Selma Oransay, MD

Dr. ORANSAY is 35 years experienced clinician in OB/ GYN. She worked in the main national maternity educational hospital of Turkey for 20 years than she moved to İstanbul and worked in private hospitals. Her published articles are mostly on topics of menopause and infertility. She is also experienced as a voluntary OB/GYN doctor in African healthcare program.

Endometriosis and chronic opioid use

The members of the American College of Obstetricians and Gynecologists have declared that gynecologists prescribe opioids after laparoscopic hysterectomy, or for relieving endometriosis pain, although guidelines are not available for when or how to use opioids for the treatment of endometriosis-associated pain, and the data on the potential negative consequences of opioid use in the general population is rising. To identify the potential risk factors for opioid use and long-term addiction, Dr. Lamvu et al., from Orlando Veterans Affairs Medical Center,…

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Comparison of diagnostic accuracy of imaging modalities for the deep infiltrating endometriosis

The treatment of deeply infiltrated endometriosis (DIE) is usually personalized and the potential success for the available therapeutical options is dependent on early and accurate diagnosis. Laparoscopy is the gold standard for the diagnosis of DIE. Other non-invasive diagnostic methods including physical examination and imaging techniques such as Transvaginal ultrasound (TVUS), transrectal ultrasound (TRUS), and magnetic resonance imaging (MRI) have never been assessed and compared for the diagnostic accuracy for the diagnosis of DIE. Zhang et al., from the Department of…

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Patients' opinion about surgical treatment of endometriosis

Delayed diagnosis and management of endometriosis and chronic pelvic pain is a major problem in gynecologic practice. Alternatively, providers may feel reluctant to perform surgery although they are aware of treatment options and surgical timing. One possible reason for this delay could be the postoperative regret of the patient if symptom relief is not achieved. To relieve the gynecologist in this regard, Misal et al., from the Department of Gynecology, Mayo Clinic, Arizona, USA calculated the postoperative contentment of patients by…

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Indocyanine green in endometriosis surgery

Recently, indocyanine green is well studied and used safely in real-time perfusion to organs or tissues, after taking into consideration its binding capacity to the plasma proteins. The usefulness and the effectiveness of near-infrared camera guided indocyanine green is proved with its common use in colorectal surgery in case of assessing the perfusion of the bowel and visualizing the transecting line. Using indocyanine green to evaluate the peritoneal endometriosis lesions is in its infancy and no current clear indications to use for…

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The peculiarity of adolescent endometriosis

Recent studies showed the prevalence of endometriosis in adolescents with chronic cyclic or acyclic pelvic pain is about 60-70%. Moreover, all stages of endometriosis, including deeply infiltrating endometriosis can be found in this population. Gubbels et al. from the Department of Obstetrics and Gynecology, University of Rochester Medical Center, NY, USA, penned a literature review of adolescent endometriosis to indicate the importance of early diagnosis. This paper recently published in the "Obstetrical and Gynecological Survey". In this comprehensive review, the…

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Endometriosis-related obstetrical complications and their outcome

Borisova et al. from the Department of Gynecology and Obstetrics of Peoples' Friendship University, Moskow, Russia, and her colleagues from the Center of Perinatal and Reproductive Medicine of University Perugia, Italy, recently published a review of the literature data about obstetrical outcomes of pregnant women with a history of endometriosis in the "Journal of Maternal-Fetal & Neonatal Medicine".  The aim of the study is to call attention to the importance of adverse obstetrical outcomes during the pregnancy follow-up of the…

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Predictors of voiding dysfunction after surgery for deep endometriosis

While surgery for deep endometriosis provides relief and improves the quality of life in symptomatic patients for whom medical therapy has limited effect, it may also create postoperative lower urinary tract dysfunction. Moreover, postoperative voiding dysfunction could affect the quality of life as many as 20-30% of patients. If clinicians have a useful nomogram to predict the aforementioned dysfunctions preoperatively, they could better inform their patients about these postoperative risks. Vesale and Roman et al. from the Department of Obstetrics…

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Deep Endometriosis or Recto-uterine Obliteration Without Endometrioma

The diagnostic help of ultrasound is increasing by its ability to diagnose deep infiltrating and rectouterine pouch obliteration in patients who are suffering from chronic pelvic pain. Clinicians are used to evaluating the rectal and parametrial areas of the endometriotic women by transvaginal ultrasound cautiously when they primarily diagnose ovarian endometrioma. This habit could be changed if the notification can be made that there could be rectal pouch obliteration and deep invasion of endometriosis even the patient has normal ovaries.…

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Benefits of Nerve-Sparing Hysterectomy

The retroperitoneal spread of endometriosis or cancer may involve pelvic autonomic nerves situated on the lateral aspects of uterosacral ligaments, vesicouterine ligaments, and medial aspects of parametria. During the conventional open hysterectomy operations, nerve-sparing excision is very difficult, simply because pelvic autonomic nerves are thin and difficult to see to the naked eye. On the contrary, during the laparoscopic hysterectomy, high definition endoscopic camera eases to perform nerve-sparing. Magrina et al. from the Department of Medical and Surgical Gynecology, Mayo Clinic, Phoenix, USA,…

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Prevalence, Risk factors and Management of Bowel Fistula after Rectosigmoid Surgery for Deep Endometriosis

Bowel fistula is a severe complication after the colorectal endometriosis surgery, but little is known about its prevalence, and reports on large series are lacking. To discuss specific management on colorectal deep endometriosis, Roman et al. conducted a retrospective study that consists of 1102 patients who underwent colorectal surgery for deep infiltrating endometriosis in French tertiary centers from 2009 to 2019. Follow-up of patients after colorectal operation ranged 4 to 124 months since authors concerned only the fistula outcome after…

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Fallopian tubes and endometriosis

There are multiple theories to explain the pathogenesis of endometriosis, among which the most popular one is Sampson's retrograde menstruation theory. The role of endometrial stem cells/progenitors are widely studied to support the origin of ectopic lesions in recent decades. Despite the spreading of endometrial tissue into the peritoneal space through the fallopian tubes, is the key event for retrograde shedding theory; however, the contributions of Fallopian tubes to endometriosis are rarely discussed. Hill et al., from the Centre of…

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Hysterectomy as a choise of chronic pelvic pain relief in endometriotic women.

Sandstrom et al. from the Department of Obstetrics and Gynecology of Umea University, Sweden, found a significant and long-lasting reduction in pain symptoms after hysterectomy among women with confirmed endometriosis and recently published their results in "BJOG". The authors performed this prospective study on 18-45 years old 137 endometriotic women who underwent a hysterectomy in a time period of five years, from 2010 to 2015.  The follow-up questionnaire was sent to all of the participants, and the data retrieved from…

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Racial and ethnic disparities and women health

The well documented racial and ethnic disparities in Obstetrics and Gynecology in the US make available to use them as an indicator of implicit bias in giving unequal health and care service to minorities. Dr. Bryant from Massachusetts General Hospital, Boston, Massachusetts, USA, discussed the concerning inequalities of health care practices related to race/ethnicity globally and their effect on women's reproductive health in the US, in his recently updated study published in "Uptodate". The author gave examples from the literature…

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Diagnosis and treatment algorithm for endometriosis

Endometriosis is a chronic and progressive disease that affects 25-30% of women between 25-35years, clinicians commonly experience during their gynecologic practice. However, the diagnosis is still late or sometimes incorrect, and this creates severe health problems and worse outcomes. A precise strategy for early diagnosis is very important for the correct therapeutic approach to the disease. Findeklee et al., from the Department of Gynecology Obstetrics and Reproductive Medicine, Saarland University Hospital, Hamburg-Germany, noticed the failure of standardization in the current…

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Endometriosis surgery and future pregnancy complications

Endometriosis is one of the known diseases for infertility in the reproductive period of women. Several studies revealed that endometriosis itself maybe the reason for some unfavorable obstetric outcomes. Localization, the type of endometriotic lesions, and the stage of endometriosis may affect pregnancy outcomes. Maternal complications can be notified as preeclampsia, antepartum and postpartum hemorrhage, increased number of cesarian sections, spontaneous hemoperitoneum, and bowel perforation. On the other hand, fetal unfavorable outcomes are preterm birth, prematurity, small for gestational age,…

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Resveratrol for infertility: A frenemy?

Ovarian aging is defined by an age-specific decline of the functional ovarian reserve. Female ovarian reserve declines progressively with increasing chronological age. Chronic damage by reactive oxygen species results in deterioration and aging through mitochondrial dysfunction, telomere shortening, cohesion dysfunction, and spindle instability known as "genetic and environmental factors". To slow down this procedure, a natural compound, "Resveratrol" can be used based on its anti-aging, anti-inflammatory, antioxidant, anti-neoplastic, cardioprotective, vasodilatation, and insulin-sensitizing effects. Despite the beneficial effects of Resveratrol on…

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Appendiceal endometriosis

Jeong et al. from the Departement of Surgery, Trinity School of Medicine, Saint Vincent, recently published their interesting appendectomy case in "Hong Kong Medical Journal". In their case, endometriosis inside the cavity of the appendix mimicked appendicitis, the patient submitted with right lower abdominal crampy pain. At the same time, she had nausea, vomiting, headache, constipation, dizziness, and menorrhagia. In her anamnesis, she told that generally, these symptoms occur when she menstruates, but this time it is particularly severe. The…

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Surgical approach to rectovaginal endometriosis.

Recto-vaginal endometriosis incidence is estimated at 3.8%-37% among women with endometriosis and when it exists it's a part of deeply infiltrated endometriosis, thus advance stage endometriosis. Raimondo et al. from the Department of Obstetrics and Gynecology of the University of Bologna, Italy, aimed to compare the feasibility and safety of total laparoscopy to vaginal assisted surgery in recto-vaginal endometriosis patients and their article is recently published in Acta Obstetricia et Gynecologica Scandinavica. 84 women with recto-vaginal endometriosis were included in…

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Fertility conservation in women with endometriosis

Endometriosis affects 10-15% of women in their reproductive period and almost half of them may need Assisted Reproductive techniques to conceive. Moreover, increased malignancy risk is threatening the women with severe endometriosis in addition to their decreased ovarian reserve. Due to all these reasons, fertility preservation with ovarian tissue cryopreservation need is rising and becoming a common interest. Lantsberg et al., from the Department of Obstetrics Gynecology of Monash University, Australia, recently published a literature review to reveal the methods…

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The Relationship Between Dyspareunia and Infertility in Endometriosis

Wahl et al. from the Center of Pelvic Pain and Endometriosis British Columbia Women's Hospital, Vancouver, Canada studied with endometriotic patients suffering from dyspareunia who were referred to their center and built a cross-sectional study to investigate the relations between dyspareunia symptoms with infertility. Their results were published recently in "Sexual Medicine". The authors hypothesized that both deep dyspareunia and superficial dyspareunia would be independently associated with infertility concerns among women with endometriosis. However, only superficial dyspareunia found to be…

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