The diagnosis of endometriosis may delay for many years due to non-deterministic symptoms and avoiding surgical interventions. Kisspeptins are hormones that interact with endometrial tissue to limit invasions during placentation and various cancers and are suggested to be also associated with endometriosis. This study evaluated if serum kisspeptin levels are associated with the invasion depth in endometriosis. Forty patients between 18 and 45 years of age and admitted to a tertiary-care Obstetrics and Gynecology Department between 2020 and 2021 with a diagnosis of endometriosis, and 40 patients without endometrioma were included in the study. Demographic, obstetric, clinical, and biochemical characteristics were evaluated in patients with superficial (SE) and deep infiltrating (DIE) endometriosis and healthy controls. Twenty patients (50%) had SE, 14 (35%) had DIE, and 22 (55%) had endometrioma in the patient group. Fertility rates were higher among controls, but similar between patients with SE and DIE. CA125 levels were significantly higher in the DIE group. SE and DIE groups had similar kisspeptin values, significantly higher than controls. CA125 and kisspeptin levels were not correlated in study groups. Serum kisspeptin levels were significantly different between endometriosis patients and healthy controls. However, kisspeptin levels were unable to differentiate endometriosis severity. Our results suggest that kisspeptins might play a role in the pathogenesis of endometriosis, which needs further assessment in more comprehensive studies.

We aimed to investigate the promoter methylation status of RASSF1A and RASSF2A tumor suppressor genes in endometrial endometrioid carcinomas with p53 wild type and mismatch repair proficient. Genomic DNAs were isolated from 50 specimens (15 formalin-fixed paraffin embedded tumor tissues, 15 paired blood samples and 20 normal endometrial tissues). Bisulfide modification and methylation-specific polymerase chain reaction were performed. As a result of the study, while no significance was found for RASSF1A gene (p = 0.08), a statistically significance was found for RASSF2A gene (p < 0.001), RASSF2A gene methylation status was also found higher in high grade tumors, advanced age (>= 50) and nonsmokers groups. Our results indicate that RASSF2A gene may play a role in the carcinogenesis of endometrioid and it could be potential biomarker for early detection for endometrioid carcinoma. Further and larger investigations are needed to confirm our results.

BACKGROUND: It is very common to offer low molecular weight heparin (LMWH) medications to women with unexplained habitual abortion, to increase the livebirth rate. Although no benefit from LMWH has been clearly demonstrated, examination of the effects of enoxaparin on placental structure is lacking. OBJECTIVE: To assess placental structural changes in pregnancies treated with enoxaparin, compared with controls. DESIGN AND SETTING: Case control study in an obstetrics and gynecology unit of a tertiary level university hospital in Turkey. METHODS: Forty patients who had had term pregnancies and live births but also histories of habitual abortion were recruited for this study. Placentas were sampled using a systematic random sampling method. Tissue samples were obtained, embedded and sectioned for routine histological analyses. Hematoxylin and eosin staining was used. Surface area and length estimates from placental components were evaluated by using Image J. Cell proliferation and apoptosis were also assessed via immunohistochemistry. RESULTS: There were no significant differences between the groups regarding maternal age, abortion rate, birth weight or gestational age. Comparison of the enoxaparin and control groups showed that there were no significant differences in terms of surface area and ratios of placental components. We found that Bcl-2 was generally expressed at high levels in the enoxaparin group, while there was no difference in terms of Ki-67 between the groups. CONCLUSIONS: This study demonstrates that enoxaparin did not show any significant effect on the placental structure of cases that had histories of habitual abortion.

This study aimed to compare different hysterectomy techniques regarding postsurgical pain. Women who underwent hysterectomy for nonmalignant etiologies between January 2019 and March 2023 were included in this retrospective study. The participants were divided into 4 groups based on the surgical techniques performed: abdominal hysterectomy (AH), laparoscopic hysterectomy, vaginal hysterectomy, and vaginal natural orifice transluminal endoscopic surgery (vNOTES). Pain scores and analgesic consumption were used for pain assessment. Parameters before the surgery and 24 hours, 1 week, 1, 3, and 6 months after the operation were retrospectively evaluated. Additionally, possible factors associated with pain, such as age, previous pelvic pain, previous abdominal surgery, indications for surgery duration of the surgery, volume of hysterectomy material, mean postoperative hospital stay, and blood transfusion were analyzed. A total of 264 patients were enrolled in this study. Thirty (11.3%) patients reported postsurgical chronic pain (PSCP). The mean number of days with postoperative pain was highest in the AH group and lowest in the vNOTES group. AH patients had the highest pain scores at the 24th hour and 1 week after surgery, and vNOTES cases had the lowest pain frequency in the 3rd- and 6th-month records. The preoperative presence of pain and higher pain intensity in the early postoperative period were other factors associated with PSCP. There was no significant difference in perioperative complications. The results of this study suggest that vNOTES is superior to other hysterectomy techniques in terms of postoperative chronic pain control without increased perioperative complication rates. Effective pain control during the early postoperative period may decrease the frequency of PSCP.