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Akkoc A, Aydin C, Topaktas R, Kartalmis M, Altin S, Isen K, Metin A. Prophylactic effects of alpha-blockers, Tamsulosin and Alfuzosin, on postoperative urinary retention in male patients undergoing urologic surgery under spinal anaesthesia. Int Braz J Urol 2017; 42:578-84. [PMID: 27286124 PMCID: PMC4920578 DOI: 10.1590/s1677-5538.ibju.2015.0256] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 08/18/2015] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Postoperative urinary retention (POUR) is one of the most common complications after surgical procedures under spinal anaesthesia. Recent studies have shown the beneficial effects of alpha-adrenergic blockers in preventing POUR. The aim of this prospective study was to investigate and compare the prophylactic effects of tamsulosin and alfuzosin on POUR after urologic surgical procedures under spinal anaesthesia. MATERIALS AND METHODS A total of 180 males who underwent elective urologic surgery were included in this study. The patients were randomly allocated into three Groups. The Group I received placebo. Patients in Group II were given 0.4mg of tamsulosin orally 14 and 2 hours before surgery. Patients in Group III were given 10mg of alfuzosin ER orally 10 and 2 hours before surgery. All patients were closely followed for 24 hours postoperatively and their episodes of urinary retentions were recorded. RESULTS There were 60 patients in each Group. Their mean age was 35.95±15.16 years. Fifteen patients in Group I (25%), 3 patients in Group II (5%) and 4 patients in Group III (6.7%) required catheterization because of urinary retention. In tamsulosin group and alfuzosin group, there were a significantly lower proportion of patients with POUR compared with the placebo Group (p=0.002 and p=0.006). The beneficial effects of tamsulosin and alfuzosin on POUR were similar between both Groups (p=0.697). CONCLUSION This study suggests that the use of prophylactic tamsulosin or alfuzosin can reduce the incidence of urinary retention and the need for catheterization after urologic surgical procedures under spinal anaesthesia.
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Affiliation(s)
- Ali Akkoc
- Department of Urology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Cemil Aydin
- Department of Urology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Ramazan Topaktas
- Department of Urology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Mahir Kartalmis
- Department of Urology, Selahaddin Eyyubi State Hospital, Diyarbakir, Turkey
| | - Selcuk Altin
- Department of Urology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Kenan Isen
- Department of Urology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Ahmet Metin
- Department of Urology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
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Abstract
PURPOSE To evaluate the effectiveness and safety of direct vision internal urethrotomy (DVIU) by using endoscopic scissors for incision of short (<1 cm) urethral strictures in adult men. PATIENTS AND METHODS Twenty-one patients who had short bulbar urethral strictures were evaluated in this study. Endoscopic scissors was used for incision of urethral strictures in all patients. Retrograde urethrography (RGU) and maximum flow rate(Qmax) <15.0 ml/s by uroflowmetry were used for the definition of recurrences. RESULTS The procedure was found successful in all patients. The mean size of stricture was 0.73 cm. The mean pre-procedure Qmax was 7.9 ml/s. The mean procedure time was 10.2 min. The mean Qmax was 19.4 ml/s at the third month postoperatively. RGU was normal in all patients at the third month postoperatively. The mean follow-up was 8.1 months. Three (14.2 %) patients underwent second DVIU due to recurrence. No complication was observed during the follow-up except urinary tract infection in two (9.5 %) patients. CONCLUSIONS DVIU using endoscopic scissors appears to be an effective and safe treatment modality for incision of short urethral strictures in adult men.
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Affiliation(s)
- Kenan Isen
- Department of Urology, Ministry of Health, Diyarbakır Gazi Yaşargil Education and Research Hospital, Fabrika Mah. 813. Sok., Altınpark Konutları, C blok, Kat: 4 No:9, Diyarbakır, 21100, Turkey,
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Tunik S, Ayaz E, Akpolat V, Nergiz Y, Isen K, Celik MS, Seker U. Effects of pulsed and sinusoidal electromagnetic fields on MMP-2, MMP-9, collagen type IV and E-cadherin expression levels in the rat kidney: an immunohistochemical study. Anal Quant Cytopathol Histpathol 2013; 35:253-260. [PMID: 24282905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To investigate the role of extremely low frequency pulsed and sinusoidal electromagnetic fields on kidney tissues. STUDY DESIGN Twenty-seven male Wistar albino rats were used. The rats were divided into 3 groups (n = 9): control group, sinusoidal electromagnetic field (SEMF) group, and pulsed electromagnetic field (PEMF) group. The SEMF and PEMF groups (pulse time 25 microsn, pulse frequency 50 Hz) were subjected to 1.5 mT, 50 Hz, exposure 6 hours a day, 5 days a week for 28 days in methacrylate boxes. Formalin-fixed, paraffin-embedded kidney tissue sections were stained with hematoxylin-eosin, Gomori and periodic acid-Schiff. In addition, matrix metalloproteinase-2 (MMP-2) and 9 (MMP-9), E-cadherin and collagen type IV expression levels were examined immunohistochemically. RESULTS Thickening of glomerular basement membranes was evident in electromagnetic fields, especially in the SEMF group. In addition, expression levels of E-cadherin were decreased with electromagnetic field (EMF) exposure. The expression level of MMP-9 increased, and MMP-2 and collagen type IV expression levels were not altered with EMF exposure. CONCLUSION Both EMFs changed the molecular component of the kidney adversely.
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Affiliation(s)
- Selcuk Tunik
- Department of Histology and Embryology, Faculty of Medicine, University of Dicle, 21280 Diyarbakir, Turkey.
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Isen K. A technique using a resectoscope sheath under direct vision and nasogastric tube for difficult catheterization following TURP. Can Urol Assoc J 2013. [DOI: 10.5489/cuaj.990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Isen K. A technique for removal of intravesical tension-free tape and. Can Urol Assoc J 2013. [DOI: 10.5489/cuaj.427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Affiliation(s)
- Kenan Isen
- Clinic of Urology, Ministry of Health, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey
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Isen K, Hatipoglu NK, Dedeoglu S, Atılgan I, Çaça FN, Hatipoglu N. Reply by the Authors. Urology 2012. [DOI: 10.1016/j.urology.2012.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Isen K. Technique using a percutaneous nephroscope and nephroscopic scissors transurethrally for treatment of complicated orthotopic ureterocele in adult women. Urology 2012; 79:713-6. [PMID: 22386426 DOI: 10.1016/j.urology.2011.11.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Revised: 11/09/2011] [Accepted: 11/29/2011] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To present an endoscopic technique for the decompression of complicated orthotopic ureterocele in adult women. METHODS Five women with complicated orthotopic ureterocele were evaluated in the present study. The ureterocele was complicated by stones in 2 patients and urinary tract infection in 4. An endoscopic technique was used for the treatment of these ureteroceles. A 26F rigid nephroscope was placed into the bladder. When the ureterocele was seen in the bladder, the nephroscopic scissors was advanced through the nephroscopic channel to the ureterocele. A puncture was made on the anterior wall of the ureterocele using the nephroscopic scissors. Next, a ureteral catheter was introduced to puncture the ureterocele. Next, a window approximately 5-10 mm in diameter was opened on the wall of the ureterocele using the nephroscopic scissors. Finally, a double-J stent and urethral catheter were placed. The stones were fragmented using a pneumatic lithotripter. All the patients were evaluated with urinalysis, urine culture, ultrasonography, and voiding cystourethrography at the third month postoperatively. RESULTS The mean procedure time was 18.4 minutes. No complication was observed during the procedure, except for mild hematuria. The mean postoperative hospital stay was 19.8 hours. All patients with stones were stone free after the procedure. No cases of postoperative urinary tract infection developed. None of these patients had de novo reflux or obstruction at 3 months postoperatively. CONCLUSION This technique could be an alternative treatment option for decompression of complicated orthotopic ureterocele in adult women.
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Affiliation(s)
- Kenan Isen
- Clinic of Urology, Ministry of Health, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey.
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Isen K. Pneumatic ureteroscopic lithotripsy: is it still a reasonable treatment option for multiple ureteric stones? Urol Int 2012; 88:316-21. [PMID: 22327396 DOI: 10.1159/000335510] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Accepted: 11/29/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To assess the efficacy and safety of ureteroscopic pneumatic lithotripsy for multiple ureteric stones. MATERIALS AND METHODS 36 patients with multiple ureteric stones were treated with ureteroscopic lithotripsy (URSL). A 8/9.8-Fr Wolf semirigid ureteroscope and pneumatic lithotripter were used for stone fragmentation. RESULTS 87 stones were treated with URSL. Successful fragmentation was achieved in 77 (88.5%) of the stones. The retreatment rate was 11.5%. The stone-free rate (SFR) of lower ureteric stones (93.3%) and middle ureteric stones (87.5%) was significantly higher compared with upper (73.3%) ureteric stones (p < 0.05). For patients with stones less than 1 cm and greater than 1 cm, the SFR was 91.5 and 75.0%, respectively (p < 0.05). Perforation occurred in 1 patient, mucosal injury occurred in 5 and stone migration in 5. No long-term complication was observed in any patient. CONCLUSIONS Ureteroscopic pneumatic lithotripsy is still a reasonable treatment option for multiple ureteric stones. The procedure has high success rates with minimal morbidity. However, success rate can be affected by stone size and ureteric location.
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Affiliation(s)
- Kenan Isen
- Department of Urology, Ministry of Health, Diyarbakır Education and Research Hospital, Diyarbakır, Turkey. kenanisen @ hotmail.com
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Affiliation(s)
- Kenan Isen
- Diyarbakır Education and Research Hospital, Turkey
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Isen K, Hatipoglu NK, Dedeoglu S, Atilgan I, Caça FN, Hatipoglu N. Experience with the diagnosis and management of symptomatic ureteric stones during pregnancy. Urology 2011; 79:508-12. [PMID: 22173175 DOI: 10.1016/j.urology.2011.10.023] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 09/29/2011] [Accepted: 10/14/2011] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To present our experience to describe diagnosis and management of symptomatic ureteric stones during pregnancy. MATERIALS AND METHODS Thirty-six pregnant women with symptomatic ureteric stones were evaluated in this study. The diagnosis was done by history, physical examination, symptoms, signs, ultrasonography, or ureteroscopy if needed. Initially, conservative management was performed on all patients. When conservative treatment failed, temporizing therapies (double-J stenting or percutaneous nephrostomy [PCN]) and (ureteroscopic lithotripsy) URSL were performed on the patients. RESULTS In 25 (69.4%) of the patients, ureteric stones was diagnosed on US. In the other 11 (30.6%) of the patients, definitive diagnosis was done by ureteroscopy in 5, and 6 of them passed their stones spontaneously. Conservative management was successful in 24 of 36 (66.6%) the patients. Temporizing therapies and URSL were required in 12 of 36 (33.4%) patients. A double-J stent was successfully placed in only 3 (8.3%) of the patients, and URSL was performed in 9 (25%). In 1 (2.7%) patient, PCN was performed because of persistent renal colic, fever, and pyonephrosis. In this patient, URSL was performed after symptoms and signs resolved, and then the percutaneous tube was removed. CONCLUSION If ultrasonography fails, ureteroscopy may be an alternative approach for definitive diagnosis. When conservative approach fails, URSL may be a good alternative approach for definitive treatment.
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Affiliation(s)
- Kenan Isen
- Department of Urology, Ministry of Health, Diyarbakir, Education and Research Hospital, Diyarbakir, Turkey.
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Isen K. A technique using a resectoscope sheath under direct vision and nasogastric tube for difficult catheterization following TURP. Can Urol Assoc J 2010; 4:434. [PMID: 21191510 DOI: 10.5489/cuaj.10053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Kenan Isen
- Department of Urology, Ministry of Health, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey
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Abstract
Vesical diverticula frequently result from bladder outlet obstructions. However, giant vesical diverticula which cause acute abdomen or intestinal obstruction are very rare. Our review of the English medical literature found 3 cases of bladder diverticula which caused gastrointestinal symptoms. Here, we present a 57-year-old man with a giant diverticulum of the urinary bladder who complained of abdominal pain, nausea and vomiting, constipation, no passage of gas or feces, and abdominal distension for 3 d. A 20 cm × 15 cm diverticulum was observed upon laparotomy. The colonic obstruction was secondary to external compression of the rectum against the sacrum by a distended vesical diverticulum. We performed a diverticulectomy and primary closure. Twelve months postoperatively, the patient had no difficulty with voiding or defecation.
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Akbulut S, Cakabay B, Sezgin A, Ozmen CA, Isen K, Bakir C. Retroperitoneal Fibrosis and Hydronephrosis due to Actinomycosis. J Gynecol Surg 2009. [DOI: 10.1089/gyn.2009.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Sami Akbulut
- Department of Surgery, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey
| | - Bahri Cakabay
- Department of Surgery, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey
| | - Arsenal Sezgin
- Department of Pathology, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey
| | - Cihan Akgul Ozmen
- Department of Radiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Kenan Isen
- Department of Urology, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey
| | - Cetin Bakir
- Department of Obstetrics and Gynaecology, Woman's Health Education and Research Hospital, Diyarbakir, Turkey
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Keklikci U, Isen K, Unlu K, Celik Y, Karahan M. Incidence, clinical findings and management of intraoperative floppy iris syndrome associated with tamsulosin. Acta Ophthalmol 2009; 87:306-9. [PMID: 18384448 DOI: 10.1111/j.1755-3768.2008.01246.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To determine the risk ratios and incidence of intraoperative floppy iris syndrome (IFIS) during cataract surgery in patients using tamsulosin, and to assess management strategies for IFIS. METHODS We performed a non-randomized, observational, prospective study, in which 594 eyes of 579 patients undergoing cataract surgery were enrolled. Surgeons were masked to the patients' drug history. Usage or non-usage of tamsulosin, duration of tamsulosin use, presence or absence of IFIS, management of IFIS and intraoperative complications were recorded in the patients' theatre notes. RESULTS Twelve of 15 (80%) IFIS patients were taking systemic tamsulosin. Twelve of 23 (52%) patients using tamsulosin showed features of IFIS. The odds ratios (ORs) and relative risk (RR) ratios show strong positive correlations between tamsulosin use and IFIS. The ORs and RR ratios and the 95% confidence intervals (CIs) are as follows: OR 206.5 (95% CI 50.9-836.5); RR 99.3 (95% CI 30.0-327.8). There were no statistically significant differences between patients with or without IFIS, who were using tamsulosin, in terms of age or duration of tamsulosin use (p > 0.05). Seven eyes (46.6%) with IFIS were successfully managed with epinephrine. Eight eyes (53.4%) with IFIS needed iris hooks. CONCLUSIONS Patients using tamsulosin appear to be at high risk of IFIS during cataract surgery. The occurrence of IFIS may not be affected by duration of tamsulosin use or age. Epinephrine may be effective in approximately 50% of eyes with IFIS. The iris hook procedure represents an effective management strategy in IFIS.
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Affiliation(s)
- Ugur Keklikci
- Department of Ophthalmology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey.
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Isen K, Utku V, Atilgan I, Kutun Y. Experience with the diagnosis and management of paraurethral cysts in adult women. Can J Urol 2008; 15:4169-4173. [PMID: 18706145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE There is no consensus on diagnosis and treatment of paraurethral cyst which is a rare benign cystic neoplasm. We present our experience to describe diagnosis and management of paraurethral cysts in adult women. MATERIALS AND METHODS Ten women were diagnosed with paraurethral cysts. Cysto-urethroscopy was performed on all patients to rule out urethral diverticulum just before surgery. All patients underwent surgical excision. Symptoms, parity, diagnostic tests, complications, recurrence and histologic examination of the cysts wall were analyzed in all patients. RESULTS The presenting symptoms were sensation of a mass, dyspareunia, and dysuria. All of the patients were multipareous. The cysts were diagnosed by physical examination and cysto-urethroscopy in most of the patients. Transvaginal ultrasonography and magnetic resonance imaging was performed in only one patient. All patients healed without complication and no sign of recurrent cyst formation was observed in any of our patients at follow-up. Histologically, the cyst wall was composed of squamous epithelium in eight patients and squamous epithelium with transitional epithelium in two patients. CONCLUSIONS Most of paraurethral cyst can be diagnosed by PE and cysto-urethroscopy. Noninvasive diagnostic tests such as TVUS or MRI can be used for ruling out urethral diverticula or other urogenital abnormalities if needed. Surgical excision is an effective treatment modality for paraurethral cyst in adult women.
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Affiliation(s)
- K Isen
- Clinic of Urology, State Hospital of Diyarbakir, Turkey
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Isen K, Em S, Kilic V, Utku V, Bogatekin S, Ergin H. Management of Bladder Stones with Pneumatic Lithotripsy Using a Ureteroscope in Children. J Endourol 2008; 22:1037-40. [DOI: 10.1089/end.2007.0342] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Kenan Isen
- Department of Urology, State Hospital of Diyarbakir, Diyarbakir, Turkey
| | - Suat Em
- Department of Urology, State Hospital of Diyarbakir, Diyarbakir, Turkey
| | - Vehbi Kilic
- Department of Urology, State Hospital of Diyarbakir, Diyarbakir, Turkey
| | - Vedat Utku
- Department of Urology, State Hospital of Diyarbakir, Diyarbakir, Turkey
| | - Salih Bogatekin
- Department of Urology, State Hospital of Diyarbakir, Diyarbakir, Turkey
| | - Huseyin Ergin
- Department of Urology, State Hospital of Diyarbakir, Diyarbakir, Turkey
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Isen K, Sinik Z, Alkibay T, Sezer C, Sözen S, Atilla S, Ataoglu O, Isik S. Magnetic resonance imaging and morphometric histologic analysis of prostate tissue composition in predicting the clinical outcome of terazosin therapy in benign prostatic hyperplasia. Int J Urol 2001; 8:42-8. [PMID: 11240824 DOI: 10.1046/j.1442-2042.2001.00243.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine whether magnetic resonance imaging (MRI) or quantitative color-imaged morphometric analysis (MA) of the prostate gland are related to the clinical response to terazosin. METHODS Thirty-six male patients with symptomatic benign prostatic hyperplasia (BPH) with a serum prostate-specific antigen level of 4-10 ng/mL underwent MRI with body coil, transrectal prostate ultrasonography and biopsy prior to terazosin therapy. For MRI-determined stromal and non-stromal BPH, the ratio of the signal intensity of the inner gland to the obturator internus muscle was evaluated. Histologic sections were stained with hematoxylin and eosin. The MA of the specimens was performed by Samba 2000. Results of the two techniques were interpreted according to the terazosin therapy results. RESULTS The mean stromal percentage was 60.5 +/- 18.0%. No statistically significant relationship was found between the clinical outcome of terazosin and the MRI findings. The MA results showed a significant relationship between the percentage of stroma and the percent change of the peak urinary flow rate, but not with the percent change of the international prostate symptom score after terazosin therapy (P < 0.05). CONCLUSION Magnetic resonance imaging alone is not sufficient in predicting the response to terazosin therapy. Morphometric analysis of BPH tissue composition can be used in predicting the clinical outcome of terazosin therapy but it is suitable only in patients for whom prostatic biopsy is necessary in order to rule out prostate cancer.
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Affiliation(s)
- K Isen
- Department of Urology, Karaelmas University School of Medicine, Zonguldak, Turkey
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Isen K, Küpeli B, Sinik Z, Sözen S, Bozkirli I. Antibiotic prophylaxis for transrectal biopsy of the prostate: a prospective randomized study of the prophylactic use of single dose oral fluoroquinolone versus trimethoprim-sulfamethoxazole. Int Urol Nephrol 2000; 31:491-5. [PMID: 10668944 DOI: 10.1023/a:1007115312039] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We investigated the efficacy of prophylactic use of single dose oral ofloxacin and trimethoprim-sulfamethoxazole regimens for transrectal prostate biopsy in 110 men. In the ofloxacin, trimethoprim-sulfamethoxazole and control groups, urinary infection was found in 2 (4.76%), 3 (6.66%) and 6 (26.08%) patients, respectively. Both of these antibiotic regimens produced a statistically significant reduction in urinary infection (p<0.02, p<0.05). Our study indicates that single dose fluoroquinolone or trimethoprim-sulfamethoxazole prophylaxis seems to be effective, practical and economical.
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Affiliation(s)
- K Isen
- Department of Urology, Gazi University, Faculty of Medicine, Ankara, Turkey
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Abstract
BACKGROUND AND OBJECTIVE Extracorporeal shockwave lithotripsy (SWL) is accepted as first-line therapy for kidney stones. The aim of this study was to evaluate SWL therapy in patients with congenital urinary system anomalies. PATIENTS AND METHODS A total of 120 patients with congenital urinary system anomalies and kidney stones who underwent SWL treatment were evaluated. Of these patients, 44 (37%) had horseshoe kidneys, 22 (18%) had rotation anomalies, 13 (11%) had pelvic kidneys, and 41 (34%) had ureteral duplications. The mean stone size was 2.09+/-0.71 (range 0.8-4.6) cm2, and a total of 232 sessions (1.93 sessions/patient) were applied. RESULTS The overall stone-free rate after completion of the SWL treatments was 70% (84 patients). In horse shoe kidneys the stone-free rate was 68%, and sufficient fragmentation was achieved in another 21%. These values were 59% and 32%, respectively, for malrotated kidneys, 54% and 39% for pelvic kidneys, and 83% and 12% for ureteral duplications. The 10 patients in whom SWL treatment remained unsuccessful had horse-shoe kidneys (five cases), malrotated kidneys (two cases), pelvic kidney (one case), and ureteral duplication (two cases). Open surgery was performed in eight patients with renal anomalies, and ureteroendoscopic lithotripsy was performed in two patients with ureteral duplication. CONCLUSION Shockwave lithotripsy is an effective and reliable treatment method in patients with congenital urinary system anomalies, especially when the stones are <2 cm. Patients with ureteral duplication had the overall best stone-free rates. However, patients who have stones > or =3 cm in horseshoe or malrotated kidneys and duplex systems seem to be better candidates for percutaneous nephrolithotomy or open surgery.
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Affiliation(s)
- B Küpeli
- Department of Urology, Gazi University School of Medicine, Ankara, Turkey.
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Biri H, Küpeli B, Isen K, Sinik Z, Karaoğlan U, Bozkirli I. Treatment of lower ureteral stones: extracorporeal shockwave lithotripsy or intracorporeal lithotripsy? J Endourol 1999; 13:77-81. [PMID: 10213099 DOI: 10.1089/end.1999.13.77] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE In this study, 1121 patients with lower ureteral stones were evaluated to compare the effectiveness of extracorporeal shockwave lithotripsy (SWL) and ureteroscopy with three different lithotripsy modalities. METHODS Of these patients, 726 were treated with SWL, whereas 430 underwent ureteroscopy, with pneumatic lithotripsy (PL), ultrasonic lithotripsy (USL), and electrohydraulic lithotripsy (EHL) performed in 125 (29.0%), 276 (64.2%), and 29 (6.8%) patients, respectively. Thirty-five patients underwent both types of treatment because of unsuccessful SWL therapy. RESULTS In the SWL group, the stone-free rate was 42.2% and the fragmentation rate was 59.5%. These values were 96.8% and 98.4% for PL, 89.4% and 90.5% for USL, 93.1% and 96.5% for EHL, respectively. CONCLUSIONS These data show that SWL was less effective than ureteroscopic lithotripsy (p < 0.001). The PL modality had the highest stone-free and fragmentation rate, and EHL had the highest complication rate (43.5%). Ureteroscopic lithotripsy is the most effective treatment choice in lower ureteral stones no matter which kind of energy is used, and PL is the most effective and least morbid approach.
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Affiliation(s)
- H Biri
- Department of Urology, University of Gazi, School of Medicine, Ankara, Turkey
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Biri H, Isen K, Sinik Z, Onaran M, Küpeli B, Bozkirli I. Sertraline in the treatment of premature ejaculation: a double-blind placebo controlled study. Int Urol Nephrol 1999; 30:611-5. [PMID: 9934807 DOI: 10.1007/bf02550555] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study investigated the efficacy and the adverse effects of sertraline in the treatment of premature ejaculation (PE). Thirty-seven patients with PE were randomly assigned to receive either sertraline or a placebo. Of them 22 were given 50 mg of sertraline per day and the other 15 patients were given an identical placebo one per day. After 4 weeks, the latency to ejaculation in the sertraline group was found to be significantly longer than that of the placebo group (p<0.01). None of the patients discontinued therapy due to adverse effects. These results indicate that sertraline is an effective therapy for PE.
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Affiliation(s)
- H Biri
- Department of Urology, Medical School of Gazi University, Ankara, Turkey
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Küpeli B, Biri H, Isen K, Onaran M, Alkibay T, Karaoğlan U, Bozkirli I. Treatment of ureteral stones: comparison of extracorporeal shock wave lithotripsy and endourologic alternatives. Eur Urol 1998; 34:474-9. [PMID: 9831788 DOI: 10.1159/000019786] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
AIM OF THE STUDY The aim of the study is to compare the effectiveness of ESWL and ureteroscopic lithotripsy with pneumatic, ultrasonic and electrohydraulic modalities in patients with ureteral stones. PATIENTS AND METHOD In this study, 1,970 patients with ureteral stones were evaluated. ESWL and ureteroscopic lithotripsies were performed in 1,580 and 484 patients, respectively. The ESWL group was treated with a Siemens Lithostar plus. Ureteroscopic lithotripsy was performed with pneumatic lithotripsy (PL), ultrasonic lithotripsy (USL) and electrohydraulic lithotripsy (EHL) in 140 (28.9%), 311 (64.3%) and 33 (6.8%) patients, respectively. 94 patients underwent both because of unsuccessful ESWL therapy. RESULTS In the ESWL group, the stone-free rate was 49.9% and the fragmentation rate 71.0%. These values were: 95.0 and 97.1% for PL; 88.1 and 89.4% for USL; 90.9 and 93.9% for EHL, respectively. Ureteroscopic lithotripsy has been found more effective than ESWL in the treatment of middle and lower ureteral calculi (p < 0.001) and PL has the greatest success rate within these endoscopic groups. CONCLUSION ESWL therapy can be the first-line therapy in upper ureteral stones keeping the other modalities for unfragmented stones. However, ureteroscopic lithotripsy is the most effective treatment choice in lower ureteral stones no matter which kind of energy used and PL is the most effective and less complicated among the other types.
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Affiliation(s)
- B Küpeli
- School of Medicine, Department of Urology, Gazi University, Ankara, Turkey.
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Sinik Z, Isen K, Biri H, Kupeli B, Sozen S, Deniz N, Bozkirli I. Combination of pneumatic lithotripsy and transurethral prostatectomy in bladder stones with benign prostatic hyperplasia. J Endourol 1998; 12:381-4. [PMID: 9726409 DOI: 10.1089/end.1998.12.381] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We present our experience with combined pneumatic lithotripsy and transurethral resection of the prostate (TURP) in 52 patients with bladder stone(s) and benign prostatic hyperplasia (BPH). All stones were fragmented with the pneumatic Swiss Lithoclast. Pneumatic lithotripsy and evacuation caused a mean increase of 16 minutes in operating time. No complications, other than mild hematuria, were observed intraoperatively because of pneumatic lithotripsy. We observed early and long-term complications related to the procedure in 13% of patients. The average hospital stay was 3.2 days. The combination of pneumatic lithotripsy and TURP appears to be an effective, safe, and economical treatment method for patients with bladder stone(s) and BPH.
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Affiliation(s)
- Z Sinik
- Department of Urology, Gazi University School of Medicine, Ankara, Turkey
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