Elif Demirci

Emergency peripartum hysterectomy in a tertiary obstetric center: nine years evaluation

Aims:u2002 The aim of this study was to estimate the incidence, indications, risk factors, complications, and maternal morbidity and mortality associated with obstetric hysterectomy performed at the Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital between January 2000 and January 2008.

Long-Term Results of Burch Colposuspension

The study included 220 women who had undergone Burch colposuspension. Group I (65 women) was studied prospectively and the mean follow-up was 1.5 years. Group II (155 women) was studied retrospectively and the mean follow-up was 4.5 years. The cure rate was 87.7% in group I and 77.4% in group II. The cure rate was significantly higher following the primary procedure than the secondary procedure. At follow-up, late complications in 220 women were: cystocele in 18; rectocele in 32; enterocele in 35; dyspareunia in 6, and groin or suprapubic pain in 15. In group I, of the 11 women with detrusor instability preoperatively, 10 were cured and in 1 detrusor instability persisted postoperatively. Two women had de novo detrusor instability. In conclusion, the cure rate of Burch colposuspension is satisfactory, although it declines a little with time. Women who had previous anti-incontinence surgery have a greater probability of recurrence. The procedure elevates the bladder neck into the abdominal cavity and stabilizes it. Surgical failure is related to inadequate elevation and stabilization of the bladder neck.

A Retrospective Review of Perioperative Complications in 360 Patients who had Burch Colposuspension

EDITORIAL COMMENT: We accepted this paper for publication because it reports a large experience with the Burch colposuspension operation and presents the complications encountered. It also provides a detailed review of the complications reported by others. In this series of 360 patients, 75.8% had an abdominal hysterectomy performed at the time of the Burch colposuspension. Our urogynaecologist reviewer tells us that this is a very high proportion of hysterectomies although there is a body of opinion that believes that a hysterectomy improves the results when the Burch operation is done in the treatment of women with genuine stress incontinence of urine. The incidence of hysterectomy has to be factored in to the data presented in this paper with regard to the complications that followed the operation. N.B.

The Effects of Abdominal Hysterectomy on Bladder Neck and Urinary Incontinence

We assessed the bladder neck (BN) by perineal ultrasonography of 39 patients before and 1 year after hysterectomy, and we compared them with 30 control cases in terms of stress urinary incontinence. We evaluated the BN position and mobility in the downwards and backwards directions. The bladder neck was found to be significantly lower at rest, in the downwards direction, in the postoperative period. The stress position of the BN was not significantly different. Its downwards mobility decreased, but not significantly. There was no significant difference in the location of the BN with respect to the pubis, at rest and during stress, in the backwards direction, between the preoperative and postoperative periods. Backwards mobility of the BN decreased significantly following hysterectomy. Stress incontinence was not significantly different between the study group and the control group after one year. We concluded that hysterectomy did not weaken urethral support and did not increase the rate of stress incontinence.

Sonographic measurement of cervical length and risk of preterm delivery.

Aim:u2002 To study the relationship between cervical lengths measured by ultrasound and risk of preterm delivery.

Vaginal removal of prolapsed pedunculated submucosal myoma during pregnancy

Pedunculated submucosal myomas are generally associated with infertility and are most often encountered during the preconception period. This report describes a 38-y-old pregnant woman in whom a pedunculated submucosal myoma resulted in preterm labor and was successfully removed vaginally at 26 wk gestation. The procedure described here is simple and quick and can be performed during pregnancy, if necessary.

Perioperative Complications in Abdominal Sacrocolpopexy, Sacrospinous Ligament Fixation and Prolift Procedures

BACKGROUNDnPelvic organ prolapse is an important problem for women. To overcome this issue, different operational technics are in use, such as abdominal sacrocolpopexy, sacrospinous fixation, and the total Prolift procedure.nnnAIMSnThis study assessed perioperative complications in abdominal sacrocolpopexy, sacrospinous fixation, and the total Prolift procedure.nnnSTUDY DESIGNnRetrospective comparative study.nnnMETHODSnPerioperative complications were defined as any complication occurring during surgery or the first 6 weeks postoperatively. Forty-five patients underwent abdominal procedures, 60 patients underwent sacrospinous fixation, and 43 patients underwent the total Prolift procedure.nnnRESULTSnIn the abdominal group, one bladder injury, four hemorrhages, and three wound dehiscences occurred. In the sacrospinous group, one rectal injury and one postoperative vault infection occurred. In the Prolift group, one bladder injury and one hemorrhage occurred. Minor complications were more frequent in the abdominal group than the others. The operating time and hospital stay of the abdominal group were significantly longer than the others. The Pro-lift procedure had less operating time and hospital stay than other procedures.nnnCONCLUSIONnThe total Prolift may be a novel alternative for apical prolapse with low perioperative morbidities and complications.

Pure ovarian choriocarcinoma: a difficult diagnosis of an unusual tumor presenting with acute abdomen in a 13-year-old girl

A 13-year-old girl before sexual debut presented with lowerabdominal pain and a positive urine pregnancy test. Onadmission her face was very pale, and a physical examin-ation revealed an acute abdomen with rigidity and tenderness.She was in intermediate shock. Ultrasound examinationshowed presence of fluid arising from the posterior cul-de-sac up to the liver, consistent with a possible hemoperiton-eum, and identified a 68 78-mm mass in the right adnexa.Laboratory studies revealed the following values: white bloodcells 12 10

Perioperative Complications in Vaginal Mesh Procedures Using Trocar in Pelvic Organ Prolapse Repair

Introduction and HypothesisThis study aimed to document intraoperative and early postoperative complications associated with the use of vaginal mesh with trocar in pelvic organ prolapse (POP) repair.MethodsThis is a retrospective review of 120 cases of vaginal repair of POP using vaginal mesh. Of the 120 patients, 31 underwent anterior mesh repair (Light mesh 10, Avaulta 1, Perigee 1, and Prolift 19); 35 underwent posterior mesh repair (Light mesh 2, Posterior IVS 17, and Prolift 16); and 54 underwent anterior and posterior mesh (total) repair (Light mesh 8, Prolift 32, and Prolift M 14).ResultsThree bladder injuries (2.5%) and one distal rectal injury (0.8%) occurred during dissection. Three of four organ injuries (75%) had previous prolapse repair. Overall four patients (3%) required transfusion. Urinary retention exceeding 5xa0days occurred in four patients. Three of them (60%) also underwent TVT-O. Groin pain occurred in two patients one of whom underwent TVT-O. Gluteal pain occurred in one patient. Early mesh exposure occurred in the vaginal cuff of a patient who underwent hysterectomy.ConclusionsThe vaginal mesh procedures may be done with relatively few perioperative complications. However, there is a need for more randomized controlled trials with long-term follow-up to clarify its postoperative long-term complications and morbidities.

Ten-year results of Marshall Marchetti Krantz and anterior colporraphy procedures

To evaluate subjective results of Marshall Marchetti Krantz (MMK) and anterior colporraphy (AC) procedures.