Person: ONUR, AHMET RAHMİ
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ONUR
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AHMET RAHMİ
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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 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 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 Ürodinami işleminde standart şekilli bir form ile hasta bilgilendirilmesinin kaygı düzeylerine etkisi: prospektif klinik çalışma(2022-11-09) ŞAHİN, BAHADIR; ŞEKERCİ, ÇAĞRI AKIN; ONUR, AHMET RAHMİ; ÇAM, HAYDAR KAMİL; TARCAN, TUFAN; Özkan O. C. , Güçtaş A. Ö. , Şahin B., Şekerci Ç. A. , Onur A. R. , Çam H. K. , Tarcan T.Publication Open Access Clinical preferences and treatment attitudes among urologists, gynecologists, and geriatricians: An independent online questionnaire survey for comparison of treatment choices in the management of overactive bladder(2022-09-01) ONUR, AHMET RAHMİ; Onur R., BAYRAK Ö., COŞKUN B., TAHRA A., OCAKOĞLU G., Buyuran G., Mega E., Ugurlucan F. G. , Ozturk G. B.; Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Üroloji Anabilim DalıObjective Overactive bladder (OAB) is a common clinical problem with associated morbidities both in men and women. Although real-life management strategies have been examined among urologists (URO), treatment choices may differ between different specialties. In the present study, an online survey was conducted to determine and compare the management strategies and clinical preferences of UROs, obstetricians/gynecologists (OB/GYN), and geriatricians (GER) in the treatment of OAB in their daily practices. Methods Between December 2020 and February 2021, an online questionnaire was sent to URO, OB/GYN, and GER specialists/residents. Current strategies and attitudes toward treatment of OAB in patients = 65 years. Results A total of 733 specialists/physicians (433 URO, 236 OB/GYN, and 64 GER) completed the online survey. Patients with OAB were more likely to present to URO compared to OB/GYN and GER (p = 0.001). A combination of behavioral modification and pharmacotherapy (antimuscarinics and/or beta-3 agonists) were chosen for the initial treatment of patients with OAB in both specialties with a significantly higher proportion by URO than by OB/GYN (51.9% vs. 38.1%; p = 0.001). Antimuscarinics were the most frequently prescribed medications by both the URO and OB/GYN specialties (81.8% vs. 78.4%; p = 0.27). Combination therapy with antimuscarinics was preferred more often by URO (91.5% vs. 77.1%; p = 0.001) when no or an inadequate response after initial treatment occurred. Multiple medication use, comorbidities, and risk of cognitive side effects affected medication preference by all specialists, especially by GER (p = 0.018). Conclusions Patients with OAB present to UROs, OB/GYN and GER more frequently compared to other specialities. Although antimuscarinics and beta-3 adrenoceptor agonists are equally recommended as first-line pharmacotherapy for OAB, antimuscarinics were preferred for most patients as the initial molecule by all specialties. Beta-3 agonists are increasingly preferred for elderly patients.Publication Open Access Sacral neuromodulation in patients with detrusor underactivity: Is biological sex an indicator(2022-03-01) ONUR, AHMET RAHMİ; ONUR A. R., Tayebi S., Salehi-Pourmehr H., Jahantabi E., Perrouin-Verbe M., Naseri C., Hajebrahimi S., Hashim H.Objectives This study aimed to report sacral neuromodulation (SNM) outcomes in detrusor underactivity (DU). Methods A multicentric, multinational, retrospective case series was conducted between March 2017 and June 2021 in three different referral centers. Initial test phase stimulation included either a percutaneous nerve evaluation (PNE) or an advanced lead evaluation test phase (ALTP) before permanent SNM implantation. The test phases were performed under local anesthesia, either in the outpatient (PNE) or operating room (ALTP), in the prone position, which was implanted in the third or fourth sacral foramina under fluoroscopic guidance. Patients with favorable response to the initial test phase during the first 2 weeks underwent the implantable pulse generator (IPG) implantation (Medtronic neurostimulation generator device InterStim (TM)). Favorable response was defined as >= 50% improvement in symptoms, frequency of clean intermittent catheterization (CIC) and/or decrease in postvoid residual (PVR), increase in voided volume, or improvement in bladder voiding efficiency (BVE) based on the bladder diary. Results Fifty-eight patients were recruited with a mean age of 39.95 +/- 15.28 years. Among the 58 cases, 36 (62.1%) patients responded to the initial stage. Of these, 12 patients (30.8%) with non-neurogenic etiology and nine patients (52.9%) with neurologic etiology did not respond to the initial test phase; thus, they did not undergo full implantation (p = 0.141). Voided volume, PVR, and the median maximum flow rate (Qmax) improved significantly (p < 0.001) in both sexes; however, there was no statistical difference between both genders. Most female cases (78.3%), and nearly half of the men (51.4%), responded to the test phase and were candidates for the IPG phase. Among the 35 cases who underwent IPG, 27 patients (72.2% of males, and 77.8% of females; p = 0.700) had a favorable response to IPG. 46.6% of patients had a successful outcome at the end of the study. Conclusion This multicentric study showed that SNM effectively and safely provided symptom improvement in refractory DU in males similar to females which is an important finding as previously it has been suggested that SNM works better in nonobstructive urinary retention in women and not in women.