Normotensive Postpartum Posterior Reversible Encephalopathy Syndrome (PRES) as a Rare Cause of Seizures: Two Case Reports

Posterior reversible encephalopathy syndrome (PRES) is a syndrome characterized by various neurological findings such as headache, visual disturbances, seizures and altered consciousness, and imaging findings of edema in the posterior cerebral regions. Clinical and radiological findings are often reversible. Etiology may include hypertension, cytotoxic drugs, and autoimmune diseases. It often develops on the background of eclampsia and high blood pressure in the postpartum period. In this article, two cases of PRES, which developed under normal blood pressure values during pregnancy and postpartum period and characterized by seizure, are presented

Anatomic Structure Of The Internal Iliac Artery And Its Educative Dissection For Peripartum And Pelvic Hemorrhage

The abdominal aorta is divided into two parts (right and left) at the level of the fourth-fifth lumbar vertebra and called the common iliac artery. Anterior to the sacroiliac joint, common iliac arteries are divided into external and internal iliac arteries. The external iliac artery supplies the lower limb, and the internal iliac artery is the major vascular supply of the pelvis. Internal iliac artery is divided into anterior and posterior trunk. The anterior trunk supplies the pelvis, visceral organs, and the posterior trunk supplies pelvic parietal structures. The broad ligament envelopes the uterus anteriorly and posteriorly with its sheets and continues as the pelvic peritoneum at the lateral side of the pelvic wall. After cutting the pelvic peritoneum, the retroperitoneal area is visualized and the internal iliac artery with other great vessels of the abdomen can be noted.PubMedScopu

A Novel Technique for Mapping the Vascularity of Labia Minora Prior to Labiaplasty: Cold Light Illumination

yassa, murat/0000-0001-8661-1192; dogan, ozan/0000-0002-0016-8749WOS: 000442303900015PubMed: 30140106Objective Aim of the study was to assess the feasibility of a novel technique to determine the vascularity of labia minora prior to labiaplasty. Methods A cold light source employed in laparoscopic procedures was used to illuminate the outer surface of the labia minora as described in this prospective descriptive study. Results Of the patients, 46.1% (n = 41) had upper third prominence, 36% (n = 32) had middle third prominence, and 18% (n = 16) had lower third prominence according to the Banwell classification of morphologies. Right labia minora width was 0-2 cm in 51.7% (n = 46), 2-4 cm in 47.2% (n = 42) and > 4 cm in 1.1% (n = 1) of cases. Left labia minora width was 0-2 cm in 52.8% (n = 47), 2-4 cm in 41.6% (n = 37) and > 4 cmin 5.6% (n = 5) of cases. The incidence of Anterior 2 and Posterior 1 vessels in the differentmorphologies were statistically significantly different (p = 0.007, p = 0.018). The Anterior 2 vessel was higher in the lower morphology group whereas the Posterior 1 vessel was higher in the upper morphology group. A central vessel was observed in 93.3% (n = 83) of patients in the left labium minus and the right labiumminus. The incidence of the Posterior 1 vessel was significantly higher in the left labium minus than in the right labium minus (p = 0.021). Discussion This novel technique to assess labial vascularity using a cold light source could be very useful to reduce dehiscence by avoiding excessive resection of highly vascularized tissue. Most units can easily access a cold light source, which can be used to assess labial vascularity prior to labiaplasty

A randomized prospective comparison of the needleless mini-sling "hammock" and "U-shape" configurations for management of stress urinary incontinence: 18 month follow-up results

yassa, murat/0000-0001-8661-1192; dogan, ozan/0000-0002-0016-8749WOS: 000431871800015PubMed: 29556707Objective To compare the efficacy of needleless mini-sling placed either retropubic (U-shape) or trans-obturator (hammock-shape) to treat stress urinary incontinence. Setting One hundred and twenty six women were randomized in a 2:1 ratio to receive hammock-shaped or U-shaped of Contasure-NDL. Methods All surgical procedures were performed by one senior surgeon experienced in anti-incontinence surgery with mesh. Cough-stress test was considered for objective outcome. Subjective outcomes consisted of International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Patient Global Impression of Improvement (PGI-I) and three-item Likert scale to measure satisfaction. Assessments were performed preoperatively and at postoperative 6th, 12th and 18th month. Results The objective cure rates at postoperative 6th and 12th month were significantly lower in U-shape group compared to hammock-shape group (85.4 vs. 96.4%; p = 0.034) and was comparable with hammock-shape group at 18 th month postoperative (90.2 vs. 96.4%, respectively; p = 0.216). The subjective cure rates at postoperative 6th, 12th and 18th month were similar between groups (90.2/90.2/100% vs. 96.4/96.4/96.4%, respectively; p > 0.05). Median of total ICIQ-SF scores was significantly lower in hammock-shaped group (1.62 +/- 2.92) compared to U-shape (3.80 +/- 2.64) at 18th month (p < 0.001). The rate of patients reported as very satisfied or satisfied to the Likert scale was 90.2% in U-shape group and 96.4% in hammock group. Patients' responses to PGI-I were majorly distributed to "much better" and "very much better" with a mean score of 1.93 +/- 2 in U-shape and 1.33 +/- 1 in hammock group at 18th month of follow-up (p < 0.001). Conclusion U-shape placement of needleless single-incision mini-sling mimicking the retropubic route did not satisfy in achieving the patient's goal when compared to hammock-shape placement

A randomized comparison of a single-incision needleless (Contasure-needlelessA (R)) mini-sling versus an inside-out transobturator (Contasure-KIMA (R)) mid-urethral sling in women with stress urinary incontinence: 24-month follow-up results

yassa, murat/0000-0001-8661-1192; dogan, ozan/0000-0002-0016-8749WOS: 000443429400022PubMed: 29549394There is a shortage of reliable data on the efficiency of the under-investigated mini-slings to treat stress urinary incontinence (SUI). We aimed to compare the effectiveness of the single-incision needleless mini-sling (SIMS) with the transobturator inside-out mid-urethral sling (TOT). Two hundred one women with clinically proven SUI were included in this single-center prospective randomized trial. The patients were randomly allocated to the groups. All surgeries were done by the same single surgeon. Examinations were done by one other blinded surgeon. The patients were followed up for 24 months. Objective cure was defined as the absence of SUI and negative cough-stress test. Subjective cure was defined as no stress leakage of urine after surgery in a validated questionnaire. Failure of the surgery was defined as the need for reoperation. Every complaint was categorized by the IUGA/ICS Classification of Prosthesis-related Complications. The objective (85.4% versus 89.9%, p = 0.362) and subjective (87.6% versus 89.9%, p = 0.636) cure rates were similar with the TOT and SIMS at the postoperative month 24, respectively. The mesh exposure 1 cm rate was 3.4% for both groups, and the mesh exposure > 1 cm rate was 2.2% for both groups. Overall failure rates were 3.4% and 2.2% for the TOT and SIMS group, respectively. No viscus organ perforation was noted. Complications with the SIMS procedure were less painful compared with TOT (p = 0.024). Single-incision needleless mini-slings exhibited similar cure rates as the trans-obturator mid-urethral slings from both the patient and clinician points of view in 24 months of follow-up. Mini-slings resulted in significantly less postoperative pain than trans-obturator mid-urethral slings