Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Urge Üriner İnkontinansı Olan Kadınlarda Pelvik Taban Kas Kuvveti ile Semptom Ciddiyeti, Yaşam Kalitesi ve Cinsel Fonksiyon Arasındaki İlişki: Korelasyon Çalışması
The Relationship Between Pelvic Floor Muscle Strength and Symptom Severity, Quality of Life and Sexual Function in Women with Urge Urinary Incontinence: Correlation Study
Tuğba BİRBEN KURTa, Bülent YILMAZb, Şeyda TOPRAK ÇELENAYc
aRecep Tayyip Erdoğan Üniversitesi Güneysu Fizik Tedavi ve Rehabilitasyon Yüksekokulu, Nörolojik Fizyoterapi-Rehabilitasyon ABD, Rize, Türkiye
bRecep Tayyip Erdoğan Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum ABD, Rize, Türkiye
cAnkara Yıldırım Beyazıt Üniversitesi Sağlık Bilimleri Fakültesi, Fizyoterapi ve Rehabilitasyon ABD, Ankara, Türkiye
Turkiye Klinikleri J Health Sci. 2022;7(4):1060-7
doi: 10.5336/healthsci.2022-89230
Article Language: TR
Full Text
ÖZET
Amaç: Bu çalışmanın amacı, urge üriner inkontinansı (UÜİ) olan kadınlarda pelvik taban kas kuvveti (PTKK) ile inkontinans semptom ciddiyeti, yaşam kalitesi ve cinsel fonksiyon arasındaki ilişkiyi incelemektir. Gereç ve Yöntemler: Çalışmaya 18-65 yaş arası UÜİ'si olan 40 kadın hasta dâhil edildi. Hastaların fiziksel ve klinik özellikleri kaydedildi. PTKK Modifiye Oxford Skalası ile inkontinans semptomları Uluslararası İnkontinans Konsültasyon Anketi-Kısa Formu [International Incontinence Consultation Questionnaire-Short Form (ICIQSF)] ile yaşam kalitesi King Sağlık Anketi (KSA) ile cinsel disfonksiyonu Pelvik Organ Prolapsusu/Üriner İnkontinansı Cinsel Fonksiyon Anketi [Pelvic Organ Prolapse/Urinary Incontinence by Sexual Function Questionnaire (PISQ-12)] ile değerlendi. İstatistiksel analiz için Spearman korelasyon katsayısı kullanıldı. Bulgular: UÜİ'si olan kadınlarda PTKK ile ICIQ-SF skoru (rho=-0,338; p=0,033) ile negatif yönde, PISQ-12 ile ilgili fiziksel etkilenim (rho=0,452; p=0,003) ve toplam skor (rho=0,427; p=0,006) arasında ise pozitif yönde ilişki olduğu tespit edildi. PTKK ile KSA alt boyutları ve PISQ-12'nin diğer alt boyutları arasında ise anlamlı ilişki olmadığı görüldü (p>0,05). Sonuç: Bu çalışmada, UÜİ'si olan kadınlarda PTKK azaldıkça inkontinans semptom şiddetinin ve cinsel disfonksiyonların arttığı bulundu. Ancak bu hasta grubunda PTKK ile yaşam kalitesi arasında anlamlı bir ilişki olmadığı saptandı. Kliniklerde bu hasta grubunda UÜİ semptomlarının azaltılması ve cinsel fonksiyonun iyileştirilmesi için çeşitli fizyoterapi ve rehabilitasyon yaklaşımlarının kullanılarak PTKK'yi artırmayı içeren tedavi programlarının oluşturulması önemli olabilir.

Anahtar Kelimeler: Pelvik taban; cinsel disfonksiyon; urge üriner inkontinans; yaşam kalitesi
ABSTRACT
Objective: The aim of this study was to examine the relationship between pelvic floor muscle strength (PFMS) and severity of incontinence symptoms, quality of life and sexual function in women with urge urinary incontinence (UUI). Material and Methods: Forty female patients aged 18-65 years with UUI were included in the study. Physical and clincal characteristics of the patients were recorded. PFMS were evaluated by Modified Oxford Scale, incontinence symptoms by International Incontinence Consultation Questionnaire-Short Form (ICIQ-SF), quality of life by King Health Questionnaire (KHQ), sexual dysfunction by Pelvic Organ Prolapse/Urinary Incontinence by Sexual Function Questionnaire (PISQ-12). Spearman correlation coefficient was used for statistical analysis. Results: In female with UUI, there was a negative correlation between PFMS and ICIQ-SF scores (rho=-0.338; p=0.033), a positive correlation was found between PFMS and PISQ-12-related physical effection (rho=0.452; p=0.003) and total score (rho=0.427; p=0.006). There was no significant relationship between PFMS and KHQ sub-dimensions and other sub-dimensions of PISQ-12 (p>0.05). Conclusion: In this study, it was found that the severity of incontinence symptom and sexual dysfunctions increased as PFMS decreased in women with UUI. However, there was no significant relationship between PFMS and quality of life in this patient group. In clinics, it may be important to establish treatment programs that include increasing PFMS by using various physiotherapy and rehabilitation approaches to reduce UUI symptoms and improve sexual function in this patient group.

Keywords: Pelvic floor; sexual dysfunction; urge urinary incontinence; quality of life
REFERENCES:
  1. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al; Standardisation Sub-committee of the International Continence Society. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21(2):167-78. [Crossref]  [PubMed] 
  2. Hunskaar S, Arnold EP, Burgio K, Diokno AC, Herzog AR, Mallett VT. Epidemiology and natural history of urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2000;11(5):301-19. [Crossref]  [PubMed] 
  3. Wein AJ. Classification of neurogenic voiding dysfunction. J Urol. 1981;125(5):605-9. [Crossref]  [PubMed] 
  4. Gameiro MO, Moreira EC, Ferrari RS, Kawano PR, Padovani CR, Amaro JL. A comparative analysis of pelvic floor muscle strength in women with stress and urge urinary incontinence. Int Braz J Urol. 2012;38(5):661-6. [Crossref]  [PubMed] 
  5. Nandy S, Ranganathan S. Urge incontinence. 2021 Sep 20. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. [PubMed] 
  6. Güner H, Yazıcı FG. Kadın genital sistemi ve pelvik taban anatomisi. Güner H, editör. Ürojinekoloji. 1. Baskı. Ankara: Atlas Kitapçılık Tic. Ltd. Şti.; 2000.
  7. Pizzol D, Demurtas J, Celotto S, Maggi S, Smith L, Angiolelli G, et al. Urinary incontinence and quality of life: a systematic review and meta-analysis. Aging Clin Exp Res. 2021;33(1):25-35. [Crossref]  [PubMed]  [PMC] 
  8. Radzimińska A, Strączyńska A, Weber-Rajek M, Styczyńska H, Strojek K, Piekorz Z. The impact of pelvic floor muscle training on the quality of life of women with urinary incontinence: a systematic literature review. Clin Interv Aging. 2018;13:957-65. [Crossref]  [PubMed]  [PMC] 
  9. Luginbuehl H, Baeyens JP, Taeymans J, Maeder IM, Kuhn A, Radlinger L. Pelvic floor muscle activation and strength components influencing female urinary continence and stress incontinence: a systematic review. Neurourol Urodyn. 2015;34(6):498-506. [Crossref]  [PubMed] 
  10. Grimes WR, Stratton M. Pelvic floor dysfunction. 2021 Nov 22. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. [PubMed] 
  11. Verbeek M, Hayward L. Pelvic floor dysfunction and its effect on quality of sexual life. Sex Med Rev. 2019;7(4):559-64. [Crossref]  [PubMed] 
  12. Mota RL. Female urinary incontinence and sexuality. Int Braz J Urol. 2017;43(1):20-8. [Crossref]  [PubMed]  [PMC] 
  13. Zeiger BB, da Silva Carramão S, Del Roy CA, da Silva TT, Hwang SM, Auge APF. Vaginal pessary in advanced pelvic organ prolapse: impact on quality of life. Int Urogynecol J. 2021:1-8. [PubMed]  [PMC] 
  14. Persu C, Chapple CR, Cauni V, Gutue S, Geavlete P. Pelvic Organ Prolapse Quantification System (POP-Q)-a new era in pelvic prolapse staging. J Med Life. 2011;4(1):75-81. [PubMed]  [PMC] 
  15. Laycock J, Jerwood D. Pelvic floor muscle assessment: the PERFECT scheme. Physiotherapy. 2001;87(12):631-42. [Crossref] 
  16. Çetinel B, Özkan B, Can G. ICIQ-SF Türkçe versiyonu validasyon (geçerlilik) çalışması [The validation study OF ICIQ-SF Turkish Version]. Türk Üroloji Dergisi. 2004;30(3):332-8. [Link] 
  17. Kaya S, Akbayrak T, Toprak Çelenay Ş, Dolgun A, Ekici G, Beksaç S. Reliability and validity of the Turkish King's Health Questionnaire in women with urinary incontinence. Int Urogynecol J. 2015;26(12):1853-9. [Crossref]  [PubMed] 
  18. Cam C, Sancak P, Karahan N, Sancak A, Celik C, Karateke A. Validation of the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) in a Turkish population. Eur J Obstet Gynecol Reprod Biol. 2009;146(1):104-7. [Crossref]  [PubMed] 
  19. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009;41(4):1149-60. [Crossref]  [PubMed] 
  20. Schober P, Boer C, Schwarte LA. Correlation coefficients: appropriate use and interpretation. Anesth Analg. 2018;126(5):1763-8. [Crossref]  [PubMed] 
  21. Cacciari LP, Dumoulin C, Hay-Smith EJ. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women: a cochrane systematic review abridged republication. Braz J Phys Ther. 2019;23(2):93-107. [Crossref]  [PubMed]  [PMC] 
  22. Woodley SJ, Boyle R, Cody JD, Mørkved S, Hay-Smith EJC. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2017;12(12):CD007471. Update in: Cochrane Database Syst Rev. 2020;5:CD007471. [PubMed]  [PMC] 
  23. Sobhgol SS, Charandabee SM. Related factors of urge, stress, mixed urinary incontinence and overactive bladder in reproductive age women in Tabriz, Iran: a cross-sectional study. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(3):367-73. [Crossref]  [PubMed] 
  24. Kim H, Yoshida H, Suzuki T. The effects of multidimensional exercise treatment on community-dwelling elderly Japanese women with stress, urge, and mixed urinary incontinence: a randomized controlled trial. Int J Nurs Stud. 2011;48(10):1165-72. [Crossref]  [PubMed] 
  25. Toprak Çelenay Ş, Karaaslan Y, Oskay K, Küçükdurmaz F. Aşırı aktif mesaneli kadınlarda pelvik taban kas kuvveti ile mesane semptom ciddiyeti ve kaygı düzeyi arasındaki ilişkisi [The relationship between pelvic floor muscle strength and bladder symptom severity and anxiety level in women with overactive bladder]. Türkiye Sağlık Bilimleri ve Araştırmaları Dergisi. 2018;1(2):1-7. [Link] 
  26. Cho ST, Kim KH. Pelvic floor muscle exercise and training for coping with urinary incontinence. J Exerc Rehabil. 2021;17(6):379-87. [Crossref]  [PubMed]  [PMC] 
  27. Chiaffarino F, Parazzini F, Lavezzari M, Giambanco V; Gruppo Interdisciplinare di Studio Incontinenza Urinaria (GISIU). Impact of urinary incontinence and overactive bladder on quality of life. Eur Urol. 2003;43(5):535-8. [Crossref]  [PubMed] 
  28. Schreiner L, dos Santos TG, Knorst MR, da Silva Filho IG. Randomized trial of transcutaneous tibial nerve stimulation to treat urge urinary incontinence in older women. Int Urogynecol J. 2010;21(9):1065-70. [Crossref]  [PubMed] 
  29. Firra J, Thompson M, Smith SS. Paradoxical findings in the treatment of predominant stress and urge incontinence: a pilot study with exercise and electrical stimulation. Journal of Women's Health Physical Therapy. 2013;37(3):113-23. [Crossref] 
  30. Kafri R, Deutscher D, Shames J, Golombp J, Melzer I. Randomized trial of a comparison of rehabilitation or drug therapy for urgency urinary incontinence: 1-year follow-up. Int Urogynecol J. 2013;24(7):1181-9. [Crossref]  [PubMed] 
  31. Haraldstad K, Wahl A, Andenæs R, Andersen JR, Andersen MH, Beisland E, et al; LIVSFORSK network. A systematic review of quality of life research in medicine and health sciences. Qual Life Res. 2019;28(10):2641-50. [Crossref]  [PubMed]  [PMC] 
  32. Fayers PM, Machin D. Quality of Life: the Assessment, Analysis and Interpretation of Patient-Reported Outcomes. 2nd ed. Chichester: John Wiley & Sons; 2013.
  33. Hwang UJ, Lee MS, Jung SH, Ahn SH, Kwon OY. Relationship between sexual function and pelvic floor and hip muscle strength in women with stress urinary incontinence. Sex Med. 2021;9(2):100325. [Crossref]  [PubMed]  [PMC] 
  34. Gomes TA, Faber MA, Botta B, Brito LGO, Juliato CRT. Severity of urinary incontinence is associated with prevalence of sexual dysfunction. Int Urogynecol J. 2020;31(8):1669-74. [Crossref]  [PubMed] 

.: Up To Date

Login



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