MyMedR

Fulltext Extrapelvic Endometriosis: A report of two cases

Nor Azlin, M.I., Amelia, A.Z., Zainul Rashid, M.R.

International Medical Journal Malaysia, 2006;5(1):1-4.

MyJurnal

Extrapelvic endometriosis is fairly rare and may occur in numerous sites throughout the body. Unnecessary investigation may be performed before the diagnosis could be made. Here we present two cases where endometriotic nodules occurred on a caesarean section scar and in the vagina. Further management is discussed in the report.

Matched MeSH terms: Endometriosis

De novo formation of adhesions in endometriosis: the role of iron and free radical reactions

Arumugam K, Yip YC

Fertil Steril, 1995 Jul;64(1):62-4.

PMID: 7789581

OBJECTIVE: To show that raised iron levels in the peritoneal fluid (PF) of patients with endometriosis catalyze free radical reactions that results in the tissue destruction and fibrosis seen in these patients.

DESIGN: A case-controlled study of the iron levels (microgram/mL) in the pelvic PF of 12 patients with moderate-to-severe disease, 15 patients with minimal-to-mild disease and in 17 women with normal pelvises were compared. As an index of free radical reactions through lipid peroxidation, the levels of malondialdehyde levels (ng/mL) were assessed simultaneously in the same specimens.

RESULTS: Controlling for the phase of the menstrual cycle, significantly higher levels of iron were seen in patients with endometriosis, the levels being correlated with the severity of the disease. However no such corresponding relationship was seen in the malondialdehyde levels in the PF.

CONCLUSIONS: These results suggest that raised iron levels in the PF do not play a role in catalyzing free radical reactions as judged by the degree of lipid peroxidation.

Matched MeSH terms: Endometriosis/complications*; Endometriosis/metabolism*

Endometriosis and social class: an Asian experience

Arumugam K, Welluppilai S

Asia Oceania J Obstet Gynaecol, 1993 Sep;19(3):231-4.

PMID: 8250754

The social class distribution in 147 patients confirmed to have endometriosis at laparoscopy was done to see if the disease was associated with affluence. Two hundred and eighty-one patients confirmed not to have endometriosis was used as controls. The patients were derived from a background population for which the social class characteristics was known. Endometriosis was significantly (p < 0.001) associated with social class 1 and 2. However there was no association between social class distribution and the severity of the disease developed.

Matched MeSH terms: Endometriosis/epidemiology*

Fulltext Endometriosis of the appendix presenting as acute appendicitis

Khoo JJ, Ismail MS, Tiu CC

Singapore Med J, 2004 Sep;45(9):435-6.

PMID: 15334288

While endometriosis is fairly common, endometriosis of the appendix is a very rare occurrence. Correct pre-operative diagnosis is uncommon and definitive diagnosis is established by histology of the appendix. We present a case of endometriosis of the appendix that manifested as acute appendicitis in a 40-year-old woman.

Matched MeSH terms: Endometriosis/diagnosis*

Fulltext Endometriosis associated with ureteric obstruction

Tharmaratnam A

Med J Malaysia, 1991 Dec;46(4):365-70.

PMID: 1840447

Endometriosis and its complications are not uncommon in Malaysian women. Two cases of ureteric obstruction due to endometriosis are reported and the literature on ureteric obstruction and endometriosis reviewed. It is emphasized that the possibility of ureteric obstruction must be suspected when there is extensive endometriotic disease or if the patient presents with loin pain or pain on one side of the abdomen. Ultrasound scan of the kidneys and, if necessary, an intravenous pyelogram will have to be done on the slightest suspicion. Patients with endometriosis will have to be followed up until the menopause or even later if they are on hormone replacement therapy.

Matched MeSH terms: Endometriosis/complications*

Endometriosis and race

Arumugam K, Templeton AA

Aust N Z J Obstet Gynaecol, 1992 May;32(2):164-5.

PMID: 1520204

The pelvic findings of 202 infertile women undergoing diagnostic laparoscopy in Kuala Lumpur, Malaysia were compared to that of 464 infertile women undergoing diagnostic laparoscopy in Aberdeen, United Kingdom. Endometriosis was significantly more common in the women from Kuala Lumpur (51% against 22%, p less than 0.001). There was however no significant difference seen in the severity of the disease (AFS Classification, 1985). These findings confirm our clinical impression that endometriosis is more common in Asian women when compared to Caucasian women.

Matched MeSH terms: Endometriosis/ethnology*; Endometriosis/epidemiology

Endometriosis and social class

Arumugam K, Templeton AA

Med J Aust, 1990 Nov 05;153(9):567.

PMID: 2233493

Matched MeSH terms: Endometriosis/epidemiology*

Fulltext Prognostic factors influencing pregnancy rate after stimulated intrauterine insemination

Tay PY, Raj VR, Kulenthran A, Sitizawiah O

Med J Malaysia, 2007 Oct;62(4):286-9.

PMID: 18551930 MyJurnal

To determine the prognostic factors such as age, diagnosis, number of cycle attempts and semen parameters on the pregnancy rate of controlled ovarian hyperstimulation (COH) /intrauterine insemination (IUI). Three hundred and seventeen women who underwent 507 consecutive COH/IUI cycles were recruited from 1st January 2002 to 31st December 2005 inclusively. This retrospective study was done in University Malaya Medical Centre, a tertiary care academic centre. The main outcome measure was pregnancy rate according to age, infertility diagnosis, duration of infertility, semen parameters, and the number of treatment cycles. The overall pregnancy rates were 16.9% per cycle and 25.9% per couple. Pregnancy rates decreased with advancing maternal age. Pregnancy rate was also significantly lower in patient with postwash total motile sperm count (TMSC) < or = 20 million/ml compared to those with TMSC >20 million/ml. The cumulative pregnancy rates varied greatly by diagnosis from 16% for patients with male factor infertility to 60% for patients with ovulatory disorder. Pregnancies among patients with male infertility, tubal factors infertility and endometriosis were achieved during the first three cycles. There is a clear age-related decline in fecundity associated with COH/IUI treatment. Women of > 40 years old, couple with postwash TMSC < or = 20 million/ml, severe endometriosis and tubal factors have a particularly poor prognosis.

Matched MeSH terms: Endometriosis

The pattern of the pathology of ovarian tumours in pregnancy in the Singapore-Malaysia region

Sinnathuray TA

Med J Malaya, 1971 Sep;26(1):53-5.

PMID: 4258576

Matched MeSH terms: Endometriosis/epidemiology*

An evaluation of quality of life in women with endometriosis who underwent primary surgery: a 6-month follow up in Sabah Women & Children Hospital, Sabah, Malaysia

M F A, Narwani H, Shuhaila A

J Obstet Gynaecol, 2017 Oct;37(7):906-911.

PMID: 28617056 DOI: 10.1080/01443615.2017.1312302

Endometriosis is a complex disease primarily affecting women of reproductive age worldwide. The management goals are to improve the quality of life (QoL), alleviate the symptoms and prevent severe disease. This prospective cohort study was to assess the QoL in women with endometriosis that underwent primary surgery. A pre- and post-operative questionnaire via ED-5Q and general VAS score used for the evaluation for endometrial-like pain such as dysmenorrhoea and dyspareunia. A total of 280 patients underwent intervention; 224 laparoscopically and 56 via laparotomy mostly with stage II disease with ovarian endometriomas. Improvements in dysmenorrhoea pain scores from 5.7 to 4.15 and dyspareunia from 4.05 to 2.17 (p

Matched MeSH terms: Endometriosis/complications; Endometriosis/psychology*; Endometriosis/surgery*

The Effect of Surgical Intervention of Endometriosis to CA-125 and Pain

Abdul Karim AK, Abd Aziz NH, Md Zin RR, Mohd Mokhtar N, Shafiee MN

Malays J Med Sci, 2020 Dec;27(6):7-14.

PMID: 33447130 DOI: 10.21315/mjms2020.27.6.2

Endometriosis is an inflammatory condition characterised by the presence of endometrial growth beyond the uterine cavity. It is a debilitating disease requiring multiple modalities of treatment. In considering surgery as the option of treatment, the benefits should outweigh the risk. Besides direct surgical risk, intervention may lead to a reduction of ovarian reserve, in addition to premature menopause and low fecundity. To date, there is an inconclusive evidence to support any specific parameters in monitoring disease progression following surgical intervention. Serum cancer antigen (CA)-125 is expressed by coelomic epithelium and has been extensively studied as a biomarker for endometriosis. Elevated expression of CA-125 has been shown in endometrial tissues and the marker increased indirectly from peritoneal irritation that accompanies an extensive form of endometriosis. Additionally, the visual analogue scale (VAS) scores have been used as an objective measurement for measuring pain, especially in a complex disease such as endometriosis. This review aims to consolidate a series of clinical trials that utilised CA-125 level and VAS score as tools for monitoring patients undergoing surgery for endometriosis.

Matched MeSH terms: Endometriosis

Fulltext Minimally invasive thoracoscopic mesh repair of diaphragmatic fenestrations for catamenial pneumothorax due to likely thoracic endometriosis: a case report

Cieslik L, Haider SS, Fisal L, Abdul Rahman JA, Sachithanandan A

Med J Malaysia, 2013 Aug;68(4):366-7.

PMID: 24145272 MyJurnal

Matched MeSH terms: Endometriosis*

Common Genetic Variation in Circadian Rhythm Genes and Risk of Epithelial Ovarian Cancer (EOC)

Jim HS, Lin HY, Tyrer JP, Lawrenson K, Dennis J, Chornokur G, et al.

J Genet Genome Res, 2015 09 15;2(2).

PMID: 26807442

Disruption in circadian gene expression, whether due to genetic variation or environmental factors (e.g., light at night, shiftwork), is associated with increased incidence of breast, prostate, gastrointestinal and hematologic cancers and gliomas. Circadian genes are highly expressed in the ovaries where they regulate ovulation; circadian disruption is associated with several ovarian cancer risk factors (e.g., endometriosis). However, no studies have examined variation in germline circadian genes as predictors of ovarian cancer risk and invasiveness. The goal of the current study was to examine single nucleotide polymorphisms (SNPs) in circadian genes BMAL1, CRY2, CSNK1E, NPAS2, PER3, REV1 and TIMELESS and downstream transcription factors KLF10 and SENP3 as predictors of risk of epithelial ovarian cancer (EOC) and histopathologic subtypes. The study included a test set of 3,761 EOC cases and 2,722 controls and a validation set of 44,308 samples including 18,174 (10,316 serous) cases and 26,134 controls from 43 studies participating in the Ovarian Cancer Association Consortium (OCAC). Analysis of genotype data from 36 genotyped SNPs and 4600 imputed SNPs indicated that the most significant association was rs117104877 in BMAL1 (OR = 0.79, 95% CI = 0.68-0.90, p = 5.59 × 10-4]. Functional analysis revealed a significant down regulation of BMAL1 expression following cMYC overexpression and increasing transformation in ovarian surface epithelial (OSE) cells as well as alternative splicing of BMAL1 exons in ovarian and granulosa cells. These results suggest that variation in circadian genes, and specifically BMAL1, may be associated with risk of ovarian cancer, likely through disruption of hormonal pathways.

Matched MeSH terms: Endometriosis

Fulltext The role of probiotics in improving menstrual health in women with primary dysmenorrhoea: A randomized, double-blind, placebo-controlled trial (the PERIOD study)

Zakaria IA, Mohammed Zain NA, Teik CK, Abu MA, Zainuddin AA, Abdul Aziz NH, et al.

Womens Health (Lond), 2024;20:17455057241234524.

PMID: 38444064 DOI: 10.1177/17455057241234524

BACKGROUND: Primary dysmenorrhea is associated with poorer quality of life; however, the causal mechanism remains unclear. A vast body of literature supports the use of oral probiotics for relief from the symptoms of endometriosis; however, to our knowledge, no study has prescribed probiotics for primary dysmenorrhea.

OBJECTIVE: The aim of this study is to investigate the effects of 3-month supplementation with oral probiotics on quality of life and inflammatory markers in women with primary dysmenorrhea.

DESIGN: Randomized placebo-controlled trial.

METHODS: A total of 72 patients (36 patients in each arm) were randomized to receive either oral sachets containing 5 billion colony-forming units each of Lactobacillus acidophilus BCMC (BCrobes Microbial Cells) 12130, Lactobacillus casei subsp BCMC 12313, Lactobacillus lactis BCMC 12451, Bifidobacterium bifidum BCMC 02290, Bifidobacterium longum BCMC 02120, and Bifidobacterium infantis BCMC 02129 each or placebo twice daily for 3 months. Main outcome measures were visual analog scale, verbal rating scale, physical and mental health scores using Short-Form 12-Item version 2 questionnaire, frequency of nonsteroidal anti-inflammatory drug use, and changes in inflammatory markers (interleukin-6, interleukin-8, and tumor necrosis factor alpha) before and after treatment.

RESULTS: There was no significant difference in the quality of life scores between the probiotic and placebo groups. Both groups showed significant improvement in pain (visual analog scale) and severity (verbal rating scale) scores but the probiotic group had much lower nonsteroidal anti-inflammatory drug use (odds ratio: 0.69, 95% confidence interval: 0.26-1.83) and better mental health scores (mean change: 6.5, p = 0.03 versus 6.1, p = 0.08) than the placebo group. There was a significant confounding effect of nonsteroidal anti-inflammatory drug use on quality of life scores. No significant difference was found in inflammatory cytokines.

CONCLUSION: Tested oral probiotics improved mental health and potentially reduced the use of nonsteroidal anti-inflammatory drugs; however, there was no significant change in inflammatory markers. Further research with a larger sample size is needed to confirm the findings.

REGISTRATION: This study is registered under ClinicalTrials.gov (NCT04119011).

Matched MeSH terms: Endometriosis*

Fulltext Balloon endometrial thermoablation--an alternative management of adenomyosis with menorrhagia and dysmenorrhoea

Chan CLK, Annapoorna V, Roy AC, Ng SC

Med J Malaysia, 2001 Sep;56(3):370-3.

PMID: 11732085

A 45 years old Chinese housewife presented with menorrhagia and dysmenorrhoea due to adenomyosis failed to respond to various medical treatments. She was treated with balloon thermoablation. The total menstrual blood loss (MBL) decreased from 96.94 ml before to 37.57 ml, six months after thermoablation. The pictorial blood loss chart (PBLC) showed similar decrease in blood loss. Dysmenorrhoea was also cured. At three year follow up, there was no recurrence. This is the first report which shows thermoablation decreases MBL objectively and can be tried to treat adenomyosis.

Matched MeSH terms: Endometriosis/complications*; Endometriosis/therapy*

Intestinal obstruction due to rectal endometriosis: a surgical enigma

Jarmin R, Idris MA, Shaharuddin S, Nadeson S, Rashid LM, Mustaffa WM

Asian J Surg, 2006 Jul;29(3):149-52.

PMID: 16877213

Obstructed rectal endometriosis is an uncommon presentation. The clinical and intraoperative presentation may present as malignant obstruction. The difficulty in making the diagnosis may delay the definitive management of the patient. We report a unique case of rectal endometriosis mimicking malignant rectal mass causing intestinal obstruction and discuss the management of the case.

Matched MeSH terms: Endometriosis/complications*; Endometriosis/diagnosis; Endometriosis/surgery*

Reviewing the role of progesterone therapy in endometriosis

Abdul Karim AK, Shafiee MN, Abd Aziz NH, Omar MH, Abdul Ghani NA, Lim PS, et al.

Gynecol Endocrinol, 2019 Jan;35(1):10-16.

PMID: 30044157 DOI: 10.1080/09513590.2018.1490404

Endometriosis is a benign, chronic inflammatory condition characterized by the presence and growth of endometrial implants outside the uterine cavity. The cause of endometriosis is multifactorial. It is due to the diversity of hypothesis and plausibility of hormonal alterations which could play a major role. Evidence has shown that progesterone resistance is a key factor for endometriosis sufferers. Medical therapy can avoid surgical intervention, which may lead to a reduced in ovarian reserve, and its effects of earlier menopause and reduced fecundity. Progesterone receptor isoform has provided new insight as the potential treatment. Progestin, anti-progestin and selective progesterone receptor modulators usage, which target these receptors, could avoid hypo-estrogenic side effects, which can be debilitating. Numerous types of these medications have been used on and off labeled to treat endometriosis with varying success. This review aims to consolidate series of clinical trials using progestins in endometriosis.

Matched MeSH terms: Endometriosis/drug therapy*

Fulltext Beneficial Effects of Green Tea Catechins on Female Reproductive Disorders: A Review

Kamal DAM, Salamt N, Zaid SSM, Mokhtar MH

Molecules, 2021 May 03;26(9).

PMID: 34063635 DOI: 10.3390/molecules26092675

Tea is one of the most widely consumed beverages worldwide after water, and green tea accounts for 20% of the total tea consumption. The health benefits of green tea are attributed to its natural antioxidants, namely, catechins, which are phenolic compounds with diverse beneficial effects on human health. The beneficial effects of green tea and its major bioactive component, (-)-epigallocatechin-3-gallate (EGCG), on health include high antioxidative, osteoprotective, neuroprotective, anti-cancer, anti-hyperlipidemia and anti-diabetic effects. However, the review of green tea's benefits on female reproductive disorders, including polycystic ovary syndrome (PCOS), endometriosis and dysmenorrhea, remains scarce. Thus, this review summarises current knowledge on the beneficial effects of green tea catechins on selected female reproductive disorders. Green tea or its derivative, EGCG, improves endometriosis mainly through anti-angiogenic, anti-fibrotic, anti-proliferative and proapoptotic mechanisms. Moreover, green tea enhances ovulation and reduces cyst formation in PCOS while improving generalised hyperalgesia, and reduces plasma corticosterone levels and uterine contractility in dysmenorrhea. However, information on clinical trials is inadequate for translating excellent findings on green tea benefits in animal endometriosis models. Thus, future clinical intervention studies are needed to provide clear evidence of the green tea benefits with regard to these diseases.

Matched MeSH terms: Endometriosis

Fulltext Potential Health Benefits of Curcumin on Female Reproductive Disorders: A Review

Kamal DAM, Salamt N, Yusuf ANM, Kashim MIAM, Mokhtar MH

Nutrients, 2021 Sep 07;13(9).

PMID: 34579002 DOI: 10.3390/nu13093126

Curcumin is one of the main polyphenolic compounds in the turmeric rhizome. It possesses antioxidant, anti-inflammatory, anti-cancer, anti-arthritis, anti-asthmatic, anti-microbial, anti-viral and anti-fungal properties. This review aims to provide an overview of the potential health benefits of curcumin to treat female reproductive disorders, including polycystic ovary syndrome (PCOS), ovarian failure and endometriosis. Comprehensive information on curcumin was retrieved from electronic databases, which were MEDLINE via EBSCOhost, Scopus and Google Scholar. The available evidence showed that curcumin reduced the high level of androgen in PCOS. Studies in rodents suggest that curcumin resulted in the disappearance of cysts and the appearance of healthy follicles and corpora lutea. Furthermore, animal studies showed curcumin improved the overall function of the ovary in ovarian diseases and reversed the disturbance in oxidative stress parameters. Meanwhile, in vitro and in vivo studies reported the positive effects of curcumin in alleviating endometriosis through anti-inflammatory, anti-proliferative, anti-angiogenic and pro-apoptotic mechanisms. Thus, curcumin possesses various effects on PCOS, ovarian diseases and endometriosis. Some studies found considerable therapeutic effects, whereas others found no effect. However, none of the investigations found curcumin to be harmful. Curcumin clinical trials in endometriosis and ovarian illness are still scarce; thus, future studies need to be conducted to confirm the safety and efficacy of curcumin before it could be offered as a complementary therapy agent.

Matched MeSH terms: Endometriosis/drug therapy*

Fulltext Extra pelvic endometriosis and catamenial pneumothorax

Rachagan SP, Zawiah S, Menon A

Med J Malaysia, 1996 Dec;51(4):480-1.

PMID: 10968038

Extra pelvic endometriosis is rare and its presentation is varied. A case of pulmonary and umbilical endometriosis which presented as catamenial pneumothorax is presented. Due to poor response to medical treatment, a total abdominal hysterectomy and bilateral salpingo-oophorectomy was done to relieve the patient of her recurrent symptoms.

Matched MeSH terms: Endometriosis/complications*; Endometriosis/physiopathology*

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