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Öğe Does Preoperative Use of Dutasteride Decrease Bleeding During Open Prostatectomy?(Urol & Nephrol Res Ctr-Unrc, 2018) Demirbas, Arif; Resorlu, Berkan; Gulpinar, Murat Tolga; Kardas, Sina; Doluoglu, Omer Gokhan; Tepeler, Abdulkadir; Kilinc, Muhammet FatihPurpose: To investigate whether use of dutasteride, a 5-alpha reductase inhibitor, for at least four weeks preoperatively affected the blood loss during open prostatectomy (OP). Materials and methods: Retrospective analysis was made of the data of 110 patients who had undergone OP. Group I comprised 50 patients that used dutasteride for 4 weeks preoperatively, and Group II comprised 60 patients that did not use the drug. The groups were compared in respect of age, total prostate specific antigen (TPSA) levels, prostate volumes, preoperative hemoglobin (Hgb) and hematocrit (Hct) levels, postoperative reduction of Hgb and Hct, percentage reduction in Hgb and Hct, and the administration of postoperative blood products. Results: No differences were determined between the two groups in respect of prostate volumes, TPSA, preoperative Hgb and Hct levels (P = .813, P = .978, P = .422, P = .183, respectively). Postoperative Hgb reduction was 2.19 +/- 1.36 g/dL in Group I, and 2.5 +/- 1.47 g/dL in Group 11 (P = .260). Hgb reduction was calculated as 16.4 +/- 9.7% in Group I and 17.6 +/- 9.7% in Group II (P = .505). Reductions in Hct were 5.8 +/- 3.7% in Group I, and 7.3 +/- 4.4% in Group II, and percent reductions were 14.8 +/- 9.4% in Group I and 17.3 +/- 10.2% in Group II (P = .068, P = .182, respectively). Conclusion: The use of dutasteride before OP did not affect blood loss during surgery, therefore surgery should not be delayed for the administration of dutasteride to patients.Öğe Evaluating Ureteral Wall Injuries with Endoscopic Grading System and Analysis of the Predisposing Factors(Mary Ann Liebert, Inc, 2016) Karakan, Tolga; Kilinc, Muhammet Fatih; Demirbas, Arif; Hascicek, Ahmet Metin; Doluoglu, Omer Gokhan; Yucel, Mehmet Ozgur; Resorlu, BerkanObjective: To analyze the predictive factors for intraoperative ureteral wall injury due to semirigid ureteroscopy (URS) used in the treatment of ureteral calculi. Methods: The data of 437 patients who had URS due to ureteral stones were prospectively analyzed. The ureteral wall injuries that occurred during URS were reviewed endoscopically at the end of surgery and divided into two groups as low grade (grades 0 and 1) and high grade (grades 2, 3, and 4) according to classification of ureteral wall injuries. Those two groups were compared for patient and stone characteristics and perioperative findings. Results: Ureteral wall injury was seen in 133 (30.4%) patients after surgery. According to the endoscopic classification of the lesions after URS, grades 0, 1, 2, and 3 injury were seen in 69.5%, 16.4%, 11.2%, and 2.7% of the patients, respectively. There were no grade 4 injuries in our series. Two groups showed statistically significant differences for the location (prox- vs distal and mid-ureter) and size of the stone (9.9mm vs 14.03mm), presence of preoperatively urinary tract infection (UTI) (12% vs 50.8%), needed balloon dilatation (9.8% vs 36.1%), duration of surgery (33.6min vs 43.3min), and surgical success rate (90% vs 76%) (p=0.01, for all). Stone size, location, duration of surgery, and presence of preoperative infection were determined as independent prognostic factors for mucosal injury. Conclusion: The ureteral wall injury grading system may be used for standardized reporting of ureteral lesions after ureteroscopy. Big, proximal ureteral stone, longer operation time, and presence of UTI are the risk factors for ureteral wall injury during URS.Öğe The Effect of Intraurethral Dexpanthenol on Healing and Fibrosis in Rats With Experimentally Induced Urethral Trauma(Elsevier Science Inc, 2015) Yardimci, Ibrahim; Karakan, Tolga; Resorlu, Berkan; Doluoglu, Omer Gokhan; Ozcan, Serkan; Aydin, Arif; Demirbas, ArifOBJECTIVE To determine the efficacy of dexpanthenol applied early after urethral trauma for preventing inflammation and spongiofibrosis. MATERIALS AND METHODS Twenty-seven rats were randomized and divided into 3 groups, with 9 rats in each group. The urethras of all rats were traumatized with a pediatric urethrotome knife at 6-o' clock. For 14 days, group I was given 0.9% saline twice a day (control group), group II was given dexpanthenol 500 mg/kg ampules once a day and 0.9% saline once a day, and group III was given dexpanthenol 500 mg/kg ampules twice a day intraurethrally using a 22 ga catheter sheath. On day 15, the penises of the rats were degloved to perform penectomy. RESULTS The mean fibrosis scores were 2.4, 2.2, and 1.4, and mean inflammation scar scores were 2, 1.4, and 1.3 in groups I, II, and III, respectively. There was a significant difference between groups I and II for inflammation (P = .011); however, the difference for fibrosis was not significant (P = .331). The differences between groups I and III were statistically significantly different both for inflammation and fibrosis (P = .004 and P = .003, respectively). Groups II and III were not different significantly for inflammation (P = .638); however, there was less fibrosis in group III, in which high-dose dexpanthenol was administered. CONCLUSION We showed that dexpanthenol applied early after urethral trauma significantly decreased inflammation and spongiofibrosis. We hope that our study will help to decrease strictures after urethral trauma and contribute to pharmaceutical investigations aiming to improve the success of the surgery for urethral strictures. (C) 2015 Elsevier Inc.Öğe The effect of music therapy during shockwave lithotripsy on patient relaxation, anxiety, and pain perception(Taylor & Francis Ltd, 2016) Akbas, Alpaslan; Gulpinar, Murat Tolga; Sancak, Eyup Burak; Karakan, Tolga; Demirbas, Arif; Utangac, Mehmet Mazhar; Dede, OnurObjectives: To research the effect of listening to music during shock wave lithotripsy (SWL) on the patient's pain control, anxiety levels, and satisfaction. Patients and methods: The study comprised 400 patients from three hospitals. Half of patients listened to music during their first SWL session but not during their second session. The other half had no music for the first session but the second session was accompanied by music. During all sessions, with and without music, pulse rates, blood pressure, State-Trait Anxiety Inventory-State Anxiety scores (STAI-SA), Visual Analog Scale (VAS scores for pain), willingness to repeat procedure (0=never to 4 happily), and patient satisfaction rates (0=poor to 4=excellent) were assessed. Results: There was no statistical difference between the two groups in terms of blood pressure and pulse rates. In both groups, the STAI-SA and VAS pain scores were lower in the session when music was listened to (p< 0.001). The patients requested more SWL treatment be completed while listening to music and their satisfaction was greater. Conclusion: Music lowered the anxiety and pain scores of patients during SWL and provided greater satisfaction with treatment. Completing this procedure while the patient listens to music increases patient compliance greatly and reduces analgesic requirements.Öğe The protective effect of Papaverine and Alprostadil in rat testes after ischemia and reperfusion injury(Brazilian Soc Urol, 2018) Karagoz, Mehmet Ali; Doluoglu, Omer Gokhan; Unverdi, Hatice; Resorlu, Berkan; Sunay, Mehmet Melih; Demirbas, Arif; Karakan, TolgaObjective: To investigate the effect of papaverine and alprostadil on testicular torsion-detorsion injury in rats. Materials and Methods: A total of 40 male Wistar-Albino rats were used in this study. Four hours of right testicular torsion was applied to each group, excluding sham operated group. The torsion-detorsion (T/D), T/D + papaverine and T/D + alprostadil groups received saline, papaverine and alprostadil at the same time as surgical detorsion, respectively. At 14 days after the surgical detorsion, ischaemic changes and the degree of damage were evaluated with Cosentino scoring and the Johnson tubular biopsy score (JTBS). Results: JTBS was determined as 8.8 +/- 2.7 in the Sham group, 5.08 +/- 1.9 in the T/D+papaverine group, 5.29 +/- 2.3 in the T/D +alprostadil group and 2.86 +/- 1.9 in the TD group. The JTBS was determined to be statistically significantly high in both the T/D + papaverine group and the T/D + alprostadil group compared to the T/D group (p=0.01, p=0.009). In the T/D + papaverine group, 3 (43 We) testes were classified as Cosentino 2, 3 (43%) as Cosentino 3 and 1 (14 %) as Cosentino 4. In the T/D +alprostadil group, 5 (50 %) testes were classified as Cosentino 2, 3 (30 %) as Cosentino 3 and 2 (20%) as Cosentino 4. Conclusion: The present study indicated that spermatic cord administration of alprostadil and papaverine showed a protective effect against ischemia/reperfusion injury after right-side testes torsion and histological changes were decreased after testicular ischemia reperfusion injury.
