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Aydın, Serdar

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Serdar

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Aydın

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Aydın, Serdar

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2021 - 202421

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    Novel vaginal cerclage assisted laparoscopic cervico-sacropexy technique for uterovaginal prolapse
    (SAGE Publications Ltd, 2024) Aydın, Serdar; Çekiç, Sebile Güler; School of Medicine; Koç University Hospital
    Aim Laparoscopic hysteropexy is a complicated procedure that requires specialized surgical skills, including precise dissection and suturing. The aim is to describe the technical considerations for performing a new, feasible, and minimally invasive technique to correct apical and concurrent apical and anterior vaginal wall defects.Method A retrospective analysis was conducted on 70 consecutive women who underwent surgery for stage >= 3 uterovaginal prolapse. As a part of the technique, an anterior 2-cm long transverse incision was made at the anterior cervicovaginal junction, and the bladder was dissected through blunt and sharp dissection to the level of the isthmus. A posterior colpotomy was performed. A polypropylene tape was inserted into the cervical connective tissue, and the free arms of the tape were inserted into the peritoneum via the posterior colpotomy. Two arms of the tape were passed from the tunnel parallel and medial to a right sacrouterine fold, then fixed to the anterior longitudinal ligament via the laparoscopic route.Results The tape can be inserted into the cervix in a median of 15 min, and the laparoscopy procedure can be completed in 24 min. No mesh erosion or long-term complications occurred. At a 1-year control, there were no cases of recurrence.Conclusions This novel cervico-sacrocolpopexy technique is a feasible and safe, minimally invasive way to correct apical or multicompartment defects, with a short operation time and an anatomical result that mimics the normal sacrouterine ligament.
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    Advancements in three-dimensional bioprinting for reproductive medicine: a systematic review
    (Elsevier Sci Ltd, 2024) Aydın, Serdar; Yaşlı, Mert; Yıldız, Şule; Urman, Cumhur Bülent; School of Medicine; Koç University Hospital
    Reproductive failure due to age, genetics and disease necessitates innovative solutions. While reproductive tissue transplantation has advanced, ongoing research seeks superior approaches. Biomaterials, bioengineering and additive manufacturing, such as three-dimensional (3D) bioprinting, are harnessed to restore reproductive function. 3D bioprinting uses materials, cells and growth factors to mimic natural tissues, proving popular for tissue engineering, notably in complex scaffold creation with cell distribution. The versatility which is brought to reproductive medicine by 3D bioprinting allows more accurate and on-site applicability to various problems that are encountered in the field. However, in the literature, there is a lack of studies encompassing the valuable applications of 3D bioprinting in reproductive medicine. This systematic review aims to improve understanding, and focuses on applications in several branches of reproductive medicine. Advancements span the restoration of untapped potential in reproductive medicine.
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    Successful outcome following a multimodal pelvic rehabilitation program in a woman with neurogenic bladder and bowel dysfunction: a case report
    (Taylor and Francis, 2024)  ; Albayrak, Havvanur; Atlı, Ecenur; Aydın, Serdar; Taşkıran, Özden Özyemişçi;  ; School of Medicine; Koç University Hospital
    Background Neurogenic bladder and bowel dysfunctions lead to physical, social, and emotional disability and affects one's quality of life. Initial treatment is conservative including several rehabilitation techniques such as pelvic floor muscle training, biofeedback, electrical stimulation, and posterior tibial nerve stimulation. Objective In this case report, a 45-year-old woman with neurogenic bladder and bowel dysfunction was presented. Case Description Her urinary and fecal incontinence symptoms began twenty years before this episode of care, after an incomplete spinal cord injury secondary to spinal ependymoma and syringomyelia. She discontinued medical treatments due to side effects and ceased intermittent catheterization. A multimodal pelvic rehabilitation program was administered consisting of posterior tibial nerve stimulation, active pelvic floor muscle training accompanied by biofeedback, and electrical stimulation of pelvic floor muscles. Outcomes There were clinically important favorable differences in the scores of King's health questionnaire (reductions in symptom severity from 25 to 18 and in each of the impact of incontinence, physical and social limitations, personal relationships, sleep/energy, and severity measures from 100 to 67), pelvic floor distress inventory (decreased from 257 to 146) and female sexual function index (increased from 15.1 to 25.1) after 12 weeks of a multimodal pelvic rehabilitation program. Manual muscle tests demonstrated improvements in pelvic floor muscle strength and endurance. Conclusion A 12-week multimodal pelvic rehabilitation program reduced urinary and fecal incontinence symptoms, together with improvements in her sexual life and alleviation of neuropathic pain.
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    A systematic review of uterine cervical elongation and meta-analysis of Manchester repair
    (ELSEVIER, 2024) Aktoz, Fatih; Çekiç, Sebile Güler; Urman, Cumhur Bülent; Aydın, Serdar; School of Medicine; Koç University Hospital
    Objective: This review aims to consolidate current research on cervical elongation, a common but often overlooked complication in pelvic organ prolapse and hysteropexy procedures. It seeks to define, diagnose, and manage cervical elongation, aiming to establish standardized criteria and strategies to enhance clinical outcomes for this condition. Data Sources: A comprehensive search of the PubMed/MEDLINE, Cochrane Library, and Web of Science databases was executed utilizing the keywords: "cervical elongation," "long cervix uteri," "Manchester," and "cervical amputation". Data were gathered and organized in an Excel spreadsheet, with the analysis conducted according to each category, methodology, or reference range. Study Eligibility Criteria: All types of study designs with full-text availability, including randomized controlled trials, cohort studies, case-control studies, case reports, and systematic reviews, were considered for inclusion. Included studies were fully accessible in English and focused on the topic of interest. Exclusions were made for studies addressing cervical elongation not pertinent to pelvic organ prolapse, and publications such as secondary analyses, case reports, literature reviews, and opinion papers. Results: Out of 108 relevant studies, only 63 defined their inclusion criteria; of these, 57 were utilized for the narrative review and 8 were used in a meta-analysis comparing the Manchester operation with vaginal hysterectomy. Magnetic Resonance Imaging offers the highest sensitivity in measuring cervical elongation, its practical limitations and high cost necessitate the use of the more feasible Pelvic Organ Prolapse Quantification System (POP-Q), particularly effective for stage 2 and 3 prolapse cases. The POP-Q point C emerges as a pivotal marker for identifying cervical elongation, with specific measurements indicating the condition's presence. The Manchester-Fothergill procedure presents a viable management option for isolated cervical elongation, showing fewer complications and comparable recurrence rates to vaginal hysterectomy. Conclusion: This review highlights the diagnostic and definitional diversity of cervical elongation within populations experiencing pelvic organ prolapse. It emphasizes the critical role of preoperative cervical evaluation, particularly in patients with uterine descensus for selecting the most appropriate surgical intervention.
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    Additive manufacturing and three-dimensional printing in obstetrics and gynecology: a comprehensive review
    (Springer Heidelberg, 2023) Dabbagh, Sajjad Rahmani; Aydın, Serdar; KU Arçelik Research Center for Creative Industries (KUAR) / KU Arçelik Yaratıcı Endüstriler Uygulama ve Araştırma Merkezi (KUAR); Koç Üniversitesi İş Bankası Yapay Zeka Uygulama ve Araştırma Merkezi (KUIS AI)/ Koç University İş Bank Artificial Intelligence Center (KUIS AI); School of Medicine
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    Additive manufacturing and three-dimensional printing in obstetrics and gynecology: a comprehensive review
    (Springer, 2023) Yaşlı, Mert; Dabbagh, Sajjad Rahmani; Taşoğlu, Savaş; Aydın, Serdar; Undergraduate Student; PhD Student; Faculty Member; Faculty Member; School of Medicine; Graduate School of Sciences and Engineering; School of Medicine; School of Medicine; N/A; N/A; N/A; Koç University Hospital; N/A; N/A; 291971; 132535
    Three-dimensional (3D) printing, also known as additive manufacturing, is a technology used to create complex 3D structures out of a digital model that can be almost any shape. Additive manufacturing allows the creation of customized, finely detailed constructs. Improvements in 3D printing, increased 3D printer availability, decreasing costs, development of biomaterials, and improved cell culture techniques have enabled complex, novel, and customized medical applications to develop. There have been rapid development and utilization of 3D printing technologies in orthopedics, dentistry, urology, reconstructive surgery, and other health care areas. Obstetrics and Gynecology (OBGYN) is an emerging application field for 3D printing. This technology can be utilized in OBGYN for preventive medicine, early diagnosis, and timely treatment of women-and-fetus-specific health issues. Moreover, 3D printed simulations of surgical procedures enable the training of physicians according to the needs of any given procedure. Herein, we summarize the technology and materials behind additive manufacturing and review the most recent advancements in the application of 3D printing in OBGYN studies, such as diagnosis, surgical planning, training, simulation, and customized prosthesis. Furthermore, we aim to give a future perspective on the integration of 3D printing and OBGYN applications and to provide insight into the potential applications.
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    Sleep, depression, anxiety and fatigue in women with premature ovarian insufficiency
    (Taylor & Francis, 2022) Ates, Seda; Ozcan, Pinar; Bakar, Rabia Zehra; Cetin, Caglar; N/A; Aydın, Serdar; Faculty Member; School of Medicine; 132535
    Purpose To assess sleep disturbances, levels of anxiety, depression and fatigue in women with premature ovarian insufficiency (POI). Materials and methods The study included 62 women with POI and 62 age-matched controls. Women in both groups completed questionnaires. Pittsburgh Sleep Quality Index, Insomnia severity index, Epworth Sleepiness Scale, Hospital Anxiety and Depression Scale and Fatigue Severity Scale were used. Results We found poor sleep quality, higher levels of insomnia in women with POI than in controls. Depression was much more prevalent and severe in POI women. Total anxiety score, the severity of anxiety and fatigue did not differ significantly between the groups. According to the multivariable logistic regression analysis, being married and having POI were associated with worse quality of sleep, and having more children was associated with an increase in depression levels in the whole cohort. Backward analysis showed that when POI status was taken as a reference, married women were at 6.5 fold increased risk of poor sleep quality. Conclusions Women with premature ovarian failure are more likely to suffer from poor sleep quality, insomnia and depression than healthy women.
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    Reliability and diagnostic performance of smartphone colposcopy
    (Wiley, 2021) Karasu, Ayse F. G.; Marasli, Mustafa; Bademler, Neslihan; Kiran, Gurkan; Dural, Hanife R.; N/A; Aydın, Serdar; Faculty Member; School of Medicine; Koç University Hospital; 132535
    Objective To evaluate the interobserver and intraobserver reliability of smartphone colposcopy (SPC) versus conventional colposcopy and to determine diagnostic performance. Methods A smartphone back camera was used to capture cervical images before and after application of acetic acid, and after application of lugol solution. Captured images were reviewed independently by two experienced colposcopists and findings were noted as per colposcopy. Smartphone-based diagnostic performance was calculated, and kappa statistics were used for measurement of agreement between SPC and conventional colposcopy findings. Results A total of 114 women were included in the study. The kappa statistic for intraobserver reliability was 0.77 for both normal colposcopic findings and the transformation zone, indicating substantial agreement. Kappa values were 0.54 for acetowhite epithelium, 0.51 for lugol staining, and 0.51-0.60 for atypical vascularization. Kappa values for interobserver reliability were 0.76 for normal colposcopic findings, 0.56 for acetowhite epithelium, and 0.60 for lugol staining. The sensitivity, specificity, PPV, and NPV of SPC for CIN2+ were 88.2 (95% CI, 72.5-96.7), 48.7 (95% CI, 37.4-60.2), 0.42 (95% CI, 0.36-0.48), and 0.91 (95% CI, 0.79-0.96), respectively. Conclusion SPC showed substantial agreement between the histologic diagnoses based on the captured images and conventional colposcopic findings.
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    Development of a low-fidelity laparoscopic sacrocolpopexy simulation model and evaluation of curriculum
    (Lippincott Williams & Wilkins, 2021) Karaoglan, Tunahan; Bilginer, Umur; Aydın, Serdar; Faculty Member; School of Medicine; 132535
    Objectives Minimally invasive sacrocolpopexy (SCP) is a compelling surgical procedure that requires advanced laparoscopic suturing and dissection skills and knowledge of pelvic retroperitoneal anatomy. The aim of this study was to develop a low-cost laparoscopic SCP model and educational curriculum to improve dissection and suturing skills along with anatomic knowledge to avoid complications. Methods The pelvic SCP model was developed with easily available material that was placed on the commercial pelvic bone model to construct a vagina, major vessels, ureter, peritoneum, and areolar tissue. A comprehensive curriculum encompassing didactic and technical skills components on the pelvic model was used to teach laparoscopic SCP. Participants completed precurriculum and postcurriculum multiple-choice questionnaires to evaluate the didactic component. A modified Objective Structured Assessment of Technical Skills (OSATS) tool was used to measure technical skills before and after technical skills curriculum. Results Among the 10 senior residents, 6 (60%) were studying at their fourth postgraduate year, and 3 (30%) were studying at their third postgraduate year. Postcurriculum test scores (14.5 vs 10.6) for assessment of cognitive knowledge were significantly improved (P < 0.001). The median postcurriculum OSATS scores (26.5; range, 18-30) were significantly improved (P = 0.005). Laparoscopic SCP OSATS scores increased from median 21 to median 26.5 after cognitive and technical curriculum, showing a 21.4% improvement. The majority (70%) of residents believed that the SCP model would be useful to enhance skills acquisition before performing the skill in the operating room. Conclusions A low-fidelity laparoscopic SCP curriculum showed improvement in cognitive knowledge and technical skills.
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    Successful outcome following a multimodal pelvic rehabilitation program in a woman with neurogenic bladder and bowel dysfunction: a case report
    (Taylor & Francis Inc, 2022) N/A; Albayrak, Havvanur; Taşkıran, Özden Özyemişçi; Atlı, Ecenur; Aydın, Serdar; Doctor; Faculty Member; Other; Faculty Member; N/A; School of Medicine; N/A; School of Medicine; Koç University Hospital; N/A; Koç University Hospital; N/A; N/A; 133091; N/A; 132535
    Background Neurogenic bladder and bowel dysfunctions lead to physical, social, and emotional disability and affects one's quality of life. Initial treatment is conservative including several rehabilitation techniques such as pelvic floor muscle training, biofeedback, electrical stimulation, and posterior tibial nerve stimulation. Objective In this case report, a 45-year-old woman with neurogenic bladder and bowel dysfunction was presented. Case Description Her urinary and fecal incontinence symptoms began twenty years before this episode of care, after an incomplete spinal cord injury secondary to spinal ependymoma and syringomyelia. She discontinued medical treatments due to side effects and ceased intermittent catheterization. A multimodal pelvic rehabilitation program was administered consisting of posterior tibial nerve stimulation, active pelvic floor muscle training accompanied by biofeedback, and electrical stimulation of pelvic floor muscles. Outcomes There were clinically important favorable differences in the scores of King's health questionnaire (reductions in symptom severity from 25 to 18 and in each of the impact of incontinence, physical and social limitations, personal relationships, sleep/energy, and severity measures from 100 to 67), pelvic floor distress inventory (decreased from 257 to 146) and female sexual function index (increased from 15.1 to 25.1) after 12 weeks of a multimodal pelvic rehabilitation program. Manual muscle tests demonstrated improvements in pelvic floor muscle strength and endurance. Conclusion A 12-week multimodal pelvic rehabilitation program reduced urinary and fecal incontinence symptoms, together with improvements in her sexual life and alleviation of neuropathic pain.