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02 March 2021, Volume 37 Issue 3 Previous Issue    Next Issue

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Characteristics and treatment options of adolescent endometriosis. HUA Ke-qin，YI Xiao-fang 2021, 37(3): 277-281.  DOI: 10.19538/j.fk2021030102 Abstract ( )   Adolescent endometriosis presents in girls aged 10-19，which is the leading cause of secondary dysmenorrhea in adolescents，and may be associated with obstructive anomalies. Increasing awareness of this disease will help to make earlier diagnosis and avoid progression of the disease.  Tailored medical or surgical treatment helps to achieve the goals of therapy， including controlling pain，preserving fertility，delaying progression and preventing recurrence.

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Strategies for fertility protection in endometriosis. ZHANG Ting-ting，FANG Xiao-ling 2021, 37(3): 281-285.  DOI: 10.19538/j.fk2021030103 Abstract ( )   子宫内膜异位症是育龄期女性的常见病、多发病，可从病理性和医源性两个方面影响育龄期女性的卵巢储备功能，降低患者的生育力。且该疾病对卵巢储备功能的损害是进行性发展的，可导致不孕或卵巢功能衰竭。因此，注重子宫内膜异位症患者的卵巢功能保护，制定合适的生育力保护策略十分重要。

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Considerations in surgery for ovarian endometrioma. XU Ping，ZHANG Xin-mei 2021, 37(3): 285-287.  DOI: 10.19538/j.fk2021030104 Abstract ( )   Ovarian endometrioma is the most common subtype of endometriosis for which surgical treatment is performed. The timing of surgical treatment and the protection of ovarian function have attracted much attention. This article declares clinical principles and considerations related to surgery for ovarian endometrioma based on the patients’ requirement for fertility and recurrence. Furthermore，it is emphasized that qualified specialists should be determined according to the difficulty of operation so as to control operation quality and to pay attention to fertility protection and thoroughness of the surgery.

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Problems related to surgical treatment for ureteral endometriosis. WANG Wei，YAO Shu-zhong 2021, 37(3): 287-290.  DOI: 10.19538/j.fk2021030105 Abstract ( )   Ureteral endometriosis（UE）is often asymptomatic and the symptom of UE is untypical. A large percentage of patients with UE may have an asymptomatic loss of renal function. Therefore，it is important to make an early diagnosis and timely treatment. Surgical intervention is the golden standard for the treatment of UE. The surgical technique must be chosen according to the type of UE，and the size and location of the lesions. Surgical approaches to UE may include：ureterolysis，ureteral segmental resection with end-to-end anastomosis，and ureteral segmental resection with ureteral reimplantation. Surgical treatment is considered effective and safe. Nevertheless，explicit attention must be paid to the fact that complications can occur. The complications must be treated in time.

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Perimenopausal endometriosis and endometriosis-associated malignancy. GUO Hong-yan，LIU Lu 2021, 37(3): 290-292.  DOI: 10.19538/j.fk2021030106 Abstract ( )   Compared with premenopausal endometriosis，perimenopausal and postmenopausal endometriosis are often more under-recognized because of low incidence. The malignant potential of postmenopausal endometriosis has been widely known and supported by clinical evidence. Malignant transformation of endometriosis mostly occurs in the ovary，and a few are cancers related to endometriosis outside the ovary. The current treatment plan for endometriosis—associated ovarian cancer （EAOC）is still the same as that of ordinary epithelial ovarian cancer although EAOC has its special pathogenesis and clinical features.In recent years，great progress has been made in its molecular biological mechanism，which may predict the risk of malignant transformation to ovarian cancer，and influence the clinical decision. We may be able to design a risk assessment model for the malignant transformation of endometriosis and select appropriate individualized clinical strategies for patients with endometriosis.

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Importance of patient education in the long-term management of endometriosis. JI Miao-miao，YUAN Ming 2021, 37(3): 292-296.  DOI: 10.19538/j.fk2021030107 Abstract ( )   Endometriosis（EM）is a common and frequently-occurring disease，often accompanied by severe pain，recurrence，and malignant transformation. At present，EM has been regarded as a costly chronic disease，but the public awareness of EM is relatively poor. This paper aims to help patients establish the concept that EM treatment is a long-term process through patient education，and help patients recognize the clinical manifestations of EM such as pain and infertility.Corresponding treatment measures should be taken according to the needs of patients.The paper also aims to let patients learn about the possible side effects after drug treatment and that it is necessary to take medication to reduce or avoid recurrence.The patient education is supposed to give fertility guidance to patients with fertility requirements，appropriately inform patients of the risk of malignant transformation of endometriosis，identify anxiety and depression of patients，and help them establish social support systems. Finally，both doctors and patients will jointly develop a life-long management plan to promote the long-term management of EM.

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Problems related to clinical diagnosis and early treatment of endometriosis. YUAN Zeng，WANG Li-jie 2021, 37(3): 296-301.  DOI: 10.19538/j.fk2021030108 Abstract ( )   As a common chronic disease  in gynecology，the incidence of endometriosis  is rising year by year，with difficult diagnosis and poor treatment. Diagnostic delay of endometriosis is a problematic phenomenon in adolescent and adult women，resulting in a delay in subsequent treatment and disease progression. Early diagnosis and early treatment of endometriosis are two major issues that need to be solved urgently.

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Diagnosis and treatment characteristics of thoracic endometriosis syndrome. DAI Yi，LENG Jin-hua 2021, 37(3): 301-303.  DOI: 10.19538/j.fk2021030109 Abstract ( )   Pulmonary and pleural endometriosis is a very rare extrapelvic endometriosis，which is collectively known as thoracic endometriosis syndrome. The clinical features are menstrual related periodicity，including catamenial hemoptysis，catamenial pneumothorax and catamenial hemothorax. Diagnosis usually needs to exclude other common causes of pneumothorax，hemoptysis and pleural effusion. Pathological diagnosis is difficult，so it's ausually clinical diagnosis. GnRH-a experimental treatment is helpful for diagnosis. There is no standard treatment recommended，and drug therapy is still recommended as the first-line treatment in most literatures. Surgical treatment is considered only when drug treatment is ineffective or there is contraindication.

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Application and selection of medical treatment in the long-term management of endometriosis. PENG Chao，ZHOU Ying-fang 2021, 37(3): 303-308.  DOI: 10.19538/j.fk2021030110 Abstract ( )   Medical treatment of endometriosis is of very important value because it is a chronic and recurrent disease that can hardly be cured only by conservative surgery. Many drugs have been developed for relieving pain symptoms associated with endometriosis，such as nonsteroids anti-inflammatory drugs，conjugated oral contraceptives，progestins，androgen derivative，GnRH-agonists or GnRH-antagonists and traditional Chinese medicine. Experts consensus has been achieved and published in China on postoperative long-term management to relieve pain and to prevent recurrence of endometriosis. Medical treatment in the long-term management of endometriosis should be guided by clinical problems and centered on patients，drugs  should be selected according to age and stage so that an integrated treatment is performed. In recent years，early prevention of endometriosis has been advocated，and empirical drug therapy is recommended for adolescents with dysmenorrhea and menstrual related pain，or for those clinically diagnosed with endometriosis without surgical indications，to relieve pain and reduce the incidence of endometriosis or delay the progression of endometriosis.