Derya Yaşar’s research while affiliated with Istanbul Medipol University and other places

Background/Aim: Most women who have completed childbearing request tubal ligation, as it is an effective and irreversible form of contraception. Single incision laparoscopic surgery (SILS) which is currently standard in most surgical specialties, eliminates multiple port incisions and provides faster recovery with better cosmesis. However, there is less data about single incision laparoscopic bilateral tubal ligation. We aimed to compare the results of single-incision-two port laparoscopic tubal ligation and conventional three port laparoscopic tubal ligation. Methods: Patients who desired tubal ligation procedure as a contraceptive method were randomly allocated to two groups as single-incision-two port laparoscopic tubal ligation (Group 1) and conventional three port laparoscopic tubal ligation (Group 2) between April 2015 to January 2020 in the Obstetrics and Gynecology clinics of two university hospitals. A prospective comparative study was conducted, and sixty patients were included in each group, which were compared in terms of operation time, blood loss, length of hospital stay, complications, port site hernia, postoperative pain score, conversion rate, cosmesis and failure of sterilization. Results: There was no need to convert to open surgery in either group. Average blood loss was similar between the groups (107.6 ml vs 98.4 ml, P=0.14). Operating time was significantly longer in group 2 compared to group 1 (38 minutes vs. 26 minutes, P=0.02). Higher pain scores were observed in group 2 compared to group 1 at the 24th postoperative hour (2.21 vs 3.82, P=0.012). Patients in group 1 were more satisfied with the single incision in the umbilicus based on cosmetic outcome scores (4.88 vs 3.16, P=0.018). There were no reported intraoperative complications in either group. No port site hernias and failure of sterilization were observed in any of the patients. All patients were followed up for a mean of 19 months (range: 12–60 months). Conclusion: Single incision two port laparoscopic tubal ligation does not increase the risk of complications and appears safe. It provides better cosmetic outcomes and lower pain scores compared to conventional laparoscopy.

AIM: Urethral diverticula is a rare diagnosis of women complaining lower urinary tract dysfunction. It may present with stone formation due to stasis and chronic infection within the diverticulum.There is also a possible risk of carcinogenesis. Suspicion by the physician is essential step for diagnosis. Magnetic resonance imaging and Urethroscopy are gold standard methods for diagnosis. Translabial ultrasound with three or four-dimensional imaging is a cost effective alternative method.Herein we planned to share our experience on translabial ultrasound imaging for identification of urethral diverticula. METHODS: We examined 6 patients with multiplanar translabial ultrasound imaging as well as diagnosed with office urethroscopy performed by Urology team in a tertiary urology unit between 2014 and 2020. Patients' demographics, symptoms and findings on clinical examination were collected from hospital charts. Archived ultrasound images were analyzed for size,complexity and location of diverticula. RESULTS: While 2 women complaining of dribbling and recurrent urinary tract infections 4 of them complained of dysuria and vaginal mass. All of 6 women confirmed to have a urethral diverticulum on urethroscopy and translabial ultrasound imaging. We evaluated a reguler size cystic structure anterior location of the ürethral rhabdosphincter with a 24.2mm maximum diameter (range, 8-32 mm). The Urologyst observed a communicating tract at ürethroscopy in a woman located at 5 o'clock position. CONCLUSIONS: Translabial ultrasonography is a simple, safe and non-invasive method for the diagnosis of urethral diverticula. It may facilitate surgical excision of the diverticula as provides exact information on size and location of the diverticula. Also, we think that translabial ultrasonography will be used in larger group of women with urethral symptomatology in Urogynaecology practice.