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    Combined periprostatic and intraprostatic local anesthesia for prostate biopsy: A double-blind, placebo controlled, randomized trial
    (Elsevier Science Inc, 2008) Çam, Kamil; Şener, Murat; Kayıkçı, Ali; Akman, Yavuz; Erol, Ali
    Purpose: Transrectal ultrasonography guided prostate biopsy is the principle procedure in the histological diagnosis of prostate cancer. Recently a trend toward increasing the number of cores has been popularized. This practice further increases the need for a proper anesthetic application. However, there is no consensus on a standard local anesthetic strategy, while groups at most institutions currently prefer periprostatic anesthesia. We prospectively evaluated the contribution of intraprostatic anesthesia for transrectal prostate biopsies even when the sampling number was doubled to 12 cores. Materials and Methods: A total of 200 patients who underwent prostate biopsy with transrectal ultrasound guidance were included. The 2 groups received the usual periprostatic anesthesia. Consequently patients were prospectively randomized into 2 groups. Group 1 received additional intraprostatic lidocaine injection, while group 2 received the same amount of injection of 0.9% NaCl. The efficiency of applied local anesthesia was assessed by a visual analog pain scale. Results: The study groups were comparable regarding patient age, prostate size and cancer rate. Pain scores revealed that the combination of intraprostatic and periprostatic local anesthesia provided significantly better pain control than periprostatic infiltration alone. No difference was observed regarding the morbidity rate in the 2 groups. Conclusions: The current study suggested that adding intraprostatic local anesthesia provides a significantly efficient strategy during transrectal ultrasound prostate biopsy, even in cases of 12-core sampling. Subsequent trials are needed to establish a standard analgesia policy for prostate biopsy.
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    Contemporary approach in the medical treatment for benign prostatic hyperplasia
    (2003) Çiçekçi, B.; Çam, Kamil; Akman, Yavuz; Erol, Ali
    Benign prostatic hyperplasia (BPH) contemporarily constitutes one of the major public health problems as its incidence increases with aging. Surgical treatment modalities were the main stay in the management of BPH. However, several medical treatment alternatives have been developed and extensively utilised especially during the last decade. Consequently, medical treatment alternatives have decreased the number of surgeries for BPH all over the world. In this review, current medical treatment approaches in the management of BPH were discussed.
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    Prospective assessment of the efficacy of single dose versus traditional 3-day antimicrobial prophylaxis in 12-core transrectal prostate biopsy
    (Wiley, 2008) Çam, Kamil; Kayıkçı, Ali; Akman, Yavuz; Erol, Ali
    Objectives: To prospectively evaluate the efficacy of single dose antibiotic prophylaxis in 12-core transrectal ultrasonography (TRUS) guided prostate biopsy. Methods: A total of 400 patients who underwent prostate biopsy with TRUS guidance were included. The patients were prospectively randomized in three groups regarding antibiotic prophylaxis. The first group (139 patients) received a single gram of intramuscular ceftriaxone, while the second group (131 patients) had a 3-day course of oral ciprofloxacin. The third group (130 patients) had single oral 500 mg of ciprofloxacin. All patients had urine cultures prior to biopsy and on the second day after biopsy. Results: The study groups were compared in terms of the results of urine cultures and clinical parameters. Overall, only seven patients (1.8% of the cases) had positive urine cultures with no difference between these three groups. Additionally, no significant difference was observed regarding morbidity rates in all groups. Only eight patients (2%) developed major complications requiring hospitalization. There was no increase in the rate of infectious complications when the biopsy core numbers were increased up to 12. Conclusions: The current study suggests that a single oral dose of antimicrobial prophylaxis is reasonable in TRUS prostate biopsy even in the case of 12-core sampling.
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    The ratio of external genital anomalies in male children attending primary school in Düzce
    (2005) Kayıkçı, Muhammet Ali; Çam, Kamil; Akman, Yavuz; Erol, Ali
    Introduction: The aim of the study was to identify the rates of external genital anomalies in male children who are attending primary school in Düzce. Materials and methods: A total of 1534 children out of 13420 male students attending to 25 primary schools in Düzce were included into the study. The age range was between 7 and 16. The same physician examined all students, and external genital anomalies were identified and noted. Results: In this study, a total of 110 (7.2%) anomalies were identified in 104 students. The most common anomalies were varicocele (3.22%), phimosis (1.49%) and undescended testis (1.10%). Conclusion: The rate of external genital anomalies was found to be remarkably high. Actually, almost all of these anomalies had had to be diagnosed and managed before the school ages. Consequently, the results of the current study suggest that there is an insufficient examination and follow up during the neonatal period extending up to school ages. In addition to this, parents do not have any information about these pathologies. Such undiagnosed pathologies will cause significant psychological and urological problems in these children. They may also progress to tumor or infertility. Therefore, this observation should be regarded as an important public health issue.
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    Single vs. Double Dartos Interposition Flaps in Preventing Urethrocutaneous Fistula after Tubularized Incised Plate Urethroplasty in Primary Distal Hypospadias: A Prospective Randomized Study
    (Karger, 2009) Erol, Ali; Kayıkçı, Ali; Memik, Ömür; Çam, Kamil; Akman, Yavuz
    Introduction: This prospective study was designed to compare symmetrical overlapping double flaps with a single dartos flap in regard to fistula formation as an adjunct to tubularized incised plate urethroplasty (TIPU). Patients and Methods: 77 consecutive children with primary coronal or subcoronal hypospadias were randomized into 2 groups. A single layer dartos flap was used to cover the anastomotic site in the first group (37 patients). A wider dorsal dartos flap bisectioned in the midline was utilized in the second group of 40 patients. The complication rates were compared. Results: There was no difference between the 2 groups in terms of age, and meatal location. Postoperative median follow-up was 34 months. Urethrocutaneous fistula occurred in 3 patients (8.1%) of the monolayer group. No fistula developed in the second group with double flaps. Conclusions: The current study proposes that the use of double dorsal flaps, although statistically not significant, better prevents fistula formation compared to monolayer dartos flaps following TIPU operation. Copyright (C) 2009 S. Karger AG, Basel
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    Surgical treatment alternatives in the management of benign prostatic hyperplasia [Selim prostat hiperplazisinde cerrahi tedavi seçenekleri]
    (2003) Kayıkçı, Muhammet Ali; Çam, Kamil; Akman, Yavuz; Erol, Ali
    Benign prostatic hyperplasia (BPH) contemporarily constitutes a major public health problem especially in developed countries as its incidence increases with aging. Although several medical treatment alternatives have been developed, surgical management still provides the most successful clinical outcome. Trans-urethral prostate resection (TUR-P) is accepted as the gold standard in the management of BPH. However, in considering the relatively high rate of morbidity of TUR-P, several minimally invasive surgical treatment alternatives have been developed. In this review, we discussed the surgical treatment alternatives in the management of BPH.