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Öğe The Effect of Obturator Nerve Blockade on Oncological Outcomes of Patients with Lateral Wall Localized Non-Muscle Invasive Bladder Cancer(Galenos Publ House, 2023) Horsanali, Mustafa Ozan; Eren, Hueseyin; Dil, Eyuep; Caglayan, Alper; Erdogan, Oezguer; Karaarslan, Sermin; Ayguen, HakanObjective: To investigate the effect of obturator nerve blockade on oncological outcomes of patients with a diagnosis of lateral wall localized non -muscle invasive bladder cancer.Materials and Methods: One hundred six patients diagnosed with lateral wall localized non-invasive bladder cancer were evaluated between January 2015 and March 2020 in this retrospective, cross-sectional observational study. The patients were divided into two groups: patients receiving only spinal anesthesia and those receiving spinal anesthesia combined with ultrasound-guided obturator nerve blockade. Oncological outcomes of the groups were compared statistically.Results: We observed recurrent tumors in 25 patients (45.5%) in Group 1 and 11 patients (21.6%) in Group 2. Additionally, we observed tumor progression in eight patients (14.5%) in Group 1 and two patients (3.9%) in Group 2. We observed statistical significance in differences between groups regarding tumor size, recurrence rate, adequate muscle tissue sampling, ability for complete resection, and persistent obturator reflex. The efficacy rate of obturator blockade was 92.1% in Group 2. One-year recurrence-free survival (RFS) was 98.0% and 5-year RFS was 23.5% for Group 1, while for Group 2, they were 97.4% and 57.2%, respectively. Conclusion: The obturator reflex is a common and challenging reflex that may cause major complications and result in unintended consequences, such as incomplete resection or tumor recurrence with transurethral resection of bladder tumors. In this study, we demonstrated that combining spinal anesthesia with obturator nerve blockade for lateral wall localized non-muscle invasive bladder cancer may prevent tumor recurrence and reduce peroperative complications.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.