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    Comparative analysis of combined spinal-epidural anesthesia and general anesthesia in percutaneous nephrolithotomy: a prospective study on surgical team and operating room personnel satisfaction
    (Springer, 2024) Burlukkara, Salih; Kabalak, Afife Ayla; Ates, Alpay; Baran, Ozer; Aykac, Aykut; Ozok, Hakki Ugur
    Objective We aimed to investigate the efficacy and complications of combined spinalepidural anesthesia and general anesthesia in percutaneous stone surgery prospectively. Materials and methods The study prospectively included patients who underwent percutaneous nephrolithotomy with general anesthesia (Group.1) or combined spinal-epidural anesthesia (Group.2) at the Department of Urology, Training and Research Hospital, Karabuk University. between December 2018 and December 2019. The effect of the anesthesia technique on the comfort and satisfaction of the operating room personnel, surgeon and anesthesia team were prospectively evaluated and recorded. Results During the postoperative period, the spinal anesthesia group had a significantly lower visual analog score than the general anesthesia group. No patient in either group required narcotic analgesics during the postoperative period. In terms of overall satisfaction scores, the surgeon performing the surgical procedure had a significantly higher satisfaction score in the general anesthesia group than in the CSEA group. The score was considered good in the general anesthesia group and moderate in the CSEA group. Personnel satisfaction was higher in the patient group that underwent CSEA. In the general anesthesia group, the score was considered to be average. In the CSEA group, the satisfaction score was considered good, with a statistically significant difference (p < 0.05). The anesthesia team's satisfaction score was moderate, with no significant difference between the CSEA and general anesthesia groups (p > 0.05). Conclusion PCNL under CSEA can be performed safely in certain individuals. Different anesthetic techniques may have varied levels of satisfaction among the surgical team.
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    Evaluation of Dynamic Thiol/Disulfide Homeostasis in Patients with Non-Muscle Invasive Bladder Tumor
    (Galenos Publ House, 2023) Burlukkara, Salih; Baran, Ozer; Aykac, Aykut; Sunay, M. Mehmet
    Objective: To evaluate the thiol-disulfide homeostasis in patients with a diagnosis of non-muscle invasive bladder tumor (NMIBC), which is a new oxidative stress marker, and to investigate the relationship between the development of NMIBC and native thiol, total thiol, and dynamic disulfide values. Materials and Methods: Fifty-three patients who were operated for bladder tumor in Karabuk University Karabuk Training and Research Hospital, Clinic of Urology between February and November 2020 and diagnosed with NMIBC in the pathological examination and 60 healthy volunteers were included in the study. Plasma native thiol, total thiol and disulfide levels of these two groups were measured and compared. Results: There was a statistically significant difference between the two groups in terms of native thiol, total thiol and disulfide values. In the subgroup analysis in those diagnosed with NMIBC, native thiol values were found to be 255,870 mu mol/L in the low grade patient group and 169,420 mu mol/L in the high grade patient group. This difference was statistically significant. Conclusion: The thiol disulfide homeostasis shifted to the disulfide side in the NMIBC group. It was determined that an increase in serum disulfide level and a decrease in native thiol level may have diagnostic value in predicting NMIBC. In addition, in the group diagnosed with NMIBC, there was a significant decrease in native thiol values as the pathological grade increased. This was interpreted as a shift of the equilibrium towards the oxidant side as the tumor showed an aggressive course.
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    Serum relaxin-3 and galanin levels in individuals with erectile dysfunction with and without type 2 diabetes mellitus
    (2024) Yılmaz, Ümit; Burlukkara, Salih; Demir, Demirhan Orsan
    This study was designed to determine the serum relaxin-3 and galanin levels in individuals with erectile dysfunction with and without type 2 diabetes mellitus (T2DM). A total of 154 individuals aged 30-60 were included in the study and the participants were divided into three groups: D-ED group (individuals with T2DM and ED) (n=49), ND-ED group (individuals with ED without T2DM) (n=55), and control group (individuals without T2DM and ED) (n=50). The age, BMI, and IIEF-5 score were recorded for all participants. The HDL, LDL, triglycerides, cholesterol, HbA1c and testosterone were determined from the blood taken from the participants, and galanin and relaxin-3 levels were measured in serum samples by ELISA method. The IIEF-5 score of the D-ED group was statistically lower than that of the ND-ED and control groups, and the IIEF-5 score of the ND-ED group was also lower than that of the control group. Serum testosterone levels in the control group were statistically higher than in the D-ED and ND-ED groups. The galanin level of the D-ED group was elevated than the control and ND-ED groups, but the galanin level of the ND-ED group was lower than the control group. The relaxin-3 levels were decreased in the D-ED and ND-ED groups compared to the control group. Galanin levels increased in individuals with T2DM and ED, however decreased in individuals with ED without T2DM. In addition, reduced relaxin-3 level may play a role in the development of ED.
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    Stent Encrustation due to Forgotten Double-J Stents: A Series of Five Cases
    (Galenos Yayincilik, 2020) Burlukkara, Salih; Aykac, Aykut; Baran, Ozer
    Although Double-J stents have become very common in the urological practice and are effectively used for various reasons, several complications related to it, such as hematuria, infection, irritative symptoms, pain, perforation, encrustation, and migration, have been observed. The present study reports five case reports of stent encrustation due to forgotten stents.
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    Wunderlich Syndrome, Tuberous Sclerosis-Related Giant Renal Angiomyolipoma Rupture: Case Report
    (Galenos Yayincilik, 2018) Baran, Ozer; Aykac, Aykut; Oner, Serkan; Aktumen, Alpay; Burlukkara, Salih; Sunay, Mehmet Melih; Ozok, Hakki Ugur
    Angiomyolipoma (AML) is a mesenchymal tumor of the kidney that is composed of morphologically abnormal smooth muscle cells, blood vessels, and adipose-like foci. Renal AML is usually clinically asymptomatic and detected incidentally during imaging. Rarely, renal AML can cause life-threatening spontaneous massive retroperitoneal hemorrhage, known as Wunderlich syndrome. A 39-year-old man with tuberous sclerosis was admitted to the emergency room with left flank pain, hematuria, and nausea. On physical examination, there was a hard sensitive mass extending from the upper left half of the abdomen to the midline. Left renal AML and extensive retroperitoneal hematoma measuring about 360x220x195 mm were detected on abdominal computed tomography. The patient exhibited signs of hypovolemic shock and emergency total nephrectomy was performed. He was discharged from the intensive care unit on postoperative day 1 and from the hospital on day 5.