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    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, Fatih
    Objective: 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.
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    Öğe
    A SAFE AND EFFECTIVE METHOD FOR REMOVING ORGANIZED BLOOD HEMATOMA FROM THE BLADDER: THE CLOT MORCELLATION TECHNIQUE
    (2023) Ors, Bumin; Akıncıoğlu, Emir; Yildirim, Umit; Uslu, Mehmet; Eskıdemır, Umıt; Gökalp, Fatih
    Introduction: Urinary retention caused by bladder clots can be an extremely challenging medical condition when these blood clots are difficult to remove. We established an alternative technique to evacuate blood clots from the bladder by using morcellator devices following endoscopic urologic operations when all other conventional methods failed. Material and Method: The clot morcellation technique (CMT) used to treat 12 male patients who had severe clot retention and failed with conventional techniques following TUR-P, TUR-B, or laser prostatectomy. We describe how to use the morcellator to manage bladder blood clots and discuss this novel technique's outcomes. Results: We successfully used this technique to remove a large quantity of hematoma and empty the bladder in all patients with clot retention. The median time of clot removal was 6.9±4.4 minutes. The median estimated volume of hematomas was 80mL (range 20-400). There were no preoperative or postoperative complications. Conclusion: The evacuation of clotted blood in the bladder can be complicated and operational interventions need to be applied. However, having a clot-free bladder at the end of the procedure can be time-consuming and may not always be guaranteed. When other traditional treatments fail to completely remove the blood clot, the CMT is a rapid, easy, safe, and effective method to remove the blood clot entirely