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Öğe 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, SelahattinObjective: 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.Öğe 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, SelahattinAmaç: 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.Öğe Blood cell indices in High-Grade Squamous Intraepithelial Lesions(2022) Gamsızkan, Zerrin; Coşkun, Sinem Kantarcıoğlu; Erdemir, Gökhan; Yavuzcan, AliLow patient motivation and relatively long procedures can sometimes limit the gains of the PAP test. At this point, the clinician may need additional stimulating tests to persuade patients to perform screening tests. The aim of this study was to determine the predictive value of hematological parameters for the high-grade squamous intraepithelial lesion (HG-SIL). Ninety-one patients possessing HG-SIL with complete blood counts and 111 healthy patients with normal cervical cytology were reviewed retrospectively. The age, WBC, and RBC count were significantly different in patients with HG-SIL than in controls. A cutoff value was found 42.5 for age (42% sensitivity and 58 % specificity, AUC: 0.604), 8.65 for WBC (44% sensitivity and 68% specificity, AUC: 0.570), and 4.47 for RBC (65% sensitivity and 58% specificity, AUC: 0.628) in ROC curve analysis. The results of the study show that the age of the patients, RBC, and WBC counts are important in precancerous intraepithelial lesions. Clinicians should warn female patients in the risk group to have regular gynecological examinations and screenings.Öğe 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 KamilBackground: 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.Öğe Can triglyceride related indices be reliable markers in the assessment of polycystic ovarian syndrome?(Walter De Gruyter Gmbh, 2024) Yavuzcan, Ali; Keyif, Betul; Yavuzcan, Gizem; Goynumer, GokhanObjectives: This study aimed to evaluate the diagnostic utility of the Triglyceride Glucose (TyG), Triglyceride Glucose-Body Mass (TyG-BMI), and Lipid Accumulation Product (LAP) indices for both screening Polycystic Ovary Syndrome (PCOS) and diagnosing insulin resistance (IR) in women diagnosed with PCOS. Methods: Retrospective data from medical records of 124 women were analyzed, with 71 in the PCOS group and 53 in the non-PCOS group. The PCOS diagnosis followed the 2003 Rotterdam criteria. Basic clinical and biochemical parameters were compared. The TyG index was computed using the formula ln [Triglyceride (TG) (mmol/L) x fasting plasma glukose (FPG) (mg/dL)/2]. TyG-BMI value was derived as TyG x BMI. LAP was calculated as (waist circumference (WC-58) x TG (mmol/L). IR was identified if Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) was >2.7. Results: TyG-BMI (AUC=0.62) and LAP indices (AUC=0.61) did not demonstrate statistically significant diagnostic performance for PCOS. Regarding IR in PCOS patients, the highest AUC was for TyG-BMI (0.84, 95 % CI: 0.73-0.93, p<0.001) with a cutoff at 116.15, showing 80 % sensitivity and 86 % specificity. LAP had an AUC of 0.86 with a cutoff of 30.21 (sensitivity 80 %, specificity 81 %), while TyG showed an AUC of 0.78 (95 % CI: 0.67-0.89, p<0.001) with a cutoff of 4.47, demonstrating a sensitivity of 70 % and specificity of 72 %. Conclusions: Numerous biochemical markers have been explored for PCOS detection, however, many are expensive, not universally available, and necessitate specific test kits. TyG, TyG-BMI, and LAP indices might not serve as reliable markers for PCOS screening but could offer utility in identifying IR in Turkish women diagnosed with PCOS.Öğe 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, SelahattinObjectives: 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 fertilityÖğe 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, FeyzaInformation 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.Öğe The correlation between immunohistochemical expression of MMP-2 and the prognosis of epithelial ovarian cancer(Studio K, 2014) Ekinci, Tekin; Özbay, Pelin Özün; Yiğit, Seyran; Yavuzcan, Ali; Uysal, Selda; Soylu, FeritObjectives: The Objectives: The goal of the study was to evaluate the correlation of matrix metalloproteinase-2 (MMP-2) expression with tumor spread, metastasis, survival and recurrence in early and advanced-stage Epithelial Ovarian Cancer (EOC). Material and methods: Medical records of patients, hospitalized at the Department of Obstetrics and Gynecology Izmir Ataturk Training and Research Hospital between 2003 and 2008, were reviewed. Patient age, tumor size, localization, histologic type and tumor grade, stage, metastasis status, patient outcomes and follow-up data were obtained from the records of the obstetrics and gynecology clinic, as well as during face-to-face or telephone interviews. Results: The percentage of MMP-2 staining (expression) in the epithelial cells was not significantly associated with tumor stage and grade, histologic type, tumor diameter; recurrence and overall survival (p>0.05). A significant correlation was found between the percentage of MMP-2 staining (expression) and metastasis status (p<0.05). The staining intensity of MMP-2 was not significantly associated with tumor stage and grade, diameter; recurrence, metastasis and overall survival (p>0.05), but was with histologic type (p<0.05). Total scores were not significantly associated with tumor stage and grade, histologic type, tumor diameter, recurrence, metastasis and overall survival (p>0,05). Stromal staining (expression) of MMP-2 was not significantly correlated with tumor stage and grade, histologic type, tumor diameter and outcomes (p>0.05), but was with recurrence and presence of metastasis (p<0.05). No significant association was found between the overall survival and percentage of MMP-2 staining (p>0.05), total score (p>0.05) and staining intensity (p>0.05). The association of disease-free survival with the percentage of MMP-2 staining (p>0.05), total score (p>0.05), staining intensity (p>0.05) and stromal staining (p>0.05) was not statistically significant. The survival of patients with positive stromal staining was significantly shorter compared to cases with negative stromal staining (p<0.05). Conclusions: Large-scale, comprehensive research is needed to verify whether MMP 2 may be used as a routine prognostic factor for EOC.Öğe 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, SelahattinThe 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.Öğe Diagnosing Polycystic Ovary Syndrome Using Triglyceride-Related Indices: Is It Possible Without Rotterdam Criteria?(Aras Part Medical Int Press, 2023) Keyif, Betul; Yavuzcan, Ali; Kurdoglu, Mertihan[No abstract available]Öğe Does Uterine Manipulator Type Affect Surgical Outcomes of Laparoscopic Hysterectomy?(Wolters Kluwer Medknow Publications, 2021) Yavuzcan, Ali; Altintas, Rasit; Yildiz, Gazi; Basbug, Alper; Bastan, Merve; Caglar, MeteObjectives: Many surgeons use uterine manipulator (UM) during laparoscopic hysterectomy (LH). In this study, we aimed to compare the outcomes of LH operations performed by using partially reusable UM with the articulated system (artUM) and disposable (dUM) UM without articulation. Materials and Methods: A total of 99 patients underwent the LH operation. This study was carried out with 35 of those 99 Caucasian patients who met the inclusion criteria. Group 1 consisted for 7 LH operations using the articulated RUMI (R) II/KOH-Efficient (TM) (Cooper Surgical, Trumbull, CT, USA) system (artUM), while Group II consisted of 28 patients using old-type V Care (R) (ConMed Endosurgery, Utica, New York, USA) dUM as UM. Results: Mean operation time was found to be 157.1 +/- 42.0 min. The operation time was found statistically longer in Group 1, consisted of artUM used patients (P = 0.006 and P < 0.05). No statistically significant difference was found between two groups in terms of surgical results such as, delta hemoglobin value (P = 0.483 and P < 0.05), length of hospital stay (P = 0.138 and P < 0.05), and postoperative maximum body temperature (P = 0.724 and P < 0.05). Conclusion: The UM type did not alter the surgical outcomes except the operating time in our study. According to our results, the surgical technique is a more significant variable than instruments used in LH for normal size uterus. Further prospective, large-scale studies comparing various UM systems are mandatory.Öğe 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, SelahattinAmaç: 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 gözükmektedirÖğe Düzce İlinde Nöral Tüp Defekti Saptanan Olguların Değerlendirilmesi(2013) Yavuzcan, Ali; Topuz, Seren; Çağlar, Mete; Dilbaz, Serdar; Üstün, Yusuf; Kumru, SelahattinAmaç: 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 duyulmaktadırÖğe The effect of adenomyosis on the outcomes of laparoscopic hysterectomy(Aves, 2016) Yavuzcan, Ali; Başbuğ, Alper; Bastan, Merve; Çağlar, Mete; Özdemir, İsmailObjective: 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.Öğe The Effect of Cognitive Behavioral Group Therapy on Infertility Stress, General Health, and Negative Cognitions: A Randomized Controlled Trial(Springer, 2019) Karaca, Aysel; Yavuzcan, Ali; Batmaz, Sedat; Cangür, Şengül; Çalışkan, ArifeThis study determined the effect of a cognitive behavioral group therapy (CBGT) program administered to infertile women on infertility-related stress, depressive and anxious thoughts, and general health state. A randomized controlled design was used for this study. The study was conducted with 107 infertile women: 55 in the experimental group and 52 in the control group. The CBGT was administered to the experimental group for 11 weeks. The pretest, posttest, and trimester follow-up results of this group were compared with those of the control group. The experimental group's Fertility Problem Inventory pretest mean score was 188.47 +/- 30.699, posttest mean score was 135.84 +/- 22.571, and follow-up mean score was 140.61 +/- 20.16. A statistically significant difference was found between the experimental and control groups' pretest, posttest, and follow-up mean scores on depressive and anxious cognitions (CCL), FPI and its subscales, and the General Health Questionnaire-28 and its subscales (p < 0.05). The CBGT intervention reduced the infertility-related psychosocial problems experienced by infertile women and promoted improvement in their depressive and anxious cognitions, and their mental health.Öğe 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, SelahattinObjective. 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.Öğe 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, MeteBackground: 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.Öğe Evaluation of Estrogen, Progesterone, and GCDFP-15 Expression in Uterine Leiomyomas(Springer India, 2015) Havva, Erdem; Feyza, Basar; Nilufer, Kadioglu; Murat, Oktay; Handan, Ankarali; Ali, Yavuzcan; Serdar, Dilbaz; Erdem, Havva; Başar, Feyza; Kadıoğlu, Nilüfer; Murat, Oktay; Ankaralı, Handan; Yavuzcan, Ali; Dilbaz, SerdarApproximately, one fourth of women have leiomyomas. Leiomyomas are benign tumors that originated from smooth muscle cells. Estrogen is claimed to relate as a cause but exact mechanism has not fully understood. In this study, 95 leiomyoma cases that have been diagnosed by our department in years between 2010 and 2012 were examined. Age ranges of patients, sizes, locations, and numbers of leiomyomas were identified. Immunohistochemically ER (estrogen), PR (progesterone), and Gross cystic disease fluid protein-15 stains were performed to the paraffin blocks and their percentages of staining were noted. Statistically, submucosal and intramural locations were significantly related to ER and PR (p < 0,001). There were significant relationship between ER and PR in 30-50 years age group (p < 0,001). There were significant relationship between ER, PR and locations (p < 0,001), numbers (p < 0,001), sizes of leiomyomas (below 5 cm; p < 0,001), (between 5 and 10 cm; p = 0,037), larger than 10 cm; p = 0,002). Consequently, relationship between leiomyoma and ER, PR were revealed in this study. Also, relationship between leiomyoma locations and patient ages were identified statistically. There was no immunoreactivity with GCDFP-15 in leiomyomas.Öğe 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, SelahattinObjective: 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.Öğe Evaluation of the outcomes of laparoscopic hysterectomy for normal and enlarged uterus (> 280 g)(Springer Heidelberg, 2014) Yavuzcan, Ali; Çağlar, Mete; Üstün, Yusuf; Dilbaz, Serdar; Kumru, SelahattinThe aim of this study was to evaluate intraoperative and postoperative outcomes of laparoscopic hysterectomy (LH) with routine intraoperative cystoscopy (CYS) for enlarged uterus (> 280 g). The patients, who underwent LH procedure in the Department of Obstetrics and Gynecology in Duzce University Faculty of Medicine between July 2012 and July 2013, were included in this study. Perioperative outcomes were compared between patients with and without enlarged uterus. Uterus weight of the operated patients ranges between 38 and 700 g. Mean uterus weight was 196.40 +/- A 142.32 g. Although we found longer operation time (148.75 +/- A 32.37 vs. 128.28 +/- A 27.58) and higher delta hemoglobin (2.98 +/- A 3.09 vs. 1.61 +/- A 1.29) in patients with enlarged uterus undergoing LH, these findings were not statistically significant (p = 0.077 and 0.058). No significant difference was found between the two groups in terms of need for insertion of pelvic drainage (p = 0.664), duration of bladder catheterization (p = 0.673), time of first postoperative flatus (p = 0.509) and the duration of hospitalization (p = 0.844). None of the patients had postoperative fever. The two groups were not significantly different in terms of postoperative body temperature (p = 0.736). In normal uterus group, 1 patient developed ureterovaginal fistula and 1 patient required re-operation. No major complication was observed in large uterus group. In our study, we compared the outcomes of LH in patients with large uterus measuring up to 700 g. and patients with normal uterus, and we achieved successful results by making minor changes in the operation technique and performing diagnostic CYS at the end of the operation.
