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.

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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The prevalence and severity of endometriosis today

Ghiasi M. et al., a group of researchers from the USA, presented a comprehensive review of the prevalence, incidence, and stage of endometriosis worldwide as reported over the past 30 years. Researchers performed a search in four databases, including PubMed, Web of Science, EMBASE, and CINAHL for relevant manuscripts.  Search terminologies were “endometriosis” AND “prevalence” or “incidence” or “epidemiology”, or “frequency”, or “occurrence”, or “statistics.” A total of 69 cross-sectional and cohort studies were included for the qualitative synthesis between…

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A nonhormonal treatment of endometriosis: Dichloroacetate

In women with endometriosis, peritoneal mesothelial cells show higher glycolysis, lower mitochondrial respiration, decreased enzymatic activity of pyruvate dehydrogenase and increased production of lactate compared to women without the disease. Transforming growth factorβ1 and lactate are elevated in the peritoneal fluid of endometriosis patients. Lactate can stimulate cell migration and invasion, and immune escape during tumorigenesis, with the same processes implicated in the etiology of endometriosis. Increased lactate concentrations in the pelvic peritoneal fluid may facilitate the invasion of ectopic…

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MRI findings predicting the need for colorectal surgical treatment of deep infiltrating endometriosis

LAY SUMMARY: Brusic A. et al., a group of researchers from Australia, conducted a retrospective study to identify the features of deep infiltrating endometriosis on MRI which have an association with colorectal surgical bowel resection. They have recently published their study in the journal named European Journal of Radiology. One-hundred twenty-two MRIs were included in the analysis. The median age at the time of MRI was 35 years. Of 122 patient MRIs, 71 experienced dyschezia, and 18 patient MRIs experienced…

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Cannabis usage among Australian women with endometriosis

Sinclair J. et al., a group of researchers from Australia, conducted a cross-sectional online survey to determine the prevalence, tolerability, and self-reported effectiveness of cannabis in women with endometriosis. This study included 484 women with complete responses. Of all women, 76% reported using a self-management strategy in the past 6 months, and 13% of these women self-reported using cannabis for endometriosis symptom management. Respondents had a median age of 30 years (25−36) and were mainly from urban areas (79% urban…

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A rigorous literature review on endometriosis

Bulun SE. et al., from Feinberg School of Medicine, Northwestern University, Chicago, conducted a rigorous literature review on endometriosis. This outstanding review by Dr. Bulun et al. addresses the definition, remarkable medical features, clinically useful research findings, prevalence and distribution, histopathology and mechanisms of endometriosis as well as key biological processes in endometriosis. In addition, it provides innovations in the clinical management of endometriosis, management of endometriosis-related infertility and advanced or future cell-based treatments including induced pluripotent stem cells. This…

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