J Laparoendosc Adv Surg Tech A. 2014 Mar;24(3):165-70. doi: 10.1089/lap.2013.0270.

Safety and Effect on Quality of Life of Laparoscopic Douglasectomy with Radical Excision for Deeply Infiltrating Endometriosis in the Cul-de-Sac.

Hong DG1, Kim JY, Lee YH, Chong GO, Cho YL, Lee YS.

Author information

Abstract

Abstract Objective: To evaluate the safety and effects on health-related quality of life (HRQOL) of radical excision of deeply infiltrating endometriosis (DIE) in the cul-de-sac. Patients and Methods: This study included 390 patients with pathologically proven DIE in the cul-de-sacwho underwent laparoscopic surgery between January 2000 and December 2011. The preoperative and postoperative visual analog scale (VAS) pain scores and HRQOL data from the 36-item Short Form (SF-36) questionnaire were recorded in 343 patients. Surgical outcomes, complications, and HRQOL were compared between patients who underwent hysterectomy and those who did not. Data were analyzed using the paired t test, Student's t test, and Pearson's correlation analysis. Results: In the group overall, the VAS pain score and all SF-36 scales improved after surgery. In patients who underwent hysterectomy, all SF-36 scales improved except physical functioning, role-physical, general health, and vitality. In patients who did not undergo hysterectomy, all SF-36 scales improved except general health. There were significant associations between gonadotropin-releasing hormone agonist therapy and SF-36 mental health, SF-36 mental component summary, and oral medication use. The VAS pain score and SF-36 body pain score showed the greatest improvement, and the SF-36 general health score showed the least improvement. Patients who underwent hysterectomy had more severe disease and poorer surgical outcomes than those who did not undergo hysterectomy. Conclusions: Laparoscopic radical excision of DIE in the cul-de-sac is safe and significantly improves HRQOL, especially in terms of pain. The severity of endometriosis may affect the degree of improvement in HRQOL scores.

PMID:

 

24625348

 

[PubMed - in process]

Eve's Daughters, or, Go With the Flow

In the beginning, there was pain.

My periods began when I was 13-years-old, and I only remember them accompanied with pain. I bled heavily each month for six to eight days. As I got older, I would find myself passed out on my bedroom or bathroom floor from painful cramps. I would pass heavy blood clots, was often lightheaded, and regularly was prescribed iron supplements and over-the-counter medications like ibuprofen. When Alleve came on the market, I was thrilled to try a new pain reliever. They would dull, but never eradicate, the pain. My periods were always preceded with hefty bouts of PMS; I suffered from bloating, fatigue, headaches, skin rashes, and swelling in my knees and fingers.

When I'd report these symptoms to my doctor, he told me that periods can be like that. Some girls have problems, others don't. I just happened to be one of the girls who had a problem period. My mother told me the same thing, adding, "That's what my mother told me. It was like that for me and for other girls I knew growing up, too." As Carol Pearson discusses in her TEDTalk, as Zora Neale Hurston wrote inTheir Eyes Were Watching God ("Black women are the mules of the world"), as Eve was told after she fed into her curiosity and took a bite of that forbidden fruit, I learned -- whether the lesson was intended to be learned this way or not -- that being a girl, becoming a woman, was painful. And I had to live with that pain. I had to learn to handle pain.

And so I did. I went with the flow.

What I didn't know was that I had endometriosis.Endometriosis is a disease that affects 10 percent of women globally. It knows no race, class, or socioeconomic status. Some doctors refer to endometriosis as a benign cancer. Padma Lakshmi, model and co-founder of the Endometriosis Foundation of America, describes the disease as "a web, like a vapor, like weeds in a garden that permeate everything, and stain everything. And metaphorically as well as clinically what you have to go and do, whether it is with laparoscopy or therapy or just understanding and support, is you have to go in there... and get rid of it. Not only getting rid of it in the womb, but getting rid of it in the heart and the mind."

Read the rest http://www.huffingtonpost.com/nicole-brittingham-furlonge/eves-daughters-or-go-with_b_5010896.html

Adhesiolysis - Treatment for Chronic Pelvic Pain - saved from possible extinction? Dr Wiseman of the International Adhesion Society

Burden of adhesions in abdominal and pelvic surgery: systematic review and met-analysis

Transvaginal hydrolaparoscopy. as diagnostic tool Endometriosis Adhesions

JSLS. 2012 Jul-Sep;16(3):461-5. doi: 10.4293/108680812X13462882736295.

Transvaginal hydrolaparoscopy.

Ezedinma NA1, Phelps JY.

Author information

Abstract

Transvaginal hydrolaparoscopy (THL) is being performed regularly in Europe and China, but rarely in the United States. The reasons may be physicians' unfamiliarity with the procedure and their uneasiness over potential rectal puncturing due to the proximity of the rectum to the vaginal trocar insertion site. THL has the advantage over hysterosalpingography (HSG) in that it allows for direct visualization of the tubal mucosa in addition to determining tubal patency. THL has advantages over traditional laparoscopy in that it does not require an abdominal incision and has the capability of being conducted in an outpatient office setting with local anesthesia. Studies have shown that THL has comparable accuracy to laparoscopy with 96.1% concordance between THL and laparoscopic findings. THL may be combined with chromopertubation and salpingoscopy. In addition to diagnostic purposes, THL may be used for operative intervention including adhesiolysis, endometriosis ablation, and ovarian drilling. Studies from France and China report the occurrence of rectal injury from 0% to1%. Despite the advantages of THL and low reports of rectal injury, THL has not gained popularity in the United States. The purpose of this article is to familiarize gynecologists in the United States with THL.

PMID:

 

23318074

 

[PubMed - indexed for MEDLINE] 

PMCID:

 

PMC3535799

 

Free PMC Article

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Transvaginal endoscopy and small ovarian endometriomas: unravelling the missing link?

Gynecol Surg. 2014;11:3-7. Epub 2013 Oct 17.

Gordts S, Puttemans P, Gordts S, Valkenburg M, Brosens I, Campo R.

Author information

Abstract

The incidence of endometriosis in the infertile female is estimated to be between 20 and 50 %. Although the causal relationship between endometriosis and infertility has not been proven, it is generally accepted that the disease impairs reproductive outcome. Indirect imaging techniques and transvaginal laparoscopy now offer the possibility of an early stage diagnosis. Although it remains debated whether the disease is progressive, treatment in an early stage is recommendable as it carries less risk for ovarian damage, hence premature ovarian failure. Under water, inspection with the technique of transvaginal hydrolaparoscopy (THL) accurately shows the invagination of the ovarian cortex as minimal superficial lesions but with the presence of well-differentiated endometrial like tissue at the base, the lateral walls and especially the inner edges of the small endometrioma. An inflammatory environment is responsible for the formation of connecting adhesions with the broad ligament and lateral wall with invasion of endometrial-like tissue and formation of adenomyotic lesions. In around 50 % of the small endometriomas, adhesiolysis is necessary at the site of invagination with opening of the cyst, to free the chocolate content and hereby recognize the underlying endometrioma. The detailed inspection of these early-stage endometriotic lesions at THL reunites the hypothesis of Sampson with the observation of Hughesdon.

KEYWORDS:

Endometrioma, Endoscopy, Hydroflotation, Ovarian endometriosis, Pathogenesis, Surgery, Transvaginal hydrolaparoscopy

PMID:

 

24611037

 

[PubMed]

http://www.ncbi.nlm.nih.gov/pubmed/24611037

Living With Endometriosis

Thank you!

One of the best Endometriosis Videos I have ever seen. You did a great job and our best wishes to you.
https://www.youtube.com/watch?v=bVZ8nXVtlvU

About Endometriosis from Endometriosis.org You Can Fight Endometriosis

02/05/2014 | 3:38 PM

MIT bioengineer works to unravel endometriosis

By Carolyn Y. Johnson / Globe Staff

For four years, MIT bioengineer Linda Griffith has been slowly unraveling the biology of endometriosis, a complicated and poorly understood disease that she has silently struggled with her entire life. The condition—in which tissue normally found in the uterus grows elsewhere in the body—is remarkably common. It causes severe pain and infertility and affects up to 10 percent of women, yet relatively little is known about what causes it, how to prevent it, or even how to effectively treat it.

Read More http://www.boston.com/news/science/blogs/science-in-mind/2014/02/05/endometriosis/QPaGvDagBHnTjXQFqUZBTL/blog.html

Breaking News Genzyme Seprafilm

Lurpon all over again...grrrrr

Attorney General J.B. Van Hollen Announces Settlement with Genzyme Corporation to Resolve Allegations of Off-Label Marketing

March 07, 2014

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Targeted News Service

MADISON, Wis., March 6 -- The WisconsinAttorney General issued the following news release:

Attorney General J.B. Van Hollen announced today that Wisconsin has joined with other states and the federal government to settle allegations thatGenzyme Corp. (Genzyme) marketed and caused false claims to be submitted to federal and state health care programs for use of a "slurry" version of its Seprafilm adhesion barrier. Seprafilm is a thin film intended to reduce adhesions after surgery by forming a bio-resorbable barrier between abdominal tissue and organs. Genzyme is a biotechnology corporation based in Cambridge, Mass., and was acquired by Sanofi-Aventis SA in April 2011. As part of the settlement, Wisconsin Medicaid will receive $44,698.27 in restitution and other recoveries. Medicaid is a health insurance program for the needy and disabled jointly funded by the state and federal governments. The agreement resolves allegations that Genzyme sales representatives taught doctors and other staff to cut the Seprafilm sheets into small pieces, add saline and allow the pieces to dissolve until the desired consistency was reached. This mixture was referred to as "slurry." Genzyme sales representatives traded recipes for slurry, and trained each other in how to create it. The slurry was used in laparoscopic surgeries by inserting a catheter filled with the mixture into the body and applying it into the abdominal cavity. Seprafilm isFDA-approved for use in open abdominal surgery but not for minimally invasive surgeries, such as laparoscopic surgery. Allegedly, as a result of this conduct,Genzyme knowingly caused hospitals and other purchasers of Seprafilm to submit false and fraudulent claims to health care programs for uses that were not reimbursable.

TNS 30FurigayJof 140307-4659904 30FurigayJof

Copyright:	(c) 2014 Targeted News Service
Wordcount:	276

March is Worldwide Endometriosis Awareness Month

some ways to participate

1. Million Women March for Endometriosis - Endomarch 2014

   www.millionwomenmarch2014.org/‎
   

   
   

   Join us for Million Women March for Endometriosis - Endomarch 2014, March 13,2014, in Washington, D.C..
2. 
   

   Join us around the World - Million Women March for Endometriosis

   www.millionwomenmarch2014.org/country-captains/‎
   

   
   

   40+ items - WORLDWIDE LOCATIONS. The following country ...
   

   Country Captains Contact Endometriosis Network Canada: Erika at erika ...

   Country Captain, Mette at endomarch.denmark@gmail.com. WEBSITE: http ...
3. 
   

   Endomarch 2014 - Thursday, March 13, 2014 - Camran Nezhat

   www.nezhat.org/endometriosis/million-woman-march-for-endometriosis....‎
   

   
   

   Updated January 30 2014. Want to make a difference in the lives of more than 200 million women with endometriosis? Then please join us for the first ever ...
4. 
   

   Endometriosis Awareness 2014 « Endometriosis.org: The Global ...

   endometriosis.org/news/support.../endometriosis-awareness-2014/‎
   

   
   

   5 days ago - Endometriosis Awareness Week is 3 – 9 March 2014. National support groups, and individual women with endometriosis, raise awareness of ...
5. 
   

   The World Symposium on Endometriosis | March 27-29 2014 Atlanta ...

   www.endometriosisatlanta.com/‎
   

   
   

   It is my pleasure to invite you to the 2nd World Symposium on Endometriosis:Endometriosis, Cancer, and Fertility, March 27-29, 2014 in Atlanta, Georgia.
6. 
   

   Million Woman March for Endometriosis | Endometriosis UK

   endometriosis-uk.org/civicrm/event/info?reset=1&id=54‎
   

   
   

   Date: 13th March 2014. Place: London. Distance: 2.5 miles. What is the Million WomanMarch? Across the globe, millions of women will be taking part in a  ...
7. [PDF]
   

   Million Women March on Endometriosis - American College of ...

   https://www.acog.org/.../20140113PressRelea...‎
   

   
   

   American College of Obst...

   Jan 13, 2014 - Endometriosis will occur worldwide on Thursday, March 13, 2014, ...March,” which began on Facebook and whose numbers have been  ...

What it costs to have endometriosis

J Manag Care Pharm. 2007 Apr;13(3):262-72.

Actuarial analysis of private payer administrative claims data for women with endometriosis.

Mirkin D, Murphy-Barron C, Iwasaki K.

Author information

Abstract

BACKGROUND:

Endometriosis is a painful, chronic disease affecting 5.5 million women and girls in the United States and Canada and millions more worldwide. The usual age range of women diagnosed with endometriosis is 20 to 45 years. Endometriosis has an estimated prevalence of 10% among women of reproductive age, although estimates of prevalence vary greatly. Endometriosis is the most common gynecological cause of chronic pelvic pain, but published information on its associated medical care costs is scarce.

OBJECTIVE:

The aim of this study was to determine (1) the prevalence of endometriosis in the United States, (2) the amount of health care services used by women coded with endometriosis in a commercial medical claims database during 1999 to 2003, and (3) the endometriosis-related costs for 2003, the most recent data available at the time the study was performed.

METHODS:

This study was a retrospective review of administrative data for commercial payers, which included enrollment, eligibility, and claims payment data contained in the Medstat Marketscan database for approximately 4 million commercial insurance members. All claims and membership data were extracted for each woman aged 18 to 55 years who had at least 1 medical or hospital claim with a diagnosis code for endometriosis (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 617.00-617.99) for 1999 through 2003. Claims data from 1999 through 2003 were used to determine prevalence and health care resource utilization (i.e., annual admission rate, annual surgical rate, distribution of endometriosis-related surgeries, and prevalence of comorbid conditions). The cost analysis was based on claims from 2003 only. Cost was defined as the payer-allowed charge, which equals the net payer cost plus member cost share.

RESULTS:

The prevalence of women with medical claims (inpatient and/or outpatient) containing ICD-9-CM codes for endometriosis was 1.1% for the age band of 30 to 39 years and 0.7% over the entire age span of 18 to 55 years. The medical costs per patient per month (PPPM) for women with endometriosis were 63% greater ($706 PPPM) than those of the average woman per member per month ($433) in 2003; inpatient hospital costs accounted for 32% of total direct medical costs. Between 1999 and 2003, these women with endometriosis who were identified by either inpatient and/or outpatient claims had high rates of hospital admission (53% for any reason; 38% for an endometriosis-related reason) and a high annual surgical procedure rate (64%). Additionally, women with endometriosis frequently suffered from comorbid conditions, and these conditions were associated with greater PPPM costs of 15% to 50% for women with an endometriosis diagnosis code, depending on the condition. Interstitial cystitis was associated with 50% greater cost ($1,061 PPPM); depression, 41% ($997 PPPM); migraine, 40% ($988 PPPM); irritable bowel syndrome, 34% ($943 PPPM); chronic fatigue syndrome, 29% ($913 PPPM); abdominal pain, 20% ($846 PPPM); and infertility, 15% ($813 PPPM).

CONCLUSIONS:

Women with endometriosis have a high hospital admission rate and surgical procedure rate and a high incidence of comorbid conditions. Consequently, these women incur total medical costs that are, on average, 63% higher than medical costs for the average woman in a commercially insured group.

PMID:

 

17407392

 

[PubMed - indexed for MEDLINE] 

Fre

Happy New Year!

Hoping this is your year to shine! 

Why does my hip hurt so bad?

Ok this is plausible...but what doc can I convince OR is it from that evil lupron..eating my bones away?

Perineural spread of endometriosis along the obturator nerve into the adductor thighcompartment

2012   Japanese journal of radiology

We report the case of a young woman with recurrent unilateral hip pain. A polylobular cystic mass was found in the right adductor space. Magnetic resonance imaging (MRI) revealed a polynodular mass migrating from the intrapelvic region along the obturator nerve. Because of a history of cyclic pain and the characteristics on MRI (hypointense rim and spots of spontaneous hyperintense signal on T1-weighted images), an endometrioma was suspected. The diagnosis of endometriosis was later confirmed through ultrasound-guided biopsy.

		(Waer et al. 2012)
		Waer P, Samson I, et al. (2012). Perineural spread of endometriosis along the obturator nerve into the adductor thigh compartment. Jpn J Radiol 30 (5): 446-9.

PMID: 22350637  DOI: 10.1007/s11604-01 http://www.torna.do/s/Perineural-spread-of-endometriosis-along-the-obturator-nerve-into-the-adductor-thigh-compartment/?x=5&y=1

Harry Reich Sex and Endometriosis

WHAT IF ENDOMETRIOSIS WAS A MEN’S HEALTH ISSUE?

The world would be a different place!
JORDAN DAVIDSON

As a health journalist and a co-founder of Endo Warriors, a support organization for women with endometriosis, I often get asked “what is endometriosis?”

Which is funny since it is estimated that 176 million women worldwide have endometriosis and yet no one knows about this global health issue.

http://www.hormonesmatter.com/endometriosis-mens-health-issue/

Visit Endo Warriors - https://www.facebook.com/endowarriorssupport