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    Bladder Neck Collagen Injection in the Treatment of Congenital Retrograde Ejaculation: A Case Report
    (CUREUS INC, 2017) Cakiroglu, Basri; Sinanoglu, Orhun; Arda, Ersan
    The present study describes the first successful treatment of a congenital retrograde ejaculation case with a submucosal collagen injection to the bladder neck. A 28-year-old male (height 170 cm, weight 80 kg) attended to the urology outpatient clinic with complaints of scattered urine stream and absence of ejaculation. The laboratory tests, including hormone profile (follicle stimulating hormone, luteinizing hormone, and testosterone) and the routine blood count were within normal ranges, whereas semen analysis demonstrated a total absence of ejaculation. The analysis of post-ejaculate urine specimens revealed an elevated sperm concentration indicative of retrograde ejaculation. The cystoscopy was performed; the prostatic urethra was normal, the verumontanum was in the orthotopic position, and the bladder neck was wide opened. Dextranomer/hyaluronic acid copolymer (Deflux, 8 ml) was injected into the bladder neck at clock positions of one, five, seven, and 11 o'clock. During the same procedure, the large opening in the vesical collum was obliterated. During the first followup (four weeks after surgery), the patient was able to produce a normal (2.8 ml) ejaculation volume. The sperm analysis revealed normozoospermia, with 25 million spermatozoa/ml, 26% (a) and 57% (a + b) motility, and 14% normal morphology. The submucosal bladder neck collagen injection is a minimally invasive technique that quickly restores anterograde ejaculation and should be considered in the patients with congenital or acquired retrograde ejaculation and for those who did not respond to the medical treatment.
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    Comparison of transurethral incision of the prostate and silodosin in patients having benign prostatic obstruction in terms of retrograde ejaculation
    (PAGEPRESS PUBL, 2017) Cakiroglu, Basri; Hazar, Aydin Ismet; Sinanoglu, Orhun; Arda, Ersan; Ekici, Sinan
    Background: To compare the functional outcomes and retrograde ejaculation (RE) after transurethral incision of the prostate (TUIP) or silodosin in bladder outlet obstruction (BOO) secondary to a small prostate. Methods: Prospectively collected data from December 2011 through December 2014 of 192 LUTS patients having fertility concerns with prostate volume smaller than 40 ml receiving either TUIP or silodosin treatment were prospectively reviewed. The treatment outcomes were evaluated and compared. Results: TUIP was performed in 96 cases and silodosin 8 mg was prescribed in 96 cases. At 12th months after TUIP or continuous silodosin treatment, the decrease in mean International Prostate Symptom Score (IPSS) and postvoiding residual urine (PVR) and the improvement of mean maximal flow rate (Q(max)) were significant (p = 0.000). The improvement in IPPS and Qmax was significantly higher in TUIP group compared to silodosin group (p = 0.005, p = 0.000) with a lower rate of retrograde ejaculation (RE) in TUIP group. (11/96 vs 33/96) (p = 0.000) Conclusions: Both TUIP and silodosin ensures comparable improvement in PVR, IPSS and Q(max) with a lower rate of RE on the TUIP group in prostates weighing less than 40 grams suggesting that TUIP is a better choice in younger patiens seeking preservation of ejaculation with fertility concerns.
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    Does Mild Hydronephrosis Induced by Full-Bladder Improve Outcomes in Patients Undergoing Shock Wave Lithotripsy for Lower Calyceal Stones?: A Prospective Randomized Study
    (UROL & NEPHROL RES CTR-UNRC, 2018) Hazar, Ismet Aydin; Cakiroglu, Basri; Sinanoglu, Orhun; Akgun, Feride Sinem; Arda, Ersan; Yuksel, Ilkan; Akdere, Hakan
    Purpose: To compare the outcomes, sessions and shock wave numbers in patients undergoing standard procedure shock wave lithotripsy (SWL) and patients undergoing SWL with mild hydronephrosis induced by full-bladder following oral hydration before SWL procedure for lower calyceal stones. Materials and Methods: Between January 2014-January 2016 a total of 371 patients who underwent SWL, for lower pole calyceal stones 2 cm, were included into the study. 127 patients were treated in the supine position (Group A), 123 in the prone position (Group B) and 121 in the prone position with full bladder and mild hydronephrosis checked by ultrasound before procedure (Group C). There were 286 men and 85 women with a mean SD age of 36 11 years Results: The mean (SD) stone sizes within the group A, group B and group C were 11 mm (+/- 3 mm), 12 mm (+/- 4.1 mm) and 11 mm ( +/- 3.8 mm) respectively. No significant difference was found in age (P =.18) and stone size between 3 groups (P =.07). The median interquartile range (IQR) number of shocks within the group A, group B and group C were 7600 (3855), 6500 (4300) and 6700 (4915) respectively. Significant difference was found in number of shock waves among 3 groups (P <.01). The difference between groups according to stone expulsion rate was found significant in all sessions (P =.01). Conclusion: The present study suggests that mild hydronephrotic status induced by full-bladder before SWL can lower cost and patient discomfort by decrease in number of sessions and increase in stone clearance.
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    Outcome of buccal mucosa urethroplasty in the management of urethral strictures
    (PAGEPRESS PUBL, 2017) Cakiroglu, Basri; Sinanoglu, Orhun; Arda, Ersan
    Objective: The objective of the study is to report the outcome of buccal mucosal urethroplasty. Materials and methods: The follow up data of 15 patients undergoing single stage urethroplasty from September 2010 to September 2015 were retropectively reviewed. They received buccal mucosa graft for urethroplasty. The patients were followed for complications and outcome. Results: Mean age was 53.7 +/- 13.6 The stricture length ranged from 3 to 6 cm (mean 4.4 +/- 0.8). The success rate for buccal mucosa urethroplasty (BMU) was 67.7% at 12th month. Three patients presenting with voiding difficulty in the 3rd month and one in the next 12 months, had urethral restenosis. One patient had fistula formation at 6th month postoperatively. Five patients underwent retreatment procedures such as internal urethrotomy, urethroplasty and/or internal urethrotomy. Conclusions: The buccal mucosa is easy to obtain and handle, therefore BMU can be safely and effectively managed outside high volume institutions.
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    Primary nocturnal enuresis: a review
    (Kowsar Corp, 2016) Arda, Ersan; Çakıroğlu, Basri; Thomas, David Terence
    Context: Nocturnal enuresis or bedwetting is the most common type of urinary incontinence in children. It has significant psychological effects on both the child and the family. Enuresis nocturna is defined as the inability to hold urine during the night in childrenwhohave completed toilet training. It is termed as being “primary” if no continence has ever been achieved or “secondary if it follows at least 6 months of dry nights. The aim of this review was to assemble the pathophysiological background and general information about nocturnal enuresis. Evidence Acquisition: This review was performed by evaluating the literature on nocturnal enuresis published between 1970 and 2015, available via PubMed and using the keywords “nocturnal enuresis,” “incontinence,” “pediatric,” “review,” and “treatment.” Results: Children with nocturnal enuresis produce urine at higher rates during the night, andmayhave lower bladder capacities. Some children with nocturnal enuresis mayalso have daytime urgency, frequency, and urinary incontinence. Treatment includes aggressive treatment of accompanying constipation or urinary tract infections, behavioral changes, and medical therapy. Alarm therapy remains the first-line treatment modality for primary nocturnal enuresis. High rates of patient compliance and relapse mean that alternative treatments remain on the agenda. Conclusions: Nocturnal enuresis is a common problem that has multifaceted effects on both the child and the family. Due to multiple etiologic factors, nocturnal enuresis is still not clearly defined. © 2016, Nephrology and Urology Research Center.