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Öğe Does the presence of anhydramnios affect the duration of medical abortion?(Via Medica, 2016) Karapinar, Oya Soylu; Gungoren, Arif; Dolapcioglu, Kenan; Silfeler, Dilek Benk; Kurt, Raziye Keskin; Sahin, Hanifi; Hakverdi, Ali UlviObjectives: The aim of the study was to determine whether anhydramnios affected the duration of medical abortion in cases with various indications as compared to cases with normal amniotic fluid volume. Material and methods: Patients who were admitted to our clinic because of medical abortion between January 2010-December 2013 were included in this retrospective study. A total of 32 pregnant women with anhydramnios (study group) and 67 pregnant women with normal amniotic fluid volume but with fetal abnormality (control group) were included in the study. Patient age, gravidity, parity, gestational age, previous delivery route, and duration of the abortion were recorded. Results: Mean duration of the abortion in the study group was 71.93 +/- 47.51 h as compared to 79.08 +/- 52.62 h in the control group. There were no statistically significant differences between the two groups in terms of duration of the abortion (p = 0.516). Also, we found no statistically significant differences in duration of the abortion with regard to previous delivery route (p = 0.220). Conclusions: There were no statistically significant differences between the study group and controls in terms of duration of the abortion. In addition, neither parity nor previous delivery route affected the duration of the abortion.Öğe The effect of dexpanthenol on experimentally induced ovarian ischaemia/reperfusion injury: a biochemical and histopathological evaluation(Springer Heidelberg, 2017) Karapinar, Oya Soylu; Pinar, Neslihan; Ozcan, Oguzhan; Dogan, Esin Atik; Bayraktar, Suphi; Sahin, Hanifi; Dolapcioglu, KenanThe aim of this study was to evaluate the effect of two different doses of dexpanthenol (Dxp) onexperimentally induced ovarian ischaemia/reperfusion (I/R) injury ina rat model. Forty female rats were randomly divided into fivegroups: Group 1: sham operation; Group 2: 3-h ischaemia; Groups 3: 3-h ischaemia, 3-h reperfusion (I/R); Group 4: I/R + 300 mg/kg Dxp intraperitoneally (i.p) Group 5: I /R + 500 mg/kg Dxpi.p. Total anti-oxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), tissue malondialdehyde (MDA) and activities of glutathione peroxidase and catalase were calculated. Ovarian tissue damage was assessed using a histopathological scoring system. The TOS and OSI values were significantly lower in Group 5, as compared to Groups 2 and 3 (p < 0.05). The MDA levels in Group 1 and Group 5 were significantly lower than those in Group 3 (p < 0.05). CAT and GSH-Px activity was higher in Group 5 than in Group 2 and Group 3 (p = 0.00). Tissue damage scores were elevated in all the groups compared with sham group, but the treatment with the different doses of Dxp before reperfusion ameliorated the tissue damage scores. The results showed that Dxp reduced ovarian I/R injury.Öğe The effectiveness of the double B-lynch suture as a modification in the treatment of intractable postpartum haemorrhage(Taylor & Francis Inc, 2018) Sahin, Hanifi; Karapinar, Oya Soylu; Sahin, Eda Adeviye; Dolapcioglu, Kenan; Baloglu, AliA broader range of more effective compression techniques are needed in the patients who have an intractable postpartum haemorrhage due to uterine atony despite medical treatment and B-Lynch sutures. The aim of this study was to report the outcome of a series of patients with haemorrhage who were managed by double B-Lynch suture. Fourteen patients who were treated in a tertiary hospital between July 2010 and February 2015 were included in the study. The intractable haemorrhage rate was 0.35% over 5 years (14/4000 births). Bleeding was controlled in all the patients with a double B-Lynch suture. The mean age of the patients was 24 +/- 3.4years. The mean estimated blood loss was 1696 +/- 272.075mL, and the mean transfusion rate was 4.2 +/- 2.5 units. Pregnancy was observed in five patients at follow up. The double B-Lynch suture seems to be an effective and reliable solution to an intractable postpartum haemorrhage resulting from uterine atony and has no unfavourable impacts on fertility. It should be considered before the use of any aggressive surgical techniques such as a hypogastric artery ligation or a hysterectomy. This the first study to investigate the effectiveness of the double B-Lynch suture, and we showed that the hysterectomy and/or hypogastric artery ligation rate can be decreased by adding a second B-Lynch suture in cases where the medical treatment or a single B-Lynch has failed. IMPACT STATEMENT What is already known on the subject? Uterine atony is the most common cause of a primary postpartum haemorrhage. When a simple massage of the uterus and medication failed to manage this condition, various surgical solutions have been sought, including uterine compression sutures, uterine artery ligation, devascularisation of the uterus, internal iliac artery ligation and, ultimately, a hysterectomy. The B-Lynch suturing technique is particularly useful because of its simplicity of application, life-saving potential, relative safety and capacity for preserving the uterus and subsequent fertility. To-date, this suturing technique, when applied correctly, has been successful with no problems and no apparent complications. However in the cases of when it falls, usually a hysterectomy or a hipogastric artery ligation is preferred. What does this study add? A double B-Lynch suture seems to be an effective and reliable method in an intractable postpartum haemorrhage due to a uterine atony and has no unfavourable impact on fertility'. What are the implications of these findings for clinical practice? The double B-Lynch suture seems to be an effective, reliable and technically easy method. With this aspect, it might be considered before any aggressive surgical techniques, such as a hypogastric artery ligation and hysterectomy in selected cases.Öğe Evaluation of vaginal agenesis treated with the modified McIndoe technique: A retrospective study(Galenos Yayincilik, 2016) Karapinar, Oya Soylu; Ozkan, Mustafa; Okyay, Ayse Guler; Sahin, Hanifi; Dolapcioglu, Kenan SerdarObjective: Retrospective analysis of cases that have undergone neovagina operation because of congenital vaginal agenesis was objected. Material and Methods: Seven cases applying with the complaints of primary amenorrhea or inability to have sexual intercourse were in the study. The cases were diagnosed with congenital vaginal agenesis and operated at Mustafa Kemal University Training and Research Hospital between 2011 and 2014. Vaginoplasty by the modified McIndoe method was performed in all cases. The main complaint, chromosomal analysis, duration of operation, preoperative and postoperative vaginal length, complications, postoperative treatment, and satisfaction from the sexual intercourse were all evaluated. Results: Average age of our patients was 28.14 +/- 8.61 (19-39) years. One patient was 46XX-45X0 mosaic Turner syndrome), 1 patient was 46XY (testicular feminization), and other 5 patients were 46XX. The average duration of operation was 2.7 +/- 0.56 (2-3.5 h). Postoperative infection was observed in 1 patient. In this infected patient, graft failure occurred and debridement was performed in reoperation. No early complications were seen in the others. Preoperative and postoperative average vaginal lengths were 1.85 +/- 0.62 (1-3 cm) and 8.71 +/- 1.11 (7-10 cm), respectively. Dyspareunia occurred in 2 cases that were not able to use dilatator regularly: 1 because of cancelation of marriage and the other because of postoperative infection; regular sexual life was achieved in remaining 5 (71%) cases. Conclusion: Although there is no consensus about the ideal method of making a functioning vagina among different specialties. The modified McIndoe technique is the most applied method by gynecologists and simple, minimally invasive and with low morbidity.Öğe Vascular effect of levonorgestrel intrauterine system on heavy menstrual bleeding: is it associated with hemodynamic changes in uterine, radial, and spiral arteries?(Taylor & Francis Inc, 2021) Sahin, Hanifi; Gungoren, Arif; Sezgin, Burak; Un, Burak; Sahin, Eda Adeviye; Dolapcioglu, Kenan; Bayik, Rahime NidaThe aim of this study was to evaluate the clinical and blood flow changes associated with the use of a levonorgestrel-releasing intrauterine device (LNG-IUD) in patients with idiopathic heavy menstrual bleeding (HMB). LNG-IUD was inserted into a total of 91 patients (39.5 +/- 5.4 years) who were diagnosed with HMB. Uterine volume, ovarian volume, uterine, radial and spiral artery blood flow, Pictorial Blood Loss Assessment Chart (PBAC) scores, and other clinical and laboratory parameters were evaluated before and 12 months after insertion of LNG-IUD. Compared to pre-insertion values, LNG-IUD dramatically improved haemoglobin, PBAC scores, and endometrial thickness. Mean resistance indices of radial and spiral arteries significantly increased 12 months after insertion. Our study results suggest that a significant increase in the resistance indices of the intra-myometrial arteries in LNG-IUD users one year after insertion may be due to its local progestational effects, indicating a possible mechanism of LNG-IUD in reducing menstrual blood flow.Impact Statements What is already known on this subject?The mechanisms of action of LNG-IUD on heavy menstrual bleeding include atrophy, decidualization and vascular changes of in the endometrium, resulting endometrial suppression. However, the exact mechanism to stop bleeding is not clear. What do the results of this study add?The present study suggests that one of the effects of the LNG-IUD on heavy menstrual bleeding is its ability to increase the resistance indexes of the intra-myometrial arteries. What are the implications of these findings for clinical practice and/or further research?These results will foster further studies on the effects of LNG-IUD on intra-myometrial arteries and will further assure clinicians on the vascular effect of LNG-IUD during management of heavy menstrual bleeding which includes hysterectomy as a final step.
