Browsing by Author "Ceylan, Y"

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    Which one is responsible for pain during transrectal guided prostate biopsy
    Lekili, M; Lu, TM; Ceylan, Y; Temelta, G; Büyüksu, C
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    Effect of anxiety and pain on success of shockwave lithotripsy (SWL) for treatment of proximal ureteral and renal pelvic stones
    Ucer, O; Ceylan, Y; Ekren, F; Ozan, E; Muezzinoglu, T
    The aim of this study is to evaluate the impact of anxiety and pain on success of shockwave lithotripsy (SWL) for treatment of proximal ureteral and renal pelvic stones smaller than 15 mm. One hundred thirty-two patients with proximal ureteral or renal pelvic stones < 15 mm who were treated by a SWL and forty controls were enrolled in the study. State-trait anxiety inventory (STAI) was used to assess anxiety of the controls and patients (before every SWL session). Pains of the patients were measured by a visual analog scale (VAS) at three times (T) of the sessions (T11 at 11 kV, T15 at 15 kV and T end of treatment). The mean STAI scores of the patients at the first SWL session and controls were 40.61 +/- 8.71 and 36.11 +/- 8.18, respectively (p < 0.05). There was statistically positive moderate relationship between STAI and VAS scores at the first SWL session. The mean size of stone in men and women were 11.16 +/- 2.88 and 11.00 +/- 3.41, respectively (p = 0.88). In the first session, the mean STAI and VAS scores of the men were significantly lower than the women. The stone-free rate (SFR) of SWL was 72.7 % in this study. The SFR of SWL in the men and women were 78 and 64 %, respectively (p < 0.05). Our data showed that the severity of anxiety and pain in the women were higher than the men. SFR of SWL in the men was higher than the women. The severity of anxiety and pain in the patients may affect SFR of SWL.
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    Is it necessary to use Sexual Health Inventory for Men (SHIM) routinely?
    Temeltas, G; Gündüz, MI; Ceylan, Y; Gümüs, BH; Büyüksu, C
    This study was conducted to evaluate the prevalence of erectile dysfunction (ED) according to the Sexual Health Inventory for Men (SHIM) and its relationship with age and education. Six hundred and thirty-nine male patients aged >= 20 years attending a urology clinic were studied. After a detailed history and physical examination, all Patients were evaluated with SHIM. Scores were categorized into 5 groups: severe (1-7), moderate (8-11), mild-moderate (12-16), mild (17-21) and normal (22-25). The patients were classified into three groups according to their application to the urology clinic: A - patients attending specifically for ED; B - patients not ED based on SHIM and attending not for ED; C - patients ED based on SHIM, but attending not for ED. In addition, patients were partitioned into 3 age groups according to their age: 20-35, 35-55 and >55 years. Educational levels were of 2 groups: lower education and higher education. Erectile dysfunction was determined in 3.7% in the 20-35 years group, 55% in 3555 years and 41% in >55 years (P < 0.01). In men having ED through SHIM and attending not for ED, the ratio of ED was higher in the lower education than in the higher education groups (P = 0.01). SHIM is a diagnostic tool used for ED, and routine application of SHIM for patients attending the urology clinic is advisable.
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    PRE/POST MEAL PSA VALUES: SHOULD IT BE MEASURED IN PRE-MEAL BLOOD SERUM?
    Müezzinoglu, T; Lekili, M; Ceylan, Y; Var, A; Büyüksu, C
    Introduction: Prostate specific antigen (PSA) is the commonly used tumor marker in the early diagnosis of prostate cancer. Although it is highly specific for prostate, its specifity is low for prostate cancer. Since it is affected by many factors other than cancer such as diurnal variations of the secretion, existing of infections or inflammations in the prostatic tissue, volume of prostate, digital rectal examination, ejaculation or rectal manipulations and surgery of the prostate, the value of serum PSA level is limited. Serum insulin level increases and reaches maximum level at first hour due to increased glucose level after meal. Thereafter the level of serum insulin values return to its normal level at approximately two hours after meal. On the other hand, insulin suppresses the production of sex hormone binding protein in liver cells. Therefore, it is logic to investigate PSA levels due to metabolic and hormonal changes after meal. We investigated changes of PSA level after meal in this prospective study. Materials and Methods: Thirty-three healthy cases were included in this study to determine changes of serum PSA levels pre and post-meal manner. All patients were given same regular diet comprised of 700 calories (50-55% carbohydrates, 25-30% lipids and 20% proteins). Blood samples were taken an hour before meal (PSA-0), and one (PSA-1) and two (PSA-2) hours after meal. Serum PSA levels were determined by chemiluminescence method. Paired sample t test and Pearson correlation coefficient were used for statistical analysis. Results: The mean age of the patients was 42 +/- 17.5 (Range 20-80) years. The mean PSA level at one hour before meal, one and two hours after meal were 0.70 +/- 0.69 ngr/ml (PSA-0), 0.74 +/- 0.75 ngr/ml (PSA-1) and 0.65 +/- 0.57 ngr/ml, (PSA-2) respectively. There was no statistically significant difference between serum PSA-0 levels with PSA-1 (p=0.106) and PSA-2 (p=0.109) levels. However, there was a statistically significant difference between first hour and second hour after meal mean PSA levels (p=0.029). Conclusion: Serum PSA values may be affected not only from prostatic disturbances, but also the changes of its metabolism and levels of PSA binding proteins. Insulin, proinsulin, C-peptid and Zn secretion increase after meal. In contrast, glukagon, cortisol, epinephrin, norepinephrin secretion decrease. These differences could also change the levels of detectable fractions of PSA temprorarily and may affect serum total PSA levels. The differences of serum PSA levels represent paralelism with the changes in serum insulin levels after meal. In this study, mean PSA levels increased at first hour after meal and decreased at second hour after meal. These differences in PSA levels could affect the decision making for indication of prostate biopsy in patients with borderline PSA levels and it should be considered when the serum samples are taken whether patients are hungry or not. The determination of ideal serum PSA sampling time would be important in order to prevent false negative or positive serum PSA results. In this way, clinicians would decide not to do invasive procedures especially in patients with borderline serum PSA levels.
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    Evaluation of pain caused by urethrocystoscopy in patients with superficial bladder cancer
    Müezzinoglu, T; Ceylan, Y; Temeltas, G; Lekili, M; Büyüksu, C
    Aim: The aim of this study is to evaluate patients' tolerance to pain caused by urethrocystoscopy ( UCS) in both diagnosis and the period of follow- up in patients with superficial bladder cancer, and to evaluate these results with respect to quality of life. Patients and Methods: Between March 2003 and October 2004, 66 patients with bladder cancer or hematuria underwent UCS and recorded their overall pain level. Results: The mean age was 60.4 ( range 26 - 83) years. UCS was done only one time in 22 patients for the diagnosis of etiology of hematuria and was done 4 times in 44 patients every 3 months for bladder cancer follow- up. The mean pain scores on first, second, third, and fourth UCS were 4.3 +/- 2.2, 4.7 +/- 2.5, 4.68 +/- 2.45, and 5.1 +/- 2.5, respectively. Statistically significant differences were found among mean pain scores of patients on first, third, and forth cystoscopic examinations ( p < 0.05). No correlation was found between age and pain scores in this study group ( p > 0.05). Conclusion: UCS is a painful surgical procedure and pain tolerance was not observed on repeated UCS. Therefore urologists need to use more effective anesthetic methods to provide better patients' tolerance to pain and quality of life during the endoscopic procedure.
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    Safety and efficacy of single-incision sling for female stress urinary incontinence: 3 years' results
    Yildiz, G; Ceylan, Y; Ucer, O; Arslan, D; Çelik, O; Gunlusoy, B
    The purpose of this study was to investigate the success and complication rates of single-incision sling for treating stress urinary incontinence (SUI), with a 3-year follow-up. This study comprised 173 female patients with SUI or mixed urinary incontinence (MUI) with dominant SUI who underwent minisling procedure. All patients had positive cough stress test preoperatively; they were followed up for 3 years after surgery (1, 3, 6, 12 months, and yearly). Total follow-up was 36 months, and mean age 51 years (44-77); 128 (74 %) patients presented SUI and 45 (26 %) MUI. Objective and subjective cure and failure rates were 83.8 % (145 cases), 6.4 % (11 cases), and 9.8 % (17 cases), respectively. There were no differences in cure rates between 1 and 3 years. Mean body mass index was 28.7 (26.1-35.2), and mean operating time 7.9 min. (6.5-11.9). There were no major intraoperative complications. Eleven patients (6.4 %) had de novo urge incontinence that resolved using anticholinergic drugs; no patient had urinary retention. Vaginal mesh extrusion was reported in nine (5.2 %) patients. The minisling system attained high success rates at 3 years' follow-up. The procedure was easy to learn and has lower complication rate.
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    The effect of SWL and URS on health-related quality of life in proximal ureteral stones
    Ceylan, Y; Ucer, O; Bozkurt, O; Gunlusoy, B; Mertoglu, O; Zumrutbas, AE; Yildiz, G; Irer, B; Muezzinoglu, T; Demir, O
    Objectives: We aimed to compare the effect of shock wave lithotripsy (SWL) and ureteroscopic lithotripsy (URS) on health-related quality of life (HRQoL) for the treatment of proximal ureteral stones. Material and methods: Between April 2014 and July 2015, patients with proximal ureteral stones who were successfully treated with URS or SWL in seven different centers were included. Patients were divided into two groups according to stone size: stones <= 10 mm and >10mm. HRQoL subscales which were evaluated by the Medical Outcome Study Short-Form 36-item survey (SF-36) Turkish version were compared for URS and SWL in these two groups one month after the performed procedure. Results: A total of 273 patients were included in the study. While 116 (52.5%) patients were treated with ureteroscopic lithotripsy, SWL was used for 105 (47.5%) patients. Fifty-two patients were excluded from the study. In proximal ureteral stones <= 10 mm, there were no statistically significant differences for any of the eight subscales of the SF-36 questionnaire. Regarding stones >10mm, it was found that the three subscales of the SF-36 questionnaire - role limitations because of physical health problems (RP), bodily pain (BP), and general health perception (GH) - were significantly lower in the SWL group compared with the URS group. Conclusions: Patients with proximal ureteral stones >10mm who were treated with URS generally may have a more favorable HRQoL than those treated with SWL in short-term follow-up.
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    Assessment of Proportion of Hidden Patients Having Symptoms of Overactive Bladder and Why Has It Been Hidden in Female Outpatients Admitted to Hospital
    Üçer, O; Demir, Ö; Zeren, MF; Ceylan, Y; Çelen, I; Zümrütbas, AE; Temeltas, G; Bozkurt, O; Günlüsoy, B; Çelik, Ö; Ekin, G; Mertoglu, O
    Purpose: To determine the proportion of patients with undetected symptoms of overactive bladder by using the overactive bladder-validated 8 (OAB-V8) screening questionnaire and investigate these symptoms were undetected in female patients who were hospitalized. Methods: We invited 2,250 female patients hospitalized in the Aegean region of Turkey to answer a self-administered questionnaire. The questionnaire included questions on evidence of lower urinary tract symptoms (OAB-V8), relevant medical history, and demographic data. Patients with a total OAB-V8 score >= 8 were defined as having OAB symptoms. Results: The proportion of patients with OAB symptoms in this study was 40.6%. Nearly 57% of the patients with OAB symptoms had not been previously admitted to any hospital for lower urinary tract symptoms (LUTS). The two most common reasons why women with OAB symptoms did not admit themselves to a hospital because of LUTS were as follows: I did not think I had a disease and The symptoms did not bother me, with a response rate of 74.7%. The mean OAB-V8 scores of the patients with these two responses were significantly lower than those of the other patients (P<0.001). Conclusions: This is the first study to demonstrate a significant proportion of women with undetected OAB symptoms. The main reasons the women did not admit themselves to a hospital were their unawareness of the disease and because the LUTS were not bothersome. Public awareness programs on this disease may resolve this problem.
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    Reliability and Validity of the Turkish Language Version of the International Consultation on Incontinence Questionnaire - Male Lower Urinary Tract Symptoms
    Mertoglu, O; Üçer, O; Ceylan, Y; Bozkurt, O; Günlüsoy, B; Albaz, AC; Demir, Ö
    Purpose: Patients receiving treatment for benign prostate hyperplasia may have persistent storage symptoms. There has been increasing debate on the precision and accuracy of the International Prostate Symptom Score questionnaires over other questionnaires in evaluating all the complaints of lower urinary tract symptoms (LUTS). The aim of this study was to perform the validity and reliability analysis of the Turkish version of the Internatinal Consultation on Incontinence Questionnaire-Male LUTS (ICIQ-MLUTS). Methods: Linguistic validation was studied (i.e., translation and back translation). Intelligibility was completed between October 2013 and November 2013. Data was collected between November 2013 and March 2014. The stability and reliability of the form were measured with the Cronbach test. Results: In total, 117 male patients were included in the study. At the first visit, the mean age of the patients was 59 years (range, 18-84 years). For reliability, the Cronbach alpha value was 0.798, demonstrating the internal consistency of the form (r>0.7). The internal consistency of each question was examined separately and found to be over 0.7. For the evaluation of test-retest reliability, the test was administered to 116 patients for a second time with an interval of 2-4 weeks. The first and second test scores for each question were found to be correlated (r=0.741). Conclusions: ICIQ-MLUTS is a new questionnaire, which can be used for evaluating male LUTS in Turkey. We believe that the Turkish version of the ICIQ-MLUTS is an important breakthrough in our country.
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    Predictive value of cyclooxygenase-2 over expression for identifying prostate cancer from benign prostatic hyperplasia in prostate biopsy specimens
    Ceylan, Y; Lekili, M; Muezzinoglu, T; Nese, N; Isisag, A
    BACKGROUND: We studied cyclooxygenase-2 (COX-2) immunohistochemical staining intensity both in prostatic biopsy and surgical samples of patients with prostate cancer to determine if it might provide prognostic information for the decision of re-biopsy indication. METHODS: Twenty-eight patients undergone radical prostatectomy whose final pathologic examination revealed pro static adenocarcinoma were included in the study. Twelve patients with BPH in their pathological examination of both prostatic biopsy and open prostatectomy were considered as a control group. Intensity of COX-2 receptor was examined with immunohistochemical staining according to standard techniques. RESULTS: Positive COX-2 receptor staining was obtained 89.3% of biopsy samples and 93% of surgical samples in all cancer patients. The rate of agreement in COX-2 receptor staining of biopsy samples and radical prostatectomy samples was 76% in same patients (P=0.54). Similarly, the COX-2 receptor levels in biopsy specimens of patients with BPH open surgery compared with samples of the agreement still rate was 41% (P=0.41). Prostate cancer exchanging COX-2 receptor levels in patients with biopsy specimens in patients with BPH were found significantly more (P=0.008). CONCLUSIONS: In this study the feasibility of presence of COX-2 receptor staining in biopsy samples was shown. We have also demonstrated that COX-2 staining intensity was higher in prostatic biopsy samples of patients with prostatic cancer than patients with BPH. This leads a conclusion that, higher COX-2 expression levels in biopsy specimens may be used to decide re-biopsy in borderline preoperative PSA levels as well as in the cases with suspicious pathological findings for cancer.