Ismail Mete Itil

Role of perineal sonography in the evaluation of patients with stress urinary incontinence.

Objective: The aim of the study was to determine the role of perineal sonography in diagnosis of stress urinary incontinence.

Does pelvic floor muscle training abolish symptoms of urinary incontinence? A randomized controlled trial

Objective: To determine whether symptoms of urinary incontinence is reduced by pelvic floor muscle training, to determine whether urinary incontinence can be totally eliminated by strengthening the pelvic floor muscle to grade 5 on the Oxford scale. Design: Prospective randomized controlled clinical trial. Setting: Outpatient urogynecology department. Subjects: One hundred thirty cases with stress and mixed urinary incontinence. Intervention: All participants were randomly allocated to the pelvic floor muscle training group or control group. A 12-week home based exercise program, prescribed individually, was performed by the pelvic floor muscle training group. Main measures: Urinary incontinence symptoms (Incontinence Impact Questionnaire-7, Urogenital Distress Inventory-6, bladder diary, stop test and pad test) were assessed, and the pelvic floor muscle strength was measured for (PERFECT testing, perineometric and ultrasound) all participants before and after 12 weeks of treatment. Results: The pelvic floor muscle training group had significant improvement in their symptoms of urinary incontinence (P=0.001) and an increase in pelvic floor muscle strength (P=0.001, by the dependent t test) compared with the control group. All the symptoms of urinary incontinence were significantly decreased in the patients that had reached pelvic floor muscle strength of grade 5 and continued the pelvic floor muscle training (P<0.05). Conclusion: The study demonstrated that pelvic floor muscle training is effective in reducing the symptoms of stress and mixed urinary incontinence and in increasing pelvic floor muscle strength.

Prenatal sonographic detection of nasopharyngeal teratoma.

We present the case of a 34‐year‐old pregnant woman who had an elevated maternal serum α‐fetoprotein level and sonographic findings of a semisolid mass protruding from the fetuss oral cavity. The large, heterogeneous mass filled the oropharynx and nasopharynx. Abnormal Doppler waveforms were detected in the umbilical artery of the fetus, who died in utero. Postmortem examination revealed a nasopharyngeal teratoma.

How do delivery mode and parity affect pelvic organ prolapse

To determine the association between mode of delivery, parity, and pelvic organ prolapse, as assessed by the pelvic organ prolapse quantification system.

Distribution of fibronectin, laminin and collagen type IV in the materno-fetal boundary zone of the developing mouse placenta. Experimental study.

Objective: The objective of this study is to demonstrate the distribution of extracellular matrix components of fibronectin, laminin and collagen type IV in the materno-fetal boundary zone of the developing mouse placenta. Material and methods: Mice fetuses and placentas were removed serially every day until the 19th gestational day. Implantation sites were processed and stained by an immunohistochemical method by specific antiserums to fibronectin, laminin and collagen type IV. The distribution of the extracellular matrix components in cytotrophoblasts and giant cells of the developing mouse placenta were determined under light microscope. Results: Fibronectin, laminin and collagen type IV immunostaining demonstrated a dynamic relationship changing day by day after the conception. At the 16th day cytotrophoblasts and giant cells were all positively stained by the extracellular matrix components. Conclusion: This study demonstrates that the regions of the developing mouse placenta produce specialized extracellular matrices which may contain different ratios of these polypeptides.

The changes of circulating lymphocyte sub‐populations in women with preterm labour: a case‐controlled study

The aim of this study was to determine the changes in circulating T‐cell subpopulations, B cells and natural killer cells in patients with imminent preterm labour.

Overactive bladder and its effects on sexual dysfunction among women

To evaluate the relation between overactive bladder (OAB) and sexual dysfunction in sexually active nurses without stress urinary incontinence and pelvic organ prolapse.

Giant myoma and erythrocytosis syndrome.

The objective of this study is to discuss the myomatous erythrocytosis syndrome in a patient with a giant subserous uterine myoma. She presented with plethora and an abdominal mass. After venesection of 4 units of blood, the preoperative haematocrit value of 53.3% and haemoglobin value of 17.5 g/dL had decreased to 48.6% and 16.8 g/dL levels, respectively. After the operative extraction of the giant subserous myoma with attached uterus weighing 14.2 kg, the haematocrit and the haemoglobin values had regressed to 40.3% and 14.3 g/dL levels, respectively. The findings indicated that the giant subserous myoma was the cause of the myomatous erythrocytosis syndrome in this patient.

Quality of life scores improve in women undergoing colpocleisis: a pilot study

OBJECTIVE To evaluate the quality of life and surgical outcomes in women who had undergone colpocleisis. STUDY DESIGN This was a prospective small cohort study conducted between August 2010 and September 2011. Twelve women with pelvic organ prolapse were offered obliterative vaginal surgery and were informed about the surgical procedure. Ten women accepted this operation and were included in the study. Before and after colpocleisis, cases were evaluated by urogynecological examination, and quality of life was assessed by the Turkish language validated prolapse quality of life questionnaire (P-QOL), in which a low total score indicates a good quality of life. RESULTS The mean age was 74.9±4.5 (range 68-85). The general score of the P-QOL was reduced during the follow-up period, reflecting a significant effect on quality of life and clinical improvement in women with the colpocleisis operation. There was no morbidity due to colpocleisis or recurrent pelvic organ prolapse in follow-up period. CONCLUSION In our small cohort including elderly women, colpocleisis provided high levels of surgical outcomes as well as a significant improvement in quality of life without significant morbidity.

Do stages of menopause affect the outcomes of pelvic floor muscle training

ObjectiveThe purpose of our study is to determine whether there is a difference in pelvic floor muscle strength attributable to pelvic floor muscle training conducted during different stages of menopause. MethodsOne hundred twenty-two women with stress urinary incontinence and mixed urinary incontinence were included in this prospective controlled study. The participants included in this study were separated into three groups according to the Stages of Reproductive Aging Workshop staging system as follows: group 1 (n = 41): stages −3 and −2; group 2 (n = 32): stages +1 and −1; and group 3 (n = 30): stage +2. All three groups were provided an individual home exercise program throughout the 12-week study. Pelvic floor muscle strength before and after the 12-week treatment was measured in all participants (using the PERFECT [power, endurance, number of repetitions, and number of fast (1-s) contractions; every contraction is timed] scheme, perineometry, transabdominal ultrasound, Brink scale, pad test, and stop test). Data were analyzed using analysis of variance. ResultsThere were no statistically significant differences in pre-exercise training pelvic floor muscle strength parameters among the three groups. After 12 weeks, there were statistically significant increases in PERFECT scheme, Brink scale, perineometry, and ultrasound values. In contrast, there were significant decreases in stop test and 1-hour pad test values observed in the three groups (P = 0.001, dependent t test). In comparison with the other groups, group 1 demonstrated statistically significant improvements in the following postexercise training parameters: power, repetition, speed, Brink vertical displacement, and stop test. The lowest increase was observed in group 2 (P < 0.05). ConclusionsStrength increase can be achieved at all stages of menopause with pelvic floor muscle training, but the rates of increase vary according to the menopausal stage of the participants. Women in the late menopausal transition and early menopause are least responsive to pelvic floor muscle strength training. Further studies in this field are needed.