21 - 25 Şubat 2018
Wyndham Grand İstanbul Levent • İstanbul
MİNİMAL İNVAZİV JİNEKOLOJİK
CERRAHİ KONGRESİ
www.minimalinvazivjinekolojikcerrahi.org
SS-20
Endometrioma olgularında nötrofil-lenfosit oranı, platelet-lenfosit oranı ve CA 125 düzeyi
ile dens adezyon arasındaki ilişki
Tuğba Kınay, Eylem Ünlübilgin, Sevgi Koç, Fulya Kayıkçıoğlu, Ömer Lütfi Tapısız,
Şadıman Kıykaç Altınbaş, Özlem Moraloğlu Tekin
Sağlık Bilimleri Universitesi, Ankara Etlik Zübeyde Hanım Sağlık Uygulama Araştırma Merkezi,
Ankara, Türkiye, Kadın Hastalıkları ve Doğum Bölümü
AMAÇ: Endometrioma olgularında nötrofil-lenfosit oranı, platelet-lenfosit oranının ve CA 125
düzeyinin dens adezyonu öngörebilecek belirteçler olup olmadığını araştırmaktır.
YÖNTEMLER: Retrospektif kesitsel çalışmaya Ocak 2016-Aralık 2017 tarihleri arasında üçüncü
basamak bir merkezin jinekoloji kliniğinde adneksial kitle nedeni ile elektif koşullarda opere
edilen ve histopatolojik tanısı endometrioma olan olgular dahil edildi. Hastaların demografik,
klinik bilgileri ve preoperatif laboratuar sonuçları medikal kayıtlardan incelendi. Yakın zamanda
geçirilmiş enfeksiyon öyküsü olan, operasyon sırasında pelvik enfeksiyon saptanan, torsiyon veya
kist rüptürü nedeni ile acil opere edilen olgular çalışma dışı bırakıldı. Operasyon sırasında dens
adezyon saptanan ve saptanmayan hastaların nötrofil-lenfosit oranı, platelet-lenfosit oranı ve CA
125 düzeyleri karşılaştırıldı.
BULGULAR: Adneksial kitle nedeni ile opere edilen toplam 224 hastanın medikal kayıtları
incelendi. Histopatolojik tanısı endometrioma olan 54 hasta çalışmaya dahil edildi. Hastaların
ortalama yaşı 39.3 ± 5.9, gravida 2.3 ± 1.6, paritesi 1.8 ± 1.0 idi. Hastaların %53,7’sinde evre III,
%46,3’ünde evre IV endometriosis saptandı. Ortalama kist boyutu 7.0 ± 2.4 cm idi. Otuz (%55.6)
hastaya laparoskopik kistektomi, 22 hastaya (%40.7) laparoskopik ooferektomi, 2 (%3.7) hastaya
laparotomi yapıldı. Operasyon sırasında dens adezyon saptanan ve saptanmayan hastaların
median nötrofil-lenfosit oranı ( 2.4 [1.5-5.4] vs. 2.4 [1.4-4.4]), platelet-lenfosit oranı (149.3 [62.7-
302.3] vs. 136.5 [82.6-254.3]) ve CA 125 düzeyleri (39.4 U/ml [10.6-775.0] vs. 39.4 U/ml [11.4-
239.0]) benzer bulundu (p> 0.05).
SONUÇ: Çalışma grubunda nötrofil-lenfosit oranı, platelet-lenfosit oranı ve CA 125 düzeyi ile
dens adezyon arasında ilişki saptanmadı. Bu belirteçler endometrioma olgularında dens adezyon
varlığını öngörmek için kullanılamaz.
Anahtar Kelimeler: Endometrioma, dens adezyon, nötrofil-lenfosit oranı, platelet-lenfosit
oranı, CA 125
www.minimalinvazivjinekolojikcerrahi.org
21 - 25 Şubat 2018
Wyndham Grand İstanbul Levent • İstanbul
MİNİMAL İNVAZİV JİNEKOLOJİK
CERRAHİ KONGRESİ
SS-21
Evaluation Of Palm-Coein Classification with Abnormal Uterine Bleeding in Turkish
Women
Burcu Kısa Karakaya
1
, Umit Yasemin Sert
1
, Özlem Evliyaoğlu
1
, Yaprak Ustün
1
1
Burcu Kısa Karakaya,University of Health Sciences, Zekai Tahir Burak Women’s Health Education
and Research Hospital, Ankara, Turkey
2
Ümit Yasemin Sert
3
Özlem Evliyaoğlu
4
Yaprak Üstün
AIM: In 2011,the International Federation of Gynaecology and Obstetrics working group
on menstrual disorders has introduced a new classification system called ‘’PALM-COEIN’’ in
the interest of abnormal uterin bleeding(AUB). The aim of the study was to evaluate the new
classification and to compare with former classical terminology for AUB.
MATERIAL-METHODS: This retrospective study was performed in Gynaecology Clinic of Zekai
Tahir Burak Hospital between february 2015 and february 2016. each case has examined in terms
of anatomical structure, physical examination and pelvic ultrasonography. Endometrial samples
and hysterectomy specimen were obtained for histopathological investigation if applicable.
Possible underlying causes were categorised according to the new classification system.
RESULTS: The study included 637 women who presented with complaints of abnormal uterine
bleeding. The people who complained of abnormal uterine bleeding has categorized with
classical terminology and examined under the name of “hypermenorrhea” which contained 5
different pathology combinations, “menorrhagia” with nine pathologies, “metrorrhagia” with 6
pathologies, and “menometrorrhagia” including 7 pathologies. Cases which has categorizated
with PALM-COEIN classification system demonstrated the results as 190(29,82%)ovulatory
dysfunction,175(27,4%) polyp, 153(24,01%) leiomyoma, 93(14,5%) adenomyosis, 16(2,51%)
malignancy and hyperplasia,10(1,56 )not classified.
CONCLUSION: There is a general inconsistency in the classification of abnormal uterin bleeding.
As a result of existing several causes and possibility of coexisting different pathologies in a
patient, evolution of a consistent and universally accepted categorization would be an important
step to understand these complicated cases. It is clear that this new classification system will
promote the communication with patients.
Keywords: Abnormal uterine bleeding, Classification, Dysfunctional uterine bleeding,
Menstrual disorders.
21 - 25 Şubat 2018
Wyndham Grand İstanbul Levent • İstanbul
MİNİMAL İNVAZİV JİNEKOLOJİK
CERRAHİ KONGRESİ
www.minimalinvazivjinekolojikcerrahi.org
SS-22
Uterine Prolapse in Pregnancy and Management:Case Report
Omer Demir
1
, Cihan Comba
2
, Funda Güngör Uğurlucan
3
1
Erzurum Karayazı State Hospital,Erzurum,Turkey
2
Bakırköy Dr. Sadi Konuk Education and Research Hospital,Istanbul,Turkey
3
Istanbul Medical Faculty,Istanbul University,Istanbul,Turkey
Pelvic organ prolapse (POP) is a widespread condition that usually occurs in older ages, resulting
in deterioration of function of muscles, ligaments and other structures that support the pelvic
floor.There is no specific treatment of uterine prolapse during pregnancy. Treatment and
management should be based on the degree of prolapse, the pregnancy-related expectations
of the patient, and the gestational week.A 30-year-old G5P4 normal vaginal delivery patient
admitted to our clinic with complaints of organ swelling.The patient who had no medical
history had an 11-week gestation according to the last menstrual history.Gynecological and
urogynecological evaluation revealed that the uterine desensus was grade 2.The patient had
concerns about both how the continuation of the pregnancy and the organ sagging would
occur.Medical and surgical treatment options were discussed with the patient and a decision
was made to insert a pessary jointly with the patient and a pessary was selected and applied
at the appropriate size.Pessary care was done intermittently and she was taught to himself and
called to the controls.The patient now has a healthy pregnancy on her 25th gestational week and
her follow-ups continue.In treatment, bed rest is recommended with pessary application in early
gestation to prevent prolapse.Symptomatic treatment should also be applied to prevent cervical
instability.There are authors recommending laparoscopic uterine suspension operation when
conservative treatments are inadequate.Gestational age of uterine prolapse cases may vary
according to the grade of prolapse and gestational week.Cesarean section can be performed
in cases where the prolapse level is increased and another pregnancy is not wanted.As a result,
preterm labor in the case of uterine prolapse detected in pregnancy should be emphasized due
to infection with spontaneous abortion and pessary application should be kept in mind in the
early period of pregnancy.
Keywords: prolapse, pregnancy,pessary
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