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Addition of parity to the risk of malignancy index score in evaluating adnexal masses
(Elsevier Taiwan, 2014) Yavuzcan, Ali; Çağlar, Mete; Özgü, Emre; Üstün, Yusuf; Dilbaz, Serdar; Özdemir, İsmail; Kumru, Selahattin
Objective: The aim of our study was to evaluate the individual contribution of parity when incorporated as another parameter into the four risk of malignancy indices (RMI 1-4) to differentiate noninvasive benign lesions from invasive malignant ovarian lesions. Materials and methods: After calculating RMI 1-4 for each patient included in this study, the resulting RMI scores were further multiplied by the parity score (P) of each patient to calculate the RMI parity (RMIP) score. Results: A cutoff value of 300 for RMIP 1 yielded 95.0% specificity, 97.4% negative predictive value (NPV), 88.5% sensitivity, and 79.3% positive predictive value (PPV) and performed better than RMI 1 in the preoperative diagnosis of invasive malignant lesions. RMIP 2 with a cutoff value of 400 yielded 95.0% specificity, 97.4% NPV, 88.5% sensitivity, and 79.3% PPV, and it also performed better than RMI 2. A cutoff value of 400 for RMIP 3 provided 97.5% specificity, 97.5% NPV, 88.5% sensitivity, and 88.5% PPV and performed better than RMI 3. However, a cutoff value of 400 for RMIP 4 provided 90.0% specificity, 97.3% NPV, 88.5% sensitivity, and 65.7% PPV but did not perform better than RMI 4 in the preoperative diagnosis of invasive malignant lesions. Conclusion: RMIP 1-3 scales were more reliable tools for the preoperative diagnosis of invasive adnexal masses compared with the traditional RMI 1-3 scales. Copyright (C) 2014, Taiwan Association of Obstetrics & Gynecology. Published by Elsevier Taiwan LLC. All rights reserved.
Adneksiyal torsiyon yönetimi
(2014) Erkal, Neslihan; İsenlik, Bekir Sıtkı; Çağlar, Mete; Sahillioğlu, Birsen; Kumru, Selahattin
Amaç: Adneksiyal torsiyon tanısı alan hastaların klinik, uygulanan operasyon ve patoloji bulgularının değerlendirilmesiYöntemler: Ocak 2009 ile Mart 2013 tarihleri arasında kliniğimize başvurup adneksiyal torsiyon tanısı alan 14 hasta retrospektif olan çalışmamıza dahil edildi. Klinik bulgular, operasyon bulguları, patoloji sonuçlarını içeren bilgiler toplandı.Bulgular: 16-56 yaş arası olan hastaların ortalama yaşı 28,110,5 idi. Bütün hastalara ultrasonografi yapıldı ve adneksiyal kitle bütün hastalarda saptandı. Ortalama kitle boyutu 8,042,96 cm idi. Bütün hastalarda alt abdominal ağrı, bulantı ve kusma şikayeti mevcuttu. 6 hastaya laparoskopi, 8 hastaya laparatomi uygulandı. 7 (50,0%) hastaya detorsiyon ve kistektomi yapıldı. Biri ilk trimesterda, diğeri üçüncü trimesterda olan 2 hamile hastaya kistektomi ve detorsiyon uygulandı (biri laparoskopi ile). Bir hastada hidrosalpinkse bağlı izole tubal torsiyon izlendi ve laparoskopik salpenjektomi uygulandı. İki hastada paratubal kist nedeniyle tubal torsiyon izlendi. Birine laparoskopik detorsiyon ve kistektomi, birine laparotomi ile salpenjektomi yapıldı. En sık görülen patoloji seröz kistadenomdu. (28,6 %). Sonuç: Adneksiyal torsiyon daha çok üreme çağında görülen nadir jinekolojik acillerdendir. Hızlı tanı ve konservatif yaklaşım ile over ve tubaları korumak gelecekteki fertiliteyi korumak için önemlidir.
Anormal uterin kanamalı hastalarda endometrium kanseri ve benign endometrial patoloji tanısı alanların hematolojik parametrelerinin karşılaştırılması
(2014) Yavuzcan, Ali; Çağlar, Mete; Erdem, Havva; Oktay, Murat; Üstün, Yusuf; Dilbaz, Serdar; Kumru, Selahattin
Amaç: Çalışmamızın amacı 40 yaş ve üstünde anormal uterin kanama (AUK) şikayeti bulunan hastalarda evre 1 ve evre 2 endometrium kanseri tanısı alanlar ile benign endometrial patoloji tanısı alanların ortalama trombosit hacmi (MPV), nötrofil/lenfosit oranı (NLR) ve trombosit/lenfosit oranı (PLR) değerlerini karşılaştırmaktır. Yöntem: Çalışmamıza Temmuz 2012-Temmuz 2013 tarihleri arasında Düzce Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı’na AUK ön tanısıyla histeroskopi, dilatasyon küretaj yada endometrial biopsi ile endometrial örnekleme yapılan hastalar dahil edilmiştir. Hastalara ait bilgiler retrospektif olarak hasta dosyaları incelenerek elde edilmiştir. Bulgular: Hastaların ortalama yaşı 52.8111.47 yıl olarak bulunmuştur. Hastaların %37.1’si menopozdadır. Yapılan endometrial örneklemelerin sonucunda hastalardan 10 tanesinde (%14.2) endometrioid tip endometrial adenokarsinom, 1 tanesinde (%1.4) seröz papiller karsinom ve 1 tanesinde (%1.4) endometrial stromal sarkom tanısı konulmuştur. Hastaların 58 (%83) tanesinde non invaziv benign endometrial değişiklikler tespit edilmiştir. Endometrium kanseri saptanan ve saptanmayan hastalar arasında MPV,NLR ve PLR değerleri açısından istatistiksel olarak anlamlı farklılık tespit edilmemiştir (p0.148; p0.775 ve p0.942 sırasıyla). Sonuç: MPV, NLR ve PLR değerlerinin ileri evre endometrial malignitelerde yükseldiği ve prognostik bir faktör olarak kullanılabileceği bazı çalışmalarda gösterilmiştir. Ancak bu parametrelerin erken evre endometrium kanseri ve benign endometrial patoloji tespit edilen hastalar arasında gösterdiği değişimlerin net olarak ortaya konabilmesi için geniş kapsamlı yeni çalışmalara gerek duyulmaktadır.
BORDERLINE OVARIAN TUMORS (BOT); SINGLE CENTER EXPERIENCE OF 183 CASES
(Lippincott Williams & Wilkins, 2013) Güngör, Tayfun; Çetinkaya, Nilüfer; Çağlar, Mete; Yalçın, Hakan; Özdal, Bülent; Bayramoğlu, H.; Erkaya, Salim
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Can Reproductive Characteristics Predict Bladder Cancer in Women with Haematuria?
(Asian Pacific Organization Cancer Prevention, 2013) Yavuzcan, Ali; Çağlar, Mete; Kayıkçı, Muhammet Ali; Başaran, Ekrem; Tekin, Ali; Özdemir, Enver; Çam, Haydar Kamil
Background: Among women with haematuria, defining individuals under high risk for bladder cancer based on reproductive factors prior to cystoscopy would be of great benefit in the management of this condition. The aim of this study was to compare age and reproductive factors such as menopausal status, parity, age at first delivery and age at the last delivery between women who have haematuria with or without bladder cancer. Materials and Methods: A total of 463 patients underwent diagnostic cystoscopy in Duzce University Faculty of Medicine between 1 June 2008 and 1 June 2013. Female patients who presented with persistent microscopic or macroscopic haematuria and underwent standard evaluation for haematuria including urinalysis, urine culture, urine cytology, urinary tract imaging with excretory urography or computerized tomography with contrast enhancement and endoscopic evaluation of the urethra and bladder were included in this study. Exclusion criteria were tobacco use and high risk occupations for bladder cancer such as textile, dry cleaning, painting and etc. Forteen women had hematuria due to benign conditions, and 18 due to bladder cancer. Data were retrospectively retrieved from the medical records of Duzce University Hospital. Results: Patients with haematuria due to benign reasons did not significantly differ from patients who were found to have bladder cancer in terms of age (p=0.28), menopausal status (p=0.29), mean parity (p=0.38), being nulliparous (p=0.57), parity >= 3 (p=0.22), age <= 18 years at first delivery (p=1.00), age >= 30 years at last delivery (p=0.26), age >= 35 years at last delivery (p=0.23) and percentage of the patients with advanced age (>= 65 years) (p=0.18). Conclusions: It is difficult to predict a high risk for developing bladder cancer in women with haematuria based solely on reproductive factors.
Clinical symptoms and diagnostic tools that are related to infertility and hydrosalpinx formation in women with advanced stage endometriosis complicated by endometrioma
(Via Medica, 2013) Yavuzcan, Ali; Çağlar, Mete; Dilbaz, Serdar; Üstün, Yusuf; Özdemir, İsmail; Yıldız, Elif; Kumru, Selahattin
Objectives: The study included patients suffering from stage III-IV endometriosis complicated by an endometrioma (DMA). We investigated the association between age, presence of dysmenorrhea/dyspareunia, preoperative CA 125 level, size of DMA on ultrasonographic exam and infertility as well as the risk of intraoperative detection of hydrosalpinx that was not suspected on pre-operative assessment. Materials and Methods: The study included patients with stage III-IV endometriosis complicated by DMA who underwent a laparoscopic or open surgery due to pre-diagnosis of infertility or adnexal mass. Results: Dysmenorrhea had statistically significant association with infertility (p=0.031). There was no statistically significant relation between age, dyspareunia, preoperative CA 125 level, size of DMA on ultrasonographic exam and infertility (p=0.203, p=0.561, p=0.561 and p=0.668, respectively). No statistically significant relation was found between age, CA 125 level, dysmenorrhea, dyspareunia and detection of an unilateral/bilateral hydrosalpinx, that was not suspected on pre-operative assessment (p=0.179, p=0.295, p=0.895, p=0.424, respectively). There was an association between DMA size (p=0.023) and detection of unilateral/bilateral hydrosalpinx. Conclusions: Patients who desire to have children but suffer from severe dysmenorrhea must be preoperatively informed about the possibility of having stage III-IV endometriosis. Infertile patients who are about to undergo an operation, especially due to a large DMA, may turn out to have hydrosalpinx. These patients should be informed preoperatively about the possibility of having salpingectomy or the proximal tubal surgery for improving fertility
Coexistence of uterine smooth muscle tumors of uncertain malignant potential (Stump) and subserosal leiomyoma: A rare cause of postmenopausal bleeding [Malign potansiyeli belirsiz uterus düz kas tümörü (Stump) ve subserozal leiomyoma birlikteliği: postmenopozal kanamanin nadir bir nedeni]
(Gunes Kitap Kirtasiye, 2015) Başbuğ, Alper; Başbuğ, Derya; Çağlar, Mete; Yavuzcan, Ali; Baştan, Merve; Yılmaz, Mehmet; Başar, Feyza
Information about the clinical behaviour and risk factors of Uterine Smooth Muscle Tumors of Uncertain Malignant Potential (STUMPs) is extremely limited. Most of the patients with STUMP are at reproductive age. Postmenopausal bleeding (PMB) can occur about 10% of patients after menopause. An uterine leiomyosarcoma may be the cause of PMB in some cases but STUMPs are not a common cause of PMB. We reported here a 51-year-old woman presenting with PMB having STUMP and multiple bening subserosal leiomyomas. © 2017 Gunes Kitap Kirtasiye. All rights reserved.
CONCOMITANT IPSILATERAL OVARIAN PATHOLOGIES OF BORDERLINE OVARIAN TUMORS (BOT); SINGLE CENTER EXPERIENCE OF 183 CASES SINCE 1999
(Lippincott Williams & Wilkins, 2013) Erkaya, Salim; Çetinkaya, Nilüfer; Uygur, D.; Akbay, S.; Çağlar, Mete; Özdal, Bülent; Güngör, Tayfun
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CONCOMITANT UTERINE PATHOLOGIES OF BORDERLINE OVARIAN TUMORS (BOT); SINGLE CENTER EXPERIENCE OF 183 CASES
(Lippincott Williams & Wilkins, 2013) Güngör, Tayfun; Çetinkaya, Nilüfer; Özdal, Bülent; Tuğ, M.; Çağlar, Mete; Erkaya, Salim
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Decorin: a possible marker for fetal growth restriction
(Taylor & Francis Ltd, 2014) Çağlar, Mete; Yavuzcan, Ali; Göksu, Mehmet; Bülbül, Gül Alkan; İsenlik, Bekir Sıtkı; Üstün, Yusuf; Kumru, Selahattin
The aim of this study was to compare decorin (DCN) levels between pregnancies complicated by idiopathic fetal growth restriction (FGR) and uncomplicated pregnancies and to determine the relationship between DCN levels and clinical parameters. The study population consisted of two groups: control group consisted of 13 women with uncomplicated singleton pregnancies in the third trimester. Study group consisted of 14 singleton pregnancies complicated by idiopathic FGR who were admitted to the hospital for delivery in the third trimester of pregnancy. Maternal and fetal DCN levels were measured. Color Doppler flow assessments were performed. Relationship between DCN levels and clinical parameters was determined. Maternal DCN serum levels were significantly higher in complicated pregnancies by idiopathic FGR (p = 0.01). A statistically significant negative correlation was observed between maternal DCN serum levels and neonatal birth weight (r = -0.0506; p = 0.007). There was a significant correlation between umbilical artery (UA) DCN levels and UA S/D ratio (r = 0.512; p = 0.006) and UA RI (r = 0.405; p = 0.036). The risk of high DCN maternal serum levels (>7986.6 pg/mL) in pregnancy complicated by FGR was 8.25 times higher (RR = 8.25; 95% CI, 1.4-46.8). The results of our study showed that the presence of increased DCN levels in women with FGR could contribute to pathogenesis of the disease.
Determination Of The Age Of Onset To The Osteoporosis Screening Program And Frequency Of Osteoporosis: Duzce University Training And Research Hospital Sampling
(Duzce Univ, 2017) Mehmet, Yılmaz; Başbuğ, Alper; Kaya, Aşkı Ellibeş; Çağlar, Mete; Özkara, Atilla; Sungur, Mehmet Ali; Ataoğlu, Safinaz
Aim: In our study, we aimed to determine the age of onset to the osteoporosis screening program and frequency of osteoporosis in the who admitted Duzce University Training and Research Hospital Material and Methods: Between the dates 01.01.2015 and 31.12.2015, 400 women between the ages of 40 and 70, who applied to Duzce University Training and Research Hospital, Departments of Physical Therapy and Rehabilitation, Gynecology and Obstetrics, and Orthopedics, and had got their femoral neck and L1-L4 anterior vertebra BMD (Bone Mineral Density) measured with DXA method, were included in our research. With the FRAX trial questionnaire have conducted to determine major osteoporotic fracture risk, patient data were recorded via asking questions to patients. Statistics: In the statistical analysis, Independent Samples T-test was evaluated for group comparison of continuous variables, Pearson's chi-square test was used for the analysis of relations between categorical variables, and Pearson's correlation analysis was used to review the relations between continuous variables. Results: In our study, we determined the mean age of osteoporosis group as 60.6 while the frequency was demonstrated as 11.8%. Conclusion: For our region, we determined the age of onset for osteoporosis screening as 60 for women without a major osteoporotic fracture risk factor.
Does Suture Material Affect Uterine Scar Healing After Cesarean Section? Results from a Randomized Controlled Trial
(Taylor & Francis Inc, 2019) Başbuğ, Alper; Doğan, Ozan; Kaya, Aşkı Ellibeş; Pulatoğlu, Çiğdem; Çağlar, Mete
Background: Impaired healing of the uterine scar after cesarean has been associated with adverse gynecological and obstetric outcomes. Although a large number of studies have been conducted on the events leading to this, information obtained from prospective randomized studies examining the role of suture material in the formation of cesarean scar defect (CSD) is lacking. Objective: To evaluate the effects of synthetic suture materials on CSD formation. Study design: We performed a two-arm 1:1 randomized study in women with singleton pregnancies undergoing elective primary cesarean delivery after the 38th week of gestation. Uterine scar closure was performed using synthetic absorbable monofilament and multifilament sutures. The primary outcome was residual myometrial thickness (RMT) in the area of the scar, measured by transvaginal ultrasound 6-9 months after birth. Secondary outcomes included differences in mean operative time, mean estimated blood loss at the time of surgery, and the rates of postoperative gynecological sequelae. Results: Complete follow-up was obtained from 94 (88%) of 107 participants. RMT was thicker in the monofilament compared to the multifilament suture group (5.5 +/- 2.24 vs. 4.18 +/- 1.76, p = 0.01). Hemoglobin delta was higher in the monofilament suture group (1.59 +/- 0.96 vs. 1.25 +/- 0.60, p = 0.04). There was no statistically significant difference between the monofilament suture and multifilament suture groups in terms of gynecological sequelae. Conclusion: Closure of the uterine scar with monofilament suture has a positive effect on scar healing and increases RMT thickness.
Dört Farklı Malignite Risk İndeksinin (RMI 1-4) Endometrioma ve Matür Kistik Teratom AyırıcıTanısında Etkinliklerinin Değerlendirilmesi
(2013) Yavuzcan, Ali; Çağlar, Mete; Üstün, Yusuf; Dilbaz, Serdar; Özdemir, İsmail; Özbilgeç, Sıtkı; Kumru, Selahattin
Amaç: Adneksiyel kitlelerde bening-malign ayrımı için kullanılan Ca125 ve malignite risk indekslerinin (RMI 1, RMI 2, RMI 3 ve RMI 4) endometrioma (OMA) ve matür kistik teratomun preoperatif tanısındaki etkinliğini incelemektir. Gereç ve Yöntemler: Çalışmamıza adneksiyel kitle ön tanısı bulunan 83 hasta dâhil edilmiştir. Bulgular: Ca125 düzeyi, RMI 1, RMI 2, RMI 3 ve RMI 4 değerleri OMA'nın preoperatif tespitinde istatistiksel olarak anlamlı düzeyde öngörü gücüne sahiptir (p0.001; p0.002; p0.002; p0.001 ve p0.019 sırasıyla). Ca125 düzeyi ve tüm RMI 1-4 değerleri için % 95 güvenlik aralığında (% 95 CI) eğri altındaki kalan alan (AUC) anlamlı bulunmuştur. İstatistiksel olarak anlamlı olacak şekilde RMI 1 için cut off değeri 46 olarak hesaplanmıştır. RMI 1, OMA ayırıcı tanısında % 78.6 duyarlılık; % 76.8 özgüllük; % 40.7 pozitif kestirim gücü (PPV) ve % 94.6 negatif kestirim gücü (NPV) ile en başarılı indeks olarak saptanmıştır. OMA ayırıcı tanısında Ca125 için 18,5 iu/ml cut off değerinde; % 78.6 duyarlılık; % 71.0 özgüllük; % 35,5 PPV; % 94.2 NPV tespit edilmiştir. Ca125, RMI 1, RMI 2, RMI 3 ve RMI 4 değerlerinin matür kistik teratomun ayırıcı tanısında ve pozitif/negatif ayrımı yapmada istatistiksel olarak anlamlı etkisi saptanmamıştır (p0.386; p0.708; p0.626; p0.786 ve p0.203 sırasıyla). Sonuç: Çalışmamıza göre RMI 1 ve 3 ölçekleri OMA'nın preoperatif klinik tanısında Ca125'e göre daha etkin bulunsa da rutin tanı ve takipte güvenle kullanılabilmesi için daha kapsamlı çalışmalar gerekmektedir. Subjektif ve tecrübe bağımlı bir yöntem olmasına rağmen, USG'de patern tanıma metodu matür kisitk teratom ve OMA'nın preoperatif tanısında halen en etkin seçenek olarak gözükmektedir
Düzce İlinde Nöral Tüp Defekti Saptanan Olguların Değerlendirilmesi
(2013) Yavuzcan, Ali; Topuz, Seren; Çağlar, Mete; Dilbaz, Serdar; Üstün, Yusuf; Kumru, Selahattin
Amaç: Nöral tüp defektleri (NTD) embriyoda nöral tüpün kapanmasındaki hatalar sonucu oluşmaktadır. Tüm dünyada NTD'lerin bütün formlarının insidansı 1000 canlı doğumda 1,4-2 arasındadır. Çalışmamızda NTD etiyolojisinde etkili olan faktörlerin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Mayıs 2010 ila Mayıs 2013 tarihleri arasında Düzce Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı'nda yaşamla bağdaşmayan NTD bulunması nedeniyle terminasyon yapılan hastalar ve Düzce Üniversitesi Tıp Fakültesi Çocuk Hastalıkları Anabilim Dalı'nda NTD tanısıyla tedavi verilen hastalar bu çalışmaya dâhil edilmiştir. Kontrol grubu olarak Düzce İlinde sağlıklı tek canlı bebek doğumu gerçekleşen hastalar alınmıştır. Çalışma grubunda 30 ve kontrol grubu da 30 hasta olarak belirlenmiştir. Her iki grup arasında yaş, prekonsepsiyonel/konsepsiyonel dönemdeki folik asit replasmanı, önceki gebelikte NTD öyküsü, meslek, eş mesleği,maternal eğitim düzeyi, kronik hastalık öyküsü, sigara/alkol kullanımı, prekonsepsiyonel dönem ile gestasyonel vücut kitle indeksi (VKİ) değerleri arasındaki fark karşılaştırılmıştır. Bulgular: NTD riskine karşı gebelikte verilen folik asit desteği önemli bir koruyucu etken olarak saptanmıştır (p0.018). Annenin eğitim düzeyinin artması ve babanın mesleği de NTD riskinde etkili olan diğer faktörlerdir (p0.012 ve p0.017). Sonuç: Ülkemizde NTD riskini etkileyen faktörlerin daha net ortaya konabilmesi için geniş kapsamlı ve randomize olarak yapılmış yeni çalışmalara gerek duyulmaktadır
The effect of adenomyosis on the outcomes of laparoscopic hysterectomy
(Aves, 2016) Yavuzcan, Ali; Başbuğ, Alper; Bastan, Merve; Çağlar, Mete; Özdemir, İsmail
Objective: The presence of adenomyosis (ADS) may increase complication rates associated with laparoscopic hysterectomy (LH) due to an increased weight of the uterus, increased vascularization of the uterus, impaired myometrial tissue, and presence of additional gynecological pathologies such as leiomyoma or endometriosis. The aim of the present study was to evaluate perioperative and early postoperative parameters in patients with or without adenomyotic lesions. Material and Methods: The study included patients who underwent LH in a university hospital. Patient data were retrieved from the hospital records and reviewed retrospectively. Sixty-one patients (85.9%) without adenomyotic lesions comprised the control group. Ten patients with adenomyotic lesions (14.1%) were regarded as the study group. Results: In this study, the mean age of the patients was 50.93+/-9.39 years. The mean uterus size was significantly higher in patients with ADS (p=0.02). There was no statistically significant difference in perioperative variables such as delta hemoglobin (Hb), insertion of pelvic drainage catheter, and invasive assessment of the urinary tract between both the groups (p=0.27, p=1.0, and p=0.67, respectively). The difference between the groups in terms of postoperative blood transfusion was not statistically significant (p=0.25). There was no statistically significant difference in the postoperative maximum body temperature, length of hospital stay, and duration of urinary catheterization between both the groups (p=0.77, p=0.36, and p=0.75, respectively). Conclusion: LH appears to be a safe alternative for patients with ADS. Large-scale, prospective, and randomized trials are required in order to suggest the routine use of LH in patients preoperatively diagnosed with ADS.
Effect of reproductive characteristics, body mass index, and anterior/posterior vaginal compartment defects on the short-term success of abdominal sacrocolpopexy
(Taylor & Francis Inc, 2015) Çağlar, Mete; Erkal, Neslihan Boz; İsenlik, Bekir Sıtkı; Özdemir, Özgür; Yavuzcan, Ali; Üstün, Yusuf; Kumru, Selahattin
Objective. Vaginal vault prolapse is caused by the loss of apical support in the cardinal-uterosacral ligament complex. Abdominal sacrocolpopexy (ASCP) is one means of repairing vaginal vault prolapse. In the present study, we investigated the effects of reproductive factors, body mass index (BMI), and anterior or posterior vaginal compartment defects on short-term outcomes of ASCP. Method. We retrospectively studied 70 women who had undergone ASCP between February 2012 and November 2012 in our clinic. Result. There were no significant differences in the complication rate among menopausal, nonmenopausal women, and grand multiparous patients. Operational success was not significantly affected by menopausal status. The long-term rate of grade >= 2 prolapse in the apical, anterior, or posterior vaginal wall after ASCP did not differ significantly by menopausal status. Correlation analysis showed that BMI was not associated with operational success in the early postoperative period in patients with vaginal prolapse and was not associated with the detection of grade >= 2 prolapse in apical, anterior, and posterior compartments after 1 year. Conclusion. ASCP should be the first-line treatment for obese/overweight, menopausal, or grand multiparous patients with additional anterior or posterior vaginal vault prolapse.
The effects of sildenafil and tadalafil on ischemia-reperfusion injury in rat ovarian torsion model
(I R O G Canada, Inc, 2017) Toğrul, Cihan; Doğan, Ayşe Çitil; Başer, Eralp; Doğan, Murat; Albayrak, Aynur; Çağlar, Mete; Delibaşı, Tuncay
Objective: In cases of ovarian torsion (OT), reperfusion injury may further damage ovarian tissue. Tadalafil and sildenafil are phosphodiesterase-5 (PDE-5) inhibitors that are primarily used for treatment of erectile dysfunction and pulmonary hypertension. In this study, the authors investigated the effects of these agents in preventing ovarian ischemia-reperfusion injury in a rat OT model. Materials and Methods: A total of 48 young adult female Wistar Albino rats were randomized into six groups (n=8 in each group); group 1: control sham operated, group 2: sildenafil one mg/kg, group 3: tadalafil one mg/kg, group 4: sildenafil one mg/kg + ischemia/reperfusion, (I/R) two hours of ischemia and two hours of reperfusion and a single dose of oral one mg/kg sildenafil one hour before I/R, group 5: I/R, and group 6: tadalafil one mg/kg + YR two hours of ischemia and two hours of reperfusion and a single dose of oral one mg/kg tadalafil one hour before I/R. Histopathologic evaluation was performed and scored according to the degree of congestion, edema, and hemorrhage. Total histological score (THS), tissue protein carbonyl (PC), malondialdehyde (MDA) levels, and catalase (CAT) activity were also calculated. Results: Group 4, group 5, and group 6 had similar congestion, edema and THS (p > 0.05). Group 6 had significantly lower hemorrhage score, when compared with group 5 (p = 0.03). Mean PC, MDA levels, and CAT were similar between groups 4, 5, and 6 (p > 0.05). Conclusions: Tadalafil was associated with a decreased tissue hemorrhage score in I/R injury in rat ovarian torsion model.
Endometrial Curettage in Abnormal Uterine Bleeding and Efficacy of Progestins for Control in Cases of Hyperplasia
(Asian Pacific Organization Cancer Prevention, 2014) Haftaci, Simender Mesci; Ankaralı, Handan; Yavuzcan, Ali; Çağlar, Mete
Background: Abnormal uterine bleeding (AUB) is the most important symptom of endometrial hyperplasia and endometrial curettage (EC) is the gold standard diagnostic procedure. We present the results of patients who underwent EC for AUB and the efficacy of progestin administration in those with endometrial hyperplasia. Materials and Methods: A total of 415 female patients who presented to Duzce Public Hospital in 2011-2012 for AUB and who underwent EC were included. We determined the reasons for AUB, and females with hyperplasia were treated with 10 mg/day medroxyprogesterone acetate for 14 days/month or 160 mg/day megestrol acetate continuously for 3 months. We evaluated the efficacy of progestins for periods of three and/or six cycles by repeating EC. A statistical analysis of specific endometrial causes according to age of presentation was conducted using the chi-square test. Results: Among the 415 females (average age, 53.5 years) followed for 6 months, 186 had physiological changes (44.8%), 89 had simple hyperplasia (21.44%), 1 had atypical hyperplasia (0.2%), 6 had (1.44%) complex hyperplasia, 3 had (0.72%) atypical complex hyperplasia, and 5 had adenocarcinoma (1.2%). Regression rates were 72.7-100%, and the optimum results were observed after 6 months of hormonal therapy. Conclusions: The main cause of AUB was physiological change. Progestin therapy resulted in significant regression even in females with atypical hyperplasia.
Evaluation of mean platelet volume, neutrophil/ lymphocyte ratio and platelet/lymphocyte ratio in advanced stage endometriosis with endometrioma
(2013) Yavuzcan, Ali; Çağlar, Mete; Üstün, Yusuf; Dilbaz, Serdar; Özdemir, İsmail; Yıldız, Elif; Kumru, Selahattin
Objective: We compared the preoperative values of mean platelet volume (MPV) and peripheral systemic inflammatory response (SIR) markers (neutrophil/lymphocyte ratio and platelet/lymphocyte ratio) between patients with advanced-stage (stage 3/4) endometriosis having endometrioma (OMA) and patients with a non-neoplastic adnexal mass other than endometrioma (non-OMA). Material and Methods: Patients who underwent operations with the pre-diagnosis of infertility or adnexal mass and who underwent laparoscopic tubal ligation were included. Results: Haemoglobin levels, leucocyte count, platelet count, neutrophil count and lymphocyte count were not significantly different between patients with advanced stage endometriosis having OMA, patients with non-OMA and patients in the control group (p=0.970, p=0.902, p=0.373, p=0.501 and p=0.463, respectively). Patients with stage 3/4 endometriosis having OMA, patients with non-OMA and control patients were also not significantly different in terms of MPV (p=0.836), neutrophil/lymphocyte ratio (NLR) (p=0.555) and platelet/ lymphocyte ratio (PLR) (p=0.358). Preoperative cancer antigen 125 (Ca-125) levels were significantly higher in patients with OMA (p=0.006). Mean size of the OMAs was significantly lower than non- OMAs (p=0.000). Conclusion: It is very important to determine advanced stage endometriosis and OMAs during preoperative evaluation in order to inform patients and plan an appropriate surgical approach. We demonstrate that MPV, NLR and PLR values are not useful for this purpose in patients with advanced stage endometriosis that are proven to develop severe inflammation at either the cellular or molecular level. © 2013 by the Turkish-German Gynecological Education and Research Foundation.
Evaluation of sleep in women with menopause: results of the Pittsburg Sleep Quality Index and polysomnography
(Galenos Yayincilik, 2015) Ağan, Kağan; Özmerdivenli, Recep; Değirmenci, Yıldız; Çağlar, Mete; Başbuğ, Alper; Balbay, Ege Güleç; Sungur, Mehmet Ali
Objective: To investigate subjective sleep quality among women in the menopausal period and to confirm and diagnose the possible sleep disturbances with polysomnographic (PSG) evaluation objectively. Material and Methods: Sixty-seven women with menopause were enrolled in the study. Sociodemographic characteristics and the features of menopause were recorded. We assessed subjective sleep quality with Pittsburg Sleep Quality Index (PSQI). To confirm sleep disturbances and further diagnose the underlying cause, PSG evaluation was performed to women with PSQI scores of >5 who gave their approval. Results: Mean PSQI score of women with normal PSG evaluation was 12.00 +/- 3.16, while it was 11.00 +/- 2.32 in women with abnormal PSG evaluation (p=0.466); 59.7% (n=40) of women had poor sleep quality. Among these, 11 (64.7%) had abnormal results in the PSG evaluation and were diagnosed with obstructive sleep apnea syndrome (OSAS); 54.5% had mild OSAS, 27.3% had moderate, and 18.2% had severe OSAS. Conclusion: PSQI and PSG evaluations would give a chance to demonstrate sleep problems and shed a light on treatment options according to the underlying causes of sleep disturbances in menopause.

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