Objectives: The aim of this study was to determine the patient and urinary incontinence-related factors affecting help seeking behavior of Turkish women with undiagnosed urinary incontinence STUDY DESIGN: This cross-sectional study was conducted on 490 female patients aged >18 years old and were seen in general gynecology outpatients' clinic of Denizli State Hospital. According to referral complaint and results of UDI-6 questionnaire, the participants were classified into 3 groups: Group A: Help seeker patient, Group B: Non help seeker patient and Group C: Continent patient. RESULTS:Overall urinary incontinence prevalence was 24%. Nearly two thirds (67%) of the urinary incontinence patients do not complain about their urinary incontinence symptoms unless they were asked specifically about urinary incontinence. Consultation rate increased with age, duration of incontinence, menopause and the severity of urinary incontinence. After logistic regression analyses, only increasing age, UDI-6 score and severity (SSI) were found to be associated independently with help seeking behavior. CONCLUSIONS:This study showed that, older, more bothered and severe urinary incontinence patients visit physician and seek medical help. Still nearly half of women who are suffering from clinically significant urinary incontinence remain undiagnosed and untreated. Regardless the visiting reason if its asked specifically for urinary incontinence symptoms by using simple questionnaires, we can reveal and diagnose this patients' group who is suffering from urinary incontinence but yet keeps it disguise.
Infertility is defined as failure to achieve clinical pregnancy after 12 months of regular sexual intercourse. 1 Emotional stress related to infertility has been shown to impair quality of life (QoL) and could play an important role in successful infertility treatment. 2To understand the burden of emotional stress, the QoL of couples experiencing infertility was examined from a dyadic perspective, and the factors affecting the QoL of men and women were evaluated comparatively.board provided ethical approval prior to data collection and informed consent was obtained from all participants. A structured questionnaire was used to obtain demographic information known to be relevant based on previous study data. 3 The FertiQoL, an internationally developed instrument for measuring infertility-specific QoL in people experiencing infertility, 4 was used to evaluate the QoL of participants, with higher scores for any subdomain indicating better QoL. FertiQoL scores were considered to be dependent variables in the present study, with all other parameters considered independent variables.Statistical analyses were performed using SPSS version 16.0 (SPSS, Chicago, IL, USA). A two-way analysis of variance test was used to examine the influence of different categorical independent variables on FertiQoL scores, with the results stratified by gender; P<0.05 was considered statistically significant.In total, 202 couples were enrolled in the present study. The age range was 24-35 years for female participants and 28-39 years for male participants. The mean±SD duration of infertility experienced by participants was 5.0±4.9 years. The incidence of receiving psychological support (34 of 200 [17.0%] women responding vs 13 of 197 [6.6%] men responding; P=0.001) and desiring psychological support (33 of 202 [16.3%] women responding vs 13 of 198 [6.6%] men responding; P=0.003) were significantly higher among female participants, and emotional (P=0.001) and mind/body (P=0.006) FertiQoL scores were significantly lower among female participants. Two-way analysis of variance tests were used to analyze the effects of age, education, employment status, health insurance, income level, receiving psychological support, desiring psychological support, and infertility cause on the FertiQoL scores; the results were stratified by gender (Table 1). Higher emotional and mind/body FertiQoL subscale scores were recorded among male participants who were in employment in comparison with female participants (P=0.003) and compared with male participants who were unemployed (P=0.005).The present results demonstrated that, among couples experiencing infertility, QoL was higher in male participants compared with their partners; however, being unemployed was associated with decreased QoL among male participants. Female participants were more likely to utilize psychological support and to report desiring psychological support. Consequently, individualized counselling methods could be applied to individuals among couples experiencing infertility.
ÖZETAmaç: Kronik pelvik ağrılı (KPA) hastalarda ağrı tedavisinde laparoskopik olarak uterin sinirin etanol ile nörolizi-sinin (LUNEN) etkinliğinin araştırılması Yöntemler: Kimyasal bir nörolizis prosedürü olan LU-NEN, 22 hastaya uygulandı ve bunlar sadece tanısalk laparoskopi yapılan 20 kontrol hastayla karşılaştırıldı. Tedavi öncesi ve tedavi sonrası altıncı ayda Vizüel Analog Skalası (VAS) değerlendirildi, Ayrıca, ağrı kontrolünde hasta memnuniyetini sorgulayan subjektif bir ağrı değer-lendirmesi yapıldı. Methods: LUNEN, as a chemical neurolysis procedure, was performed on 22 subjects, and these were compared with 20 controls that had a diagnostic laparoscopy alone. Pre-treatment and postoperative 6 th month Visual Analogue Scale (VAS) scores were estimated and a subjective pain evaluation questioning patients' satisfaction about pain relief in the 6th month after surgery was also performed.Results: A total of 31 (73.8%) out of 42 CPP patients had a laparoscopic pelvic pathology. Preoperative VAS scores were similar in the groups; however, the mean postoperative VAS score was significantly lower in the LUNEN group than in the control group (3.18 ± 2.88 vs. 5.35 ± 3.09; p=0.02). In the LUNEN group, the number of patients who stated that their pain was relieved partially or completely was also significantly higher than in the control group (82% vs. 40%, p=0.019). Conclusion:LUNEN is a feasible, safe and effective surgical alternative to traditional surgical methods in patients suffering from CPP. J Clin Exp Invest 2016; 7 (1): 7-13
Aim:We aimed to examine the elective and emergency cervical cerclage results performed in our referral tertiary care center and evaluate their effectiveness. Materials and Methods: The results of 56 patients who underwent cervical cerclage with the diagnosis of cervical insufficiency in Bursa Yüksek İhtisas Training and Research Hospital between January 2016 and January 2020 were retrospectively analyzed. Patients who underwent Mc-Donald type transvaginal cerclage were included in the study. Patients with multiple pregnancies, abdominal cerclage, and deliver results that could not be reached were excluded from the study. According to the cerclage indication, patients were examined in two groups as elective cerclage (with history indication) and emergency cerclage (with physical examination and ultrasonography indication). Results:The gestational week when cerclage was performed was determined as 20.8 ± 0.7 and 13.9 ± 0.1 weeks for elective and emergency groups, respectively.In the elective cerclage group, the time between cerclage procedure and delivery and the week of delivery was significantly higher (151.1 ± 6.5 days / 35.2 ± 0.9 weeks vs. 23.7 ± 18.5 days / 26.6 ± 1.4 weeks, p<0.001). In relation to this, birth weight was significantly higher in the elective cerclage group than in the emergency cerclage group (2913.7 ± 129 gr vs. 1611.4 ± 232.2 g, p<0.001). Neonatal intensive care requirement was less in the elective cerclage group (p=0.011).There was no statistically significant difference between the two groups in terms of delivery method and abortion rate (p>0.05). Conclusion:Although the gestation period is more prolonged and poor perinatal outcomes are lower with emergency cerclage performed in patients presenting with painless cervical opening or a prominent short cervix on ultrasonography, these effects are not as much elective cerclage. There is a need for prospective studies to determine the efficacy of emergency cerclage compared to elective cerclage, in which patients with emergency cerclage are better randomized and with a larger number of patients.
Objective: To investigate the efficacy of laparoscopic uterine nerve ethanol neurolysis (LUNEN) for pain management in patients with chronic pelvic pain (CPP).Methods: LUNEN, as a chemical neurolysis procedure, was performed on 22 subjects, and these were compared with 20 controls that had a diagnostic laparoscopy alone. Pre-treatment and postoperative 6 th month Visual Analogue Scale (VAS) scores were estimated and a subjective pain evaluation questioning patients' satisfaction about pain relief in the 6th month after surgery was also performed.Results: A total of 31 (73.8%) out of 42 CPP patients had a laparoscopic pelvic pathology. Preoperative VAS scores were similar in the groups; however, the mean postoperative VAS score was significantly lower in the LUNEN group than in the control group (3.18 ± 2.88 vs. 5.35 ± 3.09; p=0.02). In the LUNEN group, the number of patients who stated that their pain was relieved partially or completely was also significantly higher than in the control group (82% vs. 40%, p=0.019). Conclusion:LUNEN is a feasible, safe and effective surgical alternative to traditional surgical methods in patients suffering from CPP. J Clin Exp Invest 2016; 7 (1): 7-13
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