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Yayın Diabetes mellitus ve obezitenin postmenopozal dönemdeki kadınlardaki pelvik organ prolapsusu üzerine etkileri(Maltepe Üniversitesi, 2011) Çoksüer, Hakan; Haliloğlu, Berna; Ercan, Mutlu; Köse, Murat; Keskin, Uğur; Alanbay, İbrahim; Karaşahin, Emre; Kabaca, Canan; Karateke, AteşAmaç: Diabetes mellitus ve obezitenin postmenopozal dönemdeki kadınlarda pelvik organ prolapsusuna(POP) olan etkilerini değerlendirmeyi amaçladık. Yöntemler: 49-79 yaşları arasındaki POP bulunan 104 kadın grup I(non-diabetik ve non-obez) grup II(non-obez ve diabetik) grup III(obez ve non-diabetik) ve grup IV(obez ve diabetik) olmak üzere 4 gruba ayrılmıştır. Her bir grupta POP-Q (POP-Q) sistemi kullanılarak uterin prolapsus, sistosel ve rektosel varlığı değerlendirildi. Bulgular: Sağlıklı kadınlarla karşılaştırıldığında obezitenin ve diabetes mellitusun(DM) sistosel, rektosel ve uterin prolapsus progresyonuyla ilişkili olduğu saptanmıştır(p<0.001). Obezite olan gruplardaki uterin prolapsus evresi diyabetik gruplardan belirgin olarak daha ileri bulunmuştur( p<0.001). Sonuç: Obezite ve DM; POP için risk faktörü olarak görülmektedir. Obezite, uterin prolapsusu DM'den daha fazla etkilemektedir ve modifiye edilebilir bir risk faktörüdür. Dolayısıyla yeni tedavi stratejilerinin geliştirilmesi önem arz etmektedir.Yayın Does urinary incontinence subtype affect sexual function?(ELSEVIER SCIENCE BV, 2011) Coksuer, Hakan; Ercan, Cihangir Mutlu; Haliloglu, Berna; Yucel, Mehmet; Cam, Cetin; Kabaca, Canan; Karateke, AtesObjective: Urinary incontinence (UI) may affect a woman's physical and psychological well-being in different aspects. The aim of this study was to compare the effects of urinary stress incontinence (USI), detrusor overactivity (DO) and mixed urinary incontinence (MUI) on sexual function. Study design: One-hundred and seventy urinary incontinent, sexually active women were included in this cross-sectional study. After urodynamic evaluation, participants were divided into three subgroups as USI (n = 61), DO (n = 55) and MUI (n = 54). Patients were matched according to age, parity and body mass index (BMI), rendering the sample size to 41 patients in each group. Turkish version short form of the Pelvic Organ Prolapse/Incontinence Sexual Function Questionnaire (PISQ-12) was filled out by each of the participants. Totally, 52 patients were excluded from the study (47 could not be matched and 5 incomplete questionnaire). Demographic characteristics of the participants, total and three domain scores of PISQ-12 were compared among three UI subgroups. Results: The study group was consisted of 38 (32.2%) DO, 41(34.7%) USI and 39(33.1%) MUI patients. Demographic characteristics of the patients were similar in three subgroups. Patients with a diagnosis of MUI had significantly lower mean PISQ-12 scores than the ones with USI and DO whereas patients with USI had lower mean PISQ-12 scores than patients with DO. Conclusion: Although urinary stress incontinence effects sexual function more than detrusor overactivity in terms of PISQ-12 scores, mixed urinary incontinence has the greatest impact on sexual function when compared with urinary stress incontinence and detrusor overactivity. (C) 2011 Elsevier Ireland Ltd. All rights reserved.Yayın Intestinal vaginoplasty: is it optimal treatment of vaginal agenesis? A pilot study. Surgical method of sigmoid colon vaginoplasty in vaginal agenesis(National Library of Medicine, 2006) Karateke, Ateş; Gürbüz, Ayşe; Haliloğlu, Berna; Kabaca, Canan; Köksal, NeşetThe outcome of 11 cases with vaginal agenesis who underwent intestinal vaginoplasties are presented. Patients were between 18 and 37 years old. Ileum vaginoplasty and sigmoid colon vaginoplasty were carried out in two and nine cases, respectively. Ileum necrosis at donor site requiring ileum resection and bilateral ileostomy encountered in one of the cases was the major complication. Mild stenosis responsive to finger dilatation had been detected in two women with sigmoid vaginoplasty. Excess mucous production, long operation time, and shortness of mesentery of ileum led us to abandon ileum vaginoplasty, and sigmoid colon vaginoplasty was performed in the following cases with vaginal agenesis. All of the neovaginas were patent and functional. We suggest sigmoid colon vaginoplasty as the treatment of choice because of its large lumen, thick walls resistant to trauma, adequate secretion allowing lubrication, not necessitating prolonged dilatation, short recovery time compared with ileum vaginoplasties; and in patients reluctance to prolonged use of dilatators or in those who experienced previous failure of the other treatment modalities.Yayın Metastatic ovarian carcinoma one year after surgical removal of colon carcinoma during pregnancy: a case report(Wiley, 2006) Gürbüz, A.; Kir, Gözde; Karateke, Ateş; Haliloğlu, Berna; Kabaca, CananColorectal carcinoma during pregnancy is a very rare event. We presented a woman with metachronous metastatic ovarian tumor existing 1 year after surgical removal of perforated sigmoid colon carcinoma encountered during cesarean section of woman of 36?week gestation for fetal distress. Pregnant women with suspicious abdominal mass should be evaluated for a possible colorectal carcinoma even in the absence of any other gastrointestinal symptoms associated with it and undergo rectal examination and sigmoidoscopy. In addition, as synchronous and metachronous ovarian metastases are common in these patients, ovaries must be evaluated carefully by bisection during operation for possible metastasis, and in women who do not have a desire for fertility, prophylactic oophorectomy seems an appropriate treatment modality for resecting synchronous metastasis and preventing future metastasis.Yayın Sacrocervicopexy and combined operations involving cases of total uterine prolapse. Case reports(Karger, 2004) Karateke, Ateş; Gürbüz, A.; Kir, Gözde; Haliloğlu, Berna; Kabaca, Canan; Mengüllüoğlu, MuratObjective: To determine the outcome of sacrocervicopexy and combined operations in the treatment of uterovaginal prolapse in women with desire to preserving both uterus and fertility. Clinical Presentation and Intervention: Sacrocervicopexy with Prolene mesh and combined operations were performed in 3 women with total uterine prolapse because of the patient’s desire to retain fertility in 2 cases and refusal of hysterectomy in the 3rd patient. The 1st case was a 38-year-old woman, gravida 2, parity 1; the 2nd case a 42-year-old woman, gravida 3, parity 2, and the 3rd a 39-year-old woman, gravida 1, parity 1. Douglas pouch was obliterated with Moschcowitz operation. All of the women underwent sacrocervicopexy with Prolene mesh. The repair of a paravaginal defect and prophylactic Burch urethropexy were accomplished through entering Retzius’ space. Genital hiatus was narrowed via approximating levator muscles transvaginally. No serious intraoperative complications occurred and no recurrence was detected during the follow-up period. There was no postoperative complication except for some degree of pain in the 1st postoperative month in 1 case. Conclusion: The results indicate that sacrocervicopexy and repair of all concomitant defects in the pelvic floor are effective procedures in the treatment of uterovaginal prolapse in cases where there is a desire to retain fertility and uterus.Yayın Urinary incontinence: prevalence and risk factors, association with anal incontinence and scope of incontinence in Turkish women(Mebas Medikal Basın Yayın San. ve Tic. Ltd. Şti, 2004) Gürbüz, Ayşe; Karateke, Ateş; Kabaca, Canan; Haliloğlu, Berna; Şahinoğlu, Zeki; Bilgin, ZümrütOBJECTIVE: To determine the prevalence and risk factors of urinary and anal incontinence and to assess women’s response and point of view to urinary incontinence. STUDY DESIGN: The prevalence of overall, stress, urge, mixed urinary incontinence and anal incontinence was assessed by a multichoice questionnaire form in 1021 patients who admitted to outpatient gynecology clinics of our hospital. RESULTS: Of the 1021 patients, 162(15.9%) reported urinary incontinence, comprising 79(48.8%) with stress, 50(30.9%) with urge and 33(20.4%) with mixed urinary incontinence. There were significant differences regarding age, number of pregnancies and deliveries, route of delivery, duration of labor, infant birth weight, enuresis in childhood, enuresis nocturna, constipation, flatal and fecal incontinence between patients with and without urinary incontinence (p<0.05). In comparison of subgroups (stress, urge and mixed urinary incontinence) with patients without urinary incontinence, one by one, there were statistically significant differences concerning age, number of pregnancies and deliveries, route of delivery, and enuresis nocturna (p<0.05). Of the 1021 patients, 525(51.5%) reported flatal incontinence and 32(3.1%) reported fecal incontinence. The rates of flatal and fecal incontinence in patients with urinary incontinence were 65.4%(n=106) and 6.8%(n=11), respectively. Most of the women (66.1%) did not perceive urinary incontinence as a social or hygienic problem, however 84.6% of the patients with urinary incontinence did (p<0.0001). CONCLUSION: Ageing and obstetric events were the most prominent risk factors. According to our results, patients with urinary and anal incontinence could not yet seek for medical help. Education of population is important in order to avoid complications of incontinence.Yayın Villoglandüler adenokarsinoma: diagnostik ikilem(Zeynep Kamil Kadın ve Çocuk Hastalıkları EAH, 2005) Gürbüz, Ayşe; Haliloğlu, Berna; Karateke, Ateş; Kabaca, Canan; Kır, GözdeVilloglandüler papiller adenokanser (CGPA) nispeten nadir görülen bir servikal adenokanser varyantı olup literatürde prognozunun çok iyi olduğu bildirilmektedir. Çalışmamımızda iki VGPA olgusu sunulmuştur. Olgularınızdaki klinik karara akın etkisi gözönüne alındığında VGPA'nın patolojşk ayırıcı tanısının daha ayrıntılı yapılması gerektiği kanaatindeyiz.
