Is the baboon model appropriate for endometriosis studies?

in Fertility and Sterility (2011), 96(3), 728-7333

Objective To determinethe prevalence of spontaneous endometriosis andthe incidence of induced endometriosis after endocervical canal resection in baboons. Design Induction and follow-up of endometriosis ... [more ▼]

Objective To determinethe prevalence of spontaneous endometriosis andthe incidence of induced endometriosis after endocervical canal resection in baboons. Design Induction and follow-up of endometriosis in baboons, which is one of the primate species that develop spontaneous endometriosis. Forty-one baboons were checked for the presence of spontaneous endometriosis. We then attempted to induce endometriosis in 30 of them by endocervical canal resection. Setting Institute of Primate Research, Nairobi, Kenya, and Catholic University of Louvain, Brussels, Belgium. Animal(s) Forty-one baboons were checked for spontaneous endometriosis and 30 of them were used to develop a model of induced endometriosis. Intervention(s) A total of 41 baboons underwent diagnostic laparoscopy for 10 months. In a first step, 30 of this number subsequently underwent endocervical canal resection. In a second step, 20 of the 30 underwent uterine horn resection. Main Outcome Measure(s) Follow-up by laparoscopy. Result(s) Two of the 41 baboons were diagnosed with spontaneous endometriosis (4.8%). Twelve months after the surgical procedure to induce endometriosis, 8 of 29 animals presented with endometriotic lesions diagnosed by using laparoscopy and confirmed by histologic examination. The incidence of induced endometriosis in our model was thus 27.6%. In 2 baboons, endometriosis disappeared over time, resulting in a final rate of 20.7% (6/29). Conclusion(s) The rate of spontaneous endometriosis is very low (4.8%). Endometriosis can be induced (with a rate of just 27.6%) by endocervical canal resection to stimulate retrograde menstruation. [less ▲]

Laparoscopic myolysis.

in Human Reproduction Update (2000), 6(6), 609-13

This review will focus on the different techniques and the long-term effects of the technique called myolysis on myoma growth. Indications for myolysis are essentially pelvic pain, compression symptoms ... [more ▼]

This review will focus on the different techniques and the long-term effects of the technique called myolysis on myoma growth. Indications for myolysis are essentially pelvic pain, compression symptoms and global uterine volume in order to avoid hysterectomy. In the late 1980s, myolysis was performed laparoscopically with the help of the neodynium: yttrium aluminium garnet (Nd:YAG) laser. Later, bipolar needles were developed as an alternative to the Nd:YAG laser. Diathermy and cryomyolysis were also proposed but series are small in the literature. Very recently, myoma interstitial thermo-therapy (MITT) was performed using the diode laser and a specific optical light diffuser that is designed to transmit laser light in all directions. Laparoscopic myolysis was proved to be effective in provoking myoma shrinkage, with a dramatic decrease in size and a marked devascularization of the myoma and this technique can be proposed as an alternative to myomectomy in selected patients: only those aged >40 years or those not desiring to bear any more children. [less ▲]

Endometrial laser interstitial hyperthermy: a potential modality for endometrial ablation.

in Obstetrics & Gynecology (1996), 87(3), 459-64

This study was undertaken to evaluate the efficacy and safety of an intrauterine device designed for endometrial ablation by Nd-YAG laser interstitial hyperthermy. Eight hysterectomy specimens were ... [more ▼]

This study was undertaken to evaluate the efficacy and safety of an intrauterine device designed for endometrial ablation by Nd-YAG laser interstitial hyperthermy. Eight hysterectomy specimens were treated in vitro with an output power of 30 W for 5 minutes; tissue temperatures, recorded by thermocouples, were plotted to draw time-temperature and time-distance curves. As a preliminary series, ten patients were treated, with the first five subjected to local temperature monitoring; all ten were followed-up for 6-17 months. Immediate and delayed (6 weeks) histologic data were obtained. The intramural temperature at 6 mm from the fibers ranged from 55-60C). In vivo, the cooling effect of the arterial blood flow lowered the serosal temperatures under 41C. The histologic data and the hysterographic pictures suggest that endometrial ablation was effective. This new device does not require distending medium, hysteroscopic control, or high-powered Nd-YAG laser machines. Preliminary long-term results suggest that the device could be used for endometrial ablation. [less ▲]

Treatment of dysfunctional bleeding and fibroids by advanced endoscopic techniques with the Nd:YAG laser: from the present to the future.

in Bailliere's Clinical Obstetrics & Gynaecology (1995), 9(2), 329-45

Both the electrical current of the resectoscope and the energy of the Nd:YAG laser have been effective tools in the destruction of endometrial tissue to a sufficient depth to avoid regeneration. GnRH ... [more ▼]

Both the electrical current of the resectoscope and the energy of the Nd:YAG laser have been effective tools in the destruction of endometrial tissue to a sufficient depth to avoid regeneration. GnRH-agonist therapy effects a decrease in the total uterine cavity area which facilitates surgical treatment and reduces the risk of fluid overload syndrome. The recurrence rate of meno/metrorrhagia is higher when the uterine cavity is more than 10 cm2. The use of GnRH-agonists represents an adjunct for preoperative reduction of submucosal myomas so that subsequent hysteroscopic myomectomy is possible. A two-step hysteroscopic therapy combined with GnRH-agonist therapy is performed when the largest portion of the submucosal myoma is located in the uterine wall. In cases of numerous submucosal and intramural myomas, a laparoscopic supracervical hysterectomy is performed because of the high risk of recurrence after the hysteroscopic procedure. [less ▲]