Aim: To compare the perioperative outcomes between patients who underwent myomectomy during
cesarean section and those without myomectomy during cesarean section retrospectively.
Materials and Methods: In our study, a total of 187 patients, including 125 patients who underwent
myomectomy (case) during cesarean section and 62 patients who had not undergone myomectomy
(control) during cesarean section, were included in our clinic between February 2015- October 2019.
Basic demographic characteristics of the patients, gestational week at the time of operation, the mean
number of myoma and size, locations of myoma, mean differences between hemoglobin and
hematocrit levels postoperatively, mean operation time, need for erythrocyte transfusion, and mean
hospitalization time were retrospectively evaluated.
Results: The mean diameter of the myoma in the control group is significantly higher than that of the
myomectomy group (5.75 ± 3.71 cm and 4.73 ± 3.76 cm, respectively; p:0.0057). The mean operation
time was 82.81 ± 28.69 min. and 70.08 ± 17.89 min. in the myomectomy and control groups,
respectively (p: 0.003). There was no statistically significant difference between the two groups in the
other parameters (Mean Hb, Htc differences postoperatively, mean hospitalization time, etc.).
Conclusion: Our results support that myomectomy performed during the cesarean section does not
increase perioperative morbidity and may be useful when it is performed by experienced surgeons. In
addition, myomectomy during cesarean section can decrease the need for secondary surgery due to
the myoma.
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Cagdas SAHİN , Nuri YILDIRIM, İsmail HORTU, Ali Osman AKDEMİR, Serdar ÖZŞENER, Gürkan YİĞİTTÜRK, Oytun ERBAŞ
Objective: Tadalafil is a selective phosphodiesterase type-5 inhibitor with a long half-life. It has a dual function in ischaemic and re-perfused tissues, i.e. vasodilatation and anti-oxidant effects. These features of tadalafil distinguish it from other anti-oxidants. We investigated the dual effect of tadalafil on ischaemia and reperfusion injury in the rat ovary.
Material and Methods: We established five study groups. Group 1 (n=6): sham-operated; group 2 (n=6): torsion; group 3 (n=6): torsion and Tadalafil; group 4 (n=6): torsion/de-torsion; and group 5 (n=6): torsion/de-torsion and tadalafil. Ovarian samples were harvested from animals and evaluated in terms of histopathologic changes, tissue malondialdehyde (MDA) concentrations, lactate production, and plasma cyclic guanosine monophosphate (cGMP).
Results: Follicular degeneration, oedema, haemorrhage, and inflammatory cells were significantly decreased in group 5 in comparison with group 4. Group 2 and group 3 were compared in terms of vascular congestion and haemorrhage; these parameters were significantly decreased in group 3. In addition, significantly decreased MDA and lactate concentrations were observed in group 5 in comparison with group 4. Increased cGMP concentrations were detected in group 3 and group 5.
Conclusion: We conclude that tadalafil might be useful in protecting the ovary against ischaemia and reperfusion injury. In the evet of ovarian torsion, it will provide a greater therapeutic effect than only performing de-torsion of the ovary or using other anti-oxidant agents. (J Turk Ger Gynecol Assoc 2020; 21: 35-40)
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OBJECTIVE: The aim of this study is to compare the perinatal outcomes of double cerclage via laparoscopic plus transvaginal technique in women with a history of transvaginal cerclage failure, between women with single transvaginal cerclage. STUDY DESIGN: Five women who were diagnosed with cervical insufficiency with a history of at least one vaginal cerclage failure and 10 women who were diagnosed with cervical insufficiency were included in this study. Laparoscopic cerclage was performed to all women who have a medical history of vaginal cerclage failure, before pregnancy and additional transvaginal cervical cerclage was performed during their pregnancy (Group 1). Single transvaginal cervical cerclage was performed to the 10 women who had a short cervix and/or cervical insufficiency during their pregnancy (Group 2). The number of cerclage failure, perinatal outcomes, gestational week at the time of delivery, birth weight and Apgar scores were evaluated. RESULTS: All five women in group 1 underwent a cesarean section. None of them had chorioamnionitis or poor obstetric outcomes and all gave birth after the 34th week of pregnancy. All ten women in group 2 were evaluated. Two women gave birth vaginally at the 33rd week of pregnancy. Remaining eight cases gave birth above 34th week of pregnancy. Six of the eight cases underwent cesarean section and two of the remaining were delivered vaginally. Mean birth weight of the fetuses were 2490±265 g and 2.710 ±361 g in group1 and group 2, respectively. Mean gestational age at the time of birth in group 1 and group 2 were found 36±1.83 weeks and 35.6±1.14 weeks, respectively. CONCLUSION: Laparoscopic cervical cerclage during pregnancy could be a safe and effective treatment. However, sometimes it might not be enough and transvaginal cervical cerclage may be needed to strengthen cervical tension.
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Amaç: Bu çalıĢmada nadir görülen bir over tümörü olan Brenner tümörlerinin klinik özellikleri vurgulanmaya
çalıĢılmıĢtır.
Gereç ve Yöntem: ÇalıĢmaya Ege Üniversitesi Kadın Hastalıkları ve Doğum Anabilim Dalı’nda opere edilmiĢ ve
Brenner tümörü tanısı almıĢ hastalar dahil edildi. Hastaların geriye dönük incelemelerinde, yaĢı, tümör boyutu, tümör
lokalizasyonu, operasyon endikasyonları ve yapılan operasyonun tipi, eĢlik eden histopatolojik bulgular ve tümörün
malignite durumu gibi bilgiler kaydedildi.
Bulgular: ÇalıĢmaya alınan 26 hastanın ortalama yaĢı 54’tü. Bir hastada malign Brenner tanısı konulurken diğer
hastalarda tümör benign karakterde idi. Ġki hasta dıĢında, kalan tüm olgularda tanı insidental olarak kondu ve bu
olgularda tümör boyutu 1 cm ve altındaydı.
Sonuç: Brenner tümörleri, çoğunlukla benign karakterde ve insidental olarak saptanan neoplazilerdir. Genellikle diğer
jinekolojik patolojiler nedeniyle opere edilen hastalarda, küçük boyutlarda saptanmaktadır. Malign Brenner tümörleri
ise, diğer malign epitelyal over tümörleri gibi davranmaktadır.
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