Pathogenetically oriented endoscopy in the treatment of endometrial hyperplastic processes

2021 ◽  
Vol 50 (3) ◽  
pp. 44-46
Author(s):  
E. N. Popov ◽  
D. A. Niauri
Keyword(s):  
Surgical Treatment ◽  
Therapeutic Effect ◽  
Hormonal Therapy ◽  
Endometrial Hyperplasia

The experience of using electro destruction of the endometry in 60 patients showed that the method practically doesnt have any contraindications if applied for treating hyperplastic processes in endometry and helps to obtain stable therapeutic effect. It is reasonable to consider it particularly promising inpatients with relapsing endometrial hyperplasia resistant to hormonal therapy; in case of association with severe extragenital diseases electro destruction may appear an alternative both to hormonal therapy and surgical treatment.

Endometrial hyperplasia (Clinical lecture)

2016 ◽  
pp. 10-18 ◽  
Author(s):  
I.B. Vovk ◽  
◽  
N.Е. Gorban ◽  
O.Ju. Borysiuk ◽  
◽  
...  
Keyword(s):  
Key Words ◽  
Hormonal Therapy ◽  
Endometrial Hyperplasia ◽  
Intraepithelial Neoplasia ◽  
Diagnosis And Treatment ◽  
Pathogenetic Mechanisms ◽  
Endometrial Intraepithelial Neoplasia ◽  
Mechanisms Of Development ◽  
Clinical Lecture

In clinical lecture presents modern views of endometrial hyperplasia in terms of practitioner gynecologist. The problems of classification, pathogenetic mechanisms of development of endometrial hyperplasia. Particular attention is paid to modern approaches to diagnosis and treatment of endometrial hyperplasia. Key words: hyperplasia, endometrium, classification, endometrial hyperplasia, endometrial intraepithelial neoplasia, hormonal therapy.

Clinical and diagnostic aspects of deep infiltrative endometriosis (diagnosis, treatment, recurrence)

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (4) ◽  
pp. 307-313
Author(s):  
Shakhnoza K. Muftaidinova ◽  
Leonid Z. Faizullin ◽  
Vladimir D. Chuprynin ◽  
Nikolai S. Ruseikin ◽  
Tatiana I. Smolnova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hormonal Therapy ◽  
Serum Levels ◽  
Ca 125 ◽  
Prior History ◽  
Deep Endometriosis ◽  
Preoperative Serum ◽  
Peritoneal Endometriosis ◽  
History Of ◽  
Deep Infiltrative Endometriosis

Aim. To analyze the recurrence of endometriosis after surgical treatment of patients with deep endometriosis. Materials and methods. The case histories of 90 patients aged 19 to 45 years were retrospectively analyzed. The study group consisted of 70 endometriosis patients: 20 with peritoneal endometriosis and 50 with deep infiltrative endometriosis (DIЕ). The comparison group included 20 women without endometriosis. There was an in-depth study of anamnestic data in the cohort of patients under study. The results of preoperative laboratory tests, including serum levels of the CA-125 and CA 19-9 oncomarkers, were processed. Results. Analysis of the obtained data showed that about half of the DIE patients (54%) in the main group had a history of surgical interventions for endometriosis. The number of operations was significantly higher in patients compared to the peritoneal endometriosis group (68% vs 20%, respectively; р=0.0012). Two subgroups were formed from the group of women with DIE: patients who had no history of previous surgical treatment for endometriosis and those hospitalized for repeated surgical treatment of endometriosis (patients with recurrent endometriosis). Patients with recurrent endometriosis had a significantly higher incidence of heavy menstruation, pregnancy terminations (abortions), and a high proportion of gastrointestinal diseases. Analysis of the hormonal therapy received in patients with DIE showed that every second patient with relapses (18/53%) after surgical treatment and every third patient without a prior history of surgery (5/31%) received hormonal therapy. Examination of the preoperative serum levels of CA-125 and CA 19-9 serum markers in patients with DIE showed an increase in their serum levels and a correlation with the frequency of endometriosis recurrence and the size of DIE foci. Conclusion. Despite the conservative and surgical treatment of DIE patients, the recurrence rate is still high. At present, there is no satisfactory therapy for all endometriosis patients. Therefore, the development of therapy for the conservative treatment of the disease remains an urgent task.

scholarly journals Treatment algorithm for uterine leiomyoma for women of reproductive age taking into account genetic factors

2021 ◽  
Vol 3 ◽  
pp. 81-86
Author(s):  
А.G. Kornatska ◽  
M.A. Flaksemberg ◽  
O.Y. Borysiuk ◽  
G.V. Chubei ◽  
Z.I. Rossokha
Keyword(s):  
Hormonal Therapy ◽  
Gene Polymorphisms ◽  
Uterine Leiomyoma ◽  
Endometrial Hyperplasia ◽  
Receptor Gene ◽  
Uterine Cavity ◽  
Preoperative Preparation ◽  
Estrogen Receptor Gene ◽  
Esr1 Gene ◽  
Minor Alleles

The objective: to determine the association of estrogen receptor gene polymorphisms ESR1 and progesterone PGR with the development of uterine leiomyoma (UL) and to develop a patient management algorithm based on the results of ultrasound and genetic studiesMaterials and methods. Comprehensive examination was made for 90 women with intramural myoma in the age from 26 to 45 years, which additionally included determination of the presence of the Progins polymorphism of the PGR gene and polymorphic variants A351G and T397C of the ESR1 gene. Further treatment depended on the polymorphisms of the studied genes, the number and size of myomatous nodules (MN) and their position in relation to the uterine cavity.Results. Minor alleles for the estrogen receptor gene ESR1 T397C were detected in 87.2% of women with MN over 40 mm in diameter, while they were 54.2% in women with MN less than 20 mm (p<0.05). The minor alleles of ESR1 gene locus A351G were also significantly more common in women with large MN compared to LU less than 20 mm – 69.2% versus 37.5% (p<0.05). The polymorphism of the progesterone receptor regulator gene PGR Progins was found in 33.3% of patients with small size LU and from 7.7% to 18.5% in women with large LU and MN larger than 20 mm in diameter at ultrasound.Treatment was started with hormonal therapy and in the presence of the T1/T1 genotype of the PGR Progins gene and the absence of endometrial hyperplasia according to histological examination, was prescribed hormonal therapy with mifepristone 50 mg daily for 3 months, followed by monitoring of the course of the disease.GnRH agonists were prescribed as preoperative preparation in the case of detection of PGR Progins gene polymorphisms (T1/T2 or T2/T2 genotypes), endometrial hyperplasia and MN over 40 mm. In the case of small nodules that do not deform the uterine cavity and an ESR1 gene reference genotype, contraceptive OCs were recommended for six months or more to stabilise LU growth. MN over 30 mm distorting the uterine cavity and the presence of ESR1 minor alleles of the oestrogen receptor gene were the grounds for surgical treatment of such an LU.As a result of this approach, the incidence of pain syndrome decreased by almost 4.7 times, menstrual disorders in the form of hyperpolymenorrhoea and AUB by 8 times. An improvement in general well-being was subjectively reported by 64.4% of the patients, «without change» – by 24.4% of the patients. Only 11.1% of women reported a worsening of subjective sensations, which was associated with the side effects of therapy. The size of the lymph nodes decreased considerably in 44.4% of the patients, a partial effect was noticed by 26.7% of the women. There was observed no growth of the nodes in the patients during treatment or after it. A pregnancy occurred in 68.5% of the patients and ended in childbirth in 86.5% of cases.Conclusion. Consideration of the patient’s genetic status contributes to the improvement of LU treatment outcomes. The most effective is to prescript mifepristone in patients with MN under 40 mm, including multiple ones, when the operation is associated with a high risk. In the case of larger mets (over 50 mm), hormonal therapy is less effective and can be used for preoperative preparation. This approach allows to control symptoms and reduce the size of the node in 72.2% of patients and in 68.5% of cases the pregnancy can be achieved.

scholarly journals HYSTERORESECTOSCOPY IN PATIENTS WITH ENDOMETRIAL HYPERPLASIA

2013 ◽  
Vol 3 (2(8)) ◽  
pp. 62-66
Author(s):  
O.P. Gnatko ◽  
N.G. Skuriatina ◽  
O.A. Kravchenko
Keyword(s):  
Therapeutic Effect ◽  
Endometrial Hyperplasia ◽  
Morphological Characteristics

The data on therapeutic effect of organsparing endosurgical treatment, hysteroresectoscopy,in women with endometrial hyperplasia consideringpatients’ age, morphological characteristics ofendometrium, and reproductive problems werepresented.

scholarly journals Is the Use of Frozen Section Indispensable in the Surgical Treatment of Endometrial Hyperplasia?

2015 ◽  
Vol 05 (04) ◽  
pp. 219-225
Author(s):  
Ceyhun Numanoglu ◽  
Dilek Marangoz Chapman ◽  
Aysun Fendal Tunca ◽  
Aysu Akca ◽  
Agahan Han ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Endometrial Hyperplasia ◽  
Frozen Section

P084 Delayed hormonal therapy could be an option in selected patients with lymph node metastases after surgical treatment

2014 ◽  
Vol 13 (5) ◽  
pp. 140 ◽  
Author(s):  
K.M. Nyushko ◽  
B.Y. Alekseev ◽  
A.A. Krasheninnikov ◽  
A.S. Kalpinskiy ◽  
N.V. Vorobyev ◽  
...  
Keyword(s):  
Lymph Node ◽  
Surgical Treatment ◽  
Hormonal Therapy ◽  
Lymph Node Metastases ◽  
Node Metastases

scholarly journals The use of modern minimally invasive technologies and imaging (CT) methods in the diagnosis and surgical treatment of endometrial hyperplastic processes and combined gynecological pathology

2021 ◽  
Vol 50 (1) ◽  
pp. 23-26
Author(s):  
L. V. Adamyan ◽  
E. R. Tkachenko ◽  
S. I. Kiselev ◽  
A. Kh. Gaidarova
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Computerized Tomography ◽  
Endometrial Hyperplasia ◽  
Case Reports ◽  
Uterine Disease ◽  
Prospective Analysis ◽  
Spiral Computerized Tomography

On the basis of retrospective and prospective analysis of case reports of 540 patients with recurrent endometrial hyperplasia and combined intrauterine pathology (recurrent endometrial hyperplasia + hysteromyoma and/or adenomyosis) some aspects of surgical treatment of the pathology are considered, the effectiveness of different kinds of endoscopic operations is analyzed. Potentialities of spiral computerized tomography (SCT) for diagnosis of uterine disease are examined.

scholarly journals Effects of medical and surgical treatment on the risk of major adverse cardiovascular and cerebrovascular events in Asian women with endometriosis

2019 ◽  
Author(s):  
Hsin-Ju Chiang ◽  
Kuo-Chung Lan ◽  
Yao-Hsu Yang ◽  
John Y. Chiang ◽  
Fu-Tsai Kung ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
General Population ◽  
Therapeutic Effect ◽  
Cox Proportional Hazards Model ◽  
Rank Test ◽  
Asian Women ◽  
Study Cohort ◽  
Research Database ◽  
Cerebrovascular Events ◽  
Increased Risk

Abstract Background: Endometriosis (EM) is linked to cardiovascular disease (CVD). However, whether this finding can be applied to the Asian population remained unanswered. Results are still conflicting in terms of therapeutic effect on the risk of CVD in patients with EM. Therefore, we investigated the association between EM and major adverse cardiovascular and cerebrovascular events (MACCE) and the therapeutic effect on the risk of MACCE in Asian women with EM. Methods: The Taiwan National Health Insurance Research Database was used for this retrospective population-based cohort study from 1997 to 2013. A total of 17 543 patients with EM aged between 18 and 50 years were identified from a general population of 1 million after excluding diagnoses of major CVD and cerebrovascular accident (CVA) prior to EM. The comparison group (n = 70 172) without EM was selected by matching the study cohort with age, sex, and income and urbanization levels in a 4:1 ratio. Demographic data and the frequency of comorbidities between groups were compared using the independent t test and chi-square test. The incidence and risk of MACCE were analyzed using the log-rank test and a multivariate Cox proportional hazards model. Results: During a median follow-up period of 9.2 years, Asian women with EM had a significantly higher frequency of comorbidities, medical and surgical treatment, and MACCE than did their non-EM counterparts (2.76% vs 2.18%, P < .0001). After adjustment for comorbidities, patients with EM had an approximately 1.2-fold increased risk of MACCE (95% CI 1.05-1.29; P = .0053) and a higher cumulative incidence of MACCE compared with the normal population. Among women with EM, neither medical nor surgical treatment increased the risk of MACCE, including major CVD and CVA. Furthermore, medical treatment for EM appeared to be protective against MACCE. Conclusion: Asian women with EM not only had a substantially higher frequency of comorbidities but also an increased risk of MACCE compared with the general population. In terms of medical or surgical treatment of EM, the safety concern regarding MACCE was not evident.

scholarly journals A glutaminase isoform switch drives therapeutic resistance and disease progression of prostate cancer

2021 ◽  
Vol 118 (13) ◽  
pp. e2012748118
Author(s):  
Lingfan Xu ◽  
Yu Yin ◽  
Yanjing Li ◽  
Xufeng Chen ◽  
Yan Chang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Disease Progression ◽  
Tumor Cells ◽  
Therapeutic Effect ◽  
Hormonal Therapy ◽  
Therapy Resistance ◽  
Therapeutic Resistance ◽  
Switch Mechanism

Cellular metabolism in cancer is significantly altered to support the uncontrolled tumor growth. How metabolic alterations contribute to hormonal therapy resistance and disease progression in prostate cancer (PCa) remains poorly understood. Here we report a glutaminase isoform switch mechanism that mediates the initial therapeutic effect but eventual failure of hormonal therapy of PCa. Androgen deprivation therapy inhibits the expression of kidney-type glutaminase (KGA), a splicing isoform of glutaminase 1 (GLS1) up-regulated by androgen receptor (AR), to achieve therapeutic effect by suppressing glutaminolysis. Eventually the tumor cells switch to the expression of glutaminase C (GAC), an androgen-independent GLS1 isoform with more potent enzymatic activity, under the androgen-deprived condition. This switch leads to increased glutamine utilization, hyperproliferation, and aggressive behavior of tumor cells. Pharmacological inhibition or RNA interference of GAC shows better treatment effect for castration-resistant PCa than for hormone-sensitive PCa in vitro and in vivo. In summary, we have identified a metabolic function of AR action in PCa and discovered that the GLS1 isoform switch is one of the key mechanisms in therapeutic resistance and disease progression.

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