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Article ; Online: Metformin and progestins in women with atypical hyperplasia or endometrial cancer: systematic review and meta-analysis.

Adamyan, Leila / Pivazyan, Laura / Isaeva, Sapiyat / Shapovalenko, Roman / Zakaryan, Araksya

2024

Abstract: Purpose: To assess metformin's effectiveness in adding it to progestin-based hormone therapy for treating atypical endometrial hyperplasia (AEH) and early endometrial cancer (EEC).: Methods: We conducted a systematic review and meta-analysis ... ...

Abstract	Purpose: To assess metformin's effectiveness in adding it to progestin-based hormone therapy for treating atypical endometrial hyperplasia (AEH) and early endometrial cancer (EEC). Methods: We conducted a systematic review and meta-analysis following PRISMA guidelines (registration number CRD42023399094). We searched databases for studies up to March 2023, including randomized and non-randomized clinical trials in English. Results: Out of 280 studies, 9 studies (1104 patients) were eligible. A total of 408 patients were allocated to receive metformin, and 696 patients entered the control group. Primary analysis focused on evaluating the CR showed a significant difference in patients with AEH treated with metformin (RR = 1.10, 95% CI 1.02-1.20, p = 0.02). Relapse rate (RR = 0.62, 95% CI 0.33-1.17, p = 0.14) was also evaluated. Secondary analysis indicated higher pregnancy rates (RR = 1.28, 95% CI 1.04-1.57, p = 0.02) with no significant difference in live birth rates (RR = 0.56, 95% CI 0.29-1.10, p = 0.09). Conclusion: Combined therapy is effective. Metformin shows superiority to the standard regimen in achieving better CR rate in patients with AEH and benefits pregnancy rates but not recurrence or live birth rates. Therefore, the ideal fertility-sparing treatment for EC has not yet been determined and further clinical trials are needed.
Language	English
Publishing date	2024-03-19
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	896455-5
ISSN	1432-0711 ; 0932-0067
ISSN (online)	1432-0711
ISSN	0932-0067
DOI	10.1007/s00404-024-07416-2
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Article ; Online: Laser vaporization compared with other surgical techniques in women with ovarian endometrioma: a systematic review and meta-analysis.

Adamyan, Leila / Kasyan, Victoria / Pivazyan, Laura / Isaeva, Sapiyat / Avetisyan, Julietta

Archives of gynecology and obstetrics

2022 Volume 308, Issue 2, Page(s) 413–425

Abstract: Objective: To compare outcomes after laparoscopic cystectomy versus laser vaporization in women of reproductive age with ovarian endometrioma.: Evidence review: Our systematic review and meta-analysis was registered in PROSPERO (CRD42021281781) and ... ...

Abstract	Objective: To compare outcomes after laparoscopic cystectomy versus laser vaporization in women of reproductive age with ovarian endometrioma. Evidence review: Our systematic review and meta-analysis was registered in PROSPERO (CRD42021281781) and was done according to the PRISMA 2020 checklist. Studies (published until October 2021) were identified by searching PubMed, Cochrane Library, Google Scholar, and ClinicalTrials.gov databases (key words "cystectomy", "laser vaporization", and "endometrioma"). The search was conducted independently by two investigators (L.P. and S.I.). Inclusion criteria were: women of reproductive age undergoing surgery for symptomatic endometriomas larger than 30 mm. The exclusion criteria were: women who undergo conservative treatment. Outcomes were: risk ratio for recurrence, ovarian reserve and pregnancy rates. The studies included were randomized clinical trials (RCTs) and nonrandomized clinical trials (prospective controlled, prospective cohort, retrospective studies, and other types of studies) that included a minimum of 10 patients and written in English. Tools recommended by the Cochrane Society achieved risk-of-bias assessment. Results: Totally, 874 studies were found, 9 studies were included in qualitative synthesis (822 patients). All the authors compared the efficacy and safety of cystectomy or laser vaporization in reproductive-aged women with ovarian endometrioma. The overall risk of bias for the randomized trials was 80% 'some concerns' and 20% 'low', and for the cohort studies, 50% 'some concerns' and 50% 'low'. The primary meta-analysis focused on recurrence rates (4 studies included) with no statistically significant differences found between these two interventions (RR = 0.53, 95% CI 0.24 to 1.21, P = 0.13). The next meta-analysis estimated antral follicle count (3 studies) which was significantly lower in cystectomy group (RR = - 2.56, 95% CI - 3.71 to - 1.42, P < 0.0001). Pregnancy rates were analyzed in 3 studies with no statistically significant difference (RR = 0.96, 95% CI 0.81 to 1.14, P = 0.64). Conclusions: There was no statistical difference in the recurrence rate and pregnancy rates, but the antral follicle count was higher in the laser vaporization group. However, we need more clinical trials to make stronger recommendations.
MeSH term(s)	Pregnancy ; Female ; Humans ; Adult ; Volatilization ; Endometriosis/surgery ; Laser Therapy ; Reproduction ; Ovarian Reserve ; Lasers ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2022-09-29
Publishing country	Germany
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	896455-5
ISSN	1432-0711 ; 0932-0067
ISSN (online)	1432-0711
ISSN	0932-0067
DOI	10.1007/s00404-022-06799-4
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Article: Novel Approaches to Possible Targeted Therapies and Prophylaxis of Uterine Fibroids.

Kuznetsova, Maria V / Tonoyan, Narine M / Trubnikova, Elena V / Zelensky, Dmitry V / Svirepova, Ksenia A / Adamyan, Leila V / Trofimov, Dmitry Y / Sukhikh, Gennady T

Diseases (Basel, Switzerland)

2023 Volume 11, Issue 4

Abstract: Uterine leiomyomas are the most common benign tumors in women of childbearing age. They may lead to problems of conception or complications during the gestational period. The methods of treatment include surgical (myomectomy and hysterectomy, ... ...

Abstract	Uterine leiomyomas are the most common benign tumors in women of childbearing age. They may lead to problems of conception or complications during the gestational period. The methods of treatment include surgical (myomectomy and hysterectomy, embolization of arteries) and therapeutic treatment (ulipristal acetate, leuprolide acetate, cetrorelix, goserelin, mifepristone). Both approaches are efficient but incompatible with pregnancy planning. Therefore, there is a call for medical practice to develop therapeutical means of preventing leiomyoma onset in patients planning on becoming pregnant. Based on the analysis of GWAS data on the search for mononucleotide polymorphisms associated with the risk of leiomyoma, in meta-transcriptomic and meta-methylomic studies, target proteins have been proposed. Prospective therapeutic treatments of leiomyoma may be based on chemical compounds, humanized recombinant antibodies, vaccines based on markers of the uterine leiomyoma cells that are absent in the adult organism, or DNA and RNA preparations. Three different nosological forms of the disease associated with driver mutations in the
Language	English
Publishing date	2023-11-01
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2720869-2
ISSN	2079-9721
ISSN	2079-9721
DOI	10.3390/diseases11040156
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Article ; Online: Altered Glycolysis, Mitochondrial Biogenesis, Autophagy and Apoptosis in Peritoneal Endometriosis in Adolescents.

Khashchenko, Elena P / Vysokikh, Mikhail Yu / Marey, Maria V / Sidorova, Ksenia O / Manukhova, Ludmila A / Shkavro, Natalya N / Uvarova, Elena V / Chuprynin, Vladimir D / Fatkhudinov, Timur Kh / Adamyan, Leila V / Sukhikh, Gennady T

International journal of molecular sciences

2024 Volume 25, Issue 8

Abstract: Energy metabolism plays a pivotal role in the pathogenesis of endometriosis. For the initial stages of the disease in adolescents, this aspect remains unexplored. The objective of this paper was to analyze the association of cellular and endosomal ... ...

Abstract	Energy metabolism plays a pivotal role in the pathogenesis of endometriosis. For the initial stages of the disease in adolescents, this aspect remains unexplored. The objective of this paper was to analyze the association of cellular and endosomal profiles of markers of glycolysis, mitochondrial biogenesis, apoptosis, autophagy and estrogen signaling in peritoneal endometriosis (PE) in adolescents. We included 60 girls aged 13-17 years in a case-control study: 45 with laparoscopically confirmed PE (main group) and 15 with paramesonephric cysts (comparison group). Samples of plasma and peritoneal fluid exosomes, endometrioid foci and non-affected peritoneum were tested for estrogen receptor (Erα/β), hexokinase (Hex2), pyruvate dehydrogenase kinase (PDK1), glucose transporter (Glut1), monocarboxylate transporters (MCT1 and MCT2), optic atrophy 1 (OPA1, mitochondrial fusion protein), dynamin-related protein 1 (DRP1, mitochondrial fission protein), Bax, Bcl2, Beclin1, Bnip3, P38 mitogen-activated protein kinase (MAPK), hypoxia-inducible factor 1 (Hif-1α), mitochondrial voltage-dependent anion channel (VDAC) and transforming growth factor (TGFβ) proteins as markers of estrogen signaling, glycolysis rates, mitochondrial biogenesis and damage, apoptosis and autophagy (Western-Blot and PCR). The analysis identified higher levels of molecules associated with proliferation (ERβ), glycolysis (MCT2, PDK1, Glut1, Hex2, TGFβ and Hif-1α), mitochondrial biogenesis (OPA1, DRP1) and autophagy (P38, Beclin1 and Bnip3) and decreased levels of apoptosis markers (
MeSH term(s)	Female ; Humans ; Adolescent ; Endometriosis/metabolism ; Endometriosis/pathology ; Autophagy ; Apoptosis ; Glycolysis ; Case-Control Studies ; Organelle Biogenesis ; Estrogen Receptor beta/metabolism ; Signal Transduction ; Estrogen Receptor alpha/metabolism ; Biomarkers
Chemical Substances	Estrogen Receptor beta ; Estrogen Receptor alpha ; Biomarkers
Language	English
Publishing date	2024-04-11
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms25084238
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Article ; Online: Peritoneal fluid progesterone and progesterone resistance in superficial endometriosis lesions.

Koninckx, Philippe R / Ussia, Anastasia / Adamyan, Leila / Gomel, Victor / Martin, Dan C

Human reproduction (Oxford, England)

2021 Volume 37, Issue 2, Page(s) 203–211

Abstract: Peritoneal fluid in ovulatory women is an ovarian exudate with higher estrogen and progesterone concentrations than in plasma. In the follicular phase, progesterone concentrations are as high as plasma concentrations in the luteal phase. After ovulation, ...

Abstract	Peritoneal fluid in ovulatory women is an ovarian exudate with higher estrogen and progesterone concentrations than in plasma. In the follicular phase, progesterone concentrations are as high as plasma concentrations in the luteal phase. After ovulation, estrogen and progesterone concentrations in the peritoneal fluid are 5-10 times higher than in plasma, both in women with and without endometriosis. The histologically proliferative aspect without secretory changes of most superficial subtle lesions is not compatible with the progesterone concentrations in the peritoneal fluid. Therefore, we have to postulate a strong progesterone resistance in these lesions. The mechanism is unclear and might be a peritoneal fluid effect in women with predisposing defects in the endometrium, or isolated endometrial glands with progesterone resistance, or subtle lesions originating from the basal endometrium: the latter hypothesis is attractive since in basal endometrium progesterone does not induce secretory changes while progesterone withdrawal, not occurring in peritoneal fluid, is required to resume mitotic activity and proliferation. Hormone concentrations in the peritoneal fluid are an important factor in understanding the medical therapy of endometriosis. The effect of oestro-progestin therapy on superficial endometriosis lesions seems to be a consequence of the decreased estrogen concentrations rather than a direct progestin effect. In conclusion, the peritoneal fluid, being a secretion product of the ovarian follicule, deserves more attention in the pathophysiology and treatment of endometriosis.
MeSH term(s)	Ascitic Fluid/pathology ; Endometriosis/pathology ; Endometrium/abnormalities ; Endometrium/pathology ; Estrogens ; Female ; Humans ; Progesterone ; Uterine Diseases
Chemical Substances	Estrogens ; Progesterone (4G7DS2Q64Y)
Language	English
Publishing date	2021-11-25
Publishing country	England
Document type	Journal Article
ZDB-ID	632776-x
ISSN	1460-2350 ; 0268-1161 ; 1477-741X
ISSN (online)	1460-2350
ISSN	0268-1161 ; 1477-741X
DOI	10.1093/humrep/deab258
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Article ; Online: Surgical management of endometriosis-associated pain.

Koninckx, Philippe R / Ussia, Anastasia / Porpora, Maria G / Malzoni, Mario / Adamyan, Leila / Wattiez, Arnaud

Minerva obstetrics and gynecology

2021 Volume 73, Issue 5, Page(s) 588–605

Abstract: Endometriosis and pelvic pain are associated. However, only half of the subtle and typical, and not all cystic and deep lesions are painful. The mechanism of the pain is explained by cyclical trauma and repair, an inflammatory reaction, activation of ... ...

Abstract	Endometriosis and pelvic pain are associated. However, only half of the subtle and typical, and not all cystic and deep lesions are painful. The mechanism of the pain is explained by cyclical trauma and repair, an inflammatory reaction, activation of nociceptors up to 2.7 cm distance, painful adhesions and neural infiltration. The relationship between the severity of lesions and pain is variable. Diagnosis of the many causes requires laparoscopy and expertise. Imaging cannot exclude endometriosis. Surgical removal is the treatment of choice. Medical therapy without a diagnosis risks missing pathology and chronification of pain if not 100% effective. Indications and techniques of surgery are described as expert opinion since randomised controlled trials were not performed for ethical reasons, since not suited for multimorbidity while a control group is poorly accepted. Subtle endometriosis needs destruction since some cause pain or progress to more severe disease. Typical lesions need excision or vaporisation since depth can be misjudged by inspection. Painful cystic ovarian endometriosis needs adhesiolysis and either destruction of the lining or excision of the cyst wall, taking care to avoid ovarian damage. Cysts larger than 6 cm need a two-step technique or an ovariectomy. Excision of deep endometriosis is difficult and complication prone surgery involving bladder, ureter, and bowel surgery varying from excision and suturing, disc excision with a circular stapler and resection anastomosis. Completeness of excision, prevention of postoperative adhesions and recurrences of endometriosis, and the indication to explore large somatic nerves will be discussed.
MeSH term(s)	Endometriosis/complications ; Female ; Humans ; Laparoscopy ; Neoplasm Recurrence, Local ; Pelvic Pain/etiology ; Tissue Adhesions/surgery
Language	English
Publishing date	2021-05-12
Publishing country	Italy
Document type	Journal Article
ZDB-ID	3062815-5
ISSN	2724-6450
ISSN (online)	2724-6450
DOI	10.23736/S2724-606X.21.04864-8
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Article: Prevalence of Endometriosis and Peritoneal Pockets in Women with Infertility and/or Pelvic Pain.

Koninckx, Philippe R / Ussia, Anastasia / Keckstein, Jörg / Adamyan, Leila / Wattiez, Arnaud / Martin, Dan C

Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC

2021 Volume 43, Issue 8, Page(s) 935–942

Abstract: Objective: To evaluate the prevalence of endometriosis and peritoneal pockets and to analyze whether these pockets are associated with pain.: Methods: Analysis of prospectively registered data of all women undergoing laparoscopy for infertility or ... ...

Abstract	Objective: To evaluate the prevalence of endometriosis and peritoneal pockets and to analyze whether these pockets are associated with pain. Methods: Analysis of prospectively registered data of all women undergoing laparoscopy for infertility or pelvic pain between 1988 and 2011 at KU Leuven University Hospital. Results: Of 4497 women, 191 had 238 pockets, with a prevalence of 4.7% in women with infertility only, 4.9% in women with infertility and pelvic pain, and 3.5% in women with pelvic pain only (P = 0.045 for all infertility vs. pelvic pain only). Prevalence did not vary by age. Pockets were associated with endometriosis (P < 0.0001), which was found in 77% of women with pockets. Among women with infertility only, the prevalence of endometriosis was higher in women with pockets (P = 0.0001) than in women without. The prevalence of endometriosis was similar in women with infertility and pelvic pain or pelvic pain only. Pelvic pain as an indication for surgery was associated simultaneously (through logistic regression) with endometriosis (P < 0.0001) and pockets (P = 0.040). Pelvic pain severity was associated simultaneously with pockets (P = 0.0026) and the severity of subtle (P = 0.001), typical (P = 0.030), cystic ovarian (P = 0.051), and deep endometriosis (P < 0.0001). Pelvic pain severity was not associated with endometriosis in the pockets or the diameter or location of pockets. Conclusions: The prevalence of pockets was low, at between 3.5% and 5%. Women with infertility only and pockets had more endometriosis than women without. Severe pelvic pain and pelvic pain as an indication for surgery were associated with the presence of pockets as well as the presence and severity of endometriosis.
MeSH term(s)	Endometriosis/complications ; Endometriosis/epidemiology ; Endometriosis/surgery ; Female ; Humans ; Infertility, Female/epidemiology ; Laparoscopy ; Pelvic Pain/epidemiology ; Pelvic Pain/surgery ; Peritoneum ; Prevalence
Language	English
Publishing date	2021-05-11
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2171082-X
ISSN	1701-2163
ISSN	1701-2163
DOI	10.1016/j.jogc.2021.04.009
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Article: Malignant Clinical Course of "Proliferative" Ovarian Struma: Diagnostic Challenges and Treatment Pitfalls.

Asaturova, Aleksandra / Magnaeva, Alina / Tregubova, Anna / Kometova, Vlada / Karamurzin, Yevgeniy / Martynov, Sergey / Lipatenkova, Yuliya / Adamyan, Leila / Palicelli, Andrea

Diagnostics (Basel, Switzerland)

2022 Volume 12, Issue 6

Abstract: Struma ovarii (SO) is a monodermal teratoma predominantly composed of thyroid tissue (TT) showing benign, “proliferative”, or malignant histology. By imaging, a 38-year-old patient with lower backache revealed a 6.2-cm vertebral lesion (L5). Core biopsy ... ...

Abstract	Struma ovarii (SO) is a monodermal teratoma predominantly composed of thyroid tissue (TT) showing benign, “proliferative”, or malignant histology. By imaging, a 38-year-old patient with lower backache revealed a 6.2-cm vertebral lesion (L5). Core biopsy showed well-differentiated TT without features of papillary carcinoma. A 3.5-cm left ovarian mature teratoma (lacking TT) and peritoneal nodules (showing well-differentiated TT) were also identified and surgically removed. Thyroid ultrasound and cytological examination resulted negative. Four years before, left ovarian cystectomy was performed for a histologically “proliferative” SO. According to the malignant clinical course and WHO classification, this case was overall reassessed as a recurring well-differentiated follicular carcinoma arising in SO (WD-FC-SO), despite lacking malignant histological features in any specimens. Immunophenotype: TTF-1+/PAX-8+/thyroglobulin+/CK7+/chromogranin-/synaptophysin-/inhibin-/calretinin-/HNF1B-; Ki-67 index < 5%. Polymerase chain reaction analysis resulted negative for BRAFV600E mutation. The patient refused further treatments, without recurrence after 17 months. The clinical behavior of SO may be unpredictable. Histologically benign or proliferative strumas extraordinarily metastasize, while SO with malignant features may not recur. The exceptional evidence of peritoneal implants of well-differentiated TT (peritoneal strumosis) in patients with histologically benign SO represents a metastasis of WD-FC-SO (like in our case). A multidisciplinary approach including clinical, laboratory, radiologic, and histopathological data is required.
Language	English
Publishing date	2022-06-07
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics12061411
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Article ; Online: A Review of Recent Studies on the Effects of SARS-CoV-2 Infection and SARS-CoV-2 Vaccines on Male Reproductive Health.

Adamyan, Leila / Elagin, Vladimir / Vechorko, Valeriy / Stepanian, Assia / Dashko, Anton / Doroshenko, Dmitriy / Aznaurova, Yana / Sorokin, Maxim / Garazha, Andrew / Buzdin, Anton

Medical science monitor : international medical journal of experimental and clinical research

2022 Volume 28, Page(s) e935879

Abstract: According to world statistics, men are more susceptible to the coronavirus disease 2019 (COVID-19) than are women. Considering the interconnection between infections and male infertility, investigation of the potential impact of COVID-19 on men's ... ...

Abstract	According to world statistics, men are more susceptible to the coronavirus disease 2019 (COVID-19) than are women. Considering the interconnection between infections and male infertility, investigation of the potential impact of COVID-19 on men's reproductive health is now a particularly relevant topic. Published data indicate decreased sperm quality and orchitis development in patients with COVID-19, including reduced sperm count, decreased sperm motility, and elevated DNA fragmentation index. Although mass vaccination against COVID-19 is currently being carried out worldwide using available authorized vaccines, the effect of these vaccines on men's reproductive health has not yet been investigated. There is currently no evidence that SARS-CoV-2 can be transmitted in semen, but available data suggest that it can infect spermatogonia, spermatids, Leydig cells, and Sertoli cells. Therefore, SARS-CoV-2 orchitis and reduced male fertility may be long-term complications of COVID-19, which requires further investigation. Currently, there is also no evidence that vaccines against SARS-CoV-2 have any pathological effects on spermatogenesis or male reproductive health. Thus, further studies are needed to determine the effects of COVID-19 and COVID-19 vaccines on men's reproductive health, which will help to optimize the management and rehabilitation of these patients. This review aims to discuss recent studies on the impact of the COVID-19 and COVID-19 vaccines on men's reproductive health. The article addresses various issues such as the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on testosterone biosynthesis, semen parameters, testicular tissue, and epididymis.
MeSH term(s)	COVID-19/immunology ; COVID-19 Vaccines/adverse effects ; COVID-19 Vaccines/immunology ; Humans ; Male ; Reproductive Health/trends ; SARS-CoV-2/immunology ; SARS-CoV-2/pathogenicity ; Sperm Motility/drug effects ; Sperm Motility/physiology ; Viral Vaccines/immunology
Chemical Substances	COVID-19 Vaccines ; Viral Vaccines
Language	English
Publishing date	2022-03-21
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1439041-3
ISSN	1643-3750 ; 1234-1010
ISSN (online)	1643-3750
ISSN	1234-1010
DOI	10.12659/MSM.935879
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Article: Endometriosis in Adolescents: Diagnostics, Clinical and Laparoscopic Features.

Khashchenko, Elena P / Uvarova, Elena V / Fatkhudinov, Timur Kh / Chuprynin, Vladimir D / Asaturova, Aleksandra V / Kulabukhova, Elena A / Vysokikh, Mikhail Yu / Allakhverdieva, Elvina Z / Alekseeva, Maria N / Adamyan, Leila V / Sukhikh, Gennady T

Journal of clinical medicine

2023 Volume 12, Issue 4

Abstract: Background: The early diagnosis of endometriosis in adolescents is not developed.: Objective: We aim to conduct clinical, imaging, laparoscopic and histological analyses of peritoneal endometriosis (PE) in adolescents in order to improve early ... ...

Abstract	Background: The early diagnosis of endometriosis in adolescents is not developed. Objective: We aim to conduct clinical, imaging, laparoscopic and histological analyses of peritoneal endometriosis (PE) in adolescents in order to improve early diagnosis. Methods: In total, 134 girls (from menarche to 17 years old) were included in a case-control study: 90 with laparoscopically (LS) confirmed PE, 44 healthy controls underwent full examination and LS was analyzed in the PE group. Results: Patients with PE were characterized with heredity for endometriosis, persistent dysmenorrhea, decreased daily activity, gastrointestinal symptoms, higher LH, estradiol, prolactin and Ca-125 (<0.05 for each). Ultrasound detected PE in 3.3% and MRI in 78.9%. The most essential MRI signs are as follows: hypointense foci, the heterogeneity of the pelvic tissue (paraovarian, parametrial and rectouterine pouch) and sacro-uterine ligaments lesions (<0.05 for each). Adolescents with PE mostly exhibit initial rASRM stages. Red implants correlated with the rASRM score, and sheer implants correlated with pain (VAS score) (<0.05). In 32.2%, foci consisted of fibrous, adipose and muscle tissue; black lesions were more likely to be histologically verified (0.001). Conclusion: Adolescents exhibit mostly initial PE stages, which are associated with greater pain. Persistent dysmenorrhea and detected MRI parameters predict the laparoscopic confirmation of initial PE in adolescents in 84.3% (OR 15.4; <0.01), justifying the early surgical diagnostics and shortening the time delay and suffering of the young patients.
Language	English
Publishing date	2023-02-20
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12041678
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