Female sexual function after repair of uterovaginal prolapse.

OBJECTIVE: To evaluate the impact of repair of uterovaginal prolapse using sacrospinous hysteropexy on female sexual function. METHODS: A cross-sectional study was conducted at the Urogynecology Clinic of the Suez Canal University Hospital from May 2014 to April 2019. Twenty-seven women with a diagnosis of uterovaginal prolapse and wishing to preserve their uteri were recruited. Sacrospinous ligament fixation was done. Sexual symptoms were assessed using the female sexual function index (FSFI) questionnaire just before and 6 months after the operation. RESULTS: The mean age of the participants was 36.5 ± 4 years. Sacrospinous hysteropexy only was performed for three women. Additional procedures included anterior colporrhaphy (12), posterior colporrhaphy (9), and perineorrhaphy (15). There was a significant improvement in pre- and postoperative patients' orgasm (3.1 ± [0.8] vs. 3.7 ± [1.1]; p value = 0.03) and satisfaction (3.4 ± [0.6] vs. 4.2 ± [0.8]; p value < 0.001) while there was worsening of pain (4.3 ± [1.5] vs. 3.2 ± [1.6]; p value = 0.017). There was insignificant improvement in the other three domains as well as total score of FSFI, with all patients having sexual dysfunction. CONCLUSION: Sacrospinous hysteropexy was associated with significant improvement orgasm and satisfaction domains of FSFI and significant worsening of pain.

Postpartum endometritis after uterine cleaning versus no cleaning in cesarean sections: Randomized clinical trial.

AIM: The aim of the study was to compare the rates of postpartum endometritis due to uterine cleaning and no cleaning in patients delivered by elective cesarean section. METHODS: This was a randomized clinical trial conducted at the Obstetrics and Gynecology Department, Suez Canal University Hospital, Ismailia, from June 2019 to November 2019. We recruited patients undergoing cesarean delivery aged 18-45 years with singleton pregnancy, intact membranes, either first or repeated delivery, without labor pains. Patients were allocated into two groups, uterine cleaning (336 patients) and no cleaning (312 patients). The main outcome measure was the occurrence of postpartum endometritis. RESULTS: Both groups were matched in their demographic characters. Twelve patients (3.6%) developed endometritis in the cleaning group versus one patient (0.3%) in the other one. Estimated blood loss was 754.35 ± 247.13 and 730.36 ± 232.77 for the cleaning and no cleaning groups, respectively, with a P value of 0.201. Septic wound infection (21 patients, 6.3%) was predominant in the cleaning group. CONCLUSION: Uterine cleaning after delivery of the placenta during CS can be omitted as a surgical step during the operation. It was associated with increased rates of postpartum endometritis and blood loss.

Late suture site complications of sacrospinous ligament fixation.

STUDY OBJECTIVE: To evaluate the late suture- related complications of sacrospinous ligament fixation (SSLF) as a treatment for uterovaginal prolapse and their impact on the quality of life. DESIGN: A prospective cohort study. SETTINGS: The Obstetrics and Gynecology Department of Suez Canal University Hospitals, Ismailia, Egypt from January 2014 to June 2018. PATIENTS: We recruited sixty women with uterovaginal prolapse. INTERVENTIONS: Patients underwent SSLF using the Capio suture recapturing device with non-absorbable suture material (0 braided Polyester). Postoperative visits were at six weeks then at 6, 12, 18, and 24 months after the procedure. MEASUREMENTS AND MAIN RESULTS: Outcome measures were the rate and timing of suture- related and the quality of life using the pelvic floor impact questionnaire-7 at 24 months postoperatively. The mean age of the studied population was 45.7 ± 9.8 years. Suture- related complications occurred in 55% (33/60) of patients, with vaginal discharge the most commonly reported symptom. Most of them presented in the 1st year after the procedure 72.7% (24/33), and 25% (15/60) had suture removal. However, there was a significant improvement in patients' quality of life. CONCLUSION: Sacrospinous ligament fixation has a positive impact on the quality of life, yet associated with significant but prominent suture- related complications.

Prevalence and risk factors for domestic violence among infertile Egyptian women: a cross-sectional study.

Objective: Domestic violence (DV) is an important social and public health problem affecting women globally. This study aims to assess the prevalence and risk factors of DV among infertile Egyptian women. Patients and methods: A cross-sectional hospital-based study included infertile women attending the outpatient gynaecological clinic in a tertiary University hospital was carried out between September 2017 and October 2018. After obtaining ethical approval, 304 infertile women were enrolled in the study and investigated using an interview questionnaire of Infertile Women's Exposure to Violence Determination Scale (IWEVDS). The questionnaire was examined for accuracy after translation into the Arabic language. Results: The infertile women's reported DV resulted in an average total score on the IWEVDS of 73 ± 17. The top three domains with the highest scales were DV, punishment and exposure to traditional practices domains with scale 20.84 ± 7.67, 18.25 ± 4.15 and 14.63 ± 3.18 points, respectively. Using Multivariable linear regression analysis, we found that the best-fitting predictors for this scale were the wife's age (p = .001), residency (p = .033), previous intracytoplasmic sperm injection (ICSI) (p = .016), divorce threatens (p = .022) and fear from husband (p = .026). Conclusions: Infertile Egyptian women are at an increased risk of DV. The most common forms of DV are psychological violence and verbal abuse.

Bladder function after sacrospinous hysteropexy and vaginal wall repair in women with uterovaginal prolapse.

OBJECTIVE: To evaluate the impact of repair of uterovaginal prolapse using sacrospinous hysteropexy and vaginal wall repair on the bladder function. STUDY DESIGN: The study was conducted at the urogynecology clinic of Suez Canal University Hospitals, Ismailia from January 2014 to March 2016. This study included women with a diagnosis of uterovaginal prolapse and wishing to preserve their uteri. Bladder function was evaluated through assessment of urological symptoms using a standardized questionnaire - the urogenital distress inventory (UDI-6) - in addition to urodynamic studies just before and six-months after the sacrospinous hysteropexy ±â€¯associated vaginal wall repair operation. RESULTS: Twenty-seven patients completed the study with a mean age of 36.5 ±â€¯4 years. Only 3 women had sacrospinous hysteropexy with no additional procedures. Other procedures included anterior colporrhaphy (12), posterior colporrhaphy (9) and perineorrhaphy (15). Based on UDI-6, there was no significant difference between the pre- and post-operative symptoms of stress urinary incontinence (SUI) [8/27 (29.6%) vs. 9/27 (33.3%) respectively; p value = 0.7]. The pre- and post-operative symptoms of urge urinary incontinence were also insignificantly different [13/27 (48.1%) vs. 15/27 (55.5%); p value = 0.5]. The total score of UDI-6 increased from 24.5 ±â€¯(14.2) to 32.8 ±â€¯(29.4) which was not statistically significant (p value = 0.12). Urodynamically, voiding dysfunction was found less frequently after the operation, however the difference was statistically insignificant [9/27 (33.3%) vs. 8/27 (29.6%); p value = 0.7]. CONCLUSION: Sacrospinous hysteropexy and associated vaginal wall repair do not affect the bladder function either subjectively or objectively.