Browsing by Author "Usta, Taner"

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Comparison of Ultrasound-Guided Transgluteal and Finger-Guided Transvaginal Pudendal Nerve Block Techniques: Which One is More Effective?
(KOREAN CONTINENCE SOC, 2019-01-01) Kale, Ahmet; Usta, Taner; Basol, Gulfem; Cam, Isa; Yavuz, Melike; Aytuluk, Hande G.
Purpose: Pudendal neuralgia (PN) is a painful and disabling condition, which reduces the quality of life as well. Pudendal nerve infiltrations are essential for the diagnosis and the management of PN. The purpose of this study was to compare the effectiveness of finger-guided transvaginal pudendal nerve infiltration (TV-PNI) technique and the ultrasound-guided transgluteal pudendal nerve infiltration (TG-PNI) technique. Methods: Forty patients who underwent PNI for the diagnosis of PN were evaluated. Thirty-five of these 40 patients, who were diagnosed as PN, underwent a total of 70 further unilateral PNI. All the patients underwent PNI for twice after the first diagnostic PNI, 1 week apart. Results: In the ultrasound (US)-guided TG-PNI group, the success rate was 68.8\% (11 of 16) in both ``pain in the sitting position{''} and ``pain in the region from the anus to the clitoris:{''} The success rate of blocks in the US-guided TG-PNI group was 75\% (12 of 16) in terms of pain during/after intercourse. In the finger-guided TV-PNI group, the success rate was 84.2\% in both ``pain in the sitting position{''} and ``pain in the region from the anus to the clitoris:{''} The success rate of blocks in the finger-guided TV-PNI group was 89.5\% (17 of 19) in terms of pain during/after intercourse. There was no statistically significant difference in the success rate of the 3 assessed conditions between the 2 groups (P> 0.05). Conclusions: The TV-PNI may be an alternative to US-guidance technique as a safe, simple, effective approach in pudendal nerve blocks.
Do barbed sutures with different surface textures have different effects on adhesion formation and histological features? An experimental blinded study in an animal model
(WROCLAW MEDICAL UNIV, 2019-01-01) Karacan, Tolga; Ozyurek, Eser; Turkgeldi, Lale Susan; Kiyak, Huseyin; Pesen, Simge; Yasti, Merve; Usta, Taner
Background. The obstetrics and gynecology literature has expanded in recent years to include clinical trials assessing the use of barbed sutures. The difficulty of intracorporeal suturing continues to be a barrier to a wider use of laparoscopy. Although the use of barbed sutures has been shown to ease the process of laparoscopic suturing considerably, concerns have been raised regarding a potentially increased risk of adhesions or inflammation as a result of their use. Objectives. The aim of this study was to determine whether differences in surface textures, resulting from the variations in the geometric configurations of barbs, lead to differences in intra-abdominal adhesion formation. Material and methods. A total of 27 non-pregnant female Wistar Hannover rats, weighing 200-250 g, with intact uteri were used as an adhesion formation model. The rats were randomly assigned to 3 groups: barbed suture group 1, barbed suture group 2 and control group ( no intracorporeal suture). A 2-centimeter vertical incision was performed on the anti-mesosalpingeal side of one of the uterine horns. The incision on the uterine horn was reapproximated with a running suture, entailing 3 needle punctures and left untied at one end. Six weeks after the operation, intra-abdominal adhesion formations were investigated both clinically and histopathologically. Results. Clinical adhesion scores and histopathological parameters in both the barbed suture groups were statistically significantly higher than in the control group (p < 0.05). There was no significant difference between the barbed suture groups regarding the adhesion scores. Conclusions. The 2 types of barbed sutures with different surface textures, used for myometrial closure, form a similar profile with respect to postoperative adhesion formation.
Intrapelvic Nerve Entrapment Syndrome Caused by a Variation of the Intrapelvic Piriformis Muscle and Abnormal Varicose Vessels: A Case Report
(KOREAN CONTINENCE SOC, 2021-01-01) Kale, Ahmet; Basol, Gulfem; Topcu, Ahmet C.; Gundogdu, Elif C.; Usta, Taner; Demirhan, Recep
Entrapment neuropathy of the sciatic nerve and pudendal nerve are painful syndromes that are often overlooked by physicians. Laparoscopic surgical interventions for nerve entrapment syndromes of the posterior pelvis focus on removing the compression lesion with the purpose of eliminating the suspected cause of sciatica, as well as pudendal neuralgia. Herein, the authors report the rare event of sciatic and pudendal nerve entrapment, which was caused by aberrant vessels and a variant piriformis muscle bundle, as a seldom-diagnosed cause of sciatica and pelvic pain, for both neurosurgeons and neuropelveologists. The authors present the laparoscopic decompression technique for the pudendal and sciatic nerves by giving our technical ``tips and tricks{''} enriched by a surgical video.
Is it safe to perform elective gynaecologic surgery during the two peaks of COVID-19 pandemic?
(WILEY, 2021-01-01) Kuru, Betul; Kale, Ahmet; Basol, Gulfem; Gundogdu, Elif Cansu; Yildiz, Gazi; Mat, Emre; Usta, Taner
Purpose In December 2019, the COVID-19 pandemic started in China and spread around the World. Operations were postponed in most surgical clinics to reduce the risk of contamination and increase the number of beds available in hospitals. We investigate whether elective gynaecologic surgery is safe or not under safety measures. Methods A total of 765 patients were operated on electively between 15 March and 30 October 2020 at our inpatient gynaecology clinic. We took the SARS-CoV-2 Reverse Transcriptase (RT) Polymerase Chain Reaction (PCR) test of the nasopharyngeal swab before and after the surgery. Patients were questioned for COVID-19 symptoms by phone calls on the 7th, 15th, 30th and 60th days postoperatively. Results The average age of patients was 45.6 +/- 11(19-81). Sixty-two (8.1\%) operations were performed due to gynaecologic malignancies. Three patients (0.39\%) were detected as SARS-CoV-2 RT PCR positive within 7 days after surgery. The patients did not need ICU admission or any further treatments. Conclusion Our study offers a novel perspective on elective surgery during a pandemic. The risk assessment of patients should be meticulously done and substantiated on objective variables. According to our study, in a carefully selected patient population, operating under appropriate precautions, elective gynaecologic surgical procedures during the two peaks of the COVID-19 pandemic do not pose a risk to the patients.
Telemedicine and Artificial Intelligence in the Management of Endometriosis: Future Forecast Considering Current Progress
(GEORG THIEME VERLAG KG, 2021-01-01) Kaya, Cihan; Usta, Taner; Oral, Engin