recurrence

The discovery of risk factors that might predict the recurrence of non-muscle invasive bladder cancer (NMIBC) is essential.

Therefore, this prospective cohort study aimed at examining the association between bacteriuria and pyuria before bacillus Calmette-Guérin (BCG) installation and the occurrence of intravesical recurrence (IVR) in patients diagnosed with NMIBC.

A total of 73 NMIBC patients undergoing transurethral resection of bladder tumor (TURBT) and BCG treatment were included. Pre-instillation urine samples were analyzed for pyuria and bacteriuria.

The findings of this study indicated that preoperative pyuria was present in 31 (42.5%) of the studied patients. Furthermore, a statistically significant association was detected between preoperative pyuria and preoperative proteinuria (P < 0.001), preoperative hematuria (P = 0.023), preoperative bacteriuria (P = 0.001), and muscle invasion (MI) (P = 0.028). The results of the univariate analysis indicated substantial associations between the variables of smoking, diabetes, carcinoma in situ (CIS), age, and IVR. Subsequently, a multivariate analysis indicated that diabetes (HR = 18.11, P = 0.004) and CIS (HR = 14.69, P = 0.039) had a statistically significant link with IVR.

In conclusion, our study demonstrated that diabetes, CIS, and younger age were the sole independent prognostic factors for IVR. Furthermore, no statistically significant association was observed between pyuria, bacteriuria, and smoking with bladder tumor recurrence. The analyses revealed that pyuria emerged as a statistically significant predictive factor for IVR only among individuals without pre-instillation proteinuria.

Cardiac myxomas are the most common primary cardiac neoplasm (30-50%) with clinical incident of 0.5/ million population. Tranthoracic echocardiography remains the investigation of choice. Surgical excision is curative. The present study aims to analyze demographic and clinical characteristics as well as surgical outcomes in terms of mortality and recurrence of cardiac myxoma.

Thirty patients of cardiac myxoma who met the inclusion criteria during study period study period, January-2018 to April-2024 were included. Data was analyzed for demographic characteristics, echocardiographic findings of myxoma and associated valve lesion, associated valve surgery and survival outcome.

Of all subjects, 83.33% presented with dyspnea. Majority of myxoma, 76.67% were attached to interatrial septum. Overall survival at 1- and 3- year was 91.23%. Recurrence free survival at 1-, 3- years and end of this study were 100%, 84.71% and 84.71% respectively. Myxomas with valvular incompetence are rare entity and there is paucity of data and evidences recommending concomitant valve intervention in such cases. There were no immediate peri-operative deaths, however, in contrast to other studies; surgical site infection was the most common post operative complication. Overall survival at 1- and 3- year was 91.23%. Recurrence free survival at 1-, 3- years and end of this study were 100%, 84.71% and 84.71% respectively. Recurrence occurred in first- and third-year following surgery.

Study highlights decent outcomes following cardiac myxoma resection. Case specific concomitant valve intervention spiral the success of surgery.

This study compared the Quality of Life (QoL) between new and recurrent pulmonary tuberculosis (TB) patients, a crucial indicator for those undergoing treatment.

A cross‑sectional comparative study was conducted at eight community health centres in Garut, West Java, Indonesia. Convenience sampling was used to recruit patients aged >15 years with new or recurrent pulmonary TB. QoL was assessed using the WHOQOL tool. Data were analyzed using an independent t‑test.

54 new and 60 recurrent pulmonary TB patients participated. Recurrent TB patients Mean(SD) scored significantly higher in the psychological domain 58.30 (10.63) compared to new TB patients 53.70 (10.31) (p < 0.05, t‑test: ‑2.34).

New pulmonary TB patients experience greater psychological burden, highlighting the need for targeted psychological support to improve their overall QoL.

Langerhans Cell Histiocytosis (LCH) is a rare disease and is more common in children than adults. The incidence is estimated to be approximately 5–10 cases per million children annually. LCH has a wide range of clinical manifestations with rare orbital involvement.

Here, we report a six year-old-girl with recurrent multifocal LCH a year after chemotherapy accompanied by orbital manifestation, present as proptosis of left eye, lagophthalmos, and left superior palpebral abscess with fistula. She had a history of occipital brain LCH with bone involvement, which was surgically removed four years before admission. Ocular examination showed limitations on ocular motility, proptosis, inferonasal displacement of the globe, lagophthalmos, eyelid edema, and hyperemia. In contrast, Head Magnetic Resonance Imaging (MRI) revealed a mass in the left superior orbit and the right occipital condyle. Histopathological examination reveals pathological Langerhans cells with eosinophils and giant cells. The patient was treated with symptomatic drugs while chemotherapy and eyelid reconstruction were planned.

LCH is a disorder with highly diverse clinical manifestations. Orbital involvement is one of the uncommon presentations of LCH and necessitates a comprehensive clinical assessment. Early and accurate diagnosis is crucial. Although LCH can lead to serious complications if not promptly treated, recurrence of the disease is relatively rare. Nevertheless, long-term follow-up is recommended to ensure early detection of any potential recurrence and to maintain optimal patient outcomes.

 Despite the high success rate of bronchial artery embolization (BAE), hemoptysis probably recurs. This study investigated risk factors of 12-month hemoptysis recurrence after BAE in an Iranian population.

 In this prospective cohort, we followed up 101 patients for 12 months after BAE. Outcome of interest was recurrence of hemoptysis. Target arteries were super-selectively catheterized and embolized with non-spherical polyvinyl alcohol particles (150–700 µm). Success of BAE was confirmed using post-BAE angiography. Independent t-test, and chi-square and Fisher’s exact test were used to compare variables between “recurrence” and “non-recurrence” groups. We investigated predictors of recurrent hemoptysis through univariate and multivariate logistic regression modeling. We analyzed receiver operating characteristic curve to find the optimal cutoff point for continuous risk factors. Recurrence-free rates stratified by risk factors were plotted against time using the Kaplan-Meier method.

 BAE was immediately successful in all patients. During the 12-month follow-up, hemoptysis recurred in 13.9% (95% CI: 8.2–21.6) of participants. Mean (±standard deviation) recurrence-free time was 6.9 (±3.3) months. Lung destruction (OR=5.40 [95% CI: 1.41–20.58], P value=0.013) and arterial diameter≥2 mm (12.51 [1.51–103.59], P value=0.019) were independent predictors of 12-month hemoptysis recurrence.

 Patients with destroyed lungs and embolized arteries wider than 2.0 mm are at higher risk of hemoptysis recurrence in the first year after BAE.

Positive surgical margins (PSM) following partial nephrectomy (PN) for renal cell carcinoma (RCC) are a concern due to potential implications for recurrence and survival. This systematic review and meta-analysis assess the impact of PSM on recurrence rates and progression-free survival in RCC patients.

We conducted a systematic search of PubMed, Embase, Scopus, Cochrane, and Web of Science databases from inception through July 2024. Studies examining recurrence and survival outcomes in RCC patients with and without PSM post-PN were included. A random-effects model was applied to calculate pooled hazard ratios (HR) and 95% confidence intervals (CI) for recurrence and survival.

Thirty studies met the inclusion criteria. Our analysis showed that PSM was significantly associated with a higher risk of local recurrence (HR = 2.13, 95% CI: 1.67–2.72) and a lower recurrence/progression-free survival (HR = 1.70, 95% CI: 1.40–2.07) compared to negative surgical margins. Subgroup analyses indicated consistent results across study designs and RCC histologic subtypes.

The presence of PSM following PN for RCC is associated with a 2.13-fold increase in local recurrence and a 1.7-fold reduction in progression-free survival, emphasizing the need for precise margin management during surgery. These findings highlight the importance of optimizing surgical techniques and considering adjuvant treatment strategies for patients with PSM to improve oncologic outcomes.

Lumbar disc herniation is a common condition that can lead to pain, numbness, and weakness in the legs. The standard treatment involves surgical removal of the herniated disc. However, some patients experience recurrent lumbar disc herniation. This study aimed to investigate the association between COVID-19 infection and the recurrence of lumbar disc herniation after laminectomy and discectomy surgery.

This case-control study included 150 patients who underwent lumbar laminectomy and discectomy surgery in Yazd County hospitals from 2020 to the first half of 2022. Patients were divided into two groups based on the recurrence of lumbar disc herniation; The non-recurrence group (100 patients) and the recurrence group (50 patients). Data on COVID-19 infection, number of infections, hospitalization, received treatments, and hospital stay duration were collected and analyzed using Chi-square, T-test, and ANOVA.

A significant association was found between COVID-19 infection and lumbar disc herniation recurrence (p=0.03). Patients in the recurrence group had a higher prevalence of COVID-19 infection (66% vs. 40%), hospitalization due to COVID-19 (18% vs. 7%), and treatment with remdesivir (14% vs. 4%) compared to the non-recurrence group. Additionally, the number of COVID-19 infections was significantly associated with lumbar disc herniation recurrence (p=0.01). Further analysis revealed that receiving remdesivir and symptomatic treatments for lumbar disc herniation were significantly associated with recurrence (p=0.02).

COVID-19 infection and its recurrence are associated with the recurrence of lumbar disc herniation.

Ameloblastoma is a benign odontogenic neoplasm with a high recurrence rate. Identifying cellular and molecular changes in this neoplasm may help predict the recurrence risk. Bcl‑2 and galectin‑3 are anti‑apoptotic proteins associated with the prognosis of many neoplasms. However, there are a few studies focusing on the association between these two markers and recurrence of ameloblastoma. This study aimed to investigate the association of Bcl‑2 plus galectin‑3 expression and recurrence of ameloblastoma.

This retrospective cross‑sectional study was designed on 48 paraffin‑embedded blocks diagnosed as ameloblastoma from 1998 to 2019. We retrieved follow‑up data from patients’ records and used immunohistochemical staining for Bcl‑2 and galectin‑3 antibodies. Then, we analyzed their association with recurrence using Chi‑square and Mann–Whitney test as well as recurrence‑free survival using Kaplan–Meier curves and linear Cox regression. The level of statistical significance was P < 0.05.

Twenty‑six patients had experienced the recurrence. The mean follow‑up time was 93.53 months. There was a significant association between Bcl‑2 plus cytoplasmic galectin‑3 staining and recurrence (both P < 0.001). Furthermore, in univariate analysis, high expression of Bcl‑2 was associated with less recurrence‑free survival (log‑rank: P = 0.020‑univariable Cox: P = 0.033), but in multiple Cox regression, there was no significant association (P = 0.471). High cytoplasmic galectin‑3 expression was also associated with less recurrence‑free survival (log‑rank: P = 0.007‑univariable Cox: P = 0.015‑multiple Cox: P = 0.044). Furthermore, we found a correlation between Bcl‑2 and cytoplasmic galectin‑3 staining (P = 0.001).

It seems that Bcl‑2 and cytoplasmic galectin‑3 staining might predict the risk of ameloblastoma recurrence. However, only the cytoplasmic galectin‑3 staining might be an independent predictor of ameloblastoma recurrence, and we recommend further studies. 

We used the Predictive Model Bias Risk Assessment tool (PROBAST) tool to systematically evaluate the existing models worldwide, in order to provide a reference for clinical staff to select and optimize DFU recurrence risk prediction models.

Literature on DFU recurrence risk prediction model construction published in CNKI, China Biomedical Literature Database, Vipu China Knowledge, China Biomedical Literature Database, Vipu Chinese Journal Service Platform, Wanfang Data Knowledge Service Platform, Embase, PubMed, Web of Science, Cochrane Library and other databases were systematically searched. The search period was until January 29, 2024, encompassing all relevant studies published up to that date. Literature screening and data extraction were conducted by two researchers, and the PROBAST was used to evaluate the bias risk and applicability of the included literature.

Finally, 9 literatures were included, 13 prediction models were established, and the area under the AUC or C-index ranged from 0.660 to 0.943. Nine models were validated internally and one model was validated externally. All the models constructed in the included literature are of high-risk bias, and the applicability of the models is reasonable. Common predictors in the prediction model were Wagner scale, glycosylated hemoglobin, and diabetic peripheral neuropathy.

Although most of the existing DFU risk prediction models have good prediction performance, they all have high risk of bias. It is suggested that researchers should update the existing models in the future, and future modeling studies should follow the reporting norms, so as to develop a scientific, effective and convenient risk prediction model that is more conducive to clinical practice.

Hernia repair is one of the most common procedures in general surgery, which is performed by various methods. One of the consequences of hernia repair is the recurrence of hernia in the short or long term. In this study, the rate of hernia recurrence in surgical patients with mesh and non-mesh repair methods was investigated.

This prospective cohort study was conducted on 138 patients who underwent repair surgery with mesh (28 individuals) and without mesh (110 individuals) due to hernia in Hamadan Ba’ath Hospital in 2019 and 2014. The authors investigated and compared in terms of frequency of recurrence and complications. Part of the required data was obtained from the patient’s medical records and part was obtained through telephone calls. Data analysis was done with SPSS software version 26.

The average age of the patients was 41.2±26.25 years, 88.4% were male and 11.6% were female. The frequency of hernia recurrence was 3.6% in total, all of which were in the non-mesh repair group. No significant difference was observed between hernia repair with and without mesh in terms of frequency of recurrence (P=0.583) and complications (P=0.964). Also, no significant relationship was observed between hernia recurrence with gender, age, smoking, employment status, and body mass index (P>0.05).

Hernia repair with both methods with and without meshing have a relatively favorable short-term outcome. Although meshing reduces hernia recurrence; However, there was no significant difference between the two methods of hernia repair with and without meshing in terms of recurrence and complications.

Tuberculosis (TB) remains a major public health challenge in India. Efforts outlined in the National Strategic Plan (2017-2025) are committed to achieve targets towards eliminating TB. Early identification of recurrence among cured TB cases is a crucial strategy towards this goal.  However, there are limited data on the implementation of long-term follow-up for cured cases.

A prospective mixed-method study was conducted to evaluate the implementation of long-term follow-up strategy among 180 cured TB patients. Quantitative assessment involved tracking follow-up visits at 6, 12, 18, and 24 months post-treatment success. Moreover, Focus Group Discussions (FGDs) with 46 TB Health Visitors (TB HVs) were conducted to identify barriers to the implementation of long-term follow-up strategies for cured TB cases.

Quantitative analysis revealed a decline in follow-up visits over time, and only 16.89% of patients were followed up by TB HVs during fourth visit at 24 months post-treatment. Recurrent TB was identified in 22 cases, 13.7% of which were not followed up by health workers. Qualitative analysis highlighted patient-related factors like loss to follow-up due to migration and denial of sputum testing. Health workers cited workload issues and inadequate financial incentives as barriers to implementation.

The study underscores challenges in implementing long-term follow-up strategies for cured TB patients in India. Addressing barriers such as loss to follow-up and workload issues among health workers is crucial for improving recurrence detection and management. Efforts to enhance program effectiveness must prioritize overcoming these barriers to achieve the goal of TB elimination by 2025.

 Thyroid carcinoma (TC) is a global clinical concern, and its incidence has progressively increased worldwide. Early detection of TC and subsequently decreased age at the diagnosis seem to result from extensive employment of imaging modalities, biopsy techniques, and improvements in the healthcare system.

Study Design:

 A retrospective cohort study.

 Overall, 400 patients diagnosed with TC following thyroidectomy in the Endocrinology Clinic, who were followed for fifteen years, were investigated in this study. The checklist included patients’ demographic characteristics, clinical information, and response to treatment, recurrence, and death.

 There were 19.25% men and 80.75% women. The mean age was 41.005±15.58 years. The risk of death and recurrence was significantly higher in men, patients>65 years, smokers, patients with a family history of TC, undifferentiated cancer, multifocality, and stages III and IV (P<0.001). Each additional year of life was associated with a 21% increase in the risk of death (P<0.001). Smoking was associated with a 4.36-fold increase in the risk of death (P=0.05). For each additional year of life, the probability of recurrence increased by 3% (P=0.009). Men were 4.73 times more likely to recur (P<0.001) than women.

 To employ the proper therapeutic intervention and perform meticulous postoperative surveillance, it is crucial to consider the predictive influence of pertinent elements. Diagnosing TC in its early stages is essential for the healthcare system because of the increased incidence, younger age at diagnosis, and overall favorable prognosis of TC.

Ultrasonography (US) plays a crucial role in managing recurrent and persistent tumors in thyroid cancer, the most common endocrine malignancy, affecting approximately half a million people worldwide annually.

This study investigates the use of local US criteria to differentiate between post-operative changes (such as seroma, granulation tissue, and surgical material), residual normal thyroid tissue, tumor remnants, metastatic adenopathy, and nonspecific lesions after thyroidectomy in patients with thyroid cancer.

A total of 177 thyroid cancer patients (76.3% female) were referred to the US and followed up for a final histopathological diagnosis. US results were compared with needle biopsy findings.

Histopathology confirmed 95.8% (113/118) of the US-identified lesions as malignant and 78.6% (44/56) as benign. In total, 125 lesions were malignant, while 49 were benign. The US had a sensitivity of 90.4%, specificity of 89.8%, diagnostic accuracy of 90.23%, positive predictive value (PPV) of 95.76%, and negative predictive value (NPV) of 78.57%. The positive and negative likelihood ratios were 8.9 and 0.11, respectively. Vascular patterns had the highest sensitivity, specificity, and accuracy among the parameters studied, but shape and echogenicity were unsatisfactory.

Our results demonstrated that the US has around 90% sensitivity and specificity in identifying malignancy in postoperative thyroid cancer patients. These findings suggest that neck US is an effective technique for diagnosing thyroid bed lesions.

Effective cervical intraepithelial neoplasia (CIN) treatment and detection of high-risk recurrence patients is very important.

The present study aimed to compare the recurrence rate of CIN after loop electrosurgical excision procedure (LEEP) versus cold knife conization (CKC).

This cross-sectional study involved 329 patients who underwent either LEEP (294 cases) or CKC (35 cases) in the colposcopy clinic of referral hospitals between March 2016 and March 2021. The study population was followed up every six months for two years after their first conization to monitor for any recurrence of the disease.

There was no significant difference between the two groups regards. Thirty-two patients experienced recurrence within two years after surgery. The rate of CIN recurrent was 30 (10.2%) cases in the LEEP group and 2(5.7%) cases in the CKC group, with no significant differences (P-value = 0.553, RR = 1.78; 95% CI = 0.44-7.15).

The present study compared the benefits and harms of LEEP and CKC. The recurrence rate and surgical complications associated with both methods appeared to be similar with no significant differences. However, further high-quality and comprehensive research with a long-term follow-up is necessary to confirm our findings.

Granulomatous mastitis (GM) is a chronic inflammatory disorder affecting breast tissue, with a high recurrence rate.

Regarding this impotence, this paper aims at proposing a retrospective approach to compile an extensive dataset of clinical information as well as to identify potential risk factors associated with GM recurrence.

For this purpose, data on pathologically-confirmed cases of GM were retrospectively collected from the medical archives of the Shahid Beheshti Cancer Research Center, Iran, from March 2020 to February 2023. Then, the descriptive statistics were utilized to analyze demographic information, disease-related variables, patient-related variables, and details regarding treatment modalities. Evaluation of disease recurrence occurred 24 months following the initial GM diagnosis through clinical assessments, ultrasound, or mammography. Among the 100 accessible patients, 33 experienced recurrences within 24 months.

According to the obtained results, factors significantly associated with recurrence included body mass index (28.31 vs. 26.05), history of breastfeeding and its duration (22.44 months vs. 16.95 months) (90.9% vs. 72.7%), abortion, pain (72.7% vs. 46.3%), erythema nodosum (51.5% vs. 16.4%), hypertension (18.2% vs. 3%), thyroid disease (33.3% vs. 14.9%), rheumatologic disease (69.7% vs. 13.4%), dermal involvement (51.5% vs. 10.9%), joint involvement (85.9% vs. 39.4%), and the combined treatment modalities (45.5% vs. 11.9%). Moreover, the predictive model exhibited an overall accuracy of 83.3%.

Finally, it can be concluded that abortion history, breastfeeding and its duration, combined treatment, pain, erythema nodosum, hypertension, thyroid or rheumatologic disease, dermatologic or joint signs, and Body Mass Index (BMI) could be the significant factors related to the recurrence of GM. Thus, special attention to these factors and management of baseline disease may have a predictive effect on the relapse of idiopathic granulomatous mastitis (IGM).

Labial adhesion (LA) is a total or partial labial fusion mostly seen in pre-pubertal children and is rare in premenopausal and postmenopausal periods. This review aimed to evaluate risk factors for labial fusion and the recurrence rate following surgical intervention in postmenopausal women.

According to PRISMA guidelines, international databases including Embase, World Cat, Web of Science, Scopus, Dimension, Open Grey, Cochrane, Google Scholar, and also PubMed gateway for PMC and MEDLINE were searched. The included studies were in English and published from 1985 until December 2023 with the keywords including vulvar diseases, agglutination, menopause, postmenopause, and recurrence. All studies that evaluated the clinical course and recurrence of LAs following surgical treatment in postmenopausal women were included. The inclusion criteria were the risk factors of LA recurrence rate, and the exclusion criteria were studies with missing required data, letters to editors, and conference studies.

Thirty-four case reports were enrolled. In total, 54 patients were evaluated. The most common risk factors for LA included hypoestrogenism, virginity, sexual inactivity, cervical cancer, hysterectomy, urinary tract infections, and lichen sclerosis. Only one study reported a recurrence of labial fusion following surgical intervention in a one-year follow-up.

The most common risk factors for LA were hypoestrogenism, virginity, sexual inactivity, cervical cancer, hysterectomy, urinary tract infections, and lichen sclerosis. The low recurrence rate following surgical release of labial fusion has made it an effective and safe method in postmenopausal women with negligible medium-term recurrence rates.

Prostate-specific antigen (PSA) bounce is a common phenomenon that can be observed in patients of prostate cancer treated by radiotherapy. However, the clinical, pathological, or dosimetric predictors and clinical significance of PSA bounce in stereotactic body radiotherapy (SBRT) patients is still unknown.

Between August 2006 to December 2015, 74 prostate cancer patients were treated by SBRT with Cyberknife at two medical centers. The prescription dose was 35-37.5 Gy in 5 fractions. Follow-up PSA tests were more frequently performed in one hospital than the other (median 4 vs. 10 times for initial one year). PSA bounce was defined as a rise of 0.2 ng/mL followed by a decline to or below the previous nadir.

A total of 74 patients, PSA bounce was observed in 41 patients (55.4%). On univariate analysis, the treated medical center (p = 0.02), PSA follow-up frequency (p = 0.01), patient age (p < 0.01), and total prescription dose (p = 0.03) were significant clinical factors in predicting the incidence of PSA bounce, while in multivariable analysis only the PSA follow-up frequency, and patient age remains significant.

PSA bounce was seen in a significant proportion of patients after Cyberknife SBRT. The PSA follow- up test frequency, and patient age were significant factors that were correlated with the incidence of PSA bounces in this study.

To compare the oncological outcomes of clear cell RCC (ccRCC), which is common in renal cell carcinomas (RCC), and chromophobic RCC (chRCC), which is less common, and to define the factors affecting survival in the Turkish patient population for both RCC subclassifications.

Patients with a pathologically confirmed RCC diagnosis after radical or partial nephrectomy in the Turkish Urooncology Association (TUOA), Urological Cancers Database-Kidney (UroCaD-K), were retrospectively reviewed. Patients with ccRCC and chRCC were included in the study. The primary outcomes of this study are recurrence-free survival (RFS), overall survival (OS) and cancer-specific survival (CSS) for each histological subtype.

Data from 5300 patients in the TUOA UroCaD-K are reviewed and a total of 2560 patients (2225 in the ccRCC group and 335 in the chRCC group) are included in the final analysis. In the comparison of the groups, tumor size was greater both radiologically and pathologically in chRCC (p = 0.019 vs 0.002 respectively). Recurrence- free survival (RFS), overall survival (OS) and cancer-specific survival (CSS) rates are worse in ccRCC subgroup. In the evaluation of risk factors; pathological stage, local invasion and Fuhrmann grade were found to be significant for recurrence in ccRCC. Age, body mass index and pathological stage were the risk factors affecting overall mortality (OM). Pathological tumor size was an independent risk factor for recurrence in chRCC, while age was analyzed as the only parameter affecting OM.

chRCC oncological data and OS, CSS and RFS rates were found to be better than ccRCC in the Turkish patient population.

Context:

 Deep infiltrating endometriosis (DIE) is a specific form of endometriosis in women, causing infertility and pelvic pain during reproductive age. Surgery is the treatment of choice for managing DIE, as medical therapy alone cannot adequately control symptoms.

The present study aims to investigate the recurrence and pregnancy rates following surgical treatment of DIE in women of reproductive age.

PubMed, Web of Science, Scopus, Google Scholar, Cochrane Library, and ProQuest databases were searched from 2010 to August 25th, 2024, using appropriate MeSH keywords. The quality of the included studies was assessed using the Mixed Method Appraisal Tool (MMAT), version 2018.

A total of 41 studies were included in the systematic review, and 34 studies were included in the meta-analysis. The meta-analysis comprised 6,585 individuals from 14 countries. The pooled estimated prevalence of endometriosis recurrence was 13% (95% CI: 11–17%, I²: 96.5%, Tau²: 0.01, Observations: 35). The corrected pooled estimated pregnancy rate after surgery for endometriosis was 47% (95% CI: 36–57%, I²: 96.47%, Tau²: 0.05).

Recurrence and pregnancy rates remain controversial challenges in the surgical management of DIE. This study indicates a relatively low recurrence rate after DIE surgery and an improvement in the approximate pregnancy rate following the surgical approach.

To describe the clinical and radio-pathological features of suture granuloma, an inflammatory response to retained suture material that primarily affects non-absorbable sutures.

Case report: 

We report a case of a 26-year-old female presenting with painful swelling at a caesarean section scar, previously excised for similar complaints. Physical examination revealed a solid soft tissue mass on the scar. Magnetic resonance imaging (MRI) identified a 2x2 cm lesion in the right abdominal wall, suggestive of suture granuloma. Surgical excision revealed prolene suture material within the granulomatous tissue. Histopathology confirmed foreign body reaction.

Recurrence post-prior excision underscores the importance of complete granuloma removal. Differential diagnoses included scar endometriosis and inflammatory lesions. Suture granulomas, though rare, require consideration in scar-related swelling. Collaboration between specialties ensures accurate diagnosis and management.