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Adenomyosis

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Susan M. Ascher – One of the best experts on this subject based on the ideXlab platform.

  • Adenomyosis: MRI of the uterus treated with uterine artery embolization.
    AJR. American journal of roentgenology, 2003
    Co-Authors: Reena C. Jha, Junko Takahama, Izumi Imaoka, Shahin J. Korangy, James B. Spies, C Cooper, Susan M. Ascher
    Abstract:

    OBJECTIVE. The purpose of this study was to determine the MRI features seen after uterine artery embolization and to evaluate the clinical response in patients with Adenomyosis.MATERIALS AND METHODS. Thirty women with Adenomyosis underwent uterine artery embolization and follow-up MRI for 1 year. Of the 30, 27 patients were diagnosed with uterine fibroids and Adenomyosis on the basis of MRI before uterine artery embolization. In six of the 27 patients, the dominant disease was Adenomyosis. Three of the 30 patients had Adenomyosis alone. The distribution, thickness, and enhancement of Adenomyosis were analyzed in each patient. Patients completed a symptom questionnaire.RESULTS. After uterine artery embolization, the junctional zone-myometrial ratio did not change significantly. There were regions of devascularization of Adenomyosis on contrast-enhanced images in 12 patients, all with a junctional zone thickness before uterine artery embolization of more than 20 mm (mean thickness, 39.2 mm). Eleven of the 1…

  • Adenomyosis prospective comparison of mr imaging and transvaginal sonography
    Radiology, 1994
    Co-Authors: Susan M. Ascher, Lori L Arnold, Richard H Patt, John J Schruefer, Ann S Bagley, Richard C Semelka, Robert K Zeman, James A Simon
    Abstract:

    PURPOSE: To prospectively compare conventional spin-echo magnetic resonance (MR) imaging and transvaginal sonography for the diagnosis of Adenomyosis. MATERIALS AND METHODS: Twenty women with clinically suspected Adenomyosis underwent MR imaging and transvaginal sonography performed within 3 months of each other. Pathologic proof was obtained in all cases. RESULTS: Seventeen patients were proved to have Adenomyosis. The correct diagnosis was achieved with MR imaging in 15 of 17 cases. One false-positive and two false-negative diagnoses were made with MR imaging. With transvaginal sonography, nine of 17 cases of Adenomyosis were correctly diagnosed. One false-positive and eight false-negative diagnoses occurred. The most frequent cause of false-negative diagnoses with transvaginal sonography was the misinterpretation of Adenomyosis as leiomyomas (seven cases). CONCLUSION: MR imaging is significantly better (P < .02) than transvaginal sonography in the diagnosis of Adenomyosis.

  • Familial Adenomyosis: a case report.
    Fertility and sterility, 1994
    Co-Authors: Lori L Arnold, Susan M. Ascher, James A Simon
    Abstract:

    The persuasive data not only illustrate a familial tendency towards Adenomyosis but also emphasize that Adenomyosis can be diagnosed noninvasively and accurately by MRI. A possible familial predisposition toward or a direct familial cause of Adenomyosis warrants further investigation.

Meridith J Englander – One of the best experts on this subject based on the ideXlab platform.

Stefan Kissler – One of the best experts on this subject based on the ideXlab platform.

  • uterotubal transport disorder in Adenomyosis and endometriosis a cause for infertility
    British Journal of Obstetrics and Gynaecology, 2006
    Co-Authors: Stefan Kissler, Stephan Zangos, T. J. Vogl, N. Hamscho, F. Gruenwald, Inka Wiegratz, S Schlichter, C Menzel, N Doebert, R Gaetje
    Abstract:

    Objective  Uterine hyperperistalsis and dysperistalsis are common phenomena in endometriosis and may be responsible for reduced fertility in cases of minimal or mild extent of disease. Since a high prevalence of Adenomyosis uteri has been well documented in association with endometriosis, we designed a study to examine whether hyperperistalsis and dysperistalsis are caused by the endometriosis itself or by the adenomyotic component of the disease. Design  A prospective observational study. Setting  University hospital, Department of Obstetrics and Gynaecology, Division of Reproductive Medicine and Gynaecologic Endocrinology with 300 in vitro fertilisation/intracytoplasmatic sperm injection cycles and 350 intrauterine insemination cycles/year. Population  Forty-one subjects with infertility and with laparoscopically proven endometriosis and patent fallopian tubes. Thirty-five subjects (85%) additionally showed signs of Adenomyosis. Methods  All subjects underwent T2-weighed magnetic resoresonanceging (MRI) and hysterosalpingoscintigraphy (HSSG) during the subsequent menstrual cycle. MRI revealed the extent of the adenomyotic component of the disease and the integrity of uterotubal transport capacity was evaluated by HSSG. Main outcome measures  Influence of Adenomyosis on uterotubal transport capacity in endometriosis. Results  In 35 of the 41 subjects (85%) with endometriosis, signs of Adenomyosis were detected using T2-weighed MRI. Two of six (33%) subjects with no Adenomyosis (group I) showed dysperistalsis and hyperperistalsis, compared with 14 of 24 (58%) women with focal Adenomyosis (group II) and 10 of 11 (91%) women with diffuse Adenomyosis (seven showed a failure in transport capacity and two contralateral transport). Conclusions  Our data suggest that endometriosis is associated with impeded hyperperistaltic and dysperistaltic uterotubal transport capacity. However, Adenomyosis is of even more importance, especially when diffuse Adenomyosis is detected. Both forms of Adenomyosis are commonly found in subjects with mild to moderate endometriosis. We suggest that the extent of the adenomyotic component in subjects with endometriosis explains much of the reduced fertility in subjects with intact tubo-ovarian anatomy.

  • Adenomyosis and reproduction.
    Best practice & research. Clinical obstetrics & gynaecology, 2006
    Co-Authors: Gerhard Leyendecker, Stefan Kissler, G. Kunz, Ludwig Wildt
    Abstract:

    Evidence has been provided that pelvic endometriosis is significantly associated with uterine Adenomyosis and that the latter constitutes the major factor of infertility in such conditions. Furthermore, it has become evident that both Adenomyosis and endometriosis constitute a pathophysiological and nosological entity. Mild peritoneal endometriosis of the fertile woman and premenopausal Adenomyosis of the parous and non-parous woman, as well as Adenomyosis in association with endometriosis of the infertile woman, constitute a pathophysiological continuum that is characterized by the dislocation of basal endometrium. Due to the postponement of childbearing late into the period of reproduction, premenopausal Adenomyosis might increasingly become a factor for infertility in addition to Adenomyosis associated with endometriosis of younger women. In any event, the presence or absence of uterine Adenomyosis should be examined in a sterility work-up.

  • impaired utero tubal sperm transport in Adenomyosis and endometriosis a cause for infertility
    International Congress Series, 2004
    Co-Authors: Stefan Kissler, Stephan Zangos, T. J. Vogl, N. Hamscho, F. Gruenwald, J. Kohl, Manfred Kaufmann, E. Siebzehnruebl
    Abstract:

    Abstract Background : Patients with minimal to mild endometriosis suffer from infertility. Hysterosalpingoscintigraphy (HSSG) is the only method to evaluate integrity of utero-tubal sperm trantransport capacity. Material and Methods : HSSG and magnetic resoresonanceging (MRI) in the late follicular phase in 41 endometriosis patients were done to detect integrity of sperm transport by HSSG and Adenomyosis by MRI of the uterus. Results : Eighty-five percent of patients reveal signs of Adenomyosis when suffering from endometriosis. Hence, the percentage of a complete failure of sperm transport in Adenomyosis (negative HSSG) is significantly increased, whereas sperm transport prevails in endometriosis when no signs of Adenomyosis are detected. In diffuse Adenomyosis, positive sperm transport can almost be excluded. Conclusions : Since Adenomyosis and endometriosis show a high prevalence and sperm trantransport capacity is impaired especially in Adenomyosis, the uterine component of the disease has to be regarded as the cause for infertility in minor to mild endometriosis.

Indra Adi Susianto, Indra Adi Susianto – One of the best experts on this subject based on the ideXlab platform.

  • Hasil cek plagiasi jurnal Perubahan nyeri haid paska adenomiomektomi
    'Soegijapranata Catholic University', 2020
    Co-Authors: Adi Susianto Indra, Indra Adi Susianto, Indra Adi Susianto
    Abstract:

    Latar Belakang : Kejadian Adenomyosis akhir-akhir ini meningkat pada wanita yang belum menikah dan belum pernah hamil (nuliigravid).1,2 Pengobatan untuk Adenomyosis ada wanita yang masih ingin mempertahankan fertilitasnya adalah penggunaan non steroid antiinflamasi, terapi hormone berupa Gonadotropin Releasing hormone (GnRH) agonist, danazol atau Pil kontrasepsi, tetapi efek dari penggobatan ini adalah sementara dan nyeri haid seringkali tidak berkurang Tujuan Penelitian : Untuk mengetahui derajad nyeri dan kekambuhan kembali dismenorhea berat setelah tindakan laparoskopi adenomiomektomi pada pasien fokal adenomiosis yang tidak respon terhadap pengobatan medikamentosa. Metode : Penelitian ini merupakan penelitian Kohort-Retrospective pada pasien dengan kriteria inklusi adenomiosos fokal dengan derajad VAS dismenorhea 9/10 yang gagal terapi dengan obat hipoestrogen. Dilakukan pemantauan setelah tindakan laparoskopi adenomiomektomi dan pemberian GnRh analog setiap bulan selama 6 bulan dan kemudian di pantau setiap 3 bulan untuk derajad VAS untuk dismenorhea selama 24 bulan kemudian. Hasil : Dari 92 pasien (2012 – 2017) yang dilakukan laparoskopi adenomiomektomi, didapatkan 68,4 % terjadi penurunan VAS dismenorhea secara signifikan, 14,1 % terjadi kekambuhan kembali pada 12 bulan paska tindakan dan 1 % fluktuatif. Dengan rerata VAS dismenorhea antara 0.447 sampai 0.894 dalam rentang waktu 24 bulan paska tindakan. Didapatkan 13 pasien dengan kehamilan spontan dengan 21 % berakhir dengan abortus, 3 % melahirkan pervaginam dan hanya 1 % terjadi ruptura uteri pada trimester 2 kehamilan Kesimpulan : Laparoskopi adenomiomektomi dapat menjadi alternative terapi pada pasien adenomiosis yang gagal terapi hypoestrogen dan menginginkan fertilitas

  • Hasil Peer review jurnal dengan judul Perubahan nyeri haid (dismenorhea) pada pasien paska laparoskopi adenomiomektomi
    Perpustakaan Unika Soegijapranata, 2020
    Co-Authors: Adi Susianto Indra, Indra Adi Susianto, Indra Adi Susianto
    Abstract:

    Latar Belakang : Kejadian Adenomyosis akhir-akhir ini meningkat pada wanita yang belum menikah dan belum pernah hamil (nuliigravid).1,2 Pengobatan untuk Adenomyosis ada wanita yang masih ingin mempertahankan fertilitasnya adalah penggunaan non steroid antiinflamasi, terapi hormone berupa Gonadotropin Releasing hormone (GnRH) agonist, danazol atau Pil kontrasepsi, tetapi efek dari penggobatan ini adalah sementara dan nyeri haid seringkali tidak berkurang Tujuan Penelitian : Untuk mengetahui derajad nyeri dan kekambuhan kembali dismenorhea berat setelah tindakan laparoskopi adenomiomektomi pada pasien fokal adenomiosis yang tidak respon terhadap pengobatan medikamentosa. Metode : Penelitian ini merupakan penelitian Kohort-Retrospective pada pasien dengan kriteria inklusi adenomiosos fokal dengan derajad VAS dismenorhea 9/10 yang gagal terapi dengan obat hipoestrogen. Dilakukan pemantauan setelah tindakan laparoskopi adenomiomektomi dan pemberian GnRh analog setiap bulan selama 6 bulan dan kemudian di pantau setiap 3 bulan untuk derajad VAS untuk dismenorhea selama 24 bulan kemudian. Hasil : Dari 92 pasien (2012 – 2017) yang dilakukan laparoskopi adenomiomektomi, didapatkan 68,4 % terjadi penurunan VAS dismenorhea secara signifikan, 14,1 % terjadi kekambuhan kembali pada 12 bulan paska tindakan dan 1 % fluktuatif. Dengan rerata VAS dismenorhea antara 0.447 sampai 0.894 dalam rentang waktu 24 bulan paska tindakan. Didapatkan 13 pasien dengan kehamilan spontan dengan 21 % berakhir dengan abortus, 3 % melahirkan pervaginam dan hanya 1 % terjadi ruptura uteri pada trimester 2 kehamilan Kesimpulan : Laparoskopi adenomiomektomi dapat menjadi alternative terapi pada pasien adenomiosis yang gagal terapi hypoestrogen dan menginginkan fertilitas

Jens Hertz – One of the best experts on this subject based on the ideXlab platform.

  • prevalence and risk factors of Adenomyosis at hysterectomy
    Human Reproduction, 2001
    Co-Authors: Thomas Bergholt, Lisbeth Eriksen, N Berendt, M Jacobsen, Jens Hertz
    Abstract:

    Background The present study was performed to evaluate the prevalence and possible associated risk factors for Adenomyosis. Methods Medical records were retrieved and histo-pathological material re-examined for 549 consecutive women undergoing hysterectomy in a two-year period from 1990-1991. Results The prevalence of Adenomyosis in the study varied from 10.0-18.2%, depending on different diagnostic criteria. The presence of endometrial hyperplasia at the time of hysterectomy was the only variable significantly associated with Adenomyosis (OR = 3.0; 95% CI: 1.2-8.3). No statistically significant association was found between Adenomyosis and previous caesarean section, endometrial curettage or evacuation of the uterus. Furthermore, we did not see any significant association between Adenomyosis and pain-related symptoms, indication for hysterectomy, age, parity or number of myometrial samples. Conclusions Our study stresses the need for precise diagnostic criteria for Adenomyosis, and furthermore indicates that endometrial hyperplasia and Adenomyosis may have a common aetiology.