Perioperative and postoperative complications after Ophira mini sling operations.

AIM: To evaluate perioperative and postoperative complications of mini sling operations in the surgical treatment of female urinary incontinence. METHODS: The study was comprised of 151 female patients with stress urinary incontinence (SUI) or mixed incontinence (MUI) with predominant SUI patients who underwent the mini sling procedure. The duration of the follow-up ranged from 6 to 21 months. All women had positive cough stress tests preoperatively. The procedure was performed under local (86.1 %) or spinal anesthesia (13.9 %) with the same mini slings for all cases. Patients were examined in the outpatient clinic at 1 and 6 months after surgery. RESULTS: The mean age was 49 years old (SD 10) with a range of 26-82. Of the 151 patients, 42 (27.8 %) presented MUI, while 109 (72.2 %) presented SUI. Mean parity was 3 ± 1. Mean body mass index was 28.9 ± 3.5. 60 (39.7 %) of the cases were postmenopausal. There were 73 women who participated in 6 months follow-ups and 78 women who did 1-year follow-ups. The mean operating time was 13 ± 3.1 min. There were no major intraoperative complications due to mini sling surgery. 120 (79.5 %) patients were discharged the day following the surgery. Ten patients (6.1 %) had de novo urge incontinence in their post-operative follow-ups which was resolved using anti-cholinergic drugs. Two patients (1.2 %) required sling sections due to prolonged bladder outlet obstruction. There were 15 patients that complained about de novo dyspareunia (9.9 %). Vaginal mesh extrusion was reported in 18 (11.9 %) patients. The mean preoperative and postoperative hemoglobin concentrations were 12.9 ± 1.3 and 12.5 ± 1.3 g/dL, respectively. CONCLUSION: The mini sling system can be considered an easy and effective method for treating stress urinary incontinence without major complication rates.

Borderline ovarian tumors: a study of 100 cases from a Tertiary Care Hospital.

AIM OF THE STUDY: The purpose of the study was to evaluate patients with borderline ovarian tumors. MATERIAL AND METHODS: Clinical features, treatment and survival status of 100 patients with borderline ovarian tumors were retrospectively evaluated between 1998 and 2007. RESULTS: Patients' mean age was 37.75 years (range: 15-72); 22 of them were postmenopausal. Histopathological diagnoses were serous, mucinous, endometrioid and clear cell in 54%, 41%, 2% and 3% of the patients, respectively; 70 patients had stage IA disease, 8 were at stage IB, 16 at stage IC, 2 at stage IIIA, 3 at stage IIIB and 1 at stage IIIC. Restaging laparotomies were performed on 19 patients; fertility-sparing surgery was performed on 52 patients; 2 patients received chemotherapy because of advanced-stage disease. All patients are currently alive. The 5-year disease-free survival rate for 71 cases was 100%. CONCLUSIONS: Borderline ovarian tumors have excellent prognoses, and fertility-conserving surgery can be performed in young patients with early-stage disease.

Comparison of the clinical efficacy and safety of flutamide versus flutamide plus an oral contraceptive in the treatment of hirsutism.

OBJECTIVE: To compare the clinical, hormonal, biochemical and hemotological effects of flutamide versus flutamide plus an oral contraceptive (OC) in the treatment of hirsutism. PATIENTS: Eighty-four women with hirsutism were equally randomized to receive either flutamide or flutamide plus OC. DESIGN: Eighty-four women with hirsutism were recruited from patients presenting to our hospital. Each patient underwent a complete medical and gynecological examination as well as blood cell counts, biochemical and endocrine profiles. Hirsutism scores and laboratory tests were done during the 1st, 3rd and 6th months of therapy. Thirty-seven women in the flutamide group (taking 250 mg flutamide per day) and 32 women in the flutamide plus OC group (taking 250 mg flutamide plus 35 microg ethinyl estradiol and 2 mg cyproterone acetate per day) regularly followed the therapy regimens. RESULTS: There were no significant differences in Ferriman-Gallway scores at the beginning and at the end of the therapies between the two groups (p > 0.05). At the 6th month, the decreases in Ferriman-Gallway scores were significant in both flutamide (from 18.95 +/- 4.44 to 14.46 +/- 5.02; p < 0.05) and flutamide plus OC groups (from 19.94 +/- 4.31 to 15.58 +/- 4.28; p < 0.05). In the first group, 2 of 6 oligomenorrheic women had regular cycles at the end of the therapy. Oligomenorrhea in 8 women was all changed to regular cycles in the flutamide plus OC group. Regarding the hormonal profile, only in the second group were prolactin, free testosterone and dehydroepiandrosterone sulfate levels significantly decreased (p < 0.05). Hepatic function tests were significantly increased in both groups, but they were all within normal ranges. CONCLUSION: These data suggest that both therapies were similarly effective and safe in the treatment of hirsutism. In women with oligomenorrhea and/or needing contraception, adding an OC shows better results than flutamide treatment alone in providing regular cycles.