Features of regional blood flow after endoscopic myomectomy

The state of regional blood flow in 65 patients before and after endoscopic myomectomy was studied using modem methods such as Doppler examination and color Doppler sonography. It was determined that blood flow velocity indeces obtained during the Doppler examination of myoma vessels and uterine arteries allow to estimate the morphological structure of myomas uninvasively and can be used to define the indications for conservative endoscopic surgical procedures in patients with myoma uteri. Doppler monitoring of regional blood flow during postoperative period makes it possible to evaluate the effectiveness of surgical treatment previously performed.

Is there any possibility of uterine sarcoma, STUMP and benign myoma variants in the patients operated for myoma uteri

Malignant pathologies may be observed in the histopathological examination of the patients who were operated with the diagnosis of myoma uteri. We aimed to investigate the rates of detection of uterine sarcoma, smooth muscle tumor of uncertain malignant potential and benign myoma variants who were operated due to myoma uteri. Patients who were operated with the diagnosis of myoma uteri between 2012-2018 were included. Patients with and without malignant pathology were compared in terms of their characteristics. The malignancy was encountered in 39 patients (1.5%) among 2583 patients. A significant difference was found between the patients with and without malignancy in terms of age, admission complaints, and cervical smear results. Patients in the malignant group were found to be older (52.5±11.0 vs 48.1±6.1, p=0.016). Postmenopausal bleeding was significantly a more common complaint in the malignant group (p=0.028). The rate of abnormal cytology in the cervical smear results in the malignant group was 5.1% (p=0.004). Pathology reports of the patients who were operated for myoma uteri may result with malignancy. In the preoperative evaluation, it is necessary to pay attention to the patients’ characteristics, to evaluate the risk factors for the possibility of a malignancy.

Homeopathic Approach in the Case of Secondary Infertility and Anosmia

A 38-year-old female patient diagnosed as secondary infertility, anosmia, myoma uteri, Hashimoto thyroiditis with the history of many unsuccessful IVF attempts regained her ability of smell, her thyroid antibody levels normalised, her basal hormones, AMH levels, ovarian follicular development and ovulation improved after 6 months of treatment with homeopathy and nutritional supports. In this case report, it is observed that many gynecological problems accompanied with infertility, anosmia and autoimmune problems like Hashimoto’s thyroiditis can be improved with a holistic approach to individual supportive therapies and homeopathy. It is hoped that this case report can be a reference for future studies in this field.

Contraceptive Use of Levonorgestrel Intrauterine System: Case Series

Aim: Levonorgestrel intrauterine system (LNG-RIS) is a highly effective, safe and reversible contraceptive method. It suppresses endometrial cell proliferation, thickens cervical mucus, disrupts tubal motility by creating a high levonorgestrel concentration in the endometrium and tubal mucosa. In our country, LNG-RIS is mostly used in Gynecology and Obstetrics clinics in the treatment of pathologies such as adenomyosis, endometriosis, hyperplasia and their symptoms such as menorrhagia, dysmenorrhea, pelvic pain, and is prescribed at the hospitals due to a medication report. It has a high level of protection (99.9%), and its contraceptive effect is considered to last five years, and fertility returns rapidly after removal. In this study it was aimed to evaluate retrospectively the continuation rate, the presence of unwanted effects and the patient satisfaction after insertion of LNG-RIS. Method: This is a retrospective, descriptive study of women who had been inserted LNG-IUS with contraceptive purpose in the family planning unit of the Marmara University Pendik Training and Research Hospital, between 2013-2019; the data of a total 38 patients were retrospectively analyzed. Results: The average age of the participants was 36±5 years. No pregnancy is detected during the use of the method. Five-year usage rate was 21% among users. A total of nine patients discontinued the method; one because being diagnosed with a glial tumor, two because of excessive bleeding, one other patient because having hysterectomy due to myoma uteri, two patients because the threads were not visible, two others because they have been told that their LNG-IUS had slipped down and one patient because of her pregnancy plan. The satisfaction rate was 52.6%. There was a decrease in both the duration and the amount of bleeding of menstruation but this decrease was not statistically significant. Conclusion: LNG-RIS is an effective, reliable contraception method with low side effect. It is still limited in primary care and it will be more appropriate to spread its use.

Health Education Using Lecuter And Leaflet Methods On Knowledge Of Women About Early Detection Of Utery Mioma

Uterine myoma is a benign smooth muscle tumor of the uterus consisting of smooth muscle tissue cells, fibrous binding tissue and collagen located in the uterus. This benign neoplasm is most commonly experienced by women and its prevalence continues to increase by 70%. Myoma uteri can cause big problems in health. Meanwhile, the lack of health information regarding the etiology of myomas has not yet found effective therapy. The importance of health information about early detection of acquired myoma, can increase women's knowledge of the dangers of uterine myoma. The Purpose of this study was to determine the effect of health education with lecture methods and leaflets on early detection of uterine myomas to the knowledge of women in the village of Tateli Dua. This Type of pre experimental design research used one-group pretest-posttest design to compare knowledge before and after health education. The population is women who meet the inclusion and exclusion sample criteria of 65 respondents. The independent variable is health education about early detection of myoma uteri and the dependent variable is women's knowledge. Data collection tools and measuring tools in the form of questionnaires. Data analysis was performed using software and hypothesis testing using the Wilcoxon Signed Rank Test. The test results showed that there was a significant effect of health education using lecture and leaflet methods about early detection of uterine myomas to the knowledge of women in Tateli village (p-value = 0,000 α = 0.05). It was concluded that there was a health education using lecture method and leaflets on early detection of uterine myoma to increase women's knowledge in Tateli Dua village. Keywords : Counseling, Knowledge, Early Detection of Uterine Myoma

Oxidative Stress in Endometrial Flushing Fluid of Patients with Polycystic Ovary Syndrome, Endometrioma and Uterine Leiomyoma: Comparison with Healthy Controls

<p><strong>OBJECTIVE:</strong> Polycystic ovary syndrome, myoma uteri and endometrioma are frequently seen gynecologic problems and all three diseases may cause infertility. Aim of this cross-sectional study was to compare total antioxidant status, ceruloplasmin, total sulfhydryl , total oxidant status, lipid hydroperoxide and oxidative stress index levels in endometrial flushing fluid of patients with Polycystic ovary syndrome (n=20), uterine leiomyoma (n=20), endometrioma (n=19), and healthy women (n=20).</p><p><strong>STUDY DESIGN:</strong> We compare endometrial flushing fluid of patients with polycystic ovary syndrome (n=20), uterine leiomyoma (n=20), endometrioma (n=19) and healthy women (n=20). Endometrial flushing fluid samples were collected during the implantation window of all women.</p><p><strong>RESULTS:</strong> Mean age of groups was 28.90±5.45, 37.25±2.73, 32.84±6.62 and 32.15±5.18 in Polycystic ovary syndrome, myoma uteri, endometrioma and control groups, respectively (p&lt;0.05). Mean total antioxidant status, ceruloplasmin and total sulfhydryl levels indicating antioxidant state were comparable between Polycystic ovary syndrome, myoma uteri, endometrioma and control groups (p=0.806, p=0.156, p=0.328 respectively for markers). Similarly, oxidant state-related markers didn’t differ significantly between 4 groups (p=0.090 for total oxidant status, p=0.087 for lipid hydroperoxide, p=0.312 for oxidative stress index).</p><p><strong>CONCLUSION:</strong> Endometrial flushing fluid total antioxidant status, total oxidant status, lipid hydroperoxide, ceruloplasmin, and total sulfhydryl levels during implantation window didn’t differ between women with Polycystic ovary syndrome, uterine leiomyoma, endometrioma, and healthy controls.</p>