Endometriosis: a critical appraisal of the advances and the controversies of a challenging health problem.

Minerva ginecologica · 2009 · vol. 61(4) , pp. 285–98 · PMID:19745795 · W176018633
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This review critically appraises recent advances in endometriosis understanding, including genetic factors, biomarkers, diagnostic tools, and therapeutic strategies like GnRH agonists and surgery for pain and infertility.

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Abstract

Endometriosis is an enigmatic disorder with obscure pathogenesis. The objective of this review was to critically appraise the recent advances in the etiopathogenesis, diagnosis and clinical management of endometriosis. Several studies support the familial role in the initiation of the disease with key roles of endometriosis-associated polymorphisms in the genes that control fibrinolysis, angiogenesis, steroidogesis, aromatization of androgens, proliferation and cytokine production. Many active substances (cytokines, growth factors, hormones and oxidative stress parameters) have been identified in endometriosis patients at different stages of the disease. In addition to the traditional diagnostic role of ultrasonography and CA 125, evidence is accumulating regarding a potential role sonorectovaginography. Currently the routine use of antiflammatory drugs and birth control pills is not supported by evidence. New protocols of medications incorporation new gonadotrophin releasing hormone agonists with add back therapy, androgenic agents and aromatase inhibitors have been proposed. Prospective randomiazed controlled trials proved that surgical treatment of endometriosis is better than placebo for endometriosis related pain and infertility for patients with stage I and II disease.

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Condition tags

endometriosisinfertility

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Biomarkers CA-125 Antigen Female Gastrointestinal Diseases Gastrointestinal Diseases Gastrointestinal Diseases Humans Polymorphism, Genetic Prospective Studies Randomized Controlled Trials as Topic Reproductive Techniques Ultrasonography, Doppler, Color Urologic Diseases

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.

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