Journal of Reconstructive Urology

.: REVIEW
Postprostatektomi İnkontinans Tedavisinde Erkek Slingler
Male Slings for Postprostatectomy Incontinence
Fatih YANARALa, Çağlar DİZDAROĞLUa, Ömer SARILARa, Faruk ÖZGÖRa
aÜroloji Kliniği, İstanbul Haseki Eğitim ve Araştırma Hastanesi, İstanbul, TÜRKİYE
J Reconstr Urol. 2019;9(1):16-24
doi: 10.5336/urology.2019-66416
Article Language: TR
Full Text
ÖZET
 Günümüzde, erkeklerde görülen stres üriner inkontinansın en önemli nedeni radikal prostatektomidir. Postprostatektomi üriner inkontinansın patofizyolojisinde intrensek sfinkter yetmezliği, nöral yaralanma, üretral destek defektleri ve azalmış membranöz üretral uzunluk yer almaktadır. Her ne kadar cerrahi tecrübenin artışına bağlı olarak postprostatektomi üriner inkontinansı oranı azalıyor olsa da nüfusun ve beklenen yaşam süresinin artışı nedeni ile yapılan radikal prostatektomi sayısının artması sebebiyle postprostatektomi üriner inkontinansı prevalansı artmaktadır. Son zamanlarda postprostatektomi üriner inkontinansı için sentetik erkek sling ameliyatları düşük maliyeti, daha az invaziv yapısı ve işeme sırasında mekanik manipülasyon gerekmemesi nedeni ile önemli ölçüde popülerlik kazanmıştır. Bu çalışmada, postprostatektomi üriner inkontinansı tedavisinde uygulanan erkek sling seçeneklerinin sunulması amaçlanmıştır.

Anahtar Kelimeler: Erkek; prostatektomi; subüretral slingler; üriner inkontinans
ABSTRACT
 The most important cause of stress urinary incontinence in men is radical prostatectomy. The pathophysiology of postprostatectomy urinary incontinence includes intrinsic sphincter deficiency, neural injury, urethral support defects, and decreased membranous urethral length. Although the postprostatectomy urinary incontinence rate is decreasing due to the increase in the surgical experience, the prevalence of postprostatectomy urinary incontinence increases due to the increase in the number of radical prostatectomies due to the increase in population and increase in the expected life expectancy. Recently, synthetic male sling surgeries for postprostatectomy urinary incontinence have gained considerable popularity due to the low cost, less invasive structure and no need for mechanical manipulation during voiding. In this review, we aimed to present male sling options for postprostatectomy urinary incontinence treatment.

Keywords: Male; prostatectomy; suburethral slings; urinary incontinence
REFERENCES:
  1. Pompe RS, Tian Z, Preisser F, Tennstedt P, Beyer B, Michl U, et al. Shortand long-term functional outcomes and quality of life after radical prostatectomy: patient re-ported outcomes from a tertiary high-volume center. Eur Urol Focus. 2017;3(6):615-20. [Crossref] [PubMed]
  2. Wei JT, Dunn RL, Marcovich R, Montie JE, Sanda MG. Prospective assessment of patient reported urinary continence after radical prostatectomy. J Urol. 2000;164(3 Pt 1):744-8. [Crossref]
  3. Wei JT, Montie JE. Comparison of patients? and physicians? rating of urinary inconti-nence following radical prostatectomy. Semin Urol Oncol. 2000;18(1):76-80.
  4. Herschorn S, Bruschini H, Comiter C, Grise P, Hanus T, Kirschner-Hermanns R, et al. Surgical treatment of stress incontinence in men. Neurourol Urodyn. 2010;29(1):179-90.[Crossref] [PubMed]
  5. Kowalczyk KJ, Levy JM, Caplan CF, Lipsitz SR, Yu HY, Gu X, et al. Temporal na-tional trends of minimally invasive and retropubic radical prostatectomy outcomes from 2003 to 2007: results from the 100% medicare sample. Eur Urol. 2012;61(4):803-9. [Crossref] [PubMed]
  6. Kumar A, Litt ER, Ballert KN, Nitti VW. Artificial urinary sphincter versus male sling for post-prostatectomy incontinence--what do patients choose? J Urol. 2009;181(3):1231-5.[Crossref] [PubMed]
  7. Chung E. Contemporary surgical devices for male stress urinary incontinence: a review of technological advances in current continence surgery. Transl Androl Urol. 2017;6(Suppl 2):S112-21. [Crossref] [PubMed] [PMC]
  8. Kretschmer A, Buchner A, Grabbert M, Sommer A, Herlemann A, Stief CG, et al. Pe-rioperative patient education improves long-term satisfaction rates of low-risk prostate cancer patients after radical prostatectomy. World J Urol. 2017;35(8):1205-12. [Crossref] [PubMed]
  9. Madjar S, Jacoby K, Giberti C, Wald M, Halachmi S, Issaq E, et al. Bone anchored sling for the treatment of post-prostatectomy incontinence. J Urol. 2001;165(1):72-6. [Crossref] [PubMed]
  10. Cespedes RD, Jacoby K. Male slings for postprostatectomy incontinence. Tech Urol. 2001;7(2):176-83.
  11. Carmel M, Hage B, Hanna S, Schmutz G, Tu le M. Long-term efficacy of the bone-anchored male sling for moderate and severe stress urinary incontinence. BJU Int. 2010;106(7):1012-6. [Crossref] [PubMed]
  12. Giberti C, Gallo F, Schenone M, Cortese P. The bone-anchor suburethral sling for the treatment of iatrogenic male incontinence: subjective and objective assessment after 41 months of mean follow-up. World J Urol. 2008;26(2):173-8. [Crossref] [PubMed]
  13. Guimarães M, Oliveira R, Pinto R, Soares A, Maia E, Botelho F, et al. Intermediate-term results, up to 4 years, of a bone-anchored male perineal sling for treating male stress urinary incontinence after prostate surgery. BJU Int. 2009;103(4):500-4. [Crossref] [PubMed]
  14. Sénéchal C, Limani K, Djeffal C, Paul A, Saint F, Petit J. [Perineoscrotal pain after InVance suburethral sling: cadavre anatomical study]. Progr Urol. 2008;18(7):456-61. [Crossref] [PubMed]
  15. Rehder P, Gozzi C. Transobturator sling suspension for male urinary incontinence in-cluding post-radical prostatectomy. Eur Urol. 2007;52(3):860-6. [Crossref] [PubMed]
  16. Rehder P, Freiin von Gleissenthall G, Pichler R, Glodny B. [The treatment of postprostatectomy incontinence with the retroluminal transobturator repositioning sling (Advance): lessons learned from accumulative experience]. Arch Esp Urol. 2009;62(10):860-70. [Crossref]
  17. Elzevier HW, Cornel EB. The 1-year outcome of the transobturator retroluminal repo-sitioning sling in the treatment of male stress urinary incontinence. BJU Int. 2010;106(7):1091.[Crossref] [PubMed]
  18. Gozzi C, Becker AJ, Bauer RM, Bastian PJ. Early results of transobturator sling sus-pension for male urinary incontinence following radical prostatectomy. Eur Urol. 2008;54(4): 960-1. [Crossref] [PubMed]
  19. Cornu JN, Sèbe P, Ciofu C, Peyrat L, Cussenot O, Haab F. Mid-term evaluation of the transobturator male sling for post-prostatectomy incontinence: focus on prognostic factors. BJU Int. 2011;108(2):236-40. [Crossref] [PubMed]
  20. Bauer RM, Grabbert MT, Klehr B, Gebhartl P, Gozzi C, Homberg R, et al. 36-month data for the AdVance XP® male sling: results of a prospective multicentre study. BJU Int. 2017;119(4):626-30. [Crossref] [PubMed]
  21. Bauer RM, Mayer ME, May F, Gratzke C, Buchner A, Soljanik I, et al. Complications of the AdVance transobturator male sling in the treatment of male stress urinary in-continence. Urology. 2010;75(6):1494-8. [Crossref] [PubMed]
  22. Comiter CV, Rhee EY. The ?ventral urethral elevation plus? sling: a novel approach to treating stress urinary incontinence in men. BJU Int. 2008;101(2):187-91.
  23. Comiter CV, Nitti V, Elliot C, Rhee E. A new quadratic sling for male stress inconti-nence: retrograde leak point pressure as a measure of urethral resistance. J Urol. 2012;187(2): 563-8. [Crossref] [PubMed]
  24. Comiter CV, Rhee EY, Tu LM, Herschorn S, Nitti VW. The Virtue sling-a new qua-dratic sling for postprostatectomy incontinence-results of a multinational clinical trial. Urology. 2014;84(2):433-8. [Crossref] [PubMed]
  25. Ferro M, Bottero D, D?Elia C, Matei DV, Cioffi A, Cozzi G, et al. Virtue male sling for postprostatectomy stress incontinence: a prospective evaluation and mid-term outcomes. BJU Int. 2017;119(3):482-8. [Crossref] [PubMed]
  26. Hogewoning CR, Meij LAM, Pelger RCM, Putter H, Krouwel EM, Elzevier HW. Sling surgery for the treatment of urinary incontinence after transurethral resection of the prostate: new data on the virtue male sling and an evaluation of literature. Urology. 2017;100:187-92.[Crossref] [PubMed]
  27. Kretschmer A, Hübner W, Sandhu JS, Bauer RM. Evaluation and management of postprostatectomy incontinence: a systematic review of current literature. Eur Urol Focus. 2016;2(3):245-59. [Crossref] [PubMed]
  28. Cornu JN, Batista Da Costa J, Henry N, Peyrat L, Beley S, Haab F. Comparative study of AdVance and AdVanceXP male slings in a tertiary reference center. Eur Urol. 2014;65(2): 502-4. [Crossref] [PubMed]
  29. Romano SV, Metrebian SE, Vaz F, Muller V, D?Ancona CA, de Souza EA, et al. [Long-term results of a phase III multicentre trial of the adjustable male sling for treat-ing urinary incontinence after prostatectomy: minimum 3 years]. Actas Urol Esp. 2009;33(3):309-14.
  30. Romano SV, Metrebian SE, Vaz F, Muller V, D?Ancona CA, Costa DE Souza EA, et al. An adjustable male sling for treating urinary incontinence after prostatectomy: a phase III multicentre trial. BJU Int. 2006;97(3):533-9. [Crossref] [PubMed]
  31. Lima JP, Pompeo AC, Bezerra CA. Argus T® versus Advance® sling for postprosta-tectomy urinary incontinence: a randomized clinical trial. Int Braz J Urol. 2016;42(3):531-9. [Crossref] [PubMed] [PMC]
  32. Chung E, Smith P, Malone G, Cartmill R. Adjustable versus non-adjustable male sling for post-prostatectomy urinary incontinence: a prospective clinical trial comparing pa-tient choice, clinical outcomes and satisfaction rate with a minimum follow up of 24 months. Neurourol Urodyn. 2016;35(4):482-6. [Crossref] [PubMed]
  33. Hubner WA, Gallistl H, Rutkowski M, Huber ER. Adjustable bulbourethral male sling: experience after 101 cases of moderate-tosevere male stress urinary inconti-nence. BJU Int. 2011;107(5):777-82. [Crossref] [PubMed]
  34. Bochove-Overgaauw DM, Schrier BP. An adjustable sling for the treatment of all de-grees of male stress urinary incontinence: retrospective evaluation of efficacy and complications after a minimal followup of 14 months. J Urol. 2011;185(4):1363-8. [Crossref] [PubMed]
  35. Seweryn J, Bauer W, Ponholzer A, Schramek P. Initial experience and results with a new adjustable transobturator male system for the treatment of stress urinary incontinence. J Urol. 2012;187(3):956-61. [Crossref] [PubMed]
  36. Angulo JC, Arance I, Esquinas C, Dorado JF, Marcelino JP, Martins FE. Outcome measures of adjustable transobturator male system with pre-attached scrotal port for male stress urinary incontinence after radical prostatectomy: a prospective study. Adv Ther. 2017;34(5): 1173-83. [Crossref] [PubMed]
  37. Friedl A, Muhlstadt S, Zachoval R, Giammò A, Kivaranovic D, Rom M, et al. Long-term outcome of the adjustable transobturator male system (ATOMS): results of a Eu-ro-pean multicentre study. BJU Int. 2017;119(5):785-92.[Crossref] [PubMed]
  38. Sousa-Escandón A, Cabrera J, Mantovani F, Moretti M, Ioanidis N, Neymeyer J, et al. Adjustable suburethral sling (male Remeex system) in the treatment of male stress urinary incontinence: a multicentric European study. Eur Urol. 2007;52(5):1473-9. [Crossref] [PubMed]
  39. Kretschmer A, Nitti V. Surgical treatment of male postprostatectomy incontinence: current concepts. Eur Urol Focus. 2017;3(4-5):364-76. [Crossref] [PubMed]

.: Up To Date

.: Process List

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com