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    Comparison of transcutaneous tibial nerve stimulation (TTNS) protocols for women with refractory overactive bladder (OAB): A prospective randomised trial
    (Wiley, 2021) Alkış, Okan; Sevim, Mehmet; Kartal, İbrahim Güven; Başer, Aykut; İvelik, Halil İbrahim; Aras, Bekir
    Objectives Transcutaneous tibial nerve stimulation (TTNS) is a noninvasive method used in OAB treatment. Purpose of this study is to compare the effectiveness of the TTNS procedure applied once a week and three times a week in women diagnosed with wet type refractory OAB. Methods A total of 60 patients diagnosed with wet type OAB that was refractory to medical treatment were included in the study. Participants were equally and randomly divided into two groups: TTNS treatment was performed with a duration of 30 minutes for 12 weeks, once a week to Group I and three times a week to Group II. Pretreatment and posttreatment OAB-V8/ICIQ-SF scores and voiding frequencies recorded in the bladder diary were compared between groups. Results Four patients in Group 1 and eight in Group 2 left the study without completing the treatment. TTNS was performed in both groups for 12 weeks. There was a significant decrease in the voiding frequency, OAB-V8, ICIQ-SF scores in both group 1 and group 2 (P < .001). A significant decrease in the OAB-V8 score was observed in the 5th week in Group 1, and in the 3rd week in Group 2. Complete response was observed in 6 patients (23.1%) in Group 1 after 12 weeks of TTNS procedure. In Group 2, 10 patients (45.5%) had a complete response. After the 12-week TTNS procedure, no significant difference was observed between the groups in terms of treatment response. Conclusion TTNS can be safely used before invasive treatments in resistant OAB. TTNS procedure three times a week seems more effective than performing it once a week. What's newWhat's known TTNS is one of the effective alternative treatments in resistant OAB treatment. As the number of sessions is increased in TTNS treatment, the success of the treatment can increase.
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    Holmium laser lithotripsy with semirigid ureterorenoscopy in treatment of upper ureteral and renal pelvis stones under spinal anesthesia
    (Sage Publications Ltd, 2020) Aras, Bekir; Alkış, Okan; İvelik, Halil İbrahim; Sevim, Mehmet; Başer, Aykut
    Extracorporeal shockwave lithotripsy and especially flexible ureterorenoscopy (URS) are first-choice treatments of upper ureteral and renal pelvis stones. In our study, we aimed to demonstrate that the treatment of upper ureteral and renal pelvis stones smaller than 2 cm could be performed by semirigid URS under spinal anesthesia. The data of 292 patients were retrospectively analyzed. Stones were localized in upper ureter and renal pelvis in 191 (65.4%) and 101 (34.6%) patients, respectively. The stone-free rate was found to be 72.6%. The final stone-free rate was 95.2% after additional treatments administered to 80 patients with residues. While no peri-operative complication was observed, hematuria was observed in three patients during the post-operative period, high fever was observed in 27 patients and sepsis was observed in four patients. It is a well-known fact that flexible URS is the first-choice surgical method in the treatment of upper ureteral and renal pelvis stones. In the current study, we aimed to investigate whether laser lithotripsy with semirigid URS could also be a good and cheap alternative in clinical practice, and if upper urinary tract surgeries could be performed with spinal anesthesia especially in patients with a high risk of general anesthesia.
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    Öğe
    Is prostate biopsy safe in the elderly?
    (2021) Alkış, Okan; Başer, Aykut; İvelik, Halil İbrahim; Aras, Bekir; Sevim, Mehmet; Kartal, İbrahim
    Purpose: The study was aimed to investigate the safety of the transrectal ultrasound-guided prostate needle biopsy in the elderly. Material and methods: Five hundered fifteen patients, who underwent prostate biopsy between 2017-2020, were included in the study. All patients' demographic data, comorbidities, laboratory findings, prostate volumes, prostate biopsy pathology results, and post-biopsy complications were retrospectively analyzed. The patients were divided into 2 groups: group-1 consisting of patients under the age of 65 and group-2 with above the age of 65. Results: There were 244 in group-1 and 271 patients in group-2. The mean age of group-1 was 59.50±3.98, group-2 was 71.45±4.57 years. In group-1, post-biopsy fever was observed in 5 (2%), hematuria in 44 (18%), hemospermia in 79 (32.4%), and rectal bleeding in 7 (2.9%) patients. In group-2, post-biopsy fever was observed in 15 (5.5%), hematuria in 69 (25.5%), hemospermia in 21 (7.7%), and rectal bleeding in 11 (4.1%) patients. The severe sepsis findings were observed in 2 patients (0.2%) in group-1 and 6 (2.2%) in group-2. In the logisticregression-analysis, it was determined that the risk of complication increased significantly as the age, PSA, and higher PSA density. Conclusion: In our study, it was revealed that the risk of complications was higher in the elderly and that the complications observed may be more seriously. Therefore, we consider that a more careful approach should be taken in elderly patients to prevent the complications related with prostate biopsy.