Malgré les progrès des thérapeutiques médicales et chirurgicales sur les symptômes et la fertilit... more Malgré les progrès des thérapeutiques médicales et chirurgicales sur les symptômes et la fertilité de patientes endométriosiques, des taux élevés de récidive ont été rapportés devant faire considérer l’endométriose comme une pathologie chronique. Dans ce contexte particulier, les principaux objectifs pour les praticiens sont de limiter la progression de la maladie, les récidives et d’améliorer la qualité de vie. Une relation entre une augmentation de l’intensité de la douleur et une diminution de la qualité de vie a été démontrée. Toutefois, les échelles visuelles analogiques pour mesurer le bien-être général sont insuffisantes pour quantifier l’impact de l’endométriose sur la qualité de vie. Plusieurs questionnaires généralistes, principalement le SF-36, sont disponibles en plusieurs langues, mais ne sont pas spécifiques des femmes ayant une endométriose. Des questionnaires spécifiques sont disponibles, mais ils ont été validés pour la plupart dans des populations de langue anglaise, rendant la comparaison difficile entre les pays. Malgré ces limites, la qualité de vie devrait être systématiquement évaluée par des questionnaires validés permettant d’apprécier l’impact des thérapeutiques, voire intervenir comme critère décisionnel dans le choix thérapeutique.High recurrence rates have been reported in women treated for endometriosis despite advances in medical and surgical treatments improving both fertility and symptoms. It should therefore be considered a chronic disorder. In this particular setting, the main objectives for practitioners are to limit disease progression, recurrence and to improve quality of life (QOL). Previous studies have demonstrated a relation between an increase in pain intensity and a decrease in QOL. However, visual analogue scales to measure general well-being are insufficient to quantify the impact of endometriosis on QOL. Several generic questionnaires, mainly the SF-36, are available in various languages but are not specific of women with endometriosis. Some specific questionnaires are available but have been validated in English population for the most part rending comparison between countries difficult. Despite these limits, QOL should be systematically monitored over time by a validated questionnaire for this chronic disorder and could be a criterion for therapeutic strategy.
ABSTRACT Imaging is today crucial for patient management not only thanks to its high sensibility ... more ABSTRACT Imaging is today crucial for patient management not only thanks to its high sensibility to detect uterine carcinoma (endovaginal ultrasonography for endometrial carcinoma) but also for local staging using pelvic MR imaging (until 2009 recommended by FIGO for both endometrial and cervical carcinoma) and for the evaluation of treatment response under radiochemotherapy especially for cervical carcinoma (using MR imaging and PET-CT).
Journal of Minimally Invasive Gynecology, Oct 1, 2010
To estimate the association between urinary symptoms and quality of life in patients with posteri... more To estimate the association between urinary symptoms and quality of life in patients with posterior deep-infiltrating endometriosis (DIE) with anatomical locations of endometriosis. Prospective nonrandomized study (Canadian Task Force classification II-2). Tertiary care hospital. One hundred fifty-three patients with DIE and 28 control subjects. Clinical examination completed using transvaginal ultrasonography and magnetic resonance imaging. Urinary symptoms and quality of life were evaluated using the International Prostate Symptom Score (IPSS) and Bristol Female Lower Urinary Tract Symptoms (BFLUTS) questionnaires. There was a higher incidence of urinary symptoms and a high IPSS in patients with posterior DIE compared with the control group. The IPSS questionnaire detected a relation between parametrial endometriosis and voiding symptoms (p = .03), altered quality of life (p = .02), and a high total score (p = 0.04) in patients with posterior DIE. No difference in urinary symptoms and total BFLUTS score was observed between the groups. A relation was found between parametrial endometriosis and urinary symptoms (p = .02), altered quality of life (p = .04), and high total score (p = .03) in patients with posterior DIE. At multivariable analysis, a correlation was found between parametrial endometriosis and IPSS total score (p = .03), IPSS voiding symptoms (p = .04), and IPSS quality of life (p = .009). Similarly, a correlation was found between parametrial endometriosis and BFLUTS symptoms (p = .003), BFLUTS quality of life (p = .003), and BFLUTS total score (p = .007). Patients with posterior DIE have a high incidence of urinary symptoms. Moreover, parametrial endometriosis is associated with altered urinary function and should be systematically evaluated in these patients.
Journal De Gynecologie Obstetrique Et Biologie De La Reproduction, Dec 1, 2008
Menometrorrhagia is a frequent cause of medical consulting. After a clinical examination showing ... more Menometrorrhagia is a frequent cause of medical consulting. After a clinical examination showing the uterine origin of bleeding and that excludes a cervical or vulvo-vaginal origin, transvaginal sonography (TVS) represents the first-line technique examination. TVS allows to identify endometrial diseases (atrophy, polyps or diffuse hyperplasia), endometrial carcinoma, myometrial disorders (adenomyosis, leiomyoma or vascular abnormalities), and adnexal disorders. Color Doppler sonography and hysterosonography are useful complementary tools for ultrasound performance improvement. MR imaging should be performed if TVS is not contributive or is highly recommended for staging of uterine cancers. All these techniques provide useful information for optimal planning treatment.
PurposeTo determine the value of diffusion-weighted imaging (DWI) in the evaluation of adnexal tu... more PurposeTo determine the value of diffusion-weighted imaging (DWI) in the evaluation of adnexal tumors, especially to distinguish between malignant and benign tumors.
Purpose To retrospectively evaluate the diagnostic performance of magnetic resonance (MR) imaging... more Purpose To retrospectively evaluate the diagnostic performance of magnetic resonance (MR) imaging for the diagnosis of adnexal torsion in a series of patients with an equivocal adnexal mass at ultrasonography (US) in the context of acute or subacute pelvic pain. Materials and Methods The institutional ethics committee approved the study and waived informed consent. All patients with acute or subacute pelvic pain who were undergoing MR examination for the exploration of an equivocal adnexal mass (January 2007 to December 2012) with surgical exploration or clinical and radiologic follow-up of at least 3 months were retrospectively included (n = 58). The prospective interpretations were recorded. Additionally, three radiologists who were blinded to the clinical, US, and surgical data retrospectively and independently reviewed MR images. Features associated with adnexal torsion were identified by using univariate and recursive partitioning multivariate analysis. Results Twenty-two patie...
This is a review of evolutive aspects in pelvic inflammatory disease (salpingitis, endometritis, ... more This is a review of evolutive aspects in pelvic inflammatory disease (salpingitis, endometritis, pyosalpinx, tubo ovarian abscess) assessed by different imaging modalities (Ultrasound, CT, MRI and hysterosalpingography).
Malgré les progrès des thérapeutiques médicales et chirurgicales sur les symptômes et la fertilit... more Malgré les progrès des thérapeutiques médicales et chirurgicales sur les symptômes et la fertilité de patientes endométriosiques, des taux élevés de récidive ont été rapportés devant faire considérer l’endométriose comme une pathologie chronique. Dans ce contexte particulier, les principaux objectifs pour les praticiens sont de limiter la progression de la maladie, les récidives et d’améliorer la qualité de vie. Une relation entre une augmentation de l’intensité de la douleur et une diminution de la qualité de vie a été démontrée. Toutefois, les échelles visuelles analogiques pour mesurer le bien-être général sont insuffisantes pour quantifier l’impact de l’endométriose sur la qualité de vie. Plusieurs questionnaires généralistes, principalement le SF-36, sont disponibles en plusieurs langues, mais ne sont pas spécifiques des femmes ayant une endométriose. Des questionnaires spécifiques sont disponibles, mais ils ont été validés pour la plupart dans des populations de langue anglaise, rendant la comparaison difficile entre les pays. Malgré ces limites, la qualité de vie devrait être systématiquement évaluée par des questionnaires validés permettant d’apprécier l’impact des thérapeutiques, voire intervenir comme critère décisionnel dans le choix thérapeutique.High recurrence rates have been reported in women treated for endometriosis despite advances in medical and surgical treatments improving both fertility and symptoms. It should therefore be considered a chronic disorder. In this particular setting, the main objectives for practitioners are to limit disease progression, recurrence and to improve quality of life (QOL). Previous studies have demonstrated a relation between an increase in pain intensity and a decrease in QOL. However, visual analogue scales to measure general well-being are insufficient to quantify the impact of endometriosis on QOL. Several generic questionnaires, mainly the SF-36, are available in various languages but are not specific of women with endometriosis. Some specific questionnaires are available but have been validated in English population for the most part rending comparison between countries difficult. Despite these limits, QOL should be systematically monitored over time by a validated questionnaire for this chronic disorder and could be a criterion for therapeutic strategy.
ABSTRACT Imaging is today crucial for patient management not only thanks to its high sensibility ... more ABSTRACT Imaging is today crucial for patient management not only thanks to its high sensibility to detect uterine carcinoma (endovaginal ultrasonography for endometrial carcinoma) but also for local staging using pelvic MR imaging (until 2009 recommended by FIGO for both endometrial and cervical carcinoma) and for the evaluation of treatment response under radiochemotherapy especially for cervical carcinoma (using MR imaging and PET-CT).
Journal of Minimally Invasive Gynecology, Oct 1, 2010
To estimate the association between urinary symptoms and quality of life in patients with posteri... more To estimate the association between urinary symptoms and quality of life in patients with posterior deep-infiltrating endometriosis (DIE) with anatomical locations of endometriosis. Prospective nonrandomized study (Canadian Task Force classification II-2). Tertiary care hospital. One hundred fifty-three patients with DIE and 28 control subjects. Clinical examination completed using transvaginal ultrasonography and magnetic resonance imaging. Urinary symptoms and quality of life were evaluated using the International Prostate Symptom Score (IPSS) and Bristol Female Lower Urinary Tract Symptoms (BFLUTS) questionnaires. There was a higher incidence of urinary symptoms and a high IPSS in patients with posterior DIE compared with the control group. The IPSS questionnaire detected a relation between parametrial endometriosis and voiding symptoms (p = .03), altered quality of life (p = .02), and a high total score (p = 0.04) in patients with posterior DIE. No difference in urinary symptoms and total BFLUTS score was observed between the groups. A relation was found between parametrial endometriosis and urinary symptoms (p = .02), altered quality of life (p = .04), and high total score (p = .03) in patients with posterior DIE. At multivariable analysis, a correlation was found between parametrial endometriosis and IPSS total score (p = .03), IPSS voiding symptoms (p = .04), and IPSS quality of life (p = .009). Similarly, a correlation was found between parametrial endometriosis and BFLUTS symptoms (p = .003), BFLUTS quality of life (p = .003), and BFLUTS total score (p = .007). Patients with posterior DIE have a high incidence of urinary symptoms. Moreover, parametrial endometriosis is associated with altered urinary function and should be systematically evaluated in these patients.
Journal De Gynecologie Obstetrique Et Biologie De La Reproduction, Dec 1, 2008
Menometrorrhagia is a frequent cause of medical consulting. After a clinical examination showing ... more Menometrorrhagia is a frequent cause of medical consulting. After a clinical examination showing the uterine origin of bleeding and that excludes a cervical or vulvo-vaginal origin, transvaginal sonography (TVS) represents the first-line technique examination. TVS allows to identify endometrial diseases (atrophy, polyps or diffuse hyperplasia), endometrial carcinoma, myometrial disorders (adenomyosis, leiomyoma or vascular abnormalities), and adnexal disorders. Color Doppler sonography and hysterosonography are useful complementary tools for ultrasound performance improvement. MR imaging should be performed if TVS is not contributive or is highly recommended for staging of uterine cancers. All these techniques provide useful information for optimal planning treatment.
PurposeTo determine the value of diffusion-weighted imaging (DWI) in the evaluation of adnexal tu... more PurposeTo determine the value of diffusion-weighted imaging (DWI) in the evaluation of adnexal tumors, especially to distinguish between malignant and benign tumors.
Purpose To retrospectively evaluate the diagnostic performance of magnetic resonance (MR) imaging... more Purpose To retrospectively evaluate the diagnostic performance of magnetic resonance (MR) imaging for the diagnosis of adnexal torsion in a series of patients with an equivocal adnexal mass at ultrasonography (US) in the context of acute or subacute pelvic pain. Materials and Methods The institutional ethics committee approved the study and waived informed consent. All patients with acute or subacute pelvic pain who were undergoing MR examination for the exploration of an equivocal adnexal mass (January 2007 to December 2012) with surgical exploration or clinical and radiologic follow-up of at least 3 months were retrospectively included (n = 58). The prospective interpretations were recorded. Additionally, three radiologists who were blinded to the clinical, US, and surgical data retrospectively and independently reviewed MR images. Features associated with adnexal torsion were identified by using univariate and recursive partitioning multivariate analysis. Results Twenty-two patie...
This is a review of evolutive aspects in pelvic inflammatory disease (salpingitis, endometritis, ... more This is a review of evolutive aspects in pelvic inflammatory disease (salpingitis, endometritis, pyosalpinx, tubo ovarian abscess) assessed by different imaging modalities (Ultrasound, CT, MRI and hysterosalpingography).
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Papers by Marc Bazot