External genital endometriosis: treatment and rehabilitation
https://doi.org/10.17749/2313-7347/ob.gyn.rep.2020.148
Abstract
Aim: to systematize the data on rehabilitation methods and management tactics for women with external form of genital endometriosis.
Materials and Methods. We searched for publications in the international scientific databases: scientific electronic library eLibrary, Scholar, ScienceDirect, Cochrane Library, PubMed/MEDLINE released for the last 5 years. The data on the current approach to the therapy and rehabilitation of women with external genital endometriosis are presented in the study. Search queries in Russian and English were used as follows: «endometriosis», «rehabilitation», «gynecology», «quality of life».
Results. Endometriosis is considered an independent risk factor for the development of malignant tumors not only targeting the reproductive system, but also affecting large intestine, bladder, and mammary glands. Moreover, such patients often suffer from emotional and psychosexual disorders as well as impaired socialization. Special attention should be paid to diagnostics of disease relapses to avoid potential malignant transformation of endometrioid tissue. We also provide a current view on the treatment and rehabilitation of women with external genital endometriosis. Endometriosis is a polyetiological disease that can be manifested as dysmenorrhea, dyspareunia, chronic pelvic pain, as well as dysuria and dyschesia upon affecting adjacent organs in the pathological process. Finally, we provide insights into potential therapeutic approaches for solving such manifestations.
Conclusion. It is necessary not only to conduct a combination treatment, but also develop personalized rehabilitation programs allowing to improve the quality of patient life as well as create comfortable conditions for social adaptation of women with endometriosis.
About the Authors
A. G. SolopovaRussian Federation
Antonina G. Solopova - MD, Dr Sci Med, Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children's Health, Sechenov University.
2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991.
Scopus Author ID: 6505479504
Researcher ID: Q-1385-2015
E. E. Achkasov
Russian Federation
Evgeniy E. Achkasov - MD, Dr Sci Med, Professor, Head of the Department of Sports Medicine and Rehabilitation, Sklifosovsky Institute of Clinical Medicine, Sechenov University.
2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991.
V. S. Moskvichyova
Russian Federation
Viktoriya S. Moskvichyova - Clinical Resident, Department of Sports Medicine and Rehabilitation, Sklifosovsky Institute of Clinical Medicine, Sechenov University.
2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991.
Scopus Author ID: 57201495137
Researcher ID: H-2410-2019
E. Grigorevskaya
Russian Federation
Evana Grigorevskaya - Postgraguate Student, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children's Health, Sechenov University.
2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991.
D. M. Ampilogova
Russian Federation
Diana M. Ampilogova - 5th year Student, Sklifosovsky Institute of Clinical Medicine, Sechenov University.
2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991.
References
1. Mishra V.V., Bandwal P., Agarwal R., Aggarwal R. Prevalence, clinical and laparoscopic features of endometriosis among infertile women. J Obstet Gynecol India. 2017;67(3):208-12. https://doi.org/10.1007/s13224-016-0931-x.
2. Marinho M.C.P., Magalhaes T.F., Fernandes L.F.C. et al. Quality of life in women with endometriosis: an integrative review. J Womens Health (Larchmt). 2018;27(3):399-408. https://doi.org/10.1089/jwh.2017.6397.
3. Frolova I.L., Tsakhilova S.G., Smirnova L.E., Nasredinova V.V. Modern aspects of endometriosis (literature review). [Sovremennye aspekty endometrioza (obzor literatury)]. Problemy reprodukcii. 2019;25(5):30-5. (In Russ.). https://doi.org/10.17116/repro20192505130.
4. Parasar P., Ozcan P., Terry K.L. Endometriosis: epidemiology, diagnosis and clinical management. Curr Obstet Gynecol Rep. 2017;6(1):34-41. https://doi.org/10.1007/s13669-017-0187-1.
5. Johnson N.P., Hummelshoj L., Adamson G.D. et al.; World Endometriosis Society Sao Paulo Consortium. World Endometriosis Society consensus on the classification of endometriosis. Hum Reprod. 2017;32(2):315-24. https://doi.org/10.1093/humrep/dew293.
6. Rogers P.A., Adamson G.D., Al-Jefout M. et al.; WES/WERF consortium for research priorities in endometriosis. Research priorities for endometriosis. Reprod Sci. 2017;24(2):202-26. https://doi.org/10.1177/1933719116654991.
7. Solopova A.G., Makatsariya A.D., Chukanova E.M. Endometriosis: a new approach to etiology and pathogenesis (review). [Endometrioz: novyj podhod k patogenezu (obzor)]. Georgian Med News. 2017;(273):7-11. (In Russ.).
8. Makiyan Z. Endometriosis origin from primordial germ cells. Organogenesis. 2017;13(3):95-102. https://doi.org/10.1080/15476278. 2017.1323162.
9. Sheveleva T., Bejenar V., Komlichenko E. et al. Innovative approach in assessing the role of neurogenesis, angiogenesis, and lymphangiogenesis in the pathogenesis of external genital endometriosis. Gynecol Endocrinol. 2016;32(S1):75-9. https://doi.org/10.1080/09513590.2016.1232789.
10. Efimenko T.O. The structure, nature and intensity of pain in various forms of external genital endometriosis. [Struktura, harakter i intensivnost' bolevogo sindroma pri razlichnyh formah naruzhnogo genital'nogo endometrioza]. Zhurnal akusherstva i zhenskih boleznej. 2016;65(2):24-30. (In Russ.). https://doi.org/10.17816/JOWD65224-30.
11. Kachalina T.S., Zinoviev A.N., Bogatova M.E. Comprehensive evaluation of the risks of development of recurrence of endometrious ovarian cysts. [Kompleksnaya ocenka faktorov riska razvitiya recidiva endometrioidnyh kist yaichnikov]. Medicinskij al'manah. 2017;(1):107-10. (In Russ.). https://doi.org/10.21145/2499-9954-2017-1-107-110.
12. Gustin S.M., Burke L.A., Peck C.C. et al. Pain and personality: do individuals with different forms of chronic pain exhibit a mutual personality? Pain Pract. 2016;16(4):486-94. https://doi.org/10.1111/papr.12297.
13. Grek L.P. A role of «visceral syndrome» is in genesis of cronic pelvis pain at a genital endometriosis. Sciences of Europe. 2017;22(1):34-40.
14. Solopova A.G., Moskvichyova V.S., Blbulyan T.A., Makatsariya A.D. Restoration of sexual function in patients with kraurosis vulvae. [Vosstanovlenie seksual'noj funkcii u pacientok s kraurozom vul'vy]. Akusherstvo, Ginekologia i Reprodukcia. 2019;13(1):63-9. (In Russ.). https://doi.org/10.17749/23137347.2019.13.1.063-069.
15. Zakirova Y.R., Babaeva E.I., Orazov M.R., Aryutin D.G. Complex assessment of reproductive health in patients with external genital endometriosis after surgery. [Kompleksnaya ocenka reproduktivnogo zdorov'ya pacientok s naruzhnym genital'nym endometriozom posle hirurgicheskogo lecheniya]. Chelovek. Sport. Medicina. 2016;16(4):32-42. (In Russ.). https://doi.org/10.14529/118111160404.
16. Khine Y.M., Taniguchi F., Harada T. Clinical management of endometriosis associated infertility. Reprod Med Biol. 2016;15(4):217-25. https://doi.org/10.1007/s12522-016-0237-9.
17. Coenders-Tros R., van Kessel M.A., Vernooij M.M. et al. Performance of outpatient transvaginal hydrolaparoscopy. Hum Reprod. 2016;31(10):2285-91. https://doi.org/10.1093/humrep/dew161.
18. Li X., Zeng C., Zhou Y.F. et al. Endometriosis Fertility Index for predicting pregnancy after endometriosis surgery. Chin Med J (Engl). 2017;130(16):1932-7. https://doi.org/10.4103/0366-6999.211892.
19. Maheux-Lacroix S., Nesbitt-Hawes E., Deans R. et al. Endometriosis fertility index predicts live births following surgical resection of moderate and severe endometriosis. Hum Reprod. 2017;32(11):2243-9. https://doi.org/10.1093/humrep/dex291.
20. Garavaglia E., Pagliardini L., Tandoi I. et al. External validation of the endometriosis fertility index (EFI) for predicting spontaneous pregnancy after surgery: further considerations on its validity. Gynecol Obstet Invest. 2015;79(2):113-8. https://doi.org/10.1159/000366443.
21. Lagana A.S., La Rosa V.L., Rapisarda A.M.C. et al. Anxiety and depression in patients with endometriosis: impact and management challenges. Int J Womens Health. 2017;9:323-30. https://doi.org/10.2147/IJWH.S119729.
22. Ferrandina G., Palluzzi E., Fanfani F. Endometriosis-associated clear cell carcinoma arising in caesarean section scar: a case report and review of the literature. World J Surg Oncol. 2016;14(1):300. https://doi.org/10.1186/s12957-016-1054-7.
23. Kok V.C., Tsai H.J., Su C.F., Lee C.K. The risks for ovarian, endometrial, breast, colorectal, and other cancers in women with newly diagnosed endometriosis or adenomyosis: a population based study. Int J Gynecol Cancer. 2015;25(6):968-76. https://doi.org/10.1097/IGC.0000000000000454.
24. Buppasiri P., Kleebkaow P., Tharanon C. et al. Clear cell carcinoma arising in vulvar endometriosis. Case Rep Pathol. 2018;2018:4263104. https://doi.org/10.1155/2018/4263104.
25. Enkova E.V. Impact of external genital endometriosis on the psychoemotional state and quality of life of patients. [Vliyanie naruzhnogo genital'nogo endometrioza na psihoemocional'noe sostoyanie i kachestvo zhizni pacientok]. Medicinskij sovet. 2015;(9):62-4. (In Russ.).
26. Rault E., Philip C.A., Cortet M., Dubernard G. Virtual cystoscopy and colonoscopy to assess deep infiltrating endometriosis. JEPPD. 2019;11(1):3-6. https://doi.org/10.1177/2284026518818976.
27. Fiala L., Bob P., Raboch J. Oncological markers CA-125, CA 19-9 and endometriosis. Medicine (Baltimore). 2018;97(51):e13759. https://doi.org/10.1097/MD.0000000000013759.
28. Signorile P.G., Baldi A. Supporting evidences for potential biomarkers of endometriosis detected in peripheral blood. Data Brief. 2015;5:971-4. https://doi.org/10.1016/j.dib.2015.10.047.
29. Adamyan L.V., Salimova D.F., Kondratovich L.M. Pathogenetic aspects of endometriosis-associated infertility. [Patogeneticheskie aspekty endometrioz-associirovannogo besplodiya]. Problemy reprodukcii. 2015;21(6):90-6. (In Russ.). https://doi.org/10.17116/repro201521682-88.
30. Collinet P., Fritel X., Revel-Delhom C. et al. Management of endometriosis: CNGOF/HAS clinical practice guidelines - Short version. J Gynecol Obstet Hum Reprod. 2018;47(7):265-74. https://doi.org/10.1016/j.jogoh.2018.06.003.
31. Ivanov I.I., Prochan E.N., Tarasova E.S. et al. A modern approach to endometriosis treatment in patients planning pregnancy. [Sovremennyj podhod k lecheniyu endometrioza u pacientok, planiruyushchih beremennost']. Tavricheskij mediko-biologicheskij vestnik. 2017;20(2-2):179-84. (In Russ.).
32. Zheng W., Cao L., Xu Z. et al. Anti-angiogenic alternative and complementary medicines for the treatment of endometriosis: A review of potential molecular mechanisms. Evid Based Complement Alternat Med. 2018;2018:4128984. https://doi.org/10.1155/2018/4128984.
33. Melki E. Endometriosis treatment with shock waves: A novel approach Med Hypotheses. 2019;124:114-7. https://doi.org/10.1016/j.mehy.2019.02.022.
34. Khachaturyan A.R., Yarmolinskaya M.I. Experience of using fluorescence diagnosis and photodynamic therapy genital endometriosis. [Opyt primeneniya fluorescentnoj diagnostiki i fotodinamicheskoj terapii naruzhnogo genital'nogo endometrioza]. Zhurnal akusherstva i zhenskih boleznej. 2016;65(3):64-74. (In Russ.). https://doi.org/10.17816/JOWD65364-74.
35. Marki G., Bokor A., Rigo J., Rigo A. Physical pain and emotion regulation as the main predictive factors of health-related quality of life in women living with endometriosis. Hum Reprod. 2017;32(7):1432-8. https://doi.org/10.1093/humrep/dex091.
36. Petrova E.A., Cherepovskaya V.A., Pahomova F.V. et al. Emotional and personality traits of pain perception in women with pain syndrome in endometriosis. [Emocional'nye i lichnostnye osobennosti vospriyatiya boli u zhenshchin pri endometrioze]. Uchenye zapiski Sankt-Peterburgskogo gosudarstvennogo medicinskogo universiteta imeni akademika I.P. Pavlova. 2019;26(2):62-8. (In Russ.). https://doi.org/10.24884/1607-4181-2019-26-2-62-68.
37. Razumov A.N., Puriga A.O., Yurova O.V. The modern applications of radon therapy for the medical rehabilitation of the patients. [Sovremennye vozmozhnosti radonoterapii v medicinskoj reabilitacii pacientov]. Voprosy kurortologii, fizioterapii i lechebnoj fizicheskoj kul'tury. 2015;92(4):54-60. (In Russ.). https://doi.org/10.17116/kurort2015454-60.
38. Krutova V.A., Melkoniants T.G., Makarenko L.V. et al. The experience and rehabilitation of patients operated on external genital endometriosis. [Opyt reabilitacii pacientok, operirovannyh po povodu naruzhnogo genital'nogo endometrioza]. Kubanskij nauchnyj medicinskij vestnik. 2016;157(2):101-6. (In Russ.). https://doi.org/10.25207/1608-6228-2016-2-101-105.
39. Ahkubekova N.K., Ovsienko A.B., Tereshin A.T. et al. Dynamics of the cytokine status indicators in patients with external genital endometriosis in early postoperative period under the influence of radon therapy and gonadoliberin agonists. [Dinamika pokazatelej citokinovogo statusa u bol'nyh naruzhnym genital'nym endometriozom v rannem posleoperacionnom periode pod vozdejstviem radonoterapii i agonistov gonadoliberina]. Medicinskij vestnik Severnogo Kavkaza. 2018;13(1-1):32-5. (In Russ.). https://doi.org/10.14300/mnnc.2018.13009.
40. Kullmann M., Ruhle P.F., Harrer A. et al. Temporarily increased TGFp following radon spa correlates with reduced pain while serum IL-18 is a general predictive marker for pain sensitivity. Radiat Environ Biophys. 2019;58(1):129-35. https://doi.org/10.1007/s00411-018-0768-z.
41. Kit O.I., Frenchman E.M., Menshenina A.P. et al. The role of plasmapheresis and xenon therapy in the correction of the acute consequences of surgical menopause in patients with cervical cancer. [Rol' plazmafereza i ksenonterapii v korrekcii ostryh posledstvij hirurgicheskoj menopauzy u bol'nyh rakom shejki matki]. Politematicheskij setevoj elektronnyj nauchnyj zhurnal Kubanskogo gosudarstvennogo agrarnogo universiteta. 2016;117:472-86. (In Russ.).
42. Carey E.T., As-Sanie S. New developments in the pharmacotherapy of neuropathic chronic pelvic pain. Future Sci OA. 2016;2(4):FSO148. https://doi.org/10.4155/fsoa-2016-0048.
43. Saltan G., Suntar I., Ozbilgin S. et al. Viburnum opulus L.: A remedy for the treatment of endometriosis demonstrated by rat model of surgically-induced endometriosis. J Ethnopharmacol. 2016;193:450-5. https://doi.org/10.1016/j.jep.2016.09.029.
44. Akkol E.K., Demirel M.A., Acikara O.B. et al. Phytochemical analyses and effects of Alchemilla mollis (Buser) Rothm. and Alchemilla persica Rothm. in rat endometriosis model. Arch Gynecol Obstet. 2015;292(3):619-28. https://doi.org/10.1007/s00404-015-3665-6.
45. Schwartz A.S., Gross E., Geraedts K. et al. The use of home remedies and complementary health approaches in endometriosis. Reprod Biomed Online. 2019;38(2):260-71. https://doi.org/10.1016/j.rbmo.2018.10.009.
Review
For citations:
Solopova A.G., Achkasov E.E., Moskvichyova V.S., Grigorevskaya E., Ampilogova D.M. External genital endometriosis: treatment and rehabilitation. Obstetrics, Gynecology and Reproduction. 2021;15(1):70-79. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2020.148

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.