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Öğe The Effect of Prognostic Factors and Adjuvant Radiotherapy on Survival in Patients with High-Grade Early-Stage Endometrial Cancer: A Retrospective Clinical Study(Int Scientific Information, Inc, 2019) Yilmaz, Ercan; Gurocak, Simay; Melekoglu, Rauf; Koleli, Isil; Faydali, Simge; Temelli, Oztun; Yar, TubaBackground: This retrospective clinical study aimed to investigate the effect of prognostic factors and adjuvant radiotherapy in patients with high-grade early-stage endometrial cancer on overall survival (OS) and disease-free survival (DES). Material/Methods: The medical records of patients diagnosed with high-grade, early stage (I or II) endometrial adenocarcinoma who had received adjuvant radiotherapy after surgery were reviewed. Results: Seventy-nine patients included 39 patients (49.4%) with stage II endometrial cancer, 25 patients (31.6%) with histologic grade 3 tumors, and 47 patients (59.5%) with endometrial cancer showing lymphovascular space invasion (LVSI). There were 45 patients (57.0%) who received external pelvic radiotherapy with an average dose of 46.0 Gy (range, 11.2-50.4 Gy), and 34 patients (43.0%) received vaginal brachytherapy (VBT) with an average dose of 21.5 Gy (range, 10-36 Gy). Multivariate analysis showed that tumor stage (HR, 4.066; 95% CI, 1.227-13.467; p=0.022) and histologic grade (HR, 16.652; 95% CI, 4.430-62.589; p<0.001) were independent predictors for OS. Increased serum CA-125 levels (HR, 1.136; 95% CI, 0.995-1.653; p=0.047) and histologic grade (HR, 3.236; 95% CI, 1.107-15.156; p=0.015) were independent predictors for DES. Adjuvant radiotherapy was not found to be significantly associated with improved OS (HR, 1.259; 95% CI, 0.518-3.058; p=0.612) or DES (HR, 1.056; 95% CI, 0.994-1.123; p=0.078). Conclusions: This retrospective study showed that in high-grade early-stage endometrial cancer treated with postoperative adjuvant radiotherapy, independent predictors for OS were tumor stage and grade. Adjuvant radiotherapy was not associated with improved OS or DES.Öğe The evaluation of the effect of vaginal delivery and aging on anal sphincter anatomy and function(Elsevier Masson, Corporation Office, 2018) Cay, Mahmut; Cetin, Aymelek; Ates, Mustafa; Koleli, Isil; Senol, Deniz; Kose, Evren; Ozgor, DincerObjective. - This study was conducted to evaluate the effect of vaginal delivery and aging on anal sphincter anatomy and function. Method. - Asymptomatic thirty women were included in this prospective study. Group 1 included 10 women (age range: 18-50) who had never been pregnant. Group 2 included 10 women (age range: 18-50) who had vaginal delivery. Group 3 included 10 women over 50 who had vaginal delivery. Results. - There was no statistically significant difference between the three groups in terms of resting and squeeze pressures. It was found that sphincter thickness showed statistically significant difference between the group 1 and group 3, and also group 2 and group 3. There was not statistically significant difference between the group 1 and group 2 in terms of sphincter thickness. There was a positive correlation between the age and sphincter thickness in all groups. In terms of sphincter thickness and pressure findings there was a positive correlation between the squeeze pressure and external anal sphincter thickness only in group 3. Conclusion. - The vaginal delivery did not have a negative influence on the structure and function of the anal sphincter in asymptomatic women. However, it was found that anal sphincter thickness changed strongly in a positive manner with aging. (C) 2018 Elsevier Masson SAS. All rights reserved.Öğe The evaluation of the effect of vaginal delivery and aging on anal sphincter anatomy and function (vol 47, pg 309, 2018)(Elsevier Masson, Corp Off, 2020) Cay, Mahmut; Cetin, Aymelek; Ates, Mustafa; Koleli, Isil; Senol, Deniz; Kose, Evren; Ozgor, Dincer[Abstract Not Available]Öğe The evaluation of the effect of vaginal delivery and aging on anal sphincteranatomy and function(Elsevıer masson, corporatıon offıce, 65 camılle desmoulıns cs50083 ıssy-les-moulıneaux, 92442 parıs, france, 2018) Cay, Mahmut; Cetin, Aymelek; Ates, Mustafa; Koleli, Isil; Senol, Deniz; Kose, Evren; Ozgor, Dincer; Simsek, Arife; Ozbag, DavutObjective. - This study was conducted to evaluate the effect of vaginal delivery and aging on anal sphincter anatomy and function. Method. - Asymptomatic thirty women were included in this prospective study. Group 1 included 10 women (age range: 18-50) who had never been pregnant. Group 2 included 10 women (age range: 18-50) who had vaginal delivery. Group 3 included 10 women over 50 who had vaginal delivery. Results. - There was no statistically significant difference between the three groups in terms of resting and squeeze pressures. It was found that sphincter thickness showed statistically significant difference between the group 1 and group 3, and also group 2 and group 3. There was not statistically significant difference between the group 1 and group 2 in terms of sphincter thickness. There was a positive correlation between the age and sphincter thickness in all groups. In terms of sphincter thickness and pressure findings there was a positive correlation between the squeeze pressure and external anal sphincter thickness only in group 3. Conclusion. - The vaginal delivery did not have a negative influence on the structure and function of the anal sphincter in asymptomatic women. However, it was found that anal sphincter thickness changed strongly in a positive manner with aging. (C) 2018 Elsevier Masson SAS. All rights reserved.Öğe Immunhistochemical analysis of Nuclear Factor Kappa Beta expression in etiopathogenesis of ovarian tumors(Acta Cirurgica Brasileira, 2018) Yilmaz, Ercan; Gul, Mehmet; Melekoglu, Rauf; Koleli, IsilPurpose: To investigate the place of the transcription factor nuclear kappa B (NF-kappa B), which is a marker of chronic inflammation, in the etiology of the ovarian carcinoma. Methods: NFkB analysis with the immunohistochemical method has been performed. To evaluate immunohistochemical NF-kappa B expression in the ovarian tissue, the H-score method. H-score = Sigma Pi (i+1), where Pi'' is the percentage of stained cells in each intensity category (0-100%) and i'' is the intensity indicating weak (i=1), moderate (i=2) or strong staining (i=3). Results: It has been seen that, the mean H score is statistically significantly higher in the patient group with serous and musinous adenocarcinoma diagnosis than the two other patient groups (p<0.005). Conclusions: Factor nuclear kappa B is an important mediator that acts in the chronic inflammation. The highest expression rates are determined by the immunohistochemical method in the ovarian cancer group.Öğe Intermediate-term outcomes of laparoscopic pectopexy and vaginal sacrospinous fixation: a comparative study(Brazilian Soc Urol, 2019) Astepe, Bahar Sariibrahim; Karsli, Aybike; Koleli, Isil; Aksakal, Orhan Seyfi; Terzi, Hasan; Kale, AhmetObjective: To compare the intermediate-term follow-up results of laparoscopic pectopexy and vaginal sacrospinous fixation procedures. Materials and Methods: Forty-three women who had vaginal sacrospinous fixations(SSF) using Dr. Aksakal's Desta suture carrier and 36 women who had laparoscopic pectopexies were re-examined 7 to 43 months after surgery. The PISQ-12 and P-QOL questionnaires were answered by all of the women. Results: The apical descensus relapse rates did not differ between the groups (14% in the SSF vs. 11.1% in the pectopexy group). The de novo cystocele rates were higher in the SSF group (25.6% in the SSF vs. 8.3% in the pectopexy group). There were no significant differences in the de novo rectocele numbers between the groups. The treatment satisfaction rates were high in both groups (93% in the SSF vs. 91.7% in the pectopexy group), which was not statistically significant. Moreover, the postoperative de novo urge and stress urinary incontinence rates did not differ; however, the postoperative sexual function scores (PISQ-12) (36.86 +/- 3.15 in the SSF group vs. 38.21 +/- 5.69 in the pectopexy group) were better in the pectopexy group. The general P-QOL scores were not significantly different between the surgery groups. Conclusion: The vaginal sacrospinous fixation maintains its value in prolapse surgery with the increasing importance of native tissue repair. The new laparoscopic pectopexy technique has comparable positive follow-up results with the conventional sacrospinous fixation procedure.Öğe Mean platelet volume as an inexpensive bio-marker of endometriosis(E-Century Publishing Corp, 2016) Bakir, Vuslat Lale; Dundar, Ozgur; Bodur, Serkan; Goksedef, Behiye Pinar; Aksoy, Huseyin; Alanbay, Ibrahim; Koleli, IsilObjective: Increased platelet activation has also been suggested to play a pivotal role in the development and progression of inflammation. Recently, mean platelet volume (MPV) has been investigated as a simple inflammatory marker in several diseases and it was found that MPV can be used as a marker of inflammatory disease. Therefore this study was designed to investigate and compare the values of MPV in patients with endometriosis and the MPV values in healthy women. Materials and methods: Patients with endometriosis (n = 297) and symptom-free, healthy, age-matched controls underwent tubal ligation (n = 36) were retrospectively evaluated and recruited to the study at three tertiary centers between January 2008 and December 2014. For further analysis, patients with endometriosis were divided into initial endometriosis (n = 129) and advanced endometriosis (n = 168) groups according to the severity of the disease. Receiver Operating Characteristic (ROC) curve and sensitivity and specificity report were performed for MPV value to evaluate differences between the groups. Results: MPV in patients with endometriosis were found to be higher than the control group (8.80 +/- 1.08 fL vs 8.11 +/- 1.03 fL, respectively; P < 0.001). There was no significant difference regarding mean MPV between the patients with advanced and initial endometriosis (8.72 +/- 1.60 fL and 8.90 +/- 0.97 fL, respectively; P = 0.15). ROC curve analysis suggested that the optimum MPV cut-off value for endometriosis was 8.55 fL, with a sensitivity, specificity, of 61% and 61%, respectively (AUC: 0.671). Conclusion: This study showed that significantly higher MPV levels were found in the patients with endometriosis and confirmed the previous studies indicating that endometriosis is an inflammatory process. MPV is an important, simple, inexpensive, and effortless hematological parameter and can be useful in evaluation of endometriosis patients.Öğe Molsidomine (MOL) reduces postoperative pelvic adhesion: A rat uterine horn model(2019) Koleli, Isil; Parlakpinar, Hakan; Ozhan, Onur; Tanbek, Kevser; Sahin, Nurhan; Yilmaz, Ercan; Sariibrahim, Bahar; Bakir, LaleAim: Postoperative pelvic adhesions (PPAs) are a common complication that leads to many problems. This study aimed to compare the role of Seprafilm (a protective barrier), and molsidomine (MOL), recognized for its antioxidative and antiproliferative effects, in preventing pelvic adhesion. Material and Methods: A total of 30 of female Wistar albino rats were randomly divided into 3 groups. They underwent bilateral uterine horn injury. The rats in the Sham group (n=10) received no special treatment. The rats in the Seprafilm group (n=10) were treated withSeprafilm. The rats in the MOL group (n=10) received 10 mg/kg MOL orally for 14 days. Adhesion scores were evaluated using macroscopic, microscopic, and immunohistochemical grading 14 days postoperatively. Results:The Majuzi adhesion score of the rats in the MOL group [1 (0-4)] was lower than the score of the rats in the sham [4 (2-5)] and Seprafilm [4 (1-5)] (p<0.05). The glutathione peroxidase level in the MOL group [9.34 (5.45 - 19.82)] was higher than that in the sham [7.05 (2.67 – 8.9)] and Seprafilm [5.85 (3.92 - 22.55)] groups (p<0.05). Conclusions: This study showed that MOL reduced the formation of PPAs in a rat uterine horn model.The need for larger studies is an obvious need to elucidate this issue.Öğe RETROSPECTIVE ANALYSIS OF BORDERLINE OVARIAN TUMORS: OUTCOMES AT A SINGLE CENTER(Sestre Milosrdnice Univ Hospital, 2019) Yilmaz, Ercan; Sahin, Nurhan; Koleli, Isil; Melekoglu, Rauf; Tanrikut, Emrullah; Faydali, Simge; Karaer, AbdullahWe wanted to discuss our experiences in the approach to borderline ovarian tumors, which constitute a group different from epithelial ovarian tumors with respect to their biological structure in line with retrospective information gathered from our cases. A total of 25 patients operated on for the indication of adnexal masses diagnosed as borderline ovarian tumors based on frozen section results were included in our study. Patient age, tumor diameter, tumor markers and surgeries performed were discussed in the light of the literature. Statistical analyses were performed using the SPSS software. The patient mean age was 43.84 +/- 11.34 years. The mass was localized in the right (n=13), left (n=11) or both (n=1) adnexal regions. The mean tumor diameter was 12.9 +/- 5.84 cm. Histopathologic examination established the diagnosis of serous borderline (n=14 patients) and mucinous borderline (n=11) ovarian tumors. Although the results of our study are consistent with current literature data, a greater number of current studies should be performed on borderline ovarian tumors, which are defined as a class of tumors different from epithelial ovarian tumors.Öğe Translation, cultural adaptation, and validation of Australian pelvic floor questionnaire in a Turkish population(Elsevier Science Bv, 2019) Astepe, Bahar Sariibrahim; Koleli, IsilObjectives: The aims of the study were the translation, cultural adaptation, and validation of self-administered Australian Pelvic Floor Questionnaire (APFQ) in a Turkish population. Study design: The APFQ was translated into Turkish with forward and back translation by native speakers, and the Turkish version was tested on 15 volunteer patients. 53 patients who had at least one symptom related to pelvic floor dysfunction were included as the patient group, and 51 women who had no symptoms related to pelvic floor dysfunction were included as the control group. All of the women in the patient group were examined gynecologically in the lithotomy position, the cough stress test was performed. and prolapses was evaluated with the POP-Q (Pelvic organ Prolapse Quantification System). The Urinary Distress Inventory was answered by all symptomatic women. All women answered the questionnaire again after a three-week interval. The content/face validity, reliability, stability, and construct validity were studied. Results: The Cronbach's alpha results were above 0.7 for all subscales of the questionnaire (bladder:0.842, bowel:0.733, prolapse:0.858, sexual function:0.750) showing adequate internal consistency (reliability). The test/retest analysis (stability) showed high reproducibility with an intraclass coefficient above 0.85 in the patient group and above 0.75 in the control group. Except for the sexual function subscale, discriminant validity showed a significant difference between the patient and control groups. A significant correlation was found between the total bladder subscale score and the UDI-6 scores (rho:0.828, p:0.000,) and a significant correlation was found between the total prolapse score and the POP-Q scores (rho:0.574, p:0.000). Conclusion: The Turkish version of the self-administered APFQ is a reliable and valid instrument for evaluating symptom severity and impact of pelvic floor disorders on the quality of life of Turkish speaking women. (C) 2019 Elsevier B.V. All rights reserved.Öğe Turkish obstetricians' self-birth preferences, attitudes and practices towards caesarean section on maternal request and vaginal birth after caesarean section: a national online survey(Taylor & Francis Inc, 2022) Astepe, Bahar Sariibrahim; Ayaz, Reyhan; Koleli, Isil; Yucedag, Mehtap; Yilmaz, Ozgur; Uzel, KemineThe aim of the study was to investigate the reasons for Turkish obstetricians having self-caesarean section on maternal request (CSMR) and their attitudes and practices related to CSMR and vaginal birth after caesarean section (VBAC). The questionnaire form constructed by the authors was sent online to obstetricians working in different cities of Turkey. A total of 206 obstetricians participated and answered a self-administered questionnaire. The self-birth preferences were as follows: 17% had a vaginal delivery (VD), 61.2% had a caesarean section (CS), 4.9% had both VD and CS. Of the participants with CS, 56.3% had CSMR. The most common reason for their having self-CSMR was that it was 'safe for the baby'. The most common reason for performing CSMR with their patients was 'due to birth anxiety and phobia'. Fifty-five percent of the participants said that they first recommended VD. The most common concern related to VBAC was 'I'm afraid of legal sanctions about complications'. Although many Turkish obstetricians recommend VD to their patients, they are afraid of the complaints/trials related to unforeseen complications during VD. IMPACT STATEMENT What is already known on this subject? Caesarean section (CS) rates all over the world and in Turkey are rising. The exact frequency of CS on maternal request (CSMR) is not known, but it is estimated to be between 4% and 18%. What do the results of this study add? Although Turkish obstetricians had high self-CSMR rates, they thought that it was more correct to direct patients to vaginal delivery (VD). Obstetricians are afraid of unforeseen complications during VD and related complaints and legal trials. What are the implications of these findings for clinical practice and/or further research? Physicians expect improvements in the judgement and punishment issues related to unforeseen complications in the birth process. Besides the actual rates of CSMR need to be reported in the literature and why obstetricians perform CSMR needs to be investigated globally.Öğe Vaginal sacrospinous ligament fixation versus abdominal sacrocolpopexy for the treatment of vaginal cuff prolapse: A retrospective study(2019) Koleli, Isil; Yilmaz, ErcanAim: The aim of this study was to retrospectively compare the objective and the subjective results of native tissue sacrospinous ligament fixation (SSLF) and abdominal sacrocolpopexy (ASC) operation for the treatment of vaginal cuff prolapse (VCP). Material and Methods: 25 patients who underwent native tissue SSLF and 20 patients who underwent mesh ASC procedure for VCP were evaluated with pelvic organ prolapse quantification (POP-Q) system and pelvic floor distress inventory-20 (PFDI-20) before the surgery and 12 months after surgery. The patients were asked about surgical satisfaction, postoperatively. Demographic data, intra- and postoperative complications, operation duration and hospital stay were also recorded. Results: No difference was detected between SSLF and ASC in terms of objective success rate (88% vs. 95%; p=0.617). PFDI-20 score improved significantly after the ASC and SSLF (p<0.001). The median change of the PFDI-20 score, the pelvic organ prolapse distress inventory-6 (POPDI-6) score, the colorectal-anal distress inventory-8 (CRADI-8) score and the urinary distress inventory-6 (UDI-6) score of the groups were not different (p= 0.14; p=0.44; p=0.65; p=0.53, respectively). The median operation time of the ASC group was 34 minutes longer than the SSLF group (90 vs 56 min.) (p<0.001). Similar satisfaction rates (96% in ASC and 95% in SSLF) were found among the groups (p=1). Conclusion: Objective and subjective results of SSLF and ASC operations were equal at 12-months after operation. SSLF can be a good option for patients with obesity and co-morbidity, and for whom general anesthesia is risky.Öğe Validation of the Turkish version of the International Consultation on Incontinence Questionnaire-vaginal symptoms (ICIQ-VS)(Springer London Ltd, 2019) Koleli, Isil; Astepe, Bahar SariibrahimIntroduction and hypothesisThe International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS) was developed and validated in 2006 to evaluate vaginal symptoms, sexual matters, and quality of life of patients. This study aimed to validate the Turkish version of ICIQ-VS.MethodsThe English version of the questionnaire was translated into Turkish. On the basis of the pelvic organ prolapse quantification (POP-Q) system, symptomatic women with 2 grade pelvic organ prolapse (POP) were included in the symptomatic (patient) group and asymptomatic women with 1 grade POP in the asymptomatic (control) group. The questionnaire was administered three times: after the first examination of the women (T1), 3weeks after T1 (T2), and 3months after the POP surgery (T3).ResultsA total of 111 women were included in the study (symptomatic group, n=53; asymptomatic group, n=58). The missing data were ? 2%; the test-retest reliability was between 0.807 and 0.963, and the differences between the symptomatic and asymptomatic women were significant (p ? 0.001). A significant positive correlation existed between POP-Q and the vaginal symptom score, sexual matter score, and quality-of-life score (r(s)=0.844, 0.393, and 0.698, respectively; p<0.001). The Cronbach's alpha was 0.72 for the vaginal symptom score and 0.73 for the sexual matter score. The sensitivity to change was significant (p ? 0.05). The effect size values of the vaginal symptom score, sexual matter score, and quality-of-life score were 2.55, 2.33, and 1.56, respectively.ConclusionThe Turkish version of ICIQ-VS was successfully validated in this study, and a newer version of the questionnaire was made available for assessing vaginal symptoms, sexual matters, and quality of life of patients with POP.
