By Nasuhi Engin AydinAdenomyosis : Early Diagnosis is Essential in Adolescence
By Nasuhi Engin Aydin
Dr. Martire and colleagues from Siena University, Italy, published their recent research on adenomyosis in adolescents in the journal Diagnostics. Traditionally considered a condition affecting women over 40, adenomyosis is now recognized as a disease with early onset, including during…
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By Özge ÖzkayaSystematic Approach Could Help Better Diagnose Endometriosis
By Özge Özkaya
A group of gynecologists and gynecological oncologists with extensive experience in ultrasound presented a systematic methodology to evaluate the structures within the pelvic sidewall and define useful sonographic landmarks. This approach can improve the diagnosis of gynecological pathologies such as…
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By Selma OransayAdenomyosis as a Barrier to Effective Surgery for Dyspareunia in Rectovaginal Endometriosis
By Selma Oransay
Women with endometriosis often experience severe pain during intercourse, known as dyspareunia, which can deeply affect their quality of life and intimate relationships. One form of this condition, rectovaginal septum endometriosis, involves deep, scarred tissue that can cause pain during…
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Integrating Virtual Reality Modeling for Enhanced Surgical Management of Endometriosis
By Özge Özkaya
Transvaginal ultrasound and magnetic resonance imaging (MRI) conducted by experts are generally sufficient for the surgical planning and management of endometriosis, as noted in a recent study published in the Journal of Minimally Invasive Gynecology. However, incorporating novel techniques such as 3D printing…
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Knowledge synthesis of the "Relevance of Endometriosis Diagnostic Tools"
By Selma Oransay
Spiers et al. from the Department of Obstetrics and Reproductive Medicine at Angers University Hospital in France identified significant diagnostic challenges and the absence of definitive diagnostic tools for endometriosis. In response, they evaluated existing medical literature to enhance diagnostic…
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Intraoperative Transvaginal Ultrasound-Guided Resection of Bowel Endometriosis
By Selma Oransay
Alec et al. from the Department of Obstetrics and Gynecology at Geneva University Hospitals aimed to show how to manage rectal endometriosis using ultrasound in a narrative video. The main goal of their procedure was to check the rectal wall…
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Performance of the 2021 AAGL endometriosis classification
By Selma Oransay
The most common scoring system is the revised American Society for Reproductive Medicine (rASRM) staging system for endometriosis. However, this classification system was widely criticized for failing to correlate surgical complexity and to show patients' pain scales and fertility indexes.…
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Improving fertility in peritoneal endometriosis
By Selma Oransay
Endometriosis is the most common gynecologic disease that affects 10-15% of women in their reproductive age. The causal relationship between endometriosis and infertility is not clear yet, but adhesions and anatomical distortions due to the progression of the disease are…
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Recommendations of experts on transvaginal ultrasonography
By Nasuhi Engin Aydin
Following June 2022, the Society of Radiologists in Ultrasound composed of a panel of 16 experts in imaging and management of endometriosis, the recommendations have been published in a recent issue of Radiology. Transvaginal sonography is accepted as a first-line…
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The location of adenomyosis, and recurrent abortion
By Selma Oransay
ESHRE defines repeated pregnancy loss (RPL) as the loss of pregnancies with two or more weeks of gestation. Adenomyosis is the presence of ectopic endometrium, in the myometrium. High-resolution transvaginal ultrasound and sonographic criteria can help to diagnose the disease…
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Ultrasonographic findings and the clinical symptoms of pelvic endometriosis
By Selma Oransay
Imaging techniques achieve the clinical diagnosis of endometriosis, which affects 10-15% of all women of reproductive age. Suspected patients with clinical history and symptoms need a systemic examination of the uterus, ovaries, adnexa, and peritoneal covering the rectouterine, retrocervical, and…
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By Eylül GÜNRevolutionizing endometriosis diagnosis: Advances in radiological imaging
By Eylül GÜN
With recent advances in diagnostic radiological imaging, the diagnosis of endometriosis, particularly for deep and ovarian endometriosis, has been revolutionized. Updated guidelines now recommend the initial use of endometriosis transvaginal ultrasound (eTVUS) and magnetic resonance imaging (eMRI) for diagnosis, although…
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Management of uterine adenomyomas with percutaneous cryoablation.
By Selma Oransay
Adenomyosis can negatively affect the quality of life by causing abnormal bleeding, pelvic pain, dysmenorrhea, and dyspareunia. It is often associated with endometriomas and/or leiomyomas. Treatment of the disease differs as conservative or radical, as well as pharmacological or surgical. For…
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Endometriosis vs. adenomyosis : is there a common pathogenesis ?
By Nasuhi Engin Aydin
This is a collaborative review on the pathophysiology of adenomyosis and endometriosis by academicians of the University of Leicester, UK; Fudan University, Shanghai, China and Sapienza University of Rome, Italy, published in a recent issue of “Biomolecules”. The pathophysiology of…
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Family history of endometriosis and its characteristics
By Selma Oransay
Depression and migraine are two familial disorders affected by menstrual cycle and endometriosis patients have an increased likelihood of suffering from these comorbidities. A correlation of endometriosis, migraine and depression has been already reporteed in the literature, however a link for…
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A synopsis of deep infiltrating endometriosis of the digestive system
By Eylül GÜN
The gastrointestinal tract is one of the most common locations of extrapelvic endometriosis. Its infiltrative counterpart exhibits more aggressive behavior and often needs to be distinguished from malignancies clinically. Yin et al. from Harbin, China reviewed the latest findings regarding…
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By Bahar YukselGetting help from water to replace colonoscopy and MRI for the diagnosis of deep bowel endometriosis.
By Bahar Yuksel
This retrospective study by Martyna Masternak et al. discusses the use of rectal water contrast transvaginal ultrasound (RWC-TVS) as a tool for assessing deep bowel endometriosis. The study explains how the procedure is minimally invasive, and how it involves filling…
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Ultrasonographic findings predicting parametrial deep endometriosis
By Selma Oransay
Transvaginal ultrasonographic evaluation is the primary imaging technique to rule out deep endometriosis. Although the International Deep Endometriosis Analysis Group (IDEA) published a consensus to standardize the nomenclature of ultrasonographic pelvic examination in women with suspected deep endometriosis, parametrial deep endometriosis…
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Deep Infiltrating Endometriosis and Adenomyosis have different genetic pathways
By Bahar Yuksel
It is still not defined whether adenomyosis is also a deep endometriosis component or not. In the study conducted by Marshall et al, the researchers compared the gene expression patterns between deep infiltrating endometriosis (DIE) and adenomyosis uteri in order…
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Epigenetic defects of stromal cells in endometriosis and adenomyosis lead to estrogen sensitivity
By Nasuhi Engin Aydin
Serdar Bulun, MD, J.J. Sciarra Professor and Chair Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois has delivered a conference on “Endometriosis and adenomyosis: single-cell genome-wide approaches” at the Annual International Medical Conference of the Endometriosis Foundation…
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Transvaginal Hydro laparoscopy for diagnosing and treatment of early stages of endometriosis
By Selma Oransay
Transvaginal hydro laparoscopy is a minimally invasive procedure that allows the exploration of the female pelvis. An obliterated Douglas pouch by a fixed retroverted uterus, an ovarian endometrioma greater than 2 cm, and the presence of deeply infiltrated endometriosis are…
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The bigger the uterus, the more painful the dysmenorrhea even if you don’t have endometriosis.
By Bahar Yuksel
The literature finds no correlation between ultrasound or perioperative findings and pain intensity. Thus, a tool to predict pain intensity will ease the choice for proper treatments and follow-ups. In the study led by Dr. Zhao et al., the ultrasonographic…
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A review of multimodal imaging modalities for endometriosis.
By Selma Oransay
Since there is a lack of non-invasive biomarkers to diagnose endometriosis clinically, imaging techniques such as transvaginal ultrasonography and MRI have significant importance in preoperative endometriosis diagnosis. These imaging techniques allow appropriate surgical planning before laparoscopic excision, especially in deeply…
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How Common is Adenomyosis Among Subfertile Women?
By Özge Özkaya
Around 10% of women who have reduced fertility have isolated adenomyosis, according to a new study published in the scientific journal Ultrasound in Obstetrics & Gynecology. The prevalence of the disease seems to vary according to the presence of endometriosis…
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Ultrasonographic Presurgical Staging and Classification of Endometriosis
By Selma Oransay
Laparoscopic surgery is the gold standard for diagnosing endometriosis, but a preoperative imaging procedure is strongly recommended. Transvaginal sonography by a skilled examiner is not inferior to MRI diagnostics regarding sensitivity and specificity in predicting the extension of deep endometriosis. …
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Transvaginal ultrasound or MRI for retroflexed uterus in endometriosis
By Nasuhi Engin Aydin
Dr Matsuda and colleagues from the Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan have published their study evaluating the effectiveness of transvaginal ultrasound on the diagnosis of uterine retroflexion in a recent issue of “Journal of Nippon…
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Imaging techniques for fallopian tubes
By Selma Oransay
The imaging techniques used for suspected fallopian tube pathology are ultrasound, hysterosalpingo-contrast-sonography, hysterosalpingography, computed tomography, and magnetic resonance imaging. Among several benign lesions that involve fallopian tubes, pelvic inflammatory disease, tubo-ovarian abscess, salpingitis isthmica nodosa, hydrosalpinx, tubal endometriosis, isolated fallopian…
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Diagnostic criteria for uterosacral ligament involvement in endometriosis.
By Selma Oransay
Transvaginal ultrasonography is often used to diagnose endometriosis in suspected women due to its high resolution, low cost, and relatively low discomfort. Histologic confirmation of laparoscopically removed specimens is still the gold standard for appropriate diagnosis. The team led by…
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How accurate is ultrasonography in evaluating deep infiltrating endometriosis?
By Eylül GÜN
Deep infiltrating endometriosis (DIE) appears to be the most severe form of endometriosis comprising 15-30% of all endometriosis patients. The difference in the presentation of the lesions ranges from simple adhesions to infiltrative nodules. Even though there is no consensus…
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Time to change out taboos about the radiologic evaluation of scar endometriosis
By Bahar Yuksel
Scar endometriosis is one of the rare forms of endometriosis. According to traditional belief, it has always been evaluated radiologically on menstruation days. In the study conducted by Balaban et al, the authors compared the differences in lesions according to…
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A prediction model to identify endometriosis during routine ultrasound .
By Selma Oransay
. Ureterolysis is an advanced surgical technique that involves dissection of the ureter from pelvic brim to the ureteric tunnel to avoid injury or freeing the ureter from endometriotic lesions. This manipulation usually requieres advanced surgical training and skill. In…
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Transvaginal Ultrasound Could Be Sufficient to Properly Diagnose Deep Endometriosis and Ovarians Endometriomas
By Özge Özkaya
Following the International Deep Endometriosis Analysis consensus can improve the accuracy of transvaginal ultrasound to diagnose ovarian endometriomas and deep infiltrating endometriosis, according to a new study published in the scientific journalUltrasound in Obstetrics & Gynecology. “ (…) at this…
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The predictive value of operative findings concerning ovarian reserve
By Bahar Yuksel
Having endometrioma is a proven factor that affects the ovarian reserve of patients with endometriosis. Not only its presence but also the surgery applied, and concomitant disease stage might affect the reserve. In this retrospective analysis conducted in Korea by Jisun…
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The effect of postoperative hormonal medication preferences on the recurrence rate of endometrioma
By Bahar Yuksel
Endometrioma is the most investigated type of endometriosis. The recurrence after surgery is important regarding its and reoperation’s effect on ovarian functions. In the study conducted by Seung-Hye Choi et al, the researchers questioned the effect of different postoperative hormonal…
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Evaluation of retrocervical and parametrial deep endometriosis by detailed ultrasonography
By Selma Oransay
The accuracy of ultrasonographic diagnosis of deep endometriosis in the retrocervical and parametrial areas may be poor due to the variable morphology of endometriotic lesions, the complex structure of the posterior parametrial compartment, and the difference in examiners' experience level.…
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By Hale Goksever CelikEndometriosis-associated infertility: How to manage?
By Hale Goksever Celik
Although the underlying reason for endometriosis has not been fully established, there is an association between endometriosis and infertility. Endometriosis is thought to be involved in 40-50 percent of infertility cases. However, natural conception can still occur even in women…
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The accuracy of transvaginal ultrasound and magnetic resonance imaging for deep urinary tract endometrisis.
By Selma Oransay
The prevalence of urinary tract endometriosis is 19-53% in patients within deep infiltrating endometriosis cases. The bladder and ureteral are the most common sites of the involvement. While preparing a radical surgery for a patient with deep endometriosis, the diagnosis…
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Preoperative detailed ultrasound is effective for the prediction of surgical extent.
By Bahar Yuksel
Endometriosis surgery is like opening the box of pandora when you start the surgery. A preoperative guide is extremely important for the surgeon to draw a road map. In the study conducted by Alessandra Di Giovanni et al, the effectiveness…
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Listening to patients’ complaints is the first step on the way to a diagnosis of endometriosis.
By Hale Goksever Celik
Early diagnosis and management of endometriosis are not possible due to the wide spectrum of symptoms and absence of non-invasive diagnostic biomarkers. Particularly the adolescent population is at risk for the diagnostic delay because pelvic pain and dysmenorrhea are very…
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Prevalence of endometriosis and adenomyosis by transvaginal ultrasound.
By Selma Oransay
Women who present dyspareunia, dysmenorrhea, dysuria, dyschezia, chronic abdominal, and pelvic pain, and infertility would benefit from the early investigation. If the correct diagnosis of endometriosis and/or adenomyosis can be made in advance, early treatment will improve the quality of…
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Imaging Techniques Able to Predict Depth of Endometriosis Before Surgery
By Özge Özkaya
Transvaginal ultrasound (TVUS) and pelvic magnetic resonance imaging (MRI) performed by a specialist can accurately predict the depth of rectosigmoid endometriosis before surgery, according to a new study published in the Journal of Minimally Invasive Gynecology. Both approaches are similar…
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A comparison of endometriosis Classifications: rASRM, EFI or Enzian?
By Selma Oransay
None of the endometriosis classifications provide a clinically valuable system since the very first description of the disease in 1860. One unique terminology to describe the localization and the extension of the disease is needed, which should be the same…
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Shining like fireflies: a new approach to visualize early endometriosis
By Bahar Yuksel
Endometriosis is a complex and unsolved disease that requires animal studies in order to understand its nature. There are a group of animal models designed for endometriosis studies, but most require sacrificing the animal. In the experimental study designed by the team…
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Is it iron that calls vessels to form endometriosis
By Bahar Yuksel
The trigger mechanism of endometriosis formation is still under investigation. But it is clear that there is an iron overload on endometriotic lesions. In the study conducted by Guojing Li et al, the mechanism of iron on endometriosis formation has been…
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A novel in-vitro endometriosis model with KRAS and PIK3CA mutations
By Eylül GÜN
A plethora of research has been ongoing to illuminate the pathogenesis of endometriosis which is a multifactorial disease. These studies have proven the association between some mutated cancer driver genes and endometriosis, and links between certain cancers such as ovarian…
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The new Endometriosis Surgical Complexity Classification: AAGL 2021
By Selma Oransay
Multiple endometriosis categorizations have been approved in the recent forty years. The American Fertility Society proposed ASRM with a desire to score the impact of the endometriosis in 1996, which was updated several times later (rASRM), to predict infertility after laparoscopic operations. For…
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Complex Relation Between Body mass index and endometriosis
By Selma Oransay
This research aimed to find the relationship between BMI and endometriosis especially related to surgical phenotype and lesion location. An observational cohort study was led by Holdsworth-Carson et al, from Australia. The article was recently published in "RBMO" . Many earlier studies report…
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Adenomyosis in adolescents
By Nasuhi Engin Aydin
Dr. Exacoustos and colleagues from two tertiary referral university hospitals in Italy published their results on adenomyosis in adolescent patients in a recent issue of “The Journal of Minimally Invasive Gynecology”. Adenomyosis is the presence of endometrial glands and stroma…
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Transvaginal Ultrasound Accuracy for Uterosacral Ligament, Torus Uterinus and Posterior Fornix Endometriosis
By Selma Oransay
The accuracy of transvaginal ultrasonography for the diagnosis of deep endometriosis depends on the location. The sensitivity is up to 80% when the lesion is in the rectosigmoid, but it decreases up to 66% for the detection of posterior vaginal…
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How to measure the length of recto-sigmoid deep endometriosis reliably?
By Eylül GÜN
An in-depth assessment is needed when rectosigmoid deep endometriosis is decided to be treated surgically. Surgery carries a lot of risks and it is not always easy to decide which procedure the patient would benefit the most from. Patient-oriented surgical…
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Analyses of the main classification systems of endometriosis in terms of utrasound, MRI and surgery
By Selma Oransay
Several classifications made by gynecologists, image readers, and radiologists lead to confusion while describing the situation and estimating the progress of endometriosis. Daniela Fischerova team from the Charles University of Prague, Czech Republic, analyzed the main classifications of endometriosis in three…
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A pictorial overview of abdominal wall endometriosis
By Hale Goksever Celik
Abdominal wall endometriosis is the most frequent location of extrapelvic endometriosis, and defined as the presence of ectopic endometrial tissue between the peritoneum and the skin through the abdominal wall. Although obstetric or gynecologic surgical history is indispensable for the…
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Ultrasonographic signs of adenomyosis, surgery and infertility in endometriosis patients
By Bahar Yuksel
Adenomyosis is simply defined as the presence of endometrial glands and stroma within the uterine myometrium and is related to severe menstrual bleeding, pain, and infertility. Previous reports demonstrated the coexisting of endometriosis and adenomyosis is common. In the present…
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Evaluation of preoperative risk factors of ureteral endometriosis
By Selma Oransay
Endometriosis affects the urinary tract in 1% to 5.5% of the patients, and among them, bladder involvement is 70-85%, while ureteral involvement alone is 9% to 23%. Ureteral endometriosis is most commonly unilateral, especially on the left side, usually affecting…
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Adenomyosis: accuracy of the diagnostic methods and the synchronism with deep infiltrating endometriosis
By Nasuhi Engin Aydin
Dr. Alborzi and associates from Shiraz University of Medical Sciences, Iran, have published their comprehensive retrospective research conducted on 3725 patients with clinical symptoms of endometriosis over a period of 3 years, in "Reproductive Sciences" medical journal. A relationship between…
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By Dr. Youngran ParkErastin, Ferroptosis and Endometriosis
By Dr. Youngran Park
Iron overload has been linked to endometriosis. There are abundant free iron and high oxidation in ectopic lesions, probably due to retrograde menstruation. Interestingly, iron overload in endometriosis activates NF-kB signaling and results in proinflammatory communication. More clear pieces of…
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“Advanced gynecological ultrasound” for women with suspected endometriosis
By Hale Goksever Celik
Different clinical forms of endometriosis such as superficial endometriosis, endometrioma, and deep infiltrating endometriosis are present. Although no specific diagnostic tool is available for endometriosis, clinical findings, physical examination and imaging including transvaginal ultrasound and MRI are helpful to determine…
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By Murat OsmanUltrasound for the Detection of Deep Infiltrating Endometriosis
By Murat Osman
Endometriosis is a disease that causes significant morbidity to women worldwide. Deep infiltrating endometriosis (DIE) is a term used to characterize endometriosis that has invaded deeper pelvic structures and is associated with significant inflammatory, fibrotic, and surgically complex disease. Depending…
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"Speckle sign": a novel transvaginal ultrasound finding for posterior compartment endometriosis
By Nasuhi Engin Aydin
Dr. Balcacer and associates from three medical institutions located in the USA report the results of their retrospective study on deep infiltrating endometriosis utilizing transvaginal ultrasound examination and the proposed “speckle sign” in the "Journal of Ultrasound Medicine". Pelvic ultrasound…
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Urological Challenges in Endometriosis Surgery - Guenter Noe, MD
By Özge Özkaya
In this presentation, Dr. Guenter Noé, Head of Department of Rheilandklinikum Dormagen in Germany talks about endometriosis affecting the urinary tract. Dr. Noé starts by describing the different parts of the urinary tract that can be affected by endometriosis including…
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By Irem OnurAdolescent endometriosis: Diagnostic clues?
By Irem Onur
The rates of dysmenorrhea, dyspareunia, and heavy menstrual bleeding in adolescents showing endometriosis signs on ultrasound are significantly higher compared to those without. This is according to a retrospective observational study recently published in the journal "Fertility and Sterility". The…
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Comparison of diagnostic accuracy of imaging modalities for the deep infiltrating endometriosis
By Selma Oransay
The treatment of deeply infiltrated endometriosis (DIE) is usually personalized and the potential success for the available therapeutical options is dependent on early and accurate diagnosis. Laparoscopy is the gold standard for the diagnosis of DIE. Other non-invasive diagnostic methods…
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Diagnosis and treatment of endometriosis in adolescents
By Irem Onur
The belief that dysmenorrhea, the primary symptom of endometriosis, in adolescents is an inevitable condition seen in menstruation as well as unwillingness to perform diagnostic laparoscopy may cause the delay of diagnosis of endometriosis. This is according to a recent…
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Endometriosis prevalence among adolescents with pelvic pain
By Irem Onur
An updated review conducted by the investigators at EGA Institute for Women's Health, University College London, United Kingdom, in collaboration with Birmingham Women’s and Children’s Foundation Trust of the Institute of Metabolism and Systems Research at the University of Birmingham…
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Local inflammation and follicle development in women with ovarian endometriosis
By Dr. Youngran Park
Endometriosis, a cause of subfertility, is found in almost 50% of infertile women. The elevated levels of cytokines in the follicular fluid of patients with endometriosis might account for the ovulatory dysfunction. Granulosa cells (GCs) play important roles in follicular…
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Diagnosing Deep Endometriosis Using Transvaginal Elastosonography
By Murat Osman
Deeply infiltrating endometriosis (DIE) is an advanced form of endometriosis that causes significant morbidity to a large number of women. Early detection of endometriosis is imperative for early treatment and improved outcomes for these patients. Currently, transvaginal ultrasound (TVUS) and magnetic…
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Diagnosis and treatment algorithm for endometriosis
By Selma Oransay
Endometriosis is a chronic and progressive disease that affects 25-30% of women between 25-35years, clinicians commonly experience during their gynecologic practice. However, the diagnosis is still late or sometimes incorrect, and this creates severe health problems and worse outcomes. A…
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Ultrasound diagnosis of endometriosis: One Size Does-Not-Fit-All
By Murat Osman
Deeply infiltrating endometriosis (DIE) is an advanced form of endometriosis that causes significant morbidity to many women. The Pouch of Douglas (POD), otherwise known as the rectouterine space, is the anatomic area between the posterior cervix and anterior rectum. Its…
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By Nadire DuruNAT2 as potential biomarker for the diagnosis and treatment of endometriosis
By Nadire Duru
Endometriosis affects 5–10% of women of reproductive age causing several discomforts, pelvic pain, menstrual disorders, ectopic bleeding, infertility, and sometimes even malignant transformation but its etiology remains unclear. Accumulating evidence point a key role for genetic factors and there is…
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Improved fusion imaging for the detection of Endometriosis
By Murat Osman
This paper studied a new fusion method for magnetic resonance (MR) and ultrasound (US) imaging for the appropriate diagnosis of endometriosis. The diagnosis of endometriosis in patients with a chronic pelvic disease is delayed, due to the disease, patient, and physician-led…
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Hysterolaparoscopy Plus Assisted Reproduction Improves Fertility in Women with Endometriosis
By Özge Özkaya
Hysteroscopy and laparoscopic surgery is an effective and reliable therapeutic procedure, confirmed a study published in the "Journal of Clinical Medicine". The approach is even more effective when combined with assisted reproductive techniques such as artificial insemination and in vitro…
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A Routine Pelvic Ultrasound Examination Should Include an Evaluation for Endometriosis
By Özge Özkaya
Routine pelvic ultrasound examination should be extended beyond the uterus and ovaries into the posterior and anterior pelvic compartments, according to Australian doctors. With such examinations, deep infiltrating endometriosis nodules can be searched, say the authors, allowing women to be…
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Imaging of gastrointestinal endometriosis
By Murat Osman
Endometriosis is a disease characterized by the ectopic implantation of endometrial tissue to surrounding pelvic and extra-pelvic structures. One frequent site of involvement is the gastrointestinal(GI) tract, which occurs especially among women with deep infiltrating endometriosis. Most cases of GI-involving…
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All aspects of endometriosis reviewed with focus on modern management
By Nasuhi Engin Aydin
Dr. Chapron and associates from academic centers in France published in Nature Review Endocrinology, a comprehensive review on endometriosis. The article is inclusive of all aspects of endometriosis but especially focuses on the management of the disease with its contemporary status. Having a…
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Current Status of Transvaginal Ultrasound Accuracy in the Diagnosis of Deep Infiltrating Endometriosis
By Murat Osman
Transvaginal ultrasound (TVUS) is an imaging tool that is irreplaceable for the diagnosis of multiple gynecologic conditions such as ovarian torsion, ectopic pregnancy, and uterine leiomyomas. TVUS is increasingly being used in the diagnosis of endometriosis as it can assess…
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The genetic mutations in uterine adenomyosis
By Hale Goksever Celik
Adenomyosis is defined as the localization of endometrial stromal and glandular cells in the myometrium. This disease is a reproductive-aged women disease, like endometriosis. Additionally, adenomyosis is frequently observed together with endometriosis and leiomyomas due to common histological features and…
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Treatment choices for abdominal wall endometriosis
By Selma Oransay
Welch et.al, from the Department of Radiology, Mayo Clinic, Rochester, worked with his gynecologist colleagues to underline the current treatment algorithm of abdominal wall endometriosis in Mayo Clinic. Their experience results recently published in the journal "Abdominal Radiology". Abdominal wall…
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Endometriosis Severity and Complication Risks Following Laparoscopic Surgery
By Özge Özkaya
In a research article published in the journal Acta Obstetricia et Gynecologica Scandinavica, researchers at Brigham and Women's Hospital in Boston, Massachusetts suggested that the severity of endometriosis could not be a predictor of the risk of post-operative complications. In…
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A new ultrasound subgrouping reveals good clinical correlations in adenomyosis
By Nasuhi Engin Aydin
Exacoustos and colleagues from two endometriosis tertiary referral centers in Rome, Italy published their observational, prospective study of the recently proposed transvaginal ultrasonographic scoring system in the "Journal of Minimally Invasive Gynecology". Adenomyosis or “endometriosis interna” is defined as the…
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Post-menopausal women diagnosed with Endometriosis and "Imaging"
By Murat Osman
Postmenopausal endometriosis is an underrecognized clinical entity that may present similarly to those of younger patients with endometriosis. Radiologists have an important role in the diagnosis of these patients as they recommend which imaging study should be used to differentiate…
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Transvaginal Ultrasound of Endometriosis
By Murat Osman
A recent manuscript published by Collins et al. from the Department of Radiology at Penn State Hershey Medical Center aims to review the transvaginal ultrasound (TVUS) evaluation of endometriosis and offer a protocol that is dedicated to the thorough evaluation…
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The accuracy of "lower endoscopic ultrasound" for the preoperative diagnosis of rectosigmoid endometriosis
By Hale Goksever Celik
Endometriosis affects reproductive-aged women most frequently with a prevalence of 5% to 15%. If the endometriotic lesions involve the bowel especially sigmoid colon and rectum, this subtype of endometriosis is named as "bowel" or "rectosigmoid" endometriosis. Rectosigmoid endometriosis is encountered in…
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Which Diagnosis Technique is Better?
By Özge Özkaya
Transvaginal ultrasound provides a more accurate localization of vaginal and recto-vaginal endometriosis compared to magnetic resonance imaging (MRI) according to a study published in the International Journal of Gynecology & Obstetrics. However, MRI has better accuracy in detecting bladder endometriosis…
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Infertility in women with endometriosis
By Hale Goksever Celik
Endometriosis is an estrogen-dependent gynecological disease mostly encountered in reproductive-aged women. The most common presenting complaints are dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. Despite extensive research, the etiopathogenic mechanism underlying the two has not been fully elucidated. Although human…
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By Timur SeckinFusion US/MR imaging in the evaluation of deep infiltrating endometriosis
By Timur Seckin
Scioscia M. et al., from Italy presented a case of a large deep infiltrating nodule of the uterosacral ligament and discussed the importance of a relatively new technique, fusion US/MR imaging in their article. The article containing a video of…
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A position statement of diagnosing and treating endometriosis for gynecologists.
By Selma Oransay
Endometriosis Treatment Italian Group recently declared 10 "valuable" conducts to evaluate endometriotic patients and published them in Hum. Reprod. Open. This society consists of 16 university departments and training center with expert clinicians on endometriosis from Italy. After arising the idea of…
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Transvaginal Ultrasound and the Imaging of Endometriosis
By Murat Osman
Ultrasonography (US) is an imaging tool that uses sound waves to produce a two-dimensional picture inside of the body. The ultrasonography has become especially useful in the assessment of gynecologic pathologies such as endometriosis. Depending on the severity of endometriosis,…
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The association of significant hemoperitoneum (blood in the abdominal cavity) and deep pelvic endometriosis
By Irem Onur
Although there are several theories to explain the etiology of deep endometriosis, the cause is unknown and there are currently no effective strategies to prevent its development. Bean E. et al., from University College London Hospital, UK, observed that some…
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Adenomyosis (endometriosis interna): an enigmatic disease that has to be discovered yet
By Nasuhi Engin Aydin
Scientists, Drs. Vannuccini and Petraglia from Italy have published an open access comprehensive review of Adenomyosis in "F1000Research" in March 2019 issue. Adenomyosis is a uterine disorder in which endometrial glands and stroma are pathologically demonstrated within the myometrium, i.e.…
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Building an ultrasonographic database for superficial endometriosis.
By Selma Oransay
Chowdary et al. from University of Auckland, Australia, recently published a retrospective, small group study in Australian New Zeland Journal of Obstetrics and Gynecology, to demonstrate ultrasonographic findings of mild endometriosis patients with pelvic pain are associated with their laparoscopic diagnosis.…
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Signs and Symptoms on Transvaginal Ultrasound associated with the presence of endometriosis.
By Murat Osman
Endometriosis is a disease whereby ectopic endometrial cells are present outside of the uterus. Transvaginal ultrasound (TVUS) is a highly specific test for endometriomas and deep endometriosis to assess the involvement of endometriosis in the posterior anatomic compartments. While the…
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Extragenital endometriosis and ultrasound
By Irem Onur
Contrast-enhanced ultrasound (CEUS) is a non-invasive imaging method with no exposure to radiation. There are a few reports on the use of CEUS in the assessment of endometriosis in the literature. Dong et al. reported 3 histopathologically proven cases of…
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What clinicians know about adenomyosis? Any association with severe endometriosis?
By Selma Oransay
Dior et al. from the Royal Women's Hospital in Parkville, Australia, designed a prospective study to assess the association between severity of endometriosis and sonographic evidence of adenomyosis (SEOA) in their recently published article appearing in The Journal of Minimally…
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A Brief Review of Endometriosis
By Timur Seckin
Endometriosis is a common disease among women of reproductive age. It is more frequently seen among women without prior pregnancies, women with a family history of endometriosis, and women with abnormal menstrual periods. Peiris et al., researchers from the United…
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Preoperative Staging of Endometriosis: The Value of MRI After Dynamic Transvaginal Ultrasound
By Irem Onur
Since endometriosis is a chronic and progressive disease, early diagnosis and proper staging are important for the patient and for the clinician to discuss and plan the required surgical procedures for treatment. Common diagnostic tools for pre-operative staging of deep…
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Feasibility of MRI-Transvaginal Ultrasound Imaging for Deeply Infiltrating Endometriosis
By Murat Osman
Endometriosis is a disease whereby endometrial tissue is present outside of endometrium. A specific form of endometriosis, Deeply Infiltrating Endometriosis (DIE), is characterized by endometriotic glands that invade through the endometrium and other structures in the pelvis and is associated…
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Three dimensional sono-vaginography to diagnose rectovaginal endometriosis
By Hale Goksever Celik
Deep infiltrating endometriosis is defined as the localization of ectopic endometrial tissue penetrating more than 5 mm into the affected pelvic organs. Rectovaginal endometriosis is the most severe form of deep infiltrating endometriosis in which ectopic endometrial tissue infiltrating rectum…
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Endometriosis involvement of the pouch of Douglas: TVUS vs pelvic exam
By Murat Osman
Deep infiltrating endometriosis (DIE) can lead to a partial or complete obliteration of the pouch of Douglas (POD). POD involvement has been associated with dyschezia, deep dyspareunia, and increased infertility rates. Assessing the extent of endometriosis involvement of the cul-de-sac allows…
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Multimodality imaging and clinicopathologic assessment of abdominal wall endometriosis
By Irem Onur
Abdominal wall endometriosis is a rare clinical entity frequently diagnosed with a significant delay and easily misinterpreted despite multimodality imaging. In the study of Jaramillo-Cardoso et al. which has recently been published in the journal Abdominal Radiology, the clinical, multimodality…
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Fighting with endometriosis
By Irem Onur
Maduro M.R. reviewed three separate studies on potential new targets to successfully manage endometriosis in her recent paper titled “Novel Strategies to Fight Endometriosis” published in the journal Reproductive Sciences. In the autotransplantation rat model of Torres-Reveron et al., the…
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Cosmetics and some household products could be responsible for worsening endometriosis.
By Selma Oransay
A controlled clinical study recently published in the Journal of Human Reproductive Sciences, composed by Nazir et al. from the University of Health Sciences, Lahore, Pakistan. The study compared the blood diethyl hexyl phthalate (DEHP) levels of fifty infertile women laparoscopically diagnosed…
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Transvaginal ultrasound for "rectosigmoid endometriosis" diagnosis: Is bowel preparation necessary?
By Hale Goksever Celik
Rectosigmoid endometriosis is a severe form of deep endometriosis. Women having rectosigmoid endometriosis present with pain and several intestinal complains such as constipation, diarrhea, intestinal cramping, abdominal bloating, feeling of incomplete evacuation, the passage of mucus and rectal bleeding during…
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Endometrioma and endometriosis
By Irem Onur
Exacoustos C. et al. published an article titled “The isolated ovarian endometrioma: a history between myth and reality” in the Journal of Minimally Invasive Gynecology in 2018. They aimed to examine the association between ovarian endometriomas detectable at the transvaginal ultrasound…
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How to evaluate ureteral endometriosis : A review of the literature
By Selma Oransay
In this recently published review of the literature, Barra et al. from Genova, Italy intend to provide a useful tool to guide physicians in the management of deep infiltrating endometriosis. Authors elected 67 abstracts from Pubmed and Medline in accordance with PRISMA…
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By Kasthuri NairMolecular Susceptibility to Endometriosis
By Kasthuri Nair
Fayez et al., a group of researchers from various institutions in Iran, recently published a paper in the Avicenna Journal of Medical Biotechnology titled “Arylamine N-acetyltransferase 2 Polymorphisms and the Risk of Endometriosis.” This study focused on the relationship between…
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Women recommended laparoscopy for chronic pelvic pain
By Irem Onur
Chronic pelvic pain is a diagnostic and therapeutic dilemma. It has many etiologies in many organ systems. Clinician and patient factors affect the management of chronic pelvic pain. Mirowska-Allen K.L. et al. have recently published an article titled, “The characteristics of…
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The diagnostic value of “sliding sign” and direct visualization of the bowel in rectal/rectosigmoid deep endometriosis
By Hale Goksever Celik
Deep endometriosis is the presence of endometrial subperitoneal implants of ≥5 mm localized in the rectum/rectosigmoid bowel, uterosacral ligaments, rectovaginal septum, vagina and/or bladder. The most common diagnostic screening methods are the transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI)…
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Can we predict the complexity of laparoscopic surgery by ultrasound?
By Selma Oransay
This is a multicentric, retrospective cohort study recently published in the Journal of Minimally Invasive Gynecology by Tompsett et al. in which the results of the transvaginal ultrasonographic examinations (TVS) are compared to the results of the laparoscopic operations performed…
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Is there a definitive guideline for the surgical management of endometriosis?
By Murat Osman
Endometriosis is a chronic inflammatory disease that is defined by the presence of ectopic endometrial tissue outside of the uterus. Unfortunately, endometriosis continues to be a leading cause of chronic pelvic pain in women of reproductive age. This article titled,…
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What is being done to help surgeons detect endometriosis during laparoscopy
By Murat Osman
The gold standard for the diagnosis of endometriosis is diagnostic laparoscopy and histologic confirmation. During laparoscopy, visualization of as many lesions as possible may hold better long-term clinical outcomes. Peritoneal endometriosis is difficult to diagnose intraoperatively due to the heterogeneity…
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Difficulties Associated with Diagnosing Ascites and Encapsulating Peritonitis in Endometriosis
By Kasthuri Nair
De Magalhães et al. recently published a paper titled “Ascites and Encapsulating Peritonitis in Endometriosis: a Systematic Review with a Case Report” in Revista Brasileira de Ginecologia e Obstetrícia. The team from the Universidade Federal do Ceará and the Universidade…
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Extending the Female Fertility Clock
By Kasthuri Nair
Varela, Sanchez-de-Puerta, and Garcia-Velasco are a group of scientists from various institutions in Spain and they recently published a review article titled “Fertility, IVF and reproductive genetics” in Current Opinion in Obstetrics and Gynecology. In this publication, the authors discussed…
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HOXA10: A Culprit in Endometriosis Disease Progression
By Kasthuri Nair
Zheng et al., a group of authors from the Aerospace Center Hospital in Bejing and from the First Affiliated Hospital of Wenzhou Medical University in Wenzhou, recently published a paper in Reproductive Sciences entitled “Decreased Expression of HOXA10 May Activate the…
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Direct shedding of endometrioma contents visualized by ultrasonography
By Murat Osman
Endometriosis is one of the leading causes of chronic pelvic pain in women during their childbearing years. Researchers from Italy have recently published a case report in the European Journal of Obstetrics & Gynecology and Reproductive Biology observing the direct shedding of endometriotic…
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Skin Endo Diagnosis
By Özge Özkaya
High-frequency ultrasound can be very useful for the early diagnosis of cutaneous endometriosis according to a study published in the journal Skin Research and Technology. The diagnostic tool could be used in patients who have unusual cyclical pain even before…
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O6-Methylguanine-DNA Methyltransferase Plays a Role in Endometriosis Development
By Kasthuri Nair
Shchegolev et al. recently published a paper in Bulletin of Experimental Biology and Medicine that explores the localization and behavior of O6-methylguanine-DNA methyltransferase, otherwise known as MGMT, a protein that repairs DNA and could potentially possess therapeutic properties. Their paper…
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MRI Best at Detecting Intestinal Deep Infiltrating Endometriosis
By Özge Özkaya
Magnetic resonance imaging (MRI) seems to be a better method in identifying deep infiltrating endometriosis in the intestine compared to two-dimensional ultrasonography (2DUS), found a study by researchers in Italy and Spain. However, this does not seem to be the…
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Diagnosis and management of adolescent endometriosis
By Murat Osman
Early onset endometriosis (EOE) is characterized by endometriosis that begins around menarche or early adolescence. Recent evidence suggests that this form of endometriosis may have a different pathogenic origin than that of adult-onset endometriosis. This opinion article suggests that early…
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Detection and diagnosis of deep endometriosis in the clinical setting
By Murat Osman
This review aims to evaluate the contribution of imaging techniques including transvaginal sonography (TVS) and magnetic resonance imaging (MRI) to the diagnosis of deep infiltrating endometriosis (DIE). Endometriosis is defined by the presence of endometrial tissue outside the uterus and…
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EFA Medical Conference 2017: "Breast Cancer in Young Women; Early Diagnosis Timely Intervention" Presentation by Dr. Stephanie Bernik
By Kasthuri Nair
Dr. Stephanie Bernik is the Chief of Surgical Oncology of Surgery and General Surgery at the Lenox Hill Hospital. She recently presented at the EFA 2017 Medical Conference, and her presentation was titled “Breast Cancer in Young Women; Early Diagnosis…
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Ultrasound-guided High-intensity Focused Ultrasound can Treat Abdominal Wall Endometriosis
By Kasthuri Nair
Endometriosis is a painful and complicated disease that can manifest in various ways. One particular way is Abdominal Wall Endometriosis (AWE), which usually arises from surgery. As is true for other types of endometriosis, there has yet to be a…
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With so many imaging tools and modalities, which one should be used for endometriosis?
By Murat Osman
Intestinal endometriosis affects 5 to 12% of women with endometriosis and commonly presents as dyschezia, rectal bleeding, cyclic defecation pain, constipation, and diarrhea. Currently, surgical treatment includes segmental rectal resection with colorectal anastomosis, but it is often riddled with complications.…
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Updates in the Field of Endometriosis: Imaging
By Kasthuri Nair
Hoyos, Johnson, and Puscheck wrote a chapter titled “Endometriosis and Imaging” that discusses the imagining technologies that can be used to diagnosis and examine individuals with the disease. This chapter evaluates three types of imagining, namely Ultrasound (US), Magnetic Resonance…
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Bowel Involvement in Deep Infiltrating Endometriosis
By Özge Özkaya
Cleansing the colon before an ultrasound makes it easier to detect rectal nodules of deep infiltrating endometriosis, found a study published in the Journal of Minimally Invasive Gynecology. Cleansing the colon before a surgery is called bowel preparation and is…
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Detection of Uterine Malformations and its Link to Endometriosis
By Kasthuri Nair
Dr. Abd El Fattah recently published a research article titled “Uterine Cavity Abnormalities in Patients with Endometriosis in Alexandria: A Diagnostic Test Accuracy Study” in Obstetrics and Gynecology International that delineated and presented the results of his study. The study has two…
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Mutations Associated with Cancer Were Identified in "Endometriosis without Cancer"
By Özge Özkaya
Lesions in deep infiltrating endometriosis harbor genetic mutations that are associated with cancer, found a study published in the New England Journal of Medicine. The authors believe that this new discovery may help to distinguish between aggressive and non-aggressive forms of…
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Ultrasound Ablation to Treat Endometriosis
By Murat Osman
Further Understanding: Deeply infiltrating endometriosis (DIE) often presents in the rectosigmoid colon in women with endometriosis and can be the major cause of gastrointestinal and pelvic symptoms. This preliminary study focuses on the utility of High-Intensity Focused Ultrasound (HIFU) in…
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