Browsing by Author "Ark, Hasan Cemal"

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Conservative Management of Postpartum Hemorrhage
(Elsevier Taiwan, 2015) Karaman, Erbil; Alkis, Ismet; Han, Agahan; Ark, Hasan Cemal; Buyukkaya, Betul
The Effect of Patient Position During Mid-Urethral Sling Operations on the Postoperative Outcomes of Sling Success: a Randomized Clinical Study
(Karger, 2016) Han, Agahan; Karaman, Erbil; Alkis, Ismet; Ark, Hasan Cemal; Akca, Aysu; Numanoglu, Ceyhun; Tunca, Aysun Fendal
Aims: To determine and compare the effectiveness, peri- and postoperative outcomes of mid-urethral sling (MUS) operations for urinary incontinence, using 2 different patient positions during surgery. Methods: In this study, 146 patients underwent MUS surgery in a urogynecology clinic. Of them, 72 patients underwent the intraoperative surgical procedure of reverse trendelenburg patient positioning for tape adjustment (group 1) and the remaining 74 patients had the routine surgical procedure of MUS surgery (group 2). The primary outcome was the evaluation of postoperative urine leaks, using the stress test, and secondary outcomes were quality of life, using the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF, Turkish version) and complication rates. Results: There were no significant differences in demographic variables between the 2 groups. The overall cure rates for incontinence in the lithotomy position was 97.22 and 85.13% for groups 1 and 2, respectively, in which group 1 had a statistically significant decrease in urine leak postoperatively (p < 0.05; OR 3.08, 95% CI 2.78-22.14). The postoperative ICQ-SF scores showed no significant difference between the 2 groups (p = 0.19). Conclusion: Applying a 45-degree reverse trendelenburg position for tape adjusting during MUS operation results in a greater objective cure rate compared with the typical dorsolithotomy position; however, there was no difference in the subjective outcome. (C) 2015 S. Karger AG, Basel
The Fertility Sparing Management of Postpartum Hemorrhage: a Series of 47 Cases of Bakri Balloon Tamponade
(Elsevier Taiwan, 2015) Alkis, Ismet; Karaman, Erbil; Han, Agahan; Ark, Hasan Cemal; Buyukkaya, Betul
Objective: To evaluate the success rate of Bakri balloon tamponade (BBT) for managing postpartum hemorrhage (PPH), intractable to conservative medical treatment, as a fertility sparing intervention. Materials and methods: We evaluated 47 women treated with BBT who had severe postpartum hemorrhage and uncontrollable bleeding due to failed treatment with uterotonic agents. The main outcome measure was successful management and preservation of the uterus. Results: Forty-seven women were identified for BBT treatment due to severe PPH. BBT was used to successfully manage hemorrhage in 43 patients, and there was no need for hysterectomy. Four patients required an additional surgical procedure. Of the four failures, a subtotal hysterectomy was performed in two patients, and the other two patients underwent a total hysterectomy. The overall success rate was 91.4%, which was comparable to rates reported earlier. The main cause of PPH was uterine atony (43%). Conclusion: Uterine preservation is an important issue when managing PPH. BBT is an effective, easy to use, and safe procedure for massive PPH that can minimize recourse to hysterectomy after failed medical treatment. Copyright (C) 2015, Taiwan Association of Obstetrics & Gynecology. Published by Elsevier Taiwan LLC. All rights reserved.
The Outcome of Manchester-Fotergill Operation for Uterine Decensus Repair: a Single Center Experience
(Springer Heidelberg, 2014) Alkis, Ismet; Karaman, Erbil; Han, Agahan; Gulac, Bekir; Ark, Hasan Cemal
The aim of this study was to evaluate the clinical characteristics, peri- and post-operative outcomes, and clinical effectiveness of the Manchester-Fothergill (MF) procedure for uterine descensus as a uterine-sparing surgery. In this study, 49 patients underwent the MF procedure as a uterine-sparing surgery for uterine descensus during 2008-2012 in the Department of Urogynecology at Kanuni Sultan Suleyman Research and Teaching Hospital, Istanbul, Turkey. Medical records and follow-up data were collected from 24 of the 49 patients (48.9 %). The mean age was 49.3 +/- A 9.1 years, and parity 3.6 +/- A 1.5; 41.6 % were post-menopausal; 6 patients (25 %) had grade II, and 18 (75 %) had grade III uterine prolapse; 95.8 % had associated cystoceles, and 79.1 % had associated rectoceles; 66.6 % complained of urinary incontinence. On follow-up examination, the cervical stumps were satisfactorily situated in 23 of 24 patients, and recurrent prolapse was seen in 1 patient (4.1 %). Bladder perforation was repaired at the time of the operation in 1 patient, and one complained of post-operative urinary retention. The MF procedure is a viable option to surgically correct uterine descent while preserving the uterus to treat recurrent prolapse with a low complication rate and low morbidity.