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.

Predictors for achieving pregnancy in patients with adenomyosis and endometriosis

Adenomyosis and endometriosis are benign conditions, however, both situations are associated with deterioration of life quality, a requirement of hospital administrations, and infertility. Laparoscopic surgery is the main treatment option especially for women who desire pregnancy. Shi and colleagues aimed to clarify possible factors for achieving successful birth following laparoscopic surgery in patients with coexisting adenomyosis and endometriosis. The authors divided patients into two groups according to achieving successful birth; and found that the patients who had successful delivery following…

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Ultrasonographic signs of adenomyosis, surgery and infertility in endometriosis patients

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 study, Dr. Eisenberg group investigated the differences of transvaginal ultrasonographic findings of patients for coexisting adenomyosis in endometriosis patients who underwent conservative management and laparoscopic surgery, and predictive factors for infertility. The results were recently published in the "Journal of…

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Women reject using hormonal drugs for endometriosis, an accelerating need for nonhormonal medications

Although the pathophysiology of endometriosis is poorly understood, endocrine drugs are widely used for reducing inflammation and patients’ symptoms. Burla and colleagues aimed to evaluate the patients’ thoughts and expectations about the endocrine drugs which are used in the treatment of endometriosis and analyzed a total of 1420 patients’ answers to their survey. Results showed that 57.5% of patients with endometriosis currently using hormonally active drugs to treat endometriosis and combined oral contraceptives (80%) were the most common among them.…

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Patient- centeredness in endometriosis

Endometriosis is common in fertile age, and women with endometriosis are suffering from serious symptoms including pelvic discomfort, dysmenorrhea, and infertility. Due to resemblances of endometriosis symptoms with other diseases, most endometriosis patients are faced with delays in diagnosis. To solve these problems, patient-centered modality is accepted and questionnaires were formed to understand endometriosis better. The ENDOCARE questionnaire was previously described and validated to understand endometriosis patients’ characteristics, but the Swedish version of it has not been validated yet. Grundström and…

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Vulvo- Perineal Endometriosis: From diagnosis to treatment

Vulvo- Perineal endometriosis is a very rare condition that should be kept in mind to be diagnosed and treated. Due to its very rare occurrence, most of the information in the literature on vulvo-perineal endometriosis is based on case reports and studies with a small number of patients. Miallard and colleagues reviewed 90 articles including 83 case reports and seven retrospective studies, reporting a total of 283 patients.  Authors concluded that 95.3% of patients with vulvo-perineal endometriosis had a history…

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The effect of COVID-19 pandemic on patients with endometriosis

COVID-19 pandemic and related conditions, including transport restrictions, social isolation, and difficulties accessing the professional health system, affected many women’s healthcare and daily routine. Evans and colleagues investigated the impact of COVID-19 and COVID-19 related parameters on endometriosis patients’ health situation and their daily functioning. Patients who participated in a previous study via e-mail in 2019, invited to participate in the present study, and the study link was sent via email for the 12-month survey in June 2020. The authors…

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Endometriosis alters women’s self-behavior

Endometriosis diagnosis is given to almost 15% of women of reproductive age. Although endometriosis could be asymptomatic, many women with endometriosis are faced with several symptoms including chronic pelvic pain, dysmenorrhea, dyspareunia, dyschezia, dysuria, and infertility. The wide variability of symptoms resulting in delayed diagnosis and optimal treatment deteriorate patients’ quality of life. To investigate the effect of endometriosis on womens’ behavior, Estes and colleagues, reviewed the database of Clinformatics® Data Mart (Optum, Inc. Eden Prairie, Minnesota) which includes almost…

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Which is the best for ovarian reserve preservation? Hemostatic agent or coagulation?

The way of ovarian parenchymal bed hemostasis following ovarian cystectomy is crucial for ovarian reserve protection, and discussions about different techniques on this issue are ongoing. Multiport laparoscopic surgery is the standard method for ovarian surgeries, but laparoendoscopic single-site cystectomy became popular in the treatment of benign ovarian conditions. Studies which evaluated the impact of different hemostasis technique on ovarian reserve following laparoendoscopic single-site ovarian cystectomy were limited. Park and colleagues used coagulation and hemostatic agent during the laparoendoscopic single-site ovarian cystectomy procedure,…

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The endless burden: sexual dysfunction and endometriosis

The relationship between endometriosis and sexual health in women is one of the hottest topics in obstetrics and gynecology practice. There are some previous reports that investigated the effect of endometriosis on the loss of libido, arousal disorder, orgasmic dysfunction, sexual pain, and sexual health quality. However, the number of studies focusing on the relation between endometriosis and sexual dysfunction is limited, and most of the studies did not use validated form to evaluate the sexual health of women. Yang and…

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Endometriosis in intestine! Segmental resection or linear nodulectomy?

Intestinal involvement of endometriosis is common, and the incidence was defined between 45-56%. Previous studies investigating the role of surgery in the management of intestinal endometriosis reported improvement of life quality in up to 95% of cases following surgery. However, it is not known exactly which surgery, namely shaving, mucosal skinning, linear nodulectomy, segmental resection, should be performed on which patients. Dr. Abdalla- Ribeiro, and colleagues from the Department of Obstetrics and Gynecology of Santa Casa de Misericordia, São Paulo,…

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A gentle touch on nerves affects dyspareunia

Endometriosis is a common disorder among women. Previous studies reported endometriosis-related deterioration of the quality of life. Deep dyspareunia is a common symptom of endometriosis and young patients face dyspareunia twice as much. Surgical treatments are alternative to medical therapies in cases of no benefit. Crispi and colleagues investigated the role of laparoscopic nerve-sparing endometriosis surgery on dyspareunia in 126 women. Authors divided patients into two groups according to dyspareunia,  ≤ 3 (none or mild dyspareunia) and > 3 (moderate or severe dyspareunia),…

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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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