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    DIAGNOSTIC VALUE OF DILATATION AND CURETTAGE TO DETECT INTRAUTERINE LESIONS IN WOMEN WITH ABNORMAL UTERINE BLEEDING
    (Galenos Yayincilik, 2008) Hakverdi, Sibel; Gungoren, Arif; Hakverdi, Ali Ulvi; Dolapcioglu, Kenan; Ciftci, Sinasi; Kaya, Zozan; Yalinkaya, Ahmet
    Objective: To evaluate the diagnostic inadequacy of dilatation and curettage (D&C) by comparing histologic findings derived from D&C with histologic findings obtained after hysterectomy procedure retrospectively. Material and methods: Files of 259 patients with abnormal uterine bleeding who underwent hysterectomy within two months of a diagnostic D&C were analyzed. All patients had gynecologic and ultrasonographic examination, then they underwent D&C procedure under anesthesia. Hysterectomy was performed accordingly due to the histologic findings or persistence of the symptoms. Histologic diagnosis in D&C and after hysterectomy for each patient were compared. Results: 54.5% of the women had no pathology in D&C techniques. 59.5% of remaining patients had the same the pathologic findings in the hysterectomy specimens. In 105 of 259 patients, D&C failed to detect intrauterine disorders subsequently found at hysterectomy. After hysterectomy, in 227 of 259 patients were found additional pathologic abnormalities besides the histologic diagnosis in D&C specimens. Conclusions: D&C involves additional hospital costs and risk of complications; uterine perforation, infection and laceration of the cervix. If there are lesions in the uterus, dilatation and curettage is an inadequate diagnostic tool. D&C missed 40.5% of major intrauterine disorders and endometrial lesions were still present in the removed uterus. Therefore D&C can not be assessed as a therapeutic tool. Therefore D&C is suggested to be replaced by alternative and more accurate methods of diagnosis of endometrial abnormalities.
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    Theranekron for treatment of endometriosis in a rat model compared with medroxyprogesterone acetate and leuprolide acetate
    (Elsevier, 2013) Dolapcioglu, Kenan; Dogruer, Gokhan; Ozsoy, Sule; Ergun, Yasar; Ciftci, Sinasi; Karapinar, Oya Soylu; Aslan, Erdogan
    Objectives: The aim of this study was to compare the effects of theranekron, medroxyprogesterone acetate (MPA), and leuprolide acetate (LA) on surgically induced endometriosis in a rat model. Study design: Endometriosis was surgically induced in forty female rats during estrus. After 3 weeks, a second operation was performed and the rats were randomized using a randomization table into theranekron, MPA, LA, and control groups. These treatments were continued for 3 weeks. A third operation was performed to evaluate treatment results. Then, the experimental treatments were halted and estrogen was initiated again to maintain estrus. After three additional weeks; i.e. after 9 weeks, the recurrence rate of endometrial foci was evaluated in a fourth operation and the rats were sacrificed. The volume of endometriotic foci and histopathology scores before and after treatment were compared. Results: The respective mean volumes of the endometriotic foci after 3, 6, and 9 weeks were 86.4 +/- 21.2, 16.4 +/- 8.2, and 20.1 +/- 9.6 mm(3) in the theranekron group, 78.3 +/- 20.4, 42.6 +/- 13.5, and 66.7 +/- 16.2 mm(3) in the MPA group, and 91.8 +/- 30.2, 34.4 +/- 11.4, and 72.4 +/- 21.9 mm(3) in the LA group. The respective mean histopathology scores were 2.4 +/- 0.6, 1.8 +/- 0.6, and 1.6 +/- 0.6 in the theranekron group, 2.5 +/- 0.8, 2.0 +/- 1.1, and 2.7 +/- 1.0 in the MPA group, and 2.3 +/- 0.5, 2.1 +/- 1.2, 2.4 +/- 0.8 in the LA group. After 9 weeks, the mean volume of endometriotic foci and histopathology scores were significantly lower in the theranekron group. Conclusions: Theranekron caused more evident regression of endometriotic foci than MPA or LA in a rat model. After stopping the theranekron treatment, the recurrence rate was also lower than that of the other groups. (C) 2013 Elsevier Ireland Ltd. All rights reserved.