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    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, Bilal
    Objective: 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.
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    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, Nezih
    Background 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.
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    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, Ekrem
    Objective: 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.
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    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, Bilal
    Background 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.