Publications by authors named "Emsal Pınar Topdagi Yilmaz"

19 Publications

  • Page 1 of 1

Management of Urinary Tract Endometriosis Patients by Gynecologists.

J Turk Ger Gynecol Assoc 2021 Jan 4. Epub 2021 Jan 4.

Department of Gynecology and Obstetrics, Atatürk University Faculty of Medicine, Erzurum, Turkey.

Objective: We aimed to report the postoperative outcomes of urinary tract endometriosis (UTE), which is a form of deep infiltrative endometriosis, and to contribute to the literature by presenting the obtained results.

Material And Methods: In the present study, 70 patients who underwent surgery for endometriosis at our clinic between 2005 and 2019 and had a diagnosis of UTE in the final pathological assessment were examined in detail. Patient information was retrospectively retrieved from the medical records. Data obtained pre-, peri-, and postoperatively were analyzed.

Results: Mean age of the 70 patients included according to the study criteria was 32.73 ± 7.09 years. Ureteral involvement alone was observed in 49% (n = 34) patients, bladder involvement alone was observed in 24% (n = 17) patients, and both bladder and ureteral involvement were observed in 27% (n = 19) patients. Microscopic hematuria was detected in 16% (n = 11) patients (16%), whereas preoperative urinary tract findings, such as recurrent urinary tract infections, were detected in 19% patients (n = 13). Of the patients, 56% (n = 39) were identified with dyspareunia, 56% (n = 39) with dysmenorrhea, and 30% (n = 21) with pelvic pain.

Conclusion: Although postoperative results were typically considered positive, surgical method performed in deep infiltrative endometriosis should aim to preserve fertility, improve quality of life, and reduce the complication rate to a minimum.
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http://dx.doi.org/10.4274/jtgga.galenos.2020.2020.0054DOI Listing
January 2021

What is your diagnosis?

J Turk Ger Gynecol Assoc 2021 02 4;22(1):71-73. Epub 2021 Jan 4.

Department of Obstetrics and Gynecology, Atatürk University Faculty of Medicine, Erzurum, Turkey

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http://dx.doi.org/10.4274/jtgga.galenos.2020.2019.0208DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7944237PMC
February 2021

A Novel Multimodal Treatment Method and Pilot Feasibility Study for Vaginismus: Initial Experience With the Combination of Sacral Erector Spinae Plane Block and Progressive Dilatation.

Cureus 2020 Oct 8;12(10):e10846. Epub 2020 Oct 8.

Obstetrics and Gynecology, Ataturk University School of Medicine, Erzurum, TUR.

Background Genito-pelvic pain/penetration disorder, commonly referred to as vaginismus, is a relatively common condition in women of childbearing age and has physical and psychological aspects. Various cognitive and behavioral therapies, dilatators, botulinum injections, and so on have been tried in the treatment. We hypothesize that the combination of sacral erector spinae plane (ESP) block and progressive dilatation treatment increases treatment quality. Methods We performed the sacral ESP block and progressive dilatation, which we added to multimodal treatment for resistant vaginismus cases. After the procedure, all patients were followed up during one menstrual cycle. They were recommended to have sexual intercourse on the day of the procedure. Results In 15 of our treatment-resistant cases, when we added the sacral ESP block, successful penetration after the first block was 73%. Pregnancy occurred in eight patients after the initial one-month follow-up. Four of the 15 patients needed a second block. Conclusions The sacral ESP block added to the multimodal treatment protocol significantly improves treatment quality.
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http://dx.doi.org/10.7759/cureus.10846DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7651775PMC
October 2020

Comparison of two natural tissue repair-based surgical techniques; sacrospinous fixation and uterosacral ligament suspension for pelvic organ prolapse treatment.

J Gynecol Obstet Hum Reprod 2021 Apr 8;50(4):101905. Epub 2020 Sep 8.

Department of Gynecology and Obstetrics, Atatürk University School of Medicine, Erzurum, Turkey. Electronic address:

Introduction And Purpose: The present study aims to compare the effectiveness and perioperative results of the natural tissue repair-based treatments sacrospinous fixation (SSF) and uterosacral ligament suspension (USLS) based on the preoperative Pelvic Organ Prolapse Quantification system (POP-Q).

Materials And Methods: Medical records of patients with stage ≥2 uterine prolapse between January 2011 and December 2016 were retrospectively examined. Preoperative POP-Q stages, demographic characteristics, perioperative results, and recurrence ratios in mid-term follow-up for patients were compared.

Results: Overall, 235 patients were determined according to our study's inclusion criteria. A total of 155 patients underwent vaginal hysterectomy and USLS (VH/USLS), whereas 80 patients underwent vaginal hysterectomy and SSF (VH/SSF). There were no significant differences between groups in terms of body mass index (BMI), age, and parity as well as cardiovascular disease and diabetes mellitus. There was no significant difference in terms of anatomical success and clinical success rates in the postoperative follow-up period between both groups. (p = 0.588 and 0.692, respectively). However, the assessment of results based on preoperative stages of patients revealed that recurrence and anatomical failure were higher in the stage 4 group (p < 0.001).

Conclusion: Our findings indicate that the main determinant factor in evaluating recurrence rates is preoperative POP-Q staging of the patient. Recurrence rates significantly increase with disease stage. Consistent with studies that do not report a clear superiority for USLS or SSF, we observed no significant differences between both procedures in terms of recurrence. The effectiveness of these procedures is similar. We believe that prospective, long-term follow-up studies with larger populations are required to accurately identify preoperative risk factors and compare them with mesh techniques.
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http://dx.doi.org/10.1016/j.jogoh.2020.101905DOI Listing
April 2021

Vesicovaginal fistula repair experiences in a single center high volume of 33 years and necessity of cystostomy.

Turk J Urol 2021 Jan 20;47(1):66-72. Epub 2020 Aug 20.

Department of Urology, Atatürk University Faculty of Medicine, Erzurum, Turkey.

Objective: The aim of this study was to retrospectively examine the patients who underwent surgical treatment for vesicovaginal fistula (VVF) repair in our clinic, to evaluate our surgical preferences, success, and treatment results, to compare these with the literature, and firstly to reveal the necessity of cystostomy and its effect on treatment success.

Material And Methods: Between 1985 and 2018, a retrospective evaluation was performed on the records of 102 patients who underwent surgical treatment for VVF repair. All cases underwent a detailed physical examination and had their routine laboratory tests and imaging methods. In obese patients, a Foley catheter was moved into the bladder through the fistula tract, then inflated in order to push the vagina and bladder wall upwards. A transurethral catheter was used in all cases, and cystostomy was used in 58 (56.9%).

Results: The most common cause was prior hysterectomy for benign diseases in 35 (34.31%) cases. Among a total of 102 cases with for VVF, 95 (93.1%) were primary, 5 (4.9%) secondary, and 2 (1.9%) tertiary. The transvesical and O'Connor approaches (transabdominal) were performed in 61 (59.8%) and 41 (40.2%) cases, respectively. Transvaginal approach was not used in any of the cases. Cystostomy was applied in 58 (56.9%) of cases and not applied in 44 (43.1%).

Conclusion: Complete excision of the fistula tract and sealing of the layers separately using the water-tight technique are extremely crucial factors to increase the success rate of VVF repair. In cases where good transurethral drainage is ensured, cystostomy is unnecessary and may increase the risk of infection.
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http://dx.doi.org/10.5152/tud.2020.20080DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7815243PMC
January 2021

Protective Effect of Lycopene against Reperfusion Injury in Rats with Ovarian Torsion: A Biochemical and Histopathological Evaluation.

J Lab Physicians 2020 Mar 11;12(1):32-37. Epub 2020 Aug 11.

Department of Pharmacology, Faculty of Medicine, Ataturk University, Erzurum, Turkey.

 The aim of our study was to evaluate the effect of two different doses of lycopene, an antioxidant, on experimentally induced ovarian ischemia/reperfusion (IR) injury in rat model.  Twenty-four female rats were randomly divided into four groups: sham operation (group 1), 3-hour ischemia, 3-hour reperfusion (IR) (group 2), and IR + 100 mg/kg lycopene (PO) (group 3), IR + 200 mg/kg of lycopene (group 4). The rats' superoxide dismutase (SOD), myeloperoxidase (MPO) activities, malondialdehyde (MDA), and glutathione (GSH) levels were calculated. Ovarian tissue damage was assessed using a histopathological scoring system.  Serum parameter levels and histological scores showed that treatment with lycopene may be conservative approach to prevent IR injury after the ovarian detorsion procedure.The improvement with lycopene was higher at 200 mg than at 100 mg. The MPO and MDA values were significantly lower in groups 3 and 4 as compared with group 2 ( < 0.05), whereas the MPO and MDA values were lower in group 4 as compared with group 3.The SOD and GSH values were significantly higher in groups 3 and 4 as compared with group 2 ( < 0.05), whereas the SOD and GSH values were higher in group 4 as compared with group 3.Tissue damage scores were elevated in the IR group compared with the sham group, but the treatment with different lycopene doses after reperfusion improved the histopathological tissue damage scores.  The results showed that lycopene treatment reduced ovarian IR damage. Antioxidant activity was found to increase in a dose-dependent manner. Lycopene treatment may be conservative approach for ovarian torsion patients after the detorsion procedure to prevent IR damage.
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http://dx.doi.org/10.1055/s-0040-1715553DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7419174PMC
March 2020

The relationship between C-reactive protein, carbohydrate antigen 125, and hematological parameters to endometriotic nodule localization in pelvis.

J Chin Med Assoc 2020 Jun;83(6):577-581

Department of Gynecology and Obstetrics, Atatürk University School of Medicine, Erzurum, Turkey.

Background: Endometriosis is a pelvic inflammatory process, and hormonal, environmental, and genetic factors play a role in its etiopathogenesis; especially, deep pelvic endometriosis exhibits an extensive anatomical distribution. In the present study, we evaluated the contribution of routinely measured hematological parameters to the diagnosis as the number of endometriotic nodule localization increases, when evaluated with C-reactive protein (CRP) and carbohydrate antigen (CA) 125.

Methods: The present study included patients with histopathologically confirmed diagnosis of endometriosis who underwent surgery at our hospital between January 2007 and December 2018. Their medical records were examined retrospectively.

Results: In total, 205 patients were included in the study, of which 129 patients (62.9%) with ovarian endometrioma and 76 patients (37.1%) with deep infiltrative endometriosis were assigned to Group 1 and Group 2, respectively, and the two groups were compared. Endometriotic nodules were observed in several localizations in 71 patients (34.6%) of the 205 patients with endometriosis. Pelvic nodules were grouped as per their four different localizations: uterosacral, recto-vaginal, bladder, and ureteral. Because the anatomical localization of endometriotic nodules increased in the pelvis, the variability in the levels of CA 125 and CRP as well as hematological parameters was examined. There were significant differences in hemoglobin (p < 0.036), CA 125 (p < 0.000), and CRP (p < 0.007) levels between patients with nodules in ≤2 localizations and those with nodules in ≥3 localizations.

Conclusion: Our study included a total of 205 patients. There was a significant difference in the CRP, CA 125, and hemoglobin levels between Group 1 and Group 2, but it was concluded that coexistence of the endometriotic nodule had no effect on the other hematological parameters. For this purpose, prospective studies with a larger number of patients are needed.
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http://dx.doi.org/10.1097/JCMA.0000000000000307DOI Listing
June 2020

Bilateral iliac artery aneurysm: A rare cause of postpartum recurrent hemorrhage.

Turk J Obstet Gynecol 2020 Mar 6;17(1):73-76. Epub 2020 Apr 6.

Atatürk University Faculty of Medicine, Department of Gynecology and Obstetrics, Erzurum, Turkey.

Postpartum hemorrhage (PPH) is a critical health problem that may result in maternal death. In cases of impaired maternal hemodynamics, several surgical therapies such as hypogastric artery ligation or postpartum hysterectomy may be employed to control the bleeding. A 30-year-old multiparous patient who had given birth via spontaneous vaginal delivery had undergone hysterectomy and then hypogastric artery ligation due to postpartum hemorrhage. The patient was referred to our clinic due to uncontrolled bleeding and she experienced recurrent episodes of massive hemorrhage during her follow-up in our clinic. Pelvic angiography performed by interventional radiologists to detect the bleeding focus revealed arteriovenous fistula and aneurysm in the right internal iliac artery and incomplete ligation of the left internal iliac artery. The bleeding was controlled by selective embolization through coiling of the fistula in the right internal iliac artery and branches of the left uterine artery. PPH is still an important cause of maternal mortality and vascular structural anomalies must be borne in mind in cases with delayed onset.
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http://dx.doi.org/10.4274/tjod.galenos.2020.01336DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7171545PMC
March 2020

A Very Rare Case of Brucellosis-Related Tubo-ovarian Abscess.

Rev Soc Bras Med Trop 2020;53:e20190501. Epub 2020 Feb 7.

Department of Obstetrics and Gynecology, Faculty of Medicine, Ataturk University, Erzurum, Turkey.

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http://dx.doi.org/10.1590/0037-8682-0501-2019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083361PMC
April 2020

Maternal and Fetal Outcomes in Pregnancies Complicated by Intrahepatic Cholestasis.

Eurasian J Med 2019 Oct;51(3):270-272

Department of Gynecology and Obstetrics, Atatürk University School of Medicine, Erzurum, Turkey.

Objective: This study aimed to report the maternal and fetal outcomes in women with intrahepatic cholestasis of pregnancy (ICP).

Materials And Methods: The maternal and fetal outcomes in 70 consecutive women who gave birth at Ataturk University Hospital between January 2012 and December 2017 were assessed. The clinical diagnosis of ICP and diagnosis confirmed post-delivery when all the symptoms regressed and laboratory parameters returned to normal was utilized.

Results: Liver transaminases were elevated in 61 (87%) women. The median week of delivery was 37 (range, 26-42) and the preterm delivery rate was 40% (28 women delivered spontaneously at ≤36 weeks of gestation). Preeclampsia was noted in 8 (11%) women. There were no cases of stillbirth or neonatal death.

Conclusion: The rate of stillbirth does not increase in women with ICP. However, further investigations are needed to determine if this result is related to preterm birth.
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http://dx.doi.org/10.5152/eurasianjmed.2019.18447DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6812911PMC
October 2019

Comparison of the harmonic scalpel with scissors in women who experience obturator nerve injury during lymph node dissection for gynaecological malignancies.

Ginekol Pol 2019 ;90(10):577-581

Atatürk University Medical Faculty, Department of Obstetrics and Gynecology, Erzurum, Turkey.

Objectives: Lymphadenectomy is crucial for accurate staging in most gynecological malignancies. Serious complications can occur during the surgery. The present study aimed to present the early and late findings associated with obturator nerve injury, which is rarely observed during lymphadenectomy but can result in serious sequela if not noticed.

Material And Methods: The files of the patients who underwent lymphadenectomy at our clinic between 2012 and 2018 were examined. Patients with obturator nerve incisions were identified retrospectively.

Results: In total, 287 women patients underwent lymphadenectomy at our clinic between 2012 and 2018. Examination of surgical notes revealed that nine patients underwent obturator nerve incisions using a scissor or a harmonic scalpel (energy- activated ultrasonic scissors). With respect to management of obturator nerve damage, no significant difference was found between the use of a harmonic scalpel and scissors (p < 1.000) and the trendelenburg and lithotomy positions (p < 0.167). In addition, no significant difference was found between laparoscopy and laparotomy in terms of surgical type (p < 0.167). At 6 months post-operatively, sensory-motor examinations and EMG findings of the patients were completely normal.

Conclusions: Surgeries performed for gynaecological malignancies have high mortality and morbidity rates. Moreover, in the event of a complication such as nerve damage during laparoscopy, successful management of the complication before the patient undergoes laparotomy allows the patient to continue benefitting from the advantages of the laparoscopy. The results of our study show that these high-risk surgeries should be performed in advanced and well-equipped medical centres by teams experienced in gynaecological oncology.
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http://dx.doi.org/10.5603/GP.2019.0100DOI Listing
May 2020

Incidence of occult malignancies identified during hysterectomies performed for benign indications.

J Gynecol Obstet Hum Reprod 2020 Mar 23;49(3):101620. Epub 2019 Aug 23.

Department of Gynecology and Obstetrics, Atatürk University School of Medicine, Erzurum, Turkey. Electronic address:

Objective: Hysterectomy is a commonly performed gynaecological procedure worldwide. Although most hysterectomies are performed for benign indications, the possibility of an unexpected malignancy in the final pathology results should be considered. The aim of our study was to investigate the evaluation and management of patients who underwent hysterectomy for benign reasons but were diagnosed with a malignancy in the final pathology results.

Methods: We retrospectively examined the medical records of patients who underwent hysterectomy for benign indications between 2011 and 2017, and recorded the information obtained from these patient files.

Results: In total, 1050 patients who underwent hysterectomy for benign indications were included in the study. Among these patients, 127 underwent hysterectomy for uterine prolapse, 230 for uterine myoma, 223 for treatment-resistant menometrorrhagia, 150 for treatment-resistant menometrorrhagia and uterine myoma, 61 for endometriosis, 108 for ovarian cysts, 45 for endometrial polyps, and 106 for treatment-resistant menometrorrhagia and ovarian cysts. In 13 of these patients, malignancy was unexpectedly identified via the final pathology results. Seven of these patients had sarcoma, three had cervical cancer, two had ovarian cancer, and one had metastasis of a haematological malignancy.

Conclusion: Malignancy was identified in 13 of the 1050 patients included in our study. The incidence of unexpected malignancy in these patients who underwent hysterectomies performed for benign indications was determined to be 1.23%. Seven of these 13 patients had sarcoma. Our results demonstrate the absence of reliable data for preoperative detection of sarcoma.
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http://dx.doi.org/10.1016/j.jogoh.2019.08.003DOI Listing
March 2020

Use of vacuum-assisted closure in massive puerperal genital hematoma.

Obstet Gynecol Sci 2019 May 5;62(3):186-189. Epub 2019 Apr 5.

Department of Gynecology and Obstetrics, Atatürk University School of Medicine, Erzurum, Turkey.

Puerperal genital hematomas are rare but life-threatening complications of obstetric emergencies. A pregnant patient (39 weeks) underwent a mediolateral episiotomy during a vaginal delivery. An afterbirth hematoma (approximately 20 cm in diameter) was evacuated, but the use of a vacuum-assisted wound closure system was applied after the sutures opened on the 7th postoperative day. On the 10th day of the vacuum-assisted closure (VAC) application, the wound was completely closed. VAC is an alternative treatment modality that can drain an infection and increase the proportion of granulation tissue in humid and irregular surfaces such as the perineum.
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http://dx.doi.org/10.5468/ogs.2019.62.3.186DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520543PMC
May 2019

Spontaneous Ovarian Hyperstimulation Syndrome with FSH Receptor Gene Mutation: Two Rare Case Reports.

Case Rep Obstet Gynecol 2018 15;2018:9294650. Epub 2018 Oct 15.

Department of Gynecology and Obstetrics, Atatürk University School of Medicine, Erzurum, Turkey.

Development of ovarian hyperstimulation syndrome (OHSS) is very rare in a spontaneous ovulatory cycle and it is usually seen during pregnancy. In the etiology of OHSS, higher hCG (molar pregnancies or multiple pregnancies) and thyroid-stimulating hormone (TSH) levels have been accused. In recent years, some follicle-stimulating hormone (FSH) receptor (FSHR) gene mutations have been described in patients with OHSS in the first trimester with normal hCG levels. Herein, we report two cases of FSHR gene mutation during the investigation of the etiology of spontaneous OHSS. Although OHSS is typically associated with ovulation induction, it should be kept in mind that this condition may also develop in spontaneous pregnancies.
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http://dx.doi.org/10.1155/2018/9294650DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6205315PMC
October 2018

A Rare Case Report: A Malignant Histiocytic Tumor in the Form of Ovarian Mass.

Case Rep Obstet Gynecol 2018 11;2018:1792358. Epub 2018 Feb 11.

Department of Gynecology and Obstetrics, Atatürk University School of Medicine, Erzurum, Turkey.

Histiocytic cell malignancies are very rare. Hence, the information about this disease in hematology is limited. In this case report, we present a case of malignant histiocytic tumor affecting the ovary of a 40-year-old virgin female. Primary ovarian malignancy was not considered for the patient who was approached as if she had ovarian malignancy, since there was an indication of a mass in the ovary. Therefore, an aggressive surgery was not performed. Since our patient was in the reproductive age, fertility-preserving surgery was performed. Our patient was then treated systemically by medical oncology. In conclusion, the rare malignancy group was investigated in the present study along with an evaluation of the current literature.
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http://dx.doi.org/10.1155/2018/1792358DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5828094PMC
February 2018

Serum heme oxygenase-1 levels in patients with primary dysmenorrhea.

Arch Gynecol Obstet 2017 Apr 25;295(4):929-934. Epub 2017 Feb 25.

Department of Obsterics and Gynecology, Nenehatun Hospital, Dr Refik Saydam Street, Palandöken, 25070, Erzurum, Turkey.

Purpose: Primary dysmenorrhea effects the life-quality of women negatively. The aim of this study was to evaluate heme oxygenase-1 (HO1) activity together with malondialdehyde (MDA) and nitric oxide (NO) levels in patients with primary dysmenorrhea.

Methods: A total of 28 nulliparous women with the diagnosis of primary dysmenorrhea and 26 healthy controls were included in this study. On the first day of menstruation, all patients underwent ultrasound examination to exclude pelvic pathology and the visual analogue scale was applied to patients. Patient's visual analogue scale (VAS) scores, age, body mass index (BMI), menstrual cycle length (day), length of bleeding (day) were recorded. In the same day, fasting blood samples were taken from each patient for biochemical analysis.

Results: Serum MDA, NO and HO1 levels were found to be higher in women with primary dysmenorrhea compared to healthy controls (p = 0.012, p = 0.009, p < 0.001, respectively). There were no correlation among serum levels of HO1, NO and MDA, age, BMI, cycle length, pain score and menses duration in both groups. In Pearson's correlation analysis, positive correlation was found between HO1 levels with the NO levels (r = 0.316, p < 0.05) and VAS scores (r = 0.520, p < 0.01). Also, positive correlation was found between MDA levels and VAS scores (r = 0.327, p < 0.05).

Conclusions: Serum HO1, NO and MDA levels increase in patients with primary dysmenorrhea. Antioxidant support might be helpful to reduce pain severity in primary dysmenorrhea.
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http://dx.doi.org/10.1007/s00404-017-4312-1DOI Listing
April 2017

Endometrial and Ovarian Cancer with MR Imaging Importance of Serum HE4 and CA 125 Levels in the Extent of Disease at Evaluation.

Eurasian J Med 2016 Oct;48(3):192-198

Department of Gynecology and Obstetrics, Atatürk University School of Medicine, Erzurum, Turkey.

Objective: Currently, no clinically useful tumor marker is available for primary diagnosis in endometrial cancer. Human epididymis protein-4 (HE-4) has high sensitivity and specificity as a tumor marker. Further, HE-4 has been shown to be elevated in early stage endometrial cancer and is more sensitive than CA 125. In our study, CA 125 and HE-4 reputation as a tumor marker for diagnosis of ovarian and endometrial cancer with the use of both the availability and affect the way we investigated the rate of diagnosis.

Materials And Methods: Here 20 patients with ovarian cancer, 26 patients with endometrial cancer, which had been histologically diagnosed, and 40 healthy volunteers were included. Peripheral blood samples were taken and serum CA 125 and HE-4 were tested.

Results: Serum CA 125 and HE-4 levels in patients with ovarian cancer were found to be significantly higher than those in healthy volunteers (p<0.05). Receiver-operating characteristic (ROC) analysis was performed. For patients with ovarian cancer and healthy controls, the CA 125 (0.83) and HE-4 (0.84) levels showed increased sensitivity (95%). There was no significant difference in the CA 125 levels in patients with endometrial cancer and healthy controls (p>0.05), whereas HE-4 levels were found to be higher in patients with endometrial cancer than in healthy controls (p<0.05). ROC analysis was performed. For endometrial cancer patients and healthy controls, the CA 125 (0.59) and HE-4 (0.63) levels showed increased sensitivity (88.5%).

Conclusion: In ovarian and endometrial cancer, wherein early diagnosis is the most important factor for prognosis and survival, HE-4 is a new serum tumor marker that can be used with the aim of noninvasive diagnoses. For early diagnosis, the concomitant use of CA 125 and HE-4 is more effective and reliable than using either of them alone.
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http://dx.doi.org/10.5152/eurasianjmed.2016.0259DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5268602PMC
October 2016

Serum endocan levels in endometrial and ovarian cancers.

J Clin Lab Anal 2017 Sep 13;31(5). Epub 2016 Oct 13.

Department of Obstetrics and Gynecology, Medical School of Atatürk University, Erzurum, Turkey.

Background: Ovarian and endometrial carcinomas are the two most common malignancies of the female reproductive system. Endocan is a proteoglycan that is specific to vascular endothelial cells. Increased serum levels have been reported in some tumors. The aim of this study was to investigate serum endocan levels in cases of endometrial and ovarian cancer.

Methods: Levels of serum endocan were assessed in 27 patients with endometrial cancer and 20 with ovarian cancer, and in 38 control subjects with benign ovarian or endometrial disorders. Thirty-five healthy subjects were also included. Serum endocan levels were measured using a specific enzyme-linked immunosorbent assay. Serum CA-125 levels were also measured in the patient and control groups.

Results: All patients had detectable serum endocan levels among endometrial and ovarian cancer groups except six cases. However, in the benign and healthy control groups, all endocan levels were undetectable except for two cases in the benign group and three in the healthy control group. Serum endocan levels were significantly higher in the entire patient group than in the controls (P<.0001 for both). Serum endocan levels in cases of endometrial cancer and ovarian cancer were higher than in both the control groups (P<.0001 for both). Evaluation of all groups revealed a positive correlation between serum CA-125 and endocan levels (r=.43, P<.0001).

Conclusion: Although benign ovarian or endometrial disorders do not lead to expression of endocan, malignant cases can result in measurable endocan levels. This may be useful in differentiating benign and malign diseases of the endometrium or ovary.
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http://dx.doi.org/10.1002/jcla.22079DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6816907PMC
September 2017

The Effect of Controlled Reperfusion in the Prevention of Infertility Caused by Ischemia Induced in the Contralateral Ovary in Rats with Unilateral Ovariectomy.

Gynecol Obstet Invest 2015 20;80(3):199-205. Epub 2015 Mar 20.

Department of Obsterics and Gynaecology, Nenehatun Hospital, Erzurum, Turkey.

Background/aims: To investigate the effectiveness of controlled reperfusion (CR) on ovarian tissue malondialdehyde, total glutathione and 8-hydroxyguanine levels and infertility rates in a rat model of induced ischemia-reperfusion (I/R) injury with unilateral oophorectomy.

Methods: A total of 135 adult female albino Wistar rats were divided into 9 groups (n = 15 for each group): unilateral ovariectomy + ovarian I/R (OIR), unilateral ovariectomy alone (OEG), a sham operation group (SG), and unilateral ovariectomy + CR performed at different intervals (the clips were released 10 times for 10, 8, 6, 4, 2 or 1 s and closed again 10 times for 10, 8, 6, 4, 2 or 1 s; OCR-1-6, respectively). Five rats from each group were sacrificed, and their ovaries were removed.

Results: Higher ovarian tissue malondialdehyde and 8-hydroxyguanine levels and lower ovarian tissue total glutathione levels were found in the OIR group compared with the SG, OEG and OCR-4-6 groups. The number of rats giving birth during the study period was found to be similar among the SG (n = 8), OEG (n = 8) and OCR-6 (n = 7) groups.

Conclusion: These results suggest that sterility and ovarian oxidative stress caused by I/R injury decreases in parallel to the shortening of CR duration.
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http://dx.doi.org/10.1159/000377701DOI Listing
August 2016