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Öğe Is serum vitamin D level a risk factor for idiopathic male fertility?(IMR Press, 2021) Horsanalı, Mustafa Ozan; Eren, Hüseyin; Çağlayan, Alper; Issı, YaşarBackground: Idiopathic male infertility is a health problem that is increasingly common worldwide. Aetiology of idiopathic male infertility is still controversial. In this cross-sectional retrospective study, we aimed to investigate the relationship between serum vitamin D level and sperm quality in patients with idiopathic male infertility. Methods: Between June 2018 and June 2020, 297 patients including 147 men with idiopathic infertility (as a study group) and 150 fertile men (as a control group) were retrospectively enrolled into the study. Blood samples were collected, and these samples included serum sex steroids, serum vitamin D levels, glucose tests, lipid profiles, liver function tests and kidney function tests. At least two sperm analyses, scrotal doppler ultrasonography and karyotype analysis were performed on each of the patients. Demographic, laboratory and radiological features were also recorded. The Mann Whitney-U test was used to compare groups and quantitative independent data. The Chi-square test was used for qualitative independent data. Spearman's correlation analysis was applied for correlation. Significant results were investigated and analysed further using the logistic regression test. Results: The mean age of the patients was 31.98 +/- 6.97 years. The mean serum vitamin D level of the patients was 23.16 +/- 10.40 ng/dL and the mean infertility duration of patients with idiopathic infertility was 29.88 +/- 28.86 months. We observed statistical significance in terms of serum vitamin D levels, impaired total sperm motility, progressive sperm motility and sperm morphology in idiopathic infertile men when compared to fertile men. There were no statistically significant between idiopathic infertile men and fertile men in terms of serum testosterone levels. Conclusions: We observed a positive correlation between serum vitamin D levels and impaired sperm parameters, specifically in terms of sperm morphology, total sperm motility and progressive sperm motility. Vitamin D supplementation may be a beneficial contribution to achieving high paternity rates in men with idiopathic male infertility.Öğe Original Research Association between serum vitamin D levels and acquired premature ejaculation(IMR Press, 2021) Horsanalı, Mustafa Ozan; Çağlayan, Alper; Issı, YaşarBackground and objective: Premature ejaculation is one of the most common and complex sexual diseases among men. Although there are four defined subtypes of premature ejaculation, the most common subtype is acquired premature ejaculation. This study investigated the association between serum vitamin D levels and acquired premature ejaculation. Material and methods: This retrospective cross-sectional study included 94 patients with a complaint of acquired premature ejaculation (the study group) and 92 patients without a complaint of premature ejaculation (the control group) between June 2018 and March 2020. Patients' demographic characteristics, laboratory results, intravaginal ejaculatory latency time, Turkish validated premature ejaculation diagnostic tool (PEDT), International Index of Erectile Function-5 (IIEF-5) and Beck Depression scores were statistically compared between groups. Results: The patients' mean age was 49.10 +/- 14.85 years. There were differences between the two groups regarding serum vitamin D levels, dehydroepiandrosterone sulfate, total testosterone, and follicle-stimulating hormone levels. Upon comparing the questionnaire scores, the PEDT, intravaginal ejaculatory latency time, and Beck depression scores were clinically significant between groups. The cut-off value for serum vitamin D levels was 8.37 ng/mL, with a sensitivity of 93% and specificity of 92%. Conclusion: We revealed that serum vitamin D and follicle-stimulating hormone levels were independent risk factors according to the multivariate analysis. Measurement of serum vitamin D levels in patients with acquired premature ejaculation may be useful for treatment.Öğe Predictive value of hounsfield unit in urinary system stones applied with eswl(2022) Çağlayan, Alper; Horsanali, Mustafa OzanThis study claims to examine the relationship between the Housfield unit (HU) value and the success of Electro Shock Wave Lithotripsy (ESWL) treatment. Data of 142 patients were evaluated retrospectively in this cross-sectional observational study. The threshold value for stone density is calculated as 991.20 HU in the ROC analysis. The patients are seperated into two groups with respect to this value, and their demographic characteristics, stone characteristics and success rates after ESWL treatment are statistically compared. For the variables that are statistically crucial in the univariate analysis, logistic regression analysis are used as a multivariate analysis. The mean age of all patients were 45.25±11.72 years and the mean body mass index (BMI) is 28.42±3.98 kg/m2. While our stone-free rate was 66.2% in our study, the mean stone size was 11.25±3.83mm, the Hounsfield unit value was 1007.55±337.75 HU, and the stone-skin distance was 108.02±20.02mm, respectively. We observed a crucial difference in between the Housfield unit value and stone size in univariate and multivariate analyzes between the two groups, and the stone-free rate after ESWL. The Hounsfield unit value, measured by the non-contrast computed tomography method, is a parameter for the prediction in success of patients undergoing Electro Shock Wave Lithotripsy treatment. Also, stone density above 991.20 HU in patients having urinary system stone disease requires the evaluation of alternative treatments as a condition that reduces the success of the treatment.Öğe The role of sperm DNA integrity in couples with recurrent implantation failure following IVF treatment(Wiley, 2022) Çağlayan, Alper; Horsanalı, Mustafa Ozan; Buyrukçu, Buğra AdilThere is increasing evidence from the literature that indicates the association between impaired sperm DNA integrity and male infertility. However, the data is insufficient regarding recurrent implantation failure (RIF) and sperm DNA damage. This study aimed to investigate the association between sperm DNA fragmentation and RIF cases. Basic semen parameters and sperm DNA fragmentation index (DFI) of men whose partner was suffering from RIF were compared with men whose partner was diagnosed with unexplained infertility (UEI) but had clinical pregnancies following IVF treatment. A retrospective analysis from a large-volume IVF center has been performed, and a total of 197 couples underwent analysis. Two groups were formed, couples with RIF and couples diagnosed with UEI but had clinical pregnancies (controls) following IVF cycles. The mean number of cycles showed significant differences between the groups. However, no statistical difference was observed between RIF and the control group regarding patient characteristics, semen parameters, and sperm DNA fragmentation index (DFI). Also, no statistically significant correlation was found between sperm DFI and clinical pregnancies in the unexplained infertility cohort. Our results show that sperm DNA fragmentation may not be an important contributing factor to RIF cases.Öğe Üriner sistem taş hastalığı nedeniyle ekstrakorporeal şok dalga litotripsi (ESWL) uygulanan hastalarda ağrının tedavi başarısı üzerine etkisi(2022) Çağlayan, Alper; Horsanalı, Burcu Özalp; Horsanalı, Mustafa OzanGiriş: Çalışmamızda ekstrakorporeal şok dalga litotripsi (ESWL) işlemi sırasında vizüel ağrı skoru (VAS) ile değerlendirilen ağrı skorunun böbrek taşı tanısı alan hastalarda uygulanan ESWL başarısına etkisini değerlendirmeyi amaçladık. Gereç ve Yöntem: Çalışma Ocak 2020- Ocak 2022 tarihleri arasında üst üriner sistem taşı tanısı konulan ve bu sebeple ilk defa ESWL tedavisi alan 160 hastanın verileri retrospektif incelenerek gerçekleştirildi. Hastaların demografik özellikleri, radyolojik görüntülemede üriner sistem taşının özellikleri ve işlem esnasında kaydedilen vizüel ağrı skorları kaydedildi. Hastalar ESWL tedavisi sonrası yapılan kontrollerinde taşsızlık sağlanan ve rezidü taş izlenen hastalar olmak üzere iki gruba ayrılarak gruplar istatistiksel olarak karşılaştırıldı. Bulgular: 101 (%63.1) hastada ESWL tedavisi ile taşsızlık sağlandı. ESWL tedavisinin başarı oranı %63.1 olarak hesaplandı. Hastaların sırasıyla ortalama taş boyutu, taş-cilt mesafesi ve taş yoğunluğu; 11.41±3.79 mm, 108.12±19.48 mm ve 1024.51±322.59 Hounsfield Unit (HU) olarak hesaplandı. Ortalama VAS ise 5.22±2.64 idi. Lojistik regresyon analizi sonucunda ESWL başarısında taş boyutu ve ağrı skorunun bağımsız risk faktörleri olduğu görüldü. Sonuç: ESWL üriner sistem taşlarının tedavisinde etkili bir yöntemdir. Taş boyutunun artması ve işlem sırasında izlenen yüksek VAS’nun ESWL başarısında rol oynayan en önemli risk faktörleri olduğunu ortaya koyduk. ESWL esnasında başarılı ağrı kontrolü ile tedavi başarı oranının artacağını düşünmekteyiz.Öğe Üroloji alanıyla ilgili tıbbi uygulama hatası(2022) Kaplan, Gazel; Çağlayan, Alper; Meral, OrhanHekimlerin tıbbi, idari adli ve etik sorumlulukları bulunmaktadır. Bünyesinde çok sayıda risk barındıran hekimlik mesleğinde istenmeyen olumsuz durumların meydana gelmesi neticesinde hasta veya hasta yakınları tarafından yargı mercilerine tıbbi hatalar yönünden başvurulabilmektedir. Son yıllarda gerek ülkemizde gerekse de dünyada tıbbi uygulama hatası iddiasıyla yapılan şikâyet başvurusu ve açılan dava sayısında belirgin artışın olduğu bilinmektedir. Özellikle cerrahi branşlarda meydana gelen istenmeyen durumlar neticesinde tıbbi hata bulunduğu yönünde davalar olduğu yapılan birçok çalışmada bildirilmektedir. Uzayan yargılama süreçleri, istenen hapis cezaları, ödenen yüklü tazminatlar vs. defansif tıp uygulamalarının da artışına neden olmaktadır. Bu çalışmada, Üroloji alanına yönelik tıbbi uygulama hatası iddiasıyla başlatılan yargı süreçlerinden Danıştay’a yansıyan davalarının incelenerek, en üst idari yargı merci olan Danıştay’ın yerel mahkeme ve üniversite kararlarına bakış açısı değerlendirilecektir. Bir cerrahi branş olan Üroloji alanında görev yapan hekimler için hasta ve hasta yakınları tarafından tıbbi hata iddiasında bulunulması riski azımsanmayacak düzeydedir. Ülkemizde daha önce benzer nitelikte bir çalışma yapılmamış olduğundan sunulan çalışmanın literatüre katkı sağlayacağı düşüncesindeyiz.Öğe Web-Based bibliometric evaluation of robotic radical prostatectomy in prostate cancer: analysis of Turkey data(2022) Horsanalı, Mustafa Ozan; Çağlayan, AlperAim: Prostate cancers are the second most commonly diagnosed cancers in men. The developments in robotic surgery brought along a period in which all number of articles were written. This study, we researched the field and contribution of articles written in the world and in Turkey on robot assisted radical prostatectomy with bibliometric analysis in a web-based software. Material and Methods: In our study, 1434 original articles in the world and 57 original articles in Turkey, which met the criteria, were scanned in ISI Web of Knowledge-Science (WoS) data base by using the keywords ‘robot, prostate cancer, radical prostatectomy’. The parameters, country of the article, publication year of the article, WoS category of the article, the name of the journal where the article was published, type of the article (Original), language of the article (English) and WoS index (SCI-E), were evaluated with bibliometric analysis method. Results: Analysis of countries points out that the United States of America ranked the first with 563 (39.2%) articles, while Turkey ranked in the 11th place with 57 (3.9%) articles. According to publication year, it was found that the highest number of articles published in the world was in 2020 with 173 (12.06%) articles, while it was in 2021 with 10 (17.5%) in Turkey. With respect to field categories in WoS data base, the world was found that the field of Urology-Nephrology ranked the first with 1042 (72%) articles, while similarly Urology-Nephrology ranked the first with 35 (61.4%) articles in Turkey. According to journal name, BJU International was the journal in which the highest number of articles were published in the world with 157 (10.9%), while Journal of Endourology was the journal in which the highest number of articles were published in Turkey with 10 (17.5%) articles. In the citations and H-index rates of articles by year, it was 78 in the world and 15 in Turkey which show rising curve over the last two decades. Conclusion: Current developments in robotic surgery have a significant place in world scientific publication performance. Turkey has made valuable contributions to literature since 2014 with increasing number of articles and citations.
