Browsing by Author "Sir, E"

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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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    Invasive squamous cell carcinoma originating from a giant penile condyloma
    Sir, E; Gungor, M; Ucer, O; Kebat, T
    In this case study, we present an unusual case with squamous cell carcinoma originating from a giant condyloma acuminata completely surrounding the penis. A 57-year-old circumcised heterosexual male patient presented with a penile lesion existing for 20 years. Incisional biopsy revealed acanthosis of the squamous epithelium. The patient was operated on under spinal anaesthesia. The lesion was resected circumferentially with macroscopic clearance, resulting in complete degloving of the penile shaft. Neurovascular bundles were preserved. The penile skin was constructed with a split thickness skin graft. Histopathological analysis of the lesion revealed an invasive and well-differentiated squamous cell carcinoma arising on a condyloma, and the surgical margins were free from tumour. The patient was staged as G2 T1 N0 M0 and was followed for one year. He did not have any erectile dysfunction and could engage in intercourse. Pelvic tomographic and physical examination findings did not reveal any episode of recurrence or metastasis. When encountering patients with giant condyloma acuminata, it should not be forgotten that it may be accompanied by squamous cell carcinoma. In addition, tissue excision should be as extensive as possible while keeping in mind the importance of the function. This is the first case of a penile-degloving surgery for giant penile condyloma, supporting conservative and preserving penile surgery for such tumours.
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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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    Three-dimensional modeling of nasal septal deviation
    Seyhan, A; Ozaslan, U; Sir, E; Ozden, S
    Background: Some deviated nasal septa can never be straightened completely due to their 3-dimensional (3-D) nature. Based on a Study of models and clinical cases, a basic classification and treatment strategy was proposed for 3-D septal deviations. Methods: basic types of 3-D septal L struts were crafted from pieces of thick plastic sheeting. By a carefully placed through-and-through incision in the angle area and overlapping the resultant segments, the models became 2 dimensional (2-D). We used this technique intraoperatively, in some cases resecting the overlapping area of septal tissue, along with a septal extension graft, in 11 patients who were followed up for more than 6 months. Results: External nasal deviation due to a deviated septum was obvious in 5 cases, and all were relieved postoperatively. Preoperative breathing difficulties were improved in 7 of 8 patients. Conclusion: Correction of 3-D septal L deformity can be successfully performed by constructing 2-D L struts by making a full-thickness incision of the angle area and then overlapping the segments. This approach is especially beneficial in those having a septal extension graft that need a perfectly straight caudal septum upon which to fix the extension graft.
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    A simplified use of septal extension graft to control nasal tip location
    Seyhan, A; Ozden, S; Ozaslan, U; Sir, E
    Background: For defining the shape and projection of the nasal tip, the bilateral and symmetric batten-type septal extension grafts proposed by Byrd and colleagues have drawbacks. The main problems are stiffness of the nasal tip and thickening of the septum in the nasal valve area. Methods: Since 1998, unilateral single-batten grafts, and more frequently, bilateral asymmetric batten grafts as compared with Byrd's bilateral symmetric application, have been used for 72 patients in our facility. Results: At the 6-month postoperative follow-up assessment, tip projection was found to be satisfactory in 61 patients. Less than desired projection occurred in three cases and overprojection in two cases. Nasal lobule deviation was evident in one patient. The loss of the columellar break point was evident in five cases. Conclusion: Unilateral or asymmetric bilateral batten grafts facilitate adjustment of the nasal tip intraoperatively. This technique results in a more pliable nasal tip in the horizontal plane. Construction of a three-layered cartilage in the nasal valve area is not needed, and the nasal airway is preserved. With this modification, a reliable and predictable nasal tip location is obtained with a minimum of graft usage.