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        Comparison of Ultrasound-Guided Transgluteal and Finger- Guided Transvaginal Pudendal Nerve Block Techniques: Which One is More Effective?

        Ahmet Kale,Taner Usta,Gulfem Basol,Isa Cam,Melike Yavuz,Hande G. Aytuluk 대한배뇨장애요실금학회 2019 International Neurourology Journal Vol.23 No.4

        Purpose: Pudendal neuralgia (PN) is a painful and disabling condition, which reduces the quality of life as well. Pudendal nerve infiltrations are essential for the diagnosis and the management of PN. The purpose of this study was to compare the effectiveness of finger-guided transvaginal pudendal nerve infiltration (TV-PNI) technique and the ultrasound-guided transgluteal pudendal nerve infiltration (TG-PNI) technique. Methods: Forty patients who underwent PNI for the diagnosis of PN were evaluated. Thirty-five of these 40 patients, who were diagnosed as PN, underwent a total of 70 further unilateral PNI. All the patients underwent PNI for twice after the first diagnostic PNI, 1 week apart. Results: In the ultrasound (US)-guided TG-PNI group, the success rate was 68.8% (11 of 16) in both “pain in the sitting position” and “pain in the region from the anus to the clitoris.” The success rate of blocks in the US-guided TG-PNI group was 75% (12 of 16) in terms of pain during/after intercourse. In the finger-guided TV-PNI group, the success rate was 84.2% in both “pain in the sitting position” and “pain in the region from the anus to the clitoris.” The success rate of blocks in the fingerguided TV-PNI group was 89.5% (17 of 19) in terms of pain during/after intercourse. There was no statistically significant difference in the success rate of the 3 assessed conditions between the 2 groups (P>0.05). Conclusions: The TV-PNI may be an alternative to US-guidance technique as a safe, simple, effective approach in pudendal nerve blocks.

      • KCI등재

        Intrapelvic Nerve Entrapment Syndrome Caused by a Variation of the Intrapelvic Piriformis Muscle and Abnormal Varicose Vessels: A Case Report

        Ahmet Kale,Gulfem Basol,Ahmet C. Topcu,Elif C. Gundogdu,Taner Usta,Recep Demirhan 대한배뇨장애요실금학회 2021 International Neurourology Journal Vol.25 No.2

        Entrapment neuropathy of the sciatic nerve and pudendal nerve are painful syndromes that are often overlooked by physicians. Laparoscopic surgical interventions for nerve entrapment syndromes of the posterior pelvis focus on removing the compression lesion with the purpose of eliminating the suspected cause of sciatica, as well as pudendal neuralgia. Herein, the authors report the rare event of sciatic and pudendal nerve entrapment, which was caused by aberrant vessels and a variant piriformis muscle bundle, as a seldom-diagnosed cause of sciatica and pelvic pain, for both neurosurgeons and neuropelveologists. The authors present the laparoscopic decompression technique for the pudendal and sciatic nerves by giving our technical “tips and tricks” enriched by a surgical video.

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        High-impact chronic pain: evaluation of risk factors and predictors

        İlteriş Ahmet Şentürk,Erman Şentürk,Işıl Üstün,Akın Gökçedağ,Nilgün Pulur Yıldırım,Nilüfer Kale İçen 대한통증학회 2023 The Korean Journal of Pain Vol.36 No.1

        Background: The concept of high-impact chronic pain (HICP) has been proposed for patients with chronic pain who have significant limitations in work, social life, and personal care. Recognition of HICP and being able to distinguish patients with HICP from other chronic pain patients who do not have life interference allows the necessary measures to be taken in order to restore the physical and emotional functioning of the affected persons. The aim was to reveal the risk factors and predictors associated with HICP. Methods: Patients with chronic pain without life interference (grade 1 and 2) and patients with HICP were compared. Significant data were evaluated with regression analysis to reveal the associated risk factors. Receiving operating characteristic (ROC) analysis was used to evaluate predictors and present cutoff scores. Results: One thousand and six patients completed the study. From pain related cognitive processes, fear of pain (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.87–0.98; P = 0.007) and helplessness (OR, 1.06; 95% CI, 1.01–1.12; P = 0.018) were found to be risk factors associated with HICP. Predictors of HICP were evaluated by ROC analysis. The highest discrimination value was found for pain intensity (cut-off score > 6.5; 83.8% sensitive; 68.7% specific; area under the curve = 0.823; P < 0.001). Conclusions: This is the first study in our geography to evaluate HICP with measurement tools that evaluate all dimensions of pain. Moreover, it is the first study in the literature to evaluate predictors and cut-off scores using ROC analysis for HICP.

      • Complementary and Alternative Medicine Use by Gynecologic Oncology Patients in Turkey

        Nazik, Evsen,Nazik, Hakan,Api, Murat,Kale, Ahmet,Aksu, Meltem Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.1

        The use of complementary and alternative medicines (CAM) among women with gynecologic cancer is becoming increasingly popular. Therefore, it is important to gain insight into the prevalence and factors related to the use of CAM. The aim of this study was to assess the use of CAM in women with gynecologic cancer. This is a descriptive cross-sectional study. Data were obtained from 67 gynecological cancer patients at gynecologic oncology clinic of a hospital in Turkey between October 2009 to December 2010 using a questionnaire developed specifically for this study. The instrument included questions on socio-demographic information, disease specifics and complementary and alternative medicine usage. On the basis of women's responses, all participants were divided into 2 groups: CAM users and nonusers. The findings indicated that 61.2% of the women reported the use of 1 or more CAM therapies. There were no significant differences in the sociodemographic and clinical characteristics between CAM users and nonusers (P <0.05). The most frequently used CAM method was herbal therapy (90.2%) and the second was prayer (41.5%). The main sources of information about CAM were informal (friends/ family members). A considerable proportion (56.1%) of CAM users had discussed their CAM use with their physicians or nurses. Turkish women with gynecologic cancer frequently use CAM in addition to standard medical therapy. Nurses/ oncologists caring for women with gynecologic cancer should initiate a dialogue about usage of CAM, discussing the potential adverse effects of CAM and the patient's therapeutic goals.

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