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Introduction: This study aimed to evaluate pain symptoms, functional outcomes, and quality of life (QoL) before and after surgery for rectosigmoid endometriosis. Methods: We conducted a retrospective cohort study on patients who underwent laparoscopic segmental resection, discoid resection, or shaving for DIE in a tertiary referral hospital. Pre- and postoperative data based on surgical records and questionnaires covering bowel, urinary function, and QoL were collected. Visual Analogue Scale (VAS), Constipation Severity Scale (CSS), Overactive Bladder-Validated 8-questionnaire Screener (OAB-V8), and 36-item Short Form Health Survey (SF-36) were used as scales. Results: All measures of QoL except mental health were improved at three months after surgery. The median Visual Analogue Scale (VAS) pain score significantly decreased three months after surgery (p<0.001). Women surgically treated had significantly improved results on the Constipation Severity Scale (p<0.001). Overall Overactive Bladder-Validated 8-questionnaire Screener scores did not show any significant change after surgery when compared to the preoperative scores (p<0.001). There were few complications associated with surgery for rectosigmoid endometriosis. Discussion and Conclusion: Surgery for rectosigmoid endometriosis results in improvements in all aspects of pain and bowel functions three months after surgery. A significant and clinically relevant improvement in QoL, except for mental health, was observed three months after surgery. [ABSTRACT FROM AUTHOR]

Introduction: Cesarean scar endometriosis is a rare form of extra-pelvic endometriosis. The aim of the study was to investigate the clinical and surgical outcomes of patients with cesarean scar endometriosis. Methods: We collected the clinical, surgical, and follow-up data of patients diagnosed with cesarean scar endometriosis who attended Kartal Lütfi Kırdar Research and Training Hospital, Istanbul, from April 2019 to May 2022. Results: There were 34 patients with a median age of 32.5 (range: 26-45). All cesarean scar endometriosis was located in the corners of the Pfannenstiel incision: 18 (52.9%) on the left and 16 (47.1%) on the right corners, respectively. Follow-up examination over 32 months revealed that five patients had a recurrence. The median volume of the CSE was 2467.51 mm³ (range: 635.97-56013.3). The mean size on ultrasonography was 26.1 mm. There was a significant improvement in the postoperative VAS scores for dysmenorrhea, non-cyclic pelvic pain, and dyspareunia. Discussion and Conclusion: This study indicates that surgical excision is the preferred and effective treatment. Postoperative VAS scores for dyspareunia, dysmenorrhea, and non-cyclic pelvic pain were dramatically decreased after surgical treatment. [ABSTRACT FROM AUTHOR]

Background: Endometriosis is an estrogen‐dependent, chronic inflammatory disease that affects 10% of women during the reproductive ages. Despite the estimated 50% heritability for the condition, only 26% was associated with common genetic variants. Thus, necessity of identifying rare variants for the missing heritability is implicated in the literature. Therefore, our study aimed to identify novel rare genetic variants involved in the pathogenesis of endometriosis utilizing a family of multiple affected members. Methods: A family composed of four affected women along with their two unaffected mothers were recruited at a single gynecology and infertility clinic specialized in endometriosis. All patients presented with endometriomas, which was visualized by transvaginal ultrasonography. Two affected individuals had received laparoscopic endometrioma excision and therefore were diagnosed with recurrent disease. One mother had a history of endometrial serous adenocarcinoma (ESC) for which she underwent hysterectomy with bilateral oophorectomy. Three endometriosis cases were whole exome sequenced on Illumina NextSeq 550 platform with an average of 90% coverage. Candidate genes were confirmed by Sanger sequencing and followed‐up with family segregation. Results: Novel rare variants were identified in TNFRSF1B (NM_001066.3: c.1072G>A, p.(Ala358Thr)) and GEN1 (NM_001130009.3: c.1574C>T, p.(Ser525Leu)) as possible genetic causes of endometriosis. A third novel rare variant was identified in CRABP1 (NM_004378.3:c.54G>C, p.(Glu18Asp)) only on the mother with ESC history and her daughters. Conclusion: Novel candidate genetic variants that might contribute to endometriosis were suggested that need replication through independent cohorts or validation by functional studies. The family has also received genetic counseling and that the affected daughters are on clinical follow‐up, accordingly. [ABSTRACT FROM AUTHOR]

Objective: Leiomyomas are the most common tumors of the female pelvis and uterus. Surgical excision of leiomyomas is still the most accepted treatment. This surgery can be done by laparotomy (LT) or minimally invasive approach. It is known that laparoscopy (LS) is superior to LT in terms of bleeding, postoperative pain control, and fast recovery. This study aims to report a 7-year single-center experience of patients who underwent myomectomy. Materials and Methods: A total of 291 patients who underwent myomectomy, 61 in the LS and 230 in the LT were included in the study. Their clinical and operative data were searched retrospectively using patient files and hospital's database. Results: The postoperative analgesic requirements of the patients were significantly higher in LT group than LS group. Hospital stay was longer in the LT group. Postoperative hemoglobin and hematocrit levels of the patients in the LT group were significantly lower (p=0.010). The endometrial cavity was entered more frequently into LT group (p=0.004). Conclusion: Laparoscopic myomectomy was found to be superior to laparotomic myomectomy in terms of decrease in postoperative hemoglobin level, need for postoperative analgesia, and hospital stay. In addition, LS can be superior to LT about entering to endometrial cavity because of better visualization of endomyometrium. [ABSTRACT FROM AUTHOR]

Copyright of Southern Clinics of Istanbul Eurasia is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Southern Clinics of Istanbul Eurasia is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: The purpose of this study was to assess the feasibility and efficacy of transvaginal natural orifice transluminal endoscopic surgery (v‐NOTES) staging surgery for extreme obese patients with early‐stage type‐1 endometrial cancer. Methods: Study included cases of extreme obese patients with early‐stage endometrial cancer who underwent v‐NOTES between January 2019 and June 2019 at a tertiary referral medical center. The following parameters were noted: patient age, body mass index (BMI), operating time, conversion to conventional laparoscopy or laparotomy, any intraoperative or postoperative complications, estimated blood loss, pre‐ and postoperative hemoglobin levels, postoperative pain scores of the patients using visual analogue scale (VAS) at 6th, 12th and 24th h, length of hospital stay and final pathology report. Results: Six cases of extreme obese patients with early‐stage endometrial cancer underwent hysterectomy and bilateral salpingo‐oophorectomy via the transvaginal NOTES. These six patients had a mean body mass index of 51.4 kg/m2 (SD = 6,13). No conversion to conventional laparoscopy or even laparotomy was needed in any of these patients. No adjuvant therapy was needed since all of the patients had early‐stage endometrial carcinoma. Conclusion: Given the increased risk of surgical morbidity and mortality associated with increasing BMI, it is paramount importance to establish safe surgical approaches to gynecological pathologies. We think that v‐NOTES offers greater benefit to obese patients when performed by an experienced surgeon and v‐NOTES is a safe, effective and feasible minimally invasive surgery in extreme obese patients with early endometrial cancer. [ABSTRACT FROM AUTHOR]