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Öğe Assessment and Cost Analysis for Patients Admitted to Emergency Department with Macroscopic Hematuria(Galenos Publ House, 2023) Sonmez, Leyla Ozturk; Turaliev, Nurmanbet; Ayranci, Mustafa Kursat; Ozturk, Esma Erdemir; Aydin, ArifAim: This study examined the etiological causes and their cost analysis in patients admitted and hospitalized with macroscopic hematuria (MH).Materials and Methods: Hemograms, urine, and biochemistry results of patients with MH, radiological images and pathology results, hospitalization need, hospitalization durations, and hematuria causes acquired following hospitalization, and the expenditures during this phase were registered for the patients. Laboratory values for the detected hematuria causes were compared and examined statistically.Results: Seventy-eight patients admitted to the emergency department with MH were evaluated. The most common underlying pathologies were bladder cancer (34.6%, n=27), prostate pathologies (24.3%, n=19), kidney stone (8.9%, n=7), urethral stone (7.7%, n=6), kidney cancer (7.7%, n=6), bladder stone (6.4%, n=5), urinary infection (6.4%, n=5), kidney laceration (2.6%, n=2) and arteriovenous malformation (1.3%, n=1) respectively. The mean invoice amount covering the management starting from admission with MH was 6647 +/- 10200 for each patient. In operated patients (n=54), hospitalization duration, catheterization duration, and invoice amount were found to be higher; in patients with malignancy (n=34) age, hospitalization duration, catheterization duration, and invoice amount were higher (p<0.05, all parameters).Conclusion: Among patients with MH, those with indications for surgery and malignancy have a greater impact on health expenditure. We can conclude that it will be beneficial for both the patient and the economy to start the diagnosis and treatment process before the onset of MH with prevention and early screening workups.Öğe Can Eosinophil Count, Platelet Count, and Mean Platelet Volume Be a Positive Predictive Factor in Penile Arteriogenic Erectile Dysfunction Etiopathogenesis?(Sage Publications Inc, 2017) Sonmez, Mehmet Giray; Goger, Yunus Emre; Sonmez, Leyla Ozturk; Aydin, Arif; Balasar, Mehmet; Kara, CengizBlood count parameters of patients referring with erectile dysfunction (ED) were examined in this study and it was investigated whether eosinophil count (EC), platelet count (PC), and mean platelet volume values among the suspected predictive parameters which may play a role in especially penile arteriogenic ED etiopathogenesis had a contribution on pathogenesis. Patients referring with ED complaint were evaluated. Depending on the medical story, ED degree was determined by measuring International Index of Erectile Function. Penile Doppler ultrasonography was taken in patients suspected to have vasculogenic ED. According to penile Doppler ultrasonography result, patients with arterial deficiency were included in the penile arteriogenic ED group and the patients with normal results were included in the nonvasculogenic ED group. A total of 36 patients participated in the study from the penile arteriogenic ED group and 32 patients from the nonvasculogenic ED group. Compared with the nonvasculogenic ED group, the penile arteriogenic ED group's low International Index of Erectile Function score, high EC, mean platelet volume and PC values were detected to be statistically significant (p < .001, p = .021, p = .018, p = .034, respectively). No statistically significant difference was observed among the two groups when age, white blood cells, red blood cells, and hemoglobin values were considered. Pansystolic volume velocities were detected as statistically significantly low compared with the nonvasculogenic ED group in the measurements made in 5th, 10th, 15th, and 20th minutes on the right and left sides in the penile arteriogenic ED group. High MPV value and PC is a significant predictive factor for penile arteriogenic ED and vasculogenic ED and high EC is specifically predictive of arteriogenic ED.Öğe Diagnostic Value of Adropin Levels in Acute Pulmonary Embolism Patients(Galenos Publ House, 2020) Ayranci, Mustafa Kursat; Gul, Mehmet; Sonmez, Leyla Ozturk; Aydemir, Fatma Humeyra Yerlikaya; Medni, Mohamed RefikAim: This study aimed to evaluate the relationship between serum adropin levels in patients with acute pulmonary embolism (PE). Materials and Methods: Patients pre-diagnosed with PE based on computed tomographic pulmonary angiography findings and not fulfilling any of the exclusion criteria were included in the PE group. An identical number of participants with comorbidities similar to those of the PE group were included in the control group. These patientswere selected from those who had been referred to the emergency department and were not considered to have PE based on clinical symptoms and risk scores. Results: Serum adropin levels were found to be high in the PE group. Although the adropin values were high in the case of all comorbidities, the values significantly elevated only in patients with hypertension, acute ischaemic stroke, and previous history of PE. The adropin values were quite different among the Wells score categories, and the mean adropin levels varied significantly between the PE and control groups. Conclusion: In this study, the plasma adropin levels were significantly high in patients with acute PE and exhibited high positive predictivity, sensitivity, and specificity in detecting PE.Öğe The Effect of Oxidative Stress Which Can Be Demonstrated with Thiol/Disulfide Homeostasis in Varicocele Patients on Sperm Parameters(Clin Lab Publ, 2018) Sonmez, Mehmet G.; Kozanhan, Betul; Deniz, Cigdem D.; Iyisoy, Mehmet S.; Kilinc, Muzaffer T.; Ecer, Gokhan; Sonmez, Leyla OzturkBackground: We planned to evaluate the effects of thiol/disulfide homeostasis (TDH) on sperm parameters in varicocele patients in this study. Methods: According to sperm concentration (< 15 x 10(6)/mL) sperm morphology (<4%) and progressive motility values (<32%) in the semen analysis, patients were divided into four groups as oligozoospermia (OS, n = 27), oligoasthenozoospermia (OAS, n = 20), oligoteratozoospermia (OTS, n = 26), and oligoasthenoteratozoospermia (OATS, n = 19). Patients with varicocele diagnosis but no pathology in semen analysis were accepted as the control group (n = 25). Groups with impaired semen analysis results were compared to the control group. Results: No difference was detected between OS, OAS, OTS, and OATS groups and the control group in demographical (age, BMI) and varicocele parameters (vein diameter, grade). A significant difference was observed in disulfide level, disulfide/native thiol, disulfide/total thiol rates among OS, OAS, OTS, OATS groups and the control group in the evaluation of TDH parameters. They were significantly higher in OATS group. In OS, OAS, OTS, and OATS groups, it was found that native thiol and total thiol levels were lower and disulfide level was higher than control group, and thiol/disulfide homeostasis shifted to the disulfide side. It was detected that when disulfide value increases 1 mu mol/L, the morphology deteriorated 0.3% and sperm concentration (10(6)/mL) decreased 0.74 and progressive motility decreased 0.68%. Conclusions: The results of the present study suggest that patients with varicocele who have impaired sperm parameters have oxidative stress characterized by TDH slide towards disulfide side and inadequate antioxidant response identified by a lower level of native thiol compared to controls.Öğe Etiological factors and management in priapism patients and attitude of emergency physicians(Pagepress Publ, 2017) Sonmez, Mehmet Giray; Sonmez, Leyla Ozturk; Taskapu, Hakki Hakan; Kara, Cengiz; Dundar, Zerrin Defne; Goger, Yunus Emre; Evrin, TogayObjective: To present the underlying etiological factors in patients referring with priapism, sharing how they are managed according to etiology and priapism type together with our experiences, creating awareness so that urologists and emergency physicians may play a more active role together in priapism management. Materials and methods: Patients referring to emergency service with priapism were examined. Penile Doppler ultrasonography (PDU) and/or corporeal aspiration and blood gas analysis were made in order to determine priapism type after anamnesis and physical examination. The most appropriate treatment option was chosen and applied on the patients considering priapism type, underlying etiological factors and priapism time. Presence of a statistical difference between etiological factors causing priapism, priapism type and applied treatment methods was calculated using Chi square (chi 2) test. Results: A total of 51 patients referring to emergency service with priapism attacks for 53 times were included in the evaluation. When compared to other etiological factors, number of priapism cases developing secondary to papaverine after PDU was found statistically significantly high (p < 0.001). Ischemic priapism ratio was detected statistically higher compared to other groups (p < 0.001). Aspiration and/or irrigation treatment were the most common method used for treatment at a statistically significant level (p < 0.001). All patients (100%) were hospitalized in urology service without applying any treatment in emergency service and had treatment and intervention under the control of the urologist. Conclusions: Application of non-invasive treatments in suitable priapism patients would protect patients from invasive painful interventions. We believe that emergency physicians should be more effective in priapism phase management and at least noninvasive treatment phase.Öğe Evaluating Stable Chronic Obstructive Pulmonary Disease by Ultrasound(Hindawi Ltd, 2019) Evrin, Togay; Korkut, Semih; Sonmez, Leyla Ozturk; Szarpak, Lukasz; Katipoglu, Burak; Smereka, Jacek; Guven, RamazanBackground and Aim. The purpose of the study was to evaluate the relationship between COPD severity and the diaphragmatic function measured by point-of-care US in patients with stable COPD. Method. A total of 61 patients with COPD and 40 healthy subjects who had been admitted to Ufuk University Hospital between December 2018 and May 2019 were enrolled. Point-of-care US was performed, and lung silhouette and anterior, right, and left hemidiaphragm method in M-mode were used to evaluate the diaphragm. Results. The point-of-care US measurements, lung silhouette method right (Lung Sil R), lung silhouette method left (Lung Sil L), right hemidiaphragm US method in B-mode (Ant B-Mode R), and right hemidiaphragm US method in M-mode (Ant M-Mode R), were significantly different among groups (P < 0.001 for each). FEV1 was strongly correlated with Lung Sil R, Lung Sil L, Ant B-Mode R, and Ant M-Mode R (r = 0.963, P < 0.001; r = 0.956, P < 0.001; r = 0.953, P < 0.001; and r = 0.917, and P < 0.001, respectively). Negative correlations were detected between the number of exacerbations per year and Lung Sil R and the number of exacerbations per year and Ant M-Mode R (r = -0.599, P < 0.001 and r = -0.587, and P < 0.001, respectively). Conclusion. In this study, FEV1 and annual number of exacerbations turned out to be strongly correlated US findings. The use of US in COPD patients could help to support clinical decision, but further clinical studies are necessary to confirm those findings.Öğe The Impact of Lung Ultrasound on Coronavirus Disease 2019 Pneumonia Suspected Patients Admitted to Emergency Departments(Lippincott Williams & Wilkins, 2021) Sonmez, Leyla Ozturk; Katipoglu, Burak; Vatansev, Hulya; Kaykisiz, Eylem Kuday; Yuce, Nalan; Szarpak, Lukasz; Evrin, TogayObjective The aim of this study was to identify the sensitivity and specificity of lung ultrasound (LUS) and show its place in diagnosing patients with known coronavirus disease 2019 (COVID-19) pneumonia, according to chest computed tomography and the COVID-19 reporting and data system (CO-RADS). Methods Nineteen patients who admitted to a single university hospital emergency department between March 5, 2020, and April 27, 2020, describing dyspnea were included in the study and underwent LUS by a single emergency specialist. The patient population was divided into 2 groups, COVID-19 positive and negative, and the sensitivity and specificity of LUS according to chest computed tomography were calculated for COVID-19 pneumonia diagnosis. In the subgroup analysis, the patient group was divided into real-time reverse transcription-polymerase chain reaction positive (n = 7) and negative (n = 12), and sensitivity and specificity were calculated according to the CO-RADS. Results According to the CO-RADS, significant differences were detected between the LUS positive and negative groups in terms of COVID-19 pneumonia presence. Only 1 patient was evaluated as CO-RADS 2 in the LUS positive group, and 2 patients were evaluated as CO-RADS 4 in the LUS negative group (P = 0.04). The sensitivity of LUS according to the CO-RADS for COVID-19 pneumonia diagnosis was measured to be 77.78% (95% confidence interval [CI], 39.9%-97.1%), specificity was 90% (95% CI, 55.5%-99.75%), positive predictive value was 87.5% (95% CI, 51.35%-97.8%), and accuracy was 84.21% (95% CI, 60.4%-96.62%; P = 0.004). Conclusions In conclusion, LUS is easily used in the diagnosis of COVID-19 pneumonia because it has bedside application and is fast, easy to apply, reproducible, radiation free, safe for pregnant women, and cheap.Öğe Is There a Difference Between the Readabilities of Informed Consent Forms Used for Elective and Emergency Procedures in Turkey?(Springer Heidelberg, 2020) Sonmez, Mehmet Giray; Sonmez, Leyla Ozturk; Kozanhan, Betul; Dundar, Zerrin DefneBackground: Informed consent is an important aspect of ethical medical practice. In legal terms, making an intervention without informed consent may mean negligence or malpractice and may lead to legal action, maltreatment, and even attack against the doctor. This study aims to evaluate the readability of informed consent forms (ICFs) used for elective (urology and general surgery) and emergency procedures (emergency medicine and intensive care) by comparing through readability formulas. Methods: Elective and emergency ICFs were accessed through the web sites of national health care associations. A total of 387 consent forms were evaluated and the same forms were included only once. A total of 35 consent forms were evaluated for emergency procedures, while a total of 55 consent forms were evaluated for elective procedures. Atesman and Bezirci-Yilmaz formulas defined for determining the readability level of Turkish texts and Gunning fog and Flesch Kincaid formulas measuring the general readability level were used for calculating the readability level of consent forms. Results: Even though elective ICFs are more readable compared to those of emergency procedures according to Bezirci-Yilmaz formulas, this was statistically insignificant (P = .54). The readability of elective consent forms was found to be at a significantly more difficult level to read compared to Atesman, Gunning fog, and Flesch Kincaid formulas (P = .002, P < .001, P < .001, respectively). Conclusion: Even though the procedure is emergency or elective, a difficult readability level may cause problems for the doctor in legal phases. Readable and understandable consent forms should be available to be able to explain morbidity and mortality and improve prognosis. Education level of our country should also be considered while preparing these consent forms.Öğe Is there a relationship between penile vasculogenic erectile dysfunction, platelet functions and eosinophil count?(Elsevier Espana Slu, 2017) Sonmez, Mehmet Giray; Sonmez, Leyla Ozturk; Goger, Yunus Emre; Aydin, Arif; Demirelli, Erhan; Boga, Mehmet Salih; Kara, CengizPurpose: Blood count parameters of patients referring with penile vasculogenic erectile dysfunction (ED) were examined in this study. It was investigated whether eosinophil count (EC), platelet count (PC) and mean platelet volume (MPV), values among the suspected predictive parameters which may affect vascular functions, have a contribution on ED pathology or not. Materials and methods: Patients referring erectile dysfunction complaint were evaluated. Depending on the medical story, ED degree was determined by measuring International Index of Erectile Function (IIEF). Values such as hormones, complete blood count and other laboratory markers were examined. Penile doppler ultrasonography (PDU) was performed in patients suspected to have vasculogenic ED. According to PDU result, patients with vascular deficiency were included in the penile vasculogenic ED group and patients with normal results were included in the control group. 49 patients participated in the study from the penile vasculogenic ED group and 30 patients from the control group. Intergroup comparisons were performed using the Mann-Whitney U test and the chi-square (chi(2)) test was used to assess the relationship between categorical variables within the patient groups. Results: Low IIEF score in vasculogenic ED group compared to the control group and high EC, MPV and PC values were detected to be statistically significant (p < 0.001, p = 0.026, p = 0.009, p = 0.029, respectively). No statistically significant difference was observed among the two groups when age, white blood cells, red blood cells or hemoglobin values are considered (p = 0.332, p = 0.235, p = 0.127, p = 0.696, respectively). Conclusion: High MPV value and platelet count showing the platelet functions and high eosinophil count are important factors which may play a role in penile vasculogenic ED etiopathogenesis. (C) 2016 Asociacion Espanola de Andrologia, Medicina Sexual y Reproductiva. Published by Elsevier Espana, S.L.U. All rights reserved.Öğe Ischemic priapism: Can eosinophil count and platelet functions be positive predictive factors in etiopathogenesis(Canadian Urological Association, 2017) Sonmez, Mehmet Giray; Kara, Cengiz; Karaibrahimoglu, Adnan; Sonmez, Leyla Ozturk; Goger, Yunus Emre; Balasar, Mehmet; Taskapu, Hakki HakanIntroduction: We evaluated the relation between ischemic priapism (IP) and blood count parameters in IP patients. We especially wanted to examine the contribution of eosinophil count (EC), platelet count (PC), and mean platelet volume (MPV) values, which are suspected predictive parameters for vascular endothelium damage and venoocclusive pathogenesis and etiopathogenesis, particularly in IP. Methods: A total of 40 IP patients fulfilled the study criteria. Forty healthy volunteers in a similar age group were included as the control group. Complete blood count values were compared between the two groups. Intergroup comparisons were performed using the Mann-Whitney U test, and the chi-square test was used to assess the relationship between categorical variables in the patient groups. The area under the curve was calculated by receiver operating characteristic (ROC) regression analyses. Epidemiological diagnosis percentages were calculated by finding cutoff values. Results: The IP group's high MPV, PC, and EC values compared to those of the control group were detected to be statistically significant (p<0.001, p=0,03, p=0.001, respectively). No statistically significant difference was observed between the two groups for other blood count parameters. Statistically significant values for IP were measured as MPV: positive predictive value: 84%; EC: positive predictive value: 71.4%; and PC: positive predictive value: 61.4%. Conclusions: High MPV, PC, and EC values are significant positive predictive factors in IP etiopathogenesis. No proof was detected for other blood count parameters playing an active role in IP etiopathogenesis.Öğe New treatment modalities with vaccine therapy in renal cell carcinoma(Wolters Kluwer Medknow Publications, 2019) Sonmez, Mehmet Giray; Sonmez, Leyla OzturkThe aim of implementing vaccine therapy is to activate immune response against malignant cells by overcoming the tolerance triggered by the tumor. These treatments are effective using the immune response against cancer. Not every type of cancer is suitable for vaccine therapies. For a vaccine therapy to be implemented, cancer should be immunogenic and contain tissue-specific proteins, should have a slow progression, and treatments should be feasible. For that reason, studies regarding urological cancers are mostly focused on the kidneys and the prostate. Vaccine therapies used in renal cell carcinoma (RCC) can be categorized under the following titles: autologous tumor cells, dendritic cells, genetically modified tumor cells, and protein/peptide. Although there are old studies on the implementation of vaccine therapies in RCC, researches have only been intensified recently. In addition to their effective potential for lengthening general survival, decreasing tumor burden and cancer development in long term, vaccine treatments are especially effective in metastatic RCC patients. We think that vaccine treatments would be applied more in near future since RCC are immunogenic. In this compilation, we will discuss vaccine therapies used in RCC, which urologists are not so familiar with, in the light of the up-to-date literature.Öğe Occupational burnout, job satisfaction and anxiety among emergency medicine doctors in Turkey(Professional Medical Publications, 2021) Sonmez, Leyla Ozturk; Gul, MehmetObjective: The objective of the study was to investigate possible differences in the levels of anxiety, burnout and job satisfaction among emergency medicine doctors based on their age, gender, employment duration, job title and institution. Methods: General practitioners, residents, specialists and faculty members working in emergency departments (ED) in Turkey were invited to participate in this questionnaire-based study through an e-mail link between September 2018 and January 2019. A total of 141 doctors from different cities of Turkey who completely filled the questionnaire with their own will were recruited for the study. The Maslach Burnout Inventory(MBI) was used to measure occupational burnout levels, the State-Trait Anxiety Inventory(STAI) to measure anxiety levels and the Short Form Minnesota Satisfaction Questionnaire (SFMSQ) to measure job satisfaction levels of doctors working in EDs. In assessing MBI; Emotional Exhaustion score(EE) is considered low for 0-11 points, moderate for 12-17 points and high 3 and very/ extremely satisfied (high) if job satisfaction point 3. Results: The mean age of the study group was 33.3 (?7.3) and mean employment duration was 8.37 (?6.89). In the overall study population, the emotional exhaustion(EE) was high while depersonalization(DP) and reduction of personal accomplishment(PA) were detected at medium level in the evaluation of MBI subscales. In evaluating overall study population for STAI, state and trait anxiety scores both showed the presence of mild to moderate anxiety. The overall study population evaluation results for SFMSQ were, high levels of general and intrinsic job satisfaction and low levels of extrinsic job satisfaction was measured. Younger the age and shorter the duration of employment is found to be associated with a significant increase in EE and DP and a significant decrease in PA. Conclusion: In this study, scale results showed that doctors working in EDs had high levels of occupational burnout and anxiety, while job satisfaction levels were low. In addition, a significant relationship was found between the decrease in ?age and employment duration? and the increase in ?depersonalization?.Öğe Occupational burnout, job satisfaction and anxiety among emergency medicine doctors in Turkey(Professional Medical Publications, 2021) Sonmez, Leyla Ozturk; Gul, MehmetObjective: The objective of the study was to investigate possible differences in the levels of anxiety, burnout and job satisfaction among emergency medicine doctors based on their age, gender, employment duration, job title and institution. Methods: General practitioners, residents, specialists and faculty members working in emergency departments (ED) in Turkey were invited to participate in this questionnaire-based study through an e-mail link between September 2018 and January 2019. A total of 141 doctors from different cities of Turkey who completely filled the questionnaire with their own will were recruited for the study. The Maslach Burnout Inventory(MBI) was used to measure occupational burnout levels, the State-Trait Anxiety Inventory(STAI) to measure anxiety levels and the Short Form Minnesota Satisfaction Questionnaire (SFMSQ) to measure job satisfaction levels of doctors working in EDs. In assessing MBI; Emotional Exhaustion score(EE) is considered low for 0-11 points, moderate for 12-17 points and high 3 and very/ extremely satisfied (high) if job satisfaction point 3. Results: The mean age of the study group was 33.3 (?7.3) and mean employment duration was 8.37 (?6.89). In the overall study population, the emotional exhaustion(EE) was high while depersonalization(DP) and reduction of personal accomplishment(PA) were detected at medium level in the evaluation of MBI subscales. In evaluating overall study population for STAI, state and trait anxiety scores both showed the presence of mild to moderate anxiety. The overall study population evaluation results for SFMSQ were, high levels of general and intrinsic job satisfaction and low levels of extrinsic job satisfaction was measured. Younger the age and shorter the duration of employment is found to be associated with a significant increase in EE and DP and a significant decrease in PA. Conclusion: In this study, scale results showed that doctors working in EDs had high levels of occupational burnout and anxiety, while job satisfaction levels were low. In addition, a significant relationship was found between the decrease in ?age and employment duration? and the increase in ?depersonalization?.Öğe Pseudopneumothorax: Emphysema Case Mimicking Pneumothorax(Emergency Medicine Physicians Assoc Turkey, 2019) Sonmez, Leyla Ozturk; Evrin, Togay; Ayranci, Mustafa Kursat; Unluer, Erden ErolBedside lung ultrasound (LUS) is generally emergency rooms for the patients suspected to have lung pathology. LUS is especially important for quick diagnosis and fast treatment, especially in unstable patients. Pneumothorax is the condition of air entering between pleural plaques and lung being separated from the thoracic wall. Typically, there is a low amount of lubricating fluid between visceral pleura covering the lung and parietal pleura covering the inner face of the thoracic wall. Emphysema is the abnormal widening of air sacs distal to the terminal bronchioles with the destruction of alveolar walls without fibrosis, and it is one of the obstructive lung diseases. Cases, where emphysema is confused with pneumothorax, were also defined rarely in the literature. We wanted to create awareness on the place of ultrasound on pneumothorax diagnosis by sharing the emphysema case imitating pneumothorax in LUS seen rather rare in literature.Öğe What should be done to minimize pain without any sexual function deterioration in transrectal prostate biopsy?(Polish Urological Assoc, 2017) Sonmez, Mehmet Giray; Kozanhan, Betul; Demirelli, Erhan; Sonmez, Leyla Ozturk; Kara, CengizIntroduction The aim of this study was to find an ideal method for the application of a transrectal ultrasound-guided prostate biopsy (TRUS-Bx) without deteriorating patient comfort. Material and methods TRUS-Bx was applied in a total of 93 patients. Taking the application method into consideration, these patients were divided into three groups, each consisting of 31 patients. Methods applied for pain control in the different groups were compared (groups 1, 2 and 3). Age, prostate specific antigen (PSA), prostate volume, cancer detection rate, re-biopsy consent ratio, complication rates, visual analog scale (VAS), and International Index of Erectile Function (IIEF-5) scores were compared among the groups. Results Age, PSA, prostate volume, cancer detection rate, and fever complication rate were not statistically different between the three groups. However, a statistically significant difference was detected among the groups for the VAS measured during and after TRUS-Bx, re-biopsy consent ratio, and hematuria (p < 0.001, p < 0.001, p < 0.001, and p = 0.027, respectively). There was no detected difference in pre-operation IIEF-5 scores, but the difference in IIEF-5 scores in the first month after the operation was significant (p = 0.116, p = 0.024, respectively). Conclusions Anal dilatation after the application of intrarectal topical anesthetic to provide anesthesia during TRUS-Bx and giving lidocaine hydrochloride with epinephrine for periprostatic nerve blockage (PNB) is a successful and effective method to maintain patient comfort, especially as it relates to pain control and sexual function. Anal dilatation seems to minimize any pain that may occur due to probe transition, and adding epinephrine as a vasopressor to the anesthetic agent chosen during the operation will be rather helpful for hemostasis control and pain that results from the needle.
