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Öğe Can Obstructive Sleep Apnea Syndrome be Associated with Urinary Symptoms and Erectile Dysfunction(2016) Çoban, Soner; Cam, Haydar Kamil; Güleç, Ege Balbay; Tekin, Ali; Öner, Balbay; Kayıkçı, Muhammet AliWe planned to investigate the association between Obstructive Sleep Apnea Syndrome (OSAS) and two common urological problems, namely Lower Urinary Tract Symptoms (LUTS) and Erectile Dysfunction (ED). An overnight polysomnograph test was performed for male patients over the age of 50 who presented to Düzce University Medical Faculty, Department of Chest Diseases with symptoms of OSAS. A total of 11 patients with moderate OSAS whose Apnea-Hypopnea index (AHI) was 15-30 and 18 patients with severe OSAS whose AHI was >30 were included in the study as the first group. The 21 OSAS negative patients with AHI <5 constituted the control group. Patients with diseases that could lead to LUTS and ED were excluded from the study for both groups. Urinary symptoms were evaluated with the International Prostate Symptom Score (IPSS), uroflowmetry, prostate volume. Erectile function was assessed according to the International Index of Erectile Function (IIEF). The groups were similar in terms of age, prostate specific antigen (PSA), prostate volume. No statistically significant difference was found between the groups in terms of IPSS values and uroflowmetry parameters (p>0.05). However, there was a statistically significant difference between the groups for nocturia episodes and IIEF scores (p<0.05). OSAS was not found to be an additional risk factor for LUTS other than nocturia. On the other hand, OSAS was related with ED and nocturia. We therefore believe patients with ED and/or nocturia should be evaluated for OSAS. It is also appropriate to investigate OSAS patients in terms of having ED.Öğe High Power Diode Laser Vaporization of the Prostate: Preliminary Results for Benign Prostatic Hyperplasia(Elsevier Science Inc, 2009) Erol, Ali; Çam, Kamil; Tekin, Ali; Memik, Ömür; Çoban, Soner; Özer, YavuzPurpose: Vaporization techniques using lasers have gained wide acceptance for benign prostatic hyperplasia as an alternative to transurethral prostate resection. The high power, 980 nm wavelength diode laser is a new promising alternative with a more rapid ablation rate and excellent hemostatic properties, as shown in ex vivo and in vivo animal models. We prospectively evaluated vaporization efficiency of the high power, 980 nm diode laser for bladder outlet obstruction due to benign prostatic hyperplasia. Materials and Methods: A total of 47 consecutive patients were included in the study. Inclusion criteria were maximal flow rate 12 ml per second or less with voided volume 150 ml or greater, International Prostate Symptom Score 12 or greater and quality of life score 3 or greater. Patients with a history of neurogenic voiding dysfunction, chronic prostatitis, or prostate or bladder cancer were excluded from analysis. Preoperative maximal flow rate, post-void residual urine, International Prostate Symptom Score, quality of life, International Index of Erectile Function-5, prostate specific antigen and prostate volume were compared with values at 3 and 6 months. Complications were assessed. Results: Month 3 assessment revealed that the mean +/- SD International Prostate Symptom Score decreased significantly from 21.93 +/- 4.88 to 10.31 +/- 3.79 (p = 0.0001). The mean maximal flow rate increased significantly from 8.87 +/- 2.18 to 17.51 +/- 4.09 ml per second (p = 0.0001). Quality of life score changed considerably compared to baseline. All of these values showed slight improvement at month 6. There was no deterioration in erectile function according to the International Index of Erectile Function-5 short form. Post-void residual urine decreased significantly. Prostate volume and prostate specific antigen reductions were also significant. The most common postoperative complications were retrograde ejaculation (13 of 41 patients or 31.7%) and irritative symptoms (11 of 47 or 23.4%), which subsided in the maximal flow rate at 2 weeks. Recatheterization was necessary in 2 patients due to urinary retention after catheter removal. Two patients had temporary combined urge and stress incontinence for 2 weeks. Late bleeding in 1 patient 4 weeks postoperatively necessitated catheterization and irrigation. Conclusions: The high power diode laser provided significant improvements in International Prostate Symptom Score and the maximal flow rate with low morbidity. Thus, these results of prostate vaporization with the high power diode laser, representing what is to our knowledge the first clinical study in the literature, are encouraging.Öğe Investigation the Relationship of Lower Urinary Tract Symptoms withVascular Risk Factors(2015) Çoban, Soner; Altuner, M. Şakir; Cander, Soner; Türkoğlu, Ali Rıza; Güzelsoy, Muhammet; Gül, Özen Öz; Tekin, AliOur aim was to investigate the relationship between lower urinary tract symptoms (LUTS) in terms of vascular risk factors include diabetes. In a prospective study, a total of 116 men aged 40 years or more who presented to the outpatient clinics of urology or endocrinology between January 2012 and April 2013 were included. After receiving a detailed medical history, fasting blood glucose, serum lipids including total cholesterol, HDL and triglyceride, HbA1c, creatinine, total testosterone and total prostate-specific antigen were measured. Urinalysis and uroflowmetry were done. Postvoiding residual urine and prostate volume were measured by suprapubic ultrasonography. International Prostate Symptom Score (IPSS) of the patients were determined. Existence of vascular risk factors including hypertension, hyperlipidemia, diabetes mellitus, coronary artery disease and obesity as well as age, body mass index (BMI), weight, waist circumference and body fat percentage values were recorded. Of the patients, 41 (35.3%) had hypertension, 54 (46.6%) dyslipidemia, 68 (58.6%) diabetes mellitus, 34 (29.3%) coronary artery disease and 39 (33.6%) obesity. When the patients were grouped according to the presence of the risk factors (no risk [14 patients], mild to moderate [1-2 risk factor] [65 patients] and severe [3 or more risk factors] [37 patients]), there was no a significant difference among the groups in terms of IPSS (p 0.76). The results of this prospective study show that vascular risk factors and diabetes may not be related to LUTS.Öğe Öğe The relationship between obstructive sleep apnea syndrome and two common urological disorders(European Respiratory Soc Journals Ltd, 2012) Çoban, Soner; Balbay, Ege Güleç; Çam, Kamil; Kayıkçı, Ali; Balbay, Öner Abidin…Öğe Tıkayıcı uyku apne sendromu ile alt üriner sistem yakınmaları arasındaki ilişkinin araştırılması(Düzce Üniversitesi, 2010) Çoban, Soner; Çam, H. KamilAmaç: Alt Üriner Sistem Yakınmaları (AÜSY) genel olarak yaşlı erkeklerde ortayaçıkan önemli bir halk sağlığı sorunudur. Tıkayıcı Uyku Apne Sendromu (OSAS) da birçokhastalıkla birlikte ilişki olabilen önemli bir sağlık problemidir. Bu prospektif çalışmada,önemi giderek artan iki yaygın sorun olarak AÜSY ve OSAS arasındaki ilişkinin araştırılmasıplanlandı.Gereç Yöntem: Ocak 2007- Nisan 2010 tarihleri arasında Düzce Üniversitesi TıpFakültesi Göğüs Hastalıkları Anabilim Dalı'na OSAS şüphesi ile başvuran 50 yaş üstü erkekhastalara tüm gece polisomniografi testi yapıldı. Apne-Hipopne İndeksi (AHİ): 15-30 olan ortaOSAS'lı 11 hasta ve AHİ>30 olan ağır OSAS'lı 18 hasta ilk grup olarak çalışmaya dahiledildi. AHİ<5 altında olan OSAS negatif 21 hasta ise kontrol grubuna alındı. Her iki gruptada AÜSY yol açabilecek hastalıkları olanlar çalışma dışı bırakıldı. İşeme şikayetleri;Uluslararası Prostat Semptom Skoru (IPSS), üroflometri, prostat volümü ve noktüri sayısıkullanılarak; erektil disfonksiyon (ED) değerlendirilmesi ise Uluslararası Erektil Fonksiyonİndeksine (IIEF) göre yapıldı.Bulgular: Her iki grup yaş, prostat spesifik antijen (PSA), prostat volümü, rektalmuayenedeki prostat büyüklüğü açılarından benzer bulundu. Gerek IPSS değerleri gerekse deüroflovmetri parametreleri bakımından da her iki grup arasında istatistiksel anlamlı bir farkgörülmedi. OSAS grubunda ortalama total IPSS değeri 10,58, ortalama maksimum akım hızı(Qmaks) 17,51 ml/sn iken; OSAS negatif grupta aynı değerler sırasıyla 9,19 ve 16,95 ml/snolarak bulundu (p>0,05). Buna karşın noktüri ve erektil disfonksiyon parametresi açısındanyapılan karşılaştırmada ise OSAS grubunda ortalama noktüri sayısı 1,47, IIEF skoru 15,48iken; diğer grupta bu değerler sırasıyla 0,88 ve 19,90 olarak bulundu. Aralarındaki farkistatistiksel anlamlı olarak saptandı (p<0,05).Sonuçlar: Bu çalışmada; OSAS tanısı konmuş hastalar ile OSAS tanısı almamış hastalararasında IPSS ve üroflovmetri değerleri açısından istatistiksel anlamlı bir farklılık saptanmadı.Öte yandan noktüri ve IIEF sonuçları bakımından OSAS'lı hastalarda istatistiksel olarakanlamlı farklılık belirlendi. Sonuç olarak bu çalışma verilerine göre, OSAS'ın AÜSYaçısından noktüri haricinde bir risk faktörü olmadığı tespit edildi. Öte yandan OSAS'ın,erektil disfonksiyon ve noktüri açından bir risk faktörü oluşturduğu belirlendi. Bu nedenle,gerek ED ve gerekse de noktüri ile başvuran hastaların OSAS açısından da sorgulanmasıgerektiği düşünüldü. Benzer şekilde OSAS hastalarının da ED açısından tetkik edilmesininuygun olacağı görüldü. Bu prospektif çalışma OSAS ve AÜSY arasındaki ilişkiyi sorgulayanilk araştırmalardan biri olması açısında oldukça önemli olmakla birlikte, söz konusu ilişkiyiirdeleyen son derece geniş kapsamlı çalışmalara ihtiyaç duyulduğu ortadadır.
