Pathogenesis, diagnosis and treatment of genital endometriosis

L Mettler, Mettler L
Acta obstetricia et gynecologica Scandinavica · 1989 · vol. 68(S150) , pp. 31–37 · doi:10.1111/aogs.1989.68.s150.31 · PMID:2618600 · W2408030096
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This study investigated the pathogenesis, diagnosis, and treatment of genital endometriosis, finding GnRH analogs effective, safe, and well-tolerated, with gestrinone being the preferred endocrine therapy.

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This article provides a general overview of genital endometriosis, defining the condition as the presence of endometrial epithelium and stroma in ectopic locations. The authors note that while the genetic background is partially understood, the etiology remains largely unclear despite being a slowly progressive disease. They highlight that advanced pelviscopic procedures have increased detection rates and clarified associations with sterility. This paper is centrally about endometriosis, serving as a foundational review of its pathogenesis, diagnosis, and treatment approaches.

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Abstract

The etiology of genital endometriosis remains unclear, but it is evident that persisting endometriotic foci are stimulated by ovarian steroid hormones. Many cases are treated by surgery either via laparotomy or pelviscopy. Endocrine treatments with testosterone, gestagens, danazol and gestrinone have also been used to some effect. Recently developed analogs of gonadotropin-releasing hormone (GnRH) have demonstrated the high binding capacities of receptors involved in the down-regulation of the normal cycle which result in atrophy of the endometrium. These agents could therefore be used in the treatment of endometriosis. To date, 924 patients with pelvic endometriosis have been treated in our department with conventional endocrine therapies, 40 patients were treated with buserelin (D-Ser (Bu)6 luteinizing hormone-releasing hormone monopeptide-ethylamide), 900 micrograms/day intranasally, and 50 patients with goserelin depot, a GnRH analog of D-Ser (Bu)6- Azegly10-GnRH, with depot applications (3.6 mg per 4 weeks). The stage of development of endometriosis was determined using the endoscopic endometriosis classification prior to and after endocrine treatment. A complete check of the pelvis was carried out each time and a careful revision of the endometriotic foci undertaken. Endocrine treatment of endometriosis allowed 60% of previously sterile patients to become pregnant. Ovarian function in these patients was normal. The analogs proved to be clinically effective, safe and were well tolerated. Gestrinone proved to be the endocrine treatment of preference.
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Pathogenesis, Diagnosis and Treatment of Genital Endometriosis Main Article Content Abstract Endometriosis is a slowly progres sive, partly studied disease. Its genetic background is partly clarified but its aetiology still remains totally unclear. According to Philipp and Huber(1) it is a disease where endometrial epithelium and stroma are found at a location to which it does not belong. With more advanced pelviscopic procedures en- dometriosis is detected more frequently and any relation to sterility can easily be traced(2). Article Details How to Cite (1) Mettler , L. Pathogenesis, Diagnosis and Treatment of Genital Endometriosis. Thai J Obstet Gynaecol 1989, 1, 143-152. Section Special Article This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Genital Neoplasms, Female Genital Neoplasms, Female Genital Neoplasms, Female Genital Neoplasms, Female Genital Neoplasms, Female Female Female Humans Humans

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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