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Öğe Comparison of short and long ovulation induction protocols used in ART applications according to the ovarian response and outcome of pregnancy(2002) Tavmergen E.; Tavmergen Göker E.N.; Sendag F.; Sendag H.; Levi R.This retrospective study was designed to determine whether there is any difference between short and long protocol ovulation induction with Gonadotropin Releasing Hormone agonist (GnRHa) and gonadotropins used in Assisted Reproductive Technology (ART) applications according to the number of retrieved oocytes, oocyte maturity, fertilization rates, embryo quality and the outcome of pregnancies. 240 cycles consisting of in vitro fertilization (IVF) cycles without andrologic factor and intracytoplasmic sperm injection (ICSI) cycles were evaluated. 112 cycles which were induced by short protocol GnRHa and Follicle Stimulating Hormone (FSH) + Human Menopausal Gonadotropin (HMG) combinations and 128 cycles which were induced by long protocol GnRHa and FSH + HMG combinations were compared according to the number of retrieved oocytes, cancellation rate of cycles, oocyte maturity, fertilization rates, embryo quality and pregnancy rates. The cancellation rate for short protocol cycles were found to be significantly higher than those with long protocol. The number of retrieved oocytes, mature oocytes and fertilized oocytes were also found significantly lower. The quality of embryos did not show any significant difference between these groups. The clinical pregnancy rates were evidently found to be high in the long protocol cycles. As a conclusion we have found that while the number of retrieved oocytes, mature oocytes, fertilized oocytes and clinical pregnancy rates were increasing, the cancellation rate of cycles were decreasing significantly in ART cycles induced by long protocol.Öğe Comparison of three-dimensional ultrasound and magnetic resonance imaging diagnosis in surgically proven Müllerian duct anomaly cases(Elsevier Ireland Ltd, 2016) Ergenoglu A.M.; Sahin Ç.; Şimşek D.; Akdemir A.; Yeniel A.Ö.; Yerli H.; Sendag F.Objective To determine and compare the diagnostic accuracy of 3-dimensional ultrasound (3D US) and magnetic resonance imagining (MRI) in patients with surgically diagnosed Mullerian duct anomaly (MDA). Study design Charts of patients with MDA were retrospectively evaluated. Patients who underwent both laparoscopic and hysteroscopic surgery and had 3D US and MRI examinations were included in the study. The diagnoses achieved via 3D US and MRI were compared with the surgical diagnoses to determine the diagnostic accuracy of these imagining techniques. Results Twenty-nine patients were included in the study. Three-dimensional ultrasound detected 28 out of 29 (96%) patients correctly. Only one patient was diagnosed with a uterine septum instead of uterine arcuatus. Magnetic resonance imaging detected 23 out of 29 patients correctly (79%). The Kappa indexes of the 3D US and MRI were 0.896 and 0.592, respectively. Conclusion Our results indicate that 3D US has a higher diagnostic accuracy level than MRI in evaluating MDA, especially when used in experienced hands. However, additional, well-designed studies are needed to better compare the diagnostic accuracy of the 3D US and MRI. © 2015 Published by Elsevier Ireland Ltd. All rights reserved.Öğe Different types of variable decelerations and their effects to neonatal outcome(2003) Kazandi M.; Sendag F.; Akercan F.; Terek M.C.; Gundem G.Objective: Although the only objective finding of intrapartum fetal distress is obtained through the measurement the fetal scalp pH, this invasive procedure is not available in every institution. The careful examination of fetal heart rate tracings for abnormalities, especially of the most commonly seen one, variable decelerations gains great importance under these circumstances. The aim of the present study is to determine the prognostic significance of variable decelerations in intrapartum fetal heart rate monitoring. Methods: A total of 96 fetal heart rate tracings were analysed to assess the prognostic significance of variable decelerations. Sixty-six percent (64/96) of cases exhibited atypia characterised with (1) slow return of the fetal heart rate to the baseline; (2) loss of variability during the decelerations; (3) loss of initial and/or secondary accelerations; (4) persistence of secondary acceleration (overshoot);and (5) continuation of the baseline fetal heart rate at a lower level; (6) biphasic deceleration. One and five-minute Apgar scores and umbilical artery pH were used to assess the final fetal condition. Results: Adverse fetal outcome characterised by fetal acidosis and Apgar score lower than 7 at one and five minutes were uncommon with pure variable decelerations. Typical and atypical variable decelerations were associated with low Apgar scores (<7) at one minute in 9.3% and 54.6% of cases (p<0.001) and at five minutes in 6.25% and 25% of cases (p<0.05), respectively. In addition umbilical artery pH found to be lower than 7.2 in these cases (18.75%-p<0.05). There was no danger for the fetal haemodynamic conditions when typical uterus contraction/variable deceleration ratios were two or more than two. However, risk of fetal hypoxia damage was quite high when this ratio was lower than two in atypical variable decelerations. This result is proven by the 1st and 5th minute low Apgar scores and pH (81.8% and 36.6% respectively). A typical features are helpful in the identification of distress characterised by low Apgar scores in fetuses with variable decelerations. Admission to the neonatal intensive care unit was more common in patients with atypical variable decelerations in comparison with typical variable decelerations (34.3% versus 3.1%). Conclusion: While typical variable decelerations are frequently harmless, atypical variations pose a significant risk of fetal hypoxia.Öğe Distribution of fibronectin, laminin and collagen type IV in the materno-fetal boundary zone of the developing mouse placenta: Experimental study(2002) Saylam C.; Özdemir N.; Itil I.M.; Sendag F.; Terek M.C.Objective: The objective of this study is to demonstrate the distribution of extracellular matrix components of fibronectin, laminin and collagen type IV in the materno-fetal boundary zone of the developing mouse placenta. Material and methods: Mice fetuses and placentas were removed serially every day until the 19th gestational day. Implantation sites were processed and stained by an immunohistochemical method by specific antiserums to fibronectin, laminin and collagen type IV. The distribution of the extracellular matrix components in cytotrophoblasts and giant cells of the developing mouse placenta were determined under light microscope. Results: Fibronectin, laminin and collagen type IV immunostaining demonstrated a dynamic relationship changing day by day after the conception. At the 16th day cytotrophoblasts and giant cells were all positively stained by the extracellular matrix components. Conclusion: This study demonstrates that the regions of the developing mouse placenta produce specialized extracellular matrices which may contain different ratios of these polypeptides.Öğe Does tibolone affect serum leptin levels and body weight in postmenopausal women?(2005) Gol M.; Ozsener S.; Sendag F.; Uretmen S.; Oztekin K.; Tanyalcin T.; Bilgin O.Objectives: Leptin has a significant role in body weight regulation and energy balance. We examined the effect of tibolone on the body weight and serum leptin levels in postmenopausal women. Study design: Twenty women (aged 43-60 years) participated in this prospective study. All women in this study protocol received 2.5 mg/day of tibolone. Absolute and body mass index (BMI)-corrected serum leptin concentrations and BMI values were measured at baseline, after 3 months, and after 6 months of the tibolone therapy. Results: Tibolone did not affect absolute and BMI-corrected serum leptin levels, and BMI values during the treatment. A significant linear correlation between BMI values and serum leptin levels was observed (p<0.05, r=0.67). Conclusions: Tibolone seems not to affect serum leptin levels, body weight and BMI values of postmenopausal women. There is a significant correlation between serum leptin levels and BMI values. © Springer-Verlag 2004.Öğe The effect of day 2 FSH, LH, estradiol levels on ovarian response and pregnancy outcome in ART cycles induced by short protokol GnRH-a and gonadotropins [Kisa protokol GnRHa ve gonadotropinlerle ovulasyon induksiyonu yapilan yardimli ureme teknigi uygulamalarinda; siklus basi FSH, LH, Ostradiol duzeylerinin; ovarian cevap ve gebelik sonuclari uzerine etkileri](1999) Tavmergen E.; Sendag F.; Tavmergen Goker E.N.; Benli H.; Kocyigit F.OBJECTIVE: This study was designed to evaluate the influence of serum E2, LH, FSH levels on the starting day of ovulation induction in ART cycles tooccyte maturity, fertilization rates, embryo quality and outcome of pregnancy. STUDY DESIGN: The blood levels of E2, LH, FSH were detected in patients on the 2nd day of the menstrual cycle when short protocol GnRH-a and FSH+HMG combinations were started for ovulation induction. The required gonadotropin dosage was compared to oocyte maturation, fertilization rates, embryo quality and pregnancy rates in different groups of E2, LH, FSH levels. RESULTS: 100 cases of IVF cycles without an andrologic factor and ICSI cycles were evaluated. The patients were evaluated for day 2 E2, LH, FSH levels divided into different groups as following; E2<50 pg/ml, 50 pg/ml ?E2 <75 pg/ml, E2 ?75 pg/ml; FSH < 5 miu/ml, 5 miu/ml ? FSH < 10 miu/ml, FSH ? 10 miu/ml; LH<5 miu/ml, LH ? miu/ml. Statistically significant differences were detected between day 2 E2 levels and the prognosis of pregnancy, cancellation rate of cycles. No statistically significant difference was detected with day 2 LH levels although negative correlation was detected between FSH levels and the dose of gonadotrophin hormone used, oocyte number, fertilization rates, embryo number and outcome of pregnancy. The cycle cancellation rate was higher in the group with high FSH levels. CONCLUSIONS: As a conclusion we have found that E2 levels <75 pg/ml and FSH levels <10 miu/ml on day 2, influences the outcome of ovulation induction, number of retrieved oocytes, fertilization rates, embryo number and pregnancy rates positively. In patients having higher hormone levels, the number of HMG and FSH ampules used for induction increases significantly which influences oocyte number, fertilization rates, embryo number and pregnancy rates negatively.Öğe The effects of different intraabdominal pressure protocols in laparoscopic procedures on oxidative stress markers and morphology in rat ovaries(Wroclaw University of Medicine, 2014) Biler A.; Yucebilgin S.; Sendag F.; Akman L.; Akdemir A.; Ates U.; Uyanikgil Y.; Yilmaz-Dilsiz O.; Sezer E.Background: To determine the effects of different intraabdominal pressure (IAP) on the ovaries in a laparoscopic rat model. Objectives: The aim of the study was to determine the effects on the ovaries of different intraabdominal pressures (IAP) in laparoscopic surgery in a rat model. Material and Methods: Thirty-two post-pubertal nonpregnant Sprague-Dawley rats were divided randomly into four groups. In the control group, no intraabdominal pressure (IAP) was applied. In Group Pp10 and Group Ppl5, an IAP of 10 and 15 mm Hg, respectively, were applied by carbon dioxide insufflation for 60 min, and a 30-min desufflation was carried out. In Group IPp15, a 15 mm Hg IAP was applied for 10 min, and then CO2 was desufflated for 10 min. After this ischemic preconditioning, IAP was established at 15 mm Hg for 60 min, after which CO2 was desufflated for 30 min. Erythrocyte and ovarian tissue malondialdehyde (MDA) and histopathologic damage scores were evaluated. Results: In Groups Pp10 and Ppl5, ovarian tissue MDA values were significantly increased compared to the control group. In Groups Pp10 and Pp15, erythrocyte MDA values were significantly increased when compared to Group IPp15 and the control group. Ovarian histopatological assesment scores were significantly higher in Group Ppl5 than in Groups Pp10 and IPp15. Conclusions: Pneumoperitoneum causes injuries to abdominal organ such as the ovaries. The ischemic preconditioning method is more effective in reducing oxidative stress due to laparoscopic pneumoperitoneum than lowpressure pneumoperitoneum methods.Öğe Effects of sequential combined transdermal and oral hormone replacement therapies on serum lipid and lipoproteins in postmenopausal women(2002) Sendag F.; Karadadas N.; Ozsener S.; Bilgin O.The aim of this study was to compare the effects of sequential combined transdermal and oral postmenopausal hormone replacement therapies on serum lipid-lipoprotein profiles risk markers for cardiovascular disease. A prospective randomize study was designed: Ninety-six healthy nonhysterectomised post-menopausal women were randomized to receive either transdermal continuous 17ß-estradiol, 0.05 mg/d (Estraderm TTS, Novartis, Basel, Switzerland), with transdermal sequential norethisterone acetate, 0.25 mg/d (Estragest TTS, Novartis, Basel, Switzerland), or oral continuous conjugated equine estrogens, 0.625 mg/d (Premarin 0.625 mg, Wyeth, Philadelphia, U.S.A.), with oral sequential medroxyprogesterone acetate, 10 mg/d (Farlutal 5 mg, Deva, Istanbul, Turkey). 84 women completed the trial, 42 in oral and 42 in the transdermal group. The serum levels of total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, apolipoproteins AI and apolipoproteins B at 6 months after starting treatment were compared with baseline values for both therapies. Both oral and transdermal therapies significantly reduced serum levels of total cholesterol (208-190 mg/dL and 216-199 mg/dL, respectively, p=0.0001) and LDL-cholesterol (128-112 mg/dL and 140-127 mg/dL, respectively, p=0.001). The serum levels of triglycerides did not show any significant change with oral therapy, whereas this lipid fell (128-101 mg/dL, p=0.0001) significantly with transdermal therapy. We found significant decrease in HDL-cholesterol with transdermal therapy while there was no significant change with oral therapy. Apolipoproteins AI, the major protein component of HDL2 subfraction, was increased by oral therapy and lowered by transdermal therapy. As a conclusion, we have found that serum total cholesterol and LDL-cholesterol were lowered by both therapies, with no significant differences between treatments, whereas there were significant differences between treatments according to effects on serum triglycerides and apolipoproteins AI.Öğe Effects of tamoxifen on tissue nitrite/nitrate levels and plasma lipid peroxidation in female rats(2010) Gharehbagni M.; Sendag F.; Akercan F.; Zeybek B.; Sezer E.; Terek M.C.; Karadadas N.Purpose of investigation: The effects of tamoxifen on lipid peroxidation and oxidant-antioxidant balance in an animal model were studied. Methods: Twelve female adult rats were divided into two groups and DMSO and tamoxifen dissolved in DMSO were administered. Tissues taken from the brain, liver and ovary of rats were dissected. MDA, nitrite, nitrate levels and plasma LDL oxidation in brain, ovary and liver tissues were measured and compared. Results: Induced LDL MDA levels were significantly lower in the tamoxifen group (p = 0.009). MDA levels in the liver were significantly lower in the tamoxifen group whereas nitrite levels were found significantly higher (p < 0.05). Brain and ovarian tissues demonstrated no significant difference with respect to MDA, nitrite and nitrate levels. Conclusion: Tamoxifen has no negative effects on lipid peroxidation in an animal model.Öğe Erratum to: Is ursodeoxycholic acid crucial for ischemia/reperfusion-induced ovarian injury in rat ovary? [Arch Gynecol Obstet, (2015), DOI 10.1007/s00404-015-3646-9](Springer Verlag, 2015) Akdemir A.; Sahin C.; Erbas O.; Yeniel A.O.; Sendag F.[No abstract available]Öğe Immunohistochemical expressions of p16 and p53 proteins in cervical intraepithelial neoplasia and in benign cervical tissue(2010) Tosun G.; Sendag F.; Zeybek B.; Cosan Terek M.; Guven C.; Zekiogly O.; Bilgin O.Purpose of Investigation: To evaluate the immunohistochemical expressions of p16 and p53 in cervical intraepithelial neoplasia (CIN) and do a comparison with non-neoplastic cervical lesions. Methods: Sixty cases diagnosed as CIN after histopathological examination and 25 controls diagnosed as chronic cervicitis were included in the study. Immunohistochemical expressions for pi6 and p53 were evaluated and compared in all cases. The cases in the study were defined according to the Bethesda system. Of these, 31.8% (n = 27) had a low-grade squamous intraepithelial lesion (LGSIL), and 38.8% (n = 33) had a high-grade squamous intraepithelial lesion (HGSIL). Results: There was a statistically significant difference between chronic cervicitis and CIN in terms of p53 and pl6 expression levels (p = 0.001). On the other hand, the level of p16 expression was statistically different between LGSIL and HGSIL (p = 0.001), while there was no significant difference in terms of p53 expression. Among the HGSIL cases (n = 33), 91% had pl6 expression, while 66.7% (n = 27) of the LGSIL patients had no p16 expression. In the chronic cervicitis group, 84% (n = 21) did not reveal any p16 expression, while 96% (n = 24) did not reveal any p53 expression. Various levels of p53 expressions were detected in 59.2% (n = 16) of CIN1 cases, 69.3% (n = 9) of CIN2 cases, and 90% (n = 18) of CIN3 cases. Conclusion: While pl6 is useful in detecting high-grade cervical lesions, p53 is not a good biomarker for distinguishing high-grade lesions from low grade ones.Öğe Is ursodeoxycholic acid crucial for ischemia/reperfusion-induced ovarian injury in rat ovary?(Springer Verlag, 2015) Akdemir A.; Sahin C.; Erbas O.; Yeniel A.O.; Sendag F.Purpose: Ursodeoxycholic acid is frequently used in cholestatic liver diseases. Also, it protects hepatocytes against oxidative stress induced by hydrophobic bile acids. We investigated the anti-oxidative effect of ursodeoxycholic acid on ischemia/reperfusion injury after ovarian de-torsion in rats. Methods: We designed five study groups. Group 1 (n = 6): Sham-operated group; group 2 (n = 6): torsion group; group 3 (n = 6): torsion and ursodeoxycholic acid, group 4 (n = 7): torsion/de-torsion group; and group 5 (n = 7): torsion/de-torsion and ursodeoxycholic acid. After that, ovarian samples were obtained and examined histologically and tissue levels of malondialdehyde were measured. Results: Follicular degeneration, edema and inflammatory cells were significantly decreased in groups 3 and 5 in comparison with groups 2 and 4. Also, groups 4 and 5 were compared in terms of vascular congestion and hemorrhage and these were found to be significantly decreased in group 5. In addition, levels of malondialdehyde were significantly decreased in groups 3 and 5 in comparison with groups 2 and 4. Conclusions: We concluded that ursodeoxycholic acid might be useful to protect the ovary against ischemia and reperfusion injury. © 2015, Springer-Verlag Berlin Heidelberg.Öğe Laparoscopic burch colposuspension: Comparison of effectiveness of extraperitoneal and transperitoneal techniques(Elsevier Ireland Ltd, 2004) Bulent Tiras M.; Sendag F.; Dilek U.; Guner H.Objective: To compare the effectiveness of two different laparoscopic colposuspension procedures: extraperitoneal approach using mesh fixed with tacks, and transperitoneal approach using sutures. Study design: We conducted a retrospective study of all patients (n=64) who had undergone two different techniques of laparoscopic Burch colposuspension without additional surgeries over a 6-year period. Thirty-six women underwent laparoscopic transperitoneal colposuspension with using nonabsorbable sutures (group A), whereas 28 women underwent laparoscopic extraperitoneal colposuspension with using mesh and preperitoneal balloon dissection technique (group B). Cure rate was assessed by simple cystometry with a cough stress test in the standing position. Both groups were compared with regard to cure rates, operative time, length of hospital stay, complications, estimated blood loss, and total hospital charges. Results: The mean times to follow-up were 25.7 months in the group A and 27.3 months in the group B (P=0.082). At last follow-up, 33 of 36 (91.7%) patients in the group A and 23 of 28 (82.1%) patients in the group B were continent (P=0.22). The other results were as follows for group A and B, respectively: average duration of surgery, 58.1 compared with 46.8 min (P=0.001); average hospital stay, 2.05 compared with 1.57 days (P=0.02); the intraoperative complication rate, 8.3% compared with 7.1% (P=0.62). The total hospital charges for the group B were found significantly higher (US$ 2234 versus US$ 1348, P=0.001). Conclusion: Although we found higher cure rates in laparoscopic colposuspension with the transperitoneal approach using sutures than the extraperitoneal approach using mesh fixed with tacks, there was no statistically significant difference between the two procedures. In comparison with extraperitoneal mesh technique, lower cost is the superiority of the transperitoneal suture technique. © 2004 Elsevier Ireland Ltd. All rights reserved.Öğe Morphometric changes in the endometrium and serum leptin levels during the implantation period of the embryo in the rat in response to exogenous ovarian stimulation(2004) Dursun A.; Sendag F.; Terek M.C.; Yilmaz H.; Oztekin K.; Baka M.; Tanyalcin T.To determine the changes in endometrium and serum leptin levels during the periimplantation period of the ovum in the rat in response to exogenous ovarian stimulation by hMG and recombinant FSH (rFSH). Experimental animal study. University hospital. A total of 100 female rats were stimulated with low and high doses of hMG (groups 1 and 2, respectively) and low and high doses of rFSH (groups 3 and 4, respectively) before mating after the regular cycle was observed. The control group of animals was not injected (group 5). The endometrium of the pregnant rats (n = 53) was analyzed by the morphometric method, and serum samples were obtained for leptin and E 2 levels at baseline and on the day of implantation. The mitotic index was determined separately for endometrial surface, glandular epithelium, and endometrial stroma by light microscope. Morphometric analysis of endometrium, mitotic index, and serum leptin and E 2 levels The mean number of corpora lutea was significantly higher in groups 2 and 4. The measurement of mucosal depth was found to be significantly higher in group 4 compared with the control group (0.361 ± 0.03 vs. 0.289 ± 0.04). The depth of the endometrial surface epithelium was found to be significantly higher in all study groups (groups 1-4) compared with the control group. The depth of the surface epithelium was found to be significantly lower in group 1 compared with the other study groups (groups 2, 3, and 4). The depth of the surface epithelium was also significantly lower in group 2 compared with group 3 (21.58 ± 3.56 vs. 28.21 ± 3.56). Mitotic indices that were determined at the endometrial surface epithelium and stroma were all significantly lower in all study groups (groups 1-4) compared with the control group. There was no significant increase for the baseline leptin levels compared with the levels measured on the day of implantation. In an animal model, exogenous administration of gonadotropins significantly affects the morphology of the endometrium and the mitotic index in the implantation period of the embryo. These morphological effects become more pronounced as we increase the administered dose of exogenous gonadotropins. However, no differences in leptin levels were observed relative to different gonadotropin type and dose regimens. © 2004 by American Society for Reproductive Medicine.Öğe Pelvic actinomycosis in a postmenopausal patient with systemic lupus erythematosus mimicking ovarian malignancy: Case report and review of the literature(2004) Oztekin K.; Akercan F.; Yucebilgin M.S.; Kazandi M.; Terek M.C.; Sendag F.; Zekioglu O.Pelvic actinomycosis is a chronic granulomatous suppurative disease caused by an anaerobic gram-positive organism Actinomyces israelii usually associated with intrauterine devices. Systemic lupus erythematosus is an autoimmune disorder associated with multiple primary and drug-related immunological defects that predispose patients to infections. The combination of both diseases in a postmenopausal patient is a rare occurrence. A case of a pelvic mass in a 49-year-old postmenopausal patient with systemic lupus erythematosus treated with immunosuppressive therapy for two years is presented. The patient presented with lower abdominal pain to the gynecology clinic and was found to have a pelvic tumor. She had no history of intrauterine device use. Histopathologic examination of the laparotomy specimen revealed pelvic actinomycosis.Öğe Reproductive outcomes after hysteroscopic metroplasty for uterine septum(2010) Sendag F.; Mermer T.; Yucebilgin S.; Oztekin K.; Bilgin O.Purpose of Investigation: To evaluate reproductive outcome after hysteroscopic metroplasty. Methods: We analyzed the reproductive outcome of 30 patients with different degrees of septate uterus undergoing hysteroscopic metroplasty. In all cases the procedure was performed by resectoscope. Results: The patients had a total 74 pregnancies before metroplasty. Of these, ten (14%) were carried to term, six (8%) ended in preterm delivery, and 58 (78%) ended in spontaneous abortion. At least one year following hysteroscopic metroplasty a total of 20 pregnancies occurred. Of these, 11 (55%) were carried to term, two (10%) ended in preterm delivery, seven (35%) ended in spontaneous abortion. Conclusion: Correction of uterine septum significantly improves the prognosis of the pregnancies in patients with a history of severe obstetric problems. These results are similar to the results reported in the literature. Our data analysis suggests that hysteroscopic metroplasty for uterine septum improves pregnancy outcome of patients who come to us with a desire to conceive.Öğe Retrospective analysis of hysteroscopic findings in breast cancer patients having adjuvant tamoxifen treatment(S.O.G. CANADA Inc., 2010) Sendag F.; Sahin C.; Zeybek B.; Cosan Terek M.; Oztekin K.; Bilgin O.Purpose of Investigation: To evaluate the effects of tamoxifen on the endometrium of breast cancer patients by hysteroscopy and endometrial sampling. Methods: Thirty-seven breast cancer patients using tamoxifen underwent hysteroscopy because of post-menopausal endometrial thickening or abnormal uterine bleeding. Hysteroscopic findings were compared with histopathology and ultrasonographic measurement of the endometrium. Results: Nineteen women showed endometrial abnormalities (51%) out of 37 patients. Negative and positive predictive values for hysteroscopy in detecting endometrial abnormalities were 100% and 94%, respectively. Conclusion: Endometrial surveillance is an important part of gynecological follow-up in breast cancer patients using tamoxifen and the liberal use of hysteroscopy aids in the diagnosis of abnormal endometrium.Öğe Sequential combined transdermal and oral postmenopausal hormone replacement therapies: Effects on bleeding patterns and endometrial histology(2001) Sendag F.; Terek M.C.; Karadadas N.Objectives: To determine the endometrial response and bleeding patterns in postmenopausal women taking a sequential combined hormone replacement regimen either orally or transdermally. Methods: Seventytwo postmenopausal women with amenorrhea of 6 months or longer with follicle stimulating hormone and estradiol levels in the postmenopausal range and normal endometrium were included in the study. The patients randomly received sequential combined hormone replacement regimen with oral (n=37) or transdermal route (n=35). The total duration of treatment was 6 months (6 cycles of 28 d). The subjects kept daily bleeding diaries, and endometrial biopsies were taken at baseline and after 6 months of therapy. Results: The rates of adequate progestational response (secretory or atrophic) were 83.8% and 82.9% in the oral and transdermal hormone replacement groups, respectively (p>0.05). In the oral hormone replacement group, there were 16.2% of inadequate progestational response, 2.7% had endometrial hyperplasia and 13.5% proliferative endometrium. In the transdermal hormone replacement group, there were 17.1% of inadequate progestational response, 2.9% had endometrial hyperplasia and 14.3% proliferative endometrium. Cyclic bleedings occurred in 92.4% and 92% of all cycles in the oral and transdermal treatment groups, respectively. The mean duration of bleeding per cycle were 3.9±0.9 and 3.8±0.9 d in the oral and transdermal treatment groups, respectively. Conclusion: Sequential combined transdermal hormone replacement therapy is as effective as oral therapy in preventing the development of endometrial hyperplasia. Satisfactory control of bleeding is achieved with both regimens.Öğe Single-Site Robotic Total Hysterectomy: Standardization ofTechnique and Surgical Outcomes(Elsevier, 2014) Sendag F.; Akdemir A.; Zeybek B.; Ozdemir A.; Gunusen I.; Oztekin M.K.Study Objectives: To evaluate the safety and feasibility of robotic single-site total hysterectomy and to compare the outcomes of newly implemented robotic single-site bipolar and external vessel-sealing device. Design: Retrospective study (Canadian Task Force classification II-1). Setting: University hospital. Patients: Twenty-four patients with benign indications for hysterectomy. Interventions: All patients underwent robotic-assisted single-incision transumbilical total hysterectomy using the novel da Vinci Single-Site Platform. Vaginal cuff closures were performed intracorporeally using the same technique in all cases. Measurements and Main Results: The median age of the patients was 49.5 years (range, 40-61), and body mass index was 28.5 (range, 21-34). Blood loss was 22.5 mL (range, 7-120 mL). Docking time was 5.5 minutes (range, 3-10 minutes), console time was 74.5 minutes (range, 60-160 minutes), vaginal cuff closure time was 25 minutes (range, 16-41 minutes), and total operative time was 98.5 minutes (range, 71-183 minutes). When 2 groups were created according to the energy devices used during the procedures, console time in the newly implemented bipolar group was shorter than in the external sealing device group (69.5 minutes vs 77 minutes; p = .03); however, no differences were found for uterus removal time (50.5 minutes vs 53.5 minutes; p = .13). Differences were observed in vaginal cuff closure time (18.5 minutes vs 23 minutes; p = .01). Conclusion: Robotic single-site total hysterectomy using a newly implemented bipolar grasping instrument and even with intracorporeal cuff closure is a safe and feasible procedure in appropriately selected patients. © 2014 .Öğe Successful pregnancy in an infertile woman with endometrial hyperplasia and embryo transfer: A case report(2001) Tavmergen Goker E.N.; Sendag F.; Tavmergen E.; Levi R.; Zekioglu O.BACKGROUND: Successful pregnancy in a woman with complex endometrial hyperplasia with atypia was treated conservatively with gestagens. CASE: The patient was initially diagnosed with complex hyperplasia of the endometrium with atypia by endometrial curettage and treated with several cycles of different gestagens. After repeated endometrial curettage, in vitro fertilization and embryo transfer were introduced for immediate treatment of the patient's infertility in order to avoid the risk of recurrent hyperplasia of the endometrium from estrogens. A single pregnancy was achieved after transfer of embryos obtained from intracytoplasmic sperm injection. This was performed due to poor semen characteristics. The patient delivered a normal, healthy male infant at term. CONCLUSION: Conservative treatment of complex endometrial hyperplasia with atypia in young women wishing to preserve fertility should be considered in carefully selected cases.
