Biomedical subjects

Ertan Batislam

Publications and source records attributed to Ertan Batislam.

At least 19 recordsLinked to original sources

PubMed2006

Can prilocaine infiltration alone be the most minimally invasive approach in terms of anesthesia during extracorporeal shock wave lithotripsy?

OBJECTIVES: To evaluate the analgesic effect and utility of prilocaine infiltration alone for minimal morbidity during extracorporeal shock wave lithotripsy. METHODS: A total of 114 patients with kidney stones, aged 18 to 69 years, were randomly separated into two groups. The 58 patients in group 1 received intramuscular diclophenac 30 minutes before extracorporeal shock wave lithotripsy, and the 56 patients in group 2 received prilocaine infiltration into the 30 cm2 area below the 12th rib right before the session. A visual analog scale (0 to 100 mm) was used to evaluate pain. RESULTS: The visual analog scale scores for group 2 were statistically lower at 1, 10, and 20 minutes compared with the scores for group 1 (P = 0.006, P = 0.005, and P = 0.006, respectively). However, no difference was detected at the end of the procedure. The requirement for additional analgesic was less in group 2 (P = 0.007). CONCLUSIONS: Prilocaine infiltration alone can be used for analgesic purposes efficiently and safely during extracorporeal shock wave lithotripsy with minimal morbidity.

Adolescent↗

PubMed2006

Window technique on circumcision.

OBJECTIVE: To remove the preputium by using a simple, quick and safe method without damaging glans, frenulum and urethra as well as with a good cosmetic result. PATIENTS AND METHODS: The procedure, remind the guillotine technique at first, but completely different from it. Basically, a long haemostat is applied onto preputium and skin and subdermal tissue were incised; a small window is opened at dorsal of preputial mucosa and it is excised, while observing glans and frenulum. RESULTS: The circumcisions were performed in a quick, safe and pretty bloodless way. There was no case with glans amputation, frenulum short cut or urethral damage, even if a clamp includes the foreskin with a part of glans or excess frenulum unnoticedly. CONCLUSION: This technique is simple, quick, relatively bloodless operation with cosmetically good result. Morever it is quite safe against to amputation of glans, frenular short cut or urethral fistula formation.

Circumcision, Male↗

PubMed2006

Magnetic resonance imaging (MRI) in penile metastases of extragenitourinary cancers.

BACKGROUND: The aim of present study is to evaluate the efficacy of magnetic resonance imaging (MRI) in different types of penile metastases. MATERIALS AND METHODS: In this report, we present three cases of penile metastases that have been developed secondary to extragenitourinary malignancies. Two of them did not have any primary malignancy history. RESULTS: Penile biopsies were performed in all patients and metastatic penile tumours were found due to extragenitourinary malignancies. Penile MRI was performed before biopsies. The findings of MRI were correlated with histopathologic diagnosis. Moreover, penile MRI was found to be more sensitive in the evaluation of the lesions than ultrasonography. CONCLUSION: MRI can be accepted as a reliable non-invasive method for the evaluation of the extent of penile metastases and involvement of tunica albuginea or urethral.

Adenocarcinoma↗

PubMed2006

Relationship between sexual dysfunction and psychiatric status in premenopausal women with fibromyalgia.

OBJECTIVES: To evaluate the possible relationship between the sexual and psychiatric status of premenopausal female patients with fibromyalgia compared with healthy controls. METHODS: A total of 48 female patients with fibromyalgia and 38 age-matched healthy controls were enrolled in the study. All the subjects were asked to complete the Female Sexual Function Index (FSFI) for sexual status and the State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI) for psychiatric assessment. Serum biochemical analysis was done, and the serum hormonal levels were analyzed. RESULTS: The mean BDI score for patients was significantly greater than the score for the controls (P = 0.017) and the mean FSFI score was significantly lower than the score for the controls (P = 0.001). According to the FSFI data, female sexual dysfunction was found in 26 patients (54.2%) with fibromyalgia and only 6 controls (15.8%), a significant difference (Pearson chi-square = 14.46, P = 0.000). When the subscores of each domain of FSFI were evaluated, the most common sexual problem was diminished desire in patients (n = 30, 62.5%) and controls (n = 11, 28.9%). In the correlation analysis, the FSFI score showed a significant negative correlation with the BDI (r = -0.337, P = 0.002) and STAI (r = -0.413, P = 0.004) scores. No significant correlation was revealed between the FSFI and BDI or FSFI and STAI scores in the controls. CONCLUSIONS: Depression is one of the emotional disorders commonly encountered in women with fibromyalgia, most possibly leading to sexual dysfunction. Thus, sexual dysfunction related to impaired psychiatric status should be considered a common problem in premenopausal women with fibromyalgia.

Adult↗

PubMed2006

Relationship between nocturnal penile tumescence parameters, International Index of Erectile Function symptom scores and sildenafil responses1This paper was presented at the 6th Congress of the International Society of Sexual and Impotence Research, Buenos Aires, Argentina, 17-21 October 2004.

OBJECTIVE: To evaluate the correlation between International Index of Erectile Function (IIEF) questionnaire scores, nocturnal penile tumescence parameters and sildenafil response in patients with erectile dysfunction using a minimal investigations approach. MATERIAL AND METHODS: A total of 97 patients without any risk factors for erectile dysfunction were included. After completing the IIEF questionnaire, nocturnal penile tumescence monitoring was performed in all patients for 1 or 2 nights. Subsequently, sildenafil was given at a dosage of 50 or 100 mg according to the response. The relationship between nocturnal penile tumescence results, the severity of erectile dysfunction according to the IIEF questionnaire and sildenafil response was evaluated using Pearson's chi2 test. RESULTS: Based on the questionnaire scores, 25 patients (25.8%) had mild, 44 (45.4%) had moderate and 28 (28.8%) had severe erectile dysfunction. Forty-four patients (45.4%) had normal and 53 (54.6%) had abnormal parameters after nocturnal penile tumescence recording. The sildenafil response was positive in 63 patients (64.9%) who were given 50 mg and in 26 (26.8%) who were given 100 mg. However, eight patients (8.2%) did not respond to sildenafil. While the severity of erectile dysfunction according to IIEF scores and the sildenafil response did not show any correlations with nocturnal penile tumescence results, there was a statistically significant relationship between sildenafil response and the severity of erectile dysfunction. CONCLUSION: Changing concepts in the evaluation of ED have resulted in the use of effective therapeutic applications consistent with the degree of symptoms of patients without the waste of time caused by performing expensive, invasive, ineffective and time-consuming diagnostic tests.

Adult↗

PubMed2006

Testicular nitric oxide and thiobarbituric acid reactive substances levels in obstructive azoospermia: a possible role in pathophysiology of infertility.

OBJECTIVE: The aim of the study is to evaluate the levels of nitrite/nitrate and thiobarbituric acid reactive substances (TBARS) and their relationship with seminal parameters in experimental obstructive azoospermic rats to explain the possible mechanism of impaired sperm quality in obstructive azoospermia. METHODS: A total of 10 male Spraque-Dawley rats underwent bilateral vas resection and ligation (Group-1 = vasectomy group). The findings were compared with control group (Group-2 = sham group, n = 10). Animals were sacrificed 8 weeks after surgery. Testes were removed and used for the evaluation of nitrate/nitrite and TBARS levels and for histology. Epididymal-aspirated seminal plasma was used for semen count and morphological analysis according to the Kruger criteria. RESULTS: Testicular tissue nitrate/nitrite and TBARS levels were 35.7 +/- 3.1 micromol/g protein and 3.7 +/- 0.1 nmol/g protein in Group-1, and 19.3 +/- 0.7 micromol/g protein and 3.1 +/- 0.1 nmol/g protein in Group-2, respectively. Both parameters showed statistical differences between the two groups. Testicular tissue nitrate/nitrite and TBARS levels showed negative and statistically significant correlations with sperm motility and morphology. CONCLUSIONS: The present study showed that testicular nitrate/nitrite and TBARS levels were increased in obstructive azoospermia. For that reason, we concluded that antioxidant treatment can be recommended to patients before sperm extraction for artificial reproduction due to obstructive infertility after vasectomy reversal.

Animals↗

PubMed2005

Anaesthesia and the acute phase protein response in children undergoing circumcision.

Concentrations of acute phase proteins (CRP: C-reactive protein, albumin) change during surgery. We investigated the acute phase response to circumcision and the effects of anaesthesia on this response. The children were divided into four groups; group 1 (intratracheal general anaesthesia, n=40), group 2 (general anaesthesia with mask, n=20), group 3 (ketamine, n=20), group 4 (local anaesthesia, n=35). Blood samples were obtained, 24 hours before circumcision, after premedication, and 24 hours after circumcision. CRP and albumin before circumcision were comparable for all groups. There was no increase in CRP, and albumin remained steady throughout the study. No difference was observed among the groups, and related to anaesthesia. No responsiveness may be explained with the size of injured tissue or anatomical and histological type of preputium.

Acute-Phase Proteins↗

PubMed2005

Endogenous sex steroids and bone mineral density in healthy men.

OBJECTIVE: To evaluate the role of endogenous sex steroids on bone mineral density (BMD) in healthy Turkish men. METHODS: Serum total testosterone (TT), free testosterone (FT), dehydroepiandrosterone sulfate and estradiol levels were assayed in 174 healthy men of 240 volunteers, aged 22-76 years. Dual-energy X-ray absorptiometry was used to measure the BMD (g/cm(2)) of lumbar spine, femoral neck and non-dominant proximal and distal radius-ulna sites. Linear regressions were conducted using each BMD site as the dependent variable and each sex steroid as the independent variable. Four models were run for each bone site and sex steroid; crude, age-adjusted, adjusted for age and body mass index (BMI), and adjusted for age, BMI and cigarette-smoking. RESULTS: The mean age and BMI of men enrolled in the study were 47.7 +/- 13.7 years and 26.9 +/- 3.6 kg/m(2). Log of FT was significantly associated with the BMD of distal forearm in all models analyzing the crude and adjusted effects. Dehydroepiandrosterone sulfate effect on BMD of proximal forearm came closer to the level of statistical significance when adjusted with age, BMI and cigarette-smoking. Estradiol and TT levels were not found to be associated with BMD of any sites measured. CONCLUSION: Among the endogenous sex steroids in men, predominantly FT seems to be one of the determinants of BMD. Therefore a decrease in serum levels of testosterone in aging male or secondary causes may negatively affect BMD.

Absorptiometry, Photon↗

PubMed2005

Terazosin in the treatment of premature ejaculation: a short-term follow-up.

AIM: The aim of the present study was to evaluate the efficacy of terazosine in patients with premature ejaculation and lower urinary tract symptoms (LUTS), after excluding other sexual disorders and chronic prostatitis. METHODS: A total of 90 patients with premature ejaculation and LUTS were enrolled to the study after excluding sexual disorders, prostatitis and benign prostatic hyperplasia. The patients were divided into two groups. Sixty patients in group 1 were treated with terazosine 5 mg daily for a month. Patients were followed monthly and questioned for their ejaculation problem. The results were classified as cure, improvement and ineffective. If patients showed improvement and ineffectiveness, the treatment was continued with 10 mg daily for the following month. Group 2 was included 30 patients, and placebo was applied for a month. At the end of this period, in patients who did not show any improvement, terazosine 10 mg was started. RESULTS: In the treatment group, at the 1st month follow-up, 21 patients (35%) were cured, 20 (33.3%) showed improvement. In 19 (31.7%) patients, the treatment was ineffective. In group 2, 9 (30%) patients showed improvement and the rest had no-changes after one-month follow up. There was statistically significant difference between two groups (Pearson chi2 test = 0.000). Later, terazosine 10 mg was given to the patients in group 2 and to the patients who showed improvement or unsuccessful result with terazosine 5 mg. With terazosine 10 mg, 10 (14.5%) patients were cured, 29 (42.2%) patients were improved. Finally, terazosine treatment in patients with premature ejaculation was found to be effective in 60 patients (66.7%). CONCLUSION: Alpha blockers seem to be physiological medical agents in the treatment of premature ejaculation since ejaculation is under sympathetic control. Moreover, these agents are effective in lower urinary tract and they should be used in patients with premature ejaculation and lower urinary tract symptoms.

Adrenergic alpha-Antagonists↗

PubMed2005

Giant abdominal wall abscess dissecting into thorax as a complication of ESWL.

Abscess as a complication of extracorporeal shock wave lithotripsy is a rare condition. We present the computed tomography findings of an abdominal wall abscess that occurred after extracorporeal shock wave lithotripsy for which prophylactic antibiotics had not been given. The abscess destroyed the posterior abdominal wall muscles and dissected into the thorax. The muscles were thickened and showed enhancement. A parenchymal defect in the right kidney adjacent to a caliceal stone, with strands extending from this defective region to the abscess, was observed, and was thought to be the result of parenchymal destruction caused by the shock waves. Other parts of the kidney and psoas muscle were normal. Microbiologic examination revealed Escherichia coli.

Abdominal Abscess↗

PubMed2005

Relationship between serum sex steroids and Aging Male Symptoms score and International Index of Erectile Function.

OBJECTIVES: To determine the relationship between the total and subscale scores of the Aging Male Symptoms (AMS) and International Index of Erectile Function (IIEF) questionnaires, age, and serum sex steroids levels. METHODS: A total of 348 patients enrolled in the study answered the AMS and IIEF questionnaires. Hormonal analysis, including total testosterone, free testosterone (FT), estradiol (E2), and dehydroepiandrosterone-sulphate (DHEA-S) measurement, were performed. The patients with a total AMS score of 29 were considered to have aging male symptoms and the patients with an IIEF score of less than 26 were considered to have sexual dysfunction. RESULTS: Although DHEA-S levels were significantly lower and E2 levels were greater in the men with aging male symptoms according to the AMS, the DHEA-S and FT levels were significantly lower in the men with sexual dysfunction, as determined by the IIEF score. Serum DHEA-S and FT levels and age correlated significantly with the IIEF scores. The total AMS score correlated significantly only with age. Although serum total testosterone, FT, and DHEA-S levels correlated significantly with the andrologic symptoms of AMS, the serum E2 levels correlated with psychological symptoms of AMS. CONCLUSIONS: Although aging male symptoms and the effects of hormonal changes on these symptoms have been controversial, DHEA-S and E2 might play some important roles in the symptoms of aging men.

Adult↗

PubMed2005

Optimal frequency in extracorporeal shock wave lithotripsy: prospective randomized study.

OBJECTIVES: To determine the optimal frequency of extracorporeal shock wave lithotripsy of urolithiasis, in terms of efficacy and duration, by comparing three different shock wave frequencies. METHODS: A total of 170 patients between the ages of 18 and 69 years with radiopaque kidney stones were included in the study. The patients were randomly separated into three groups. Group 1 (56 patients) received 120 shock waves per minute, group 2 (57 patients) received 90 shock waves per minute, and group 3 (57 patients) received 60 shock waves per minute. The duration, analgesic or sedative requirement, and complications were recorded for each treatment. All patients were evaluated in terms of successful treatment by radiography of the kidneys, ureters, and bladder and abdominal ultrasonography 10 days after the single-session therapy. RESULTS: No statistically significant difference was observed in patients according to age, sex, stone size, side, composition, location in the kidney, total energy level, or number of shocks. The successful therapy rate in groups 2 and 3 was prominently greater compared with that for group 1, and the difference was statistically significant (P = 0.032 between groups 1 and 2 and P = 0.015 between groups 1 and 3). The analgesic or sedative requirement in groups 2 and 3 was lower than that in group 1, and the difference was statistically significant (P = 0.003 between groups 1 and 2 and P = 0.001 between groups 1 and 3). The duration was longer in group 3 than in groups 1 and 2, and the difference was statistically significant (P = 0.000 between groups 1 and 3 and P = 0.009 between groups 2 and 3). CONCLUSIONS: The results of our study have shown that the optimal frequency during extracorporeal shock wave lithotripsy is 90 shock waves per minute in terms of duration, efficacy, and analgesic and sedative requirement at the same total energy level.

Adolescent↗

PubMed2005

Local anesthesia in transrectal ultrasound-guided prostate biopsy: EMLA cream as a new alternative technique.

OBJECTIVES: The aims of the present study were to evaluate the efficacy of eutectic mixture of local anesthetics (EMLA) cream in transrectal-guided prostate biopsy and to compare its effect with that of other injectable anesthetic procedures. MATERIAL AND METHODS: Eighty male patients with prostate-specific antigen (PSA) levels > 4 ng/ml or who had prostate nodules on digital rectal examination were randomly divided into four groups. In Group 1 (controls), prostate biopsy was performed after application of a placebo cream. In Group 2, local surface anesthesia with EMLA cream was performed 15 min before biopsy. Periprosthetic nerve blockade was performed with 1% prilocaine and 1% lidocaine in Groups 3 and 4, respectively. Pain was evaluated using a visual analog scale (VAS) after each core biopsy. In addition, blood pressure, heart rate and oxygen saturations were recorded after each biopsy and then at 5-min intervals for 15 min. RESULTS: Average VAS scores in Groups 1-4 were 5.5, 2.9, 2.4 and 2.2, respectively. There was a statistically significant difference in VAS scores between the treatment groups and the placebo group (p = 0.000). There were no statistically significant differences in VAS scores between the three treatment groups (p2-3 = 0.126, p2-4 = 0.303, p3-4 = 0.537). We detected no statistically significant differences between the groups based on the hemodynamic data (pMAP = 0.899). Moreover, these measurements did not show statistically significant changes with time in any of the groups (p > 0. 05). CONCLUSION: Intrarectal application of EMLA cream provides equal anesthesia to periprostatic nerve blockade with prilocaine and lidocaine.

Administration, Rectal↗

PubMed2005

Effectiveness of eutectic mixture of local anesthetic cream and occlusive dressing with low dosage of fentanyl for pain control during shockwave lithotripsy.

BACKGROUND AND PURPOSE: To investigate the effect and usefulness of Eutectic Mixture of Local Anesthetic (EMLA) applied with an occlusive dressing and used simultaneously with a low dose of fentanyl during shockwave lithotripsy (SWL). PATIENTS AND METHODS: One hundred sixty patients with kidney stones, aged between 19 and 68 years, were randomly divided into seven groups that were treated as follows: group 1: fentanyl 1 microg/kg by intravenous infusion (IV); group 2: IV fentanyl 0.25 microg/kg; group 3: occlusive dressing and IV fentanyl 0.25 microg/kg; group 4: placebo cream and IV fentanyl 0.25 microg/kg; group 5: EMLA cream and IV fentanyl 0.25 microg/kg; group 6: placebo cream and IV fentanyl 0.25 microg/kg with an occlusive dressing; and group 7: EMLA cream and IV fentanyl 0.25 microg/kg with an occlusive dressing. The mean arterial pressure (MAP), heart rate, ventilatory rate, and oxygen saturation (SpO(2)) were recorded on all patients. A visual analog scale 0-100 mm (VAS) was used for the evaluation of pain. The skin integrity was inspected to detect any lesions after SWL. RESULTS: The SpO(2) in group 1 was lower statistically than in the other groups. The VAS score in group 7 was clearly lower than in the others in the first, tenth, and twentieth minutes and at the end of SWL. In groups 6 and 7, additional fentanyl doses were lower than in the other groups, but only in group 7 was the total fentanyl dosage low. Skin lesions were not seen only in groups 3, 6, and 7. CONCLUSION: Use of EMLA and an occlusive dressing with low doses of fentanyl during SWL provides appropriate analgesia with minimal morbidity.

Administration, Topical↗

PubMed2005

The comparison and efficacy of 3 different alpha1-adrenergic blockers for distal ureteral stones.

PURPOSE: alpha1-Adrenergic blockers have recently been shown to increase the rate of spontaneous passage of distal ureteral stones. We compared efficacy of 3 different alpha1-adrenergic blockers for this purpose. MATERIALS AND METHODS: A total of 114 patients between 18 and 65 years old who had lower ureteral stones were included in the study. Patients were randomly divided into 4 groups. Group 1 consisted of 28 patients and acted as the control group. Group 2 comprised 29 patients who received tamsulosin, group 3 was 28 patients receiving terazosin and group 4 was 29 patients receiving doxazosin. These agents were given for up to a month and hydration was also recommended simultaneously. Every week patients were controlled with x-rays of the kidneys, ureters, bladder and urinary ultrasonography. Meanwhile the number of pain episodes, analgesic dosage and the number of days for spontaneous passage of the calculi through the ureter were also recorded. RESULTS: There were no differences between the groups with respect to age, weight, height, sex and stone size. The calculi passed through the ureter spontaneously in 15 patients in group 1 (53.57%), in 23 patients in group 2 (79.31%), in 22 patients in group 3 (78.57%), and in 22 patients in group 4 (75.86%). In groups 2 to 4 the number of pain episodes, expulsion time and analgesic dosage were found to be lower compared with those in group 1. CONCLUSIONS: alpha1-Adrenergic blockers increase the frequency of spontaneous passage of the distal ureteral calculi. All 3 agents tested were equally efficacious.

Adrenergic alpha-1 Receptor Antagonists↗

PubMed2004

Testicular tissue nitric oxide and thiobarbituric acid reactive substance levels: evaluation with respect to the pathogenesis of varicocele.

The aim of the present study is to evaluate tissue nitric oxide (NO) and thiobarbituric acid reactive substance (TBARS) levels in testicular tissue, and to determine their relationship with seminal parameters in order to explain possible effects on varicocele pathophysiology. Ten adult male Wistar rats at 8 weeks old underwent partial left renal vein ligation. A sham operation was performed on control rats in a second group of another ten rats. All animals were killed 4 weeks after surgery. The testes were removed and histological changes were observed by light microscopy with haematoxylin and eosin stain on half of each testis. The rest of testis was used for the evaluation of testicular tissue NO and TBARS levels. Epididymal aspirated seminal plasma was used for semen analysis and morphological analysis was carried out according to Kruger's criteria. Statistical analysis was performed by using Mann-Whitney U-tests and Spearman rank correlations between the two groups for NO and TBARS levels and for seminal parameters. Testicular tissue NO and TBARS levels (mean+/-SEM) were 62.8+/-10.1 micromol/g protein and 4.7+/-0.3 nmol/g protein in group 1. These parameters were 16.9+/-2.2 micromol/g protein and 3.1+/-0.2 nmol/g protein in the group 2 controls. There were significant differences between these parameters ( P(NO)=0.000, P(TBARS)=0.001). Although a positive and significant correlation between testicular tissue NO and TBARS levels was found ( r(s)=0.739, P=0.014), there was only a strong negative correlation between NO levels and sperm motility in group 1 ( r(s)=-0.815, P=0.004). We found that this effect of NO on sperm motility was independent from TBARS levels after regression analysis ( r(2)=-0.687, beta=0.825, P=0.034). Although there were statistically significant differences in seminal parameters between the two groups, there was no difference between them in the histopathological examination. We found that sperm motility was significantly related to testicular tissue NO levels only. Thus, we suggest that NO is an important mediator in the pathogenesis of varicocele. TBARS and other substances have been effective via NO pathways.

Animals↗

PubMed2004

Late-onset ureteric urinoma with intermittent jet flow as a complication of ureterolithotomy.

We present the case of a late-onset urinoma in a 47-year-old man with a history of right ureterolithotomy performed 6 months previously, following 2 unsuccessful attempts at extracorporeal shock wave lithotripsy. The ipsilateral kidney was nonfunctional and hydronephrotic. The urinoma did not show enhancement on contrast-enhanced CT and intravenous pyelography. Sonography revealed turbulence in the urinoma and jet flow from the ureter. Lab studies of fluid obtained by percutaneous puncture and aspiration yielded misleading findings for urine and revealed the presence of hemosiderin-laden macrophages. The urinoma was surgically resected and ureteroneocystostomy was performed.

Abdomen↗

PubMed2004

Torsion of an epididymal cyst.

Torsion of an epididymal cyst is a very rare condition. We present a case of torsion of an epididymal cyst in a 13-year-old boy. The patient presented with acute scrotal pain. Scrotal ultrasonography showed a 38 x 35 x 30 mm fluid-filled mass within the caput of the left epididymis. Histologically, the cells of the epididymal duct were necrotic. To our knowledge, this is the second case report in the literature.

Adolescent↗