[Physiopathology and therapeutic management of stage I and II endometriosis].

Michelle Nisolle; M Nisolle; Nisolle M; Nervo P; Patricia Nervo; P Nervo

[Physiopathology and therapeutic management of stage I and II endometriosis].

Michelle Nisolle, M Nisolle, Nisolle M, Nervo P, Patricia Nervo, P Nervo

Journal de gynecologie, obstetrique et biologie de la reproduction · 2003 · vol. 32(8 Pt 2) , pp. S11–4 · PMID:14968061 · W2416181823

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This review discusses the physiopathology of stage I and II endometriosis, including retrograde menstruation and implantation theories, and its surgical and medical management, with CO2 laser and Gn-RHa being effective options.

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The paper reviews what stage I and II endometriosis (r-AFS 1–5 and 6–15), described as mild and superficial, is known to involve in infertile women, and discusses implications for pathophysiology and clinical/therapeutic management. It summarizes literature on peritoneal endometriosis, emphasizing Sampson’s implantation theory elements including retrograde menstruation and subsequent outgrowth of endometrial cells, glands, and stroma, while noting that the exact pathophysiology remains unknown. For management of superficial lesions seen at laparoscopy, it states that surgery is not difficult at these stages but remains controversial, and it compares options such as CO2 laser, SurgiTouch vaporization (with less thermal damage), and monopolar scissors excision. It also describes medical therapy as useful when surgical treatment is incomplete or when the pelvic cavity is hypervascularized, with GnRH agonists cited as common and effective. This paper is centrally about endometriosis—specifically stage I and II endometriosis pathophysiology and therapeutic management.

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Abstract

Stage I and II endometriosis is defined by a r-AFS score respectively ranging from 1 to 5 and from 6 to 15. This mild, superficial endometriosis is a very common pathology occurring in infertile women. Nevertheless, these women with stage I/II endometriosis have usually few pelvic pain. This review summarizes the recent literature concerning new data on the pathogenesis of peritoneal endometriosis and its clinical management. Retrograde menstruation, peritoneal adhesion of shed endometrial tissue, and outgrowth of endometrial cells, glands and stroma, are essential elements in the pathogenesis of endometriosis according to Sampson's classic implantation theory. Nevertheless, exact pathophysiology of endometriosis remains unknown. Superficial endometriotic lesions observed by laparoscopy have to be treated. Surgical procedure is not difficult for stage I and II of endometriosis. Surgical procedure remains controversial. Carbon dioxide (CO2) Laser can be used for laparoscopic destruction of endometriosis. Newer procedures, such as SurgiTouch (Lumenis), are more effective in vaporization and decrease the risk thermal damage of contiguous structures. The monopolar scissors can also be used in order to excise the peritoneal endometriotic lesions. Medical treatment may be usefull if surgical treatment is not complete or if the pelvic cavity is hypervascularized. In these cases, Gonadotropin-Releasing Hormone agonists (Gn-RHa) are the most common and effective treatment.;

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Article (Scientific journals) Endometriose stade I et II: implications physiopathologiques, cliniques et therapeutiques ; 2003 • In Journal de Gynécologie, Obstétrique et Biologie de la Reproduction, 32 (8, Pt 2), p. 11-4 Peer Reviewed verified by ORBiPermalink https://hdl.handle.net/2268/105550 https://hdl.handle.net/2268/105550 PubMed 14968061 14968061 Nisolle M 2003.pdf Publisher postprint (53.51 kB) All documents in ORBi are protected by a user license. copy to clipboard copied Abstract : [en] Stage I and II endometriosis is defined by a r-AFS score respectively ranging from 1 to 5 and from 6 to 15. This mild, superficial endometriosis is a very common pathology occurring in infertile women. Nevertheless, these women with stage I/II endometriosis have usually few pelvic pain. This review summarizes the recent literature concerning new data on the pathogenesis of peritoneal endometriosis and its clinical management. Retrograde menstruation, peritoneal adhesion of shed endometrial tissue, and outgrowth of endometrial cells, glands and stroma, are essential elements in the pathogenesis of endometriosis according to Sampson's classic implantation theory. Nevertheless, exact pathophysiology of endometriosis remains unknown. Superficial endometriotic lesions observed by laparoscopy have to be treated. Surgical procedure is not difficult for stage I and II of endometriosis. Surgical procedure remains controversial. Carbon dioxide (CO2) Laser can be used for laparoscopic destruction of endometriosis. Newer procedures, such as SurgiTouch (Lumenis), are more effective in vaporization and decrease the risk thermal damage of contiguous structures. The monopolar scissors can also be used in order to excise the peritoneal endometriotic lesions. Medical treatment may be usefull if surgical treatment is not complete or if the pelvic cavity is hypervascularized. In these cases, Gonadotropin-Releasing Hormone agonists (Gn-RHa) are the most common and effective treatment. Disciplines : Reproductive medicine (gynecology, andrology, obstetrics) Nisolle, Michelle ; Centre Hospitalier Universitaire de Liège - CHU > Gynécologie-Obstétrique CHR Nervo, Patricia ; Centre Hospitalier Universitaire de Liège - CHU > Gynécologie-Obstétrique CHR Language : French Title : Endometriose stade I et II: implications physiopathologiques, cliniques et therapeutiques Alternative titles : [en] Physiopathology and Therapeutic Management of Stage I and Ii Endometriosis Publication date : December 2003 Journal title : Journal de Gynécologie, Obstétrique et Biologie de la Reproduction ISSN : 0368-2315 eISSN : 1773-0430 Publisher : Elsevier Masson, Paris, France Volume : 32 Issue : 8, Pt 2 Pages : S11-4 Peer reviewed : Peer Reviewed verified by ORBi Available on ORBi : since 17 December 2011 Scopus citations® 7 Scopus citations® without self-citations without self-citations 6 OpenAlex citations 8

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Female Humans Infertility, Female Infertility, Female Laparoscopy

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