Special Issue "New Frontiers and Updates in the Diagnosis and Treatment of Endometriosis and Endometriosis Associated Infertility"

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: closed (31 December 2021).

Special Issue Editors

Dr. Amerigo Vitagliano
E-Mail Website
Guest Editor
Gynecological Clinic, UOS Medically Assisted Procreation, University of Padova, Via Nicolò Giustiniani 3, Padova, Italy
Interests: infertility; assisted reproduction technologies; hysteroscopy; laparoscopy; reproductive biology; reproductive immunology; endometriosis
Dr. Chiara Borghi
E-Mail Website
Guest Editor
S. Anna University Hospital, Institute of Obstetrics and Gynecology, Department of Surgical Sciences. Via A. Moro 8, 44124 Cona, Ferrara, Italy
Interests: gynecologic oncology; urogynecology; gynecologic surgery

Special Issue Information

Dear colleagues,

Endometriosis is a polymorphous, subtle pathology that affects 1 in 10 women worldwide. This condition may severely affect the quality of life, modifying well-being and relationships due to chronic pelvic pain, infertility and obstetrical complications.

Despite the great advances in diagnostics, pharmacology, minimally invasive surgery and assisted reproduction technologies, endometriosis still represents an unsolved global health issue. There is an urgent need to improve the global knowledge on endometriosis as well as its clinical management.

In this Special Issue, we would like to move this field forward by inviting original clinical and basic research articles, meta-analyses and systematic reviews focusing on endometriosis and endometriosis-related infertility.

We will be grateful to receive your submissions to move the field of endometriosis forward.

Dr. Amerigo Vitagliano
Dr. Chiara Borghi
Dr. Antonio Simone Laganà
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • endometriosis
  • endometriosis diagnosis
  • infertility
  • assisted reproductive technologies
  • medical therapies
  • novel strategies
  • minimally invasive surgery

Published Papers (3 papers)

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Review

Review
Contemporary Fertility-Sparing Management Options of Early Stage Endometrioid Endometrial Cancer in Young Nulliparous Patients
J. Clin. Med. 2022, 11(1), 196; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11010196 - 30 Dec 2021
Viewed by 150
Abstract
Incidence of endometrial cancer (EC) has been increasing in recent years, especially in high-income countries. The disease commonly affects peri- and postmenopausal women; however, about 5% of women are diagnosed with EC in their reproductive age. Due to both the increasing incidence of [...] Read more.
Incidence of endometrial cancer (EC) has been increasing in recent years, especially in high-income countries. The disease commonly affects peri- and postmenopausal women; however, about 5% of women are diagnosed with EC in their reproductive age. Due to both the increasing incidence of EC among reproductive age women and trends to delayed childbearing, fertility-sparing treatment for young patients with EC has become extremely important for researchers and practitioners. Because the classic treatment with total hysterectomy and bilateral saplingo-oophorectomy is not an appropriate approach for young women demanding fertility preservation, several fertility-sparing options have been developed and summarized in this review. Utilization of different medications and their combination (progestagens, gonadotropin releasing hormones analogues, and metformin in different formulations) are tested and found as efficient for fertility-sparing treatment. New minimally invasive surgical techniques, combined with progestagens, are also confirmed as valuable. There are many novel conservative and surgical treatment approaches under investigation. Assuming that molecular biomarkers can be both diagnostic and prognostic to assist in prediction of response to a certain therapy, prognostic risk groups’ stratification along with specific biomarkers’ identification will ensure low recurrence and decrease mortality rates in young women with EC. Full article
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Review
Endometriosis and Medical Therapy: From Progestogens to Progesterone Resistance to GnRH Antagonists: A Review
J. Clin. Med. 2021, 10(5), 1085; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10051085 - 05 Mar 2021
Cited by 17 | Viewed by 1367
Abstract
Background: The first objective of this review was to present, based on recent literature, the most frequently applied medical options (oral contraceptive pills (OCPs) and progestogens) for the management of symptomatic endometriosis, and evaluate their effectiveness in treating premenopausal women with endometriosis-associated pelvic [...] Read more.
Background: The first objective of this review was to present, based on recent literature, the most frequently applied medical options (oral contraceptive pills (OCPs) and progestogens) for the management of symptomatic endometriosis, and evaluate their effectiveness in treating premenopausal women with endometriosis-associated pelvic pain, dysmenorrhea, non-menstrual pelvic pain and dyspareunia. The second objective was to review the concept of progesterone resistance and newly available treatment options. Methods: We reviewed the most relevant papers (n = 73) on the efficacy of OCPs and progestogens as medical therapy for endometriosis, as well as those on progesterone resistance and new medical alternatives (oral gonadotropin-releasing hormone (GnRH) antagonist). Eleven papers, essentially reviews, were selected and scrutinized from among 94 papers discussing the concept of progesterone resistance. Results: Having reviewed the most significant papers, we can confirm that OCPs and progestogens are effective in two-thirds of women suffering from endometriosis, but that other options are required in case of failure (in one-third of women due to progesterone resistance) or intolerance to these compounds. It is clear that there is a need for effective long-term oral treatment capable of managing endometriosis symptoms, while mitigating the impact of side effects. Biochemical, histological and clinical evidence show that estrogens play a critical role in the pathogenesis of endometriosis, so lowering levels of circulating estrogens should be considered an effective medical approach. The efficacy of three oral GnRH antagonists is discussed on the basis of published studies. Conclusion: There is a place for GnRH antagonists in the management of symptomatic endometriosis and clinical trials should be conducted, taking into account the different phenotypes in order to propose novel algorithms. Full article
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Review
Ultrasound of the Uterosacral Ligament, Parametrium, and Paracervix: Disagreement in Terminology between Imaging Anatomy and Modern Gynecologic Surgery
J. Clin. Med. 2021, 10(3), 437; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10030437 - 23 Jan 2021
Cited by 1 | Viewed by 1280
Abstract
Ultrasound is an effective tool to detect and characterize lesions of the uterosacral ligament, parametrium, and paracervix. They may be the site of diseases such as endometriosis and the later stages of cervical cancer. Endometriosis and advanced stages of cervical cancer may infiltrate [...] Read more.
Ultrasound is an effective tool to detect and characterize lesions of the uterosacral ligament, parametrium, and paracervix. They may be the site of diseases such as endometriosis and the later stages of cervical cancer. Endometriosis and advanced stages of cervical cancer may infiltrate the parametrium and may also involve the ureter, resulting in a more complex surgery. New functional, surgical anatomy requires the complete diagnostic description of retroperitoneal spaces and tissues that contain vessels and nerves. Most endometriosis lesions and cervical cancer spread involve the cervical section of the uterosacral ligament, which is close to tissues, namely the parametrium and paracervix, which contain vessels and important nerves and nerve anastomoses of the inferior hypogastric plexus. Efferent fibers of the plexus travel to the rectum, uterus, rectovaginal ligament, deep vesicouterine ligament, and bladder. These efferent fibers are essential for bladder and rectal functionality so tailored nerve-sparing surgery became a standard approach for treating deep infiltrating endometriosis and cervical cancer. An accurate diagnosis by ultrasound has significant clinical impact and is important for appropriate treatment. In this article, we try to establish a common terminology between imaging diagnostic and modern surgical anatomy. Full article
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