Browsing by Author "Güngör, M"

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    RECONSTRUCTION OF LABIUM MINUS HYPERTROPHY TAKING INTO ACCOUNT ANATOMICAL DIFFERENCES
    Güngör, M; Sir, E; Çelik, D; Seyhan, A; Yoleri, L
    Introduction: In labioplasty, wedge resection is a preferential method because of easy application and good results. In the identified wedge resection models certain zones and usually certain angles have been recommended. However, it's obvious that each enlarged labium minus shows different properties from another. The most protuberant portion, the excess volume and skin laxity are different for each case. Therefore, the zone of the triangle that will be resected and the apical angle should be planned specially for each case. Thus, we determined wedge resection zone and apical angle taking into account patient's anatomy. Material and Methods: We evaluated retrospectively 14 patients underwent labioplasty with this method. 11 (78.5 percent) patients underwent central, 2 (14.2 percent) patients underwent inferior and 1 (7.1 percent) patient underwent two different zones (central and inferior) wedge resections. We also excised redundant preputium clitoris in 2 (14.2 percent) patients. In wedge resection, apical angle varied between 60120 degrees. Results: In all patients, the labia minoras were covered by the labia majoras. None of the patients showed introitus narrowing and scar contraction. All of the patients reported that preoperative complaints disappeared or diminished. 9 (64.2 percent) patients evaluated postoperative satisfaction degree as very good and 5 (35.7 percent) patients as good. Complications were observed in 2 (% 14.2) patients. In 1 patient dehiscence of the suture line and in 1 patient asymmetry occurred. Conclusions: The results of this study demonstrate that we can get successful results when taking into account each labium minus anatomical differences.
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    Effect of Reduction Mammaplasty on Sexual Activity
    Sir, E; Üçer, O; Güngör, M; Aksoy, A; Keçeci, Y; Gümüs, B
    Aim This study aimed to evaluate the effects of reduction mammaplasty operation on sexual functions of the patients with macromastia and of their partners. Materials and Methods Thirty-nine patients with macromastia and their partners were assessed for their sexual function before and 6 months after reduction mammaplasty. Sexual function of the women and their partners were evaluated using the Index of Female Sexual Function (IFSF) and the International Index of Erectile Function (IIEF), respectively. Controls (n = 33) were chosen from healthy hospital staff and their partners. Preoperative and postoperative scores were statistically compared with the controls' scores by using Student t test. Also, preoperative and postoperative scores were compared by using paired t test. Results The mean of age and body mass index of the women and their partners in the patient and control group were similar (P = 0.07). Before the operation, the mean of IFSF scores in the patient and control group were 22.75 (3.45) and 27.28 (5.05), respectively (P < 0.001). After the operation, the mean of IFSF scores in the patient group increased significantly to 27.67 (P < 0.001). The postoperative scores of all IFSF subscales except lubrication subscale were higher than the preoperative scores. Although there was no significant difference between preoperative and postoperative IIEF-total scores, postoperative IIEF-erectile function and IIEF-intercourse satisfaction scores were significantly reduced (P < 0.05). Conclusions We found that macromastia adversely affected female sexual function but reduction mammaplasty eliminated this adverse effect. We also found that the partners' erectile function and intercourse satisfaction reduced after the operation. This reduction may be due to psychological effects.
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    Evaluation of sexual function in women with labia minora hypertrophy: A preliminary study
    Sir, E; Güngör, M; Üçer, O; Aksoy, A
    Objective: To compare the sexual functions in women with labia minora hypertrophy and age matched healthy controls. Material and method: 43 patients with labia minora hypertrophy and 30 age-matched healthy controls were enrolled in the present study. The sexual functions of the women were evaluated by using the index of female sexual function (IFSF). Results: Mean ages of the patients and controls were 30.06 +/- 7.11 and 31.34 +/- 4.12 (p = 0.41), respectively. Mean total IFSF scores of the patients and controls were 24.18 +/- 3.24 and 27.53 +/- 4.43 (p < 0.05), respectively. The subscale scores of IFSF-lubrication, orgasm, satisfaction and pain in the patient group were significantly lower than in the control group (respectively, p < 0.001, p < 0.05, p < 0.001 and p < 0.05). There was no statistically significant difference between IFSF-arousal scores of the patient and control groups (p = 0.30). The mean IFSF-desire scores of the patient group was higher than the controls (p < 0.001). Labia minora hypertrophy was significantly associated with female sexual dysfunction (odds ratio [OR] = 14.97, 95% confidence interval [Cl] = [3.66-61.21], p < 0.001). Conclusion: This study suggests that patients with labia minora hypertrophy have poorer lubrication, satisfaction, pain, and orgasm scores on the IFSF scale compared to age-matched healthy controls. (C) 2017 Asociacion Espanola de Andrologia, Medicina Sexual y Reproductiva. Published by Elsevier Espana, S.L.U. All rights reserved.
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    Assessment of sexual function in women with macromastia and their partners
    Üçer, O; Sir, E; Güngör, M; Keçeci, Y; Aksoy, A; Gümüs, B
    Objective: To investigate the sexual function in patients with macromastia and their partners. Materials and methods: 48 patients with macromastia and 30 healthy controls and their partners were enrolled in the study. The sexual function of the women and their partners was evaluated by using the Index of Female Sexual Function (IFSF) and International Index of Erectile Function (IIEF), respectively. Results: Mean ages of the patients and controls were respectively, 33.27 +/- 5.24 and 32.06 +/- 3.91 (p > 0.05). Mean IFSF scores of the patients and controls were 23.21 +/- 3.16 and 27.33 +/- 4.94 (p = 0.00), respectively. All of the subscale scores of IFSF in the patient group were significantly lower than in the control group. Mean IIEF scores of the patients' and controls' partners were 60.33 +/- 11.46 and 65.25 +/- 6.18 (p = 0.04), respectively. Conclusion: In this study, Macromastia was shown to affect sexual function of women and their partners adversely. (C) 2014 Asociacion Espanola de Andrologia, Medicina Sexual y Reproductiva. Published by Elsevier Espana, S.L.U. All rights reserved.
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    Tension Adjusted Multivectorial Static Suspension With Plantaris Tendon in Facial Paralysis
    Yoleri, L; Güngör, M; Usluer, A; Çelik, D
    Facial paralysis in the midface causes loss of cheek tonus, asymmetry at rest, and inability to smile. Static suspension is generally performed in patients who cannot tolerate time-consuming dynamic reanimation. Current methods for static slings are overly simplistic. A sling, which is generally fascia lata or palmaris tendon, is placed between the modiolus and the zygomatic arch or the temporalis fascia, with further extension to the midline of the upper end lower lips in 1 vector. Recently, sutures are placed in a multivectorial approach, but suture failure via breakage is the main problem. In this study, the long, thin, and powerful plantaris tendon was used and divided into 3 slips. Placement of these slips and their tension adjustment were revised to provide strong and long-lasting upper lip and the modiolus pull, along with creation of a well-defined nasolabial fold, and to create sufficient cheek tonus. The first slip was positioned at 35 to 45 degrees to the horizontal plane between the modiolus and the upper preauricular area, second slip at 55 to 60 degrees between the upper lip and the deep temporal fascia, and the third slip at 0 to 10 degrees between the lower lip and lower preauricular area with gradually decreasing tension from above to below in 9 patients. Upper 2 slings were also sutured to the dermis of the nasolabial fold to define it optimally. Results were assessed both objectively and subjectively. Symmetry at rest, sufficient cheek tightness to prevent drooling, and a well-defined fold were obtained.
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    A RARE CASE OF LARGE VULVAR LIPOMA
    Özaslan, U; Güngör, M; Kandiloglu, AR; Yoleri, L
    Lipomas are among the most common neoplasms in humans that originate from mesenchymal tissue. Sites of predilection of lipomas are the neck, trunk and the proximal portions of the extremities, but they may be found on any subcutaneous site. Most lipomas are a few centimeters in diameter, but they can range in size from a few millimeters to 10 cm. Rare lesions attain a much larger size. Occurrence of lipoma in the vulva has been rarely reported. A 39-year-old female with a large lipoma arising from the labium majus is presented. The mass was soft and pedunculated, measuring 15 X 13 X 8 cm. Radiologic examination with computerized tomography showed that the mass was exclusively composed of fat and some septa. The tumor was excised with its expanded skin and reconstruction of the vulva was performed. The excised specimen was 720 grams and the pathological examination was fibrolipoma. This case was reported to remind the physicians that lipomas should be considered in the differential diagnosis of a vulvar mass. Surgical excision and reconstruction of the labia majora is the treatment of choice.
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    A multicenter study of radiologically isolated syndrome in children and adolescents: Can we predict the course?
    Yilmaza, D; Teber, S; Gueltutan, P; Yildirim, M; Bektas, Ö; Alikiliç, D; Güngör, M; Kara, B; Öncel, I; Dilek, TD; Saltik, S; Kanmaz, S; Yilmaz, S; Tekgül, H; Çavusoglu, D; Karaoglu, P; Yilmaz, Ü; Orak, SA; Güngor, O; Anlar, B
    Objectives: To evaluate clinical characteristics, imaging features and etiological profile of Radiologically Isolated Syndrome (RIS) along with clinical and radiological follow-up.Methods: Demographic, clinical and radiological data of patients younger than 18 years fulfilling the criteria for RIS were retrospectively analyzed. RIS was defined by the detection of lesions meeting the revised 2010 McDonald Criteria for dissemination in space on magnetic resonance imaging (MRI) in the absence of any symptoms of demyelinating disease or an alternative cause for the MRI findings.Results: There were total 69 patients (38 girls, 31 boys). The median age at index MRI was 15.7 years, and median follow-up time was 28 months. The most common reason for neuroimaging was headache (60.9%). A first clinical event occurred with median 11 months in 14/69 (20%) of cases. Those with oligoclonal bands (OCB) in cerebrospinal fluid (CSF) and follow-up longer than 3 years were more likely to experience a clinical event (p<0.05): 25% of those with OCB manifested clinical symptoms within the first year and 33.3% within the first two years compared to 6.3% and 9.4%, respectively in those without OCB. Radiological evolution was not associated with any variables: age, sex, reason for neuroimaging, serum 25-hydroxyvitamin D level, elevated IgG index, OCB positivity, total number and localization of lesions, presence of gadolinium enhancement, achievement of 2005 criteria for DIS and duration of follow-up.Conclusion: Children and adolescents with RIS and CSF OCB should be followed-up for at least 3 years in order to detect any clinical symptoms suggestive of a demyelinating event. Because disease-modifying treatments are not approved in RIS and no consensus report justifies their use especially in pediatric RIS, close follow-up of OCB-positive patients is needed for early recognition of any clinical event and timely initiation of specific treatment.