Person: ONUR, AHMET RAHMİ
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ONUR
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AHMET RAHMİ
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Publication Open Access Single-incision midurethral sling shows less pain and similar success rate in a short-term follow-up compared to the transobturator tape method in the treatment of stress urinary incontinence(AVES, 2020-01-07) ONUR, AHMET RAHMİ; Karakeci, Ahmet; Eftal, Taner Cuneyt; Keles, Ahmet; Golbasi, Ceren; Onur, RahmiObjective: To compare the efficacy, complications, quality of life, and patient satisfaction rates in women treated for stress urinary incontinence (SUI) using the adjustable anchored single-incision midurethral sling (SIMS) and standard midurethral sling (MUS) procedures. Material and methods: A total of 113 women between October 2012 and October 2016 underwent either the adjustable SIMS (n=54) or MUS (n=57) procedure. The postoperative pain profile was assessed using a 10-point visual analog scale at the fixed time-point quality of life and an additional postoperative 3rd week appointment. We asked our patients the following two questions to evaluate their satisfaction with surgery and their preference: Would you have this kind of surgery again? (Q1), and Would you recommend this type of surgery to another patient with same symptoms? (Q2). For the evaluation of patient complaints, the Incontinence Impact Questionnaire (IIQ-7) and Urinary Distress Inventory (UDI-6) were used before and after the procedure. Results: Women in the SIMS group had a significantly lower postoperative pain profile for up to 3 weeks (p<0.001). There was no significant difference in perioperative complications and postoperative continence rates between the groups. With regard to Q1 and Q2, a significant difference was found between the groups (p=0.003 and p=0.002, respectively). While the questionnaire scores of the IIQ-7 and UDI-6 were also significantly improved at postoperative evaluations (p<0.001), there was no significant difference between the two groups. Conclusion: SIMS is associated with a significantly improved postoperative pain profile and earlier return to work when compared to MUS.Publication Open Access The attitudes of Urologists and Gynecologists about overactive bladder and treatment of it in Turkey: A questionnaire survey(AVES, 2017-02-21) ONUR, AHMET RAHMİ; Coskun, Burhan; Bayrak, Omer; Dincer, Murat; Onem, Kadir; Gurbuz, Cenk; Onur, RahmiObjective: We aimed to review the approaches of urologist and gynecologist in the management of overactive bladder (OAB). Material and methods: A questionnaire consisting of 12 items were answered by 375 urologist and 46 gynecologist. The differences between frequency of encountering OAB, their viewpoints concerning conservative treatment, and their experience related to anticholinergic drug use and the management of refractory OAB were compared. Results: The majority of the urologists, and gynecologists responded to the question How often do you encounter OAB patients in your daily practice? as 'in 10-25, and 50% of our patients', respectively (<0.001). The most common complaint consulted to urologists, and gynecologists were urge incontinence (51.1% vs. 64.8). The frequency of using questionnaire and voiding diary was similar in both specialties (23.9% vs. 25.1%, p=0.892). It was observed that 38.6% of the urologists, and 50% of the gynecologists had recommended conservative treatment as a first-line treatment of overactive bladder (p=0.049). The low sociocultural level was the most important obstacle confronting application of conservative treatment methods (54.3% vs. 37%, p=0.012). The survey participants indicated that the most important factor which affected their decision to select an anticholinergic agent as the first-line treatment of overactive bladder was higher effectiveness of these drugs (urologists; 55.7%, and gynecologists 64%, p=0.371). The patients who started to receive anticholinergic drugs most frequently complained both to their urologists, and/or gynecologists about dry mouth (76.3 vs. 74.5%). Based on the responses of the urologists, and gynecologists, the most frequent reason of anticholinergic drug withdrawal was patients' inability to tolerate side effects of these drugs (48% vs. 47.8%, p=0.697). The participants indicated that in case of unsatisfactory response to one anticholinergic agent, swithching rate to another anticholinergic drug was 56.9% among urologists vs. 59.6%, among gynecologists. In addition, 36.9% of urologists and 38.5% of gynecologists recommended another pharmaceutical form of the drug with a higher dose to their patients (p=0.279). Similar number of physicians indicated that the prescribed anticholinergic drug should be continued for at least 3 months and in case of unresponsiveness patient could be considered refractory. Majority of urologists (68.8%), and gynecologists (56.5%) chose to perform urodynamic tests in patients who are unresponsive to anticholinergic treatment, (p=0.093). Conclusion: The attitudes of urologist and gynecologist for diagnosis and treatment of OAB are mostly correlating with current guideline practices with few exceptions. Urologists tend to use bladder diaries or questionnaires less frequently whereas, gynecologists refer to urodynamic studies in patients with refractory OAB less than the urologists do. However, irrespective of the clinical speciality, conservative treatment modalities are rarely administered.Publication Metadata only The effect of using a standard Illustrated consent form on anxiety levels in the urodynamic investigation: A prospective clinical study(2022-09-07) ŞAHİN, BAHADIR; ŞEKERCİ, ÇAĞRI AKIN; ONUR, AHMET RAHMİ; ÇAM, HAYDAR KAMİL; TARCAN, TUFAN; Özkan O., Güçtaş A. Ö. , Şahin B., Şekerci Ç. A. , Onur A. R. , Çam H. K. , Tarcan T.Publication Open Access Botulinum toxin injections for treating neurogenic detrusor overactivity(AVES, 2015-10-14) ONUR, AHMET RAHMİ; Bayrak, Omer; Sadioglu, Erkan; Onur, RahmiNeurogenic detrusor overactivity (NDO) is a disorder that can cause high intravesical pressure, decreased capacity, decreased bladder compliance, and upper urinary system damage. The current treatment options for NDO are established on the basis of agents that block parasympathetic innervation of the detrusor and inhibit involuntary bladder contractions. Several side effects, such as dryness of mouth, constipation, dyspepsia, changes in visual accommodation, somnolence, and being unable to obtain consistently favorable results, caused by anticholinergic agents, which are frequently used for this purpose, decrease the patient's compliance to treatment. Procedures such as neuromodulation, auto-augmentation, and enterocystoplasty are surgical options, and they could be used as the last alternative. Thus, botulinum toxin (BTX) injections to the detrusor have been commonly performed in recent years and lead to satisfactory results. The mechanism of action of BTX in NDO is based on the principal of smooth muscle relaxation in the bladder by the transient inhibition of neuromuscular nerve signals. The aim is to decrease acetylcholine secretion by blocking presynaptic vesicles in the neuromuscular junction. When studies were evaluated, it was observed that BTX injections to the detrusor muscle are a necessary and effective option in patients with incontinence caused by NDO. This treatment option could be indicated in situations where anticholinergic agents are not effective or could not be tolerated, and it could be a valuable alternative to major surgical treatments. In this review, we evaluated the effectiveness and reliability of BTX in patients with NDO.Publication Metadata only The Role of Educational Level and Cognitive Status in Men Undergoing Artificial Urinary Sphincter Implantation REPLY(ELSEVIER SCIENCE INC, 2021) ONUR, AHMET RAHMİ; Keles, Ahmet; Onur, Rahmi; Aydos, Murat; Dincer, Murat; Koca, Orhan; Coskun, Burhan; Imamoglu, Abdurrahim; Karakeci, AhmetPublication Open Access Impact of the COVID-19 pandemic on functional urology practice: A nationwide survey from Turkey COVID-19 pandemisinin fonksiyonel üroloji uygulamasına etkisi: Türkiye çapında bir araştırma(2022-01-01) ONUR, AHMET RAHMİ; TAHRA A., Dincer M., Onur R.© 2022, Galenos Publishing House. All rights reserved.Objective: Routine urology practice has changed with the coronavirus disease-2019 pandemic. We aim to determine the urologists’ functional urology practice during the pandemic by an online questionnaire. Methods: An online questionnaire was conducted to assess the functional urology practice of Turkish urologists’ during the pandemic. The workplace, positioning as a pandemic hospital, involvement in pandemic clinics, and the relevance to functional urology were questioned. We also inquired about outpatient services, diagnostic tests, and elective surgeries during the pandemic compared with their routine practice. Results: One hundred and fifty-two participants completed the questionnaire. Of these, 32.2% replied that more than half of their daily practice was related to diagnosing and treating incontinence, prolapse, and neurourology. According to 123 participants (80.9%), there was a decrease in outpatient clinics. Diagnostic tests were also reduced, such as uroflowmetry (68.4%) and urodynamics (81.3%). The majority of respondents declared a decrease in elective surgeries as Botox injection (92.1%), surgery for urinary incontinence (93.4%), and surgery for prolapse (85%). Nearly one-quarter of respondents’ (28.9%) stated that their diagnostic methods for neurourology patients did not differ. Conclusions: One of the most affected areas in urology during a pandemic is functional urology. Although diagnostic tests and surgery for functional urology are classified as \"optional,\" the quality of life of patients will be affected by the delayed intervention.Publication Open Access The roles of vitamin b12, 25(oh) d, and folate in primary nocturnal enuresis: A single center experience in an immigration area(2022-02-01) ONUR, AHMET RAHMİ; Keles A., Karakeci A., ONUR A. R.Introduction & Objectives: In this study, we examined the associations between late preterm (LPT) birth children with nocturnal enuresis and their levels of vitamin B12, folate, iron, and 25(OH)D. Materials & Methods: Between April 2019 and December 2019, 206 children (74 girls, 132 boys) with PNE who presented at the public hospital urology clinics were included as the study group, and 111 healthy children (52 girls, 59 boys) who presented at the same hospital pediatric clinics were included as the control group. We defined primary monosymptomatic nocturnal enuresis as nighttime bedwetting (≥2 nights per week) in children between 5 and 13 years of age. Hospital records of both groups were compared for information such as age, height, weight, vitamin B12, folate, ferritin, iron values, and racial characteristics. Variables were compared using descriptive statistics and the chi-squared and Mann-Whitney U tests.Publication Open Access Management of the complications of pubovaginal sling surgery(2017-06-01) ONUR, AHMET RAHMİ; ÖMER BAYRAK;BURHAN COŞKUN;MUHAMMET MURAT DİNÇER;KADİR ÖNEM;AHMET RAHMİ ONURTo present complications of pubovaginal sling surgery (PVS) and their managements. Methods. A total of 21 patients who underwent PVS in 4 different tertiary refferal centers between June 2014 and May 2016 were reviewed retrospectively. Demographic characteristics of the patients, previous surgical history, daily pad use, Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ) were recorded. Also, the management of the complications were stated. Results. The mean age of the patients were 54.9±12.32 (range, 36-76) years. Six (28.5%) patients had a history of previous incontinence surgery and 15 (71.4%) patients were naïve. There were no intraoperative complications.The mean daily pad use was decreased from 4.04±0.95 to 0.95±0.86 (p=0.0001). While mean preoperative UDI-6 scores were decreased from 6.66±2.09 to 2.09±1.22 (p=0.0001) at postoperative sixth month; preoperative mean IIQ-7 scores decreased from 16.8±1.16 to 5.09±4.21 (p=0.0001) at postoperative sixth month. One (4.76%) patient had abdominal hernia at postoperative 2nd year, three (14.28%) patients had an increased post-micturational residual (150- 200ml) and two (9.52%) patients had urinary retention. Conclusion. Although the efficiency of PVS is high; one should aware of complications. The successful management of the complications will increase efficiency and patient satisfaction.Publication Unknown Sacral neur al neuromodulation tr omodulation treatment for urinar eatment for urinary voiding dysfunctions: results of treatment with the largest single-center series in a ter series in a tertiary referral center in T al center in Turkey(2023-02-01) KÜTÜKOĞLU, MEHMET UMUT; ALTUNTAŞ, TÜRKER; ŞAHİN, BAHADIR; ONUR, AHMET RAHMİ; KÜTÜKOĞLU M. U., ALTUNTAŞ T., ŞAHİN B., ONUR A. R.BACKGROUND: Sacral neuromodulation (SNM) is a minimally invasive treatment that modulates spinal reflexes to regulate bladder, urinary sphincter, and pelvic floor and has successfully been used in the treatment of refractory voiding dysfunctions. The aim of this study was to present our experience with SNM in a tertiary referral center with the largest number of patients and review the safety and efficacy of the procedure. METHODS: A total of 42 patients with refractory lower urinary tract symptoms were included into the study. After an initial test period, patients who showed more than 50% improvement in their symptoms underwent the second stage of SNM. Twelve patients had overactive bladder (OAB), bladder pain syndrome/interstitial cystitis (BPS/IC) and 17 had urinary retention. The clinical success was examined during follow-up by voiding diary, urodynamics, and global response assessment. RESULTS: Between February 2015 and December 2020, a total of 29 patients underwent stages I&II SNM procedures. The mean ages of patients in OAB/BPS group and retention group were 40 (37-57 years) and 35 (27-44 years), respectively. Mean follow-up time was at least 1 year. Overall, 58.5% success rate was observed in OAB, BPS/IC, and urinary retention groups. Global response assessment score in both groups increased significantly (p = 0.001). No statistically significant difference was found between success or failure rates when sex and age were variable parameters (p > 0.05). DISCUSSION: SNM appears to be an effective and safe treatment option in restoring voiding dysfunctions in patients with refractory idiopathic and neurogenic voiding dysfunctions. Our initial series revealed favorable results; however, further studies with larger series and longer follow-up are needed.Publication Metadata only Ürodi̇nami̇ işlemi̇nde standart şeki̇lli̇ bi̇r form ile hasta bi̇lgi̇lendi̇ri̇lmesi̇ni̇n kaygı düzeyleri̇ne etki̇si̇: Prospekti̇f kli̇ni̇k çalışma(2022-11-13) ŞAHİN, BAHADIR; ŞEKERCİ, ÇAĞRI AKIN; ONUR, AHMET RAHMİ; ÇAM, HAYDAR KAMİL; TARCAN, TUFAN; ÖZKAN O. C., Güçtaş A. Ö., ŞAHİN B., ŞEKERCİ Ç. A., ONUR A. R., ÇAM H. K., TARCAN T.
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