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Öğe Bilateral hypogastric artery ligation: A tertiary center experience(Harran Üniversitesi Tıp Fakültesi, 2019) Peker, Nurullah; Yavuz, Mustafa; Aydın, Edip; Ege, Serhat; Bademkıran, Muhammet Hanifi; Turan, Gökçe; Karaçor, Talip; Gül, TalipBackground: The aim of this study was to evaluate the obstetric characteristics and maternal outcomes of patients undergoing bilateral hypogastric artery ligation (BHGAL) for primary postpartum hemorrhage (PPH). Materials and Methods: Digital records and hospital archives of patients who underwent BHGAL in the postpartum period after vaginal delivery (VD) or during or after cesarean section (C/S) in a tertiary center between May 2005 and May 2018 were reviewed retrospectively. Demographic characteristics, parity, gestational week, duration of operation, hospitalisation time, estimated blood loss, laboratory values, transfused blood volume, previous C/S history, and intensive care requirement of the patients were evaluated. The efficacy of BHGAL in controlling bleeding, indications, concomitant surgeries, and intraoperative and postoperative complications were evaluated. Results: There were 276.008 deliveries in our hospital in the specified period. Of the patients with PPH, 41 patients underwent BHGAL after VD and 19 patients underwent BHGAL during or after C/S. In 25 of 28 patients with PPH due to atony, bleeding was controlled by BHGAL, while 3 patients underwent hysterectomy together with BHGAL. While the effectiveness of BHGAL in uterine atony was 89.2%, the success rate was 33.3% when all cases were considered. The most common cause of indication for BHGAL was atony and disseminated intravascular coagulation (DIC) was the most common complication in patients undergoing BHGAL. Iliac vein injury was detected in one patient due to the procedure itself. Conclusions: BHGAL is more effective on controlling PPH due to atony compared to the control of other PPH causes. Most of the complications in these patients are not related to the procedure but are due to the complications of PPH. Therefore, BHGAL continues to be a life-saving method when applied by centers with adequate surgical knowledge and equipment.Öğe Comparison of histomorphological findings of cardinal ligament in patients with and without uterine prolapse(İnönü Üniversitesi Tıp Fakültesi, 2020) Peker, Nurullah; Kırıcı, Pınar; Kaya, Şeyhmus; Yıldırım, Ayhan; Karaçor, TalipAim: This study aimed to investigate histomorphological changes in cardinal ligaments between patients with and without uterine prolapse. Material and Methods: This study included 30 patients who underwent vaginal hysterectomy for POP-Q stage 4 uterine prolapse (Group 1) and 30 patients who underwent abdominal hysterectomy for benign reasons except uterine prolapse (Group 2) at a tertiary center hospital. Demographic data, parity, uterine weight, and histomorphological findings of cardinal ligaments were compared between the two groups. Results: Age and parity were significantly higher unlike uterine weight was lower in Group 1. In histomorphological findings of cardinal ligaments, vessel wall thickness, peripheral nerve thickness and the number of cells in the connective tissue stroma counted in 1 mm2 area were statistically significantly higher in Group 1. While the presence of extravasated erythrocytes was greater in Group 1, no significant difference was found between the two groups in terms of inflammation. Conclusion: It is obvious that some histomorphological changes are formed in the cardinal ligaments of patients with uterine prolapse due to pressure on the uterus. We believe that the increase in the number of extravasated erythrocytes and the thickness of the vascular wall and peripheral nerve should be supported by further studies.Öğe Comparison of serum and salivary alpha-fetoprotein levels in pregnancies complicated with neural tube defects(Yerküre Tanıtım & Yayıncılık Hizmetleri A.Ş., 2020) Karaçor, Talip; Bülbül, Mehmet; Nacar, Mehmet Can; Kırıcı, Pınar; Önderci, Muhittin; Peker, Nurullah; Sak, SibelObjective: To compare the serum and salivary values of alpha-fetoprotein (AFP) used in screening neural tube defects (NTD) during pregnancy. To investigate whether saliva can be used instead of serum in NTD screening. Method: The study was conducted between May 2018 - November 2019 at Adıyaman University. The study included 41 pregnant women complicated by NTD and 44 healthy pregnant women. Three ml venous blood and 2 ml saliva samples were taken from both groups. Serum and saliva samples were not diluted. AFP concentration was measured at 450 nm by using commercially available enzyme-linked immunoassay. The intra‐ , and inter- test assay coefficients (CVs) of the kit were <8% and <10%, respectively. SPSS 21 program was used for data analysis. Mann-Whitney Test was used for the analysis of continuously changing parameters. The correlation coefficient was calculated by Spearman test. A p value of less than 0.05 was accepted for statistical significance. Results: When serum and salivary AFP values were compared between the two groups, the AFP values were found to be higher in both NTD group samples (p<0.001, p<0.001). In both groups, correlation analysis for serum and salivary AFP values showed a strong positive correlation (r=0.730, p<0.001). When the cut-off value for serum AFP is taken as 0.26, NTD can be determined with 100% sensitivity and 90% specificity (AUC: 0.932, p<0.001). When the cut-off value for salivary AFP is taken as 0.034, it can detect NTD with 95% sensitivity and 92% specificity (AUC: 1.00, p<0.001). Conclusion: Salivary and serum AFP values showed strong positive correlation between themselves. We believe that saliva can be used in NTD screening performed by AFP measurement.Öğe The Diagnostic Accuracy of Endometrial Sampling in Endometrial Hyperplasia(2017) Deregözü, Ayşegül; Karaçor, Talip; Acet, Mustafa; Gül, Talip; Evsen, Mehmet Sıddık; Ağaçayak, Elif; Hatirnaz, SafakOBJECTIVE: Endometrial hyperplasia is a premalignant lesion characterized with hyperplastic changes in endometrial gland and stromal structures. Its incidence is not exactly known. This study evaluated the accuracy of endometrial sampling of the patients whose pathological results were endometrial hyperplasia and had undergone hysterectomy (paraffin sections). STUDY DESIGN: Patients that diagnosed with endometrial hyperplasia by endometrial biopsy and/or hysterectomy at Dicle University School of Medicine Department of Obstetrics and Gynecology between January 2006 and July 2014 were retrospectively evaluated. Sensitivity, specificity, and positive and negative predictive values of endometrial biopsy to predict postoperative hysterectomy result were calculated. Discrete results in endometrial sampling and hysterectomy were recorded separately. Statistical analyses were conducted with corresponding appropriate methods. RESULTS: Mean ages of pre and postmenopausal patients were 42.6±4.8 (28-50) and 57.7±7.7 (50- 79) years, respectively. For the efficiency of endometrial sampling to predict definite pathologic diagnosis, sensitivity was 71.9%, specificity was 87.5%, positive predictive value was 79.3%, and negative predictive value was 82.3%. When the accuracy of endometrial sampling with the pathologic diagnosis was evaluated, 38 patients had accurate (47.5%), and 42 patients had discrete (52.5%) results. CONCLUSION: The presence of atypia determines the treatment in patients with endometrial hyperplasia. Hysterectomy should not be the first option in endometrial hyperplasia patients without atypia, and medical treatment and curettage options should be considered. Experienced staff should perform and evaluate endometrial samplings. We consider that this will increase the success in diagnosis, and could change treatment options.Öğe The effect of surgical procedure on surgical outcomes in patients undergoing emergency peripartum hysterectomy: a retrospective(Taylor & Francis, 2021) Bülbül, Mehmet; Karaçor, Talip; Peker, Nurullah; Nacar, Mehmet Can; Okutucu, GülcanObjective To investigate the effect of surgical procedure on the operation's results in patients undergoing emergency peripartum hysterectomy (EPH). Methods The records of patients who underwent EPH due to postpartum hemorrhage between 2010 and 2020 in two tertiary centers with a high crude delivery rate were retrospectively analyzed. Surgical data were compared according to the EPH type. Results During the study period, 115,709 births occurred in these two centers. EPH was administered for 181 (1.6%) of these patients. Sixty-seven (37%) of the EPH cases involved subtotal EPH (SEPH), and 114 (63%) were total EPH (TEPH). Surgical time (107.3 +/- 17.6 vs. 134.2 +/- 32.3 min, p < 0.001), erythrocyte transfusion count (2.6 +/- 1.3 vs. 4.3 +/- 6.2, p < 0.001), ureter injury (0.0 vs. 7.9%), bladder injury (1.5 vs. 28.1%), disseminated intravascular coagulation (1.5 vs. 9.6%), need for relaparotomy (4.5 vs. 14%), and intensive care unit admission (19.4 vs. 52.6%) were found to be higher in the TEPH group compared to the SEPH group (p < 0.05). In addition, the total length of hospitalization was longer in the TEPH group (4.5 +/- 2.3 vs. 6.1 +/- 4.6 day, p = 0.011). Conclusion According to the results, if the bleeding in peripartum hemorrhage requiring EPH can be controlled with SEPH, attempting to remove the cervix completely may be associated with increased surgical time, blood transfusion need, and surgical complications.Öğe The effect of vaginal bleeding and non-spesific pelvic pain on pregnancy outcomes in subchorionichematomas cases(Via Medica, 2019) Karaçor, Talip; Bülbül, Mehmet; Nacar, Mehmet Can; Kırıcı, Pınar; Peker, Nurullah; Ağaçayak, Elifbjectives: To determine the clinical differences and factors affecting early pregnancy outcome in the first and early second trimester subchorionic hematoma cases. Material and methods: This study involved with the retrospective analysis and evaluation of 81 cases diagnosed with subchorionic hematoma. The patients were grouped according to the gestational periods, symptoms at the time of admission, ratio of surrounding hematoma to the gestational sac, and whether there was a pregnancy loss. The groups were compared according to the clinical features and pregnancy outcomes. Results: The ratio of surrounding hematoma to the gestational sac in the group with pregnancy loss was significantly higher (p = 0.002). When the cut-off value was 35.5%, it could determine the possibility of a complication in pregnancy with 70% sensitivity and 75% specificity. Nonspecific pelvic pain were significantly higher in the pregnancy loss group than in the other group. Logistic regression analysis was performed to determine the effect of these two parameters on the pregnancy outcome. Although the presence of non-specific pelvic pain is more in the group with pregnancy loss; there was no effect of on pregnancy outcome (p = 0.141). The risk of pregnancy loss increased 4.5 fold if the ratio of ScH to gestational sac was above 35% (p = 0.027). Conclusions: In the cases of subchorionic hematoma, we concluded that when the ratio of surrounding hematoma to the gestational sac increased and when it was accompanied by nonspecific pelvic pain, the hospitalization period of the patients increased and the ratio of pregnancy loss was higher.Öğe Ektopik Gebelik Olgularinda Gebelik Haftasina Göre Tedavi Yaklaşimlarinin Retrospektif Değerlendirilmesi(2017) Tunç, Senem Yaman; Sak, Sibel; Peker, Nurullah; Gül, Talip; Başaranoğlu, Serdar; Karaçor, TalipÇalışmamızda tersiyer bir merkezde ektopik gebelik (EG) tanılı hastalarda tanıya giden adımlar ve tedavi yöntemleri irdelendi. Son adet tarihine (SAT) göre gebelik haftasının tedavi yöntemleriyle ilişkisi değerlendirildi.Gereç ve Yöntem: Çalışmamızda 2011-2014 tarihleri arasında, üçüncü basamak olan kliniğimizde EG tanısı ile tedavi edilen 192 olgu tanısal yöntemlerine ve tedavi seçeneklerine göre değerlendirildi.Bulgular: EG insidansı 30.8/1000 olarak bulundu. Tek doz metotreksat (MTX) tedavisinin başarı oranı % 69.8, iki doz MTX ile birlikte medikal tedavinin başarı oranı ise % 87.5 olarak bulundu. Cerrahi uygulanan hastalarda en sık cerrahi prosedürün (% 54) salpenjektomi olduğu tespit edildi. 37 hastada (% 19.2) ise izlem tedavisi yeterli oldu. Tedavi şekilleri ile belirli parametreler karşılaştırıldığında; geliş ?-hCG seviyesinin yüksek olması, fetal kardiyak atımın (FKA) pozitif olması, batında serbest mayi olması, kitle boyutunun büyük olması ve SAT' a göre gebelik haftasının büyük olması ile cerrahi tedaviye gidiş arasında istatistiksel olarak anlamlı fark olduğu saptandı (p<0,05).Sonuç: Erken dönemde tanı alan EG' de, SAT' a göre gebelik haftası küçük olan hastaların daha çok izlem ve medikal tedavi ile, daha geç dönemde tespit edilen hastalarda ise cerrahi tedaviye gidişin yüksek olduğu izlendi.Öğe Evaluation of specific heavy metal levels of pregnant women complicated by neural tube defects(İnönü Üniversitesi Tıp Fakültesi, 2020) Karaçor, Talip; Kırıcı, Pınar; Nacar, Mehmet Can; Bülbül, Mehmet; Önderci, Muhittin; Peker, NurullahAim: The etiology of neural tube defect (NTD) is still not clear enough. In our study, we aimed to evaluate plasma heavy metal levels of pregnant women with NTD and to determine whether there is a relationship between heavy metal levels and NTD severity. Material and Methods: TThis study was conducted in Adıyaman University, Department of Gynaecology and Obstetrics. The study included 38 pregnant women with NTD and 42 pregnant women with healthy infants. Pregnant women who have NTD were divided into two groups as NTD Type 1 and NTD Type 2 according to the anomaly type. Levels of heavy metals such as Mercury (Hg), Cadmium (Cd), Cobalt (Co), Lead (Pb), Manganese (Mn) and Arsenic (As) were compared between groups. Results: Plasma Hg, Co, Cd and Pb levels were higher in NTD group than control group. (p values, respectively; p <0.001, p = 0.001, p <0.001, p <0.001). As and Mn levels were not statistically different between the two groups (p values; p = .519, p = .819, respectively). In the NTD group, Hg was found to be higher in NTD Type 1 than NTD Type 2 (p <0.001). Conclusion: It is obvious that some histomorphological changes are formed in the cardinal ligaments of patients with uterine prolapse due to pressure on the uterus. We believe that the increase in the number of extravasated erythrocytes and the thickness of the vascular wall and peripheral nerve should be supported by further studies.Öğe Factors associated with complications of vaginal hysterectomy in patients with pelvic organ prolapse - a single centre's experience(Via Medica, 2019) Peker, Nurullah; Aydın, Edip; Yavuz, Mustafa; Bademkıran, Muhammed Hanifi; Ege, Serhat; Karaçor, Talip; Ağaçayak, ElifObjectives: The study aimed to examine the predisposing factors that play a role in the development of complications in patients undergoing vaginal hysterectomy. Material and methods: This retrospective analysis was performed on data provided from 239 patients who underwent vaginal hysterectomy due to uterine prolapse at a single centre between January 2008 and August 2018. Complications were defined according to Clavien-Dindo classification of complications. The patients were divided into two groups: with and without complications. We built a model using multivariable logistic regression to examine the relationships between complications and five candidate predictors. Results: Intra/postoperative complications developed in 30 patients, and the complication rate was found to be 12.5%. 87.2% of the reported complications were classified as Grade ≤2 according to Clavien-Dindo system. It was found that complications were associated with factors such as intraoperative concurrent salpingo-oophorectomy [Odds ratio (OR): 1.24 (1.1.1.4)], low preoperative haemoglobin [OR: 0.96 (0.94.0.98)], uterine weight [OR: 2.69 (2.62.2.76)], and long operation time [OR: 1.04 (1.02.1.07)]. History of pelvic surgery was not found to increase complication rate [OR: 1.11 (0.96.1.27), p = 0.13]. Our multiple logistic regression model correctly classified 74% of participants within the Receiver Operating Characteristic (ROC) curve. Conclusions: Preoperative anaemia, large uterus and concomitant adnexectomy were found to be factors associated with complications during and after vaginal hysterectomy for pelvic organ prolapse.Öğe Oksitosin ile doğum indüksiyonu alan anne bebeklerinin kord kanındaki oksidatif stres belirteçlerinin değerlendirilmesi(Dicle Üniversitesi, Tıp Fakültesi, 2012) Karaçor, Talip; Sak, Muhammet ErdalObstetriğin temel amacı, sağlıklı bir fetüsün doğumunu hem anne hem de fetüs için minimal travma ile sağlamaktır. Kadınların çoğunda term veya terme yakın doğum sancıları spontan başlar. Bazı durumlarda ise doğum eylemi son adet tarihi (SAT) ne göre fetal matürasyon sağlanmasına rağmen spontan başlamaz. Bu durumda anneye indüksiyon ajanları verilerek annenin doğum eyleminin başlaması sağlanır. Yaptığımız çalışmada, eksojen indüksiyon ajanı olan oksitosinin fetüs üzerine etkisini araştırdık. Çalışmamıza 32 hasta kontrol, 33 hasta çalışma grubu (indüksiyon alan) olmak üzere iki gruba ayrılan 65 hasta dahil edildi. Doğum indüksiyonu ajanı olarak oxitosin kullandık. Doğumundan sonra, fetal kordan alınan venöz kanda çalışma yapıldı. Her iki grupta Total Oksidan statü (TOS), Total Antioksidan Statü (TAS) ,Nitrikoksit(NO), Asimetrik dimetilarginin(ADMA), Paraoksanaz(PANX) ve Malonildialdehid(MDA) çalışıldı ve karşılaştırıldı. Her iki grup yaş ve gebelik haftası yönünden homojendi.İndüksiyon alan grupta TAS, TOS, MDA, PANX değerleri kontrol grubuna göre yüksek idi. Her iki grup arasında sonuçlar açısından istatistiki olarak fark saptandı. Her iki grup arasında NO ve ADMA düzeyleri açısından fark olmadığı görüldü.İki grup arasında APGAR değerleri açısından istatistiği fark yoktu. İndüksiyon ile oksidatif stres markırlarının arttığı; fakat yeni doğan APGAR sonuçlarında fark olmadığı görüldü. Vücütta indüksiyon ile oluşan oksitatif stresin, antioksidan savunma sistemi tarafından kompanse edilebildiği düşünüldü; fakat bu konu ile daha geniş serilerle yapılmış çalışmalara ihtiyaç vardır.Öğe RETROSPECTIVE EVALUATION OF THE TREATMENT APPROACHES OF ECTOPİC PREGNANCIES ACCORDING TO GESTATIONAL WEEK(Zeynep Kamil Kadın ve Çocuk Hastalıkları EAH, 2017) Peker, Nurullah; Tunç, Senem Yaman; Sak, Sibel; Karaçor, Talip; Başaranoğlu, Serdar; Gül, TalipOBJECTIVE: We evaluated steps leading to the diagnosis and treatment diagnosed with ectopic pregnancy patients. The relationship between gestational age belong to last menstrual period(LMP) and treatment methods were evaluated.MATERIALS AND METHODS: 192 cases of treated ectopic pregnancy were evaluated according to the diagnostic methods and treatment options between 2011-2014 in our tertiary clinic.RESULTS: The incidence of ectopic pregnancy was found 30.8/1000. A single dose of methotrexate (MTX) treatment success rate was 69.8%, and the success rate of the two-dose medical treatment with MTX was 87.5%. The most common surgical procedure for patients undergoing surgery (54%) were salpengectomy. Follow-up treatment was sufficient in 37 patients (19.2%). When the forms of treatment compared with certain parameters;There were found statistically significant difference between going to surgery with the high ß-hCG level, positive fetal cardiac beats (FHB), free fluid in the abdomen, large size of ectopic pregnancy and big gestational ages according to LMP (p <0.05). CONCLUSION: When the ectopic pregnancy diagnosed early; we investigated that patients with small gestational age belong to LMP with follow-up and medical treatment, and also we identified patients with advanced gestatioanal age were treated surgery treatment.Öğe Sezeryan skar gebeliği: olgu sunumu(Dicle Üniversitesi Tıp Fakültesi, 2011) Evsen, Mehmet Sıddık; Vural, Sezin; Obut, Mehmet; Karaçor, Talip; Taner, Mehmet ZekiSezaryen skarına implante olan gebelik, hayati tehlike içerebilen ve artan sezeryan oranı ile sıklığı artan, nadir bir klinik durumdur. Erken tanı ve tedavi bu hastalarda fertilitenin korunması ile beraber hayat kurtarıcı olabilmektedir. Transvajinal ultrasonografide uterin kavitenin boş olması ve servikal kavite varlığı ile anterior istmik bölgede myometrial devamlılığın olmaması ve gebelik ürünün bu bölgeye yerleştiğinin görülmesi tanıyı akla getirmelidir. Bu yazıda skar ektopik gebeliği saptanan hastayı literatür eşliğinde sunmayı amaçladık.Öğe Unscarred uterine rupture and subsequent pregnancy outcome-a tertiary centre experience(Via Medica, 2020) Peker, Nurullah; Aydın, Edip; Evsen, Mehmet Sıddık; Hançer, Fatma Nur; Bademkıran, Muhammed Hanifi; Ege, Serhat; Kahveci, Bekir; Karaçor, Talip; Gül, TalipObjectives: The aim of this study was to investigate the incidence, etiology and obstetric outcomes of rupture in unscarred uterine rupture and in those with a history of uterine rupture Material and methods: The hospital records of women who had delivered between May 2005 and May 2017 at a tertiary center were examined retrospectively. Data on patients with unscarred uterine rupture in pregnancy who had undergone fertility-preserving surgery were evaluated. Results: During the study period, 185,609 deliveries occurred. Of those, unscarred uterine rupture has occurred in 67 women. There were no ruptures reported in nulliparous women. The rupture was observed in the isthmic region in 60 (89.6%) patients and in the fundus in 7 (10.4%) patients. Thirty-eight (56.7%) patients had undergone a total or subtotal hysterectomy, and 29 (43.3%) patients had received primary repair. Ten patients had reconceived after the repair. Of these, eight patients who had a history of isthmic rupture, successfully delivered by elective C-section at 36-37 wk. of gestation, and two experienced recurrent rupture at 33 and 34 wk. of gestation, respectively. Both patients had a history of fundal rupture, and their inter-pregnancy interval was 9 and 11 mo., respectively. Conclusions: The incidence of rupture in unscarred pregnant uteri was found to be one per 2,770 deliveries. Owing to the high morbidity, regarding more than half of the cases with rupture eventuated in hysterectomy, clinicians should be prudent in induction of labour for multiparous women since it was the main cause of rupture in this series. Short inter-pregnancy intervals and history of fundal rupture may confer a risk for rupture recurrence. Those risk factors for recurrence should be validated in another studies.Öğe VAJİNAL HİSTEREKTOMİ SONRASI KOMPLİKASYONLARIN ORTAYA ÇIKMASINDA PREDİSPOZAN FAKTÖRLER(2013) Özler, Ali; Gül, Talip; Yaman, Neval Görük; Sak, Muhammet Erdal; Karaçor, Talip; Sak, SibelAmaç: Vajinal histerektomi sonrası komplikasyonların ortaya çıkmasında, predispozan risk faktörlerini araştırmak. Gereç ve yöntemler: Ocak 2006-Mart 2012 tarihleri arasında, üçüncü basamak sağlık merkezine başvuran ve benign patoloji nedeniyle vajinal histerektomi uygulanan 223 hastadan elde edilen verilerin retrospektif olarak analizi yapıldı. Kategorize edilen gruplar içindeki değişkenleri değerlendirmek için ki kare testi kullanıldı. Bulgular: Grup değişkenleri yaş, gebelik ve abort sayısı, parite, pelvik organ prolapsus sınışandırmasına(POP-Q) göre evreleri, hastane yatış ve üriner kateterizasyon sürelerinden oluştu. Ana komplikasyonlar hemoraji, febril morbidite ve vajinal kaf prolapsusu idi. İleri yaş (> 60), pelvik prolapsus, uzun süreli hastanede yatış ve üriner kateterizasyon komplikasyonların varlığı için predispozan faktörler idi. Sonuç: Vaginal histerektomi güvenli ve etkili bir yöntem olmasına rağmen intraoperatif veya postoperatif komplikasyonlardan tamamen yoksun değildir. İleri yaş (> 60), POP-Q evre 3-4 pelvik prolapsus, uzun süreli hastanede yatış ve üriner kateterizasyon, komplikasyonların varlığı için predispozan görünmektedir. Uygun preoperatif planlama ve titiz postoperatif bakım komplikasyon oranını azaltmak için yararlı olabilir.Öğe Yüksek Riskli HPV Pozitif Sitolojik Sonuçların, Kolposkopik Biyopsi Sonuçları İle Karşılaştırılması(Harran Üniversitesi, 2019) Karaçor, Talip; Sak, Sibel; Barut, Mert Ulaş; Peker, Nurullah; Sak, Muhammet ErdalAmaç: Yüksek risk HPV pozitif, normal veya anormal sitolojik bulgusu olan hastalarda kolposkopik biyopsi sonuçların değerlendirilmesi ve bu biyopsi sonuçları ile birliktelik gösteren yüksek risk HPV tiplerinin dağılımının belirlenmesi amaçlandı.Materyal ve Metod: Ocak 2017 ve Eylül 2017 tarihleri arasında rutin jinekolojik kontrol veya herhangi bir jinekolojik şikayetle Harran Üniversitesi Kadın Hastalıkları ve Doğum Kliniğine başvuran hastalar ile gerçekleştirildi. Hastalar 20-30, 31- 40 ve 40 yaş üstü olmak üzere 3 gruba ayrıldı. Hastalardan papsmear ve eş zamanlı olarak serviks transformasyon zonundan ve servikal eksternal os’tan HPV taraması için sürüntü alındı ve yüksek risk HPV DNA varlığı araştırıldı. Yüksek risk HPV pozitif normal veya anormal sitolojik bulgusu olan 84 hasta çalışmaya dahil edildi. Bulgular: Yüksek risk HPV pozitifliği olan 84 hastanın smear sonuçları; %61,9 inflamasyon, %6 ASCUS, %17,9 LGSIL, %10,7 yüksek dereceli servikal intraepitelyal lezyon, %1,2 atipik skuamoz hücreler-yüksek dereceli lezyonun ekarte edilemediği (ASC-H) ve % 2.4 atrofi olarak raporlandı. Smear sonucu inflamasyon olan hastalarda en sık kolposkopik biyopsi tanısı CIN I (%21,2), önemi bilinmeyen atipik skuamoz hücre olanlarda CIN II (%40), düşük dereceli servikal intraepitelyal lezyon olanlarda, epitelyal hiperplazi (%33,3) idi. Smear sonucu HSIL olan hastalarda %44,4 CIN II ve CIN III, %11,1 CIN I patolojik tanıları raporlandı. Skuamoz kanser tanısı alan iki hastada HPV 16, bir hastada ise HPV 18 pozitifliği saptanırken serviks adenokanser tanısı alan iki hastanın birinde HPV 16, diğerinde ise HPV 18 tespit edildi. Sonuç: Yüksek risk HPV pozitif olan hastalarda smear sonucundan bağımsız yapılan kolposkopik biyopsi ile displazik lezyonları saptama olasılığı artmaktadır. İleride daha kapsamlı çalışmalarla yüksek risk HPV taramasının tek başına smear testinin yerini alabileceğini düşünmekteyiz. Anahtar kelimeler: HPV, Smear, Kolposkopi, Sevikal patoloji
