Irem Onur, MD

Dr. Onur is an associate professor of pathology with subspecialty certification in cytopathology in Turkey. She is deeply interested in medical writing and conveying the latest scientific information to medical professionals as well as the public.

Exploring Pelvic Pain: Deep to Ischial Spine Including Pre-Sacral Roots - A. Taner Usta, MD

Chronic pelvic pain is defined as pain in the pelvic area that lasts for 6 months or longer and results in functional or psychological disability or requires intervention and treatment by the American College of Obstetrics and Gynecologists. There are many etiological factors of pelvic pain related to pelvic nerves including blunt trauma, surgery, obstetrical, endometriosis, vascular nerve entrapment, and fibrosis. In his speech in Endofound 2020, Dr. Taner Usta, MD, a professor in the Department of Obstetrics and Gynecology…

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Endometriosis involving the Sacral Plexus and Sciatic Nerve

Endometriosis rarely involves the sacral and sciatic nerves. A retrospective analysis led by Rouen University Hospital, France and Aarhus University Hospital, Denmark, published in the Journal of Minimally Invasive Gynecology, has evaluated preoperative complaints, intraoperative findings, surgical procedures, and postoperative outcomes in patients managed for deep endometriosis involving the sacral plexus and sciatic nerve. The study, which used data from 49 women with deep endometriosis involving the sacral roots and 3 women with deep endometriosis involving the sciatic nerve, revealed…

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Adolescent endometriosis: Diagnostic clues?

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 team led by Dr. Martire analyzed 227 young women who underwent pelvic ultrasound examination. They examined the ultrasonographic presence of different forms of endometriosis and the associated clinical endometriosis symptoms. In the current study, the median age of the participants…

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Magnetic resonance imaging classification for the management of deep pelvic endometriosis

A new study published in the journal "Human Reproduction" reported that operating time, hospital stay, and postoperative complications in patients who underwent surgery for deep endometriosis can be predicted by the MRI. This result may be useful for clinicians to preoperatively inform a patient about the risks of surgery. A team of researchers, from Paris, France, analyzed data from 150 women with deep endometriosis on MRI and who subsequently underwent surgery between 01 January 2017 and 31 December 2018. Researchers…

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Dyspareunia and Endometriosis

Women experience severe pain during intercourse related to endometriosis and this has a significant negative impact on the lives of women. This is according to an American study published in the "Journal of Pain Research". The study included 638 endometriosis patients between 19–55 years old and had painful sexual intercourse within the past 2 years. The participants completed an anonymous 24-question online survey regarding experiences with dyspareunia-related pain, the effect of dyspareunia on life, and interactions with health-care practitioners. Survey…

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The intensity of pelvic pain is higher in endometriosis patients

Silva  J.B. et al., researchers from Brazil, conducted a case-control study to determine the intensity of clinical pain, the average body composition, and the anthropometric markers including the body mass index, the perimeters (waist, abdomen, hip), and the percentage of body fat in women with a clinical diagnosis of chronic pelvic pain secondary to endometriosis. They have published their study in the journal named Revista Brasileira de Ginecologia e Obstetrícia. Earlier studies suggest that the adipose tissue has immune properties…

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The advantages of combined vaginal-laparoscopic approach on voiding dysfunction for rectovaginal endometriosis

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 Journal of Visceral Surgery. Led by Dr. Roman Horace, a team of researchers from France, Australia, and Denmark conducted a retrospective comparative cohort study on 132 patients with deep rectovaginal endometriosis with vaginal infiltration measuring more than 3cm in diameter.…

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Diagnosis and treatment of endometriosis in adolescents

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 paper, written by Pirtea P. et al., and published in the journal "Fertility and Sterility". Authors state that noninvasive markers of endometriosis at the target of research are not clinically usable yet. Ovarian endometriomas and deep infiltrating endometriosis can be…

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Endometriosis prevalence among adolescents with pelvic pain

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 School of Medicine, has recently been published in Journal of Pediatric and Adolescent Gynecology. Study shows that the prevalence of endometriosis, confirmed laparoscopically or by imaging, in adolescents with pelvic pain is high. The team led by Hirsch M. evaluated 19…

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Endometriosis Impacts Transgender Adolescents

Shim J.Y. et al, from Boston, Massachusetts retrospectively searched the electronic medical records of transmasculine patients younger than 26 years old who were diagnosed with dysmenorrhea and treated at Boston Children’s Hospital, between January 1, 2000, and March 1, 2020. They reviewed the clinical characteristics, transition-related care, and treatment outcomes of the patients and have published their study in the "Journal of Pediatric and Adolescent Gynecology". Thirty-five transmasculine young people with a diagnosis of dysmenorrhea were identified. The mean age…

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Occult microscopic endometriosis in clinically negative peritoneum

Occult microscopic endometriosis may be present in approximately 39% of patients with clinically negative appearing peritoneum undergoing laparoscopy for chronic pelvic pain. This finding is presented in a study published online this month in the International Journal of Gynecology & Obstetrics. The multi-disciplinary collaborative study was led by researchers at St. Joseph’s Hospital and Medical Center in Phoenix, Arizona University of Rochester Medical Center in Rochester, New York, USA. The leading author, Gubbels et al. evaluated the prevalence of microscopic endometriosis by retrospectively analyzing…

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A hope for postoperative symptomatic endometriosis therapy

A new chapter in the treatment of symptomatic endometriosis patients may begin since new medical approaches including oral GnRH antagonists, selective progesterone receptor modulators, aromatase inhibitors, and peritoneal immune response modulators are being actively evaluated. To date, there was only one oral GnRH antagonist that was approved for use in the United States, Canada, and Israel. However, there was a necessity for a dose and duration change based on the symptoms and findings of endometriosis patients. Surrey SE., from Colorado Center…

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Is oocyte cryopreservation useful for fertility preservation in ovarian endometriosis?

Women with endometriosis tend to have lower fecundity compared to normal couples. Furthermore,  endometrioma itself may reduce the ovarian reserve by altering ovarian physiology in the surrounding healthy ovarian tissue. The treatment for endometrioma is surgical removal in most cases, however, it may ve associated with the risk of premature ovarian failure. Kim SJ et al., a group of researchers from Korea, analyzed the clinical characteristics and controlled ovarian stimulation outcomes of fertility preservation of women with endometrioma, and sub-analyzed the results…

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Fatigue from the viewpoint of patients with endometriosis

Fatigue, feeling spoonie, is documented as a significant symptom of endometriosis in many studies. Researchers from three different institutions dealing with reproductive health conducted individual interviews with patients reporting moderate to severe endometriosis-related pain to better understand endometriosis-related fatigue and its effect on patients. The study sample included 22 endometriosis patients who had a mean age of 38.6 years (range, 27-48 years). The research team found that symptoms reported by endometriosis patients were fatigue (100%), pain with periods (86.4%), heavy…

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Are endometriosis patients at higher risk of bipolar disorder?

Endometriosis patients are prone to develop certain psychiatric disorders, including depression and anxiety, as well as bipolar disorder, according to a nationwide population-based cohort study from Taiwan. Bipolar disorder formerly called manic-depression is a chronic mental disorder characterized by unusual changes in mood, energy, activity level, and ability to perform daily tasks and fatigue. Chen et al., researchers from Taiwan, investigated the risk of bipolar disorder development in women with endometriosis as well as the effect of endometriosis treatment on the…

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The efficacy of combined hormonal contraception on pelvic pain in endometriosis patients

Chronic pelvic pain, which is experienced by more than 33% of endometriosis patients, constitutes a significant challenge for patients and physicians. A new study that appears in the journal Human Reproduction Open has explored the prevalence of endometriosis patients with a history of combined hormonal contraception (CHC) ineffectiveness for pain or discontinuation due to side-effects. The researchers have also determined the association between CHC ineffectiveness or discontinuation due to side-effects and quality-of-life, psychological scores, and underlying pain conditions. Yong PJ et al.,…

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Long-term Pregnancy Results after Surgical Removal of Endometrioma

Sun et al., from China, investigated the pregnancy outcomes and the related factors in patients with endometrioma and stage III-IV endometriosis along with a long-term follow-up postoperatively. Their study has recently been published in the journal named "Advances in Therapy". Among 347 patients with ovarian endometriosis, 59 infertile patients with stage III-IV endometriosis who had a minimum of 5 years of postoperative follow-up after undergoing laparoscopic excision of ovarian endometriomas were included in the study. The mean age was 32…

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Kisspeptin and its Receptor in the Pathogenesis of Endometriosis

It is known that matrix metalloproteinases (MMP) may play a role in the pathogenesis of endometriosis. For example, the upregulation of MMP-2 and MMP-9 may enhance the degradation of extracellular matrix proteins, facilitating cell migration and invasion. Kisspeptin (KISS1, also known as metastin), a neuropeptide hormone, encoded by the KISS1 gene, may interact with MMPs in endometrial tissue. Abdelkareem et al. evaluated the immunoreactivity of KISS1 and its receptor in the eutopic endometrium of patients with and without endometriosis, in…

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The relationship of serum concentrations of neuropilin-1 (NRP-1) and endometriosis

Although many serum biomarkers or biomarker panels for endometriosis are evaluated, none of them is exact enough to be used in daily laboratory practice. In a recent study, which has been published in Scandinavian Journal Of Clinical and Laboratory Investigation, Barberic et al., researchers from Croatia, aimed to investigate the serum concentration of neuropilin-1 (NRP-1) in women with endometriosis and to evaluate the level of NRP-1 to preoperatively predict the diagnosis of endometriosis. NRP-1 is is a transmembrane glycoprotein that serves…

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Preoperative serum CA 125 levels predict the severity of adhesions in endometriosis

Lee Y. et al., a group of researchers from Korea evaluated the correlation between preoperative serum markers and pelvic adhesions in endometriosis patients and explored the markers’ clinical value for outcome prediction. They have recently published their study in the Journal of Gynecology Obstetrics and Human Reproduction. The researchers retrospectively reviewed the medical records of patients aged 19 to 52 years who underwent laparoscopy for histologic confirmation of endometriosis from January 2015 to December 2017. A total of 152 patients…

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