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Öğe 180-W XPS GreenLight laser vaporization for benign prostate hyperplasia: 12-month safety and efficacy results for glands larger than 80 ml(Springer London, 2015) Altay, Bülent; Erkurt, Bülent; Kiremit, Murat Can; Güzelburç, Vahit; Boz, Mustafa Yücel; Albayrak, SelamiThe purpose of the current study was to evaluate the efficacy and safety of laser prostatectomy by using the latest 180-W XPS GreenLight laser with the new MoXy fiber in the surgical treatment of glands larger than 80 mL in a prospective study. From December 2011 to May 2013, 68 consecutive patients with a mean age of 71.1 +/- 9.8 years (range 49 to 85) underwent 180-W XPS laser prostatectomy at our institution. The baseline characteristics, perioperative data, and complications were recorded. Evaluation of outcomes was assessed at 3, 6, and 12 months postoperatively comparing subjective (International Prostate Symptom Score [IPSS], International Index of Erectile Function-5 [IIEF-5]) and objective (Maximal flow rate [Q(max)], postvoid residual urine [PVR], transrectal ultrasound [TRUS] volume) parameters to the preoperative data. Mean preoperative prostate volume was 104.3 +/- 29.7 mL (range 81 to 185). Mean operation time was 65.5 +/- 29.6 min (range 38 to 124), with a mean energy delivery of 398 +/- 169 kJ (range 39 to 523). The catheterization time was 20.8 +/- 1.9 h (range 6 to 92) and the hospital stay was 27.3 +/- 8.7 h (range 12 to 80). No major intraoperative complications were observed. Improvement in IPSS, Q(max), and PVR was statistically significant (p < 0.001) at 3, 6, and 12 months. Urethral strictures were observed in two patients (2.9 %). No patients required reintervention due to residual adenoma. The average volume reduction was 40.5 % at 12 months. Photoselective vaporization of the prostate (PVP) using the new 180-W XPS GreenLight laser system seems to be a safe and effective procedure and could play an important role in the surgical treatment of symptomatic benign prostatic hyperplasia (BPH) patients with larger prostate volumes.Öğe A comparison of 120 W laser photoselective vaporization versus transurethral resection of the prostate for bladder outlet obstruction by prostate cancer(Karger, 2015) Altay, Bülent; Erkurt, Bülent; Kiremit, Murat Can; Horuz, Rahim; Güzelburç, Vahit; Albayrak, SelamiObjective: To compare the mid-term outcomes of photoselective vaporization of prostate (PVP) with GreenLight HPS 120 W laser and transurethral resection of the prostate (TURP) for obstructive lower urinary tract symptoms (LUTS) in men with prostate cancer (CaP). Patients and Methods: Seventy four patients with locally advanced (T3/T4) CaP with severe LUTS or acute urinary retention (AUR) were allocated to TURP (n = 36) or PVP (n = 38). International Prostate Symptom Scores (IPSS), maximum flow rates (Qmax) and post-void residual volumes (V-res), PSA levels, prostate volumes, complications, catheter removal and hospitalization periods were recorded. Patients were reassessed at 3, 6, and 12 months. Results: The catheter removal time was significantly longer in the TURP group (3.8 +/- 1.1 vs. 1.2 +/- 0.7 days, p = 0.02), whereas failure of initial voiding trial was higher in PVP (2.7 vs. 13.1%, p = 0.01). No significant difference in IPSS, Qmax and V-res values was observed within the follow-up period between two groups. A significant difference in urethral stricture rate (8.3 vs. 0%), catheter removal time (3.8 +/- 11 vs. 1.2 +/- 0.7 days) and hospital stay ( 2.9 +/- 0.6 vs. 1.1 +/- 0.5 days) was observed in favor of PVP. Conclusions: Palliative PVP is very safe and effective by means of symptomatic relief in patients with locally advanced CaP.Öğe A review study to evaluate holmium:YAG laser lithotripsy with flexible ureteroscopy in patients on ongoing oral anticoagulant therapy(Springer, 2017) Altay, Bülent; Erkurt, Bülent; Albayrak, SelamiThe objective of this study was to evaluate the safety and efficacy of flexible ureteroscopy (FURS) and holmium:YAG laser lithotripsy for the treatment of upper urinary tract stones in patients on active oral anticoagulants. The records of 1081 patients who underwent flexible ureteroscopic holmium:YAG (Ho:YAG) laser lithotripsy for upper ureteral and renal calculi from 1999 to 2015 were retrospectively reviewed. A total of 84 patients on continuous oral anticoagulation or antiplatelet therapy (warfarin, aspirin, or clopidogrel) were identified. Of these patients, 40 were on warfarin, 25 on aspirin, 11 on clopidogrel, and 8 on both aspirin and clopidogrel. The drugs were not discontinued. The baseline characteristics, indications for anticoagulation therapy, perioperative data, stone-free rate, and complications were documented. Evaluation of outcomes was assessed at 1-, 3-, and 6-month follow-up postoperatively. Mean stone size was 19.7 +/- 9.4 (range 8 to 31 mm). Twenty patients had upper ureteral and 64 patients had intrarenal calculi. Two patients had bilateral renal calculi. Mean operation time was 78.2 +/- 23.8 min (range 17 to 144 min). Two procedures (2.3%) in warfarin group were terminated due to persistent bleeding causing visual impairment. No transfusions were required. The mean serum hemoglobin levels did not change significantly (12.9 +/- 3.7 to 12.2 +/- 3.3 g/dL). No thromboembolic or cardiac adverse events were observed perioperatively. The double-j (DJ) ureteral catheterization time was 29.6 +/- 9.3 days (range 14 to 68 days) and the hospital stay was 1.6 +/- 0.6 days (range 1 to 4). The stone-free rate was 95.2% (80 patients) at 6 months. Flexible ureteroscopic Ho:YAG laser lithotripsy in patients requiring long-term anticoagulation therapy seems to be a safe and effective procedure and should be considered as a first-line treatment option in such patients for the surgical management of upper urinary tract stones.Öğe A self-inflicted male urethral/vesical foreign body (olive seed) causing complete urinary retention(Elsevier Science Inc, 2018) Bayraktar, Zeki; Albayrak, SelamiForeign body in the urethra is a relatively rare occurrence. A variety of foreign bodies, majority of which were mostly self-inflicted for psychiatric disorder, senility, intoxication, and autoerotic stimulation, have been reported in the literature. We report a case of self-inserted foreign body (olive seed) in the urethra.Öğe Analysis of patients undergoing urological intervention amid the COVID-19: Experience from the pandemic hospital(Springer, 2020) Soytaş, Mustafa; Boz, Mustafa Yücel; Güzelburç, Vahit; Çalık, Gökhan; Kaçtan, Mehmet Çağrı; Horuz, Rahim; Akbulut, Ziya; Albayrak, SelamiPurpose It is reported that surgical procedures performed during the COVID-19 pandemic are accompanied by high complications and risks. In this study, the urological interventions applied with appropriate infrastructure and protocols during the pandemic in the pandemic hospital that is carrying out the COVID-19 struggle are analyzed. Methods Urological interventions were reviewed in the 5-week period between March 11 and April 16. The distribution of outpatient and interventional procedures was determined by weeks concurrently along with the COVID-19 patient workload, and data in the country, subgroups were further analyzed. Patients intervened were divided into four groups as Emergency, High, Intermediate, and Low Priority cases according to the EAU recommendations. The COVID-19-related findings were recorded; staff and patient effects were reported. Results Of the 160 interventions, 65 were minimally invasive or open surgical intervention, 95 were non-surgical outpatient intervention, and the outpatient admission was 777. According to the priority level, 33 cases had emergency and high priority, 32 intermediate and low priority. COVID-19 quarantine and follow-up were performed at least 1 week in 22 (33.8%) operated patients at the last week, 43 (66.2%) patients who were operated in the previous 4 weeks followed up at least 2 weeks. No postoperative complications were encountered in any patient due to COVID-19 during the postoperative period. Conclusion In the COVID-19 pandemic, precautions, isolation, and algorithms are required to avoid disruption in the intervention and follow-up of urology patients; priority urological interventions should not be disrupted in the presence of necessary experience and infrastructure.Öğe Antiplatelet (aspirin) therapy as a new option in the treatment of vasculogenic erectile dysfunction: A prospective randomized double-blind placebo-controlled study(Springer, 2018) Bayraktar, Zeki; Albayrak, SelamiTo investigate the efficiency of antiplatelet (aspirin) therapy in vasculogenic erectile dysfunction (VED) patients with a high mean platelet volume. A total of 184 patients diagnosed with VED between the ages of 18 and 76 were randomly divided into two groups and treated for 6 weeks [group 1: 120 patients (mean age 48.3), aspirin 100 mg/day; group 2: 64 patients (mean age 47.7), placebo 100 mg/day]. The changes from baseline to end point in erectile function scores on the International Index of Erectile Function (IIEF-EF) and the number of patients who answered "yes" to questions 2 and 3 of the sexual encounter profile (SEP) were compared statistically. The mean baseline IIEF-EF scores in groups 1 and 2 were 14.1 +/- 4.9 and 14.3 +/- 5.2, respectively (p = 0.7966), the number of patients who answered "yes" to SEP-2 was 62 (51.6%) in group 1 and 32 (50%) in group 2 (p = 0.8366), and the number of patients who answered "yes" to SEP-3 was 38 (31.6%) in group 1 and 20 (31.2%) in group 2 (p = 0.9557). In the aspirin group, the changes from baseline to end point in the IIEF-EF, SEP-2, and SEP-3 scores were 7.2, 36.6, and 46.6%, respectively. In the placebo group, these changes were 2.0, 9.4, and 12.5%, respectively. When compared with the placebo group, aspirin-treated subjects showed a significant improvement in all three efficacy measures (p <0.0001). 100 mg of aspirin administered once a day significantly improved EF in men with VED.Öğe Author reply(Elsevier Inc., 2016) Akça, Oktay; Zargar, Homayoun; Albayrak, Selami; Kaouk, Jihad H.Robotic retropubic prostate surgery has improved our knowl-edge of anatomy with respect to the prostatic and pelvic fasciaeas well as the neurovascular bundles.1This knowledge not onlyhas served us in the laparoscopic-based operations but is also trans-ferable to the open retropubic technique. However, oncological2and functional results of laparoscopic or open retropubic tech-niques are not significantly superior to the “open” technique ofradical perineal prostatectomy, a procedure that has changed littlesince it was first described by Young in 1905.3Although sur-geons are able to visualize and spare the neurovascular bundlesbilaterally in the retropubic approach, the overall erectile satis-faction rate was not more than 27% in a recent contemporaryseries.4With respect to the immediate return of continence aftercatheter removal, perineal prostatectomy achieves this withoutthe need for additional reconstructive maneuvers. This is achieved,owing to the minimum disturbance of the supportive anatomi-cal structures during perineal prostatectomy.Öğe Blood platelet activity in men with vasculogenic erectile dysfunction(Edizioni Scripta Manent s.n.c., 2017) Bayraktar, Zeki; Albayrak, SelamiObjective: The aim of this study was to investigate the platelet activity in patients with vasculogenic erectile dysfunction (ED). Materials and methods: The total blood count, including hemoglobin (Hgb), white blood cell (WBC), red blood cell (RBC), platelet (PLT) and mean platelet volume (MPV) parameters were measured in the patient (n = 70) and control groups (n = 50). Results: The average age was 48.1 ± 11.7 and 47.6 ± 12.3 in the patient and control groups (p = 0.8217), respectively. MPV was higher in the patient group and there was a statistically significant difference between two groups (11.27 ± 0.56 and 9.8 ± 0.91, p < 0.0001). PLT counts were lower in the patient group but there was not a statistically significant difference (196.23 ± 37.01 and 209.07 ± 36.71, p = 0.0626). In terms of haemoglobin, WBC and RBC values, there was no difference in the patient and control groups. Conclusions: Finding high MPV, which reflects the platelet activity, in the patient group shows that platelets also have a role in the VED etiopathogenesis. In the case of the confirmation of this result with additional studies, the efficiency of anti-platelet therapy in the vasculogenic ED should also be researched.Öğe Cerrahi olarak tedavi edilen böbrek kitlelerinin histopatolojisi: 178 vakanın analizi(2014) Balaban, Muhsin; Horuz, Rahim; Akça, Oktay; Albayrak, SelamiAmaç: Malignite şüphesiyle cerrahi olarak tedavi edilen böbrek kitlelerinin patolojik değerlendirmesini yaparak serimizdeki benign lezyonların sıklığını ve uygulanan tedavi yöntemlerini tespit etmek. Gereç ve Yöntemler : Şubat 2005 ile Aralık 2010 arasında malignite şüphesi nedeniyle ameliyat edilen 188 böbrek kitleli hastanın (120 erkek,68 kadın hasta) kayıtları retrospektif olarak incelendi. Bulgular: Toplam 188 hastanın 178 inin kayıt bilgileri eksiksizdi. Bu hastalardan 142 sine radikal nefrektomi (% 79), 28 ine nefron koruyucu cerrahi (%15), 4 üne sadece böbrek biyopsisi (%3) ve 4 üne de nefroüreterektomi (%3) yapıldı. 178 tümörün 66 sının (37%) tanısı insidental olarak konuldu. İnsidental saptanan kitlelerin 43 ünün (%66) boyutu 7 cm den küçüktü. Patolojik değerlendirmede 156 (%88) hastada malignite saptanırken, 22 (%12) hastada benign patolojiler bulundu. Benign kitleler sırasıyla onkositom (n=11), anjiomiyolipom (n=6), kistik nefroma (n=2), ksantogranülomatöz pyelonefrit (n=2) ve metanefrik adenom (n=1) idi. 7 cm den küçük 91 böbrek kitlesinin 22 sinde (%24) benign patoloji saptandı. Benign kitlelerin hiçbiri 7 cm den büyük değildi. Sonuç: Preoperatif malign olarak şüphe edilen kitleler, radyolojik görüntüleme yöntemlerindeki teknolojik gelişmelere rağmen, benign çıkabilmektedir. İnsidental olarak saptanan ve boyutu 7 cm den küçük olan böbrek kitlelerinde nefron koruyucu cerrahi ön planda tutulmalıdır.Öğe Chronic renal impairment predicts oncological outcomes in utuc patients undergoing rnu(2024) Wong, Chris Ho Ming; Sabuncu, Kubilay; Horuz, Rahim; Albayrak, Selami; del Pilar Laguna Pes, Maria; de la Rosette, Jean J. M. C. H.; Teoh, Jeremy Yuen ChunObjective: This study aims to explore the relationship between pre-existing renal impairment and oncological outcomes in upper tract urothelial carcinoma (UTUC) patients treated with radical nephroureterectomy (RNU) using data from a multicentre international registry. Patients and methods: Data on non-metastatic UTUC patients who underwent RNU were obtained from the Clinical Research Office of the Endourology Society Urothelial Carcinomas of the Upper Tract (CROES-UTUC) Registry. Patients were categorised into normal pre-operative renal function and chronic renal impairment (CKD) groups, with CKD defined as an estimated glomerular filtration rate below 60 mL/kg/1.73 m². Kaplan–Meier survival analysis was employed to investigate disease-free survival (DFS) and overall survival (OS). Multivariable Cox regression analysis was conducted to identify confounding variables. Results: A total of 1393 patients diagnosed with UTUC who underwent RNU between 2014 and 2019 were analysed. 875 patients (62.4%) had normal renal function, whilst 528 patients (37.6%) had CKD prior to RNU. The two groups had similar proportions of bladder cancer history, comparable cardiovascular comorbidity, similar tumour stage, and comparable proportions receiving laparoscopic or robotic-assisted RNU. In multivariable cox regression analysis, CKD was found to be associated with inferior DFS (HR = 1.419; 95%CI = 1.060–1.898; p = 0.019). Upon multivariable analysis, pre-existing renal impairment and higher T stage (HR = 4.613; 95%CI = 1.829–4.712; p < 0.001) and the use of adjuvant chemotherapy (HR = 1.858; 95%CI = 1.229–2.807; p = 0.003) were also found to associate with worse DFS. Significant cardiovascular disease and higher T stage were associated with worse OS. Existing renal impairment at baseline did not have any significant associated with OS. Conclusion: In this multicentre registry, preoperative chronic renal impairment was identified as an independent predictor of inferior DFS in patients undergoing RNU for non-metastatic UTUC. Preoperative CKD could serve as a clinical predictor of poorer oncological outcomes.Öğe Comparison of absorbed irrigation fluid volumes during retrograde intrarenal surgery and percutaneous nephrolithotomy for the treatment of kidney stones larger than 2 cm(SpringerOpen, 2016) Güzelburç, Vahit; Balasar, Mehmet; Çolakoğulları, Mukaddes; Güven, Selçuk; Kandemir, Abdülkadir; Öztürk, Ahmet; Karaaslan, Pelin; Erkurt, Bülent; Albayrak, SelamiPurpose: Irrigation-induced increase in intrarenal pressure is of concern because it may cause infection due to increased pyelovenous and pyelolymphatic absorption. This study is the first to compare prospectively the absorbed fluid volumes during percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) for stones larger than 2 cm. Materials and methods: General anesthesia was applied to all patients. Isotonic solution containing 1 % ethanol was used as irrigation fluid. Venous blood ethanol concentration was first measured with the start of irrigation and thereafter every 15 min until the patients left the recovery room. Absorbed fluid volumes were measured using the blood ethanol concentrations. Duration of irrigation, irrigated fluid volume, stone size and grade of hydronephrosis were also recorded. Results: A total of 60 patients were included the study. Fluid absorption occurred in all patients. Minimum and maximum ranges of fluid absorption were 20-573 mL for RIRS and 13-364 mL for PCNL. The increase in fluid absorbed volume was observed as a result of the given amount of irrigating fluid used in the PCNL group. Also prolongation of operation led to a significant increase in absorption in the PCNL group. Increase in body mass index, stone size, and hydronephrosis did not affect fluid absorption significantly in either of the two operation techniques in correlation analyzes. Conclusion: Both RIRS and PCNL are conducted under high pressure and can be accompanied potential complications such as SIRS. The fluid absorption confirmed in our study should be taken into consideration during RIRS and PCNL.Öğe Comparison of before and after COVID-19 urology practices of a pandemic hospital(AVES, 2020) Soytaş, Mustafa; Boz, Mustafa Yücel; Güzelburç, Vahit; Çalık, Gökhan; Horuz, Rahim; Akbulut, Ziya; Albayrak, SelamiObjective: The aim of this study is to compare the effects of COVID-19 on urology practice using pre- and post-pandemic data of a pandemic hospital.Material and methods: March 11 is considered as the beginning of COVID-19 and, changes in the number of the outpatient clinic examinations, non-surgical procedures, and surgery in the 8-week period before and during the pandemic were evaluated by weeks. Age, gender, and comorbid diseases of the operated patients were compared statistically. The symptoms, complaints, mortality, and morbidity conditions of the patients were recorded by contacting them. Descriptive data and chi-square test were used.Results: The number of COVID-19 cases has been reported as 8,916 for the hospital, 88,412 for the city and 150,593 for the country. The mean age of the operated patients before and after 11 March was 51 and 47, and comorbidities were 79 and 40, respectively, and there was no statistically significant difference(p<0.05). The number of patients examined was 2,309 and 868, the number of operated patients 173 and 94, the number of patients undergoing non-surgical procedures were 371 and 174, respectively. The names and numbers of surgical and non-surgical procedures are listed according to European Association of Urology (EAU) priority classification. In follow-up, no complication because of COVID-19 was observed in any patient.Conclusion: Our study showed that, although the numbers have decreased, similar operations can be performed in daily urology practice without any contamination and mortality during the pandemic compared to the prepandemic period, by taking precautions and following the algorithms.Öğe Contemporary management of medium-sized (10-20mm) renal stones: A retrospective multicenter observational study(Mary Ann Liebert, 2015) Kiremit, Murat Can; Güven, Selçuk; Sarıca, Kemal; Öztürk, Ahmet; Buldu, İbrahim; Kafkaslı, Alper; Balasar, Mehmet; İstanbulluoğlu, Okan; Horuz, Rahim; Çetinel, Cihangir Ali; Kandemir, Abdulkadir; Albayrak, SelamiPurpose: To evaluate contemporary management approaches to medium-sized (10-20mm) renal stones. Patients and Methods: A total of 935 patients treated for medium-sized renal stones (10-20mm) between July 2012 and March 2014 were included in the study program. Contemporary minimally invasive approaches applied in the management of such stones were evaluated and compared. Results: The cohort consisted of 561 male (60%) and 374 female (40%) patients. Of the 935 patients with medium-sized renal calculi, 535 (57.2%) were treated with shockwave lithotripsy (SWL), 201 (21.4%) with retrograde intrarenal surgery (RIRS), 110 (11.7%) with minimally invasive percutaneous nephrolithotomy (miniperc), and the remaining 89 (11.7%) patients with micropercutaneous nephrolithotomy (microperc). In the SWL group, stones were located mostly in the pelvis (51%), while in the miniperc and microperc groups, they were located mainly in the lower pole (46%, 53%, respectively). Stone-free rates after a single session were 77.2%, 86.1%, 88.8%, and 83.6% in the SWL, RIRS, microperc, and miniperc groups, respectively. Although no serious complications (above Clavien level III) were noted in any of the groups evaluated, Clavien I to II complications were common in the miniperc group. Conclusion: Although SWL is the preferred treatment option for patients with medium-sized (10-20mm) renal stones, endourologic methods also have been found to have a significant role. Relatively lower complication rates along with higher stone-free status observed with the RIRS technique compared with percutaneous approaches have made this method a valuable option in the management of such stones in recent years.Öğe COVID-19 and urology: A bibliometric analysis of the literature(John Wiley and Sons Inc, 2021) Soytaş, Mustafa; Danacıoğlu, Yavuz Onur; Boz, Mustafa Yücel; Horuz, Rahim; Albayrak, SelamiAim The aims of this research were to analyse the urological literature published during the COVID-19 pandemic and to guide future research. Material and methods Between 2019 and 2021, the Web of Science (WoS) All Databases collection was searched for publications related to COVID-19 and Urology. The keywords used during this search were coronavirus-19, COVID-19, SARS-CoV-2, novel coronavirus, 2019-nCoV, pandemic and/or urology. The top 50 cited (T50) publications were also identified and summarized. Exported Microsoft Excel files, Visualization of Similarities viewer (VOSviewer) software and descriptive assessment were used for bibliometric and statistical analyses of the publications. Results In total, 582 publications related to COVID-19 and urology were identified. In these publications, the most active author, journal, country and organisation were Francesco Porpiglia, European Urology, the United States of America (USA) and La Paz University Hospital, respectively. The most commonly used keywords were telemedicine-telehealth, SARS-CoV-2, coronavirus, pandemic, residency, testicle, semen, kidney transplantation, endourology and surgery. The most worrying issues in the articles are the negative impact of COVID-19 on resident training and permanent damage to urological organs. Conclusions We analysed all the articles related to COVID-19 and urology published to date in the WoS All Databases collection. The most commonly published articles were based on clinical and outpatient practice, telemedicine, residency training, transplantation, and testicles. The long-term adverse effects of the pandemic on urology practice and especially urological organs will need to be assessed further in future research.Öğe Cross-continental comparison of safety and protection measures amongst urologists during COVID-19(Wiley, 2020) de la Rosette, Jean J. M. C. H.; Laguna, Pilar; Alvarez Maestro, Mario; Eto, Masatoshi; Mochtar, Chaidir Arif; Albayrak, Selami; Mendoza-Valdes, Arturo; Ong, Teng Aik; Khadgi, Sanjay; Al-Terki, Abdullatif; Bolton, Damien; Gomez, Reynaldo; Klotz, Laurence; Kulkarni, Sanjay; Tanguay, Simon; Gravas, StavrosObjectives To determine the well-being of urologists worldwide during the coronavirus disease 2019 pandemic, and whether they have adequate personal protective equipment knowledge and supplies appropriate to their clinical setting. Methods Urologists worldwide completed a Societe Internationale d'Urologie online survey from 16 April 2020 until 1 May 2020. Analysis was carried out to evaluate their knowledge about protecting themselves and others in the workplace, including their confidence in their ability to remain safe at work, and any regional differences. Results There were 3488 respondents from 109 countries. Urologists who stated they were moderately comfortable that their work environment offers good protection against coronavirus disease 2019 showed a total mean satisfaction level of 5.99 (on a "0 = not at all" to "10 = very" scale). A large majority (86.33%) were confident about protecting themselves from coronavirus disease 2019 at work. However, only about one-third reported their institution provided the required personal protective equipment (35.78%), and nearly half indicated their hospital has or had limited personal protective equipment availability (48.08%). Worldwide, a large majority of respondents answered affirmatively for testing the healthcare team (83.09%). Approximately half of the respondents (52.85%) across all regions indicated that all surgical team members face an equal risk of contracting coronavirus disease 2019 (52.85%). Nearly one-third of respondents reported that they had experienced social avoidance (28.97%). Conclusions Our results show that urologists lack up-to-date knowledge of preferred protocols for personal protective equipment selection and use, social distancing, and coronavirus disease 2019 testing. These data can provide insights into functional domains from which other specialties could also benefit.Öğe Descriptive technique and initial results for robotic radical perineal prostatectomy(Elsevier Science Inc, 2016) Kaouk, Jihad H.; Akça, Oktay; Zargar, Homayoun; Caputo, Peter; Ramirez, Daniel; Andrade, Hiury; Albayrak, Selami; Laydner, Humberto; Angermeier, KennethOBJECTIVE To minimize technical challenges of radical perineal prostatectomy (RPP), we conceived and applied the robotic approach to this technique in an aim to improve surgical applicability of RPP. Radical prostatectomy via the perineal route, avoiding the intra-abdominal cavity, has been shown to be oncologically safe, with excellent functional outcomes and a short hospital stay. We report our initial results with this novel approach. MATERIALS AND METHODS We performed the procedure in 4 patients. With the patient in the exaggerated lithotomy position, following a 3 cm perineal incision, the initial perineal dissection using Belt's approach is performed, followed by single port placement and docking of the robot. RESULTS The median age for patients was 64 years (60-69). Two patients had no rectum because of the abdominoperineal resection due to inflammatory bowel diseases. One of the other 2 patients had a surgical history of aborted robotic-assisted laparoscopic radical prostatectomy and 1 patient had no surgical history. There were no perioperative complications and the patients were discharged within 16-48 hours. Urethral catheter was removed within 10 days in 3 patients, and 3 weeks in 1 patient. Two patients were immediately continent when Foley was removed. The final pathology revealed focally positive margin in those 3 patients who had surgical histories and it was margin negative in the patient with native anatomy. All patients had undetectable prostate-specific antigen postoperatively. CONCLUSION RPP was successfully completed in 4 cases, applying a single port robotic perineal approach. Initial results are encouraging, with short hospital stay and minimal postoperative pain.Öğe Descriptive technique and initial results for robotic radical perineal prostatectomy reply(Elsevier Science Inc, 2016) Akça, Oktay; Zargar, Homayoun; Albayrak, Selami; Kaouk, Jihad H.[Abstract Not Available]Öğe Efficacy and safety of combination of tadalafil and aspirin versus tadalafil or aspirin alone in patients with vascular erectile dysfunction: A comparative randomized prospective study(Springer Netherlands, 2019) Bayraktar, Zeki; Albayrak, SelamiPurpose: We aimed to investigate the efficacy and safety of tadalafil, aspirin, and tadalafil + aspirin combination therapy in vascular erectile dysfunction (VED). Methods: A total of 336 patients were randomly divided into four groups (group 1, aspirin 100 mg/day, 126 patients; group 2, tadalafil 5 mg/day, 72 patients; group 3, tadalafil 5 mg + aspirin 100 mg, 72 patients; group 4, placebo, 66 patients). In all groups, the changes from baseline to end point in erectile function scores on the International Index of Erectile Function (IIEF-EF) and the number of patients who answered “yes” to questions 2 and 3 of the sexual encounter profile(SEP) were compared statistically. Results: The changes in IIEF-EF scores after treatment were 7.2 ± 4.4, 7.3 ± 4.3, 7.5 ± 4.4, and 2.0 ± 4.6 for group 1 (p < 0.0001), group 2 (p < 0.0001), group 3 (p < 0.0001), and group 4 (p = 0.0204), respectively. The change in SEP-2 ratios after treatment were 36.6%, 36.9%, 41.7%, and 9.4% for group 1 (p < 0.0001), group 2 (p < 0.0001), group 3 (p < 0.0001), and group 4 (p = 0.2925), respectively. The change in SEP-3 ratios after treatment was 46.6%, 49.2%, 53.7%, and 12.5% for group 1 (p < 0.0001), group 2 (p < 0.0001), group 3 (p < 0.0001), and group 4 (p = 0.1456), respectively. In group 2, both the number of patients who reported side effects (p < 0.0001) and stopped using the drug due to side effects (p < 0.05) were significantly higher than the control and others groups. Conclusions: Successful results were obtained by tadalafil and aspirin monotherapy and tadalafil + aspirin combination therapy in patients with VED. However, the least side effect was observed in the tadalafil + aspirin group. Aspirin can be used alone in the treatment of patients with VED, or combined with tadalafil to reduce side effects and increase success.Öğe En bloc resection of bladder tumours: Histopathologic features of a prospective study(Springer, 2021) Müezzinoğlu, Bahar; Çakır, Aslı; Özöver, İrem; Karakuş, Burçin; Bali, Harinder Kumar; Kartal, B. Bersan; Horuz, Rahim; Albayrak, Selami; del Pilar Laguna Pes, MariaBackground and Aims: The aim of the present study was to evaluate the characteristics of patients with acute liver failure (ALF) who underwent liver transplantation (LT) at 14 centers in Turkey and to determine factors associated with mortalityÖğe Enigmatic traces determined on radical perineal prostatectomy specimens: An anatomohistological study(Journal of Clinical and Analytical Medicine, 2014) Akça, Oktay; Yalçın, Savaş; Horuz, Rahim; Boz, Mustafa; Kafkaslı, Alper; Çetinel, Cihangir; Göktaş, Cemal; Çakır, Çağlar; Albayrak, SelamiAim: An anatomohistological evaluation of tissue found on specimens of radical perineal prostatectomy which could influence oncological and functional outcome. Material and Method: A certain surgeon's batch of 41 RPP (Radical perineal prostatectomy) specimens were evaluated. The RPP specimens were dissected from apex to basis. The following slices were dissected: 1 from the Apex, 2 from the center of the prostate, and 1 from the basis. Totaling 4 selected slices. Tissue surrounding these slices were anatomohistologically evaluated working from the following 7 parameters determined in light of latest anatomical and pathological insight on the prostate:"Dorsal venous complex(DVC)", "Striated muscle(Rhabdosphincter)", "Periprostatic fascial tissue (PPFT)", "Neurovascular bundle(NVB)", "Bladder neck smooth muscle", "Surgical margins" and "Capsular incision". Results: Whilst no DVC was found in the dissected Apex slices, muscle striation was found with 39 (95,1%) of the patients. PPFT within central prostate sections was found with 36 (87,8%) of the patients, predominantly within posterior quadrants. Again within central prostate sections NVB was found with 23 (56%) of the patients. All basis slices were found to have bladder neck smooth muscle. Surgical margin positivity was found with only 5 (12,1%) of the patients. Capsular incision was found with 15 (36,5%) of the patients. Discussion: Our study provides a quantitative report of the extent to which other anatomi-cal structures are extracted when removing the prostate from the perineum employing the RPP technique. That the specimen show no trace of DVC is significant in terms of pubovesical complex sparing.
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