Adolescence is the period that the step from childhood to adulthood is taken. It is a temporal process where the child experiences a series of physiological, psychological and social changes. The age of puberty is normally between 8-13 years of age in girls, while 9-14 years of age in boys. If signs of puberty is observed before the age of 8 in girls and 9 in boys, it may indicate ‘precocious puberty’ problem.

The reason of precocious puberty problem, whose cause cannot be revealed most of the time and which is more common in girls, may be a very important underlying medical problem. It must be approached more suspicious if it is observed especially in the boys. These underlying problems may be important conditions such as brain tumors, brain abscesses and infections, tumors of the adrenal cortex, tumors and diseases of ovarian and testicular tumors.

Follow-ups of the girls such as follow-up of puberty development, menstruation, especially the regulation of the vaccinations planned for the prevention of cervical cancer are performed in Liv Hospital Adolescent Gynecology Clinic. In addition, high success is also targeted in the diagnosis and treatment of problems such as menstrual bleeding disorders, hairing. The cause of the problem is investigated by examining children in 360 degrees. The solution is performed with a multidisciplinary approach in which endocrinologist, gynecologist, psychologist and also psychiatrist are included. To stop the early adolescence is aimed by the suppression of the activated system after a good evaluation and diagnosis. The actual time of puberty is waited and the development of puberty is allowed by stopping these medications. At the same time, certainly should get help for the child’s psychological problems. Eating habits, to pay attention to in terms of materials used and, above all, medical advice and help should be received if symptoms of early adolescence are present without losing sight.

All diseases related to women’s health, changes experienced before and after pregnancy, in menopause period, and gynecological cancer cases, which are the fearful dreams of every woman, are treated in Liv Hospital Gynecological Oncology Department.

Cervical cancer is a preventable or preventable disease. For this purpose, HPV vaccination, pap smear screening and the most appropriate treatment when cancer develops are performed with great success in Liv Hospital Gynecological Oncology Clinic. It competes with the centers with internationally the best results in endometrial and ovarian cancers, successful surgeries are performed.

Robotic and laparoscopic surgeries, which are the latest technology of today, are used in the treatment of gynecological diseases in Liv Hospital. The most effective and widespread use of robotic surgery is the area of gynecological oncology. It is successfully implemented in cervical and endometrial cancer surgeries.

In Liv Hospital, not a single physician, but “Tumor Council”, which is consisting of different medical units, decides the treatment method of the patient diagnosed with cancer. Surgical intervention or chemotherapy and radiotherapy is performed to the patient according to the decision arising from this council.

Gynecological Surgeries Through Single Hole and Without a Scar Formation

Robotic surgery through single hole or port, provides gynecological surgery to be performed without a scar formation by only using umbilicus. Since abdomen is inserted through umbilicus, port site stays in the abdomen. Therefore, another incision site does not develop on abdominal wall. For this region, a perfect cosmetic result is obtained.
An apparatus called port is placed inside umbilicus in this surgery. This port contains a system which allows a passage of one camera and two separated instruments. Entire handles used are attached to robot and controlled by the surgeon. Procedure is successfully performed.

Single port robotic surgery can be performed by using any segment of abdomen. However, best cosmetic result is obtained when umbilicus is used. Therefore, it can be used in diseases which may require surgical removal of myoma, problems of ovaries and tubes and some early grade gynecological cancers.

In single hole robotic surgery which requires some experience, gynecological surgeries are surgical procedures of future. And they are literally “minimally invasive procedures. Because in operation; instead of three to four holes, single hole is used. With progression of this technique, many surgeries can be performed with this way in near future.

Treated Diseases

Cervical Cancer

It is among the top ten most common cancers in our country, it is thought that 1300 – 1500 new cases are diagnosed every year. However, 60% of cases are diagnosed at an advanced stage without giving response to the treatment. It is thought that the burden of cervical cancer will increase every day with existing socio-cultural changes, and it will create a much bigger threat for our country in the coming years. Cervical cancer of thousands of women is detected in the early stages before the occurrence of cancerous as a result of pap smear screening in cervical cancers, and the lose of the women’s lives due to cancer is prevented.

Ovarian cancer

Ovarian cancers are also among the top ten most common cancers in women. As in all of the world, at least three-quarters of patients are being diagnosed in advanced stages in our country and unfortunately these cancers are coursing deadly in at least 80 percent of in these stages. The “Golden standard” in ovarian cancer patients is not to leave any visible tumor in the first surgery. The rate of performing successful surgery in the way that not leaving any visible tumor in Liv Hospital Gynecologic Oncology Clinic is 93 percent. This rate is 60 percent in some centers in Europe and 11 percent in Canada. Cancer tumor markers are also used widely and unconsciously unfortunately across the country for possible early detection of ovarian cancer. There is no yet known effective method of screening of ovarian cancer.

Endometrium (Intrauterine Membrane) Cancer

Another important cancer among women reproductive tract cancers is endometrium cancer, namely the cancer of the intrauterine membrane. The most common cancer of the female reproductive tract in women in Western countries is endometrial cancers, and it is among the top 10 most common cancers in our country. Usually, accompanying breast, ovarian or colon cancer may occur. Although there is no screening program, most of the cases are diagnosed at an early stage due to the presence of bleeding complaint. Therefore, endometrial cancer should be kept in mind in cases of postmenopausal vaginal bleeding, and it should be examined.

Other Women’s Reproductive System Cancers

Cancers of outer female reproductive system (vulva and vagina) and special female reproductive system cancer types are treated according to international standards in Liv Hospital Gynecologic Oncology Clinic.

High-risk pregnancy is the condition that may lead to complication during pregnancy, labor or postnatal period for mother, baby or both of them.

Who are at risk?

1. Expectant mothers with systemic diseases

Maternal hypertensive disorders
Diabetes mellitus,
Epilepsy
Autoimmune diseases (immune system disorders)
Coagulation disorder

2. Infections (may affect both mother and fetus)

Maternal infections, such as HIV, cytomegalovirus, parvovirus

3. Preterm birth risk

Multiple gestation
Cervical insufficiency during pregnancy

4 Placental pathologies
5. Patients with premature membrane rupture (early water break)
6. Pregnancies with preterm labor already started
7. Fetal Problems 

– Anatomical disorders
– Chromosomal abnormalities
– Genetics syndromes
– Cardiac abnormalities
– Blood Diseases
– Infections:
– Intrauterine growth retardation

Healthcare Services for Supervising High-risk Pregnancy in Liv Hospital
Supervision of high-risk pregnancy (heart diseases, diabetes, hypertension, thyroid gland disorders, hematological diseases, liver diseases, renal diseases, etc..)

Chorion villus biopsy (placental sampling at Week 11 to 14 for chromosome analysis and other genetic disease investigations)
Amniocentesis (for chromosome analysis and other genetic disease investigations)
Fetal neurosonography (examination that focuses on brain and central nervous system)
Advanced examination of fetal heart – fetal echocardiography
4D ultrasound imaging
Fetal blood sampling (cordocentesis)
Evaluating patients at preterm birth risk especially within scope of preterm birth screen, estimated delivery date and prevention program
Evaluating pepeated miscarriages and intra-uterine deaths, and investigating placental pathologies in cooperation with Department of Perinatal pathology
Investigating thrombophilia/blood coagulation disorders and genetic mutations

The purpose of the treatment of menopause in Liv Hospital Menopause Clinic is to eliminate menopausal complaints (hot flushes, sweating, palpitations, sleep disorders, attention deficit and loss of sexual desire), osteoporosis that occur in postmenopausal (years after menopause) women, heart and vascular diseases (coronary heart disease, stroke, venous thromboembolism (VTE)), diabetes , mood, depression, lack of realization and dementia disorders.

Symptoms such as hot flushes, sweating, sleep problems, mood disorders, decrease in sex, vaginal dryness, painful intercourse, difficulty in urination, frequent urination, bone loss (osteoporosis) may be observed in menopause, which means permanent termination of menstrual bleeding as a result of the loss of ovarian activity.

The duration of the symptoms of menopause varies from person to person. It may last short in some people while it can take up to 10 years in some people. Symptoms last for an average of 3 – 5 years. Hormone replacement (substitution) treatments and osteoporosis treatment used in some patients for complaints of hot flushes and so on are the most common treatment practices in Menopause Clinic.

Liv Hospital Perinatology Clinic takes care of both mother and baby’s health during pregnancy. The aim is to identify risky situations during pregnancy and to plan pregnancy follow-up and the necessary treatment accordingly. In Liv Hospital Perinatology Clinic, which is aware of how special this period is, mother candidates are informed in high-risk pregnancy and their follow-ups during pregnancy are performed. Mother and baby are supported for the completion of this process in a healthy way.

Procedures Performed in Liv Hospital Perinatology Clinic:

• Detailed ultrasound (fetal anomaly scan with ultrasound at 20-22 weeks)
• 11-12 week ultrasound (prediction of maternal risks such as pre-eclampsia, IUGR together, etc.)
• Evaluation of blood flow in pregnant women candidate and the baby (Doppler studies)
• Amniocentesis, chorionic villus biopsy and cordocentesis
• Intrauterine transfusion
• The treatment of problems developing in identical twins (intrauterine laser or intrauterine bipolar cord electrocoagulation)