Study Objective: To investigate diverse hysterectomy techniques to determine their influence on patient outcomes, including pain levels, sexual function, anxiety, and quality of life. Of particular focus is the comparison between vessel sealing and traditional suturing in abdominal, vaginal, and laparoscopic hysterectomies. This study is unique in its comprehensive evaluation, considering patient satisfaction, recommendation rates, recovery times, and various other aspects. Method: Our prospective cohort study adhered to ethical guidelines, involving a meticulous assessment of patients, including medical history, anxiety levels, pelvic pain, sexual function, and quality of life. Surgical methods were explained to patients, allowing them to actively participate in the decision-making process. Sociodemographic information was collected, and exclusion criteria were applied. Hysterectomy methods included total abdominal hysterectomy (TAH), laparoscopic hysterectomy (TLH), vaginal hysterectomy (VH), and a modified vaginal technique known as VH Mujas. Several parameters were recorded, including operation indications, uterine volume, hospital stay, operation duration, pre-operative and post-operative complications, and more. Results: In all groups, a statistically significant increase was found in pre-operative–post-operative FSFI sexual function values (p < 0.001). The patient’s basal Beck Anxiety Scale scores significantly decreased following the decision for vaginal surgery, both in the VH and VH Mujas groups (p < 0.05). However, Beck Anxiety Scale scores at patients’ initial assessments significantly increased following the decision for abdominal and laparoscopic surgery (p < 0.001). According to the results of the SF-36 quality of life assessment, an increase was observed in all post-operative quality of life parameters in patients who underwent surgery with different methods due to VH (p < 0.05). Conclusions: Our comprehensive comparison of hysterectomy techniques demonstrated that VH, particularly when utilizing the Mujas technique, outperforms other hysterectomy methods regarding patient safety and post-operative satisfaction but also offers the benefit of minimal invasiveness. Notably, this is reflected in improved quality of life, enhanced sexual function, lower pain scores, and favorable cosmetic results. The success of a hysterectomy procedure depends on precise indications, surgical planning, proper patient selection, and effective communication. This study emphasizes the significance of these factors in achieving optimal outcomes. The development of specialized vascular closure devices can further enhance the feasibility of vaginal hysterectomy, making it a preferable choice in gynecological surgery. The study contributes valuable insights into selecting the most suitable hysterectomy method for patients and optimizing their recovery.

OBJECTIVE: We aim to compare the effectiveness of oral contraceptives and dienogest, primarily by considering the quality of life scale. We also aim to compare the Cancer Antigen-125 and Anti-mullerian Hormone values. STUDY DESIGN: Gynecological examination findings evaluated based on ESHRE and ASRM Guideline criteria are compatible with endometriosis, or a previous surgery pathology result is consistent with endometriosis, and patients whose imaging report was compatible with endometriosis were selected. Among the patients who were recommended medical treatment, patients selected as Dionegest 2mg+Ethinylestradiol 0.03 mg (Dienelle) treatment were considered Group 1, and patients deemed suitable for treatment with treatment 2mg Dionegest (Visanne) were considered Group 2. Pre-treatment Cancer Antigen-125/Anti-mullerian Hormone values and SF-36 were recorded. RESULTS: There was no significant difference between drug groups in terms of education status, body mass index, family history, smoking, alcohol consumption, age, age at menarche, menstruation pattern, duration of menstruation, infertility, gestational status, job loss due to pain complaints, operation, and MRI findings (p>0.05). There was no significant difference between the drug groups regarding the quality of life before and after treatment (p>0.05). There was no significant difference between drug groups regarding endometrioma size, Cancer Antigen-125, and anti-mullerian hormone findings (p>0.05). CONCLUSION: Evaluating our data, the efficacy and success of the two treatment protocols were the same. It seems more logical to prefer cost-effective oral contraceptive treatments with a low side-effect profile than high-cost Dionegest. Following the guidelines accepted step therapy in treating mild or moderate endometriosis, cyclic oral contraceptives may be recommended as first-line therapy.

Background: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder with significant metabolic implications, including an increased risk of cardiovascular diseases and diabetes. Kallistatin, a serine proteinase inhibitor with anti-inflammatory and antioxidative properties, has been identified as a potential biomarker for PCOS due to its role in modulating inflammation and oxidative stress. Methods: This prospective cohort study was conducted at a university hospital’s gynecology clinic. It included 220 women diagnosed with PCOS and 220 healthy controls matched for age and body mass index. Kallistatin levels were quantitatively assessed using enzyme-linked immunosorbent assay (ELISA) techniques. Associations between kallistatin levels and clinical manifestations of PCOS, including hyperandrogenism and metabolic profiles, were examined. Results: Kallistatin levels were significantly lower in patients with PCOS (2.65 ± 1.84 ng/mL) compared to controls (6.12 ± 4.17 ng/mL; p < 0.001). A strong negative correlation existed between kallistatin levels and androgen concentrations (r = −0.782, p = 0.035). No significant associations were found between kallistatin levels and insulin resistance or lipid profiles. Conclusions: The findings indicate that reduced kallistatin levels are closely associated with PCOS and could serve as a promising biomarker for its diagnosis. The specific correlation with hyperandrogenism suggests that kallistatin could be particularly effective for identifying PCOS subtypes characterized by elevated androgen levels. This study supports the potential of kallistatin in improving diagnostic protocols for PCOS, facilitating earlier and more accurate detection, which is crucial for effective management and treatment.