Person: ŞAHİN, BAHADIR
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ŞAHİN
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BAHADIR
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Publication Open Access Effect of the pandemic on surgical procedures in a tertiary care hospital: A retrospective review(2022-09-01) SAÇAK, BÜLENT; KESİMER, MEHMET DENİZ; ŞAHİN, BAHADIR; UĞURLU, MUSTAFA ÜMİT; SAKAR, MUSTAFA; YUMUŞAKHUYLU, ALİ CEMAL; Ozkan M. C. , SAÇAK B., KESİMER M. D. , ŞAHİN B., UĞURLU M. Ü. , Sirzai E. Y. , SAKAR M., Aykut A., Cicek I., YUMUŞAKHUYLU A. C.Objective: The aim of this study was to examine the impact of performing surgeries with necessary precautions and to evaluate demographic characteristics of operated patients during novel coronavirus-2019 (COVID-19) pandemic and the infection rates during hospitalization and within 14 days after surgery.Publication Metadata only Is Cognitive MR Fusion Biopsy Superior to Standard TRUS Guided Prostate Biopsy? Our Clinical Experience(2022-06-01) FİLİNTE, DENİZ; ÇAM, HAYDAR KAMİL; ŞAHİN, BAHADIR; DÖRÜCÜ, DOĞANCAN; ŞAHİN B., DÖRÜCÜ D., TİNAY İ., FİLİNTE D., ÇAM H. K.Objective: To share our clinical experience with cognitive prostate biopsy and compare results of cognitive biopsies with standard biopsies.Publication Open Access Homozygosity for a novel INHA mutation in two male siblings with hypospadias, primary hypogonadism, and high-normal testicular volume(2022-03-23) ŞAHİN, BAHADIR; DEMİRCİOĞLU, SERAP; BEREKET, ABDULLAH; GÜRAN, TÜLAY; Arslan Ateş E., Eltan M., Sahin B., Gurpinar Tosun B., Seven Menevse T., Geckinli B. B., Greenfield A., Turan S., Bereket A., Güran T.Background: The human INHA gene encodes the inhibin subunit alpha protein, which is common to both inhibin A and B. The functional importance of inhibins in male sex development, sexual function, and reproduction remain largely unknown. Objective: We report for the first time two male siblings with homozygous INHA mutations. Methods: The medical files were examined for clinical, biochemical, and imaging data. Genetic analysis was performed using next-generation and Sanger sequencing methods. Results: Two brothers complained of gynecomastia, testicular pain, and had a history of hypospadias. Biochemistry revealed low serum testosterone, high gonadotropin and anti-Mullerian hormone, and very low/undetectable inhibin concentrations, where available. Both patients had azoospermia in the spermiogram. We have identified a homozygous 2 bp deletion (c.208_209delAG, R70Gfs*3) variant, which leads to a truncated INHA protein in both patients, and confirmed heterozygosity in the parents. The external genital development, pubertal onset and progression, reproductive functions, serum gonadotropins, and sex hormones of mother and father, who were heterozygous carriers of the identified mutation, were normal. Conclusion: Homozygosity for INHA mutations causes decreased prenatal and postnatal testosterone production and infertility in males, while the heterozygous female and male carriers of INHA mutations do not have any abnormality in sex development and reproduction.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 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 Practices and utility of imaging among urological communities for urolithiasis, observations, and inferences from a targeted survey(2023-12-01) ŞAHİN, BAHADIR; ŞENER, TARIK EMRE; TANIDIR, YILÖREN; ŞAHİN B., ŞENER T. E., Dragos L., Gauhar V., TANIDIR Y.To evaluate the general practice among urologists about the use of various radiological imaging and measurement tools, and to compare the diferent preferences in radiological evaluations between Turkish and European urologists. Our study was designed as a survey study. The survey comprised 22 questions which evaluated the epidemiological information, caseload of participants, general preferences of participants on CT image slice thickness, basic radiologic workup routines prior to surgery, use of special tools and measurements on CT. Data collection was conducted with both an online poll and printed copies. A total of 222 urologists from 23 diferent countries responded to the survey. The most performed endourologic surgery was semi-rigid URS which was performed more than 25 times/year by 90.1% (n=200) of the participants. Although PCNL was performed more commonly by Turkish urologists (39.7%) compared to their European (17.3%) colleagues (p<0.001), it was still the least often performed endourological surgery among all participants (31.5%). The stone size evaluation was the most performed measurement performed by the participants. Although the group of surgeons used size measurement tools, there were diferences between the two groups. Turkish urologists used size measurement before PCNL (85.7%) as opposed to European urologists who used it mostly before URS (91.4%). Non-contrast CT images for urolithiasis are mainly evaluated by urologists themselves and a considerable number of urologists do not use additional measurement tools in evaluating CT images. Although there are similarities in the knowledge of various radiological tools, there are distinct regional diferences. Keywords Urolithiasis · Computed tomography · Evaluation · Survey · ManagementPublication Open Access Turkey prostate cancer map 2021: Turkish urooncology association prostate cancer database report(2022-03-01) ŞAHİN, BAHADIR; TİNAY, İLKER; Sahin B., Celik S., Tinay I., Eskicorapci S., ASLAN G., Sozen S., Ataus S., TURKERI L.Objective: This study aimed to present the data of patients with prostate cancer (PCa) whose detailed information was stored in the Urologic Cancer DatabaseProstate, Urooncology Association, Turkey with the title of “Turkey Prostate Cancer Map 2021.” Materials and Methods: Patient data between 1995 and 2020 were retrospectively scanned. The age of the patients, their distribution according to age groups, symptoms during diagnosis, examination findings [digital rectal examination (DRE)], prostate-specific antigen (PSA) values, biopsy methods in the diagnosis, metastatic disease rates, treatment methods, and progression rates at follow-up were examined. These results were compared with the results of the previous report, namely “Prostate Cancer Incidence (Incidence) in Turkey,” by the Urooncology Association in Turkey in 2009. Results: This study analyzed the data of 5040 patients from 19 different centers. The mean patient age was 63.6 (37-97) years. The age distribution examination revealed that most patients (49.8%) were aged 60-69 years. Of the patients, 51.8% were symptomatic at the time of diagnosis. The presence of symptoms was determined in 88.6% in 2009 data. The DRE of patients revealed that 25% of patients had malignancy findings. The PSA distribution examination revealed a >10 ng/mL PSA value in 37.5% of patients. With the increasing use of magnetic imaging resonance (MRI) in PCa diagnosis over the years, increased MR-fusion biopsy rates have been observed. Considering the biopsy data, 91% of patients were diagnosed with a classical transrectal ultrasound-guided biopsy, whereas 9% were diagnosed with MR-Fusion biopsy. Fusion biopsies revealed that 23% of patients with Prostate Imaging-Reporting and Data System (PI-RADS) 4 lesion and 57% with PI-RADS 5 lesion were diagnosed with cancer. Of the patients, 8.9% of patients had metastases during the initial diagnosis. This rate was 17% in 2009 data. The treatment methods examination after the diagnosis revealed that 73.9% of patients had undergone radical prostatectomy. This rate was 51.8% in 2009. Robotic and laparoscopic approaches, which are among the surgical modalities, have increased over the years. However, the most frequently applied modality in our country was open radical prostatectomy with 62.6%. Considering the follow-up data after treatment, 8.9% of patients had progression, of which 62.6% was biochemical, 30.2% was radiological, and 6.9% was a clinical progression. Conclusion: Technological advancements for PCa diagnosis (MRI and MR-guided biopsies) are becoming a routine part of daily practice compared to the results of the “Prostate Cancer Incidence in Turkey” project in 2009. The comparative study results revealed that the rate of symptomatic and metastatic disease decreases at the time of diagnosis, and laparoscopic and robotic surgery methods are used at increasing rates for localized diseasePublication Open Access Global Practice Patterns and Variations in the Medical and Surgical Management of Non-Obstructive Azoospermia: Results of a World-Wide Survey, Guidelines and Expert Recommendations(2024-01-01) ŞAHİN, BAHADIR; Rambhatla A., Shah R., Ziouziou I., Kothari P., Salvio G., Gul M., Hamoda T., Kavoussi P., Atmoko W., Toprak T., et al.Purpose: Non-obstructive azoospermia (NOA) is a common, but complex problem, with multiple therapeutic options and a lack of clear guidelines. Hence, there is considerable controversy and marked variation in the management of NOA. This survey evaluates contemporary global practices related to medical and surgical management for patients with NOA. Materials and Methods: A 56-question online survey covering various aspects of the evaluation and management of NOA was sent to specialists around the globe. This paper analyzes the results of the second half of the survey dealing with the management of NOA. Results have been compared to current guidelines, and expert recommendations have been provided using a Delphi process. Results: Participants from 49 countries submitted 336 valid responses. Hormonal therapy for 3 to 6 months was suggested before surgical sperm retrieval (SSR) by 29.6% and 23.6% of participants for normogonadotropic hypogonadism and hypergonadotropic hypogonadism respectively. The SSR rate was reported as 50.0% by 26.0% to 50.0% of participants. Interestingly, 46.0% reported successful SSR in <10% of men with Klinefelter syndrome and 41.3% routinely recommended preimplantation genetic testing. Varicocele repair prior to SSR is recommended by 57.7%. Half of the respondents (57.4%) reported using ultrasound to identify the most vascularized areas in the testis for SSR. One-third proceed directly to microdissection testicular sperm extraction (mTESE) in every case of NOA while others use a staged approach. After a failed conventional TESE, 23.8% wait for 3 months, while 33.1% wait for 6 months before proceeding to mTESE. The cut-off of follicle-stimulating hormone for positive SSR was reported to be 12-19 IU/mL by 22.5% of participants and 20-40 IU/mL by 27.8%, while 31.8% reported no upper limit. Conclusions: This is the largest survey to date on the real-world medical and surgical management of NOA by reproductive experts. It demonstrates a diverse practice pattern and highlights the need for evidence-based international consensus guidelines.