Search

Objective: The aim of this study was to assess the prognostic values of risk of malignancy index (RMI IV), ultrasound score, menopausal status, and serum CA125 and CA19-9 level in patients with borderline ovarian tumor (BOT). Methods: Fifty women having borderline ovarian tumor (BOT) and 5O individuals with benign adnexal mass were enrolled in this retrospective study. The sensitivity, specificity, positive predictive values, negative predictive values and diagnostic accuracy of preoperative serum levels of the CA125 and CA19-9, ultrasound findings and menopausal status, and RMI IV were calculated for prediction of discrimination between BOTs and benign adnexal masses and the results were compared. Results: The RMI IV was the best method for discrimination between BOTs and benign adnexal masses and was more accurate than the other parameters. When Receiver Operator Characteristic area under the curves for menopausal status was analyzed, serum CA 125 and CA19-9 level, ultrasound score, RMI IV(CA125), and RMI IV(CA19-9) were, 0.580, 0.625, 0.548, 0.694, 0.734 and 0.711, respectively. The best RMI IV cut-off was found to be 200 for discrimination of benign and BOT lesions. In the RMI formulation, replacing CA125 with CA19-9 didn't affect RMI IV sensitivity and specificity for discrimination. Conclusion: Compared to ultrasound, menopausal status, CA-125, CA19-9, the RMI IV was found to be the best predictive method for differentiation of BOTs from benign adnexal masses. RMI IV cut-off value of 200 is suitable for differentiation of benign and BOT's. [ABSTRACT FROM AUTHOR]

Objective: To study the levels of chitotriosidase activity in the peritoneal fluid and the plasma of patients with severe endometriosis and control subjects. Materials and methods: Twenty-five women with laparoscopically and histopathologically confirmed endometriosis (study group) and 27 control patients who had undergone laparoscopic surgery were included. Peritoneal fluid and peripheral blood were obtained from all the patients before the surgery. Chitotriosidase activities were measured. Results: Analysis of chitotriosidase activity in the peritoneal fluid of patients with endometriosis showed that there was no significant difference between endometriosis and control group, respectively (32.04 ± 64.20 vs. 15.25 ± 31.17 nmol/mL/h; p > 0.05). Analysis of chitotriosidase activity in plasma of patients with endometriosis showed significantly increased levels of chitotriosidase levels compared with the control group (74.81 ± 60.54 vs. 14.10 ± 26.17; p < 0.001), respectively. Conclusion: We found that the activity of chitotriosidase in plasma was statistically higher in severe endometriosis patients than women without endometriosis. [ABSTRACT FROM AUTHOR]

Tubal sterilization is a widely used permanent contraceptive method for women who had completed their desired childbearing. If a pregnancy occurs after tubal sterilization, it is expected to be ectopic in most of the cases. However encountering an intrauterine pregnancy after Pomeroy tubal sterilization is extremely rare. A second time intrauterine pregnancy occured in a 34-year-old woman who had undergone tubal sterilization by Pomeroy technique in her last caesarean section. We are pointing out the failure risk of tubal sterilization with its possible mechanisms which might result in a viable intrauterine pregnancy. [ABSTRACT FROM AUTHOR]

Objective: To find out whether tubal sterilization leads to loss of ovarian reserve, we assessed the hormonal and ultrasonographic parameters of ovarian reserve in women who underwent laparoscopic tubal sterilization by bipolar electrodesiccation and transection., Study Design: In this preliminary study, laparoscopic tubal sterilization was performed on 49 healthy women who had voluntarily requested elective surgical sterilization. Among the current ovarian reserve indicators, in the early proliferative phases, preoperative (baseline) and postoperative (third month) serum follicle-stimulating hormone (FSH), estradiol (E2), and anti-Mullerian hormone (AMH) levels, ovarian volume, and antral follicle counts (AFCs) were determined. Analysis of these hormonal and ultrasonographic parameters of ovarian reserve preoperatively and postoperatively was the main outcome measure., Results: Preoperative and third-month postoperative FSH, LH, E2, and AMH levels did not reveal statistically significant differences (p=0.101, p=0.180, p=0.254, and p=0.079; respectively). The ultrasonographic indicators of ovarian reserve did not change in terms of total ovarian volume and total AFC (p=0.793 and p=0.098, respectively)., Conclusions: Short-term follow-up study results revealed a slight but non-significant change in the current ovarian reserve markers, especially in the AMH levels., (Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.)

Objective: Urinary incontinence (UI) may affect a woman's physical and psychological well-being in different aspects. The aim of this study was to compare the effects of urinary stress incontinence (USI), detrusor overactivity (DO) and mixed urinary incontinence (MUI) on sexual function., Study Design: One-hundred and seventy urinary incontinent, sexually active women were included in this cross-sectional study. After urodynamic evaluation, participants were divided into three subgroups as USI (n=61), DO (n=55) and MUI (n=54). Patients were matched according to age, parity and body mass index (BMI), rendering the sample size to 41 patients in each group. Turkish version short form of the Pelvic Organ Prolapse/Incontinence Sexual Function Questionnaire (PISQ-12) was filled out by each of the participants. Totally, 52 patients were excluded from the study (47 could not be matched and 5 incomplete questionnaire). Demographic characteristics of the participants, total and three domain scores of PISQ-12 were compared among three UI subgroups., Results: The study group was consisted of 38 (32.2%) DO, 41 (34.7%) USI and 39 (33.1%) MUI patients. Demographic characteristics of the patients were similar in three subgroups. Patients with a diagnosis of MUI had significantly lower mean PISQ-12 scores than the ones with USI and DO whereas patients with USI had lower mean PISQ-12 scores than patients with DO., Conclusion: Although urinary stress incontinence effects sexual function more than detrusor overactivity in terms of PISQ-12 scores, mixed urinary incontinence has the greatest impact on sexual function when compared with urinary stress incontinence and detrusor overactivity., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Background: Although ectopic pregnancies, nonviable missed abortions or blighted ova may occur subsequent to female sterilization, intrauterine pregnancy has not been reported. The sterilization failure risk persists for years after the procedure and varies by operator technique, method of tubal occlusion and female age., Case: A viable, 8-week intrauterine pregnancy developed in a 36-year-old woman, gravidity 3, parity 2, five years after laparoscopic tubal sterilization., Conclusion: The possible mechanisms for a pregnancy after tubal sterilization may be spontaneous reanastomosis or fistula formation or a viable endosalpinx caused by the failure of electrocoagulation. Operator failure may occur when the occluding device is placed on the round ligaments. In this case study, the pregnancy was most likely related to a possible fistula formation which could have developed over the years following surgery.

Objective: To determine the appropriate dose of sublingual misoprostol administration before dilation and curettage (D&C) of the uterus in first trimester pregnancies., Study Design: Ninety nulliparous women who underwent surgical termination of first trimester pregnancy were analyzed prospectively. The first group (n = 30) received a single 200-microg dose, and the second (n = 30) and third (n = 30) groups were administered 2x 200 microg (400 microg) and 3 x 200 microg (600 microg) doses of misoprostol sublingually, respectively, with 1-hour intervals. The main outcomes evaluated were the degree of difficulty of cervical dilation, adverse effects of misoprostol according to dose administered, and participant satisfaction rate with the procedure., Results: The improvement in cervical dilation and the ease of the D&C procedure were more significant in the 600-microg misoprostol arm (p = 0.008). Because the prevalence and severity of the side effects of misoprostol were increased in a dose-dependent manner, the 400-microg arm was found to be the most efficient dose of the study with its high satisfaction rate (p < 0.001)., Conclusion: Premedication with misoprostol makes the D&C procedure easier by leading to cervical ripening. By sublingual route 400 microg of misoprostol regimen seems to be appropriate for planned first trimester surgical pregnancy termination under local anesthesia. Misoprostol should be administered only to select and hospitalized patients.

Objective: Polycystic ovary syndrome (PCOS) is an endocrinopathy characterized by chronic anovulation and hyperandrogenism. Hormonal changes can affect ocular surface and tear functions. We evaluated dry eye symptoms, clinical tear film alterations, and tear clearance in patients with PCOS., Study Design: Thirty-five women with PCOS and 22 healthy individuals were enrolled in the study. An ocular surface disease index (OSDI) questionnaire was administered, and after the routine ophthalmologic examination tear film breakup time (TBUT) and Schirmer tests were performed. Tear clearance was assessed via fluorescein dye disappearance test (FDDT)., Results: No difference was observed in Schirmer test between the groups, however OSDI scores were significantly higher (p = 0.01) and TBUT was significantly lower (p = 0.01) in PCOS patients than in the control women. FDDTs were not different between the PCOS and control subjects., Conclusion: Our findings suggest that patients diagnosed with PCOS should be advised to obtain an ophthalmic examination, especially for dry eye.