1.Patient-reported outcomes after hemorrhoid surgery: early results from a prospective, nationwide, real-world, cohort study on diverse approaches
Metin KEMENT ; Atıf TEKIN ; Hakan BAYSAL ; Salih TOSUN ; Orhan ALIMOĞLU ; İlker SÜCÜLLÜ ; Osman CIVIL ; Nevin SAKOĞLU ; Naciye Çiğdem ARSLAN ; Cihad TATAR ; Ali Emre NAYCI ; Aziz ARI ; Ensar ÇAKIR ; Rozan KAYA ; İlknur TURAN ; Taygun GÜLŞEN ; Serhat MERIÇ ; Erkan YAVUZ ; Nihat BUĞDAYCI ; Farid Mohamad HAMAD ; Sezai LEVENTOĞLU ; Ramazan KOZAN ; Özkan AKPINAR ; Hakan YANAR ; Fatih YANAR ; Hasan Fehmi KÜÇÜK ; Mehmet KARAHAN ; Selçuk KAYA ; Nail Can ADIGÜZEL ; Tolga ÖNDER ; İlker ABCI ; Ahmet Zeki AYDIN ; Ömer Faruk ÖZKAN ; Nurhilal KIZILTOPRAK ; Berkay ÖZCAN ; Anıl ORHAN ; Alp Ömer CANTÜRK ; Murat TAN ; Yusuf BILGIN ; Harun ÇOK ; Azamet CEZIT ; Mehmet Mahir FERSAHOĞLU ; Mustafa ÖNCEL
Annals of Coloproctology 2025;41(6):573-585
Purpose:
Real-world evidence comparing surgical techniques for symptomatic hemorrhoidal disease (HD) remains limited, despite the availability of multiple approaches. This study aimed to evaluate short-term, interim outcomes from a prospective, nationwide cohort study that compared the effectiveness of different operative techniques based on patient-reported outcome measures (PROMs) in patients with symptomatic HD.
Methods:
A prospective, nationwide cohort study was conducted at 20 tertiary care centers across Turkiye between July 2022 and July 2024. Adult patients aged 18 years or older with symptomatic HD (grades I–IV) who underwent surgery during this period were included. The choice of procedure was determined by the operating surgeon, and patients were categorized into excisional, fixative, and ablative groups according to the surgical approach used. The primary outcomes were changes in the Hemorrhoidal Disease Symptom Score, Short Health ScaleHD, visual analog scale for pain, and patient satisfaction, assessed from the preoperative period to postoperative day 7 and postoperative week 6.
Results:
The study included a total of 315 patients after excluding those who did not fulfil the inclusion criteria. Among them, 239 (78.9%) were male, with a mean age of 43.7±11.7 years. The distribution of patients across surgical groups was 207 (65.7%) in the excisional group, 30 (9.5%) in the fixative group, and 78 (24.8%) in the ablative group. All groups demonstrated significant improvements in PROM scores from preoperative to postoperative assessments. However, no statistically significant differences were observed between groups at any time point for PROM scores or for changes in PROM scores across consecutive evaluations (P≥0.05 for all comparisons). Urinary retention occurred more frequently, and hospital stays were longer in the fixative group (P=0.006 and P<0.001, respectively). The excisional group had a greater need for narcotic use and longer duration of use (P=0.003 and P<0.001, respectively).
Conclusion
This real-world cohort study shows that all 3 surgical approaches are effective for HD, providing comparable short-term symptomatic relief and patient satisfaction. These techniques appear equally valid treatment options, and the choice of procedure may best be individualized based on patient-specific characteristics and surgeon preference.Trial registration: ClinicalTrials.gov identifier: NCT05429060
2.Clinical Manifestations of Overactive Bladder With Migraine as a Comorbidity: A Prospective Cross-Sectional Study
Aykut BASER ; Sinan ELIAÇIK ; Mehmet Murat BAYKAM ; Funda Uysal TAN
International Neurourology Journal 2020;24(4):375-381
Purpose:
The aim of this study was to investigate the clinical manifestations of overactive bladder (OAB) with migraine as a comorbidity and to shed light on possible new treatment strategies.
Methods:
This study included patients aged 18 years and older who were admitted to urology and neurology outpatient clinics between March 1, 2019 and March 1, 2020 for OAB and migraine. The study questionnaire contained 3 sections: (1) questions on demographic characteristics, (2) a migraine ID test, and (3) the Overactive Bladder Inquiry Form - V8 (OAB-V8) form.
Results:
A total of 265 patients participated in the study. The average age of the participants was 39.75±11.93 years. The patients were divided into 3 groups according to the coexistence of OAB with migraine: group 1, OAB(+)/migraine(+); group 2, OAB(+)/migraine(-); and group 3, OAB(-)/migraine(+). The mean OAB-V8 score was 22.82 ±8.15 in group 1 and 25.64±7.49 in group 2. The mean OAB-V8 score of OAB patients with migraine as a comorbidity was statistically significantly lower than that of OAB patients without migraine (P=0.015). The median visual analogue scale (VAS) score was 7.11 (range, 2–10) in group 1 and 5.95 (range, 2–10) in group 3. This finding indicates that in patients with migraine, having OAB was associated with significantly higher VAS scores (P<0.001).
Conclusions
OAB and migraine may be comorbid conditions coexisting in a single patient. This comorbidity may lead to a lower perception of OAB symptoms in OAB patients or, conversely, to a higher perception of migraine pain. Further studies are needed to elucidate how treatments for each of these diseases can affect the other disease.
3.Evaluation of the Protective Effect of Beta Glucan on Amikacin Ototoxicity Using Distortion Product Otoacoustic Emission Measurements in Rats.
Tuba BAYINDIR ; Aliye FILIZ ; Mustafa IRAZ ; Serdar KAYA ; Mehmet TAN ; Mahmut Tayyar KALCIOGLU
Clinical and Experimental Otorhinolaryngology 2013;6(1):1-6
OBJECTIVES: This experimental study investigated the possible protective effect of beta glucans on amikacin ototoxicity. METHODS: Thirty-eight rats with normal distortion product otoacoustic emissions (DPOAEs) were divided into four groups. Group K was the control group. Group A was injected intramuscularly (i.m.) with amikacin 600 mg/kg/day between days 1-15. Group AB was given beta glucan gavage 1 mg/kg/day on days 0-15 and given amikacin 600 mg/kg/day i.m. on days 1-15. Group B was administered only beta glucan gavage, 1 mg/kg/day, on days 0-15. The DPOAEs were elicited in different frequency regions between 2,003 and 9,515 Hz, as distortion product diagrams (DPgrams), before and after the medication was administered, in all groups, on days 1, 5, 10, and 15. RESULTS: No significant changes in the DPgrams were observed in group K. In group A, significant deterioration was observed at the 8,003 and 9,515 Hz frequencies on day 10, and at the 3,991, 4,557, 5,660, 6,726, 8,003, and 9,515 Hz frequencies on day 15. For group AB, statistically significant deterioration was observed at the 2,824, 8,003, and 9,515 Hz frequencies on day 15. The results for group B showed a significant improvement of hearing at the 2,378, 2,824, 3,363, and 3,991 Hz frequencies on day 1, at the 3,363, 3,991, and 8,003 Hz frequencies on day 10, and at the 8,003 Hz frequency on day 15. CONCLUSION: This study suggests that amikacin-induced hearing loss in rats may be limited to some extent by concomitant use of beta glucan.
Amikacin
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Animals
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beta-Glucans
;
Hearing
;
Hearing Loss
;
Rats

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