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    Evaluation of risk factors for necrotic tissue resections in elderly patients with groin hernia
    (Edizioni Luigi Pozzi, 2023) Karatas, Turgay; Selcuk, Engin Burak; Karatas, Mehmet; Tahtali, Ibrahim Nuvit; Yildirim, Atilla; Arslan, Ahmet Kadir
    Aim: To reveal the relationships between patient findings and tissue resection in elderly patients. Materials and methods: Between September 2020 and September 2022 three hundred eighty four patients over the age of 60 who were operated with the diagnosis of groin hernia were retrospectively analyzed. Gender, age, height, weight and body mass index value, groin and inguinal hernia types, hernia sides, primary or recurrent cases, hernia sac content, incarceration, tissue necrosis and resection presence, and accompanying pathologies were recorded. These findings were compared and evaluated in order to determine the relationships between patient findings and tissue resection, and the findings at risk for tissue resection. Results: Of the patients in the study, 352 (91.7%) were male and 32 (8.3%) were female. The mean age, height, weight and BMI were 67.48 +/- 5.893 years, 169.27 +/- 6.113 cm, 73.28 +/- 7.878 kg and 25,566 +/- 2.3518 kg/m2, respectively. There were 369 inguinal, 15 femoral, 285 indirect, 84 direct, 312 primary, and 72 recurrent hernias. Incarceration was present in 65 (16.9%) patients, 19 (4.9%) of these patients underwent resection due to tissue necrosis (twelve omentum and seven small intestine). Tissue resection was 3.1% in male, 25% in female, 4.3% in inguinal, 20% in femoral, 5.6% in indirect, 0% in direct, 3.5% in primary and 11.1% in recurrent hernias. Tissue resections were significantly higher in females, femoral hernias, indirect inguinal hernias and recurrent cases (p<0.05). Conclusions: We can say that female gender, femoral, indirect and recurrent hernias are important risk factors for tissue resection in elderly patients.
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    Incidence of emergency surgery in anterior abdominal wall hernias
    (Bayrakol Medical Publisher, 2023) Karatas, Turgay; Selcuk, Engin Burak; Karatas, Mehmet; Yildirim, Atilla; Tahtali, Ibrahim Nuvit; Arslan, Ahmet Kadir
    Aim: This prospective study was conducted to analyze the incidence of emergency surgery in anterior abdominal wall hernias (AWH). Material and Methods: A total of 659 patients with anterior AWH were examined. Patients with anterior AWH who underwent elective or emergency surgery were included in the study. In this study, groin and non-groin hernias constitute anterior AWHs. Gender, age, anesthesia and repair methods, elective and emergency surgery, hernia types, side of groin hernias, recurrent or primary hernias were determined and recorded. Emergency surgery incidences of hernias were evaluated in terms of gender, age, hernia types, groin hernia sides, primary or recurrent hernias.Results: Emergency surgery was performed in 64 patients (9.7%). The incidence of emergency surgery was found to be higher in females. In anterior AWHs, the emergency surgery incidence was found to be higher in non-groin hernias than in groin hernias (P<0.001). The emergency surgery incidence was highest in femoral hernias among groin hernias and incisional hernias in non-groin hernias. In terms of primary and recurrent cases, the emergency surgery incidence was significantly higher in recurrent cases (P<0.001). However, when the emergency surgical incidence of all anterior AWHs such as inguinal, femoral, incisional, umbilical and epigastric hernias in the study were compared, no significant difference was found among them. Discussion: Emergency surgery incidence was found to be higher in females and in recurrent cases. However, there was no significant difference in the incidence of emergency surgery among all anterior AWH types.
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    The new therapeutic option for female stress and stress-predominant mixed urinary incontinence: Periurethral hypertonic saline (10%) injection
    (Wiley, 2022) Tahtali, Ibrahim Nuvit; Yildiz, Turan; Dincer, Muhammed Murat
    Objectives We aimed to evaluate the safety and efficacy of periurethral hypertonic saline (10% NaCl) injection in the treatment of stress urinary incontinence (SUI) and stress-predominant mixed urinary incontinence (S-MUI) in women. Methods This was a prospective study conducted between January 2014 and April 2018 with 64 women (44 SUI and 21 S-MUI). Patients with SUI and S-MUI were evaluated using the Urinary Distress Inventory 6. Quality of life was evaluated with the Incontinence Quality of Life Scale and lower urinary tract symptoms of the women were evaluated with the International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Modules. Incontinence status and treatment success were assessed via the Stamey incontinence grade and pad test. Results The subjective success rate was 58.5%, and the objective success rate was 81.5%. The rate of reinjection was 21.5%, and the mean duration of reinjection was 8.92 months (3-19 months). Minor adverse effects were observed in 30.4% of the 79 injections. International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Modules and Incontinence Quality of Life Scale scores improved remarkably starting from the first month. Urinary Distress Inventory 6 scores in the S-MUI group also improved. Conclusions The results indicate that hypertonic saline injection is an effective and safe method in the treatment of SUI and S-MUI. Since hypertonic saline is a much cheaper and more accessible substance compared to bulking agents, it seems to be a viable alternative for urinary incontinence treatment in women.