General Gynecology and Pelvic Floor
zahra yazdi; hoora Amuzegar; Monireh Mirzaie; Seyed Mohammad Hashem Montazeri
Volume 8, Issue 2 , January and February 2023, , Pages 188-193
Abstract
we present a case of A 26-year-old woman with hypothyroidism that was treated with levothyroxine,and was hospitalized at 25 weeks of gestational age that diagnosis of ovarian torsion and underwent detorsion surgery, but finally, after a few weeks during cesarean section, no trace and evidence of the ...
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we present a case of A 26-year-old woman with hypothyroidism that was treated with levothyroxine,and was hospitalized at 25 weeks of gestational age that diagnosis of ovarian torsion and underwent detorsion surgery, but finally, after a few weeks during cesarean section, no trace and evidence of the ovary was observed, which suggests the phenomenon of spontaneous ovarian absorption.
General Gynecology and Pelvic Floor
Nahla W. Shady; Hassan A. Farouk; Hany F. Sallam
Volume 7, Issue 5 , July and August 2022, , Pages 391-398
Abstract
Background & Objective: To see if 900 mg of vaginal isonicotinic acid hydrazide (INH) given 12 hours before insertion of a T380A copper intrauterine device (IUD) was more effective than placebo in increasing insertion ease and reducing insertion discomfort in nulliparous ...
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Background & Objective: To see if 900 mg of vaginal isonicotinic acid hydrazide (INH) given 12 hours before insertion of a T380A copper intrauterine device (IUD) was more effective than placebo in increasing insertion ease and reducing insertion discomfort in nulliparous ladies.Materials & Methods: A double-blind, randomized controlled study recruited nulliparous women who wanted to use the Copper IUD for contraception. Women who were WHO-eligible for IUD implantation were recruited and randomly assigned (1:1) to vaginal INH 900 mg or placebo (n=100 in each group), 12 hours before the IUD was placed. The primary endpoint was the ease of insertion for the providers. The number of unsuccessful IUD insertions was also recorded.Results: The groups had similar baseline characteristics. The ease of insertion score in the INH group was lower than in the placebo group (3 (2-5).5 vs. 6 (3-8); P=0.01), indicating that physicians in the INH group had an easier time inserting the device. The INH group had a reduced mean pain score during the procedure (3.97 ± 0.991 vs. 6.42 ± 0.66; P=0.001). In the INH group, two incidences of failed IUD insertion occurred (2%) compared to four cases in the control group (4 percent). 0.594 is the p-value. Conclusion: Self-administered INH 900 mg vaginally 12 hours before a copper T380A IUD insertion successfully reduced discomfort during insertion and improved women's satisfaction and ease of insertion as measured by physicians in nulliparous teenagers and young ladies.
General Gynecology and Pelvic Floor
Arvin Arian; Zinat Ghanbari; Seyedeh Nooshin Miratashi Yazdi; Maryam Deldar Pesikhani; Majid Yousefi
Volume 7, Issue 4 , March and April 2022, , Pages 296-303
Abstract
Background & Objective: Pelvic floor dysfunctions (PFD) are common disorders among women and affect about 50% of them over 50. About 400,000 American women undergo surgery due to the severity of these disorders. The aim of this study was to investigate the correlation of patients' symptoms with both ...
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Background & Objective: Pelvic floor dysfunctions (PFD) are common disorders among women and affect about 50% of them over 50. About 400,000 American women undergo surgery due to the severity of these disorders. The aim of this study was to investigate the correlation of patients' symptoms with both static and dynamic MRI findings.Materials & Methods: In this study, we performed MRI on 60 women suspected of pelvic floor disorders in the Imam Khomeini Hospital complex. Following rectal enema of 60-120 cc sonography gel and vaginal enema of 5-10 cc gel, we performed MRI with 3 Tesla equipment (Siemens Magnetom Trio) utilizing multichannel (16 rows) surface coil on the supine position. Static MRI was performed with high-resolution T2 FSE sequences in sagittal, axial, and coronal planes. Dynamic imaging was done using mid-sagittal T2 HASTE or true FISP in 3 different phases (rest, squeeze, strain and defecogram). The radiologists were blinded to the clinical data of patients.Results: Our study included 60 patients with a mean age of 52.7±14.3 years. Regarding the MRI findings in patients with urinary symptoms, except for the level I fascial defect, the other findings were not related to the patients' symptoms. Among patients with defecation symptoms, other MRI findings did not have a significant relationship with the patient's symptoms except for severe rectal descent. The association between endopelvic fascial defects and levator muscle injury with sexual complaints was not statistically significant.Conclusion: In conclusion, these results suggest that the patients' symptoms are not good predictors for MRI findings and are limited in reliability. Thus, MRI must be counted necessary to further evaluate patients with pelvic floor abnormalities. Other studies regarding MRI findings' correlation with different symptoms in these patients are required.
General Gynecology and Pelvic Floor
Sarah Lotfi; Abbas Ahmadi
Volume 7, Issue 4 , March and April 2022, , Pages 354-355
Abstract
Infertility is the failure of the male or female reproductive system to conceive after 12 months or more of regular unprotected sexual intercourse (1). Failure to ovulate, problems in the menstrual cycle, infections, inadequate egg maturation, ejaculation problems, antibodies that attack sperm and tumors ...
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Infertility is the failure of the male or female reproductive system to conceive after 12 months or more of regular unprotected sexual intercourse (1). Failure to ovulate, problems in the menstrual cycle, infections, inadequate egg maturation, ejaculation problems, antibodies that attack sperm and tumors are some of the reasons that can make a man or a woman infertile. COVID-19 is a disease caused by a new type of coronavirus; it is an infectious disease caused by the acute respiratory syndrome of coronavirus 2 (SARS-CoV-2).This article is about the fact that patients with COVID-19 are more prone to infertility than other normal people. There is a possibility that this coronavirus could have a pathophysiological effect on the testes. Additional data have shown that active COVID-19 infection significantly reduces the ratio of testosterone to LH, showing a significant effect on the response of Leydig cells to LH stimulation (2). Men are said to be more likely to get COVID-19 than women; even the mortality rate is higher (3). The testes can be a potential target for the SARS-CoV-2 virus, and testicular damage and subsequent infertility after COVID-19 infection can be explained theoretically (4). It was only in May that six semen samples were positive for SARS-CoV-2 (5).
General Gynecology and Pelvic Floor
Parvin Bastani; Malahat Ebrahimpour; Fatemeh Mallah; Sakineh Hajebrahimi; Hanieh Salehi Pourmehr
Volume 7, Issue 2 , September and October 2021, , Pages 105-113
Abstract
Background & Objective: Pelvic organ prolapse (POP) is accompanied by a remarkable decline in the quality of life. Determining the best surgical approach for women with POP is difficult because of outcome variations. We compared the outcomes of pelvic organ prolapse (POP) treatment by abdominal sacrocolpopexy ...
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Background & Objective: Pelvic organ prolapse (POP) is accompanied by a remarkable decline in the quality of life. Determining the best surgical approach for women with POP is difficult because of outcome variations. We compared the outcomes of pelvic organ prolapse (POP) treatment by abdominal sacrocolpopexy (ASC) and vaginal sacrospinous ligament suspension (SSLS) for advanced apical prolapse beyond the level of the hymen (stage≥ II). Materials & Methods: This retrospective study was conducted on a case series of 58 ASC and 48 SSLS surgeries, which were performed through the posterior approach for advance prolapse during January 2019-April 2020. Pelvic Floor Disability Index (PFDI-20) questionnaire was completed both at the first visit and a year postop. All patients were visited ten days after the procedure and re-visited after 2, 4, 6, and 12 months.Results: Of a total of 106 women, 80 cases completed the study (n=40 in each group). Within-group analysis showed that the overall score of PFDI-20 and its subscales decreased in both evaluated groups after surgery (P < /em><0.001). However, the between-group analysis revealed that this reduction in the ASC group was statistically significant in the total score of PFDI, POPDI-6, and UDI-6 subscales (P < /em><0.05). In addition, vaginal length was demonstrated to improve in both groups, which was statistically significant in the ASC group (P < /em>=0.001). The stage of prolapse was improved in both groups (P < /em><0.001), and it was more significant in the ASC group (P < /em>=0.049). There was no statistically significant difference between the SSLS and ASC in terms of the rate of satisfaction (93% vs. 100%; P < /em>=0.241).Conclusion: According to our findings, ASC and SSLS diminished the symptoms of POP. The surgery approach should be chosen based on the condition of patients, POP stage, and the experience of surgeons.
General Gynecology and Pelvic Floor
Behnaz Nouri; Ahmad Reza Baghestani; Paricheher Pooransari
Volume 6, Issue 2 , March 2021, , Pages 87-94
Abstract
Backround and Objective: Cervical ripening/dilatation is necessary for gynecologic procedures, but pharmacological dilators have several adverse effects. In this regard, evening primrose oil (EPO) has been shown as an effective dilator, though it has few complications. This randomized clinical trial ...
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Backround and Objective: Cervical ripening/dilatation is necessary for gynecologic procedures, but pharmacological dilators have several adverse effects. In this regard, evening primrose oil (EPO) has been shown as an effective dilator, though it has few complications. This randomized clinical trial (RCT) aimed to compare the effect of EPO and misoprostol on cervical ripening/dilatation.Methods: In this double–blind RCT study, women of reproductive age without history of normal vaginal delivery (NVD) and menopause women (age range: 20–75 years) were enrolled. The subjects who were candidates of hysteroscopy, dilatation, and curettage were randomly assigned into two groups. In one group, 2 capsules of 500 mg EPO (N=81) and in the other group 2 capsules of 200 µg misoprostol (N=84) were placed in posterior fornix 2 hours before surgery. The time to reach complete dilatation (Hegar 3 to 10 mm), size of the first Hegar used to apply force, bleeding volume, and cervical laceration were compared between the groups using the IBM SPSS Statistics for Windows, Version 21.0 (Armonk, NY: IBM Corp).Results: The two study groups had similar demographic information, number of pregnancies, cesarean sections, and NVDs (P < /em>>.05), but had different frequency of surgical types (P < /em>=.018). EPO group had a larger mean size of the Hegar (7.32 vs. 6.58 mm; P < /em>=.004) and shorter time to reach complete dilatation (242.35 vs. 331.79 min; P < /em>=.002); however, bleeding volume and frequency of cervical laceration were not different between the groups (1.41 vs. 2.00 cc and 8.6% vs. 14.3%, respectively; P < /em>>.05).Conclusion: The superiority of EPO capsules to misoprostol for cervical ripening before gynecologic procedures in women of reproductive age without history of normal NVD and menopause women suggests it as an appropriate alternative to misoprostol.
General Gynecology and Pelvic Floor
Zahra Rezaei; Negin Azimi
Volume 6, Issue 1 , January 2021, , Pages 6-9
Abstract
Background & Objective: Persistent ectopic pregnancy (PEP) occurs due to incomplete removal of trophoblastic tissue during tubal pregnancy surgery treatment. If PEP is not diagnosed and treated in time, it can have high mortality and morbidity. This study aimed to evaluate the efficacy ...
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Background & Objective: Persistent ectopic pregnancy (PEP) occurs due to incomplete removal of trophoblastic tissue during tubal pregnancy surgery treatment. If PEP is not diagnosed and treated in time, it can have high mortality and morbidity. This study aimed to evaluate the efficacy of methotrexate (MTX) administration in the prevention of PEP after linear laparoscopic salpingostomy in tubal pregnancy.Materials & Methods: This randomized clinical trial study was conducted on 140 subjects with a diagnosis of unruptured tubal pregnancy, who were randomly divided into intervention and control groups. While the intervention group underwent a prophylactic injection of 50 mg MTX, the control group did not receive any dose of MTX. PEP was considered if there was an increase in serum BHCG levels or a decrease of less than 20% in serum BHCG levels.Results: There was no significant difference between the intervention and control groups in terms of baseline variables such as age, severity, parity, and gestational age. While in the intervention group only one patient (1.4%) had PEP, in the control group 11 (15.7%) patients had PEP (P < /em>=0.003).Conclusion: MTX administration seems to be an effective method in preventing PEP after linear laparoscopic salpingostomy in tubular pregnancy.
