The Neural Immune Mechanisms and Genetic Influences on C

慢性盆腔疼痛占所有妇科就诊的10%，对成千上万的女性来说是一个严重的问题。大多数患有慢性盆腔疼痛的女性患有子宫内膜异位症。为了确定盆腔粘连在女性盆腔疼痛中的可能作用，我们对38名接受过两次手术的女性慢性盆腔疼痛患者进行了腹腔镜子宫内膜异位症切除术后的粘连重建和粘连松解。与只有子宫内膜异位症病变的部位相比，粘连或粘连合并子宫内膜异位症病变的部位在第二次手术中明显更容易复发。与薄粘连相比，厚粘连明显增加粘连重建的可能性。与相邻卵巢窝或输卵管的病变相比，卵巢子宫内膜异位症病变或粘连在后续手术中更有可能与粘连相关。大多数患者在根治性手术切除子宫内膜异位症治疗盆腔疼痛后出现粘连。子宫内膜异位症手术后粘连形成的高发生率强调了优化手术技术以潜在地减少粘连形成的重要性。

Chronic pelvic pain accounts for 10 percent of all gynecology visits and is a significant problem for thousands of women. Most women with chronic pelvic pain have endometriosis. To determine the possible contribution of pelvic adhesions in women with pelvic pain, we evaluated adhesion reformation following laparoscopic excision of endometriosis and adhesiolysis in women with chronic pelvic pain in 38 women who had two surgeries. Adhesions, or adhesions combined with endometriotic lesions, were significantly more likely to reform at second surgery compared to sites having only an endometriosis lesion. Thick adhesions were associated with a significantly increased likelihood of adhesion reformation, compared to thin adhesions. Endometriotic lesions or adhesions involving the ovary were more likely to be associated with adhesions at a subsequent surgery, compared to lesions in the adjacent ovarian fossa or fallopian tube. Most patients developed adhesions after radical surgical excision of endometriosis for pelvic pain. The high incidence of adhesion formation following surgery for endometriosis underscores the importance of optimizing surgical techniques to potentially reduce adhesion formation. In order to better understand endometriosis, chronic pelvic pain and their co-morbidities, we analyzed a survey of almost 4000 women with surgically diagnosed endometriosis conducted by the Endometriosis Association. Almost all responders had pain (99%), and many reported infertility (41%). In this cohort of women with endometriosis, hypothyroidism, fibromyalgia, chronic fatigue syndrome, autoimmune diseases, allergies, and asthma were all significantly more common than in women in the general U.S. population. In the coming year, we plan to conduct a more in depth analysis of women with endometriosis to assess the diagnostic process and utilization and effectiveness of treatments, to estimate the prevalence of co-morbid diseases including cancers, endocrine diseases, and infections, and to evaluate the reproductive and gynecologic health of women who responded to the survey.