The importance of uterosacral ligament anatomy in overactive bladder: A preliminary study.

OBJECTIVE: To evaluate whether uterosacral ligament (USL) thickness measured using magnetic resonance imaging (MRI) was associated with overactive bladder (OAB) in otherwise healthy women. MATERIALS AND METHODS: The study comprised 27 women with OAB and 27 healthy women (control group) who were followed up at the Obstetrics and Gynecology Department of a tertiary referral center. All subjects were evaluated using pelvic MRI to determine the transverse USL thickness. These measurements were compared between the two groups. p values less than 0.05 were considered statistically significant. RESULTS: The mean age of women in the OAB and control groups were 43.88±9.36 years and 39.92±5.36 years, respectively. The mean body mass index in the OAB group was 29.77±4.82 kg/m2 and 27.49±3.44 kg/m2 in the control group. In the comparison of Pelvic Organ Prolapse Quantification system stages between the groups, no statistically significant relationship was determined. In the OAB group, the mean right USL thickness was 2.04±0.34 mm, and the mean left USL was 2.04±0.52 mm. In the control group, the mean right USL thickness was 2.17±0.47 mm, and the mean left USL was 2.09±0.51 mm. There were no statistically significant differences in terms of USL thickness between the OAB and control groups (p>0.05). CONCLUSION: No previous studies have been identified in the literature that have investigated the relationship between USL thicknesses and urinary incontinence. In the present study, no significant relationship could be demonstrated between right and left USL thicknesses of the OAB and control groups. This was a preliminary study, and further research with larger sample sizes is required to reach a final conclusion.

Interleukin-10 and -12 in human milk at 3 stages of lactation: a longitudinal study.

This study was undertaken to analyze postpartum changes in concentrations of interleukin (IL)-10 and IL-12 through the 3 stages of lactation. A total of 87 human milk samples were collected from 29 healthy mothers during the colostrum (0-3 days), early milk (14-17 days), and mature milk (44-47 days) phases. Enzyme-linked immunosorbent assay tests were performed on the milk samples. IL-10 was detected in 7 and IL-12 in 4 of the colostrum samples. In the transitional milk samples, IL-10 was present in 4 and IL-12 in 2; however, both of these cytokines became undetectable in mature milk samples. The decrease in concentrations of IL-10 and IL-12 was statistically significant during the postpartum period (P=.001 and P=.024, respectively). IL-10 levels in the colostrum samples were higher than in the transitional samples (P=.018, with use of the post hoc test). No statistically significant differences between IL-12 levels were noted in the colostrum samples and the transitional samples (P=.068, with use of the post hoc test). A negative correlation was observed between concentrations of IL-10 in colostrum and the total number of pregnancies (R=-.401; P=.031). The findings of the present study suggest that mean concentrations of IL-10 and IL-12 are decreased in human milk as lactation continues through its 3 phases.

Septate uterus with a double cervix and longitudinal vaginal septum.

OBJECTIVE: To report the clinical features of 9 cases and review the previously reported 8 cases of an uncommon müllerian anomaly, characterized by the presence of a complete uterine septum with cervical duplication and represent a a longitudinal vaginal septum. STUDY DESIGN: Retrospective clinical study. RESULTS: Nine patients aged 21-32 presented to our clinic with complaints of dyspareunia, dysmenorrhea, and primary or secondary infertility. All 9 patients displayed a single uterus with smooth fundal contour, double cervix and longitudinal vaginal septum. Some additional abnormal findings were associated with these anomalies in some patients: polycystic ovaries in 3 cases and different degrees of endometriosis in 2 cases. Most of the patients had normal tubal patency. CONCLUSION: According to a MEDLINE search, only 8 cases of septate uterus with cervical duplication and a longitudinal vaginal septum have been reported to date. We report 9 more cases, which suggest that this atypical septate uterus type is probably more frequent than reported. These cases support the bidirectional müllerian theory and may imply the presence of another type of mullerian anomaly.

Emergency peripartum hysterectomy.

OBJECTIVE: To review the incidence, indications, risk factors, and complications associated with emergency peripartum hysterectomy. STUDY DESIGN: We analyzed retrospectively 38 cases of emergency peripartum hysterectomy operations performed between January 1996 and June 2001 at Zekai Tahir Burak Women's Health Research and Education Hospital. The indications, risk factors and the associated complications were noted. Standard tests were used to calculate odds ratios (ORs) and their 95% confidence intervals (CI). RESULTS: Thirty-eight cases of postpartum hysterectomy were performed. All of these cases were referred to our center from rural areas. The rate of peripartum hysterectomy was 1/3736 deliveries. The main indications for hysterectomy were placenta accreata, uterine rupture and uterine atony. There were four maternal deaths. CONCLUSION: Peripartum hysterectomy is a necessary life saving operation. Timely operation minimizes the morbidity and mortality.

Reproductive outcome of septate uterus after hysteroscopic metroplasty.

We evaluated the reproductive outcome after hysteroscopic metroplasty in the patients with septate uterus. The reproductive performance of 361 patients with septate uterus during the follow-up period of 18 months after the surgery was analyzed retrospectively for a period of 10 years. A total of 180 (49.8%) pregnancies were achieved after metroplasty during the follow-up period of 18 months. Of the 180 pregnancies 117 (57.2%) reached to term and 34 (18.8%) ended in preterm delivery and the remaining 29 (16%) resulted in abortion. Of the preterm babies 18 (52.9%) were able to live. We obtained 135 (75%) live babies totally. Hysteroscopic metroplasty improves the reproductive performance of septate uterus significantly especially in the cases with recurrent pregnancy loss and should be considered highly as a corrective approach for such patients.