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Arslan O.S.,Elazig Research and Education Hospital | Sumer C.,Elazig Research and Education Hospital | Cihangiroglu G.,Elazig Research and Education Hospital | Kanat-Pektas M.,Etlik Ihtisas Research and Education Hospital | Gungor T.,Dr Zekai Tahir Burak Women Health Research And Education Hospital
Archives of Gynecology and Obstetrics | Year: 2011

Introduction: Primary ovarian leiomyosarcomas are rare gynecological tumors, which usually affect postmenopausal women. Materials and methods: This short communication aims to remind this uncommon malignant pathology by describing a case and presenting a short review of the literature. Conclusion: Unfortunately, these tumors are aggressive and have a poor prognosis. © 2010 Springer-Verlag.


Gungor T.,Dr Zekai Tahir Burak Women Health Research And Education Hospital | Kanat-Pektas M.,Etlik Ihtisas Research and Education Hospital | Ozat M.,Dr Zekai Tahir Burak Women Health Research And Education Hospital | Zayifoglu Karaca M.,Dr Zekai Tahir Burak Women Health Research And Education Hospital
Archives of Gynecology and Obstetrics | Year: 2011

Background: The present review aims to increase the awareness of the gynecologists by analyzing all the case reports which refer to endometriosis presenting either with only ascites or with massive ascites with pleural effusion. Methods: To conduct the present review, the CENTRAL (in the Cochrane Library, current issue), MEDLINE (Silver Platter, from 1950 to 2010), and EMBASE (from 1950 to 2010) electronic databases were searched. As a result, all the publications based on the keywords relating to the review topic were acquired. Results: Since the description of first case in 1954, endometriosis-related ascites was reported to occur in a total of 63 women who were aged between 19 and 51 years. Approximately 63.0% of the recruited women for whom ethnicity was specified were of African origin (29 out of 46). Of the 50 subjects with known obstetric history, 41 (82.0%) were nulliparous. Abdominal distention, anorexia/weight loss, abdominal pain, and menometrorrhagia were the most frequently encountered clinical symptoms, whereas pelvic mass was the most common physical finding. The serum concentrations of CA 125 were between 20 and 3,504 IU/ml for 19 women whose CA 125 levels were determined. Pleural effusion was also present in 38.1% of the reviewed subjects (24 out of 63). The clinical features of the women with endometriosis-related ascites and pleural effusion were similar to those of the women who had only endometriosis-related ascites. Conclusion: Endometriosis-related ascites and/or pleural effusion refers to extensive disease with a high risk for recurrence which usually affects non-Caucasian, nulliparous women of reproductive age and leads to clinical symptoms resembling those of an ovarian malignancy. Therefore, clinicians should consider endometriosis in differential diagnosis of pelvic masses and also include endometriosis in diagnostic workup of ascites or pleural effusion. © 2010 Springer-Verlag.


Kepenekci I.,Ankara University | Keskinkilic B.,Ankara University | Akinsu F.,Dr Zekai Tahir Burak Women Health Research and Education Hospital | Cakir P.,Ankara University | And 3 more authors.
Diseases of the Colon and Rectum | Year: 2011

PURPOSE: Dysfunction of pelvic floor may cause many different symptoms, such as urinary and anal incontinence, obstructed defecation and constipation. No previous studies have examined all of these symptoms together. The purposes of the present study were to determine prevalence of pelvic floor disorders among the female population and to evaluate the impact of age, parity, and mode of delivery on these disorders. METHODS: The study was performed on a general population of Turkish women. Women were excluded who were pregnant, who were within 6 months postpartum, who had cognitive disorders or neurological diseases, and who had a history of previous gastrointestinal, anorectal, or gynecological surgery. A questionnaire about urinary incontinence, anal incontinence, constipation, and obstructed defecation along with an extensive obstetric history was administered to 4002 women in face-to-face interviews. All symptoms were defined according to the standard terminology. RESULTS: The median age of the participants was 41 years (range, 15-86). Of the women interviewed, 1067 had no deliveries, 434 women delivered by cesarean only, and 2501 women had one or more vaginal deliveries. Five hundred thirty women had delivered one child, 1880 women had delivered 2 to 3 children, and 582 women had delivered≥4 children. Overall, 67.5% of women experienced pelvic floor dysfunction of at least one major type. The prevalence of each pelvic floor disorder evaluated in this study was as follows: anal incontinence, 19.8%; urinary incontinence, 50.7%; constipation, 33.2%; and obstructed defecation, 26.8%. Analysis of risk factors demonstrated that age was the major factor associated with the development of pelvic floor dysfunction. Vaginal delivery and higher parity increased the risk of both urinary and defecatory symptoms of pelvic floor dysfunction. CONCLUSION: The study data demonstrate that pelvic floor dysfunction is a common problem among women and it is strongly linked to childbirth and aging. © The ASCRS 2010.


Uygur D.,Dr Zekai Tahir Burak Women Health Research And Education Hospital | Guler T.,Near East University | Atacag T.,Near East University | Comunoglu C.,Near East University | Kuzey G.M.,Near East University
Journal of the American Board of Family Medicine | Year: 2012

Purpose: To determine the effects of lubrication of the vaginal speculum before insertion during a Papanicolaou test on perceived pain and quality of the cytology specimen. Methods: Four hundred eligible women participating in cervical cancer screening and an early detection program were randomized with respect to lubricant gel use before speculum insertion. Perceived pain during speculum insertion and cytology results were assessed in study groups. Results: The mean age of the patients was 45.7 years (range, 23-77 years). Pain score of the NO GEL group was significantly higher than that of the GEL group (2.3 and 1.6, respectively; P < .05). For premenopausal women, lubricant gel use significantly reduced the pain scores of the participants (P < .05). Cytological interpretations of the Papanicolaou test specimens were comparable among all groups. Conclusions: During the collection of Papanicolaou test specimens, lubrication of the vaginal speculum with a small amount of K-Y Jelly (a water-soluble lubricant gel) decreases the pain associated with insertion of the vaginal speculum among postmenopausal women without obscuring the cytological interpretation of conventional or liquid-based cytology. In women of reproductive age, lubrication of the speculum with K-Y Jelly does not cause a meaningful effect with respect to perceived pain.


Kanat-Pektas M.,Dr Zekai Tahir Burak Women Health Research And Education Hospital
Archives of gynecology and obstetrics | Year: 2011

The present study aims to document the experience of a single center on the reproductive outcome of a cohort of women who were treated with conservative surgery for borderline ovarian tumors and to specify whether their fertility potential is associated with age, tumor histology and surgery type. A total of 55 women who had undergone conservative surgery for borderline ovarian tumors between January 1999 and January 2009 were eligible. Recurrence rate, fertility outcome and the number of pregnancies were analyzed retrospectively. Among the study group, 11 women were not sexually active both at the time of surgery and during the follow-up period. Thus, a total of 44 patients attempted pregnancy after conservative surgery and 52.3% of them (23 out of 44) were able to conceive either spontaneously or by in vitro fertilization. The ability to conceive was shown to be associated with age, tumor histology and type of conservative surgery. As expected, the fertility potential correlated positively with decreasing age (correlation coefficient = 0.705, p = 0.001). Moreover, the existence of non-serous histology and the implementation of unilateral cystectomy were found to be associated with the ability to reach a clinical pregnancy (correlation coefficient = 0.585, p = 0.001 and correlation coefficient = 0.587, p = 0.001, respectively). The primary treatment of borderline ovarian tumors refers to conservative surgery. Younger age, non-serous histology and unilateral cystectomy appear to be associated with favorable reproductive outcome in women who undergo conservative surgery for borderline malignancy of ovary.


Kanat-Pektas M.,Dr Zekai Tahir Burak Women Health Research and Education Hospital | Yenicesu O.,Dr Zekai Tahir Burak Women Health Research and Education Hospital | Gungor T.,Dr Zekai Tahir Burak Women Health Research and Education Hospital | Bilge U.,Dr Zekai Tahir Burak Women Health Research and Education Hospital
Archives of Gynecology and Obstetrics | Year: 2010

Objective The purpose of the present study was to investigate the predictive power of sexual hormones and tumor markers in endometrial cancer. Methods A total of 135 healthy women were prospectively compared with 135 women who had histopathologically confirmed endometrial cancer. Both the groups of women were matched by age and body mass index. Results When compared with healthy controls, women with endometrial cancer had significantly higher serum levels of CA-125, CA 19-9, prolactin and thyroid-stimulating hormone, whereas significantly lower serum concentrations of a-fetoprotein, CA 15-3, follicle-stimulating hormone and luteinizing hormone (LH). Tumor stage correlated positively and significantly with serum levels of prolactin, CA-125 and CA 19-9 as did tumor grade with serum concentrations of LH, estradiol, prolactin and CA- 125. Serum CA-125 levels>35 U/ml were found to have a sensitivity of 42.2%, specificity of 87.4%, positive-predictive value of 77.0% and negative-predictive value of 60.2%. Besides endometrial cancer could be diagnosed with 16.3% sensitivity, 100.0% specificity, 100.0% positive- and 54.4% negative-predictive values with serum prolactin levels>30 ng/ml. Conclusions Because serum concentrations of CA-125 can be elevated in various malignancies, it is obvious that it is neither specific nor accurately diagnostic for endometrial tumors. What is more, the distinct effects of physiological factors on prolactin secretion shadow the credibility of this hormone in early diagnosis of endometrial tumors. Thus, either prolactin or CA-125 is far from being utilized as the sole entity for screening endometrial cancer. Therefore, both parameters should be regarded as the components of a biochemical screening panel that is to be developed in future. © Springer-Verlag 2009.


Yilmaz N.,Dr Zekai Tahir Burak Women Health Research And Education Hospital | Kanat-Pektas M.,Dr Zekai Tahir Burak Women Health Research And Education Hospital | Kilic S.,Dr Zekai Tahir Burak Women Health Research And Education Hospital | Gulerman C.,Dr Zekai Tahir Burak Women Health Research And Education Hospital
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2010

Aim.The objectives of this study are to compare the risk of psychological depression after medical and surgical abortions in first two trimesters and to evaluate the risk factors for post-abortion depression. Method.A retrospective study was conducted throughout 367 women who underwent surgical abortion and 458 women who underwent medical abortion between January 2006 and January 2007 in Dr. Zekai Tahir Burak Women's Health Hospital. Women were assessed by clinical psychologists one week after the intervention. The clinical characteristics and psychological assessment of these women were statistically correlated by means of non-parametric tests. Results.Of the study population, 27.1 was diagnosed with post-abortion depression. The frequency of post-abortion depression was 34.3 in surgical abortion patients and 22.8 in medical abortion patients. The women who underwent surgical abortion were found to have significantly elevated risk of post-abortion depression. The women with a high risk of post-abortion depression were significantly younger and had a more frequent history of psychiatric and depressive disorders. Conclusion.An important quotient of women experiences post-abortion mood depression which is significantly more frequent after surgical abortion. Women with past psychiatric and anxiety disorders should be carefully monitored for depression when they would undergo an abortion. © 2010 Informa UK Ltd.


Kunt C.,Dr Zekai Tahir Burak Women Health Research And Education Hospital | Ozaksit G.,Dr Zekai Tahir Burak Women Health Research And Education Hospital | Keskin Kurt R.,Dr Zekai Tahir Burak Women Health Research And Education Hospital | Cakir Gungor A.N.,Dr Zekai Tahir Burak Women Health Research And Education Hospital | And 3 more authors.
Archives of Gynecology and Obstetrics | Year: 2011

Objective: The present study aims to compare anti-Mullerian hormone (AMH) with other ovarian reserve markers and to find a cut-off value of AMH for predicting ovarian response towards controlled ovarian hyperstimulation in an in vitro fertilization (IVF) program. Materials and methods: A prospective analysis was performed in 180 patients undergoing their first IVF trial, which is being conducted at a department of assisted reproduction in a tertiary medical center. The main outcome measures were determined as age and antral follicle count as well as the serum concentrations of follicle stimulating hormone, luteinizing hormone (LH), estradiol (E2), inhibin B and AMH. The predictive power of the aforementioned measures in specifying ovarian response was determined by means of discriminate analyses. Results: As expected, day 3 LH levels were significantly high in the poor responder group. The poor responders had significantly lower antral follicle counts, retrieved oocyte number, and mature oocyte counts as well as day 3 AMH levels (5.8 ± 2.32 vs. 1.8 ± 0.80 ng/ml). There was a positive correlation with antral follicle count, basal AMH, E2 and follicle count on the day of HCG administration and negative correlation with age. The AMH level was addressed as the only significant factor in determination of mature oocyte number. A cut-off point for serum AMH concentration indicating the value of 2.97 ng/ml was found to predict the poor ovarian response with a sensitivity of 100.0% and a specificity of 89.6%. However, the same cut-off point was not as predictive for the non-conception circumstance. Conclusion: The present study concludes that AMH is a promising biochemical marker for the prediction of ovarian response and that a cut-off point indicating the value of 2.97 ng/ml can be adopted for this prediction. © 2011 Springer-Verlag.


Ozer A.,Dr Zekai Tahir Burak Women Health Research and Education Hospital | Ozaksit G.,Dr Zekai Tahir Burak Women Health Research and Education Hospital | Kanat-Pektas M.,Dr Zekai Tahir Burak Women Health Research and Education Hospital | Ozer S.,Dr Zekai Tahir Burak Women Health Research and Education Hospital
Journal of Obstetrics and Gynaecology Research | Year: 2010

Aim: The present study aims to assign the reference values for nasal bone length (NBL) screened at 11-14 weeks of pregnancy in the Turkish population, determining whether the NBLs specified for Caucasians can be validated for Turkish people. Materials & Methods: The values of NBL were investigated in a total of 415 singleton fetuses that had Turkish parents and normal neonatal outcome. Sonographic measurements of NBL were done on a transabdominal midsagittal plane at 11-14 weeks' gestation. Regression analysis was used to assess the relationship between NBL and crown-rump length (CRL). Reference values, including the 5th, 50th and 95 thpercentiles, were calculated for each gestational age. Results: The mean NBL was estimated to be 2.5 mm for 11-11+6/7 weeks, 2.9 mm for 12-12+6/7 and 3.4 mm for 13-13+6/7 weeks' gestation. The measurements of NBL showed a significant increase with CRL so that a linear and direct correlation was found between NBL and CRL (NBL = 0.267 + 0.043 × CRL, P < 0.001). Moreover, a significant and linear relationship was detected between NBL and gestational age (NBL = -3.858 + 0.537 × gestational age, P < 0.001). Conclusion: The measurement of NBL is found to be achievable in the majority of first trimester pregnancies. The reference range of NBL in normal Turkish fetuses is established so that basic data can be recorded for further studies related to NBL measurements in screening for various chromosomal abnormalities including Down syndrome within Turkish population. © 2010 Japan Society of Obstetrics and Gynecology.


Sucak A.,Dr Zekai Tahir Burak Women Health Research and Education Hospital | Kanat-Pektas M.,Dr Zekai Tahir Burak Women Health Research and Education Hospital | Gungor T.,Dr Zekai Tahir Burak Women Health Research and Education Hospital | Mollamahmutoglu L.,Dr Zekai Tahir Burak Women Health Research and Education Hospital
Singapore Medical Journal | Year: 2010

Introduction: This study was carried out to investigate changes in the plasma leptin concentrations during preeclampsia treatment and to determine whether antihypertensive treatments, aimed at decreasing leptin levels, would improve foetal outcomes. Methods: A prospective study was undertaken in 57 pregnant women with preeclampsia (37 with mild and 20 with severe preeclampsia) and 46 normal pregnant women who were matched in maternal and gestational age and body mass index. The mild preeclampsia group was treated with alpha-methyldopa, while the severe preeclampsia group was treated with a combination of alpha-methyldopa and nifedipine. Results: The severe preeclampsia group had significantly lower platelet counts, higher systolic and diastolic blood pressures and elevated serum uric acid concentrations. Pre-treatment plasma leptin levels were significantly increased in the severe preeclampsia group (range 18.3-49.5) compared to the the mild preeclampsia group (range 20.7-45.4) and normal controls (range 8.6-19.2). Post-treatment plasma leptin levels in both the mild and severe preeclampsia groups (range 10.2-23.5 and 11.3-24.4, respectively) were statistically similar to those of the control group (range 9.1-20.7). Estimated foetal weight, intrauterine growth retardation and demise were statistically similar in the three study groups. Conclusion: Plasma leptin concentrations were found to be elevated in women diagnosed with severe preeclampsia. However, the exact mechanism underlying the increased plasma leptin levels in preeclampsia and the functional role of leptin in the development of hypertension need to be further clarified. Leptin has a promising future as a valuable marker to identity women with a high risk for preeclampsia.

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