‘Algological bonds of endometriosis’. Features of clinical management of patients with typical and atypical symptoms of endometriosis

Mekan R. Orazov, V.E. Radzinsky, Evgeny D. Dolgov
In: Medical alphabet · 2023 · pp. 16–22 · doi:10.33667/2078-5631-2023-19-16-22 · W4388459755
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This paper proposes a three-level pathogenetic concept linking pelvic pain to distant algological patterns in endometriosis and presents a management algorithm based on pathogenetic staging.

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This article proposes a three-level pathogenetic concept aimed at linking the main manifestation of endometriosis—pelvic pain—with other, often “atypical” algologic (pain-related) patterns, and then outlines an algorithm for managing patients based on this pathogenetic staging. Drawing on the authors’ framing of chronic pelvic pain and endometriosis-related pain, it specifically addresses differences between typical and atypical symptom presentations. A stated limitation is that the approach is conceptual and focused on constructing a pathogenetic framework rather than presenting new empirical patient outcomes. This paper is centrally about endometriosis — it focuses on clinical management and a pathogenetic model linking typical and atypical pain manifestations in endometriosis.

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Abstract

Endometriosis remains one of the most mysterious and controversial diseases in modern gynecology. Contemporary statistical data demonstrate the extreme relevance of actively implementing effective therapeutic approaches into the clinician’s everyday practice. However, a significant challenge associated with endometriosis is the pain syndrome. The question of so-called atypical algological manifestations of endometriosis, which previously seemed unrelated to the pathogenesis of the primary disease, is increasingly raised. In this regard, the aim of this article was to propose a three-level pathogenetic concept capable of linking the primary manifestation of endometriosis (pelvic pain) with other often distant algological patterns, as well as to create an algorithm for managing these patients based on their pathogenetic staging.
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«Алгологические узы эндометриоза». Особенности клинического менеджмента пациенток с типичными и нетипичными симптомами эндометриоза https://doi.org/10.33667/2078-5631-2023-19-16-22 Аннотация Эндометриоз по-прежнему остается одним из самых загадочных и контраверсионных заболеваний современной гинекологии. Современные статистические данные демонстрируют чрезвычайную актуальность активного внедрения эффективных терапевтических подходов в повседневную практику клинициста. Однако проблемой является ассоциированный с эндометриозом болевой синдром. Все чаще поднимается вопрос о т. н. атипичных алгологических проявлениях эндометриоза, которые, как казалось ранее, никак не соотносились с патогенезом основного заболевания. В этой связи целью данной статьи являлось предложение трехуровневой патогенетической концепции, способной связать основное проявление эндометриоза (тазовая боль) с другими нередко отдаленными алгологическими паттернами, а также составление алгоритма ведения данных пациенток, исходя из их патогенетического стадирования. Об авторах М. Р. ОразовРоссия Оразов Мекан Рахимбердыевич, д. м. н., проф. кафедры акушерства и гинекологии с курсом перинатологии Москва В. Е. Радзинский Россия Радзинский Виктор Евсеевич, заслуженный деятель науки РФ, член-корреспондент РАН, д. м. н., проф., зав. кафедрой акушерства и гинекологии с курсом перинатологии Москва Е. Д. Долгов Россия Долгов Евгений Денисович, клинический ординатор кафедры акушерства и гинекологии с курсом перинатологии Москва Список литературы 1. Yilmaz B. D., Bulun S. E. Endometriosis and nuclear receptors // Human reproduction update. 2019; 25 (4): 473–485. 2. Arnold MJ, Osgood AT, Aust A. Chronic Pelvic Pain in Women: ACOG Updates Recommendations. Am Fam Physician. 2021 Feb 1; 103 (3): 186–188. PMID: 33507045. 3. Bulun SE, Yilmaz BD, Sison C, Miyazaki K, Bernardi L, Liu S, Kohlmeier A, Yin P, Milad M, Wei J. Endometriosis. Endocr Rev. 2019 Aug 1; 40 (4): 1048–1079. DOI: 10.1210/er.2018–00242. PMID: 30994890; PMCID: PMC 6693056. 4. Simopoulou M., Rapani A., Grigoriadis S., Pantou A., Tsioulou P., Maziotis E., Tzanakaki D., Triantafyllidou O., Kalampokas T., Siristatidis C., Bakas P., Vlahos N. Getting to Know Endometriosis-Related Infertility Better: A Review on How Endometriosis Affects Oocyte Quality and Embryo Development. Biomedicines. 2021; 9: 273. https://doi.org/10.3390/biomedicines9030273 5. Arnold MJ, Osgood AT, Aust A. Chronic Pelvic Pain in Women: ACOG Updates Recommendations. Am Fam Physician. 2021 Feb 1; 103 (3): 186–188. PMID: 33507045. 6. Chronic pelvic pain: ACOG Practice Bulletin, Number 218. Obstet Gynecol. 2020; 135: e98–e109. DOI: 10.1097/AOG.0000000000003716 7. Радзинский В. Е., Оразов М. Р., Костин И. Н. Хроническая тазовая боль в гинекологической практике. Доктор.Ру. 2019; 7 (162): 30–35. 8. Bourdel N., Matsusakï S., Roman H., Lenglet Y., Botchorischvili R., Mage G., Canis M. Endometriosis in teenagers. Gynecol. Obstet. Fertil. 2006; 34: 727–734. 9. Briceag I, Costache A, Purcarea VL, Cergan R, Dumitru M, Briceag I, Sajin M, Ispas AT. Fallopian tubes – literature review of anatomy and etiology in female infertility. J. Med Life. 2015; 8 (2): 129–31. 10. Ballweg M. L. Impact of endometriosis on women’s health: Comparative historical data show that the earlier the onset, the more severe the disease. Best Pract. Res. Clin. Obstet. Gynaecol. 2004; 18: 201–218. 11. Greene R., Stratton P., Cleary S. D., Ballweg M. L., Sinaii N. Diagnostic experience among 4334 women reporting surgically diagnosed endometriosis. Fertil. Steril. 2009; 91: 32–39. 12. Оразов М. Р., Радзинский В. Е., Долгов Е. Д. Современные возможности терапевтического менеджмента пациенток с эндометриозом в различные возрастные периоды. Women’s Clinic. 2023; 2: 10–18. 13. Zeitoun K., Takayama K., Sasano H., Suzuki T., Moghrabi N., Andersson S., Johns A., Meng L., Putman M., Carr B. Deficient 17β-hydroxysteroid dehydrogenase type 2 expression in endometriosis: Failure to metabolize 17β-estradiol. J. Clin. Endocrinol. Metab. 1998; 83: 4474–4480. 14. Noble L. S., Takayama K., Zeitoun K. M., Putman J. M., Johns D. A., Hinshelwood M. M., Agarwal V. R., Zhao Y., Carr B. R., Bulun S. E. Prostaglandin E 2 stimulates aromatase expression in endometriosis-derived stromal cells. J. Clin. Endocrinol. Metab. 1997; 82: 600–606. 15. Bulun S. E., Yang S., Fang Z., Gurates B., Tamura M., Zhou J., Sebastian S. Role of aromatase in endometrial disease. J. Steroid Biochem. Mol. Biol. 2001; 79: 19–25. 16. Laganà A. S. et al. The pathogenesis of endometriosis: molecular and cell biology insights // International journal of molecular sciences. 2019; 20 (22): 5615. 17. Оразов М. Р., Токтар Л. Р. Боль по кругу. StatusPraesens. Гинекология, акушерство, бесплодный брак. 2020; 4: 42–47. 18. Smolarz B., Szyłło K., Romanowicz H. Endometriosis: epidemiology, classification, pathogenesis, treatment and genetics (review of literature) //International journal of molecular sciences. 2021; 22 (19): 10554. 19. Яковлева Э. Б., Бабенко О. М., Бугаев А. Б. Современный взгляд на проблему лечения хронической тазовой боли. Медицина неотложных состояний. 2014; 2 (57): 134–139. 20. Русина Е. И., Ярмолинская М. И., Пьянкова В. О. Глубокий инфильтративный эндометриоз. Спорные вопросы: за и против. Гинекология. 2020; 5. 21. Quintana R. L. Endometriosis infiltrativa profunda en la vejiga, resección quirúrgica por laparoscopia. Reporte de un caso y revisión de la bibliografía. REVISTA MEXICANA DE MEDICINA DE LA REPRODUCCIÓN. 2022; 13. – № . d. 22. Kor E. et al. Relationship between the severity of endometriosis symptoms (dyspareunia, dysmenorrhea and chronic pelvic pain) and the spread of the disease on ultrasound //BMC Research Notes. 2020; 13: 1–8. 23. Gutman G., Nunez A. T., Fisher M. Dysmenorrhea in adolescents //Current Problems in Pediatric and Adolescent Health Care. 2022; 101186. 24. Gete D. G., Doust J., Mortlock S., Montgomery G., Mishra G. D. 2023. Associations between endometriosis and common symptoms: findings from the Australian Longitudinal Study on Women’s Health. American Journal of Obstetrics and Gynecology. 25. Mechsner S. 2022. Endometriosis, an Ongoing Pain–Step-by-Step Treatment. Journal of Clinical Medicine. 2022; 11 (2): 467. 26. Lai ZZ, Yang HL, Ha SY, Chang KK, Mei J, Zhou WJ, Qiu XM, Wang XQ, Zhu R, Li DJ, Li MQ. Cyclooxygenase‑2 in Endometriosis. Int J. Biol. Sci. 2019 Oct 23; 15 (13): 2783–2797. DOI: 10.7150/ijbs.35128. PMID: 31853218; PMCID: PMC 6909960 27. Kim H. J. et al. Dienogest May Reduce Estradiol-and Inflammatory Cytokine-Induced Cell Viability and Proliferation and Inhibit the Pathogenesis of Endometriosis: A Cell Culture-and Mouse Model-Based Study. Biomedicines. 2022; 10 (11): 2992. 28. Оразов М. Р., Радзинский В. Е., Долгов Е. Д., Абрамашвили Ю. Г. Патогенез и патогенетические опции в менеджменте эндометриоза. Вопросы гинекологии, акушерства и перинатологии. 2023; 22(1): 92–104. DOI: 10.20953/1726–1678–2023–1–92–104 29. Оразов М. Р., Радзинский В. Е., Орехов Р. Е., Таирова М. Б. Эффективность профилактики рецидивов после хирургического лечения эндометриоза яичников. Вопросы гинекологии, акушерства и перинатологии. 2022; 21 (3): 53. 30. Uludag S. Z., Demirtas E., Sahin Y., Aygen E. M. Dienogest reduces endometrioma volume and endometriosis-related pain symptoms. Journal of Obstetrics and Gynaecology. 2021; 41 (8): 1246–1251. 31. Vignali M., Belloni G. M., Pietropaolo G., Barbasetti Di Prun A., Barbera V., Angioni S., Pino I. Effect of Dienogest therapy on the size of the endometrioma. Gynecological Endocrinology. 2020; 36 (8): 723–727. 32. Bono Y., Kyo S., Kiyono T., Mizumoto Y., Nakamura M., Maida Y., Takakura M., Fujiwara H. Concurrent estrogen action was essential for maximal progestin effect in oral contraceptives. Fertility and Sterility. 2014; 101: 5. 33. Mueck A. O., Sitruk-Ware R. Nomegestrol acetate, a novel progestogen for oral contraception. Steroids. 2011; 76 (6): 531–539. Рецензия Для цитирования: Оразов М.Р., Радзинский В.Е., Долгов Е.Д. «Алгологические узы эндометриоза». Особенности клинического менеджмента пациенток с типичными и нетипичными симптомами эндометриоза. Медицинский алфавит. 2023;(19):16-22. https://doi.org/10.33667/2078-5631-2023-19-16-22 For citation: Orazov M.R., Radzinsky V.E., Dolgov E.D. ‘Algological bonds of endometriosis’. Features of clinical management of patients with typical and atypical symptoms of endometriosis. Medical alphabet. 2023;(19):16-22. (In Russ.) https://doi.org/10.33667/2078-5631-2023-19-16-22 JATS XML

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