Pub Date : 2021-10-15DOI: 10.33719/yud.2021;16-3-877768
Hüseyin Kocatürk, M. S. Altay, F. Bedir, Banu Bedir
Objective: Erectile dysfunction (ED) following robot-assisted radical prostatectomy (RARP) is an important problem. The purpose of this study was to evaluate the effectiveness of and patient satisfaction with intracavernosal alprostadil used in the treatment of ED. Material and Methods: Patients using intracavernosal alprostadil in the treatment of ED following RARP were assessed retrospectively. Patients’ demographic characteristics, pre- and postoperative International Index of Erectile Function (IIEF) scores, and general satisfaction evaluated using questions 13 and 14 of the IIEF form were all recorded. Complications developing during treatment, dosages used, and reasons for discontinuation were investigated. Results: Thirty-four patients with a mean age of 61.73±5.80 years were included in the study. Preoperative ED was determined in 52.9% (n=18) of patients. The mean IEFF of the patients who used preoperative, postoperative 1st month, postoperative 3 months after tadalafil use and intracavernosal alprostadil was 20.64 ± 3.46, 15.08 ± 2.09, 15.32 ± 2.18, 26.67 ± 2.30, respectively. The mean length of use of intracavernosal alprostadil was 8.20±2.48 months, and full erection was achieved in 70.58% of patients. Hematoma associated with intracavernosal alprostadil use developed in 2.9% of patients, ecchymosis in 8.8%, and pain in 8.8%. In addition, 73.5% of patients continued to take their medication during the follow-up process. Patients’ general satisfaction following alprostadil therapy was statistically significantly high. Conclusion: Intracavernosal alprostadil therapy following RARP represents a good therapeutic option due to its high success in achieving full erection, low complication rates, and high patient satisfaction. Keywords: erectile dysfunction, Alprostadil, robot-assisted radical prostatectomy
{"title":"Evaluation of the efficacy and patient satisfaction of the intracavernosal alprostadil in the treatment of erectile dysfunction following robot-assisted radical prostatectomy","authors":"Hüseyin Kocatürk, M. S. Altay, F. Bedir, Banu Bedir","doi":"10.33719/yud.2021;16-3-877768","DOIUrl":"https://doi.org/10.33719/yud.2021;16-3-877768","url":null,"abstract":"Objective: Erectile dysfunction (ED) following robot-assisted radical prostatectomy (RARP) is an important problem. The purpose of this study was to evaluate the effectiveness of and patient satisfaction with intracavernosal alprostadil used in the treatment of ED. Material and Methods: Patients using intracavernosal alprostadil in the treatment of ED following RARP were assessed retrospectively. Patients’ demographic characteristics, pre- and postoperative International Index of Erectile Function (IIEF) scores, and general satisfaction evaluated using questions 13 and 14 of the IIEF form were all recorded. Complications developing during treatment, dosages used, and reasons for discontinuation were investigated. Results: Thirty-four patients with a mean age of 61.73±5.80 years were included in the study. Preoperative ED was determined in 52.9% (n=18) of patients. The mean IEFF of the patients who used preoperative, postoperative 1st month, postoperative 3 months after tadalafil use and intracavernosal alprostadil was 20.64 ± 3.46, 15.08 ± 2.09, 15.32 ± 2.18, 26.67 ± 2.30, respectively. The mean length of use of intracavernosal alprostadil was 8.20±2.48 months, and full erection was achieved in 70.58% of patients. Hematoma associated with intracavernosal alprostadil use developed in 2.9% of patients, ecchymosis in 8.8%, and pain in 8.8%. In addition, 73.5% of patients continued to take their medication during the follow-up process. Patients’ general satisfaction following alprostadil therapy was statistically significantly high. Conclusion: Intracavernosal alprostadil therapy following RARP represents a good therapeutic option due to its high success in achieving full erection, low complication rates, and high patient satisfaction. Keywords: erectile dysfunction, Alprostadil, robot-assisted radical prostatectomy","PeriodicalId":33828,"journal":{"name":"Yeni Uroloji Dergisi","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69671313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-29DOI: 10.33719/yud.2021;16-2-792827
M. Kılıç, M. Çulpan, A. Yıldırım, T. Çaşkurlu
Objective: Although laparoscopic partial nephrectomy (LPN) is minimally invasive, it is also a technically challenging procedure. Currently, open partial nephrectomy (OPN) remains the only alternative in many centers for T1 kidney tumors. We reported our initial experience of LPN compared to OPN regarding clinical, oncological findings and renal functions. Material and Methods: Between 2004-2013, 81 patients who underwent OPN (n=55) or LPN (n=26) for clinically T1 renal tumors were included. Perioperative and postoperative data were compared, retrospectively. Follow-up times for OPN and LPN groups were 72.9± 41.1 and 47.6± 32.4 months, respectively (p<0.05). Results: The mean tumor size and RENAL nephrometry scores were similar for both groups. Zero-ischemia was performed in all of the LPN and 15% of the OPN procedures. Estimated blood loss and perioperative transfusion rates were higher in OPN group. Complications including grade < 3 and ≥ 3 did not differ significantly between the groups. The decrease in creatinine-clearance at 6th month was statistically significant in OPN group, while stable in LPN. Positive surgical margin rates were 6.6% for OPN and 17.6% for LPN, p=0.19. One patient in LPN developed local recurrence and underwent nephrectomy. In OPN group,one local recurrence and one distant metastasis were observed in two independent patients. Both patients recieved tyrosine kinase inhibitor. Conclusion: Although LPN is accepted as a technically challenging procedure, LPN provided comparable outcomes to OPN including clinical, oncological findings and renal functions, even in the early learning phase. Zero-ischemia technique for LPN was feasible and safe with favorable perioperative and renal functional outcomes. Keywords: laparoscopy; learning curve; partial nephrectomy; renal cancer; surgical margins; zero-ischemia.
{"title":"Comparison of early experience laparoscopic versus open partial\u0000nephrectomy in terms of clinical, oncological and renal functional outcomes","authors":"M. Kılıç, M. Çulpan, A. Yıldırım, T. Çaşkurlu","doi":"10.33719/yud.2021;16-2-792827","DOIUrl":"https://doi.org/10.33719/yud.2021;16-2-792827","url":null,"abstract":"Objective: Although laparoscopic partial nephrectomy (LPN) is minimally invasive, it is also a technically challenging procedure. Currently, open partial nephrectomy (OPN) remains the only alternative in many centers for T1 kidney tumors. We reported our initial experience of LPN compared to OPN regarding clinical, oncological findings and renal functions.\u0000Material and Methods: Between 2004-2013, 81 patients who underwent OPN (n=55) or LPN (n=26) for clinically T1 renal tumors were included. Perioperative and postoperative data were compared, retrospectively. Follow-up times for OPN and LPN groups were 72.9± 41.1 and 47.6± 32.4 months, respectively (p<0.05).\u0000Results: The mean tumor size and RENAL nephrometry scores were similar for both groups. Zero-ischemia was performed in all of the LPN and 15% of the OPN procedures. Estimated blood loss and perioperative transfusion rates were higher in OPN group. Complications including grade < 3 and ≥ 3 did not differ significantly between the groups. The decrease in creatinine-clearance at 6th month was statistically significant in OPN group, while stable in LPN. Positive surgical margin rates were 6.6% for OPN and 17.6% for LPN, p=0.19. One patient in LPN developed local recurrence and underwent nephrectomy. In OPN group,one local recurrence and one distant metastasis were observed in two independent patients. Both patients recieved tyrosine kinase inhibitor. \u0000Conclusion: Although LPN is accepted as a technically challenging procedure, LPN provided comparable outcomes to OPN including clinical, oncological findings and renal functions, even in the early learning phase. Zero-ischemia technique for LPN was feasible and safe with favorable perioperative and renal functional outcomes. \u0000Keywords: laparoscopy; learning curve; partial nephrectomy; renal cancer; surgical margins; zero-ischemia.","PeriodicalId":33828,"journal":{"name":"Yeni Uroloji Dergisi","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69670960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}