Biomedical subjects

Ahmet Onoglu

Publications and source records attributed to Ahmet Onoglu.

4 recordsLinked to original sources

PubMed2002

Long-term histopathologic and morphologic changes after thermal endometrial ablation.

STUDY OBJECTIVE: To outline long-term histologic features of endometrial ablation. DESIGN: Prospective longitudinal study (Canadian Task Force classification II-3). SETTING: Tertiary-care teaching hospital. PATIENTS: Twenty-six patients. INTERVENTION: Thermal ablation followed by second-look office hysteroscopy with endometrial biopsy. MEASUREMENTS AND MAIN RESULTS: Mean follow-up time to second-look hysteroscopy after ablation was 33.4 +/- 2,1 months. Complete atrophy, partial adhesions or obliteration of the cavity, and fibrosis were observed at second-look hysteroscopy. Whereas all random biopsies were normal before ablation, biopsies after ablation revealed diminished endometrial glands with necrosis and scarring. The number of endometrial glands was not correlated with amount of bleeding or menstrual pattern. No premalignant or malignant lesions were found after ablation. CONCLUSION: Although efficacy of endometrial ablation is related to initial thermal destruction and correlated with postablation hysteroscopic and histologic findings, endometrial regrowth is an expected development, not a failure of ablation.

Adult↗

PubMed2002

Comparison of the clinical efficacy and safety of flutamide versus flutamide plus an oral contraceptive in the treatment of hirsutism.

OBJECTIVE: To compare the clinical, hormonal, biochemical and hemotological effects of flutamide versus flutamide plus an oral contraceptive (OC) in the treatment of hirsutism. PATIENTS: Eighty-four women with hirsutism were equally randomized to receive either flutamide or flutamide plus OC. DESIGN: Eighty-four women with hirsutism were recruited from patients presenting to our hospital. Each patient underwent a complete medical and gynecological examination as well as blood cell counts, biochemical and endocrine profiles. Hirsutism scores and laboratory tests were done during the 1st, 3rd and 6th months of therapy. Thirty-seven women in the flutamide group (taking 250 mg flutamide per day) and 32 women in the flutamide plus OC group (taking 250 mg flutamide plus 35 microg ethinyl estradiol and 2 mg cyproterone acetate per day) regularly followed the therapy regimens. RESULTS: There were no significant differences in Ferriman-Gallway scores at the beginning and at the end of the therapies between the two groups (p > 0.05). At the 6th month, the decreases in Ferriman-Gallway scores were significant in both flutamide (from 18.95 +/- 4.44 to 14.46 +/- 5.02; p < 0.05) and flutamide plus OC groups (from 19.94 +/- 4.31 to 15.58 +/- 4.28; p < 0.05). In the first group, 2 of 6 oligomenorrheic women had regular cycles at the end of the therapy. Oligomenorrhea in 8 women was all changed to regular cycles in the flutamide plus OC group. Regarding the hormonal profile, only in the second group were prolactin, free testosterone and dehydroepiandrosterone sulfate levels significantly decreased (p < 0.05). Hepatic function tests were significantly increased in both groups, but they were all within normal ranges. CONCLUSION: These data suggest that both therapies were similarly effective and safe in the treatment of hirsutism. In women with oligomenorrhea and/or needing contraception, adding an OC shows better results than flutamide treatment alone in providing regular cycles.

Administration, Oral↗

PubMedDate not supplied

Role of laparoscopic uterine artery coagulation in management of symptomatic myomas: A prospective study using ultrasound and magnetic resonance imaging.

STUDY OBJECTIVE: The aim of this study was to evaluate the efficacy of laparoscopic uterine artery coagulation (LUC) in symptomatic myomatous patients. DESIGN: Prospective study (Canadian Task Force classification II). SETTING: Tertiary care center PATIENTS: Twenty-one women with myomatous uteri. INTERVENTIONS: Laparoscopic uterine artery coagulation. MEASUREMENTS AND MAIN RESULTS: Laparoscopic uterine artery coagulation for myoma was performed by three-puncture laparoscopy, and the difference in uterine and/or myoma volume was determined every 3 months for 12 months clinically and using ultrasonographic and MRI calculations of uterine volume. In addition, pre and postprocedure uterine Doppler indices were determined. Main outcome measures were symptomatic improvement after LUC and reduction in volume calculated by ultrasonography and magnetic resonance imaging (MRI). All treated women reported less bleeding after treatment. At 12 months, a 57% reduction in bleeding was seen in these patients. The mean postoperative pictorial blood loss assessment was significantly lower at 12 months: 303 +/- 30.4 mL (95% CI 284-328) baseline versus 173.5 +/- 17.8 mL (95% CI 164-184) after treatment, p < .05. Postoperative pain was documented in all the patients with a visual analog scale, with a mean of 1.6 cm recorded. The mean reduction in uterine volume (pre- to post-LUC) was 195 +/- 24.3 cm3 (range 89-438). The mean operating time was 52.1 +/- 7.2 minutes (95% CI 49.8-55.4), and the mean estimated blood loss was 65.2 +/- 11.8 dL (95% CI 59.6-70.8). Mean hospitalization time was 32.3 +/- 6.6 hours (95% CI 29.2-35.4). The complication rates were low with the procedure (fever, infection). No patient required hysterectomy due to complications. Ninety percent of the women were satisfied with the procedure. CONCLUSION: Laparoscopic uterine artery coagulation is effective in the management of symptomatic myomas, reducing bleeding and the volume of both uterus and myomas as documented by ultrasonography and MRI. Laparoscopic uterine artery coagulation is a cost-effective and low-morbidity option compared with conventional approaches such as myomectomy or hysterectomy. If the patient's predominant complaint is the feeling of a mass and/or bleeding, alternative treatment options should be explored. The results of this study are encouraging, but more research is needed to validate the cost-effectiveness and long-term results.

Adult↗

PubMedDate not supplied

Comparison of the long-term histopathologic and morphologic changes after endometrial rollerball ablation and resection: a prospective randomized trial.

STUDY OBJECTIVE: To compare long-term histologic features of endometrial rollerball ablation versus resection. DESIGN: Randomized clinical trial (Canadian Task Force classification I). SETTING: Akdeniz University School of Medicine. PATIENTS: Women with menorrhagia undergoing endometrial ablation. INTERVENTION: Comparison of patients with menorrhagia undergoing endometrial resection and ablation. MEASUREMENTS AND MAIN RESULTS: Endometrial rollerball ablation (n = 23 women) and resection (n = 25) were followed by second-look office hysteroscopy with endometrial biopsy. Mean follow-up to second look hysteroscopy after rollerball ablation and loop resection was 33.4 +/- 2.1 and 31.1 +/- 2.6 months, respectively. Complete atrophy and partial adhesion or obliteration of the cavity and fibrosis were observed at second-look hysteroscopy and were similar in both groups. Whereas all random biopsy specimens after both ablation and resection revealed diminished endometrial glands with varied necrosis and scarring, the number of endometrial glands per field was not correlated with amount of bleeding or menstrual pattern. Bleeding patterns were similar between the groups. No precancerous or malignant lesion was found after the procedures. CONCLUSION: Although efficacy of both endometrial ablation and resection is related to initial thermal destruction and correlated with postablation hysteroscopic and histologic findings, endometrial regrowth may be expected and is not a failure of ablation. Both procedures revealed histopathologically and clinically similar results.

Adult↗