Journal of the Turkish German Gynecological Association最新文献

{"title":"What is your diagnosis?","authors":"Harun Egemen Tolunay, Ebru Yuce, Türkan Örnek Gülpınar, Demet Karnak","doi":"10.4274/jtgga.galenos.2022.2022-4-6","DOIUrl":"10.4274/jtgga.galenos.2022.2022-4-6","url":null,"abstract":"A 28-year-old Afro-Asian, 16-week twin pregnant woman attended our center due to fatigue and fever. At her first antenatal visit at 10 weeks, dichorionic twin pregnancy was present. One of the fetuses had negative fetal cardiac activity, the other did not have any abnormal ultrasonographic findings and findings were consistent with 10 weeks. The nuchal translucency and nasal bone were normal. She had a healthy pregnancy eight years previously, which delivered through a normal vaginal route. Fetal ultrasonographic findings were consistent with 16 weeks twin pregnancy with vanishing twin at hospital admission. The amniotic fluid of the live fetus was normal, the sac margins were regular, and the cervical length was 40 mm. The dead fetus was consistent with 9-10 weeks. The patient was hospitalized because of fatigue and fever. In the laboratory findings, the C-reactive protein (CRP) value was very high (105 mg/L) and D-dimer value was 2250 ng/mL. White blood cell count and international normalized ratio were in normal ranges. Hemoglobin value was only 7 mg/dL. She has febrile episodes, ranging 37.2-38 °C. No microorganisms were grown. No findings suggestive of choroamnionitis were found. We started empric antibiotics (piperacillin-tazobactam) for suspicion of common microorganisms. In three days, there was no decline in the CRP values or procalcitonin levels were detected. COVID-19 polymerase chain reaction (PCR","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"24 2","pages":"138-139"},"PeriodicalIF":1.4,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/68/26/JTGGA-24-138.PMC10258571.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9677352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal and perinatal outcomes of COVID-19 vaccination during pregnancy.","authors":"Hasan Süt,&nbsp;Gülşah Aynaoğlu Yıldız,&nbsp;Erdal Şeker,&nbsp;Coşkun Ümit,&nbsp;Mustafa Koçar,&nbsp;Acar Koç","doi":"10.4274/jtgga.galenos.2023.2022-9-10","DOIUrl":"10.4274/jtgga.galenos.2023.2022-9-10","url":null,"abstract":"<p><strong>Objective: </strong>To investigate maternal adverse effects and perinatal and neonatal outcomes of women receiving coronavirus disease-2019 (COVID-19) vaccination during pregnancy.</p><p><strong>Material and methods: </strong>Seven hundred and sixty pregnant women who were followed up in obstetrics outpatients were included in this prospective cohort study. COVID-19 vaccination and infection histories of the patients were recorded. Demographic data, including age, parity, and presence of systemic disease and adverse events following COVID-19 vaccination were recorded. Vaccinated pregnant women were compared with unvaccinated women in terms of adverse perinatal and neonatal outcomes.</p><p><strong>Results: </strong>Among the 760 pregnant women who met study criteria, the data of 425 pregnant women were analyzed. Among these, 55 (13%) were unvaccinated, 134 (31%) were vaccinated before pregnancy, and 236 (56%) pregnant women were vaccinated during pregnancy. Of those who were vaccinated, 307 patients (83%) received BioNTech, 52 patients (14%) received CoronaVac, and 11 patients (3%) received both CoronaVac and BioNTech. The local and systemic adverse effect profiles of patients who received COVID-19 vaccination either before or during pregnancy were similar (p=0.159), and the most common adverse effect was injection site pain. COVID-19 vaccination during pregnancy did not increase the ratio of abortion (<14 wk), stillbirth (>24 wk), preeclampsia, gestational diabetes mellitus, fetal growth restriction, second-trimester soft marker incidence, time of delivery, birth weight, preterm birth (<37 wk) or admission to the neonatal intensive care unit compared to the women who were not vaccinated during pregnacy.</p><p><strong>Conclusion: </strong>COVID-19 vaccination during pregnancy did not increase maternal local and systemic adverse effects or poor perinatal and neonatal outcomes. Therefore, regarding the increased risk of morbidity and mortality related to COVID-19 in pregnant women, the authors propose that COVID-19 vaccination should be offered to all pregnant women.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"24 2","pages":"120-124"},"PeriodicalIF":1.4,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/aa/6d/JTGGA-24-120.PMC10258573.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9998640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of multiple high-risk human papillomavirus infections for cervical biopsies and findings in colposcopic procedures","authors":"Serkan Akış,&nbsp;Uğur Kemal Öztürk,&nbsp;Esra Keleş,&nbsp;Cihat Murat Alınca,&nbsp;Canan Kabaca,&nbsp;Murat Api","doi":"10.4274/jtgga.galenos.2023.2022-8-10","DOIUrl":"https://doi.org/10.4274/jtgga.galenos.2023.2022-8-10","url":null,"abstract":"<p><strong>Objective: </strong>The clinical outcome of high-risk HPV (hr-HPV) infection varies according to genotype(s). Patients may harbor either one single hr-HPV (s-HPV) or multiple HPV (m-HPV) genotypes. Recently, the relationship between m-HPV infections and high-grade dysplasia has been investigated, and controversial results have been obtained. Therefore, the clinical significance of m-HPV is not clear. This study aimed to evaluate which group is associated with higher grade dysplasia by analyzing colposcopic punch biopsies.</p><p><strong>Material and methods: </strong>A total of 690 patients who were scheduled for a diagnostic excisional procedure between April 2016 and January 2019 due to the detection of high-grade cervical intraepithelial neoplasia (CIN 2/3) in colposcopy were included. Patients who were not scheduled for colposcopic examination or cervical punch biopsy, or who were scheduled for an excisional procedure due to smear-biopsy incompatibility or persistent low-grade dysplasia were excluded. Patients with a negative HPV test and an unknown HPV genotype were also excluded.</p><p><strong>Results: </strong>Among the patients scheduled for excision (n=404), 74.5% had a s-HPV and 25.5% had a m-HPV infection. The proportion of CIN 1, 2 and 3 per patient in the m-HPV group was significantly higher than the s-HPV group (p=0.017). When this analysis was made for the number of CIN 2+3 per patient in the s-HPV and m-HPV groups, it was 1.29 (389/301) and 1.36 (140/103), respectively, and no difference was found (p=0.491).</p><p><strong>Conclusion: </strong>Patients in the m-HPV group, who underwent more colposcopic cervical biopsies, had higher numbers of CIN lesions, regardless of age and cytology results.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"24 2","pages":"101-108"},"PeriodicalIF":1.4,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/90/76/JTGGA-24-101.PMC10258572.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9621697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parameters affecting outcomes of transumbilical and periumbilical median incisions in ovarian cancer patients.","authors":"Christos Iavazzo,&nbsp;Ioannis D Gkegkes,&nbsp;Panagiotis Peitsidis,&nbsp;John Spiliotis","doi":"10.4274/jtgga.galenos.2023.2023-1-12","DOIUrl":"10.4274/jtgga.galenos.2023.2023-1-12","url":null,"abstract":"©Copyright 2023 by the Turkish-German Gynecological Education and Research Foundation. Journal of the Turkish-German Gynecological Association is published by Galenos Publishing House. Licensed under a Creative Commons Attribution-NonCommercial (CC BY-NC-ND) 4.0 International License. To the Editor, With a great deal of interest, we read the article entitled: “Comparison of transumbilical and periumbilical median incisions in ovarian cancer surgery” by Yumru Çeliksoy et al. (1). The authors identified no differences in women in terms of infections, deep surgical site infections, evisceration and incisional hernias when comparing the two groups in their retrospective study. Incisional hernia is a very common postoperative complication after midline incision. Recently, a retrospective study showed higher incisional hernia rates in patients with body mass index >25 kg/m2 undergoing transumbilical incision (2). Moreover, in the same study no difference was shown comparing the use of PDS® (Ethicon) or Vicryl® (Ethicon) sutures for the abdominal closure. We would like to ask the authors whether they identified any differences in infection or in hernia rates in obese, glycemic or diabetic patients. Furthermore, it would be of interest if the type of abdominal closure, such as PDS® or Vicryl® sutures, had an effect on the outcomes. Last but not least, we would like to enquire about the cosmetic result after periumbilical median incisions as asymmetry might be identified due to slewing of the scalpel blade (3). Once again, we would like to thank the authors for their excellent study. Christos Iavazzo1, Ioannis D. Gkegkes2,3, Panagiotis Peitsidis4,5, John Spiliotis6","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"24 2","pages":"140-141"},"PeriodicalIF":1.4,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a9/69/JTGGA-24-140.PMC10258576.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9981855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endometrioid endometrial cancer treated with open or laparoscopic approach: is there a dilemma?","authors":"Christos Iavazzo,&nbsp;Alexandros Fotiou,&nbsp;Ioannis D Gkegkes,&nbsp;Nikolaos Vrachnis","doi":"10.4274/jtgga.galenos.2023.2022-11-1","DOIUrl":"https://doi.org/10.4274/jtgga.galenos.2023.2022-11-1","url":null,"abstract":"We thank you for your general appreciation of our manuscript and kind comments. Our data highlight the superiority of the laparoscopic approach over open surgery for the treatment of endometrioid endometrial cancer in terms of overall morbidity, intraoperative complications, blood loss, post-surgical recovery, as well as the incidence and severity of postoperative complications in this population. Both approaches permitted a systematic pelvic and para-aortic lymphadenectomy with a sufficient amount of resected lymph nodes. The laparoscopic approach appears to be as safe as the conventional open technique, but provides a better surgical outcome and might therefore be more beneficial for the patient.","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"24 2","pages":"142-143"},"PeriodicalIF":1.4,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/42/d0/JTGGA-24-142.PMC10258574.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9981857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Centile charts of cervical length in singleton and twin pregnancies between 16 and 24 weeks of gestation","authors":"Bertan Akar,&nbsp;Yasin Ceylan,&nbsp;Alper Kahraman,&nbsp;Emre Köle,&nbsp;Eray Çalışkan","doi":"10.4274/jtgga.galenos.2023.2022-7-3","DOIUrl":"10.4274/jtgga.galenos.2023.2022-7-3","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to determine the standard mid-trimester cervical lengths of singleton and twin pregnancies.</p><p><strong>Material and methods: </strong>This study was conducted by retrospective analysis of mid-trimester transvaginal cervical measurements of women with singleton and twin pregnancies that were examined by a single perinatologist in a single center.</p><p><strong>Results: </strong>A total of 4621 consecutive asymptomatic pregnant women admitting for advanced obstetric ultrasound screening were evaluated. Of these 4340 (93.9%) were second trimester singleton pregnancies and 281 (6.1%) were twin pregnancies and were included. Mean cervical length measurements of singleton and twin pregnancies were 38.2±6.5 mm and 37.6±7.2 mm respectively (p=0.17). Overall, the 5^th percentile of cervical length measurement after analysing singleton and twin pregnancies together was 29.4 mm at 16 weeks, 30 mm at 17 weeks, 30 mm at 18 weeks, 30 mm at 19 weeks, 30 mm at 20 weeks, 30 mm at 21 weeks, 30 mm at 22 weeks, 31 mm at 23 weeks, 29 mm at 24 weeks.</p><p><strong>Conclusion: </strong>In our population the 5^th precentile value of cervical length which is 30 mm in singletons and 10^th percentile cervical length which is 31 mm in twins can be used to follow-up and treat pregnant women at risk for preterm delivers.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"24 2","pages":"114-119"},"PeriodicalIF":1.4,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b0/c0/JTGGA-24-114.PMC10258568.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9996628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal and neonatal outcomes in adolescent pregnant women with one prior Cesarean section in Baghdad","authors":"Shaymaa Kadhim Jasim,&nbsp;Hayder Al-Momen,&nbsp;Maisaa Anees Wahbi,&nbsp;Rand Almomen","doi":"10.4274/jtgga.galenos.2023.2022-7-11","DOIUrl":"https://doi.org/10.4274/jtgga.galenos.2023.2022-7-11","url":null,"abstract":"<p><strong>Objective: </strong>Repeat adolescent pregnancy is a hot topic worldwide and imposes a challenge on the health system, especially when faced with limited resources. We aimed to assess maternal and neonatal outcomes in adolescent pregnant women with one prior cesarean section (CS).</p><p><strong>Material and methods: </strong>Singleton adolescent pregnant women with one prior CS scar were recruited and divided into two groups based on the obstetric decision for delivery and/or mother’s wish, either trial of labor (TL) or elective cesarean section (ECS). If TL failed, an emergency CS was performed.</p><p><strong>Results: </strong>Out of the total 109 involved women, TL and ECS groups included 78 (71.6%) and 31 (28.4%) women, respectively. Emergency CS was done for 57 (52.3%) women from the TL group, leaving only 21 (19.3%) women with successful TL who had statistically significant (non-recurrent) indications of the prior CS [12 (57.1%)]. Malpresentation (n=24; 77.4%) was the major indication in the ECS group, while fetal distress (n=29; 50.9%) was the main cause of failed TL. Total maternal morbidities in the TL group were significantly higher for adjusted [1.5 (1.1-4.2)] and non-adjusted odds ratios (OR) [2.4 (1.6-5.6)]. Neonatal complications, such as admission to neonatal intensive care unit, were higher in the TL group without reaching significance. However, the adjusted OR [1.9 (1.1-3.3)] for perinatal asphyxia was significantly increased in TL group.</p><p><strong>Conclusion: </strong>Maternal morbidities and perinatal asphyxia were significantly higher in the TL group of adolescent women compared with the ECS group in this study.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"24 2","pages":"86-91"},"PeriodicalIF":1.4,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/34/3b/JTGGA-24-86.PMC10258566.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9615957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurovascular bundle-sparing ventral clitoroplasty in adult patients: description of the technique and long-term outcome on clitoral functions","authors":"Meltem Sönmezer","doi":"10.4274/jtgga.galenos.2023.2022-12-14","DOIUrl":"10.4274/jtgga.galenos.2023.2022-12-14","url":null,"abstract":"<p><strong>Objective: </strong>To describe the technique and assess long term effects of neurovascular bundle-sparing adult clitoroplasty on clitoral functions in patients.</p><p><strong>Material and methods: </strong>A case series study enrolling three patients diagnosed with adult clitoromegaly who underwent neurovascular bundle-sparing ventral clitoroplasty operation. All of the patients were examined at the first, third, sixth, twelfth and twenty-fourth months post-operatively to evaluate clitoral functions.</p><p><strong>Results: </strong>Three patients diagnosed with adult clitoromegaly, aged 17, 21 and 24 years, were enrolled in the study. The primary complaint of all patients was unpleasant enlarged appearance and hypersensitive clitoris. Mean calculated clitoral index was 143 mm², 150 mm², and 120 mm². Operation time was 90, 140 and 120 minutes, respectively. No major complication occurred during the operation but moderate ecchymosis and edema of the vulva occurred in all patients, lasting up to three weeks. On follow up examination, partial sensorial loss was noted at the first month in one patient, which completely resolved by the third month and beyond. Two patients who were sexually active reported that they were very comfortable with intercourse and cosmetic appearance. No clitoral enlargement or pain were reported by patients through the 24-month follow up period.</p><p><strong>Conclusion: </strong>Neurovascular bundle-sparing ventral clitoroplasty is a safe and cosmetically acceptable procedure, which effectively preserves the neurovascular bundle and long-term clitoral functions.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"24 2","pages":"109-113"},"PeriodicalIF":1.4,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3d/16/JTGGA-24-109.PMC10258570.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9621694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative care in the caesarean intensive care unit: experience from a tertiary maternity hospital","authors":"Seval Yılmaz Ergani,&nbsp;İskender Dicle,&nbsp;Alperen Aksan,&nbsp;Müjde Can İbanoğlu,&nbsp;Betül Tokgöz Çakır,&nbsp;Tugba Kinay,&nbsp;Salim Erkaya,&nbsp;Can Tekin İskender,&nbsp;Sevki Celen,&nbsp;Ali Turhan Cağlar,&nbsp;Yaprak Ustun","doi":"10.4274/jtgga.galenos.2022.2021-9-27","DOIUrl":"https://doi.org/10.4274/jtgga.galenos.2022.2021-9-27","url":null,"abstract":"Objective: The aim was to determine whether follow-up in the intensive care unit (ICU) for the postoperative first eight hours was beneficial for early intervention in postpartum hemorrhage. Material and Methods: In our hospital, all patients are admitted to the ICU for the first eight hours after cesarean section. Patients with postpartum hemorrhage after cesarean delivery who received medical and/or surgical treatment between 2016 and 2020 were reviewed in the presented study retrospectively. Results: All cases (n=36,396) who underwent cesarean delivery were reviewed. Three hundred and fifty-nine patients with postpartum hemorrhage were identified and included. In the study group the time between cesarean section and diagnosis of postpartum hemorrhage was 10.1±19.1 hours, and the time between cesarean section and re-laparotomy was 9.26±23.1 hours. A total of three maternal deaths occurred after cesarean section in our hospital. In the last five years, the mortality rate in patients delivering by cesarean section was 3.9 per 100,000. The incidence of postpartum hemorrhage in cesarean deliveries at our hospital was calculated to be 1.0%, and the rate of obstetric near-miss events was calculated to be 0.6 per 1000 live births. Conclusion: Follow-up of patients in the ICU in the first eight postoperative hours after cesarean section may result in a lower number of relaparotomies due to postpartum hemorrhage, a shortened interval between cesarean section and re-laparotomy, and a lower maternal mortality rate.","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"24 1","pages":"42-47"},"PeriodicalIF":1.4,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ad/dd/JTGGA-24-42.PMC10019003.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9482102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic radical hysterectomy and total vaginectomy for vaginal malignant melanoma with cervical metastasis","authors":"Mehmet Ali Vardar,&nbsp;Ghanim Khatib,&nbsp;Ahmet Barış Güzel,&nbsp;Ümran Küçükgöz Güleç,&nbsp;Mesut Mısırlıoğlu","doi":"10.4274/jtgga.galenos.2022.2022-4-5","DOIUrl":"https://doi.org/10.4274/jtgga.galenos.2022.2022-4-5","url":null,"abstract":"<p><p>The presented case is a 63-years-old multiparous woman admitted with the complaint of postmenopausal bleeding. On gynecologic examination multifocal lesions were detected, including 1 cm on lateral vaginal wall, 4 cm on posterior vaginal wall and 0.5 cm on the left lateral part of the cervix. Histopathology examination gave a diagnosis of epithelioid malignant melanoma. Consequently, laparoscopic radical hysterectomy and total vaginectomy with bilateral pelvic and inguinofemoral lymph node dissection were planned. On both sides, pararectal and paravesical spaces were created and the ureter was identified. Then, the vesicouterine and vesicovaginal spaces were developed. Uterine artery and superior vesical artery were coagulated, cut and the lateral parametrium was prepared. The left ureter was dissected and the ureteral tunnel was unroofed up to the bladder entrance. Subsequently, the anterolateral parametrium was transected. Then, the infundibulopelvic and sacrouterine ligaments were sealed and transected. At this time, the rectovaginal space was developed. Bilateral paracolpos were transected. The endopelvic fascia with the levator muscles were sealed and cut circumferentially. Anteriorly, the pubovesicocervical fascia was transected and the bladder was mobilized up to the uretrovesical junction. Thereafter, through a vaginal approach, the cervix and vagina were inverted by grasping the cervix with a tenaculum. An incision on the posterior vaginal wall at the introitus was made and the urogenital diaphragm was dissected to connect with the pelvic cavity. The vaginal entrance was cut circumferentially and the surgical specimen was extracted. In conclusion, laparoscopy can be considered as a feasible approach for radical hysterectomy and total vaginectomy in selected patients.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"24 1","pages":"84-85"},"PeriodicalIF":1.4,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8d/00/JTGGA-24-84.PMC10019016.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9187579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}