Browsing by Author "Karabulut, Alaattin"

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Citation - WoS: 2
Citation - Scopus: 3
Perspectives and Knowledge About Fertility Preservation Strategies Among Female Cancer Patients in Turkey
(Wiley-Hindawi, 2023) Emirdar, Volkan; Karatasli, Volkan; Acet, Ferruh; Okay, Gulin; Gode, Funda; Karabulut, Alaattin; Arslan, Cagatay
Objectives. To evaluate the knowledge level and perspectives of female cancer patients regarding fertility preservation techniques before gonadotoxic treatment. Material and Methods. This was a prospective observational survey-based study conducted between 2016 and 2020 in Izmir Economy University Medical Park Hospital. A total of 150 female cancer patients aged 18-42 years were included. The participants completed a 17-item questionnaire, developed by the research team to evaluate their knowledge and perspectives on fertility preservation techniques. Results. The mean age of the patients was 39.5 +/- 4.9 years. Only 64.7% of the patients were referred to fertility counseling by a gynecologist, while 72.6% of the patients knew of the risk of infertility after cancer treatment. There was a significant correlation between the health status and cancer stage of the patient (p=0.003). The estimated future chance of becoming pregnant spontaneously or through fertility preservation techniques was significantly higher in patients with a higher education level (p=0.041 or 0.008, respectively). Satisfaction with the counseling process was reported as high or low by 66.7% or 20% of the patients, respectively. Conclusions. The rate of referral of reproductive-age cancer patients to fertility preservation counseling is still not satisfactory. Education level was the only variable significantly associated with a motivation to become pregnant after cancer treatment, either spontaneously or through fertility preservation techniques.
Role of Postoperative Renal Ultrasound in Identifying Ureteral Injury despite Normal Intraoperative Jet Flow
(Galenos Publ House, 2026) Ozer, Pinar Tugce; Ileri, Alper; Inan, Abdurrahman Hamdi; Kantarci, Sercan; Yildirim, Fatih; Dagli, Ugurcan; Karabulut, Alaattin
Objective: This study evaluated the diagnostic utility of early postoperative renal ultrasound in detecting ureteral injury in patients who had undergone total laparoscopic hysterectomy (TLH) for benign indications, despite documented normal intraoperative ureteral jet flow on cystoscopy. Materials and Methods: In this retrospective cohort study at a high-volume tertiary center, data from 3,170 patients who underwent TLH between January 2022 and October 2025 were analyzed. Inclusion required normal bilateral ureteral jet flow on routine intraoperative cystoscopy, a renal ultrasound within the first 24 postoperative hours, and at least 30 days of clinical follow-up. The primary outcome was the diagnostic yield of postoperative ultrasound for identifying ureteral injuries not apparent during surgery. Injuries were confirmed by advanced imaging or surgical exploration. Results: The overall ureteral injury rate was 0.79% (n=25). Of these injuries, eight were diagnosed intraoperatively, while seventeen occurred despite documented normal bilateral ureteral jet flow during the procedure. Among the latter group, renal ultrasonography performed on postoperative day 1 detected 14 injuries, representing 56% of all injuries. Three injuries (12%) presented later, around postoperative day 10, and were not identified on initial imaging. Early postoperative ultrasonography demonstrated good sensitivity and a high negative predictive value as a screening tool. Comparison with preoperative baseline imaging enhanced diagnostic performance in identifying new-onset obstruction, particularly newly developed pelviectasis. Conclusion: Normal intraoperative ureteral jet flow does not preclude ureteral injury, particularly those with delayed presentation, such as thermal damage. Early postoperative renal ultrasonography is a valuable non-invasive screening tool that identifies a significant proportion of injuries missed by cystoscopy alone. Comparative evaluation of routine postoperative ultrasonography with preoperative imaging may provide a meaningful contribution to the early diagnosis of ureteral injury following TLH.