A Review of Our Experience in Trans Obturator Tension Free Vaginal Tape Surgery in 16 Patients

OBJECTIVE: We aim to share our surgical experience in 16 patients that were complaining of genuine stress urinary incontinence, in which trans obturator tension (TOT) free vaginal tape procedure was performed. STUDY DESIGN: 16 patients complaining of genuine stress incontinence were admitted into the study group. Patients were all multiparous with a mean age of 36 ± 3. All patients were carefully examined and urodynamically tested for diagnosis. After getting positive results as genuine stress incontinence, surgery was planned. Patients were operated using outside-inside TOT technique. RESULTS: All patients except for one were found to be completely cured of stress incontinence in the reevaluation period. Urogynecological examinations and urodynamical tests were performed to objectively confirm these foundings. Therefore our objective cure ratio in 16 patients is found to be 93.75% as well as our subjective cure ratio. CONCLUSION: TOT is described as a minimally invasive procedure that can be performed even under local anesthesia to an outpatient which is an effective and easy to learn surgical technique

Kartagener Syndrome: A Rare Cause of Infertility

Kartagener’s syndrome is defined as motility dysfunction of the epithelial cilia lining the respiratory tract, fallopian tubes and the flagella of the sperm and genetically classified as a rare autosomal recessive disease consisting almost half of all primary ciliary dyskinesia cases. In this brief case review we aim to share our experience concerning Kartagener’s syndrome from a gynecologic point of view regarding an unexplained infertility patient

Relation with postpartum maternal morbidity of different types of anesthesia in preeclamptic patients

Objective: The aim of this study is to investigate the effect of different anesthesia types administered to patients with preeclampsia on postoperative maternal morbidities. Methods: Medical records of pregnant women complicated with preeclampsia delivered by cesarean from January 2010 to December 2016 in our clinic were retrospectively reviewed. Results: There was not a statistically significant difference between patients receiving spinal anesthesia and general anesthesia in terms of additional parenteral analgesic requirement at postoperative period (p = 0.520). The length of stay in hospital and δHb (preoperative hemoglobin value minus postoperative hemoglobin value) were not different between spinal anesthesia and general anesthesia groups (p = 0.140 and 0.648, respectively). The rate of postoperative antihypertensive medication requirement was statistically significant in patients with severe preeclampsia who underwent general anesthesia (p = 0.009, x2 = 6.867, odds ratios = 4.276 (1.531–11.942)). The time passing to reach the first normal blood pressure level in patients with severe preeclampsia was 11.95 ± 9.11 h in patients with spinal anesthesia, 10.55 ± 4.95 h in patients with general anesthesia, and the difference was not statistically significant (p = 0.504). Conclusion: The need for antihypertensive medication is greater in patients with severe preeclampsia receiving general anesthesia. There is a need for comprehensive, prospective, and randomized controlled trials to establish the relationship between postpartum morbidity and the different types of anesthesia

Investigation of the endometrial thickness and estrogen level in athletes and sedentaries

Background: The present study aims to examine the effect of estrogen level between volleyball player’s and sedentary women’ endometrial thickness with regular exercise. Materials and Methods: Seventeen athletes taking place in the 3rd Turkish Women Volleyball League and 17 sedentary women participated in this study. The mean age of athletes was 20.70 ± 2.11 and sedentaries 21.70 ± 0.77 years has been identified. In the period between 10 and 11 days of their menstrual cycle, 2 cc venous blood was taken from the subjects. Data calculation was done using the SPSS 21 statistical package program. Descriptive statistics included the arithmetic averages of data and standard deviations (SD) and the error level of p < 0.05 was considered to be significant. Results: No statistically significant relation was found between the sports and sedentary women’s mean age and BMI values (age: p = 0.076, BMI: p = 0.134 and p > 0.05). No significant differences were found between the two groups’ estradiol and endometrial thicknesses (estradiol: p=0.01, endometrial thicknesses: p = 0.01 and p < 0.05). Conclusions: The results showed that the average thickness of the endometrium and estrogen levels of athletes are lower than in sedentaries, and these results indicate that sports may have a preventive effect against uterine cancer and endometrial thickening. © 2019 S.O.G. CANADA Inc.. All rights reserved

Endometrial Cancer - Evaluation of Diagnostics Treatment and Prognosis in 150 Patients

OBJECTIVE: In this study we aim to discuss diagnostic and tratment modalities and prognostic factors of 150 patients that were admitted to our clinic between October 2002 and May 2009 in a retrospective way in regard with the current literature. STUDY DESIGN: Patients’ all demographic data were recorded upon admittance, diagnostic and treatment options that were perfomed were also recorded and thus are used in this study. RESULTS: Patients’ median age was 67.1±11 ,2 (52-79) , Trans vaginal ultrasonography (TVUSG) was used to measure endometrial thickness and the median was 15.7± 4.91 mm (6-36). All patients were diagnosed with fractional curretage before admittance to the gynecological oncology clinic, all underwent total abdominal hysterectomy bilateral salpingoopherectomy and bilateral pelvic–para aortic lymphadenectomy (performed if FIGO critera are met). Surgical staging results were as follows; 78% Stage 1, 10% Stage 2, 8% Stage 3 and 4% were Stage 4. Histopathological differentiation resulted largely in favor of Endometrioid adenocarcinoma with 132 patients (88%), 6 cases of Serous papillary carcinoma (4%), 7 cases of Clear cell carcinoma (4.6%), 3 cases of Mucinous carcinoma (2%) and 2 cases of Undifferentiated carcinoma (1.3%). In terms of grading, 28 patients (18.6%) were classified as high grade and among 132 patients that were classified as endometrioid carcinoma 69 were grade I (52.2%), 52 were grade II (39.3%) and 11 were grade III (8.3). In terms of myometrial invasion beyond 50%, grade I patients were less likely to, with only 5.2%, and 39% and 76.3% for grades II and III respectively. Lymph node dissection was performed on 71 patients among which 8 had positive pelvic lymph nodes (5.3%) and 2 had positive aortic lymph nodes (1.3%). All high grade patients had positive peritoneal cytology. Lymphovascular space invasion was present in 36 of the patients (24%) of which 3 were grade I (8.3%), 12 were grade II (33.3%) and 11 were grade III (30.5%). Among 16 patients that had cervical invasion 14 also had lymphovascular space invasion (LVSI) (87.5%). CONLCLUSION: Survival in endometrial carcinoma depends on many factors starting with the FIGO staging, histological type of the tumour, its histological grade, lymphovascular invasion, treatment modalities and patient specific variables such as age, BMI, parity

Histomorphometric changes in the placenta and umbilical cord during complications of pregnancy

Pregnancy complications may cause morphological changes and circulation defects in the placenta, which may lead to morbidity and mortality in fetuses and newborns. We investigated structural changes in the placenta and umbilical cord under various abnormal maternal conditions. Placenta and umbilical cord specimens were obtained from pregnant women during labor at 37 - 42 weeks gestation. Volumetric measurements were made for each placenta and umbilical cord using the Cavalieri method. Significant differences were observed for volumetric densities of total villi, syncytial knots, intervillous vessels and perivillous fibrin deposition. We observed particular increases in the volumetric parameters of the pre-eclampsia group compared to the other groups. The tunica media of the umbilical arteries was increased significantly with intrahepatic cholestasis

Giant Angiomyoma of the Broadligament: A Case Report

Angiomyoma of broad ligament region is rare and there is only one reported case of angiomyoma of this region in the literature. A 43 year old women was operated because of broad ligament mass. The pathologic examination revealed broad ligament angiomyoma. It was amed to report the present case regarding its extremely rare localisation for angiomyoma

Emergency Cervical Cerclage: A Case Report

This report describes emergency cervical cerclage performed at Ondokuz Mayıs University. A women with singleton pregnancy in 20 weeks gestation presented with a cervical dilatation of 10 cm and membrane prolapse. After exclusion of labor, preterm rupture of membranes and chorioamnionitis, an emergency cervical cerclage was proposed to the patient. The membranes were replaced using the technique of overfilling the urinary bladder and then performing McDonald’s cerclage. The patient received prophylactic antibiotics and tocolytics. Pregnancy ended in live birth. The extension of pregnancy in the survivor was 17 weeks, and the gestational age at delivery 37 weeks. Emergency cerclage should be considered as a management option in women with painless cervical dilatation and membrane prolapse in the midtrimester