Nash Sayed Moawad

Endometriosis (EuE) is a chronic, incurable disease. Due to limited efficacy, high recurrence rates, and serious side effects of current treatments, development of new, targeted, nonhormonal therapies is urgently needed. We previously reported that niclosamide, an FDA‐approved anthelmintic drug, attenuates endometriotic lesion growth. We further identified folate receptor‐β (FRβ)‐positive macrophages as contributors to disease progression. Significantly, niclosamide inhibits FRβ ⁺ macrophages and reduces inflammation, innervation, and angiogenesis. To develop niclosamide as a nonhormonal and selective immune cell‐targeted therapy for EuE, we engineered a folic acid (FA)‐conjugated 2‐deoxyglucose dendrimer (FA‐2DG‐D) using click chemistry to enable selective FRβ‐mediated uptake. Conjugation of niclosamide to FA‐2DG‐D yielded a targeted nanotherapeutic (FA‐2DG‐D‐Niclo) with enhanced aqueous solubility, controlled intracellular release, and excellent batch‐to‐batch reproducibility. In a mouse model of EuE, FA‐2DG‐D demonstrated lesion‐specific accumulation and selective internalization by FRβ ⁺ macrophages with minimal off‐target organ retention. A single intraperitoneal dose of FA‐2DG‐D‐Niclo (25 or 50 mg/kg/bw of niclosamide) significantly reduced FRβ ⁺ macrophage burden, suppressed lesion number and volume, and markedly improved EuE‐associated hyperalgesia at 2 weeks post‐treatment. Together, these findings establish FRβ ⁺ macrophages as a potential target in EuE and present FA‐2DG‐D‐Niclo as a nonhormonal, macrophage‐focused nanomedicine for precise and effective endometriosis treatment.

Leiomyomas are the most common pelvic tumors. Submucosal fibroids are a common cause of abnormal bleeding and infertility. Hysteroscopic myomectomy is the definitive management of symptomatic submucosal fibroids, with high efficacy and safety. Several techniques have been introduced over time and will be covered in depth in this manuscript. Advances in optics, fluid management, electrosurgery, smaller diameter scopes, and tissue removal systems, along with improved training have contributed to improving the safety and efficiency of hysteroscopic myomectomy.

Journal of Gynecologic Surgery

This study was designed to determine the rates of reoperation following laparoscopic management of endometriosis, with additional aims to examine long-term fertility and quality of life outcomes. This is a retrospective study and a prospective questionnaire of subjects who underwent laparoscopic surgery for pelvic pain and/or endometriosis from 2010 to 2015. The rate of reoperation was 8.60%. Following surgery, 83.3% of previously infertile subjects with endometriosis attempted to conceive with an 80.0% success rate. Subjects had significant improvement in each quality of life measurement and most sexual function indices analysed.