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Papers by berna haliloglu

Research paper thumbnail of Stepwise Rising CO 2 Insufflation as an Ischemic Preconditioning Method

Journal of Laparoendoscopic & Advanced Surgical Techniques, 2007

The pneumoperitoneum (Pp) is associated with ischemia and reperfusion (I/R) injury and oxidative ... more The pneumoperitoneum (Pp) is associated with ischemia and reperfusion (I/R) injury and oxidative stress. Various ischemic-preconditioning (IP) methods were used to reduce ischemic injury in intra-abdominal organs. In this experimental, randomized, controlled trial with a blind assessment of the outcome, we evaluated the effects of a new IP method, stepwise rising CO 2 insufflation, on oxidative stress and inflammatory cytokine response.

Research paper thumbnail of Serotonin dilemma in postmenopausal women: Is it low or high

Maturitas, 2008

Objective: In this study, we have studied with premenopausal (PM), naturally menopausal (NM) and ... more Objective: In this study, we have studied with premenopausal (PM), naturally menopausal (NM) and surgically induced menopausal (SM) women in order to investigate the differences in serum cortisol, dehydroepiandrosterone sulfate (DHEA-S), follicle stimulating hormone (FSH) and estradiol (E2) levels on serum serotonin levels. Methods: Forty premenopausal (36.7 ± 3.5 years), 40 naturally menopausal (54.2 ± 8.4 years) and 38 surgically induced menopausal (55.4 ± 11.2 years) women were included in the study. None of the subjects were using antidepressants or hormone replacement therapy. In NM and SM, years since menopause (YSM) were 3.16 ± 1.58 and 3.36 ± 1.89, respectively. Cortisol, DHEA-S, FSH and E2 levels were determined by immunochemiluminisence while serotonin levels were determined by HPLC. Results: Serum serotonin levels in NM women were higher than the other two groups [144.23 ± 45.29 g/L vs 61.35 ± 37.72 g/L in SM women and 98.74 ± 50.29 g/L in PM women]. E2 and DHEA-S were positively correlated, while FSH and cortisol were negatively correlated with serotonin in NM and SM. There was no significant correlation between serotonin and age or YSM. In the PM group, there was no significant correlation between serotonin and the hormones. Conclusion: In conclusion, increased serotonin levels in naturally menopausal women may be a compensatory mechanism to decreased E2 levels as it is postulated that there is strong interaction between E2 and the serotoninergic system.

Research paper thumbnail of Comparison of uterine artery blood flow with levonorgestrel intrauterine system and copper intrauterine device

Contraception, 2011

Background: As a contraceptive method, we investigated whether the levonorgestrel-releasing intra... more Background: As a contraceptive method, we investigated whether the levonorgestrel-releasing intrauterine system (LNG-IUS) has any effect on uterine artery blood flow when compared with copper intrauterine device (IUD). Study Design: Sixty women with copper IUD and 60 women with LNG-IUS were included in the study. The age, gravidity, parity, body mass index (BMI) and menstrual flow pattern using a pictorial chart were recorded. All women were assessed by ultrasonography at the preinsertion period and 1 year after insertion. The pulsatility and resistance indices (PI and RI, respectively) of the uterine artery and endometrial thickness were evaluated in the preinsertion and postinsertion periods. Results: In copper IUD users, preinsertion and postinsertion ultrasonographic assessments were not significantly different. However, postinsertion RI was significantly higher compared with preinsertion RI in LNG-IUS users (p=.001). The PI was also increased 1 year after insertion, but it did not reach statistically significant levels (p=.08). Endometrial thickness was also significantly decreased in the postinsertion period in women with LNG-IUS (p=.04). Conclusion: The significant increase in uterine artery RI in LNG-IUS users 1 year after insertion might be due to its local progestational effects. It might also indicate the mechanism of the LNG-IUS in reducing menstrual blood flow.

Research paper thumbnail of An Extremely Rare Cause of Acute Abdomen in Pregnancy: Ruptured Pancreatic Mucinous Cystadenocarcinoma

Pancreas, 2007

Pancreatic cystadenocarcinoma is an extremely rare neoplasm in pregnancy. To our knowledge, there... more Pancreatic cystadenocarcinoma is an extremely rare neoplasm in pregnancy. To our knowledge, there have been 2 published cases of pancreatic mucinous cystadenocarcinoma (PMC) during pregnancy in the literature; one of which was reported to have ruptured into the abdominal cavity. We present a second case of ruptured PMC resulting in acute abdomen in 36 weeks of pregnancy. Rupture of mucinous cystic neoplasms of pancreas including PMC should be remembered in acute abdomen during pregnancy.

Research paper thumbnail of Thrombotic thrombocytopenic purpura and pregnancy treated with fresh-frozen plasma infusions after plasmapheresis: a case report

Blood Coagulation & Fibrinolysis, 2007

Thrombotic thrombocytopenic purpura is a serious, highly mortal disease that goes with pregnancy.... more Thrombotic thrombocytopenic purpura is a serious, highly mortal disease that goes with pregnancy. The diagnosis may be difficult due to similar symptoms to other pregnancy-related diseases. Treatment of the patient differs with the clinic. Plasmapheresis continued with fresh-frozen plasma infusion may be a good choice.

Research paper thumbnail of Negative correlation between D-dimer and homocysteine levels during pregnancy and the postpartum period: a prospective study

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2010

Objective: There have been conflicting data about the role of increased levels of homocysteine (H... more Objective: There have been conflicting data about the role of increased levels of homocysteine (Hcy) on haemostatic system. We aim to investigate prospectively the relation between serum Hcy levels and changes in haemostatic system in pregnancy and postpartum period. Study design: Sixty-eight healthy pregnant women were included in the study. Blood samples were obtained in the 11th gestational week, 25th gestational week, 32nd gestational week and postpartum 4th week. The haemoglobin levels, white blood cell count (WBC), platelet count, activated partial thromboplastin time (aPTT), prothrombin time (PT), fibrinogen, D-dimer, Hcy, vitamin B12, and folate levels were measured. Results: Serum Hcy levels were negatively correlated with D-dimer levels (r = À0.57, p < 0.0001). The highest levels of D-dimer (1046.62 AE 322.01 ng/ml) were achieved in the third trimester and the lowest levels of serum Hcy (4.45 AE 1.23 mmol/l) were detected in the same trimester. In postpartum fourth week, Ddimer levels were decreased to normal levels (238.27 AE 198.59 ng/ml) while the serum Hcy levels were reached to the highest levels (7.99 AE 1.36 mmol/l). Conclusion: The negative correlation between Hcy and D-dimer levels may be a compensatory mechanism to maintain the normal haemostatic balance in pregnancy. Hence, possible advantage of low Hcy levels in pregnancy may be to prevent undesired thrombosis. ß

Research paper thumbnail of Bone turnover and maternal 25(OH) vitamin D3 levels during pregnancy and the postpartum period: should routine vitamin D supplementation be increased in pregnant women

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2011

Research paper thumbnail of The role of urethral hypermobility and intrinsic sphincteric deficiency on the outcome of transobturator tape procedure: a prospective study with 2-year follow-up

International Urogynecology Journal, 2010

Introduction and hypothesis The aim of this study is to investigate the effect of intrinsic sphin... more Introduction and hypothesis The aim of this study is to investigate the effect of intrinsic sphincter deficiency (ISD) and urethral hypermobility on the outcome of the transobturator tape (TOT). Methods Sixty-five women were divided into three groups: group I, ISD with hypermobile urethra (n = 18); group II, ISD with fixed urethra (n = 16); and group III, hypermobile urethra without ISD (n = 31). Cure of stress urinary incontinence was defined if the patient had negative cough stress test. Cure and improvement rates were compared at 6, 12, and 24 months. Results The cure and improvement rates of groups I and III were similar at 6, 12, and 24 months (96.1% vs 96.6%, 96.1% vs 96.6%, and 87.5 vs %96.4%, respectively). Group II had the lowest cure and improvement rates (68.7%, 66.7%, and 66.7%, respectively). Conclusion A lack of urethral hypermobility may be a risk factor for TOT failure.

Research paper thumbnail of Metastatic ovarian carcinoma one year after surgical removal of colon carcinoma during pregnancy: a case report

International Journal of Gynecological Cancer, 2006

Abstract. Gurbuz A, Kir G, Karateke A, Haliloglu B, Kabaca C. Metastatic ovarian carcinoma one y... more Abstract. Gurbuz A, Kir G, Karateke A, Haliloglu B, Kabaca C. Metastatic ovarian carcinoma one year after surgical removal of colon carcinoma during pregnancy: a case report. Int J Gynecol Cancer 2006;16(Suppl. 1):330–333.Colorectal carcinoma during pregnancy is a very rare event. We presented a woman with metachronous metastatic ovarian tumor existing 1 year after surgical removal of perforated sigmoid colon carcinoma encountered during cesarean section of woman of 36-week gestation for fetal distress. Pregnant women with suspicious abdominal mass should be evaluated for a possible colorectal carcinoma even in the absence of any other gastrointestinal symptoms associated with it and undergo rectal examination and sigmoidoscopy. In addition, as synchronous and metachronous ovarian metastases are common in these patients, ovaries must be evaluated carefully by bisection during operation for possible metastasis, and in women who do not have a desire for fertility, prophylactic oophorectomy seems an appropriate treatment modality for resecting synchronous metastasis and preventing future metastasis.

Research paper thumbnail of Abdominal surgical approach to a case of complete cervical and partial vaginal agenesis

Fertility and Sterility, 2005

Objective: To construct a uterovaginal canal in a patient with a complete cervical agenesis and p... more Objective: To construct a uterovaginal canal in a patient with a complete cervical agenesis and partial vaginal agenesis. Design: Case report. Setting: Zeynep Kamil Women's and Children Hospital. Patient(s): A 15-year-old woman presented with lower abdominal pain. On examination, partial vaginal agenesis with a 4-cm vagina was noted. A pelvic ultrasonography revealed hematometra and the absence of a cervix. Intervention(s): Surgical therapy included creation of an ostium by making 1.5-cm midline vertical hysterotomy incision, trimming away the fibrous tissue at the distal portion of uterus, and attaching the proximal end of the vagina to the uterus by the abdominal route. A stent was left in place for 2 weeks. Main Outcome Measure(s): Pelvic ultrasonography and clinical follow-up evaluation. Result(s): Regular menstrual periods were observed for 6 months beginning at the first month. The follow-up pelvic ultrasonography was normal. Conclusion(s): Cervicoplasty attaching the mucosal lining of the endometrium to that of the vagina permits the creation of a patent cervical canal with short stenting time. (Fertil Steril 2005;84:217.e9 -11.

Research paper thumbnail of Intestinal vaginoplasty: seven years' experience of a tertiary center

Fertility and Sterility, 2010

Objective: To investigate the long-term effects of intestinal vaginoplasty in cases with Mayer-Ro... more Objective: To investigate the long-term effects of intestinal vaginoplasty in cases with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. Design: Prospective study. Setting: Division of Pelvic Reconstructive Surgery, Department of Gynecology and Obstetrics, at a women's and children disease education and research hospital. Patient(s): Between 2003 and 2009, 29 patients with MRKH syndrome underwent intestinal vaginoplasty. Intervention(s): Two of the patients were treated with ileal and 27 with sigmoid vaginoplasty. Main Outcome Measure(s): The age, marital status, associated anomalies, method used for bowel transposition (isoperistaltic/antiperistaltic), type of abdominal incision, and intra-and postoperative complications were evaluated.

Research paper thumbnail of A case of microglandular adenocarcinoma of the endometrium

Gynecologic Oncology, 2005

Backround. Microglandular adenocarcinoma is a rare type of endometrium carcinoma and had some pot... more Backround. Microglandular adenocarcinoma is a rare type of endometrium carcinoma and had some potential diagnostic problems with difficulties in discriminating from some malign and benign lesions of cervix.

Research paper thumbnail of Third trimester nonrecurrent fetal loss is associated with factor V Leiden and prothrombin gene mutations

Journal of Maternal-fetal & Neonatal Medicine, 2005

To determine the role of factor V Leiden and prothrombin gene mutation in the pathogenesis of une... more To determine the role of factor V Leiden and prothrombin gene mutation in the pathogenesis of unexplained second and third trimester nonrecurrent fetal loss. One hundred and fourteen women with unexplained nonrecurrent late fetal loss made up the study group, and 106 normal pregnant women with a history of delivery of at least one healthy fetus and no history of late fetal loss made up the control group. The study group was further divided into two subgroups: second (n = 36) and third (n = 78) trimester fetal loss. All women were tested for factor V Leiden and G20210A prothrombin gene mutations. Twenty-one (18.4%) of the women in the study group and seven (6.6%) of the women in the control group were heterozygous carriers of factor V Leiden mutation (OR = 3.19). Eleven (9.6%) of the women in the study group and three (2.8%) of the women in the control group were heterozygous carriers of prothrombin gene mutation (OR = 3.66). In assessing with regard to trimesters, 18 (23%) factor V Leiden and 10 (12.8%) prothrombin gene mutations were present in the group of third trimester fetal loss (OR = 4.24 and OR = 5.04, respectively). Three (8.3%) factor V Leiden and one (2.7%) prothrombin gene mutation were detected in women with second trimester fetal loss (OR = 1.28 and OR = 0.40, respectively). Factor V Leiden and prothrombin gene mutations were associated with third trimester nonrecurrent fetal loss. These mutations should be screened in women with third trimester but not second trimester unexplained nonrecurrent late fetal loss.

Research paper thumbnail of Comparison of TVT and TVT-O in patients with stress urinary incontinence: Short-term cure rates and factors influencing the outcome. A prospective randomised study

Australian & New Zealand Journal of Obstetrics & Gynaecology, 2009

Background: Recently, mid-urethral slings have been commonly used in treatment of patients with s... more Background: Recently, mid-urethral slings have been commonly used in treatment of patients with stress urinary incontinence (SUI).Aims: To investigate tension-free vaginal tape (TVT) and tension-free obturator tape (TVT-O) for surgical treatment of SUI for cure rates (primary endpoint), complications and factors influencing cure rate (secondary endpoints).Methods: One-hundred and sixty-four patients were included in the study (n = 81 for TVT, n = 83 for TVT-O). The cure rates, complications, preoperative and postoperative urodynamic evaluation, Q-tip test, the Turkish version of Incontinence Impact Questionnaire (IIQ-7) and Urogenital Distress Inventory (UDI-6) scores were recorded. At three and 12 months, the patients were evaluated regarding outcome measures.Results: The cure rates were similar in TVT and TVT-O groups, 88.9% versus 86.7% respectively. Mean operative time was significantly shorter in TVT-O group (P = 0.001). The cure rate was significantly higher in both groups in patients with urethral hypermobility when compared with those with no hypermobility (P = 0.001).Conclusions: The TVT and TVT-O procedures appear to be equally effective for the treatment of SUI. Also, urethral hypermobility seems to be a factor influencing cure rate of mid-urethral slings.

Research paper thumbnail of Intestinal vaginoplasty: is it optimal treatment of vaginal agenesis? A pilot study

International Urogynecology Journal, 2006

The outcome of 11 cases with vaginal agenesis who underwent intestinal vaginoplasties are present... more The outcome of 11 cases with vaginal agenesis who underwent intestinal vaginoplasties are presented. Patients were between 18 and 37 years old. Ileum vaginoplasty and sigmoid colon vaginoplasty were carried out in two and nine cases, respectively. Ileum necrosis at donor site requiring ileum resection and bilateral ileostomy encountered in one of the cases was the major complication. Mild stenosis responsive to finger dilatation had been detected in two women with sigmoid vaginoplasty. Excess mucous production, long operation time, and shortness of mesentery of ileum led us to abandon ileum vaginoplasty, and sigmoid colon vaginoplasty was performed in the following cases with vaginal agenesis. All of the neovaginas were patent and functional. We suggest sigmoid colon vaginoplasty as the treatment of choice because of its large lumen, thick walls resistant to trauma, adequate secretion allowing lubrication, not necessitating prolonged dilatation, short recovery time compared with ileum vaginoplasties; and in patients reluctance to prolonged use of dilatators or in those who experienced previous failure of the other treatment modalities.

Research paper thumbnail of Mucoepidermoid variant of adenosquamous carcinoma arising in ovarian dermoid cyst: a case report and review of the literature

International Journal of Gynecological Cancer, 2006

Abstract. Karateke A, Gurbuz A, Kir G, Haliloglu B, Kabaca C, Devranoglu B, Yakut Y. Mucoepiderm... more Abstract. Karateke A, Gurbuz A, Kir G, Haliloglu B, Kabaca C, Devranoglu B, Yakut Y. Mucoepidermoid variant of adenosquamous carcinoma arising in ovarian dermoid cyst: a case report and review of the literature. Int J Gynecol Cancer 2006;16(Suppl. 1):379–384.A 40-year-old woman with mucoepidermoid variant of adenosquamous carcinoma arising in dermoid cyst in left ovary is presented. The patient was staged as IC. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and pelvic and para-aortic lymph node sampling were carried out. The disease recurred in postoperative 12th month. To our best knowledge, this is 12th case of adenosquamous carcinoma in dermoid cyst and third case of mucoepidermoid variant of adenosquamous carcinoma in the literature.

Research paper thumbnail of The role of urethral hypermobility and intrinsic sphincteric deficiency on the outcome of transobturator tape procedure: a prospective study with 2-year follow-up

International Urogynecology Journal, 2010

Introduction and hypothesis The aim of this study is to investigate the effect of intrinsic sphin... more Introduction and hypothesis The aim of this study is to investigate the effect of intrinsic sphincter deficiency (ISD) and urethral hypermobility on the outcome of the transobturator tape (TOT). Methods Sixty-five women were divided into three groups: group I, ISD with hypermobile urethra (n = 18); group II, ISD with fixed urethra (n = 16); and group III, hypermobile urethra without ISD (n = 31). Cure of stress urinary incontinence was defined if the patient had negative cough stress test. Cure and improvement rates were compared at 6, 12, and 24 months. Results The cure and improvement rates of groups I and III were similar at 6, 12, and 24 months (96.1% vs 96.6%, 96.1% vs 96.6%, and 87.5 vs %96.4%, respectively). Group II had the lowest cure and improvement rates (68.7%, 66.7%, and 66.7%, respectively). Conclusion A lack of urethral hypermobility may be a risk factor for TOT failure.

Research paper thumbnail of Metastatic ovarian carcinoma one year after surgical removal of colon carcinoma during pregnancy: a case report

International Journal of Gynecological Cancer, 2006

Abstract. Gurbuz A, Kir G, Karateke A, Haliloglu B, Kabaca C. Metastatic ovarian carcinoma one y... more Abstract. Gurbuz A, Kir G, Karateke A, Haliloglu B, Kabaca C. Metastatic ovarian carcinoma one year after surgical removal of colon carcinoma during pregnancy: a case report. Int J Gynecol Cancer 2006;16(Suppl. 1):330–333.Colorectal carcinoma during pregnancy is a very rare event. We presented a woman with metachronous metastatic ovarian tumor existing 1 year after surgical removal of perforated sigmoid colon carcinoma encountered during cesarean section of woman of 36-week gestation for fetal distress. Pregnant women with suspicious abdominal mass should be evaluated for a possible colorectal carcinoma even in the absence of any other gastrointestinal symptoms associated with it and undergo rectal examination and sigmoidoscopy. In addition, as synchronous and metachronous ovarian metastases are common in these patients, ovaries must be evaluated carefully by bisection during operation for possible metastasis, and in women who do not have a desire for fertility, prophylactic oophorectomy seems an appropriate treatment modality for resecting synchronous metastasis and preventing future metastasis.

Research paper thumbnail of Abdominal surgical approach to a case of complete cervical and partial vaginal agenesis

Fertility and Sterility, 2005

Objective: To construct a uterovaginal canal in a patient with a complete cervical agenesis and p... more Objective: To construct a uterovaginal canal in a patient with a complete cervical agenesis and partial vaginal agenesis. Design: Case report. Setting: Zeynep Kamil Women's and Children Hospital. Patient(s): A 15-year-old woman presented with lower abdominal pain. On examination, partial vaginal agenesis with a 4-cm vagina was noted. A pelvic ultrasonography revealed hematometra and the absence of a cervix. Intervention(s): Surgical therapy included creation of an ostium by making 1.5-cm midline vertical hysterotomy incision, trimming away the fibrous tissue at the distal portion of uterus, and attaching the proximal end of the vagina to the uterus by the abdominal route. A stent was left in place for 2 weeks. Main Outcome Measure(s): Pelvic ultrasonography and clinical follow-up evaluation. Result(s): Regular menstrual periods were observed for 6 months beginning at the first month. The follow-up pelvic ultrasonography was normal. Conclusion(s): Cervicoplasty attaching the mucosal lining of the endometrium to that of the vagina permits the creation of a patent cervical canal with short stenting time. (Fertil Steril 2005;84:217.e9 -11.

Research paper thumbnail of Intestinal vaginoplasty: seven years' experience of a tertiary center

Fertility and Sterility, 2010

Objective: To investigate the long-term effects of intestinal vaginoplasty in cases with Mayer-Ro... more Objective: To investigate the long-term effects of intestinal vaginoplasty in cases with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. Design: Prospective study. Setting: Division of Pelvic Reconstructive Surgery, Department of Gynecology and Obstetrics, at a women's and children disease education and research hospital. Patient(s): Between 2003 and 2009, 29 patients with MRKH syndrome underwent intestinal vaginoplasty. Intervention(s): Two of the patients were treated with ileal and 27 with sigmoid vaginoplasty. Main Outcome Measure(s): The age, marital status, associated anomalies, method used for bowel transposition (isoperistaltic/antiperistaltic), type of abdominal incision, and intra-and postoperative complications were evaluated.

Research paper thumbnail of Stepwise Rising CO 2 Insufflation as an Ischemic Preconditioning Method

Journal of Laparoendoscopic & Advanced Surgical Techniques, 2007

The pneumoperitoneum (Pp) is associated with ischemia and reperfusion (I/R) injury and oxidative ... more The pneumoperitoneum (Pp) is associated with ischemia and reperfusion (I/R) injury and oxidative stress. Various ischemic-preconditioning (IP) methods were used to reduce ischemic injury in intra-abdominal organs. In this experimental, randomized, controlled trial with a blind assessment of the outcome, we evaluated the effects of a new IP method, stepwise rising CO 2 insufflation, on oxidative stress and inflammatory cytokine response.

Research paper thumbnail of Serotonin dilemma in postmenopausal women: Is it low or high

Maturitas, 2008

Objective: In this study, we have studied with premenopausal (PM), naturally menopausal (NM) and ... more Objective: In this study, we have studied with premenopausal (PM), naturally menopausal (NM) and surgically induced menopausal (SM) women in order to investigate the differences in serum cortisol, dehydroepiandrosterone sulfate (DHEA-S), follicle stimulating hormone (FSH) and estradiol (E2) levels on serum serotonin levels. Methods: Forty premenopausal (36.7 ± 3.5 years), 40 naturally menopausal (54.2 ± 8.4 years) and 38 surgically induced menopausal (55.4 ± 11.2 years) women were included in the study. None of the subjects were using antidepressants or hormone replacement therapy. In NM and SM, years since menopause (YSM) were 3.16 ± 1.58 and 3.36 ± 1.89, respectively. Cortisol, DHEA-S, FSH and E2 levels were determined by immunochemiluminisence while serotonin levels were determined by HPLC. Results: Serum serotonin levels in NM women were higher than the other two groups [144.23 ± 45.29 g/L vs 61.35 ± 37.72 g/L in SM women and 98.74 ± 50.29 g/L in PM women]. E2 and DHEA-S were positively correlated, while FSH and cortisol were negatively correlated with serotonin in NM and SM. There was no significant correlation between serotonin and age or YSM. In the PM group, there was no significant correlation between serotonin and the hormones. Conclusion: In conclusion, increased serotonin levels in naturally menopausal women may be a compensatory mechanism to decreased E2 levels as it is postulated that there is strong interaction between E2 and the serotoninergic system.

Research paper thumbnail of Comparison of uterine artery blood flow with levonorgestrel intrauterine system and copper intrauterine device

Contraception, 2011

Background: As a contraceptive method, we investigated whether the levonorgestrel-releasing intra... more Background: As a contraceptive method, we investigated whether the levonorgestrel-releasing intrauterine system (LNG-IUS) has any effect on uterine artery blood flow when compared with copper intrauterine device (IUD). Study Design: Sixty women with copper IUD and 60 women with LNG-IUS were included in the study. The age, gravidity, parity, body mass index (BMI) and menstrual flow pattern using a pictorial chart were recorded. All women were assessed by ultrasonography at the preinsertion period and 1 year after insertion. The pulsatility and resistance indices (PI and RI, respectively) of the uterine artery and endometrial thickness were evaluated in the preinsertion and postinsertion periods. Results: In copper IUD users, preinsertion and postinsertion ultrasonographic assessments were not significantly different. However, postinsertion RI was significantly higher compared with preinsertion RI in LNG-IUS users (p=.001). The PI was also increased 1 year after insertion, but it did not reach statistically significant levels (p=.08). Endometrial thickness was also significantly decreased in the postinsertion period in women with LNG-IUS (p=.04). Conclusion: The significant increase in uterine artery RI in LNG-IUS users 1 year after insertion might be due to its local progestational effects. It might also indicate the mechanism of the LNG-IUS in reducing menstrual blood flow.

Research paper thumbnail of An Extremely Rare Cause of Acute Abdomen in Pregnancy: Ruptured Pancreatic Mucinous Cystadenocarcinoma

Pancreas, 2007

Pancreatic cystadenocarcinoma is an extremely rare neoplasm in pregnancy. To our knowledge, there... more Pancreatic cystadenocarcinoma is an extremely rare neoplasm in pregnancy. To our knowledge, there have been 2 published cases of pancreatic mucinous cystadenocarcinoma (PMC) during pregnancy in the literature; one of which was reported to have ruptured into the abdominal cavity. We present a second case of ruptured PMC resulting in acute abdomen in 36 weeks of pregnancy. Rupture of mucinous cystic neoplasms of pancreas including PMC should be remembered in acute abdomen during pregnancy.

Research paper thumbnail of Thrombotic thrombocytopenic purpura and pregnancy treated with fresh-frozen plasma infusions after plasmapheresis: a case report

Blood Coagulation & Fibrinolysis, 2007

Thrombotic thrombocytopenic purpura is a serious, highly mortal disease that goes with pregnancy.... more Thrombotic thrombocytopenic purpura is a serious, highly mortal disease that goes with pregnancy. The diagnosis may be difficult due to similar symptoms to other pregnancy-related diseases. Treatment of the patient differs with the clinic. Plasmapheresis continued with fresh-frozen plasma infusion may be a good choice.

Research paper thumbnail of Negative correlation between D-dimer and homocysteine levels during pregnancy and the postpartum period: a prospective study

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2010

Objective: There have been conflicting data about the role of increased levels of homocysteine (H... more Objective: There have been conflicting data about the role of increased levels of homocysteine (Hcy) on haemostatic system. We aim to investigate prospectively the relation between serum Hcy levels and changes in haemostatic system in pregnancy and postpartum period. Study design: Sixty-eight healthy pregnant women were included in the study. Blood samples were obtained in the 11th gestational week, 25th gestational week, 32nd gestational week and postpartum 4th week. The haemoglobin levels, white blood cell count (WBC), platelet count, activated partial thromboplastin time (aPTT), prothrombin time (PT), fibrinogen, D-dimer, Hcy, vitamin B12, and folate levels were measured. Results: Serum Hcy levels were negatively correlated with D-dimer levels (r = À0.57, p < 0.0001). The highest levels of D-dimer (1046.62 AE 322.01 ng/ml) were achieved in the third trimester and the lowest levels of serum Hcy (4.45 AE 1.23 mmol/l) were detected in the same trimester. In postpartum fourth week, Ddimer levels were decreased to normal levels (238.27 AE 198.59 ng/ml) while the serum Hcy levels were reached to the highest levels (7.99 AE 1.36 mmol/l). Conclusion: The negative correlation between Hcy and D-dimer levels may be a compensatory mechanism to maintain the normal haemostatic balance in pregnancy. Hence, possible advantage of low Hcy levels in pregnancy may be to prevent undesired thrombosis. ß

Research paper thumbnail of Bone turnover and maternal 25(OH) vitamin D3 levels during pregnancy and the postpartum period: should routine vitamin D supplementation be increased in pregnant women

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2011

Research paper thumbnail of The role of urethral hypermobility and intrinsic sphincteric deficiency on the outcome of transobturator tape procedure: a prospective study with 2-year follow-up

International Urogynecology Journal, 2010

Introduction and hypothesis The aim of this study is to investigate the effect of intrinsic sphin... more Introduction and hypothesis The aim of this study is to investigate the effect of intrinsic sphincter deficiency (ISD) and urethral hypermobility on the outcome of the transobturator tape (TOT). Methods Sixty-five women were divided into three groups: group I, ISD with hypermobile urethra (n = 18); group II, ISD with fixed urethra (n = 16); and group III, hypermobile urethra without ISD (n = 31). Cure of stress urinary incontinence was defined if the patient had negative cough stress test. Cure and improvement rates were compared at 6, 12, and 24 months. Results The cure and improvement rates of groups I and III were similar at 6, 12, and 24 months (96.1% vs 96.6%, 96.1% vs 96.6%, and 87.5 vs %96.4%, respectively). Group II had the lowest cure and improvement rates (68.7%, 66.7%, and 66.7%, respectively). Conclusion A lack of urethral hypermobility may be a risk factor for TOT failure.

Research paper thumbnail of Metastatic ovarian carcinoma one year after surgical removal of colon carcinoma during pregnancy: a case report

International Journal of Gynecological Cancer, 2006

Abstract. Gurbuz A, Kir G, Karateke A, Haliloglu B, Kabaca C. Metastatic ovarian carcinoma one y... more Abstract. Gurbuz A, Kir G, Karateke A, Haliloglu B, Kabaca C. Metastatic ovarian carcinoma one year after surgical removal of colon carcinoma during pregnancy: a case report. Int J Gynecol Cancer 2006;16(Suppl. 1):330–333.Colorectal carcinoma during pregnancy is a very rare event. We presented a woman with metachronous metastatic ovarian tumor existing 1 year after surgical removal of perforated sigmoid colon carcinoma encountered during cesarean section of woman of 36-week gestation for fetal distress. Pregnant women with suspicious abdominal mass should be evaluated for a possible colorectal carcinoma even in the absence of any other gastrointestinal symptoms associated with it and undergo rectal examination and sigmoidoscopy. In addition, as synchronous and metachronous ovarian metastases are common in these patients, ovaries must be evaluated carefully by bisection during operation for possible metastasis, and in women who do not have a desire for fertility, prophylactic oophorectomy seems an appropriate treatment modality for resecting synchronous metastasis and preventing future metastasis.

Research paper thumbnail of Abdominal surgical approach to a case of complete cervical and partial vaginal agenesis

Fertility and Sterility, 2005

Objective: To construct a uterovaginal canal in a patient with a complete cervical agenesis and p... more Objective: To construct a uterovaginal canal in a patient with a complete cervical agenesis and partial vaginal agenesis. Design: Case report. Setting: Zeynep Kamil Women's and Children Hospital. Patient(s): A 15-year-old woman presented with lower abdominal pain. On examination, partial vaginal agenesis with a 4-cm vagina was noted. A pelvic ultrasonography revealed hematometra and the absence of a cervix. Intervention(s): Surgical therapy included creation of an ostium by making 1.5-cm midline vertical hysterotomy incision, trimming away the fibrous tissue at the distal portion of uterus, and attaching the proximal end of the vagina to the uterus by the abdominal route. A stent was left in place for 2 weeks. Main Outcome Measure(s): Pelvic ultrasonography and clinical follow-up evaluation. Result(s): Regular menstrual periods were observed for 6 months beginning at the first month. The follow-up pelvic ultrasonography was normal. Conclusion(s): Cervicoplasty attaching the mucosal lining of the endometrium to that of the vagina permits the creation of a patent cervical canal with short stenting time. (Fertil Steril 2005;84:217.e9 -11.

Research paper thumbnail of Intestinal vaginoplasty: seven years' experience of a tertiary center

Fertility and Sterility, 2010

Objective: To investigate the long-term effects of intestinal vaginoplasty in cases with Mayer-Ro... more Objective: To investigate the long-term effects of intestinal vaginoplasty in cases with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. Design: Prospective study. Setting: Division of Pelvic Reconstructive Surgery, Department of Gynecology and Obstetrics, at a women's and children disease education and research hospital. Patient(s): Between 2003 and 2009, 29 patients with MRKH syndrome underwent intestinal vaginoplasty. Intervention(s): Two of the patients were treated with ileal and 27 with sigmoid vaginoplasty. Main Outcome Measure(s): The age, marital status, associated anomalies, method used for bowel transposition (isoperistaltic/antiperistaltic), type of abdominal incision, and intra-and postoperative complications were evaluated.

Research paper thumbnail of A case of microglandular adenocarcinoma of the endometrium

Gynecologic Oncology, 2005

Backround. Microglandular adenocarcinoma is a rare type of endometrium carcinoma and had some pot... more Backround. Microglandular adenocarcinoma is a rare type of endometrium carcinoma and had some potential diagnostic problems with difficulties in discriminating from some malign and benign lesions of cervix.

Research paper thumbnail of Third trimester nonrecurrent fetal loss is associated with factor V Leiden and prothrombin gene mutations

Journal of Maternal-fetal & Neonatal Medicine, 2005

To determine the role of factor V Leiden and prothrombin gene mutation in the pathogenesis of une... more To determine the role of factor V Leiden and prothrombin gene mutation in the pathogenesis of unexplained second and third trimester nonrecurrent fetal loss. One hundred and fourteen women with unexplained nonrecurrent late fetal loss made up the study group, and 106 normal pregnant women with a history of delivery of at least one healthy fetus and no history of late fetal loss made up the control group. The study group was further divided into two subgroups: second (n = 36) and third (n = 78) trimester fetal loss. All women were tested for factor V Leiden and G20210A prothrombin gene mutations. Twenty-one (18.4%) of the women in the study group and seven (6.6%) of the women in the control group were heterozygous carriers of factor V Leiden mutation (OR = 3.19). Eleven (9.6%) of the women in the study group and three (2.8%) of the women in the control group were heterozygous carriers of prothrombin gene mutation (OR = 3.66). In assessing with regard to trimesters, 18 (23%) factor V Leiden and 10 (12.8%) prothrombin gene mutations were present in the group of third trimester fetal loss (OR = 4.24 and OR = 5.04, respectively). Three (8.3%) factor V Leiden and one (2.7%) prothrombin gene mutation were detected in women with second trimester fetal loss (OR = 1.28 and OR = 0.40, respectively). Factor V Leiden and prothrombin gene mutations were associated with third trimester nonrecurrent fetal loss. These mutations should be screened in women with third trimester but not second trimester unexplained nonrecurrent late fetal loss.

Research paper thumbnail of Comparison of TVT and TVT-O in patients with stress urinary incontinence: Short-term cure rates and factors influencing the outcome. A prospective randomised study

Australian & New Zealand Journal of Obstetrics & Gynaecology, 2009

Background: Recently, mid-urethral slings have been commonly used in treatment of patients with s... more Background: Recently, mid-urethral slings have been commonly used in treatment of patients with stress urinary incontinence (SUI).Aims: To investigate tension-free vaginal tape (TVT) and tension-free obturator tape (TVT-O) for surgical treatment of SUI for cure rates (primary endpoint), complications and factors influencing cure rate (secondary endpoints).Methods: One-hundred and sixty-four patients were included in the study (n = 81 for TVT, n = 83 for TVT-O). The cure rates, complications, preoperative and postoperative urodynamic evaluation, Q-tip test, the Turkish version of Incontinence Impact Questionnaire (IIQ-7) and Urogenital Distress Inventory (UDI-6) scores were recorded. At three and 12 months, the patients were evaluated regarding outcome measures.Results: The cure rates were similar in TVT and TVT-O groups, 88.9% versus 86.7% respectively. Mean operative time was significantly shorter in TVT-O group (P = 0.001). The cure rate was significantly higher in both groups in patients with urethral hypermobility when compared with those with no hypermobility (P = 0.001).Conclusions: The TVT and TVT-O procedures appear to be equally effective for the treatment of SUI. Also, urethral hypermobility seems to be a factor influencing cure rate of mid-urethral slings.

Research paper thumbnail of Intestinal vaginoplasty: is it optimal treatment of vaginal agenesis? A pilot study

International Urogynecology Journal, 2006

The outcome of 11 cases with vaginal agenesis who underwent intestinal vaginoplasties are present... more The outcome of 11 cases with vaginal agenesis who underwent intestinal vaginoplasties are presented. Patients were between 18 and 37 years old. Ileum vaginoplasty and sigmoid colon vaginoplasty were carried out in two and nine cases, respectively. Ileum necrosis at donor site requiring ileum resection and bilateral ileostomy encountered in one of the cases was the major complication. Mild stenosis responsive to finger dilatation had been detected in two women with sigmoid vaginoplasty. Excess mucous production, long operation time, and shortness of mesentery of ileum led us to abandon ileum vaginoplasty, and sigmoid colon vaginoplasty was performed in the following cases with vaginal agenesis. All of the neovaginas were patent and functional. We suggest sigmoid colon vaginoplasty as the treatment of choice because of its large lumen, thick walls resistant to trauma, adequate secretion allowing lubrication, not necessitating prolonged dilatation, short recovery time compared with ileum vaginoplasties; and in patients reluctance to prolonged use of dilatators or in those who experienced previous failure of the other treatment modalities.

Research paper thumbnail of Mucoepidermoid variant of adenosquamous carcinoma arising in ovarian dermoid cyst: a case report and review of the literature

International Journal of Gynecological Cancer, 2006

Abstract. Karateke A, Gurbuz A, Kir G, Haliloglu B, Kabaca C, Devranoglu B, Yakut Y. Mucoepiderm... more Abstract. Karateke A, Gurbuz A, Kir G, Haliloglu B, Kabaca C, Devranoglu B, Yakut Y. Mucoepidermoid variant of adenosquamous carcinoma arising in ovarian dermoid cyst: a case report and review of the literature. Int J Gynecol Cancer 2006;16(Suppl. 1):379–384.A 40-year-old woman with mucoepidermoid variant of adenosquamous carcinoma arising in dermoid cyst in left ovary is presented. The patient was staged as IC. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and pelvic and para-aortic lymph node sampling were carried out. The disease recurred in postoperative 12th month. To our best knowledge, this is 12th case of adenosquamous carcinoma in dermoid cyst and third case of mucoepidermoid variant of adenosquamous carcinoma in the literature.

Research paper thumbnail of The role of urethral hypermobility and intrinsic sphincteric deficiency on the outcome of transobturator tape procedure: a prospective study with 2-year follow-up

International Urogynecology Journal, 2010

Introduction and hypothesis The aim of this study is to investigate the effect of intrinsic sphin... more Introduction and hypothesis The aim of this study is to investigate the effect of intrinsic sphincter deficiency (ISD) and urethral hypermobility on the outcome of the transobturator tape (TOT). Methods Sixty-five women were divided into three groups: group I, ISD with hypermobile urethra (n = 18); group II, ISD with fixed urethra (n = 16); and group III, hypermobile urethra without ISD (n = 31). Cure of stress urinary incontinence was defined if the patient had negative cough stress test. Cure and improvement rates were compared at 6, 12, and 24 months. Results The cure and improvement rates of groups I and III were similar at 6, 12, and 24 months (96.1% vs 96.6%, 96.1% vs 96.6%, and 87.5 vs %96.4%, respectively). Group II had the lowest cure and improvement rates (68.7%, 66.7%, and 66.7%, respectively). Conclusion A lack of urethral hypermobility may be a risk factor for TOT failure.

Research paper thumbnail of Metastatic ovarian carcinoma one year after surgical removal of colon carcinoma during pregnancy: a case report

International Journal of Gynecological Cancer, 2006

Abstract. Gurbuz A, Kir G, Karateke A, Haliloglu B, Kabaca C. Metastatic ovarian carcinoma one y... more Abstract. Gurbuz A, Kir G, Karateke A, Haliloglu B, Kabaca C. Metastatic ovarian carcinoma one year after surgical removal of colon carcinoma during pregnancy: a case report. Int J Gynecol Cancer 2006;16(Suppl. 1):330–333.Colorectal carcinoma during pregnancy is a very rare event. We presented a woman with metachronous metastatic ovarian tumor existing 1 year after surgical removal of perforated sigmoid colon carcinoma encountered during cesarean section of woman of 36-week gestation for fetal distress. Pregnant women with suspicious abdominal mass should be evaluated for a possible colorectal carcinoma even in the absence of any other gastrointestinal symptoms associated with it and undergo rectal examination and sigmoidoscopy. In addition, as synchronous and metachronous ovarian metastases are common in these patients, ovaries must be evaluated carefully by bisection during operation for possible metastasis, and in women who do not have a desire for fertility, prophylactic oophorectomy seems an appropriate treatment modality for resecting synchronous metastasis and preventing future metastasis.

Research paper thumbnail of Abdominal surgical approach to a case of complete cervical and partial vaginal agenesis

Fertility and Sterility, 2005

Objective: To construct a uterovaginal canal in a patient with a complete cervical agenesis and p... more Objective: To construct a uterovaginal canal in a patient with a complete cervical agenesis and partial vaginal agenesis. Design: Case report. Setting: Zeynep Kamil Women's and Children Hospital. Patient(s): A 15-year-old woman presented with lower abdominal pain. On examination, partial vaginal agenesis with a 4-cm vagina was noted. A pelvic ultrasonography revealed hematometra and the absence of a cervix. Intervention(s): Surgical therapy included creation of an ostium by making 1.5-cm midline vertical hysterotomy incision, trimming away the fibrous tissue at the distal portion of uterus, and attaching the proximal end of the vagina to the uterus by the abdominal route. A stent was left in place for 2 weeks. Main Outcome Measure(s): Pelvic ultrasonography and clinical follow-up evaluation. Result(s): Regular menstrual periods were observed for 6 months beginning at the first month. The follow-up pelvic ultrasonography was normal. Conclusion(s): Cervicoplasty attaching the mucosal lining of the endometrium to that of the vagina permits the creation of a patent cervical canal with short stenting time. (Fertil Steril 2005;84:217.e9 -11.

Research paper thumbnail of Intestinal vaginoplasty: seven years' experience of a tertiary center

Fertility and Sterility, 2010

Objective: To investigate the long-term effects of intestinal vaginoplasty in cases with Mayer-Ro... more Objective: To investigate the long-term effects of intestinal vaginoplasty in cases with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. Design: Prospective study. Setting: Division of Pelvic Reconstructive Surgery, Department of Gynecology and Obstetrics, at a women's and children disease education and research hospital. Patient(s): Between 2003 and 2009, 29 patients with MRKH syndrome underwent intestinal vaginoplasty. Intervention(s): Two of the patients were treated with ileal and 27 with sigmoid vaginoplasty. Main Outcome Measure(s): The age, marital status, associated anomalies, method used for bowel transposition (isoperistaltic/antiperistaltic), type of abdominal incision, and intra-and postoperative complications were evaluated.