Is the presence of deep infiltrative endometriosis underestimated in the surgical management of endometriosis?

Objectives:The aim of the study was to determine the presence of deep infiltrative endometriosis (DIE) in the surgical management of endometriosis.Material and methods: Operation notes and histopathological reports of women with endometriosis were retrospectively analyzed in the Ege University Hospital between 2008 and 2018. A total of 191 women with suspicious of endometriosis but without clinical signs of DIE were enrolled in the study. Laparoscopic diagnosis of DIE was compared with histopatho-logical reports. There was no histopathology before surgery. Endometriosis was suspected only based on symptoms.Results: A total of 213 lesions that were thought to be DIE were removed from 191 women with endometriosis. Among these 213 lesions, 179 specimens were reported as endometriosis and 34 lesions as fibro-adipose tissue. Forty-nine right uterosacral ligaments were excised, and endometriosis was detected in 44 out of 49 specimens. Histopathological examination of 45 left uterosacral ligaments revealed endometriosis in 35 specimens. Finally, 25 endometriotic nodules were removed from the recto-vaginal space, and 22 of these were verified as endometriosis by a pathologist. The positive predictive value of laparoscopic visualization for DIE in the group suspected of endometriosis but without any clinical findings of DIE was 84%.Conclusions: Women with the suspicious of endometriosis, qualified to surgery, because of infertility or pain, should be prudently investigated to confirm or to exclude coexistence of DIE even if no preoperative sign of DIE was observed to provide complete resection. Otherwise, DIE continues to grow, causes pain postoperatively, and complicates subse-quent surgery

Endometriozisli olguların endometriumları ile normal endometriumların ve ayrıca endometriyozisli olguların ektopik endometrial dokuları ile ötopik endometriumlarının Tenascin-C ekspresyon farklılığı açısından karşılaştırılması

Bu tezin, veri tabanı üzerinden yayınlanma izni bulunmamaktadır. Yayınlanma izni olmayan tezlerin basılı kopyalarına Üniversite kütüphaneniz aracılığıyla (TÜBESS üzerinden) erişebilirsiniz.[Abstarct Not Available

Yüzyirmiyedi adenomyozis olgusunun değerlendirilmesi

Objective: The aim of this study is to determine the prevalence of adenomyosis uteri and also investigate both its relation with previous uterine surgery and the other uterine pathological conditions which may be found within the same uterus. Material and Method: One hundred and twenty seven patients with the diagnosis of histopathologically proven adenomyosis uteri of all the treated patients by hysterectomy in our clinic between the dates of January 2002 and 2003 were included in the present study. Results: Eighty seven of the patients (68.5%) were between 40-50 years-old and 29 patients were between 51-60 years-old. Six patients (4.7%) were nulliparous, whereas the rest (95.3%) was multiparous. Myoma uteri were the most frequent indication for the surgery with 73 patients (%57.5). When compared with other pathologies, myoma uteri was significantly more frequent that the other etiologies (p;lt;0.01). History of previous cesarean section and dilatation and curettage were found 14 (11%) and 79 (62.2%) respectively. Conclusion: Adenomyosis was more commonly encountered in multiparous women and it usually coexists with myoma uteri. Transcervical or transabdominal uterine surgical procedures may contribute to the pathogenesis of disease.Amaç: Bu çalışma, kliniğimizde opere edilmiş adenomyozisli olguların prevalansını belirlemek ayrıca geçirilmiş uterin cerrahi travma öyküsünün hastalık patogenezindeki rolünü sorgulamak ve de hastalığa eşlik eden diğer uterin patolojilerin belirlenmesi amacıyla planlanmıştır. Gereç ve Yöntem: Kliniğimizde Ocak 2002 ile Ocak 2003 tarihleri arasında histerektomi uygulanmış ve patolojik inceleme sonucunda adenomyozis saptanmış 127 olgu retrospektif olarak kendi aralarında değerlendirilmiştir. Bulgular: Hastaların 87'si (%68.5) 40-50 yaşları arasında, 29'u ise (%22.8) 51-60 yaşları arasındaydı. Altı hasta (%4.7) nullipar, 121 hasta (%95.3) ise multipardı. Operasyon endikasyonları içerisinde birinci sırada 73 olgu ile (%57.5) myoma uteri saptandı. Myoma uteri aynı zamanda adenomyozise eşlik eden en sık patoloji olarak belirlendi ve diğer uterin patolojilerle kıyaslandığında bu sıklık istatistiksel olarak anlamlı bulundu (p0.01). Geçirilmiş sezaryen ve küretaj öyküleri sırasıyla 14 (%11) ve 79 (%62.2) hastada mevcuttu. Sonuç: Adenomyozis özellikle multipar kadınlarda sık karşılaşılan bir uterin patoloji olup, en sık olarak myoma uteri ile birlikte izlenir. Uterusa yapılan transservikal ya da transabdominal cerrahi işlemler hastalığın patogenezinde önemli olabilir

Abdominal wall endometrioma arising in a cesarean scar: A case report

The term endometrioma usually refers to a well circumscribed mass of endometriosis and besides the ovaries, it has been also described in pelvic structures, intraperitoneally and superficially within the abdominal wall scars developed secondary to the utero-ovarian procedures such as cesarean section, amniocentesis and rarely with laparoscopic operations. Here we report a 29-year-old woman presenting with an abdominal mass, which proved to be endometrioma. Preoperative diagnose was made based on the history, physical examination, color Doppler sonography and computed tomography (CT) scan. The mass was resected surgically with wide excision.The term endometrioma usually refers to a well circumscribed mass of endometriosis and besides the ovaries, it has been also described in pelvic structures, intraperitoneally and superficially within the abdominal wall scars developed secondary to the utero-ovarian procedures such as cesarean section, amniocentesis and rarely with laparoscopic operations. Here we report a 29-year-old woman presenting with an abdominal mass, which proved to be endometrioma. Preoperative diagnose was made based on the history, physical examination, color Doppler sonography and computed tomography (CT) scan. The mass was resected surgically with wide excision