OBJECTIVE:The aim of this study was to investigate if adipose-derived stromal vascular fraction (SVF) treatment has any protective effect on ovarian function in rats with cyclophosphamide (CP) induced ovarian damage. DESIGN:This was an experimental animal study. PARTICIPANTS/MATERIALS, SETTING, METHODS:25 mature cycling Wistar-Albino rats were randomized into four groups (n = 5 per group). Rats in groups 1 and 2 received single dose of intraperitoneal (i.p.) 1 mL/kg sodium chloride 0.9% (NaCl). Groups 3 and 4 received single dose of 75 mg/kg i.p. CP. On seventh day, SVF was prepared from adipose tissues of 5 additional rats and groups 1 and 3 received 0.9% NaCl i.p. injections while groups 2 and 4 received 0.2 mL i.p. injections of SVF. On day 21 all rats were euthanized, and serum anti-mullerian hormone (AMH) levels, primordial, primary, secondary, antral, and atretic follicle counts, AMH positive staining follicle counts along with AMH staining intensity of the follicles were evaluated. RESULTS:Among two CP induced ovarian damaged groups, SVF treated group showed significantly higher secondary and antral follicle and lower atretic follicle counts, significantly higher mean serum AMH levels, AMH positive antral follicle count and higher intensity of AMH positive follicle scores for primary, secondary, and antral follicles when compared to untreated group. Moreover, group 1 showed no significant difference for all parameters except antral follicle count and AMH positive staining intensity scores for antral follicles when compared to group 4. LIMITATIONS:This study was conducted on experimental rat model. CONCLUSION:Our study demonstrated a significant protective effect of SVF against CP-induced ovarian damage which reveals the apparent need for further investigation of its precise mechanisms of action as it may provide a new treatment approach for women with premature ovarian failure.

Objectives: We investigated the potential of glutathione to protect ovarian function in rats exposed to cyclophosphamide by measuring serum anti-Mullerian hormone levels, follicle counts, and related parameters. Design: Forty-two adult female Sprague-Dawley rats were randomly divided into six groups and treated with various combinations of cyclophosphamide, glutathione, and sodium chloride. On day 21, the rats were anaesthetized, and their ovaries were removed for examination. Participants/Materials, Setting, Methods: Histopathological examination, serum anti-Mullerian hormone (AMH) concentrations, follicle counts, anti-Mullerian hormone-positive staining of follicle percentages were analyzed. Statistical analysis was performed using a one-way analysis of variance and Tukey’s test, with significance set at p<0.05. Primary evaluations included serum anti-Mullerian hormone concentrations and ovarian follicle counts. Secondary measures encompassed histopathological examination and percentages of anti-Mullerian hormone-positive staining of follicles. Results Significant differences were observed in follicle counts, anti-Mullerian hormone-positive follicle parameters, and serum anti-Mullerian hormone concentrations among the six groups. Group 2 (treated with cyclophosphamide) had the lowest primordial, primary, secondary, and antral follicle counts and the highest atretic count. Group 6, treated with cyclophosphamide and 200 mg/kg glutathione, showed improved follicle counts compared to those in group 2. Reducing the glutathione dose to 100 mg/kg was ineffective. Limitations This was an experimental animal investigation with a comparatively modest sample size. Experimental studies should be conducted to determine the optimal dosage and duration of glutathione therapy. Information gathered from an experimental animal model may not yield precisely similar outcomes in humans; therefore, additional investigations are necessary to examine the impact of glutathione on women experiencing POI. Conclusions The anti-oxidative protective effect of directly administered glutathione was demonstrated for the first time. Low-dose glutathione was ineffective, whereas a high dose yielded significant ovarian protection against cyclophosphamide. Our findings provide valuable insights for supplementing clinical trials on the protective effects of glutathione against ovarian damage.

Objective: Comparison of hormonal, metabolic and inflammatory markers of glutathione with metformin and Diane-35 in a rat model of PCOS induced by dehydroepiandrosterone.Methods: Twenty-five female rats were randomized into four groups. Group 1 was administered a subcutaneous dose of 0.2 ml saline/day. Group 2 was given 0.2 ml of 1% carboxymethyl cellulose (CMC)/day orally for 28 days. A PCOS model was established with DHEA in rats. Group 3 was given 4.5 mg/kg/day of Diane-35 orally dissolved in 1% CMC for 28 days. Group 4 was given 300 mg/kg/day of metformin orally dissolved in 1 ml of saline for 28 days, and Group 5 was administered 100 mg/kg of glutathione intraperitoneally on days 35, 42, and 49. On day 56, the rats were sacrificed. Serum markers and follicle count were examined.Results: Serum IL-6, hs-CRP, insulin, testosterone, SHBG, and MDA values were significantly lower in the glutathione group than in the PCOS group (p = 0.0006, p = 0.023, p = 0.0082, p = 0.0007, p = 0.0048, and p < 0.0001, respectively).The number of all follicles was similar between the control and glutathione groups (p < 0.05). When we compared the other groups with the PCOS group, the number of primary, secondary, atretic, and cystic follicles was significantly lower in the metformin and glutathione groups. The number of primordial and antral follicles was significantly higher than in the PCOS group.Conclusions: Glutathione plays anti-inflammatory and antioxidant roles, similar to metformin, by lowering serum IL-6, insulin, testosterone, CRP, and MDA levels; decreasing atretic/cystic follicle count; and improving antral follicle count and folliculogenesis in PCOS patients.

To demonstrate the effect of silicon dioxide, citric acid and sodium selenite combination vaginal gel (DeflaGyn (R)) on critical parameters in carcinogenesis in vitro HeLa cell culture medium. Various parameters including cell viability, intracellular reactive oxygen species, genotoxicity, apoptosis, mitochondrial membrane potential and glutathione levels were evaluated by applying varying doses of vaginal gel to HeLa cell culture medium. The vaginal gel showed a dose-dependent cytotoxic effect on HeLa cells. The IC50 (half maximal inhibitory concentration) gel concentration for HeLa cells at 24 h was calculated on the concentration-response curve and was found to be 80.15% of DeflaGyn (R). Increasing DeflaGyn (R) concentrations (12.5-100%) increased iROS (intracellular reactive oxygen species) levels 1.3-fold on average compared to the control (0.1% DMSO (dimethyl sulfoxide)). DNA damage and apoptosis levels increased significantly with concentration in a dose-dependent manner. Similarly, a decrease was observed in the mitochondrial membrane potential (MMP levels decreased statistically significantly up to 70.14%) and intracellular glutathione levels, and all changes were proportional to the dose. Although it is known that the combination of vaginal gel facilitates the regression of cervical dysplasia and clearance of high-risk HPV (Human Papilloma Virus) types, there is no detailed information on the mechanism by which it provides these effects. In the present study, we found that the specific vaginal gel had a dose-dependent effect on various parameters thought to be important in the process of cervical carcinogenesis. Further studies are needed to reveal the pathways through which the gel is effective and whether it has similar effects in vivo.

ABS TRACTCondyloma acuminata is a disease that is frequently seen in the perianal and genital area.It can be transmitted by sexual intercourse, in which the agent is usually the human papillomavirus.Although giant condyloma acuminata is often with benign histology, may rarely develop squamous cell carcinoma may rarely develop or it may progress as a locally aggressive disease.Due to the physiological changes during pregnancy, the growth rates are relatively higher in pregnant women than non-pregnant women.Even though there are many treatment methods for giant condyloma acuminata, many results are not very satisfactory and local recurrence rates are quite high.In this report we are presenting a successful treatment of a 14-week pregnant patient with surgical excision.

Objective: Our study's primary objective was to examine the effects of four different prophylactic protocols on the prevention of postpartum hemorrhage following vaginal birth, including carbetocin only, oxytocin only, and a combination of carbetocin or oxytocin with tranexamic acid.Design: A multicentric randomized controlled trial.Participants/materials, setting, and methods: This multicentric center prospective randomized controlled trial was conducted at the Department of Obstetrics and Gynecology of Bezmialem University and Van Health Teaching and Research Hospital from August 2022 to January 2023. The collected data included age, gravidity, parity, gestational age at birth, duration of delivery stages, prepartum hemoglobin and hematocrit concentrations, changes in hemoglobin and hematocrit concentrations, intrapartum blood loss, estimated blood loss after 2 h of vaginal delivery, Apgar scores at 1 and 5 min, birth weight, and neonatal intensive care unit (NICU) admission. Intrapartum blood loss was objectively measured in milliliters using a postpartum drape with a calibrated bag. The amount of bleeding was measured by subtracting the empty weight of the pads placed under the patient in the patient's bed within 2 h after delivery. Group I: carbetocin 100 mu g/mL (n = 75), group II: oxytocin 5 IU/mL (n = 75), group III: carbetocin and tranexamic acid 50 mg/mL (n = 75), group IV: oxytocin and tranexamic acid (n = 75).Results: The hemoglobin concentration decrease significantly differed between groups (1.03 +/- 1.04, 1.3 +/- 0.85, 1.4 +/- 0.85, 1.41 +/- 0.87, respectively; p < 0.001). Group 4 has the highest decrease in hemoglobin and hematocrit concentrations. When we investigated the subgroup differences, the decrease in hemoglobin concentration was significantly higher in group 2 than group 1 (1.30 +/- 0.85 vs. 1.03 +/- 1.04; p = 0.023), in group 2 than group 3 (1.3 +/- 0.85 vs. 1.04 +/- 0.9; p = 0.013), and in group 4 than group 3 (1.41 +/- 0.87 vs. 1.04 +/- 0.9; p < 0.001). The decrease in hematocrit level was significantly different between groups (3.07 +/- 3.23, 3.55 +/- 2.44, 2.13 +/- 3.09, 4.25 +/- 2.52; p < 0.001, respectively). No significant differences were observed in terms of mean blood loss between the four groups (277.19 +/- 208.10, 294.13 +/- 198.64, 274.33 +/- 199.57, and 283.97 +/- 178.11; p = 0.445, respectively). Furthermore, there was no significant difference between the groups in the rate of need for blood transfusion (1.3%, 5.4%, 4%, and 4%, respectively; p = 0.6).Limitations: The most important limitation of the study is a relatively small number of participants.Conclusion: In conclusion, our findings suggest that carbetocin may be more successful than oxytocin and oxytocin plus tranexamic acid regimens in terms of postpartum hemoglobin reduction, and there is no difference in terms of the need for blood transfusion when it is used for postpartum hemorrhage prophylaxis after vaginal delivery.

Objective: To assess the impacts of Platelet-Rich Plasma(PRP) and Granulocyte Colony-Stimulating Factor(G-CSF) on a rat model with induced ovarian follicular damage caused by cyclophosphamide(Cy).Materials and Methods: Forty-two Sprague-Dawley rats were randomly allocated into seven distinct groups as; Group 1(control): NaCl intraperitoneal (IP) injection was administered on days D1, D7, and D14. Group 2(Cy):Cy IP injection on D1 + NaCl IP injection on D7 and D14 were administered. Group 3(PRP): PRP IP injection on D1,D7 and D14 were administered. Group 4(Cy + PRP):Cy IP injection on D1 and PRP IP injection on D1, D7 and D14 were administered. Group 5(G-CSF): G-CSF IP injection on D1, D7 and D14 were administered. Group 6(Cy + G-CSF):Cy IP injection on D1+ G-CSF IP injection on D1, D7 and D14 were administered. Group 7(Cy + PRP + G-CSF):Cy IP injection on D1+ PRP IP injection on D1,D7 and D14+ G-CSF IP injection on D1,D7 and D14 were administered. Follicular number, histological scores of AMH and INSL3 stained follicles at different stages of follicular development, and serum Anti-Mullerian hormone(AMH) were evaluated.Results: The primary, secondary, and antral follicle intensity scores for AMH-positive staining were most prominent in Groups 3 and 5. There was no significant difference between groups 4, 6 and 7 compared to group 1 in terms of follicule counts and AMH staining. The intensity scores of AMH-positive staining follicles were notably reduced in group 2 compared to groups 4, 6, and 7, with a significant difference (p < .01). Among the groups, group 2 exhibited the least intense antral follicle staining for INSL3, displaying a significant difference(p < .01) compared to the remaining groups.Conclusions: Autologous PRP and G-CSF might protect ovarian function in the face of ovarian damage caused by Cy-induced effects.

OBJECTIVES:To compare the efficacy of three regimes of uterotonic agents on PPH in women undergoing cesarean section in our RCT. MATERIAL AND METHODS:This study was a randomized controlled study (NCT05083910) performed at the Bezmialem Vakif University between July 2021 and January 2022. All women were randomly allocated into three groups: Group I (n = 52) - oxytocin only; Group II (n = 52) - the combination of oxytocin plus intrauterine misoprostol; Group III (n = 52) - carbetocin only. The primary outcome measures were: PPH to evaluate with the change between the concentrations of preoperative and postoperative hemoglobin, hematocrit and intraoperative blood loss. RESULTS:The blood loss characteristics, including the change in hemoglobin and the change in hematocrit concentration, intraoperative blood loss, intraoperative additional hemostatic uterine sutures and the need for additional uterotonics, were lowest in group III, although all groups were comparable in terms of blood loss parameters. Group III had the highest blood loss ratio, exceeding 1000 mL. For the combination of oxytocin and intrauterine misoprostol, the ARR was 3.8% (95% CI 20.02-12.33), with a RR of 1.18 (95% CI 0.58-2.39) and a NNT of 26 (95% CI 8.1-4.9); for carbetocin, the ARR was 5.8% (95% CI 22.15-10.61), with a RR of 1.27 (95% CI 0.63-2.53) and a NNT of 17 (95% CI 9.41-4.51). CONCLUSIONS:Our results demonstrate that carbetocin shows no superiority in the prevention of PPH in women undergoing cesarean section. Oxytocin still seems to be a highly effective alternative to prevent PPH.

Thus far, the traditional method of performing staging surgery in ovarian cancer has been laparotomy. Although randomized controlled trials are lacking, minimally invasive options are deemed safe and sufficient for staging and treatment of early-stage ovarian cancer. This study aims to compare the intraoperative and early postoperative outcomes of patients who underwent staging surgery via laparoscopy or laparotomy because of ovarian cancer. This retrospective study was conducted among 37 patients undergoing staging surgery done via laparoscopy (Group 1) or laparotomy (Group 2) between February 2018 and May 2022 at a single center. Intraoperative and early postoperative results were collected. Regarding postoperative complications between the two groups, the formation of lymphoceles and hernias in Group 2 was significantly higher compared to Group 1 (p = 0.019 and p = 0.050, respectively). When these groups were compared regarding Clavien-Dindo classification, Grade 1 complications were high among the laparoscopy group. In contrast, Grade 2, 3A and 3B complications were significantly higher in the laparotomy group (p = 0.002). Regarding hospital stay during the postoperative period, the patients in Group 2 stayed significantly longer compared to Group 1 (p = 0.001). As an alternative to open surgery for diagnosing and staging ovarian cancer, the laparoscopic approach is reliable and can be applied safely to patients. However, more prospective randomized studies are needed to support the obtained data.

Introduction: Due to the superficial peritoneal spread of ovarian cancer, upper abdominal surgical procedures are often required to achieve optimal surgical cytoreduction. This study compares the mortality and morbidity rates of patients undergoing upper and lower abdominal cytoreductive surgery in our institution.Material and Methods: Patients who underwent cytoreductive surgery for ovarian malignancies from 2014 to 2020 were retrospectively identified from an institutional database. Upper abdominal cytoreduction was defined anatomically as debulking of disease proximal to the ligament of Treitz. Perioperative and postoperative outcomes were analyzed.Results: A total of 148 operations were performed. A single gynecologic oncologist performed all procedures. When all cytoreductive procedures were evaluated, diaphragm injury, blood transfu-sion, hospital stay, atelectasis, pneumonia, effusion, wound infection and need for intensive care were found to be statistically significantly higher in patients who underwent upper abdominal surgery compared to patients in the lower abdominal surgery group (p=0.001, p=0.017, p=0.002, p=0.045, p=0.006, p=0.005, respectively). Conclusion: In patients scheduled for cytoreductive surgery with the diagnosis of ovarian cancer, upper abdominal surgery is a viable procedure, although it carries a higher risk of complications compared to lower abdominal surgery alone. Upper abdominal surgery in advanced ovarian cancer can be applied to patients with an acceptable complication profile when the possible survival advantage is considered.

INTRODUCTION AND HYPOTHESIS:The objective of this cross-sectional, epidemiological study was to characterize urinary tract and bowel symptom prevalence and the extent of discomfort/bother associated with them. Additionally, the authors aimed to explore factors associated with both conditions among Turkish female university students. Also, an insight into women's "communication regarding urinary incontinence and anal incontinence" with their family members was sought.METHODS:This is an internet-based national cross-sectional study. A study-specific 30-item questionnaire containing validated measures of symptom prevalence and bother (Urogenital Distress Inventory questionnaire short form and Colorectal-Anal Distress Inventory) were incorporated into the survey. Out of a total of 2,125 e-mail invitations that were sent, 1,226 responded with data included in this analysis.RESULTS:The age and BMI of all respondents were 26.53 ± 10.082, 23.45 ± 6.609 respectively. Nine hundred and eighty-five (80.5%) respondents claimed that they did not suffer a UI episode in the last year, whereas 10 people (0.08%) claimed that they had a urinary incontinence episode every day. Three hundred and fifty-seven responders (29.1%) stated that they suffered from "gas incontinence," 6 (0.5%) stool incontinence, and 20 (1.6%) declared that they had episodes of both stool and gas incontinence. Five hundred and forty-four participants (44%) reported that they had family relatives with a problem of "urinary incontinence" and 576 (47%) stated they had a conversation on "urinary incontinence." Seventy-five of the responders (6.1%) stated that they had a family member with "anal incontinence" and 246 (20.1%) responded that they had a conversation regarding "anal incontinence" with them.CONCLUSION:We have demonstrated that the prevalence of UI was 19.5%. Twenty-nine percent stated they suffered "gas incontinence," 0.5% stool incontinence, and 1.6% declared that they had episodes of both stool and gas incontinence.

Epidermoid cysts are cutaneous or subcutaneous masses caused by the implantation of epidermal elements into the dermis. This case report presented an epidermal cyst of the perineum clinically mimicking endometriosis in a female patient. A 20-year-old virgo female patient was admitted to our clinic with complaints of severe pain, especially in the right leg, and postmenstrual bleeding for three years. In the transrectal ultrasound, a 54*39 mm cystic lesion with dense internal echo was detected in the medial neighborhood of the pelvic floor right obturator internus muscle. Since the cystic lesion detected in the contrast-enhanced pelvic MRI was evaluated as an epidermoid cyst and no significant endometrioma or endometriosis focus was detected, an operation was planned. Surgical excision should be performed not only for symptom relief and diagnosis but also to exclude rare malignancy. However, it is vital to master the pelvic and perineal anatomy along with careful surgery.

Aim: To determine possible risks for mother and baby in advanced age pregnancies. Materials and Methods: This study is a retrospective archive review examining 14192 cases who gave live births between 24 and 42 weeks between 2020-2023. Results: The frequency of preeclampsia, gestational hypertension, gestational diabetes mellitus, rupture of membranes and possible miscarriage was high in advanced-age pregnant women compared to other groups. When the groups were compared according to neonatal outcomes, the frequency of low birth weight in adolescence was high than in advanced-age pregnant women. When the groups were compared in terms of macrosomia, the frequency of macrosomia was high in the older age group than in the other groups. Conclusion: It should be known that pregnancies at an advanced-age can be more complicated for both mother and baby, and pregnancy follow-up should be done more carefully.

Aim: Our aim is to evaluate the level of knowledge, compliance with the screening program, and tendency to inform patients of the doctors working in FHCs where HPV testing is performed within the scope of the cervical cancer screening program in our country.Methods: This cross-sectional study was performed between June and September 2022 with 113 family physicians working in different FHCs in different provinces in Turkey. Questionnaires prepared by the researchers were delivered to family physicians via online platforms.Results: When the different age groups were evaluated, in two of the 24 knowledge-level questions (How many types of HPV are there? Can HPV infect men?) the rate of correct answers for participants under the age of 35 years was statistically significantly higher (p = 0.007; p = 0.032). With regard to professional experience, the group with fewer than 10 years of experience gave a statistically significant correct answer to two questions (How many types of HPV are there? Can HPV infect men?; p = 0.008; p = 0.037). It was observed that 107 (94.7%) of the 113 family physicians who participated in the survey recommended that their patients use condoms during intercourse, 110 (97.3%) recommended cervical cancer screening tests to patients who applied for another reason, 105 (92.9%) recommended the HPV vaccine to patients and their relatives and 60 (53.1%) recommended the HPV vaccine to patients who applied for another reason.Conclusions: The success of HPV vaccination programs is directly related to the beliefs of health personnel and their recommendations to the general population.

The study aimed to investigate the effects of cystocele and rectocele on the stages of vaginal birth and maternal and newborn outcomes. A total of 672 multiparous pregnant women between the ages of 18 to 40 who underwent normal vaginal delivery in our tertiary center between November 2022 and February 2023, were included in this prospective study. Among the participants, 348 (51.8%) had no abnormalities, 78 (11.6%) had rectocele only, 112 (16.7%) had cystocele only, and 134 (19.9) had both cystocele and rectocele. Patients with the coexistence of cystocele and rectocele experienced a notably extended duration for both the first stage and second stage of labor, although the extension in the second stage was not statistically significant. Among the maternal complications, the development of maternal laceration and chorioamnionitis was significantly more common in the patient group with cystocele and rectocele compared to the other groups. When the groups were assessed for postpartum bleeding, while the bleeding risk increased from the normal group to the rectocele + cystocele group, this increase was not statistically significant. There was no difference between the groups in terms of neonatal outcomes. The delivery time of pregnant women with cystocele and rectocele, in the absence of additional risk factors, was determined to be significantly longer than that of the control group. We think that these patients should receive more vigilant monitoring, and this criterion should be kept in mind when assessing the indication for a cesarean section.

Research question: What is the efficacy and possible positive effect of additional rescue subcutaneous (s.c.) progesterone therapy for restoration of progesterone concentration on embryo transfer day and pregnancy rates during programmed artificial frozen embryo transfer (FET) cycles with vaginal progesterone tablet plus i.m. progesterone? Design: Multicentre prospective cohort study (NCT04769401) including a total of 238 programmed artificial FET between February 2021 and September 2021. Patients were divided into >= 10 ng/ml and <10 ng/ml according to serum progesterone concentrations on embryo transfer day; 25 mg of s.c. progesterone was added to patients with <10 ng/ml; blood samples were taken 2 days later. The primary outcome was the ongoing pregnancy rate. Results: The proportion of patients having >= 10 ng/ml serum progesterone concentrations on embryo transfer day was 70.7%. There was no statistically significant difference with regard to cumulative pregnancy rate, ongoing pregnancy rate and miscarriage between the groups (55.4% versus 61.5%, P = 0.4; 78.2% versus 72.5% per pregnancy, P = 0.5; 21.8% versus 27.5%, P = 0.5, respectively, >= 10 ng/ml and <10 ng/ml). Eighty-three per cent of patients with low serum progesterone concentrations on embryo transfer day reached an adequate progesterone concentration with rescue s.c. progesterone treatment; 90% of pregnancy rates in patients with serum progesterone concentrations <10 ng/ml on embryo transfer day were in patients who reached adequate serum progesterone concentrations with daily rescue s.c. progesterone treatment. Conclusions: The measurement of serum progesterone concentrations on embryo transfer day may create the opportunity for rescue progesterone administration on that day for patients who fail to reach adequate serum progesterone concentrations, achieving similar pregnancy rates without cancellation of the cycle.

Introduction/Background Ovarian cancer is still the most lethal type of gynecological cancer because it does not show signs of the disease in the early period and there is no effective screening method. Cancer stage is an independent risk factor affecting the prognosis of the disease; and after primary staging surgery in the early stage and optimal cytoreductive surgery in the advanced stage, the disease-free and overall survival times of patients without visible residual tumor tissue increase significantly. Due to the superficial peritoneal spread of ovarian cancer, upper abdominal surgical procedures are often required to achieve surgical optimal cytoreduction. The aim of this study is to compare the mortality and morbidity rates of patients undergoing upper and lower abdominal cytoreductive surgery in our institution. Methodology Patients who underwent cytoreductive surgery for ovarian malignancies from 2014 to 2020 were retrospectively identified from an institutional database. Upper abdominal cytoreduction was defined anatomically as debulking of disease proximal to the ligament of Treitz. Perioperative and postoperative outcomes were analyzed. (p<0.05 is referred as statistically significant) Results A total of 148 operations were performed. All operations were performed by a single gynecologist oncologist. In operations with combined upper and lower abdominal cytoreduction versus only lower abdominal cytoreduction; diaphragm injury, blood transfusion, length of stay, atelectasis, pneumonia, effusion, wound infection and need for intensive care unit were found to be statistically significantly higher in patients undergoing upper abdominal surgery than in patients undergoing lower abdominal surgery. Conclusion Upper abdominal surgery is a valid procedure for optimal cytoreduction in ovarian cancer. However, there is a greater risk of some complications occurring compared to lower abdominal surgery. Upper abdominal surgery in advanced ovarian cancer can be applied to patients with an acceptable complication profile when the possible survival advantage to be obtained is taken into account.

Objective:The gynecologic patient benefits from early discharge in many ways.A growing evidence of literature suggests that same-day discharge is safe for minimally invasive hysterectomy for benign indications.The primary outcome was the acceptability rate of early discharge after informing patients that if they wish they can be discharged from the hospital within 24 hours or they might stay longer.The secondary outcomes were to evaluate the 30 day emergency department and hospital readmission rates between same-day discharge and delayed discharge after laparoscopic hysterectomy in an academic referral centre.Material and Methods: This is an observational non-randomised prospective clinical trial.Patients who underwent laparoscopic hysterectomy at an hospital deemed "fit for discharge" were evaluated.Variables including patient comorbidities and other details were prospectively collected for each patient.Postoperative outcomes were followed for 30 days following the operation utilizing the hospital's central medical record system.All patients were scheduled for postoperative 1 month control to account for any other hospital visits or admissions besides our centre.Results: From October 2021 to April 2022, a total of 275 laparoscopic hysterectomies were performed at our department.After exclusion criteria 194 patients were deemed fit for discharge using a check-list.96 (49.5 %) of these preffered to be discharged before 24 hours while the slight majority of 98 patients (50.5 %) opted to stay over 24 hours.The groups were similar with regards to age, BMI, clinical and surgical characteristics.The only effective variable reaching statistical significance between the two groups was the duration of the operation.Our readmisson rate was 1.04 % in the early discharge group and 1.02 % in the late discharge group.Conclusion: Duration of surgery was the sole variable effecting patient preference of early discharge.There was no difference in complications or 30-day emergency department visits in either group.Even though it was considered safe to be early discharged to home, as evident by low complication and readmission rates, more than half of our patients did not prefer to do so.Promoting nursing staff and home based visits may increase the acceptability of early discharge.

Introduction/Background Ovarian cancer ranks 4th among the deadliest cancers in women and has the highest mortality rate among all gynecological malignancies. In women who are believed to have ovarian cancer but have poor performance status or have advanced disease believed to be beyond the scope of primary cytoreductive surgery and whose pathology cannot be obtained before staging surgery, NACT can be given to patients with acid cytology and/or tru-cut biopsy referral. Our aim is to determine the accuracy, adequacy, safety and reliability of these minimally invasive interventional procedures. Methodology This is a retrospective analysis of 63 patients with a prediagnosis of ovarian cancer in our hospital between 2014 and 2021, who underwent ultrasound-guided acid cytology and tru-cut biopsy, and also had postoperative final pathology results. Results When the pathology results of the patients who received acid cytology, tru-cut biopsy, acid cytology and tru-cut biopsy at the same time were compared with the postoperative final pathology results, it was seen that the PPV was 100% in all groups. It was revealed that the sensitivity of acid cytology was 64%, the specificity was 100%, the NPV was 12%, and the accuracy of the test was 65%. The sensitivity of the Tru-cut biopsy was 91%, the specificity was 100%, the NPV was 42%, and the accuracy of the test was 92%. In the case of both procedures, the sensitivity was calculated as 93% and the accuracy of the test was calculated as 93%. There were no false positive cytology and biopsy results that could lead to unnecessary NACT therapy in the study. 97 minimally invasive procedures were performed under ultrasound guidance. Conclusion Minimally invasive procedures can be safely applied to patients with low complication and high accuracy rates, since they provide NACT in patients who are thought to be candidates for interval surgery.