"Removal without Replacement" Strategy for Uncontrolled Prosthetic Tricuspid Valve Endocarditis Associated with Abortion Sepsis

Isolated tricuspid valve (TV) endocarditis associated with abortion is a rare entity with a poor prognosis. We report the case of a 22-year-old woman with a diagnosis of isolated prosthetic TV endocarditis secondary to recurrent abortion. The patient had progressed to multiorgan failure and disseminated intravascular coagulation during her clinical course. Because of the high operative risk and uncontrolled infection, we performed an unusual surgical approach that has not previously been reported. Resection of infected valvular tissue without replacement of the prosthesis led to a rapid convalescence period and complete cure

Combined procedure of cesarean delivery and preperitoneal mesh repair for inguinal hernia: An initial experience

Background: Combined surgery for cesarean delivery and preperitoneal mesh repair for inguinal hernia has not been previously reported. Objectives: Our aim was to describe the method and to present the results of this simultaneous surgery through a single incision. Methods: From 2012 to 2014, 15 patients underwent cesarean delivery combined with preperitoneal mesh repair for inguinal hernia. All patient characteristics and perioperative findings were recorded. Results: Among 15 patients, 13 had unilateral inguinal hernias and two had bilateral hernias. The mean times spent for unilateral and bilateral hernias were 35.8 minutes (range, 30–45 minutes) and 67.5 minutes (range, 65–70 minutes), respectively. Direct and indirect hernias were present in one and 15 patients, respectively. One patient had mixed hernia. No significant complication was observed perioperatively. Hospital stay ranged from 1 day to 3 days (mean, 1.87 days), and all patients were discharged without any problem. No recurrence was found during the follow-up periods. Conclusion: Single anesthesia, single incisional scar, and single hospitalization are the major advantages of this simultaneous approach of cesarean delivery and preperitoneal mesh repair for inguinal hernia. Our analysis suggests that this combined procedure can be performed safely in selected cases

The effect of stress incontinence operations on sexual functions: Laparoscopic burch versus transvaginal Tape-O

Aim: Stress urinary incontinence (SUI) has some negative emotional and physical effects on sexual functions. In this study, we aimed to question the effects of surgical treatment of stress incontinence on sexual function using the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) form. Materials and Methods: A total of 77 sexually active women who were surgically treated for SUI between 2014 and 2015 at a university hospital. Tension-free transvaginal tape (TVT-O) operation and the laparoscopic Burch procedure were performed on 42 and 35 patients, respectively. Patients with isolated stress incontinence were included in this study. All patients enrolled were invited to fill out the PISQ-12 questionnaire before surgery and 6 months after surgery. Results: The mean total postoperative PISQ-12 score in both TVT-O and Burch groups was significantly increased compared to the preoperative period (P < 0.001 and P < 0.001, respectively). When the PISQ-12 scores were evaluated according to the subgroups, physical and partner-dependent scores significantly increased in the postoperative period compared to the preoperative period in the TVT-O group (P < 0.001 and P = 0.004, respectively). Conclusions: Rate of the surgery success for SUI is positively correlated with the improvement of sexual functions. Minimally invasive methods in SUI surgery has been progressively increasing day-by-day. The lesser invasive approaches seem to replace the more invasive approaches in the near future

Hipertansif hastalarda N- amino terminal prohormon beyin natriüretik peptid düzeyleri ile ilişkili faktörler

Objectives: In this study we ınvestigated that which the factors affecting the level of N- amino terminal prohormone brain natriuretic peptid (NT-pro BNP) in hypertensive population. Methods: A total of 309 hypertensive patients (mean age 50.5 ± 10.7, 49.2% male) were enrolled into the study. Lower group was defined as NT-pro BNP 60 pg/dl or low, high group was defined as NT-pro BNP 60 pg/dl higher. The patients with secondary hypertensive, heart failure, coronary artery disease, valvular diseases, chronic renal failure (serum creatinine >1.5 mg/dl, blood urea nitrogen>30 mg/dl) and chronic obstructive pulmonary disease were excluded from the study. Results: Left ventricular mass index, 24-h systolic blood pressure, day systolic blood pressure, night systolic blood pressure and night diastolic blood pressure higher in high group than lower group. In stepwise linear regression analysis, a significant relation was found between sex, left ventricular mass index, age, night systolic blood pressure and higher NT-pro BNP levels (R²=0.236, ß= -0.258, P<0.001, ß=0.185, P=0.006, ß=0.174, P=0.010, ß=0.160, p=0.015 respectively)., Conclusion: Age, gender, left ventricle mass index and night systolic blood pressure were found as independent predictive factors on NT-pro BNP in hypertensive patients