Martin Hirsch

STUDY OBJECTIVE: To determine the characteristics of adolescent and young adult patients undergoing surgery for severe endometriosis METHODS: We analyzed the British Society for Gynaecological Endoscopy (BSGE) database, a multicenter databa…

STUDY QUESTION: How does the frequency and location of endometriosis lesions observed at laparoscopy vary with patient age? SUMMARY ANSWER: We find that older patients have more deep lesions and ovarian endometriomas at laparoscopy, althou…

OBJECTIVE: Without standardized guidelines, the management of thoracic endometriosis syndrome (TES) continues to fuel debate. Previous reviews have reported poor outcomes but lack data on complications, hospital length of stay (LOS) and che…

BACKGROUND: Rectovaginal/colorectal endometriosis is severe form of endometriosis requiring complex surgery, where pre-operative gonadotrophin releasing hormone agonists (GnRHa) are used to improve the surgical outcomes but the evidence sup…

Background: The efficacy of medical and surgical treatment of endometriosis-associated pain is a source of ongoing controversy. There is a lack of evidence about gonadotropin-releasing hormone agonists (GnRHa) use on long-term pain control,…

OBJECTIVE: To compare the effectiveness of endometriosis excision alone to excision plus hysterectomy, with and without bilateral oophorectomy, for endometriosis-related symptoms. DESIGN: Multicentre prospective cohort. SETTING: Eighty-si…

OBJECTIVE: To determine whether obstetric outcomes differ between women with endometriosis and those without, where all women undergo first-trimester screening for endometriosis. DESIGN: A prospective observational cohort study. SETTING: …

Background: There is no agreed consensus on the optimal surgical treatment for pain associated with endometriosis. Objectives: To compare improvement in symptoms and quality-of-life in patients undergoing excisional endometriosis surgery (E…

PURPOSE OF REVIEW: The use of hormonally suppressive medication to reduce levels of reproductive hormones around the time of surgery is widely used in the management of endometriosis. This review summarizes the current evidence concerning t…

PURPOSE OF REVIEW: Fibroids are benign pelvic masses and constitute the most common gynaecological condition. They create a significant health and social burden to many women because of heavy menstrual bleeding and fibroid pressure symptoms…

Fertility preservation (FP) is an established and recognised intervention for those undergoing gonadotoxic treatments, principally for malignancy. The surgical treatment of endometrioma and the disease itself reduce ovarian reserve and has …

STUDY QUESTION: What outcomes should be reported in all studies investigating uterus-sparing interventions for treating uterine adenomyosis? SUMMARY ANSWER: We identified 24 specific and 26 generic core outcomes in nine domains. WHAT IS KNO…

The claimant presented with abdominal pain from the age of 18 years through to the age of 36 years. When she finally underwent a laparoscopy, she was found to have grade 4 endometriosis which had spread around her ovaries, colon and the wal…

Transabdominal cerclage (TAC) is a recognised treatment for recurrent spontaneous late miscarriage or preterm birth due to cervical weakness. This can be performed via an open procedure before and during pregnancy, or a laparoscopic techniq…

PURPOSE OF REVIEW: Adenomyosis is a condition where endometrium-like tissue spreads within the myometrium. Although its prevalence in the general population is not exactly known, its clinical manifestations are well established and include …

BJOG mini commentary on study BJOG-21-1829TITLE: Putting patients at the centre of pain managementAlexandra Wojtaszewskaa, Arvind Vashishtb, Martin Hirschc,daWatford General Hospital, Watford, United KingdombInstitute for Women’s Health, Un…

PURPOSE OF REVIEW: To review the recent evidence around the treatment of infertility in patients with endometriosis. RECENT FINDINGS: The management of endometriosis associated infertility remains challenging. There have been an increasing …

Background: Adenomyosis is a common benign gynaecological condition that has been associated with heavy and/or painful periods, subfertility and poor obstetric outcomes including miscarriage and preterm delivery. Studies evaluating treatmen…

BACKGROUND: It is important to evaluate sequalae for complex chronic health conditions such as endometriosis and mental health disorders. Endometriosis impacts 1 in 10 women. Mental health outcomes can be a primary determinant in many physi…

STUDY QUESTION: Which outcomes and outcome measures are reported in interventional trials evaluating the treatment of adenomyosis? SUMMARY ANSWER: We identified 38 studies, reporting on 203 outcomes using 133 outcome measures. WHAT IS KNOWN…