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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By Özge ÖzkayaIntegrating 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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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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By Nasuhi Engin AydinRecommendations 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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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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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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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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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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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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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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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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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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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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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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“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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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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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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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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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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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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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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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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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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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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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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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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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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By Kasthuri NairDifficulties 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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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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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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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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