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    The Effect of Hands-On Cadaver and Live Surgery Practice on Surgeons' Performance in Urogynecologic Operations: One-Year Follow-Up
    (Mary Ann Liebert, Inc, 2020) Akar, Bertan; Aslancan, Reyhan; Dogan, Ozan; Basbug, Alper; Sivaslioglu, Akin; Caliskan, Eray
    Objective: Surgical procedures need a combination of theoretical knowledge and practical experience to be performed properly. Postresidency education programs provide opportunities to practice new surgical techniques. This article evaluates 2 different educational strategies for learning new techniques in the field of urogynecology. One of the strategies is commonly practiced theoretical education plus observation of live surgeries, and the other strategy is a threefold approach of theoretical education, as well as cadaver training and performing live surgery. Materials and Methods: The study was designed as a prospective cohort study. The occupational experiences of 58 obstetricians and gynecologists were documented prior to the educational interventions. Two groups were created, based on the participants' preferences. Group 1 had theoretical education followed by observation of live surgery through broadcasting. Group 2 had theoretical education, plus a 1-day cadaver-based surgery course, as well as assisting tutors in hands-on operations. At a 1-year follow up, different types of surgeries performed throughout the year by each surgeon were recorded and analyzed using SPSS. Results: Prior to the course, both groups had similar experiences in urogynecologic operations (p > 0.05). In Group 2, significantly more surgeons began to perform tension-free vaginal tape (TVT) interventions regularly after the course (p < 0.001), a procedure considered more technically demanding. Surgeons utilizing any of the midurethral slings including TVT, transobturator tape, or mini-slings increased by 20% in Group 2, a statistically significant increase (p = 0.03). Conclusion: A threefold approach of theoretical education, cadaver practice, and live surgery significantly increases surgeon adaptation to utilization of midurethral slings, compared to exclusively theoretical education with observation of live surgery. (J GYNECOL SURG 20XX:000)
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    Previous Antibiotic Use and Its Influence on Antifungal Susceptibility of Candida Strains
    (2019) Aslancan, Reyhan; Kaya, Aşkı Ellibeş; Çalışkan, Eray
    Aim: Antifungal drug resistance of Candida strains is a cause ofrecurrent or persistent vulvovaginal candidiasis (VVC). In order toprevent patient discomfort and to diminish the treatment cost ofthe disease, it is essential to identify the causative strain, determine the drug resistance status, and understand the mechanismof resistance.Material and Method: Vaginal discharge specimens were collected from 300 patients. Sixty-five Candida albicans and thirtyfive non-albicans species were identified. The susceptibility tovoriconazole, fluconazole, and amphotericin-B was examined.Previous antibiotic use and its correlation with the antifungal drugresistance were studied.Results: Fluconazole, voriconazole and amphotericin-B susceptibilities of Candida albicans strains were 92.3%, 86.2%, and 100%respectively. The non-albicans group’s susceptibilities to these antifungals were 45.7%, 22.9%, and 85.7% respectively (p=0.00 for all).After nitroimidazole use, 92.8% of infections were caused by Candidaalbicans, and 7.2% of them non-albicans strains (p=0.01). All the infections occurred after macrolide use was non-albicans infections(100%). There were no detected candida albicans infections (p=0.01).Conclusion: Since resistance to voriconazole, fluconazole, andamphotericin-B was more frequent in the non-albicans group,physicians should suspect from non-albicans strains for treatmentresistant VVC cases. Previous antibiotic use have not increasedthe amphotericin B, fluconazole and voriconazole resistance ofboth candida albicans and non-albicans strains. Recurrent infections which have no response to amphotericin B, fluconazole orvoriconazole treatment may be due to a different mechanism otherthan antifungal resistance of Candida species. The decreasedamount of lactobacilli in vaginal flora might be the reason for recurrent VVC.