Gynecology Oncology
Behnaz Nouri; Maliheh Arab; Sare Naz
Articles in Press, Accepted Manuscript, Available Online from 26 April 2024
Abstract
Background & Objective: The etiology of endometriosis is unknown and many hormonal, inflammatory, genetic and environmental factors are effective in the formation of endometriosis. The present study investigated the epidemiology of endometriosis in patients referred to Shohadaye Tajrish Hospital ...
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Background & Objective: The etiology of endometriosis is unknown and many hormonal, inflammatory, genetic and environmental factors are effective in the formation of endometriosis. The present study investigated the epidemiology of endometriosis in patients referred to Shohadaye Tajrish Hospital in six years.Materials & Methods: This descriptive study performed on endometriosis Iranian women who referred to Shohadaye Tajrish Hospital between 2016 and 2022. The sample size of this study was determined using the census method, and 711 patients. For analysis SPSS version 22 was used, and results were reported as Mean ± SD. Results: Finally, 711 patients enrolled in this study and the average age of patients was 34.69± 7.53 years and mean age of onset of disease was 29.97±4.61years. More than 55% of patients had healthy weight and normal body mass index. 17.72 percent of patients had history of infertility in her life’s. Conclusion: Endometriosis patients’ life in many aspects, including their job, lifestyle, education, marital status and health care is affected.
General Gynecology and Pelvic Floor
Elham Akbari; Fereshteh Sarbazi; Behnaz Nouri; Anita Karimi; Sahar Khoshravesh
Articles in Press, Accepted Manuscript, Available Online from 26 April 2024
Abstract
Background: Nowadays, the prevalence of uterine myoma in pregnant women has increased due to the increasing age of pregnancy in women. Due to the possibility of bleeding andmiscarriage, the surgical management of uterine myoma with myomectomy is limited, andmany obstetricians and gynaecologists recommend ...
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Background: Nowadays, the prevalence of uterine myoma in pregnant women has increased due to the increasing age of pregnancy in women. Due to the possibility of bleeding andmiscarriage, the surgical management of uterine myoma with myomectomy is limited, andmany obstetricians and gynaecologists recommend that myomectomy be performed afterdelivery. In this case report, a pregnant woman (window period) with a negative result of ßhCG test and ultrasound in terms of pregnancy undergoes myomectomy surgery to remove a large uterine myoma.Case presentation: A 40-year-old patient referred to the physician because of vaginalbleeding caused by a large uterine myoma and primary infertility for 10 years. ßhCG test andultrasound of the patient was negative in terms of pregnancy and she underwentmyomectomy surgery while the patient is in the early stages of pregnancy (window period).Therefore, the patient was under the supervision of a gynecologist and was visited everyweek. With continuous follow-up, the newborn was born without any problems at 37 weeks. Conclusion: Although in this study with proper management during surgery, progesteronetherapy and continuous and regular follow-ups, the newborn was born healthy, butconfirmation of myomectomy during pregnancy requires the implementation of more studies.
General surgery
Behnaz Nouri; Ladan Ajori; Maliheh Arab; Sepideh Sattarzad Fathi
Volume 9, Issue 2 , March and April 2024, , Pages 154-160
Abstract
Background & Objective: The aim of this study was to describe the female to male (FTM)transgenders demographic, epidemiologic characteristics and outcomes after laparoscopic hysterectomy and bilateral oophorectomy surgery by one surgeon in FTM transgender people.Materials & Methods: This ...
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Background & Objective: The aim of this study was to describe the female to male (FTM)transgenders demographic, epidemiologic characteristics and outcomes after laparoscopic hysterectomy and bilateral oophorectomy surgery by one surgeon in FTM transgender people.Materials & Methods: This retrospective cohort study on FTM patients that referred to one of the referral centers for transgender surgeries in the capital of Iran (Tehran) since 2016 and 2022. Consecutive method used for sampling method. Data analyzing was done by SPSS, descriptive statistical, Pearson correlation coefficient and t-test.Results: We identified 105 FTM transgender patients undergoing laparoscopic hysterectomy and bilateral oophorectomy. The mean age was 24.74±5.41 years, and the mean age of first experience of transgender was10.51±3.68 years. There was a significant correlation between transgender and marital status (P<0.04, r= 0.2) and unemployment (P<0.05, r= 0.5). There was a significant correlation between age of first experiences of transgender and educational status (P<0.05, r= -0.1).49.5%of patients have complications after surgery.Conclusion: Hysterectomy and bilateral oophorectomy by laparoscopic approach may have appropriate outcomes for reassignment surgery. Also, this study suggests that probably less educational, occupational problems occur for transgender patients if they undergo gender reassignment surgery at a younger age.
General Gynecology and Pelvic Floor
Behnaz Nouri; Ladan Ajori; Zohreh Ahmadvand; Saba Fahimhi
Volume 8, Issue 6 , November and December 2023, , Pages 614-619
Abstract
Background & Objective: Adnexal torsion is a complete or incomplete twisting of the ovary, fallopian tubes, or ovarian cyst around its vascular axis, which can cause blood flow disruption. This disorder is rare but serious and accounts for about 3% of women's emergency surgeries. Early diagnosis ...
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Background & Objective: Adnexal torsion is a complete or incomplete twisting of the ovary, fallopian tubes, or ovarian cyst around its vascular axis, which can cause blood flow disruption. This disorder is rare but serious and accounts for about 3% of women's emergency surgeries. Early diagnosis of this disease and the necessary surgeries are very important to preserve fertility. The purpose of this study is to investigate the epidemiology, clinical symptoms, imaging and pathology of patients with torsion of the adnexa referred to the emergency rooms of Mahdiyeh and Shohadaye Tajrish hospitals.Materials & Methods: This study is a retrospective cross-sectional study. In the present study, 190 patients with torsion of the adnexa were examined in the period 2011–2021, in Mahdiyeh and Shohadaye Tajrish hospitals. Demographic, clinical and surgical information about patients was extracted from medical records. Data analysis was done using SPSS version 22 statistical software.Results: The average age of 190 patients was 29.2. Most of the ovarian torsion patients had a history of more than one previous delivery (57.9%) and also, an ovarian mass was observed in 157 patients, and the ovarian mass of 146 patients was larger than 5 cm. The rate of ovarian preservation in this study was 61%. Hemorrhagic cysts were the most common type of cyst in patients and were reported in 37 patients.Conclusion: It is necessary to identify effective diagnostic methods. Therefore, it may be useful to investigate more serum biomarkers for early detection of adnexal torsion and to reduce diagnostic errors.
Obstetrics and Gynecology
Behnaz Nouri; Maliheh Arab; Mohammad Nasiri
Volume 8, Issue 5 , September and October 2023, , Pages 481-487
Abstract
Background & Objective: Endometriosis is one of the most common diseases in the female population. The range of diagnostic delays in this disease is long and leads to adverse health-related consequences. The aim of this study was to evaluate diagnostic experiences in patients with endometriosis ...
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Background & Objective: Endometriosis is one of the most common diseases in the female population. The range of diagnostic delays in this disease is long and leads to adverse health-related consequences. The aim of this study was to evaluate diagnostic experiences in patients with endometriosis who are candidates for laparoscopic surgery.Materials & Methods: This cross-sectional study was performed on 433 patients with endometriosis who were candidates for laparoscopic surgery referred to Shohada-Tajrish Hospital in Tehran, Iran, between January 2016 and December 2021. A questionnaire including demographic and clinical information, MRI, and pathology reports were collected from participants. The MRI lesions were segmented and the results were compared with pathology and clinical examination. For statistical analysis SPSS software, version 22 was used.Results: A total of 433 participated in this study with a mean age of 34.18±7.99. The average estimated duration of disease symptoms (months) was 40.58±42.33. The predictive value of clinical symptoms is weak compared to MRI. However, the probability that the disease is not present when the clinical signs are negative is acceptable in most of the endometriosis sites. MRI considerably shows the true negative rate, but its sensitivity is only relatively acceptable for the diagnosis of ascites (67.66%). Calculating the accuracy of MRI reports probably shows the overall classification of the patients via MRI test.Conclusion: despite extensive research, there are no suitable and accurate non-invasive methods for diagnosing endometriosis. MRI and clinical examination alone are not useful for definitive diagnosis and it is better to examine biomarkers and artificial intelligence for non-invasive and accurate diagnosis of this disease.
Gynecology Oncology
Behnaz Nouri; Malihe Arab; Nazli Najeddin Choukan
Volume 8, Issue 5 , September and October 2023, , Pages 494-500
Abstract
Background & Objective: Endometriosis is a common and benign disease of the female genital system, which is often seen in reproductive age and leads to infertility, dysmenorrhea, and dyspareunia. The aim of this study is to investigate the anatomical location and characteristics of endometriosis ...
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Background & Objective: Endometriosis is a common and benign disease of the female genital system, which is often seen in reproductive age and leads to infertility, dysmenorrhea, and dyspareunia. The aim of this study is to investigate the anatomical location and characteristics of endometriosis lesions in laparoscopic surgery.Materials & Methods: In this cross-sectional study, 557 endometriosis patients who referred to the gynecology department of Shohadaye-Tajrish Hospital and underwent laparoscopic surgery during 2016-2021 were evaluated. Statistical analysis of data was done using SPSS software version 24.P-value less than 0.05 was considered statistically significant level.Results: The results of this study show that the highest anatomical distribution of endometriosis lesions was ovarian endometriosis, and the lowest was vagina. Also, the highest rate of surface lesions is uterus and bladder, and the lowest is superficial lesions of the cul-de-sac cyst.Conclusion: Our results demonstrate that the distribution of endometriosis lesions is asymmetric.
Obstetrics and Gynecology
Maryamsadat Hosseini; Farah Farzaneh; Mahsa Mirhadi; Seyed Ali Akbar Mahdavi Anari; Ladan Ajori; Saghar Salehpour; Tayebeh Jahed Bozorgan; Parichehr Pooransari; Shideh Ariana; Minoo Yaghmaei; Behnaz Nouri; Shahrzad Zadehmodarres; Sedighe Hosseini; Mehrdad Haghighi; Mir Mohammad Miri; Seyedpouzhia Shojaei; Ali Reza Mirkheshti; Dariush Abtahi; Tannaz Valadbeigi
Volume 7, Issue 4 , March and April 2022, , Pages 286-295
Abstract
Background & Objective: The COVID-19 infection remains a major pandemic threatening global health. Studies revealed that pregnant women are more prone to develop severe illness, with an increased risk of morbidity and mortality. So the objective of this study is to report the clinical presentation ...
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Background & Objective: The COVID-19 infection remains a major pandemic threatening global health. Studies revealed that pregnant women are more prone to develop severe illness, with an increased risk of morbidity and mortality. So the objective of this study is to report the clinical presentation and perinatal outcomes after COVID-19 infection during pregnancy or the puerperium.Materials & Methods: In this case series study, since February 2020, 25 pregnant women with a definitive diagnosis of the COVID-19 infection were registered. Their clinical signs and symptoms, laboratory findings, CT manifestations, pregnancy status, were recorded at the first visit, and they were followed six months after diagnosis.Results: The most common symptoms were cough, feeling feverish, and dyspnea. Twenty mothers required hospitalization, 5 out of 20 monitored in COVID-ICU. The chest CT scan demonstrated a grand glass appearance in 77% of cases among admitted patients. The total mortality rate in C-ICU (COVID-19 ICU) admitted patients were 80%.Conclusion: In this case series, among 25 pregnant women with confirmed COVID-19, the most vulnerable patients were in the early third trimester and twin pregnancy.
Gynecology Oncology
Somayyeh Noei Teymoordash; Maliheh Arab; Maryam Talayeh; Masoomeh Raoufi; Behnaz Ghavami; Behnaz Nouri
Volume 6, Issue 2 , March 2021, , Pages 99-104
Abstract
Background: A variety of presentations may be manifested by retained sponge, including intestinal obstruction, intestinal fistula, malabsorption syndrome and chronic pain from adhesions; in some cases, it may have an asymptomatic clinical course.Case report: In a 41-year-old female, gravida 4 para 4, ...
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Background: A variety of presentations may be manifested by retained sponge, including intestinal obstruction, intestinal fistula, malabsorption syndrome and chronic pain from adhesions; in some cases, it may have an asymptomatic clinical course.Case report: In a 41-year-old female, gravida 4 para 4, with a history of laparotomy performed for an ovarian adenocarcinoma three years prior to her referral, a gossypiboma was incidentally detected on follow up imaging. The gossypiboma was safely excised by a midline laparotomy.Conclusion: Asymptomatic gossypiboma should be considered in patients presenting with a mass, who have undergone laparotomy in the past.
Gynecology Oncology
Somayyeh Noei Teymoordash; Maliheh Arab; Noushin Afsharmoghadam; Behnaz Nouri; Tayebeh Jahed bozorgan; Maryam Talayeh
Volume 5, Issue 3 , November 2020, , Pages 103-109
Abstract
Pseudomyxoma peritonei (PMP) is characterized by mucinous ascites in the peritoneal cavity and might involve the omentum and peritoneum. The PMPs originating from the ovary are mostly caused by ruptured ovarian mature teratomas and mucinous ovarian carcinomas. The present case is a rare advanced mucinous ...
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Pseudomyxoma peritonei (PMP) is characterized by mucinous ascites in the peritoneal cavity and might involve the omentum and peritoneum. The PMPs originating from the ovary are mostly caused by ruptured ovarian mature teratomas and mucinous ovarian carcinomas. The present case is a rare advanced mucinous borderline ovarian tumor and late recurrence in PMP in a 52-year-old menopaused woman. She presented with gradual abdominal enlargement and cystic abdominopelvic lesion with internal septa and ascites. The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, infracolic omentectomy, lymphadenectomy, and appendectomy. Histopathologic examination revealed mucinous borderline tumors. About 5.5 years after the first surgery, she presented with abdominal bloating and a sonography report of peritoneal seeding in the abdomen and pelvis. Abdominal exploration showed gelatinous-mucinous ascites and disseminated peritoneal carcinomatosis. The final histopathologic evaluation indicated PMP. Although the recurrence of mucinous borderline tumors is in an average of two years, the present case had relapsed after 5.5 years as pseudomyxoma with borderline pathology.
Behnaz Nouri; Paricheher pooransari; Fateme Ghorbani
Volume 4, Issue 4 , September and October 2019, , Pages 146-150
Abstract
Background & Objective: Cesarean hysterectomy is a major surgical risk happening in the setting of life threatening hemorrhagic events during or immediately after the cesarean section. In this study we assessed patients undergoing cesarean hysterectomy to determine their general and clinical characteristics.
Materials ...
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Background & Objective: Cesarean hysterectomy is a major surgical risk happening in the setting of life threatening hemorrhagic events during or immediately after the cesarean section. In this study we assessed patients undergoing cesarean hysterectomy to determine their general and clinical characteristics.
Materials & Methods: In this descriptive cross-sectional study, 34 consecutive patients undergoing cesarean hysterectomy in training hospitals in Tehran, Iran, from 2016 to 2017 were enrolled. The age, BMI, gravid, parity, Apgar score, risk factors, chief complaints, drug history, and previous medical and surgical history were assessed and finally the preventability rate was determined.
Results: The chief complaint was vaginal leak (VL), abnormal uterine bleeding (AUB), labor pain, and preeclampsia in 38.2%, 29.4%, 14.7%, and 2.9% of patients respectively, and the other patients had more than one complaint. Type of surgery was total, and supra-cervical in 58.8%, 41.2% of patients respectively. Bladder injury occurred in 41.2% of patients. Two cases were preventable, one was non-preventable, and all others were mixed.
Conclusion: It may be concluded that the general characteristics among our patients undergoing cesarean hysterectomy is similar to those reported by similar studies. However further studies with larger sample size and multi-center sampling among Iranian patients are needed to develop more definite results.