Browsing by Author "Sahan, Ahmet"

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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.
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.
Impact of Autologous Transobturator Sling Surgery on Female Sexual Function: a Comparative Study With Mesh Used Mid-Urethral Sling Surgeries
(Karger, 2021) Cubuk, Alkan; Sahan, Ahmet; ozkaptan, Orkunt; Dincer, Erdinc; Karaaslan, Onur; Sarilar, Omer; Akca, Oktay
Introduction: To avoid mesh-related complications, autologous transobturator-tape (a-TOT) technique is a viable option in stress urinary incontinence (SUI) surgery. The method differs from TOT and retropubic tape (RT) in the usage of autologous tissue. We hypothesized that a-TOT improves female sexual dysfunction (FSD) more than TOT and RT. Methods: This is a retrospective cohort study. Patients who underwent a-TOT, TOT, and RT surgeries were surveyed regarding the cure of SUI, complications, and FSD parameters. The groups were compared according to baseline and postoperative data. Results: A-TOT, TOT, and RT groups included 37, 69, and 36 patients, respectively. The median follow-up time was 19 months. The groups were similar in terms of preoperative characteristics. The objective cure, subjective cure, and overall complication rates were comparable among the groups (p > 0.05). A-TOT group had significant improvements in mean female sexual function index (FSFI) scores, TOT group deteriorated, and RT group remained stable (p = 0.001, p = 0.001, and p = 0.226, respectively). The postoperative mean total FSFI scores were 25.73 +/- 2.46, 23.17 +/- 3.35, and 21.53 +/- 2.47 for the a-TOT, TOT, and RT groups, respectively. The a-TOT group had better results than the TOT and RT groups (p < 0.05 and p < 0.05), and besides, the difference between the TOT and RT groups was statistically significant (p < 0.05). According to percentage changes in domain scores following the operations, the a-TOT group had significantly better results in desire, arousal, lubrication, satisfaction, and pain domains than the TOT group (p < 0.05) as well as better desire, arousal, and pain domains (p < 0.05) than the RT group. Discussion/Conclusions: Besides comparable outcomes in SUI treatment, the a-TOT technique provides improvements in female sexual functions while TOT worsens and RT does not change. Favorable outcomes in sexual functions caused by improvements in desire, arousal, satisfaction, and pain domains are observed following the a-TOT technique.
The Impact of Tumor Invasion To Muscularis Mucosae- Vascular Plexus on Patient Outcome in Pt1 Bladder Urothelial Carcinoma
(Pagepress Publ, 2020) Sahan, Ahmet; Gerin, Fatma; Garayev, Asgar; Bozkurtlar, Emine; Cubuk, Alkan; Ozkaptan, Orkunt; Tinay, Ilker
Objectives: T1 bladder cancer has a wide range of tumor behavior and lamina propria invasion depth has a high potential risk of disease progression. To evaluate the patient outcome according to the tumor invasion to the muscularis mucosae-vascular plexus (MM-VP) in pT1 bladder urothelial carcinoma (BUC). Materials and methods: This study is a retrospective analysis of patients consecutively recorded from 2007 to 2013. A total of 93 patients with a history of primary pT1 BUC and complete follow-up were included. We used a pathological substaging system according to the tumor invasion regarding the MM-VP: pT1a (invasion above MM-VP) and pT1b (MM-VP invasion). We evaluated recurrence-free survival (RFS), progression-free survival (PFS), disease-specific-survival (DSS) based on this sub-staging system. Results: Pathological evaluation regarding the MM-VP invasion revealed 53 patients (57%) as pT1a BUC and 40 patients (43%) as pT1b BUC. The mean follow-up was 78.8 months. During the follow-up period; 60 patients (64.5%) had tumor recurrences, 32 patients (34.4%) had progression to invasive disease, 18 patients (19.4 %) died during follow-up related to the BUC. In 29 (54.7%) of pT1a and in 31(77.5%) of pT1b tumors, the recurrent disease was recorded during the followup period (p = 0.023). DSS rates at 5 years for pT1a and pT1b were 80.2% and 60.8%, respectively. PFS, RFS, and DSS rates were similar for pT1a/pT1b and did not reach statistical significance (p > 0.05). Conclusions: Sub-staging of pT1 BUC according to the MM-VP invasion showed a limited impact on the outcome in our patient cohort. However, the presence of pT1b disease caused a significantly higher rate of recurrence.
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.
Safety of Upper Pole Puncture in Percutaneous Nephrolithotomy With the Guidance of Ultrasonography Versus Fluoroscopy: a Comparative Study
(Karger, 2020) Sahan, Ahmet; Cubuk, Alkan; Ozkaptan, Orkunt; Canakci, Cengiz; Eryildirim, Bilal; Toprak, Tuncay; Ertab, Kasim
Introduction:The aim of this study was to compare the safety of ultrasonography-guided (UG) puncture and fluoroscopy-guided (FG) upper pole access (UPA) in percutaneous nephrolithotomy (PCNL).Methods:Consecutive patients with a solitary UPA were enrolled into the study from 2012 to 2020 and analyzed in a retrospective manner. In total, 177 patients were divided into 2 groups according to the method during the puncture phase of the access: FG (n= 105) and UG (n= 72). The UG and FG groups were compared in terms of complications (i.e., pleural injury and blood transfusion rate) and surgical outcomes.Results:Gender, side, grade of hydronephrosis, type of access (i.e., supracostal vs. subcostal), Guy's stone score, age, stone diameter, skin-to-stone distance, and stone density were similar in the 2 groups (p> 0.05). Only in 25.9% of cases, UPA was done using a subcostal approach. The overall complication rates were similar between the groups (p> 0.178). For the UG and FG groups, the rate of pleural injury (8.5 vs. 4.1%) and the blood transfusion rate (8.5 vs. 2.8%) were also similar (p> 0.05). The fluoroscopy time and mean hemoglobin drop were significantly lower in the UG group than in the FG group (134.2 vs. 82.2 s, respectively,p= 0.001; 20.8 +/- 9.8 vs. 16.8 +/- 7.9 g/L, respectively,p= 0.001). Stone-free rate (SFR) was also similar in the FG and UG groups (77.1 vs. 75.0%, respectively,p= 0.742).Conclusion:While it is commonly expected that the complication rates are lower in UG puncture for UPA in PCNL than they are in FG puncture, the present study failed to show this difference. However, the radiation exposure time seemed to be lower in UG puncture than FG puncture and had a similar stone-free rate (SFR) for UPA in PCNL.