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To compare the classical double-layer uterine closure to a double-layer purse-string uterine closure (Turan technique) in cesarean section regarding short- and long-term results.Patients were randomized into either the double-layer purse-string uterine closure arm (study group, 84 patients) or the classical double-layer uterine closure arm (control group, 84 patients). For short-term comparison, a detailed transvaginal ultrasound examination was planned in all patients 6 weeks after the operation and a wedge-shaped defect in the uterine incision scar was accepted as uterine scar defect and recorded. For the long-term comparison, subsequent pregnancies of these patients were followed up for any complication.The number of patients with ultrasonographically visible uterine scar defect was 12 (23.5% of all scar defects) in the study group whereas it was 39 (76.5% of all scar defects) in the control group (P0.001, χ(2) = 15.42). Demographic data, operation time, hospitalization time, preoperative and postoperative hemoglobin values were not significantly different between the groups. During the 2-year of the follow-up period, five patients in the study group and six patients in the control group became pregnant again. No complication during their pregnancies and second cesarean operation were encountered.With the Turan technique, the uterine incision length becomes shorter, and the frequency of uterine scar defect is lower regarding short-term results. More data is needed for long-term results. ClinicalTrials.gov NCT01287611.

To investigate the value of tetracycline sclerotherapy for management of recurrent or persisting non-neoplastic ovarian cysts in comparison to the aspiration without sclerotherapy.Ninety-six patients with proven non-neoplastic ovarian cysts were randomized into two groups. Group 1 patients underwent cyst aspiration together with tetracycline sclerotherapy (n=48). Group 2 patients underwent only cyst aspiration without tetracycline sclerotherapy (n=48). Then, all patients were followed up monthly with ultrasonography for 12months. The procedure was considered to have failed if the recurring cyst, detected by ultrasound, was 4cm in size or greater.There were no differences between the two groups regarding demographic data, initial cyst volume and tumor markers. Recurrence rates within 12months were 14.6% in group 1 and 50% in group 2 (P0.001).Based on the recurrence rates, we suggest transvaginal aspiration together with tetracycline sclerotherapy rather than only simple transvaginal aspiration in the management of non-neoplastic ovarian cysts.

The aim of this study was to compare the effects of intrauterine-system-releasing 20 µg daily of levonorgestrel (LNG IUS) plus 1 mg 17 beta-estradiol daily, orally with combined oral pill containing 1 mg 17 beta-estradiol/2 mg drospirenone daily as hormone replacement therapy, on health-related quality of life (HRQoL) and climacteric symptoms in postmenopausal women.A 6-month prospective clinical trial was conducted at the Department of Obstetrics and Gynecology, Dr Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey. Ninety postmenopausal women were accepted to be part of the study. The Euro Quality of Life-5 Dimensions (EQ-5D) and Euro Quality of Life Visual Analogue Scale (EQ VAS) indexes for HRQoL and Kupperman indexes were compared between two groups of patients.Kupperman indexes of both treatment groups decreased gradually over 6 months, but indexes decreased significantly more in the group with intrauterine-system-releasing 20 µg daily of levonorgestrel. Elevations were observed in EQ-5D indexes and VAS values of both groups. EQ VAS values significantly increased in the group on intrauterine progestogen system. Similar changes were observed in the EQ-5D indexes of both groups.A hormone replacement therapy regimen that includes an intrauterine progestin system decreased climacteric symptoms and increased HRQoL in postmenopausal women during a follow-up period of 6 months. The extent of the relief of symptoms was greater in this group than in women receiving oral combined hormone replacement therapy. It seems therefore that the intrauterine progestin system could represent a method of choice for endometrial suppression in women using estrogen replacement therapy with distinct advantages over systemically administered progestogens, which have been the subject of considerable debate as reported in the recent literature.