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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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    McDonald versus modified Shirodkar rescue cerclage in women with prolapsed fetal membranes
    (Taylor & Francis Ltd, 2020) Basbug, Alper; Bayrak, Mehmet; Dogan, Ozan; Kaya, Aski Ellibes; Goynumer, Gokhan
    Purpose: We compared the efficacy of modified Shirodkar and McDonald rescue cerclage techniques in women with singleton pregnancies. Methods: The study sample included 47 women who presented at two tertiary hospitals in Turkey from 2008 to 2017 and underwent rescue cerclage due to cervical incompetence and cervical dilatation with fetal membranes prolapsed into the vagina. The outcomes were compared by cerclage technique used, Shirodkar or McDonald. Results: The McDonald cerclage was applied in 27 cases, and modified Shirodkar cerclage in 20 cases. A longer cerclage-to-birth interval (83.8 +/- 37.6 vs. 63.7 +/- 38.9 days) and later gestational age at delivery (33 vs. 31 weeks) were observed with the Shirodkar cerclage, although these differences were not statistically significant (p = .08 and .63, respectively). Both groups had similar delivery rates after 28, 32, and 37 weeks (p = .20, .15, and .25, respectively), whereas the modified Shirodkar technique resulted in a higher rate of live births although these differences were not statistically significant (85% vs. 63%, p = .09). Conclusion: The effects of the McDonald and modified Shirodkar cerclage procedures on prolonging pregnancy and improving the live birth rate were similar. Therefore, either technique can be applied to prevent neonatal loss due to advanced prematurity.
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    A randomized comparison of a single-incision needleless (Contasure-needleless®) mini-sling versus a mid-urethral sling (Contasure-KIM®): 60-month follow-up results
    (Elsevier, 2025) Dogan, Ozan; Kadirogullari, Pinar; Comert, Erhan Huseyin; Basbug, Alper; Yassa, Murat
    Objectives: Mid-urethral sling (MUS) insertion is the gold standard approach to treat stress urinary incontinence (SUI) and adaptable single-incision mini-slings (SIMSs) aim to reduce complications. A previous study of our team has found that SIMSs were comparable to transobturator slings in cure rates after 24 months of follow-up. This study aims to compare the rates of cure, complications and re-intervention of both slings over a long-term follow-up of 5 years. Study Design: In this prospective trial, 179 women with SUI were randomly assigned to groups. A single surgeon performed all surgeries, and a blinded surgeon conducted 60-month follow-up exams. Objective and subjective cure was defined as a negative cough-stress test, and the absence of SUI based on ICIQ-SF, particularly. Failure was defined as the need for reoperation. Results: The 5-year subjective cure rates were comparable between TOT (75.0 %) and SIMS (65.8 %) groups (p = 0.281). Both groups exhibited decreased subjective cure rates from 24 to 60 months (p = 0.044 for TOT, p = 0.001 for SIMS). Mesh complication rates over 24 months were similar in TOT (7.9 %) and SIMS (6.8 %) groups (p = 0.528). Objective cure rates at 60 months were similar for both TOT (78.9 %) and SIMS (69.9 %) groups (p = 0.139). Reintervention for SUI was not significantly different between TOT (6.6 %) and SIMS (12.3 %) at 60 months (p = 0.098). Conclusion: Single-incision needleless mini-slings showed similar cure rates to trans-obturator mid-urethral slings in 60-month follow-up. However, the objective cure rates decreased significantly from 24 to 60 months in the SIMS group (89.9 % to 69.9 %) compared to the TOT group (85.4 % to 78.9 %) (p = 0.002).
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    A randomized prospective comparison of the needleless mini-sling hammock and U-shape configurations for management of stress urinary incontinence: 60-month follow-up results
    (Springer Heidelberg, 2024) Dogan, Ozan; Basbug, Alper; Eren, Ecem; Yassa, Murat
    ObjectiveTo compare needleless mini-slings placed in a retropubic (U-shape) or trans-obturator (hammock-shape) configuration for treating stress urinary incontinence at 60th month.MethodsAll surgeries, conducted by a senior surgeon, involved objective and subjective assessments preoperatively and at 6, 12, 18, and 60 months postoperatively using cough-stress tests, ICIQ-SF, PGI-I, and a Likert scale.ResultsAfter 60 months, no significant differences were found in cure rates, mesh complications, or reinterventions between U-shaped and hammock-shaped groups. However, a significant decrease in cure rates was observed at 18 and 60 months in both groups. Notable differences in ICIQ-SF, Likert scale, and PGI-I scores were seen in the hammock-shaped group, while the U-shaped group showed differences in ICIQ-SF and PGI-I scores, but not in the Likert scale.ConclusionGiven the lack of significant differences, asserting the superiority of either retropubic (U-shape) or transobturatorly (hammock-shape) needleless mini-slings for treating stress urinary incontinence is challenging.