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Background: Vaccination can have an impact on menstruation, and this impact may be more notable in women with inflammatory gynecological pathologies such as endometriosis. Objectives: We aimed to investigate the impact of mRNA-based SARS-CoV-2 vaccines on menstrual cycle–related symptoms in women with endometriosis and assess the effect of hormonal therapy on potential SARS-CoV-2 vaccination-induced menstrual changes. Design: A total of 848 women who received at least two doses of mRNA-based COVID-19 vaccines were prospectively recruited: 407 with endometriosis (endometriosis group) and 441 healthy controls (non-endometriosis group). Methods: Data regarding demographics, clinical characteristics, hormonal treatment, and menstrual-associated symptoms in the first and second cycle after vaccination were collected through an online survey. Results: A similar percentage of patients in both the endometriosis and the non-endometriosis group self-reported menstrual-associated changes the first (52.6% versus 48.8%, respectively) and second cycle after vaccination (29.0% versus 28.1%, respectively). Although the total symptoms recorded were not different between the two groups, several specific symptoms were statistically more frequent in the endometriosis group. These were pain disorders and fatigue in the first cycle after vaccination and pain disorders, menstrual headache and fatigue in the second cycle after vaccination. Bleeding frequency/regularity disorders were found to be more frequent in the non-endometriosis group in the first cycle after vaccination. Patients under hormonal treatment reported fewer changes in menstrual symptoms in the first and second cycle after vaccination compared with those not receiving this treatment. Similarly, patients in the endometriosis group receiving hormonal treatment reported fewer changes in menstrual-associated symptoms compared with those not following any hormonal treatment in the first and second menstrual cycle after the last vaccination. Conclusion: Women with endometriosis immunized with mRNA-based SARS-CoV-2 vaccines did not perceive greater worsening or new menstrual-associated symptoms after complete COVID-19 vaccination compared with healthy controls. Hormonal treatment may have a protective effect against worsened or new menstrual symptoms induced by COVID-19 vaccination. [ABSTRACT FROM AUTHOR]

Adenomyosis and endometriosis are similar gynecological diseases that decrease sexual quality of life and, in the case of endometriosis, satisfaction in couple relationships. This study aimed to assess sexual quality of life and couple satisfaction in women diagnosed with adenomyosis (AD) or deep infiltrating endometriosis (DIE). The study population included three groups of couples: one composed of 58 couples in which the woman was diagnosed with AD by transvaginal ultrasound (AD group), a second group comprising 55 couples in which the woman was diagnosed with isolated DIE by transvaginal ultrasound (DIE group), and a third group composed of 60 couples in which the women did not have AD or endometriosis (non-AD/DIE group). All women completed the Sexual Quality of Life-Female (SQOL-F) questionnaire, and all the couples completed the Dyadic Adjustment Scale (DAS). Sexual quality of life was significantly worse in women with AD or DIE compared with non-AD/DIE controls. Dyadic adjustment was significantly worse in the AD and DIE groups compared with the non-AD/DIE group. AD and DIE may impair quality of sexual life and couple relationships. Clinicians should be aware of this issue when treating women with AD or DIE. [ABSTRACT FROM AUTHOR]

Context: Chronic glucocorticoid (GC) overexposure, resulting from endogenous Cushing's syndrome (CS) or exogenous GC therapy, causes several adverse outcomes, including persistent central fat accumulation associated with a low-grade inflammation. However, no previous multiomics studies in visceral adipose tissue (VAT) from patients exposed to high levels of unsuppressed GC during active CS or after remission are available yet. Objective: To determine the persistent VAT transcriptomic alterations and epigenetic fingerprints induced by chronic hypercortisolism. Methods: We employed a translational approach combining high-throughput data on endogenous CS patients and a reversible CS mouse model. We performed RNA sequencing and chromatin immunoprecipitation sequencing on histone modifications H3K4me3, H3K27ac, and H3K27me3) to identify persistent transcriptional and epigenetic signatures in VAT produced during active CS and maintained after remission. Results: VAT dysfunction was associated with low-grade proinflammatory status, macrophage infiltration, and extracellular matrix remodeling. Most notably, chronic hypercortisolism caused a persistent circadian rhythm disruption in VAT through core clock genes modulation. Importantly, changes in the levels of 2 histone modifications associated to gene transcriptional activation (H3K4me3 and H3K27ac) correlated with the observed differences in gene expression during active CS and after CS remission. Conclusion: We identified for the first time the persistent transcriptional and epigenetic signatures induced by hypercortisolism in VAT, providing a novel integrated view of molecular components driving the long-term VAT impairment associated with CS. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the accuracy of transvaginal ultrasound (TVUS) in predicting detrusor infiltration and ureteral meatus involvement in patients with bladder endometriosis (BE) to select which cystoscopic procedures could be avoided and, secondarily, to assess the relationship between symptoms and the characteristics of nodules and the association of BE with other forms of endometriosis. Methods: Patients with BE diagnosed by TVUS were classified according to detrusor infiltration: BE with partial involvement of the muscular layer (group 1) and total muscular layer involvement with bladder protrusion (group 2). We analyzed the accuracy of TVUS compared with subsequently performed cystoscopy, the correlation with symptoms, and the association with other forms of endometriosis. Results: Among the 22 patients included, TVUS showed 9 patients with BE nodules partially affecting the detrusor (group 1) with normal cystoscopic findings (TVUS negative predictive value, 100%). Transvaginal ultrasound detected 13 nodules with total involvement, all visible by cystoscopy (TVUS positive predictive value, 100%). Transvaginal ultrasound also identified ureteral orifices that were free of involvement at greater than 10 mm from the BE nodule in 21 of 22 women (TVUS sensitivity, 95%). Ultrasound criteria for adenomyosis and endometriosis in other locations were present in 20 of 22 patients. Conclusions: Transvaginal ultrasound can identify the infiltration of BE nodules in the bladder wall and predict cystoscopic findings with great accuracy. Nodules that partially affect the muscular layer have normal cystoscopic findings, thereby obviating the need for this procedure. Bladder endometriosis nodules are commonly associated with other forms of endometriosis and do not usually affect the ureteral meatus. Access the CME test here and search by article title. [ABSTRACT FROM AUTHOR]

Study Objective: To evaluate serial generation of microparticles (MPs) after laparoscopic stripping or CO2 laser vaporization in the surgical treatment of patients with ovarian endometrioma (OE).Design: A prospective, randomized, blinded, pilot study (Canadian Task Force classification I).Setting: Tertiary care university hospital from December 2014 to July 2016.Patients: Thirty women with unilateral OE undergoing laparoscopic surgery.Intervention: Patients were randomly selected to undergo either CO2 laser vaporization (L group) or laparoscopic stripping (S group) of OE.Measurements and Main Results: Blood samples were collected before surgery and at 2 hours, 24 hours, 1 month, and 3 months after surgery. An MP generation curve after OE surgery was created. MP generation was greater in the S group than in the L group at all time points evaluated. The MP generation curve showed a significantly higher area under the curve after excisional surgery (p <.05).Conclusion: The higher MP levels in the S group suggest an increased inflammation and procoagulant response after this procedure. [ABSTRACT FROM AUTHOR]

Adenomyosis was the main topic in the 2016 Society of Endometriosis and Uterine Disorders (SEUD) Congress. Latest evidence in endometriosis and other uterine disorders, such as fibroids and abnormal uterine bleeding (AUB) were also covered. About 106 oral communications, practical sessions, and debates on etiology, pathogenesis, diagnosis and treatment of the different themes were presented. Posters on the same topics were on view. Live surgical sessions and video sessions were also held. Six "tips and tricks" sessions in endometriosis and uterine disorders were scheduled at the beginning of each day throughout the congress. Monographic own-language sessions comprising Canadian, Spanish, Asian, Russian and Latin American participants were held with presenters contributing their own vision of the congress topics. Finally, the congress ended with a patient session: dedicated to those who are affected by endometriosis: pain, quality of life, sex-life, and environment were issues covered by specialists and the testimonies of the patients also had their place in the congress. [ABSTRACT FROM AUTHOR]

Aims The primary outcome was to evaluate the subjective success rates of two laparoscopic POP operation techniques: uterine-sparing surgery versus a subtotal hysterectomy plus cervicopexy. Methods Prospective cohort of 45 women with symptomatic POP recruited between January and December 2010 who self-selected surgery group: group A (n = 15), sacral laparoscopic hysteropexy was performed and group B (n = 30), laparoscopically conducted subtotal hysterectomy plus cervicopexy. All patients had a positive answer in the 'Epidemiology of prolapse and incontinence' questionnaire (EPIQ, question number 35) and also had a POPQ ≥2nd degree. The primary outcome was the subjective success rate, measured by a negative answer to the Q35 of EPIQ: 'Do you have a sensation that there is bulge in vagina or that something is falling out from your vagina' and also by rating their symptoms improvement by the 'Patient Global Impression of Improvement'. The secondary outcome was the objective success rate assessed by pelvic examination: cure was considered when POPQ <2nd degree in all vaginal compartments at 6 and 12 months. Results Baseline demographic characteristics were similar between groups. Subjective success rate was significantly superior in group B both after 6 and 12 months ( P = 0.001). Similarly, objective pelvic examination led to a significantly higher rate of successful apical outcome in group B after 6 and 12 months ( P = 0.009 and P = 0.002, respectively). Neither major complications nor vaginal mesh erosions were registered. Conclusions The overall success rate was significantly higher in the laparoscopic subtotal hysterectomy plus cervicopexy group, compared with the laparoscopic sacral hysteropexy group. Neurourol. Urodynam. 34:???-???, 2015. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]