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    An effective treatment option for pain caused by urolithiasis: A randomised-controlled trial of local active warming with heat-patch
    (Blackwell Publishing Ltd, 2021) Mutlu, Hüseyin; Ertaş, Kasım; Kokulu, Kamil; Sert, Ekrem Taha; Diri, Mehmet Akif; Gül, Murat
    Background: There is growing interest in physical medicine treatment options for renal colic. In this study, we aimed to determine whether or not heat-patch treatment with no drug was effective in relieving renal colic. Methods: For this purpose, patients who were diagnosed with renal colic in the emergency department were randomised to have either heat-patch or sham treatment. The Visual Analogue Scale (VAS) scores of renal colic, body temperature (Btemp), and sub-patch skin temperature (Stemp) values were measured at 0, 15, 30, 45, and 60 minutes. In addition, the salvage treatment needs of the groups were compared. Results: The average age of the study group was 30.5 ± 8.3 years and that of the sham group was 31.0 ± 8.2 years (P =.75). According to the baseline VAS score of the patients, 15, 30, 45, and 60 minutes VAS scores significantly decreased in the heat-patch group (P <.001). The Btemp values did not differ significantly between the heat-patch and sham groups. In addition, no statistically significant difference was found between the two groups in terms of Stemp values at 0 and 15 minutes (P =.39 and P =.10, respectively). However, there was a significant difference in the heat-patch group in terms of Stemp values at 30, 45, and 60 minutes compared with the sham group (P <.001). The salvage treatment rates for the heat-patch and sham groups were 11.5% and 31.4%, respectively (P =.01). Conclusion: As non-pharmaceutical treatment, the heat-patch has been shown to be a possible candidate for pain relief in patients with urolithiasis. Further research should concentrate on multicentre and large scale randomised studies.
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    Bipolar prostate thermotherapy for the improvement of chronic prostatitis symptoms and ejaculation problems
    (Taylor and Francis Ltd., 2021) Diri, Mehmet Akif; Gül, Murat
    This study aims to evaluate the efficacy of the new bipolar radiofrequency thermotherapy device (TEMPRO) on urinary and sexual functions in patients with chronic prostatitis. Between April 2017 and September 2018, 42 male patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) were included. The patients had received at least 6 months of treatment via conventional medical treatments. NIH-Chronic Prostatitis Symptom Index (CPSI), International Index of Erectile Function–Erectile Function part (IEEF-EF), and Premature Ejaculation Profile (PEP). The intravaginal ejaculation latency times (IELT) of the patients were recorded before and 6th months after the procedure. Bipolar radiofrequency thermotherapy was applied with TEMPRO system containing a16Fr applicator. The mean age of the patients was 42.62 ± 8.25 years. All patients were treated with local anesthesia, and three patients were unable to complete the procedure. After 6 months, significant improvements were observed in the NIH-CPSI total (20.25 vs. 12.18; p <.001) and subgroup scores, PEP scores (0.98 ± 1.12 vs. 2.06 ± 1.03; p <.001) and IELT (68.24 ± 56.78 vs. 103.02 ± 188.56; p <.001). There was no significant difference between IIEF-EF scores. Symptomatic improvement was observed in 78.57% (33/42) of the patients. Bipolar radiofrequency thermotherapy, which is a transurethral method in patients with CP/CPPS, decreases the severity of the disease and improvement of the symptom scores on urinary and sexual function.
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    Effect of bipolar radiofrequency thermotherapy on benign prostate hyperplasia
    (Blackwell Publishing Ltd, 2020) Diri, Mehmet Akif; Gül, Murat
    This study aims to evaluate the safety and efficacy of the new bipolar radiofrequency thermotherapy device (TEMPRO) in treating patients with benign prostate hyperplasia (BPH). Between December 2017 and November 2018, 72 male patients with BPH were included. All patients completed the International Prostate Symptom Score (IPSS) and International Index of Erectile Function-5 (IIEF-5) questionnaires. Physical examinations were performed, and prostate volume, prostatic urethral length and post-voiding residual urine (PVR) were measured using ultrasound. Uroflowmetry was used to calculate the maximum flow rate of urination (Qmax). Bipolar radiofrequency thermotherapy was applied with TEMPRO system containing a 16Fr applicator. All patients were re-evaluated at 6 months post-operatively. The mean age of the patients was 63.22 ± 6.68 years. All patients were treated with local anaesthesia, and three patients were unable to complete the procedure. The median (IQR) visual analogue scale score was 1 (0–3) at 6 hr post-operatively. After 6 months, significant improvements were observed in the IPSS, QoL, Qmax and PVR values of the patients (p <.001 for Qmax, IPSS and QoL; p =.03 for PMR). The success rate of the procedure was similar between patients with prostate volumes <70 and >70 ml. Due to its low rate of complication, the TEMPRO© treatment is effective in treating BPH, especially among aged patients and those with serious symptoms.
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    Effect of simple calculation and reading aloud on cognitive function and depression in postoperative older adults
    (Wiley, 2022) Çetinkaya, Funda; Diri, Mehmet Akif; Gül, Murat
    Background This study was conducted to determine the effect of simple calculation and reading aloud on postoperative cognitive function and depression level in older adults. Method The study was a randomised controlled experimental study. A personal information form, Mini-Mental State Examination (MMSE) and Geriatric Depression Scale (GDS) were used for data collection. Results In the evaluation of MMSE and GDS scores of the intervention and control groups 4 weeks after the operation, the differences between the two groups were found to be statistically significant. Conclusion The results found that simple calculation and reading aloud after surgery had a positive effect on cognitive function and depression level in older people.
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    Surrogate testes: Allogeneic spermatogonial stem cell transplantation within an encapsulation device may restore male fertility
    (Churchill Livingstone, 2020) Gül, Murat; Dong, Lihua; Wang, Danyang; Diri, Mehmet Akif; Andersen, Claus Yding
    Toxic insult to the gonads by chemotherapy or radiotherapy can lead to permanent infertility. It’s an important health concern because each year more than 4000 male patients are at risk of azoospermia in the United States due to gonadotoxicity of the regimens used. There are also several benign/genetic diseases whose natural course can result in infertility without gonadotoxic therapy. Considering the fact that most of these people are cured and survive with the advent of modern medicine, infertility is related to serious psychological and relationship implications and parenthood is a significant issue for those patients. Semen cryopreservation option is available for postpubertal adolescent and adult men, while children do not have this storing option since they do not have mature spermatozoa. However, their testes contain spermatogonial stem cells (SSCs), which are initiators of spermatogenesis. Promising findings in animal studies and human cell lines have encouraged scientists that SSCs may be hope for restoring fertility option of patients who cannot produce functional sperm and who have no other choice to preserve their future fertility. For this reason, several centers around the world already began to collect and cryopreserve testicular tissue or cells with anticipation that SSC-based therapies will be available in the near future; however, an optimal transplantation design in humans is yet to be developed. Here we propose an allogeneic testicular stem cell transplantation with an encapsulation device to restore fertility in patients with infertility. We endeavor to discuss the reliability of this method with the current literature and bring the evidence on its feasibility.
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    The effect of dutasteride on microscopic and macroscopic changes of testosterone replacement treatment on prostate tissue
    (Wıley, 2018) Diri, Mehmet Akif; Diri, Banu; Yıldız, Levent; Büyükalpelli, Recep
    Testosterone replacement therapy has a growing interest in daily practice; however, debates on its safety for prostate cancer still continue. Dutasteride-a 5 alpha-reductase inhibitor-was shown to be effective in preventing prostate cancer. We therefore aimed to evaluate the effect of testosterone replacement therapy and dutasteride treatment on prostate tissue in castrated rats. Rats were randomised in four groups after bilateral orchidectomy as follows: Group I received testosterone + dutasteride, Group II received only testosterone, Group III had no medical treatment, and Group IV was the control group. After 3 months, rats were sacrificed and laboratory and histopathological examinations were performed. In Groups I and II, prostate volume, T and DHT levels were significantly higher compared to Group III and controls. Groups I and II had also significantly greater preneoplastic histopathological signs; however, in intergroup analyses, Group I showed less premalignant changes compared to Group II. We concluded that dutasteride was effective when combined with testosterone therapy in preventing premalignant histopathological changes in prostate tissue. Further evidence is needed to confirm our findings.
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    The effects of listening to music on anxiety, pain, and satisfaction during urodynamic study: A randomized controlled trial
    (S. Karger AG, 2019) Diri, Mehmet Akif; Çetinkaya, Funda; Gül, Murat
    Introduction: To assess the influence of music therapy on perceived anxiety and pain during outpatient urodynamic study (UDS) in a prospective, randomized fashion. Methods: Between January and December 2018, a total of 70 patients were randomized to either have music therapy (study) or not have (control) in a 1:1 ratio. To the study group, Sufi music was delivered at low tempo. All participants performed the State-Trait Anxiety Inventory evaluation after the procedure and assessed their degree of pain, satisfaction, and willingness to undergo an additional or repeat procedure using the Visual Analog Scale. Results: Patient demographic and baseline characteristics were found to be similar between the 2 groups. Though music did not significantly alleviate pain (4.6 ± 1.2 vs. 4.4 ± 1.7; p = 0.76) and anxiety (47.7 ± 7.75 vs. 46.4 ± 6.5; p = 0.36), it had a positive impact on the patient's willingness to repeat UDS (3.4 ± 1.4 vs. 6.1 ± 1.3; p = 0.005) and provided overall satisfaction (4.6 ± 0.61 vs. 7.2 ± 1.33; p = 0.004). Conclusions: Music is a practical, harmless, and inexpensive non-pharmacological option that can be adopted during medical and surgical procedures, although according to this present study, listening to music during UDS had no effect on pain and anxiety levels.
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    YouTube as a source of information about premature ejaculation treatment
    (Elsevier B.V., 2019) Gül, Murat; Diri, Mehmet Akif
    Introduction: An increasing number of patients are seeking premature ejaculation (PE) therapy online. Although health care information on the Internet about PE is abundant, the quality of information about its treatment on YouTube, the most visited online video streaming service, is unknown. Aim: The aim of this study was to assess the role of videos pertaining to the treatment of PE through YouTube. Methods: A cross-sectional study was performed through YouTube using the keywords “cure premature ejaculation,” “end premature ejaculation,” “stop premature ejaculation,” or “premature ejaculation treatment.” The videos were sorted as reliable or nonreliable by 2 urologists as they may contain scientifically proven information or not. Nonrelevant, non-English, and silent videos were excluded. Video demographics were analyzed by the quality and source of the video. Main Outcome Measures: A 5-point global quality scale, a 5-point modified reliability (DISCERN) tool, kappa statistic, the intraclass correlation coefficient, and descriptive statistics in the form of proportions and percentages were used. Results: Of the 800 videos, 668 were excluded because they were duplicates (n = 389), irrelevant (n = 49), not in English (n = 284), or had no audio (n = 51). Of the 132 videos, 93 (70%) were described as reliable and 39 (30%) as nonreliable. The kappa statistic for interobserver agreement was 0.832. In the reliable information group, the reliability (2.55 ± 1.03) and quality scores of the contents (2.74 ± 1.06) were statistically higher than those in the nonreliable information group (0.23 ± 0.53 and 1.15 ± 0.48, respectively; P < .05). The majority of the nonreliable information group comprised medical advertisement/for-profit companies (51%) and individuals (41%). There was no significant difference between the reliable and nonreliable information groups in terms of average views (P = .873) and viewed videos per day (P = .538). Clinical Implications: Evaluating videos about the management of PE holds promise for understanding what men are exposed to. Strength & Limitations: The study simultaneously investigated the quality and accuracy of YouTube videos by several aspects using validated instruments. As for limitations, there is no consensus in the literature regarding how to assess health care-related online videos, and the results were not derived from patients’ perceptions. Conclusion: The study highlights data about the treatment of PE on YouTube. Videos with reliable information outnumbered those with nonreliable information. This is the first study to demonstrate that YouTube is an important source of data on PE management. Physicians and health care providers should contribute reliable content, and YouTube should remove deceptive videos before patients watch them Gul M, Diri MA. YouTube as a Source of Information About Premature Ejaculation Treatment. J Sex Med 2019;16:1734–1740.