A Rare Case of Unrecognized and Uncommon Bladder Perforation after Transobturator Tape Procedure

The transobturator tape (TOT) procedure has become practically widespread worldwide. Complications seem to be rare, but recognizing them intraoperatively is the most significant step because some of the complications which may appear in postoperative period can be challenging for both physicians and patients. The purpose of this case, with this patient who was operated on with open surgery, is to evaluate this rarely seen unrecognized and uncommon bladder perforation after TOT procedure and thus make some contribution to the literature. Here, we present a case report about the treatment of a 48-year-old woman patient with unrecognized and uncommon bladder perforation after TOT procedure, 5 months postoperatively. Cystoscopic evaluation is not recommended routinely, but it must be performed if the patient is complicated enough to create doubt and also the surgeon's skill and ability are not sufficient enough to operate decently

Diagnosing postpartum depression in a mother of developmentally delayed infant: a case report

Postpartum depression is the most common clinical entity of childbirth. Although there are conflicting results about the influence of postpartum depression on the children, the consequences of the illness might extend to preschool age or further. Because physicians encounter mothers at the same time with the babies in the examination room, it might be of particular importance to have the knowledge of symptoms of maternal depression and pay attention to the mental and physical well-being of both the mother and the baby. In this article we would like to present an 18 month old child who presented with psychomotor retardation with a mother diagnosed as postpartum depression

Diagnosis and management of iatrogenic ureteral injury in total laparoscopic hysterectomy

Ureteral injury is common in gynecological surgeries due to the proximity to organs. The risk of ureteral injury is higher in laparoscopic hysterectomy operations compared to abdominal or vaginal hysterectomies. Obesity, endometriosis, pelvic adhesions, history of previous surgery, enlarged uterus, and intraoperative hemorrhage are some of the risk factors identified for ureteral injury. Intraoperative cystoscopy and postoperative urinary ultrasonography can be used in the diagnosis of early ureteral injury. Management of ureteral injury differs according to the extent, type, and localization of the injury. In evaluating the ureteral injury, early diagnosis and early repair in appropriate patients are essential in morbidity and medicolegal

Impact of paternal age on intracytoplasmic sperm injection cycle results

Background: The purpose of this study is to compare the impacts of the paternal age of patients included in the intracytoplasmic sperm injection-embryo transfer cycle administered with long protocol. Methods: The patients administered with long agonist protocol, who were primary infertile and had normal over reserves, were divided into two groups based on their sperm concentration. The patients with sperm concentration of over 15 million/ml were defined as group 1, while those with sperm concentration below 15 million/ml were defined as group 2.Results: 602 patients, 302 of whom were in group 1 and 300 of whom were in group 2, enrolled in this study. With regard to treatment results, the implantation rates and clinical pregnancy rates were significantly higher in group 1. In an assessment made to determine if the advanced male age had any impact on the clinical pregnancy rates, it was determined that there was a significant decrease in the clinical pregnancy rates only in group 2. When the patients in group 2 were divided and compared into two patient subgroups, i.e. those below 37 years old and over 37 years old, higher number of mature oocytes, embryos was obtained at a lower dose of recombinant follicular stimulant hormone (r-FSH) in the younger patient subgroup, which significantly increased the clinical pregnancy rates with implementation rates.Conclusions: While the pregnancy and implantation rates significantly decreased by advanced paternal age in oligospermic patients administered with ICSI, the abortus rates increased

Effects of secondary trimester maternal serum screening on the results of pregnancy

In our study it was aimed to research the relations between pregnancy complications and frequencies of maternal and fetal complications which can be observed after the further follow-ups with biochemical indicators in gravid individuals whom found to be risky in quad test.120 patients who applied and had their labors conducted in İstanbul Training and Research Hospital and took quad test AFP (alpha fetoprotein), HCG (human chorionic gonadotropin), uE3 (unconjugated estriol), inhibin-A are included in our study. Conclusions planned to be obtained in this study are, IUGR (intrauterine growth deficiency), macrosomia, gestational diabetes, preeclampsia and preterm birth. 64 (% 53, 4) out of 120 patients participated in the study had normal labors while 56 (%46, 6) of the patients had labors with caesarean birth. On 70 (%58.3) patients whom did not develop obstetric complications, AFP value calculated as average as 1.00±0.74 MoM, uE3 value calculated as  0.89±0.4 MoM, hCg value calculated as 0.97±0.5 MoM and inhibin A value calculated as an average of  0.95±0.5 MoM.  On 50 (%41.6) patients whom developed obstetric complications, AFP value found as average of 1,06±0,74, uE3 value found as 0.96±0.39 MoM, hCG value found as 0.99±0.77 MoM and Inhibin A value found as 1.023±0.62 MoM. There were no significant deviation between the cases with obstetric complications and cases without obstetric complications in terms of AFP, uE3, HCG and Inhibin A values. There were no significant relation between threshold values of AFP, HCG, uE3 and inhibin A which are used in quad test as secondary trimester serum indicators in low risk populations and pregnancy complications

Second trimester termination of pregnancy complicated with multiple fetal abnormalities and also placenta percreta

We read with great interest the article by Matsuzaki S and et al., in which the authors presented a case series named “Successful management of placenta percreta by cesarean hysterectomy with transverse uterine fundal incision”.

Kisspeptin levels in idiopathic hypogonadotropic hypogonadism diagnosed male patients and its relation with glucose-insulin dynamic

WOS: 000390162300014PubMed ID: 27616469Male hypogonadism is defined as the deficiency of testosterone or sperm production synthesized by testicles or the deficiency of both. The reasons for hypogonadism may be primary, meaning testicular or secondary, meaning hypothalamohypophyseal. In hypogonadotropic hypogonadism (HH), there is indeficiency in gonadotropic hormones due to hypothalamic or hypophyseal reasons. Gonadotropin-releasing hormone (GnRH) is an important stimulant in releasing follicular stimulant hormone (FSH), mainly luteinizing hormone (LH). GnRH omitted is under the effect of many hormonal or stimulating factors. Kisspeptin is present in many places of the body, mostly in hypothalamic anteroventral periventricular nucleus and arcuate nucleus. Kisspeptin has a suppressor effect on the metastasis of many tumors such as breast cancer and malign melanoma metastases, and is called "metastin'' for this reason. Kisspeptin is a strong stimulant of GnRH. In idiopathic hypogonadotropic hypogonadism (IHH) etiology, there is gonadotropic hormone release indeficiency which cannot be clearly described. A total of 30 male hypogonatropic hypogonadism diagnosed patients over 30 years of age who have applied to Haydarpasa Education Hospital Endocrinology and Metabolic Diseases Service were included in the study. Compared to the control group, the effect of kisspeptin on male patients with hypogonatropic hypogonadism and on insulin resistance developing in hypogonadism patients was investigated in our study. A statistically significant difference was detected between average kisspeptin measurements of the groups (p < 0.01). Kisspeptin measurement of the cases in the patient group were detected significantly high. No statistically significant relation was detected among kisspeptin and LH/FSH levels. Although a positive low relation was detected between kisspeptin measurements of patient group cases and homeostasis model assessment of insulin resistance (HOMA-IR) measurements, this relation was statistically insignificant. When the patient and control groups were compared for HOMA-IR, no statistically significant difference was detected. The reason for high kisspeptin levels in the patient group compared to the control group makes us consider that there may be a GPR54 resistance or GnRH neuronal transfer pathway defect. When patients and control groups were compared for HOMA-IR, the difference was not statistically significant. It is considered that kisspeptin is one of the reasons for hypogonatropic hypogonadism and has less effect on insulin resistance

Does non-steroidal anti-inflammatory drugs increase tumor necrosis factor-alpha levels?

Background: The study was designed to investigate the possible effects of the non-steroidal anti-inflammatory drugs on the levels of TNF-alpha in osteoarthritis patients.  Methods: Three different non-steroidal anti-inflammatory drug; diclofenac sodium (100 mg), indomethacin (25 mg) and nabumethon (500 mg) have been included to the study. Twenty osteoarthritis patients who do not have another inflammatory disease for each group of NSAID were recruited from outpatients’ clinics of our hospital. Blood samples of these patients were collected before (at 0 hour) and after (at first and sixth hours) one of these NSAIDs was given orally for the sequential measurements of the serum levels of TNF-α.Results: In all groups, levels of TNF-alpha were similar at the beginning of the study before the placebo and drugs. One hour later, after the NSAIDs were given, increased levels of TNF-alpha were obtained in diclophenac and nabumethone (55.4 ± 52.4 and 35.7 ± 27.9) groups. In contrast to diclofenac group, increased levels of TNF-alpha was insignificant in nabumethone group (P>0.05). However, at six hours later after drugs have been given, TNF-alpha levels decreased to basic levels at the beginning in only nabumethone group. Levels of the TNF-alpha in diclofenac group (101.9 ± 142.2) increased significantly at sixth hour, too. In contrast to this result, insignificant increase has been found in indomethacin and nabumethone groups (39.6 ± 34.6 and 30.2 ± 15.9). No significant changes were obtained in control group.Conclusions: This study shows that levels of TNF-alpha may increase after NSAIDs have been taken orally. NSAIDs effects in our study, increasing TNF-alpha levels may cause unexpected results and may also alter the inflammation.  

Development and management of ovarian hyperstimulation syndrome in spontaneous singleton pregnancy

Ovarian hyperstimulation syndrome (OHSS) is one of the most life-threatening complications of ovulation induction. However, rarely, OHSS can develop spontaneously during pregnancy without induction of ovulation. It has been shown in the literature that some diseases such as polycystic ovary syndrome (PCOS), hypothyroidism, and pituitary adenoma may accompany spontaneous OHSS. Spontaneous OHSS should be included in the differential diagnosis in first-trimester pregnancies with nausea, vomiting, and acute abdomen. The focus should be on preventing possible complications and initiating early treatment immediately after diagnosis