Objective:To investigate differences in perioperative complications and short-term outcomes of patients who underwent abdominal sacrocolpopexy / sacrohysteropexy, laparoscopic sacrocolpopexy / sacrohysteropexy, or laparoscopic pectopexy due to apical prolapse.Materials and Methods:A retrospective cohort study was performed on 110 patients who underwent apical prolapse surgery between January 1, 2011, and July 31, 2017. Only symptomatic uterine or vaginal vault prolapse patients with stage 2-4, according to the pelvic organ prolapse quantification system, were included. Baseline and intraoperative variables of groups; perioperative complications, including hemorrhage, urinary, and wound complications, blood transfusion, ileus, and short-term outcomes were compared.Results:A total of 68 abdominal sacrocolpopexies (44 sacrocolpopexies and 24 sacrohysteropexies), 14 laparoscopic sacrocolpopexies (10 sacrocolpopexies and 4 sacrohysteropexies), and 28 laparoscopic pectopexies (16 pectopexies and 12 pectohysteropexies) were analyzed. Baseline characteristics and intraoperative variables were similar. However, the mean operating time was significantly shorter in the laparoscopic pectopexy group (74.9 min) when compared with that of the other groups (p < 0.01). During the six-month follow-up period, no prolapse recurrence and mesh erosion / exposure were observed in any group. De-novo stress urinary incontinence, urgency, and defecation problems, as well as perioperative complication rates, were not statistically significantly different between the groups.Conclusions:Although the complication rates and short-term outcomes were not significantly different between the groups, minimally invasive approaches were associated with reduced procedural-related morbidity. Laparoscopic pectopexy is a promising endoscopic prolapse surgery and can be an alternative technique to sacrocolpopexy.

A plateau in the learning curve for TLH was reached after the first 75 cases. We can infer that there is a learning curve for TLH as confirmed by the decrease in operating time (accompanied by no change in complications) correlated to gain in experience. On the other hand, one should not disregard the fact that laparoscopy is not a complication-free surgery and achievement of the learning curve does not exclude complications. Gynaecological surgeons can perform TLH securely during the learning curve.

Objective:To investigate the effect of anemia on perinatal outcomes as preterm delivery (PTD) and low birth weight (LBW) in the different stages of pregnancy.Methods:Medical records of 39,587 Turkish pregnant women who delivered between January 2011 and September 2014 were reviewed. Anemia during pregnancy was defined as hemoglobin (Hb)< 11 g/dl, low birth weight was defined as birth weight <2500 gr and PTD was defined as <37 weeks. The pregnant women were divided into three groups (Hb<10 gr/dl, Hb 10-11 gr/dl, Hb>11 gr/dl). Perinatal outcomes were compared between these anemic and non-anemic groups.Results:The anemia prevalence in our study was 25.1%. In the first and second trimester of Hb<10g/dl group LBW ratio was significantly higher (respectively 13.5%, 9.8%, p=0.03; 22.7%, 14.7%, p=0.01). In the second and third trimesters of Hb<10 g/dl group PTD ratio was significantly higher (respectively 29.1%, 19%, p=0.00; 17.7%, 15.4% p=0.02). In the first trimester Hb<10 g/dl group cesarean section rate was significantly higher (respectively 65.2%, 57.6%, p = 0.01).Conclusions:LBW infants and preterm birth rate was higher in Hb <10 gr/dl group than non-anemic in the first, second and third trimester. Hb <10 gr/dl group had higher cesarean rate in first trimester. The mean birth weight was significantly lower in anemic pregnant women in the second trimester. Preterm birth and cesarean section rate, in the group of anemic throughout pregnancy was higher than those of non-anemic in the whole pregnancy period.

Objective:To compare the obstetric outcomes of cesarean section in women who had a history of four or more previous cesarean sections with those who had a history of two or three previous cesarean sections.Methods:Total 1318 women who underwent repeat cesarean section between January 2013 and January 2016 were retrospectively reviewed. Of these, 244 (18.5%) had previously had four or more cesarean sections (multiple repeat cesarean section group) and 1074 (81.5%) had previously had two or three cesarean sections (control group). Demographic characteristics and obstetric outcomes were compared using the Independent t and chi-square tests.Results:The adhesion rate (p < 0.001), number of blood transfusion (p = 0.044), operation time (p = 0.012), length of hospital stay (p < 0.001) and tubal ligation surgery (p < 0.001) were significantly higher in multiple repeat cesarean section group compared to control group.Conclusion:Although multiple repeat cesarean section are asscociated with adhesion occurrence, higher number of blood transfusion, increased operation time and length of hospital stay, there is no remarkable difference in serious morbidity associated with multiple repeat cesarean section.