Ömer Demir

To evaluate the impact of the COVID-19 pandemic on cesarean section (CS) rates and the distribution of deliveries according to the Robson Ten Group Classification System (RTGCS) in a secondary-level hospital in Türkiye. This retrospective cohort study was conducted at Fatsa State Hospital using electronic medical records. Two periods were compared: pre-pandemic (March 2019–February 2020) and pandemic (March 2020–February 2021). All women who delivered during these periods were included. Deliveries were classified according to the RTGCS. For each group, total births, number of cesarean deliveries, intragroup CS rates, and contribution to the overall CS rate were calculated. Categorical variables were compared using the chi-square test, with p

Post-void residual (PVR) urine volume is routinely evaluated in women with urinary incontinence and/or pelvic organ prolapse (POP). However, its clinical relevance in postmenopausal women without these conditions remains insufficiently defined. This exploratory study aimed to investigate the association between PVR volume and patient-reported urinary symptom burden, as measured by the King's Health Questionnaire (KHQ), in postmenopausal women without urinary incontinence or prolapse. A secondary objective was to descriptively compare PVR volumes and uroflowmetry parameters between women reporting no urinary impact and those reporting mild-to-moderate impact. Seventy postmenopausal women evaluated at the Gynecology and Urogynecology Clinics of Karadeniz Technical University Faculty of Medicine between 2022 and 2024 were enrolled in this cross-sectional observational study. Demographic data, uroflowmetry parameters, PVR volumes measured by transabdominal ultrasonography, and KHQ scores were recorded. Participants were stratified according to their response to a global KHQ impact item reflecting perceived urinary burden. Statistical analyses were conducted using SPSS, with significance set at p < 0.05. No a priori sample size or power calculation was performed, and the study should therefore be interpreted as exploratory. Correlation coefficients and 95% confidence intervals were calculated. The mean age of participants was 55.5 ± 4.1 years. As expected based on the stratification criterion, women reporting urinary impact demonstrated higher KHQ domain scores. However, no statistically significant differences were observed between groups in uroflowmetry parameters or PVR volumes. Furthermore, no significant correlations were identified between PVR volume and KHQ scores in the overall cohort (p > 0.05). All correlations were weak and confidence intervals crossed zero. In this exploratory cross-sectional cohort of postmenopausal women without incontinence or prolapse, no statistically significant association was detected between PVR volume and patient-reported urinary impact. Given the limited sample size, exploratory symptom stratification, and use of a predominantly incontinence-oriented questionnaire, these findings should be interpreted as inconclusive rather than confirmatory of absence of association. In addition, the use of the King's Health Questionnaire, which is primarily designed for urinary incontinence, may have limited the ability to capture voiding-specific symptoms. Larger, methodologically standardized studies are warranted to clarify the role of PVR in this population.

Introduction: This study aimed to evaluate the impact of single and multiple human papillomavirus (HPV) positivity on cervical intraepithelial lesions, specifically focusing on whether the addition of high-risk HPV types to HPV-16 or HPV-18 affects the progression to high-grade lesions. Methods: A retrospective analysis was conducted on 612 HPV-positive patients from Karadeniz Technical University Faculty of Medicine, Department of Obstetrics and Gynecology (2018–2023), who underwent Pap smear and HPV genotyping. Demographic, cytological, and histopathological data were collected, with HPV types categorized as HPV-16, HPV-18, and other high-risk types. Colposcopic biopsy results were used to assess the risk of cervical intraepithelial neoplasia. Results: Among 612 HPV-positive patients, 137 had HPV-16 (17.4%), 39 had HPV-18 (4.9%), and 503 had other high-risk types (63.8%). HPV-16 and multiple high-risk HPV types exhibited a higher proportion of cytological abnormalities. Histopathological analysis showed that the presence of other high-risk HPV types alongside HPV-16 was associated with a lower risk of progression to high-grade lesions compared to HPV-16 alone. Specifically, HPV-16 combined with other high-risk types showed a significantly lower rate of cervical intraepithelial neoplasia. Conclusion: The addition of other high-risk HPV types to HPV-16 may slow the progression to high-grade cervical lesions, contradicting the literature that suggests multiple HPV infections increase the risk. These findings contribute to the ongoing debate on the role of multiple HPV types in cervical lesion progression. Key Message: The presence of additional high-risk HPV types alongside HPV-16 may reduce the likelihood of progression to high-grade cervical lesions, suggesting a possible attenuating effect of multiple HPV infections rather than a synergistic risk.

Üriner inkontinans, idrarın istem dışı kaçışı olarak tanımlanır ve stres üriner inkontinans intraabdominal basınç artışı ile ortaya çıkan idrar kaçırmadır. Bu durum kadınların %60’ını yaşamlarının bir döneminde etkiler ve mesane ile üretrayı destekleyen bağ dokuların zayıflaması ya da intrensik sfinkter yetmezliği önemli nedenler arasındadır. Konservatif yöntemlerin yetersiz kaldığı olgularda periüretral ve transüretral enjeksiyon tedavi seçeneği olarak kullanılmaktadır. Kollajen, poliakrilamid hidrojel, karbon kaplı mikrosferler ve kalsiyum hidroksiapatit başlıca kullanılan ajanlardır. Uygulama periüretral veya sistoskopi eşliğinde transüretral yolla yapılabilmekte, başarı oranları %32.7 ile %93.3 arasında değişmektedir. Enfeksiyon, üriner retansiyon, de novo urge inkontinans ve enjeksiyon yenilenme ihtiyacı en sık komplikasyonlardır. Cochrane derlemesinde enjeksiyonlar konservatif tedavilere göre daha etkin, cerrahi yöntemlere göre ise daha zayıf bulunmuştur. Güncel kılavuzlarda, ileri yaşta, intrensik sfinkter yetmezliği bulunan, cerrahiye uygun olmayan ve daha az invaziv yöntem isteyen seçilmiş hastalarda enjeksiyon tedavisinin tercih edilebileceği vurgulanmaktadır. Bununla birlikte uzun dönem etkinlik ve güvenlik sonuçlarının daha kapsamlı çalışmalarla desteklenmesi gerektiği belirtilmiştir.

OBJECTIVE: In this study, an investigation was undertaken to determine whether the well-being of the fetus is affected in pregnant women who have a severe fear of childbirth.

Behçet’s Disease Diagnosed with a Multidisciplinary Approach in Pregnancy - Bezmialem Science