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Öğe Analgesic efficacy of ultrasound guided paravertebral block in percutaneous nephrolithotomy patients: a randomized controlled clinical study(BMC, 2020) Yaman, Ferda; Tuglu, DevrimBackground: Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variety of operations on the thorax, abdomen or pelvis. PVB is straightforward, efficacious in operations performed. This study was undertaken to evaluate how efficacious ultrasound-guided thoracic paravertebral block is when used in patients undergoing percutaneous nephrolithotomy (PCN). Methods: A total of 44 patients, falling in categories I to III of the American Society of Anesthesiologists, and aged between 18 and 65 years, who were scheduled for PCN, were randomly distributed into two groups. The anaesthetic intervention group (PVB) contained 22 individuals, who were injected at level T8-T9 with 20 mL 0.25% bupivacaine as a single administration. In the control group C, also containing 22 individuals, the intervention was not carried out The groups were compared after PCN in terms of opioid use, pain score, opioid adverse effects profile and the need for supplemental analgesia. Results: Visual analogue scale pain scores whilst at rest or moving were lower at the level of statistical significance in the PVB group compared to controls at 2 and 4 h post-surgery. At 6 and 8 h post-surgery, the control group had a lower VAS score when moving, and this result reached statistical significance (p < 0.05). The controls used more opioid relief than the PVB group and had lower scores for satisfaction (p < 0.05). Conclusion: Ultrasound-guided PVB using bupivacaine and an in-plane technique provides effective analgesia in PNL. It is associated with high scores on patient satisfaction and minimal complications.Öğe The antioxidant effect of dexmedetomidine on testicular ischemia-reperfusion injury(Acta Cirurgica Brasileira, 2015) Tuglu, Devrim; Yuvanc, Ercan; Yilmaz, Erdal; Gencay, Isin Yazici; Atasoy, Pinar; Kisa, Ucler; Batislam, ErtanPURPOSE: To investigate the protective effect of dexmedetomidine (Dex) on testicular damage induced by ischemia-reperfusion injury in rats. METHODS: Sham group underwent left scrotal exploration only (group 1). The ischemia-reperfusion only group underwent left testicular torsion and detorsion (group 2). The ischemia-reperfusion plus Dex group underwent left testicular torsion, received 50 mu g/kg Dex (group 3) and 100 mu g/kg Dex (group 4) intraperitoneally at minute 180 of ischemia and then underwent detorsion. We determined histopathological findings and performed specific biochemical analyses. RESULTS: Increasing doses of Dex significantly increased TAS, and significantly decreased OSI. Analyzing the antioxidant effects of increasing doses of Dex in torsion and contrlateral testicles: Dex 100 mu g/kg statistically significant increased the tissue total antioxidant status (TAS) and oxidative stress index (OSI) when compared with Dex 50 mu g/kg but not found significantly change on the tissue total oxidant status (TOS). However, Dex did not significantly improve these histological alterations. CONCLUSION: The antioxidant effects of dexmedetomidine on testicular ischemia-reperfusion injury in ipsilateral and contrlateral testis, but in the histopathological level, there was no difference statistically according to Johnsen's scoring system between groups at both sides.Öğe Aromatase inhibitors in infertile patients: effects on seminal parameters, serum and seminal plasma testosterone levels, and estradiol levels during short-term follow-up(Tubitak Scientific & Technical Research Council Turkey, 2009) Basar, M. Murad; Tuglu, DevrimAim: To evaluate the effects of an aromatase inhibitor (anastrozole) on seminal parameters, and on serum and seminal plasma testosterone/estradiol ratios in infertile patients, as well as to clarify its place among empirical infertility treatment modalities. Patients and Methods: The study included 32 patients with spermatozoa numbering > 5 million/mL in ejaculate and a serum testosterone/estradiol ratio < 0.14. Anastrozole, an aromatase-inhibiting agent, was given (1 mg b.i.d.) and patients were re-evaluated 2 months later based on semen analysis, and measurements of serum and seminal plasma testosterone and estradiol levels. Results: Semen analysis parameters before and after treatment, respectively, were as follows: number of spermatozoa: 12.4 +/- 4.1 million/mL and 22.3 +/- 5.7 million/mL; motility: 33.4 +/- 4.2% and 47.6 +/- 7.4%; normal morphology: 5.4 +/- 1.3% and 8.9 +/- 2.7%. Differences between the values before and after treatment were statistically significant (P < 0.05). Serum testosterone level was 4.1 +/- 1.2 ng/mL, estradiol level was 52.1 +/- 9.4 pg/mL, and testosterone/estradiol ratio was 0.13 +/- 0.03 at the beginning of treatment. These values were 3.2 +/- 0.6 ng/mL, 68.4 +/- 7.3 pg/mL, and 0.05 +/- 0.001, respectively, in seminal plasma. Following 2 months of anastrozole treatment, testosterone and estradiol levels, and the testosterone/estradiol ratio showed statistically significant changes in serum and seminal plasma. While testosterone levels significantly increased, estradiol levels decreased (serum P-T = 0.001, P-E2 = 0.001; seminal plasma P-T = 0.001, P-E2 = 0.001). Conclusion: Aromatase inhibitors are a potential treatment method for infertile male patients with increased plasma estradiol levels and decreased plasma testosterone/estradiol ratios.Öğe Audiometry Results and TEOAE and DPOAE Amplitudes in Men Taking a Phosphodiesterase Type 5 Inhibitor for Erectile Dysfunction(Sage Publications Inc, 2017) Ontepeli, Sertan; Muluk, Nuray Bayar; Tuglu, Devrim; Sipal, TimucinWe conducted a prospective study of transient evoked otoacoustic emissions (TEOAEs) and distortion-product otoacoustic emissions (DPOAEs) in men who were taking an oral phosphodiesterase type 5 (PDE5) inhibitor for erectile dysfunction. Our study group was made up of 30 men (60 ears), aged 34 to 60 years (mean: 50.9). They were randomly divided into three groups; 10 men were given sildenafil (Viagra) at 50 mg twice a week, 10 were given tadalafil (Cialis) at 20 mg twice a week, and 10 were given vardenafil (Levitra) at 20 mg twice a week. All patients took their drug for 3 weeks, for a total of 6 tablets for each patient. Audiometric tests and TEOAE and DPOAE measurements were performed before and after treatment. Post-treatment audiometry demonstrated improvement in hearing in all three groups. However, post-treatment TEOAE amplitudes and DPOAE amplitudes differed among the three groups; they were significantly higher in the sildenafil group at 1.0 kHz and the same in the tadalafil group; in the vardenafil group, the DPOAE amplitude was significantly lower at 3.0 kHz while there was no change in the TEOAE amplitude. We speculate that the possible mechanism for these findings is that PDE5 inhibitors block degradation of cyclic guanosine monophosphate (cGMP) and induce dilation of the cochlear microcirculation, resulting in an increase in cochlear blood flow. We also believe that the decrease in DPOAE amplitudes at 3.0 kHz seen in the vardenafil group may be related to an accumulation of nitric oxide/cGMP complex, which is toxic to the cochlea; however, since there was no change in TEOAE amplitude in the vardenafil group, this influence may be minimal. Further studies are needed to obtain a more comprehensive assessment of the effects of PDE5 inhibitors on hearing with the use of higher doses and longer durations of therapy.Öğe Case Report: Incidental Testicular Tumor(Wiley-Blackwell, 2014) Tuglu, Devrim; Bal, F.; Yuvanc, E.; Kirdağ, Mustafa Koray; Atasoy, Pınar; Yılmaz, Erdal; Batislam, Ertan…Öğe CAUSES OF SILDENAFIL CITRATE TREATMENT DISCONTINUATION IN PATIENTS WITH ERECTILE DYSFUNCTION(Aves, 2005) Tuglu, Devrim; Basar, M. Murad; Akbulut, Ziya; Gungor, Sefa; Tekdogan, Umit Y.; Atan, AliIntroduction: 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.Öğe Citrate levels in fresh tomato juice: A possible dietary alternative to traditional citrate supplementation in stone-forming patients(Elsevier Science Inc, 2008) Yilmaz, Erdal; Batislam, Ertan; Basar, Murad; Tuglu, Devrim; Erguder, ImgeOBJECTIVES To detect citrate levels in fresh tomato juice, to reveal whether it can be studied for prevention of recurrent hypocitraturic nephrolithiasis. METHODS Juices of tomato, orange, lemon, and mandarin were extracted and blended with a hand blender, and 10 samples of 100 mL were taken from each. Citrate, oxalate, calcium, phosphorus, magnesium, sodium, potassium, chloride, and pH levels were examined in these. The same variables were re-evaluated after the samples were stored at +4 degrees C for 1 week. RESULTS In fresh tomato juice, higher citrate and magnesium levels as well as lower sodium and oxalate levels were detected as compared with the other juices. No differences were observed with regard to all variables among fresh orange, lemon, and mandarin juices. The level of citrate in the fresh tomato juice was higher at a statistically significant level than that in tomato juice that was stored for 1 week. The amount of oxalate increased in stored tomato juice. CONCLUSIONS Fresh tomato juice is considered a rich source of citrate. Furthermore, a high level of magnesium and a low level of sodium and oxalate content were detected in fresh tomato juice, the usability of which in recurrent hypocitraturic nephrolithiasis can be investigated in clinical studies.Öğe The effect of coenzyme Q and selenium on kidney in rats with partial unilateral ureteral obstruction(Aves, 2019) Kirdag, Mustafa Koray; Tuglu, Devrim; Yuvanc, Ercan; Kisa, Ucler; Balci, Mahi; Batislam, Ertan; Yilmaz, ErdalObjective: In this study, we aimed to investigate the antioxidant effects of selenium and coenzyme Q on renal damage in a partial unilateral ureteral obstruction (PUUO) in a rat model. Material and methods: A total of 24 Sprague-Dawley rats were divided into four groups as Group 1 Control Group, Group 2, PUUO Group, Group 3 PUUO + coenzyme Q group, Group 4 PUUO + selenium group. Paraoxonase (PON), total antioxidant capacity (TAC), and total oxidant levels (TOS) were analyzed biochemically from tissue and blood samples. Tissue samples were examined histopathologically. Results: The TAC in the tissues was found to be statistically significantly increased in Groups 3 and 4, compared to Group 2. Tissue TOS was found to be significantly reduced in Groups 3 and 4, compared to Group 2. Serum PON levels were significantly increased in Group 3 and 4, compared to Group 1 and 2. Histopathological examination showed that interstitial inflammation and congestion were lesser in the coenzyme Q and selenium groups than in the PUUO group. A more significant decrease was found in the selenium group than in the coenzyme Q group. Conclusion: Our study results showed that coenzyme Q and selenium reduced the oxidation and the damage in tissue in PUUO in rats.Öğe Effect of sildenafil citrate treatment on serum dehydroepiandrosterone sulfate levels in patients with erectile dysfunction(Elsevier Science Inc, 2006) Tekdoğan, Ümit; Tuncel, Altuğ; Tuglu, Devrim; Basar, M. Murad; Atan, AliObjectives. To investigate the effect of sildenafil citrate treatment on serum dehydroepiandrosterone sulfate (DHEAS) levels in patients with erectile dysfunction (ED). Methods. A total of 124 men with a mean age of 45.9 years were included in the study. Group 1 consisted of 78 patients with ED, as determined by the Sexual Health Inventory of Male (SHIM) scale (score less than 2 1). Group 2 consisted of 46 healthy men with a SHIM score of 21 or greater. The 78 patients with ED took 100 mg sildenafil citrate at least eight times in 1 month. The SHIM scale was administered and serum DHEAS levels measured before and after treatment in the ED group. The serum DHEAS levels were also measured in the control group. The treatment response was defined as positive if the SHIM score was 21 or greater after sildenafil administration. Results. At the end of sildenafil citrate treatment, the serum DHEAS levels and SHIM scores had increased significantly in the ED group (P = 0.013 and P = 0.001, respectively). In groups 1 and 2, the mean pretreatment serum DHEAS level of the men younger than 50 years old was 200.1 +/- 77.9 and 279.4 +/- 125.4 mu g/dL, respectively (P = 0.013). The elevation of the serum DHEAS levels and SHIM scores was more significant in the sildenafil responders (P = 0.002 and P = 0.001), respectively. Conclusions. Serum DHEAS levels were significantly greater in the patients younger than 50 years old than in the older patients in the ED group. The serum DHEAS levels increased significantly after sildenafil citrate treatment in the ED group (especially in the younger men). Also, patient age was an important factor affecting the sildenafil citrate response.Öğe Effect of SWL on renal hemodynamics: could a change in renal artery contraction-relaxation responses be the cause?(Springer, 2012) Yilmaz, Erdal; Mert, Cagatay; Keskil, Zuhal; Tuglu, Devrim; Batislam, ErtanThe aim of this study was to reveal the effect of shock wave lithotripsy (SWL) on renal artery contraction-relaxation responses and the relation of this effect with renal hemodynamics. Twenty-four rabbits are divided into six different groups. The first two groups evaluated as the control groups. After isolating the kidneys, we applied phenylephrine (Ph) and acetylcholine (Ach) in the first group and sodium nitroprusside (SNP) and histamine (H) in the second group. In the third, fourth, fifth and sixth groups, 14.5 kV shock wave (SW) was focused on the left kidneys. We adjusted the number of shocks to a total of 500, 1,500, and 3,000 SW, in the third, fourth and fifth groups, respectively. After isolating the kidneys, Ph, Ach was given in groups 3, 4 and 5. In the sixth group, to get the SNP and the H responses, 3,000 shocks modality was utilized. Marked contractile responses were obtained by phenylephrine in the control group. In kidneys that were exposed to 500 shocks SWL procedures, a decrease in contractile responses and hence, in perfusion pressures in different concentrations of phenylephrine was noted. However, a notable change in relaxation responses occurred after 3,000-shock applications. No difference in relaxation responses to nitroprusside, a direct vasodilating agent, was observed in any group, compared to the control group. Another cause of deterioration of renal hemodynamics after SWL can be attributed to the reduction in renal artery contraction-relaxation responses that result in the vascular smooth muscle and endothelial damage.Öğe The effect of varicocele on seminal plasma and serum inhibin-B levels in adolescent and adult men(Springer, 2010) Basar, M. Murad; Kisa, Ucler; Tuglu, Devrim; Kacmaz, Murat; Basar, HalilIn the present study, the relationship between serum/seminal plasma and serum FSH and seminal parameters was evaluated in adults and adolescent varicocele patients and compared with normal fertile cases. A total of 50 adult patients with varicocele (Group-1) and 50 adolescents with varicocele (Group-2) were enrolled into the study. Fifty fertile cases without any scrotal pathology were accepted as control group (Group-3). Serum gonadotropin, sex steroids and serum and seminal plasma inhibin-B levels were measured, and semen analysis was performed after 2 and 5 days of sexual abstinence. All parameters were compared among three groups by using one-way ANOVA test. There were statistically significant differences among three groups on seminal parameters due to disturbed spermatogenesis in patients with varicocele (P < 0.05). However, there were not statistical differences between serum and seminal plasma Inhibin-B levels among groups. In varicocele patients, serum inhibin-B levels showed negative and significant correlation only with FSH levels (r = -0.253, P = 0.011). On the contrary, neither serum nor seminal plasma inhibin-B levels showed significant correlation with seminal parameters. While varicocele affects different mechanisms in the regulation of spermatogenesis in testes, serum and seminal plasma inhibin-B have not any role in decreased spermatogenesis in varicocele.Öğe Effectiveness of eutectic mixture of local anesthetic cream and occlusive dressing with low dosage of fentanyl for pain control during shockwave lithotripsy(Mary Ann Liebert, Inc, 2005) Yilmaz, Erdal; Batislam, Ertan; Basar, M. Murad; Tuglu, Devrim; Özcan, Şaziye; Basar, HalilBackground 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 mu g/kg by intravenous infusion (IV); group 2: IV fentanyl 0.25 mu g/kg; group 3: occlusive dressing and IV fentanyl 0.25 mu g/kg; group 4: placebo cream and IV fentanyl 0.25 mu g/kg; group 5: EMLA cream and IV fentanyl 0.25 mu g/kg; group 6: placebo cream and IV fentanyl 0.25 mu g/kg with an occlusive dressing; and group 7: EMLA cream and IV fentanyl 0.25 mu g/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 SPO2 in group I 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.Öğe The Effects of Nocturnal Blood Pressure Patterns and Autonomic Alterations on Erectile Functions in Patients with Hypertension(Urol & Nephrol Res Ctr-Unrc, 2019) Yuvanc, Ercan; Dogru, Mehmet Tolga; Simsek, Vedat; Kandemir, Huseyin; Tuglu, DevrimPurpose: Hypertension (HT) is known to be of the main risk factors for erectile dysfunction (ED). But non-dipping (<%10 drop in the night) of HT is not investigated truly. The aim of this study was to test the hypothesis that the non-dipper hypertensive patients are more prone to develop erectile dysfunction. Materials and Methods: This was a cross-sectional clinical study. 70 HT patients diagnosed by Ambulatory blood pressure monitoring (ABPM) were classified into 3 groups (No ED, mild to moderate and severe) according to their International Index of Erectile Function (IIEF) scores. All three groups were compared for their dipping status by ABPM, heart rate variability (HRV) by holter monitoring. Results: In our study non-dipper hypertensives had statistically more erectile dysfunction (P = 0.004). Also severe ED patients with non-dipping pattern had decreased dipping blood pressure levels then those of ED(-) patients with non-dipping HT (P = .003) Conclusion: Autonomic dysfunction especially sympathetic overactivity is associated with both non dipping pattern of HT and erectile dysfunction as a common pathologic pathway, besides there might be an association between ED and non dipping HT.Öğe Evaluation of pheniramine maleate and zofenopril in reducing renal damage induced by unilateral ureter obstruction. An experimental study(Termedia Publishing House Ltd, 2021) Yuvanc, Ercan; Tuglu, Devrim; Ozan, Tunc; Kisa, Ucler; Balci, Mahi; Batislam, Ertan; Yilmaz, ErdalIntroduction: Obstruction of the ureter may occur due to congenital, iatro-genic or other reasons. This can cause hydronephrosis in the early stage and can lead to cellular inflammation, necrosis and atrophy in the kidney tissue. The aim of this paper is to evaluate the protective effect of pheniramine maleate (PM) and zofenopril on renal damage caused by hydronephrosis due to unilateral partial ureter obstruction. Material and methods: Twenty-four female Sprague Dawley rats were divided into 4 groups. Group 1: sham group, group 2: partial unilateral ureteral obstruction (PUUO) group, group 3: PUUO + PM group, group 4: PUUO + zofenopril group. Paraoxonase (PON), total antioxidant status (TAS) and total oxidant status (TOS) of tissue and blood samples were measured and calculated. Tissue samples were evaluated histopathologically. Results: An increase in tissue TAS and a decrease in tissue TOS and OSI levels were detected in groups 3 and 4 compared to group 2 (both: p < 0.01). Tissue PON levels showed an increase in groups 3 and 4 compared to groups 1 and 2 (both: p < 0.01). Histopathological evaluation showed a decrease in interstitial inflammation and congestion in groups 3 and 4 compared to the control group (p < 0.001). The decrease was observed to be more significant in group 4 compared to group 3 (p < 0.01). Conclusions: In our experimental study, we observed that PM and zofenopril reduce the oxidation and tissue damage caused by unilateral partial obstruction.Öğe Investigation of the antioxidant effects of pheniramine maleate and nebivolol on testicular damage in rats with experimentally induced testis torsion(Acta Cirurgica Brasileira, 2018) Yuvanc, Ercan; Tuglu, Devrim; Ozan, Tunc; Kisa, Ucler; Balci, Mahi; Batislam, Ertan; Yilmaz, ErdalPurpose: To investigate the biochemical, histopathologic, and spermatogenetic changes in the detorsionated testicle after experimental torsion and to study the antioxidant effects of pheniramine maleate and nebivolol. Methods: Twenty-four Sprague-Dawley male rats were divided into 4 groups: Group 1: Sham; Group 2: Torsion/Detorsion (T/D); Group 3: T/D + Pheniramine maleate (PM); Group 4: T/D + Nebivolol (NB) group. Paroxanase (PON), total antioxidant status (TAS), total oxidant status (TOS), and oxidative stres index (OSI) were measured, and spermatogenetic and histopathologic evaluation was performed in tissue and blood samples. Results: The evaluation of tissue TAS indicated no statistically significant difference in Group 3 compared to Group 2. A statistically significant increase was detected in Group 4 compared to Group 2. Serum PON levels revealed a statistically significant increase in Groups 3 and 4 compared to Groups 1 and 2. The Johnsen testicular biopsy score decreased in Groups 3 and 4, but the decrease was not statistically significant. Conclusions: Pheniramine maleate and nebivolol have antioxidant effects against ischemia-reperfusion damage. They also support tissue recovery, which is more significantly observed by nebivolol.Öğe Local Anesthesia with 20 mL prilocaine infiltration: The ultimate point for analgesia during shockwave lithotripsy?(Mary Ann Liebert, Inc, 2008) Yilmaz, Erdal; Batislam, Ertan; Tuglu, Devrim; Yuvanc, ErcanPurpose: The effectiveness of 10 mL and 20 mL local prilocaine infiltration for analgesic purposes during shockwave lithotripsy (SWL) was compared, and the differences in pain intensity and need for additional analgesics were defined. Patients and Methods: One hundred and twenty-one patients between the ages of 16 and 69 with kidney stones were randomly separated into two groups. The 60 patients in group 1 received 10 mL prilocaine subcutaneously and deep lumbar infiltration into the area 1 cm below the twelfth rib 2 minutes before SWL. The 61 patients in group 2 received 20 mL subcutaneously and deep lumbar infiltration of prilocaine to the same locale, again 2 minutes before the process. All the patients received one session of SWL. For measurement of pain intensity, the 0 to 100 mm visual analog scale ( VAS) was used at 1 minute and every 10 minutes during the process. Intravenous fentanyl was administered to patients who had steady or increasing intensity of pain during the process. Results: VAS values were statistically significantly higher in patients in group 1 compared with patients in group 2 during the process. While 40 patients received additional analgesia in group 1, only three patients in group 2 needed additional analgesia. Conclusion: Use of 20 mL subcutaneous and deep lumbar prilocaine infiltration during SWL for analgesic purposes is recommended as an efficient, cost-effective, anesthetist-independent, and reliable method.Öğe Multiple urethral anomalies: Parameatal urethral cyst, penile curvature, incomplete hypospadiac anterior duplication of the urethra and distal hipospadias(Canadian Urological Association, 2015) Tuglu, Devrim; Yuvanc, Ercan; Yilmaz, Erdal; Gur, Serhan; Batislam, ErtanThe male genitourinary system is quite complex. There are numerous known anomalies of the male urethra either as isolated cases or in combination with other disorders. An improved understanding of the embryology and anatomy of the normal male urethral development might help explain the causes of the various urethral abnormalities. We contribute to the etiology of congenital anomalies with this multiple urethral anomalies case.Öğe Preparation and Characterization of Infection-Resistant Antibiotics-Releasing Hydrogels Rods of Poly[hydroxyethyl methacrylate-co-(poly(ethylene glycol)-methacrylate]: Biomedical Application in a Novel Rabbit Penile Prosthesis Model(Wiley, 2008) Arica, M. Yakup; Tuglu, Devrim; Basar, M. Murad; Kilic, Dilek; Bayramoglu, Guelay; Batislam, ErtanIn this work, preparation and characterization of novel three different antibiotic loaded penile prosthesis in the rod form were investigated by copolymerization of 2-hydroxyethylmethacrylate (HEMA) with poly(ethylene glycol)-methacrylate, (PEG-MA). To achieve this goal, a series of novel copolymer hydrogels were prepared in rod form using HEMA and PEG-MA monomers via UV initiated photopolymerization. The thermal stability of the copolymer was found to be lowered by increase in the ratio of PEG-MA in the rod structure. Contact angle measurements on the surface of copolymer hydrogel demonstrated that the copolymer gave rise to a significant hydrophilic surface compared with pure poly(HEMA). The blood protein adsorption and platelet adhesion were significantly reduced on the surface of the copolymer hydrogels compared with control pure poly(HEMA). Poly(HEMA:PEG-MA;1:1)-1 formulation containing different antibiotics (20 mg antibiotic/g polymer) released about 90, 91, and 55% of the total loaded cephtriaxon, vancomycin, and gentamicin in 48 h at pH 7.4, respectively. Finally, antibiotics loaded biocompatible poly(HEMA:PEG-MA;1:1)-1 hydrogel compositions was used as a penile prosthesis in preventing cavernous tissue infections in a rabbit prosthesis model. The efficacy of the three different antibiotics loaded hydrogel system was evaluated in four different groups of rabbits, in which various infectious agents were inoculated. The animals were sacrificed after predetermined time periods, and clinical, histological and microbiological assessment on the implant side were carried out to detect infections. Eventually, we concluded that three different antibiotic loaded penile prostheses (i.e. poly(HEMA:PEG-MA;1:1)-1 hydrogel systems) were as effective as parenteral antibiotics applications. (C) 2007 Wiley Periodicals, Inc.Öğe Unknown complication of preputial calculi: preputial skin fistula(Springer, 2013) Tuglu, Devrim; Yuvanc, Ercan; Yilmaz, Erdal; Batislam, Ertan; Gurer, Yahya Kemal Yavuz…Öğe Window technique on circumcision(Springer, 2006) Basar, Halil; Yılmaz, Erdal; Basar, Mehmed Murat; Batislam, Ertan; Tuglu, DevrimObjective: 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.
