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Öğe Is There a Relationship Between Pelvic Organ Prolapse and Tissue Fibrillin-1 Levels?(Korean Continence Soc, 2015) Eser, Ayla; Unlubilgin, Eylem; Hizli, Fatih; Acar, Muradiye; Kamalak, Zeynep; Kosus, Aydin; Kosus, NerminPurpose: Pelvic organ prolapse is a multifactorial disorder in which extracellular matrix defects are implicated. Fibrillin-1 level is reduced in stress urinary incontinence. In Marfan syndrome, which is associated with mutations in Fibrillin-1, pelvic floor disorders are commonly observed. We hypothesize that Fibrillin-1 gene expression is altered in pelvic organ prolapse. Methods: Thirty women undergoing colporrhaphy or hysterectomy because of cystocele, rectocele, cystorectocele, or uterine prolapse were assigned to a pelvic prolapse study group, and thirty women undergone hysterectomy for nonpelvic prolapse conditions were assigned to a control group. Real-time polymerase chain reaction was conducted on vaginal tissue samples to measure the expression of Fibrillin-1. Expression levels were compared between study and control groups by Mann-Whitney U test with Bonferroni revision. Results: Fibrillin-1 gene expression was not significantly lower in the study group than in the control group. Similarly, no significant correlation between Fibrillin-1 levels and grade of pelvic prolapse was found. Age over 40 years (P = 0.018) and menopause (P = 0.027) were both associated with reduced Fibrillin-1 levels in the pelvic prolapse group, whereas the delivery of babies weighing over 3,500 g at birth was associated with increased Fibrillin-1 expression (P = 0.006). Conclusions: The results did not indicate a significant reduction in Fibrillin-1 gene expression in pelvic prolapse disorders; however, reduced Fibrillin-1 may contribute to increased pelvic organ prolapse risk with age and menopause. Increased Fibrillin-1 gene expression may be a compensatory mechanism in cases of delivery of babies with high birth weight. Further studies are needed for a better understanding of these observations.Öğe Novel Approach For Pain Control In Patients Undergoing Prostate Biopsy: Ilio-Hypogastric Nerve Block With Or Without Topical Application Of Prilocaine-Li-Docaine: A Randomized Controlled Trial(Urology and Nephrology Research Centre, 2015) Hizli, Fatih; Argun, Güldeniz; Özkul, Fatih; Güven, Eşref O?uz; Arık, Ali Ihsan; Başay, Sinan; Koş???us, AydinPurpose: To Investigate The Efficacy Of A Novel Anesthetic Technique Called Iliohypogastric Nerve Block (Inb) For Pain Control In Patients Undergoing Prostate Biopsy. Materials And Methods: A Total Of 59 Consecutive Patients Who Underwent Transrectal Ultrasound Guided Prostates Biopsies Were Included In The Study. Patients Were Randomized Into Four Groups: (1) Control, No Method Of Anes-Thesia Was Administered, (2) Intrarectal Prilocaine-Lidocaine Cream Application, (3) Inb And (4) Inb + Intrarectal Prilocaine-Lidocaine Cream Application (Combined Group). Patients Were Asked To Use A Scale Of 0-10 In A Visual Analogue Scale (Vas) Questionnaire About Pain During Probe Insertion (Vas 1) And Prostate Biopsy (Vas 2). Results: The Mean Vas 1 And Vas 2 Scores Were 0.7 And 4.9 For Controls, 0.5 And 1.8 For Inb, 0.5 And 2.6 For The Intrarectal Cream Group, And 0.4 And 1.8 For The Combined Group. The Mean Vas 1 Scores Were Not Different Between Groups. Howev-Er, The Mean Vas 2 Scores Were Significantly Lower In Inb, Prilocaine-Lidocaine Cream And Combined Groups Compared To The Control Group (P <.001). In Addition, The Inb Group Had Significantly Lower Vas 2 Scores Compared To The Cream Application Group (P =.03). On The Other Hand, There Was No Difference Between The Inb And Combined Groups (P =.8). Conclusion: Any Form Of Anesthesia Was Superior To None. However, Inb Alone Seemed To Be Superior To Prilocaine-Li-Docaine Cream Application In Patients Undergoing Prostate Biopsy. Addition Of Prilocaine-Lidocaine Cream Application To Inb May Not Provide Better Analgesia © 2021 Elsevier B.V., All rights reserved.Öğe Novel Approach for Pain Control in Patients Undergoing Prostate Biopsy: Iliohypogastric Nerve Block with or without Topical Application of Prilocaine-Li-docaine: A Randomized Controlled Trial(Urol & Nephrol Res Ctr-Unrc, 2015) Hizli, Fatih; Argun, Guldeniz; Ozkul, Fatih; Guven, Oguz; Arik, Ali Ihsan; Basay, Sinan; Kosus, AydinPurpose: To investigate the efficacy of a novel anesthetic technique called iliohypogastric nerve block ([NB) for pain control in patients undergoing prostate biopsy. Materials and Methods: A total of 59 consecutive patients who underwent transrectal ultrasound guided prostates biopsies were included in the study. Patients were randomized into four groups: (1) control, no method of anesthesia was administered. (2) intrarectal prilocaine-lidocaine cream application, (3) INB and (4) [NB + intrarectal prilocaine-lidocaine cream application (combined group). Patients were asked to use a scale of 0-10 in a Visual Analogue Scale (VAS) questionnaire about pain during probe insertion (VAS 1) and prostate biopsy (VAS 2). Results: The mean VAS 1 and VAS 2 scores were 0.7 and 4.9 for controls, 0.5 and 1.8 for INB, 0.5 and 2.6 for the intrarectal cream group, and 0.4 and 1.8 for the combined group. The mean VAS 1 scores were not different between groups. However, the mean VAS 2 scores were significantly lower in [NB, prilocaine-lidocaine cream and combined groups compared to the control group (P <.001). In addition, the INB group had significantly lower VAS 2 scores compared to the cream application group (P =.03). On the other hand, there was no difference between the INB and combined groups (P =.8). Conclusion: Any form of anesthesia was superior to none. However, INB alone seemed to be superior to prilocaine-lidocaine cream application in patients undergoing prostate biopsy. Addition of prilocaine-lidocaine cream application to [NB may not provide better analgesia.Öğe Novel approach for pain control in patients undergoing prostate biopsy: Iliohypogastric nerve block with or without topical application of prilocaine-lidocaine: A randomized controlled trial(Urology and Nephrology Research Centre info@unrc.ir, 2015) Hizli, Fatih; Argun, Güldeniz; Özkul, Fatih; Güven, Eşref O?uz; Arık, Ali Ihsan; Başay, Sinan; Koş???us, AydinPurpose: To investigate the efficacy of a novel anesthetic technique called iliohypogastric nerve block (INB) for pain control in patients undergoing prostate biopsy. Materials and Methods: A total of 59 consecutive patients who underwent transrectal ultrasound guided prostates biopsies were included in the study. Patients were randomized into four groups: (1) control, no method of anesthesia was administered, (2) intrarectal prilocaine-lidocaine cream application, (3) INB and (4) INB + intrarectal prilocaine-lidocaine cream application (combined group). Patients were asked to use a scale of 0-10 in a Visual Analogue Scale (VAS) questionnaire about pain during probe insertion (VAS 1) and prostate biopsy (VAS 2). Results: The mean VAS 1 and VAS 2 scores were 0.7 and 4.9 for controls, 0.5 and 1.8 for INB, 0.5 and 2.6 for the intrarectal cream group, and 0.4 and 1.8 for the combined group. The mean VAS 1 scores were not different between groups. However, the mean VAS 2 scores were significantly lower in INB, prilocaine-lidocaine cream and combined groups compared to the control group (P < .001). In addition, the INB group had significantly lower VAS 2 scores compared to the cream application group (P = .03). On the other hand, there was no difference between the INB and combined groups (P = .8). Conclusion: Any form of anesthesia was superior to none. However, INB alone seemed to be superior to prilocaine-lidocaine cream application in patients undergoing prostate biopsy. Addition of prilocaine-lidocaine cream application to INB may not provide better analgesia. © 2015 Elsevier B.V., All rights reserved.Öğe The effects of hypnotherapy during transrectal ultrasound-guided prostate needle biopsy for pain and anxiety(Springer, 2015) Hizli, Fatih; Ozcan, Osman; Selvi, Ismail; Eraslan, Pinar; Kosus, Aydin; Bas, Okan; Yikilmaz, Taha NumanSeveral studies evaluating the tolerance of transrectal ultrasound (TRUS)-guided needle biopsies showed that moderate-to-severe pain was associated with the procedure. Additionally, prebiopsy anxiety or rebiopsy as a result of a prior biopsy procedure is mentioned as factors predisposing to higher pain intensity. Thus, in this study, we investigated the effects of hypnotherapy during transrectal ultrasound-guided prostate needle biopsy for pain and anxiety. Sixty-four patients presenting for TRUS-guided prostate needle biopsy were randomly assigned to receive either 10-min presurgery hypnosis session (n = 32, mean age 63.5 +/- A 6.1, p = 0.289) or a presurgery control session (n = 32, mean age 61.8 +/- A 6.8, p = 0.289). The hypnosis session involved suggestions for increased relaxation and decreased anxiety. Presurgery pain and anxiety were measured using visual analog scales (VAS), Beck Anxiety Inventory (BAI), and Hamilton Anxiety Scale (HAS), respectively. In our statistics, p < 0.05 was considered statistically significant. Postintervention, and before surgery, patients in the hypnosis group had significantly lower mean values for presurgery VAS [mean 1 (0-8); p = 0.011], BAI (6.0 vs 2.0; p < 0.001), and HAS (11.0 vs 6.0; p < 0.001). The study results indicate that a brief presurgery hypnosis intervention can be an effective means of controlling presurgical anxiety, and therefore pain, in patients awaiting diagnostic prostate cancer surgery.
