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Objetivo: Mostrar por primera vez cómo afecta aflibercept a las lesiones de endometriosis. Material y métodos: Endometriosis inducida quirúrgicamente en ratas hembras albinas Wistar. Las ratas con endometriosis se dividieron aleatoriamente en tres grupos: control (Co), aflibercept (Af) y acetato de leuprolida (Le). Luego, Af, aflibercept y Le recibieron acetato de leuprolida. El grupo de control no fue tratado. Los pesos y cambios en las adherencias intraabdominales de las ratas antes y después del tratamiento se registraron de acuerdo con la puntuación de adherencia de Blauer. La sangre extraída para el sacrificio fue analizada. Las lesiones endometriósicas se evaluaron en tamaño, volumen, histología e inmunohistoquímica (factor de crecimiento endotelial vascular [VEGF] y CD31). El nivel de significación se aceptó como p < 0.05. Resultados: Aflibercept redujo significativamente el volumen del implante endometrial (p = 0.002). La puntuación histológica epitelial (EHS) del explante mostró una diferencia significativa entre aflibercept y acetato de leuprolida (p = 0.006) y entre los grupos de aflibercept y control (p = 0.002). Aflibercept disminuyó la expresión de VEGF-H y CD31 (p = 0.001) más que el acetato de leuprolida. Aflibercept mejoró las adherencias (p = 0.006). Conclusión: Aflibercept tiene más éxito que el acetato de leuprolide en el tratamiento de la endometriosis.

Aim: Hypogonadotropic hypogonadism (HH) is a rare clinical condition resulting from gonadal insufficiency due to low pituitary gonadotropin levels. Since ovulation occurs rarely in these patients, the probability of spontaneous pregnancy is very low. The study aimed to evaluate the in vitro fertilization (IVF) treatment outcomes in patients with HH and to compare these results with that of patients with unexplained infertility (UI) who underwent IVF treatment. Material and Methods: In this study, 36 cycles of 28 HH patients who underwent IVF treatment and 72 cycles of 68 patients who underwent IVF treatment for UI were included. Demographic data, ovarian hyperstimulation and cycle outcomes, clinical pregnancy rates, and predictive factors for clinical pregnancy were evaluated retrospectively, and the two groups were compared. Results: In the HH group, clinical pregnancy, and live birth rates per cycle after IVF were significantly higher compared with the UI group (n=16, 44.4% vs. n=17, 23.6%, p=0.027; and n=14, 38.9% vs. n=14, 19.4%; p=0.030, respectively). Although the number of antral follicles (p=0.001) and retrieved oocytes (p=0.042) were significantly higher in the UI group, the number of mature oocytes and grade I-II embryos were similar in the HH and UI groups. The total gonadotropin dose used and duration of stimulation in the HH group were significantly higher than in the UI group (both p=0.001). Conclusion: HH patients responded well to IVF treatment and had better IVF outcomes compared to women who underwent IVF for UI. No prognostic factor that affected pregnancy success in HH patients was detected.

Background: The studies which investigated the relationship between anti-Mullerian hormone (AMH) level and abortion rate have conflicting results. Aims: This retrospective study aimed to evaluate the relationship between AMH levels and abortion in women who achieved pregnancy with in vitro fertilisation (IVF) treatment. Settings and Design: This retrospective study was conducted in the Department of Gynecology and Obstetrics, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, between January 2014 and January 2020. Materials and Methods: Patients below 40 years of age who conceived after IVF-embryo transfer treatment during a 6-year period and had a serum AMH level measurement were included. The patients were divided into three groups according to the serum AMH levels as low AMH (L-AMH, ≤1.6 ng/mL), intermediate AMH (I-AMH, 1.61–5.6 ng/mL) and high AMH (H-AMH, >5.6 ng/mL). The groups were compared in terms of obstetric, treatment cycle characteristics and abortion rates. Statistical Analysis Used: The Mann–Whitney U-test was used in comparison of non-parametric data of two groups; the Kruskal–Wallis test was used to compare the data of more than two groups. When a statistically significant difference was found in the Kruskal–Wallis test result, the groups were compared in pairs using the Mann–Whitney U-test, and the groups that made a statistical difference were determined. The Pearson's Chi-square and Fisher's exact tests were used to compare the independent categorical variables. Results: L-AMH (n = 164), I-AMH (n = 153) and H-AMH (n = 59) groups were similar in terms of obstetric histories and number of cycles applied, with an abortion rate of 23.8%, 19.6% and 16.9%, respectively (P = 0.466). The same analyses were repeated in two subgroups under 34 years of age and above, and no difference was found in terms of miscarriage rates. The number of oocytes retrieved and the number of mature oocytes were higher in H-AMH group compared to intermediate and low groups. Conclusion: No relationship was found between serum AMH level and abortion rate in women who achieved clinical pregnancy with IVF treatment.

Objectives: The aim is to use three-dimensional transvaginal ultrasonography (3-D TVUS) to evaluate the success of hysteroscopic metroplasty for the uterine septum and to compare the pregnancy outcomes. Materials and Methods: Thirty-eight patients with uterine septum who had hysteroscopic uterine septum resection were recruited. Preoperative 3-D TVUS measurements of the septal apex to the uterine fundus (s1), septal apex to internal os distance (s2), and intercornual distance (s3) were compared with the postoperative values. The pregnancies of the patients were followed up for a year postoperative period. Results: Out of the 38 patients, thirty-five had partial uterine septum (class U2a), while 3 patients had complete uterine septum (class U2b). Eighteen (47.36%) of the patients who underwent uterine septum resection achieved pregnancy, and thirteen of these pregnancies were (72.2%) term pregnancies, and all term pregnancies resulted in a live birth. Natural conception was achieved in 77.7% (14 of 18) of the patients. Term pregnancy occurred in 68.7% (11 of 16) of the patients with a partial septum and in 66.6% (2 of 3) of the patients with a complete uterine septum. A comparison of the 3-D TVUS measurements of the uterus pre- and postoperatively showed a decrease in s1 and an increase in s2 (P < 0.05). The uterine cavity length of pregnant patients was found to be higher than nonpregnant patients (P < 0.05). Conclusion: Reproductive results of hysteroscopic metroplasty were favorable in achieving live and term birth. three-dimensional TVUS can be preferred as a noninvasive effective method in objective evaluation of the success of the hysteroscopic surgery.

Anti-Müllerian hormone (AMH) is a glycoprotein that secreted by the granulosa cells of the pre-antral and antral ovarian follicles that have a diameter

Aim: The aim is to evaluate the pregnancy outcomes of patients with uterus unicornis for 5-year experience in a tertiary center. Material & Method: Twenty patients with uterus unicornis who were diagnosed with hysterosalpingography and/or 3D TVUSG between 2017 and 2021 and then confirmed with laparoscopy and simultaneous hysteroscopy were recruited for this retrospective study. The reproductive outcome and obstetric complications of the patients were followed up for two years postoperative period. Results: Overall 20 patients who fulfilled the inclusion criterion were recruited for the study. The mean age was 28.65±5.03 years. Thirteen patients (65%) had primary infertility while the remaining seven had secondary infertility with two of them having a previous ectopic pregnancy. Rudimentary communicating uterine horn was observed in 7 (35%) of the patients. The horns were excised during laparoscopy. Overall, 14 (70%) pregnancies were achieved during the 2 years follow-up period. Twelve (85.7%) patients had a live birth, (71.4% term delivery, 21.4% preterm delivery), and two had a first-trimester spontaneous abortion (15.3%). Six (50%) of 12 patients who had a live birth received tocolytics for preterm labor. Conclusion: Unicorn uterus is a rare anomaly diagnosed mostly during infertility work-out and might be related to the poor obstetric outcome, but early diagnosis is important for successful pregnancy results for preterm delivery especially in the secondary infertile group. In addition, rudimentary horn excision is recommended due to the high risk of obstetric complications.

Amaç: Bu çalışmanın amacı endometrial kalınlık ölçümü 5 mm üzerinde olan asemptomatik postmenopozal kadınlarda salin infüzyon sonografi sonrası dilatasyon ve kuretaj ile sonohisterobiopsinin (SHB) tanısal değerlerinin karşılaştırılmasıdırGereç ve yöntem: Transvajinal ultrasonografi ile endometrium kalınlığı 5 mm üzeri tespit edilen asemptomatik postmenopozal kadınlar histeroskopi öncesinde iki gruba ayrıldı. Salin infuzyon sonografi (SIS) ile eş zamanlı sonohisterobiopsi yapılan 50 olgu çalışma grubu olarak (Grup 1), salin infuzyon sonografi ardından kuretaj yapılan hastalar ise kontrol grubu olarak belirlendi(Grup2). Bulgular: Olguların %35’inde endometrium kanseri açısından en az 1 tane risk faktörü vardı. SIS ve sonrasında kuretaj yapılan hastaların %60’ ınde histopatolojik incelemede polip bulundu. SHB bulguları SIS ve kuretaj yapılan olgularla karşılaştırıldığında histeroskopik bulgularla daha uyumlu bulundu. SHB ile endometrial poliplerin kesin tanı ve tedavisi için eşik değer % 96 duyarlılık ve %100 özgüllük ile 10 mm olarak bulundu.Sonuç: SHB endometrial patolojilerin tanı ve tedavisinde yüksek duyarlılık ve özgüllüğe sahip etkili ve güvenli bir yöntemdir.

AbstractBackground/Aims:To evaluate the effect of gestational weight gain on the amount of postpartum bleeding.Methods: An observational study reviewed medical records of with low-risk singleton pregnancies who delivered vaginally at 37 weeks of gestation or beyond between May 1 and November 1, 2018 at a tertiary referral center. Demographic and clinical characteristics were obtained from the medical records. The relationship between the increased rate in BMI during pregnancy and amount of blood loss in the postpartum first hour was evaluated. Results:A total of 411 women was included in the study. In the study population, the mean blood loss was 57.3±43.9 ml in the 3rd stage of labor and 113.2±76.9 ml in the postpartum first hour. No correlation was found between the increase in BMI during pregnancy and blood loss during the 3rd stage of labor (r=0.006) and postpartum first hour (r=0.037). Nulliparity, history of postpartum hemorrhage in previous pregnancy, premature rupture of membranes, and episiotomy were found to be risk factors for increased postpartum blood loss during the 1st hour (p lt; 0.05). Conclusions: Increase in BMI was not related with the amount of postpartum bleeding in women with low-risk pregnancy who had a vaginal delivery.

Objective: The main detrimental factor in female fertility is maternal age. Clinical pregnancy and live birth rates decline gradually with age and this decline is dramatical over 40 years. In this study, we examined the in vitro fertilization/intracytoplasmic sperm injection cycle outcomes of women aged 40 years and over. Study Design: This retrospective cohort study included 336 fresh in vitro fertilization/ICSI cycles of women aged ≥40 years. Six groups, stratified by one-year intervals were composed according to age: 40 years; 41 years; 42 years; 43 years; 44 years, and ≥45 years. The primary outcomes were the clinical pregnancy and live birth rates. Results: The clinical pregnancy rate was 18.6% in 40 years old women and it decreased to 4% in women aged ≥45 years. The live birth rates in women aged 40 and 41 years (10% and 6.1% respectively) were higher than the live birth rates in women aged 42 and 43 years (4.3% and 3.8% respectively). There was no live birth in women aged 44 and over. The miscarriage rate was 46.2% at age 40 and it increased to 100% at age 44 and over. Conclusion: The clinical pregnancy and the live birth rates decreased significantly with every single year after 40 years of age. In patients between the ages of 40-43, the live birth rate is acceptable but starting an in vitro fertilization cycle beyond 43 years of age does not seem to be reasonable.

ObjectiveTo investigate the correlation between sonographic, hysteroscopic, and pathological findings in postmenopausal asymptomatic patients with sonographically thickened endometrium.MethodsThe records of postmenopausal patients who attended the Menopause Outpatient Clinic of a tertiary women's hospital in Ankara, Turkey between January 1, 2012 and December 15, 2013 were retrieved. A total of 266 postmenopausal women without vaginal bleeding underwent hysteroscopic evaluation and endometrial sampling. Patients whose pathological records indicated an endometrial thickness equal to or greater than 6 mm (double layer) on transvaginal ultrasonography without any symptoms were included in the study.ResultsThe most frequently detected focal intrauterine lesions in asymptomatic women were endometrial polyps, which were diagnosed in 168 (63.1%) cases. Twenty-four (9%) patients were diagnosed as having simple hyperplasia, 4 (1%) atypical hyperplasia, and 8 (3%) endometrial adenocarcinoma. Two of the patients with adenocarcinoma were diagnosed based on endometrial polyps, and 6 cases showed endometrial hyperplasia on hysteroscopy, while histological examination showed endometrial carcinoma.ConclusionWe suggest 10.5 mm as the cutoff value for endometrial thickness and recommend hysteroscopy following dilatation and curettage to increase diagnostic efficacy and provide definitive treatment in asymptomatic postmenopausal women with thickened endometrium.

Objective: To evaluate the effect of the GnRH antagonist on gonadotropin ovulation induction in women with PCOS. Materials and methods: A total of 175 intrauterine insemination (IUI) cycles in women with polycystic ovary syndrome (PCOS) were included in the study. Women in the control group (n = 87) underwent controlled ovarian stimulation (COS) with recombinant follicle stimulating hormone (r-FSH) only, while women in the study group (n = 88) were administered r-FSH plus cetrorelix. Results: As expected, the mean value of luteinizing hormone and progesterone, on the day of human chorionic gonadotropin administration were statistically significantly lower in patients receiving GnRH antagonist than the control group (p = 0.002). Premature luteinization occurred in only one of the patients in the GnRH antagonist group (1.1%) and in 15 of the 88 cycles in the control group (17.2%), showing a significant difference between the two groups (P = 0.001). The clinical pregnancy rate per cycle was higher in GnRH-antagonist group compared to the control group but the difference did not reach to a statistical significance (25% vs 14.9%, P = 0.096). Conclusions: Adding GnRH-antagonist in COS/IUI cycles in women with PCOS resulted in a lower incidence of premature luteinization but did not improve pregnancy rates. However, owing to some benefits, antagonist therapy could be considered as a reasonable alternative to IVF in order to reduce PCOS patients'emotional distress. Keywords: Controlled ovarian hyperstimulation, GnRH antagonist, In vitro fertilization, PCOS, Premature luteinization

Objective: To determine the role of anti-Mullerian hormone (AMH) levels in predicting the response to clomiphene citrate (CC) therapy for ovulation induction in women with unexplained infertility. Materials and methods: For this retrospective study, fifty consecutive patients who responded to CC were taken as Group 1, while fifty consecutive patients who failed to show adequate ovulatory response with CC were taken as Group 2. We compared the AMH levels of the two groups and receiver operating characteristic (ROC) curve was used to determine the threshold for AMH in predicting the ovulatory response to CC therapy. Results: Mean age, body mass index, luteinizing hormone, prolactin, and thyroid-stimulating hormone values were similar in the two groups. AMH and antral follicle count (AFC) values were higher in Group 1 than in Group 2 (p = 0.001 and p = 0.001, respectively). There was a statistically significant negative correlation between FSH and AFC (r = −0.339, p = 0.001), while AFC and AMH displayed a statistically significant positive correlation (r = 0.713 and p = 0.001). AMH values and AFC were found to be predictors of the adequate ovulatory response to CC. The area under the ROC curve was 0.86 vs 0.80, respectively. At an AFC cutoff value of 14, the sensitivity and specificity for prediction of ovulation were 68% and 80%, respectively. Conclusion: The AMH and AFC cut-off values for the prediction of positive ovarian response to CC in patients with unexplained infertility were 2.78 ng/mL and 14, respectively. If further prospective and randomized studies confirm our results, these thresholds may be useful to predict successful ovulation induction and reduce the unresponsive cycles. Keywords: Anti-Mullerian hormone, Clomiphene citrate, Ovulation induction, Unexplained fertility

Objective: The aim of the presented study is to investigate the impact of progesterone change in the late follicular phase on the pregnancy rates of both agonist and antagonist protocols in normoresponders. Study design: A total of 201 normoresponder patients, who underwent embryo transfer were consecutively selected. 118 patients were stimulated using a long luteal GnRH agonist protocol and 83 using a flexible antagonist protocol. The level of change in late follicular phase progesterone was calculated according to the progesterone levels on the hCG day and pre-hCG day (1 or 2 days prior to hCG day) measurement. Results: Clinical pregnancy rates were comparable between long luteal and antagonist group (35.6 and 41%, respectively). The incidence of progesterone elevation on the hCG day was 11% in long luteal and 18% in antagonist group (p = 0.16). In pregnant cycles, p levels both on the hCG day and pre-hCG day measurement were significantly higher in antagonist than agonist cycles (p = 0.029, p = 0.038, respectively). The change of p level was statistically significant in non-pregnant cycles both for the agonist (-0.17 ± 0.07; 95% CI: −0.29 to −0.37) and antagonist groups (−0.18 ± 0.07; 95%CI: −0.31 to −0.04). Conclusions: Late follicular phase progesterone levels were stable during the cycles of pregnant patients irrespective of the protocols and were shown to be higher in pregnant patients in antagonist cycles when compared to agonist cycles.

Objective: Endometriosis is a chronic inflammatory disease pathologically defined as the presence of endometrial-like tissue outside the uterine cavity. It is one of the most important diseases affecting women of reproductive age. The process of endometriotic implant growth is mediated by many complex interactions of immunologic, hormonal, genetic, and environmental mediators. Vitamin C (ascorbic acid), besides playing a role in preventing invasion and metastasis, is an antioxidant having anti-inflammatory and -angiogenic effects. In this study, we aimed to investigate the effect of vitamin C on the prevention and regression of endometriotic implants in a rat model of endometriosis. Materials and Methods: This was a prospective, comparative, experimental animal study. After endometriotic implants were induced simultaneously, rats were divided into three groups. Group A was given 500 mg/kg of intravenous vitamin C every 2 days, starting immediately after implantation (n = 11). All rats had a second operation 21 days after the initial one and had the lesion volumes measured. Group B was given 500 mg/kg of intravenous vitamin C every 2 days, starting 21 days after this operation (n = 11). All rats were sacrificed 21 days after the third operation. Implant volume, weight measurements, and histopathological evaluation of the lesions were carried out. Group A received vitamin C throughout the study, while Group C (n = 11) was not given any medication. The findings in the three groups were compared. Results: At the second laparotomy after the induction, Group A had the smallest implant volume with a statistically significant difference compared to Group B (p = 0.012). The end-of-study volumes of endometriotic implants of group B were significantly smaller than the first volumes (p

Background The association between blood types and ovarian reserve is investigated in this study. Materials and Methods As an index of ovarian reserve, women with a follicle stimulat- ing hormone (FSH) level of ≥10 mIU/ml in the early follicular phase were designated as having diminished ovarian reserve. In this prospective study, early follicular phase serum FSH and estradiol levels and blood types were evaluated in 500 patients who were admitted to the Infertility Department of Ministry of Health Etlik Zübeyde Hanım Women’s Health Training and Research Hospital between January 2012 and June 2012. Women with serum FSH level

Acute renal failure (ARF) is rarely associated with pregnancy. However, it is a severe health-deteriorating problem of pregnant women without a known kidney disease. Although its incidence is relatively low in developed countries (1/20000), it is still a serious health issue in the developing world. In addition to any of the etiological factors that may result in ARF in non-pregnant women, pregnancy also increases the vulnerability of some special diseases that may result with the renal injury. In this review we aimed to summarize antepartum and postpartum causes of renal failure via summarizing two cases of renal failure.

It is important to determine the origin and malignancy risk of pelvic pathologies preoperatively and thus decide the route and extent of the surgery. In this case report, we present three cases operated for presumed adnexal masses those were intraoperatively diagnosed to be nongynecological benign masses originating from adjacent organs with a brief review of the literature. Three cases underwent surgery with a pre-operative diagnosis of adnexal mass but intraoperatively diagnosed to be mucinous cystadenoma of appendix, mesenteric cyst and gastrointestinal stromal tumor. Non-gynecological masses should be considered in the differential diagnosis of adnexal masses and centers operating on a considerable number of adnexal masses should be capable of managing rare nongenital masses that can be accidentally encountered during the operation.

A 13-year-old patient with a complaint of worsening lower abdominal pain during the past 4 months was admitted to the emergency department. An abdominopelvic ultrasound scan revealed a distended uterocervical cavity suggestive of hematometrocolpos. Imperforate hymen was observed on examination of the external genitalia. MRI scan revealed an air-fluid level representing pyometrocolpos within a distended vagina. Posterior vaginal extraperitoneal leakage as the sign of a fistula between the vagina and the rectovaginal space was detected. Although laparoscopic approach was planned, malodorous pus expelled after the insertion of the Veress needle, it was decided to proceed to laparotomy. Pus with peritoneal microabscess formations was observed at laparotomy. The imperforate hymen and TVS were excised vaginally. A more complex anomaly should be suspected in cases with hematometra and concomitant imperforated hymen without any bulging and thorough evaluation using radiological imaging techniques should be performed before surgical approach.

OBJECTIVE: The aim of this study was to determine the possible predictors of total gonadotropin dose (TGD) required to achieve ovulation in patients with unexplained infertility or male subfertility. STUDY DESIGN: A prospective study on 230 patients (n:178 unexplained infertility, n:52 male subfertility) scheduled for controlled ovarian stimulation (COH) and intrauterine insemination (IUI) was designed to determine the association between basal follicle stimulating hormone (FSH), luteinizing hormone (LH), estrodiol (E2) levels, antral follicle count (AFC), age and body mass index (BMI) and total gonadotropin doses needed to achieve follicular growth. RESULT: Regression analysis revealed an association between basal FSH level, BMI and AFC with total gonadotropin dose (P=0.001, P=0.002, P=0.045). BMI was positively correlated with TGD (r:0.400, P=0.001). Mean BMI of patients who required a total dosage of >1500 IUs of gonadotropin was 29.7±4.8kg/ m2 where as it was 24.9±3.2kg/ m2 for patients who received

OBJECTIVE: To compare the complete evacuation rate of two different single dose misoprostol regimens in termination of missed abortion within 24 hours. STUDY DESIGN: Hundred and one women with a diagnosis of missed abortion were randomized into two groups. Women in Group I received four tablets of misoprostol (800 mg) vaginally. In Group II, two tablets of misoprostol were administered vaginally simultaneously with two tablets taken orally. Women were evaluated by transvaginal sonography after the initiation of vaginal bleeding (primary visit) or in cases with no bleeding within 24 hours after the administration. In cases that had not completed the abortion at the primary visit, a surgical evacuation was performed. Mean expulsion time, clinical outcomes, side-effects, complications and any additional interventions required were analyzed in two groups. RESULTS: There was no statistically significant difference between the two groups in terms of age, number of previous pregnancies, the complete evacuation rate at the primary visit or mean expulsion time. The complete evacuation rate within 24 hours was 18% in Group I and 14% in Group II (p=0.38). The overall complete evacuation rate was 16% (n=16). There was a statistically significant difference between the groups for mean hemoglobin values before and after treatment (0.64 vs 0.62 respectively, p

OBJECTIVE: To evaluate the endometrial changes in patients with proven ectopic pregnancies and the v alue of endometrial histopathology in diagnosis of ectopic pregnancies. STUDY DESIGN: Medical records of 71 patients with prov en ectopic pregnancies and who had endometrial curettage results were rev iewed. Ectopic pregnancy was conf irmed either at operation or at transv aginal ultrasound ev aluation with clearly visualized characteristic adnexal mass in the presence of an empty uterus and serum beta-subunit human chorionic gonadotropin level abov e the discriminatory zone. Histopathologic f indings of the endometrial curettage materials were ev aluated. RESULTS: The mean age of the patients was 30±5.9 y ears. The mean gestational age (by date of last menstrual period) at presentation was 36.9 day s. The most common symptoms at presentation were both v aginal bleeding and missed menstruation. Rev iew of the endometrial curettages revealed that the most common type of endometrium associated with ectopic pregnancy was secretory (52.2%) followed by decidual reaction (15.5%), proliferative endometrium (14.1%), Arias-Stella reaction (11.2%), and endometrial f ragments (7%). CONCLUSION: Since ectopic pregnancy is associated with v arious ty pes of endometrial histopathology, it is not valuable in the diagnosis and should be performed in selected patients f or differential diagnosis when TVUS, serial serum b-HCG levels are inconclusive.

OBJECTIVE: The aim of this study was to ev aluate indications, effectiv eness and safety of laparoscopically assisted v aginal hysterectomy f or benign adnexal or uterine pathologies. STUDY DESIGN: We rev iewed the records of 35 consecutive women who underwent laparoscopically assisted v aginal hysterectomy f or benign reasons between January 2002 and December 2004. All the patients were not suitable candidates for abdominal or vaginal hysterectomy either because of concomitant adnexal masses or lack of uterine prolapse. The exclusion criteria included prolapse, uterine or adnexal neoplasm, pelv ic inflammation, vaginal stenosis and any pathology with a uterine size of more than 14 weeks. RESULTS: Indications for laparoscopically assisted v aginal hysterectomy were leiomyoma uteri (45.7%), intractable uterine bleeding (17.1%), myoma uteri with adnexal masses (14.3%), postmenopausal (8.6%) or bilateral (8.6%) adnexal masses and tamoxifen related endometrial pathology (5.7%). Mean operating time was 149.31 minutes (range 90-210) and the mean postoperative hospital stay was 2.4 days (range 2-10). Only one bladder laceration occurred during the operations which required conv ersion to laparotomy (2.8%). CONCLUSION: Laparoscopically assisted vaginal hysterectomy was f ound as a f easible and safe approach in the surgical management of a selected group of patients with benign pathologies.