Reproductive Outcome After Surgical Treatment of Endometriosis – Retrospective Analytical Study

Objective: The aim of the study was to investigate the reproductive outcomes of patients after surgical treatment of endometriosis. Material and Methods: The study included 100 infertile women, aged 21 to 41 years, who underwent surgical treatment of endometriosis. From January 2007 to January 2012, excision of endometriosis was performed by operative laparoscopy or laparotomy. Demographic, clinical, surgical and reproductive outcomes of 52 patients were retrospectively analyzed. Result: Twenty-three pregnancies (44%) were obtained in 52 patients, resulting in 16 term pregnancies, 4 spontaneous abortions under 16 weeks gestation, 2 spontaneous abortions at 20 gestational weeks and 1 ectopic pregnancy. Twenty nine patients did not achieve pregnancy and 68.9% (20/29) of them were treated with IVFICSI. Spontaneous pregnancies were obtained within 7 months after the surgery, whereas IVF-ICSI pregnancies were obtained within the period of 11 months. Seven patients were stage I, 14 patients stage II, 19 patients stage III, and 12 patients stage IV according to the American Fertility Society (AFS) Classification of Endometriosis. The pregnancy rate was 57% in stages I-II, 47% in stage III, 16% in stage IV endometriosis; and the rate of term pregnancies was 83%, 66%, and 0%, respectively. Seven pregnancies (7/14) were obtained in patients with bilateral endometriosis and 5 of them resulted in term pregnancy. Sixteen pregnancies (16/38) were obtained in patients with unilateral endometriosis and 11 of them resulted in term pregnancy. Conclusion: After surgical treatment of endometriosis, the pregnancy and live birth rates seem to be improved. Reproductive outcome is closely associated with the AFS score. Bilaterality of endometriosis does not affect pregnancy outcome

Docetaxel induces moderate ovarian toxicity in mice, primarily affecting granulosa cells of early growing follicles

Advances in cancer therapy have focused attention on the quality of life of cancer survivors. Since infertility is a major concern following chemotherapy, it is important to characterize the drug-specific damage to the reproductive system to help find appropriate protective strategies. This study investigates the damage on neonatal mouse ovary maintained in vitro for 6 days, and exposed for 24 h (on Day 2) to clinically relevant doses of Docetaxel (DOC; low: 0.1 µM, mid: 1 µM, high: 10 µM). Furthermore, the study explores the putative protective action exerted by Tri-iodothyronine (T3; 10(−7) M). At the end of culture, morphological analyses and follicle counts showed that DOC negatively impacts on early growing follicles, decreasing primary follicle number and severely affecting health at the transitional and primary stages. Poor follicle health was mainly due to effects on granulosa cells, indicating that the effects of DOC on oocytes were likely to be secondary to granulosa cell damage. DOC damages growing follicles specifically, with no direct effect on the primordial follicle reserve. Immunostaining and western blotting showed that DOC induces activation of intrinsic, type II apoptosis in ovarian somatic cells; increasing the levels of cleaved caspase 3, cleaved caspase 8, Bax and cleaved poly(ADP-ribose) polymerase, while also inducing movement of cytochrome C from mitochondria into the cytosol. T3 did not prevent the damage induced by the low dose of DOC. These results demonstrated that DOC induces a gonadotoxic effect on the mouse ovary through induction of somatic cell apoptosis, with no evidence of direct effects on the oocyte, and that the damaging effect is not mitigated by T3

The effects of reflexology on anxiety and pain in patients after abdominal hysterectomy: A randomised controlled trial

WOS: 000429763000022PubMed ID: 29458915Objectives: This study aimed at finding out the effects of reflexology on pain, anxiety levels after abdominal hysterectomy. Desing & methods: The study was performed on women hospitalized in the intensive care unit and gynecology services of Ege University Hospital in Izmir after abdominal hysterectomy between September 2013 and September 2014. This study was designed and conducted as a randomized controlled trial. The study sample consisted of 63 female patients: 32 in the experimental group and 31 in the control group. The postoperative daily monitoring sheet, Spielberger State Anxiety Inventory (SAI), was employed to collect research data and "visual analog scale" to evaluate pain levels. Results: The female patients' average age was found to be 47.23 +/- 4.71. The three-day monitoring showed a significant difference between the experimental and control groups in terms of average pain levels and anxiety scores after reflexology (p < 0.05). Conclusion: Foot reflexology may serve as an effective nursing intervention to increase the well-being and decrease the pain of female patients after abdominal hysterectomy, and nurses should be aware of the benefits of reflexology.Ege University Scientific Research Projects CommitteeEge University [13-HYO-008]The authors would like to thank them for financial support to Ege University Scientific Research Projects Committee (13-HYO-008). That greatly improved the manuscript, and the participants of the study for their highly appreciated cooperation

Recurrent uterine rupture after hysterescopic resection of the uterine septum

Introduction: Uterine rupture after hysteroscopic septum resection is a rare complication, and its frequency is reported to be approximately 1-2.7%. Uterine perforation and monopolar resection during hysteroscopy are well-known risk factors for subsequent uterine rupture during pregnancy. PRESENTATION OF CASE: We present a case of recurrent uterine ruptures during consecutive pregnancies in a patient who had undergone hysteroscopic septum resection for recurrent pregnancy loss. DISCUSSION: Recurrent uterine rupture due to hysteroscopic septum resection in pregnancy is a very rare condition. In the present case we noted that the first two uterine ruptures resulted from uterine contractions; however, the third rupture occurred spontaneously and earlier in gestation. As each uterine rupture occurred earlier than the rupture in the previous gestation, a history of uterine rupture during pregnancy should raise provider suspicion about the possibility of earlier uterine rupture recurrence. CONCLUSION: Uterine rupture may occur in pregnancies after hysteroscopic resection of the uterine septum. However, if a patient has a history of uterine rupture during previous pregnancies, the risk of uterine rupture may increase for earlier gestational ages in subsequent pregnancies. The patient must be informed about both the risks of uterine rupture during pregnancy after hysteroscopic septum resection and that recurrent ruptures may occur at earlier gestational weeks than during previous pregnancies. © 2012 Surgical Associates Ltd

Subcutaneous metastasis of endometrial adenocarcinoma: Case report of an incidental diagnosis during abdominal sonography

WOS: 000220019000028PubMed ID: 15032296A rare case of subcutaneous metastasis from endometrial adenocarcinoma detected incidentally on the anterior abdominal wall during routine abdominal sonography is reported. A 62-year-old woman with clinical FIGO Stage IA, grade 2 endometrial mixed type (endometrioid and mucinous) adenocarcinoma was found with a subcutaneous mass located in the abdomen 18 months after initial surgery