Long-Term Results of the TVT, TOT and Burch Procedure for the Treatment of Stress Urinary Incontinence

Aim: The aim of this study was to compare the surgical procedures for the treatment of stress urinary incontinence and to define which method is more effective and safe. Methods: Records of the patients who were treated for stress urinary incontinence between April 2003 and December 2010 were evaluated. Patients who underwent tension-free vaginal tape (TVT) and transobturator tape (TOT) procedures, and Burch colposuspension were compared for evaluating the efficacy of the operation. Chisquare test and Fischer’s Exact Test were used for categorical variables; continuous variables were analyzed by using student’s t-test. A p value less than 0.05 was considered statistically significant. Results: Follow-up records of 97 patients were analyzed for this study. TVT was the most frequently used anti-incontinence procedure (n=39, 40.2%) followed by TOT (n=34, 35.1%) and Burch (n=24, 24.7%). The mean preoperative and postoperative International Consultation on Modular Questionnaire (ICIQ) scores were 16.4±2.01 and 4.68±5.6, respectively (p=0.0001). There was no significant difference between the operations according to subjective evaluation. The subjective cure/improvement rate for Burch was 87.5%, and was 74.3% and 88.2% for TVT and TOT, respectively. Conclusion: There were no significant differences between Burch, TVT and TOT for long-term efficacy. Surgical procedure should be chosen based on surgical experience and presence of additional surgical procedure. (The Me di cal Bul le tin of Ha se ki 2012; 50: 122-6

Malignant Struma Ovarii in a Postmenopausal Asymptomatic Woman: A Case Report

Introduction: Struma ovarii is an ovarian tumor that consists predominantly thyroid tissue and accounts for only 2% of all mature teratomas. It is usually a benign condition - malignant transformation has been reported to occur in about 5% of all struma ovarii cases. Case: A 58-year-old postmenopausal woman attended our outpatient clinic for her annual gynecologic exam, on which a palpable ovary was incidentally found. Ultrasound and magnetic resonance imaging work-up showed two-centimeter solid mass on the right ovary. Laparoscopic salpingo-oophorectomy was performed; the histology report revealed a focus of thyroid papillary carcinoma in a struma ovarii. The patient underwent surgical staging procedure according to the ovarian cancer guideline. The tumor was in stage 1A, thus, no further treatment was indicated apart from follow-up. Conclusion: Malignant struma ovarii is a rare neoplasm of the ovary. Surgical staging should be included in the treatment, like in the other germ cell ovarian tumors. (The Medical Bulletin of Haseki 2011;49: 117-