Mechanical bowel preparation for laparoscopic hysterectomy, is it really necessary?

In this prospective randomised single-blind case-controlled cohort study the aim was to compare the effects of mechanical bowel preparation (MBP) on field of vision and surgical comfort during total laparoscopic hysterectomy procedures. The study group was made of 102 patients that had undergone total laparoscopic hysterectomy (TLH), between July 2012 and June 2014. Statistical comparison was made between the means of durations of operation between the two groups divided by visual indexing (VI). The patients with a VI score of less than 2 and those with VI score of 2 or higher were compared in terms of operation duration in regard to the criteria described above. According to calculations, the p value is .664, therefore, making the result statistically not significant at p ≤ .05. In conclusion it can safely be reported that mechanical bowel preparation before laparoscopic hysterectomy was not found to be necessary in this study group.Impact statement Considering recent publications on the subject, the benefits of mechanical bowel preparation before gynaecologic laparoscopy is still a debateable subject and in that regard what we wish to share is that our study is based on an objective visual indexing tool not used before thus making our results reliable on deciding whether or not patients should receive mechanical bowel preparation prior to laparoscopic surgery for benign reasons

Prophylactic ligation of uterine arteries at its origin in laparoscopic surgical staging for endometrial cancer

Aim The aim of this study was to compare the surgical outcomes between patients who were staged laparoscopically for early-stage endometrioid-type endometrial cancer (EC) between those who underwent prophylactic ligation of uterine arteries (UAs) prior to pelvic lymphadenectomy and the patients who were operated with standard procedure. Methods This retrospective study was conducted in women diagnosed with early-stage and low/intermediate-risk endometrioid-type EC. The control group included patients who underwent standard laparoscopic pelvic lymphadenectomy and the study group concerned patients who underwent prophylactic ligation of UA prior to pelvic lymphadenectomy. The prophylactic ligation of UA procedure was performed at a point just proximal to its origin. Results The mean lymph node count dissected in the study group was higher in terms of statistical significance (17.5 +/- 2.2 vs. 19.8 +/- 3.6, p = 0.003 and p < 0.05). The rate of the patients who had a positive pelvic lymph node detected did not differ between groups (7.4% vs. 16.7%, p = 0.258 and p < 0.05). The operation time (OT) of the patients in the study group did not differ between groups (p = 0.546 and p < 0.05). Hemoglobin drop (-0.5 +/- 0.7) and hematocrite drop (-0.8 +/- 0.9) values in the study group were found to be lower in the study group (p = 0.000, p = 0.000, and p < 0.05). Conclusions Performing prophylactic ligation of UA at its origin prevents unwanted bleeding and facilitates the laparoscopic pelvic lymphadenectomy procedure.WOS:0007002433000012-s2.0-85115674696PubMed: 3457156

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

Comparing Trans Obturator Tension Free Vaginal Tape Surgery with Needleless Suburethral Sling

Aim: Urinary incontinence is described by the International Continence Society as an involuntary urinal discharge that can be objectively proved to cause hygenic and social problems. We aim to share our surgical experience in 51 patients in which trans obturator tension free vaginal tape procedure [TOT] is compared with needleless suburethral sling placement, also known as minisling. Material and Method: 51 patients complaining of genuine stress incontinence between December 2011 and December 2012 were retrospectively involved in the study group. All patients were 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 and minisling technique, results were compared in terms of blood loss, operation time, and the surgical effectiveness of the technique. Results: Operation time was 27 +/- 6 minutes for TOT and 11 +/- 4 minutes for minisling respectively. Comparison of operation time and blood loss was in favor of the minisling group. Disscussion: TOT and minisling are both described as minimally invasive procedures that can be performed under regional anesthesia to an outpatient with minisling bearing all the advantages of TOT without needle complications

Progesterone Supplement and Luteal Phase Deficiency in Unifollicular Intrauterine Insemination Cycles

Aim: Intrauterine insemination is a widely used technique with advantages of being a simple and less invasive method with a lower cost when compared to other assisted reproductive techniques. In the present prospective randomized controlled study we aim to prove that progesterone supplementation is a beneficial factor in pregnancies achieved with intra uterine insemination and also we want to emphasise that luteal phase deficiency does not always occur in multifollicular cycles but can be seen in unifollicular cycles as well. Material and Method: Patients diagnosed with unexplained infertility between December 2011 and December 2012 were admitted to the study group. 278 IUI cycles with COH using recombinant FSH induction were recorded. Results: The effect of progesterone supplement on achieving pregnancy was statistically significant (p<0.05) with a rate of 33.66% when compared to the non-receiving group that had a rate of 12.22%. Discussion: Progesterone supplementation, either in defective luteal phase or not has a chance of improving pregnancy rates in general and contrary to the notion that luteal phase deficiency mainly occurs in multifollicular cycles, it can be seen in unifollicular patients as well

The Effect of Myths About Sexuality and the Level of Knowledge About Sexuality on the Marital Satisfaction in Married Couples

To look into the effect of sexual myths and level of knowledge about sexuality on marital satisfaction in married couples. The study was carried on with 104 voluntary respondents; 57 of which are married women and 47 are married men. The data has been collected with Personal Information Questionnaire, Marital Adjustment Test, Sexual Myths Analysis Questionnaire and The Golombok Rust Inventory of Sexual Satisfaction (GRISS), data has been analyzed with SPSS 15.0 software package (Statistical Package for Social Sciences). According to these findings, as the belief in sexual myths increases, the sexual satisfaction decreases; yet the increase in the belief in sexual myths does not affect the marital satisfaction. The findings implicate that as the knowledge about sexuality increases, the sexual satisfaction increases while the marital satisfaction decreases. As the number of sexual myths increases, marital adjustment decreases. The findings don't show any significant correlation between sexual satisfaction and marital adjustment

Comparison of Modified Biophysical Profile with Doppler Ultrasonographic Analysis in Determining Fetal well Being in the Third Trimester

OBJECTIVES: In this study we aim to compare modified biophysical profile with Doppler ultrasonographic analysis in determining fetal well being in the third trimester. STUDY DESIGN: Our research is based on 99 voluntary pregnant patients ahead of 36 weeks who admitted to our hospital for labor between December 2009 and March 2010. Doppler ultrasonography and biophysical scoring were applied to all patients admitted to the study group. Following delivery, birth weight and APGAR scores of the 1st and 5th minute were noted down by the pediatrician. Prognosis and survey of all newborns admitted to the Neonatal Intensive Care Unit after delivery were closely monitored. The effectiveness of modified biophysical profile and obstetric Doppler analysis in determining the perinatal outcome was based on the evaluation of certain parameters such as; fetal distress, presence of meconium, admittance to NICU and APGAR score of the 5th minute. RESULTS: Our research is based on 99 voluntary pregnant patients between 18 and 40 years old and who are ahead of 36 weeks that were admitted to our hospital for labor between December 2009 and March 2010. Patients' median age was 23.30±4.91, gravida changing between 1 and 5 with a median of 2 and parity changing between 0 and 2 with a median of 1. Birth weight measurements varied from 2680g to 3900g with a median of 3192.22±277.42 grams. Caesarean section was performed on 20 patients (20.2%). The remaining 79 (79.8%) were delivered vaginally CONCLUSION: Modified biophysical profile was found to be a more reliable tool than Doppler analysis in determining perinatal outcome and in prediction of acute fetal distress. But combining modified biophysical profile with Doppler analysis has yielded a higher sensitivity aiding in the diagnosis of perinatal outcome and acute fetal distress. In conclusion, in order to effectively predict acute fetal distress and to maintain a reliable screening method, combined use of these tests, namely modified biophysical profile and umbilical artery Doppler analysis, has proven to be the most valuable and effective method as shown in our study