Search

Objective To evaluate the feasibility, safety, and surgical outcomes of laparoscopic trachelectomy after supracervical hysterectomy. Methods This multicenter study was conducted at Tanta University, Benha University, and Aminah Laparoscopy Center (Benha, Egypt) from June 1, 2018 to October 31, 2021. Forty patients were recruited for this study and counseled on laparoscopic trachelectomy to treat their symptoms after supracervical hysterectomy. Furthermore, cervical biopsy was performed to detect and exclude any malignancy. Histopathological examination of cervical specimens was performed after surgery. Operative details and outcomes were recorded. Results The median age of the patients was 42 years (range, 38–47). The median body mass index was 25 years (range, 22–28). The median interval between hysterectomy and the clinical presentation was 4.40 years (range, 3.58–5.25). Most patients presented with abnormal vaginal discharge (40%) and bleeding (25%). Moreover, a cervical biopsy result revealed stump carcinoma in three cases (7.5%) that were excluded. The median operative time was 210 minutes (range, 170–220). The median blood loss was 270 mL (range, 220–320). Additionally, histopathological examinations revealed that chronic non-specific cervicitis was present in 54.05% of trachelectomy specimens. There were no significant differences between symptomatic and asymptomatic patients regarding operative outcomes, except adhesions, which were more significantly increased in symptomatic patients (P=0.015). Minimal complications, both operative and postoperative, were related to the procedure. Conclusion Although the operative time was long and adhesions were common during laparoscopic trachelectomy, the procedure was feasible and safe, with minimal complications.

Objective: Early prediction of placenta accreta is crucial for proper decision making, proper preoperative preparation and proper planning for the best management. To review published data and extract strong evidence about early prediction of placenta accreta spectrum (PAS). Mechanism: Published data were extracted from trusted search engines and literature databases, such as Google Scholar, Cochrane library, Clinical Key, PubMed, Researchgate, and Medline, in the period from 1 January 2000 to 31 August 2023. Revision of collected data was conducted by the 3 authors and final results were gathered. Findings in Brief: Many articles were found addressing prediction of PAS but the vast majority of these articles were in the late second and third trimesters. Prediction of PAS in early pregnancy was addressed by few articles which were analyzed in this research. In this study, evidence-based analysis found that PAS could be predicted by many modalities. Conclusions: Early prediction of PAS allows good preparation of both patient and obstetrician to conduct the best management with minimal complications. PAS could be predicted early by either clinical risk factor, imaging in early pregnancy or by biomarkers.

Objectives: The aim of this study is to evaluate the applicability and feasibility of Colpotomizer-assisted total abdominal hysterectomy (CATAH), a new technique for uterine removal in benign uterine pathologies. Materials and Methods: This study is a prospective cohort study conducted at a tertiary University hospital in Egypt. Eligible patients (n = 88) for total abdominal hysterectomy (TAH) were divided into two groups; the study group who underwent TAH by the CATAH technique and the control group who underwent TAH by the conventional technique. Demographic data, operative time, blood loss, and operative complications were recorded. Results: The mean operative time was significantly reduced (64.47 ± 3.60 min) in the study group than in the control group (86.42 ± 5.54 min, P < 0.001). The mean time for cervical removal was significantly less (8.60 ± 1.39 min) in the study group than (17.77 ± 2.62 min) in the control group (P < 0.001). The mean volume of blood loss was less (197.38 ± 39.42 ml) in the study group than in the control group (462.69 ± 167.96 ml). Complications were fewer in the study group than in the control group. Conclusion: The CATAH technique was feasible, quicker with less intraoperative and postoperative complications than the conventional technique for TAH in benign uterine pathologies.

Objective: The objective of this study is to measure levels of Vitamin D3 and leptin and assess their relation of each to the pathogenesis of polycystic ovary syndrome (PCOS). Design: This was a cohort observational study. Settings: This study was conducted at the Department of Obstetrics and Gynecology, Tanta University. Materials and Methods: Ninety lean women were enrolled in this study and were allocated into two groups with 45 patients in each group: the first group (study group) who are lean women with PCOS and the second group (control group) who are the lean infertile patients without PCOS. Blood samples were collected and tested for study parameters. Results: There were no significant differences regarding demographic characteristics between both groups. The differences were in ovarian volume and hormonal profiles. Serum leptin was found to be significantly increased in lean PCOS than in control groups. Vitamin D3 levels were found to be lower in the lean PCOS group than in control group. Conclusion: Lean PCOS women are a unique group with specific hormonal profiles different from the typical PCOS profiles. Leptin and Vitamin D3 may have a role in the pathogenesis of lean PCOS, but large studies are still required regarding this unique group.