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Öğe An analysis of 37 patients with uterine leiomyosarcoma at a high-volume cancer center [Yüksek hacimli bir kanser merkezinde uterin leiomyosarkomlu 37 olgunun analizi](Turkish Society of Obstetrics and Gynecology, 2015) Solmaz U.; Dereli L.; Demirtaş G.S.; Ekin A.; Mat E.; Gezer C.; Hasdemir P.S.; Sayhan S.; Sancı M.; Aşkar N.Objective: To evaluate the clinicopathologic characteristics, treatment methods, survival, and prognosis of uterine leiomyosarcoma (ULMS). Materials and Methods: All patients with ULMS who were treated between January 1998 and October 2012 were retrospectively reviewed. A total of 37 women who met the inclusion criteria were included in the present study. Univariate and multivariate analyses were used to identify the risk factors for overall survival (OS) and progression-free survival (PFS). Results: The majority of patients had stage 1 disease (IA, n=9 (24.3%); IB, n=23 (62.1%)). All patients underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Additionally, only pelvic, and pelvic plus para-aortic lymphadenectomy was performed in 5 (13.5%) and 8 (21.6%) women, respectively. Adjuvant treatment was administered to 27 (72.9%) patients. Patients who did not receive adjuvant therapy had stage 1 disease. Recurrences occurred in 5 (13.5%) patients. The median follow-up period was 71 months (range 1-158 months). The 5-year PFS and OS rates were 68% and 74%, for all patients. The 5-year OS rates for women with stage 1 and ? stage 2 disease were 82% and 27%, respectively. Multivariate analysis confirmed stage 1 disease as the only independent predictor of both PFS (Odds ratio (OR) 10.955, 95% confidence interval (CI) 1.686-71.181, (p=0.012)) and OS (OR 57.429, 95% CI 3.287-1003.269, (p=0.006)). Conclusions: Extensive surgery is not associated with prognosis and stage 1 disease is the only independent good prognostic factor for survival in patients with ULMS. © 2015, Turkish Society of Obstetrics and Gynecology. All rights reserved.Öğe A case of heteretopic pregnancy after li·neer salpingostomy and laparoscopic management: A case report [Geçi·ri·lmi·ş Li·neer Salpi·ngostomi· Sonrasi Spontan Heterotopi·k Gebeli·k Olgusu Ve Laparoskopi·k Tedavi·: Olgu Sunumu](2012) Yeniel A.O.; Ergenoglu A.M.; Sanhal C.Y.; Itil I.M.; Aşkar N.Incidence of heterotopic pregnacy is definition that 1/30000. Prior surgery specially tubal surgery is one of the most important risk factors. We presented heterotopic pregnancy with literature that was in reproductive age and had prior ectopic pregnancy history treated by salpingostomy. In this patient had a succesful vaginal delivey before ectopic pregnancy. Choice of lineer salpingostomy in treatment of ectopic pregnancy should be discussed with patient and her husband for future fertility. Next pregnancy of in these patient should be ectopic pregnancy and heterotopic pregnancy that we presented.Öğe Comparing the Transvaginal Tape (TVT) and Transobturator Tape (TOT) in stress urinary incontinance for their efficiency and their effects on quality of life [Stres i·nkonti·nans olgularinin cerrahi· tedavi·si·nde Transvagi·nal Tape (TVT) ve Transobturator Tape (TOT) uygulamalarinin etki·nli·gi·ni·n ve yaşam kali·tesi· üzeri·ne etki·leri·ni·n karşilaştirilmasi](2010) Mehdiyev M.; Itil I.M.; Şendag F.; Akdemir A.; Aşkar N.Objective: To compare the success rates, complications and the effects on the quality of life TOT and TVT operation. Material and method: 32 patients who were diagnosed as stress urinary incontinance between March 2005 and November 2006 were included in the study. All patients filled urinar diary and underwent urodinamical examination after negative urine culture. To evaluate the quality of life I-QoL questionnaire was used. The patients were randomised for TOT and TVT operations. Results: 17 patients underwent TOT operation while 15 patients underwent TVT operation. The mean operation time of TOT group (13.5 min) was significantly shorter than TVT groups (18.3 min). There were no intraoperative complications in TOT group whereas one bladder injury and one rigt inguinal side subcutaneous hematoma in TVT group. In early postoperative period no complication was seen in TOT group but 3 globe vesicale cases were seen in TVT group. There were no differences about blood loss between two groups. The mean hospitalisation time was 2 days in bouth two groups (except complicated cases). 1.5 months after the operation all patients were evaluated with cough stress test, residuel urine volume, subjective complains and I-QoL questionnaire, no differences were detected between two groups. One patient in TOT group and three patients in TVT group was complicated with denovo urge incontinance. In our study the objective success rates was 82.3% and 86.7% in TOT and TVT groups respectively. Conclusions: In our study we found that the success rates of TOT and TVT operations were similar and complication rates of TOT was less than TVT group. Further studies that include wide patient populations and long term follow-up are needed to get more objective results.Öğe How frequent are overactive bladder symptoms in women with urodynamic verification of an overactive bladder? [Ürodinami ile aşi{dotless}ri{dotless} aktif mesane tani{dotless}si{dotless} konmuş kadi{dotless}nlarda aşi{dotless}ri{dotless} aktif mesane semptomlari{dotless} hangi si{dotless}kli{dotless}kta bulunmaktadi{dotless}r?](2012) Yeniel A.O.; Ergenoglu M.A.; Meseri R.; Aşkar N.; Itil I.M.Objective: To determine the relationship between overactive bladder symptoms and urodynamic verification of overactive bladder. Material and Methods: Between June 2011 and November 2011, 159 patients underwent urodynamics (UDS) at our urogynecology unit in the Ege University Hospital. Of these, 95 patients who complained of urgency, did not have any overt neurological diseases, bladder outlet obstruction and did not take any medication affecting the lower urinary tract function were evaluated. SPSS (ver. 15.0) was used to evaluate the data and the chi-square test and t test for independent samples were used for analysis. Results: The mean age was found to be 54.5±12. Frequency was the most frequent symptom in women with overactive bladder (OAB) (82.1%), nocturia (57.8%) and (57.8%) urgency urinary incontinence followed in frequency. Detrusor over activity incidence was found to be 38.9%. There was no significant relationship between the presence of detrusor over activity (DOA) and OAB symptoms. Leak at urodynamics was found in 46.3% and there is no significant association with detrusor overactivity. Total bladder capacity was found to be significantly lower in women who had DOA (p=0.000). Conclusion: It appears that overactive bladder symptoms do not predict detrusor over activity. Urodynamic investigation is not mandatory in the initial management of women with only OAB symptoms. © 2012 by the Turkish-German Gynecological Education and Research Foundation.Öğe Hymen imperforate: A report of three cases [Hi·men i·mperforatus: Üç olgu sunumu](2011) Yeniel A.Ö.; Ergenoglu A.M.; Bayrak Z.; Itil I.M.; Aşkar N.Imperforate hymen is a congenital anomaly that is rarely seen in woman genital system. Imperforate hymen is reported %0,1 of all newborns and it is think that cause of imperforate hymen is congenital defect in the degeneration of central cells of hymen. Although it is generally isolated anomally, sometimes genitourinary anomalies may associate this defect. Patients who has this anomally are generally asymptomatic until puberty and in the period of adolescence, patients administer with a primary amenore and cyclic pelvic pain. History and pelvic examination are the main steps in diagnosis. To determine possible associated anomalies imaging studies are usefull. Treatment of this anomally consist of vaginal reconstrictive surgery. We presented three imperforate hymen cases with literature in this case report.Öğe Pulmonary embolus arising from sloughed off myoma in late puerperium [Geç lohusali{dotless}kta myoma baugli{dotless} pulmoner embolism](2010) Ergenoglu A.M.; Yeniel A.O.; Ulukuş M.; Aşkar N.Pulmonary embolus is a rare and serious complication of myoma uteri in the puerperium that resulted in late postpartum hysterectomy A 38-year-old, multiparous woman with a large myoma located on the left lateral wall of the uterus underwent emergency cesarean section due to fetal distres at 28 weeks. During the operation, a 15 cm sized intramural myoma was left without any intervention. On the 40th day postpartum the patient returned to the clinic with sepsis and pulmonary embolus because of obstruction of lochia drainage by the sloughed off myoma. The patient underwent hysterectomy and medical therapy for pulmonary embolus. We presented an unusual complication of uterine leiomyoma in the late postpartum period after cesarean section. Whatever the mode of sloughing off ofthe myoma, the results of the obstruction of lochia drainage may be devastating as in our case. To avoid these complications, clinicians must be aware of these symptoms and prompt intervention is essential.
