Browsing by Author "Güler, Oğuz (57193256616)"

Objective: This multi-center study aims to determine the efficiency and safety of endometrial myomectomy (EM) for the removal of uterine fibroids during cesarean section (CS). Methods: Retrospective review of 360 women diagnosed for fibroids during pregnancy. They all delivered by CS between 2014 and 2019. The study groups included 118 women who only underwent EM, 120 women who only had subserosal myomectomy by traditional technique and 122 women with fibroids who decided to avoid cesarean myomectomy, as control group. They were analyzed and compared the surgical outcomes. Results: The EM, subserosal myomectomy and control groups were statistically (p > 0.05) similar for to age, body mass index (BMI), gravidity, parity, gestational age at delivery, indications for CS, number of excised fibroids, size of the largest myoma. Postoperative hemoglobin values and ? (?) hemoglobin concentrations were lower in SM group (10.39gr/dl vs 9.98 gr/dl vs 10.19–1.44 gr/dl vs 1.90 gr/dl vs 1.35; p = 0.047, p = 0.021; respectively) Hybrid fibroids were significantly more frequent in the EM group than subserosal myomectomy and control groups (respectively, 33.1% vs 23.3% vs 27.0%, p = 0.002). Surgery time was significantly longer in the subserosal myomectomy group than EM and control groups (respectively, 46.53 min vs 37.88 min vs 33.86 min, p = 0.001). Myomectomy took significantly longer time in the subserosal myomectomy than EM group (13.75 min vs 8.17 min, p = 0.001). Conclusions: Endometrial myomectomy is a feasible choice for treatment of fibroids during CS, and, basing on our results could be an alternative to traditional cesarean subserosal myomectomy. © 2020 Taylor & Francis Group, LLC.

Uterine fibroids or myomas are the most common pathology of the female genital system. They affect one in three women aged 35 and over, with a rate increase from the age of 40, involve a direct and indirect healthcare expense for the diagnosis and medical and surgical treatment, resulting in a high social cost of the disease. Uterine fibroids unfortunately create both gynecological and obstetric problems, as they determine most hysterectomies and cause infertility, abortions, and obstetric complications, for example, premature births or placental abruption. In this chapter we will deal with the complex world of fibroids, with a complete overview, starting from biology, passing through histology and anatomy, continuing through gynecology, and ending in obstetrics. The authors propose to illustrate everything there is to know about fibroids in gynecology and obstetrics, up to complete the roundup with surgical treatments in both gynecology and obstetrics. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.

Uterine fibroids or myomas are the most common pathology of the female genital system. They affect one in three women aged 35 and over, with a rate increase from the age of 40, involve a direct and indirect healthcare expense for the diagnosis and medical and surgical treatment, resulting in a high social cost of the disease. Uterine fibroids unfortunately create both gynecological and obstetric problems, as they determine most hysterectomies and cause infertility, abortions, and obstetric complications, for example, premature births or placental abruption. In this chapter we will deal with the complex world of fibroids, with a complete overview, starting from biology, passing through histology and anatomy, continuing through gynecology, and ending in obstetrics. The authors propose to illustrate everything there is to know about fibroids in gynecology and obstetrics, up to complete the roundup with surgical treatments in both gynecology and obstetrics. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.

Objectives: The safety of cesarean myomectomy has been proven by previous studies. Our study aimed to reveal the long-term perinatal, obstetric, and surgical outcomes of cesarean myomectomy (CM) by comparing different CM techniques. Material and methods: This retrospective multicentric case–control study involved 7 hospitals and included 226 singleton pregnancies that underwent repeated cesarean section (CS) between 2015 and 2020. Among these pregnancies, 113 of 226 cases had CM (Group A), and 113 had only CS (Group B). Of the 113 cases in which CM was performed, 58 underwent endometrial myomectomy (EM) (Subgroup A1) and 55 underwent serosal myomectomy (SM) (Subgroup A2). The groups were compared in terms of obstetric, perinatal, and surgical outcomes, and fibroid recurrence, myomectomy scar healing rate, and adhesion formation were noted. Results: There was no significant difference between the groups in terms of maternal age, body mass index, gravidity, parity, and fibroid diameter in previous CS (p > 0.05). In the perinatal and obstetric evaluation of the groups, there was no significant difference between the groups in terms of neonatal weight, Apgar score, fetal growth restriction, preterm premature rupture of membranes, preterm delivery, hypertension in pregnancy, and diabetes mellitus (p > 0.05). The fibroid recurrence rate was 28.3%, and the myomectomy scar good healing rate was 99.1%. There was no difference between the groups in terms of CS duration, preoperative and postoperative hemoglobin levels, perioperative blood transfusion rates, febrile morbidity, and prolonged hospitalization (p > 0.05). In terms of adhesion formation, although the adhesion rate of the SM group was higher than that of the EM group, no statistically significant difference was detected between the groups. Conclusion: This study showed that in pregnancies following CM, obstetrical, perinatal, and surgical outcomes were unaffected. Obstetricians can safely use CM, either the trans-endometrial or serosal technique, as it is a safe and effective method with long-term results. 2024 Güler, Hatırnaz, Sparic, Basbug, Erol, Kalkan, Ulubaşoğlu, Trojano, Ürkmez and Tinelli.