Tuberculosis endometritis presenting as A leiomyoma

Genitourinary tuberculosis is a common extrapulmonary manifestation of tuberculosis. Taking into consideration that genitourinary tuberculosis may be associated with a diversity of presentations, its diagnoses may be difficult. A young woman with an initial presumptive diagnosis of a uterine leiomyoma presented with abdominal pain and a pelvic mass that after further investigations, she was diagnosed with genital tuberculosis

Comparison effect of physiotherapy with surgery on sexual function in patients with pelvic floor disorder: a randomized clinical trial

Female sexual dysfunction is a common problem among general population, especially in urogynecological patient, and can lead to a decrease in quality of life and affect martial relationship. This study was compared the effect of surgical methods versus physiotherapy on sexual function in pelvic floor disorder. This randomized controlled trial was performed in Urogynecology clinic since August 2007 to December 2009 on 90 patients aged from 25-55 years with previous delivery, positive history of sexual dysfunction with stage <3 of pelvic organ prolapsed and divided in two groups. Group A [n=45] received standard rectocele repair and prineorrhaphy, group B [n=45] received physiotherapy for eight weeks twice a week [electrical stimulation, Kegel exercises]. The female sexual function index [FSFI] used to evaluate the sexual function in cases before and after intervention. Frequency of variable scores [libido, orgasm, dysparunia] included without disorder, frequently good, sometimes good, very much and extreme were compared between two groups. Libido and arousal were improved in both groups [p=0.007, p=0.001 respectively]. Orgasm and dyspareunia were improved in group B [p=0.001]. Dysparunia was more painful in group A. There was significant difference between two groups [improvement of orgasm and dysparunia in group B] [p=0.001]. It seems that physiotherapy is an appropriate method for treatment of sexual disorder in pelvic floor disorder.

Sexual dysfunction in patients with polycystic ovary syndrome and its affected domains

Background: Polycystic Ovary Syndrome [PCOS] is presented with characteristic complications such as chronic an ovulation, obesity, and hyperandrogenism which can affect sexual function in women of reproductive age

Objective: Herein we evaluated the frequency and predisposing factors of sexual dysfunction in infertile PCOS patients

Materials and Methods: In this cross-sectional study, 130 married women with a definite diagnosis of PCOS who were referred due to infertility were recruited. They were evaluated concerning their sexual function in the domains of desire, arousal, lubrication, orgasm, satisfaction and pain with the female sexual function index [FSFI] questionnaire

Results: The frequency of sexual dysfunction was verified 57.7% in PCOS patients with the domains of desire and arousal being commonly affected in 99.2% and 98.5%of cases respectively. BMI had a significant effect on sexual desire and arousal [p=0.02] while the effect of hirsutism was significant on all domains [p<0.001 for total FSFI score] except for dyspareunia

Conclusion: PCOS patients markedly suffer from sexual dysfunction as comorbidity. It seems appropriate to screen all PCOS patients for sexual function with a simple short questionnaire such as FSFI. Targeted interventions could be considered to help improve their quality of life along with other treatments

Effect of adding human chorionic gonadotropin to the endometrial preparation protocol in frozen embryo transfer cycles

Human chorionic gonadotropin [HCG], one of the initial embryonic signals, is probably a major regulator of the embryo-endometrial relationship. This study aims to assess the advantage of HCG supplementation during the secretory phase of hormonally prepared cycles for the transfer of cryopreserved-thawed embryos. This study was a randomized clinical trial. Infertile women who were candidates for frozen-thawed embryo transfers entered the study and were divided into two groups, HCG and control. The endometrial preparation method was similar in both groups: all women received estradiol valerate [6 mg] po per day from the second day of the menstrual cycle and progesterone in oil [100 mg] intramuscular [I.M.] when the endometrial thickness reached 8 mm. Estradiol and progesterone were continued until the tenth week of gestation. In the HCG group, patients received an HCG 5000 IU injection on the first day of progesterone administration and the day of embryo transfer. In this study, 130 couples participated: 65 in the HCG group and 65 in the control group. There was no statistically significant difference between groups regarding basic characteristics. Implantation rate, chemical pregnancy, clinical pregnancy, ongoing pregnancy, and abortion rates were similar in both groups. Although HCG has some advantages in assisted reproductive technology [ART] cycles, our study did not show any benefit of HCG supplementation during the secretory phase of frozen cycles [Registration Number: IRCT201107266420N4].

frequency of pelvic floor dysfunctions and their risk factors in women aged 40-55

The aims of this study were to determine the frequency of urinary and fecal incontinence and their determinants in pre-menopausal and menopausal women in Iran. This one-year cross-sectional study was performed on 304 women aged 40-55 who were admitted to women's clinic at Imam Khomeini Hospital. Symptoms of urinary, gas, and fecal incontinence and pelvic organs prolapse were diagnosed by a specialist through examination and a questionnaire. Patients were divided into two groups of with and without [urinary, gas, and fecal] incontinence symptoms. The probable risk factors of these disorders were studied and registered in the questionnaire and compared using t-test, chi-squared test, and regression of quantitative and qualitative variables. Generally, 129 [42%] out of 304 women had pelvic floor dysfunction [urinary and fecal incontinence, and pelvic organs prolapse]. Risk factors including menopause, hormone therapy, history of hysterectomy, inactivity, age, BMI, and first child's birth weight were compared between the two groups using chi-squared and t tests. There was a statistically significant difference between the two groups [P=0.000] as risk factors were more frequently observed in women with incontinence symptoms. Some risk factors of pelvic floor dysfunction are menopause, hormone therapy, history of hysterectomy, inactivity, age, BMI, and first child's birth weight. Therefore, some strategies should be included in women's health education programs to prevent the above-mentioned risk factors

Evaluation of depression and mental health status in women with poly cystic ovary syndrome

Poly Cystic Ovary Syndrome [PCOS] is a common endocrine condition that affects up to one fifth of the women of reproductive age. The overall prevalence of the depressive disorders has been shown to be about 12% in a large multi-centric study of obstetric-gynecologic patients. This study was designed to evaluate the distribution of depression and mental health status in women with PCOS. This cross-sectional study was performed on 100 women with PCOS who were selected among patients attending the gynecologic and obstetric clinics of two referral centers. They completed Beck Depression Inventory [BDI] and General Health Questionnaire [GHQ-28]. The prevalence of depression in women with PCOS was 45% according to BDI. According to GHQ-28, 30% of our patients were considered as possible cases of mental disorder. We found that the prevalence of depression was significantly high in women with PCOS. We believe that the treatment of PCOS must include psychological treatment to improve mental health status as well

[Comparison of efficacy and side-effects of Oxybutynin and Tolterodine in the treatment of overactive bladder]

Overactive bladder [OAB] is one of the most prevalent diseases of lower urinary system. OAB disease is defined by the Standardization Subcommittee of the International Continence Society as urinary urgency, with or without urge incontinence, usually with frequency and nocturia with no proven infection or other obvious pathology. Treatment with the antimuscarinic agents tolterodine and oxybutynin is the mainstay of therapy for overactive bladder. The study was undertaken to compare the efficacy and side-effects of tolterodine and oxybutynin in a number of Iranian women. This study consisted of two trials and done in Imam Khomeini Hospital in 2009; in one trial, 50 patients with overactive bladder were randomized to 4 weeks of treatment with 2 mg of twice-daily tolterodine, and in the other to 5 mg of three times a day oxybutynin. Urodynamic investigations, Episodes of urge urinary incontinence and adverse events were also evaluated. The results showed a good association between the questionnaire and cystometry data but urodynamic studies showed significant differences in efficacy. Tow groups showed significant improvements in all Symptoms, but The results showed that the two drugs had no significant differences in efficacy. The data obtained by questionnaire indicated that both drugs increased quality of life but there were no significant differences between the two in symptom cure. Dry mouth was the most common side-effect in the two groups but unlike other studies it was higher in the tolterodine group. Therefore, our study did not show any preference between oxybutynin and tolterodine

Vaginal symptoms after reconstructive surgery for prolapsed pelvic organ

Pelvic organ prolapse is a common disorder in women over the world and its general treatment is surgery. Therefore it is important to consider if vaginal symptoms, quality of life and sexual function after surgery improve. The purpose of this study was to assess vaginal symptoms in women 3 months after surgery for pelvic organ prolapse. In this study 50 eligible women were evaluated between March 2007 and May 2008. These women underwent physical examination for prolapse staging and medical status and completed the ICIQ-VS questionnaire pre- and post operation 3 months later]. Mean age was 44.86 [31-74] years and%72 were premenopausal. Vaginal symptoms, sexual function and quality of life scores improved in order [8.88 Vs 18.04, 17.16 Vs 34.48, 2.76 Vs 4.8, all P<0.05]. Vaginal symptoms, sexual function and quality of life after surgery improved. It appears that in Iranian patients, the performance of reconstruction surgery alone results in satisfaction