Factors affecting sexual function in premenopausal age women with type 2 diabetes: a comprehensive study

OBJECTIVE

To compare the factors affecting sexual function in premenopausal women with type 2 diabetes using the female sexual function index (FSFI).

DESIGN

Cross-sectional study.

SETTING

Premenopausal women with type 2 diabetes and healthy volunteers in an academic research environment.

PATIENT(S)

Sixty-two type 2 diabetic women were compared with 50 controls. The FSFI scores of the patients were compared according to age, duration of diabetes, marriage, socioeconomic status, parity, menstruation regularity, body mass index (BMI), and smoking.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

Female sexual function index scores.

RESULT(S)

The mean FSFI score in diabetics was lower than in controls. Menstrual irregularity and duration of diabetes affected female sexual function unlike age, BMI, socioeconomic status, duration of marriage, or parity. Regularly menstruating women had higher FSFI scores (27.1 ± 6.7) than irregularly menstruating women (20.7 ± 7.4). Type 2 diabetics were divided into three groups according to duration of diabetes. The women having diabetes longer than 10 years had the worse sexual function. Also, smoking affected inversely female sexual well being.

CONCLUSION(S)

Menstrual disturbance, smoking, and longer duration of diabetes (more than 10 years) impair FSFI scores in premenopausal women with type 2 diabetes.

A new medical treatment with botulinum toxin in persistent genital arousal disorder: successful treatment of two cases

Persistent genital arousal disorder is described in a spontaneous, persistent, and uncontrollable genital arousal in women, with or without orgasm or genital engorgement, unrelated to any feelings of sexual desire. This study aimed to argue that application of Botulinum toxin in the periclitoral region in order to block the dorsal nerve of the clitoris might decrease symptoms of persistent genital arousal disorder. The authors presented 2 cases, in which application of Botulinum toxin resulted in improvement of the symptoms of persistent genital arousal disorder. Botulinum toxin type A treatment protocol is seen as a promising application for the persistent genital arousal disorder. However, further controlled studies in large samples are needed.

Glyceryl trinitrate for the treatment of preterm labor

OBJECTIVE

This study was conducted to compare the tocolytic efficacy of glyceryltrinitrate (GTN) with that of magnesium sulfate (MgSO4) and to investigate serum nitric oxide metabolites before and after tocolysis.

MATERIAL AND METHODS

In total, 48 women between 27 and 34 weeks' gestation with threatened preterm labor and intact membranes were randomly allocated to receive either GTN or MgSO4 tocolysis. Main outcome measures included tocolytic efficacy and maternal side effect(s) of the tocolytic agent. Obstetric and neonatal outcomes as well as pretreatment and posttreatment nitric oxide (NO) metabolites were assessed.

RESULTS

Forty-one patients were included into the final analysis. Uterine contraction cessation times were 3.66±1.28 and 6.83±3.47 hours for GTN and MgSO4 groups, respectively. Similarly, maternal side effects were significantly lower in the GTN group than in the MgSO4 group, and no serious maternal side effects were recorded. Serum NO metabolite levels before treatment were significantly lower in the treatment groups than in the controls. Serum nitrite levels were significantly increased after tocolytic treatment both in MgSO4 and GTN groups.

CONCLUSION

GTN effectively delays preterm delivery and reduces neonatal morbidity and mortality with less maternal side effects and seems to be an effective and safe alternative to MgSO4.

Effect of parity on healthy promotion lifestyle behavior in women

BACKGROUND

Health-promoting lifestyle behaviors are not only for the prevention of a disease or discomfort, but are also behaviors that aim to improve the individual's general health and well-being. Nurses have an important position in the development of healthy lifestyle behaviors in women.

OBJECTIVE

The aim of this study was to assess the effect of parity on health-promoting lifestyle behaviors in women.

METHOD/DESIGN

This descriptive and cross-sectional survey was performed in Adana, Turkey. This study was conducted with 352 women. The questionnaire consisted of two parts; the first part consisted of questions that assessed the socio-demographic and obstetric characteristics, and the second part employed the "Health Promotion Lifestyle Profile Scale" (HPLP). Data analysis included percentage, arithmetic average, and ANOVA tests.

RESULTS

The results revealed that 24.1% of the women had no parity, 13.6% had one parity, 30.7% had two parities, 14.6% had three parities, and 17% had four and above parities. The mean total HPLP was 126.66±18.12 (interpersonal support subscale, 24.46±4.02; nutrition subscale, 21.59±3.92; self-actualization subscale, 24.42±4.30; stress management subscale, 18.73±3.81; health responsibility subscale, 21.75±4.31; and exercise subscale, 15.71±4.22).

CONCLUSIONS

The health behavior of women was moderate. A statistically significant correlation was found between the number of parities and the Health Responsibility, Nutrition, Interpersonal Support, which is the subscale of the HPLP Scale.

Complications of gynecological laparoscopy: experience of a single center

BACKGROUND

The purpose of this study was to describe the prevalence and type of laparoscopic complications seen in a teaching hospital.

MATERIALS AND METHODS

Four hundred and forty-one diagnostic and operative laparoscopic procedures were performed by the same senior resident/resident surgical team. Direct entry technique was used for all procedures.

RESULTS

The procedures included 74 (16.8%) diagnostic and 367 (83.2%) operative laparoscopies. The overall complication rate was 7.7% (34 cases). Conversion to laparotomy occurred in 16 cases (3.6%).

CONCLUSIONS

The complication rate was found to be slightly higher than the rates quoted in the literature. This rate of 7.7% is still an acceptable one.

Is advanced bipolar v anced bipolar vessel sealing de essel sealing device really eff eally effective in decreasing the pelvic lymphocele ratio in open surgery for endometrial cancer?

BACKGROUND

We aim to show pelvic lymphocele (PL) rates in patients who were operated for endometrial cancer (EC) and underwent systematic paraaortic bilateral pelvic lymph node dissection (PABPLND) with advanced bipolar vessel sealing device (ABVSD).

METHODS

The medical files of all patients who underwent open surgery for EC between January 2017 and December 2021 were retrospectively analyzed. One hundred three patients who operated with the diagnosis of high-intermediate and high-risk endometrial cancer were included. Systematic PABPLND was performed with total abdominal hysterectomy with or without bilateral salpingo-oophorectomy during surgery to all patients. All operations were performed by same three surgeons who were expert in their field. While the lymph packages were removed during surgical dissection, the distal afferent and proximal efferent lymphatic channels were sealed with LigaSure™ blunt tip sealer/divider (Medtronic, Covidien, USA). The patients were scanned with computed tomography (CT) between 8 and 12 weeks postoperatively. Lymphocele diagnosis was confirmed by radiologists and largest diameter was recorded. Clinical-pathological findings of all patients were recorded.

RESULTS

Mean age and body mass index (BMI) of all participants were 58.6 ±10.2 years and 28.1± 5.6 kg/m2 . The most histopathological findings were endometrioid type (84.5%) and grade 2 (44.2%) ECs. The pelvic lymphocele (PL) was detected with CT in 24 of 103 patients at 8 to 12 weeks postoperatively. Only two PL patients were symptomatic. The first patient had symptoms of pelvic fullness and compression while the second patient had infected image. PL was located to right pelvic area in first case while the second was located on the vaginal cuff.

DISCUSSION

The dissection and sealing of major lymph vessels were achieved during the removal of all lymph packages with LigaSure™ blunt tip laparoscopic sealer/divider. The use of advanced bipolar systems can reduce the formation of PL in lymph node dissection in endometrial cancer.

A retrospective study of pregnant patients with acute pancreatitis

OBJECTIVE

Acute pancreatitis is a rare disease in pregnant patients. Although it may have serious maternal and fetal consequences, morbidity and mortality rates have decreased recently due to appropriate and rapid treatment with earlier diagnosis. The aim of this study was to evaluate pregnant patients diagnosed with acute pancreatitis.

METHODS

The study included pregnant patients diagnosed with acute pancreatitis who were admitted to Adana City Training and Research Hospital in Adana, Turkey, between January 2014 and January 2022. Patients' files were screened. Patients' demographics, acute pancreatitis etiology, severity, complications, and applied treatment, as well as maternal and fetal outcomes were evaluated.

RESULTS

The study included 65 pregnant patients with acute pancreatitis. The mean age was 26.6±5 (19-41) years. Acute pancreatitis was observed in the third trimester. The most common cause of acute pancreatitis was gallstones, and its severity was often mild. Only two patients required endoscopic retrograde cholangiopancreatography, and the remaining patients were treated medically. Maternal and infant death developed in a patient with necrotizing acute pancreatitis secondary to hyperlipidemia.

CONCLUSION

The most common etiology of acute pancreatitis in pregnancy was gallstones. Acute pancreatitis occurred in the third trimester. Most of the patients had mild acute pancreatitis. Maternal and fetal complications were rare. We think that the reasons for the low mortality rate were mild disease severity and biliary etiology, and most patients were in the third trimester, as well as early diagnosis and no delay in the intervention.

The role of fetal fibronectin and plasminogen activator inhibitor 1 biomarkers in antenatal prediction of placenta accreta spectrum

In this study, we aimed to assess the determining role of foetal fibronectin (FFN) and plasminogen activator inhibitor type (PAI-1) levels in the antenatal prediction of placenta accreta spectrum in cases with risk factors for placenta accreta spectrum. Singleton live pregnancies with placenta previa or low-lying placenta within 32-34 weeks of gestation were included in the study. The cases were divided into two groups after delivery as those with PAS and those with normal placentation. 54 cases diagnosed with placenta previa or low-lying placenta were included in the study. 17 of the cases underwent peripartum hysterectomy due to placenta accreta spectrum. 37 cases with normal placentation underwent caesarean delivery. Foetal fibronectin (p:.03) and PAI-1 (p:.02) levels were determined to be significantly different between cases with placenta accreta spectrum and cases with normal placentation. AUC for foetal FFN was calculated to be 0.69, while the AUC for, PAI-1was 0.66. Results for both FFN and PAI-1 were not found useful enough for the diagnosis of PAS. IMPACT STATEMENTWhat is already known on this subject? We lack biomarkers which can identify placenta accreta spectrum.What do the results of this study add? Maternal plasma levels of FFN and PAI-1 significantly altered in PASWhat are the implications of these findings for clinical practice and/or future research? If multiple of median values of FFN and PAI-1 levels in maternal blood are determined in future studies, it can be used in the antenatal diagnosis of PAS cases.

Mayer-rokitansky-kuster-hauser syndrome with presacral schwannoma presenting as a pelvic mass: A literature review and case report

A 32-year-old woman was admitted to our gynecology outpatient clinic with primary amenorrhea, a pelvic mass, and pain. Sonographic examination and magnetic resonance imaging revealed an approximately 124×103 mm heterogeneous mass. Moreover, laparotomy revealed fibrotic uterine bands with normal ovaries, tubes, and a solid retroperitoneal lesion. On the second postoperative day, the mass was removed, and the patient was discharged with full recovery. Microscopic examination of the pelvic mass confirmed the diagnosis of schwannoma. To the best of our knowledge, this is the first report on the co-occurrence of Mayer-Rokitansky-Küster-Hauser syndrome and schwannoma, without the presence of any other pathology.

The importance of size of cervical ectopy to predict postcoital bleeding: is there any cut-off value?

OBJECTIVE

To investigate the relationship between size of cervical ectopy and existence of postcoital bleeding (PCB) in non-symptomatic women.

MATERIALS AND METHODS

Study population were recruited from women ages 18-65 years, sexually active who applied to the present outpatient department. They were asked whether they had had postcoital bleeding in the last three months. After ful visualization of the cervix, the existence of ectopy was noted and measured. The smears were taken from all patients with endobrushes.

RESULTS

The authors found a relationship between the size of ectopy and PCB. In the prediction of PCB, the lesion's size (of both antero-posterior and transverse diameters) of 3.5 mm as the cut off level, sensitivity, and specificity were found to be 70% and 76%, respectively.

CONCLUSION

The full visualization of the cervix is important because of the relationship between the existence of ectopy and PCB.

Effects of natural progesterone on endometriosis in an experimental rat model: is it effective?

To assess the effects of the natural progesterone on the endometriosis in a rat model.

MATERIALS AND METHODS

Endometriosis was surgically induced in 20 rats by transplanting an autologous fragment of endometrial tissue onto the inner surface of the abdominal wall. Rats in control group had no medication but 2.5 mg/kg/weekly natural progesterone was administered to rats in study group for four weeks. After that, all rats were sacrificed and dimensions of endometriosis were measured and they were evaluated morphologically and histologically. Scoring systems were used to evaluate preservation of epithelia.

RESULTS

Two rats in the study group and one rat in the control group died of complications related to surgery. At the end of the treatment, there was a reduction in the size of the endometriotic lesions in the study group (p < 0.01). According to histological evaluation, the study group had lower score than control goup which was statistically significant (p = 0.014).

CONCLUSIONS

Natural progesterone is effective against endometriosis in rat model.