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Ömer Gülpınar,Ahmet Hakan Haliloğlu,Mehmet İlker Gökce,Nihat Arıkan 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.5
Purpose: In the treatment of interstitial cystitis, intravesical hyaluronic acid application may be suggested as a treatment option. In this randomized prospective study, the authors aimed to identify whether instilling the hyaluronic acid with electromotive drug administration (EMDA) would increase the tissue uptake and improve the efficacy. Materials and Methods: The data of 31 patients who had been diagnosed with bladder pain syndrome/interstitial cystitis (BPS/IC) between 2004 and 2005 were examined. The patients were randomized to two groups: patients in group A received hyaluronic acid directly with a catheter and patients in group B received hyaluronic acid with EMDA. The patients were followed for 24 months and the two groups were compared at certain time intervals. The primary end points of the study were visual analogue scale (VAS) score, global response assessment, and micturition frequency in 24 hours. Results: There were 6 males and 25 females. The two groups were similar in baseline parameters. The decrease in VAS score and the micturition frequency in 24 hours were significantly lower with EMDA at months 6 and 12. The difference between the two groups was not significant at months 1 and 24. Also, treatment with EMDA, positive KCl test, and pretreatment voiding frequency >17 were associated with higher response rates. Conclusions: Hyaluronic acid installation is an effective glycosaminoglycan substitution therapy in patients with BPS/IC. Instillation of hyaluronic acid via EMDA can improve the efficacy of the treatment; however, lack of long-term efficacy is the major problem with this glycosaminoglycan substitution therapy.
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Ömer Gülpınar,Evren Süer,Mehmet İlker Gökce,Ahmet Hakan Haliloğlu,Erdem Öztürk,Nihat Arıkan 대한비뇨의학회 2013 Investigative and Clinical Urology Vol.54 No.6
Purpose: To evaluate the long-term outcomes of artificial urinary sphincter (AUS) implantation and to report the complication rates, including mechanical failure, erosion,and infection. Materials and Methods: From June 1990 to May 2011, AUS (AMS 800) implantations were performed in 56 adult males by one surgeon. Various demographic and preoperative variables, surgical variables, and postoperative outcomes, including success and complication rates with a median follow-up of 96 months, were recorded retrospectively. Results: The mean age of the patients at the time of AUS implantation was 61.8 (±14.2)years. During the follow-up period, the total complication rate was 41.1% (23 patients). The incidence of complications was significantly lower during the follow-up period after 48 months (p<0.05). Kaplan-Meier analysis revealed that 5- and 10-year failure-free rates were 50.3% and 45.2%, respectively. Conclusions: Long-term durability and functional outcomes are achievable for the AMS 800, but there are appreciable complication rates for erosion, mechanical failure, and infection of up to 30%.
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Effect of Type 2 Diabetes Mellitus on Prognosis of Nonmetastatic Renal Cell Cancer
Evren Süer,Erdem Öztürk,Ömer Gülpınar,Aytaç Kayış,Sümer Baltacı 대한비뇨의학회 2013 Investigative and Clinical Urology Vol.54 No.8
Purpose: We evaluated the prognostic value of type 2 diabetes mellitus (DM) in patients treated surgically for localized renal cell carcinoma (RCC). Materials and Methods: Between 1995 and 2011, 588 patients with renal tumor diagnoses were treated surgically and 492 patients with pathologically confirmed nonmetastatic RCC diagnoses were included in the study. The associations of clinical and pathologic parameters with a type 2 DM diagnosis were evaluated. Kaplan-Meier estimations for disease-specific survival (DSS) and overall survival (OS) were generated according to type 2 DM diagnosis, and the log-rank test was used to compare survival according to the variables. Results: The mean age of the patients was 56.7±12 years (range, 15 to 84 years; median, 58 years) and the mean length of follow-up was 35.9±28 months (range, 1 to 145 months; median, 34.3 months). Of the 492 patients, 62 (12.6%) had a diagnosis of DM at the time of surgery (group I) and 430 did not have DM (group II). The mean age and the incidence of clear cell RCC histological subtype were significantly higher in group I than in group II (p<0.001 and p=0.036, respectively). Although DSS and OS were lower in group I, this difference was not significant. Type 2 DM was not detected as an independent prognostic factor for DSS and OS. Conclusions: This study investigated the role and effect of DM on the prognosis of localized RCC that was treated surgically. The present study did not detect DM as an independent prognostic factor for RCC.
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