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    Do Antiplatelet Drugs Use Contribute to Clinical Outcomes in Patients Receiving Penile Low- Intensity Shock Wave Therapy (Li-SWT) for Erectile Dysfunction?
    (Merthan TUNAY, 2023) Geyik, Serdar; Değer, Mutlu; Akdoğan, Nebil; Kankılıç, Nazım; Yılmaz, İsmail Önder; Arıdoğan, İbrahim Atilla
    Low-intensity extracorporeal shock wave therapy (Li-SWT) is one of the recommended treatment options in patients with erectile dysfunction (ED). Li-SWT is safe in patients using antiplatelet drugs (APs), however, there are no specific studies on the contribution of APs use to clinical improvement in erectile function. We aimed to evaluate the early clinical results of Li-SWT administration and whether the use of APs had an additional positive contribution to clinical improvement and safe in ED patients. Methods: Patients with ED for more than 6 months despite using (5 mg/day) PDE5i were included in our study. Patients treated with Li-SWT and using PDE5i were classified as Group 1, patients treated with Li-SWT and using APs and using PDE5i were considered Group 2. The evaluation results of the International Index of Erectile Function-Erectile Function Area(IIEF-EF) in all patients baseline and after treatment were examined. Results: There are 25 patients in each group. Analysis of IIEF-EF scores showed significant increases in both groups after treatment [group 1 (p=0.001); group 2 (p=0.001)]. When the IIEF-EF scores of the groups before and after the treatment were compared with each other; it was shown that baseline scores were similar(p=0.746) and that APs use had no statistically significant effect on post-treatment scores (p=0.613) No side effects were seen in APs. Conclusions: This study showed that penile Li-SWT significantly increases the IIEF-EF scores and response of (5 mg/day) PDE5i in ED patients and safe, also in AP users. However, Using AP in Li- SWT does not contribute positively to clinical results.
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    Management Patterns of Male Urethral Stricture Disease among Urologists: What Do the Guidelines Say? What Do Urologists Do?
    (Iniestares, S.A., 2024) Değer, Mutlu; Cebeci, Oğuz Özden; Ateş, Tunahan; Geyik, Serdar; Girgin, Reha; Bozkurt, Ozan
    The aim of the present study is to evaluate and analyze the daily clinical practice for male urethral stricture disease (MUSD) among urologists. Methods: Considering the latest guidelines on urethral stricture disease, a survey was developed regarding the various treatment options and preferences in different sites of male urethral stricture disease. The survey was sent to urologists via e-mail and phone application. Results: A total of 266 urologists completed the survey and were included in the final analysis. In regard to workplace, 62 (23.3%), 58 (21.8%), 71 (26.7%), and 75 (28.2%) respondents worked in university hospitals, training and research hospitals, state hospitals, and private practice hospitals, respectively. In regard to the diagnostic method used in male urethral strictures, 88.7% of the participants would choose uroflowmetry + postvoiding residual (UF + PVR), and 64.6% would choose retrograde urethrography (RUG). Direct vision internal urethrotomy (DVIU) was the most frequently chosen method in penile urethral strictures (PUS), being chosen by 72.9%. Direct vision anterior internal urethrotomy was the most common method for both ?2 cm and >2 cm strictures, 63.1%, and 30.8%, respectively. The most preferred graft for augmentation urethroplasty was buccal mucosa (75.8%). Endoscopic incision/resection (transurethral resection (TUR)) is the most frequently applied treatment method for posterior urethral/vesicourethral anastomotic strictures (86.4%). Conclusions: The present study clearly shows that most urologists still prefer DVIU and urethral dilatation to urethroplasty in MUSD, which contradicts current guidelines. Urologists should be encouraged to perform urethroplasty and/or refer patients to experienced centres for recurrent MU
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    Outcomes of Transurethral Deep Lateral Incision in Bladder Neck Contractures
    (Aksaray Üniversitesi, 2025) Babayiğit, Muammer; Geyik, Serdar; Bayburtluoğlu, Veysel
    following prostate surgeries. The aim of this study is to evaluate the outcomes of transurethral deep lateral incision without intralesional agents in the management of recurrent BNC and to compare the results with existing literature. Material and Method: A retrospective analysis of 12 patients who underwent transurethral deep lateral incision for recurrent BNC between January 2023 and June 2024 was performed. Data collected included demographic characteristics, surgical details, and postoperative outcomes. Success was defined as the absence of dilation requirements and a lack of obstructive uroflowmetric patterns within 6 months. Complications were classified according to the modified Clavien-Dindo system. Results: The mean age of the patients was 68.25 years. Etiologies included radical prostatectomy (5 patients), transurethral resection of the prostate (5 patients), and combined radical prostatectomy with radiotherapy (2 patients). The mean operative duration was 32.67 minutes, and the overall success rate was 83.3%. Two patients (16.6%) experienced recurrence requiring additional intervention. Postoperative incontinence was observed in 16.6% of cases and was managed conservatively. No intralesional agents were used, and the procedure achieved comparable success rates to more complex techniques with fewer associated complications. Conclusion: Transurethral deep lateral incision is an effective and minimally invasive technique for managing recurrent BNC, offering high success rates without the need for intralesional agents. This approach can be considered a primary treatment option before resorting to more invasive surgical methods.