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    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 Fatih
    Purpose: 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.
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    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, Berkan
    Objective: 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.
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    Mean platelet volume and platelet distribution as a diagnostic marker for penile vascular disease in patients with erectile dysfunction
    (Elsevier Doyma Sl, 2016) Resorlu, Mustafa; Adam, Gurhan; Doluoglu, Omer Gokhan; Bozkurt, Selen; Sancak, Eyup Burak; Akbas, Alpaslan; Gulpinar, Murat Tolga
    Objective: To investigate the relationship between platelet activation parameters that are involved in the vascular response, the atherothrombotic process, and erectile function, in which epithelial dysfunction plays a significant role. Materials and methods: A study was performed on patients who had a color Doppler ultrasound (CDUS) of the penis due to erectile dysfunction. The patients were divided into two groups: those with normal CDUS findings, and those with vascular dysfunction on CDUS. Patients were also divided into two groups according to their scores using the International Index of Erectile Function (IIEF). The relationships between platelet activation factors, vascular parameters, and severity of the disorder were analyzed. Results: A total of 91 patients who fulfilled the inclusion criteria were included in the study. CDUS showed vascular dysfunction in 55 patients (Group I), while the findings were normal in 36 patients (Group II). Age., cholesterol level, disease duration, mean platelet volume (MPV), and platelet distribution width (PDW) were compared between Groups I and II, with Group I showing significantly higher values. The parameters that could affect Doppler ultrasound results were analyzed using multivariate regression analysis. This showed that PDW and disease duration were independent prognostic factors (p=.021 and p=.005, respectively). When the patients were divided into two groups according to their IIEF scores, in those with mild (Group A) and severe disease (Group B), it was found that there were significant differences between the groups with age, disease duration, and PDW, while two groups were found similar in terms of MPV, cholesterol levels, and hormone parameters. Conclusion: It is supposed that increased platelet activation parameters, and PDW in particular, give important information for disease progression and follow-up of vascular dysfunction in erectile dysfunction. (C) 2015 Asociacion Espanola de Andrologia, Medicina Sexual y Reproductiva. Published by Elsevier Espana, S.L.U. All rights reserved.
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    Retrograde Intrarenal Surgery in Cross-fused Ectopic Kidney
    (Elsevier Science Inc, 2015) Resorlu, Mustafa; Kabar, Mucahit; Resorlu, Berkan; Doluoglu, Omer Gokhan; Kilinc, Muhammet Fatih; Karakan, Tolga
    Cross-fused renal ectopia is a rare congenital anomaly in which both kidneys are fused and located on the same side. We report a case of right-to-left cross-fused renal ectopia and nephrolithiasis, in whom retrograde intrarenal surgery was used to treat the stone disease. To our knowledge, this is the first case of retrograde intrarenal surgery of a crossed-fused ectopic kidney. (C) 2015 Elsevier Inc.
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    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, Arif
    OBJECTIVE 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.
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    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, Tolga
    Objective: 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.
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    Ureteroscopy in proximal ureteral stones after shock wave lithotripsy failure: Is it safe and efficient or dangerous?
    (Canadian Urological Association, 2015) Kilinc, Muhammet Fatih; Doluoglu, Omer Gokhan; Karakan, Tolga; Dalkilic, Ayhan; Sonmez, Nurettin Cem; Aydogmus, Yasin; Resorlu, Berkan
    Introduction: We assessed the effectiveness of ureteroscopy (URS) in proximal ureteral stones performed after shock wave lithotripsy (SWL) failure, and determined outcomes in terms of success rate, complications, and operation time. Methods: We analyzed data of patients with previous unsuccessful SWL (Group I) and the ones that did not have SWL or URS before (Group II) for proximal ureteral stones between December 2007 and August 2014. Group I included 346 patients who underwent complementary URS and Group II 209 patients who underwent primary URS. Success rates, operation time and complications were compared between groups. Results: Success rates of complementary and primary URS were 78.9% and 80.9%, respectively. The difference in success rates was not statistically significant between groups (p = 0.57). The complication rates of complementary URS was 12.1%, and 9.5% in primary URS (p = 0.49). No statistically significant differences were noted in terms of gender, age, stone size and side, or lithotripter type between groups. The mean operation time and need for balloon dilatation were higher in complementary URS group compared to the primary URS group, and the difference was statistically significant (p < 0.05). Conclusions: Complementary URS may be used safely after SWL failure in proximal ureteral stones. Its success rate and morbidities are similar to primary URS, except for longer operation time and an increased need for balloon dilatation.