systematic Reviews Review – Intervention. 2020 https://doi.org/10.1002/14651858.CD003678.pub3.
Zakhari A, Delpero E, McKeown S, et al. Endometriosis recurrence following post-operative hormonal suppression: a systematic review and meta-analysis. Hum Reprod Update. 2021;27(1):p:96-107. https://doi: 10.1093/humupd/dmaa033.
Trivedi P, Selvaraj K, Mahapatra PD, et al. Effective post-laparoscopic treatment of endometriosis with dydrogesterone. Gynecol Endocrinol. 2007:23 Suppl1:p:73-6. https://doi: 10.1080/09513590701669583.
Vercellini P, Somigliana E, Daguati R, et al. Postoperative oral contraceptive exposure and risk of endometrioma recurrence. Am J Obstet Gynecol. 2008;198(5):504. https:// doi: 10.1016/j.ajog.2007.11.010.
Harada T, Momoeda M, Taketani Y, et al. Low-dose oral contraceptive pill for dysmenorrhea associated with endometriosis: a placebo-controlled, double-blind, randomized trial. Fertil Steril. 2008;90(5):p:1583-8. https://doi: 10.1016/j.fertnstert.2007.08.051.
Berkley KJ, Rapkin AJ, Papka RE. The pains of endometriosis. Science. 2005;308(5728):p:1587-9. https:// doi: 10.1126/science.1111445.
Johnson NP, Hummelshoj L, World Endometriosis Society Montpellier Consortium. Consensus on current management of endometriosis. Hum Reprod. 2013;28(6):p:1552-68. https://doi:10.1093/humrep/det050.
Broi MGD, Ferriani RA, Navarro PA. Ethiopathogenic mechanisms of endometriosis-related infertility. JBRA Assist Reprod. 2019;23(3):273-280. https:// doi: 10.5935/1518-0557.20190029.
Grammatis AL, Georgiou EX, Becker CM. Pentoxifylline for the treatment of endometriosis-associated pain and infertility. Cochrane Database Syst Rev. 2021;8(8):CD007677. https:// doi: 10.1002/14651858.CD007677.pub4.
Garcia-Velasco JA, Mahutte NG, Corona J, et al. Removal of endometriomas before in vitro fertilization does not improve fertility outcomes: a matched, case-control study. Fertil Steril. 2004;81(5):p:1194-7. https:// doi: 10.1016/j.fertnstert.2003.04.006.
Marcoux S, Maheux R, Bérubé S. Laparoscopic surgery in infertile women with minimal or mild endometriosis. Canadian Collaborative Group on Endometriosis. N Engl J Med. 1997;337(4):p:217-22. https:// doi:10.1056/NEJM199707243370401.
Nankali A, Kazeminia M, Jamshidi PK, Shohaimi S, Salari N, Mohammadi M, Hosseinian-Far A. The effect of unilateral and bilateral laparoscopic surgery for endometriosis on Anti-Mullerian Hormone (AMH) level after 3 and 6 months: a systematic review and meta-analysis. Health Qual Life Outcomes. 2020;18(1):314. https://doi: 10.1186/s12955-020-01561-3.
Rush G, Misajon RA, Hunter JA, Gardner J, O'Brien KS. The relationship between endometriosis-related pelvic pain and symptom frequency, and subjective wellbeing. Health Qual Life Outcomes. 2019;17(1):123. https://doi: 10.1186/s12955-019-1185-y.
Vesali S, Razavi M, Rezaeinejad M, Maleki-Hajiagha A, Maroufizadeh S, Sepidarkish M. Endometriosis fertility index for predicting non-assisted reproductive technology pregnancy after endometriosis surgery: a systematic review and meta-analysis. BJOG. 2020;127;7: P:800-809. https://doi.org/10.1111/1471-0528.16180.
Maheux-Lacroix S, Nesbitt-Hawes E, Deans R, Won H, Budden A, Adamson D, Abbott JA. Endometriosis fertility index predicts live births following surgical resection of moderate and severe endometriosis. Human Reproduction. 2017;1;32(11): p:2243–2249. https://doi.org/10.1093/humrep/dex291.
Dan H, Limin F. Laparoscopic ovarian cystectomy versus fenestration/coagulation or laser vaporization for the treatment of endometriomas: a meta-analysis of randomized controlled trials. Gynecol Obstet Invest. 2013;76(2):p:75-82. https://doi: 10.1159/000351165.
Cohen J, Thomin A, D'Argent EM, Laas E, Canlorbe G, Zilberman S, Belghiti J, Thomassin-Naggara I, Bazot M, Ballester M, Daraï E. Fertility before and after surgery
for deep infiltrating endometriosis with and without bowel involvement: a literature review.
Minerva Ginecol. 2014;66(6):p:575-87.
ML, Seyer-Hansen M, Forman A. Does surgery for deep infiltrating bowel endometriosis improve fertility? A systematic review. Acta Obstet Gynecol Scand. 2017;96(6):p:688-693. https://doi.org/10.1111/aogs.13152.
Berlanda N, Vercellini P, Somigliana E, Frattaruolo MP, Buggio L, Gattei U. Role of surgery in endometriosis-associated subfertility. Semin Reprod Med. 2013:31(2):P:133-43. https://doi: 10.1055/s-0032-1333478.
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