Browsing by Author "Aslan, Kiper"

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A huge vaginal stone in a spastic paraplegic woman
(Springer London Ltd, 2022-05-11) Aslan, Kiper; ASLAN, MÜNİR KİPER; Akkok, Tuğba; AKKÖK, TUĞBA; Kasapoglu, Işıl; KASAPOĞLU, IŞIL; Uncu, Gürkan; UNCU, GÜRKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-9277-7735; AER-7173-2022
A meshless practical laparoscopic sacrohysteropexy modification and long-term outcomes
(Elsevier, 2020-11-01) Orhan, Adnan; Özerkan, Kemal; Kasapoglu,Işıl; Ocakoğlu, Gökhan; Aslan, Kiper; Uncu, Gürkan; ORHAN, ADNAN; ÖZERKAN, KEMAL; KASAPOĞLU, IŞIL; OCAKOĞLU, GÖKHAN; ASLAN, MÜNİR KİPER; UNCU, GÜRKAN; Uludağ Üniversitesi/ Tıp Fakültesi/Doğum ve Jinekoloji Bölümü/Ürojinekol ve Minimal İnvas Jinekol Ünitesi; Uludağ Üniversitesi/Sağlık Bilimleri Enstitüsü/Biyoistatistik Anabilim Dalı; 0000-0002-7558-8166; 0000-0002-1114-6051; 0000-0002-9277-7735; V-5292-2019; AER-7173-2022; AAH-9694-2021; AAT-3479-2021; AAH-9791-2021; AAH-5180-2021; K-2269-2016
Study Objective: To describe a new modification of laparoscopic sacrohysteropexy without using a mesh and report the 3-year outcomes.Design: A prospective cohort study.Setting: Minimally Invasive Gynecology Unit, Bursa Uludag University Hospital, Turkey.Patients: Women who were diagnosed with >= stage 2 uterine prolapse.Interventions: A laparoscopic sacrohysteropexy modification using a polyester fiber suture instead of a standard polypropylene mesh.Measurements and Main Results: The primary outcome was the anatomic success of the repair, with success defined as objective parameters using the pelvic organ prolapse quantification system. The secondary outcomes were subjective outcomes, which were assessed using the quality-of-life scales. Forty-seven women who underwent the procedure were followed up for a minimum of 3 years. Forty-four of the 47 patients had stage 0 or 1 prolapse at the end of the second year, according to the primary outcomes. The anatomic success rate was 93.6%. In the secondary outcomes, 2 patients were not satisfied with their pelvic floor after the second year. The subjective cure rate was 95.7%. There was a statistically significant improvement in both pelvic organ prolapse quantification and quality-of-life scores in the third postoperative year. The mean operating time was 84.6 minutes, and the mean estimated blood loss was 21.3 mL. There were no bladder or bowel complications in the perioperative or postoperative period.Conclusion: Laparoscopic sacrohysteropexy can be performed safely with this meshless modification in uterine prolapse as an alternative. (c) 2020 AAGL. All rights reserved.
Amh levels may predict for mullerian anomalies and pregnancy outcomes patients with pcos.
(Elsevier, 2020-09-01) Aslan, Kiper; ASLAN, MÜNİR KİPER; Albayrak, Özge; Bilgiç, Kübra Özlem; BİLGİÇ, KÜBRA ÖZLEM; Kasapoglu, Işıl; KASAPOĞLU, IŞIL; Avci, Berrin; AVCI, BERRİN; Uncu, Gurkan; UNCU, GÜRKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-9277-7735; AAH-9694-2021; AER-7173-2022; AAT-3479-2021
Anatomic and functional outcomes of paramesonephric remnant-supported laparoscopic double-layer peritoneal pull-down vaginoplasty technique in patients with mayer-rokitansky-kuster-hauser syndrome: Uncu modification
(Elsevier, 2018) Ata, Barış; Uncu, Gürkan; Özerkan, Kemal; Kasapoğlu, Işıl; Atalay, Mehmet Aral; Orhan, Adnan; Aslan, Kiper; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-7558-8166; 0000-0002-9277-7735; AAT-3479-2021; V-5292-2019; AAH-9694-2021; AAH-9791-2021; AER-7173-2022; 6603716169; 6603345841; 55800494800; 53863297800; 56671094200; 56740498500
Objective: To describe modifications to the double-layer peritoneal pull-down laparoscopic vaginoplasty technique (Davydov operation) and evaluate anatomic and functional outcomes of the new technique, known as the Uncu modification. Design: Case series (Canadian Task Force classification III). Setting: Tertiary care university hospital. Patients: Women with Mayer-Rokitansky-Kuster-Hauser syndrome (MRKHS) who underwent surgery between 2010 and 2016. Interventions: Laparoscopic double-layer peritoneal pull-down vaginoplasty with paramesonephric remnant support to the neovagina. Measurements and Main Results: Long-term anatomic and functional satisfaction results. Twenty-seven women with MRKHS underwent surgery with the Uncu-modified Davydov procedure. At 1 year after surgery, the mean vaginal length in these patients was 7.91 +/- 1.4 cm. Among the 23 patients who had regular vaginal intercourse, the mean functional satisfaction score was 8.65 +/- 1.2. One patient had a perioperative bladder injury, and another patient had a rectovaginal fistula at 3 months after the operation. One woman who did not comply with the prescribed postoperative mold exercises had complete closure of the introitus. Conclusion: The Uncu modified laparoscopic double-layer peritoneal pull-down technique appears to be an effective and safe surgical management option that is easy to learn and perform by gynecologic surgeons.
Are all antral follicles the same? Size of antral follicles as a key predictor for response to controlled ovarian stimulation
(Taylor & Francis, 2021-06-21) Kasapoğlu, Işıl; Orhan, Adnan; Aslan, Kiper; Şen, Esra; Kaya, Ayşenur; Avcı, Berrin; Uncu, Gürkan; KASAPOĞLU, IŞIL; ORHAN, ADNAN; ASLAN, MÜNİR KİPER; KAYA, AYŞENUR; AVCI, BERRİN; UNCU, GÜRKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Histoloji ve Embriyoloji Anabilim Dalı.; 0000-0002-7558-8166; 0000-0002-9277-7735; AAH-9694-2021; AER-7173-2022; CXJ-7203-2022; V-5292-2019; JWJ-7388-2024; ELU-2357-2022; AAT-3479-2021
The aim of this study was to evaluate whether antral follicle size has any value with respect to antral follicle count (AFC) in predicting ovarian response to controlled ovarian stimulation. Patients who were considered to be normal responders based on their ovarian reserve markers were consecutively recruited. Total AFC was the number of 2-10 mm follicles in both ovaries. Antral follicles were separated into two subgroups according to the size: 2-5 mm and 6-10 mm follicles. Patients were divided into two main groups according to ovarian response to COS. Group 1 (suboptimal response, 4-9 oocytes retrieved, n = 61) and Group 2 (normal responders, >= 10 oocytes retrieved, n = 65). Demographic parameters were comparable between the groups. The number of 2-5 mm follicles was significantly lower in the suboptimal response group (5 [4:7] and 8 [6:10], respectively, p < .001). The ratio of 2-5 mm follicles to total antral follicles was also significantly lower in Group 1 (44.4% and 75%, respectively, p < .001). The ratio of small antral follicles was positively correlated with ovarian response (r = 0.587, p < .001). In conclusion, the ratio of small (2-5 mm) antral follicles could be a more specific predictive marker than AFC for ovarian response.IMPACT STATEMENT What is already known on this subject? Prediction of the ovarian response during ovarian stimulation is commonly based on antral follicle count and anti-mullerian hormone. The ovarian response may be inadequate even in patients with normal antral follicle count and anti-mullerian hormone. What do the results of this study add? A high ratio of small-size (2-5 mm) basal antral follicles is a predictive factor for higher ovarian response to ovarian hyperstimulation. What are the implications of these findings for clinical practice and/or further research? To obtain optimal ovarian response, the antral follicles should be evaluated initially in a more detailed and systematic way by taking their sizes into consideration in addition to their counts. Small antral follicle count rather than whole antral follicle count may be beneficial for optimising the ovarian response. Future studies may determine the cut off values of small antral follicle count for high/poor ovarian response.
Clinical importance of placental membrane microscopic chorionic pseudocysts in preeclampsia
(IMR, 2015-03-04) Özerkan, Kemal; Demir, Bilge Çetinkaya; Baykara, Sema; Aslan, Kiper; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0002-9277-7735; 0000-0001-6897-3392; AAH-9694-2021; AER-7173-2022; AAH-9834-2021; AAH-9791-2021; 6603345841; 36923039100; 54945413500; 57189730867
Objective: To determine the importance of placental membrane microscopic chorionic pseudocysts (MCP) in preeclamptic and normal placentas and evaluate the association between MCP and neonatal complications in preeclamptic patients. Materials and Methods: In this prospective case-control study, microscopic examination of placentas was performed, including MCP count, in 33 preeclamptic and 35 normal control pregnant women from December 2008 to May 2009. The MCP were counted in placentas for each patient and modeled as a continuous variable to assess the difference between the two groups. Results: The mean MCP count was similar for preeclamptic (7 2) and control patients (7 2; not significant). A weak positive correlation was noted between placental weight and MCP (r = 0.253; p <= 0.04). In the preeclamptic patients, mean MCP count was significantly higher for neonates that did not have neonatal respiratory distress syndrome (NRDS) (p <= 0.05) and who did not admitted to neonatal intensive care unit (NICU) than admitted to NICU (P <=.03). The risk for developing NRDS was 20.3-fold greater in neonates of preeclamptic patients who did not have than had MCP (odds ratio, 20.3 95% confidence interval, 1.0 to 48; P <=.05). The MCP count cutoff value was <= 1 for developing NRDS (sensitivity 83%; specificity, 70%). Conclusion: The absence of MCP was significantly associated with the development of NRDS in neonates. The MCP count was inversely associated with the risk of NRDS in newborns of high-risk pregnancies caused by preeclampsia.
Comparison of semen parameters in the same patients before and after diagnosis of COVID-19
(Wiley, 2023-09-01) Çakır, Cihan; Kuşpınar, Göktan; Kurt, Gizem; Berber, Miray; Aslan, Kiper; Kasapoğlu, Işıl; Uncu, Gürkan; Avcı, Berrin; ÇAKIR, CİHAN; KUŞPINAR, GÖKTAN; Kurt, Gizem; Berber, Miray; ASLAN, MÜNİR KİPER; KASAPOĞLU, IŞIL; UNCU, GÜRKAN; AVCI, BERRİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Histoloji ve Embriyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-8332-7353; 0000-0002-9277-7735; AAH-5249-2021; HTQ-5866-2023; DBD-8926-2022; JLV-2420-2023; AER-7173-2022; CXJ-7203-2022; AAT-3479-2021; ELU-2357-2022
Clinical and histopathological evidence suggest that the male reproductive system may be negatively impacted in patients with coronavirus disease (COVID-19). The objective of this study is to investigate the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on semen parameters by comparing semen analyses before and after COVID-19 diagnosis in the same patient. We retrospectively analyzed 342 semen analyses by reviewing medical records. The study included two groups of patients: (i) those who underwent two consecutive semen analyses within 6 months, one before (n = 114) and one after (n = 114) COVID-19 diagnosis, and (ii) a control group (n = 114) that was age-matched and did not receive a diagnosis of COVID-19. The study results indicated a significant decrease in semen volume, total sperm count per ejaculate, progressive motile sperm count, total motile sperm count, and normal sperm morphology after SARS-CoV-2 infection in comparison to their respective values before the infection. Subgroup analyses showed that the duration of COVID-19 diagnosis (short-term vs. long-term) did not impact the changes in semen parameters. However, fever during the COVID-19 process had a negative effect on semen parameters, particularly sperm concentration, unlike in patients without fever. In conclusion, our findings suggest that SARS-CoV-2 infection is associated with a decline in semen quality, which may potentially impact male fertility. Furthermore, it's important to note that the negative effects on semen parameters may persist in the long-term. Our results also indicate that fever during active infection could be a significant risk factor that negatively affects spermatogenesis.
Does endometriosis have more detrimental effect on ovarian reserve in the presence of autoimmunity? A prospective observational study
(Oxford Univ Press, 2023-06-01) UNCU, GÜRKAN; Uncu, Gürkan; Aslan, Kiper; Nerimanova, C.; Kasapoglu, Işıl; KASAPOĞLU, IŞIL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.
Does pituitary suppression affect live birth rate in women with congenital hypogonadotrophic hypogonadism undergoing intra-cytoplasmic sperm injection? A multicenter cohort study
(Taylor & Francis, 2017-04-08) Mümüşoğlu, Sezcan; Ata, Barış; Turan, Volkan; Demir, Berfu; Kahyaoğlu, İnci; Ata, Ayşe Seyhan; Yılmaz, Bülent; Yakın, Kayhan; Bozdağ, Gürkan; Aslan, Kiper; Avcı, Berrin; Uncu, Gürkan; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Histoloji Embriyoloji Anabilim Dalı.; 0000-0002-9277-7735; AAH-9694-2021; ABE-6685-2020; AER-7173-2022; AAT-3479-2021; 56740498500; 6603017388; 6603716169
In this retrospective multicenter cohort study, women with congenital hypogonadotrophic hypogonadism (CHH) (n = 57) who underwent intra-cytoplasmic sperm injection in-between 2010-2014 were compared to age-matched controls with tubal factor infertility (n = 114) to assess ovarian stimulation cycle and pregnancy outcomes. Live birth rates (LBRs) per started cycle were 31.6 and 24.6% in CHH and controls groups, respectively (p = 0.36). Comparable success rates were also confirmed with the logistic regression analysis (OR: 1.44, 95% CI: 0.78-2.67, p = 0.24). Of the 57 women with CHH, 19 were stimulated with the gonadotropin-releasing hormone (GnRH) antagonist protocol, 13 with the long-GnRH-agonist protocol. Pituitary suppression (PS) was not employed in the remaining 25 cases. Compared to women with PS, women without PS had significantly higher embryo implantation rates (21.6 versus 52.6%, p = 0.03). Although there was a trend favoring no PS, LBRs (25.0 versus 40.0%, p = 0.26) per cycle were short of statistical significance. LBRs per cycle (57.1 versus 31.2%, p = 0.11) and miscarriage rates (11.1 versus 16.7%, p = 0.75) were similar between CHH women who were given estrogen + progesterone and progesterone alone to support the luteal phase. In conclusion, the optimal stimulation protocol appears to be exogenous gonadotropin stimulation alone, without PS, and progesterone-only luteal phase support in CHH patients.
Does the recurrence of ovarian endometrioma affect the pregnancy rates in IVF?
(Elsevier, 2015-09-01) Aslan, Kiper; Kasapoğlu, Işıl; Avcı, Berrin; Ata, Barış; Uncu, Gürkan; ASLAN, MÜNİR KİPER; KASAPOĞLU, IŞIL; AVCI, BERRİN; Ata, Barış; UNCU, GÜRKAN; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları; Uludağ Üniversitesi/Tıp Fakültesi/Histoloji ve Embriyoloji Bölümü; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinolojisi Bölümü; 0000-0002-9277-7735; 0000-0003-1106-3747; ABE-6685-2020; AAH-9694-2021; AER-7173-2022; C-8049-2013; AAT-3479-2021; CXJ-7203-2022
Evaluation of endometrioma pathophysiology and related ovarian damage by PTEN / AKT apoptosis signaling pathway
(Elsevier Science, 2020-09-01) Şen, Furkan; Aslan, Kiper; Kuşpınar, Göktan; Çakır, Cihan; Kasapoglu, Işıl; Avcı, Berrin; Uncu, Gürkan; ŞEN, HAMZA FURKAN; ASLAN, MÜNİR KİPER; KUŞPINAR, GÖKTAN; ÇAKIR, CİHAN; KASAPOĞLU, IŞIL; AVCI, BERRİN; UNCU, GÜRKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; 0000-0002-9277-7735; 0000-0002-8332-7353; AAH-5119-2021; AAT-3479-2021; HTQ-5866-2023; AER-7173-2022; AAH-9694-2021; AAH-5249-2021; KEU-2073-2024; CXJ-7203-2022; ELU-2357-2022
Incidence of congenital uterine abnormalities in polycystic ovarian syndrome (CONUTA Study)
(Elsevier, 2022-02-23) Aslan, Kiper; Albayrak, Özge; Orhaner, Aylin; Kasapoğlu, Işıl; Uncu, Gürkan; ASLAN, MÜNİR KİPER; Albayrak, Özge; Orhaner, Aylin; KASAPOĞLU, IŞIL; UNCU, GÜRKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-9277-7735; AER-7173-2022; AAT-3479-2021; GLW-1161-2022; GML-8923-2022; CXJ-7203-2022
Objective: To investigate whether the frequency of uterine cavity abnormalities in PCOS patients higher than the normo-ovulatory patients.Study design: This retrospective cohort study was conducted at the ART center of a tertiary university hospital. A total of 103 patients; 51 PCOS, and 52 male factor infertility were enrolled in the study between the years 2011-2019. HSG images of all patients were numbered and evaluated by ten senior reproductive endocrinologists and surgeons whom were blinded to the research and choose the most appropriate figure for each patient's HSG image and marked the shape of cavity according to the ASRM and ESGE/ESHRE classification.Results and demographic parameters were compared between PCOS and male factor infertility groups. Results: The percentage of the normal uterine cavity was significantly lower in the PCOS group than control group as 51 % and 66.7 %, 77 % and 94.2 % according to the ASRM and ESHRE/ESGE classifications, respectively. The frequency of Partial Septate Uterus (ESHRE-ESGE U2a / ASRM Va, 21.6% vs 5.8 % p < 0.05), Complete Septate Uterus (ESHRE-ESGE U2b / ASRM Vb, 7.8% vs 0% p < 0.01) and Dysmorphic Uterus (ESHRE-ESGE U1c) / ASRM VII) 3.9 % vs 0p < 0.05) were significantly higher in PCOS patients than controls. The frequency of arcuate uterus classified as VI in ASRM and considered as normal in ESHRE/ESGE was 16 % and 17.3 % in PCOS and control groups, respectively, without statistically significant difference.Conclusions: This study provides that, compared to the healthy population, the frequency of uterine cavity abnormality is clearly higher in PCOS patients.
Is fibroid location associated with hemorrhage and complication rates following laparoscopic myomectomy?
(Springer, 2020-05-26) Aslan, Kiper; Orhan, Adnan; Türkgeldi, Engin; Süer, Ebru; Düzok, Nergis; Özerkan, Kemal; Ata, Barış; Uncu, Gürkan; ASLAN, MÜNİR KİPER; ORHAN, ADNAN; SÜER, EBRU; DÜZOK, NERGİS; ÖZERKAN, KEMAL; UNCU, GÜRKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-9277-7735; 0000-0002-7558-8166; 0000-0002-5008-3292; K-2269-2016; AAH-9716-2021; AAT-3479-2021; AAH-9791-2021; AER-7173-2022; AAU-2710-2020; AAH-9694-2021; V-5292-2019
Objective To determine whether hemorrhage and complication rates vary according to the location of the dominant fibroid following laparoscopic myomectomy. Background Laparoscopic myomectomy is associated with less postoperative pain, analgesic requirement, shorter hospitalization period, and less febrile complications when compared to conventional laparotomy. Despite the advantages, complications like hemorrhage, blood transfusion, bowel and urinary tract injury, and conversion to laparotomy may be seen in laparoscopic myomectomy. We do not know whether the fibroid location affects these complications. Materials and methods Women, who underwent laparoscopic myomectomy at two different tertiary academic hospitals, were analyzed retrospectively. Only women with at least one intramural fibroid (Monroe type 3, 4, or 5) were included. Patients were categorized according to localization of the dominant fibroid, i.e., anterior uterine wall, posterior uterine wall, and fundus. Change in hemoglobin levels before and after surgery and complication rates were compared across categories. Results Two hundred nineteen women with a mean age of 35.7 +/- 6 years were included. There were 81 women with fundal fibroid, 56 with anterior wall, and 72 with posterior wall fibroid. The other ten women with intraligamentary and isthmic fibroid were excluded. The mean fibroid diameter was 6.7 +/- 2.6, 6.6 +/- 2.3, and 6.7 +/- 2.3 cm in the fundal, anterior, and posterior groups, respectively (p = 0.9). The median (25th-75th percentile) changes in hemoglobin levels were 1.5 (0.8-2.2), 1.3 (0.6-2.1), and 1.3 (0.9-2) g/dl in fundal, anterior, and posterior wall groups, respectively (p = 0.55). There were 5 (6.2%), 5 (8.9%), and 2 (2.8%) complications in fundal, anterior, and posterior wall groups, respectively (p = 0.33). Conclusion The incidence of hemorrhage or complication does not seem to vary depending on the fibroid location. However, the sample size was limited; observed values suggest that fibroid location does not affect hemorrhage and complication rates.
Kısa abstinens süresiyle ardışık ejakülasyonun sperm kromatin bütünlüğü ve antioksidan aktiviteye etkisi
(Bursa Uludağ Üniversitesi, 2022-07-20) Işıklar, Seda; Çakır, Cihan; Kaspoğlu, Işıl; Kuşpınar, Göktan; Aslan, Kiper; Uncu, Gürkan; Avcı, Berrin; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Histoloji ve Embriyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0003-3922-2009; 0000-0002-8332-7353; 0000-0002-1953-2475; 0000-0002-0338-8368; 0000-0002-9277-7735; 0000-0001-7660-8344; 0000-0001-8135-5468
Üremeye yardımcı tedavi uygulamalarında tercih edilen tedavi yaklaşımına göre semen parametrelerinin embriyoloji laboratuvarı sonuçlarına ve klinik başarıya etkisi değişmektedir. Semen parametreleri abstinens süresine ve androloji laboratuvarında uygulanan yıkama protokollerine göre değişmekte ve insemine edilecek sperm materyalinin kalitesini etkilemektedir. Bu çalışmada normozoospermik erkeklerde kısa abstinens süresinin rutin semen parametrelerine, sperm kromatin ve DNA bütünlüğüne, oksidatif strese karşı gelişen antioksidan kapasiteye etkisinin değerlendirilmesi amaçlandı. Aynı hastadan ardışık ejakülasyonla 2-5 günlük abstinens süresi sonrası (n=36) ve 1 saat abstinens süresi sonrası (n=36) alınan numuneler yıkama öncesi ve yıkama sonrası değerlendirildi. Yıkama öncesinde sperm volümünün ve total motil sperm sayısının kısa abstinens grubunda anlamlı olarak azaldığı bulundu. Yıkama sonrasında gruplar arasında motilitenin değişmediği, konsantrasyonun kısa abstinens grubunda anlamlı olarak azaldığı görüldü. Abstinens süresi kısa tutulduğunda sperm kromatin hasarının ve DNA fragmantasyon oranının azaldığı, antioksidan kapasitede bir değişiklik oluşturmadığı saptandı. Sonuç olarak normozoospermik olgularda, abstinens süresinin kısa tutulması sperm konsantrasyonunu ve total progressif motil sperm sayısını azaltmakla birlikte, uygulanacak üremeye yardımcı tedavi yaklaşımına göre inseminasyonda kromatin ve DNA bütünlüğü açısından daha kaliteli sperm kullanılmasına imkan sağlayacaktır. Ardışık ejakülasyon ve abstinens süresindeki kısalma aktioksidan kapasitede olumlu ya da olumsuz bir etki oluşturmamaktadır.
Long term sexual outcomes of mayer rokitansky küster hauser syndrome patients after uncu-modified davydov procedure
(Universa Press, 2023-09-01) Aslan, Kiper; ASLAN, MÜNİR KİPER; Gürbüz, T. B.; GÜRBÜZ, TANSU BAHAR; Rhan, A.; Kasapoglu, Işıl; KASAPOĞLU, IŞIL; Zerkan, K.; Uncu, Gürkan; UNCU, GÜRKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-9277-7735; AER-7173-2022
Background: Mayer-Rokitansky-Kister-Hauser (MRKH) syndrome has an incidence of 1 in 4000. The absence of the vagina and uterus results in sexual dysfunction and infertility. The first-line treatment is vaginal dilatation. There exists a number of second-line surgical options including the Uncu-modified Davydov procedure.Objective: To determine the complication rate, anatomical outcomes, and long-term sexual outcomes of MRKH syndrome patients after Uncu-modified Davydov procedure.Materials and Methods: Patients with MRKH syndrome who underwent paramesonephric remnant-supported laparoscopic double-layer peritoneal pull-down vaginoplasty (aka Uncu-modified Davydov procedure) between January 2008 and December 2021. The procedure involves laparoscopic circular dissection of the pelvic peritoneum followed by pulling down, through the opened vaginal orifice, and suturing the vaginal cuff with the support of uterine remnants. The long-term complication rate, anatomical outcomes, and sexual function outcomes (as measured by Female Sexual Function Index (FSFI)) were ascertained.Main Outcome Measures: The long-term complication rate, anatomical outcomes and FSFI survey results.Results: A total of 50 patients with MRKH syndrome underwent the Uncu-modified Davydov procedure between Jan 2008- Dec 2021. There were four perioperative complications: three bladder injuries (6%) and one rectal serosa injury (2%). Four long-term postoperative complications were identified: one vesicovaginal fistula (2%), one recto-vaginal fistula (2%), and two vaginal stenoses (4%). All patients were physically examined at least one year after surgery. The mean vaginal length was 8.4 + 1.9 cm. The mean FSFI score was 31.5 + 3.9 (minimum score of 24, maximum score of 36).Conclusion: The Uncu-modified Davydov procedure has been demonstrated to be a safe and effective treatment option with high female sexual function index scores for patients with MRKH syndrome. What is new? The long-term complication rate, anatomical and sexual outcomes of Uncu-modified laparoscopic peritoneal pull-down vaginoplasty were reported in this study. The results indicated that the surgical approach could be used in selective MRKH patients who failed first-line self-dilatation therapy.
Low molecular weight heparin-aspirin-prednisolone combination does not increase the live birth rate in recurrent implantation failure: A retrospective cohort study
(Springer Heidelberg, 2023-05-30) Aslan, Kiper; Kasapoğlu, Işıl; Çınar, Ceren; Çakır, Cihan; Avcı, Berrin; Uncu, Gürkan; ASLAN, MÜNİR KİPER; KASAPOĞLU, IŞIL; ÇINAR, CEREN; ÇAKIR, CİHAN; AVCI, BERRİN; UNCU, GÜRKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Histoloji ve Embriyoloji Anabilim Dalı.; 0000-0002-9277-7735; 0000-0002-8332-7353; AER-7173-2022; CXJ-7203-2022; IUD-1217-2023; AAH-5249-2021; ELU-2357-2022; AAT-3479-2021
This study investigates the triple combination of adjuvants (low molecular weight heparin (LMWH)-aspirin-prednisolone) whether it improves the live birth rates of IVF&ICSI patients with previous implantation failure. This retrospective study included 1095 patients with >2 failed either fresh or frozen single embryo transfer cycles between 2014 Jan and 2021 Jan. Patients were divided into two subgroups. Group A consisted of patients with only vaginal progesterone for luteal phase support. Group B consisted of patients with triple (daily subcutaneous LMWH, daily 150 mg aspirin, and daily 16 mg prednisolone) luteal phase supplementation to vaginal progesterone. Demographic parameters, cycle characteristics, embryology, and pregnancy outcomes were compared, and the study's primary outcome was the live birth rate. Demographic parameters were similar between the groups. Positive b-hCG, miscarriage, and live birth rates were similar between groups as Group A vs. Group B, positive b-hCG 30.8% (190/617) vs. 35.4% (169/478), miscarriage rates 4.4% (27/617) vs. 6.7% (32/478), and live birth rates 20.4% (126/617) vs. 23.8% (114/478), respectively. When patients were stratified according to previous failures, live birth rates were still similar. Pregnancy outcomes were significantly improved in only patients with diminished ovarian reserve (Group A vs. Group B, positive b-hCG 24.2% vs. 34.3%, live birth rate 12.1% vs. 21.9%, p < 0.01). Whether the embryo transfer was fresh or frozen-thawed did not affect the results. A combined supplementation of LMWH, aspirin, and prednisolone in the luteal phase does not improve live birth rates of IVF&ICSI patients with previous implantation failure except potentially for patients with diminished ovarian reserve.
Luteal fazda vajinal laktobasil desteğinin IVF/ICSI sikluslarında taze embriyo transferi uygulanan hastalarda implantasyon oranlarına etkisi
(Bursa Uludağ Üniversitesi, 2020-07-09) Aslan, Kiper; Kasapoğlu, Işıl; Kuşpınar, Göktan; Avcı, Berrin; Uncu, Gürkan; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Histoloji ve Embriyoloji Anabilim Dalı.; 0000-0002-9277-7735; 0000-0002-1953-2475; 0000-0002-0338-8368; 0000-0001-8135-5468; 0000-0001-7660-8344
Bu prospektif çalışmanın amacı IVF/ICSI sikluslarında taze embriyo transferi uygulanan infertil hastalarda luteal fazda vajinal laktobasil desteğinin implantasyon oranlarına etkisini araştırmaktır. Vajinal mikrobiyota ve infertilite ilişkisi günümüzde oldukça popüler bir araştırma konusudur ve yapılan çalışmalarda bozulmuş vajinal mikrobiyotanın infertil hastalarda gebelik sonuçlarını olumsuz olarak etkilediği bilinmektedir. Biz de bu sebeple çalışmamızda 88 infertil hastaya kontrollü ovaryan hiperstimülasyon sonrası oosit toplandığı gün vajinal 1x4 tablet vajinal laktobasil desteği sağlayarak, gebelik sonuçlarını laktobasil desteği uygulanmayan 88 kontrol hastası ile karşılaştırdık. Sonuçlarda grupların demografik verileri birbirine benzerdi. Ve çalışmanın birincil sonucu olan implantasyon oranları çalışma grubunda %38,6 kontrol grubunda %32,9 olarak bulundu. Sonuçlar kontrol grubunda daha yüksek olmasına rağmen istatistiksel olarak benzerdi. Çalışmanın sonucu olarak taze embriyo transferi yapılan infertil hastalarda luteal fazda laktobasil desteği sağlanmasının gebelik sonuçlarına etkisi gözlenmedi.
Meckel gruber syndrome, a case report
(Taylor, 2015-01-01) Aslan, Kiper; Aslan, Elif Kulahçı; Orhan, Adnan; Atalay, Mehmet Aral; ASLAN, MÜNİR KİPER; ASLAN, ELİF; ORHAN, ADNAN; Atalay, Mehmet Aral; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı; 0000-0002-9277-7735; 0000-0002-6553-1350; 0000-0002-7558-8166; 0000-0002-9685-956X; AER-7173-2022; AAH-9694-2021; V-5292-2019; JRN-8064-2023; GBG-9889-2022
Introduction: Meckel-Gruber Syndrome was first described by J R Meckel in 1822. It is an autosomal recessive disorder, and is caused by the failure of mesodermal induction. The typical triad of Meckel-Gruber Syndrome (MGS) involves meningo-encephalocele, polycystic kidneys and postaxial polydactyly. The worldwide incidence varies from 1 in 1.300 to 1 in 140.000 live births.Case: In this report, we present a case of MGS in which the diagnosis was made at 19 weeks of gestation based on ultrasonographic findings of the typical triad of the disease (encephalocele, polycystic kidneys, and polydactyly) These features were suggestive of the diagnosis of Meckel Gruber Syndrome (MGS). She had also placenta previa totalis. The patient was counselled regarding the lethal outcome of MGS. Unfortunately, the family did not approve the termination of pregnancy. At the 32nd week, she referred to hospital with complaints of vaginal bleeding and uterine contractions. An emergency cesarean section was perfomed due to plasental malposition. A 1380 gr, female fetus was delivered. First and 5th minute Apgar scores were 1 and 0, respectively. Consequently, the baby died after 45 minutes of neonatal resuscitation.Conclusion: MGS is a lethal disorder. One cannot speak about survival of the fetus because of the pulmonary hypoplasia. The parents should be counseled about prognosis of the fetus and the outcome. Counselers should strictly give information about the recurrence risk for the next pregnancies.
Mesh complications on youtube
(Elsevier, 2020-09-01) Orhan, Adnan; ORHAN, ADNAN; Göktürk, Gözde Güner; Özerkan, Kemal; ÖZERKAN, KEMAL; Kasapoglu, Işıl; KASAPOĞLU, IŞIL; Aslan, Kiper; ASLAN, MÜNİR KİPER; Uncu, Gurkan; UNCU, GÜRKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-7558-8166; 0000-0002-9277-7735; K-2269-2016; AAH-9791-2021; AER-7173-2022; AAH-9694-2021; AAT-3479-2021; V-5292-2019
Objective: There has been a heated discussion about mesh materials in urogynecology in recent years. The role of social media in this discussion is critical. This study aims to make a systematic analysis of videos uploaded to YouTube about mesh complications in urogynecology.Study Design: YouTube was searched using specific terms about mesh materials. The primary outcome was the relationship between the video characteristics-which were publisher identity, attitude, the main focus of the video country, and year- and the mesh debate in urogynecology.Results: We analyzed 1128 YouTube videos about mesh complications. There was no distinction between stress urinary incontinence and pelvic organ prolapse when referring to the mesh material in 79 % of the videos. 35.2 % of the videos were in the News group, 31.2 % were in the Patients group, 19.6 % were in the Doctors group, and 14.0 % were in the Lawyers group. Videos in the News (75.7 %), Patients (92.6 %), and Lawyers (99.4 %) groups mostly had a negative attitude, while videos in the Doctors (48.9 %) group mostly had an informative attitude. News (43.2 %) and Patients (51.2 %) group videos were predominantly from the United Kingdom. However, Lawyers (81.0 %) and Doctors (44.3 %) videos were predominantly from the USA. In the last three years, the news and patients videos have increased by an average of 40 % each year.Conclusion: YouTube has influenced the mesh dilemma with a negative attitude. As long as social media is at the center of this discussion, a healthy outcome cannot be achieved.
Outcomes of laparoscopic peritoneal vaginoplasty operation in patients with mullerian agenesis
(Oxford University, 2017-07) Ata, Barış; Uncu, Gürkan; Orhan, Adnan; Aslan, Kiper; Kasapoğlu, Işıl; Atalay, Mehmet Aral; Özerkan, Kemal; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-7558-8166; 0000-0002-9277-7735; AAT-3479-2021; V-5292-2019; AAH-9694-2021; AER-7173-2022; AAH-9791-2021