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    Diagnostic Role of Hysteroscopy In Women With Abnormal Uterine Bleeding: A Single-Center Retrospective Study
    (Yüzüncü Yıl Üniversitesi Tıp Fakültesi, 2025) Günkaya, Samet Osman; Tekelioğlu, Meltem; Karataş, Suat; Şahin, Fatih; Keskin, İlkhan; Bestel, Melih; Tuğ, Niyazi
    Hysteroscopy is a minimally invasive technique that has advantages over blind curettage, such as direct visualization of the intrauterine cavity, biopsy of the suspicious area, and simultaneous treatment of benign intracavitary lesions. The stud y aims to evaluate the diagnostic role of hysteroscopy in endometrial and focal intracavitary lesions. This retrospective study was conducted in the department of obstetrics and gynecology of a tertiary center between January 2018 and July 2022. Diagnostic hysteroscopy was performed on women with abnormal uterine bleeding, and lesions seen during hysteroscopy were noted and excised using a resectoscope. Uterine sampling with blind curettage was applied to all patients. The resected lesions and uterus samples were evaluated histopathologically. Diagnostic accuracy of hysteroscopy was higher than 90% in each group classified according to morphology of endometrium as normal, atrophic and hyperplastic. Sensitivity, specificity and diagnostic accuracy were higher than 90% for focal intracavitary pathologies. Sensitivity for endometrial hyperplasia and cancer were 80% and 50%, respectively. Hysteroscopy is exceedingly viable for distinguishing intracavitary pathologies such as polyps, myomas and foreign bodies in ladies with abnormal uterine bleeding. However, for the diagnosis of endometrial hyperplasia and cancer, a hysteroscopy-guided biopsy with uterine curettage is needed to be combined with hysteroscopy. © 2025, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
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    Evaluation of increased intracranial pressure with the optic nerve sheath diameter by ultrasound in epiduroscopic neural laser discectomy procedures
    (AM SOC INTERVENTIONAL PAIN PHYSICIANS, 2021) Beyaz, Serbülent Gökhan; Kaya, Burak; Ülgen, Ali Metin; Şahin, Fatih; Kocayiğit, Havva; Issı, Zeynep Tuncer
    Background: In order to clarify the camera image and open the adhesions mechanically during epiduroscopy, saline is injected continuously in the epidural area. As a result, an increase in intracranial pressure is to be expected in theory. Increased intracranial pressure can be evaluated by measuring by optic nerve sheath diameter. Objectives: This study was designed to evaluate the relationship between optic nerve sheath diameter measurements and intracranial pressure, after injecting fluid to the epidural area during epiduroscopy procedures performed in our clinic. Study Design: Retrospective study. Setting: Sakarya University Training and Research Hospital. Methods: During the epiduroscopy procedure, pre and postoperative bilateral optic nerve sheath diameters were measured with an ultrasonography probe. With the patients' eyelids closed, the probe was placed on the orbita in the sagittal plane, measuring 3 mm posterior of the papilla. Results: While there was a statistically significant difference between pre- and post-operative optic nerve sheath diameter measurements, there was no significant correlation with processing time, amount of fluid delivered, or fluid delivery rates. Limitations: One of the limitations of this study is the retrospective collection of data. A second limitation is that repetitive measurements were not performed, instead of a single postoperative measurement. Conclusion: We think more prospective randomized controlled studies are required to examine the increase in the diameter of the optic nerve sheath, which is an indirect indicator of increased intracranial pressure after epiduroscopy applications, in order to determine whether the pressure increase is associated with the rate of fluid delivery, the total fluid amount, or the processing time.
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    The interrelation between body mass index and post-dural puncture headache in parturient women
    (Wolters Kluwer Medknow Publications, 2021) Beyaz, Serbülent Gökhan; Ergönenç, Tolga; Sarıtaş, Aykut; Şahin, Fatih; Ülgen, Ali Metin; Eman, Ali; Doğan, Burcu
    Background and Aims: Post-dural puncture headache is seen more frequently in pregnant women due to stress, dehydration, intra-abdominal pressure, and insufficient fluid replacement after delivery. Obesity protects against post-dural puncture headache in pregnant women; increased intra-abdominal fat tissue reduced cerebrospinal fluid leakage by increasing the pressure in the epidural space. Therefore, this study investigated the influence of body mass index on post-dural puncture headache in elective cesarean section patients in whom 27G spinal needles were used. Material and Methods: The study included 464 women who underwent elective cesarean section under spinal anesthesia. Dural puncture performed with a 27G Quincke spinal needle at the L3-4 or L4-5 intervertebral space and given 12.5 mg hyperbaric bupivacaine intrathecally. The patients were questioned regarding headache and low back pain 6, 12, 24, and 48 h after the procedure, and by phone calls on days 3 and 7. Results: Post-dural puncture headache developed in 38 (8.2%) patients. Of the patients who developed post-dural puncture headache, 23 (60.5%) had a body mass index <30 and 15 (39.5%) had a body mass index =30. Of the patients who did not develop post-dural puncture headache, 258 (60, 6%) had a body mass index <30 and 168 (39, 4%) had a body mass index =30. Conclusion: This prospective study found the body mass index values did not affect post-dural puncture headache in the elective cesarean section performed under spinal anesthesia. © 2021 Wolters Kluwer Medknow Publications. All rights reserved.