Can striae be used as a marker for the prediction of pelvic organ prolapse?

OBJECTIVE: To investigate the relationship between two connective tissue pathologies: striae and pelvic organ prolapse (POP). STUDY DESIGN: Four hundred and eighty-eight women who had undergone gynaecological surgery were divided into two groups. The study group (n=244) consisted of symptomatic patients with POP, and the control group (n=244) consisted of cases who underwent surgery for benign gynaecological conditions without evidence of POP. The groups were compared in terms of the presence, intensity and severity of striae, as well as their general characteristics. RESULTS: The presence of striae (p=0.001), number of striae (p=0.001) and Davey score (p=0.00001) were significantly higher in the study group, and the absence of striae was more common in the control group (p=0.00001). According to multivariate analysis, the presence of striae, an increased number of striae (>15) and a Davey score >2 increased the risk of POP 1.29 fold (p=0.03, 95% confidence interval [CI] 1.14-1.35), 1.19 fold (p=0.04, 95% CI 1.14-1.25) and 2.51 fold (p=0.01, 95% CI 1.66-3.78), respectively. CONCLUSION: Striae may serve as a promising marker for POP. In particular, women who develop striae should be cautious about their risk for developing POP in the future, and should be informed about preventive methods for POP.

Treatment of uterine prolapse with bilateral hydronephrosis in a young nulliparous woman; a new minimally invasive extraperitoneal technique.

A 37-year-old nulligravid woman presented with a 2-year history of uterine prolapse along with mixed incontinence. Gynecological examination confirmed third degree cystocele and uterine prolapse. Renal ultrasonography showed enlarged kidneys and marked dilation of the bilateral pelvicalyceal system. She was hospitalized and a ring pessary was inserted after bladder catheterization. Her preoperative evaluation was performed and the patient was operated one month after her first admission. Anterior colporrhaphy along with Kurt Extraperitoneal Ligamentopexy was performed without any complication. A control visit on second postoperative month revealed recovery of incontinence symptoms and no prolapse was observed. To our knowledge this is the first reported treatment of a case with bilateral hydronephrosis due to uterine prolapse that were corrected and overcame with a novel minimally invasive extraperitoneal approach by fixation of bilateral round ligaments to the rectus fascia sheet.

Relation of peritoneal fluid and serum vascular endothelial growth factor levels to endometriosis stage.

OBJECTIVE: It is a well known fact that endometriosis is linked with apoptosis, extracellular matrix formation, and angiogenesis. In this study, the authors aim to investigate the relation between the extent of endometriosis and vascular endothelial growth factor (VEGF). MATERIALS AND METHODS: Twenty-one patients who received laparoscopic intervention due to endometriosis constituted the patient group, whereas 19 patients who were operated due to extra-endometrial benign cyst were included in the control group. Following the laparoscopic pelvic assessment, peripheral blood samples and two cc of free peritoneal fluid from the Douglas pouch were obtained simultaneously. The samples were studied with regards to VEGF level via solid phase sandwich enzyme-linked immunosorbent assay (ELISA) method. RESULTS: In the patient group, eight cases were diagnosed with Stages I and II endometriosis, while 13 cases were diagnosed with Stages III and IV endometriosis. Among the Stage I and II cases, serum VEGF levels were statistically significantly higher, as compared to the Stage III and IV cases, as well as the control group. Discussion: In conclusion, the authors found a relationship between elevated serum VEGF levels and early stage endometriosis.

Unilateral massive ovarian edema in a woman with polycystic ovaries.

Massive ovarian edema is a rare cause of ovarian enlargement in young women. We report the case of a 20-year-old woman with unilateral massive ovarian edema with findings on ultrasound of an enlarged policystic ovary and pedicle arterial and venous blood flow observed with color and pulsed wave Doppler examination. Massive ovarian edema can be managed conservatively and blood flow in the pedicle of the ovary is detected by color and pulsed wave Doppler examination.

Unilateral massive ovarian edema and polycystic ovaries. A case report.

Massive ovarian edema is a rare cause of ovarian enlargement in young women. We report a case in a 20-year-old woman with unilateral edema associated with the ultrasound appearance of polycystic ovary disease. Arterial and venous blood flow in the pedicle was observed with color and pulsed wave Doppler examination. Conservative management was successful.

Mullerian adenosarcoma of the uterus associated with tamoxifen therapy.

Mullerian adenosarcoma of the uterus is a biphasic tumor exhibiting benign epithelial and malignant stromal component. This tumor may occasionally be associated with tamoxifen therapy which is used as an adjuvant drug for breast carcinoma. Reviewing the literature, we found only 12 adenosarcoma cases associated with tamoxifen therapy Thus, the clinical and pathological findings in a 58 years old postmenopausal woman who developed uterine adenosarcoma, following low dose tamoxifen therapy after 8 years, was discussed in this report.