Arzu Doruk

The Effect of Myoma Uteri and Myomectomy on Sexual Function

INTRODUCTION This is a report about the effects of myoma uteri and myomectomy on sexual function in women. AIM The aim of this article was to determine the effects of myoma uteri and myomectomy on sexual function in women. METHOD The study was designed as a controlled clinical study in an academic clinical research center. The study patients consisted of 80 women with myoma uteri and 75 control women. Baseline characteristics and properties of the myomas were recorded. A validated questionnaire was used to determine pre- and postoperative sexual function in the patients. MAIN OUTCOME MEASURE Female sexual function index (FSFI) scores of the women were recorded before and after surgery. RESULTS Women with myoma uteri had lower FSFI pain and satisfaction scores than women without it, even after correction for possible confounders. Fundal and posterior myomas were associated with pain, whereas only posterior myomas were related to the overall FSFI scores. However, although there was no relation between the volume of the myomas and the FSFI scores, women with a uterine volume over 200 cm(3) had significantly lower mean FSFI satisfaction, pain, and total scores. The mean FSFI pain and total scores of the patients improved significantly after undergoing a myomectomy. CONCLUSIONS The findings of this study suggest that a potential impairment of sexual function exists in women with myomas. This is mainly because of pain during sexual intercourse, although it does not seem to have an effect on either the arousal or orgasmic phases. Furthermore, the performance of a myomectomy may alleviate pain during intercourse, and thereby improve sexual function in the patients.

The effect of myomectomy on health‐related quality of life of women with myoma uteri

Aim:  An equal consideration should be paid to improving health‐related quality of life (HRQoL) in addition to successful medical outcome. Many studies have evaluated the effect of other methods rather than myomectomy on HRQoL, and have focused solely on the presence of myoma without regarding any concurrent pelvic pathology.

Spontaneous Twin Pregnancy in Uterus Bicornis Unicollis

Abnormal fusion of the Müllerian ducts or failure of resorption of the septum causes varying degrees of congenital uterine malformation. They are often associated with reproductive problems such as miscarriage, premature labour, premature rupture of the membranes, or malpresentation. Twin gestation in a case of bicornuate uterus is extremely rare. A 37-year-old multiparous woman conceived a twin dichorionic diamniotic pregnancy spontaneously. Three-dimensional ultrasound revealed bicornuate uterus with one embryo in each cavity. Perinatal course was uneventful. At 35 weeks of pregnancy, spontaneous labour started and twin babies were delivered by bilateral low transvers caesarean section. Because of the rare occurrence of twin gestation in bicornuate uterus, there is no uniform guideline to manage these cases appropriately. Delivery by planned caesarean section could avoid the possible obstetric complications by dystocia.

Effect of cervical length on second trimester pregnancy termination.

Aim:  To evaluate the value of sonographic measurement of cervical length as a predictor of abortion or delivery within 24 h by misoprostol in second trimester termination of pregnancy (TOP).

A case series on fetal ovarian cysts

Objective: We aimed to discuss the ultrasonographic characteristics and follow-ups of 7 fetuses which were established with the diagnosis of prenatal fetal ovarian cyst and followed up between 2012 and 2017. Cases: Sonographic findings and prenatal and postnatal progress of a total of 7 cases with fetal ovarian cyst which were detected by chance during the routine gestational follow-ups performed in the third trimester of pregnancy were presented. While four of the seven cases were lost during prenatal and postnatal periods, it was observed that 3 cases persisted in their follow-ups. Conclusion: Fetal ovarian cysts are the abdominal cystic masses which are diagnosed with a gradually increasing frequency. The majority of them are functional cysts. Regular follow-up of the cyst size and ultrasonographic characteristics is the most frequently used method in the approach. Waiting for follow-up and spontaneous regression in fetal ovarian cysts which do not exhibit septation and increase in the size, and have thin walls and no heterogeneous cystic content seems to be an appropriate approach.

Central nervous system findings associated with co-twin death in twin pregnancy: Correlation between ultrasonography and magnetic resonance findings

Objective: In this article, we aimed to discuss central nervous system findings appearing in living fetus after co-twin death in a twin pregnancy and therefore the correlation and its supplementary characteristics between magnetic resonance imaging (MRI) and ultrasonography. Case: Of the thirty-tree-year-old patient who was pregnant for the second time, 24x25 mm hyperechogenic view compatible with hemorrhage in frontal horn of the left lateral ventricle was observed in the surviving fetus after in utero loss of monochorionic co-twin at 27 weeks of gestation. It was also found that the adjacent cerebral parenchyma was also in heterogeneous view. In the MRI carried out, hemorrhage indicators reaching to parenchyma and opening to ventricle were observed on bilateral basal ganglions, being more distinct on the left. With these findings, the lesion was evaluated as grade IV germinal matrix hemorrhage. While the woman was pregnant for 29 weeks and 6 days, one male baby which was 1153 g was delivered by cesarean section after the rupture of membrane. Conclusion: Ultrasonography and magnetic resonance imaging complete each other in the diagnosis of the complications of central nervous system appearing in the surviving co-twin after the death of other co-twin. MRI provides better anatomical details for revealing ischemia-associated late sequels.