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Moraloglu O.,Dr Zekai Tahir Burak Womans Health Education And Research Hospital | Tonguc E.,Dr Zekai Tahir Burak Womans Health Education And Research Hospital | Var T.,Dr Zekai Tahir Burak Womans Health Education And Research Hospital | Zeyrek T.,Dr Zekai Tahir Burak Womans Health Education And Research Hospital | Batioglu S.,Dr Zekai Tahir Burak Womans Health Education And Research Hospital
Reproductive BioMedicine Online | Year: 2010

This report aimed to examine the effects of atosiban on pregnancy outcome after IVF-embryo transfer. A prospective, randomized, placebo-controlled clinical study was performed. A total of 180 women undergoing intracytoplasmic sperm injection who had top-quality embryos were randomly allocated into treatment and control groups. All the patients had infertility due to tubal factor, hormonal-anovulatory disorders, male factor or unexplained reasons. The treatment group received intravenous administration of atosiban before embryo transfer with a total administered dose of 37.5 mg. In the control group, the same number of cycles was performed with placebo medication. The clinical pregnancy rate (PR) per cycle and implantation rate (IR) per transfer were 46.7% and 20.4% in the atosiban-treated group, which were significantly higher than in the control group (28.9% and 12.6%, respectively, P = 0.01). The miscarriage rates of groups 1 and 2 were 16.7% and 24.4%, respectively (P = 0.01). These results have indicated that atosiban increases the IR and PR after IVF-embryo transfer. These results suggest that atosiban treatment before embryo transfer is effective in priming of the uterus for implantation. This is the first study to investigate the possible contributions of atosiban for improving the PR after IVF-embryo transfer. © 2010, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved. Source


Kokanali D.,Dr Zekai Tahir Burak Womans Health Education And Research Hospital | Ugur M.,Dr Zekai Tahir Burak Womans Health Education And Research Hospital | Kuntay Kokanali M.,Dr Zekai Tahir Burak Womans Health Education And Research Hospital | Karayalcin R.,Dr Zekai Tahir Burak Womans Health Education And Research Hospital | Tonguc E.,Dr Zekai Tahir Burak Womans Health Education And Research Hospital
Archives of Gynecology and Obstetrics | Year: 2011

Purpose To compare different repair techniques and different suture materials for episiotomy. Methods 160 women having vertex delivery with right-mediolateral episiotomy were randomly allocated to four groups. In the groups where continuos technique was performed, vaginal mucosa, perineal muscles and the skin were sutured continuously. In the groups of interrupted technique, vaginal mucosa was sutured with continuous sutures, then muscle layers and skin were closed by interrupted sutures. Two different types of synthetic absorbed suture material were used: monofilament type is in form of polyglycolide-co- caprolactone and multifilament one is polyglactin 910-Rapide. Perineal pain during different activities on the first and tenth day postpartum and also during sexual intercourse 6 weeks after the delivery was questioned by visual analogous scale (VAS). Furthermore, repair time, amount of suture and episiotomy complications were investigated in each groups. Results On the first day after delivery, the perineal pain scores, the repair time, the amount of suture were statistically less in the continuous technique groups. The differences between the pain at tenth day and during sexual intercourse 6 weeks after the delivery were statistically same. Conclusions The continuous suturing techniques for episiotomy closure, compared to interrupted methods, are associated with less short-term pain, are quicker and also need less suture material. © Springer-Verlag 2010. Source


Kokanali M.K.,Dr Zekai Tahir Burak Womans Health Education And Research Hospital | Doganay M.,Dr Zekai Tahir Burak Womans Health Education And Research Hospital | Aksakal O.,Dr Zekai Tahir Burak Womans Health Education And Research Hospital | Cavkaytar S.,Dr Zekai Tahir Burak Womans Health Education And Research Hospital | And 2 more authors.
European Journal of Obstetrics Gynecology and Reproductive Biology | Year: 2014

Objectives To identify risk factors for mesh erosion in women undergoing vaginal sling procedures for urinary incontinence with synthetic meshes, and to estimate the incidence of mesh erosion after these procedures. Study design Retrospective study of women who underwent vaginal sling procedures between January 2007 and January 2013. In total, 1439 consecutive women with stress urinary incontinence were investigated. Five hundred and sixty-six (39.3%) women underwent a tension-free vaginal tape (TVT) procedure and 873 (60.7%) women underwent a transobturator tape (TOT) procedure. All procedures were performed using meshes of the same type and size. Women who experienced mesh erosion were defined as cases, and women who were not re-admitted or identified with mesh erosion during the study period were defined as controls. Demographics, operative techniques and outcomes were taken from medical records. Multivariate regression identified the odds of mesh erosion. Results Sixty-one of 1439 (4.2%) women were found to have mesh erosion in the postoperative period: 41 (67.2%) after TOT procedures and 20 (32.8%) after TVT procedures. The rate of mesh erosion was 4.7% in the TOT group and 3.5% in the TVT group, and this difference was significant (p < 0.05). Mean age, body mass index, current smoking, menopausal status and diabetes mellitus were significantly higher among cases than controls. Univariate analysis showed that length of vaginal incision >2 cm, recurrent vaginal incision for postoperative complications, and previous pelvic organ prolapse or incontinence surgery were significant risk factors for erosion. Multivariate analysis demonstrated that older age, diabetes mellitus, current smoking, length of vaginal incision >2 cm, recurrent vaginal incision for postoperative complications, and previous pelvic organ prolapse or incontinence surgery were independent risk factors for mesh erosion. Conclusions Mesh erosion following vaginal sling procedures is a frustrating complication with relatively low incidence. It was found to occur more often after TOT procedures than TVT procedures. Older age, diabetes mellitus, smoking, length of vaginal incision >2 cm, recurrent vaginal incision for postoperative complications, and previous vaginal surgery for pelvic organ prolapse or incontinence increased the risk of mesh erosion. Identification of risk factors may enable surgeons to prevent or minimize this complication. © 2014 Elsevier Ireland Ltd. Source


Cavkaytar S.,Dr Zekai Tahir Burak Womans Health Education And Research Hospital | Kokanali M.K.,Dr Zekai Tahir Burak Womans Health Education And Research Hospital | Ceran U.,Dr Zekai Tahir Burak Womans Health Education And Research Hospital | Topcu H.O.,Dr Zekai Tahir Burak Womans Health Education And Research Hospital | And 2 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2014

Background: To assess the role of sonographic endometrial thickness and hysteroscopic polyp size in predicting premalignant and malignant polyps in postmenopausal women. Materials and Methods: A total of 328 postmenopausal women with abnormal uterine bleeding and thickened endometrium underwent operative hysteroscopy due to detection of endometrial polyps were included in this retrospective study. Preoperative endometrial thickness measured by transvaginal ultrasonography and polyp size on hysteroscopy were noted. Hysteroscopic resection with histology was performed for endometrial polyps. Endometrial thickness and polyp size were evaluated on the basis of final diagnosis established by histologic examination. Receiver operator characteristic curves were calculated to assess the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of endometrial thickness and polyp size for detecting pemalignant and malignant polyps. Results: Premalignant and malignant polyps were identified in 26 (7.9%) of cases. Sonographic measurement showed a greater endometrial thickness in cases of premalignant and malignant polyps when compared to benign polyps. On surgical hysteroscopy, premalignant and malignant polyps were also larger. Endometrial thickness demonstrated a sensitivity of 53.8%, specificity of 85.8%, PPV of 24.6% and NPV of 95.6% at a cut-off limit of 11.5 mm with diagnostic accuracy of 83.2%. Polyp size has a diagnostic accuracy of 94.8% with a sensitivity of 92.3%, specificity of 95.0%, PPV of 61.5% and NPV of 99.3% at a cut-off point of 19.5mm. Conclusions: Endometrial thickness measured by transvaginal ultrasonography is not sufficient in predicting premalignant and malignant endometrial polyps in postmenopausal women with abnormal uterine bleeding and thickened endometrium. Polyp size on hysteroscopy is a more accurate parameter, because of better sensitivity and specificity. However, while polyp size =19.5mm seems to have a great accuracy for predicting premalignancy and malignancy, histologic evaluation is still necessary to exclude premalignant and malignant polyps. Source


Cavkaytar S.,Dr Zekai Tahir Burak Womans Health Education And Research Hospital | Kokanal M.K.,Dr Zekai Tahir Burak Womans Health Education And Research Hospital | Baylas A.,Dr Zekai Tahir Burak Womans Health Education And Research Hospital | Topcu H.O.,Dr Zekai Tahir Burak Womans Health Education And Research Hospital | And 2 more authors.
Journal of the Turkish German Gynecology Association | Year: 2014

Objective: To assess the obstetrics risk factors for postpartum urinary retention after vaginal delivery.Material and Methods: Of 234 women with a vaginal delivery, 19 (8.1%) women who had postpartum urinary retention were cases, and 215 (91.9%) women who did not were controls. Postpartum urinary retention was defined as the presence of postvoid residual bladder volume ≥150 mL or the inability to void within 6 hours after vaginal delivery. Logistic regression analysis identified risk factors for urinary retention.Results: Prolonged duration of the second stage of labor (OR=0.46, 95% CI for OR=0.06-3.67, p<0.001), presence of episiotomy (OR=0.07, 95% CI for OR=0.01-0.68, p=0.022) and perineal laceration (OR=97.09, 95% CI for OR=7.93-1188.93, p<0.001), and birth weight of >4000 g for the newborn (OR=0.04, 95% CI for OR=0.01-0.20, p<0.001) were found as independent risk factors for postpartum urinary retention after vaginal delivery.Conclusion: Postpartum urinary retention after vaginal delivery is a relatively common condition. Awareness of risk factors, including prolonged second stage of labor, episiotomy, perineal lacerations, and macrosomic birth, may allow us to take the necessary precautions against this complication. © 2014 by the Turkish-German Gynecological Education and Research Foundation. Source

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