Objective: To evaluate the feasibility and safety of mini-laparoscopic hysterectomy (mLH). Design: Retrospective cohort study. Settings: Tertiary private hospital. Patients: 46 mLH were performed during the period between January 2016 and February 2018. Interventions: A total of 46 women underwent mLH. Median age was 48 years [range 38-71], and median body mass index was 23 [range 18-39]. 65,2% (n = 30) of patents had at least one abdominal surgery, including caesarean section, endometriosis surgery, and myomectomy. Fibroids, adnexal masses, endometrial cancer and breast cancer were the main indications. The first entry into the peritoneal cavity was established through umbilicus with a 5-mm disposable trocar using direct trocar insertion technique. This port was used to introduce a 5-mm 30 0 telescope. A second 5-mm trocar was placed in the right lower quadrant for vessel sealing energy devices. Other ancillary trocars were inserted 3-mm (Karl Storz Endoscope mini-laparoscopy set). mLH was combined with bilateral salpingo-oophorectomy in majority (84,7%). Pelvic and paraaortic lymphadenectomy were performed in 7 patients with endometrial cancer. Measurements/Results: The mean operative time was 136 minutes with a mean CO2 consumption of 251 ml. There were no intraoperative complications. No conversion to either conventional laparoscopy or open surgery occurred. One patient had a severe bradycardia, and another patient had fever that dissolved at the second postoperative day. Median visual analogue scale scores were 2 [range 0-7) at 24 hours and 1 [range 0-7) at 3 days postoperatively. The average length of stay was 2 days [range 0-5], and the average time to return to everyday activities was 7 days [range 4-12]. Conclusions: Mini-laparoscopy provides similar instrument triangulation and dexterity requiring minimal additional training, besides its advantages in cosmetic outcome, postoperative pain, and port site complications. Minilaparoscopy can be feasible and safe in most cases in clinics performing laparoscopy as the standard route of hysterectomy.

BackgroundDiagnosis of polycystic ovary syndrome (PCOS) depends on 2003 Rotterdam Criteria. According to these criteria there are four possible combinations resulting in various phenotypes. We aimed (i)to confirm that the levels of body mass index (BMI), anti-müllerian hormone (AMH) levels and insulin resistance (IR) are higher in PCOS patients and higher in phenotype-A among PCOS patients, and (ii)to determine cut-off values for the diagnosis of PCOS and phenotype-A.Materials and methodsThis study was conducted in an IVF Center, between November 2019 and January 2021. Data of infertile women participating in the study was evaluated retrospectively. Parameters such as menstruation pattern, clinical hyperandrogenism, age, BMI, follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, thyroid stimulating hormone (TSH), prolactin, AMH, dehydroepiandrosterone sulphate (DHEA-S), fasting blood glucose, fasting insulin levels, antral follicle counts (AFC) and ovarian volumes were recorded for each patient. Women were grouped as PCOS and non-PCOS, and PCOS group was further divided into 4 sub-groups according to their phenotypes. Data of infertile patients with PCOS patients were compared with infertile non-PCOS patients and PCOS phenotypes were compared among each other.ResultsData of 244 infertile patients was included in the study. BMI, AMH, AFC, and HOMA-IR were statistically higher in PCOS patients, compared to non-PCOS patients. We found the AMH level of >3.105 ​ng/ml to be having 90.8% sensitivity and 90% specificity to diagnose a patient as PCOS. Among different phenotypes, also BMI, AMH, and insulin resistance index (HOMA-IR) levels were significantly higher in infertile PCOS phenotype-A when compared to other three phenotypes (p:0.003, p:0.000, and p:0.000, respectively). The AMH cut-off value to estimate phenotype-A was found as 6.095 ​ng/ml with 69.2% sensitivity and 86.7% specificity. We did not found threshold levels of BMI and HOMA-IR with high sensitivity to identify phenotype-A.ConclusionProperly diagnosing PCOS and determining the phenotype are crucial due to the long-term health conditions. Therefore, we suggest that serum AMH level could be included in PCOS diagnosis criteria, and the value of 3.105 ​ng/ml would have a 90.8% sensitivity and 90% specificity. Also, to identify phenotype-A, AMH level could be used. Therefore, we speculate that AMH may serve to identify PCOS and PCOS phenotype-A in places where ultrasound imaging is not straightforward to perform or not easily accessible.

Objective:We tried to provide an overview of philatelic materials related to Gynecology and Obstetrics. Design:Sample philatelic materials including stamps, first day covers and stamped postcards, all related to obstetrics and gynecology, from the senior author's personal archive were grouped according to their titles and evaluated in detail. Setting:We examine how stamp designers use visual imagery to convey information to those who see, collect, and use stamps. Method:Sample philatelic materials, related to obstetrics and gynecology, were grouped according to their titles and evaluated in detail. Main outcome measures:Stamps dedicated to the Obstetrics and Gynecology are usually printed in order to (a)pay tribute to the pioneers of Obstetrics and Gynecology, (b)commemorate important Obstetrics and Gynecology Facilities&Hospitals, (c)announce solid improvements and innovations in the field or (d)memorialize important meetings. Results:The initial use of postage stamps was solely to pay the fare of a postal service. Later on it was discovered that by using stamps it was possible to distribute ideas and news among people and also to inform them about developments, inventions, achievements and historical facts. Collecting Gynecology related philatelic materials is a very specialized branch of medical philately. In general, the subjects of the stamps dedicated to Obstetrics and Gynecology are, pioneers of Obstetrics and Gynecology, important Obstetrics and Gynecology Facilities&Hospitals, solid improvements and innovations in the field and important meetings. Conclusion:Even though use of postage stamps is decreasing, they are still among the best mediums to convey messages to broad audience. Funding:None.

No abstract

No abstract