Evaluation of patients undergoing abdominal sacrocolpopexy due to symptomatic pelvic organ prolapse in terms of gastrointestinal complications

Objectives: To evaluate the intra- and postoperative gastrointestinal complications following abdominal sacrocolpopexy and determine the possible causes

Methods: A total of 86 patients who underwent abdominal sacrocolpopexy due to symptomatic pelvic organ prolapse between January 2014 and January 2016 at Ýzmir Tepecik Training and Research Hospital Obstetrics and Gynecology Clinic were retrospectively reviewed using the hospital information system. Patients were divided into two groups: those with and without prolonged length of hospital stay. They were evaluated in terms of gastrointestinal complications and risk factors

Results: The reason for prolonged hospitalization was nausea and vomiting in 24 [88%] of 27 patients. The symptoms in these patients were recovered with hydration, stopping of oral intake, and administration of antiemetics. Nasogastric decompression and parenteral nutrition were required in three [11%] patients due to clinical and radiological evidence of ileus. The parameter that significantly prolonged the length of hospital stay was prior abdominal surgery [p < 0.05]

Conclusion: There were obvious gastrointestinal complications in three out of 27 patients with prolonged length of hospital stay. These findings may be beneficial for preoperative patient counselling

Role of various complete blood count parameters in predicting the success of single-dose Methotrexate in treating ectopic pregnancy

Objective: The protocol of 15 percent BhCG decrease between Days four and seven is frequently used for evaluating the success of methotrexate administration in treating ectopic pregnancy. Our objective was to study the usage of hematologic parameters for evaluating the success of methotrexate administration in treating ectopic pregnancy

Methods: This study was conducted between February 2014 and December 2016. Data of 434 patients were retrospectively scanned for the study. One hundred sixty-one patients whose Day one, four and seven results were recorded in the hospital information system and who were followed up until their BhCG levels decreased <10 IU/L were enrolled in the study. Three types of complete blood cell count parameters of the patients were used: 1] Neutrophil-to-lymphocyte ratio [NLR]. 2] Platelet distribution width [PDW], 3] Platelet count [PLT]

Results: Patients were separated into two groups as those who were treated with single-dose methotrexate and those who required surgical treatment. A significant difference was detected between the groups in terms of NLR levels on Days 1, 4, and 7 [p=0.012, p=0.035, and p=0.001, respectively]. There was no significant difference detected between the groups for PDW and PLT counts on Days one, four and seven

Conclusion: NLR can also be used as an alternative to BhCG for evaluating the success of single-dose methotrexate administration in treating ectopic pregnancy. However, there is need for further studies on this topic

Does menopausal status impact urinary continence outcomes following abdominal sacrocolpopexy without anti-incontinence procedures in continent women?

Objective: We investigated the impact of menopausal status on urinary continence following abdominal sacrocolpopexy [ASC] without an anti-incontinence procedure in continent women

Methods: We conducted a clinical follow-up study of 137 patients diagnosed with stage 3 or higher pelvic organ prolapse [POP] without urinary incontinence between January 2012 and December 2014. Patients were provided with detailed a priori information pertaining to the abdominal sacrocolpopexy procedure and were invited to attend follow-up visits at 1, 3, 12, and 24 months. Follow-up visits included a gynecological examination, cough test, and validated Urinary Distress Inventory6 [UDI-6] and Incontinence Impact Questionnaire?[[110.-7] questionnaires

Results: The mean follow-up time for the cohort was 16.5 +/- 3.45 months. The study group was divided according to menopausal status: premenopausal [Group-1] and postmenopausal women [Group-ll]

Anatomical recurrence was not detected during the follow-up period in either group, but de novo stress urinary incontinence was seen in 15 of 53 [28.3%] Group-l patients and in 6 of 84 [7.1%; p < 0.01] Group-ll patients

Conclusions: The risk of de novo stress urinary incontinence in postmenopausal women after ASC is low. However, premenopausal patients have a higher incidence of de novo stress incontinence which affect quality of life