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    Comparison of two catheterizable continence mechanisms for urinary diversion
    (1998) Ersay, Ahmet; Boylu, Şükrü; Akgün, Yılmaz; Taçyıldız, İbrahim; Aban, Nedim; Şahin, Hayrettin
    Benchekroun hydraulic ileal valve and hipple valve techniques are widely used continent valve systems in recontructive urology, We compared continence, catheterizability and complications of the nipple and Benchekroun hydraulic ileal valve ruling out the inherent error of comparing different reservoirs under different conditions. A pouch was constructed with two methods present side by side. Comparable data from each valve were statistically evaluated through Mann-Whitney U test. Although the rate of complications such as dessusception and difficult catheterization for each valve are close, leakage of the Benchekroun hydraulic ileal valve was observed at significantly higher pouch volumes than in the nipple valve (337.1±105.4 cc vs. 213. 558.9 cc). Maximal leak point pressures were not different statistically for both valves, when the pouch filled to the capacity and its half (75.9±35.0 vs 48.4±20.5 and 64.8±28.0 vs 47.3±20.2 respectively). In the light of this result Benchekroun hydraulic ileal valve seems to be superior to the nipple valve at higher pouch volumes.
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    Factors affecting mortality of Fournier's gangrene: Review of 70 patients
    (Wiley, 2007) Ersay, Ahmet; Yilmaz, Gulsen; Akgun, Yilmaz; Celik, Yusuf
    Background: Fournier's disease is a potentially fatal, acute, gangrenous infection of the scrotum, penis or perineum associated with a synergistic bacterial infection of the subcutaneous fat and superficial fascia. Methods: The clinical records of 70 patients treated for Fournier's gangrene were evaluated retrospectively to determine prognostic indices and to stress Fournier's Severity Index (FSI), influencing outcome. Results: The mortality rate in this study was 22.8%. Length of the hospitalization time and FSI were detected as effective factors on mortality of Fournier's gangrene (P < 0.05) by Binary Logistic Regression analysis and the area under the receiver operating characteristic curve of these variables was also found to be significant (P < 0.001). The average FSI was determined as 4.66 +/- 2.31 in survivors and 11.56 +/- 2.68 in non-survivors and 5.11 +/- 2.83 in patients with primary genito-urinary infection but 7.56 +/- 4.35 in primary anorectal infection. The FSI was also found predictive of hospitalization time and number of debridements among survivors. Conclusion: Fournier's Severity Index is a simplified way of comparing patients with this disease and may also have some significance in predicting outcome. The FSI is a more significant and predictive tool that should be popularized to predict the prognosis in Fournier's gangrene.
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    Intravesical oxybutynin affects bladder permeability
    (2001) Ersay, Ahmet; Demirtaş, Ömer Can
    To investigate the effects of intravesical application of oxybutynin chloride on bladder permeability we designed an animal model. Female Guinea pigs were given 3 different test solutions; phosphate buffered saline (PBS), 50% acetone and 1.27 × 10-2 M oxybutynin chloride solution. Then 99mTc-DTPA 45 ?Ci in 2 ml normal saline was instilled into the bladder lumen in each animals and allowed to dwell for 30 minutes. At the end of exposure time, the net count data in each 1 ml serum sample were corrected for radioactive decay and converted to the total percentage of administered dose. 99mTc-DTPA absorption percentages of both acetone and oxybutynin groups were significantly higher than that of PBS group (mean 3.2 ± 2.9% p < 0.001). Intravesical oxybutynin application increases bladder permeability 5 times compared with PBS administration. This observation can also explain how rapid absorption of oxybutynin through the bladder into the systemic circulation occurs.
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    Oxybutynin effects on Staphylococcus epidermidis biofilm production
    (Lippincott Williams & Wilkins, 2008) Gedik, Abdullah; Ersay, Ahmet; Atmaca, Selahattin; Sener, Alper
    Background: Oxybutynin is a tertiary amine and has chemical similarities like prolamine sulfate. Protamine sulfate's effect on bacterial viability has been shown in some studies; however, there is scanty data regarding the effect of oxybutynin on bacterial viability. Accordingly, the aim of the present study was to investigate the effect of oxybutynin on bacterial viability. Methods: Twenty of Staphylococcus epidermidis (S. epidermidis) strains were isolated from patients who had catheter-associated urinary tract infection. These strains were exposed to 5 different concentrations of oxybutynin in tryptic soy broth (TSB) media (max: 5 mg/mL, min: 0.05 mg/mL). Quantitative growth patterns were measured by spectrophotometer. Under the same media conditions, biofilm production of individual strains was measured by Deighton's micromethod at the end of the 6-hour incubation period. Results: After the incubation period, weak and strong slime-producing bacteria groups were obtained and both groups' slime productions were extensively low at 5 mg/mL concentration of oxybutynin. Slime production of S. epidermidis was inversely correlated with oxybutynin concentrations. Conclusion: Although there was a dose-dependent reduction of biofilm production, there seemed to be no bactericidal effect of oxybutynin on S. epidermidis.