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Öğe Ağırlık Kontrolü ve Beslenme Eğitiminin Erektil Disfonksiyon Tedavisindeki Yeri ve Öneminin Değerlendirilmesi(2019) Arda, Ersan; Cakiroglu, Basri; Karacan, Elif; Akdere, Hakan; Şentürk, Aykut BuğraAmaç: Erektil disfonksiyonun (ED) etyolo- jisinde ve tedavisinde beslenme ve vücut ağırlık kontrolünün yeri ve önemini araştırmak. Gereç ve Yöntemler: Kasım 2013 - Aralık 2015 tarihleri arasında üroloji polikliniğinde ED tanısı konulan 152 hasta beslenme eğitimi ve ağırlık tedavisi için diyet polikliniğine yönlendi- rilerek beslenme ve vücut ağırlık kontrolü sağlan- maya çalışıldı. Bu hastalara üroloji polikliniğinde Uluslararası Erektil Fonksiyon İndeksi Formu (IIEF) doldurularak diyet polikliniğinde 2 aylık takip sonrası IIEF skoru yeniden değerlendirildi. Bu iki IIEF skoru arasındaki farkın istatistiksel olarak anlamlılığına bakıldı. Temel beslenme alışkanlıkları ve antropometrik ölçümlere ilişkin bilgileri (boy uzunluğu (cm), vücut ağırlığı (kg), vücut kitle indeksi (VKİ) (kg/m2), bel-kalça çev- resi (cm), bel-kalça oranı, boyun çevresi ve vücut yağ oranı sorgulayan anket formu, günlük besin alımı, beslenme durumunun belirlenmesi için besin tüketim sıklığı formu ve biyokimyasal kan parametreleri formu uygulandı. Bulgular: Çalışmaya toplam 152 hasta katıl- mıştır. Çalışmaya katılanların yaşları ortalaması 41.69 ±11.22 dir. Tedavi öncesi IIEF, VKİ, Homa İndexi sırasıyla 19.5, 30.1kg/m2, 5.05 mg/dl iken tedavi sonrası IIEF, VKİ ve Homa İndex sırasıy- la 21, 29kg/m2, 4.46 mg/dl olarak bulunmuştur (p<0,001). Ayrıca tedavi öncesi ile sonrası sisto- lik kan basınçları arasında istatistiksel olarak an- lamlı düşüş görülmüştür (p=0.008). Buna karşın tedavi öncesi diastolik kan başınçları ile tedavi sonrasındaki değerler arasında anlamlı bir fark tespit edilmedi. Sonuç: Beslenme ve ağırlık kontrolü ile erektil disfonksiyonun tedavisine katkı sağlamak mümkündür.Öğe Analgesic Effects of Oligonol, Acupuncture and Quantum Light Therapy on Chronic Nonbacterial Prostatitis(Zamensalamati Publ Co, 2015) Akdere, Hakan; Oztekin, Ilhan; Arda, Ersan; Aktoz, Tevfik; Turan, Fatma Nesrin; Burgazli, Kamil MehmetBackground: Chronic Nonbacterial Prostatitis (CNBP) is a condition that frequently causes long-term pain and a significant decrease in the quality of life. Objectives: The present study aimed to examine the analgesic effects of oligonol, acupuncture, quantum light therapy and their combinations on estrogen-induced CNBP in rats. Materials and Methods: This experimental study was conducted in Edirne, Turkey, using a simple randomized allocation. A total of 90 adult male Wistar rats were randomized into 9 groups of 10 rats each: Group I, control; Group II, CNBP, Group III, oligonol only, Group IV, acupuncture only; Group V, quantum only; Group VI, oligonol + quantum; Group VII, acupuncture + oligonol; Group VIII, quantum + acupuncture; Group IX, acupuncture + quantum + oligonol. Oligonol treatment was given at a dose of 60 mg/ day for 6 weeks. Conceptual vessels (CV) 3 and 4, and bilaterally urinary bladder (Bl) 32 and 34 points were targeted with 1-hour acupuncture stimulation. The quantum light therapy was applied in 5-minute sessions for 6 weeks (3-times/a week). For pain measurements, mechanical pressure was applied to a point 2 cm distal to the root of the tail to elicit pain and consequent parameters (peak force, latency time of response and total length of measurement) were assessed. Results: Analgesic effects were observed with all treatment regimens; however, the most prominent median analgesic effect was shown in the quantum light therapy in combination with acupuncture for estrogen-induced CNBP (PF1 = 663.9, PF2 = 403.4) (P = 0.012). Furthermore, we observed that monotherapy with quantum light showed a better analgesic efficacy as compared to oligonol and acupuncture monotherapies (PF1 = 1044.6, PF2 = 661.2) (P = 0.018, P = 0.008, P = 0.018; respectively). Conclusions: All treatment modalities showed a significant analgesic effect on CNBP in rats, being most prominent with the quantum light therapy.Öğe Analysis of T1c prostate cancers treated at very low prostate-specific antigen levels(Galenos Yayincilik, 2009) Kaplan, Mustafa; Arda, ErsanBackground:The Prostate Cancer Prevention Trial (PCPT) has challenged the validity of recommended prostate-specific antigen (PSA) thresholds for prostate biopsy (>2.5 ng/ml) given the 17% prostate cancer (pCA) detection rate at PSA of 1.1-2.0. The outcome of patients treated at PSA is poorly defined, and advantages associated with such an early diagnosis are uncertain. Objective: Compare the outcome of patients with Tlc pCA with pretreatment PSA and 2.6-4.0. Design, setting, and participants: Since 1998, 351 patients with clinical stage Tlc and PSA 4.0 have been treated at our institution; 84 (24%) of those patients had PSA 2.5. Clinical information was obtained from a prospective database. Treatment was radical prostatectomy, brachytherapy, and external-beam radiotherapy in 261 (74%), 67 (19%), and 23 (7%) patients, respectively. Measurements: Progression-free probability and pathological end points. Results and limitations: No significant differences between the groups were observed in terms of biopsy (18% vs 22%) or specimen Gleason score 7-8 (44% vs 56%), non organ-confined cancer (11% vs 13%), indolent cancer (34% vs 24%), or 5-yr progression -free probability (89% vs 93%; p > 0.1 for all). More biologically unimportant cancers (defined as pathologically organ-confined and Gleason were identified among patients with PSA (55% vs 41%, p = 0.050), and indolent cancers were three times more frequent than non organ-confined cancers among these patients (p = 0.003). Conclusions: The pathological features and outcome of patients treated at low PSA levels are favorable and similar for patients with PSA versus 2.6-4.0. However, >50% of the former have potentially biologically unimportant cancer. We failed to identify a therapeutic benefit to the diagnosis of cancers below accepted PSA thresholds for biopsy.Öğe The association of Intron 4 VNTR and Glu298Asp polymorphisms of the nitric oxide synthetase 3 gene and vasculogenic erectile dysfunction in Turkish men(Taylor & Francis Inc, 2019) Arda, Ersan; Ay, Arzu; Akdere, Hakan; Akdeniz, EsraSeveral studies have focused on the impaired role of endothelial nitric oxide synthase (NOS3) gene polymorphism and its association to erectile dysfunction (ED). However, currently controversial results have been reported due to their significant heterogeneity. The present study aimed to assess the genotypic distribution and the allelic frequency of Intron 4 VNTR and Glu298Asp gene polymorphisms in vasculogenic ED patients compared to healthy controls of a specific region of Turkey. A total of 75 patients with ED (median age: 56, IQR:10.5) and 75 healthy controls (median age: 56, IQR:10.5) were prospectively analyzed. All subjects were equally evaluated by the same physician with detailed history-taking, physical examination, International Index of Erectile Function (IIEF) questionnaire, and blood tests (incl. glucose, testosterone, triglyceride and total cholesterol level). Those with an IIEF score under 26 were considered to have ED, by classifying them according to their scores as mild (22-25), moderate (11-21) and severe (1-10) ED. Color doppler ultrasonography was carried out in patients with an IIEF score <22. Hypertension, diabetes mellitus, coronary artery disease, and smoking status were significantly associated with the ED group compared to control subjects with p values of <0.001, <0.001, 0.002 and <0.001, respectively. Overall genotype frequencies was 47 (31%) a/a, 22 (15%) a/b, 82 (55%) b/b for Intron 4 VNTR and 56 (37%) GG, 78 (52%) GT, 16 (11%) TT for the Glu298Asp polymorphism. The frequencies of Intron 4 VNTR a/a allele and Glu298Asp GT allele were associated with severe ED, while a/b and TT were associated with moderate or mild, and b/b and GG were associated with no ED. In contrast to Glu298Asp, statistically significant differences in genotypic frequencies of Intron 4 VNTR gene polymorphism between ED and control subjects was established.Öğe Bilateral same-session flexible ureterorenoscopy for renal and/or ureteric stone disease treatment(Arab Assoc Urology, 2018) Arda, Ersan; Cakiroglu, BasriObjective: To evaluate the effectiveness and safety of bilateral same-session flexible ureterorenoscopy (f-URS) in the treatment of bilateral renal and/ or ureteric stone disease. Patients and methods: From October 2007 to December 2015, 62 patients who had undergone bilateral, same-session f-URS were included in the study. The procedures were performed under general anaesthesia, in lithotomy, and initiated on the side in which the patient was clinically symptomatic or on the side in which the stone was smaller. Plain abdominal radiography, intravenous urography, renal ultrasonography and/or non-contrast computed tomography scans were conducted in all patients. The success rate was defined as, patients who were stone-free or only had residual fragments of < 3 mm. Results: A total of 62 patients (43 male, 19 female), with a mean (SD) age of 39 (15.1) years, were included. The mean (SD) stone size was 23.2 (6.11) mm with a mean (SD) operative time of 58.8 (16.24) min. The stone-free rates were 90.3% and 100% after the first and second procedures, respectively. The mean (SD) hospital stay was 1.58 (0.72) days. There were minor complications (Clavien-Dindo grade I-II) in 10 (16%) patients and major complications (Clavien-Dindo III-IV), e.g. distal ureter laceration and laser injury of the ureter, in two patients. Conclusion: Same session bilateral f-URS is a successful and safe method for bilateral renal and/or ureteric stones. (C) 2018 Production and hosting by Elsevier B.V. on behalf of Arab Association of Urology.Öğe Bladder Neck Collagen Injection in the Treatment of Congenital Retrograde Ejaculation: A Case Report(Springernature, 2017) Cakiroglu, Basri; Sinanoglu, Orhun; Arda, ErsanThe present study describes the first successful treatment of a congenital retrograde ejaculation case with a submucosal collagen injection to the bladder neck. A 28-year-old male (height 170 cm, weight 80 kg) attended to the urology outpatient clinic with complaints of scattered urine stream and absence of ejaculation. The laboratory tests, including hormone profile (follicle stimulating hormone, luteinizing hormone, and testosterone) and the routine blood count were within normal ranges, whereas semen analysis demonstrated a total absence of ejaculation. The analysis of post-ejaculate urine specimens revealed an elevated sperm concentration indicative of retrograde ejaculation. The cystoscopy was performed; the prostatic urethra was normal, the verumontanum was in the orthotopic position, and the bladder neck was wide opened. Dextranomer/hyaluronic acid copolymer (Deflux, 8 ml) was injected into the bladder neck at clock positions of one, five, seven, and 11 o'clock. During the same procedure, the large opening in the vesical collum was obliterated. During the first followup (four weeks after surgery), the patient was able to produce a normal (2.8 ml) ejaculation volume. The sperm analysis revealed normozoospermia, with 25 million spermatozoa/ml, 26% (a) and 57% (a + b) motility, and 14% normal morphology. The submucosal bladder neck collagen injection is a minimally invasive technique that quickly restores anterograde ejaculation and should be considered in the patients with congenital or acquired retrograde ejaculation and for those who did not respond to the medical treatment.Öğe Can the Urologists Perform Stone Analysis, Metabolic Evaluation and Metaphylaxis at Urinary Tract Stone Disease in Tekirdağ?(2019) Yazıcı, Cenk Murat; Akgül, Hacı Murat; Arda, Ersan; Akpınar, HalukObjective: As the urolithiasis is an endemic situation in our country, the urologists are well-experienced about thissituation. The prevention of urolithiasis recurrence is as important as the surgical treatment. For this reasonmetabolic evaluation and medical treatment of stone disease is extremely important. This study aimed to evaluateurological specialists' views of metabolic evaluation and medical treatment of urolithiasis. Thus, the main problemsand the probable solutions about medical treatment and metabolic evaluation of urinary system stone disease can beevaluated.Methods: The urologists working at Tekirdag were invited to the study. A face-to-face questionnaire, which wascomposed of three parts, was performed to the participants. In the first section, the demographic characteristics of theparticipants were evaluated. In the second and third sections, the approach of participants to metabolic evaluationand medical treatment in urolithiasis were investigated, respectively.Results: A total of 29 urologist who routinely performed endourological surgery were included to the study. When weevaluated their endourological practice, 65.5% of the participants were performing 10-25 endourological surgery permonth. When we asked the approach of participants about the metabolic evaluation, 34.5% reported that they did notperform metabolic evaluation to their adult patients and 65.5% did not perform to the children with urolithiasis. Allparticipants believed the efficacy of medical treatment however, 66% of the participants were performing at less thanhalf of their patients in clinical practice.Conclusions: The clinical practice about metabolic evaluation, stone analysis and metaphylaxis were lower thanexpected. Most of the participants were not able to make metabolic evaluation and stone analysis. Further studies areneeded to resolve the problems associated with metabolic evaluation and metaphylaxis administration.Öğe Chronic Bacterial Prostatitis in a Turkish Population: The Microbiological Etiology and Distribution(Aves, 2018) Arda, Ersan; Cakiroglu, Basri; Arikan, Mehmet Gurkan (Trakya author); Gozukucuk, RamazanObjective: To investigate the category 2 frequency and microorganism distribution of patients diagnosed with chronic prostatitis in a Turkish population. Methods: Data of 3200 patients diagnosed with chronic prostatitis in the urology outpatient clinic between 2009 and 2014 were retrospectively reviewed. The symptom scores were calculated considering the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) according to pain (0-21 points), quality of life (0-12 points), and urinary (0-10 points) subdomains to a total score of 0-43 points. All patients were checked for symptoms, urinalysis, expressed prostatic secretion (EPS), or urine after prostatic massage (VB3) culture and PCR (Polymerase Chain Reaction) of EPS or VB3 for Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, Mycoplasma genitalium, and Trichomonas vaginalis. Results: The mean age of the patients was calculated as 37.7 +/- 7.4 (range 22-65) years. The average of total NIH-CPSI score was determined as 9.08 (range 1-40). In 223 of 3200 patients, positive culture and/or PCR results were observed. The results were as follows: E. coli 27 (12.1%), E. faecalis 18 (8.1%), S. epidermidis 15 (6.7%), S. haemolyticus 10 (4.5%), S. aureus 5 (2.2%), S. agalactiae 4 (1.8%), Pseudomonas 3 (1.3%), C. trachomatis 24 (10.8%), U. urealyticum 95 (42.6%), M. genitalium 6 (2.7%), M. hominis 14 (6.3%), and T. vaginalis 2 (0.9%). Conclusion: In a Turkish population, category 2 patients constitute 7% of all chronic prostatitis patients. This ratio is consistent with the NIH classification of prostatitis data, but it differs etiologically with U. urealyticum, E. coli, and C. trachomatis being the most proliferated pathogens in our study.Öğe The clinical significance of abnormal ejaculation by silodosin. Is it important?(Wiley, 2021) Akgul, Murat; Yazici, Cenk; Sipal, Timucin; Arda, ErsanWe aimed to evaluate the effect of the abnormal ejaculation (AEj) on patients using silodosin in terms of drug cessation. We also analysed the possible factors that may affect the decisions of patients with AEj to proceed or change their medication. The patients (n = 118) treated with silodosin 8 mg daily were prospectively analysed. In order to evaluate the erectile function, ejaculatory function, depression and sexual satisfaction; IIEF, MSHQ-EjD, Beck's depression and Golombok-Rust questionnaires were given to patients respectively. Patients were re-evaluated at the 3rd month of their treatment. The rate of AEj was 52.5%. Nearly 42% of the patients with AEj desired to stop their medication whereas it was 7.1% at patients without AEj (p < .001). The pre-treatment International Prostate Symptom Score (IPSS) and the decrease in IPSS score were significantly lower in patients who demand to stop their treatment (p < .05). AEj was significantly higher in patients who wanted to stop their medication (p < .001). Even if they had an AEj, patients who were happy with the clinical efficacy of silodosin did not want to change their drug. In addition to this, pre-treatment ejaculatory status was an important indicator for patients to decide drug cessation due to AEj side effect of silodosin.Öğe Comparison of prostate cancer detection rates between the Vienna nomogram and the 10-core biopsy protocol(Sage Publications Ltd, 2020) Arda, Ersan; Demir, Zafer; Yuksel, Ilkan; Cek, MeteObjective: To compare the Vienna nomogram and the 10-core prostate biopsy protocol regarding whether there is superiority in prostate cancer detection. Methods: Between January and December 2012, a total of 215 patients applying to our outpatient clinic with lower urinary tract symptoms were evaluated, prospectively. Patients with a prostate-specific antigen level of 2.5-10 ng/mL and/or suspicious digital rectal examination were included in the study. Exclusion criteria were determined as recent pelvic radiotherapy, lower urinary tract surgery, history of acute urinary retention, or indwelling urinary catheter. Biopsies were taken systematically with at least 10 cores considering prostate volume and patient age. According to Vienna nomogram, in patients requiring 6- or 8-core biopsies, tissue sampling was completed to 10 cores (our standard protocol), whereas in patients requiring more than 10 cores additional tissue sampling was performed. Results: After the determination of inclusion/exclusion criteria, 170 patients were enrolled in our study. The median (min-max) age, prostate-specific antigen value, and prostate volume were 65 (48-86) years, 7.6 ng/dL (2.5-10), and 55 cc (17-150), respectively. Prostate cancer was detected in 49 (28.8%) patients with transrectal ultrasound-guided prostate biopsy according to the Vienna nomogram. We found that our standard 10-core biopsy protocol would have diagnosed prostate cancer in 46 (27.1%) patients in the same study group showing no statistically significant difference (p > 0.005). Conclusion: The findings of this study suggest that considering cancer detection rates no statistically significant differences were found between both methods. Further prospective research in this aspect is needed to define the ultimate prostate biopsy protocol.Öğe Contrary effects of coenzyme Q10 and vitamin E after testicular ischemia/reperfusion in a rat model validated with glucose metabolism imaging(Sage Publications Ltd, 2021) Arda, Ersan; Yuksel, Ilkan; Akdere, Hakan; Akdeniz, Esra; Yalta, Tulin D.; Aktoz, Tevfik; Altun, Gulay D.Objective: To evaluate the efficacy of antioxidants in cellular-level post-ischemia/reperfusion injury of the testis and to validate these effects with F-18-fluorodeoxyglucose positron emission tomography. Methods: Fifty-six adult male rats were randomly divided into seven groups-Group 1: sham; Group 2: ischemia/reperfusion only group; Group 3: ischemia was induced and vitamin E (100 mg/kg) was administered intraperitoneally 30 min before reperfusion; Group 4: vitamin E was given intraperitoneally without ischemia/reperfusion; Group 5: ischemia was induced and coenzyme Q10 (10 mg/body weight) was administered intraperitoneally 30 min before reperfusion; Group 6: coenzyme Q10 was administered intraperitoneally without ischemia/reperfusion; Group 7: ischemia was induced and coenzyme Q10 + vitamin E was administered intraperitoneally 30 min before reperfusion. After detorsion, fluorodeoxyglucose was applied to all groups according to the animals' weight and fluorodeoxyglucose positron emission tomography was performed after 1 h. In pursuit of imaging, orchiectomy was performed for histopathological and biochemical evaluations. Results: A significant effect of group on catalase, maximum standardized uptake value, and seminiferous tubule diameters (p < 0.005) was observed. According to this, combining ischemia/reperfusion with vitamin E increased the maximum standardized uptake value significantly higher than in all other groups; in addition, catalase was significantly higher than in Groups 4-6. Histopathological outcomes revealed that sham had significantly larger seminiferous tubule diameter than Groups 2-4. Also, ischemia/reperfusion was the only group which had significantly smaller seminiferous tubule diameters than Groups 6 and 7. Conclusion: In contrast to vitamin E, coenzyme Q10 provided remarkable regression of oxidative stress-induced enzymes and revealed consistent effects on histopathological outcomes, which were validated with fluorodeoxyglucose positron emission tomography imaging.Öğe Correlation of Ultrasonically Determined Bladder Wall Thickness and Prostatic Calcification With the Urinary, Psychosocial Dysfunction, Organ Specific, Infection and Neurological/Systemic Symptoms, and Tenderness Scoring System(Elsevier Science Inc, 2019) Arda, Ersan; Cakiroglu, Basri; Akdeniz, Esra; Akdere, Hakan; Yuksel, Ilkan; Senturk, Aykut B.OBJECTIVE To evaluate ultrasonically determined bladder wall thickness (BWT) and prostatic calcification presence, in men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and to correlate the findings with patient characteristics and the urinary, psychosocial dysfunction, organ specific, infection and neurological/systemic symptoms, and tenderness (UPOINT) classification system. MATERIAL AND METHODS Between January 2008 and December 2017, data of 1294 patients diagnosed with chronic prostatitis, in a single urology clinic, meeting a number of selective inclusion/exclusion criteria, were retrospectively analyzed. Patients, compliant to fill out all requested questionnaires, between the ages of 21-65 years were included to the study. Exclusion criteria were noncompliance of filling out required questionnaires, acute and/or chronic bacterial prostatitis, history of genitourinary cancer, history of recent prostate surgery, and diagnosis of neurological diseases affecting the bladder. RESULTS The median patient age and UPOINT subdomain was determined as 37 (IQR = 13, range 21-65) and 2 (IQR = 1, range 0-5), respectively. Median values for BWT, National Institute of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), and International Index of Erectile Function were 3 (IQR = 1, range 2-6, 7), 4 (IQR = 6, range 1-23), and 25 (IQR = 10, range 1-30), respectively. The presence of calcification demonstrated a significant association with total NIH-CPSI score and BWT, whereas its relation with age and total UPOINT score was insignificant. However in contrast to calcification status, BWT >= 3.3 showed a strong and statistically significant relation to all the described measurements. CONCLUSION Measurement of BWT can be used as an accessible and objective method for the diagnose of CP/CPPS according to UPOINT scoring system. (C) 2018 Elsevier Inc.Öğe Could Retrograde Intrarenal Surgery be Used as an Efficient Technique in the Treatment of Calyceal Diverticula Stones(Coll Physicians & Surgeons Pakistan, 2022) Cakiroglu, Basri; Tas, Tuncay; Aksoy, Suleyman Hilmi; Arda, ErsanObjective: To evaluate the efficacy of retrograde intrarenal surgery (RIRS) and holmium laser lithotripsy in the treatment of symptomatic renal calyceal diverticular (CD) stones. Study Design: A case series. Place and Duration of Study: Department of Urology, Hisar Intercontinental Hospital, from 2008 and 2019. Methodology: Patients who underwent holmium laser lithotripsy with RIRS to manage symptomatic CD stones were evaluated retrospectively. Demographics, stone size, operation and hospital stay duration, the success of treatment and complications were noted. Result: Among the 30 treated patients, 13 patients were female and 17 were male. The mean age was 45.4 +/- 11.9 (26-64), the stone diameter was 14.4 +/- 4.1 mm, operation time was 70.47 +/- 35.7 (35-155) minutes, and mean length of hospital stay was 1.27 +/- 0.5 (1-3) days. In those patients who underwent RIRS, 26 (86.7%) were successfully treated while in 4 of 30 patients (13.3%) the procedure was not successful. Complications were observed in 10 (33.3%) patients. Clavien-I complications were demonstrated in 6 patients, Clavien III complications were demonstrated in 3 patients. One patient had urosepsis, 2 patients had ureteral laceration, and one patient with Clavien IV complication had perirenal hematoma. Conclusion: Laser lithotripsy therapy with RIRS is a safe and effective treatment for symptomatic calyceal diverticular stones and can be offered as the first-line treatment for calyceal diverticular stones.Öğe Does Mild Hydronephrosis Induced by Full-Bladder Improve Outcomes in Patients Undergoing Shock Wave Lithotripsy for Lower Calyceal Stones?: A Prospective Randomized Study(Urol & Nephrol Res Ctr-Unrc, 2018) Hazar, Ismet Aydin; Cakiroglu, Basri; Sinanoglu, Orhun; Akgun, Feride Sinem; Arda, Ersan; Yuksel, Ilkan; Akdere, HakanPurpose: To compare the outcomes, sessions and shock wave numbers in patients undergoing standard procedure shock wave lithotripsy (SWL) and patients undergoing SWL with mild hydronephrosis induced by full-bladder following oral hydration before SWL procedure for lower calyceal stones. Materials and Methods: Between January 2014-January 2016 a total of 371 patients who underwent SWL, for lower pole calyceal stones 2 cm, were included into the study. 127 patients were treated in the supine position (Group A), 123 in the prone position (Group B) and 121 in the prone position with full bladder and mild hydronephrosis checked by ultrasound before procedure (Group C). There were 286 men and 85 women with a mean SD age of 36 11 years Results: The mean (SD) stone sizes within the group A, group B and group C were 11 mm (+/- 3 mm), 12 mm (+/- 4.1 mm) and 11 mm ( +/- 3.8 mm) respectively. No significant difference was found in age (P =.18) and stone size between 3 groups (P =.07). The median interquartile range (IQR) number of shocks within the group A, group B and group C were 7600 (3855), 6500 (4300) and 6700 (4915) respectively. Significant difference was found in number of shock waves among 3 groups (P <.01). The difference between groups according to stone expulsion rate was found significant in all sessions (P =.01). Conclusion: The present study suggests that mild hydronephrotic status induced by full-bladder before SWL can lower cost and patient discomfort by decrease in number of sessions and increase in stone clearance.Öğe Early Clinical Results of the Tolerability, Safety, and Efficacy of Autologous Platelet-Rich Plasma Administration in Erectile Dysfunction(Elsevier Sci Ltd, 2021) Tas, Tuncay; Cakiroglu, Basri; Arda, Ersan; Onuk, Ozkan; Nuhoglu, BarisIntroduction: Platelet-rich plasma (PRP) is useful in the treatment of different conditions and diseases as it contains concentrated levels of many growth factors. Aim: The aim of this study was to investigate the effectiveness of autologous PRP application in the treatment of erectile dysfunction (ED) in patients with metabolic syndrome. Methods: In this prospective study conducted in June 2019, 31 patients with ED were included. The International Index of Erectile Function-Erectile Function domain (IIEF-EF) questionnaires were used to evaluate erectile function (EF). After administering the intracavernous autologous PRP 3 times with an interval of 15 days, IIEF-EFs were evaluated 1, 3, and 6 months later. Main Outcome Measure: IIEF in the 1st, 3rd, and 6th months and adverse events. Results: While the mean IIEF-EF was 18 before the application, the mean IIEF-EF was 20 in the first, third, and sixth months after the procedure (P < .001). However, even though IIEF-EF values increased numerically, median value remained within the mild-moderate classification (scores between 17 and 21). Postprocedure sexual satisfaction scores were significantly higher than preprocedure values (8 vs 6, respectively; P 1/4 .002). In the first follow-up of a patient after the 3rd injection, a 4-mm diameter fibrotic plaque was observed on the ventral side in the middle of the penis shaft. Conclusion: In conclusion, our findings suggest that larger studies as well as placebo-controlled studies are needed to add PRP to the treatment protocol in ED. Copyright (C) 2021, The Authors. Published by Elsevier Inc. on behalf of the International Society for Sexual Medicine.Öğe Evaluation of Risk Groups for the Prediction of Biochemical Progression in Patients Undergoing Radical Prostatectomy(Galenos Publ House, 2022) Madendere, Serdar; Turkkan, Gorkem; Arda, Ersan; Caloglu, Vuslat Yurut; Kuyumcuoglu, UgurObjective: The aim of this study was to investigate the potential relationship between biochemical progression and prognostic risk factors in patients with prostate cancer (PCa) patients undergoing radical prostatectomy (RP). Materials and Methods: After inclusion/exclusion criteria were applied, 216 patients who underwent RP were included in this study. Follow-up protocol included prostate specific antigen (PSA) measurements; every 3 months for the first year, every 6 months for the second year, and an annual check after 2 years. Preoperative and postoperative PSA measurements, pathological stage, Gleason score (GS), extraprostatic extension, positive surgical margins and seminal vesicle invasion were evaluated. Uni- and multivariable analyses were used to detect the relationship between biochemical progression, biochemical progression-free survival (BPFS) and prognostic risk factors. Results: Median follow-up was 29 months. Biochemical progression was observed in 39 (18.1%) patients, in 18 (9.7%) of 185 patients with first postoperative PSA level of <0.2 ng/dL, and 21 (67.7%) of 31 patients with first postoperative PSA level of >= 0.2 ng/dL. Patients with first postoperative PSA level of >= 0.2 ng/dL had a statistically significant higher risk of biochemical progression and shorter BPFS (odds ratio: 2.41; 95% confidence interval: 1.84-3.10; p<0.001), in univariate and multivariate analyses. Patients with GS =8 or T3-4 or positive surgical margins had a statistically significant higher risk of biochemical progression (p<0.001, p=0.003, p<0.001). Conclusion: Postoperative PSA level higher than >= 0.2 ng/dL was the most important predictor of biochemical progression and BPFS after RP. GS >= 8, T3-4 stages, and positive surgical margins are also related to biochemical progression.Öğe Evaluation of the Reliability, Utility, and Quality of theInformation in Testicular Cancer Self-examVideos Shared on YouTube(2020) Taş, Tuncay; Arda, Ersan; Çakıroğlu, Basri; Uçar, TahaObjective: The aim of this study was to assess the testicular cancer self-examination (TSE) videos on YouTube. Material and Methods: This study was conducted to evaluate the content, reliability and quality of internet videos related to TSE. The search engine of YouTube® was queried for the keyword ‘TSE’ in April 01, 2019. Videos were scaled according to the time since upload day, running time, number of comments and number of like/dislike. All videos were also categorized according to source into 3 groups: Health information websites/TV programs; independent users; university channels/medical professionals. DISCERN questionnaire score (DISCERN) Journal of the American Medical Association benchmark criteria (JAMAS), Global Quality Scores (GQS), TSE-Comprehensiveness (TSE-C) and Video Power Index (VPI) were used. Results: Total of 68 videos were included and 32 of videos were excluded due to being unrelated or repeated. When VPI values were examined according to the video source, there was no statistically significant difference (p>0.05). According to the video source, there was a statistically significant difference in terms of DISCERN scores (p=0.049) and TSE-C scores (p=0.019). DISCERN scores of the videos whose source is university channels/medical professionals are higher than the DISCERN scores of the videos whose source is independent users (p=0.042). There was a statistically significant difference in terms of JAMAS scores (p=0.009). Conclusion: It is concluded that the information of TSE videos on YouTube is a weak source when evaluated in terms of reliability, benefit and quality.Öğe Investigation of the Correlation Between Pelvic Anthropometric Measurements and Penile Length of 250 Turkish Boys Aged 0-5 Years(2016) Akdere, Hakan; Yılmaz, Ali; Arabacı, Özcan; Özdemir, Yavuz; Arda, ErsanAmaç: Çalışmamızda 0-60 ay arası çocukların gerilmiş penis uzunluğu (GPU) ölçüldü ve yaş-boy-kilo-interspinöz mesafe ve pubis yüksekliği gibi antropometrik parametrelerle ilişkisi değerlendirildi. Elde ettiğimiz veriler, benzer diğer literatür çalışmaları ile karşılaştırıldı.Gereç ve Yöntem: Çalışmamız, 0-60 ay yaş arası 250 erkek çocukta yapıldı. Bütün çocukların gerilmiş penis uzunluğu, kilosu, boyu, interspinöz mesafesi ve pubis yüksekliği tek bir ürolog tarafından değerlendirildi. Bu değerlendirmeler optimal poliklinik şartlarında gerçekleştirildi.Bulgular: Çocukların ortalama boyu 55.82±3.22 cm, ortalama vücut ağırlığı 4729.08±54.23 gr, ortalama interspinöz mesafesi 12.757±1.21 cm, ortalama pubis yüksekliği 2.56±0.46 cm, GPU 2.69±0.57 cm olarak ölçüldü. Gerilmiş penis uzunluğu ile çocukların yaşı, ağırlığı, boyu ve interspinöz mesafesi arasında belirgin bir ilişki bulundu (sırasıyla: r=0.240, p=0.001; r=0.242, p=0.001; r=0.204, p=0.006; r=0.224, p=0.002). GPU ve pubis yüksekliği arasında anlamlı bir ilişki bulunmadı (r=0.97, p=0.191).Sonuç: Penis uzunluğundaki anomalileri doğru değerlendirebilmek için yaşa ve ırka özgü ortalama GPU değerleri bilinip, bu veriler göz önünde tutularak muayene yapılmalıdır. Çalışmamız 0-60 ay yaş aralığındaki beyaz ırk çocuklar için güncel referans değerler sağlamıştır. Antropometrik ölçümlerle birlikte değerlendirildiğinde bu veriler klinisyenlere tanı ve tedavi süreci aşamalarında yararlı olabilirÖğe Linguistic and clinical validation of the Turkish version of Acute Cystitis Symptom Score for the diagnosis and patient-reported outcome in acute uncomplicated cystitis(Korean Urological Assoc, 2023) Arda, Ersan; Alidjanov, Jakhongir; Ates, Sinan; Cek, Mete; Piatz, Adrian; Wagenlehner, Florian M.; Naber, Kurt G.Purpose: The Acute Cystitis Symptom Score (ACSS) was developed as a self-reporting questionnaire for diagnosing and monitor-ing acute uncomplicated cystitis (AC) in female patients. The study aims at the translation of the ACSS into Turkish from the original Uzbek including its linguistic, cognitive and clinical validation.Materials and Methods: After forward and backward translation of the ACSS from Uzbek to Turkish and vice versa, the cognitive assessment of the Turkish ACSS was performed on 12 female subjects to achieve the final study version.Results: The clinical validation was performed on a total of 120 female respondents including 64 Patients with AC and 56 controls without AC. For clinical diagnosis of AC, the predefined summary score of the typical symptoms of >6 showed high values (95% confidence interval) for sensitivity (0.88 [0.77-0.94]), specificity (0.98 [0.91-1.00]), and diagnostic accuracy (0.93 [0.86-0.97]). All patients were followed up between five to nine days after the baseline visit. Forty-four (68.75%) patients used antimicrobial treat-ment, whereas the rest (31.25%) preferred non-antimicrobial treatment. The severity scores of the typical symptoms and the qual-ity of life were reduced significantly at follow-up. Using different (favored) thresholds for successful and non-successful treatment a clinicalsuccess rate between 54.7% and 64.1% (60.9%) was achieved.Conclusions: After translation from the original Uzbek and cognitive assessment, the Turkish ACSS showed similar good results for clinical diagnosis and patient-reported outcome as in other languages validated so far and could therefore now be used for clinical studies as well as in everyday practice.Öğe Malignant Mesothelioma of Tunica Vaginalis Testis: Macroscopic and Microscopic Features of a Very Rare Malignancy(Springernature, 2017) Arda, Ersan; Arikan, Mehmet Gurkan; Cetin, Gizem; Kuyumcuoglu, Ugur; Usta, UfukMalignant mesothelioma of the tunica vaginalis testis (MMTVT) is an extremely rare tumour, usually mimicking benign pathologies of the scrotum. Our case is an 84-year-old male patient who appealed with a painless, left-sided scrotal swelling longer than 2 months. Although the level of tumour markers was normal, ultrasonographic examination results forced us to perform an inguinal scrotal exploration. Multiple small papillary tumours, both on tunica vaginalis and tunica albuginea, were detected intraoperatively. Due to these findings, radical orchiectomy was performed. A pathological evaluation showed malignant mesothelioma (MM) of the tunica vaginalis testis. Exposure to asbestos is a well-known risk factor. Furthermore, a history of trauma, herniorrhaphy and chronic hydroceles is blamed as a possible risk factor. Scrotal ultrasonography is the mainstay of primary diagnosis and, therefore, it should not be overlooked when dealing with benign scrotal cysts or hydroceles, which are very common pathologies at these decades, too. Radical inguinal orchiectomy is the primary treatment choice for localised MMTVT disease, whereas in signs of lymph node metastasis, inguinal lymph node dissection is required. Radical resection should be completed with chemotherapy and/or radiotherapy for an advanced or recurrent disease. This case, which is very rarely reported in the literature and detected during inguinal exploration, along with the pathological works that supported the diagnosis, was presented with this report.
