Evidence map›Paper›PMID 39067674›Full record

SynthesisFertility and sterility2024

Functional determinants of uterine contractility in endometriosis and adenomyosis: a systematic review and meta-analysis.

Noemi Salmeri, Giorgia Di Stefano, Paola Viganò, Pamela Stratton, Edgardo Somigliana, Paolo Vercellini

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Fertility and sterility, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  7. Observational
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  15. Endometriosis and autoimmunity.Autoimmunity reviews · 2025
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Noemi SalmeriDepartment of Obstetrics and Gynaecology, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy; Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, Maryland. Electronic address: salmeri.noemi@hsr.it.
Giorgia Di StefanoAcademic Center for Research on Adenomyosis and Endometriosis, Department of Clinical Sciences and Community Health, Università degli Studi, Milano, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
Paola ViganòAcademic Center for Research on Adenomyosis and Endometriosis, Department of Clinical Sciences and Community Health, Università degli Studi, Milano, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
Pamela StrattonOffice of the Clinical Director, Intramural Research Program, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland.
Edgardo SomiglianaAcademic Center for Research on Adenomyosis and Endometriosis, Department of Clinical Sciences and Community Health, Università degli Studi, Milano, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
Paolo VercelliniAcademic Center for Research on Adenomyosis and Endometriosis, Department of Clinical Sciences and Community Health, Università degli Studi, Milano, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.

Funding

Intramural NIH HHS Z99 NS999999
6 · The paper itself

Abstract

importanceEvidence suggests that aberrant uterine contractility in nonpregnant women with endometriosis and adenomyosis contributes to symptoms and potentially heralds their pathogenesis. However, uterine peristalsis remains understudied, inconsistently measured, and poorly understood.

objectiveTo summarize evidence on uterine contractility across the menstrual cycle phases in women with endometriosis and adenomyosis. DATA SOURCES: PubMed/MEDLINE, Embase, and Scopus databases searched up to May 2, 2024. STUDY SELECTION AND SYNTHESIS: Observational studies compared quantitative measures of uterine contractility using magnetic resonance imaging, ultrasound, electrophysiology, or direct intrauterine pressure recording across different menstrual cycle phases between women with endometriosis/adenomyosis and controls on the basis of predefined problem/population, intervention, comparison, and outcome criteria. Study quality was assessed using the Newcastle-Ottawa Scale. Pooled estimates for primary (risk ratios with 95% confidence intervals [CIs]) and secondary (mean difference [MD] with 95% CIs) outcomes were calculated using random-effects models. MAIN OUTCOMES: Pooled risk of retrograde menstruation uterine contraction pattern in cases vs. controls; pooled MD in continuous measures of uterine contractility (frequency, amplitude, and velocity of contractions) across all the menstrual cycle phases in cases vs. controls.

resultsNine studies met the inclusion criteria; most were studies that evaluated women with endometriosis. An increased risk of retrograde uterine contractions during menstruation was observed in women with endometriosis compared with that in controls (risk ratio, 8.63; 95% CI, 3.24-22.95; I CONCLUSION AND RELEVANCE: The approximately ninefold increased risk of retrograde pattern during menstruation in endometriosis supports the potential role of retrograde menstruation in its etiopathogenesis. Abnormal uterine contractility, likely not limited to the menstrual phase, may be a mechanical factor contributing to development of endometriosis and related symptoms, including menstrual pain and infertility, with limited, mostly concordant evidence for adenomyosis. REGISTRATION NUMBER: PROSPERO ID CRD42024512273-accepted on February 23, 2024.

Indexed as

AdenomyosisEndometriosisMenstrual CycleUterine ContractionFemaleHumansUterusadenomyosisEndometriosismenstrual cycleretrograde menstruationuterine contractions

Identifiers

PMID39067674
PMCPMC11624067

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.