Rengin Karataylı

The treatment of 65 women with imperforate hymen by a central incision and application of Foley catheter.

Objective  To determine the surgical outcome of 65 women with imperforate hymen treated with a central surgical incision and insertion of a Foley catheter.

Management and outcomes of adnexal masses during pregnancy: A 6-year experience

Aim:  To demonstrate adnexal masses detected during gestations in a 6‐year period.

Contraceptive efficacy and side effects of Implanon

Objective To determine the efficacy and side effects of Implanon® used for long-term contraception. Material and method Prospective study of 80 patients who used Implanon® for long-term contraception between January 2004 and January 2006. Side effects, efficacy and removals were recorded. Results Amenorrhoea, infrequent bleeding and frequent bleeding were reported by 33 (41.25%), 19 (23.75%) and 14 patients (17.5%), respectively. Non-menstrual side effects comprised breast tenderness in 15 patients (18.75%), acne in eight (10%), headache and dizziness in three (3.75%); depressive mood disorders, pelvic pain and loss of libido were mentioned each by two of the women (2.5%). During the study period, Implanon® was removed from 20 participants. No problem was encountered during its placement or removal. Conclusion Patients considering use of Implanon® must be carefully selected and informed about its expected side effects before placement.

Ovarian cancer during pregnancy

To evaluate the clinical features, pregnancy outcome, and treatment of patients with ovarian cancer diagnosed during pregnancy.

Comparison of Single versus Double Intrauterine Insemination

OBJECTIVE To compare the outcomes of single versus double intrauterine insemination. MATERIALS AND METHODS This prospective randomized study was carried out in 100 infertile patients. One intrauterine insemination was applied 36 hours after human chorionic gonadotropin (hCG) injection to 50 patients in the first group. To 50 patients in the second group, two intrauterine inseminations were applied, of which the first was applied 24 hours after and the second 48 hours after the hCG injection. RESULTS In the first group, pregnancies were detected in eight patients (pregnancy rate per patient was 16%, pregnancy rate per cycle was 10.6%). In the second group, pregnancies were detected in five patients (pregnancy rate per patient was 10%, pregnancy rate per cycle was 6.4%). There was no statistically significant difference between the two groups ( p > 0.05). CONCLUSION Single intrauterine insemination can be considered to be more reasonable than double intrauterine insemination treatment, taking into consideration the economic cost and the psychologic trauma to the patients. However, further studies with larger sample sizes are needed in order to reveal any actual differences between the two methods.

Obsessive–compulsive disorder in postmenopausal women: prevalence, clinical features, and comorbidity

Objective: Studies about obsessive–compulsive disorder (OCD) during the postmenopausal period have been insufficient. The purpose of the current study was therefore to examine the prevalence rate, clinical characteristics, and comorbidity of OCD in postmenopausal women. Methods: A total of 269 consecutive postmenopausal women admitted to a gynaecology outpatient clinic were included in the study. OCD and comorbid disorders was diagnosed by means of the Structured Clinical Interview for DSM-IV. The Yale–Brown Obsessive– Compulsive Scale was used to determine the types of obsessions and compulsions. Results: The prevalence rate of OCD was 7.1% in the sample. Two women (0.7%) reported that OCD developed during the postmenopausal period. The most common obsessions were contamination and symmetry/exactness, whereas the most common compulsions were cleaning/washing and checking. OCD was unrelated to variables examined in the present study. The comorbidity rate of other psychiatric disorders was 63.2% in OCD patients. The most common comorbid disorder was generalized anxiety disorder. Conclusions: OCD was not rare in postmenopausal women admitted to a gynaecology outpatient clinic. In addition, OCD appears to be frequently comorbid with depressive or other anxiety disorders in the postmenopausal period.

A New Technique For the Treatment of Transverse Vaginal Septum by Foley Catheter

We report a new surgical technique for the management of transverse vaginal septum in a 13-year-old girl who presented with abdominal pain. Imaging techniques yielded hematocolpos. The patient and her family refused vaginal surgery in order to preserve hymenal integrity for sociocultural beliefs. At laparotomy, a vertical incision was made on posterior vaginal wall. An artery forceps was introduced from the hymenal opening while preserving the hymenal integrity. The septum located on the upper third of vagina was perforated by the help of a forceps introduced from posterior vaginal wall via an abdominal route. A Foley catheter was introduced from the introitus toward the septal perforation and was held by the forceps. The balloon of the catheter was placed on the perforated septum and it was insufflated with 10 ml of fluid. The Foley catheter was in place for 2 weeks. After removal of the catheter, she received oral contraceptive pills for 3 months postoperatively. She had regular spontaneous menses on follow-up for 6 months duration.

NONCARDIOGENIC PULMONARY EDEMA DUE TO RITODRINE USAGE IN PRETERM LABOR

A 34-year-old woman at 28 weeks of gestation presented at the emergency department of our hospital with shortness of breath, cough, sweating, and deterioration of consciousness, which had begun 3 days ago. The history given by her relatives revealed that she had received intravenous ritodrine (later found to be in the form of a constant infusion at 60 µg/min for 2 days) together with two doses of betamethasone (Celestone, Schering) at 12-hour intervals for accelerating fetal lung maturation in a private clinic. After this initial intervention, treatment was continued with oral tocolytic tablets (ritodrine tablets). There was nothing else notable in her medical history. Physical examination of the unconscious patient revealed a body temperature of 37.2°C, arterial blood pressure of 90/60 mmHg, pulse rate of 142/min, and respiration rate of 27/min, with hyperventilation and slight rales over bilateral lungs. She was intubated immediately. Fetal measurements were concordant with a 28-week pregnancy, and the amount of amniotic fluid was found to be normal. Ultrasonic estimation of fetal weight was 1,100 g. The hemoglobin level, hematocrit, leukocyte count and platelet counts were 12 g/dL, 37.2%, 9.100/mm 3 and 223,000/mm 3 , respec

Micronuclei frequencies in lymphocytes and cervical cells of women with polycystic ovarian syndrome

Objective: The aim of this study was to determine micronucleus (MN) frequencies in exfoliated cervical cells and peripheral blood lymphocytes of women with polycystic ovarian syndrome (PCOS). Materials and Methods: Fifteen patients with PCOS and 11 healthy control patients were included in the study. Cervical smears and peripheral blood were collected from all patients. Specimens were analyzed for MN frequencies and compared between the groups. In addition to MN, other nuclear anomalies connected with both genotoxicity and cytotoxicity were evaluated. Results: The MN frequencies in cervical smear and peripheral blood lymphocytes were compared in patients with PCOS and normal controls. There was no statistically significant difference between the groups regarding micronucleus frequency in peripheral blood lymphocytes (p=0.239). The mean MN scores in exfoliated cervical cells of patients with PCOS and normal controls were 1.19±0.57 and 0.74±0.34, respectively. The difference regarding micronucleus frequencies in cervical cells was statistically significant between the groups (p=0.032). Conclusion: Although study group is small, our study results support that there is an increased micronucleus frequency in cervical exfoliated cells of PCOS patients; this is a determinant of genetic hazard in the disease.

Alternative surgical approach for the management of uterine prolapse in young women: Preliminary results

To demonstrate an alternative surgical approach for the management of uterine prolapse in young women by a technique that was previously defined for post‐hysterectomy vaginal vault suspension in published work and also to demonstrate successful operative results.