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UTERUS SPARING PELVIC ORGAN PROLAPSE SURGERY

Yıl 2013, Cilt: 76 Sayı: 3, 59 - 64, 29.05.2013

Öz

Pelvik organ prolapse is a common condition affecting women of all ages. Contemporary women postpone their pregnancies to their late 30’s and prefer to preserve their fertility in advanced years. Therefore, uterus preserving pelvic organ prolapse surgery has gained wide acceptance. Surgical techniques including abdominal (open, laparoscopic, robotic) or vaginal methods may be preferred. The aim of this review is to discuss the most commonly used uterus preserving surgical techniques for the treatment of pelvic organ prolapse.

Kaynakça

  • Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C, Cottenden A, Davila W, de Ridder D, Dmochowski R, Drake M, Dubeau C, Fry C, Hanno P, Smith JH, Herschorn S, Hosker G, Kelleher C, Koelbl H, Khoury S, Madoff R, Milsom I, Moore K, Newman D, Nitti V, Norton C, Nygaard I, Payne C, Smith A, Staskin D, Tekgul S, Thuroff J, Tubaro A, Vodusek D, Wein A, Wyndaele JJ; Members of Committees; Fourth International Consultation on Incontinence. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn 2010;29:213-40.
  • Achtari C, Dwyer PL. Sexual function and pelvic floor disorders. Best Pract Res Clin Obstet Gynaecol 2005;19:993–1008.
  • Altman D, Granath F, Cnattingius S, Falconer C. Hysterectomy and risk of stress-urinaryincontinence surgery: nationwide cohort study. Lancet 2007;370:1494–1499.
  • Arthure HG, Savage D. Uterine prolapse and prolapse of the vaginal vault treated by sacral hysteropexy. J Obstet Gynaecol Br Emp 1957;64:355-60.
  • Ayhan A, Esin S, Guven S, Salman C, Ozyuncu O. The Manchester operation for uterine prolapse. Int J Gynaecol Obstet 2006;92:228-33.
  • Chmielewski L, Walters MD, Weber AM, Barber MD. Reanalysis of a randomized trial of 3 techniques of anterior colporraphy using clinically relevant definitions of success. Am J Obstet Gynecol 2011; 205: 69.e1-8.
  • Costantini E, Mearini L, Bini V, Zucchi A, Mearini E, Porena M. Uterus preservation in surgical correction of urogenital prolapse. Eur Urol 2005;48:642–649.
  • Constantini E, Porena M, Lazzeri M, Mearini L, Bini V, Zucchi A. Changes in female sexual function after pelvic organ prolapse repair. Int Urogynecol J 2013; 24:1481-1487. de Landsheere L, Ismail S, Lucot JP, et al. Surgical intervention after transvaginal Prolift mesh repair: retrospective single-center study including 524 patients with 3 years’ median follow-up. Am J Obstet Gynecol 2011; 206:83e81–87e81.
  • Dietz V, Schraffordt Koops SE, van der Vaart CH. Vaginal surgery for uterine descent; which options do we have? A review of the literature. Int Urogynecol J Pelvic Floor Dysfunct 2009;20:349
  • Diwan A, Rardin CR, Kohli N. Uterine preservation during surgery for uterovaginal prolapse: a review. Int Urogynecol J Pelvic Floor Dysfunct 2004;15:286–292.
  • Dökmeci F. Pelvik organ prolapsusu ve üriner inkontinansta tedavi seçenekleri. Turkiye Klinikleri J Med Sci 2005; 1: 32-36.
  • FDA executive summary: surgical mesh for the treatment of women with pelvic organ prolapse and stress urinary incontinence. 2011; http://www.fda.gov/downloads/advisorycommittees/ committeesMeetingMaterials/MedicalDevices/Medi calDevicesAdvisoryComittee/ObstetricsandGynecol ogy Devices/UCM270402.pdf.
  • Gamble TL, et al. Bilateral graft-augmented sacrospinous hysteropexy: 1-year anatomic and functional outcomes following surgery for uterine preservation. J Pelvic Med Surg 2008;14, 275–279.
  • Good MM, Korbly N, Kassis NC, Richardson ML, Book NM, Yip S, Saguan D, Gross C, Evans J, Harvie HS, Sung V; Society of Gynecologic Surgeons Fellows Pelvic Research Network. Prolapse-related knowledge and attitudes toward the uterus in women with pelvic organ prolapse symptoms. Am J Obstet Gynecol 2013. doi:pii: S0002-9378(13)00595-4. 1016/j.ajog.2013.06.001
  • Hagen S, Stark D. Conservative prevention and management of pelvic organ prolapse in women. Cochrane Database Sys Rev 2011: CD003882
  • Hasson HM. Cervical removal at hysterectomy for benign disease. J Rep Med 1993; 38:781–790. Hefni M, El-Toukhy T.
  • Sacrospinous cervicocolpopexy with follow-up 2 years after successful pregnancy. Eur J Obstet Gynecol Reprod Biol 2002;103:188-90.
  • Korbly NB, Kassis NC, Good MM, Richardson ML, Book NM, Yip S, Saguan D, Gross C, Evans J, Lopes VV, Harvie HS, Sung VW. Patient preferences for uterine preservation and hysterectomy in women with pelvic organ prolapse. Am J Obstet Gynecol 2013; doi:pii: S00029378(13)00821-1. 10.1016/j.ajog.2013.08.003.
  • Kovac SR, Cruikshank SH. Successful pregnancies and vaginal deliveries after sacrospinous uterosacral fixation in five of nineteen patients. Am J Obstet Gynecol 1993;168:1778-83.
  • Kow N, Goldman HB, Ridgeway B, Management options for women with uterine prolapse interested in uterine preservation. Curr Urol Rep. 2013 Oct; 14: 395-402.
  • Krause HG, Goh JT, Sloane K, Higgs P, Carey MP. Laparoscopic sacral suture hysteropexy for uterine prolapse. Int Urogynecol J Pelvic Floor Dysfunct 2006;17: 378-81. Maher CF, Cary MP, Slack MC, Murray CJ, Milligan M, Schluter P. Uterine preservation or hysterectomy at sacrospinou s colpopexy for uterovaginal prolapse. Int Urogynecol J Pelvic Floor Dysfunct 2001;12: 381-4. Marana HR, Andrade JM, Marana RR, Matheus de Sala M, Philbert PM, Rodrigues R. Vaginal hysterectomy for correcting genital prolapse. Longterm evaluation. J Reprod Med 1999; 44: 529-34. Marchionni M, Bracco GL, Checcucci V, Carabaneanu A, Coccia EM, Mecacci F, Scarselli G. True incidence of vaginal vault prolapse. Thirteen years of experience. J Reprod Med 1999;44: 679-84. Moiety FM, Hegab HM, Ghanem IA, Zedan WM, Salem HA. Abdominal sacrohysteropexy for uterovaginal prolapse: a prospective study on 33 cases. Arch Gynecol Obstet 2010;281: 631-6.
  • Mourik SL, Martens JE, Aktas M. Uterine preservation in pelvic organ prolapse using robotic assisted laparoscopic sacrohysteropexy: quality of life and technique. Eur J Obstet Gynecol Reprod Biol 2012: 165: 122-7.
  • Neuman M, Lavy Y. Conservation of the prolapsed uterus is a valid option: medium term results of a prospective comparative study with the posterior intravaginal slingoplasty operation. Int Urogynecol J Pelvic Floor Dysfunct 2007;18: 889-93.
  • Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 1997;89: 501-6.
  • Pattel MS, Mellen C, O’ Sullivan DM, Lassala CA. Pessary use and impact on quality of life and body image. Female Pelvic Med Reconstr Surg 2011; 17: 298-30
  • Petros PE. Vault prolapse II: Restoration of dynamic vaginal supports by infracoccygeal sacropexy, an axial day-case vaginal procedure. Int Urogynecol J Pelvic Floor Dysfunct 2001;12 :296-303.
  • Price N, Slack A, Jackson SR. Laparoscopic hysteropexy: the initial results of a uterine suspension procedure for uterovaginal prolapse. BJOG 2010;117: 62-8.
  • Richardson DA, Scotti RJ, Ostergard DR. Surgical management of uterine prolapse in young women. J Reprod Med 1989; 34: 388–392.
  • Rogo-Gupta L. Current trends in surgical repair of pelvic organ prolapse. Curr Opin Obstet Gynecol 2013; 25: 395-398.
  • Roovers JP, van der Vaart CH, van der Bom JG, van Leeuwen JH, Scholten PC, Heintz AP. A randomised controlled trial comparing abdominal and vaginal prolapse surgery: effects on urogenital function. BJOG 2004;111: 50-6.
  • Samuelsson EC, Victor FT, Tibblin G, Svärdsudd KF. Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. Am J Obstet Gynecol 1999;180: 299-305.
  • Sayer T, Lim J, Gauld JM, et al. Medium-term clinical outcomes following surgical repair for vaginal prolapse with tension-free mesh and vaginal support device. Int Urogynecol J 2012; 23: 487–493.
  • Silva WA, Pauls RN, Segal JL, Uterosacral vault suspension: five-year outcomes. Obstet Gynecol 2006; 108: 255-263.
  • Smith PH, Ballantyne B. The neuroanatomical basis for denervation of the urinary bladder following major pelvic surgery. Br J Surg 1968; 55: 929–933.
  • Subak LL, Waetjen LE, van den Eeden S, Thom DH, Vittinghoff E, Brown JS. Cost of pelvic organ prolapse surgery in the United States. Obstet Gynecol 2001; 98: 646-51.
  • Symmonds RE, Williams TJ, Lee RA, Webb MJ. Posthysterectomy enterocele and vaginal vault prolapse. Am J Obstet Gynecol 1981;140: 852-9.
  • Takahashi S, Obinata D, Sakuma T, Nagane Y, Sato K, Mochida J, Ichinose T, Yamaguchi K. Tensionfree vaginal mesh procedure for pelvic organ prolapse: a single-center experience of 310 cases with 1-year follow up. Int J Urol 2010;17: 353-8.
  • Thakar R, Ayers S, Clarkson P, Stanton S, Manyonda I. Outcomes after total versus subtotal abdominal hysterectomy. N. Engl J Med 2002; 347: 1318–1325.
  • Thakar R, Sultan AH Hysterectomy and pelvic organ dysfunction. Best Pract Res Clin Obstet Gynaecol 2005; 19: 403–418.
  • Thys SD, Roovers JP, Geomini PM, Bongers MY. Do patients prefer a pessary or surgery as primary treatment of pelvic organ prolapse? Gynecol Obstet Invest 2012; 74: 6-12.
  • Tipton RH, Atkin PF. Uterine disease after the Manchester repair operation. J Obstet Gynaecol Br Common 1970;77: 852-3 van Brummen HJ, van de Pol G, Aalders CI, Heintz AP, van der Vaart CH. Sacrospinous hysteropexy compared to vaginal hysterectomy as primary surgical treatment for a descensus uteri: effects on urinary symptoms. Int Urogynecol J Pelvic Floor Dysfunct 2003;14: 350-5. Vitobello D, Siesto G, Bulletti C. Robotic sacral hysteropexy for pelvic organ prolapse. Int J Med Robot 2012; 8: 114-7.
  • Walter JE, Lovatsis D, Easton W, et al. Transvaginal mesh procedures for pelvic organ prolapse. J Obstet Gynaecol Can 2011; 33: 168–174.
  • Weber AM, Walters MD, Piedmonte MR, Ballard LA. Anterior colporrhaphy: a randomized trial of three surgical techniques. Am J Obstet Gynecol 2001; 185: 1304-1306.
  • Williams BF. Surgical treatment for uterine prolapse in young women. Am J Obstet Gynecol 1966; 95: 967Yalçın Ö, Delier H. Üriner inkontinans ve pelvik organ prolapsusu: tanı ve tedavi seçimi. TJOD Uzmanlık Sonrası Eğitim Dergisi 2004; 8: 198-201. Zucchi A, Lazzeri M Porena M, Del Zingaro M, Costantini E. Uterus preservation in prolapse surgery. Nat Med 2010; 7: 626–633.

UTERUS KORUYUCU PELVİK ORGAN PROLAPSUS TEDAVİSİ

Yıl 2013, Cilt: 76 Sayı: 3, 59 - 64, 29.05.2013

Öz

Pelvik organ prolapsusu kadınlarda çok sık rastlanan ve her yaşta görülebilen bir sorundur. Günümüzde kadınlar, gebeliği 30’lu yaşların sonlarına ertelemekte ve ilerleyen yaşlarda da doğurganlıklarını korumayı tercih etmektedir. Dolayısıyla günümüzde pelvik organ prolapsus tedavisinde uterus koruyucu cerrahi ön plana çıkmaktadır. Uterus koruyucu cerrahi teknikler arasında abdominal (açık, laparoskopik veya robotik) veya vaginal yöntemler tercih edilebilir. Bu derlemenin amacı pelvik organ prolapsusunun tedavisinde en sık uygulanan ve uterusun korunduğu cerrahi tekniklerin tartışılmasıdır.

Kaynakça

  • Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C, Cottenden A, Davila W, de Ridder D, Dmochowski R, Drake M, Dubeau C, Fry C, Hanno P, Smith JH, Herschorn S, Hosker G, Kelleher C, Koelbl H, Khoury S, Madoff R, Milsom I, Moore K, Newman D, Nitti V, Norton C, Nygaard I, Payne C, Smith A, Staskin D, Tekgul S, Thuroff J, Tubaro A, Vodusek D, Wein A, Wyndaele JJ; Members of Committees; Fourth International Consultation on Incontinence. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn 2010;29:213-40.
  • Achtari C, Dwyer PL. Sexual function and pelvic floor disorders. Best Pract Res Clin Obstet Gynaecol 2005;19:993–1008.
  • Altman D, Granath F, Cnattingius S, Falconer C. Hysterectomy and risk of stress-urinaryincontinence surgery: nationwide cohort study. Lancet 2007;370:1494–1499.
  • Arthure HG, Savage D. Uterine prolapse and prolapse of the vaginal vault treated by sacral hysteropexy. J Obstet Gynaecol Br Emp 1957;64:355-60.
  • Ayhan A, Esin S, Guven S, Salman C, Ozyuncu O. The Manchester operation for uterine prolapse. Int J Gynaecol Obstet 2006;92:228-33.
  • Chmielewski L, Walters MD, Weber AM, Barber MD. Reanalysis of a randomized trial of 3 techniques of anterior colporraphy using clinically relevant definitions of success. Am J Obstet Gynecol 2011; 205: 69.e1-8.
  • Costantini E, Mearini L, Bini V, Zucchi A, Mearini E, Porena M. Uterus preservation in surgical correction of urogenital prolapse. Eur Urol 2005;48:642–649.
  • Constantini E, Porena M, Lazzeri M, Mearini L, Bini V, Zucchi A. Changes in female sexual function after pelvic organ prolapse repair. Int Urogynecol J 2013; 24:1481-1487. de Landsheere L, Ismail S, Lucot JP, et al. Surgical intervention after transvaginal Prolift mesh repair: retrospective single-center study including 524 patients with 3 years’ median follow-up. Am J Obstet Gynecol 2011; 206:83e81–87e81.
  • Dietz V, Schraffordt Koops SE, van der Vaart CH. Vaginal surgery for uterine descent; which options do we have? A review of the literature. Int Urogynecol J Pelvic Floor Dysfunct 2009;20:349
  • Diwan A, Rardin CR, Kohli N. Uterine preservation during surgery for uterovaginal prolapse: a review. Int Urogynecol J Pelvic Floor Dysfunct 2004;15:286–292.
  • Dökmeci F. Pelvik organ prolapsusu ve üriner inkontinansta tedavi seçenekleri. Turkiye Klinikleri J Med Sci 2005; 1: 32-36.
  • FDA executive summary: surgical mesh for the treatment of women with pelvic organ prolapse and stress urinary incontinence. 2011; http://www.fda.gov/downloads/advisorycommittees/ committeesMeetingMaterials/MedicalDevices/Medi calDevicesAdvisoryComittee/ObstetricsandGynecol ogy Devices/UCM270402.pdf.
  • Gamble TL, et al. Bilateral graft-augmented sacrospinous hysteropexy: 1-year anatomic and functional outcomes following surgery for uterine preservation. J Pelvic Med Surg 2008;14, 275–279.
  • Good MM, Korbly N, Kassis NC, Richardson ML, Book NM, Yip S, Saguan D, Gross C, Evans J, Harvie HS, Sung V; Society of Gynecologic Surgeons Fellows Pelvic Research Network. Prolapse-related knowledge and attitudes toward the uterus in women with pelvic organ prolapse symptoms. Am J Obstet Gynecol 2013. doi:pii: S0002-9378(13)00595-4. 1016/j.ajog.2013.06.001
  • Hagen S, Stark D. Conservative prevention and management of pelvic organ prolapse in women. Cochrane Database Sys Rev 2011: CD003882
  • Hasson HM. Cervical removal at hysterectomy for benign disease. J Rep Med 1993; 38:781–790. Hefni M, El-Toukhy T.
  • Sacrospinous cervicocolpopexy with follow-up 2 years after successful pregnancy. Eur J Obstet Gynecol Reprod Biol 2002;103:188-90.
  • Korbly NB, Kassis NC, Good MM, Richardson ML, Book NM, Yip S, Saguan D, Gross C, Evans J, Lopes VV, Harvie HS, Sung VW. Patient preferences for uterine preservation and hysterectomy in women with pelvic organ prolapse. Am J Obstet Gynecol 2013; doi:pii: S00029378(13)00821-1. 10.1016/j.ajog.2013.08.003.
  • Kovac SR, Cruikshank SH. Successful pregnancies and vaginal deliveries after sacrospinous uterosacral fixation in five of nineteen patients. Am J Obstet Gynecol 1993;168:1778-83.
  • Kow N, Goldman HB, Ridgeway B, Management options for women with uterine prolapse interested in uterine preservation. Curr Urol Rep. 2013 Oct; 14: 395-402.
  • Krause HG, Goh JT, Sloane K, Higgs P, Carey MP. Laparoscopic sacral suture hysteropexy for uterine prolapse. Int Urogynecol J Pelvic Floor Dysfunct 2006;17: 378-81. Maher CF, Cary MP, Slack MC, Murray CJ, Milligan M, Schluter P. Uterine preservation or hysterectomy at sacrospinou s colpopexy for uterovaginal prolapse. Int Urogynecol J Pelvic Floor Dysfunct 2001;12: 381-4. Marana HR, Andrade JM, Marana RR, Matheus de Sala M, Philbert PM, Rodrigues R. Vaginal hysterectomy for correcting genital prolapse. Longterm evaluation. J Reprod Med 1999; 44: 529-34. Marchionni M, Bracco GL, Checcucci V, Carabaneanu A, Coccia EM, Mecacci F, Scarselli G. True incidence of vaginal vault prolapse. Thirteen years of experience. J Reprod Med 1999;44: 679-84. Moiety FM, Hegab HM, Ghanem IA, Zedan WM, Salem HA. Abdominal sacrohysteropexy for uterovaginal prolapse: a prospective study on 33 cases. Arch Gynecol Obstet 2010;281: 631-6.
  • Mourik SL, Martens JE, Aktas M. Uterine preservation in pelvic organ prolapse using robotic assisted laparoscopic sacrohysteropexy: quality of life and technique. Eur J Obstet Gynecol Reprod Biol 2012: 165: 122-7.
  • Neuman M, Lavy Y. Conservation of the prolapsed uterus is a valid option: medium term results of a prospective comparative study with the posterior intravaginal slingoplasty operation. Int Urogynecol J Pelvic Floor Dysfunct 2007;18: 889-93.
  • Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 1997;89: 501-6.
  • Pattel MS, Mellen C, O’ Sullivan DM, Lassala CA. Pessary use and impact on quality of life and body image. Female Pelvic Med Reconstr Surg 2011; 17: 298-30
  • Petros PE. Vault prolapse II: Restoration of dynamic vaginal supports by infracoccygeal sacropexy, an axial day-case vaginal procedure. Int Urogynecol J Pelvic Floor Dysfunct 2001;12 :296-303.
  • Price N, Slack A, Jackson SR. Laparoscopic hysteropexy: the initial results of a uterine suspension procedure for uterovaginal prolapse. BJOG 2010;117: 62-8.
  • Richardson DA, Scotti RJ, Ostergard DR. Surgical management of uterine prolapse in young women. J Reprod Med 1989; 34: 388–392.
  • Rogo-Gupta L. Current trends in surgical repair of pelvic organ prolapse. Curr Opin Obstet Gynecol 2013; 25: 395-398.
  • Roovers JP, van der Vaart CH, van der Bom JG, van Leeuwen JH, Scholten PC, Heintz AP. A randomised controlled trial comparing abdominal and vaginal prolapse surgery: effects on urogenital function. BJOG 2004;111: 50-6.
  • Samuelsson EC, Victor FT, Tibblin G, Svärdsudd KF. Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. Am J Obstet Gynecol 1999;180: 299-305.
  • Sayer T, Lim J, Gauld JM, et al. Medium-term clinical outcomes following surgical repair for vaginal prolapse with tension-free mesh and vaginal support device. Int Urogynecol J 2012; 23: 487–493.
  • Silva WA, Pauls RN, Segal JL, Uterosacral vault suspension: five-year outcomes. Obstet Gynecol 2006; 108: 255-263.
  • Smith PH, Ballantyne B. The neuroanatomical basis for denervation of the urinary bladder following major pelvic surgery. Br J Surg 1968; 55: 929–933.
  • Subak LL, Waetjen LE, van den Eeden S, Thom DH, Vittinghoff E, Brown JS. Cost of pelvic organ prolapse surgery in the United States. Obstet Gynecol 2001; 98: 646-51.
  • Symmonds RE, Williams TJ, Lee RA, Webb MJ. Posthysterectomy enterocele and vaginal vault prolapse. Am J Obstet Gynecol 1981;140: 852-9.
  • Takahashi S, Obinata D, Sakuma T, Nagane Y, Sato K, Mochida J, Ichinose T, Yamaguchi K. Tensionfree vaginal mesh procedure for pelvic organ prolapse: a single-center experience of 310 cases with 1-year follow up. Int J Urol 2010;17: 353-8.
  • Thakar R, Ayers S, Clarkson P, Stanton S, Manyonda I. Outcomes after total versus subtotal abdominal hysterectomy. N. Engl J Med 2002; 347: 1318–1325.
  • Thakar R, Sultan AH Hysterectomy and pelvic organ dysfunction. Best Pract Res Clin Obstet Gynaecol 2005; 19: 403–418.
  • Thys SD, Roovers JP, Geomini PM, Bongers MY. Do patients prefer a pessary or surgery as primary treatment of pelvic organ prolapse? Gynecol Obstet Invest 2012; 74: 6-12.
  • Tipton RH, Atkin PF. Uterine disease after the Manchester repair operation. J Obstet Gynaecol Br Common 1970;77: 852-3 van Brummen HJ, van de Pol G, Aalders CI, Heintz AP, van der Vaart CH. Sacrospinous hysteropexy compared to vaginal hysterectomy as primary surgical treatment for a descensus uteri: effects on urinary symptoms. Int Urogynecol J Pelvic Floor Dysfunct 2003;14: 350-5. Vitobello D, Siesto G, Bulletti C. Robotic sacral hysteropexy for pelvic organ prolapse. Int J Med Robot 2012; 8: 114-7.
  • Walter JE, Lovatsis D, Easton W, et al. Transvaginal mesh procedures for pelvic organ prolapse. J Obstet Gynaecol Can 2011; 33: 168–174.
  • Weber AM, Walters MD, Piedmonte MR, Ballard LA. Anterior colporrhaphy: a randomized trial of three surgical techniques. Am J Obstet Gynecol 2001; 185: 1304-1306.
  • Williams BF. Surgical treatment for uterine prolapse in young women. Am J Obstet Gynecol 1966; 95: 967Yalçın Ö, Delier H. Üriner inkontinans ve pelvik organ prolapsusu: tanı ve tedavi seçimi. TJOD Uzmanlık Sonrası Eğitim Dergisi 2004; 8: 198-201. Zucchi A, Lazzeri M Porena M, Del Zingaro M, Costantini E. Uterus preservation in prolapse surgery. Nat Med 2010; 7: 626–633.
Toplam 44 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Derleme
Yazarlar

Funda Güngör Uğurlucan

Cenk Yaşa Bu kişi benim

Ercan Baştu

Özlem Dural

Önay Yalçın Bu kişi benim

Yayımlanma Tarihi 29 Mayıs 2013
Gönderilme Tarihi 29 Mayıs 2013
Yayımlandığı Sayı Yıl 2013 Cilt: 76 Sayı: 3

Kaynak Göster

APA Güngör Uğurlucan, F., Yaşa, C., Baştu, E., Dural, Ö., vd. (2013). UTERUS KORUYUCU PELVİK ORGAN PROLAPSUS TEDAVİSİ. Journal of Istanbul Faculty of Medicine, 76(3), 59-64.
AMA Güngör Uğurlucan F, Yaşa C, Baştu E, Dural Ö, Yalçın Ö. UTERUS KORUYUCU PELVİK ORGAN PROLAPSUS TEDAVİSİ. İst Tıp Fak Derg. Eylül 2013;76(3):59-64.
Chicago Güngör Uğurlucan, Funda, Cenk Yaşa, Ercan Baştu, Özlem Dural, ve Önay Yalçın. “UTERUS KORUYUCU PELVİK ORGAN PROLAPSUS TEDAVİSİ”. Journal of Istanbul Faculty of Medicine 76, sy. 3 (Eylül 2013): 59-64.
EndNote Güngör Uğurlucan F, Yaşa C, Baştu E, Dural Ö, Yalçın Ö (01 Eylül 2013) UTERUS KORUYUCU PELVİK ORGAN PROLAPSUS TEDAVİSİ. Journal of Istanbul Faculty of Medicine 76 3 59–64.
IEEE F. Güngör Uğurlucan, C. Yaşa, E. Baştu, Ö. Dural, ve Ö. Yalçın, “UTERUS KORUYUCU PELVİK ORGAN PROLAPSUS TEDAVİSİ”, İst Tıp Fak Derg, c. 76, sy. 3, ss. 59–64, 2013.
ISNAD Güngör Uğurlucan, Funda vd. “UTERUS KORUYUCU PELVİK ORGAN PROLAPSUS TEDAVİSİ”. Journal of Istanbul Faculty of Medicine 76/3 (Eylül 2013), 59-64.
JAMA Güngör Uğurlucan F, Yaşa C, Baştu E, Dural Ö, Yalçın Ö. UTERUS KORUYUCU PELVİK ORGAN PROLAPSUS TEDAVİSİ. İst Tıp Fak Derg. 2013;76:59–64.
MLA Güngör Uğurlucan, Funda vd. “UTERUS KORUYUCU PELVİK ORGAN PROLAPSUS TEDAVİSİ”. Journal of Istanbul Faculty of Medicine, c. 76, sy. 3, 2013, ss. 59-64.
Vancouver Güngör Uğurlucan F, Yaşa C, Baştu E, Dural Ö, Yalçın Ö. UTERUS KORUYUCU PELVİK ORGAN PROLAPSUS TEDAVİSİ. İst Tıp Fak Derg. 2013;76(3):59-64.

Contact information and address

Addressi: İ.Ü. İstanbul Tıp Fakültesi Dekanlığı, Turgut Özal Cad. 34093 Çapa, Fatih, İstanbul, TÜRKİYE

Email: itfdergisi@istanbul.edu.tr

Phone: +90 212 414 21 61