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    Changes of Pudendal Somatosensory Evoked Potentials (PSEP) after Sildenafil Application in Erectile Dysfunction with Diabetic Polyneuropathy (PNP)
    (Wiley-Blackwell Publishing, Inc, 2004) Basar, M.; Ulkatan, S.; Batislam, E.; Yilmaz, E.; Uysal-Tan, F.; Basar, H.
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    Comparison of three analgesics for extracorporeal shock wave lithotripsy
    (Taylor & Francis As, 2002) Özcan, S.; Yilmaz, E.; Büyükkoçak, Ü.; Basar, H.; Apan, A.
    Objective: The aim of the study was to compare the clinical efficacy of three different analgesic drugs with respect to their level of sedation, analgesia and quick mobilisation without cardiopulmonary depression, for outpatient extracorporeal shock wave lithotripsy (ESWL) procedure. Material and Methods: Sixty outpatients undergoing elective ESWL using a third generation lithotriptor were studied. The patients were randomly divided into three groups of twenty patients. All patients received midazolam (2 mg) intravenously five minutes before the procedure. In group F, fentanyl was given (I mug kg-(1) IV) at the same time with midazolam. In group D, diclofenac sodium was given (I mg kg-(1), IM) intramuscularly 45 minutes before ESWL. In group T, tramadol was given (1.5 mg kg-(1)) 30 minutes before ESWL. Arterial pressure, heart rate, respiratory rate and oxygen saturation were recorded before the procedure, after sedation, at the first minute, and every ten minutes during the procedure. Pain intensity was identified with a Visual Analogue Scale. The level of sedation was evaluated by using the Observer's Assessment of Alertness/Sedation Scale. All patients were asked to assess their satisfaction with the seven point Verbal Rating Scale before discharge. Side-effects were also recorded during the procedure. Results: The incidence of nausea and vomiting was higher in fentanyl group compared with the other groups. In patients who received fentanyl, the decrease of oxygen saturation at the first and tenth minute of the procedure was statistically significant (p < 0.05). Conclusions: Diclofenac sodium and tramadol were found to be safe and effective analgesics with lower side-effects than fentanyl.
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    Consumption of aqueous garlic extract leads to significant improvement in patients with benign prostate hyperplasia and prostate cancer
    (Pergamon-Elsevier Science Ltd, 2003) Durak, I.; Yilmaz, E.; Devrim, E.; Perk, H.; Kacmaz, M.
    Aim: Investigation of possible effects of garlic extract supplementation on disease parameters of patients with benign prostate hyperplasia. (BPH). and prostate cancer (PC). Materials and methods: Twenty seven patients with BPH and 9 patients with prostate cancer participated in the study. Patients consumed aqueous garlic extract at the daily amount of 1 ml/kg weight for a month and then, pre- and post- disease parameters were examined. Results: Mass of prostate was found to be significantly lowered in the BPH group after extract consumption. Urinary frequency was established to be decreased, maximum and average rates of urine flow significantly increased after experimental period. In the cancer group, significantly lowered total and free PSA values were measured after extract consumption. No change was however observed in the mass of prostate of this group. The parameters of urinary frequency, maximum and average rates of urinary flow were also established to be significantly improved in the cancer group. Conclusions: Results suggest that garlic extract supplementation leads to significant improvement in disease parameters of the patients with BPH and PC. (C) 2003 Elsevier Science Inc. All rights reserved.
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    Continence recovery time after radical prostatectomy: implication of prostatic apical tumor
    (Edizioni Minerva Medica, 2013) Sipal, T.; Tuglu, D.; Yilmaz, E.; Atasoy, P.; Batislam, E.
    Aim. Despite the role of prostatic apex on post-radical prostatectomy incontinence (PPI) has been encountered, the impact of prostatic apex tumor on urinary recovery has been poorly adressed. We aimed to evaluate the effect of prostatic apex tumor on PPI. Methods. Between January 2008 and December 2011, a total 36 consecutive patients who underwent open retropubic radical prostatectomy (RRP) for prostate adenocancer (PCa) were analyzed. The patients were divided into two groups according to the presence of prostatic apical tumor. Urinary incontinence was assessed at regular intervals following RP using validated Incontinence Questionnaire-Short Form and 24-hour pad use based on patients' reports. Urinary continence was defined as wearing no pads. All patients' functional and oncological data were recorded. Results. Overall urinary continence rate at one year was 90%. There was a statistical difference between two groups in terms of urinary recovery (P=0.024). The 1 week, 1 month, 3 month, 6 months and 1 year postoperative continence rates were 28%, 50%, 85%, 92.9% and 92.9%, respectively, in patients with apex infiltration (-) group, compared with 0%, 22.7%, 45.5%, 72.7% and 86.4%, respectively, in patients with infiltration (+) group. Conclusion. The results provided that infiltration of the prostatic apex could significantly affect urinary continence recovery time after RP and advanced pathologic stage could be a risk for PPI.
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    Effects of electrohydraulic extracorporeal shock wave lithotripsy on submandibular gland in the rat: electron microscopic evaluation
    (Elsevier Sci Ireland Ltd, 2002) Bayar, N.; Kaymaz, F.F.; Apan, A.; Yilmaz, E.; Cakar, A.N.
    Objectives: Extracorporeal shockwave lithotripsy (ESWL) has been applied in sialolithiasis as a new treatment modality. The aim of this experimental study is to investigate the local effects of electrohydraulic ESWL applied to the right submandibular gland of the rats. Methods: This prospective study was conveyed in four groups groups I, II, III and IV: each group consisting of 20, 20, 18 and 9 rats, respectively, with a randomized distribution, Groups I, II, III and IV received 250, 500, 1000 and 2000 shock waves at 14-16 kV (average 15.1 kV), respectively, to the right submandibular glands on the 0th day. In groups I, II, III, right submandibular glands of the rats were removed on the 0th 1st, 7th and 15th days, in group IV, this procedure could be managed only on the 0th and 7th days. Light and electron microscopic evaluation were assessed, Using the light microscopic changes, severity of damage score of the glands (SDS) was found. Statistical analysis was done using SDSs. Results: Light and electron microscopic observations have shown that the damage produced by the shock waves were confined to focal areas in the acinar cells (AC), granulated convoluted tubule (GCT) cells and blood vessels at all doses applied. Vacuolization in the cytoplasms of the AC and GCT cells, disintegration of membranes, alteration in the cytoplasmic organization, swelling of the mitochondria and loss of the features were observed on electron microscopy. Increase in the secretion rate; stasis and dilatation in the blood vessels: blebbing and loss of features in the cytoplasm of the endothelial cells were observed, According to the result of the statistical analysis using SDSs, at 250 shock wave dose, a statistically significant difference between the SDSs of the days (0th, 1st, 7th and 15th) was found (P < 0.05), The SDS on the 0th day was found to have the lowest value among the other days. And also a statistically significant difference was found on the 0th day between the SDSs at doses of 250, 500, 1000 and 2000 shock waves (P < 0.05). The SDS at 250 and 500 shock waves was found to have the lower value than the SDS at the 2000 shock wave. It was observed that produced damage was less prominent by small doses (250, 500 doses) initially (0th day). Electrohydraulic ESWL caused a "patchy type" generalized pathology on submandibular glands of the rats and damaged focal areas were widespread all through the gland from the 1st day on. Conclusion: Formation of the damage was concluded to be related to the direct effect of the shock waves rather than the dose used. Electrohydraulic lithotripters are not suitable for sialolithiasis because of the focus problems, local tissue damage and the risk of the damage to the adjacent structures. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
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    Four analgesic techniques for shockwave lithotripsy: Eutectic mixture local anesthetic is a good alternative
    (Mary Ann Liebert, Inc, 2003) Basar, H.; Yilmaz, E.; Ozcan, S.; Büyükkoçak, Ü.; Sari, F.; Apan, A.; Batislam, E.
    Background and Purpose: Various sedative and analgesic medication has been used for shockwave lithotripsy (SWL). The aim of this study was to evaluate the efficacy of different anesthesia modalities in these patients. Patients and Methods: One hundred patients were randomly divided into four groups. The first (Group F) received fentanyl 1 mug/kg intravenously (IV), the second (Group D) received diclofenac sodium 1 mg/kg-intramuscularly (IM), the third (Group T) received tramadol 1.5 mg/kg IM, and the fourth (Group E) was given 15 g of eutectic mixture local anesthetic (EMLA) cream containing lidocaine and prilocaine. After routine preoperative evaluation, all patients received midazolam 2 mg IV 5 minutes before lithotripsy for sedative premedication. In all groups, a supplemental 25-mug bolus of fentanyl was administered IV when patients complained of pain, moved, or grimaced in response to the shockwaves. Pain intensity was evaluated on a 0- to 100-mm visual analog scale (VAS). The level of sedation was determined using the Observer's Assessment of Alertness/Sedation (OAS/S). Side effects such as bradypnea, oxygen desaturation, bradycardia, pruritus, and nausea and vomiting were recorded. Results: There were no statistically significant differences among the four groups with regard to VAS, OAS/S scores, or side effects. In Group F, the mean arterial pressure was decreased significantly at 10 and 20 minutes. The patients in this group also manifested a decrease of oxygen saturation at the first, tenth, and twentieth minutes and the end of SWL. Conclusion: Application of EMLA cream was as safe and effective as fentanyl, diclofenac, and tramadol,. and reduction of the fentanyl dose during SWL was possible.
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    Music decreases anxiety and provides sedation in extracorporeal shock wave lithotripsy
    (Elsevier Science Inc, 2003) Yilmaz, E.; Özcan, S.; Basar, M.; Basar, H.; Batislam, E.; Ferhat, M.
    Objectives. To evaluate the efficacy of music on sedation in extracorporeal shock wave lithotripsy (ESWL) treatment to compare its anxiolytic effects with those of midazolam. Methods. Ninety-eight urolithiasis patients were randomly divided into two groups. Hemodynamic parameters, including mean arterial pressure, heart rate, respiration rate, and oxygen saturation, were recorded in all patients. In 50 patients (group 1), 2 mg of midazolam was administered intravenously 5 minutes before ESWL. In group 2 (n = 48), music chosen by the patients was listened to with a headset and continued during the treatment. The visual analog scale (0 to 100 mm), Observer's Assessment of Alertness/Sedation Scale, State and Trait Anxiety Inventory-Trait Anxiety test, and State and Trait Anxiety Inventory-State Anxiety test were administered for the evaluation of pain, sedation level, and patient anxiety. Results. For the hemodynamic parameters, a statistically significant decrease in mean arterial pressure was noted at the end of the ESWL procedure in group 2 and in oxygen saturation from the 10th minute to the end of the treatment in group I. Although the visual analog scale, Observer's Assessment of Alertness/Sedation Scale, and State and Trait Anxiety Inventory-State Anxiety test did not show statistically significant differences, the State and Trait Anxiety Inventory-Trait Anxiety score was found to be lower in the music group (group 2) than in the midazolam group (group 1). Conclusions. With the anxiolytic effects of music, ESWL can be performed more effectively with the patient in a comfortable state. Listening to music by patients during the ESWL session is a feasible and convenient alternative to sedatives and anxiolytics.
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    Prostatic urethral leukoplakia with prostatic abscess
    (Taylor & Francis As, 2002) Küpeli, S.; Yilmaz, E.; Atasoy, P.; Tulunay, O.
    We present a case of prostatic abscess and coexistent leukoplakia of the urethra in a 51-year-old man. He had been suffering from diabetes mellitus for 10 years and following cessation of high fewer, transurethral electrovaporesection was performed.
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    Protective effects of udenafil citrate, piracetam and dexmedetomidine treatment on testicular torsion/detorsion- induced ischaemia/reperfusion injury in rats
    (Wiley-Blackwell, 2016) Tuglu, D.; Yuvanc, E.; Ozan, T.; Bal, F.; Yilmaz, E.; Atasoy, P.; Batislam, E.
    The aim of this study was to investigate the antioxidant properties of udenafil citrate (1.4 mg kg(-1)-2.8 mg kg(-1)), dexmedetomidine 25 mu g kg(-1) and piracetam 200 mg kg(-1) administered on ipsilateral/contralateral testes after ischaemia in a rat model of testicular torsion/detorsion (T/D) and define its protective effect histologically. Fifty-six Wistar albino rats were included and randomly assigned into 6 groups. No intervention was performed in control group (Group 1, n = 8) and in torsion/detorsion group, (Group 2, n = 8). Udenafil 1.4 mg kg(-1) was given to torsion/detorsion group (Group 3, n = 10), udenafil 2.8 mg kg(-1) was given to torsion/detorsion group (Group 4, n = 10), piracetam 200 mg kg(-1) was given to torsion/detorsion group (Group 5, n = 10) and dexmedetomidine 25 mu g kg(-1) was given to torsion/detorsion group (Group 6, n = 10) intraperitoneally after 60 mins of testicular torsion. Biochemical and histopathological testicular injury were evaluated. When the tissue was examined by TOS values, Group 3, Group 4 and Group 5 were significantly lower than Group 2. In contrary Group 6 values were significantly higher than Group 2. The increasing doses of udenafil demonstrated antioxidant properties on the testis tissue and histopathological that protects the testicles.
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    Relationship between nocturnal penile tumescance (NPT) rigi scan monitoring results, symptom scores (IIEF) and Sildenafil responses
    (Wiley-Blackwell Publishing, Inc, 2004) Basar, M.; Tuglu, D.; Yilmaz, E.; Basar, H.; Batislam, E.
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    Relationship with international index of erectile function (IIEF) and international prostate symptom scores' (IPSS) degrees in patienst with BPH after 50 years old
    (Wiley-Blackwell Publishing, Inc, 2004) Basar, M.; Yilmaz, E.; Unal, S.; Basar, H.; Batislam, E.
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    Retinal nerve fiber layer thickness in the acute phase of sildenafil treatment
    (Verduci Publisher, 2015) Ornek, K.; Tuglu, D.; Ogurel, R.; Ornek, N.; Yilmaz, E.; Batislam, E.
    OBJECTIVE: To evaluate the early effect of sildenafil on the retinal nerve fiber layer (RNFL) thickness. PATIENTS AND METHODS: Sixty eyes of 60 patients were enrolled in the study. The patients underwent RNFL analysis by scanning laser polarimetry (Nerve Fiber Analyzer, GDx VCC: 5.3.3; Laser Diagnostic Technologies, San Diego, CA, USA) before and after a single 100 mg dose of sildenafil. Sixty eyes of 60 volunteers of similar age and sex distribution were taken as the control group. The RNFL thickness parameters evaluated included temporal, superior, nasal, inferior, temporal (TSNIT) average, superior average (SA), inferior average (IA), TSNIT standard deviation (SD), and nerve fiber index (NFI). RESULTS: The mean age of the patients was 53,52 +/- 9,26 years. The mean pre- and post-treatment TSNIT, SA, IA, TSNIT SD, and NFI of the patients were 57.46 +/- 4.94 mu versus 56.90 +/- 4.59 microns (mu), 68.93 +/- 6,12 mu versus 67,79 +/- 5,49 mu, 66,71 +/- 7.10 mu versus 66.31 +/- 6.82 mu, 24 +/- 3.86 mu versus 23.40 +/- 4.05 mu, and 16.50 +/- 6.08 mu versus 14.92 +/- 6.76 mu, respectively. There were no statistically significant differences between pre- and post-treatment RNFL thicknesses (p = 0.527, p = 0.281, p = 0.754, p = 0.416, p = 0.185, respectively). CONCLUSIONS: A single 100 mg dose of sildenafil seems to have no unfavorable effect on RNFL thickness in the acute phase of treatment.
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