Prenatal diagnosis of fetal cardiac rhabdomyoma associated with tuberous sclerosis: A case report.

Cardiac tumors are rarely diagnosed in utero. Rhabdomyomas are the most common fetal cardiac tumors. They are usually diagnosed during the first year of life after obstruction of a valve orifice or a cardiac chamber; but they can be detected by echocardiography as early as the second trimester. Rhabdomyomas are usually small. Fetal hydrops and pericardial effusion are rare. The most important indication of tuberous sclerosis in the prenatal period is cardiac rhabdomyoma. Early diagnosis of cardiac rhabdomyoma is thus important for early diagnosis of tuberous sclerosis. This case report concerns the prenatal diagnosis of both multiple fetal cardiac rhabdomyomas and tuberous sclerosis.

Outcomes of vaginal hysterectomy and constricting colporrhaphy with concurrent levator myorrhaphy and high perineorrhaphy in women older than 75 years of age.

OBJECTIVES: We performed constricting anterior and posterior colporrhaphy, levator myorrhaphy, and high perineorrhaphy with concurrent hysterectomy, and investigated the intraoperative complications, and short-term outcomes of these constricting procedures in patients aged 75 years or older. METHODS: We searched our hospital database for cases, between January 2011 and January 2014, of women aged over 75 years who underwent surgery for pelvic organ prolapse of stage 2 or higher, via vaginal hysterectomy, constricting anterior and posterior colporrhaphy, levator myorrhaphy, and high perineorrhaphy, with or without treatment of urinary incontinence. All volunteers were evaluated via pelvic examination using the pelvic organ prolapse quantification system, the modified Decision Regret Scale-Pelvic Floor Disorders form, the Satisfaction Decision Scale-Pelvic Floor Disorders form, and the Pelvic Floor Distress Inventory form. RESULTS: Fifty-four patients were included in the study. The mean follow-up time was 24.4 months after constricting surgery (range: 8-44 months). There were four cases (7%) of de novo urge incontinence (the symptoms resolved upon prescription of anticholinergic medication). Two patients developed de novo stress urinary incontinence after the procedure and were treated via transobturator sling surgery using Safyre T(®) polypropylene monofilament slings. No anatomical or subjective recurrence of prolapse was noted during the follow-up period. No patient required additional surgery for recurrence of prolapse. CONCLUSION: Constricting anterior and posterior colporrhaphy, levator myorrhaphy, and high perineorrhaphy with concurrent hysterectomy is a feasible, safe, and effective surgical option in elderly patients at low anesthesiological risk. The decision to perform an incontinence procedure should be individualized based on preoperative findings after prolapse reduction.

Sexual dysfunction in infertile Turkish females: prevalence and risk factors.

OBJECTIVES: Our aim was to evaluate the prevalence of and risk factors for sexual dysfunction in infertile Turkish females. STUDY DESIGN: We interviewed 352 infertile and 301 fertile females in the Department of Obstetrics and Gynaecology at Tepecik Training and Research Hospital in Izmir, Turkey. The female sexual function index (FSFI) was used to assess the relationship between infertility and female sexual function. RESULTS: The mean age was similar between the infertile and control groups (29.2±4.3 vs. 28.7±4.0, respectively; p=0.120). The prevalence of sexual dysfunction in infertile females was higher than that in the fertile control group (32.9 vs. 17.2%, p<0.001), and the total FSFI score (26.2±2.5 vs. 28.2±1.7) and the score on each domain of sexual function parameters were significantly lower in the infertile group than in the control group (all p<0.001). Multivariate logistic regression analysis indicated that a duration of marriage and of infertility ≥3 years (odds ratio [OR] 3.79, 95% confidence interval [CI] 1.75-8.20, p=0.001; OR 3.18, 95% CI 1.54-6.55, p=0.002, respectively) and a history of previous infertility treatment (OR 3.07, 95% CI 1.63-5.76, p<0.001) were risk factors for sexual dysfunction in infertile females. CONCLUSIONS: Female sexual dysfunction was higher in the infertile group than the fertile control group in this Turkish population. Duration of marriage and of infertility ≥3 years and a history of previous infertility treatment were the primary risk factors for sexual dysfunction in infertile females.