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    Correlation of resistive index of prostatic capsular artery to clinical symptoms in men with chronic prostatitis/chronic pelvic pain syndrome
    (Wiley, 2023) Yitgin, Yasin; Karakose, Ayhan
    Objectives To evaluate the relation between resistive index (RI) of prostatic capsular arteries by transrectal Doppler ultrasonography in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and its correlation with lower urinary tract symptoms, erectile dysfunction and premature ejaculation parameters of CP/CPPS. Methods In total, we included 68 patients presenting with chronic prostatitis/chronic pelvic pain syndrome. We formed two groups, as Group 1 of 35 patients with a RI = 0.7 and Group 2 of 33 patients with RI < 0.7. All patients were assessed with International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF-5), premature ejaculation diagnostic tool (PEDT) and National Institutes of Health Chronic Prostatitis Symptom Index (CPSI). In addition, the RI of the prostate capsular artery was measured in all patients using Doppler ultrasound. Statistical analyses were performed with SPSS version 18. A p value < .05 was considered significant. Results Demographic characteristics were similar in the two groups. IPSS was 11.3 +/- 6 in Group 1 and 9.7 +/- 5.3 in Group 2. IIEF-5 was 18.6 +/- 2 in Group 1 and 20.4 +/- 2.3 in Group 2. PEDT was 12.4 +/- 5.6 in Group 1 and 11.2 +/- 4 in Group 2. CPSI (total) was 19.3 +/- 12.3 in Group 1 and 10.6 +/- 7.7 in Group 2. There was significant statistical difference in IPSS, IIEF-5, and CPSI between the two groups (p < .001, p < .001, p < .001 respectively). However, we found no significant difference in PEDT between the two groups (p = .19). Conclusions There is a significant correlation between the lower urinary tract symptoms and erectile dysfunction parameters and the RI of the prostatic capsular artery in CP/CPPS and RI is an effective and noninvasive method to assess the severity of the disease.
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    EFFICACY AND SAFETY OF POSTOPERATIVE INTRAVESICAL ADMINISTRATION OF TRANEXAMIC ACID AFTER TRANSURETHRAL RESECTION OF THE PROSTATE
    (Istanbul Univ, Fac Medicine, Publ Off, 2023) Yitgin, Yasin; Karakose, Ayhan
    Objective: To evaluate the safety and efficacy of postoperative intravesical administration of tranexamic acid after transurethral resection of the prostate.Material and Method: The data of 112 patients who underwent surgery for lower urinary tract symptoms associated with benign prostatic obstruction (BPO) were retrospectively analysed. We formed two groups. Group 1 consisted of 57 patients who received tranexamic acid by irrigation fluid after the operation; group 2 consisted of 55 patients who did not receive tranexamic acid. Demographic data of patients and prostate characters, as well as operative and postoperative data were analysed. Postoperative bleeding in all patients was evaluated using the haemoglobin levels at the preoperative, and at 0-and 24-h postoperative were evaluated and noted.Result: The mean ages of the patients were 66.9 +/- 7.2 (55-81) years in the intervention group, and those in the control group were 68.6 +/- 7.6 (55-80) years. There were no significant differences between the groups for demographic data, prostate volume and IPSS. The reduction in Hb at 24 hours postoperatively was greater in the control group compared to the TXA group. Statistically significant differences were found between the two groups in terms of postoperative haemoglobin decrease, bladder irrigation time and total amount of irrigation fluid. There were no statistically significant differences between each group regarding the operation, weight of resected adenoma, hospitalization time and catheter removal time.
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    A new alternative approach to management of acute phase Peyronie's disease: low intensity extracorporeal shockwave therapy and platelet-rich plasma
    (Edizioni Minerva Medica, 2023) Karakose, Ayhan; Yitgin, Yasin
    BACKGROUND: The aim of this study was to investigate the efficacy, safety, and outcomes of the combination of low intensity external shock wave therapy (Li-ESWT) and platelet-rich plasma (PRP) therapy in acute phase Peyronie's disease (PD). METHODS: The datas of patients admitted with acute phase Peyronie's between January 2014 and January 2022 were reviewed retrospectively. In total, we included total 159 patients who used combination of vitamin E 600 mg/day plus colchicine 1.5 mg/day plus oral daily 5 mg tadalafil (N.=77) in group 1 and received Li-ESWT+PRP combination therapy plus oral daily 5 mg tadalafil (N.=82) in group 2. We noted characteristics of fibrous plaques, pain status, penile curvature degree, and erectile function parameters. All patients were visited at the 3rd and 12th months after the treatment. RESULTS: Preoperative demographic characteristics were similar in the two groups. There was a statistically significant improvement in the mean plaque size, penile curvature degree, IIEF-5 and VAS scores in the intervention group after the treatment. Ecchymosis and hematoma were not observed at the injection site and Li-ESWT application areas in the intervention group. No local or systemic drug reactions were noted in either group. CONCLUSIONS: Combination of Li-ESWT and PRP are highly effective and safety to early treatment in the acute phase PD.