Contrary to reports in the literature of poor results with mini-slings, the tissue fixation system mini-sling demonstrated a higher cure rate and lower complication rate than the transobturator tape.

This study has shown that maternal vitamin D deficiency is related with an increased risk of SGA delivery. Further studies are needed to explain the relationship with vitamin D deficiency and poor perinatal outcomes.

Lower vitamin D levels in the third trimester correlates with decreased PFMS.

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Objective:Current guidelines suggest annual co-test follow-up in non-16/18 high-risk HPV positive patients without abnormal cytologic findings. Considering the relatively high false-negative rates of cervical cytology, a follow-up period of one year might constitute an additional risk for development of cervical malignancies in these patients. The current study aims to evaluate colposcopic biopsy results of cytologically normal patients detected to carry high risk HPV by screening tests. Materials and Methods:A total of 160 patients with normal cervical cytology and high-risk HPV subtypes who underwent colposcopic examination were included in the study. Patients were divided into two groups according to their HPV results: HPV 16-18 and other types (non-16/18 high-risk subtypes). ECC, cervical biopsy, LEEP/conization results were analyzed for both groups. Histopathological results of the groups were compared in terms of ≤LSIL, HSIL and cervical cancer rates. Results:Cervical biopsy results in the “16-18” group were assessed as HSIL in 40 (48.2%) patients, LSIL in 6 patients (7.2%) and normal in 37 (44.6%) patients. ECC results revealed HSIL in 9 (10.8%) patients and LSIL in 1 (1.2%) patient. Nineteen out of 42 patients who underwent LEEP/conization had HSIL (surgical margin positivity was reported in 4 cases), while 3 patients had LSIL. None of the cases had cervical carcinoma.Conclusion:The present study detected that 15.6% of women infected with non-16/18 high-risk HPV subgroups developed ≥HSIL lesions. Although this rate seems lower than HPV 16-18 group, it is still too high to be overlooked. In conclusion, we suggest further clinical trials with larger number of patients to be conducted on this topic.

Aim: The objective of this study was to present our experiences of tissue extraction via the transvaginal (TV) route after a mini-laparoscopic gynecological surgery and compare them with our transabdominal (TA) specimen extraction experiences. Methods: This prospective randomized controlled study was conducted in a tertiary care center between July 2014 and February 2016. Fifty-eight women who were undergoing mini-laparoscopy for adnexal mass removal were randomized into two groups according to the surgical specimen removal by the TV route (n = 28) or the TA route (n = 30). The main outcome measures were the postoperative incisional pain, cosmetic outcomes and overall satisfaction rate. The secondary outcome measures were additional blood loss, additional operation duration and the need for morcellation. Results: The TV group had significantly lower visual analog scale scores than the TA group at 6 and 24 h postoperatively. The morcellation needs were lower in the TV group than in the TA group. Three months after the surgery, the participants scored a higher rate of overall satisfaction in the cosmetic outcomes in the TV group than in the TA group. Conclusion: Tissue extraction through a posterior colpotomy after mini-laparoscopic surgery may be a feasible technique for improving cosmetic results, decreasing postoperative pain and decreasing the need for morcellation when compared to TA specimen retrieval.

Nowadays the use of minimally invasive techniques for hysterectomy, which is the most performed gynaecological procedure, is being increasingly adopted. Vaginal hysterectomy is recommended method for hysterectomy for all patients. If vaginal hysterectomy is inappropriate, minimal invasive surgical techniques, like laparoscopic or robotic surgery is recently being performed in various centers [1]. During the last 20 years TLH implementation rate has increased and TLH was accounted for 9.9% of all hysterectomies in 1997 and 11.8The final step of TLH is suturing vaginal cuff. According to surgeon's preference several techniques and sutures are available. Laparoscopic suturing with intracorporeal or extracorporeal techniques, interrupted or continuous suturing and transvaginal cuff closure can be performed. The closure of the vaginal cuff is the most difficult part of TLH because of the difficulty of laparoscopic suturing techniques. Requirement of advanced surgical skills, long learning curve and time-consuming process are important disadvantages of operation. In a questionnaire study, surgeons declared that they are performing TLH less than abdominal or vaginal hysterectomy because of technical difficulties associated with TLH [3].Although vaginal cuff dehiscence is a rare complication of hysterectomy; intestinal evisceration, peritonitis, intestinal injury and sepsis are serious complications associated to dehiscence [4]. There are studies reporting that, the rate of cuff dehiscence is higher after laparoscopic and robotic hysterectomy than after vaginal and abdominal hysterectomies [5][6][7][8][9]. The reasons for high cuff dehiscence rate after endoscopic surgery are reported as; inserting sutures too close to surgical area (<1 cm) due to misleading effect of laparoscopic magnification, failure to close full-thickness or non-compliant laparoscopic suture techniques [4]. Using barbed-delayed sutures and double thickness closing or using automatic suture devices are recommended techniques to reduce cuff dehiscence [10,11].

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