Increased levels of polychlorobiphenyls in Italian women with endometriosis

Endometriosis has been hypothesised to be linked to persistent and toxic organochlorinated chemicals. Dioxins and dioxin-like compounds have in particular been associated with the disease, mainly on the basis of experimental studies. Data in women are conflicting. A case-control study on 80 Italian nulliparous women of reproductive age was carried out to assess whether there is a correlation between the presence of endometriosis and blood levels of polychlorobiphenyls (PCBs), a family of ubiquitary environmental pollutants which comprises congeners with dioxin-like activity. Higher levels of PCBs were found in women with endometriosis. A mean cumulative value of 410 ng g(-1), lipid base, was found in cases versus the value of 250 ng g(-1) observed in the control group (odds ratio for upper tertile 4.0, CI 95% 1.3-13; p = 0.0003). PCB increase involved both dioxin-like (PCBs 105, 118, 156, and 167) and non-dioxin-like congeners (PCBs 101, 138, 153, 170, 180). (c) 2005 Elsevier Ltd. All rights reserved

Pain and ovarian endometrioma recurrence after laparoscopic treatment of endometriosis: a long-term prospective study

Objective: To identify prognostic factors for pain and endometrioma recurrence after complete laparoscopic excision of endometrioma(s). Design: Prospective observational study. Setting: Tertiary care university hospital. Patient(s): One-hundred sixty-six consecutive women affected by uni- or bilateral ovarian endometrioma(s). Intervention(s): Laparoscopic conservative treatment of endometriosis. Main Outcome Measure(s): Patient demographic characteristics, surgical findings, and Surgical results were prospectively recorded. Postoperative follow-ups were carried out every 3 months to identify pain and/or endometrioma recurrence for a Minimum of 3 years. Result(s): Dysmenorrheal, dyspareunia, and chronic pelvic pain recurred in 14.5%, 6%, and 5.4% of women, respectively. Prior surgery for endometriosis, adhesion extension, and use of ovarian Stimulation drugs (OSD) were unfavorable prognostic factors for pain symptoms. Ovarian endometrioma recurred in 9.6% of cases; negative factors were prior surgery for endometriosis. OSD, pelvic adhesions, and high American Society for Reproductive Medicine disease scores. Postoperative pregnancy showed a significant protective effect on pain and disease recurrences. Conclusion(s): Prior surgery, presence of adhesions, and ovulation drugs are negative prognostic factors. Pregnancy has a protective effect on disease and pain recurrence. (Fertil Stefil (R) 20 10;93:716-21. (C)2010 by American Society for Reproductive Medicine.