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Article ; Online: A Different Obturator Nerve Block Approach Using Nerve Stimulation Device Under Fluoroscopy Guidance in the Transurethral Resection of Lateral Bladder Wall Tumors

Cuneyd Sevinc / Tahir Karadeniz

Haseki Tıp Bülteni, Vol 59, Iss 2, Pp 122-

2021 Volume 127

Abstract: Aim:This study aims to define the efficacy and safety of a different obturator nerve block technique using fluoroscopy and nerve stimulation device during transurethral resection of bladder tumor (TUR-BT).Methods:Sixty patients with lateral bladder wall ... ...

Abstract	Aim:This study aims to define the efficacy and safety of a different obturator nerve block technique using fluoroscopy and nerve stimulation device during transurethral resection of bladder tumor (TUR-BT).Methods:Sixty patients with lateral bladder wall tumors who had TURBT were retrospectively analyzed for the formation of obturator reflex. Thirty patients received spinal anesthesia (SA) and 30 patients received SA combined with an obturator nerve block (ONB). ONB was performed in the lithotomy position. A percutaneous needle was advanced to the superolateral portion of the obturator foramen under fluoroscopic guidance. The nerve was localized with a nerve stimulation device and 5 mL of 2% prilocaine was injected to perineural area. Additionally, the tumor base was marked intravesically by resectoscope with fluoroscopy and 5 mL of %2 prilocaine was administered to nearby tissue. Obturator reflex formation reflex-related related complications were compared between the two groups.Results:The results of our study yielded a statistically significant difference in the favor of ONB compared to SA alone for the occurrence of obturator reflex (13% vs 43%, p=0.020), bladder perforation (0% vs 23.3%, p=0.002), and absence muscle tissue in the pathological specimen (10% vs 40%, p=0.01).Conclusion:ONB with the help of a nerve stimulation device, directed by fluoroscopy is effective to prevent obturator reflex and related complications.
Keywords	fluoroscopy ; obturator nerve ; reflex ; urinary bladder neoplasms ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	616
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	Galenos Yayinevi
Document type	Article ; Online
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Article ; Online: An Open Radical Prostatectomy Approach that mimics the Technique of Robot-assisted Prostatectomy: A Comparison of Perioperative Outcomes.

Özkaptan, Orkunt / Balaban, Muhsin / Sevinc, Cuneyd / Karadeniz, Tahir

Urology journal

2019 Volume 16, Issue 2, Page(s) 168–173

Abstract: Purpose: To report on an ascending radical retropubic prostatectomy (RRP) technique and determine whether this technique has better perioperative, oncological and functional outcomes than the standard RRP technique applied in our clinic Material and ... ...

Abstract	Purpose: To report on an ascending radical retropubic prostatectomy (RRP) technique and determine whether this technique has better perioperative, oncological and functional outcomes than the standard RRP technique applied in our clinic Material and Methods:The perioperative and functional outcomes of the 246 patients that underwent standard RRP (N = 150) or modified RRP (N = 96) were evaluated, retrospectively. In the modified RRP technique the dorsal vasculare complex (DVC) was controlled at first. Thereafter, the bladder neck was incised at the prostate-vesical junction. After seminal vesicles and vasa were exposed, posterior dissection was continued until to the apex. Finally, the urethra was divided. To assess the differences between the two groups the independent sample T-test and chi-square test were used. Results: The mean volume of estimated blood loss (EBL) was significantly longer in the standard RRP group than in the modified RRP group (610 vs. 210 ml, respectively; P= .001). The mean operative time (OT) was significantly less in the modified RRP group (177 vs. 134 min, respectively; P = .003), as were the transfusion rate TR (P = .041). With regard to the rate of postoperative complications, a statistically significant difference was observed between the two groups (P = .014). Continence rates after 3 and 12 months postoperatively were 98.95% and 98.95 % in the modified RRP group, and 97.33% and 98.66% in the standard RRP group, respectively ( P = .83). Conclusion: We observed that the EBL, TR and OT were significantly lower when we applied the modified RRP technique to patients. This modified technique might be applicable for institutions as an alternative procedure for the standard RRP technique.
MeSH term(s)	Aged ; Humans ; Male ; Middle Aged ; Prostatectomy/methods ; Prostatic Neoplasms/surgery ; Retrospective Studies ; Robotic Surgical Procedures ; Treatment Outcome
Language	English
Publishing date	2019-05-05
Publishing country	Iran
Document type	Comparative Study ; Journal Article
ZDB-ID	2251940-3
ISSN	1735-546X ; 1735-1308
ISSN (online)	1735-546X
ISSN	1735-1308
DOI	10.22037/uj.v0i0.4739
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Article ; Online: Minimally invasive approach for the management of urological complications after renal transplantation: single center experience.

Özkaptan, Orkunt / Sevinc, Cuneyd / Balaban, Muhsin / Karadeniz, Tahir

Minerva urologica e nefrologica = The Italian journal of urology and nephrology

2018 Volume 70, Issue 4, Page(s) 422–428

Abstract: Background: The aim of the study was to characterise urological complications after renal transplantation and to evaluate the role of minimally invasive management for urological complications.: Methods: A total of 920 kidney transplantations were ... ...

Abstract	Background: The aim of the study was to characterise urological complications after renal transplantation and to evaluate the role of minimally invasive management for urological complications. Methods: A total of 920 kidney transplantations were performed between 2008 and 2015. All patients were followed up for at least 1 year after transplantation. Complications regarded as urological were urinary leakage, ureteral stricture, urinary malignancy, bladder outlet obstruction (BOO) and urinary calculi. We evaluated data from the time of occurrence of urological complications and the type of the management prescribed. Results: Among 920 transplantations performed in our clinic, 41 (4.4%) urological complications arose. Twenty (48.8%) of the complications occurred during the first 3 months and 21 (51.2%) occurred after 3 months, postoperatively. Ureteral strictures were found in 14 (34.1%) patients, urinary tract stones in seven (17%), BOO in 6 (14.6%) and urinary leakage was observed in 5 (12.1%) patients. Ureteral stricture was managed with endoscopic approach in eight (61.3%) patients. Urinary tract stones and urinary leakage were managed in 7 (100%) and 4 (75%) patients with endoscopic approach. Overall 29 (70.7%) of 41 urological complications were managed with endourological approaches. Conclusions: It is likely that the importance of open surgery could decrease in the future. Endoscopic management of urological complications have come to have an important role in the treatment of urological complications after transplantation.
MeSH term(s)	Adult ; Aged ; Endoscopy ; Female ; Humans ; Kidney Transplantation/methods ; Lithiasis/etiology ; Lithiasis/surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures/methods ; Postoperative Complications/surgery ; Retrospective Studies ; Urologic Diseases/diagnostic imaging ; Urologic Diseases/etiology ; Urologic Diseases/surgery ; Urologic Surgical Procedures/methods
Language	English
Publishing date	2018-03-28
Publishing country	Italy
Document type	Journal Article
ZDB-ID	632505-1
ISSN	1827-1758 ; 0393-2249 ; 0026-4989
ISSN (online)	1827-1758
ISSN	0393-2249 ; 0026-4989
DOI	10.23736/S0393-2249.18.03078-3
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Article ; Online: Pelvic dimensions do not impact on complications and operative difficulty in radical cystoprostatectomy and orthotopic neobladder.

Özkaptan, Orkunt / Balaban, Muhsin / Sevinc, Cüneyd / Topsakal, Medih / Karadeniz, Tahir

Minerva urologica e nefrologica = The Italian journal of urology and nephrology

2019 Volume 71, Issue 4, Page(s) 386–394

Abstract: Backround: To evaluate the factors including pelvic dimensions, which might influence operative difficulty and complications after open radical cystoprostatectomy and orthotopic neobladder reconstruction in men.: Methods: A total of 198 RC patients ... ...

Abstract	Backround: To evaluate the factors including pelvic dimensions, which might influence operative difficulty and complications after open radical cystoprostatectomy and orthotopic neobladder reconstruction in men. Methods: A total of 198 RC patients operated in our institution with preoperative magnetic resonance (MRI) were analyzed were included in the study. Pelvic dimensions, including interspinous distance (ISD), bony femoral - (BFW) and soft tissue width (SW), apical prostate depth (AD), upper conjugate (UC), lower conjugate (LC) were measured by preoperative MRI. BFW, ISD, and SW indexes were defined as BFW/AD, ISD/AD, and SW/AD, respectively. Complicatons were classified according to the Clavien-Dindo classification system. As indicators of surgical difficulty; transfusion rate (TR), estimated blood loss (EBL), operative time (OT) and hospital stay (HS) were assessed. SPSS version 17.0 was used for statistical analyses. Results: A total of 239 complications developed in 143 of the 198 patients (72.2%). Correlation analysis revealed a significant indirect relationship between TR and SW/AD (P=0.023). For EBL, there were significant indirect correlations between the SW/AD, BFW/AD and ISD/AD indexes (P=0.026, P=0.05, P=0.009; respectively). Additionally, OT was directly correlated body mass index (BMI) (P=0.001); and indirectly correlated with UC, SW/AD, and BFW/AD (P=0.047, P=0.038, P=0.016, respectively). On multivariate logistic regression analyses higher American Society of Anesthesiologist (ASA) score was associated with major complications. Multivariate analyses revealed that pathological stage was a significant predictor of EBL. Conclusions: Patients with smaller pelvises might undergo more difficult surgeries. However, it seems that small sized pelvis does not impact on operative difficulty and complication rate in radical cystoprostatectomy and orthotopic neobladder.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Blood Loss, Surgical/statistics & numerical data ; Blood Transfusion/statistics & numerical data ; Humans ; Length of Stay ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Operative Time ; Pelvis/anatomy & histology ; Pelvis/diagnostic imaging ; Pelvis/surgery ; Postoperative Complications/epidemiology ; Prostate/diagnostic imaging ; Prostate/surgery ; Prostatectomy/methods ; Reconstructive Surgical Procedures/methods ; Urinary Bladder/diagnostic imaging ; Urinary Bladder/surgery
Language	English
Publishing date	2019-05-07
Publishing country	Italy
Document type	Journal Article
ZDB-ID	632505-1
ISSN	1827-1758 ; 0393-2249 ; 0026-4989
ISSN (online)	1827-1758
ISSN	0393-2249 ; 0026-4989
DOI	10.23736/S0393-2249.19.03195-3
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Article ; Online: Academic productivity and obstacles encountered during residency training: A survey among residents in orthopedics and traumatology programs in Turkey.

Demirtaş, Abdullah / Karadeniz, Hilmi / Akman, Yunus Emre / Duymuş, Tahir Mutlu / Çarkcı, Engin / Azboy, İbrahim

Acta orthopaedica et traumatologica turcica

2020 Volume 54, Issue 3, Page(s) 311–319

Abstract: Objective: This study aimed to investigate the academic productivity of and the obstacles encountered by orthopedic residents in Turkey.: Methods: Overall, 220 orthopedic specialists who were registered in the Ministry of Health and had started ... ...

Abstract	Objective: This study aimed to investigate the academic productivity of and the obstacles encountered by orthopedic residents in Turkey. Methods: Overall, 220 orthopedic specialists who were registered in the Ministry of Health and had started orthopedic residency between 2009 and 2010 were invited to participate in a survey through e-mail. The survey comprised a total of 19 questions to evaluate the academic works conducted and obstacles encountered during residency. Academic work was defined as an article published in the peer-reviewed journals as well as an oral or poster presentation at a national or international congress. Case reports, letters to the editor, and technical notes were excluded. Results: Data were obtained from 116 respondents who completed the survey. In peer-reviewed journals in Science Citation Index (SCI) or SCI-Expanded, the mean number of articles published with and without the first name per resident was 0.09 and 0.73, respectively. In peer-reviewed journals other than those in SCI and SCI-Expanded, the mean number of articles published with and without the first name per resident was 0.37 and 1, respectively. The mean number of oral and poster presentations per resident at national and international congresses was 2.63 and 4.67, respectively. No significant difference in the number of academic works was noted between the regions and institutions (p>0.05). A significant positive correlation was observed between the number of associate professors and assistant professors in the clinic and the total number of academic works (article plus presentation) (p<0.01 and p=0.017, respectively). Regarding encouragement and support to academic works, 6.9% of the respondents found the clinic to be excellent, 20.7% good, 24.1% moderate, and 48.3% bad. No significant difference in encouragement and support to academic works was noted among the institutions (p=0.115). The most common obstacle encountered in conducting academic works was long working hours (74.5%). Conclusion: Regardless of the region and institution, the participation of orthopedic residents in academic works is low in Turkey. Several obstacles were encountered in conducting academic works, with the most common being long working hours. Level of evidence: Level IV, Diagnostic study.
MeSH term(s)	Academic Performance ; Humans ; Internship and Residency/methods ; Internship and Residency/standards ; Needs Assessment ; Orthopedics/education ; Publications/statistics & numerical data ; Surveys and Questionnaires ; Traumatology/education ; Turkey
Language	English
Publishing date	2020-05-22
Publishing country	Turkey
Document type	Journal Article
ISSN	2589-1294
ISSN (online)	2589-1294
DOI	10.5152/j.aott.2020.03.243
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Article ; Online: Reporting Complications in Radical Cystoprostatectomy and Orthotopic Neobladder in Male Patients Using a Standard Reporting Methodology

Orkunt Özkaptan / Alkan Çubuk / Muhsin Balaban / Cüneyd Sevinç / Osman Murat İpek / Tahir Karadeniz

Southern Clinics of Istanbul Eurasia, Vol 31, Iss 1, Pp 31-

2020 Volume 35

Abstract: INTRODUCTION[|]This study aims to evaluate the 90-day complication rate and 3-month mortality after open radical cystoprostatectomy using a standardized method to report complications.[¤]METHODS[|]We retrospectively reviewed the data of 209 RC male ... ...

Abstract	INTRODUCTION[\|]This study aims to evaluate the 90-day complication rate and 3-month mortality after open radical cystoprostatectomy using a standardized method to report complications.[¤]METHODS[\|]We retrospectively reviewed the data of 209 RC male patients operated by the same surgical team between March 2008 and December 2017 in our institution. Patients' characteristics, clinical outcome, pathological parameters and reflectors of surgical difficulty were retrospectively collected from the hospital medical record. Postoperative complications were graded according to the Clavien-Dindo classification, whereas Martin criteria were used to report complications. SPSS version 22.0 was used for the statistical analyses.[¤]RESULTS[\|]A total of 239 complications developed in 143 of the 198 patients (72.2%). Thirtynine (19.7%) of these complications occurred after thirty days postoperatively. The mean operation time was 412.6+- minutes (300–485). Mean EBL was 1107+-617.3 ml (400–3600). Overall mean hospitalization time was 19.2+-7.3 days (7–30). Perioperative transfusion was given in 78.8% of the patients (n=156). Major complications (Clavien 3-5) were observed in 41 (20.7%) patients. The most common complication categories were gastrointestinal (28.8%). Ileus was the most common complication, occurring in 21.2% of the patients.[¤]DISCUSSION AND CONCLUSION[\|]Our results support the consideration of a more extended follow-up period to define the morbidity of RC. The standardization of the reporting criteria for complications will allow direct comparisons between studies. The complication rates after utilizing a standard reporting methodology were higher compared to studies that do not employ such methodologies.[¤]
Keywords	orthotopic neobladder ; postoperative complication ; radical cystoprostatectomy ; standard methodology ; Medicine ; R
Subject code	616
Language	English
Publishing date	2020-03-01T00:00:00Z
Publisher	KARE Publishing
Document type	Article ; Online
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Article ; Online: Radical Cystoprostatectomy in Patients with Behçet's Disease: The Report of Four Cases and Review of The Literature.

Sevinc, Cuneyd / Özkaptan, Orkunt / Balaban, Muhsin / Yucetas, Ugur / Karadeniz, Tahir

Urology journal

2016 Volume 13, Issue 5, Page(s) 2871–2875

MeSH term(s)	Adult ; Behcet Syndrome/complications ; Cystectomy/methods ; Female ; Humans ; Male ; Middle Aged ; Prostatectomy/methods ; Prostatic Neoplasms/complications ; Prostatic Neoplasms/surgery ; Urinary Bladder Neoplasms/complications ; Urinary Bladder Neoplasms/surgery
Language	English
Publishing date	2016-10-10
Publishing country	Iran
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	2251940-3
ISSN	1735-546X ; 1735-1308
ISSN (online)	1735-546X
ISSN	1735-1308
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Article ; Online: Outcome of penile prosthesis implantation: are malleable prostheses an appropriate treatment option in patients with erectile dysfunction caused by prior radical surgery?

Sevinc, Cuneyd / Ozkaptan, Orkunt / Balaban, Muhsin / Yucetas, Ugur / Karadeniz, Tahir

Asian journal of andrology

2017 Volume 19, Issue 4, Page(s) 477–481

Abstract: The aim of our study was to evaluate the outcome of penile prosthesis implantation in patients with various comorbidities as a cause of erectile dysfunction (ED). The data of 181 patients who underwent surgery between 1998 and 2012 in two centers were ... ...

Abstract	The aim of our study was to evaluate the outcome of penile prosthesis implantation in patients with various comorbidities as a cause of erectile dysfunction (ED). The data of 181 patients who underwent surgery between 1998 and 2012 in two centers were evaluated. The mean age of the patients was 52.2 years (range: 31-71 years). The study group contained 162 patients (89.5%) with malleable prostheses and 19 (10.5%) with inflatable implants. All patients were re-evaluated 1 month later to assess prosthesis function and complications, and further re-examinations were performed if needed. Satisfaction was defined as having satisfactory intercourse and happiness with the device in general. The follow-up period was at least 12 months for each patient. The postoperative complication rate was 32% (n = 58). The number of complications with inflatable and malleable prostheses was 7 (3.9%) and 51 (28.1%), respectively. Overall, 21 prostheses (11.6%) had to be removed because of various complications and patient dissatisfaction. Patients with prior radical surgery had higher extraction rates (ƛ = 14.606, P < 0.05, Chi-square test). The main reasons for removal were erosion (n = 11; 6.1%) and infection (n = 3; 2.1%). With respect to satisfaction during intercourse, we found that 104 (57.5%) patients described themselves as very satisfied with the prosthesis, while 21 (11.6%) were unsatisfied. The high explantation rate in patients with prior surgery was remarkable in our study. Our results revealed that a malleable prosthesis should not be the preferred type of implant for patients with prior surgery.
Language	English
Publishing date	2017-07
Publishing country	China
Document type	Journal Article
ZDB-ID	2075824-8
ISSN	1745-7262 ; 1008-682X
ISSN (online)	1745-7262
ISSN	1008-682X
DOI	10.4103/1008-682X.178846
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Article: The management of total avulsion of the ureter from both ends: Our experience and literature review.

Sevinc, Cuneyd / Balaban, Muhsin / Ozkaptan, Orkunt / Yucetas, Ugur / Karadeniz, Tahir

Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica

2016 Volume 88, Issue 2, Page(s) 97–100

Abstract: Objective: To evaluate the treatment modalities of total ureteral avulsion and to clarify the risk factors of this serious complication.: Methods: This study retrospectively analyzed the data of 3 patients with complete ureteral avulsion during ... ...

Abstract	Objective: To evaluate the treatment modalities of total ureteral avulsion and to clarify the risk factors of this serious complication. Methods: This study retrospectively analyzed the data of 3 patients with complete ureteral avulsion during ureteroscopy. Of the three patients, two had distal ureteral complete avulsion, and one total ureteral avulsion on both ends. Ureteroneocystostomy (UNC) was immediately performed after distal ureteral avulsion cases. Ileal ureter substition was performed on the same session after the total ureteral avulsion in both ends. Two of the patients were under chronic use of corticosteroid treatment due to diagnosis of idiopathic trombocytopenic purpura and myastenia gravis and all patients had unsuccesful shockwave litotripsy (SWL) treatment history with at least 1 month period before surgery. Results: The patient who had ileal ureter substitution was followed at 3-month intervals by ultrasonography and renal function tests and she was uneventful after a 2 year follow-up period. The patients treated with UNC were followed up at 3 month interval by ultrasonography and renal function tests. They had normal renal function 1 year after the operation Conclusion: Complete ureteral avulsion is a rare but severe complication. Treatment modality can vary and ileal ureter can be applied succesfully in the total ureter avulsion in both ends when bladder capacity is not enough for a Boari flap. Failed SWL and/or corticosteroid treatment history of patients seems to increase the risk of the ureteral avulsion.
MeSH term(s)	Adult ; Aged ; Cystostomy/methods ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Risk Factors ; Ureter/diagnostic imaging ; Ureter/injuries ; Ureter/surgery ; Ureteral Diseases/diagnostic imaging ; Ureteral Diseases/surgery ; Ureteroscopy/adverse effects ; Urologic Surgical Procedures/methods
Language	English
Publishing date	2016-07-04
Publishing country	Italy
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	1153526-x
ISSN	2282-4197 ; 1124-3562 ; 1120-8538
ISSN (online)	2282-4197
ISSN	1124-3562 ; 1120-8538
DOI	10.4081/aiua.2016.2.97
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Article: Salvage urethroplasty using skin grafts for previously failed long-segment urethral strictures.

Sevinc, Cuneyd / Balaban, Muhsin / Ozkaptan, Orkunt / Kutlu, Necmettin / Karadeniz, Tahir

The Kaohsiung journal of medical sciences

2016 Volume 32, Issue 9, Page(s) 464–468

Abstract: The aim of this study was to describe a technique using full-thickness skin grafts (FTSGs) from different parts of the body for salvage urethroplasties and the present outcomes. A total of 24 men underwent urethroplasties for strictures averaging 7.7 cm ( ...

Abstract	The aim of this study was to describe a technique using full-thickness skin grafts (FTSGs) from different parts of the body for salvage urethroplasties and the present outcomes. A total of 24 men underwent urethroplasties for strictures averaging 7.7 cm (range, 5-17 cm) in length, using FTSGs from the inner arm, inner thigh, or abdominal skin. Each of these cases had at least one failed urethroplasty. Twenty-four patients underwent surgery for 26 urethral strictures, with a mean follow-up period of 23.2 (5-44) months and a mean operation time of 140 (115-180) minutes. Reconstruction of the urethra with skin grafting was successful in 18 out of the 26 procedures during the first attempt (69%). A "redo" skin grafting was performed for the eight failed cases, with four successful procedures (50%). Overall, the success rate was 84% (22 out of 26 urethral strictures); however, the failed cases developed abscesses and later, ureterocutaneous fistulas. No hair formation from the skin grafts was seen. Skin grafts provide useful alternative graft sources for previously failed long-segment urethral strictures in which the buccal mucosae are not available or are insufficient for salvage urethroplasties with an acceptable success rate.
MeSH term(s)	Adolescent ; Humans ; Male ; Middle Aged ; Salvage Therapy ; Skin Transplantation ; Treatment Failure ; Urethral Stricture/surgery ; Urologic Surgical Procedures ; Young Adult
Language	English
Publishing date	2016-09
Publishing country	China (Republic : 1949- )
Document type	Journal Article ; Observational Study
ZDB-ID	639302-0
ISSN	1607-551X ; 0257-5655
ISSN	1607-551X ; 0257-5655
DOI	10.1016/j.kjms.2016.07.006
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