Browsing by Author "Orhan, Adnan"

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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.
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.
Cutaneous fistulization of an ovarian mature cystic teratoma: An unusual occurrence
(Karger, 2015-01-01) Atalay, Mehmet Aral; Orhan, Adnan; Atalay, Fatma Öz; Saydam, İlkay; Demir, Bilge Çetinkaya; Atalay, Mehmet Aral; ORHAN, ADNAN; ÖZ ATALAY, FATMA; Saydam, İlkay; ÇETİNKAYA DEMİR, BİLGE; Uludağ Üniversitesi/Tıp Fakültesi/Cerrahi Patoloji Bölümü; Uludağ Üniversitesi/Tıp Fakültesi/Doğum ve Jinekoloji Bölümü; 0000-0002-9685-956X; 0000-0002-7558-8166; 0000-0001-6845-9991; AAH-9834-2021; V-5292-2019; GBG-9889-2022; JHC-4482-2023; DRD-3800-2022
A bilobulated mature cystic teratoma (MCT) at the left ovary measuring 6 cm in diameter fistulized to the left lower quadrant of the anterior abdominal wall, contralateral to McBurney's point. This is the first reported case of a MCT fistulized to the skin. Symptoms, if present, usually depend on the size of the teratoma. However, most patients with a MCT are asymptomatic. Complications such as rupture of the cyst capsule are quite rare. Moreover, complication of fistulization is highly infrequent.
A DFT-based QSAR study on inhibition of human dihydrofolate reductase
(Elsevier, 2016-09-05) Karabulut, Sedat; Sizochenko, Natalia; Leszczynski, Jerzy; Orhan, Adnan; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-7558-8166; V-5292-2019; 56671094200
Diaminopyrimidine derivatives are frequently used as inhibitors of human dihydrofolate reductase, for example in treatment of patients whose immune system are affected by human immunodeficiency virus. Forty-seven dicyclic and tricyclic potential inhibitors of human dihydrofolate reductase were analyzed using the quantitative structure-activity analysis supported by DFT-based and DRAGON-based descriptors. The developed model yielded an RMSE deviation of 1.1 a correlation coefficient of 0.81. The prediction set was characterized by R-2 = 0.60 and RMSE = 3.59. Factors responsible for inhibition process were identified and discussed. The resulting model was validated via cross validation and Y-scrambling procedure. From the best model, we found several mass-related descriptors and Sanderson electronegativity-related descriptors that have the best correlations with the investigated inhibitory concentration. These descriptors reflect results from QSAR studies based on characteristics of human dihydrofolate reductase inhibitors.
Different treatment modalities and outcomes in cesarean scar pregnancy: A retrospective analysis of 31 cases in a university hospital
(Via Medica, 2019) Orhan, Adnan; Kasapoğlu, Işıl; Çetinkaya Demir, Bilge; Özerkan, Kemal; Düzok, Nergis; Uncu, Gürkan; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Kliniği.; 0000-0002-7558-8166; AAT-3479-2021; V-5292-2019; AAH-9834-2021; AAH-9791-2021; 56671094200; 55800494800; 36923039100; 6603345841; 57205616125; 6603716169
Objectives: There is no standardized treatment modality or a generally accepted guideline in cesarean scar pregnancy (CSP) treatment. The aim of this study is to retrospectively evaluate the outcomes of the different treatment modalities used in CSP treatment. Material and methods: 31 CSP patients retrospectively evaluated between May 2011 and February at Uludag University Hospital in Bursa, Turkey included in the study. A graphical flowchart according to the treatment modalities and timeline graphics of the patients were used. Main outcome measures were recurrent CSPs and healthy pregnancies in clinical follow-up after a successful CSP treatment. Results: 31 CSP patients were treated with six different treatment modalities in our series. Recurrent CSP was diagnosed in three patients after a successful CSP treatment. All of these recurrent CSPs were treated with O/C procedure in their first CSP. Six patients conceived again in clinical follow-up after successful treatment of CSP. Conclusions: CSP is a serious maternal complication that risks the mother's life, and this problem is growing because of the increased cesarean rates. Invasive procedures applied to the uterus in CSP treatment may cause recurrent CSP in the next pregnancy of the patient. When considering the treatment options of the CSP, minimally invasive treatment modalities and the subsequent gestation of the patient should be taken into account.
Does antenatal magnesium sulphate improve hearing function in premature newborns?
(Galenos Yayıncılık, 2019-12-02) Kasapoğlu, Işıl; Çetinkaya, Bilge Demir; Altay, Mehmet Aral; Orhan, Adnan; Özkan, Hilal; Çakır, Salih Çağrı; Toker, Rabia tütüncü; Kasapoğlu, Fikret; Özerkan, Kemal; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kulak Burun Boğaz Anabilim Dalı.; 0000-0002-3129-334X; 0000-0002-7558-8166; 0000-0001-6845-9991; 0000-0001-5761-4757; 0000-0002-9685-956X; ABI-4540-2020; V-5292-2019; AAH-9834-2021; AAH-9791-2021; A-8779-2013; 55800494800; 36923039100; 53863297800; 56671094200; 16679325400; 57205555920; 55958250400; 56254721200; 6603345841
Objective: To evaluate whether antenatal magnesium sulphate (MgSO4) exposure has a neuroprotective effect against hearing impairment in premature newborns. Material and Methods: Retrospective cohort study was performed with prematurely (<37 weeks) delivered newborns at a tertiary university hospital. Newborns of 92 women who received MgSO4 infusions (study group) for various indications were compared to newborns of 147 women who did not receive MgSO4 infusions (control group). All eligible premature newborn underwent hearing screening by auditory brainstem response (ABR) testing before being discharged from the hospital. Results: The fail rate for ABR hearing screening was 3.3% (n= 3) in the study group and 10.9% (n=16) in the control group (p=0.034). The rate of concurrent use of betamethasone was higher in the study group (72.8%; n=67) compared to control group (29.2%; n=43) (p<0.001). Other neonatal parameters, such as the number of neonates who were small for gestational age and the rate of microcephaly were similar between the groups (p=0.54, p=0.48, respectively). After adjusting for co-variates including the use of betamethasone and gestational age at delivery, no statistically significant association between antenatal administration of MgSO4 and ABR fail rates were found (p=0.07). Conclusion: These results do not suggest a significant benefit in terms of hearing impairment in premature newborns when antenatal MgSO4 infusion was given.
Endometrioma related reduced ovarian reserve: Preliminary results of the ERROR study
(Oxford University, 2017-07) Kasapoğlu, Işıl; Orhan, Adnan; Uyanıklar, Özlem Özgün; Uncu, Gürkan; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-9800-256X; 0000-0002-7558-8166; GXG-7943-2022; V-5292-2019; AAT-3479-2021
Endometrioma-related reduction in ovarian reserve (ERROR): A prospective longitudinal study
(Elsevier, 2018-03-12) Ata, Barış; Seyhan, Ayşe; Oğuz, Şule Yıldız; Kasapoğlu, Işıl; Uyanıklar, Özlem; Orhan, Adnan; Uncu, Gürkan; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-7558-8166; 0000-0002-9800-256X; V-5292-2019; AAT-3479-2021; CXJ-7203-2022; GXG-7943-2022; 55800494800; 56512405500; 56671094200; 6603716169
Objective: To evaluate whether endometrioma is associated with a progressive decline in ovarian reserve, and to compare the rate of decline with natural decline in ovarian reserve. Design: Prospective, observational study. Setting: Tertiary university hospital, endometriosis clinic. Patient(s): Forty women with endometrioma and 40 age-matched healthy controls. Intervention(s): Women with endometriomas who did not need hormonal/surgical treatment at the time of recruitment and were expectantly managed. Controls were age-matched, healthy women. All participants underwent serum antimullerian hormone (AMH) testing twice, 6 months apart. Sexually active patients with endometrioma also underwent antral follicle count. Main Outcome Measure(s): Change in serum AMH levels. Result(s): Median (25th-75th percentile) serum AMH level at recruitment was 2.83 (0.70-4.96) ng/mL in the endometrioma group and 4.42 (2.26-5.57) ng/mL in the control group. The median percent decline in serum AMH level was 26.4% (11.36%-55.41%) in the endometrioma group and 7.4% (-11.98%, 29.33%) in the control groups. Twenty-two women with endometrioma who had antral follicle count (AFC) had median AFC of 10 (8-12) at recruitment and 8 (6.3-10) at 6 months. Conclusion(s): Women with endometrioma experience a progressive decline in serum AMH levels, which is faster than that in healthy women.
From where does the uterine artery originate? A prospective, observational laparoscopic anatomic study
(Elsevier, 2020-07-01) Taşkıran, Çağatay; Vatansever, Doğan; Orhan, Adnan; Özerkan, Kemal; Kasapoglu, Işıl; Sendemir, Erdoğan; Uncu, Gürkan; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anatomi Anabilim Dalı.; 0000-0002-7558-8166; 0000-0001-9699-4342; V-5292-2019; AAH-9791-2021; AAT-3479-2021; V-5292-2019; AAH-9791-2021; AAT-3479-2021
Study Objective: To determine and categorize the anatomic variations of the uterine artery (UA) as observed during laparoscopic hysterectomy with retroperitoneal dissection for benign conditions.Design: A prospective, observational study.Setting: A hospital department of obstetrics and gynecology, Uludag University Hospital, Bursa, Turkey.Patients: A total of 378 female patients who presented with indications for laparoscopic hysterectomy for benign disease.Interventions: Laparoscopic hysterectomy with retroperitoneal dissection was performed bilaterally in all patients between March 2014 and October 2018. The vascular anatomy beginning at the bifurcation of the common iliac artery down to the crossing of the UA with the ureter was exposed and subsequently studied. The UA was identified, and its variable branching patterns were recorded. The patterns were then categorized into groups adapted from classic vascular anatomy studies.Measurements and Main Results: Retroperitoneal dissections of 756 UAs were performed in 378 female patients. The UA was the first anterior branch of the internal iliac artery in 80.9% of the cases (Model 1; Main Model). Three additional models adequately described other variations of the UA as follows: Model 2 (Cross Model), 3.7%; Model 3 (Trifurcation Model), 3.1%; and Model 4 (Inverted-Y Model), 7.4%. The origin of the UA could not be determined in 7.4% of the cases.Conclusion: The UA is the first anterior branch of the internal iliac artery in more than 80% of females. Surgeons should be aware of the anatomic variations of the UA to perform safe and efficient procedures.
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.
Kliniğimizde 2000- 2010 yılları arasında sezaryen oranları ve değişen endikasyonlar
(Uludağ Üniversitesi, 2012-06-11) Demir, Bilge Çetinkaya; Ocakoğlu, Gökhan; Özerkan, Kemal; Orhan, Adnan; Cengiz, Candan; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.
Çalışmamızda 2000-2010 yılları arasında kliniğimizde yaptırılan doğumlar içerisinde sezaryen sıklığını belirlemek ve yıllar içerisinde değişen endikasyon ve sıklıklara vurgu yapmak amaçlanmıştır. Ocak 2000- Aralık 2010 tarihleri arasında kliniğimizde meydana gelen tüm doğum olguları retrospektif olarak tarandı. On yıllık süre içerisinde yaptırılan 10239 doğumun 5135’i normal doğum ile (%50.10), 5104’ü ise sezaryen ile (%49.90) gerçekleştirildi. Sezaryen sıklığı 2000 yılında %41.88 iken anlamlı bir artış göstererek 2010 yılında %54.12’e ulaştı (p= 0.021). Yıllar içerisinde eski sezaryen nedeni ile yapılan sezaryen sıklığı %25.06’dan % 39.50’ye yükseldi (p<0.001). İsteğe bağlı sezaryen oranının ise %5.78’den %0.58’e gerilediği izlendi. Kliniğimizde sezaryen sıklığı yıllar içerisinde anlamlı bir şekilde artmıştır. Bu artış özellikle eski sezaryenlı hasta oranının artması nedeniyledir ve beraberinde plasentasyon anomalilerinin sıklığında artışa neden olmuştur. Sezaryen sıklığının düşürülmesi için isteğe bağlı yapılan operasyonların azaltılması, ilk gebelikte endikasyonların dikkatli değerlendirilmesi, doğumhanelerde ebelerin rolünün arttırılması gibi önlemler uygulamaya konulmalıdır.
Laparoscopic evacuation of an early pregnancy
(Elsevier Science Inc, 2019-03-01) ÖZERKAN, KEMAL; ÇETİNKAYA DEMİR, BİLGE; ORHAN, ADNAN; Orhan, Adnan; Demir, Bilge Cetinkaya; Kasapoglu, Işıl; Uncu, Gürkan; UNCU, GÜRKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/KAdın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-7558-8166; 0000-0001-6845-9991; AAH-9791-2021; K-2269-2016; AAH-9834-2021; V-5292-2019; AAT-3479-2021
Laparoscopic hysterectomy trends in challenging cases (1995-2018)
(Elsevier, 2019-12) Orhan, Adnan; Özerkan, Kemal; Kasapoğlu, Işıl; Ocakoğlu, Gökhan; Demir, Bilge Çetinkaya; Uncu, Gürkan; Gunaydın, Tuba; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Cerrahi Tıp Bilimleri/Kadın Hastalıkları ve Doğum Bölümü.; 0000-0002-5844-7070; 0000-0002-7558-8166; V-5292-2019; AAI-6453-2021; AAH-5180-2021; AAT-3479-2021; AAH-9791-2021; 56671094200; 6603345841; 55800494800; 15832295800; 36923039100; 57210182831; 57210182831
Objective: : To investigate the effect of challenging factors on laparoscopic hysterectomy trends within twenty-four years. Population and Method: : This was a trend analysis study of 7558 women who underwent hysterectomy for benign indications between 1995-2018 in Bursa Uludag University Hospital, Turkey. A trend analysis of obesity, previous laparotomy (>= 3) and uterine specimen weight (>= 500 g) was applied for abdominal hysterectomy (TAH), vaginal hysterectomy (VH), and laparoscopic hysterectomy (TLH) rates in this period. The primary outcome was laparoscopic hysterectomy trends throughout the years. We measured the effect of obesity, previous laparotomies and large uterus on TLH trends as secondary outcomes. Results: : The ratio of TLHs to all hysterectomies was 2.4% in 1995 and 44.7% in 2018 which increased 33 times higher over 24 years. The percentage of obese patients in TLH cases increased from 1% to 37%, the rate of patients who had three or more previous laparotomy in TLH cases increased from 0% to 32.2%, and the percentage of patients who had more than 500 g uterus specimen in laparoscopic hysterectomy cases increased from 0% to 32.8%. Conclusion: : Laparoscopic hysterectomy trends are increasing in challenging cases. Obesity, previous surgeries, and large uteruses are no longer a limiting factor for laparoscopic hysterectomy. (C) 2019 Elsevier Masson SAS. All rights reserved.
Laparoscopic sacral colpopexy with polyester fiber suture: Ozerkan modification
(Springer London, 2020-08-01) Özerkan, Kemal; Orhan, Adnan; Kasapoğlu, Işıl; Ata, Barış; Uncu, Gürkan; ÖZERKAN, KEMAL; ORHAN, ADNAN; KASAPOĞLU, IŞIL; UNCU, GÜRKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-7558-8166; AAH-9791-2021; K-2269-2016; AAT-3479-2021; V-5292-2019
Introduction and hypothesis Mesh-related problems are significant complications of laparoscopic sacral colpopexy. The conventional technique precludes performing laparoscopic sacral colpopexy without using a mesh. We describe the Ozerkan modification for laparoscopic sacral colpopexy using a polyester fiber suture instead of a standard mesh and report 1-year objective and subjective outcomes. Methods Women diagnosed with stage >= 2 vaginal vault prolapse were prospectively recruited for the Ozerkan modification between 2015 and 2017. The primary outcome was the anatomic success of the repair, defined by objective parameters using the pelvic organ prolapse quantification system (stage 0 or 1). Secondary outcomes were subjective outcomes assessed with the quality of life scores. Results Twenty-two women underwent the Ozerkan modified laparoscopic sacrocolpopexy. Mean operation time was 85.6 min. Mean estimated blood loss was 71 ml. One patient was lost during the clinical follow-up in the outpatient clinic up to 1 year. Nineteen of 21 patients had stage 0 or 1 prolapse at the end of 1 year. Two patients were not satisfied with their pelvic floor after 1 year. Both the objective and subjective cure rates were 90.4%. There were no bladder or bowel complications during the peri- or postoperative period. Conclusions The new modification of laparoscopic sacral colpopexy seems a feasible and safe option to avoid mesh complications in the treatment of vaginal vault prolapse.
Laparoskopik matür kistik teratom eksizyonu sonrası kistin büyüklüğü ile içerdiği farklı mezodermal ve ektodermal doku komponentleri arasındaki ilişki
(Bursa Uludağ Üniversitesi, 2019-08-29) Orhan, Adnan; Kasapoğlu, Işıl; Arık, Şeyda; Atalay, Fatma Öz; Özerkan, Kemal; Demir, Bilge Çetinkaya; Şen, Hamza Furkan; Uncu, Gürkan; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; Bursa Uludağ Üniversitesi/Sağlık Bilimleri Enstitüsü/Tıp - Biyoistatistik Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Patoloji Anabilim Dalı.
Overin matür kistik teratomu (MKT) ikinci ve üçüncü dekattaki kadınların en sık görülen over tümörüdür. Hemen tamamı benign olan bu tümörlerin rüptür, torsiyon ve malignite gibi çeşitli komplikasyonları vardır. Her üç germ yaprağından da köken alabilen bu tümörlerde kemik, kıkırdak, diş gibi farklı germ yapraklarına ait dokular izlenebilir. Bu çalışmanın amacı laparoskopik MKT eksizyonu yaptığımız hastaların tümör içeriklerindeki doku farklılıklarını gözlemek ve bu dokuların MKT kist büyüklüğü ile olan ilişkisini araştırmaktır. Retrospektif olarak planlanan bu çalışmaya 01.01.2006 – 31.12.2018 tarihleri arasında bir üniversite hastanesinde laparoskopik MKT eksizyonu uygulanan hastalar alındı. Hastaların demografik özellikleri, MKT çapı, bilateralite oranı, lobülasyon, içeriğindeki kıl, diş, kemik dokusu varlığı ayrıntılı olarak incelendi. Çalışmaya 236 hasta alındı. 222 hastaya laparoskopik MKT kist eksizyonu uygulanmıştı. 14 hastada ise diğer laparoskopik operasyonlar sonrasında patoloji spesimeninde matür kistik teratom saptanmıştı. Bilateralite oranı %15,2 idi. 4-5 cm çapında 58, 5-6 cm çapında 78, 6-7 cm çapında 82, 7 cm’den büyük 54 MKT saptandı. MKT’un çapı arttıkça içerisinde kıl, diş veya kemik doku bulunma veya lobule olma ihtimali belirgin olarak artıyordu. İstatistiksel olarak bakıldığında özellikle 7 cm den büyük kistlerde her üç dokuyu da içerme ve lobülasyon olasılığı en yüksek anlam düzeyine ulaşıyordu. Sonuç olarak laparoskopik MKT eksizyonu yapılan olgularda kist boyutu ile içerdiği farklı germ yapraklarına ait doku komponentleri ve lobülasyon durumu doğru orantılıdır. Bu durum özellikle 7 cm ve üstü matür kistik teratomlarda daha belirgindir.
Long-term follow-up of laparoscopic sacrocolpopexy: Comparison of two different techniques used in urology and gynecology
(Springer, 2019-04) Orhan, Adnan; Özerkan, Kemal; Vuruskan, Hakan; Ocakoğlu, Gökhan; Kasapoğlu, Işıl; Koşan, Bahadır; Uncu, Gürkan; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-7558-8166; V-5292-2019; AAI-1958-2021; AAT-3479-2021; AAH-9791-2021; HLG-6346-2023; AAH-5180-2021; 56671094200; 6603345841; 6507328150; 15832295800; 55800494800; 57205391969; 6603716169
Introduction and hypothesisNumerous studies have found that the short-term results of laparoscopic sacrocolpopexy for pelvic organ prolapse are safe and effective. This study evaluates the long-term results of the laparoscopic sacrocolpopexy operation between the urology and gynecology branches.MethodsA prospective study enrolling 206 patients was conducted to evaluate laparoscopic sacrocolpopexy as a surgical treatment for vaginal vault prolapse from 2011 to 2014. Two different surgical branches (urology and gynecology) applied laparoscopic sacrocolpopexy to their patients with their own techniques. The long-term results were assessed postoperatively after 4years by pelvic examinations, including the Pelvic Organ Prolapse Quantification system (POP-Q) and quality-of-life assessments using validated questionnaires.ResultsA total of 190 patients (94 urology and 96 gynecology patients) received a full clinical follow-up examination between April 2014-June 2018. Postoperative pelvic organ prolapse recurrence rates in each compartment were similar in both groups during the 4years; 87.2% of the urology and 86.5% of the gynecology patients had no prolapse in any compartment according to the POP-Q system. The reoperation rate was 5.3% for the urology and 6.2% for the gynecology group. Mesh erosion was detected in two patients in both groups. Three patients responded to local estrogen therapy, and we removed the mesh vaginally in one patient. The subjective cure rate was 89.4% in the urology and 88.5% in the gynecology group after 4years.ConclusionsAlthough different surgical branches perform laparoscopic sacrocolpopexy with their own techniques, long-term anatomical and functional results are similar between the branches. From a urogynecological point of view, laparoscopic sacrocolpopexy is a gold standard surgical procedure that can be performed by both urologists and gynecologists with similar long-term outcomes.
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