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    An in vitro pilot study investigating placenta-derived mesenchymal stem cell coating on polypropylene mesh materials
    (Springer London Ltd, 2024) Aslan, Erdogan; Maytalman, Erkan; Samur, Dilara Nemutlu; Kole, Emre; Gunizi, Ozlem Ceren
    Introduction and hypothesis: Polypropylene meshes (PM) used in pelvic organ prolapse surgery are being withdrawn from the market. Although concerns about the usage of PMs in stress incontinence surgery have been raised, it is still one of the best methods of curing stress urinary incontinence. With advancements in stem cell-based therapies, especially mesenchymal stem cells (MSCs), it is believed that coating the synthetic meshes with MSCs may minimize excessive tissue reactions ultimately leading to clinical problems such as pain, erosion or extrusion of the implanted material. In our study we tried to show the possibility of coating the PM with placenta-derived MSCs.Methods: Mesenchymal stem cells obtained from six placentas were isolated, cultured, and identified. MSCs were then soaked in either fibronectin or collagen prior to co-culturing with strips of PMs. One group is used as a control, and hence was not pretreated before co-culturing. Specimens were fixed and stained with both Gram and hematoxylin and eosin and marked with Vybran Dil and DAPI. All preparations were examined under a light microscope. The IMAGEJ program was utilized to determine the surface area of meshes coated with MSCs.Results: We clearly showed that PMs can be coated successfully with placenta-derived MSCs. The percentage of the coated area is significantly increased when meshes were pretreated with fibronectin or collagen (p<0.0001).Conclusions: Placenta-derived MSCs can successfully coat PMs. The immunomodulatory properties of MSCs, which may be of great advantage in preventing the side effects of meshes, should be tested by in vivo and hopefully human studies before clinical applications.
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    Female Sexual Function Index Outcome After Posterior Vaginal Tightening Approach and Anterior Cervical Ring Repair when Indicated
    (Springer, 2025) Kole, Emre; Akar, Bertan; Deniz, Alparslan; Kole, Merve Cakir; Aslan, Erdogan; Caliskan, Eray
    BackgroundFemale sexual dysfunction is believed to be associated with pelvic floor dysfunction in most cases. However, correcting prolapse does not always necessarily correct sexual function. The reason for this might be secondary to disregarding anatomically relevant structures during surgical interventions. We aimed to demonstrate that posterior vaginal tightening approach avoiding anteriorly located structures, such as clitoral complex, would yield better results in terms of sexual function.MethodsFifty-seven postmenopausal women with primary complaints of vaginal laxity and Grade I and II prolapse were operated. All patients received posterior vaginal tightening operation, and a cervical ring repair was utilized when indicated (n:25). Perineal repair was done if there was any defect (n:13). Levator plication is not done in any patients. FSFI (Turkish Version) was applied to each patient prior to surgery and at 6th month postoperatively. A Likert-type scale is also utilized to assess the patient satisfaction from the procedures.ResultsAll the domains and the total score of FSFI were observed to be improved. Only the improvement in the pain domain scores was not statistically significant. Satisfaction of the patients from the surgery on a Likert scale was so as to: very satisfied 27 (47.4%), satisfied 12 (21.1%), neither satisfied nor dissatisfied 8 (14%), dissatisfied 5 (8.8%), very dissatisfied 1(1.7%).ConclusionSexual function of women with vaginal laxity can be improved when vulvovaginal erotogenic complex is not disrupted. This can be achieved via a posterior approach while maintaining successful anatomic correction of both posterior and anterior compartments.Level of Evidence IIIThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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    Labiaplasty Outcomes and Complications in Turkish Women: A Multicentric Study
    (Springer London Ltd, 2024) Koele, Emre; Dogan, Ozan; Arslan, Gaye; Koele, Merve cakir; Aslan, Erdogan; Caliskan, Eray
    Introduction and HypothesisWe aimed to evaluate the outcomes, complication rates, and complication types of different labiaplasty techniques.MethodsIn this cross-sectional retrospective study, a total of 2,594 patients who underwent surgery owing to hypertrophy or asymmetry of the labium minus were retrospectively analyzed. Data were collected by individual interviews with 43 experts from different centers. The patients were between 18 and 50 years of age. During the interview information about the presence and nature of complications, and about concomitant or revision surgeries, were gathered. The surgeons who performed these surgeries were also questioned about their training and surgical experience.ResultsThe most frequently observed complication was complete dehiscence, accounting for 29% of all complications. Complete dehiscence was most commonly seen after wedge resection (16 cases). The second most common complication was labium majus hematoma, accounting for 12.5% of all cases. Among the labiaplasty techniques, wedge resection had the highest complication rate at 3% (26 cases out of 753 patients). This was followed by composite labiaplasty at 1.2% (5 cases out of 395 patients), Z-plasty at 0.8% (1 case out of 123 patients), and trimming labiaplasty at 0.5% (7 cases out of 1,323 patients).ConclusionConsidering the heterogeneity and low quality of the existing studies on this subject, this study provides valuable information for surgeons practicing in this field. However, further research is clearly warranted as female genital aesthetic procedures are being performed with a steadily increasing trend.