Murat Osman

Senior Research Columnist: Murat Osman is a MD candidate at The George Washington University School of Medicine and Health Sciences. His interest in research is primarily focused on Medical Oncology and Radiology. He is also focused on cultivating his passion for medical science and human health through scientific writing and advocacy.

Are there contributing factors to the co-presence of Irritable Bowel Syndrome and Endometriosis?

Recently, there has been an association between the presence of endometriosis and increased visceral and pressure hypersensitivity, chronic pelvic pain, and other pain and mood disorders. IBS is a functional bowel disorder that is characterized by recurrent abdominal pain or discomfort that improves with defecation. Using different forms of questionnaires including the Birmingham IBS scale, researchers can measure the severity of IBS symptoms. Between December 2013 and April 2015, 373 women with endometriosis were seen in a tertiary referral center…

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With so many imaging tools and modalities, which one should be used for endometriosis?

Intestinal endometriosis affects 5 to 12% of women with endometriosis and commonly presents as dyschezia, rectal bleeding, cyclic defecation pain, constipation, and diarrhea. Currently, surgical treatment includes segmental rectal resection with colorectal anastomosis, but it is often riddled with complications. Thus, identifying such lesions as early as possible may lessen the severity of post-treatment complications and disease symptoms. Transvaginal ultrasonography (TVUS), rectal endoscopic sonography (RES) and magnetic resonance imaging (MRI) can be used to detect and localize intestinal endometriosis. Transvaginal…

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Comprehensive review on the drug delivery options being used for endometriosis and uterine fibroids.

Both endometriosis and uterine fibroids (uterine leiomyomas) contribute to infertility, chronic pain, and dysmenorrhea across the world. Thus, drug delivery methods ranging from contraceptives to biochemical systems based on nanotechnology are currently being used and developed. Specifically, long-acting implantable contraceptives that release selective progesterone receptor modulators (SPRMs), androgens, aromatase inhibitors, gonadotropin-releasing hormone (GnRH) agonists, and immunomodulators are potential options.  The recently published review article in the journal Drug Delivery and Translational Research, entitled "Drug delivery for the treatment of endometriosis…

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Women with endometriosis are increasingly seeking alternative medical therapies for symptom relief

Cyclic premenstrual pain and discomfort (CPPD) encompasses a number of symptoms commonly experienced by many women including premenstrual syndrome (PMS) and is experienced by both women with and without endometriosis. CPPD includes physical and emotional symptoms associated with menstruation including anxiety, depression, bloating, headache, cramping, and breast tenderness. Thus, almost all women have or will experience at least one of these associated symptoms during their lifetime. Some women have found a benefit in using alternative therapies to alleviate some of…

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First-line surgery followed by ART versus ART alone among women with colon-involving endometriosis.

Endometriosis, a disease characterized by the presence of endometrial tissue outside the uterus, may cause pelvic and gynecologic complications that affect fertility in women of reproductive age. Several forms of endometriosis have been observed that are characterized by the varying anatomic spreading of endometriotic lesions. One classification, deep infiltrating endometriosis (DIE), is marked by highly invasive endometriotic lesions to the outer portion of the pelvis and may include the colon. The aim of this study was to examine the correlation…

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Severe Dyspareunia is Related with "Cul-de-sac" and "Uterosacral Ligament" Endometriosis

Endometriosis and especially deep infiltrating endometriosis has been associated with an increased risk of severe dyspareunia. Studies reporting the anatomical sites associated with deep dyspareunia and the severity of pain, and the risk factors of these anatomic sites are incongruent; thus need to be confirmed. In this study, published in the scientific journal "Sexual Medicine", 548 women with either currently diagnosed endometriosis, no confirmed presence of endometriosis, or suspected endometriosis were included. For each patient, the bladder, pelvic floor, cervix,…

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Special considerations for the evaluation of Endometriosis on MRI

Pelvic endometriosis may involve either superficial peritoneal or ovarian tissues or may spread to the organs and ligaments of the pelvis in what is known as deeply infiltrating endometriosis (DIE). According to the size and location of these lesions, patients can experience mild discomfort to excruciating pain. Accurate evaluation of endometriotic lesions can only be achieved by knowing the anatomy of each organ and its intimate structural relations. Visualizing and characterizing these lesions in the least invasive and accurate manner…

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Retinoic Acid Signaling Involved in Endometrial Decidualization

Decidualization occurs in the eutopic endometrium during the luteal phase and is controlled by signaling pathways such as cyclic adenosine monophosphate (cAMP) and progesterone. Researchers from the Northwestern University School of Medicine reported in their recent paper entitled "Altered Retinoid Signaling Compromises Decidualization in Endometriotic Stromal Cells" which appeared in the scientific journal Reproduction, that they found significant differences in the uptake, metabolism, and action of the retinoic acid pathway. Many IVF clinics have observed that women with endometriosis have reduced…

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Cryoablation to Treat Abdominal Wall Endometriosis

Endometriosis of the abdominal wall (AWE) is often painful and requires hormone therapy or surgery for clinical management. Thus, non-invasive treatment options to help reduce pain and the progression of these lesions will help patients who suffer from this disease. This article presents researchers’ experiences using image-guided cryoablation to treat superficial abdominal wall endometriosis in 3 patients. Three patients from the Rhode Island Hospital underwent ultrasound and CT-guided cryoablation from 2015 to 2016. Cryoablation is a procedure whereby a mass…

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T-Cell Dysfunction May Worsen Endometriosis

Researchers from the Kyoto Prefectural University of Medicine, Japan, have found that T regulatory lymphocytes (Treg) may be the reason for the formation of the chronic inflammatory environment involved in endometriosis, a study published in The Journal of Clinical Endocrinology & Metabolism. Tissue samples were surgically collected from 55 women with (27patients) or without (28patients) endometriosis and included ovarian endometrioma, endometrium, peritoneal fluid, and peripheral blood. Using flow cytometry and other molecular methods, researchers compared the immunologic profile of three different…

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Characteristics of endometriosis in adolescents and young girls

Endometriosis is not an uncommon disease. Even among adolescent girls and young women, endometriosis may cause severe symptoms and lead to complications. Understanding the clinical variability of endometriosis in younger and older patients may lead to insight on the risk factors involved in the development of this disease. 900 women with surgically and histologically proven endometriosis were included in the study. Out of 900 women, two clinical groups were made based on age. Group 1 consisted of adolescent girls between…

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Could the cell surface protein "EWI-2" be the new diagnostic marker for endometriosis?

Further Understanding: Researchers from the Reproductive Medicine Center of Wuhan University sought to observe the differential expression of EWI-2, (a cell surface protein and an early activation marker, also known as IGSF8 - Immunoglobulin superfamily member 8) in 145 women affected by endometriosis through their normal and ectopic endometrium (endometriosis). Additionally, they compared the EWI-2 levels in varying phases of the menstrual cycle. The researchers aimed to understand if the levels of this gene could be used as a predictive…

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Endometriosis as a Barrier to Fertility

Some of the articles in the from the journal "Acta Obstetricia et Gynecologica Scandinavica (AOGS) issue are discussed in further detail below: Pain caused by endometriosis has been seen to significantly impact women's physical, psychosocial, and sexual health. Although endometriosis has been documented and theorized since the early 20th century, the current understanding of its pathophysiology and molecular triggers is limited. In this issue of AOGS (Acta Obstetricia et Gynecologica Scandinavica), the emphasis is placed on studies that aim to elucidate the…

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Does laparoscopic excision or laparoscopic ablation offer the best long-term pain relief from endometriosis?

This systematic and meta-analysis of several studies aimed to compile data regarding the reduction of dysmenorrhea (menstrual pain), dyschezia (difficult defecation), dyspareunia (painful sexual intercourse), chronic pelvic pain and Endometriosis Health Profile (EHP-30) score 2-12 months after treatment. Visual analog scale (VAS) and Endometriosis Health Profile 30 (EHP-30) methods were used to assess post-treatment effects and outcomes. EHP-30 is a self-report questionnaire used in the clinical practice to assess endometriosis-related symptoms and quality of life. Pooling of the results from 2 studies…

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Ultrasound Ablation to Treat Endometriosis

Further Understanding: Deeply infiltrating endometriosis (DIE) often presents in the rectosigmoid colon in women with endometriosis and can be the major cause of gastrointestinal and pelvic symptoms. This preliminary study focuses on the utility of High-Intensity Focused Ultrasound (HIFU) in the treatment of these lesions as opposed to surgery. HIFU is an ablative procedure that relies on the magnification of acoustic waves to damage target tissues through thermal energy. Since this technology is relatively new, advanced expertise in the use…

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Complexity of Urinary Tract Endometriosis: Highlights from a Review

Understanding the Clinical Complexity of Urinary Tract Endometriosis: Highlights from a Review While endometriosis predominantly affects the pelvic reproductive organs, spread to the urinary tract has also been observed and requires a different subset of surgical techniques for treatment. Accurate assessment and evaluation of the extent and location of these urinary tract lesions are critical to prevent further progression of the disease. In a recently published review paper in NatureReviews Urology, Nazhat et al. offer a summary of the recent…

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