Single-center Experiences of Ovarian Sex Cord Stromal Tumors

Objective:The aim of this study is to examine the sex cord stromal tumors of the ovary operated in our clinic in the last 4 years and to contribute to the literature on this rare tumor.Method:The clinical and laboratory findings of 34 patients with pathological diagnosis of ovarian sex cord stromal tumor, who were operated in our obstetrics and gynecology clinic between 2016 and 2020, were evaluated retrospectively. Pathological diagnoses were classified and other accompanying pathologies and complaints were evaluated for each type.Results:Ovarian sex cord stromal tumors usually attract attention with the peripheral effects of the hormones produced by the tumor tissue. They rarely come to very large sizes. They are mostly benign. When the hormone estrogen is produced, accompanying endometrial pathologies should not be overlooked. Hormonal complaints in patients improve dramatically after surgery both clinically and laboratory. Oncological follow-up is required following diagnosis in some malignant types.Conclusion:If ovarian sex cord stromal tumor is suspected, preoperative blood androgen levels, inhibin A, and alpha feto protein (AFP) should be evaluated. In addition, ultrasonographic and, if necessary, endometrial histopathological evaluations are important for patient follow-up as well as diagnosis. The patient's fertility desire and age should be considered during treatment

Dörtlü HPV aşisinin vulvar kondilom nüksü üzerine etkisi

IEEE International Ultrasonics Symposium, IUS 201521 October 2015 through 24 October 2015118680Aim: We tried to assess both prophylactic and therapeutic efficacies of quadrivalent vaccine for vulvar condylomas. Material and Methods: Thirty three women with vulvovaginal condylomas and variable degree of cervical preinasive lesions were treated with cauterization at gynecological oncology clinic of Zeynep Kamil Women and children’s health Training and Research hospital between 2006 to 2014. After cauterization treatment, subjects were vaccinated by quadrivalent HPV vaccine at 0, 2 and 6th months from the treatment. Subjects were followed for 48 months by repeat cervical smears/year and routine urogenital examination. Results: Among 33 cases with vulvar condylomas, there were 6 (18 %) cases with HGSIL, 4 (12 %) cases with ASCUS, 8 (24 %) cases with LGSIL and 15 (46 %) cases with normal cervical smear. Colposcopy directed biopsy revealed 3 (9 %) cases with CIN1, 1 (3 %) case with CIN 3, 29 (88 %) cases with normal histopathology. Distribution of HPV screening results were as follows:HPV 16 in 2 (6 %) cases, HPV 35 in 1 (3 %) case, HPV 56 in 1 (3 %) case, there were 18 (54 %) cases with HPV negative result and 11 (34 %) cases with low risk HPV type. Condyloma recurrence was observed in 4 (12 %) cases. There was only 1 (3 %) case of women with abnormal smear (LGSIL) in control smears during 48 months of follow up. Conclusion: In our study, we included only regularly followed women through 48 months period, and our data revealed lowered condyloma recurrence after cauterization and quadrivalent vaccination

Effect of Gum Chewing on Intestinal Functions after Gynecological Operations: A Randomized Controlled Study

OBJECTIVE: We aimed to assess the efficacy of gum chewing on intestinal functions after gynecological operations. STUDY DESIGN: A total of 86 women who underwent gynecological operation with different indications were randomly assigned to 2 groups: Group 1 was assigned to gum chewing after operation (n=52), while Group 2 was directed to routine postoperative care (n=52). Time of first bowel sound and defecation after surgery were recorded to assess the effect of gum chewing. Operation time, blood loss, type of incision, pre and postoperative serum hemoglobin levels were all evaluated. RESULTS: There was no difference between groups in terms of age, duration of operation, intraoperative blood loss, pre and postoperative serum hemoglobin levels, duration to first bowel sound, flatulence and defecation (p>0.05). Age (r=0.234, p=0.032), type of incision (r=0.228, p=0.037) were significantly correlated with the time to first bowel sound. Type of incision (r=0.295, p=0.006), duration of operation (r=0.277, p=0.01) and intraoperative blood loss (r=0.298, p=0.006) were significantly correlated with the time to first flatulence. In multivariate regression analyses, none of the variables were found to be significant parameter for time to first bowel sound (p>0.05). CONCLUSION: Gum chewing does not affect some of the gastrointestinal functions after gynecological operations and there is no single parameter for time to first bowel sound, first flatulence and first defecation, individual surgical and medical condition differences should be kept in mind while evaluating intestinal functions

Comparison Effect of Direct Trocar and Veress Needle Entry Techniques on Gut Functions after Laparoscopic Procedures: Randomized Clinical Trial

OBJECTIVE: The aim of this study was to compare the effect of two different laparoscopic entry methods on postoperative gastrointestinal functions. STUDY DESIGN: A total of 108 women who underwent gynecological operation via laparoscopic approach with different indications were randomly assigned to 2 groups: In Group 1 pneumoperiteneum was achieved by direct trocar entry (n=72), while in group 2, Veress needle was used. RESULTS: Correlation analyses showed a significant association between the technique for abdominal entry and postoperative hemoglobin and hematocrit concentrations, time to maximal intraabdominal pressure and the body mass index. Comparison of groups with different laparoscopic entry techniques showed a significant difference between groups in terms of postoperative hemoglobin and hematocrit concentrations, time to obtain maximal intraabdominal pressure and time to first flatulence (p < 0.05, Table 2). No intra or postoperative complications was observed. CONCLUSION: Direct or Veress needle entry methods were both safe to create pneumoperitoneum with similar postoperative gastrointestinal functions except for earlier first flatulence in Veress needle group while direct trocar entry was found to be associated with favorable postoperative blood count and shorter duration to obtain enough intraperitoneal pressure

Which factors are associated with the recurrence of endometrioma after cystectomy?

Endometrioma is the most common form of endometriosis and is a sign of wide-spread disease in symptomatic patients. Medical treatment options can be successful in endometrioma smaller than 1 cm, but ineffective for growing and symptomatic endometriomas. Conservative surgical interventions that preserve fertility, such as laparoscopic removal or destruction of endometriotic tissue or aspiration of cystic content are typically used to treat the condition. One of the most frustrating aspects of endometrioma treatment is disease recurrence. The underlying mechanisms explaining recurrence are uncertain. Several risk factors have been evaluated in order to predict recurrence after cystectomy. In looking at the results overall, our study can conclude that the presence of greater cyst dimension, higher CA-125 level, presence of preoperative symptoms of non-cyclic pelvic pain, dysmenorrhoea and adhesion extension may be associated with recurrent endometrioma. In clinical practice, identification of risk factors for recurrence helps clinicians to inform patients.Impact statement What is already known on this subject: Endometrioma is the most common form of endometriosis and is a sign of wide-spread disease in symptomatic patients. One of the most frustrating aspects of endometrioma treatment is disease recurrence. Several risk factors have been evaluated in order to predict recurrence after cystectomy. However, the risk factors have not been precisely defined. What the results of this study add: This study aimed to investigate the contribution of possible risk factors to the recurrence of endometrioma after laparoscopic surgery. In looking at the results overall, our study can conclude that the presence of greater cyst dimension, higher CA-125 level, adhesion extension, presence of preoperative symptoms of non-cyclic pelvic pain and dysmenorrhoea may be associated with recurrent endometrioma. What the implications of these findings are for clinical practice and/or further research: In clinical practice, identification of risk factors for recurrence helps clinicians to inform patients. Detection of preoperative risk factors would be helpful in counselling patients on their future prognosis. This may also increase treatment success by providing accurate preoperative treatment planning and by assisting the scheduling of postoperative follow-ups

Retrospective Analysis of 114 Cases Treated for Dermoid Cyst

Objective: The purpose of this study is to evaluate the clinical findings, tumor markers, surgical treatment ap­proaches and final pathological results of the dermoid cyst subjects treated at our hospital. Methods: The study was planned retrospectively. 114 subjects with dermoid cyst were included from our hos­pitals electronic log system. Along with the demographic data’s, pre-operative clinical findings, tumor sizes, ul­trasonographic characteristics, tumor marker results, surgical treatment method (laparotomy-laparoscopy), administered surgical treatment procedure (cystectomy, oopherectomy, salpingo-oopherectomy, total abdominal hysterectomy-salpingo-oopherectomy) and pathology re­sults were recorded from the patient files. Results: Mean age of the patients was 33.59±12.79 years (11-70). Abdominal pain was observed in 32 patients (%28.07) as the most common complaint during hospi­tal admission. 70 patients (%38.59) were determined in­cidentally. Average cyst size was 47.70±48.49 cm2 dur­ing the ultrasonographic examination. Ca 125 level was higher than normal limits in only 12 (%10.52) patients and Ca 19-9 level was higher in only 29 (%25.43) of patients. The most common final histopathological diagnosis was dermoid cyst in 103 (%90.40) patients. Other histopatho­logical diagnoses were immature teratoma, squamous cell carcinoma and serous carcinoma. Conclusion: Ovarian dermoid cysts are usually benign neoplasms and rarely show malign transformations. Tu­mor markers are not fairly enough to make discrimina­tions. However especially in older patients treatment should be done cautiously due to the raised risk of ma­lignity