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Öğe Myomectomy During Caesarean Section: Seven Years' Experience(Premchand Shantidevi Research Foundation, 2017) Dolgun, Zehra Nihal; Okten, Sabri Berkem; Aslanova, Rakhshanda; Ozer, Dilek Pinar; Ordu, Ozge; Sayin, Niyazi CenkIntroduction: The incidence of myomas during pregnancy is reported as 1.6-10.7% depending on gestational age. Increased rates of Caesarean Section (CS) together with advanced maternal age bring the decision for caesarean myomectomy (myomectomy during caesarean section) into question. Aim: To compare the obstetric features and clinical outcomes of pregnant women with uterine leiomyoma who had myomectomy together with caesarean section to those who had caesarean section only. Materials and Methods: A retrospective study was performed on a total of 50 pregnant women with myoma that underwent caesarean section in the Obstetrics and Gynaecology Department of Trakya University Medical Faculty between 2007 and 2014. Obstetric history, operative details and type, size and location of leiomyoma were noted and compared. Data were analysed using the IBM Statistical Package for Social Sciences version 17.0 (SPSS Inc., Chicago, IL, USA). Parametric tests were applied to data with normal distribution and non-parametric tests were applied to data without normal distribution. Results: Two groups displayed similar features in terms of age, parity, gestational weeks, type and location of leiomyomas. Notably, average size of leiomyomas was larger (p=0.03) and duration of operation was significantly longer in patients that underwent caesarean myomectomy (72.69 +/- 26.73 minutes vs. 56.25 +/- 6.64 minutes) (p=0.003). Duration of hospitalisation and preoperative/postoperative values for haemoglobin and hematocrit levels did not show any clinically significant difference (p > 0.05). Conclusion: Our results demonstrate that caesarean myomectomy is a safe and effective procedure in especially cases with large uterine leiomyomas.Öğe A Rare Case of Rectovaginal Fistula Following Consensual Vaginal Intercourse(Wiley-Blackwell, 2014) Ugurel, Vedat; Ozer, Dilek Pinar; Varol, FusunIntroductionPostcoital nonobstetric vaginal lacerations due to consensual sexual act are generally minute mucosal tears. In some cases, the vaginal mucosa is lacerated deeper and the bleeding may require suturing of opened vessel ends or even transfusion. AimThe aim of this case report is to present a rare case of acute fistula formation by penile penetration through the full thickness of the rectovaginal wall after consensual vaginal intercourse and to its management in emergency settings. MethodsWe report a rare case of isolated rectovaginal laceration sparing anal sphincters and perineum in a 24-year-old woman following her second consensual vaginal intercourse with her new partner. Speculum examination demonstrated a 4cm laceration on the left posterior vaginal wall forming a fistula between the rectum and vagina, 2cm above the hymenal ring and not extending to the posterior fornix or perineum. Three layer suturing of rectal, vaginal mucosa, and rectovaginal septum was enough to treat the acute fistula in this case. ResultsAfter 2 months follow-up, we observed the complete healing of the rectovaginal laceration with no fistula formation and the patient resumed her sexual activity. Long term follow-up of patients is necessary to observe complete healing and to ensure the absence of a chronic fistula formation. ConclusionSimple suturing of rectal and vaginal mucosa, appropriate antiseptic precautions, and antibiotic coverage are enough to treat acutely formed low rectovaginal fistulas resulting from coitus. Decision to form colostomy and diversion of feces in the repair of such injuries should be taken cautiously. Uurel V, ozer DP, and Varol F. A rare case of rectovaginal fistula following consensual vaginal intercourse. J Sex Med 2014;11:1345-1348.