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Öğe Are HoLEP Surgical Videos on YouTube Biased and Misleading or Are They Leading the Industry?(Galenos Yayincilik, 2022) Koras, Omer; Gokalp, Fatih; Yildirak, Ekrem; Sigva, Hakan; Tamkac, Nezih; Porgali, Sefa Burak; Kulak, BilalObjective: In this study, we aimed to evaluate the content and quality of the most relevant YouTube videos related to holmium laser enucleation of the prostate (HoLEP) surgery. Materials and Methods: The keywords HOLEP, laser enucleation and prostate enucleation were used to perform a search on YouTube. NonEnglish language videos, videos with less than 4-minute duration, and repetitive videos were excluded. The reactions of the viewers to the videos were evaluated by recording the total views, views/month and likes and dislikes parameters. The data were divided into two groups based on the source of upload: Group 1 consisted of healthcare providers and group 2 comprised of commercial companies and for-profit organizations. Results: A total of 117 videos were included in the study. A significant portion of the videos (77.7%) had been uploaded by healthcare providers. There was no statistically significant difference between the uploading groups in terms of the DISCERN and the Global Quality score, scores (p=0.484 and p=0.108, respectively). However, Patient Education Materials Assessment Tool for Audiovisual Materials understandability and actionability scores were statistically significantly higher in group 2 (p=0.004 and p=0.022, respectively). In addition, when the misinformation scale was evaluated, there were significantly more videos with high-degree misinformation in group 2 (5.5% vs 33.3%, p=0.001). Conclusion: On video sharing platforms, such as YouTube, the number of reliable videos with accurate and appropriate guidance about diseases and treatments should be increased, and these videos should be allowed to be posted after they have been approved by relevant institutions, including healthcare associations and universities.Öğe Are the Testicular Self-examination Videos on YouTube Misleading?(Galenos Publ House, 2023) Gokalp, Fatih; Akarken, IlkerObjective: For early diagnosis, testicular self-examination (TSE) is crucial. Videos of TSE have increased on social media platforms. In this study, we assessed the reliability of TSE videos on YouTube.Materials and Methods: The keywords including testicular self-examination, and testis mass were used for searching on YouTube (http://www.youtube.com). A total of 1311 videos were investigated, and a total of 207 videos were included in the study. Shorter videos (below 1.30 minutes) and irrelevant videos were not included in the study.Results: The median number of views was 1846 (interquartile range: 406-30310). Most of the videos were uploaded by profit organizations (57.5%). The DISCERN score and Global Quality Score (GQS) were significantly higher in the health professional group (p=0.003, and p<0.001, respectively). In addition, the degree of information was generally low in both groups. However, misinformation was statistically lower in the health professional group.Conclusion: YouTube is a popular platform for promoting videos about TSE. In particular, not checking health-related videos while uploading causes poor quality videos to be uploaded. Videos of TSE have a low degree of misinformation. However, the DISCERN and GQS were also low.Öğe Bariatric surgery has positive effects on patients' and their partners' sexual function: A prospective study(Wiley, 2021) Gokalp, Fatih; Koras, Omer; Ugur, Mustafa; Yildirak, Ekrem; Sigva, Hakan; Porgali, Sefa B.; Tamkac, NezihBackground Obesity has been associated with severe conditions and sexual dysfunction. Bariatric surgery has effects positively patients' sexual function. Objectives To assess the effect of bariatric surgery on sexual functions of couples. Materials and Methods The study included 57 obese patients and their sexually active partners. Male participations were assessed with the International Index of Erectile Function (IIEF) and Male Sexual Health Questionaries (MSHQ-4), and female participations were assessed with the Female Sexual Function Index (FSFI). Results There were 31 (54.4%) male patients and 26 (45.6%) female patients in the study. The median IIEF score of the male patients statistically increased postoperatively (p < 0.001). The IIEF subgroup areas were found to have increased after surgery. The median FSFI score of the female patients statistically increased postoperatively (p < 0.001). The median FSFI of male patients' partners significantly increased postoperatively (p < 0.001). All FSFI domains were statistically significantly increased (p < 0.001, all areas). The median IIEF value of the postoperative partners of the female patients also increased statistically significant (p < 0.001). In addition, the increases in the IIEF's subdomains in terms of sexual desire (p < 0.001), intercourse satisfaction (p < 0.001), and general satisfaction (p < 0.001) were statistically significant. Conclusion The sexual functions of both males and females and also their' partners were improved after bariatric surgery. Patients with preoperative poor sexual function achieve significant benefits over patients without sexual dysfunction.Öğe Comparison of Preoperative Urine Culture and Intraoperative Renal Pelvis Culture in Patients Who Underwent Flexible Ureterorenoscopy(Galenos Publ House, 2022) Gokalp, Fatih; Koras, Omer; Polat, Salih; Sahan, Murat; Baba, Dursun; Bozkurt, Ibrahim Halil; Eker, AnilObjective: There is no correlation between the preoperative bladder urine culture (PBUC) sensitivity test and the results of the renal pelvic urine culture (RPUC) test. Materials and Methods: A total of 129 patients who underwent f-URS included the study. Preoperatively, PBUC was collected in all cases, and RPUC was taken when starting the surgery. Results: In PBUC, there was growth in 25 (19.4%) patients and in RPUC, there were only in 35 (27.1%) cases. Preoperative tomographic urine density at the renal pelvis [odds ratio (OR): 0.848, p<0.001], grade >= 2 hydronephrosis (OR: 18.970, p=0.001), and lower calyceal stone location (OR: 0.033, p=0.017) were determined as independent predictive factors for RPUC growth. The ability of tomographic urine density to foresee positive RPUC positivity was determined to be 0.858 (0.780-0.936). The tomographic urine density threshold for RPUC positivity prediction was 4.5, with 80% sensitivity and 77.7% specificity. Conclusion: PBUCs do not necessarily mean accurate colonization. Obtaining renal pelvis urine samples is important for managing postoperative infectious complications. Patients that have preoperative hydronephrosis and nominal tomographic urine density could develop RPUC even if the preoperative bladder urine samples are negative.Öğe Correlation of Multiparametric Prostate MRI with Prostate Biopsy and Radical Prostatectomy Histopathology(Galenos Publ House, 2024) Sigva, Hakan; Gorur, Sadik; Gokalp, Fatih; Tamkac, Nezih; Porgali, Sefa Burak; Yildirak, EkremObjective: Prostate cancer (PCa) is the most common cancer responsible for cancer deaths in men after lung cancer. In this study, we aimed to obtain information about the Gleason score of PCa by prostate image reporting and data system (PIRADS) scoring of multiparametric magnetic resonance imaging (mpMRI) by comparing mpMRI results with the histopathology of prostate biopsy and radical prostatectomy specimen. Materials and Methods: A total of 214 patients who applied to the outpatient clinic of Hatay Mustafa Kemal University Faculty of Medicine, Department of Urology between January 2019 and April 2021 with elevated prostate-specific antigen (PSA) levels were included in the study. All patients underwent mpMRI before the biopsy procedure. PIRADS scoring was performed by the same radiologist. Prostate biopsy was systematically performed by experienced urologists as 12 quadrant biopsies. Results: When the mpMRI results of the patients are evaluated; the most common patterns are seen as PIRADS 2 and PIRADS 4, followed by PIRADS 3 lesions, followed by PIRADS 5 lesions, and PIRADS 1 lesions, which were the least frequent. When the analysis was applied to predict PCa over the pyrans value, the receiver operating characteristics analysis result for the diagnosis of the disease showed statistically significant levels of area under the curve (0.860; p<0.001), with a sensitivity of 81% and a sensitivity of 3 and above PIRADS 3 and above. It can predict cancer with 75 specificity. In the correlation analysis, there was a low but significant correlation between PIRADS and PSA value (r=0.252; p<0.001). Conclusion: We found that patients presenting with elevated PSA levels and mpMRI had a high power in detecting PCa. We also found a strong relationship between ISUP rating and PIRADS. As a result, it is thought that the pathology of the patients can be predicted using mpMRI.Öğe The effect of intravesical cocktail therapy combined with low-dose amitriptyline on primary bladder pain syndrome(Springer London Ltd, 2022) Abat, Deniz; Altunkol, Adem; Gokalp, FatihIntroduction and hypothesis We compared the effectiveness of intravesical combination treatment and intravesical treatment plus low-dose amitriptyline in patients with primary bladder pain syndrome (PBPS). Methods A total of 53 patients were included in the study. Demographic data, voiding frequency, nocturia, visual analog scale (VAS) scores, validated O'Leary-Sant IC Symptom Index (ICSI), and IC Problem Index (ICPI) scores and scores on the Short Form-36 (SF-36) questionnaire were collected from the patients at the beginning of the treatment, and at the 6th week and 6th month of the treatment. The patients were divided into two groups. Group 1 received intravesical treatment for 6 weeks. Group 2 received intravesical treatment plus amitriptyline at a dosage of 10 mg/day. Results The frequencies of voiding and VAS scores were significantly improved in groups 1 and 2 at the 6th week compared with pretreatment (in group 1 p < 0.001, p < 0.001, and in group 2 p < 0.001, p < 0.001 respectively). The median ICSI and ICPI scores also significantly decreased in groups 1 and 2 (in group 1 p < 0.001, p < 0.001, and in group 2 p < 0.001, p < 0.001 respectively). Scores on the dimensions of the SF-36 questionnaire were significantly improved in both groups. There was no significant change in terms of VAS, nocturia, ICSI or ICPI scores when comparing the 6th week and 6th month results in groups 1 and 2 (all p > 0.05). Only role functioning/emotional achieved a significant improvement in group 2 (p = 0.007). Conclusions Intravesical combination therapies are effective in PBPS treatment. Adding low-dose amitriptyline to intravesical therapy in patients with PBPS improves emotional status.Öğe Elastographic evaluation of the effect of sickle cell anemia on testicles: a prospective study(Wiley, 2022) Koras, Omer; Gorur, Sadik; Bayramogullari, Hanifi; Ilhan, Gul; Gokalp, Fatih; Kacmaz, Murat; Ilgezdi, AlicanTo quantitatively determine testicular tissue stiffness values using shear wave elastography (SWE) in males that have sickle cell anemia (SCA) and to evaluate the relationship between elastography results and semen analysis parameters and hormone levels. Fifty patients diagnosed with SCA and followed up in the hematology outpatient clinic were evaluated in the urology outpatient clinic as the study group. In addition, there were 88 patients without any SCA-related complaints in the control group. We compared these groups with respect to their values, spermiogram parameters, testicular volume, and SWE values. Among patients in the SCA group, 28% had impaired sperm parameters. When testicular elastography was assessed, the testicular volumes were materially lower in the SCA group in comparison to the control group [right testicular volume: 14.76 (12.77-18.12) and 19.68 (15.12-24.18), respectively, p < 0.001; left testicular volume: 14.11 (11.06-17.32) and 16.59 (13.38-20.13), respectively, p = 0.015]. Additionally, the left testis central stiffness and the left testis inferior stiffness were significantly higher in the SCA group (p < 0.001 and p = 0.014, respectively). The age and hydroxyurea use had a worse effect on sperm parameters in patients with SCA (odds ratio: -0.161 and -1.914, standard deviation: 0.071 and 0.921, and p = 0.024 and p = 0.038, respectively). We consider that the technique utilized in this study for SWE values is fast and can be adopted as a reliable diagnostic tool and follow-up practice in routine clinical practice to evaluate the acuteness of damage to the testicles in patients having SCA.Öğe Factors affecting long-term renal functions after partial vs radical nephrectomy for clinical T1 renal masses: A Multicentre Study of the Urooncology Association, Turkey(Wiley-Hindawi, 2021) Izol, Volkan; Gokalp, Fatih; Sozen, Sinan; Ozden, Ender; Bayazit, Yildirim; Muezzinoglu, Talha; Kara, OnderPurpose To compare the functional outcomes of patients who underwent partial (PN) or radical nephrectomy (RN) for clinical T1 (cT1) renal tumours using the Kidney Cancer Database of the Urooncology Association, Turkey. Methods We retrospectively reviewed 1004 patients who underwent PN and RN for cT1 renal tumours at multiple academic tertiary centres between 2000 and 2018. Patients with preoperative end-stage chronic kidney disease and/or metastatic disease were excluded. Results There were 452 patients in the PN group and 552 patients in the RN group. The median follow-ups were 74.9 and 83.7 months in RN and PN cohort. The eGFR was significantly reduced in both groups on postoperative day 1 (PN = 13.7 vs RN = 19.1 mL/min/1.73 m(2): P < .001). In the PN group, eGFR showed a tendency to recover according to a quadratic pattern and reached preoperative levels in the first and third years (95.6 +/- 28.8 mL/min/1.73 m(2) and 96.9 +/- 28.9 mL/min/1.73 m(2), respectively), with no significant difference between the eGFRs in the 1st and 3rd years (P = .710). To define groups at risk, different cut-off values for the GFR were considered. Among patients with a baseline GFR < 90, the RN cohort had significantly lower eGFRs in the first and third years than the PN cohort (P = .02). Logistic regression showed that comorbidities, coronary artery disease, diabetes and hypertension had no adverse impacts on the changes in the eGFR (P = .60, P = .13, and P = .13, respectively). Conclusion For the treatment of stage T1 kidney tumours, open or laparoscopic partial nephrectomy has the benefit to preserve renal function.Öğe How did the COVID-19 pandemic affect audience's attitudes in webinars?(Wiley-Hindawi, 2021) Tanidir, Yiloren; Gokalp, Fatih; Akdogan, Nebil; Batur, Ali Furkan; Sekerci, Cagri Akin; Egriboyun, Sedat; Deger, MutluIntroduction Following the COVID-19 pandemic, the face-to-face meetings are delayed to a future date, which is still not clear. However, seminars, meetings and conferences are necessary for updating our knowledge and skills. Web-based seminars (webinars) are the solutions to this issue. This study aimed to show the participant behaviour when webinars present at the COVID-19 pandemic era. Methods From December 2017 to July 2020, 58 webinars were broadcasted via the Uropedia, electronic library of SUST. Data of all webinars were collected with the YouTube analytics and application of the Uropedia. Data of streaming webinars included participant behaviours such as content views, engagement time, total unique attendees, average engagement time and the number of audience to leads. Data were split into two groups; group-1 is webinars before COVID-19 (before March 2020) and group-2 is the webinars during COVID-19. Results Total broadcast time and total page view number were found to be 112.6 hours (6761 minutes) and 15 919, respectively. The median participant age was 40.1 y. Median content view and median engagement time were found to be 261.0 and 12.2 minutes, respectively. Comparison of two groups revealed a significant increment in the content views (group-1; 134.0 range = 86.0-87.0 and group-2; 414.0 range = 296.0-602.0, P < .001) and the number of the unique attendees (group 1; 18.0 range = 10.0-26.0 and group-2; 57.0 range = 27.0-100.0, P < .001) following COVID-19. However, the median engagement time of the audience did not seem to change with the COVID-19 pandemic (group-1; 11.5 range = 10.0-13.3 minutes and group-2; 13.2 range = 9.4-18.1 minutes, P = .12). Conclusion The webinars are effective ways to share information and have many advantages, including low cost, reaching a high number of audiences. Audience number and page visits seemed to increase following the COVID-19 pandemic. However, this era did not seem to affect the critical attitude of the audience, which is engagement time.Öğe How Is High Power (200w) Thulium Laser Vapoenucleation of the Prostate Impacting Functional Parameters? Short-Term Follow-Up Results(2023) Yıldırım, Ümit; Ezer, Mehmet; Uslu, Mehmet; Örs, Bumin; Gokalp, FatihObjective: There are limited studies in the literature analyzing the results of the high- power Thulium:YAG laser vapoenucleation technique. In this current study, it was aimed to examine the effectiveness and reliability of 200 W Thulium:YAG laser vapoenucleation used in the treatment of benign prostatic hyperplasia and the effect of this procedure on lower urinary tract symptoms, erectile and ejaculatory functions. Material and Methods: Data were collected prospectively from patients who underwent Thulium vapoenucleation (ThuVEP) in our clinic between December 2021 and June 2022 to treat signs and symptoms of benign prostatic hyperplasia. Following the application of the exclusion criteria, a sample size of 50 cases was obtained, and the data were analyzed retrospectively. In the first and sixth months following surgery, all patients were compared to their preoperative status in terms of lower urinary tract symptoms, erectile function, and ejaculatory symptoms. The Modified Clavien- Dindo Classification was also used to classify the complications that occurred. Results: The patients’ IPSS scores showed a notable and significant improvement at the end of the 6-month follow-up (27 vs. 5; p<0.001). When compared to the preoperative state, erectile functions as measured by the IIEF-5 score did not significantly change with the surgery (17 vs. 18; p=0.067). At the end of the follow-up period, there was a substantial deterioration of ejaculatory functions as measured by the MSHQ-EjD score (10 vs. 6.5; p<0.001). During and after the procedure, complications at the Clavien 3a level were seen in 2 (4%) of the patients, but no complications above this level were seen. Conclusion: The high-power (200 W) ThuVEP method used in the surgical treatment of symptomatic benign prostatic hyperplasia is reliable and effective in terms of functional results according to short-term results.Öğe A novel enema method can prevent infectious complications of transrectal ultrasound-guided prostate biopsy: A single-centre experience(Wiley, 2021) Gokalp, Fatih; Koras, Omer; Gursoy, Didar; Sigva, Hakan; Porgali, Sefa Burak; Tamkac, Nezih; Kulak, BilalBackground TRUS biopsy is the preferred method for diagnosing prostate cancer, but it can cause infectious complications that arise with the contribution of fluoroquinolone resistance. We aimed to explore the potential protective effect of a second rectal enema before biopsy. Methods From January 2015 to December 2020, 419 patients were assessed retrospectively. Patients with a history of anticoagulant use, uncontrolled diabetes, urological surgery, prostate biopsy or recent hospitalisation or overseas travel, as well as those with the previous prostatitis, were excluded from the study. The patients were subsequently divided into two groups: Group 1 (n = 223) had received one enema, on the morning of the biopsy and Group 2 (n = 196) had received two, with the additional enema administered half an hour before the procedure. Results There was no significant difference between the groups in terms of age(P = .076), BMI (P = .489), diabetes (P = .265), prostate-specific antigen (PSA) level (P = .193), free/total PSA (f/t PSA) ratio (P = .518) and prostate size (P = .661) or in relation to cancer detection (P = .428). The median hospitalisation date was significantly higher in Group 1 (P = .003) as was urinary tract infection (UTI) development (P = .004). However, there was no significant difference in terms of fever and sepsis (P = .524 and P = .548, respectively). Additionally, subgroup analysis demonstrated that UTI was significantly lower in patients with diabetes mellitus who had received a second enema (P = .004), though there was no significant difference in UTI between the groups in those without diabetes mellitus (P = .215). Multivariable analysis showed that age and diabetes were significant risk factors for the development of UTI (OR: 1.074, 95% CI: 1.027-1.130, P = .002 and OR: 1.220, 95% CI: 0.131-0.665, P = .003, respectively). Furthermore, the second enema was a significant protective factor for preventing UTI (OR: -1.794, 95% CI: 2.208-16.389, P < .001). Conclusion Older age and the presence of diabetes mellitus are independent risk factors for UTI after prostate biopsy. A second enema procedure before biopsy may protect patients from related infectious complications and could therefore be used as an alternative preventative method.Öğe Oncological Outcomes of Patients with Non-Clear Cell Renal Cell Cancers: Subtypes of Unclassified and Translocation Renal Cell Cancers(Urol & Nephrol Res Ctr-Unrc, 2023) Gokalp, Fatih; Celik, Serdar; Sozen, Tevfik Sinan; Ozen, Abdurrahim Haluk; Aslan, Guven; Izol, Volkan; Baltaci, SumerPurpose: We aimed to compare oncological outcomes in the two rare subtypes, unclassified renal cell cancer (un-RCC) and translocation RCC (tRCC), vs clear cell RCC (ccRCC). Materials and Methods: Between 2004 and 2019, from Turkish Urooncology Society Database, we identified 2324 patients for histological subtypes including 80 unRCC (3.4%), 19 tRCC (0.8%) and 2225 ccRCC (95.8%). Results: The overall (15.8%) and cancer-specific mortalities (11.1%) were found to be higher in tRCC group and the recurrence free mortality (13.8%) was found to be higher in unRCC group. Larger pathological tumor size (p = 0.012) and advanced pathological T stage (p = 0.042) were independent predictive factors on overall mortality in patients with unRCC tumors. Conclusion: The oncological outcomes of the unRCC and tRCC are worse than ccRCC and pathological tumor size and pathological stage are predictive factors for mortality in the unRCC.Öğe Recent Advances in Elongated and Round Spermatid Injection(Galenos Yayincilik, 2021) Gokalp, Fatih; Gorur, SadikAzoospermia is commonly identified in patients with infertility. Non-obstructive azoospermia (NOA) includes primary or secondary and incomplete testicular failure. Before testicular sperm extraction (TESE), donor insemination is the only option available in men with NOA. The combination of microTESE and intracytoplasmic sperm injection has considerably increased the fertilization rate. However, mature spermatozoa can be found in half of the patients. This situation prompted experts to use spermatids to assist in reproductive techniques. Elongated spermatid injection (ELSI) and round spermatid injection (ROSI) are among the possible treatments for couples who cannot find mature spermatozoa after microTESE in patients with NOA. This review provides an updated summary of the most recent available topics on ELSI and ROSI in the literature.
