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Öğe Asemptomatı?k kadınlarda pelvı?k taban kas fonksı?yonuna farklı kontraksı?yon yöntemlerı?nı?n etkı?si(Turkey Association Physiotherapists, 2021) Ünlü, İdil Esin; Özengin, Nuriye; Serindağ, Sevinç; Bakar, Yeşim; Ankaralı, Handan; Topçuoğlu, Ata; Topçuoğlu, Mehmet AtaAmaç: Bu çalışma, asemptomatik kadınlarda farklı kontraksiyon yöntemlerinin pelvik taban kas fonksiyonu üzerine etkisini transabdominal ultrasonografi ile değerlendirmeyi amaçladı. Yöntem: Araştırmaya asemptomatik olduğu Global Pelvik Taban Rahatsızlık Anketi ile belirlenen ve gönüllü olan 120 kadın dahil edildi. Kadınların fiziksel ve sosyodemografik özellikleri kaydedildikten sonra fizyoterapist tarafından bir saatlik eğitim verildi. Bu eğitimde dört farklı kontraksiyon yöntemi (pelvik taban kas kontraksiyonu, Hollowing in manevrası, korseleme manevrası, anal kontraksiyon) teorik ve pratik olarak öğretildi. Kadınların pelvik taban kas fonksiyonu transabdominal ultrasonografi altında değerlendirildi. Ölçümler her bir kontraksiyon için üç kez tekrarlandı ve üç ölçümün ortalaması analize alındı. Kontraksiyonların sıralaması rastgele yöntemle belirlendi. Kontraksiyon tipine göre pelvik taban kas fonksiyonu Tekrarlı Ölçümlerde Varyans Analizi testiyle karşılaştırıldı. Sonuçlar: Kadınların kontraksiyon tipine göre pelvik taban kas fonksiyonu karşılaştırıldığında anlamlı fark olduğu bulundu (p=0,001). Bu test sonuçlarına göre pelvik taban kas fonksiyonunun korseleme manevrasında en yüksek olduğu, bunu sırasıyla Hollowing in manevrası, pelvik taban kas kontraksiyonu ve anal kontraksiyonun takip ettiği saptandı. Tartışma: Kadınların pelvik taban kas fonksiyonunun korseleme manevrasında en yüksek, anal kontraksiyon tipinde ise en düşük olduğu bulundu. Pelvik taban kas eğitimi verilirken korseleme manevrasını içeren egzersizlerin öğretilmesinin pelvik taban kas fonksiyonunu artırmada daha etkili olabileceği düşüncesindeyiz.Öğe Circulating oxidized low-density lipoprotein and paraoxonase activity in preeclampsia(Karger, 2005) Uzun, Hafize; Benian, Ali; Madazlı, Rıza; Topçuoğlu, Mehmet Ata; Aydın, Seval; Albayrak, MustafaPreeclampsia is one of the most frequent complications of pregnancy, however, little is known about its etiology. The objective of this study was to investigate the association of oxidized low-density lipoprotein ( oxLDL) and paraoxonase (PON1) activity in women with either preeclampsia or normotensive (NT) pregnancy. The study groups included 41 pregnant women with preeclampsia and 33 normotensive pregnant women. In all patients maternal serum total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides (TGs) were measured using enzymatic methods. Serum PON1 activities and malondialdehyde (MDA) concentrations were measured by spectrophotometric methods, and oxLDL was measured by enzyme-linked immunoassay ( ELISA). Serum concentrations of lipid parameters ( TC, LDL, VLDL, and TGs) were significantly higher in preeclampsia compared with NT controls ( p < 0.001, p < 0.05, p < 0.05, and p < 0.001, respectively). Serum concentrations of MDA and oxLDL were significantly higher, while PON1 activity was significantly lower in preeclampsia compared with NT controls ( p < 0.001, p < 0.001, and p < 0.001, respectively). A positive correlation was detected between oxLDL and MDA ( r = 0.876), and a negative correlation was detected between both MDA and oxLDL and PON1 ( r = - 0.837 and r = - 0.759, respectively). Our data demonstrate that preeclampsia is associated with increased oxLDL and decreased PON1 activity. Elevated oxidative stress, oxLDL, dyslipidemia and decreased PON1 activities may cause vascular endothelial damage and contribute to the pathophysiology of preeclampsia.Öğe Comparing the efficacy of the Knack maneuver on pelvic floor muscle function and urinary symptoms using different teaching methods: A prospective, nonrandomized study(SPRINGER LONDON LTD, 2022) Yeşilyurt, Seda Yakıt; Özengin, Nuriye; Topçuoğlu, Mehmet AtaIntroduction and hypothesis This study was aimed at comparing the efficacy of Knack maneuver training taught using different techniques on pelvic floor muscle (PFM) function, urinary symptoms, and perception of improvement in women with stress urinary incontinence (SUI). Methods We conducted a prospective nonrandomized study of 46 women with SUI. Assessments included: PFM functions (secondary outcome, SO) using a Myomed 932 EMG biofeedback device, urinary incontinence symptoms using the International Consultation on Incontinence Questionnaire Urinary Incontinence-Short Form (ICIQ-SF; primary outcome), the Urogenital Distress Inventory-6 (UDI-6; SO), and the Incontinence Severity Index (ISI; SO), and perception of improvement using the Global Perceived Impact scale. The women were divided into three groups according to their preference: group 1 (Knack maneuver training with electromyography biofeedback), group 2 (Knack maneuver training with verbal instruction), and group 3 (Knack maneuver training with vaginal palpation). An education program was also given to all women individually. The training program was 1 day per week for 4 weeks. Results There was an improvement in UDI-6, ICIQ-SF, and ISI scores in all groups (p<0.05). The maximum voluntary contraction (MVC) of the PFMs increased in group 2 (p=0.002), whereas both the MVC of PFMs and PFM contraction during Valsalva increased in group 3 (p=0.011 and p=0.042). Conclusions Regardless of the teaching methods, the Knack maneuver and education programs were effective on urinary symptoms in women with mild to moderate SUI. The Knack maneuver training with vaginal palpation and verbal instruction improved MVC of PFMs. All three different teaching methods might be used in SUI treatment programs.Öğe Comparison of Spine Posture, Mobility and Body Image Perception in Healthy and Primary Dysmenorrhea Women(2024) Duru, Zeynep; Doğan, Hanife; Topçuoğlu, Mehmet Ata; Özengin, NuriyeThe aim of this research was to compare spinal posture, mobility and body image perception between healthy women and women with primary dysmenorrhoea. A total of 120 women, 57 healthy and 63 with Primary dysmenorrhoea, were included in the study. The mean age of the participants was 22 years in the group with primary dysmenorrhoea and 21 years in the healthy group; BMI results were 23.05 and 21.45, respectively. Participants' pain severity, attitudes towards menstruation and menstrual symptoms, physical activity levels and body image perceptions were assessed with the corresponding questionnaires. Participants' spinal posture and mobility were assessed with Spinal Mouse device. In our study, pain score of women with Primary dysmenorrhoea was higher than healthy women (p<0.001). Sacrum-hip angle (p=0.005), inclination angle (p=0.014) and mobility of these regions ((p=0.006), (p=0.001)) were lower in the Primary dysmenorrhoea group compared with the healthy group. Menstrual symptoms were more severe in women with Primary dysmenorrhoea (p<0.001) and their attitudes towards menstruation were more negative (p=0.013, p=0.003, p=0.034, p=0.023, p<0.001, p<0.001). Physical activity levels (p=0.294) and body image perceptions of Primary dysmenorrhoea and healthy women were similar (p=0.225). As a result we found that the spinal posture and mobility of women with Primary dysmenorrhoea differed negatively from healthy women and that they approached menstruation cognitively worse. These results may be important for women with Primary dysmenorrhoea to be aware of their own bodies. We think that women with Primary dysmenorrhoea should be educated about this issue.Öğe Double intrauterine device: Presented with protruding urethral stone(2008) Kandıralı, Engin; Topçuoğlu, Mehmet Ata; Semerciöz, Atilla; Metin, Ahmetİntrauterin araçlar doğum kontrol yöntemi olarak sık kullanılmaktadır. Uterus perforasyonu ve intrauterin aracın yer değiştirmesi seyrek görülen ciddi bir komplikasyondur. Burada üretra taşı bulgusuyla başvuran hastada saptanan çift intraüterin araç vakası sunulmuştur.Öğe Effect of childbirth education on the perceptions of childbirth and breastfeeding self-efficacy and the obstetric outcomes of nulliparous women(Taylor & Francis Inc, 2020) Bilgin, Nevin Çıtak; Ayhan, Fatma; Koçyiğit, Fatma; Yorgun, Songül; Topçuoğlu, Mehmet Ata; Ak, BedriyeIn this quasi-experimental and prospective study, we aimed to determine the effect of education about childbirth on the perceptions of nulliparous women regarding the experience of childbirth, obstetric outcomes (e.g., type of delivery, use of induction, and instrument-assisted delivery), and breastfeeding self-efficacy. The study population comprised 121 women, of whom 64 and 57 were classified into the education and control groups, respectively. Study data were collected using a participant identification form, the Perception of Birth Scale, Visual Analog Scale, and Breastfeeding Self-Efficacy Scale-Short Form. Compared to the control group, participants in the education group held significantly more positive birth-related perceptions (p = 0.000) and experienced a lower level of pain during delivery (p = 0.016). However, education did not affect the obstetric outcomes. During the first month postpartum, a higher level of breastfeeding self-efficacy was reported by mothers in the education group than by those in the control group. In conclusion, systematic childbirth education positively affected the mothers? perceptions of the childbirth experience and their breastfeeding self-efficacy, but had no effect on the type of delivery or other birth-related obstetric interventions.Öğe The effect of different contraction methods on pelvic floor muscle contraction in asymptomatic women(Wiley, 2017) Yavuz, İdil Esin; Özengin, Nuriye; Serindağ, Sevinç; Bakar, Yeşim; Ankaralı, Handan; Topçuoğlu, Mehmet AtaHypothesis / aims of study The relation between pelvic floor muscles and abdominal muscles allows the protection of urinary continence under increased urethral pressure (1). It was seen that abdominal muscle co-activation contributed to pelvic floor muscle contraction (2, 3). Sapsford et al. reported that pelvic floor muscles became activated during abdominal muscle contraction and the opposite was true, in other words, abdominal muscles became activated during pelvic floor muscle contraction (3). Two contractions have been defined in the literature for abdominal muscle training namely the hollowing and bracing maneuvers. The hollowing maneuver is used for Pilates exercise training and the bracing maneuver is used during stabilization exercises. It was mentioned that pelvic floor muscles contracted in both of these exercise types. Pelvic floor muscle contraction and anal contraction methods are used during pelvic floor muscle training. This study was aimed to determine which of the four different contraction methods enabled pelvic floor muscle function the most and to determine the exercises that should be prioritized while creating an exercise program.Öğe The effect of e-pelvic floor muscle training on symptoms in women with stress urinary incontinence: A randomized controlled trial(Routledge Journals, Taylor & Francis Ltd, 2023) Kamalı, Sena; Özengin, Nuriye; Topçuoğlu, Mehmet AtaThe aim of this study was to investigate how e-pelvic floor muscle training (e-PFMT) affected urinary incontinence (UI) symptoms and quality of life (QoL) in women with stress urinary incontinence (SUI). Fifty-five women with SUI symptoms were randomly assigned to the intervention (n = 27) or the control (n = 28) group. Both groups were given lifestyle advice about SUI. The intervention group performed e-PFMT three days a week, one day via videoconference, and was supervised by a physiotherapist for eight weeks. UI symptoms were assessed by the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), the Incontinence Severity Index (ISI), the Urinary Distress Inventory-6 (UDI-6), and QoL was assessed by the King's Health Questionnaire (KHQ) before and after intervention. After intervention, the Patient Global Impression of Improvement (PGI-I) scale was used to assess improvement, and the Visual Analogue Scale (VAS) was used to assess adherence. While the intervention group's ICIQ-UI SF, ISI, and UDI-6 scores improved (p < .001), there was no change in the control group (p > .05). Except for personal relationship limitations, all KHQ scores improved in the intervention group. The control group's role limitations and sleep/energy disturbances scores worsened. ICIQ-UI SF (p = .004), ISI (p < .001), and UDI-6 (p < .001) scores of the intervention group were improved compared to the control group. PGI-I and adherence were found to be higher in the intervention group compared to the control group. e-PFMT performed via videoconference to women with SUI, was found to be effective in improving UI symptoms and QoL as compared to lifestyle instructions only.Öğe Effects of flurbiprofen and tiaprofenic acid on oxidative stress markers in osteoarthritis: a prospective, randomized, open-label, active- and placebo-controlled trial(Elsevier Science Inc, 2005) Tüzün, Şansın; Uzun, Hafize; Aydın, Seval; Dinç, Ahmet; Sipahi, Sevtap; Topçuoğlu, Mehmet Ata; Yücel, RıfatBackground: The relationship between oxidative stress and osteoarthritis (OA) has been widely investigated. Serum malondialdehyde (MDA), nitric oxide (NO), and Cu/Zn superoxide dismutase (SOD) levels are useful markers of oxidative stress. Because of the importance of oxidative stress markers in the pathogenesis of OA, treatment might involve modification of these markers to control oxidative stress. Objective: The aim of this study was to compare the effects of 2 conventional NSAIDs on markers of oxidative stress in patients with OA of the knee. Methods: This 3-week, prospective, randomized, open-label, active- and placebo-controlled study was conducted at the Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey Adult patients with clinically and radiographically diagnosed moderate OA of the knee who were previously untreated were enrolled. Patients were randomly assigned to 1 of 3 treatment groups: flurbiprofen 100 mg PO (tablets) BID, tiaprofenic acid 300 mg PO (tablets) BID, or placebo tablets BID. Patients were evaluated using clinical assessment and laboratory testing before treatment (week 0; baseline) and at the end of week 3. The primary end points were the differences in serum MDA, NO, and SOD levels versus placebo. Clinical parameters-pain at rest and on motion-were evaluated using a 10-cm visual analog scale (0 = no pain to 10 = worst pain imaginable). The duration (in minutes) of morning stiffness was recorded by patients, using patient diaries. The differences between treatment groups were assessed using multivariate analysis. Results: Thirty-nine patients (20 women, 19 men; mean [SD] age, 59.0 [11.3] years) were included in the study Mean serum MDA and NO levels were significantly decreased at 3 weeks compared with baseline in the 2 active-treatment groups (all, P < 0.001); these values remained statistically similar to baseline in the placebo group. Serum SOD levels were increased significantly from baseline in the 2 active-treatment groups (both, P < 0.00 1), but not in the placebo group. No significant differences in serum MDA and NO levels were found between the group receiving flurbiprofen and that receiving tiaprofenic acid. Serum SOD levels were significantly higher in the flurbiprofen group compared with the tiaprofenic acid and placebo groups (both, P < 0.0 1). The mean (SD) score for pain at rest was significantly lower at 3 weeks compared with baseline with flurbiprofen and tiaprofenic acid (both, P < 0.00 1), but not with placebo. The mean score for pain on motion was significantly reduced from baseline values only with tiaprofenic acid (P < 0.001). The duration of morning stiffness was significantly shorter at 3 weeks compared with baseline in all 3 study groups (all, P < 0.001). The mean scores for pain on motion and duration of morning stiffness were significantly reduced with tiaprofenic acid compared with placebo (both, P < 0.05). The study had some limitations (ie, small sample size, no blinding, the short duration of the study, and the weak correlation between serum and synovial fluid levels of NO). Conclusions: In this comparison of the effects of 3 weeks of treatment with flurbiprofen 100 mg BID and tiaprofenic acid 300 mg BID in patients with knee OA, both treatments effectively reduced serum MDA and NO levels compared with placebo. Only tiaprofenic acid significantly improved pain at rest and on motion and duration of morning stiffness compared with placebo.Öğe Effects of hormone replacement therapy on plasma and tissue fibrinolytic activity in a rat model of surgically induced menopause(Canadian Soc Clinical Investigation, 2014) Topçuoğlu, Mehmet Ata; Albayrak, Mustafa; Erman, Hayriye; Balcı, Huriye; Karakuş, MesutPurpose: The purpose of this study was to analyze the effects of estrogen deficiency and hormone replacement therapy (HRT) on fibrinolytic activity in a rat mode of surgically induced menopause. Methods: Twelve-week-old, sexually mature female Sprague-Dawley rats, each weighing 200-250 g, were randomly divided into four groups: (1) sham- operated group, (2) ovariectomy group, (3) ovariectomy group followed by oral administration of daily 17 beta-estradiol (0.02 mg/kg/day) (E2) + norethisterone acetate (0.01 mg/kg/day), and (4) ovariectomy group followed by oral administration of daily 17 beta-estradiol (0.01 mg/kg/day) + drospirenone (0.02 mg/kg/day). Tissue plasminogen activator (tPA) antigen, plasminogen activator inhibitor-1 (PAI- 1) antigen, and PAI-1/tPA levels were measured as markers of fibrinolysis in plasma and liver and brain tissue. Results: Compared with sham-operated rats, ovariectomized rats showed higher levels of fibrinolytic activity; however, the increased fibrinolytic activity in plasma and liver tissue was significantly reduced by HRT regimens. No change was observed in the levels of fi brinolytic activity in brain tissue. Conclusions: HRT showed beneficial effects by decreasing fibrinolytic activity related to surgically induced menopause. Short-term HRT treatment was associated with a shift in the procoagulant-anticoagulant balance toward a procoagulant state.Öğe Investigation of the presence of pregnancy rhinitis in the third trimester with rhinomanometry(2021) Filiz, Rüstem; Ural, Ahmet; Topçuoğlu, Mehmet Ata; Dağli, MuharremAim: Pregnancy rhinitis (PR) is characterized with nasal symptoms during pregnancy without any signs of respiratory infection and it usually disappears within 2 weeks after delivery. We aimed to investigate the relationship between pregnancy rhinitis and findings derived from anterior rhinoscopy (AnR), anterior rhinomanometry (ARM) and subjective nasal obstruction score (SNOS). Methods: This prospective, controlled study was performed in otorhinolaryngology and obstetrics and gynecology departments of our tertiary care center. A total of 30 pregnant women in the third trimester and 30 non-pregnant women were involved. All participants underwent otorhinolaryngology examination, as well as clinical evaluation for AnR, ARM and SNOS. Results: Pregnancy rhinitis was detected in 66.7% of the pregnant women. The mean AnR was 3.60 ± 1.35 in pregnant women and 0.77 ± 0.73 in the control group. Total nasal inspiratory resistance (TNID) was 0.46±0.23 in pregnant women and 0.27±0.06 in the control group. The mean SNOS was 1.37±0.72 in pregnant women and 0.57±0.63 in the control group. AnR, ARM and SNOS findings were significantly higher in pregnant women (p<0.05). There is a low positive and significant correlation between AnR, ARM, and SNOS values in pregnant women (p<0.05). Conclusion: Our data yielded that nasal obstruction and pregnancy rhinitis were common in pregnant women. Nasal symptoms and complaints must be carefully examined during pregnancy. Further prospective, controlled, randomized trials on larger series are warranted to elucidate the clinical and pathophysiological features of pregnancy rhinitis.Öğe Is there a relationship between polycystic ovary syndrome and the FABP1 gene rs2197076 single nucleotide polymorphism?(2019) Karakuz, Arzu Güler; Ekici, Mustafa Ayhan; Topçuoğlu, Mehmet Ata; Düzenli, Selma Gepdiremen; Öztabağ, Cansu KaraAim: Polycystic ovary syndrome (PCOS) is a multifactorial, endocrine, and metabolic disorder seenin 10%-20% of women of reproductive age. Due to the close relationship observed between theincreased risk of type 2 diabetes and insulin resistance and the polymorphism of the fatty acid bindingprotein 1 (FABP1) gene rs2197076 single nucleotide polymorphism (SNP), we investigated thefrequency of the FABP1 gene rs2197076 SNP in patients with PCOS.Methods: This is a prospective case-control study. The study included 151 women—75 patients withPCOS and 76 healthy women. A real-time polymerase chain reaction was performed for the FABP1rs2197076 polymorphism. Additionally, biochemical and hormonal levels of the patients werestudied.Results: Menstrual irregularities, the body mass index (BMI), hirsutism scores, the luteinizinghormone / follicular stimulating hormone ratio, dehydroepiandrosterone sulfate and testosteronelevels were significantly higher in the PCOS group than in the control. There was no significantdifference between the PCOS and control groups in terms of FABP1 rs2197076 genotype distributionand FABP1 rs2197076 allele frequency distribution.Conclusion: There was no increase in the genotype distribution and allelic frequency of the FABP1 geners2197076 SNP in PCOS patients. Further studies are needed on this subject.Öğe Labial fusion causing acute urinary retention in a young adult: A case report(Wiley-Blackwell Publishing, Inc, 2009) Topçuoğlu, Mehmet Ata; Koç, Önder; Duran, Bülent; Dönmez, MelahatLabial fusion is defined as a partial or complete adherenceof the labia minora. The labia minora adhesion is a commonpaediatric gynaecological problem, and occurs morefrequently between three months and three years.1 Adhesionsof the labia are rare in adult population. There are a fewcases in the literature. The aetiology of labial adhesionprobably relates to vaginal inflammation or irritation, and isassociated with low oestrogen status.2 Labial fusions may becaused by infections, inflammatory conditions, dermatologicalconditions, lack of sexual activity, local trauma, genitalcircumcision and recurrent urinary tract infections.3 If thelabial adhesions are severe or related to urinary problems,surgical treatment should be considered.Öğe Pityrosporum folliculitis during pregnancy: a possible cause of pruritic folliculitis of pregnancy(Mosby-Elsevier, 2005) Parlak, Ali Haydar; Boran, Çetin; Topçuoğlu, Mehmet AtaPityrosporum folliculitis (PF) is believed to be a common disease but is frequently misdiagnosed as ‘‘acneiform eruption’’ or ‘‘acne.’’1 Only one case of PF during pregnancy has been reported in the literature.Öğe The role of performing a routine four-quadrant cervical biopsy in patients with negative colposcopic findings in increasing the identification rate of cervical intraepithelial neoplasms(2019) Çetin, Çağlar; Serindağ, Sevinç Rabia; Topçuoğlu, Mehmet Ata; Ekici, Mustafa AyhanAim: In patients with high-risk human papilloma virus (HPV), there is no consensus on the inclusion of cervical biopsy for diagnostic purposes in cases whereas there is no pathological finding in colposcopy. In this study, we aimed to investigate the effect of simultaneous routine cervical biopsy in patients with normal colposcopic findings on the rate of cervical intraepithelial neoplasia diagnosis. Methods: This retrospective study included 119 patients with colposcopy indications who had no cervical pathology between January 2015 and March 2017 and the histopathological results were evaluated. Results: The mean age of the population was 45.75±9.52 years. The histopathological results obtained in our study patients are as follows; 38.7% (n=46) LSIL, 28.7% (n=33) chronic cervicitis, 15, 3 % (n=19) coilositosis, 9.2% (n=11) HSIL, 2.5% (n=5) adenocarcinoma, 1.7% (n=2) carcinoma in situ and 2.1% (n=3) squamous carcinoma. LSIL 33 (27.5%), HSIL and advanced lesion 11 (9.2%) were detected in patients with normal cervical cytology before colposcopy. LSIL 26 (21.7%), HSIL and advanced lesion were found to be 13 (10.8%) in patients with abnormal cervical cytology. There was no significant difference in terms of biopsy pathology results between normal and abnormal cervical cytology results. Conclusions: In patients with HPV positive and normal colposcopic findings, adding simultaneous routine four-quadrant cervical biopsy to the colposcopy might increase the detection rate of cervical intraepithelial lesions.Öğe Spitz nevus of the genital mucosa(Medknow Publications, 2009) Polat, Mualla; Topçuoğlu, Mehmet Ata; Tahtacı, Yasemin; Hapa, Aslı; Yılmaz, FahriWe herein report an 11-year-old girl who came to our clinic with a swelling on the genital area of 2 months duration. Dermatological examination of the patient was performed and a pigmented lesion was found on the inner surface of the labium majus of the mucosa. The lesion was well circumscribed and approximately 1 cm in diameter, with homogenous color distribution. The patient was diagnosed as Spitz nevus on the basis of clinical and histopathological findings. Our case is probably the first reported case of Spitz nevus localized to the genital mucosa in the English literature.Öğe Stres Üriner İnkontinanslı Kadınlarda Pelvik Taban Kas Eğitimine Ek Olarak Uygulanan Elektromiyografik Biofeedback Eğitiminin Etkisinin İncelenmesi(2017) Özengin, Nuriye; Çankaya, Hatice; Bakar, Yeşim; Topçuoğlu, Mehmet Ata; Ankaralı, HandanAmaç: Stres üriner inkontinanslı kadınlarda pelvik taban kas eğitimine ek olarak uygulanan elektromiyografik biofeedback eğitiminin yaşam kalitesi, idrar kaçırma miktarı ve pelvik taban kas kuvveti üzerine etkisinin araştırılması amaçlandı.Gereç ve Yöntemler: Çalışmaya stres üriner inkontinanslı 52 kadın hasta dahil edildi. Hastalar pelvik taban kas eğitimi (n=27) ve pelvik taban kas eğitimiyle birlikte elektromiyografik biofeedback eğitimi (n=25) alanlar olarak iki gruba ayrıldı. Hastaların algılanan yaşam kalitesi ve algılanan kuruluk hissi için bir vizüel analog skala kullanıldı. Pelvik taban kas kuvveti, vajinal basınç manometresi ile; idrar kaçırma miktarı ise 1 saatlik ped testi ile değerlendirildi. Değerlendirmeler, tedavi öncesinde ve 8 haftalık tedavi sonrasında gerçekleştirildi.Bulgular: Pelvik taban kas eğitimi ve pelvik taban kas eğitimine ek olarak uygulanan elektromiyografik biofeedback eğitimleri grup içi analizlerinde, tedavi öncesinde ve sonrasında algılanan kuruluk hissi, algılanan yaşam kalitesi, pelvik taban kas kuvveti ve idrar kaçırma miktarında iyileşme olduğu saptandı (p<0,05). Gruplar arası değerlendirmelerde fark saptanmadı (p>0,05). Tartışma ve Sonuç: Stres üriner inkontinanslı kadınların tedavisinde pelvik taban kas eğitimine ek olarak uygulanan elektromiyografik biofeedback eğitiminin ilave bir iyileştirici etkisi olmadığı saptandıÖğe Transvaginal round-infundibulopelvic ligament colposuspension after vaginal hysterectomy in high-grade uterovaginal prolapse: 11-year outcome(Elsevier, 2020) Ekici, Mustafa Ayhan; Çetin, Çaglar; Kayar, Batuhan; Albayrak, Ömür; Topçuoğlu, Mehmet Ata; Ural, Ülkü MeteObjective: To interpret the long-term outcomes of transvaginal round-infundibulopelvic ligament colposuspension after vaginal hysterectomy in patients with stage 3-4 uterovaginal prolapse. Study design: This retrospective case-control study from 2007 to 2016 analysed patients' medical records and evaluated gynaecological examinations over 11 years of follow-up. One hundred and forty-three patients who underwent transvaginal round-infundibulopelvic ligament colposuspension after vaginal hysterectomy were evaluated. The prespecified primary outcome evaluated at 11-year follow-up was apical prolapse of stage 2 or higher evaluated by the Pelvic Organ Prolapse Quantification System (POP Q), in combination with bothersome bulge symptoms or repeat surgery for recurrent apical prolapse. The secondary outcome was overall anatomical failure (recurrent prolapse of stage 2 or higher in apical, anterior or posterior compartment). The rate of recurrence of apical prolapse was compared between groups using the McNemar test. Results: The mean (+/- standard deviation) follow-up period was 88.15 +/- 2.519 months (95 % confidence interval 83.17-93.13). The pre-operative diagnoses were stage 3 uterovaginal prolapse in 23 (16.08 %) patients, stage 4 uterovaginal prolapse in 120 (83.91 %) patients, rectocele in 119 (83.21 %) patients, cystocele in 138 (96.50 %) patients and stress urinary incontinence in 53 (37.06 %) patients. Ten (8.33 %) patients with stage 4 uterovaginal prolapse developed postoperative apical prolapse, whereas none of the patients with stage 3 uterovaginal prolapse developed postoperative apical prolapse. Postoperatively, the POP-Q stages of apical prolapse were significantly lower compared with pre-operatively (p < 0.001). Postoperatively, the apical prolapse rate was 7.0 %, the recurrent cystocele rate was 2.07 %, the recurrent rectocele rate was 5.5 %, and the recurrent stress urinary incontinence rate was 18.87 %. Overall, postoperative anatomical failure occurred in 21 of 143 (14.68 %) women. One (0.69 %) patient developed perioperative bladder perforation, two (1.39 %) patients experienced voiding difficulty, and eight (5.59 %) patients experienced vaginal spotting. Conclusion: Transvaginal round-infundibulopelvic ligament colposuspension during vaginal hysterectomy is an effective and useful method that reduces the rate of postoperative apical prolapse in patients with high-grade uterovaginal prolapse. (C) 2020 Elsevier B.V. All rights reserved.
