2020 Jul 16;19(4):323-333. doi: 10.1002/rmb2.12340. Women in their 30s and 40s may develop a pneumothorax during their menstrual cycle. 2006 Oct;88(6):547-9, (12) Personal communication; Michael Soltero, MD Cardiothoracic and Vascular surgeon, (13) Personal communication; Edward Murphy, MD Cardiothoracic surgeon, (14) Personal communication with CPT patient treated at Stanford University, (15) Endometriosis of the diaphragm: four cases treated with a combination of laparoscopy and thoracoscopy. 2020 Jun;17(2):107-109. doi: 10.5114/kitp.2020.97274. On the other extreme, there are doctors who insist that an FDA-approved synthetic drug with well-documented side effects is really safer than a bioidentical hormone chemically identical to the molecule made by the ovaries. Successful treatment depends upon the gynecologist and thoracic surgeon/pulmonary specialist working together to provide treatment options. From 1993 to 2008, ten women presented at our department with CP. Bagan P, Barthes FL, Assouad J, Souilamas R, Riquet M. Ann Thorac Surg. Another version of this involves connecting the catheter to a one-way valve allowing air to escape passively (Heimlich valve). Am J Med. Clipboard, Search History, and several other advanced features are temporarily unavailable. Thoracostomy - (Chest tube/chest drain) A tube is inserted through the chest wall and into the pleural space. Recurrence rate varied from 14.3% to 55%. Partial diaphragmatic resection and/or excision of visceral pleural implants, as well as talc pleurodesis, are sometimes carried out as part of treatment. Epub 2017 Jul 31. Catamenial pneumothoraces (CM PMX) are thought to be a rare cause of spontaneous pneumothoraces in females. This treatment stopped her collapses and monthly chest pain even though she continued to menstruate (8). In doing our own research, we've encountered strong opinions on both sides of this argument. COVID-19 is an emerging, rapidly evolving situation. Most catamenial pneumothoraces are small and self-resolving. Since then, it has been performed with success in the United States, although the frequency is unknown. GnRH Therapy (non-bioidentical) - Gonadotropin Releasing Hormone agonists suppress menstruation and create a state of chemically induced artificial menopause (2, 6). Initial treatment is a chest tube if the pneumothorax is large enough and symptomatic. In California, this tandem approach is being utilized in a dual laparoscopic procedure, whereby both sides of the diaphragm are evaluated for endometrial progression (14, 24). Because dia-phragmatic lesion is frequent and may be occult, we propose the systematic coverage of the diaphragmatic surface by a polyglactin mesh to prevent catamenial pneumothorax recurrence even when the diaphragm ap- Catamenial pneumothorax: A collapsed lung that occurs at the same time as menstruation. Leong AC, Coonar AS, Lang-Lazdunski L. Ann R Coll Surg Engl. Catamenial pneumothorax is a rare condition in which spontaneous pneumothorax is recurrent. Surgical treatment should be accom-plished during menstruation for an optimal visualization of pleurodiaphragmatic endometriosis. The possibility of endometriosis should be considered in reproductive-aged women with catamenial symptoms of chest pain or shortness of breath. 2003;124:1004-1008, (10) Surgical treatment of catamenial pneumothorax: a single centre experience. We retrospectively reviewed our experience with catamenial pneumothorax (CP) in terms of treatment and follow-up. Rev Mal Respir. Sometimes talc is added to encourage adhesion formation. The diagnosis was made at an older age than that of pelvic endometriosis. This site needs JavaScript to work properly. 2000 Sep;20(5):547-548, (18) Personal communication with CPT patients treated with hysterectomy and/or oophorectomy, (19) Endometriosis - morphology, clinical presentations and molecular pathology. They can be prescribed in several forms including pharmacy-compounded transdermal creams and subdermal pellets as well as pharmaceutical preparations of oral pills/capsules and transdermal patches (27). 2002;69(3):275-276, (7) Jerilynn Prior, MD, The Centre for Menstrual Cycle and Ovulation Research (CeMCOR), (8) Personal communication with CPT patient on the Sottopelle program, (9) Catamenial pneumothorax- a prospective study. Previously, these were generally used no longer than six months. Ann Thorac Surg. Since the first report appeared in literature in 1958 [1] , it has always been considered an unusual condition [2] . Gonadotropin releasing hormone agonists are drugs that suppress ovulation and prevent the release of other hormones including estrogen or progesterone. Right pneumothorax and diaphragmatic endometriosis are found in most patients. Usually onset of lung collapse is less than 72 hours after menstruation. (2)Section of Cardiothoracic Surgery, Emory University, Atlanta GA. Author information: (1)Section of Cardiothoracic Surgery, Emory University, Atlanta GA. Electronic address: john.michael.fallon@emory.edu. The prevalence of catamenial pneumothorax of all cases of pneumothorax in women of reproductive age ranges from 7.3% to 36.7%. BMC Women's Health. This procedure can be performed during thoracotomy or thoracoscopy, and was first introduced in the literature in The Annuals of Thoracic Surgery in 2003 (3). The use of oral contraceptives alone, without other treatment methods reportedly has a low success rate in stopping collapses (2, 5). If a catamenial pneumothorax is linked to endometriosis, surgery may be the preferred treatment, as it allows a surgeon to remove any lesions or blood in the chest cavity, as well as look at other areas endometriosis is commonly found, such as the abdomen and pelvis. Stern H, Toole AL, Merino M. Chest. Some doctors advocate their use over conventional synthetic preparations, claiming they carry less risk of side effects (29, 30, 31). Robotic-Assisted Surgical Treatment of Catamenial Pneumothorax. Surgical treatment should be accomplished during menstruation for an optimal visualization of pleurodiaphragmatic endometriosis. 2011;11:27, (31) The effects of compounded bioidentical transdermal hormone therapy on hemostatic, inflammatory, immune factors; cardiovascular biomarkers; quality-of-life measures; and health outcomes in perimenopausal and postmenopausal women. Hormonal therapy should be added to treatment in selected cases. eCollection 2020 Oct. Kaya C, Iliman DE, Eyuboglu GM, Bahceci E. Kardiochir Torakochirurgia Pol. Progestins and gonadotropin-releasing hormone agonists (GnRH) are frequently used to stop menstruation (19). Together, they can figure out if it's really consistently related to the periods. 2008;44(8):437-48, (3) Catamenial pneumothorax: retrospective study of surgical treatment. Joseph J, Reed CE, Sahn SA. 2011 Sep;26(9):2322-9. doi: 10.1093/humrep/der189. The incidence of catamenial pneumothorax has been underestimated for a few number of reasons. Diaphragmatic endometriosis and/or nodules were observed in 265 of 297 cases (89%). The prevalence of catamenial pneumothorax of all cases of pneumothorax in women of reproductive age ranges from 7.3% to 36.7%. Abstract: Catamenial pneumothorax (CP) is the most common form of thoracic endometriosis syndrome, which also includes catamenial hemothorax, catamenial hemoptysis, catamenial hemopneumothorax and endometriosis lung nodules, as well as some exceptional presentations. This includes endometrial suppression therapy using a variety of synthetic hormonal drugs to suspend the menstrual cycle (3, 4). A pleurectomy can also be performed which involves removal of the pleura to encourage the lung to adhere directly with the chest wall (12). Bioidential hormones are defined as having the same chemical structure as hormones made in the body (30). Recently, the etiology of catamenial pneumothorax has been more accurately diagnosed because of increased awareness and interest in the disease. Aggressive treatment options include surgical procedures to remove endometrial implants, repair diaphragmatic fenestrations, abrade pleural surfaces, remove the pleura or remove the ovaries to induce surgical menopause. Epub 2011 Jun 16. Accessibility As in VATS, biopsy, bleb resection and pleurodesis can be performed. Use of these drugs can cause significant side effects which some patients may find difficult to tolerate (29). Hormonal treatment with surgery prevents the repeat of catamenial and/or endometriosis-related pneumothorax. Hormonal therapy temporarily improved outcome for 6 months in 2 patients. The … Treatment and prognosis Most catamenial pneumothoraces are small and self-resolving. A second occurrence may be treated more aggressively with a sclerosing agent (2). Until recently, catamenial pneumothorax (CP) and thoracic endometriosis (TE) have been considered as unusual clinical conditions. Joseph J, Sahn SA. Methods of study selection:
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