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BACKGROUND: Uterine manipulators may decrease the incidence of complications associated with total laparoscopic hysterectomy (TLH), but contrary views exist regarding the use of uterine manipulators for TLH. There are insufficient data on the safety of TLH without a uterine manipulator in both benign and malignant cases. Data on the safety and outcomes of TLH performed without a uterine manipulator remain limited. While some studies have investigated this issue, direct comparisons between TLH with and without the use of a manipulator, particularly across both benign and malignant indications, are still relatively scarce. OBJECTIVE: The purpose of this study was to analyze the results and complications of TLH either with (group B) or without a uterine manipulator (group A), which was performed for benign and malignant indications. STUDY DESIGN: A retrospective comparative study was conducted to evaluate the results of TLH with and without the use of a uterine manipulator. Group A included 138 patients, and Group B included 1300 patients. Patient characteristics, surgical indications, uterine weight, blood loss/transfusion, intraoperative urinary/intestinal complications, postoperative complications, and the rate of conversion to laparotomy were analyzed. RESULTS: Patient characteristics and uterine weights were similar. There was a significant decrease in hemoglobin in group B (1.37 versus 1.52, p < 0.05). There was no significant difference in the transfusion rates between the two groups. The intraoperative complication rates were 4.3% in group A and 2.8% in group B (p > 0.05). After adjustment for malignant indication, group allocation was not significantly associated with intraoperative complications (OR = 0.57; 95% CI 0.23-1.42; p = 0.227). Rates of bladder, ureteral, and intestinal injuries were similar, although conversion to laparotomy was higher in group A (2.3% vs. 0%). Postoperative complication rates were also comparable between groups, and logistic regression showed no significant association after adjustment for malignancy (OR = 0.54; 95% CI 0.21-1.35; p = 0.184). CONCLUSION: Our findings indicate that TLH without a uterine manipulator can be safely performed in selected patients. However, as the procedure is technically more demanding and evidence remains limited, further multicenter prospective studies are needed to validate these results and guide appropriate patient selection. TRIAL REGISTRATION: The study was conducted in accordance with the ethical standards set forth in the Declaration of Helsinki and approved by the Ethics Committee of Süleyman Demirel University (approval date: 08/06/2022, approval number: 12/165). Informed consent was obtained from the participants prior to participation.

Background/Objectives: Bowel resection may be necessary during cytoreductive surgery (CS) in advanced epithelial ovarian cancer to achieve complete tumor removal. However, concerns about increased perioperative risks and unclear survival benefits have led to ongoing debate. This study aimed to evaluate the impact of bowel resection on perioperative mortality and overall survival (OS) in patients undergoing CS. Methods: We retrospectively reviewed 127 patients with FIGO stage IIB–IV epithelial ovarian cancer who underwent primary or interval CS between 2007 and 2021. Patients were stratified based on the performance of bowel resection. Clinical, surgical, and survival data were analyzed using Kaplan–Meier survival analysis and Cox proportional hazards modeling. Primary outcomes were 90-day mortality and OS. Results: Bowel resection was performed in 58 patients (46%) with more extensive disease and poorer ECOG performance scores. Although the resection group had increased perioperative risks (e.g., higher transfusion rates and ICU use), OS was similar between groups (log-rank p = 0.122). Multivariate analysis identified that increasing age (HR = 1.042, p = 0.005) was independently associated with poorer OS, whereas lymph node dissection (HR = 0.450, p = 0.003) and undergoing primary CS (HR = 0.540, p = 0.047) were associated with improved survival. Bowel resection was not independently associated with OS. Conclusions: Bowel resection does not adversely affect OS when optimal cytoreduction is achieved. Although it increases perioperative complexity, it can be safely incorporated into CS in selected patients. These findings support its use as part of an individualized surgical strategy for advanced ovarian cancer.

Aims: We aimed to determine the quality and readability levels of the texts that health readers access from websites related to HPV. Methods: 64 websites related to "human papilloma virus" were evaluated by using the Google search engine, in terms of readability and website information quality. The websites were divided into 6 groups according to their origins. Ateşman and BezirciYılmaz readability formulas were used for readability, DISCERN measurement tool and JAMA criteria were used for website information quality and reliability. The information quality and reliability of the websites were evaluated by an obstetrician and gynecologist and a gynecological oncology surgeon. Results: When the websites were evaluated according to the Ateşman readability formula, the readability score was found to be 57.2 and they were found to be moderately readable. According to the Bezirci-Yılmaz readability formula, the average readability score of all websites was found to be 12.8, that is, a readability at the undergraduate level was determined. When evaluated with the DISCERN tool, the average quality level of all websites was determined as "poor". It was seen that the texts prepared by the obstetrics and gynecology associations and the obstetricians and gynecologists were of higher quality than the other groups. It was observed that the quality of the texts was lower according to the gynecological oncology surgeon. Conclusion: It is noteworthy that the texts prepared by the obstetrics and gynecology associations received higher quality scores than the other groups. Website information resources prepared by obstetrics and gynecology associations should be increased and the readability and quality of other internet health information needs to be improved.