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We aimed to evaluate the pregnancy characteristics and obstetric outcomes in patients after perforation of the uterus. Study design: A retrospective cohort study was conducted and included all patients who were diagnosed with uterine perforation and treated in a tertiary referral medical center between the years 1996 and 2018. Up to two deliveries after perforations were investigated. Results: During the study period, 51 women were diagnosed with uterine perforation during gynecological procedures, including intrauterine device (IUD) insertion. The mean age of patients at the time of diagnosis was 27.9 (±4.7) years. The majority, 76.5% (n = 39), experienced perforation during IUD insertion, and 23.5% (n = 12) of the patients experienced perforation during surgical procedures. Most of the patients were multiparous or grand multiparous, 45.8. % (n = 22) and 39.6% (n = 19) respectively. Anteflexed uterus was found in 86.4% of the patients (n = 38). Five patients (9.8%) had pelvic abscesses after the IUD insertion. A total of 50 patients had 71 deliveries subsequent to uterine perforation. One patient experienced intrauterine fetal death due to fetal malformations. One patient experienced uterine rupture. No other major obstetric complications were noted. Conclusions: Uterine perforation may be associated with adverse obstetric outcomes. The possibility of uterine rupture must be considered while managing the deliveries of patients after uterine perforation. Moreover, a larger cohort and further studies are needed to establish an association between uterine perforation and adverse outcomes of the subsequent deliveries.

Bladder injury is the most common urological trauma following the gynecological procedure. Normal vaginal delivery candidates with unresponsive and prolonged ascites and bladder‐emptying complaints should be examined for bladder rupture. We also suggest measurement of ascitic fluid creatinine levels in these patients.

Aim andObjective: To compare the analgesic effectiveness of the patient-controlled inhaled nitrous oxide (Entonox®) with intravenous opioids (pethidine/midazolam) in reducing pain during minor gynecological operative procedures, including manual vacuum aspiration (MVA), fractional curettage and dilatation and curettage. Materials and Methods: Patients undergoing minor gynecological procedures from August 2021 to December 2022 were randomized to receive nitrous oxide or intravenous pethidine (50–75 micrograms) plus midazolam (2 mg). Pain scores during and post-procedure, satisfaction level, and side effects were assessed and compared. Results: A total of 106 patients met the inclusion criteria, including 53 in the pethidine/midazolam group and 53 in the nitrous oxide group. Baseline characteristics were comparable (p-value > 0.05). Pain scores during, immediately and 30 min after procedures were not significantly different in two groups (4.94 ± 3.15, 2.74 ± 2.57, 1.58 ± 2.13 vs. 5.47 ± 2.80, 2.98 ± 2.70, 1.64 ± 2.70; p-value: 0.174, 0.634, 0.889, for pethidine/midazolam vs. nitrous oxide group, respectively. Satisfaction scores were comparable in both groups (p-value > 0.05). However, the rate of side effects was significantly lower in the nitrous oxide group (3.8% vs. 28.3%; p-value 0.001). Additionally, the discharge scores showed a significantly faster recovery time in the nitrous oxide group at 60 and 90 min after the procedure; median (IQR): 10 (9–10) vs. 9 (8–10) and 10 (10–10) vs. 10 (8.5–10); p-value 0.002 and 0.029, respectively). Conclusions: Nitrous oxide is as effective as pethidine/midazolam for pain relief in minor gynecological operative procedures but associated with significantly lower side effects and significantly faster recovery time.

Araştırmamızda günübirlik jinekolojik cerrahi uygulanan kadınlara verilen eğitimin kaygı ve ağrı düzeylerine etkisinin değerlendirilmesi amaçlanmıştır. Müdahaleli klinik araştırma, İstanbul ilindeki Bahçeşehir Üniversitesi Özel Medicalpark Hastanesinde 1 Ocak-30 Haziran 2020 tarihlerinde gerçekleştirilmiştir. Araştırma, günübirlik jinekolojik işleme özel planlı eğitim verilen 80 müdahale grubu kadın ve standart bilgilendirme yapılan 80 kontrol grubu kadın olmak üzere toplam 160 kadınla tamamlanmıştır. Araştırma verilerinin toplanmasında veri toplama formu; Sosyodemografik, obstetrik ve jinekolojik özelliklerin yer aldığı kişisel bilgi formu, durumluk ve süreklilik anksiyete ölçeği, ağrı değerlendirme formu kullanılmıştır. Araştırmada elde edilen verilerin analizler için R vers. 2.15.3 programı kullanılmıştır. p0.05). Müdahale grubundaki 46-65 yaş grubundaki kadınların durumluk anksiyete puan ortalamaları kontrol grubundaki 46-65 yaş arasındaki kadınlardan daha yüksek olduğu belirlenmiştir. Kontrol ve müdahale grubundaki kadınların 10.dk ve 1.saat ağrı düzeyleri, durumluk ve sürekli anksiyete toplam puan ortalamaları arasında istatistiksel olarak anlamlı farklılık belirlenmemiştir. Bunun yanında kontrol ve müdahale grubundaki kadınların 10dk ve 1.saat ağrı düzeyleri ile durumluluk anksiyete düzeyleri arasında anlamlı bir ilişki saptanmamıştır. Araştırmamızda, kontrol ve müdahale grubundaki kadınların ağrı düzeyleri ve durumluluk anksiyete düzeyleri arasında bir farklılık saptanmamıştır. Bunun nedeninin araştırmamıza katılan kadınların eğitim düzeyinin yüksek olması ve standart bilgilendirme yapılan kontrol grubundaki kadınların yapılan işleme ilişkin yeterli düzeyde bilgi verilmesine bağlı olduğu düşünülmektedir. The aim of the study was to evaluate the effect of the education given to women who underwent outpatient gynecological surgery on anxiety and pain levels. The clinical trial with intervention was carried out at Bahçeşehir University Private Medicalpark Hospital in Istanbul between January 1st and June 30th, 2020. The study was completed with a total of 160 women, 80 women in the intervention group who were given special planned training for the day-to-day gynecological procedure and 80 women in the control group, who were given standard information. Data collection form for collecting research data; Personal information form including socio-demographic, obstetric and gynecological characteristics, State and Trait Anxiety Scale, Numerical Pain Scale were used. For the analysis of the data obtained in the research, R vers. The 2.15.3 program was used. p0.05). It was determined that the mean state anxiety scores of women aged 46-65 in the intervention group were higher than women aged 46-65 in the control group. It was determined that the trait anxiety mean scores of the women in the intervention group under the age of 30 were higher than the women in the control group under the age of 30. No statistically significant difference was found between the 10th minute and 1st hour pain levels, state and trait anxiety total mean scores of the women in the control and intervention groups. In addition, no correlation was found between the anxiety levels and pain scores of the women in the control intervention groups. In our study, no difference was found between the pain and anxiety levels of women in the control and intervention groups, but no relationship was found between their pain and both state and trait anxiety. The reason for this is thought to be due to the high level of education of the women participating in our study and the fact that the women in the control group, who were given standard information, were given appropriate information about the procedure.

Although the majority of peritonitis cases in peritoneal (PD) dialysis patients are caused by gram-positive cocci, streptococcus agalactiae, a gram-positive group B β haemoliticus streptococcus, may rarely be found in this group of patients. We present a case of acute peritonitis caused by streptococcus agalactiae with bacteriemia and septic shock occurring after a curettage indicated because of gynecologic bleeding. The patient did not receive antimicrobial prophylaxis since the gynecologist considered this case as a "routine" procedure without the need to administer antibiotics. Our case demonstrate that small procedures may cause great problems and therefore one should always give priority to individual approach regardless of the protocol for "routine" surgery, especially if there are no indications for the emergency procedure