BhCG as a Rupture Marker in Ectopic Pregnancy: A Retrospective Study

Objective:To find effective criteria in determining the risk of ectopic pregnancy rupture in patients with ectopic pregnancy.Method:The data of 101 patients who were hospitalized with the diagnosis of ectopic pregnancy in the tertiary center between January 2018 and January 2021 were analyzed retrospectively. Demographic data of the patients, the month of admission, the patients’ beta-human corionic gonadotropin (BhCG) values at the time of admission, blood type, endometrial thickness measured with transvaginal ultrasound, presence of adnexal mass suggestive of ectopic pregnancy and treatments applied to the patients were recorded. These data were compared between patients who had surgery for ectopic pregnancy rupture and those whose treatment was completed without it.Results:In the statistical analysis of the data, ectopic pregnancy rupture was found significantly more frequent for a threshold value of BhCG >4000 IU/L. Other data were not statistically significant.Conclusion:In cases of ectopic pregnancy, if the BhCG value at the time of admission exceeds the threshold value, the possibility of surgical approach increases. Medical treatment may be more successful at lower BhCG levels

Single-center Experiences of Ovarian Sex Cord Stromal Tumors

Objective:The aim of this study is to examine the sex cord stromal tumors of the ovary operated in our clinic in the last 4 years and to contribute to the literature on this rare tumor.Method:The clinical and laboratory findings of 34 patients with pathological diagnosis of ovarian sex cord stromal tumor, who were operated in our obstetrics and gynecology clinic between 2016 and 2020, were evaluated retrospectively. Pathological diagnoses were classified and other accompanying pathologies and complaints were evaluated for each type.Results:Ovarian sex cord stromal tumors usually attract attention with the peripheral effects of the hormones produced by the tumor tissue. They rarely come to very large sizes. They are mostly benign. When the hormone estrogen is produced, accompanying endometrial pathologies should not be overlooked. Hormonal complaints in patients improve dramatically after surgery both clinically and laboratory. Oncological follow-up is required following diagnosis in some malignant types.Conclusion:If ovarian sex cord stromal tumor is suspected, preoperative blood androgen levels, inhibin A, and alpha feto protein (AFP) should be evaluated. In addition, ultrasonographic and, if necessary, endometrial histopathological evaluations are important for patient follow-up as well as diagnosis. The patient's fertility desire and age should be considered during treatment

The Impact of COVID-19 Pandemic on Female Sexual Behavior

Objective:The Coronavirus disease-2019 (COVID-19) related isolation has resulted in economic damage, loneliness, fear of death, and depression all around the world. Self-isolation and social distance lead to unintended psychological effects and negatively affect sexual life. This study aimed to investigate women’s sexual behavior during the COVID-19 pandemic in our country.Method:This prospective, observational study was conducted in a tertiary referral hospital between June 27 and July 27, 2020. A questionnaire consisting of 13 questions regarding the sexual life during the COVID-19 pandemic was applied to 169 women aged 18-45 years. Demographic characteristics were recorded. The questions evaluating sexual behavior about the relationship with partner, sexual desire, frequency of intercourse, sexual satisfaction, and fertility desire were asked.Results:The mean age of the participants was 32.9±7.74 years (18-45). Regarding the per capita monthly income, 84 (60%) patients had a decrease, 53 (37.9%) of them remained stable, and only 3 (2.1%) of them had an increase during the pandemic. Sexual desire was decreased by 32.9% of the participants and remained the same in 58.6% of the participants. A higher rate of 40.5% was observed in the decreased group than in the stable income group with 22.7% (p=0.03). A statistically significant difference was found between the decrease in sexual desire rates. However, when the change in income level of the groups and their sexual satisfaction rates were compared, it was found that sexual satisfaction increased in those with a lower income level, and the difference was statistically significant (p=0.04).Conclusion:Acute stress caused by the COVID-19 pandemic negatively affected sexuality. The decreased income level reduces sexual desire, but we observed an increase in sexual satisfaction rates in this group

Comparison of barbed unidirectional suture with figure-of-eight standard sutures in vaginal cuff closure in total laparoscopic hysterectomy

The aim of the study was to compare postoperative vaginal cuff complications due to the use of barbed sutures (V-Loc™ 180 unidirectional suture; Covidien, Mansfield, MA) and standard braided sutures (Vicryl®; Ethicon Inc., Somerville, MA) during vaginal cuff closure of patients undergoing a total laparoscopic hysterectomy (TLH) due to benign diseases. Eighty-nine patients were in the standard suture group and 208 patients were included in the barbed suture group. Vaginal cuff dehiscence was identified in only three (3.3%) patients within the standard suture group and none in the barbed suture group. Five (5.6%) patients in the standard suture group and two (0.9%) patients in the barbed suture group developed postoperative cuff infection/cellulitis. Duration of the surgery was significantly shorter in the barbed suture group than in the standard suture group (p < .05). V-Loc™ 180 unidirectional barbed suture, which is used during TLH for vaginal cuff closure, is an applicable, safe and tolerable alternative to a standard suture.IMPACT STATEMENT What is already known on this subject: Barbed sutures are a relatively new type of suture that include sharp barbs inserted on monofilament material in various configurations, and are used for approximating tissues without any need for surgical knotting. They have increasingly been used in obstetrics and gynaecology in recent years, particularly in total laparoscopic hysterectomy and laparoscopic myomectomy. At present, there are a limited number of studies of V-Loc™ suture in the literature. What the results of this study add: We demonstrated that barbed sutures used for enabling vaginal cuff integrity did not cause major morbidity and mortality for the patient. We suggest that V-Loc™ 180 barbed sutures offer a practical, safe and tolerable alternative for surgeons because they are easy to use, do not cause a significant increase in vaginal cuff complications, and shorten the operating time. Our study with V-Loc™ 180 unidirectional barbed suture is the second largest series after the study of Cong et al. What the implications are of these findings for clinical practice and/or further research: We believe that the barbed suture, the surgery results of which are openly discussed in our study, will be more prominent in clinical practice owing to the shortened operating time, and that the use of these sutures does not cause a significant increase in vaginal cuff complications

Tear osmolarity and tear function assessment in patients with polycystic ovary syndrome

ABSTRACT Purpose: Polycystic ovary syndrome (PCOS) is an endocrine disease characterized by chronic anovulation and hyperandrogenism. Hormonal changes can affect tear function. This study evaluates tear function and impact of hyperandrogenism on it in PCOS patients. Methods: Fifty patients with PCOS and thirty control volunteers were examined for tear break-up time, Schirmer-I and tear osmolarity. Also, serum levels of total testosterone, FSH, LH and AMH were determined in venous blood samples in the early follicular phase. PCOS patients were divided into two groups by plasma total testosterone level: Group A with normal (≤0.513 ng/ml;n=27), Group B with higher hormone level (>0.513 ng/ml;n=23). Healthy control group indicated as Group C (n=30). Results: LH, total testosterone levels were higher in the PCOS group than in the control group (p=0.012; p=0.025). Mean values of tear break-up time and Schirmer-I were different between groups and especially Group A and C were near to each other differing from B (p>0.05). Tear osmolarity results were higher in Group B, compared to A and C (p=0.049; p=0.033). No significant difference detected in tear osmolarity value means of Group A and C (p=0.107). AMH levels were higher in Group B, compared to A and C (p=0.002; p=0.001). AMH levels in Group A were higher than that of C (p=0.002). Positive correlation between levels of total testosterone and AMH was detected in all PCOS patients (n=50;Pearson's r=0.579; p<0.001). Conclusion: Tear function can be affected in PCOS patients with hyperandrogenism. Tear osmolarity is the most sensitive and objective assessment method for ocular surface changes in PCOS