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Öğe Comparison of hydrosonography and diagnostic hysteroscopy in the evaluation of infertile patients(2004) Yucebilgin M.S.; Aktan E.; Bozkurt K.; Kazandi M.; Akercan F.; Mgoyi L.; Terek M.C.Objective: In the present study we evaluated the value of hydrosonography in the screening for intracavitary structural pathologies in patients with a history of infertility before the implementation of assisted-reproductive technology. Hysterescopy was regarded as the gold standard procedure. Study design: A retrospective study. Material and methods: A total number of 115 infertile women aged between 19 and 47 (33.4 ± 5.3), who were candidates for assisted reproductive techniques, were enrolled in this retrospective analysis. The study comprised data obtained from patients undergoing infertility investigation between 2001 and 2003 at Ozel Ege IVF Center and the Department of Obstetrics and Gynecology of Ege University Faculty of Medicine. The results obtained by hydrosonography were later compared with those of hysteroscopy. Sensitivity, specificity, positive predictive value and negative predictive value for hydrosonography were calculated. Results: In a total of 115 women, 53 (46%), 24 (20%), 30 (26%) and 8 (7%) were found to have normal endometrial cavities, submucous myoma, endometrial polyps and uterine septum, respectively, on hydrosonography. Forty-five (85%) of 53 women, who were supposed to have normal findings of a hydrosonography, were confirmed by hysteroscopy. In the remaining eight women (15%), two had endometrial polyps, three had uterine septum, one had submucous myoma and two had intrauterine synechia on hysteroscopic examinations. The sensitivity, specificity, positive and negative predictive values of hydrosonography in the detection of structural endometrial cavity lesions were 85%, 75%, 75% and 84%, respectively. Two intrauterine adhesions were not recognized by hydrosonography. Conclusion: Hydrosonography may be a useful tool in the evaluation of intrauterine cavity structural pathologies in infertile patients with the exception of intrauterine adhesions. In addition, hydrosonography was found to be sensitive in the detection of intrauterine septum.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 Preemptive meloxicam for postoperative pain relief after abdominal hysterectomy(2004) Akarsu T.; Karaman S.; Akercan F.; Kazandi M.; Yucebilgin M.S.; Firat V.Objective: This study was conducted to evaluate the analgesic efficacy of meloxicam in abdominal hysterectomy. Methods: The study population consisted of 52 patients scheduled for total abdominal hysterectomy who were ASA 1 or 2 physical status female. Patients were allocated randomly to receive orally either 15 mg of meloxicam (Group M, n = 27) or placebo (Group P, n = 25) before anesthesia induction. After intravenous administration of 1.5 mg kg-1 of tramadol, anesthesia was induced with an intravenous loading dose of 1-2 mg kg-1 propofol. Anesthesia was maintained on intravenous infusion of propofol at 6-12 mg kg-1 h-1 plus tramadol at 1 mg kg -1 h-1, vecuronium, and a 2:1 nitrous oxide-oxygen mixture. Results: The relative propofol consumption was lower in Group M than in Group P, (p < 0.05). The time for analgesic rescue decreased in the order Group M > Group P (p < 0.01). The degree of sedation was similar between the groups (p > 0.05) and the visual analog scores (10-cm scale) and verbal rating scale data differences were present in the first 2 h only (p < 0.05). When side-effects were evaluated nausea and vomiting were found to be lower in group M than in group P (p < 0.05). Conclusion: Preemptive meloxicam provided better postoperative analgesia than placebo.Öğe Pulmonary edema after ritodrine therapy during pregnancy and subsequent cesarean section with epidural anesthesia(2004) Karaman S.; Ozcan O.; Akercan F.; Terek M.C.; Yucebilgin M.S.; Firat V.Ritodrine, a beta-sympathicomimetic drug that is frequently used for the prevention of preterm birth. Preterm delivery is an important cause of low birth weight. One of the most important side-effects of ritodrine is pulmonary edema. In patients developing pulmonary edema after ritodrine therapy, aggressive fluid resuscitation during the operation period should be avoided. Successful epidural anesthesia can be achieved with a slow-onset epidural block after moderate fluid infusion. We report the management of a pregnant patient developing pulmonary edema after ritodrine therapy and undergoing cesarean section with epidural anesthesia.Öğe Reproductive outcome after surgical treatment of endometriosis-retrospective analytical study(Via Medica, 2013) Cirpan T.; Akman L.; Yucebilgin M.S.; Terek M.C.; Kazandi M.Objective: The aim of the study was to investigate the reproductive outcomes of patients after surgical treatment of endometriosis. Material and Methods: The study included 100 infertile women, aged 21 to 41 years, who underwent surgical treatment of endometriosis. From January 2007 to January 2012, excision of endometriosis was performed by operative laparoscopy or laparotomy. Demographic, clinical, surgical and reproductive outcomes of 52 patients were retrospectively analyzed. Result: Twenty-three pregnancies (44%) were obtained in 52 patients, resulting in 16 term pregnancies, 4 spontaneous abortions under 16 weeks gestation, 2 spontaneous abortions at 20 gestational weeks and 1 ectopic pregnancy. Twenty nine patients did not achieve pregnancy and 68.9% (20/29) of them were treated with IVFICSI. Spontaneous pregnancies were obtained within 7 months after the surgery, whereas IVF-ICSI pregnancies were obtained within the period of 11 months. Seven patients were stage I, 14 patients stage II, 19 patients stage III, and 12 patients stage IV according to the American Fertility Society (AFS) Classification of Endometriosis. The pregnancy rate was 57% in stages I-II, 47% in stage III, 16% in stage IV endometriosis; and the rate of term pregnancies was 83%, 66%, and 0%, respectively. Seven pregnancies (7/14) were obtained in patients with bilateral endometriosis and 5 of them resulted in term pregnancy. Sixteen pregnancies (16/38) were obtained in patients with unilateral endometriosis and 11 of them resulted in term pregnancy. Conclusion: After surgical treatment of endometriosis, the pregnancy and live birth rates seem to be improved. Reproductive outcome is closely associated with the AFS score. Bilaterality of endometriosis does not affect pregnancy outcome. © Polskie Towarzystwo Ginekologiczne.
