Browsing by Author "Ertas, Kasim"

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Comparison of Supine-Prone Percutaneous Nephrolithotomy Methods in the Treatment of Kidney Stones in Pediatric Patients: Prospective Randomized Study
(Springer, 2024) Eryilmaz, Recep; Ertas, Kasim; Aslan, Rahmi; Sevim, Mehmet; Keles, Muhammed Fatih; Taken, Kerem
Mini-PCNL is one of the most effective surgical methods in the treatment of kidney stones in pediatric patients. In this study, we aimed to compare PCNL in the supine-prone position in pediatric patients (especially operation time, postop complications, hospital stay and stone-free rates).We conducted our study in a randomized and prospective manner. Patients with lower pole stones larger than 1 cm, stones larger than 1.5 cm in the pelvis, upper pole, midpole or multiple locations, and patients who did not respond to ESWL or whose family that preferred mini-PCNL to be the primary treatment were included in the study. Patients with any previous kidney stone surgery, patients with coagulation disorders and patients with retrorenal colon were excluded from the study. Between 2021 and 2023, a total of 144 patients underwent PCNL. 68 of these patients had supine PCNL and 76 prone PCNL. Postoperative Clavien grade1 complication occurred in a total of 7 patients in the prone position; Clavien grade1 complication occurred in 1 patient in the supine position. The mean operation time for prone PCNL was 119.88 +/- 28.32 min, and the mean operative time for supine PCNL was 98.12 +/- 14.97 the mean hospitalization time in prone PCNL was 3.56 +/- 1.12 days, and 3.00 +/- 0.85 days in supine PCNL. In conclusion, supine PCNL is a safe and effective method in the treatment of pediatric kidney stones and postoperative complications were observed to be less; the operation time and hospital stay were shorter in supine PCNL.
Comparison of the Safety and Efficacy of the On-Demand Use of Sertraline, Dapoxetine, and Daily Use of Sertraline in the Treatment of Patients With Lifelong Premature Ejaculation: a Prospective Randomised Study
(Wiley, 2020) Sahan, Ahmet; Cubuk, Alkan; Ozkaptan, Orkunt; Toprak, Tuncay; Ozcan, Tolga; Ertas, Kasim; Tarhan, Fatih
This study compared the safety and efficacy of the on-demand (OD) use of sertraline (50 mg), sertraline (100 mg) and dapoxetine (30 mg), and the daily use of sertraline (50 mg) in the treatment of patients with premature ejaculation (PE). This prospective randomised study involved 120 lifelong PE patients (intravaginal ejaculatory latency time [IELT]: <1 min; Arabic Index of Premature Ejaculation [AIPE] score: < 30) without secondary causes of PE, identified between March 2018 and May 2020. Patients were divided into 4 groups (30 patients per group) and treated for 8 weeks. Assessments were conducted using the AIPE form as a diagnostic tool. Sertraline (50 mg, daily; 196.7 +/- 115.5 s) and sertraline (100 mg, OD; 173.3 +/- 97.0 s) had similar IELT and AIPE scores. The latter groups had better results in comparison with sertraline (50 mg, OD; 100.5 +/- 54.4 s) and dapoxetine (93.7 +/- 53.5 s; p < 0.01). Sertraline (100 mg, OD) had a similar efficacy to that of sertraline (50 mg, daily) and was more effective than sertraline (50 mg, OD) and dapoxetine (30 mg, OD). Sertraline (100 mg, OD) can be considered in the treatment of lifelong PE treatment, having tolerable side effects.
Does Tamsulosin Use Before Ureteroscopy Increase the Success of the Operation
(Coll Physicians & Surgeons Pakistan, 2022) Demir, Murat; Ertas, Kasim; Aslan, Rahmi; Eryilmaz, Recep; Sevim, Mehmet; Taken, Kerem
Objective: To investigate the effect of preoperative tamsulosin use on the success and complications rates of ureteroscopy for ureteral stone removal. Study Design: A randomised clinical trial. Place and Duration of Study: Department of Urology, Dursun Odabas Medical Center, Van Yuzuncu Yil University, Turkey, from December 2020 to June 2021. Methodology: Patients were scheduled for ureteroscopy due to ureteral stones, and were randomly divided into two groups; 67 patients preoperatively were given 0.4 mg tamsulosin for 7 days and 70 patients were not given tamsulosin. Each patient's intraoperative surgical complications, preoperative and postoperative pain, postoperative fever, need for analgesia, stone-free rate, and double J ureteral stent (DJ) insertion rates were recorded and evaluated. Results: A total of 137 patients, 103 (75.1%) males, and 34 (24.8%) females, were included. In 70 (51.1%) of these patients, the stone was on the right side, while in 67 (48.9%) the stone was on the left side. The stone was in the distal ureter in 47 (34.3%) patients, in the middle in 38 (27.7%) patients, and the proximal in 52 (37.9%) patients. The patients who were given tamsulosin had lower preoperative visual analog scale (p=0.02), operation time (p=0.003), post-ureteroscopic lesion scale (p=0.01), postoperative 24th-hour visual analog scale (p=0.03), fever (p=0.02), and analgesic need (p=0.04), while their rate of accessing the stone (p=0.02); and their stone-free rates (p=0.02) was higher. Conclusion: Preoperative tamsulosin use increases the success of the operation and reduces complications.
Effect of Combined Use of Tolterodine and Continuous Positive Airway Pressure Vs Continuous Positive Airway Pressure Only Treatment on Overactive Bladder Symptoms in Women With Moderate-To Obstructive Sleep Apnea Syndrome: a Randomized Clinical Trial
(Springer London Ltd, 2022) Ertas, Kasim; Yildiz, Hanifi; Demir, Murat; Aslan, Rahmi; Eryilmaz, Recep; Kirmizitoprak, Sevder; Taken, Kerem
Introduction and hypothesis Obstructive sleep apnea syndrome is associated with urological symptoms, including overactive bladder (OAB). This study aims to determine whether combined tolterodine and CPAP therapies are more effective for patients with OSAS than CPAP treatment only. Methods Women who underwent polysomnography test and were diagnosed with moderate-to-severe OSAS with apnea-hypopnea index (AHI) were included in the study. Data were collected on AHI, OAB awareness-8-item tool (OAB-V8), incontinence questionnaire-urinary incontinence short form (ICIQ-UI-SF), total daily urine volume (DUV), and the Benefit, satisfaction with treatment and willingness (BSW) tool. Eligible patients were randomized to receive either CPAP treatment only or combined CPAP and tolterodine treatment for 3 months. Results Among 103 participants, a total of 60 were included. Patients in both treatment arms showed significant improvements in OAB-V8, ICIQ-UI-SF, and total DUV compared to their baseline. The mean OAB-V8 was 15.7 at baseline and 5.6 at 3 months for the combined treatment arm and 16.6 and 7.6 at 3 months for the CPAP group only (mean baseline-adjusted between-group difference -1.1 [95% CI, -12.3 to -7.4]; p < 0.001). The improvement in the mean ICIQ-UI-SF was also statistically more significant in the combined therapy group than in the CPAP only arm (mean baseline-adjusted between-group difference -3.27 [95% CI, -4.6 to -1.59]; p < 0.001). No statistical significance was found in the improvement of total DUV between the groups. Conclusions In this study, combined use of tolterodine with CPAP provides beneficial effects to CPAP treatment only regarding OAB symptoms. Further research is required to confirm these findings in a large cohort.
The Effect of Covid-19 Epidemic on the Sexual Function of Healthcare Professionals
(Wiley, 2021) Bulut, Ender Cem; Ertas, Kasim; Bulut, Dilek; Koparal, Murat Yavuz; Cetin, Serhat
Studies have shown that healthcare professionals struggling with epidemics develop symptoms of post-traumatic stress disorder. The aim of this study is to show how often and severely erectile dysfunction, one of the components of post-traumatic stress disorder, is seen among healthcare professionals during COVID-19 outbreak. The Impact of Event Scale-Revised (IES-R) and the Index of Erectile Function-5 (IIEF-5) were applied to 159 male healthcare professionals working in COVID-19 units and a control group of 200 people. Healthcare professional group was divided into subgroups according to occupation (physician, nurse), age-group (18-25, 26-30, >30), marital status and unit of work (Suspected Patient Area, Diagnosed Patient Area). Both stress disorder and erectile dysfunction were seen at higher rates in healthcare professionals group (p < .001). The median IIEF-5 scores of nurses, married subjects and those working in the Diagnosed Patient Area, were found to be higher (p < .001, p = .014, p = .011 respectively). During the COVID-19 outbreak, healthcare professionals are exposed to psychological trauma and their sexual function may be negatively affected. The measures to be taken are important to estimate which groups are more affected.
The Effect of Plasma Rich Platelet Graft on Post-Operative Complications in Mid-Penile Hypospadias
(Wiley, 2020) Eryilmaz, Recep; Simsek, Metin; Aslan, Rahmi; Beger, Burhan; Ertas, Kasim; Taken, Kerem
Hypospadias is one of the most common penile congenital anomalies, which often requires a surgical approach. After the hypospadias is repaired, urethral fistula can occur in around 20% of patients. In this study, we used platelet-rich plasma (PRP) to reduce the urethral fistula and other post-operative complications after hypospadias repair. Only patients with primary mid-penile hypospadias were included study. Patients with forms other than mid-penile hypospadias and cases with previous hypospadias surgery were excluded from the study. A total of 40 hypospadias patients were included in this study. These patients were divided into groups A and B with 20 patients in each group. Hypospadias repair was performed with the Snodgrass TIPU technique on both groups. PRP was used with group A, and PRP was not use with group B. These two groups were compared in terms of early and long-term post-operative complications. Both early and long-term post-operative UCF, urethral stenosis and post-operative infection rates were lower in the group using PRP, group A. PRP has the potential to prevent post-operative complications occurring after hypospadias repair, particularly post-operative infection.
Examining Changes on Testicular Structure and Sperm Analysis of Covid-19 Patients
(Wiley, 2022) Ertas, Kasim; Eryilmaz, Recep; Yokus, Adem; Korpe, Kadir; Geduk, Nurullah; Ozkan, Mazlum; Aslan, Rahmi
This study aimed to examine the testicular functions with sperm analysis of patients with COVID-19. The study was carried out with male patients aged between 18 and 50 years with positive RT-PCR test and SARS-CoV-2 virus between December 2020 and April 2021. A total of 103 participants were included in the study. The mean age was 31.24 +/- 5.67 (19-45) years and the mean body mass index of the participants was 28.41 +/- 4.68 kg/m(2). The patients were divided into two groups, group-1 was patients who had COVID-19, group-2 was healthy men. A semen analysis of both groups was performed, and the serum total testosterone, FSH, LH, anti-mullerian hormone and Inhibin-B tests were analysed and recorded. The testicular dimensions and testicular densities were examined by ultrasound and elastography for both groups. Comparing the patient and control groups results, this study found that the sperm count per 1 cc (p = 0.01) and total motility (p = 0.01) in group-1 was lower than in the control group, the testicular dimensions decreased (for right testis group-2 was 15.39 +/- 4.78 ml versus group-1 was 12.11 +/- 4.62 cm(3) p < 0.01, for left testis group-2 was 16.01 +/- 5.12 versus group-1 was 11.92 +/- 4.78 cm(3); p < 0.01), and the shear wave velocities were significantly higher in group-1 patients. In conclusion, sperm parameters deteriorate in men who have symptomatic disease with SARS-CoV-2 infection. The fact that the cause of this deterioration is characterized by changes at the cellular level in the testis raises doubts about the persistence of this condition.
The Impact of Anterior Calyceal Stones on the Outcomes of Percutaneous Nephrolithotomy for Complex Kidney Stones: a Comparative Study
(Edizioni Minerva Medica, 2021) Sahan, Ahmet; Dincer, Erdinc; Ozkaptan, Orkunt; Cubuk, Alkan; Ertas, Kasim; Eryildirim, Bilal; Akca, Oktay
BACKGROUND: This study aimed to evaluate the possible effect of anterior calyceal stones on the surgical outcomes of percutaneous nephrolithotomy. METHODS: Consecutive patients with complex kidney stones from 2012 to 2020 were evaluated retrospectively. In total, 219 patients were divided into 2 groups based on the presence of anterior calyceal stones (group 1; N.=89) or not (group 2; N.=130). The groups were compared in terms of surgical outcomes (i.e., stone-free rate [SFr], operation time, and hemoglobin drop) and complications. RESULTS: The patient demographics and stone characteristics were similar between the groups. Multiple access was more frequently done in group 1 than it was in group 2 (47.2% vs. 30.8%; P=0.014), and the SFR was lower in group 1 (51.7%) than it was in group 2 (67.7%; P=0.017). Of the anterior calyceal stones in group 1, 42.6% could not be cleaned. However, when excluding patients who have only anterior residual stones from the statistical analysis, the groups had similar SFRs (68.5% vs. 67.7% for group 1 and group 2, respectively). CONCLUSIONS: The presence of complex kidney stones with anterior calyceal extension are associated with higher residual stones rates in the anterior calyx. Also, it increases multiple access, the operation time, and level of hemoglobin drop.
An Innovative Approach To Lifelong Delayed Ejaculation: Does Attachment Style Play a Role
(Springer, 2022) Demir, Murat; Isik, Mesut; Araz, Seyhmuz; Ozveren, Huseyin; Kirli, Umut; Ertas, Kasim
Purpose To examine whether there is a correlation between attachment styles, which is a developmental psychology theory, and lifelong DE. Methods The research was planned as prospective, multi-centric and cross-sectional study. Thirty patients who were consecutively admitted to the urology outpatient clinic and diagnosed with lifelong DE and 30 age-matched healthy controls were included in the study. All participants gave a detailed medical history and underwent a complete physical examination, and their laboratory and endocrine (prolactin and testosterone) results were evaluated. Additionally, all patients had to fill out socio-demographic information form, the Experiences in Close Relationships-Revised (ECR-R) Questionnaire, Arizona Sexual Experiences Scale (ASEX), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). Results The mean age of the DE patients was 33.5 +/- 7.5 years. In the DE group, insecure attachment (both anxious and avoidant attachment), anxiety and depression scores were found to be significantly higher (p < 0.001, effect size medium or large) than the control group. Ejaculation times (both for vaginal intercourse and masturbation) were correlated with both insecure (anxious and avoidant) attachment types, as well as their anxiety and depression scores (p < 0.001). The ASEX satisfaction, ejaculation and total scores were found to be higher in DE patients (higher scores indicating greater sexual dysfunction) than in the control group. Conclusion The large and significant relationships found between lifelong DE and attachment insecurities point to childhood developmental processes. The findings may help us better understand lifelong DE. There is a need for further extensive research on this subject.
Is Bacterial Colonization in Ureteral Double-J Stents Significant and Is It Predictable
(Galenos Yayincilik, 2020) Sahan, Ahmet; Cubuk, Alkan; Ertas, Kasim; Garayev, Asgar; Talibzade, Ferhat; Sekerci, Cagri Akin; Tanidir, Yiloren
Objective: Since microscopic hematuria and pyuria can be observed in patients with a ureteral double-1 (DJ) stent in place, urinalysis findings are not considered significant in terms of predicting stent-related infections. This study evaluates the presence of bacterial colonization and the value/effectiveness of urine tests in predicting the results of DJ stent cultures. Materials and Methods: In the present prospective study, we analyzed data from patients who were treated with a DJ stent placement following endourological surgery due to ureteral stones. DJ stents were removed only after the urine cultures appeared sterile or after a period of empiric antibiotic use. The relationship between urinalysis results and stent cultures was assessed. Results: A total of 65 patients (mean age, 42.6 +/- 13.5 years; 16 females and 43 males) were evaluated. Bacterial colonization was detected in 12 (18%) DJ stent cultures with Enterococcus faecalis (n=4), extended-spectrum beta-lactamase producer (ESBL (+) Escherichia coli (n=4), Corynebacterium urealyticum (n=2), candida (n=1) and methicillin-resistant Staphylococcus aureus (n=1) growth being reported. The antibiogram results of the patients that showed colonization in their cultures demonstrated penicillin (n=4), ampicillin (n=4), tetracycline (n=3), imipenem (n=2), and linezolid (n=1) sensitivity. The rate of leukocyte esterase- and nitrite-positive patients, of those having significant number of leukocytes, and urine culturepositive patients in the groups with and without positive urine culture was 58.5 0 10, 32 0 10, 49 0 10, and 7.5% vs 50%, 16.6 0 10, 50 0 10, and 8.5%, respectively. There were no statistically significant differences between the groups (p=>0.05). None of the study patients applied to our hospital with active infection following DJ stent removal. Conclusion: Urinalysis is insufficient in predicting catheter culture results. Based on the results of this study, we assume that stent culture for removed DJ stents is not a necessity; empirical antibiotic therapy with ampicillin-tetracycline should be started in patients with postoperative infection.
Youtube as a Health Information Source: Covid-19 and Andrology
(Galenos Yayincilik, 2021) Demir, Murat; Taken, Kerem; Eryilmaz, Recep; Aslan, Rahmi; Ertas, Kasim
Aim: The purpose of this study is to evaluate the quality and reliability of YouTube videos about infertility, erectile dysfunction and sex relationship with coronavirus disease-2019 (COVID-19). Methods: In this prospective study, videos were selected on 20.12.2020 and variable parameters were studied on the same day. Nonvariable parameters such as quality and reliability were studied until 25.12.2020. "Corona, infertility", "corona, erectile dysfunction", "corona, sex", "COVID, infertility", "COVID, erectile dysfunction", COVID, sex", "pandemic, infertility" "pandemic, erectile dysfunction" and "pandemic, sex" search words scanned in a private search mode on the YouTube website. Unrelated, not English, do not contain any information videos excluded. The remaining videos were evaluated according to the presenter source and the presented audience with modified discern and Global Quality Scala (GQS) forms. Results: Fourteen (14%) of 100 videos were about erectile dysfunction, 56 (56%) were about infertility and 30 (30%) were about sex. Fifteen (15%) of the videos were presented by individual sources, 4 (4%) by non-physician healthcare professionals, 48 (48%) by individual physicians, 17 (17%) by physician groups, 13 (13%) by news agencies, and 3 (3%) by private companies. While 87 (87%) of the target group was the general public, 13 (13%) of them were healthcare professionals. According to the presenter source, the modified discern and GQS scores of the physician group were higher than the other groups. However, the number of views and likes in these two groups was low. Conclusion: Videos offered by physician groups and targeted by healthcare professionals on YouTube are of higher quality and more reliable. However, the popularity of videos is not a suitable indicator of quality.