General Gynecology and Pelvic Floor
Leila Pourali; maryam salehi; reyhaneh rahmani; elmira fardi; sedigheh ayati; hasan Mehrad-Majd; mehrdad gazanchian; elham rahmanipour; mohammad ghorbani; Ali mehri
Articles in Press, Accepted Manuscript, Available Online from 16 July 2023
Abstract
Background: Vaginal birth after Caesarean (VBAC) is often offered as an option after a single caesarean section (CS).
Objectives: to evaluate the success rate of vaginal birth after two caesarean sections (VBAC-2).
Search strategy: Systematic review and meta-analysis
Selection criteria and Data collection: ...
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Background: Vaginal birth after Caesarean (VBAC) is often offered as an option after a single caesarean section (CS).
Objectives: to evaluate the success rate of vaginal birth after two caesarean sections (VBAC-2).
Search strategy: Systematic review and meta-analysis
Selection criteria and Data collection: We searched MEDLINE, EMBASE, PubMed, Scopus, using search terms (cesarean OR cesarean OR caesarean OR caesarian) AND (“Vaginal birth after” OR VBAC) AND (two OR Twice OR second OR multiple Two independent reviewers performed the study selection, and abstracted and tabulated data and pooled estimates were obtained. Meta-analyses were performed using Open-meta and Comprehensive Meta-Analysis.
Main results: Mean success rate of VBAC-2 was 72% (2174 out of 3020 cases) with a range of 24-90%. Mean hysterectomy rate was 0.43% ranging from 0% to 1.7%. Our meta-analysis showed no significant difference between VBAC-2 and CS-3 in the case of hysterectomy, with a pooled odds ratio (OR) of 0.699, but with a wide confidence interval (95% CI was 0.347-1.407). VBAC-2 being associated with 2 fold increased risk of perinatal mortality compared to CS-3.
Conclusion: Vaginal delivery is a suitable option for women with two previous cesarean sections, the outcomes are significantly more favorable for women with history of vaginal birth.
General Gynecology and Pelvic Floor
Mahnaz Ashrafi; Behnood Farazmand; Souzan Soufizadeh Balaneji; Maryam Dadkhah
Articles in Press, Accepted Manuscript, Available Online from 01 October 2023
Abstract
Background: Polycystic ovarian syndrome (PCOS), the most common cause of infertility, is widely treated with clomiphene citrate and human gonadotropins. Letrozole, an aromatase inhibitor, can also induce ovulation in patients resistant to clomiphene. However, there has been no comprehensive study comparing ...
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Background: Polycystic ovarian syndrome (PCOS), the most common cause of infertility, is widely treated with clomiphene citrate and human gonadotropins. Letrozole, an aromatase inhibitor, can also induce ovulation in patients resistant to clomiphene. However, there has been no comprehensive study comparing ovulation induction with clomiphene and letrozole versus clomiphene and human gonadotropin. This study aimed to compare an aromatase inhibitor with human gonadotropin for patients with clomiphene-resistant polycystic ovary syndrome. Methods: This randomized clinical trial was conducted on PCOS women resistant to clomiphene at Akbarabadi hospital, Tehran, Iran. Patients were randomly divided into two groups. The first group received letrozole and clomiphene citrate and the second received clomiphene citrate and human gonadotropin.Results: Total number of 120 patients enrolled in our study. No significant difference was seen between the two groups in terms of demographic and basic clinical characteristics (P>0.05). We also found no significant difference between the two groups in terms of hirsutism, galactorrhea, pregnancy rate, human chorionic gonadotropin (HCG) intake, primary and secondary infertility, and number of follicles (P>0.05). Conclusion: The combination of letrozole and clomiphene citrate was as effective as human gonadotropin and clomiphene citrate and it could be a treatment option for patients with infertility due to PCOS.Keywords: Clomiphene, Human menopausal gonadotropin, Letrozole, Polycystic ovary syndrome, Ovulation
General Gynecology and Pelvic Floor
Rihab Majeed Shareef; Najah Shaker Yassen; Sallama Hamid Alkhudair
Articles in Press, Accepted Manuscript, Available Online from 13 November 2023
Abstract
Background: Melatonin play a role in pubertal development and reproductive function through the Hypothalamus-hypophysis-gonadal axis. In addition, melatonin production decreases with age, so that indolamine could be an anti-ageing agent. To assess Intra follicular melatonin level's role in ovarian ...
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Background: Melatonin play a role in pubertal development and reproductive function through the Hypothalamus-hypophysis-gonadal axis. In addition, melatonin production decreases with age, so that indolamine could be an anti-ageing agent. To assess Intra follicular melatonin level's role in ovarian reserve and the IVF cycle outcomes.
Patients and method: A prospective cross-sectional study was conducted from April 2022 to April 2023. Patients on a mini-long agonist, short agonist, and antagonist protocols were enrolled in the current study. Using ultrasound, the follicle development was observed from the stimulation day until the hCG day (done every 2 or 3 days).
Results: Melatonin were positively correlated with oocyte retrieved (r=0.705, P<0.001), number of fertilized oocyte (r=0.68, P<0.001), number of zygotes cleaved (r=0.660, P<0.001), high quality embryos (r=0.591, P<0.001), embryos for transplantation (r=0.604, P<0.001), percent of high quality embryos (r=0.58, P<0.001), and with percent of blastocyst rate.
Conclusion: Melatonin mean levels in follicular fluid were significantly decreased in poor response than in standard and high response. The follicular fluid melatonin levels were associated with each oocyte quantity and quality and can expect ICSI consequences and act as highly important biochemical indicators of ovarian reserve.
General Gynecology and Pelvic Floor
Hadeer Mahmoud Hazem; Baydaa Hussein abed awn
Articles in Press, Accepted Manuscript, Available Online from 22 January 2024
Abstract
Background & Objective: This study's main objective was to establish physical characteristics (pH and flow rate) and dental caries experience among women with PCOS and to perform an assessment of dental caries relationship to salivary antioxidant biomarker (total antioxidant capacity and uric acid).Materials ...
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Background & Objective: This study's main objective was to establish physical characteristics (pH and flow rate) and dental caries experience among women with PCOS and to perform an assessment of dental caries relationship to salivary antioxidant biomarker (total antioxidant capacity and uric acid).Materials and Methods: There was 80 women in the study (40 female with PCOS and 40 healthy female served as controls) with ages ranging from 25 to 30 years and with a range of body mass indices 18.5-24.9 (normal weight). Unstimulated saliva was obtained. Both salivary pH and flow rate were discovered immediately. After that, saliva was subjected to biochemical analysis to determine salivary TAC and UA levels using ELISA method. Dental caries diagnosis and registration were assessed using WHO in 2013.Results: In the PCOS group, the mean salivary flow rate and pH were lower than in the control group, with a statistically significant difference (P<0.05). The salivary (TAC) and (UA) mean values were higher in the PCOS group than in the healthy females, with a statistically significant difference (P<0.05). while dental caries fractions was positively not significant correlated with total antioxidant capacity and uric acid in the study group except (DMFT) was positively significant correlated with antioxidant Parameter (TAC) (P< 0.05 ) and (DS and DMFT) were positively significant with uric acid among women with PCOS (P< 0.05).Conclusions: Furthermore, Salivary TAC and UA were elevated in PCOS which can be used in the future as indicators for the PCOS diagnosis.
General Gynecology and Pelvic Floor
Zainab Abdulrazzaq Hameed; Abdul Karim salem Mahood; Zainab Abbas Hassooni
Articles in Press, Accepted Manuscript, Available Online from 30 January 2024
Abstract
Endometrial carcinoma (EC) is one of commonest ten cancers, and represents fourth most widespread malignancy in females, it mainly happen in postmenopausal women. Endometrial cancer creates from the endometrium and is classified, depend on the development mechanism, into kinds 1 and 2, which are responsive ...
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Endometrial carcinoma (EC) is one of commonest ten cancers, and represents fourth most widespread malignancy in females, it mainly happen in postmenopausal women. Endometrial cancer creates from the endometrium and is classified, depend on the development mechanism, into kinds 1 and 2, which are responsive and non-responsive to estrogen, respectively and have significantly diverse gene expression profiles. This study was carried out in Laboratories of the College of Science/ Department of Biology and in a local lab during the period between December 2021 to August 2022. The study of PCR was used to detection HOXA11 expression .We aimed to describe the histological changes of tumors malignant and benign and normal tissues of the endometrial and determine the relationships between HOXA11 expression with the histopathological variables involving, stage, grade, muscle and lymph nodes invasiveness and histological types. results shows the values of HOXA11 expression and a significant difference (P-value>0.001) between patients with endometrial cancer and control group, these results regarding the values means of HOXA11 expression a significant difference (P-value=0.021) between patients with benign tumor and the control and the values means of HOXA11 expression a significantly difference (P-value >0.001) between patients with endometrial cancer and benign tumor.
General Gynecology and Pelvic Floor
Zinat Ghanbari; Leila Pourali; Tahereh Eftekhar; Maryam Deldar Pesikhani; Soudabeh Darvish; Zahra Lotfi; Elnaz Ayati
Volume 9, Issue 2 , March and April 2024, , Pages 144-149
Abstract
Background & Objective: Defecatory dysfunction is a common problem among women who are referred for urogynecological care. Pelvic organs prolapse (POP) which is a downward displacement of pelvic organs is one of the common conditions among patients with defecatory problems. This study was planned ...
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Background & Objective: Defecatory dysfunction is a common problem among women who are referred for urogynecological care. Pelvic organs prolapse (POP) which is a downward displacement of pelvic organs is one of the common conditions among patients with defecatory problems. This study was planned to evaluate the correlation of obstructive defecatory symptoms with the site and severity of pelvic organ prolapse and the anorectal manometry results.
Materials & Methods: This cross-sectional study was performed between Dec 2018 and Nov 2019. A total of 150 women with symptoms of defecatory problems were enrolled. Patients were classified in two groups according to each compartment prolapse staging and severity: stage ≤2 and stage >2. The correlation between defecatory symptoms and pelvic organ prolapse examination, anorectal examination and anal manometry were evaluated.
Results: A total of 150 women were evaluated. There was a significant correlation between higher stage of anterior compartment prolapse (cystocele stage>2) and constipation (P=0.035). Although all the defecatory symptoms were more frequent in anterior prolapse stage>2, but the difference was not significant (P>0.05). There was no significant correlation between defecatory symptoms and severity of posterior compartment prolapse. There was a significant correlation between stage>2 of apical prolapse and all the defecatory symptoms (P≤0.05). The abnormal anal resting and squeeze pressure and abnormal balloon expulsion test were more frequent in stage >2 of all compartments prolapse, but the difference was not significant (P>0.05).
Conclusion: Obstructed defecation syndrome was more frequent in patients with higher stages of anterior and apical prolapse. Abnormal manometry results were more frequent in patients with defecatory dysfunction with advanced vaginal prolapse.
General Gynecology and Pelvic Floor
Mona K. Omar; Ayman S. Dawood; Samah Ahmed Radwan; Ahmed M. Ossman
Volume 9, Issue 2 , March and April 2024, , Pages 163-173
Abstract
Background & Objective: Conservative treatment of placenta accreta spectrum (PAS) become increasingly performed, especially due to acceptance of many obstetricians to preserve the uterus. To evaluate cesarean scar integrity following PAS conservative surgery using Shehata's technique and other conservative ...
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Background & Objective: Conservative treatment of placenta accreta spectrum (PAS) become increasingly performed, especially due to acceptance of many obstetricians to preserve the uterus. To evaluate cesarean scar integrity following PAS conservative surgery using Shehata's technique and other conservative techniques because more than one level of pelvic devascularization was used. This cross-sectional study was conducted at Tanta University in the period from June 1, 2019 to October 31, 2022.
Materials & Methods: All patients underwent conservative uterine sparing technique (Shehata's technique) were assessed by 2 D ultrasound at 6-18 months later to detect the integrity of the CS scar. Fifty women with a history of other conservative treatment of PAS used as control.
Results: Women who were operated with Shehata’s technique showed less incidence of scar dehiscence with less size of scar defects and more thickness of the myometrium over the scar site and more vascularity of these scars.
Conclusion: Shehata's technique resulted in a more integrated scar with less incidence of dehiscence and more vascularity of the compared to other conservative methods of treatment of PAS. Therefore, it is an effective and safe method in treatment of PAS.
General Gynecology and Pelvic Floor
Shams Anmar Burhan; Raed Ghazi Reshan; Abdelaziz El Refaeey; Amoura M. Abou-El-Naga
Volume 9, Issue 2 , March and April 2024, , Pages 218-224
Abstract
Background & Objective: The presence of anesthetic drugs in the serum with potential negative effects on hormone concentration and pregnancy rate has been shown in a number of human research. To assess the effects on blood hormone concentration and pregnancy rate of two different medications (remifentanil ...
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Background & Objective: The presence of anesthetic drugs in the serum with potential negative effects on hormone concentration and pregnancy rate has been shown in a number of human research. To assess the effects on blood hormone concentration and pregnancy rate of two different medications (remifentanil vs. fentanyl) used for general anesthesia during oocyte retrieval.
Materials & Methods: the present prospective comparative study was conducted at Iraq's "High Institute of Infertility Diagnosis and Assisted Reproductive Technologies/Al-Nahrain University/Baghdad/Iraq" infertility center and was approved by Mansoura University for its validity. Sixty infertile women who were having (ICSI) for a range of infertility-related reasons that entered the study. The women's ages varied from 20 to 45 years. The study's length was extended from September 2022 to September 2023. According to the general anesthetic protocol for oocyte retrieval, those patients were divided into two groups. Midazolam, propofol, and fentanyl were given to the group one, while remifentanil, midazolam, and propofol were given to the group two.
Results: Compare the hormone levels before and after fentanyl anesthesia. The current study's findings indicated that remifentanil led to a greater pregnancy rate (40.0%) than fentanyl (36.7%). According to the results, there were significantly higher LH levels after fentanyl anesthesia (P = 0.014). However, insignificantly higher FSH (P = 0.481) and prolactin (P = 0.076) levels post-fentanyl anesthesia. Also, significantly higher LH levels after remifentanil anesthesia (P = 0.046), insignificantly higher FSH levels (P = 0.383) and prolactin levels (P = 0.16) after remifentanil anesthesia. In the fentanyl group, the recovery time was substantially longer (P<0.001).
Conclusion: Because of its quicker recovery time and much greater pregnancy rate, remifentanil is preferred over fentanyl in normal general anesthetic treatments for egg harvest in ICSI operations.
General Gynecology and Pelvic Floor
Behnaz Nouri; Ladan Ajori; Zohreh Ahmadvand; Saba Fahimhi
Volume 8, Issue 6 , November and December 2023, , Pages 614-619
Abstract
Background & Objective: Adnexal torsion is a complete or incomplete twisting of the ovary, fallopian tubes, or ovarian cyst around its vascular axis, which can cause blood flow disruption. This disorder is rare but serious and accounts for about 3% of women's emergency surgeries. Early diagnosis ...
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Background & Objective: Adnexal torsion is a complete or incomplete twisting of the ovary, fallopian tubes, or ovarian cyst around its vascular axis, which can cause blood flow disruption. This disorder is rare but serious and accounts for about 3% of women's emergency surgeries. Early diagnosis of this disease and the necessary surgeries are very important to preserve fertility. The purpose of this study is to investigate the epidemiology, clinical symptoms, imaging and pathology of patients with torsion of the adnexa referred to the emergency rooms of Mahdiyeh and Shohadaye Tajrish hospitals.Materials & Methods: This study is a retrospective cross-sectional study. In the present study, 190 patients with torsion of the adnexa were examined in the period 2011–2021, in Mahdiyeh and Shohadaye Tajrish hospitals. Demographic, clinical and surgical information about patients was extracted from medical records. Data analysis was done using SPSS version 22 statistical software.Results: The average age of 190 patients was 29.2. Most of the ovarian torsion patients had a history of more than one previous delivery (57.9%) and also, an ovarian mass was observed in 157 patients, and the ovarian mass of 146 patients was larger than 5 cm. The rate of ovarian preservation in this study was 61%. Hemorrhagic cysts were the most common type of cyst in patients and were reported in 37 patients.Conclusion: It is necessary to identify effective diagnostic methods. Therefore, it may be useful to investigate more serum biomarkers for early detection of adnexal torsion and to reduce diagnostic errors.
General Gynecology and Pelvic Floor
Zinat Ghanbari; Leila Pourali; Tahereh Eftekhar; Maryam Deldar Pesikhani; Soudabeh Darvish; Elnaz Ayati; Zahra Lotfi
Volume 8, Issue 5 , September and October 2023, , Pages 431-437
Abstract
Background & Objective: Pelvic organ prolapse (POP) is the herniation of the pelvic organs to or beyond the vaginal wall. Patients with POP may present with specific symptoms like vaginal bulge or pressure or associated symptoms including urinary, defecatory or sexual dysfunction, which could ...
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Background & Objective: Pelvic organ prolapse (POP) is the herniation of the pelvic organs to or beyond the vaginal wall. Patients with POP may present with specific symptoms like vaginal bulge or pressure or associated symptoms including urinary, defecatory or sexual dysfunction, which could negatively affect the quality of life in these patients. This study aimed to assess the surgical outcomes of native-tissue apical suspension by sacrospinous ligament fixation (SSLF) versus uterosacral ligament suspension (ULS).Materials & Methods: This prospective cohort study was conducted to evaluate the outcomes of native-tissue apical suspension for pelvic organ prolapse within one year after the surgery from March 2017 to July 2019 at Imam Khomeini hospital, an academic hospital of Tehran University of Medical Sciences, Tehran, Iran. Inclusion criteria were patients with uterine prolapse at Stage 2 or 3 according to the Pelvic Organ Prolapse Quantification System (POP–Q) who planned for total vaginal hysterectomy and apical suspension using uterosacral ligament suspension (ULS) or sacrospinous ligament fixation (SSLF) with no history of pelvic organ prolapse surgery. The main outcome was surgical consequences within 1 year after surgery.Results: There was no significant difference between the two groups in terms of relapse of anterior, posterior, or apical compartment prolapse. According to the clinical recurrence, although vaginal bulging and pressure were more common in sacrospinous ligament fixation (SSLF) group, the difference was not significant. The number of patients with severe buttock and pelvic pain was significantly higher in the sacrospinous ligament fixation (SSLF) group.Conclusion: sacrospinous ligament fixation (SSLF) and uterosacral ligament suspension (ULS) are both optimal procedures with the same complications and similar surgical outcomes; however, uterosacral ligament suspension (ULS) had lower post-operative pelvic pain, and also the number of retreatment was lower in this group.
General Gynecology and Pelvic Floor
Zinat Ghanbari; Maryam Deldar Pesikhani; Parivash Jelodarian; Reihane Sadat Hosseini
Volume 8, Issue 5 , September and October 2023, , Pages 528-532
Abstract
Postoperative abscess after colpocleisis is rare. We reported a 67-year-old woman with an abscess after a month of Le Fort colpocleisis. Two abscesses of approximately 5 cm in size were drained. The injection of antibiotics continued up to 7 days after the surgery, and the drain was taken on the 4th ...
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Postoperative abscess after colpocleisis is rare. We reported a 67-year-old woman with an abscess after a month of Le Fort colpocleisis. Two abscesses of approximately 5 cm in size were drained. The injection of antibiotics continued up to 7 days after the surgery, and the drain was taken on the 4th day after the operation due to the improvement of the patient's general conditions and no discharge. It is recommended to consider pelvic abscess in patients suffering from fever, pain, pelvic pressure, and diarrhea after pelvic surgeries. Early diagnosis and treatment will reduce mortality and disability in patients.
General Gynecology and Pelvic Floor
Zahra Yazdi; Hoora Amuzegar; Monireh Mirzaie; Seyed Mohammad Hashem Montazeri
Volume 8, Issue 2 , March and April 2023, , Pages 188-193
Abstract
We present a 26-year-old woman with hypothyroidism that was treated with levothyroxine, and was hospitalized at 25 weeks of gestational age with diagnosis of ovarian torsion and underwent detorsion surgery, but finally, after a few weeks and during cesarean section, no trace and evidence of the ovary ...
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We present a 26-year-old woman with hypothyroidism that was treated with levothyroxine, and was hospitalized at 25 weeks of gestational age with diagnosis of ovarian torsion and underwent detorsion surgery, but finally, after a few weeks and 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.
