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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Superiority of hysterectomy over lesion excision in the treatment of rectovaginal endometriosis
By Selma Oransay
Confirmative treatment of endometriosis includes excision or ablation of visible lesions while conserving the uterus and ovaries. On the contrary, the radical approach involves total hysterectomy and even bilateral oophorectomy to create a hypo-estrogen state, remove adenomyosis if it exists,…
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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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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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Painful Sex Might Be a Valid Indication for Endometriosis Surgery
By Özge Özkaya
According to a new study published in the Journal of Minimally Invasive Gynecology, the type of endometriosis surgery, and pain improvement after surgery may be linked. More precisely, rectovaginal endometriosis surgery may be associated with reduced dyspareunia or painful intercourse. “Clinicians…
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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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"Transumblical single-port laparoscopy" for deep infiltrating endometriosis.
By Selma Oransay
Deep infiltrating endometriosis patients have multi-system involvements, severe pelvic adhesions, and pelvic pain. Dyspareunia, dysmenorrhea, infertility, gastrointestinal symptoms, and lower urinary tract symptoms seriously affect their quality of life. Although hormonal therapy may be the first choice for treating endometriosis,…
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Which surgery for deep endometriosis? Laparoscopic shaving or rectal resection?
By Selma Oransay
This keynote lecture entitled "Deep endometriosis: The place of laparoscopic shaving" was presented by Dr. Jacques Donnez, the director of the infertility research unit at the Catholic University of Louvain, Brussels, Belgium, at the Annual International Medical Conference of the Endometriosis Foundation…
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Is there any advantage of addition of hysterectomy on deep endometriotic pelvic pain or on the quality of life?
By Selma Oransay
The addition of hysterectomy and salpingo-oophorectomy to the endometriosis excision surgery provided greater benefits when compared to excision surgery alone, according to the results of a comparison study that was recently published in the journal named "Facts Views and Visions in Obstetrics…
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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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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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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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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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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 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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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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Does Delivery Mode Affect the Ovarian Reserve?
By Selma Oransay
Mohr-Sasson et al. from Sheba Medical Center, Israel, performed a prospective case-control study to assess whether ovarian reserve decreases after cesarian delivery. The study included only women with singleton pregnancies and the change in ovarian reserve after vaginal or cesarian…
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The added value of transvaginal hydro-laparoscopy for infertile women
By Selma Oransay
The added value of invasive diagnostic laparoscopy has been questioned, postponed by the increased usage of ultrasonography for the evaluation of infertile patients. Gordts et al. from Life Expert Center, Leuven, Belgium have been working on an alternative way called "transvaginal hydro-laparoscopy" to…
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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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Technical Facts for the Prevention of Complications After Deep Endometriosis Surgery
By Özge Özkaya
There are no differences in the risk of rectovaginal fistula in women with rectovaginal endometriosis who were managed by a liberal or restrictive policy of preventive stoma according to a study by French researchers published in the Journal of Minimally…
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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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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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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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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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By Irem OnurThe advantages of combined vaginal-laparoscopic approach on voiding dysfunction for rectovaginal endometriosis
By Irem Onur
The patients with rectovaginal endometriotic nodules with extensive vaginal infiltration who are managed combined vaginal-laparoscopic approach have a lower risk of postoperative bladder dysfunction when compared to surgery via laparoscopy alone. This is according to a manuscript published in the…
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Prevalence, Risk factors and Management of Bowel Fistula after Rectosigmoid Surgery for Deep Endometriosis
By Selma Oransay
Bowel fistula is a severe complication after the colorectal endometriosis surgery, but little is known about its prevalence, and reports on large series are lacking. To discuss specific management on colorectal deep endometriosis, Roman et al. conducted a retrospective study…
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By Timur SeckinTransvaginal sonography for predicting the distance between rectosigmoid endometriosis and the anal verge
By Timur Seckin
For optimal surgery, pre-surgical assessment of the distance between rectosigmoid deep endometriosis lesions and the anal verge (Lesion to Anal Verge Distance-LAVD) is recommended by many specialists. A group of researchers from Norway, Austria, and Australia studied the accuracy of…
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Surgical approach to rectovaginal endometriosis.
By Selma Oransay
Recto-vaginal endometriosis incidence is estimated at 3.8%-37% among women with endometriosis and when it exists it's a part of deeply infiltrated endometriosis, thus advance stage endometriosis. Raimondo et al. from the Department of Obstetrics and Gynecology of the University of…
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Cycle-related gastrointestinal complaints in reproductive age young women
By Timur Seckin
An analysis of 1-year data on 266 patients who presented to the Clinic and Polyclinic for Gynecology and Reproductive Medicine at Jena University Hospital to undergo surgery for endometriosis and its symptoms was performed by Nicolaous K. et al., a…
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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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By Murat OsmanTransvaginal 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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How Long Does it Take to Be Diagnosed with Endometriosis?
By Özge Özkaya
It takes a median of eight years to reach a diagnosis of endometriosis from when the symptoms of the condition first appear confirmed a new British study. Interestingly, it seems that the earlier the symptoms appear, the later the disease…
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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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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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The pain and its severity in deeply infiltrating endometriosis patients
By Selma Oransay
Liang et al. from the Department of Obstetrics and Gynecology of the First Affiliated Hospital of Sun Yat-sen University, China, recently published an interesting paper in the Journal of Pain Research, a prospective study to reveal the relationship between neurogenesis and other potential…
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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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By Hale Goksever CelikThree 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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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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Should I Have Surgery Before Trying to Conceive?
By Özge Özkaya
The presence of rectouterine nodules is associated with a lower chance of becoming pregnant with in vitro fertilization (IVF), according to a study published in the Journal of Gynecology Obstetrics and Human Reproduction. This finding is important as it can…
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The vaginal delivery rate of singleton term pregnancies still remains the same after total deep infiltrating endometrosis excisions
By Selma Oransay
This recently published report in the Journal of Fertility Sterility is planned as a matched case-control study, by Nirgianakanis et al. from the University of Bern, Switzerland. Authors claimed their study is the first because previous studies on pregnancy outcome after laparoscopic…
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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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Fluorescence Guided Surgery: a New Technique to Treat Deep Infiltrating Endometriosis
By Özge Özkaya
Fluorescence-guided surgery could help differentiate recto-vaginal deep infiltrating endometriosis nodules (RVDIEN) from healthy rectal tissue and remove them successfully without perforating the rectum, according to a study published in the scientific journal Surgical Innovation. The method could offer a better,…
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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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Personalised Medicine for Endometriosis?
By Özge Özkaya
The lining of the uterus of women with endometriosis is different from that of women without the disease even if they have chronic pelvic pain found a study published in the scientific journal Biology of Reproduction. The difference is found…
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By Deniz KocasCoping with vulvovaginal pain in intimate situations
By Deniz Kocas
Chronic vulvovaginal pain has a serious impact on women’s lives, affecting daily activities including sexual activities. Avoiding sexual activity has been shown to be a central coping strategy in other pain populations and has also been seen in women with…
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By Kasthuri NairWhich Endometriosis Treatment is Better: NETA or Extended-cycle OC (Seasonique®)?
By Kasthuri Nair
Scala et al. recently shared the findings of their patient preference prospective study in a journal article titled “Norethindrone acetate versus extended-cycle oral contraceptive (Seasonique®) in the treatment of endometriosis symptoms: A prospective open-label comparative study,” which was published in the…
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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: "Endometriosis: hormonal or surgical? My reality!" Presentation by Dr. Harry Reich
By Kasthuri Nair
Dr. Harry Reich, the Former Director of Advanced Laparoscopic Surgery at Columbia University Department of OBGYN, was the last speaker in the Mission and History part of the EFA 2017 Medical Conference. His presentation was titled “Endometriosis: hormonal or surgical?…
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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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The Benefits of Vaginal Administration of Drugs
By Kasthuri Nair
There are numerous methods of drug administration used by healthcare providers today. Buggio and colleagues suggest the vagina as another avenue for delivery. They recently published a paper titled "Per vaginam" topical use of hormonal drugs in women with symptomatic…
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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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