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Öğe Evaluation of iliococcygeal fixation procedure for pelvic organ prolapse: preoperative properties and short term postoperative outcomes(2024) Köle, Emre; Hasanova, Ilaha; Şahin, Ramazan Oğuz; Ayanoglu, Esra; Aksoy, Lale; Deniz, Alparslan; Aslan, ErdoğanAim: The aim of this study was to evaluate the short-term outcomes of patients who underwent iliococcygeal fixation (ICF) for the surgical treatment of pelvic organ prolapse (POP) and to assess the safety and feasibility of the ICF procedure. Patients and Methods: Our study is retrospectively done with the data of 50 POP patients who underwent ICF in our clinic within the dates 01.04.2022 and 31.03.2024. A total of 44 women were found to be eligible for follow-up. Demographic data and pre- and post-operative clinical data at 3 months were assessed. Results: According to the findings of our study, the difference between the median duration of surgery in NSD and CS patients is statistically significant, and the duration of surgery is longer in NSD patients (80 minutes (70-85) vs 60 minutes (50 -67,5), (p<0,05)). Only one recurrence, one hematoma and infection, and one bladder injury had occurred. Conclusion: According to our study, ICF is a safe, durable and surgically feasible procedure that can be done concomitantly with other procedures. Thus, we strongly advocate this procedure until the ideal mesh is found since it avoids many serious complications of SSLF.Öğe Examination of pelvic structures of women with polycystic ovary syndrome using magnetic resonance imaging pelvimetry(2024) Köle, Emre; Özen, Selda; Deniz, Merve Erol; Kole, Merve Cakir; Deniz, Alparslan; Aksoy, Lale; Aslan, ErdoğanObjective: Our study aimed to evaluate patients with Polycystic Ovary Syndrome (PCOS) using Magnetic Resonance (MR) pelvimetry to determine if there is a specific pelvic type associated with hyperandrogenemia. Method: This study retrospectively analyzed data collected from pelvic MR imaging performed on 36 patients diagnosed with PCOS who attended the outpatient clinic of Alanya Education and Research Hospital between 2021 and 2022. All cases were of reproductive age, between 18 and 49 years, and were initially diagnosed with PCOS via ultrasound, had a history of hirsutism or amenorrhea, followed by subsequent MR imaging. A control group of 35 patients, matched for reproductive age without PCOS diagnosis, hirsutism, amenorrhea, or menstrual irregularities, who underwent MR imaging for any other reason were recruited Results: No significant differences were observed between the groups in terms of age, gravidity, parity, abortions, except for weight and Body Mass Index (BMI). Comparison of MR pelvimetry results between the groups, including pelvic inlet transverse diameter (cm), interspinous diameter (cm), midsagittal pelvic inlet anteroposterior diameter (cm), and midsagittal pelvic outlet anteroposterior diameter (cm), revealed no significant differences. Conclusion: Unfortunatelly, the results did not provide convincing evidence to prove our hypothesis. If it were, we believe, it would provide a bridge between the animal expriments and clinical studies regarding the ethiplogy of PCOS.Öğe Female sexual function outcomes in patients operated for pelvic floor dysfunction: Comparison of synthetic mesh with native tissue repair(2023) Akar, Bertan; Köle, Emre; Karagün, Gaye; Aslan, Erdoğan; Çalışkan, ErayObjectives: We aimed to evaluate the impact of urogynecologic mesh implantations on sexual function using female sexual function index (FSFI) questionnaire Materials and Methods: In this cross-sectional retrospective study, a total of 187 patients which found to have pelvic organ prolapse or stress urinary incontinence (SUI) surgery were investigated between 2015 and 2022. Patients whose main complaint was SUI and had tension free vaginal tape operation (n=21) or transobturator tape operation (n=17) constituted the “Midurethral mesh group” (n=38). Those who had cystocele repair with double obturator trapezoid mesh formed the “Cystocele repair with mesh’’ group (n=35). Patients who had cystocele repair with natural tissue repair without any mesh implant in the vagina or elsewhere in the pelvis constituted the “Natural tissue repair’’ group (n=79). The patients were informed about the study and their consent was obtained. Results: The mean time elapsed since surgery till FSFI measurement was 32±6.5 months in Midurethral Mesh group; 34±7.1 months in the “Cystocele repair with mesh group and 33±7 months in the natural tissue repair group (p>0.05). Total FSFI scores 22.8±6.8, 22.2±7.5, 22.5±7.9 and the frequency of patient with scores lower than 26.5, which is the cut-off for disfunction, was 27 (71.1%), 20 (57.1%) and 47 (59.5%) similar in the three groups (p>0.05). The FSFI subdomain scores such as desire, arousal, lubrication, orgasm, satisfaction, pain was similar in the three groups (p>0.05 for all comparisons). Discussion: Our study demonstrated that surgical repair of symptomatic pelvic organ prolapse and SUI surgery using mesh implants or natural tissue repair had similar results of major parameters of sexual function after surgery.Öğe hCG Administration in Luteal Rescue: Intracavitary or Subcutaneously in Agonist Induced Ovulation in IVF Cycles(2023) Aksoy, Lale; Doğer, Emek; Köle, Merve Çakır; Köle, Emre; Aksoy, Hale; Aslan, Erdoğanresult in the cancellation of the cycle and be fatal in 3 women out of 100,000. The aim of this study is to compare the admission of human chorionic gonadotropin (hCG) subcutaneously versus intracavitary during ovum pick-up (OPU) in agonist induced ovulation in IVF cycles in terms of pregnancy outcomes. Methods: This study was carried out in Kocaeli University Faculty of Medicine, Department of Obstetrics and Gynecology Assisted Reproductive Techniques Clinic as a retrospective study. 157 patients who underwent IVF treatment between January 2018 and February 2020, with ?25 follicles detected in ultrasound and 1 mg of triptorelin acetate was administered for ovulation trigger, and 36 hours later of whom ?20 oocytes were obtained in OPU were enrolled in this study. 109 patients who were administered 1500 IU of hCG subcutaneously belonged to Group 1, and 1500 IU hCG was administered intracavitary to 48 patients as Group 2. Results: Infertility causes, and characteristics of both groups were similar. Number of retrieved oocytes, Metaphase 2 (MII) oocytes and fertilization rates were similar in both groups. Implantation rate per embryo transferred was higher in the intracavitary group (p = 0.01). There was no significant difference for pregnancy rate, clinical pregnancy rate, ongoing pregnancy rate, livebirth rate and OHSS frequency between both groups. Twin pregnancy rate was significantly higher in the intracavitary group. Conclusions: Administration of 1500 IU hCG intracavitary at the time of OPU is associated with improved implantation rates when compared to subcutaneous hCG administration without a significant raise in OHSS occurrence. Prospective, randomized studies with bigger patient cohort are needed. © 2023 The Author(s).Öğe Kovid-19 Pandemisinden Öğrenilen Dersler: Hayatı Tehdit Eden Bir Dönemde Gebelik Kaygı Düzeyi Artıyor(Alanya Alaaddin Keykubat Üniversitesi, 2023) Köle, Emre; Aksoy, Lale; Görgülü, Gökşen; Demir, Hakan; Köle, Merve Çakır; Aslan, ErdoğanAmaç: Bu çalışmada, COVID-19 enfeksiyonlu hamile kadınlardaki epidemiyolojik verilerle birlikte, pandemi sürecinde hastalığın oluşturduğu psikolojik etkileri ve pandemide artan anksiyetenin gebelik sonuçlarına etkilerini vurgulamayı amaçladık. Materyal ve Yöntemler: Bu çalışma,15 ila 49 yaşlarındaki 100 kadında gerçekleştirildi ve katılımcılar, Kadın Hastalıkları ve Doğum Polikliniği, Pandemi Polikliniği ve Gebelik Polikliniği'ne başvuranlardan seçildi. Kırk altı COVID-19 pozitif gebe kadın, kontrol grubu olarak negatif COVID-19 PCR testi olanlarla karşılaştırıldı. Katılımcılara bir anket ve Beck Anksiyete Envanteri uygulandı. Bulgular: Beck Anksiyete Envanteri kullanılarak yapılan bu çalışmada COVID-19 pozitif gebe grubunda anksiyete düzeylerinin COVID-19 negatif gebe grubuyla karşılaştırıldığında anlamlı derecede yüksek olduğunu gösterildi (p=0.001). Gruplar, pandemi sırasında gebe kalma ve doğum yapma açısından karşılaştırıldığında, "şiddetli anksiyete" nin COVID-19 negatif hamile grubunda anlamlı derecede arttığı bulundu (p=0.032). Sonuç: Beck Anksiyete Envanterine dayalı olarak, COVID-19 pozitif olanların negatif gruplarla karşılaştırıldığında gebelik sırasında anksiyete düzeylerini anlamlı derecede artırdığını tespit ettik.
