Objective:To investigate differences in perioperative complications and short-term outcomes of patients who underwent abdominal sacrocolpopexy / sacrohysteropexy, laparoscopic sacrocolpopexy / sacrohysteropexy, or laparoscopic pectopexy due to apical prolapse.Materials and Methods:A retrospective cohort study was performed on 110 patients who underwent apical prolapse surgery between January 1, 2011, and July 31, 2017. Only symptomatic uterine or vaginal vault prolapse patients with stage 2-4, according to the pelvic organ prolapse quantification system, were included. Baseline and intraoperative variables of groups; perioperative complications, including hemorrhage, urinary, and wound complications, blood transfusion, ileus, and short-term outcomes were compared.Results:A total of 68 abdominal sacrocolpopexies (44 sacrocolpopexies and 24 sacrohysteropexies), 14 laparoscopic sacrocolpopexies (10 sacrocolpopexies and 4 sacrohysteropexies), and 28 laparoscopic pectopexies (16 pectopexies and 12 pectohysteropexies) were analyzed. Baseline characteristics and intraoperative variables were similar. However, the mean operating time was significantly shorter in the laparoscopic pectopexy group (74.9 min) when compared with that of the other groups (p < 0.01). During the six-month follow-up period, no prolapse recurrence and mesh erosion / exposure were observed in any group. De-novo stress urinary incontinence, urgency, and defecation problems, as well as perioperative complication rates, were not statistically significantly different between the groups.Conclusions:Although the complication rates and short-term outcomes were not significantly different between the groups, minimally invasive approaches were associated with reduced procedural-related morbidity. Laparoscopic pectopexy is a promising endoscopic prolapse surgery and can be an alternative technique to sacrocolpopexy.

Objective To create a model for prediction of success of uterine‐preserving procedures in women with placenta accreta spectrum (PAS). Methods PAS‐ID is a multicenter study that included 11 centers from 9 countries. Women with PAS, who were managed between January 1, 2010 and December 31, 2019, were retrospectively included. Data were split into model development and validation cohorts, and a prediction model was created using logistic regression. Main outcome was success of uterine preservation. Results Out of 797 women with PAS, 587 were eligible. Uterus‐preserving procedures were successful in 469 patients (79.9%). Number of previous cesarean sections (CS) was inversely associated with management success (adjusted odds ratio [aOR] 0.02, 95% confidence interval [CI] 0.001–3.63 with five previous CS). Other variables were complete placental invasion (aOR 0.14, 95% CI 0.05–0.43), type of CS incision (aOR 0.04, 95% CI 0.01–0.25 for classical incision), compression sutures (aOR 2.48, 95% CI 1.00–6.16), accreta type (aOR 3.76, 95% CI 1.13–12.53), incising away from placenta (aOR 5.09, 95% CI 1.52–16.97), and uterine resection (aOR 102.57, 95% CI 3.97–2652.74). Conclusion The present study provides a prediction model for success of uterine preservation, which may assist preoperative and intraoperative decisions, and promote incorporation of uterine preservation procedures in comprehensive PAS protocols.

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Granulocyte colony-stimulating factor (G-CSF) is a glycoprotein commonly used in the field of medicine to treat neutropenia. Granulocyte colony-stimulating factor has also crucial roles in ameliorating the ischemia/reperfusion (I/R) injury in particular tissues. In this study, we aimed to investigate the protective effect of G-CSF on ovarian damage in experimental ovarian I/R injury. Thirty adult female rats were used. Rats were separated randomly into 5 groups; Group 1: sham group (abdominal wall was opened and closed surgically), Group 2: torsion group with 3-hour ischemia using vascular clips. Group 3: torsion + G-CSF group with 3-hour ischemia 30 minutes after the administration intraperitoneal (i.p.) of 100 µg/kg of G-CSF. Group 4: torsion-detorsion group with 3 hour ischemia and 3 hour reperfusion. Group 5: torsion-detorsion + G-CSF group with 3 hour ischemia followed by 100 µg/kg of G-CSF i.p. administration 30 minutes prior to 3 hour of detorsion/reperfusion. Ovarian tissue damage was scored on histopathology. Ovarian tissue malondialdehyde (MDA) was measured biochemically. In comparison with the sham group, both the torsion and torsion-detorsion groups had significantly higher scores for follicular degeneration, vascular congestion, edema, hemorrhage, and leukocyte infiltration ( P < .05). When compared group torsion-detorsion + G-CSF to group torsion-detorsion, parameters aforementioned significantly decreased in group torsion-detorsion + G-CSF ( P < .05). Granulocyte colony-stimulating factor has also decreased MDA levels notably both in the torsion + G-CSF and torsion-detorsion + G-CSF groups ( P < .05, P < .01). Our experimental study suggests that G-CSF can be a novel agent for the treatment of ovarian I/R injury.

Background/aim: This study aimed to investigate differences in perioperative complications and short-term outcomes of patients who underwent abdominal sacrocolpopexy/sacrohysteropexy, laparoscopic sacrocolpopexy/sacrohysteropexy, sacrospinous ligament fixation (SSLF), and iliococcygeus fixation due to apical prolapse. Materials and methods: The present retrospective cohort study included 145 patients who underwent apical prolapse surgery performed by the same surgeons between 1/1/2011 and 30/6/2017. There were 68 abdominal sacrocolpopexies (44 sacrocolpopexies and 24 sacrohysteropexies), 13 laparoscopic sacrocolpopexies (10 sacrocolpopexies and 3 sacrohysteropexies), 57 SSLFs, and 7 iliococcygeus fixations. Patients' short-term outcomes, perioperative complications, blood loss, operative time, and hospital stay were analyzed. Results: The mean operating time in the laparoscopic sacrocolpopexy group was 179.6 min versus 122.8, 117.3, and 107.1 min in the SSLF, abdominal sacrocolpopexy, and iliococcygeus fixation groups, respectively (P < 0.01). The hospital stay was significantly shorter in the iliococcygeus fixation group (1.86 days) when compared with that of other groups (P < 0.01). During a 6-month follow-up period, no prolapse recurrence or mesh exposure was observed in any groups. Wound complications were more frequent in the abdominal sacrocolpopexy group. However, the overall complication rate of each group did not differ significantly (P = 0.332). Conclusion: Overall, complication rates and short-term outcomes for the abdominal, laparoscopic, and vaginal surgical procedures were not statistically significantly different. However, minimally invasive approaches were associated with reduced procedural-related morbidity.