Yazar "Pulatoğlu, Çiğdem" seçeneğine göre listele
Listeleniyor 1 - 12 / 12
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Discriminating Performance of Early Uterine and Cervical Artery Pulsatility and Resistivity In Pre-Invasive Cervical Lesions(Yerkure Tanitim Yayincilik Hizmetleri As, 2018) Doğan, Ozan; Pulatoğlu, Çiğdem; Başbuğ, Alper; Kaya, Aşkı Ellibeş; Yassa, MuratObjectives: The aim of the present study was to investigate the diagnostic effectiveness of uterine and cervical vascularity alone or in combination with human papillomavirus (HPV) DNA testing and with cytology. Methods: Data were prospectively collected from 129 patients in an outpatient clinic of a secondary setting. Routine liquid-based cervical cytology and HPV-DNA testing were obtained. An abnormal result of any of these high-risk types was viewed as positive. Pulsatility (PI) and resistance (RI) indices of uterine (UA) and cervical (CA) arteries were assessed by Doppler sonography. Pathological diagnosis was considered as the gold standard for assessment. Diagnostic efficiency of alone and joint screening of the three indices for discriminating cervical intraepithelial neoplasia (CIN-I) or above from below was assessed. Results: UA-RI and CA-RI were significantly lower in the HPV (+) group than in the controls (p=0.02 and p=0.03, respectively). In subsequent sub-analysis among patients with positive HPV-DNA, UA-PI was significantly higher in the HPV-16 (+) group than in the HPV-18 (+) group (p=0.04). High-risk HPV (Hr-HPV) testing had the highest sensitivity compared with Doppler and cytology (76.5%, 64.7%, and 58.5%, respectively). Combining CA-RI with cytology or Hr-HPV significantly reduced the sensitivity (23.5% and 29.4, respectively) but improved the specificity from 54.4% to 69.8% and 40.9% to 70.7%, respectively. Combining UA-PI with Hr-HPV slightly increased the positive predictivity when compared with testing Hr-HPV alone (36.1% vs. 33.3%). Conclusion: The potential of the Doppler indices of UA and CA was doubtful in discriminating CIN-I or above lesions in the early period. In addition, RI of UA and CA differed with regard to the presence of HPV infection, whereas CA-RI differed in high-risk HPV cases.Öğe 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, MeteBackground: 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.Öğe The Female Genital Self-Image Scale (FGSIS): cross-cultural adaptation and validation of psychometric properties within a Turkish population(Springer London Ltd, 2019) Kaya, Aşkı Ellibeş; Yassa, Murat; Doğan, Ozan; Başbuğ, Alper; Pulatoğlu, Çiğdem; Çalışkan, ErayIntroduction and hypothesisWomen's perceived satisfaction from their own genital appearance is linked to genital image and sexual esteem. A comprehensive and easy to use scale to measure self-image was scarce in the literature. It was aimed in the present study to complement cross-culturally adapted and validated into Turkish version of the Female Genital Self-Image Scale (FGSIS) and to assess its psychometric properties.MethodsAfter cross-cultural adaptation, the Turkish version of the FGSI, Female Sexual Distress Scale-Revised (FSDS-R), and Female Sexual Function Index (FSFI) were administered to 461 female participants. Content/face validity, exploratory, and confirmatory factor analysis, internal consistency, and reliability were appropriately assessed. Predefined and specific hypotheses were formulated for construct validity.ResultsOur findings indicated excellent content/face validity, sufficient internal consistency (Cronbach's alpha 0.818), and test-retest reliability [intraclass correlation coefficient (ICC) 0.951]. Construct validity was demonstrated by proving the hypothesis that participants who have performed at least one vaginal/clitoral masturbation for the last month reported significantly higher FGSIS scores compared with those who abstained (Z -6.37, p<0.001). Factor analyses formed one factor structure. In the proposed two-factor construct, all seven items demonstrated good to high correlations with their subdomains and lower correlations with the other domain, indicating sufficient convergent validity.ConclusionsThe FGSIS was successfully validated for use in the Turkish population. The scale exhibited strong psychometric properties to assess perceived female genital image. It might be reliably used in genital cosmetic surgeries and in a variety of gynecologic conditions.Öğe Maternal and neonatal outcomes related to iron deficiency anemia and serum ferritin status: A multicenter prospective study from Eastern Marmara, Turkey(Tekirdağ Namık Kemal Üniversitesi, 2019) Pulatoğlu, Çiğdem; Başbuğ, Derya; Akar, Bertan; Şimşek, Hayal; Çakır, Pınar; Başbuğ, Alper; Çalışkan, ErayBackground: Iron deficiency is the most common nutritional deficit in the world. More than 50% of anemia in pregnancy results from iron deficiency and it is suggested that it may be associated with negative pregnancy outcomes. Aim: The aim of this study was to evaluate the incidence of irony deficiency anemia in pregnancy in the East Marmara region of Turkey in order to determine its prevalence in the country along with the effects and associations of iron supplementation or iron status on maternal and neonatal outcomes. Study Design: The study was designed as a prospective, longitudinal qualitative study. Method: This study was conducted in six centers in three provinces of the East Marmara region(Turkey) and included a total of 1102 pregnant women. Blood samples were collected for hematological status and serum ferritin levels during pregnancy, and the adverse maternal and perinatal outcomes were determined. Results: The rate of anemia among the women included in the study was 19.8%, with 44% of them receiving iron supplementation. The maternal age was lower in the anemic group(26.5 vs. 27.7, p = 0.01). Selective iron use was more frequent in the anemic group, while routine iron use was more frequent in the non-anemic group(47.1% vs. 29.3%; p = 0.01). Conclusions: Iron deficiency anemia is a frequent problem in pregnancy. However, many anemic pregnant women do not receive iron therapy. Iron supplementation may have positive effects on some maternal and perinatal outcomes. In order to combat iron deficiency anemia in pregnancy, widespread use of iron supplements should be established.Öğe Mikro Besin Takviyesinin Maternal–Fetal Sonuçlara Etkisi: D vitamini, Kalsiyum ve Magnezyum(2018) Doğan, Ozan; Kaya, Aşkı Ellibeş; Pulatoğlu, Çiğdem; Akar, Bertan; Başbuğ, Alper; Çalışkan, ErayAmaç: Fetal ve maternal sağlığa olumlu etkileri olması nedeniyle gebelik döneminde artan ihtiyaçla orantılı olarak vitamin ve mineral desteğine ihtiyaç vardır. Bu çalışmada mikro besin takviyesi olarak D vitamini, Kalsiyum (Ca) ve Magnezyum (Mg) desteği alan gebelerin postnatal sonuçlarını ve gebelik komplikasyonlarını araştırmak amaçlandı.Gereçler ve Yöntem: Yapılan bu prospektif, longitudinal ve kalitatif çalışmaya Ocak 2016 ve Ocak 2018 tarihleri arasında 18-40 yaş arası toplam 2114 hasta dahil edilmiştir.Bulgular: Maternal yaş aralığı tüm hasta grupları için 28.11 6.12‘ dir. Multivitamin kullanan grubun yaş ortalaması D vitamini grubuna göre daha düşük saptandı(p 0.001). Yalnızca Mg ve D vitamini kullanan grupta yüksek lisans seviyesinde eğitim görenler daha fazlaydı(p0.001). Mg, Ca, D vitamini ve multivitamin kullananımı ile gebelik komplikasyonları arasında anlamlı ilişki bulunamadı. Multivitamin kullanan gebelerde LGA daha fazla görüldü(p0.038). İlk gebelik yaşı Ca ve mulivitamin kullanan grupta Mg ve D vitamini kullanan gruba göre daha düşük bulunmuştur(p0.001).Sonuç: Annenin sağlıklı bir gebelik geçirmesi, maternal komplikasyonlardan korunması, fetusun büyüme ve gelişmesi için annenin düzenli beslenmesinin yanı sıra vitamin ve mineral takviyesi önemlidir. Bu takviyelerin literatürde gösterilmiş olan yararlarını desteklemek ve rutin kullanımda yer vermek için daha çok prospektif çalışmaya ihtiyaç vardır.Öğe Predictive factors of methotrexate treatment success in ectopic pregnancy: A single-center tertiary study(Kare Publ, 2018) Pulatoğlu, Çiğdem; Doğan, Ozan; Başbuğ, Alper; Kaya, Aşkı Ellibeş; Yıldız, Ahmet; Temizkan, OsmanOBJECTIVE: It is controversial whether medical or surgical treatment options have more successful results in ectopic pregnancy treatment. Although high pretreatment serum hCG levels have been known to be the most important predictor, the appropriate treatment modality for a specific range of hCG level remains unclear. Furthermore, the variables that make a patient a bad candidate for single-dose methotrexate treatment is unclear. The aim of this study was to identify predictive factors associated with the success of single-dose methotrexate treatment in women with ectopic pregnancy. METHODS: In this retrospective study, 101 women with tubal ectopic pregnancies who had been treated with single-dose methotrexate were selected. The gestational ages, pretreatment hCG values, ectopic mass size, and fluid presence in the abdomen were compared between the groups. RESULTS: The mean age of the patients was 30.6 +/- 5.8 (range, 19-42) years, and the gestational age at first injection was 7.0 +/- 2.13 (range, 2.3-13.6) weeks. The overall treatment success rate was 77.2% (n=79). The mean duration of hospital stay was 4.21 +/- 1.89 days in the successfully treated group and 6.92 +/- 2.13 days in the failure group (p<0.05). The rate of treatment failure in patients with abdominal fluid was 37.8%, and it was 12.7% in the non-fluid group (p=0.03). hCG values on days 1, 4, and 7 were significantly higher in the unsuccessful group (3887-2589 mIU/mL, 2814-1287 mIU/mL, and 1119-285 mIU/mL, respectively; p<0.05). The cutoff hCG value, which determined the failure of methotrexate treatment, was found to be 1362 mIU/mL. CONCLUSION: In present study, patients with hCG value <1362 mIU/mL were found to be good candidates for methotrexate treatment. Although not strictly decisional, this hCG threshold level can be used to decide on the likelihood of methotrexate success or failure. Detection of abdominal fluid on ultrasonography also can be assessed as a bad prognostic factor, but size of ectopic mass does not correlate with methotrexate treatment success.Öğe A randomized comparison of a single-incision needleless (Contasure-needlelessA (R)) mini-sling versus an inside-out transobturator (Contasure-KIMA (R)) mid-urethral sling in women with stress urinary incontinence: 24-month follow-up results(Springer London Ltd, 2018) Doğan, Ozan; Kaya, Aşkı Ellibeş; Pulatoğlu, Çiğdem; Başbuğ, Alper; Yassa, MuratThere is a shortage of reliable data on the efficiency of the under-investigated mini-slings to treat stress urinary incontinence (SUI). We aimed to compare the effectiveness of the single-incision needleless mini-sling (SIMS) with the transobturator inside-out mid-urethral sling (TOT). Two hundred one women with clinically proven SUI were included in this single-center prospective randomized trial. The patients were randomly allocated to the groups. All surgeries were done by the same single surgeon. Examinations were done by one other blinded surgeon. The patients were followed up for 24 months. Objective cure was defined as the absence of SUI and negative cough-stress test. Subjective cure was defined as no stress leakage of urine after surgery in a validated questionnaire. Failure of the surgery was defined as the need for reoperation. Every complaint was categorized by the IUGA/ICS Classification of Prosthesis-related Complications. The objective (85.4% versus 89.9%, p = 0.362) and subjective (87.6% versus 89.9%, p = 0.636) cure rates were similar with the TOT and SIMS at the postoperative month 24, respectively. The mesh exposure 1 cm rate was 3.4% for both groups, and the mesh exposure > 1 cm rate was 2.2% for both groups. Overall failure rates were 3.4% and 2.2% for the TOT and SIMS group, respectively. No viscus organ perforation was noted. Complications with the SIMS procedure were less painful compared with TOT (p = 0.024). Single-incision needleless mini-slings exhibited similar cure rates as the trans-obturator mid-urethral slings from both the patient and clinician points of view in 24 months of follow-up. Mini-slings resulted in significantly less postoperative pain than trans-obturator mid-urethral slings.Öğe A randomized prospective comparison of the needleless mini-sling "hammock" and "U-shape" configurations for management of stress urinary incontinence: 18 month follow-up results(Springer Heidelberg, 2018) Doğan, Ozan; Başbuğ, Alper; Kaya, Aşkı Ellibeş; Pulatoğlu, Çiğdem; Yassa, MuratObjective To compare the efficacy of needleless mini-sling placed either retropubic (U-shape) or trans-obturator (hammock-shape) to treat stress urinary incontinence. Setting One hundred and twenty six women were randomized in a 2:1 ratio to receive hammock-shaped or U-shaped of Contasure-NDL. Methods All surgical procedures were performed by one senior surgeon experienced in anti-incontinence surgery with mesh. Cough-stress test was considered for objective outcome. Subjective outcomes consisted of International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Patient Global Impression of Improvement (PGI-I) and three-item Likert scale to measure satisfaction. Assessments were performed preoperatively and at postoperative 6th, 12th and 18th month. Results The objective cure rates at postoperative 6th and 12th month were significantly lower in U-shape group compared to hammock-shape group (85.4 vs. 96.4%; p = 0.034) and was comparable with hammock-shape group at 18 th month postoperative (90.2 vs. 96.4%, respectively; p = 0.216). The subjective cure rates at postoperative 6th, 12th and 18th month were similar between groups (90.2/90.2/100% vs. 96.4/96.4/96.4%, respectively; p > 0.05). Median of total ICIQ-SF scores was significantly lower in hammock-shaped group (1.62 +/- 2.92) compared to U-shape (3.80 +/- 2.64) at 18th month (p < 0.001). The rate of patients reported as very satisfied or satisfied to the Likert scale was 90.2% in U-shape group and 96.4% in hammock group. Patients' responses to PGI-I were majorly distributed to "much better" and "very much better" with a mean score of 1.93 +/- 2 in U-shape and 1.33 +/- 1 in hammock group at 18th month of follow-up (p < 0.001). Conclusion U-shape placement of needleless single-incision mini-sling mimicking the retropubic route did not satisfy in achieving the patient's goal when compared to hammock-shape placement.Öğe Relationship between adnexal mass and endometrial thickness in postmenopausal period(2018) Başbuğ, Alper; Doğan, Ozan; Yassa, Murat; Pulatoğlu, Çiğdem; Kaya, Aşkı Ellibeş; Çalışkan, ErayEndometrial cancer is the most common gynecological cancer. Increased postmenopausal endometrial thickness may be an indicator of endometrial cancer. Transvaginal ultrasound (TV-USG) is the primary imaging method for evaluating endometrial thickness in the postmenopausal period. The aim was to employ transvaginal ultrasonography in the evaluation of adnexal masses synchronously seen in postmenopausal women with increased endometrial thickness. The work was designed as a retrospective study. The medical records of 155 patients evaluated for increased postmenopausal endometrial thickness were examined. Ultrasonography had been performed on the women in the study for routine follow-up, postmenopausal hemorrhage, pelvic pain, pelvic mass on examination and family history of gynecological cancer. All patients had undergone endometrial evaluation with fractional dilatation and curettage (D & C) or pipelle endometrial sampling. Histopathological diagnosis was based on endometrial sampling results. Adnexal mass was present simultaneously in 17.4% (n 27) of the women included in the study, while 82.6% (n 128) had no gynecological pathology other than increased endometrial thickness. The endometrial thickness in the women with postmenopausal adnexal masses was greater than in those without adnexal mass (11.7 mm vs. 7.8 mm, p 0.009). Non-atypical and atypical endometrial hyperplasia was more frequent in the group with postmenopausal adnexal mass (11.1% vs. 2.8%, 11.1% vs. 3.79, p 0.03, p 0.04, respectively). Final histopathological evaluation of patients operated on for adnexal masses revealed tubo-ovarian abscess in 1.9% (n 1), benign ovarian tumor in 25.9% (n 7) and malignant ovarian tumor in 11.1% (n 3) of the patients. In postmenopausal women, adnexal masses can be seen simultaneously with increased endometrial thickness. In this regard, transvaginal ultrasound offers important opportunities for evaluation of both the endometrium and adnexa. Pre-surgery transvaginal ultrasound as well as multivariate serum markers may be used in evaluation models.Öğe Relationship of orgasm with measurable dimensions of clitoris and visibility of clitoral glans(Fatih BAŞAK, 2020) Pulatoğlu, Çiğdem; Kaya, Aşkı EllibeşAim: The clitoris is the dominant sexual organ in the female, varies in size and plays an active role in genital sensation and orgasm. Since the importance of clitoral glans visibility is known, surgeries of clitoris are increasing day by day. However, there is insufficient literature on the subject. The aim of this study is to determine the effect of measurable dimensions of clitoris and the clitoral glans visibility on female sexual function.Methods: Seventy-seven patients included in this cross-sectional study were examined in the lithotomy position and the measurable dimensions of the clitoris, the visibility of the clitoral glans and the length of the prepuce were noted. The Female Sexual Function Index (FSFI) was applied to all participants, which were divided into two groups, as those with normal orgasmic function and orgasmic dysfunction. One researcher made all measurements.Results: There were no statistically significant differences in clitoral glans width, length, or prepuce length (P=0.11, P=0.63, P=0.35, respectively). Clitoral glans was visible in 41 of 51 patients in the normal orgasmic function group, which was significantly higher than the group with orgasmic dysfunction (P<0.001).Conclusion: Since there is a significant relationship between clitoral glans visibility and orgasm, genital surgeries performed to increase clitoral glans visibility can facilitate sexual satisfaction and/or increase orgasm intensity. The fact that the relationship between measurable dimensions of clitoris, length of prepuce and orgasm cannot be shown suggests that clitoral glans visibility is more important than clitoral size for sexual stimulation.Öğe Surgical anatomy of the pectineal ligament during pectopexy surgery: The relevance to the major vascular structures(2020) Pulatoğlu, Çiğdem; Doğan, Ozan; Medişoğlu, Mahmut Sabri; Yassa, Murat; Kaya, Aşkı Ellibeş; Selçuk, İlker; Bayık, Rahime NidaObjective: During pectopexy surgery, the prolapsed uterus or the vaginal apex is fixed to the pectineal ligament. The anatomic structures found in thelateral part of the prevesical and paravaginal space above the obturator fossa, raise the importance of the surgical steps required to prevent complications.This study was conducted to evaluate the proximity of vascular structures to the pectineal ligament.Materials and Methods: The distances between the surgical suturing area during pectopexy surgery and the external iliac vein, pubic anastomotic vessel(corona mortis) and obturator canal were measured bilaterally in seven fresh female cadavers.Results: The total length of the pectineal ligament was 5.9±0.76 cm on the left and 6.5±1.14 cm on the right side; the midpoint of the pectineal ligamentwas 2.8±0.52 cm on the left and 3.6±0.47 cm on the right side. From the midpoint of the left pectineal ligament, the mean distance to the left externaliliac vein was 1.04±0.23 cm, to the left corona mortis it was 2.15±0.48 cm, and to the left obturator canal it was 3.12±0.95 cm. From the midpoint of theright pectineal ligament, the mean distance to the right external iliac vein was 1.25±0.43 cm, to the right corona mortis it was 2.37±0.63 cm, and to theright obturator canal it was 3.57±0.93 cm.Conclusion: The anatomic findings of the study confirmed that the pectineal ligament was in close association with main vessels. The external iliac veinwas measured as the closest anatomic structure to the pectineal ligament. Surgeons must be careful to minimize life-threatening complications because of the proximity of the pectineal ligament to main vessels.Öğe Uterine Prolapse during First Trimester Managed with Vaginal Pessary(2018) Doğan, Ozan; Başbuğ, Alper; Kaya, Aşkı Ellibeş; Başbuğ, Derya; Pulatoğlu, ÇiğdemUterine prolapse during pregnancy is a rare condition with an estimated incidence of1:10,000–15,000 pregnancies. Premature labor and delivery are the most prevalent complicationsin pregnancies with pelvic organ prolapse. Various treatment methods from conservativeapproaches to surgery are possible. In this paper we report a 27 year-old patientwho was treated with Arabin pessary due to uterine prolapse in the first trimester.
