Sanli Erkan

Comparison of transvaginal sonography, saline infusion sonography and hysteroscopy in the evaluation of uterine cavity pathologies

Aims:  To determine whether performing transvaginal sonography (TVS) and saline infusion sonography (SIS) before hysteroscopy could reduce the number of diagnostic hysteroscopies performed for the evaluation of uterine cavity abnormalities.

Primary psoas muscle abscess diagnosed and treated during pregnancy: case report and literature review

BACKGROUND: Primary psoas muscle abscess is rare and can be difficult to diagnose, particularly during pregnancy. CASE: To our knowledge, this is the first case of primary psoas muscle abscess diagnosed during pregnancy. Clinical investigation did not reveal any infection spreading from adjacent structures. Surgical drainage and simultaneous Cesarean delivery of the infant, combined with appropriate antibiotics, enabled a cure. CONCLUSION: The possibility of psoas muscle abscess should be taken into account when investigating lower back pain during pregnancy if conventional approaches are unsatisfactory.

Transvaginal ultrasound-guided aspiration and instillation of hyperosmolar glucose for treatment of unruptured tubal heterotopic pregnancy

ObjectivesTo report a case of tubal heterotopic pregnancy (HP) treated conservatively with transvaginal ultrasound-guided aspiration and instillation of hyperosmolar glucose.MethodsAspiration of the tubal ectopic pregnancy and hyperosmolar glucose instillation was performed with a 16-gauge needle under transvaginal ultrasound guidance.ResultsUnruptured tubal HP with positive cardiac activity was treated successfully without any further interventions, and intrauterine pregnancy has reached full-term without any complications.ConclusionsEarly diagnosis of this life-threatening condition is the key to its successful treatment. Transvaginal ultrasound-guided aspiration and hyperosmolar glucose injection can be safely performed for the treatment of unruptured tubal HP.

Posterior hemidissection for nonpuerperal uterine inversion

A novel surgical technique using posterior hemidissection was introduced to treat a case of uterine inversion that was caused by a submucous fibroid and could not be managed by standard procedures. A 46-year-old woman gravida 6 para 4 2 living children presented with a mass that had been protruding from her vagina for three days. She was diagnosed as having nonpuerperal uterine inversion and underwent emergency abdominoperineal surgery. The uterus uterine ligaments fallopian tubes and ovaries could not be seen on exploration and there was a 2-cm hole in the Douglas pouch. The mass on the inverted fundus was resected but the uterus could not be reinserted into the pelvis by pulling the round ligaments (Huntington procedure). (excerpt)

Transobturator tape (TOT) procedure with fluoroscopic guidance: gaining confidence and valuable experience!

ObjectivesTo report a successful transobturator tape (TOT) procedure performed under fluoroscopic guidance without any complications.MethodsThe diagnosis of stress urinary incontinence (SUI) was confirmed with urodynamic tests in a 54-year-old woman. TOT procedure was performed under the guidance of fluoroscopy.ResultsSUI was treated successfully with TOT procedure. Fluoroscopic guidance not only decreased the length of the procedure but also avoided the possible complications. The operator gained confidence and valuable experience.ConclusionsTOT procedure can be successfully performed under fluoroscopic guidance avoiding the possible complications and enhancing the learning curve period. We recommend the usage of fluoroscopy especially for the inexperienced operators. The benefits overweigh the cost of fluoroscopy and the absorbed dose of radiation which is calculated to be lower than accepted limits.