Ahmet Kale - Academia.edu (original) (raw)
Papers by Ahmet Kale
International Neurourology Journal, 2021
Entrapment neuropathy of the sciatic nerve and pudendal nerve are painful syndromes that are ofte... more Entrapment neuropathy of the sciatic nerve and pudendal nerve are painful syndromes that are often overlooked by physicians. Laparoscopic surgical interventions for nerve entrapment syndromes of the posterior pelvis focus on removing the compression lesion with the purpose of eliminating the suspected cause of sciatica, as well as pudendal neuralgia. Herein, the authors report the rare event of sciatic and pudendal nerve entrapment, which was caused by aberrant vessels and a variant piriformis muscle bundle, as a seldom-diagnosed cause of sciatica and pelvic pain, for both neurosurgeons and neuropelveologists. The authors present the laparoscopic decompression technique for the pudendal and sciatic nerves by giving our technical “tips and tricks” enriched by a surgical video.
Kocatepe Tıp Dergisi, 2015
Çalışmamızın amacı hastanemiz kadın hastalıkları ve doğum polikliniklerine rutin gebelik takibi i... more Çalışmamızın amacı hastanemiz kadın hastalıkları ve doğum polikliniklerine rutin gebelik takibi için başvuran hastalarda gestasyonel diyabetes mellitus (GDM) sıklığını araştırmak ve bu olguların perinatal sonuçlarını analiz etmektir.
Southern Clinics of Istanbul Eurasia
The sciatic nerve is the nerve of the lower limb. It is derived from spinal nerves, fourth Lumbar... more The sciatic nerve is the nerve of the lower limb. It is derived from spinal nerves, fourth Lumbar (L4) to third Sacral (S3). The sciatic nerve innervates the muscles of the posterior thigh and additionally has sensory functions. Sciatica is the given name to the pain sourced by irritation of the sciatic nerve. Sciatica is most commonly induced by compression of a lower lumbar nerve root (L4, L5, or S1). Various intrapelvic pathologies include gynecological, vascular, traumatic, inflammatory, and tumoral disorders that may cause sciatica. Intrapelvic pathologies that mimic disc herniation are quite always ignored. Surgical approach and a functional exploration by laparoscopy or robotic surgery have significantly increased the intrapelvic pathology's awareness, resulting in sciatica. After a detailed assessment of the patient, which causes intrapelvic pathologies, deciding whether surgical or medical therapy is needed, notable results in sciatic pain remission can be done.
Erken evre serviks kanseri (EvreIA1-Evre IIA) tedavisinde geleneksel radikal histerektomi yapilan... more Erken evre serviks kanseri (EvreIA1-Evre IIA) tedavisinde geleneksel radikal histerektomi yapilan hastalarda postoperatif donemde pelvik taban disfonksiyonu gorulmektedir. Bu calismada Kocaeli Derince Egitim ve Arastirma Hastanesi Kadin Hastaliklari ve Dogum Kliniginde Ocak 2015-Ocak 2018 yillari arasinda Erken evre serviks tanisi alan laparaskopik sinir koruyucu radikal histerektomi (LSKRH) yapilan 13 olgunun klinik ilk deneyimini, operasyon sonrasi kontrollerinde Urogenital Distress Inventory (UDI 6) anket testi ve hasta memnuniyet skoru (HMS) sonuclarini degerlendirmek amaclandi. Calisma kapsaminda 13 hastanin dosyasi retrospektif olarak incelendi.Hastalarimizin yas ortalamasi 52,7±11,00 idi ve %61,53’u postmenapozal donemde idi. Hastalarin operasyon suresi ortalama 223,46±51,85 dk, hastanede kalis suresi ortalama 8±3,05 gun ve sonda cekilme suresi ortalama 4,76± 5,19 gun olarak tespit edildi. Postoperatif rezidu ortalamasi 38,84±11,39 ml olarak tespit edildi. Komplikasyon olarak...
Prague medical report, 2021
It has been stated that the effectiveness of pectopexy method for the treatment of pelvic organ p... more It has been stated that the effectiveness of pectopexy method for the treatment of pelvic organ prolapse (POP) is similar to sacrocolpopexy. We aimed to search the effects of pectopexy method to the quality of life, sexual function and urinary incontinence. Thirty-one patients who were operated for POP with the technique of laparoscopic pectouteropexy/pectocolpopexy between January 2016 and November 2017 were included the study. Exclusion criteria were pelvic inflammatory disease, suspect of malignancy, pregnancy, prior POP or continence surgery. Quality of life inventories were (P-QOL, PISQ-12, UDI-6, IIQ-7) recorded preoperatively and at the postoperative third month. Results were compared statistically. The percentage of patients with menopause was 67.7% (n=21) and with reproductive term was 32.3% (n=10). Mean prolapse related quality of life inventory (P-QOL) score was 83.45 ± 8.7 (64-98) preoperatively and 8.61 ± 6.4 (0-23) postoperatively (p<0.05). The preoperative and post...
Study Objective To report outcomes of the vascular entrapment of the sacral plexus treated by min... more Study Objective To report outcomes of the vascular entrapment of the sacral plexus treated by minimally invasive surgery. Design Retrospective cohort study. Setting Tertiary unit specializing in advanced gynecologic surgery and neuropelveology. Patients or Participants A total of 23 patients suffering from chronic pelvic pain with the involvement of the lumbosacral plexus were included in this study. 9 out of 23 patients underwent robot-assisted laparoscopic surgery and conventional laparoscopic surgery with 3D technology were performed in 14 patients for treatment of the vascular entrapment of the lumbosacral plexus. Interventions Laparoscopic or robot-assisted laparoscopic excision of the abnormal vessels located on the lumbosacral plexus and decompression of the nerve roots. Measurements and Main Results The mean age of the patients was 35.13. All patients were suffering from chronic pelvic pain and the most common coexisting symptoms were dysmenorrhea, sciatica, vulvodynia and p...
Aplastic anemia in pregnancy is a rare condition with high maternal morbidity and mortality rates... more Aplastic anemia in pregnancy is a rare condition with high maternal morbidity and mortality rates. Intensive hematological support during antenatal course remains the mainstay of the therapy. A successful obstetric outcome can be best accomplished with the clinical collaboration of the obstetrician and the hematologist. We present a patient with moderately severe aplastic anemia who was managed with intensive hematological support given repeatedly once in a month during pregnancy. She delivered a healthy infant by cesarean section. Gebelikte aplastik anemi yuksek mortalite ve morbidite oranlarina sahip ender bir durumdur. Tedavinin temelini gebelik suresi boyunca uygulanan yogun hematolojik destek olusturmaktadir. Basarili bir obstetrik sonuc en iyi sekilde obstetrisyen ve hematologun klinik isbirligi ile gerceklestirilebilir. Bu yazida orta ciddi aplastik anemisi olup, gebeligi suresince ayda bir kez tekrarlanan yogun hematolojik destekle tedavi edilen bir hasta sunulmaktadir. Hast...
Aim of study: Aim of our study is to determine the relation between high risk HPV(16,18,31,33) ty... more Aim of study: Aim of our study is to determine the relation between high risk HPV(16,18,31,33) types, Pap smear and punch biopsy results. Material and methods: We used for our study patients which referred with abnormal cervical lesions and pathological cytology findings, from 2010-2017 years in Derince Training and Research Hospital. The data of the patients who underwent colposcopy were examined retrospectively. 151 patients were included in the study. Results: As a result of study-high risk lesions (CIN2-3) were observed in 18,18% (n=8/44) of NORMAL,10% (n=2/20) of ASCUS,27,27% (n=6/22) of LSIL,50% (n=5/10) of HSIL smear result reported patients. The result was reported as cervical squamous cell carcinoma in 1 patient with HSIL and 1 patient with LSIL. As a result, high–risk lesions (CIN2 and CIN3) were found 30,18% (n=16/53) in pathologic evaluation in HPV type 16 and 18 positive patients. In one patient with HPV18 was detected cervical squamous cell carcinoma. In our study was ...
Özet Amaç: Elektif sezaryen nedeniyle spinal yada genel anestezi yap›lan gebelerin, maternal ve y... more Özet Amaç: Elektif sezaryen nedeniyle spinal yada genel anestezi yap›lan gebelerin, maternal ve yenido¤an kortizol seviyelerini ölçmek. Yöntem: Elektif sezaryen yap›lacak gebeler rastgele olarak genel (n=32, Grup 1) ve spinal anestezi (n=39, Grup 2) fleklinde iki gruba ayr›ld›. Maternal kortizol seviyeleri sezaryen operasyonun 5.dakikas›nda ve yenido¤an kord kan› kortizol seviyeleri do¤umun 5.dakikas›nda al›nd›. ‹statistiksel analizde student-t ve Pearson correlation coefficient testi kullan›ld›. p<0.05 istatistiksel olarak anlaml› kabul edildi. Bulgular: Maternal kortizol seviyeleri genel anestezi alan grupta (14.20± 2.45 μg/dl) spinal anestezi alan gruba (8.90± 2.18 μg/dl) göre daha yüksekti (p<0.001). Yenido¤an kord kan› kortizol seviyeleri genel anestezi alan grupta (12.88± 5.06 μg/dl) spinal anestezi alan gruba göre daha yüksekti (6.74± 2.61 μg/dl) (p<0.001). Genel ve spinal anestezi alan grupta maternal ve yenido¤an kortizol seviyeleri aras›nda pozitif korelasyon sapt...
Aim: In this study, we aimed to examine the effectiveness of hypogastric artery ligation method i... more Aim: In this study, we aimed to examine the effectiveness of hypogastric artery ligation method in obstetric hemorrhage and its effects on fertility. Patients and Methods: Sixty-two patients who underwent bilateral hypogastric artery ligation (HAL) due to obstetric bleeding at Kocaeli Derince Training and Research Hospital between November 1, 2011 and November 1, 2016 were retrospectively evaluated. Results: In patients with postpartum hemorrhage, bleeding was controlled with HAL in 47 (84%) of them, while hysterectomy was performed in addition to HAL in 9 (16%) patients. While 17 patients gave consent for bilateral tubal ligation before the operation, none were in the hysterectomy group. Postoperative follow-up information was obtained for 31 of the remaining 36 patients. It was observed that 7 of the patients had an intrauterine device inserted, 3 gave birth in our center, 18 had regular menstrual periods, and 3 had hysteroscopy due to irregular menstrual periods, which revealed n...
Journal of Obstetrics and Gynaecology Research
OBJECTIVE Congenital infections can cause newborn hearing loss. Although vertical transmission of... more OBJECTIVE Congenital infections can cause newborn hearing loss. Although vertical transmission of coronavirus disease 2019 (COVID-19) infection is theoretically possible, this has not been proven yet. To our knowledge, there is no previous report on whether COVID-19 infection during pregnancy can cause congenital hearing loss. This paper aimed to find an answer to this question. METHOD This retrospective, single-center study was performed between April 2020 and May 2021 at a tertiary care referral center in Turkey. A total of 422 pregnant women who had coronavirus infection during pregnancy were followed and 203 of them gave birth in our institution. Results of hearing screening tests of 199 newborns were assessed retrospectively. RESULTS Of patients included in the study, 23 (11.6%) had the disease in the first trimester, 62 (31.2%) in the second trimester, and 114 (57.3%) in the third trimester. In the first hearing test performed on newborns, unilateral hearing loss was observed in 21 babies (10.5%). Hearing tests of these newborns were found to be normal in the second test performed 15 days later. CONCLUSION Considering the incidence of congenital hearing loss, the absence of hearing loss in our newborn population does not confirm the argument that coronavirus infection does not cause congenital hearing loss. This issue should be evaluated with larger patient series. In addition, it should be kept in mind that hearing loss can occur at later ages as well.
Gynecology and Pelvic Medicine
Pelvic pain is defined as pain localized to the pelvis below the umbilicus and usually caused by ... more Pelvic pain is defined as pain localized to the pelvis below the umbilicus and usually caused by pelvic organs, as well as pelvic bones, muscles, nerves, joints or blood vessels (1). It can be categorized as acute or chronic. The American College of Obstetrics and Gynecologists defines chronic pelvic pain (CPP) as "pain in the pelvic area that lasts for 6 months or longer and results in functional or psychological disability or requires intervention and treatment" (2,3). CPP can be constant or intermittent. It can be associated with menstruation (dysmenorrhea) or with sexual intercourse (dyspareunia) (4). According to an extensive review conducted in 2014 the prevalence of noncyclical CPP was reported between 5.7% and 26.6% (5). CPP is the reason for 1 out of 10 gynecological outpatient visits, indication for 15-40%
Journal of Obstetrics and Gynaecology Research
The purpose of this study was to assess the feasibility and efficacy of transvaginal natural orif... more The purpose of this study was to assess the feasibility and efficacy of transvaginal natural orifice transluminal endoscopic surgery (v‐NOTES) staging surgery for extreme obese patients with early‐stage type‐1 endometrial cancer.
Our aim was to investigate the effect of platelet-rich plasma (PRP) derivatives, which can be pro... more Our aim was to investigate the effect of platelet-rich plasma (PRP) derivatives, which can be produced from the patient’s own blood and have minimal side effects, on endometriosis. To the best of our knowledge, this is the first study in the literature that studies the relationship between PRP and endometriosis. Endometriosis foci were created in the first operation. In the second operation (30 th day) groups were formed. Group 1 (n= 8) was administered saline, group 2 (n= 7) leukocyte- and platelet-rich plasma (L-PRP), and group 3 (n= 8) pure platelet-rich plasma (P-PRP). Group 4 (n= 10) was used to obtain PRP. In the last operation (60 th day), the endometriotic foci were measured, and then excised. There was no statistically significant difference between the pre and post volumes of the endometriotic foci, between their volume differences and volume difference rates (p…
Journal of Minimally Invasive Gynecology
STUDY OBJECTIVE To evaluate the effect of intraoperative superior hypogastric blocks on postopera... more STUDY OBJECTIVE To evaluate the effect of intraoperative superior hypogastric blocks on postoperative pain management. DESIGN Prospective observational cohort study (Canadian Task Force classification II-2). SETTING Kocaeli Derince Training and Research Hospital, University of Health Sciences, Department of Anesthesiology and Reanimation, Department of Gynecology and Obstetrics, Kocaeli, Turkey. PATIENTS Sixty female patients who underwent elective laparoscopic hysterectomy were included in this study. Patients were divided into 2 groups: those who had intraoperative superior hypogastric plexus (SHP) block (Hypo; n = 30) and those who did not have intraoperative SHP block (No-Hypo; n = 30). INTERVENTIONS Intraoperative SHP blocks were performed with the modified laparoscopic technique previously described by us. MEASUREMENTS AND MAIN RESULTS Rescue analgesic time was calculated in minutes as the time interval between the last administration of analgesic in the operating room or postanesthesia care unit and the first analgesic demand in the surgical ward. Rescue analgesic times were found to be significantly higher in the Hypo group. Nonsteroidal anti-inflammatory drugs and opioid requirements in the postanesthesia care unit and in the surgical ward were significantly lower in the Hypo group. There was no difference between groups in postoperative nausea and vomiting. CONCLUSIONS Intraoperative SHP block is a preferable modality for postoperative analgesia in patients undergoing hysterectomy. The surgical laparoscopic modified anterior approach we describe is an uncomplicated and easily applicable method. More effective results would be seen if used together with wound site local anesthetic infiltration or abdominal wall plane blocks. (Clinical trial registration no. NCT03427840.).
Kocaeli Medical Journal
3 36 6 °°C C ı ıs sı ıt tı ıl lm mı ış ş % %1 10 0' 'l lu uk k p po ov vi id do on n-i iy yo ot t... more 3 36 6 °°C C ı ıs sı ıt tı ıl lm mı ış ş % %1 10 0' 'l lu uk k p po ov vi id do on n-i iy yo ot t s so ol lü üs sy yo on nu un nu un n s se ez za ar ry ye en n o op pe er ra as sy yo on nl la ar rı ın nd da a h ha as st ta an nı ın n h he em mo od di in na am mi iğ ği i ü üz ze er ri in ne e e et tk ki is si i E Ef ff fe ec ct t o of f 3 36 6 °°C C h he ea at te ed d 1 10 0% % p po ov vi id do on ne e-i io od di in ne e s so ol lu ut ti io on ns s o on n p pa at ti ie en nt t' 's s h he em mo od dy yn na am mi ic cs s i in n c ca ae es se er re ea an n o op pe er ra at ti io on ns s
Journal of Endometriosis and Pelvic Pain Disorders
Introduction: The aim of this case to present a woman with neurovascular entrapment causing persi... more Introduction: The aim of this case to present a woman with neurovascular entrapment causing persistent sciatica. We presented the surgical management and the feasibility, safety, and early postoperative outcomes, as well as step-by-step explanation of the surgical technique that it was enriched via original video footage. Case description: A 29-year-old woman has been suffering from chronic pelvic pain and sciatica for 1 year. She had received medical physical treatment for 6 months and did not have any response to pain. Her visual analog scale score was 8/10 points. Neurovascular entrapment was considered as a preliminary diagnosis. The laparoscopic approach showed that an aberrant hypogastric vein branch compressing the sciatic nerve and sacral 2 nerve root. The decompression of these nerves was performed successfully. The total operation time was 50 min. There was no intraoperative and postoperative complication. The visual analog scale score on the postoperative 24th-h was 1/10 ...
Journal of Endometriosis and Pelvic Pain Disorders
The nerves located in the deepest areas can be exposed and dissected via laparoscopic magnificati... more The nerves located in the deepest areas can be exposed and dissected via laparoscopic magnification. This technological innovation does not only help us to avoid surgery-related complications but also allows us to diagnose the vascular entrapment syndromes. The aim of this article is to demonstrate female neuroanatomy and autonomic plexus via enriched photos and videos to reveal the relationship of the pelvic nervous system with gynecological operations.
International Neurourology Journal, 2021
Entrapment neuropathy of the sciatic nerve and pudendal nerve are painful syndromes that are ofte... more Entrapment neuropathy of the sciatic nerve and pudendal nerve are painful syndromes that are often overlooked by physicians. Laparoscopic surgical interventions for nerve entrapment syndromes of the posterior pelvis focus on removing the compression lesion with the purpose of eliminating the suspected cause of sciatica, as well as pudendal neuralgia. Herein, the authors report the rare event of sciatic and pudendal nerve entrapment, which was caused by aberrant vessels and a variant piriformis muscle bundle, as a seldom-diagnosed cause of sciatica and pelvic pain, for both neurosurgeons and neuropelveologists. The authors present the laparoscopic decompression technique for the pudendal and sciatic nerves by giving our technical “tips and tricks” enriched by a surgical video.
Kocatepe Tıp Dergisi, 2015
Çalışmamızın amacı hastanemiz kadın hastalıkları ve doğum polikliniklerine rutin gebelik takibi i... more Çalışmamızın amacı hastanemiz kadın hastalıkları ve doğum polikliniklerine rutin gebelik takibi için başvuran hastalarda gestasyonel diyabetes mellitus (GDM) sıklığını araştırmak ve bu olguların perinatal sonuçlarını analiz etmektir.
Southern Clinics of Istanbul Eurasia
The sciatic nerve is the nerve of the lower limb. It is derived from spinal nerves, fourth Lumbar... more The sciatic nerve is the nerve of the lower limb. It is derived from spinal nerves, fourth Lumbar (L4) to third Sacral (S3). The sciatic nerve innervates the muscles of the posterior thigh and additionally has sensory functions. Sciatica is the given name to the pain sourced by irritation of the sciatic nerve. Sciatica is most commonly induced by compression of a lower lumbar nerve root (L4, L5, or S1). Various intrapelvic pathologies include gynecological, vascular, traumatic, inflammatory, and tumoral disorders that may cause sciatica. Intrapelvic pathologies that mimic disc herniation are quite always ignored. Surgical approach and a functional exploration by laparoscopy or robotic surgery have significantly increased the intrapelvic pathology's awareness, resulting in sciatica. After a detailed assessment of the patient, which causes intrapelvic pathologies, deciding whether surgical or medical therapy is needed, notable results in sciatic pain remission can be done.
Erken evre serviks kanseri (EvreIA1-Evre IIA) tedavisinde geleneksel radikal histerektomi yapilan... more Erken evre serviks kanseri (EvreIA1-Evre IIA) tedavisinde geleneksel radikal histerektomi yapilan hastalarda postoperatif donemde pelvik taban disfonksiyonu gorulmektedir. Bu calismada Kocaeli Derince Egitim ve Arastirma Hastanesi Kadin Hastaliklari ve Dogum Kliniginde Ocak 2015-Ocak 2018 yillari arasinda Erken evre serviks tanisi alan laparaskopik sinir koruyucu radikal histerektomi (LSKRH) yapilan 13 olgunun klinik ilk deneyimini, operasyon sonrasi kontrollerinde Urogenital Distress Inventory (UDI 6) anket testi ve hasta memnuniyet skoru (HMS) sonuclarini degerlendirmek amaclandi. Calisma kapsaminda 13 hastanin dosyasi retrospektif olarak incelendi.Hastalarimizin yas ortalamasi 52,7±11,00 idi ve %61,53’u postmenapozal donemde idi. Hastalarin operasyon suresi ortalama 223,46±51,85 dk, hastanede kalis suresi ortalama 8±3,05 gun ve sonda cekilme suresi ortalama 4,76± 5,19 gun olarak tespit edildi. Postoperatif rezidu ortalamasi 38,84±11,39 ml olarak tespit edildi. Komplikasyon olarak...
Prague medical report, 2021
It has been stated that the effectiveness of pectopexy method for the treatment of pelvic organ p... more It has been stated that the effectiveness of pectopexy method for the treatment of pelvic organ prolapse (POP) is similar to sacrocolpopexy. We aimed to search the effects of pectopexy method to the quality of life, sexual function and urinary incontinence. Thirty-one patients who were operated for POP with the technique of laparoscopic pectouteropexy/pectocolpopexy between January 2016 and November 2017 were included the study. Exclusion criteria were pelvic inflammatory disease, suspect of malignancy, pregnancy, prior POP or continence surgery. Quality of life inventories were (P-QOL, PISQ-12, UDI-6, IIQ-7) recorded preoperatively and at the postoperative third month. Results were compared statistically. The percentage of patients with menopause was 67.7% (n=21) and with reproductive term was 32.3% (n=10). Mean prolapse related quality of life inventory (P-QOL) score was 83.45 ± 8.7 (64-98) preoperatively and 8.61 ± 6.4 (0-23) postoperatively (p<0.05). The preoperative and post...
Study Objective To report outcomes of the vascular entrapment of the sacral plexus treated by min... more Study Objective To report outcomes of the vascular entrapment of the sacral plexus treated by minimally invasive surgery. Design Retrospective cohort study. Setting Tertiary unit specializing in advanced gynecologic surgery and neuropelveology. Patients or Participants A total of 23 patients suffering from chronic pelvic pain with the involvement of the lumbosacral plexus were included in this study. 9 out of 23 patients underwent robot-assisted laparoscopic surgery and conventional laparoscopic surgery with 3D technology were performed in 14 patients for treatment of the vascular entrapment of the lumbosacral plexus. Interventions Laparoscopic or robot-assisted laparoscopic excision of the abnormal vessels located on the lumbosacral plexus and decompression of the nerve roots. Measurements and Main Results The mean age of the patients was 35.13. All patients were suffering from chronic pelvic pain and the most common coexisting symptoms were dysmenorrhea, sciatica, vulvodynia and p...
Aplastic anemia in pregnancy is a rare condition with high maternal morbidity and mortality rates... more Aplastic anemia in pregnancy is a rare condition with high maternal morbidity and mortality rates. Intensive hematological support during antenatal course remains the mainstay of the therapy. A successful obstetric outcome can be best accomplished with the clinical collaboration of the obstetrician and the hematologist. We present a patient with moderately severe aplastic anemia who was managed with intensive hematological support given repeatedly once in a month during pregnancy. She delivered a healthy infant by cesarean section. Gebelikte aplastik anemi yuksek mortalite ve morbidite oranlarina sahip ender bir durumdur. Tedavinin temelini gebelik suresi boyunca uygulanan yogun hematolojik destek olusturmaktadir. Basarili bir obstetrik sonuc en iyi sekilde obstetrisyen ve hematologun klinik isbirligi ile gerceklestirilebilir. Bu yazida orta ciddi aplastik anemisi olup, gebeligi suresince ayda bir kez tekrarlanan yogun hematolojik destekle tedavi edilen bir hasta sunulmaktadir. Hast...
Aim of study: Aim of our study is to determine the relation between high risk HPV(16,18,31,33) ty... more Aim of study: Aim of our study is to determine the relation between high risk HPV(16,18,31,33) types, Pap smear and punch biopsy results. Material and methods: We used for our study patients which referred with abnormal cervical lesions and pathological cytology findings, from 2010-2017 years in Derince Training and Research Hospital. The data of the patients who underwent colposcopy were examined retrospectively. 151 patients were included in the study. Results: As a result of study-high risk lesions (CIN2-3) were observed in 18,18% (n=8/44) of NORMAL,10% (n=2/20) of ASCUS,27,27% (n=6/22) of LSIL,50% (n=5/10) of HSIL smear result reported patients. The result was reported as cervical squamous cell carcinoma in 1 patient with HSIL and 1 patient with LSIL. As a result, high–risk lesions (CIN2 and CIN3) were found 30,18% (n=16/53) in pathologic evaluation in HPV type 16 and 18 positive patients. In one patient with HPV18 was detected cervical squamous cell carcinoma. In our study was ...
Özet Amaç: Elektif sezaryen nedeniyle spinal yada genel anestezi yap›lan gebelerin, maternal ve y... more Özet Amaç: Elektif sezaryen nedeniyle spinal yada genel anestezi yap›lan gebelerin, maternal ve yenido¤an kortizol seviyelerini ölçmek. Yöntem: Elektif sezaryen yap›lacak gebeler rastgele olarak genel (n=32, Grup 1) ve spinal anestezi (n=39, Grup 2) fleklinde iki gruba ayr›ld›. Maternal kortizol seviyeleri sezaryen operasyonun 5.dakikas›nda ve yenido¤an kord kan› kortizol seviyeleri do¤umun 5.dakikas›nda al›nd›. ‹statistiksel analizde student-t ve Pearson correlation coefficient testi kullan›ld›. p<0.05 istatistiksel olarak anlaml› kabul edildi. Bulgular: Maternal kortizol seviyeleri genel anestezi alan grupta (14.20± 2.45 μg/dl) spinal anestezi alan gruba (8.90± 2.18 μg/dl) göre daha yüksekti (p<0.001). Yenido¤an kord kan› kortizol seviyeleri genel anestezi alan grupta (12.88± 5.06 μg/dl) spinal anestezi alan gruba göre daha yüksekti (6.74± 2.61 μg/dl) (p<0.001). Genel ve spinal anestezi alan grupta maternal ve yenido¤an kortizol seviyeleri aras›nda pozitif korelasyon sapt...
Aim: In this study, we aimed to examine the effectiveness of hypogastric artery ligation method i... more Aim: In this study, we aimed to examine the effectiveness of hypogastric artery ligation method in obstetric hemorrhage and its effects on fertility. Patients and Methods: Sixty-two patients who underwent bilateral hypogastric artery ligation (HAL) due to obstetric bleeding at Kocaeli Derince Training and Research Hospital between November 1, 2011 and November 1, 2016 were retrospectively evaluated. Results: In patients with postpartum hemorrhage, bleeding was controlled with HAL in 47 (84%) of them, while hysterectomy was performed in addition to HAL in 9 (16%) patients. While 17 patients gave consent for bilateral tubal ligation before the operation, none were in the hysterectomy group. Postoperative follow-up information was obtained for 31 of the remaining 36 patients. It was observed that 7 of the patients had an intrauterine device inserted, 3 gave birth in our center, 18 had regular menstrual periods, and 3 had hysteroscopy due to irregular menstrual periods, which revealed n...
Journal of Obstetrics and Gynaecology Research
OBJECTIVE Congenital infections can cause newborn hearing loss. Although vertical transmission of... more OBJECTIVE Congenital infections can cause newborn hearing loss. Although vertical transmission of coronavirus disease 2019 (COVID-19) infection is theoretically possible, this has not been proven yet. To our knowledge, there is no previous report on whether COVID-19 infection during pregnancy can cause congenital hearing loss. This paper aimed to find an answer to this question. METHOD This retrospective, single-center study was performed between April 2020 and May 2021 at a tertiary care referral center in Turkey. A total of 422 pregnant women who had coronavirus infection during pregnancy were followed and 203 of them gave birth in our institution. Results of hearing screening tests of 199 newborns were assessed retrospectively. RESULTS Of patients included in the study, 23 (11.6%) had the disease in the first trimester, 62 (31.2%) in the second trimester, and 114 (57.3%) in the third trimester. In the first hearing test performed on newborns, unilateral hearing loss was observed in 21 babies (10.5%). Hearing tests of these newborns were found to be normal in the second test performed 15 days later. CONCLUSION Considering the incidence of congenital hearing loss, the absence of hearing loss in our newborn population does not confirm the argument that coronavirus infection does not cause congenital hearing loss. This issue should be evaluated with larger patient series. In addition, it should be kept in mind that hearing loss can occur at later ages as well.
Gynecology and Pelvic Medicine
Pelvic pain is defined as pain localized to the pelvis below the umbilicus and usually caused by ... more Pelvic pain is defined as pain localized to the pelvis below the umbilicus and usually caused by pelvic organs, as well as pelvic bones, muscles, nerves, joints or blood vessels (1). It can be categorized as acute or chronic. The American College of Obstetrics and Gynecologists defines chronic pelvic pain (CPP) as "pain in the pelvic area that lasts for 6 months or longer and results in functional or psychological disability or requires intervention and treatment" (2,3). CPP can be constant or intermittent. It can be associated with menstruation (dysmenorrhea) or with sexual intercourse (dyspareunia) (4). According to an extensive review conducted in 2014 the prevalence of noncyclical CPP was reported between 5.7% and 26.6% (5). CPP is the reason for 1 out of 10 gynecological outpatient visits, indication for 15-40%
Journal of Obstetrics and Gynaecology Research
The purpose of this study was to assess the feasibility and efficacy of transvaginal natural orif... more The purpose of this study was to assess the feasibility and efficacy of transvaginal natural orifice transluminal endoscopic surgery (v‐NOTES) staging surgery for extreme obese patients with early‐stage type‐1 endometrial cancer.
Our aim was to investigate the effect of platelet-rich plasma (PRP) derivatives, which can be pro... more Our aim was to investigate the effect of platelet-rich plasma (PRP) derivatives, which can be produced from the patient’s own blood and have minimal side effects, on endometriosis. To the best of our knowledge, this is the first study in the literature that studies the relationship between PRP and endometriosis. Endometriosis foci were created in the first operation. In the second operation (30 th day) groups were formed. Group 1 (n= 8) was administered saline, group 2 (n= 7) leukocyte- and platelet-rich plasma (L-PRP), and group 3 (n= 8) pure platelet-rich plasma (P-PRP). Group 4 (n= 10) was used to obtain PRP. In the last operation (60 th day), the endometriotic foci were measured, and then excised. There was no statistically significant difference between the pre and post volumes of the endometriotic foci, between their volume differences and volume difference rates (p…
Journal of Minimally Invasive Gynecology
STUDY OBJECTIVE To evaluate the effect of intraoperative superior hypogastric blocks on postopera... more STUDY OBJECTIVE To evaluate the effect of intraoperative superior hypogastric blocks on postoperative pain management. DESIGN Prospective observational cohort study (Canadian Task Force classification II-2). SETTING Kocaeli Derince Training and Research Hospital, University of Health Sciences, Department of Anesthesiology and Reanimation, Department of Gynecology and Obstetrics, Kocaeli, Turkey. PATIENTS Sixty female patients who underwent elective laparoscopic hysterectomy were included in this study. Patients were divided into 2 groups: those who had intraoperative superior hypogastric plexus (SHP) block (Hypo; n = 30) and those who did not have intraoperative SHP block (No-Hypo; n = 30). INTERVENTIONS Intraoperative SHP blocks were performed with the modified laparoscopic technique previously described by us. MEASUREMENTS AND MAIN RESULTS Rescue analgesic time was calculated in minutes as the time interval between the last administration of analgesic in the operating room or postanesthesia care unit and the first analgesic demand in the surgical ward. Rescue analgesic times were found to be significantly higher in the Hypo group. Nonsteroidal anti-inflammatory drugs and opioid requirements in the postanesthesia care unit and in the surgical ward were significantly lower in the Hypo group. There was no difference between groups in postoperative nausea and vomiting. CONCLUSIONS Intraoperative SHP block is a preferable modality for postoperative analgesia in patients undergoing hysterectomy. The surgical laparoscopic modified anterior approach we describe is an uncomplicated and easily applicable method. More effective results would be seen if used together with wound site local anesthetic infiltration or abdominal wall plane blocks. (Clinical trial registration no. NCT03427840.).
Kocaeli Medical Journal
3 36 6 °°C C ı ıs sı ıt tı ıl lm mı ış ş % %1 10 0' 'l lu uk k p po ov vi id do on n-i iy yo ot t... more 3 36 6 °°C C ı ıs sı ıt tı ıl lm mı ış ş % %1 10 0' 'l lu uk k p po ov vi id do on n-i iy yo ot t s so ol lü üs sy yo on nu un nu un n s se ez za ar ry ye en n o op pe er ra as sy yo on nl la ar rı ın nd da a h ha as st ta an nı ın n h he em mo od di in na am mi iğ ği i ü üz ze er ri in ne e e et tk ki is si i E Ef ff fe ec ct t o of f 3 36 6 °°C C h he ea at te ed d 1 10 0% % p po ov vi id do on ne e-i io od di in ne e s so ol lu ut ti io on ns s o on n p pa at ti ie en nt t' 's s h he em mo od dy yn na am mi ic cs s i in n c ca ae es se er re ea an n o op pe er ra at ti io on ns s
Journal of Endometriosis and Pelvic Pain Disorders
Introduction: The aim of this case to present a woman with neurovascular entrapment causing persi... more Introduction: The aim of this case to present a woman with neurovascular entrapment causing persistent sciatica. We presented the surgical management and the feasibility, safety, and early postoperative outcomes, as well as step-by-step explanation of the surgical technique that it was enriched via original video footage. Case description: A 29-year-old woman has been suffering from chronic pelvic pain and sciatica for 1 year. She had received medical physical treatment for 6 months and did not have any response to pain. Her visual analog scale score was 8/10 points. Neurovascular entrapment was considered as a preliminary diagnosis. The laparoscopic approach showed that an aberrant hypogastric vein branch compressing the sciatic nerve and sacral 2 nerve root. The decompression of these nerves was performed successfully. The total operation time was 50 min. There was no intraoperative and postoperative complication. The visual analog scale score on the postoperative 24th-h was 1/10 ...
Journal of Endometriosis and Pelvic Pain Disorders
The nerves located in the deepest areas can be exposed and dissected via laparoscopic magnificati... more The nerves located in the deepest areas can be exposed and dissected via laparoscopic magnification. This technological innovation does not only help us to avoid surgery-related complications but also allows us to diagnose the vascular entrapment syndromes. The aim of this article is to demonstrate female neuroanatomy and autonomic plexus via enriched photos and videos to reveal the relationship of the pelvic nervous system with gynecological operations.