Endometrioma Unveiled: A Comprehensive Review of the Pathogenesis, Diagnosis, and Current Management Strategies of Ovarian Endometriosis

Houriah Nukaly, Razan Azmi Dalloul, Amal Mohamed Kayali, Jumanah Y Nassar, Saeed Asiry
In: Authorea, Inc. · 2023 · doi:10.22541/au.169516724.49578158/v1 · W4386852738
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This review comprehensively examines the pathogenesis, diagnosis, and management strategies for endometriosis, particularly ovarian endometrioma, comparing it with adenomyosis and exploring factors influencing disease risk and treatment approaches.

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Abstract

Introduction Endometriosis is a chronic estrogen-dependent disease characterized by the ectopic presence of endometrial glands and stroma outside the uterine cavity, estimated to affect up to 10% of reproductive-aged women.1 Although the clinical picture of the disease is widely varied, chronic pelvic pain appears to be the most prevalent presentation among patients with endometriosis. Furthermore, endometriosis has been identified as the most common cause of secondary dysmenorrhea.2 While the contributing factors leading to endometriosis remain unclear, several risk factors have been highlighted in the literature suggested to play a role in the pathogenesis of endometriosis. A recent systematic review highlighted consumption of red meat, trans fatty acids (TFA), and saturated fatty acid (SFA) increase the risk of endometriosis, whereas a higher intake of total dairy [all low-fat and high-fat dairy foods] was connected with lower risk of developing endometriosis.3Similarly, vitamin D, calcium, and fruits and vegetables consumption are additional factors that led to a decreased risk of endometriosis.4,5 Interestingly, Asian women are more likely to develop endometriosis which suggests race\ethnicity may play a role in developing endometriosis, as well as disease severity.6Furthermore, lean body size, menarche before the age of 12 years, and short menstrual cycle length have been associated with a lower risk.7 Endometriosis can be broadly classified into three subtypes according to its pathophysiology and anatomical location: superficial endometriosis, ovarian endometrioma (OMA), and deep infiltrating endometriosis (DIE).8 Superficial endometriosis, also known as peritoneal endometriosis found in 15-50% of women diagnosed with endometriotic lesions.9 While ovarian Endometrioma, also known as chocolate cyst, is found in 50% of women complaining of infertility.10 Further, Deep infiltrating endometriosis consider the most severe form of endometriosis, with an estimated prevalence of 14–20% in women with endometriosis.11 Several options can be used for the management of endometriosis including medical, surgical, and assisted reproductive technology (ART). The treatment of choice depends on the patient’s condition, if the main complaint is chronic pain, analgesics, and hormonal treatments can be used.12 However, a large majority of endometriosis patients seeking treatment for infertility, surgery or medically assisted reproduction may be the optimal choice of management for endometriosis-associated infertility.13 In this review, we aim to compare and contrast the pathology of adenomyosis with endometriosis as well as investigate uterine disorders. In addition, understanding the unique aspects of endometriosis and adenomyosis may direct future research, leading to enhanced management plans and therapeutic techniques, and potentially novel therapeutic interventions. Thus, this presents an opportunity for researchers to advance medical knowledge and divulge new insights into the underlying etiology of uterine disorders.

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Condition tags

endometriosisadenomyosisdie_deep_infiltratingendometriomachronic_pelvic_paindysmenorrheainfertility

Citation neighborhood

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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (78)

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