Yazar "Okuyan, Erhan" seçeneğine göre listele

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    Comparison of treatment results of urinary incontinence verified/or not verified with urodinamic evaluation by using UDI-6, IIQ-7 questionnaire forms
    (2020) Okuyan, Erhan; Cakir, Caner; Gunakan, Emre; Ozkaya, Enis; Kucukozkan, Tuncay; Ozyurek, Eser Sefik
    Aim: Treatment of mixed type incontinence includes surgical and/or medical options. The efficacy of treatment frequently depends on the patient based choice. Thus, we aimed to compare treatment efficacy with UDI-6 and IIQ-7 questionnaire forms in groups with/without urodynamics in the diagnosis of mixed type incontinence.Material and Methods: In our study, 60 patients were registered. Patients were evaluated in 2 groups including 30 patients that: agreed (Group 1) to and did not agree (Group 2) for a urodynamic exam. "Quality of life" scoring questionnaires, urodynamics records, and urethral angle measurements were performed in both groups. Patients in the groups were evaluated in subgroups whether they received TOT (Transobturator tape) and/or medical treatment. Group 1; A: TOT patients, B: TOT + medical treatment, C: Only medical treatment; Group 2; D: TOT + medical treatment, E: Only medical treatment. Results: The mean age of the patients was 49 and 70% of patients were postmenopausal. Most of the patients were obese 45% of patients had had a BMI of >40kg/m2. The rate of TOT received the patients in Group 1 and 2 were 21 (70%) and 13 (43.3%), respectively. An analysis of questionnaire scores %94.4 of all patients stated a regression in symptoms after treatment. Both surveys showed positive changes in all groups. The change ratio in the survey scores was 81.1% and 67.3% in Group 1 and 2 respectively in UDI- 6 survey similarly with IIQ-7 survey results as 81.1% and 63.5 % in Group 1 and 2 respectively. In the comparison of medical treatment subgroups (C and E) the change rate was significantly lower in patients who did not agree with urodynamic in UDI 6 and IIQ7 surveys ( 86.4% vs 55.0%, p.001 and 79.7% vs. 50.5%, p0.001.Conclusion: Although it is limited in urge type dominant incontinence patients, non-complex UI patients benefit from appropriate treatment regardless of urodynamics evaluation. In the management of UI patients' QoL questionnaires before and after treatment might be helpful.
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    Evolution of microbial ecology: A rare multidrug-resistant (Enterobacter Cloacae) surgical wound infection after cesarean delivery: Our experience of 5946 cesarean deliveries
    (2020) Bayramoglu, Zeynep; Okuyan, Erhan; Yoldas, Adem; Tay, Hayrettin
    To demonstrate the rapidly changing multidrug-resistant microbial environment and its challenges from the viewpoint of microbiologists, pathologists, and obstetricians.In our research; upon our encounter with a rare multidrug resistance wound infection following a cesarean section; we retrospectively analyzed 5946 cesarean sections performed in our clinic between 2017- 2019. Of the 5946 patients, 978 (16.44%) were literate and 4968 (%83.56) were illiterate. The average age of our patients is 23.44 and their average weight is 78.35 kg. The number of patients taken to emergency cesarean was 954, and 4992 of our patients were operated due to recurrent cesarean section. The number of patients operated under general anesthesia was 347, and 5599 patients received spinal anesthesia. In 2 years, 5946 patients had surgical site infection in 23 (0.39%) patients. Only one of our patients had multidrug-resistant Enterobacter Cloacae. None of our patients with surgical site infection had maternal mortality. Drug-resistant bacterial infection increases hospital stay, healthcare costs, and mortality, and for all nations, this problem is growing exponentially. Nowadays, understanding the multifactorial genetic basis of multidrug resistance should investigate genetic signatures in invasive infection.
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    Safe, easily applicable mini-laparotomic surgical steps in cornual ectopic pregnancy: Case report and demonstration of surgical technique
    (2020) Okuyan, Erhan; Altundal, Caglar; Bayramoglu, Zeynep
    In the management of rare cornual ectopic pregnancy, there is no consensus on surgical treatment modalities in obstetric practice. In this article, we aimed to describe the safe and easily applicable minilaparotomic surgical steps with black pencil drawings. A 5-centimeter-size of Pfannenstiel incision was made to enter the abdomen with sterile covering under operating room conditions. After evaluating the topographic anatomy of the uterus and adnexa, a window was opened just below the ligamentum ovarii proprium and skeletonization of the cornual ectopic pregnancy was achieved. Then, ligamentum ovarii proprium was ligated and cut by using 1.0 vicryl and U sutures were placed in 3 planes after skeletalization of cornual ectopic pregnancy mass. After cornuotomy was performed and the pregnancy material was removed the uterine myometrium layer and serosa were closed separately with baseball stitches. Total operation time was 20 minutes, perioperative blood loss was recorded as 50 ccs/dl and the patient was discharged at 24th hour without any complications. With this surgical technique applied with minilaparotomic incision, fertility-preserving surgery can be performed in a short time without causing excessive blood loss or hysterectomy. Studies involving many cases are needed to prove perioperative and postoperative results of this surgical technique.