Browsing by Author "Eroglu, Askin"

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Comparison of Three Different Antibiotic Protocols Used as Prostate Biopsy Prophylaxis in Terms of Infectious Complications
(2020) Eroglu, Askin; Kilic, Sahin
Objective: Development of urinary infection and sepsis following prostate biopsy procedure is the main problem. Despite use of antibiotic prophylaxis, which becomes a routine procedure in prostate biopsy, urinary infection and sepsis may significantly be observed. Furthermore, there is no consensus in terms of the type and duration of prophylaxis. This study aimed to compare the incidence of infectious complications, which developed during 3 different prophylaxis protocols used in our institution. Materials and Methods: Four hundred and eighteen prostate biopsy procedures performed in our institution between 2010 and 2017 were evaluated retrospectively. Patients were divided into 3 groups based on their prophylactic antibiotic protocols. First group patients (n=136) were given ciprofloxacin and gentamicin 80 mg. Second group patients (n=180) were given cefpodoxime and gentamicin 80 mg. Third group patients (n=102) were given cefpodoxime and gentamicin 160 mg. Three groups were compared in terms of post-biopsy infectious complications. SPSS 20 statistical program was used for data evaluation. Results: There was no statistically significant difference between the groups in terms of age, prostate specific antigen level and prostate volume. Urinary tract infection following the prostate biopsy was seen in 11 (8.1%) patients in group 1, 8 (4.4%) patients in group 2 and, 2 (1.9%) patients in group 3. Five of these patients were hospitalized due to deterioration of their overall health status and fever. When 3 groups were statistically compared, infection incidence was significantly different between the first and the third group (p<0.05). Conclusion: Bacterial resistance against fluoroquinolones is particularly increasing day by day. Fluoroquinolone resistance in Escherichia coli strains in our country is reported between 39-63%. In this study, infectious complications were found to be less in cefpodoxime plus gentamicin 160 mg prophylaxis, when compared to ciprofloxacin plus gentamicin 80 mg. Replacing quinolones with cefpodoxime and gentamicin in the antibiotic prophylaxis protocols used before prostate biopsy can minimize risk of infection.
Development of Antibiotic Resistance Against Ureaplasma urealyticum Strains Isolated from Urogenital Samples
(2018) Eroglu, Askin; Saracoglu, Musa; Divrik, Rauf Taner
Objective: To assess any change in the antibiotic sensitivity of Ureaplasma urealyticum strains isolated from urogenital samples in the course of time. Materials and Methods: Hospital records were retrospectively examined and cases with growth of U. urealyticum in urogenital samples in the years 2008 and 2013 were identified. Furthermore, the change in the course of time was examined by taking into consideration the cases we reported in 2001. Results: Higher rates of sensitivity against tetracycline and doxycycline were observed in 60 patients with isolated U. urealyticum. Higher rates of resistance against ofloxacin and ciprofloxacin were observed. A significant difference was found in resistance against antibiotics when the records of 2008 and 2013 were compared. A statistically significant increase was found in resistance against ofloxacin and ciprofloxacin when the records of 2001 were compared with the records of 2008 and 2013 (p< 0.0005). Conclusion: U. urealyticum strains demonstrated high levels of resistance to quinolones. Resistance development is increasing in the course of time. Sensitivity against tetracycline and doxycycline has continued at high rates. It would be beneficial to consider these results during empirical treatment to be applied in cases ineligible for culturing.
Evaluation of Treatment Applications and Antibiotic Resistance Rates for Community Acquired Urinary Tract Infections in Turkey and a Review of the Literature
(2020) Eroglu, Askin; Alasehir, Elcin Akduman
Objective: Increased extended-spectrum beta lactamase (ESBL) production is associated with higher rates of community-acquired strains in urinary tract infections (UTI) leading to an increase in the resistance rates, duration of treatment and costs. We aimed to investigate the resistance rates of ESBL-positive urine culture strains in our clinic, reviewed the literature and analysed antibiotics used in UTI treatment in outpatients in Turkiye. Materials and Methods: 2913 patients who were admitted to the outpatient clinics of Maltepe University Faculty of Medicine and Baskent University Faculty of Medicine were evaluated retrospectively. Data on prescribed antibiotics in outpatients with the diagnosis of UTI from all cities of Turkiye were collected through the Turkish Ministry of Health, Turkish Medicines and Medical Devices Agency. Results: Out of 563 ESBL-positive (19.3%) urine culture isolates, 450 (79.9%) were Escherichia coli and 89 (15.8%) were Klebsiella sp. Resistance rates were as follows: 98.8% to cefuroxime, 67.6% to ciprofloxacin, 12.5% to fosfomycin, 8.7% to amikacin, 1.4% to meropenem and 15% to nitrofurantoin. The most commonly prescribed antibiotics were ciprofloxacin (22.25%), fosfomycin (21.10%) and nitrofurantoin (12.82%). Conclusion: Our study suggests that the antibiotic resistance rates of most antibiotics prescribed for UTI in Turkiye are above the suggested rate of 10-20% to be used as empirical therapy. Updating and dissemination of guidelines for UTI in the light of antibiotic prescribing and resistance surveillance studies will contribute to the rational use of antibiotics in Turkiye.
Prevalence of Anal Incontinence and Constipation in Female Patients with Urinary Incontinence
(2018) Eroglu, Askin; Saracoglu, Musa; Divrik, Rauf Taner
Objective: To investigate the prevalence of anal incontinence and constipation in patients with urinary incontinence. Materials and Methods: Adult female patients who presented with the complaint of urinary incontinence were evaluated with anal incontinence and constipation assessment survey prepared on the basis of "the International Consultation on Incontinence Questionnaire-Short Form", "the Overactive Bladder 8-Question Awareness Tool" and "the Rome 3" criteria. Results: Two hundred female patients with urinary incontinence were evaluated. The patients were in the age group of 18-88 with the average age of 55.24 +/- 16.86 standard deviation. Stress incontinence was present in 19.5%, urge incontinence in 36% and mixed incontinence in 44.5% of the subjects. Seventy-seven percent of patients presented with flatal incontinence, 7.5% with fecal incontinence and 52.5% presented with constipation. There was no difference between sub-groups created according to age groups and types of urinary incontinence in terms of frequency of gastrointestinal symptoms. The incidence of constipation was statistically significantly higher in patients presenting with findings of urinary incontinence for more than 1 year and in those with overactive bladder (p< 0.01 and p< 0.001, respectively). Conclusion: Flatal incontinence was found in 77%, fecal incontinence in 7.5% and constipation in 52.2% of female adult patients with urinary incontinence. The incidence of constipation was higher at the level of statistical significance in patients presenting with findings of urinary incontinence for more than 1 year and in those with overactive bladder.
The prognostic value of routine second transurethral resection in patients with newly diagnosed stage pT1 non-muscle-invasive bladder cancer: results from randomized 10-year extension trial
(2019) Eroglu, Askin; Ekin, Rahmi Gokhan; Koc, Gokhan; Divrik, Rauf Taner; 31760524
Purpose To evaluate the impact of routine second TUR on the long-term outcome of patients with newly diagnosed stage pT1 non-muscle-invasive bladder cancer (NMIBC) Material and methods A total of 210 patients (mean age 62.1 years, 89.5% were males) with stage pT1 NMIBC who underwent first TUR were prospectively randomized into two groups including second TUR (n = 105) and no second TUR (n = 105) groups. Data on recurrence, disease progression, 7-year and 10-year recurrence-free survival (RFS), progression-free survival (PFS) and overall survival (OS) were recorded. Results The median follow-up time was 119 months (IQR 65-168). Per-protocol (PP) analysis revealed that compared to patients without second TUR, patients with second TUR had significantly higher 5-year, 7-year and 10-year rates for RFS (59.4%, 57.9% and 54.8% vs. 36.3%, 31.7% and 26.8%, respectively, p < 0.001) and PFS (93.3%, 91.9% and 90.4% vs. 74.0%, 71.4% and 68.5%, respectively, p < 0.001). According to PP and intention-to-treat (ITT) analyses, the 10-year OS rate was significantly higher in patients with second TUR (59.1 vs. 40.8%, p = 0.004). Multivariate analysis revealed that undergoing second TUR (OR 1.661, 95% CI 1.156-2.385, p = 0.006) was an independent determinant of prolonged OS. Conclusions In conclusion, these findings indicate the prognostic value of second TUR in stage pT1 NMIBC patients, not only for RFS and PFS advantages but also for the long-term OS advantage. Therefore, second TUR should be routinely performed in all stage pT1 NMIBC patients with life expectancy of at least 10 years, given the positive contribution to all oncological outcomes.
The utility of intravenous ketamine for the management of intraoperative penile erection: a retrospective single-center analysis of endourological surgeries over a 4-year
(2020) Eroglu, Askin; Tuncali, Bahattin; Ekin, Rahmi Gokhan; 31992278
Background To assess the prevalence of intraoperative penile erection in our endourology practice and the utility of intravenous ketamine in the management of the condition. Methods Of 402 endoscopic urological procedures performed in our clinic over a 4-year (2015-2019) period, a total of 9 cases with intraoperative penile erection impeding instrumentation during endourological surgery were included. Data on patient age, weight, height, American Society of Anesthesiologists (ASA) physical status classification system scores, type and duration of surgery, type and level of anesthesia, onset of erection, treatment characteristics and treatment outcome were recorded for each patient. Results The mean (SD) age was 68.3 years (range, 66.0-77.0 years). ASA physical status category I and II were noted in 55.6 and 44.4% of patients, respectively. All cases received spinal anesthesia (n = 9) at T8-10 dermatome levels, for TURP in 7 (77.8%) cases and for TURBT in 2 (22.2%) cases. The onset of penile erection was post-urethroscope in 7 (77.8%) cases. The average total ketamine dose was 34.3 mg (range, 18.0-75.0 mg). The average duration of the operation was 91.7 min (range, 40.0-140.0 min). Ketamine treatment resulted in resolved erection with delayed procedure in 7 (77.8%) cases, while conversion to general anesthesia was required in 2 (22.5%) cases. Conclusions In conclusion, the prevalence of intraoperative penile erection during spinal anesthesia for endourological surgery was 2.2% in our experience. These findings demonstrated that intravenous injection of ketamine is an effective and safe method for immediate resolution of intraoperative penile erection with a high success rate.