İyatrojenik vajen darlığının emilebilir bir oksidize rejenere seluloz ile genişletilmesi

OBJECTIVE: Iatrogenic vaginal stenosis adversely affects the sexual life of couples. The definitive treatment of this condition is possible by redilatation of vagina. This study aims to investi- gate the outcomes of vaginal dilatation procedure performed using an absorbable oxidized regenerated cellulose. MATERIAL AND METHODS: 29 patients who could not have intercourse due to Iatrogenic vaginal stenosis underwent va- gina enlargement surgery using an absorbable oxidized rege- nerated cellulose in the period of April 2014 to August 2020. The results were analysed with the help of the standard ‘Patient Global Impression of Improvement Scale (PGI-I) which evalua- tes patient satisfaction in particular. RESULTS: The mean follow-up period was 16 monts (14 - 24 months). No major perioperative complication was detected except from perianal hemotoma treated with antibiotics and drainage in a case. At 6th month follow up visit, 27 patients re- ported pain free sexual intercourse. Two patients needed re-di- latation 4 and 6 months later respectively.Based on the scores of patients as “much better ‘’and ‘’very much better” on the PGI-I scale, satisfaction rate was 93% at 6th month follow up visit. CONCLUSIONS: Vaginal dilatation surgery with absorbable oxidized regenerated cellulose seems to be a safe and effecti- ve procedure with positive anatomical and functional results. However, many comparative studies are needed to fully the ef- ficiency and safety of this procedure.AMAÇ:Vajinanıniatrojenikolarakfazladaraltılması,çiftlerin cinsel hayatını olumsuz etkilemektedir. Bu durumun kesin tedavisi ise tekrar vajinanın genişletilmesi ile mümkündür. Bu çalışma, emi- lebilir oksidize rejenere seluloz kullanılarak uygulanan vajina ge- nişletme işleminin sonuçlarını değerlendirmeyi amaçlamaktadır. GEREÇ VE YÖNTEM: İatrojenik vajina darlığı nedeniyle ilişkiye giremeyen 29 hastaya, Nisan 2014 ile Ağustos 2020 tarihleri arasında, emilebilir oksidize rejenere seluloz kullanılarak vajina genişletme ameliyatı yapıldı. Bu ameliyatın sonuçları, özellikle hasta memnuniyetini değerlendiren standart ‘’Hasta Memnu- niyet Ölçeği’’ yardımıyla incelendi. BULGULAR: Hastalar, ortalama 16 ay (14 - 24 ay) takip edildi. Drenaj ve antibiyoterapi ile tedavi edilmiş bir perianal hemo - tom vakası dışında perioperatif dönemde kaydedilmiş majör komplikasyon saptanmadı. Altı haftanın sonunda, 27 hasta ağ- rısız cinsel ilişkiye girebildiğini belirtti. Iki hastada ise, sırasıyla 4 ve 6 ay sonra, vajina genişletme ameliyatı tekrar uygulandı. Cer- rahiden altı ay sonra, memnuniyet ölçeğindeki “daha iyi ‘’ve ‘’çok daha iyi” cevaplarına göre ameliyat sonrası hasta memnuniyet oranı %93 olarak saptandı. SONUÇ: Emilebilir oksidize rejenere seluloz kullanılarak yapılan vajina genişletme ameliyatı, olumlu anatomik ve fonksiyonel sonuçlara sahip etkili ve güvenilir bir işlem gibi görünmektedir. Ancak, bu yöntemin güvenilirliğinin ve etkinliğinin tam olarak değerlendirilebilmesi için çok sayıda karşılaştırmalı çalışmaya ihtiyaç vardır

Interobserver variability of Eastern Cooperative Oncology Group (ECOG) performance status in gynecologic oncology patient

..

First Trimester Renin and Aldosterone Levels of Pregnant Women With Prognosis of Preeclampsia and/or Related Adverse Pregnancy Outcomes

Objective: To evaluate the first-trimester renin and aldosterone levels in pregnancies complicated by prognosis of preeclampsia and/or related adverse pregnancy outcomes.Methods: We measured serum levels of renin and aldosterone in pregnant women for first trimester screening test. Total of 180 pregnant women were included in the study and 144 of them completed the study. All pregnant women were followed during pregnancy for preeclampsia and related complications. Renin and aldosterone levels in preeclampsia and/or poor obstetric prognosis group were compared with normal pregnancy outcome group.Results: Preeclampsia developed in 13 pregnant women and one or more poor obstetric outcome developed in 36 women. Renin and aldosterone levels were not significantly different in preeclamptic women or those with poor obstetric outcome compared with the controls.Conclusion: We think that maternal first trimester renin and aldosterone levels do not have a role in the pathogenesis and prediction of preeclampsi

Can first trimester maternal serum follistatin like 3 levels predict developing gestational diabetes mellitus?

Purpose: The purpose of this study is to determine whether the first trimester maternal serum levels of follistatin like 3 (FSTL3) are altered in patients who develop gestational diabetes mellitus (GDM).Methods: This is a prospective nested case-control study that included 170 singleton pregnant women recruited in their first trimester. All women were followed up until the delivery and 144 of them completed the study. The maternal serum levels of FSTL3 were measured at 11-14 weeks of gestation. The GDM-affected women (n=19) were compared with the GDM-free control women (n=125) for potential serum biomarkers including the FSTL3 levels.Results: There were no significant differences in maternal age, maternal pre-pregnancy body mass index, and neonatal birth weight between the GDM group and the GDM-free control group. Women with GDM had significantly greater weight gain during pregnancy than the women without GDM. Serum concentration of glycosylated hemoglobin was significantly higher in women with GDM. There were no significant differences in serum FSTL3 levels (p=0.578) between the GDM group and the GDM-free control group.Conclusions: Our results suggest that the first trimester maternal serum FSTL3 levels are not altered in women who develop GDM and thus do not support the use of serum FSTL3 levels for early prediction of GDM.WOS:0004027138000152-s2.0-84989227715PubMed: 2762397

Effect of human papillomavirus subtype on the rate of positive surgical margin after cervical conization

Objective. Human papillomavirus (HPV) infection is a risk factor for cervical carcinoma. Over 100 types of HPV have been identified. The excisional procedures are recommended for women with high-grade cervical intraepithelial neoplasia. Surgical margin status is an important predictor of the risk of relapse. The aim of the current study was to evaluate whether HPV genotype is a predictive factor of positive surgical margin after cervical cone excision. Materials and Methods. The records of 448 HPV-infected patients who underwent loop electrosurgical excision or cold knife conization at a tertiary gynecological cancer center were retrospectively reviewed. The patients were divided into 6 groups according to HPV positivity: HPV 16 only, HPV 18 only, HPV 16/18, other high-risk HPV (hrHPV), HPV 16/hrHPV, and HPV 18/hrHPV. Results. There was no significant difference between the HPV groups in terms of age, parity, menopausal status, endocervical canal involvement, conization method, and the rates of positive margin (P = .15, P = .49, P = .07, P = .20, P = .24, P = .39, respectively). Conclusion. The results show that HPV subtypes might not be associated with endocervical canal involvement and the rates of positive margin. In addition, margin status was not related to the conization method and the number of excised cervical tissue

The effect of abdominal drainage on post-operative morbidity; a prospective cohort study

The aim of this study was to investigate the effect of drains used in current clinical practice on operation parameters and post-operative morbidity. The comprehensive data obtained through the prospective design were analysed in detail according to whether abdominal drainage was applied. Abdominal drainage was present in 44.1% of patients who met the inclusion criteria. Drains were placed significantly more frequently during oncologic surgery (p = .007). The mean mobilisation (p = .001), first flatus (p = .001), and first oral intake (p = .029) times were longer in the drain group than those in the non-drain group. In patients who underwent oncological surgeries, no significant differences were observed except for the pre-operative duration of bowel preparation (p = .006) and first flatus time (p = .003). Our results suggest that drain placement in gynecological procedures does not provide an additional advantage.IMPACT STATEMENT What is already known on this subject? Post-operative drainage of the abdominal cavity has been controversial for many years. However, whether abdominal drainage provides an additional benefit in lower and upper abdominal surgical procedures remains unclear. What do the results of this study add? Most studies have examined post-operative pain and surgical site infections. We examined the relationship between abdominal drainage and demographic and pre-/post-operative clinical features in detail. We demonstrated that abdominal drainage in gynecological procedures may not provide an additional advantage. What are the implications of these findings for clinical practice and/or further research? The present study provides valuable information that can guide physicians in deciding whether to use post-operative abdominal drainage. This topic warrants investigation with randomised data in the future

Does HPV type affect the rate of positive surgical margin after cervical cone excision?

..

Validation of Turkish version of Eastern Cooperative Oncology Group Performance Status (ECOG-PS) for gynecologic oncology patients

..

The rate of HPV and smear positivity in the follow-up period of patients that underwent cervical excisional procedures

..

Predictors of gas passage time interval at postoperative period in gynecologic oncologic surgery: Is drainage necessary?

..