Bahar Yuksel, MD

Bahar Yuksel graduated from Istanbul University Istanbul Medical School at the top of the class of 2010. She completed her residency in Istanbul Medical School Obstetrics and Gynecology Department by the top score Residency Board Exam. Between 2016 and 2017 she studied at Stanford School of Medicine and did research about ovarian physiology.  Her projects were funded by The Scientific And Technological Research Council Of Turkey several times. Her main interests are endometriosis and ovarian physiology. Now she has her practice in Istanbul as an Ob&Gyn , member of Turkish Endometriosis and Adenomyosis Society and works for the Endometriosis Foundation of America (EndoFound.org) as Research Associate.

Problems in the treatment of deep infiltrating endometriosis

The Deep Infiltrating Endometriosis (DIE) is very aggressive in nature with infiltrating the whole pelvic, colon, rectum, bladder, ureter, and pelvic wall. D’Alterio and colleagues analyzed the advantages and disadvantages of both medical and surgical therapies for DIE. The authors concluded that medical therapies have potential benefits in the relief of pain and DIE related symptoms, but each therapy has side effects such as abnormal uterine hemorrhage, breast pain, psychological lability and risk of deep vein thrombosis for progestogens and…

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Testosterone levels effect embryo implantation rates in patients with endometriosis

Endometriosis is associated with infertility either causing poor oocyte and embryo qualities or poor endometrial receptivity. The effect of androgen levels on IVF outcomes has been described earlier, but the present study conducted by Ling Huang et assocates is the first which examined advanced stage endometriosis patients, and is the one that a predictive cutoff value for testosterone levels has been explained. This original article entitled "Low basal serum testosterone level is detrimental to the embryo implantation in the patients with…

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Tubo-ovarian abscess and endometriosis

A tubo-ovarian abscess is the result of pelvic inflammatory disease in women and the previous reports demonstrated that almost one of the third women with a pelvic inflammatory disease had a tubo-ovarian abscess. The main treatment modalities for tubo-ovarian abscess are antibiotic regimen and surgical exploration if necessary. On the other hand, endometriosis patients have an increased risk of pelvic inflammatory disease, resulting in treatment difficulties and longer hospitalization  Studies that investigated the effect of endometriosis on the tubo-ovarian abscess…

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The effects of endometriosis on life satisfaction.

Endometriosis is well-known for its debilitating effects on women suffering from it. In the review conducted by Masoumeh Namazi et al, the authors have collected studies searching for the wellbeing of women with endometriosis. They have analyzed 46 studies that covered their inclusion criteria. Following the selection, the articles have undergone sectioning for pathogenesis, and the effects of endometriosis on the sexual, physical, physiological, and social life of women. Finally, the obstetrical outcome and related problems of the women with…

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The cause of PAIN in patients with adenomyosis

Adenomyosis is known to be a painful disease with heavy menstrual cycles and negatively affects fertility. Even adenomyosis and endometriosis look alike, it is still crucial to call them as different variation of the same disease. The mechanism underlying the pain in adenomyosis is still unknown. In the study conducted by Bingxin Yang et al, the correlation between pain, Plasminogen activator inhibitor-1 (PAI-1) and fibrosis levels in the adenomyosis lesions is evaluated. Plasminogen activator inhibitor-1 is known to have a…

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The incidence of endometriosis and pelvic pain in transgender man

Transgender operations are quite common all around the world and hysterectomies are performed almost 1 in 5 of this population. The studies conducted until now mostly evaluated operative and postoperative outcomes, but the present research also questioned the preoperative symptoms and their relationship with operative findings. Dr. Ferrando et al. from the Center for Urogynecology & Pelvic Reconstructive Surgery, S and Center for LGBT+ Care, Cleveland Clinic, analyzed a ten-year data retrospectively and examined the symptoms related to menstrual disorders and…

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Cancer risk Evaluation in Korean Endometriosis Cohort

The relationship between endometriosis and cancer has always been challenging. The previous studies revealed an increased risk in endometriosis-associated ovarian cancers regarding the alterations in cancerogenic genes or by the effect of iron and hem coming with retrograde menstruation and causing oxidative stress in the peritoneum. The study conducted by Kyung Jin Eoh analyzing the Korean population revealed as the overall cancer rate is increased in women with endometriosis, even at younger ages. The authors showed not only ovarian, uterine,…

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The role of hormonal treatment after endometriosis surgery

Postoperative hormonal suppression after endometriosis surgery still does not have a uniform approach. The meta-analysis study conducted by Zakhari et al. aimed to find a significant answer regarding this burden. They analyzed the database systems including MEDLINE, Embase, Cochrane CENTRAL, and Web of Science databases up to March 2020. They only chose randomized controlled trials or prospective studies mentioning postoperative follow-ups for at least 6 months. Finally, thirteen randomized clinical trial and 4 prospective studies out of 10 797 articles found…

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The largest series of diaphragmatic endometriosis

Diaphragmatic endometriosis is one of the most common extra pelvic endometriosis types, yet the correct incidence is unclear. In the study conducted by Ceccaroni Marcello et al from the International School of Surgical Anatomy, Verona, Italy, the authors analyzed the data of 215 patients diagnosed with DE in the last 15 years. The lesion symptomatology of all patients, pelvic staging, DE lesion types, and type of surgeries applied were evaluated. For typing,  lesions were classified as “Foci” for bidimensional superficial…

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Is hemoglobin the immune trigger of endometriosis?

The role of inflammatory cells in endometriosis has been a popular subject. However, the effects of blood inside the endometriomas were not clarified yet. The study conducted by Kusunoki et al. and published in the "Medical Molecular Morphology" journal has focused on investigating the effects of hemoglobin on the macrophage-induced inflammatory environment of endometriotic cyst, the distribution of immune cells in the endometriotic cyst wall, and the role of Hb induced macrophage-activation in endometriotic cysts. The endometrioma cyst walls and the…

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The recurrence risk of endometrioma in older age

Ovarian endometrioma is more common in reproductive ages and the recurrence rate is around 20 percent in the first 2 years after the initial surgery. The use of postoperative hormonal therapy is a mutual option to decrease recurrences. The rate of recurrence for women older than 40 years is not well studied. The effect of hormonal therapy to prevent recurrence may be important in this age because of the high comorbidity of those women and the probable contraindication of using…

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Does hysterectomy bring a total relief in patients with endometriosis?

There is a common belief that hysterectomy is the last option to relieve the pain in patients with endometriosis by stopping the production of menstrual material. The study entitled "Impact of hysterectomy on analgesic, psychoactive and neuroactive drug use in women with endometriosis, national cohort study" conducted in Sweden using a nation-wide surgery and drug use follow up system claimed it otherwise. The authors led by Dr.Brunes collected the data of patients who had a hysterectomy for benign diseases and selected…

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Endometrial fluid analysis as a new diagnostic test for endometriosis diagnosis

There is still a huge demand for finding a minimally invasive diagnostic test for endometriosis and yet none has been defined properly. The present study which was conducted in Cleveland Clinic by Natalia C. Llarena et al between March 2017 and October 2018 searched for the answer to this ever-going question and analyzed the cytokine profile for endometrial aspirates. The authors analyzed 60 patients including healthy controls and endometriosis patients while excluding any patients who have reasons for the potentially…

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Can a grape ingredient, resveratrol, be the promised warrior to defeat endometriosis?

Endometriosis is a chronic estrogen-dependent disorder and has a known relationship with angiogenesis, inflammation, and oxidative stress. Resveratrol is a part of a "polyphenol" compound which are thought to act like antioxidants, protects the body against damage. This compound is normally found in the skin of red grapes, but you can also find it in peanuts and berries. In a recent study conducted by Khazei et al. a phytoestrogen called Resveratrol which has anti-inflammatory, anti-estrogenic, anti-angiogenic, and antioxidant effects has been…

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Fallopian tube endometriosis

Endometriosis affects various tissues including pelvic and extra-pelvic organs. Fallopian tube endometriosis is not a widely studied topic in endometriosis, hence the real incidence is unknown as not all studies evaluate microscopically diagnosed Fallopian tube endometriosis. In the retrospective database study conducted by McGuinness and Farr Nezhad et al, the investigators sought to find the answers for the real incidence of tubal endometriosis. They analyzed the operative data of patients who underwent surgery for suspected endometriosis, and also evaluated the results…

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The more than expected prevalence of endometriosis in patients with Mullerian abnormalities

Congenital müllerian anomalies resulting in a spectrum of uterine abnormalities are caused by the abnormal embryologic fusion of the müllerian ducts to form a normal uterine cavity.  They are often unrecognized because they are usually asymptomatic. The presence of a uterine anomaly increases the risk of pregnancy loss and adverse pregnancy outcomes. The classification of uterine anomalies by American Fertility Society classification includes hypoplasia/agenesis, unicornuate, didelphys, bicornuate, septate, arcuate, and diethylstilbestrol-related. The prevalence of uterine malformations is up to 38 percent…

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Mental stress promotes mice endometriosis

Endometriosis is a disease for which pathogenesis and progression are not fully understood. Inflammation is one of the key candidates that might be related to the creation or progression of endometriosis. In the study conducted by Kawakita et al from Japan, the relation of mental stress on endometriosis distribution and the inflammatory reaction was examined. The authors created a mouse model and exposed one group to mental stress, and checked the presence of stress by daily controlled serum cortisol levels.…

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Reproductive capacity and recurrence rate after surgery for Stage III/IV endometriosis 

If gaining fertility back is the main goal, the surgical removal of endometriosis lesions is globally recognized as first-line therapy. Even though, pre- and postoperative hormone therapy leads to a significant decrease in the spread of the disease measured with the revised ASRM scores it is not an option for fertility preservation. In the study conducted in Hannover Medical School, the authors aimed to establish postoperative recurrence and pregnancy rates in patients after surgical resection of moderate and severe endometriosis lesions (rASRM stage…

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