Development of metabolic syndrome after bilateral total thyroidectomy despite the L-t4 replacement therapy: A prospective study.

OBJECTIVES: The literature about the frequency of metabolic syndrome in patients with multinodular goitre and a new onset of metabolic syndrome after total thyroidectomy is limited. The aim of this study was to investigate the effects of total thyroidectomy and thyroid hormones on a new onset of metabolic syndrome in patients who underwent total thyroidectomy and have received thyroid hormone replacement. MATERIAL AND METHODS: Fifty-nine patients who underwent total thyroidectomy for multinodular goitre were included in this prospective study. Patients' height, weight, and waist circumference were measured, and the body mass index was calculated. Peripheral blood samples were obtained preoperatively and at the 12th and 24th month after total thyroidectomy to examine the lipid profile, glucose homeostasis, and thyroid function tests. RESULTS: The lipid profile and blood pressure parameters deteriorated, and the mean body mass index and waist circumference with the metabolic syndrome rates significantly increased at the 12th and 24th months follow-up. Preoperative body mass index (Exp[B] 1.60; p=0.003) was independently associated with metabolic syndrome at the 2nd year after total thyroidectomyin a multivariate regression analysis. CONCLUSION: The frequency and severity of MetS is high in adult patients with non-toxic multinodular goitre after total thyroidectomy. The frequency of metabolic syndrome increased in patients with a high body mass index after total thyroidectomy.

A rare cause of inguinal hernia: scrotal cystocele.

Herniation of the urinary bladder into the inguinal canal is rare. It constitutes 1-3% of all inguinal hernias. Bladder herniation is usually asymptomatic, and it is usually diagnosed during surgery or as a result of intra-operative bladder injury. Male patients with lower urinary tract symptoms or with a history of previous hernia surgery are at increased risk of bladder herniation. Typically, patients complain of inguinal or scrotal swelling, dysuria and shrinkage of scrotal swelling after voiding. Early diagnosis with radiological imaging is important to prevent complications during surgery. Intravenous pyelography, retrograde cystography, pelvic ultrasound, computed tomography and magnetic resonance imaging can be used for preoperative diagnosis. In this report, a patient is presented who presented to our clinic with scrotal swelling and was diagnosed with scrotal bladder herniation by retrograde cystography, taken due to clinical suspicion based on his history.