Browsing by Author "Erbin, Akif"

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Comparative Evaluation of Bilateral Pudendal Nerve Blockade and Periprostatic Nerve Block in Transrectal Ultrasound Guided Prostate Biopsy: a Prospective Randomised Trial
(Polish Urological Assoc, 2020) Aslan, Rahmi; Erbin, Akif; Eryilmaz, Recep; Taken, Kerem
Introduction Although the periprostatic nerve block (PNB) is accepted as the standard method for local anesthesia prior to transrectal ultrasound (TRUS)-guided prostate biopsy, it is not the most ideal method. We aimed to analyze the effectiveness and safety of bilateral pudendal nerve blockage (PuNB) by comparing with PNB. Material and methods Between June 2019 and October 2019, a total of 108 patients with elevated serum prostate specific antigen values (PSA >= 4 ng/ml) and/or abnormal digital rectal examination findings were included in the study. After exclusion criteria, the remaining 91 patients were randomly divided into two groups as PuNB (n = 46) and PNB (n = 45). Pain during local anesthesia application was recorded as a visual analog scale (VAS) 1, pain during placement of the rectal probe and manipulation was recorded as VAS 2 and pain during needle penetration into prostate tissue and sampling was recorded as VAS 3. Results No significant difference was found between the two groups with regard to age, body mass index, serum PSA, prostate volume and prostate cancer rates. Mean VAS-2 score was significantly lower in the PuNB group when compared with the PNB group. There was no significant difference in terms of VAS-1 and VAS-3 scores. There was no significant difference between the groups in terms of mild and severe complications. Conclusions Both techniques are safe for TRUS-guided prostate biopsy; however, PuNB provided more effective pain control compared to PNB especially during placement of rectal probe and manipulation.
Evaluation of Hemorrhoidal Disease and Lower Extremity Venous Insufficiency in Primary Adult Varicocele: a Prospective Controlled Study
(Sage Publications inc, 2019) Aslan, Rahmi; Erbin, Akif; Celik, Sebahattin; Ucpinar, Burak; Sahinalp, Sahin; Yildizhan, Murat; Taken, Kerem
Background The study investigated the association between varicocele, lower extremity venous insufficiency and hemorrhoidal disease. Methods The study included 62 patients with varicocele and 60 voluntary subjects with no varicocele. Patients who were diagnosed as having varicocele on physical examination and Doppler ultrasonography were included in the study group. Examination of lower extremity venous insufficiency was performed by physical examination and Doppler ultrasonography. Examination of hemorrhoidal disease was performed by a general surgery specialist. Results The patients with varicocele had a statistically significant (p < 0.05) higher rates of venous insufficiency of the lower extremities and had a borderline significant difference of higher hemorrhoidal disease rates (p = 0.05). Therewithal incidences of hemorrhoidal disease and lower extremity venous insufficiency were significantly higher in body mass index > 25 and age > 30 years of varicocele patients. Conclusion There is a statistically significant relation between varicocele, lower extremity venous insufficiency, and hemorrhoidal disease. In particular, varicocele patients who are aged over 30 years and overweight are at higher risk.
Periprostatic Nerve Block Alone Versus Combined With Perineal Pudendal Nerve Block or Intrarectal Local Anesthesia During Transrectal Ultrasound-Guided Prostate Biopsy: a Prospective Randomized Controlled Trial
(Wiley, 2019) Aslan, Rahmi; Erbin, Akif; Celik, Sebahattin; Ucpinar, Burak; Eryilmaz, Recep; Taken, Kerem
Objectives To compare the efficacy, safety and cost of combinations of perineal pudendal nerve block + periprostatic nerve block and intrarectal local anesthesia + periprostatic nerve block with the standard technique (periprostatic nerve block). Methods The study was designed as a randomized prospective controlled trial. Patients with elevated serum prostate-specific antigen values (prostate-specific antigen >= 4 ng/mL) and/or abnormal digital rectal examination findings were included in the study. Patients with anorectal diseases, chronic prostatitis, previous history of prostate biopsy and anorectal surgery were excluded from the study. A total of 148 patients (group 1 [periprostatic nerve block], n = 48; group 2 [intrarectal local anesthesia + periprostatic nerve block], n = 51; group 3 [perineal pudendal nerve block + periprostatic nerve block], n = 49) were included in the final analysis. Pain during insertion and manipulation of the transrectal ultrasound probe was recorded as visual analog scale 1, pain during penetration of the biopsy needle into the prostate and sampling was recorded as visual analog scale 2, and pain during the entire procedure recorded as visual analog scale 3. Results The mean visual analog scale 1 score was significantly lower in group 3, when compared with group 1 and group 2 (P < 0.001). There was no significant difference between the groups in terms of the mean visual analog scale 2 score. The mean visual analog scale 3 score was significantly lower in group 3 when compared with other groups (P < 0.001). The total cost for transrectal ultrasound-guided biopsy in the intrarectal local anesthesia + periprostatic nerve block group was significantly higher than the other two groups. Conclusions The combination of perineal pudendal nerve block and periprostatic nerve block provides more effective pain control than intrarectal local anesthesia plus periprostatic nerve block and periprostatic nerve block alone, with similar complication rates and without increasing cost.
The Synergistic Effects of Testosterone and Phophodiesterase-5 Inhibitor Combination on Oxidative Stress Markers, Matrix Metalloproteinases and Oxidative Dna Damage: a Randomized Controlled Experimental Study
(Elsevier Espana Slu, 2022) Aslan, Rahmi; Taken, Kerem; Erbin, Akif; Alp, Hamit Hakan; Eryilmaz, Recep; Sarilar, Omer; Huyut, Zubeyir
Purpose: To investigate the effects of combined tadalafil and testosterone usage on oxidative stress, DNA damage and MMPs in testosterone deficiency. Methods: Fifty rats were randomly divided into 5 groups (group-1: sham group-placebo, group-2: bilateral orchiectomy (ORX), group-3: bilateral ORX+ tadalafil, group-4: bilateral ORX + testosterone, group-5: bilateral ORX + tadalafil + testosterone). Group-3 received tadalafil (5 mg/kg/day, oral). Group-4 was administered testosterone undecanoate (100 mg/kg i.m., single dose). Group-5 was administered a combination of tadalafil and testosterone undecanoate. All groups were compared with regard to serum nicotinamide adenine dinucleotide phosphate oxidase-4 (NOX-4), total thiol, matrix metalloproteinase-2 (MMP-2), MMP-3 and MMP-9, tissue inhibitor of metalloproteinases-1 (TIMP-1) and TIMP-2 and 8-hydroxy-2-deoxy guanosine (8-OHdG) levels. Results: Total thiol levels of group-2 were significantly lower than the other groups and thiol levels were higher in group-1 and group-5 than in the other groups. NOX4, MMP2 and 9 levels in group-2 were higher than in the other groups. MMP-9 levels in group-5 were lower than in groups 3 and 4 (p = .001). The level of 8-OHdG in groups 2 and 3 was higher than in the other groups (p = .001). In correlation analysis, 8-OHdG, MMP2, and 9 levels were negatively correlated with total thiol, whereas NOX4 and 8-OHdG levels were positively correlated with MMPs values. Conclusions: The combination of testosterone with PDE-5 inhibitor suppresses MMP-9 levels and increases total thiol levels better than testosterone alone and tadatafil atone. Therefore, testosterone can be considered for use with PDE-5 inhibitor from the initial stage in case of testosterone deficiency. (C) 2022 Asociacion Espanola de Andrologia, Medicina Sexual y Reproductiva. Published by Elsevier Espana, S.L.U. All rights reserved.