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    Causes of sildenafil citrate treatment discontinuation in patients with erectile dysfunction
    (2005) Tu?lu, Devrim; Başar, M. Murad; Akbulut, Ziya; Güngör, Sefa; Tekdo?an, Ümit Y.; Atan, Ali
    Introduction: Although there are many methods in the treatment of erectile dysfunction, no one is successful and sufficient in all the patients. Sildenafil treatment has been found the most successful method among ED treatments. In spite of high efficacy of sildenafil, some patients still stop sildenafil treatment due to various reasons. The aim of the present study is to evaluate the causes of sildenafil citrate treatment discontinuation in the patients with erectile dysfunction. Materials and methods: A total of 217 patients who admitted to our outpatient clinic due to erectile dysfunction were included in the study. They were evaluated with a detailed medical and sexual history and physical examination. Erectile function was assessed with IIEF scores before and after the treatment. The patients' ages ranged from 22 to 74 years (52.3±11.7). They suffered from erectile dysfunction for 34.3±31.3 months (2-240 months). Sildenafil citrate 50 mg was given for a month. At the end of this period, patients were re-evaluated and questioned about the efficacy of sildenafil citrate, its' side effects and whether they wanted to continue the treatment or not. Later, sildenafil 100 mg was recommended to patients desiring to use higher dose of it, and they were questioned 4 week later. Finally, the efficacy and side effects of sildenafil was evaluated, and the causes of dropout were obtained from the patients who discontinued sildenafil treatment. Results: At the 4th week control, sufficient erection was observed in 163 patients (75.1%), no erection was encountered in 54 patients (24.9%). Out of 163 patients, 131 (80.4%) who had sufficient erection with sildenafil left the treatment. The causes of discontinuation in these patients were the high price of the drug in 86 patients (%65.6), improvement of erection problem in 26 (%19.8), fear of asparagus news appearing in the media in 12 patients (%9.2), and side effects of sildenafil in 7 patients (%5.3). Of sildenafil failed patients (n: 54), 12 (22.2%) accepted to try sildenafil 100 mg, 42 (77.8%) did not accept to try sildenafil 100 mg. The reasons not, to try sildenafil 100 mg for these patients were high prize in 20 patients (47.6%), consideration of penile prosthesis in 2 patients (3.2%), side effects of sildenafil 50 mg in 13 patients (30.9%), nothing for 7 patients (16.7%). At the end of the treatment period, only 35 (16.1%) patients continued to use sildenafil 50 or 100 mg, 182 patients (83.9%) left the treatment due to different causes. These causes were high prize in 108 patients (59.3%), improvement of erection quality in 26 patients (14.3%), side effects in 20 patients (10.9%), asparagus news in 12 patients (6.6%), inefficacy in 7 patients (3.8%), choosing other treatment alternatives in 2 patients (1.1%). The other 7 (3.8%) did not describe any cause. Side effects were headache in 15 patients (6.9%), sweating in 12 patients (5.5%), visual problems in 6 patients (2.8%) and chest pain in 4 patients (1.8%). Conclusion: Although Sildenafil treatment is found very effective with acceptable side effects in the treatment of ED regardless to the etiology, discontinuation of the drug is very high. In this study, 80.4% of the patients in whom sildenafil treatment was successful left the treatment. The most important factor of this low ratio is the difficulty of buying the drug due to economic problems.
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    The Difference of Heart Rate Recovery between Males with and without Erectile Dysfunction
    (Wiley-Blackwell, 2010) Doğru, M. Tolga; Başar, M. Murad; Haciislamoglu, Ahmet
    Material and Methods: A total of 135 participants (mean age: 45.0 +/- 11.8 years) were enrolled into the study. Detailed biochemical and hormonal analyses, 12-lead electrocardiography and EST (Treadmill) were performed in all participants. Erectile function was assessed using the International Index of Erectile Function (IIEF) questionnaire form. Patients were categorized into two groups according to their IIEF scores as ED (+) (IIEF < 26) and ED (-) (IIEF >= 26). Afterward, statistical analyses were performed to evaluate the correlations between ED and HRR and CHIND. Results: A total of 65 patients were ED (+) (mean age 44.9 +/- 6.4 years), while 70 patients (mean age 43.7 +/- 7.7 years) had normal erectile status. There were statistically significant differences in CHIND (P = 0.015) and HRR time (P = 0.037) between ED (+) and ED (-) patients. In correlation analysis, IIEF score was found positively correlated with HRR and metabolic equivalent (MET) values (r(HRR) = 0.293, P = 0.037; r(METs) = 0.388, P = 0.011, respectively). Linear regression analysis revealed that METs value and total exercise time had a more linear relationship with IIEF score compared to the other EST parameters (p(METs) = 0.002 and p(TET) = 0.015, respectively). Conclusion: Chronotropic incompetence and dynamic postexercise autonomic dysfunction are present in ED patients. This condition may reflect decreased functional capacity and exercise intolerance in these patients. Ann Noninvasive Electrocardiol 2010;15(3):223-229.
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    Effects of vardenafil on intraocular pressure and orbital hemodynamics
    (Mary Ann Liebert, Inc, 2007) Taner, Pelin; Başar, M. Murad; Ünal, Birsen; Batislam, Ertan
    \Purpose: The aim of this study was to investigate the effects of vardenafil on systemic blood pressure, intraocular pressure (IOP), and orbital hemodynamics. Methods: Twenty-one (21) volunteers suffering erectile dysfunction, with an average age of 51.5 +/- 6.2 years, were enrolled into the study. Brachial blood pressures and IOP were measured, the peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) of the ophthalmic, central retinal, and posterior ciliary arteries were evaluated by color Doppler ultrasonography (CDU) before vardenafil intake. All measurements were repeated after 20 min of vardenafil intake. A paired Student t test was used to evaluate the changes. Results: Systolic blood pressure did not change significantly where diastolic blood pressure decreased significantly (P = 0.043) after drug ingestion. There was no significant change in IOP. Increase in EDV of CRA was significant (P = 0.04), but the increase of orbital blood flow velocities of OA and PCA were insignificant. Conclusions: The recommended dose of vardenafil has no negative effects on orbital hemodynamics and IOP in patients with erectile dysfunction.
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    Female sexual and hormonal status in patients with bronchial asthma: Relationship with respiratory function tests and psychological and somatic status
    (Elsevier Science Inc, 2007) Başar, M. Murad; Ekici, Aydanur; Bulcun, Emel; Tuğlu, Devrim; Ekici, Mehmet S.; Batislam, Ertan
    OBJECTIVES To assess the relationship among the sexual, hormonal, physical, and psychological status of women with bronchial asthma (BA) compared with that of healthy volunteers. METHODS Thirty-eight women with BA were enrolled in the study. The patients were asked to complete the Female Sexual Function Index, General Health Questionnaire, and Medical Outcomes Study Short Form 36-item Health Survey (SF-36). Using the answers on the SF-36, the mental and physical component summary scores were calculated. A total of 20 healthy women were enrolled in the study as the control group. The same questionnaires were given to this group as well. Statistical analysis was performed using the Mann-Whitney U test and Pearson correlation tests. RESULTS At the end of the study, statistically significant differences were observed for all questionnaire scores (P <0.05). The most common female sexual dysfunction was diminished arousal (n = 30, 78.9%) in women with BA. In the correlation analysis, the total Female Sexual Function Index score had a statistically significant and positive correlation with the mental component summary score (r = 0.503, P = 0.001) and a negative correlation with the General Health Questionnaire score (r = -0.380, P = 0.020). CONCLUSIONS The results of our study have shown that BA, as a chronic medical condition, can be a cause of female sexual dysfunction with mental and psychiatric mechanisms.
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    Relationship between international index of erectile function and international prostate symptom scores degress in patients with benign prostate hyperlasia after 50 years old
    (2005) Başar, M. Murad; Yılmaz, Erdal; Ünal, Serhat; Başar, Halil; Batislam, Ertan
    Amaç: Bu çalışmanın amacı alt üriner sistem semptomu olan hastalarda uluslar arası erektil fonksiyon skoru ile uluslar arası prostat semptom skoru değerleri arasındaki ilişkiyi değerlendirmektir. Yöntem ve Gereç: Yirmi beş ile 81 yaşları arasında toplam 263 hasta dijital rektal muayene, transrektal ultrasonografi, serum biyokimya analizi, prostat spesfic antijen ile değerlendirildi. Prostat ve erektil fonksiyon sorgulama formları tüm hastalar tarafından dolduruldu. Bu değerlendirmelerden sonra, 50 ile 78 yaşları arasında 82 hasta çalışmaya dahil edildi. Hastalar alt üriner sistem semptomlarının ciddiyetine göre hafif, orta ve ciddi olarak; erektil fonksiyon sorgulama form skorlarına göre normal veya hafif, orta ve ciddi erektil disfonksiyon olarak ayrıldı. Bulgular: Ortalama yaş 61.36.9 yıl idi. Ortalama uluslar arası prostat semptom ve uluslar arası erektil fonksiyon skorları sırasıyla 14.86.6 ve 13.48.7 idi. Sorgulama formlarına göre hastaların alt üriner sistem semptomları ile erektil disfonsksiyon dereceleri arasında ilişki bulnmadı (Pearson x22.886, p0.581). İki sorgulama formu değerleri arasında negativ, fakat istatistiksel olarak anlamsız korelasyon izlendi (r-0.227, p0.102). Sonuç: Benign prostat hiperplazisi ve erektil disfonksiyon yaşlı hastalarda en yaygın patoloji olmasıonda rağmen, bu iki patoloji araısndaki ilişki sadece aynı cins ve aynı yaşama başlamasına bağlıdır.
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    Relationship between serum sex steroids and Aging Male Symptoms score and International Index of Erectile Function
    (Elsevier Science Inc, 2005) Başar, M. Murad; Aydın, Gülümser; Mert, H. Çağatay; Keles, Işık; Çağlayan, Osman; Orkun, Sesim; Batislam, Ertan
    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 (EA 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 I IEF score of less than 26 were considered to have sexual dysfunction. Results. Although DHEA-S levels were significantly lower and E-2 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 E-2 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 E-2 might play some important roles in the symptoms of aging men.
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    Seminal plasma transforming growth factor- B (TGF- B) and epidermal growth factor (EGF) levels in patients with varicocele
    (2008) Kısa, Üçler; Başar, M. Murad; Ferhat, Mehmet; Çağlayan, Osman
    Amaç: Bu çalışmanın amacı varikoselli infertil hastalar ile normal fertil olgular arasında seminal plazma EGF ve TGF-p düzeylerini karşılaştırmak, ve seminal plazma EGF ve TGF-P düzeyleri, semen parametreleri ve serum hormon düzeyleri arasındaki ilişkiyi incelemektir. Materyal ve Metot: Varikoselli 100 infertil hasta (Grup-1) çalışmaya alındı. İki ile 5 günlük cinsel perhiz sonrası semen analizi uygulandı. Semen analiz sonuçlarına göre bu hastalar oligoastenoeratozoospermisi olanlar (Grup-1) ve normal semen analizi olanlar (Grup-2) olarak iki gruba ayrıldı. İlave olarak, skrotal patolojisi olmayan 100 fertil olgu kontrol grubu (Grup-3) olarak kabul edildi ve semen analizi bunlarda da uygulandı. Seminal plazma EGF ve TGF-p düzeyleri ELİZA yöntemi ile ölçüldü. Ayrıca, tüm olgularda serum gonadotropin ve seks steroid düzeyleri ölçüldü, istatistiskel analiz tek yönlü ANOVA test ve post hoc Bonferoni test ile yapıldı. Bulgular: Her iki grup arasında semen analizi parametreleri bakımından anlamlı farklık vardı (P 0,05). Seminal plazma EGF ve TGF-p düzeyleri varikoselli olgularda (Grup-1 ve Grup-2) Grup-3'den daha yüksekti. Ancak, istatistiksel fark sadece TGF-p düzeylerinde saptandı (P 0,017). Seminal plazma EGF ve TGF-P seminal parametreler ile negatik ilişki göstermekteydi (P 0,05). Bununa karşın, bu büyüme faktörleri ile serum hormon düzeyleri arasında ilişki, yoktu. Sonuç: Bu çalışma göstermektedir ki, seminal plasma EGF ve TGF-P düzeylerindeki artış varikoselli hastalarda seminal parametrelerde azalma ile birliktedir. Bununla birilkte, etki TGF-p ile daha belirgindir.