Acute renal failure due to complete labial fusion: A case report

AbstractAcute renal failure is characterized by rapidly disruption in kidney function and postrenal causes typically result from obstruction of urinary flow. Multiple etiologies were described for acute renal failure, but labial fusion in postmenopausal female is a quite rarely encountered pathology among postrenal causes. Only a few cases have been presented in postmenopausal women presenting with urinary retention. We present a case with acute renal failure due to complete labial fusion in a postmenopausal woman and its treatment

Fresh Versus Frozen Testicular Sperm Samples in Microdissection Testicular Sperm Extraction Intracytoplasmic Sperm Injection Treatment

Objective: The present study aims to compare the clinical outcomes of fresh versus frozen testicular samples in patients with non-obstructive azoospermia who would undergo intracytoplasmic sperm injection procedure. Study Design: This is a retrospective review of 541 patients with non-obstructive azoospermia who consecutively underwent microdissection testicular sperm injection and intracytoplasmic sperm injection between January 2010 and October 2014. Results: A total of 4896 mature oocytes were collected from the partners of azoospermic men and 1894 sperms were retrieved by microdissection testicular sperm procedures. About 1036 fresh sperms were used to perform intracytoplasmic sperm injection in 296 men with non-obstructive azoospermia whereas 858 in 245 azoospermic men. Approximately 1228 embryos were obtained after intracytoplasmic sperm injection and 1080 embryos were transferred. After embryo transfer, 146 clinical pregnancies occurred and 125 pregnancies ended up with live birth. The fertilization, implantation, clinical pregnancy and live birth rates were respectively 44.6%, 33.4%, 28.0% and 24.7% for 296 fresh microdissection testicular sperm cycles. On the other hand, the fertilization, implantation, clinical pregnancy and live birth rates were respectively 46.5%, 32.7%, 25.7% and 21.2% for 245 frozen microdissection testicular sperm cycles. There was no statistically significant difference between the fresh and frozen microdissection testicular sperm injection cycles in aspect of fertilization, implantation, clinical pregnancy and liver birth rates (p=0.125, p=0.194, p=0.196 and p=0.182). Conclusion: The utilization of fresh and frozen sperms in microdissection testicular sperm - intracytoplasmic sperm injection cycles has similar clinical outcomes. The use of frozen sperms obtained by testicular sperm can be considered as an efficient and safe approach for avoiding unnecessary ovarian hyperstimulation and repetitious interventions on testicular tissues

Is caesarean myomectomy a safe procedure? A comparative study

OBJECTIVE: Uterine myomas are the most common benign pelvic tumours observed during the reproductive period.Increased risks of haemorrhage and postoperative morbidity lead professionals to avoidmyomectomy at the time of Cesarean (C-section). The present study retrospectively analysed the dataof patients who had undergone C-section only and those that had undergone C-section and simultaneous myomectomy. STUDY DESIGN: The data of 42 patients (Group 1) who had underwent caesarean myomectomy andof 50 patients underwent C-section only (Group 2) out of 92 patients that had been taken into C-sectionon the basis of obstetric indications were retrospectively analysed in this study. The relevant patient datawere recorded with the inclusion of demographic data, gestational week, and preoperative and postoperative laboratory findings. Types, locations and sizes (the largest diameter) of individual myomas wereidentified and noted.RESULTS: The mean diameter of myomas was 66.3±30.2 mm. Ten patients that had underwent caesarean myomectomy (23.8%) developed a need for intensive care. No statistically significant differencewas found in laboratory parameters between Group 1 and Group 2.CONCLUSION: Caesarean myomectomy, when performed by experienced obstetricians, does not leadto a significant increase in maternal morbidity and mortality. Although the short-term effects of this procedure are known, there is a need for the conduct of more comprehensive studies to establish its longterm effects on fertility or how it will affect the next pregnancy processe

Retrospective Analysis of Patients with Genitourinary Fistula

Objective: To present the outcomes of patients treated at a tertiary center for a diagnosis of genitourinary fistula secondary to gynecological and obstetric etiologies. Study Design: In this retrospective study, analysis was made of 18 patients with a diagnosis of genitourinary fistula in a tertiary center between January 2006 and June 2016. Patient data were taken from the archives and patient histories. A record was made of examinations, diagnostic methods such as cystoscopy and fistulography and appropriate medical treatments, demographic data, intraoperative and post-operative complications, duration of hospital stay, surgical operations and types, diameter and location of fistulas. Results: Of the 18 cases, 14 were secondary to obstetric trauma. In 10 of these 14 cases, fistula had developed after difficult vaginal delivery and in four cases, after caesarean section. Four of the 18 cases were secondary to gynecological surgeries, namely hysterectomy and cystocele repairs. Vesicovaginal fistulas were repaired transvaginally while vesicouterine fistulas and bilateral ureterovaginal fistulas were repaired transabdominally. The mean hospital stay was 3.8±1.5 days (2-7 days). Patients were followed up closely in the first 3 months and recurrence developed in only one case. Conclusion: Fistulas secondary to gynecological procedures are uncommon while fistulas secondary to inadequate perineal care, insufficient labor monitoring and difficulties in vaginal delivery techniques are more prevalent in Turkey. Thorough evaluation, using all diagnostic tools for complete diagnosis, understanding the pathophysiology and choosing the best surgical procedure are mandatory to obtain good outcomes after the surgica

Effects of the treatment modalities in Bartholin's abscess

BACKGROUND: Bartholin's abscess is a gynecological pathology commonly observed in the reproductive period. The etiology attributes this pathology to a wide range of factors. Even though there is more than one treatment option, there has yet to emerge a consensus regarding the ideal method. The present study aims to present patients operated on due to the presence of Bartholin's abscess. METHODS: The data pertaining to 15 patients that had applied to our clinic with various complaints and had been subject to silver nitrate treatment upon the diagnosis of Bartholin's abscess (Group 1) and to 21 patients that had been subject to surgical excision after the same diagnosis (Group 2) were reviewed retrospectively. The review was followed by the recording of age, gravidity, parity, presenting symptoms, mass sizes and locations, operative durations, and observed complications of the patients. The data thus compiled were evaluated through statistical analyses. RESULTS: In the specified timeframe, 36 patients were observed to have been operated upon, 15 patients to have been subject to silver nitrate treatment (Group 1) and 21 patients to have been subject to surgical excision (Group 2). All operated patients were in the reproductive period. Mass locations tended to be in the right side in both groups (93.3% and 90.5%). No statistically significant difference was observed between the operated groups in mass sizes (P=0.892). The operative durations were significantly shorter among patients in Group 1 (P=0.001). Any increase in mass size and operative duration was observed to increase the risk of complications. CONCLUSIONS: Increased mass size and extended operative duration are the two most important risk factors in the emergence of complications. It should be kept in mind that an effective course of treatment can be secured with minimum side effects through the performance of the operation in the shortest duration possible and with the use of suitable techniques. We are of the opinion that appropriate results can be achieved upon the consideration of minimally invasive treatment modalities in all aspects

Serum and follicular fluid irisin levels in poor and high responder women undergoing IVF/ICSI

WOS: 000382459500005PubMed ID: 27249590OBJECTIVE: We examined the follicular fluid (FF) and serum levels of irisin in high and poor responders undergoing IVF/ICSI to test whether irisin has a role in the metabolic regulation of energy homeostasis in growing follicle. PATIENTS AND METHODS: Twenty infertile women with PCOS and 20 poor responder participants undergoing controlled ovarian stimulation (COS) with GnRH antagonist protocol for IVF/ICSI treatment were allocated. Blood was obtained at the time of oocyte retrieval. The follicular fluid content of mature follicles was collected from both high and poor responder women. Irisin levels were measured by using EIA. RESULTS: There was no significant difference between serum and FF-irisin levels in women with PCOS. (11.18 +/- 5.14 mu g/mL vs. 11.06 +/- 4.93 mu g/mL, p < 0.96). In contrast, serum levels of irisin in poor responders were significantly higher than in the FF-irisin levels (13.13 +/- 4.27 mu g/mL vs. 10.09 +/- 4.14 mu g/mL, p < 0.01). FF-irisin levels of PCOS subjects were positively and significantly correlated with serum levels of irisin (r: 0.81, p < 0.00). Serum irisin was positively associated with serum levels of total testosterone but was negatively associated with HOMA-IR in the overall patient population. FF-irisin levels were also noted to be negatively correlated with HOMA-IR. Although there is no correlation between serum irisin and AMH levels, FF irisin levels were negatively correlated with serum AMH levels in PCOS subjects. Contrary to PCOS group there were no significant correlation between serum and FF-irisin levels in poor responder group (r: 0.21; p < 0.35). CONCLUSIONS: The present study is the first attempt to explore the role of irisin in oocyte development by measuring FF and serum levels of this molecules in patients with poor and high responders undergoing IVF/ICSI

Is Caesarean Myomectomy a Safe Procedure? A Comparative Study

OBJECTIVE: Uterine myomas are the most common benign pelvic tumours observed during the reproductive period.Increased risks of haemorrhage and postoperative morbidity lead professionals to avoid myomectomy at the time of Cesarean (C-section). The present study retrospectively analysed the data of patients who had undergone C-section only and those that had undergone C-section and simultaneous myomectomy. STUDY DESIGN: The data of 42 patients (Group 1) who had underwent caesarean myomectomy and of 50 patients underwent C-section only (Group 2) out of 92 patients that had been taken into C-section on the basis of obstetric indications were retrospectively analysed in this study. The relevant patient data were recorded with the inclusion of demographic data, gestational week, and preoperative and postoperative laboratory findings. Types, locations and sizes (the largest diameter) of individual myomas were identified and noted. RESULTS: The mean diameter of myomas was 66.3±30.2 mm. Ten patients that had underwent caesarean myomectomy (23.8%) developed a need for intensive care. No statistically significant difference was found in laboratory parameters between Group 1 and Group 2. CONCLUSION: Caesarean myomectomy, when performed by experienced obstetricians, does not lead to a significant increase in maternal morbidity and mortality. Although the short-term effects of this procedure are known, there is a need for the conduct of more comprehensive studies to establish its longterm effects on fertility or how it will affect the next pregnancy processes

Long-term changes in sexual functions following complicated pregnancies and deliveries

Objective: The aim of this study is to evaluate the effects of complicated pregnancy and delivery (P/D) on sexual functions and to determine possible risk factors that affect sexual functions. Methods: Women, who have the history of severe preeclampsia, placenta previa totalis, abruption placentae or postpartum uterine atonia, comprised the study group. The control group was comprised the women matched for age, parity, mode of delivery, vocation, the level of income and education status. Their fear of getting pregnant again and fear of death in the most recent delivery were measured by questionnaires. The Arizona Sexual Experience Scale was used to assess the sexual functions. We compared sexual functions of the women with and without suffering from complicated P/D. Results: Fear of death during the last delivery and fear of getting pregnant again were significantly more intense in the study group (p=0.002 and p<0.001, respectively). The rates of volunteers detected sexual dysfunction in the study and control groups were 55.1% and 38.7%, respectively (p=0.081). Fear of death during the last delivery was found to be significant risk factors for sexual dysfunction (odds ratio [OR] = 1.653; 95% CI = 1.131-2.415; p=0.009). Conclusion: In conclusion, sexual dysfunction rate of women with a history of complicated pregnancy and delivery, was almost equal that of women with a history of health pregnancy and delivery. Fear of death during the last delivery was found to be most important risk factor for sexual dysfunction. J Clin Exp Invest 2013; 4 (4): 429-43

The evaluation of diagnostic and clinical findings in grand multiparous patients with endometrial cancer

Objective: The aim of the present study is to evaluate differences in diagnostic and clinical characteristics of the grand multiparous patients with endometrial cancer comparing with the other patients with endometrial cancer.Methods: A total of 34 patients that operated for endometrial cancer between January 2006 and August 2012 in our clinic were included. The patients were divided into three groups according to the number of births; group 1 (nulliparous patients, n=8), group 2 (the number of delivery from one to four, n=12), group 3 (grand multiparous patients, n=12). The diagnostic, clinical and histopathological data of the patients in the group 3 (grand multiparous patients) were compared with those of the other groups.Results: The mean age of the patients in group 3 (grand multipara) was found to be significantly higher than those of the other groups (p0.05). The percentages of patients with the tumor stage 1A in the groups 1, 2 and 3 were found to be 75%, 64.2% and 83.3%, respectively. All of the grand multiparous patients (group 3) were found to have stage 1 tumor.Conclusion: In conclusion, grand multiparous patients were diagnosed at advanced age but their diseases were endometrioid type endometrial cancer at an early stage. The protective effect of pregnancies against endometrial cancer decreases at advanced age. The period of time after last birth may be a factor on the risk of endometrial cancer. Key words: Endometrial cancer, grand multiparity, nulliparity, pregnanc