Clinical Characteristics and Outcomes of Laparoscopic Surgery in Ovarian Endometrioma Cases Treated at a Gynecology Clinic.

OBJECTIVES: The aim of this study was to retrospectively investigate the clinical and surgical outcomes of patients diagnosed with ovarian endometrioma in a hospital gynecology clinic and to investigate the safety and efficacy of treatment with laparoscopic surgery. METHODS: The data of 44 patients who were operated on for ovarian endometrioma were analyzed retrospectively. RESULTS: The mean age of the patients was 30.1±5.3 years. The mean cyst size was 7.0±5.3 cm. In all, 54% of the patients had dysmenorrhea, and 29.5% of the patients were infertile. Laparoscopy was successfully performed in all of the patients, and no complications were observed in any patient. Furthermore, it was found that ovarian reserve tests in the infertile patients were not negatively affected. CONCLUSION: With sufficient experience, laparoscopy is a very safe and effective method of surgery in ovarian endometrioma. If a laparoscopic cystectomy is performed with the proper technique, it does not adversely affect ovarian reserve.

Influence of placental cord drainage in management of the third stage of labor: a multicenter randomized controlled study.

OBJECTIVE: The aim of this study is to assess the effect of placental drainage during active management of the third stage of labor on reducing both blood loss and the length of the third stage. STUDY DESIGN: This prospective randomized controlled trial included 485 patients who underwent vaginal delivery in two tertiary hospital. Subjects were randomly allocated to the cord drainage group, in which the cord was unclamped after cutting (n = 242), or the control group, in which the cord was left clamped (n = 243). The primary outcome was mean blood loss during the third and fourth stages of labor. RESULTS: The mean estimated blood loss was significantly lower in the cord drainage group than in the control group (207.04 ± 123.3 vs. 277.63 ± 246.9 mL, respectively; p ˂ 0.001). The third stage of labor was significantly shorter in the cord drainage group than in the control group (3.5 ± 1.9 vs. 7.7 ± 3.4 minutes, respectively; p ˂ 0.001). No adverse events occurred during the cord drainage period. CONCLUSION: Active management of the third stage of labor with the cord drainage method significantly reduced postpartum blood loss and the duration of the third stage.

A case of parasitic myoma 4 years after laparoscopic myomectomy.

We present a case of parasitic myoma complaining of abdominal pain, constipation, dyspareunia and dysmenorrhea 4 years after laparoscopic myomectomy. We performed laparoscopic myomectomy for multiple parasitic myomas. Three myomas were very firmly attached to bowel and mesentery. Parasitic myoma after laparoscopic surgery is very rare condition there are almost 35 cases in the literature. It is related with variable symptoms or can be asymptomatic. Laparoscopic surgeons should be aware of this situation, and further investigation should be made in case of suspicion. Surgery for parasitic myomas can be difficult in case of bowel and mesentery involvement and patient should be informed about the extensive surgery.