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    Minimally invasive renal transplantation
    (Nova Science Publishers, Inc., 2023) Sogutdelen, Emrullah; Kemahli, Eray; Sener, Alp
    The prevalence of CKD has become a major health concern, affecting 1 in 7 (14%) people in the United States. Additionally, CKD is increasing globally due to the aging of the population and an increase in chronic diseases such as hypertension and diabetes. In 2019, more than 150,000 solid organ transplants were performed worldwide, of which over 60% were kidney transplants. This chapter will focus mostly on the use and increasing importance of minimally invasive methods (laparoscopy and robotics) in kidney transplantation. The increase in the number and long term success of kidney transplants in the light of immunological, pathological, and pharmacological developments over the years. As minimally invasive techniques were improved across multiple surgical disciplines, these methods began to be used for the first time in donor nephrectomies; the first reports highlighting laparoscopic and robotic-assisted laparoscopic donor nephrectomies were performed by Ratner at Johns Hopkins University in 1995 and by Horgan at the University of Illinois, Chicago, in 2000, respectively. The most important parameter in kidney transplantation is patient and graft survival. Cross-matching, preemptive transplantation, short ischemia and anastomotic times, and grafts obtained from living donors all have an impact on graft survival. Patient and graft survival are similar in both conventional open and minimally invasive transplant models. The goal of minimally invasive surgery has always been to minimize surgical trauma and related complications such as postoperative pain, wound-related complications, and cosmetic side effects by using optical and electronic visualization equipment with several small incisions instead of a single large incision. In addition, enhanced imaging allows the surgical field and structural anatomy to be more clearly visualized. However, there are some limitations such as expensive imaging equipment, lack of tactile feedback, and steep learning curves that come up with novel technologies. Robot-assisted laparoscopic surgery partially removes the technical limitations of laparoscopy. This innovation has significantly expanded the indication for minimally invasive surgery in more sensitive and complex surgeries, thanks to its advantages such as higher resolution and 3D imaging, greater motion sensitivity, improved dexterity, and tremor filtration. © 2023 Nova Science Publishers, Inc. All rights reseverd.
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    The role of phosphodiesterase type-5 inhibitors in Benign Prostatic Hyperplasia, current approaches
    (Galenos Yayincilik, 2013) Kemahli, Eray; Gucuk, Adnan; Uyeturk, Ugur
    Both benign prostatic hyperplasia (BPH) that manifested with lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are common health problems reducing quality of life in aging males. It has presumed that phosphodiesterase type 5 (PDE5) inhibitors which are primarily used in the treatment of ED may have therapeutic effects on BPH because of possible common pathophysiology between BPH and ED. There are many recent studies relevant to the this issue. Especially, after the FDA approval of tadalafil in the treatment of BPH, it has been entered to our daily practice as monotherapy or in combination with alpha-blocker drugs. PDE5 inhibitors may be preferred as a first line treatment option in patients who suffer both BPH and ED simultaneously, however, it is possible to use in patients with BPH only. Younger patients with low body mass index and with severe LUTS have more benefit with PDE5 inhibitor therapy. Flushing, gastroesophageal reflux, headache, and dyspepsia are the most frequently reported adverse effects of PDE5 inhibitors. These adverse effects are mild to moderate, and require the therapy to be discontinued in a small portion of patients. In this review, it is aimed to evaluate the use of PDE5 inhibitors in the treatment of BPH with the current literatures.