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Öğe Bibliometric analysis of most cited Peyronie's disease and its management publications(Frontiers Media Sa, 2024) Sahin, Mehmet Fatih; Dogan, Cagri; Akgul, Murat; Yazici, Cenk Murat; Seramet, Serkan; Dayisoylu, Hulusi SitkiIntroduction Peyronie's disease (PD) is a common urologic illness, motivating numerous scientific investigations and publications. Scientific publications have more authors each year. A bibliometric review of the PD literature might help urologists and sexual medicine professionals comprehend publication tendencies in this subject. The current study was aimed at presenting a bibliometric analysis of PD, which is one of the important and trending subjects of andrology.Methods On January 5, 2023, Web of Science scanned documents with the terms Peyronie's disease Peyronie's disease treatment, Peyronie's disease management, Peyronie's disease surgery and Peyronie's disease injection from 1975 through 2023. Titles, years, authors, citations, citation indices, journal names, authors' countries of origin, article categories, and funding sources were recorded.Results Clinical Efficacy, Safety and Tolerability of Collagenase Clostridium Histolyticum for the Treatment of Peyronie Disease in 2 Large Double-Blind, Randomized, Placebo Controlled Phase 3 Studies has the most citations and citation index. Most of the T100 articles were published in 2020, primarily in the Journal of Urology. These articles mainly focused on treatment, especially surgeries. All of these articles were in English, and the vast majority of them were by authors from the US who were most frequently collaborated with by other authors.Conclusion This research analyzed the top 100 PD studies. This research focused on pathophysiology, innovative surgical procedures, and new approaches of PD. It also recommended bigger databases and more financing for research.Öğe Evaluation of information accuracy and clarity: ChatGPT responses to the most frequently asked questions about premature ejaculation(Oxford Univ Press, 2024) Sahin, Mehmet Fatih; Keles, Anil; Oezcan, Ridvan; Dogan, Cagri; Topkac, Erdem Can; Akgul, Murat; Yazici, Cenk MuratBackground Premature ejaculation (PE) is the most prevalent sexual dysfunction in men, and like many diseases and conditions, patients use Internet sources like ChatGPT, which is a popular artificial intelligence-based language model, for queries about this andrological disorder.Aim The objective of this research was to evaluate the quality, readability, and understanding of texts produced by ChatGPT in response to frequently requested inquiries on PE.Methods In this study we used Google Trends to identify the most frequently searched phrases related to PE. Subsequently, the discovered keywords were methodically entered into ChatGPT, and the resulting replies were assessed for quality using the Ensuring Quality Information for Patients (EQIP) program. The produced texts were assessed for readability using the Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease Score (FRES), and DISCERN metrics.Outcomes This investigation has identified substantial concerns about the quality of texts produced by ChatGPT, highlighting severe problems with reading and understanding.Results The mean EQIP score for the texts was determined to be 45.93 +/- 4.34, while the FRES was 15.8 +/- 8.73. Additionally, the FKGL score was computed to be 15.68 +/- 1.67 and the DISCERN score was 38.1 +/- 3.78. The comparatively low average EQIP and DISCERN scores suggest that improvements are required to increase the quality and dependability of the presented information. In addition, the FKGL scores indicate a significant degree of linguistic intricacy, requiring a level of knowledge comparable to about 14 to 15 years of formal schooling in order to understand. The texts about treatment, which are the most frequently searched items, are more difficult to understand compared to other texts about other categories.Clinical Implications The results of this research suggest that compared to texts on other topics the PE texts produced by ChatGPT exhibit a higher degree of complexity, which exceeds the recommended reading threshold for effective health communication. Currently, ChatGPT is cannot be considered a substitute for comprehensive medical consultations.Strengths and Limitations This study is to our knowledge the first reported research investigating the quality and comprehensibility of information generated by ChatGPT in relation to frequently requested queries about PE. The main limitation is that the investigation included only the first 25 popular keywords in English.Conclusion ChatGPT is incapable of replacing the need for thorough medical consultations.Öğe The impact of preoperative ureteral stent duration on retrograde intrarenal surgery results: a RIRSearch group study(Springer, 2024) Sahin, Mehmet Fatih; Akgul, Murat; Cakir, Hakan; Ozman, Oktay; Basatac, Cem; Cinar, Onder; Siddikoglu, DuyguA JJ stent placed before retrograde intrarenal surgery (RIRS) may ease the procedure. However, it is important to note that a prolonged duration of double J stent (DJS) placement before RIRS may increase the risk of postoperative urinary tract infection (UTI). Various publications have established this association, although the duration of the DJS before surgery is scarce. Our study investigates the relationship between the pre-stenting period and postoperative UTI and establishes a cut-off period to minimize this risk. We included a total of 500 cases with preoperative DJS prior to RIRS. The patients were divided into five groups according to their preoperative stenting duration (Group 1: 0-15 days; Group 2: 16-30 days; Group 3: 31-45 days; Group 4: 46-60 days; Group 5: >60 days). Demographic and clinical data of the patients, stone properties, operation data, perioperative and postoperative complications (including fever and UTI), hospitalization time, and stone-free rates (SFR) were compared. The groups contained 53, 124, 102, 63, and 158 patients. The demographics of the patients in each group were similar. There was no statistically significant difference between DJS duration, perioperative/postoperative complications, and SFR, except for the ureteral access sheath (UAS) insertion rate. (p = 0.001). The postoperative fever/UTI rate was the lowest in Group 1 (p = 0.046) compared to other durations. Stent duration does not impact SFR. Longer stents enhance UAS insertion success but increase postoperative infection risk. Our results suggest that RIRS should be performed within two weeks, ideally 20 days following stent insertion, to minimize postoperative infection risk.Öğe Prognostic Role of Tumor Percentage in Multiparametric MRI for Upgrade Prediction Before Radical Prostatectomy(Galenos Publ House, 2024) Arikan, Mehmet Guerkan; Ecer, Goekhan; Sahin, Mehmet Fatih; Hereklioglu, Savas; Goekalp, Fatih; Arda, Ersan; Akguel, BurakObjective: To determine the parameters that can predict upgrade with multiparametric magnetic resonance imaging (mpMRI) findings before radical prostatectomy Materials and Methods: The study included 69 patients who were diagnosed with prostate cancer (PCa) between January 2017-December 2020 and subsequently underwent RP. Patients were divided into two groups by comparing prostate biopsies and RP specimens as patients with upgrade (group 1) and patients without upgrade (group 2). Of the 69 patients, 26 were in group 1 and 43 in group 2. The images were evaluated by a single radiologist experienced in mpMRI using the Prostate Imaging Reporting and Data System v2.1 scoring system. Biopsy and RP pathology specimens were evaluated by an experienced neuropathologist. Results: The median prostate-specific antigen (PSA) levels were higher in patients with upgraded pathology [8.60 (5.90-14.00) ng/dL vs. 7.70 (5.20-10.00) ng/dL, respectively; p=0.040]. The prostate volume [31.88 (23.40-51.48) vs. 48.06 (23.40-87.35); p=0.009] and PSA density [3.72 (2.17-5.62) vs. 5.75 (3.35-9.6), respectively; p=0.007] were lower in patients with upgraded pathology. The tumor percentage on mpMRI was not different between the groups [3.70 (1.80-16.20 Conclusions: Although the percentage of tumors on multiparametric mpMRI is an inadequate pattern to predict upgrade in PCa patients, prospective studiesÖğe Responses of Five Different Artificial Intelligence Chatbots to the Top Searched Queries About Erectile Dysfunction: A Comparative Analysis(Springer, 2024) Sahin, Mehmet Fatih; Ates, Huseyin; Keles, Anil; Ozcan, Ridvan; Dogan, Cagri; Akgul, Murat; Yazici, Cenk MuratThe aim of the study is to evaluate and compare the quality and readability of responses generated by five different artificial intelligence (AI) chatbots-ChatGPT, Bard, Bing, Ernie, and Copilot-to the top searched queries of erectile dysfunction (ED). Google Trends was used to identify ED-related relevant phrases. Each AI chatbot received a specific sequence of 25 frequently searched terms as input. Responses were evaluated using DISCERN, Ensuring Quality Information for Patients (EQIP), and Flesch-Kincaid Grade Level (FKGL) and Reading Ease (FKRE) metrics. The top three most frequently searched phrases were erectile dysfunction cause, how to erectile dysfunction, and erectile dysfunction treatment. Zimbabwe, Zambia, and Ghana exhibited the highest level of interest in ED. None of the AI chatbots achieved the necessary degree of readability. However, Bard exhibited significantly higher FKRE and FKGL ratings (p = 0.001), and Copilot achieved better EQIP and DISCERN ratings than the other chatbots (p = 0.001). Bard exhibited the simplest linguistic framework and posed the least challenge in terms of readability and comprehension, and Copilot's text quality on ED was superior to the other chatbots. As new chatbots are introduced, their understandability and text quality increase, providing better guidance to patients.Öğe Retrograde Intrarenal Surgery Learning Curves of Urology Residents Supervised by an Experienced Endourologist: An RIRSearch Study(Karger, 2023) Sahin, Mehmet Fatih; Ozman, Oktay; Cakir, Hakan; Cinar, Onder; Akgul, Murat; Basatac, Cem; Simsekoglu, Muhammed FatihIntroduction: Although retrograde intrarenal surgery (RIRS) is being performed with increasing frequency, there are only a limited number of studies about the learning curve (LC). This study aimed to analyze the LC of RIRS for five surgeons who underwent the same training. Materials and Methods: The data of the 410 patients who underwent RIRS between April 2017 and 2022 in a single institution, which were performed consecutively by five surgeons, were analyzed. All 50 cases performed by each surgeon were included and numbered consecutively and separately, according to the date of the operation. The combined stone-free rate (SFR) was calculated for each surgeon's cases in the same row, and the LCs were created using moving average and cumulative sum (CUSUM) analyses. Separate multivariable analyses identified each period's (LC vs. beyond) characteristics. Results: The LCs from the combined SFRs reached a plateau after approximately 50 cases for both the CUSUM and the moving average. The effect of stone burden on SFR was more evident in the first 50 cases compared to subsequent cases in the multivariable analyses (p = 0.001 and p = 0.047, respectively). Case order and stone density were independent factors in the first 50 cases (OR: 1.02 [95% CI 1.00-1.04], p = 0.04 and OR: 0.99 [95% CI 0.99-1.00], p = 0.04) but not significant in subsequent cases (OR: 0.97 [95% CI 0.94-1.00], p = 0.1 and OR: 1.00 [95% CI 0.99-1.00], p = 0.7, respectively). Compared to single locations except the lower calyx, the unfavorable effect of the multiple-stone localization on SFR grew in strength after the 50th case (OR: 0.42 [95% CI 0.23-0.78], p = 0.01 and OR: 0.20 [95% CI 0.09-0.46], p < 0.001, respectively). Conclusions: This is the first study reporting on the RIRS LCs of urology residents. While stone burden, density, and multiple-stone localization were the factors determining SFR in the learning period, after completing the LC, the effect of stone burden weakened and multiple-stone localization became stronger.Öğe Still Using Only ChatGPT? The Comparison of Five Different Artificial Intelligence Chatbots' Answers to the Most Common Questions About Kidney Stones(Mary Ann Liebert, Inc, 2024) Sahin, Mehmet Fatih; Topkac, Erdem Can; Dogan, Cagri; Seramet, Serkan; Ozcan, Ridvan; Akgul, Murat; Yazici, Cenk MuratObjective: To evaluate and compare the quality and comprehensibility of answers produced by five distinct artificial intelligence (AI) chatbots-GPT-4, Claude, Mistral, Google PaLM, and Grok-in response to the most frequently searched questions about kidney stones (KS).Materials and Methods: Google Trends facilitated the identification of pertinent terms related to KS. Each AI chatbot was provided with a unique sequence of 25 commonly searched phrases as input. The responses were assessed using DISCERN, the Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P), the Flesch-Kincaid Grade Level (FKGL), and the Flesch-Kincaid Reading Ease (FKRE) criteria.Results: The three most frequently searched terms were stone in kidney, kidney stone pain, and kidney pain. Nepal, India, and Trinidad and Tobago were the countries that performed the most searches in KS. None of the AI chatbots attained the requisite level of comprehensibility. Grok demonstrated the highest FKRE (55.6 +/- 7.1) and lowest FKGL (10.0 +/- 1.1) ratings (p = 0.001), whereas Claude outperformed the other chatbots in its DISCERN scores (47.6 +/- 1.2) (p = 0.001). PEMAT-P understandability was the lowest in GPT-4 (53.2 +/- 2.0), and actionability was the highest in Claude (61.8 +/- 3.5) (p = 0.001).Conclusion: GPT-4 had the most complex language structure of the five chatbots, making it the most difficult to read and comprehend, whereas Grok was the simplest. Claude had the best KS text quality. Chatbot technology can improve healthcare material and make it easier to grasp.Öğe The effect of the pandemic period on Bladder Pain Syndrome patients under amitriptyline treatment(Wiley, 2023) Sahin, Mehmet Fatih; Ozcan, Ridvan; Malak, Arzu; Dogan, Cagri; Yazici, Cenk Murat; Ozcan, Muege; Akgul, MuratIntroductionCOVID-19 is a disease that may cause anxiety, depression, and stress. Bladder pain syndrome (BPS) is a disease in which stress and psychological factors might negatively affect its course. In this study, we aimed to examine the possible clinical aggregation of the pandemic period on BPS patients. Materials and MethodsA total of 35 BPS patients diagnosed between 2010 and 2018 were included. All patients were using medical treatment, and the follow-up period was at least 6 months. According to our clinical follow-up protocol, the BPS patients were given the King's Health Questionnaire (KHQ), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Overactive Bladder Form V8 (OAB-V8), and Visual Analog Score (VAS) in every visit. In the sixth month of the pandemic, the clinical course of the patients was questioned by telephone or video interview, and their treatment continuities were questioned. Information was received about the delays in their follow-up and the difficulties in accessing healthcare opportunities. The same questionnaires were filled out and compared with pre-pandemic scores. ResultsThe mean age of the patients included in the study was 50.2 +/- 13.32 (min:20, max:74), 11 were males and 24 were females. The mean follow-up periods were 71.8 +/- 35.6 months. All questionnaire scores showed an increase compared to the pre-pandemic period. A statistically significant increase was detected during the pandemic in all sub-units of the KHQ. The VAS and OAB-V8 scores of 16 patients who requested hospital admission were significantly higher than before the pandemic. However, there was no statistically significant difference in the increase in VAS and OAB-V8 scores of the 19 patients who refused to come to the hospital. ConclusionBPS patients have been negatively affected by the emotional effects of the COVID-19 pandemic. Due to the fear, stress, anxiety, and depression, the symptoms of BPS patients exacerbated, and the patients could not receive the necessary support due to a lack of regular follow-ups.Öğe The Effect of Ventilation Mode in Anesthesia on Renal Mobility During Retrograde Intrarenal Surgery: A Single-Blind Randomized Study(Urol & Nephrol Res Ctr-Unrc, 2023) Dogan, Cagri; Akgul, Murat; Sahin, Ayhan; Yazici, Cenk Murat; Sahin, Mehmet Fatih; Altin, Enes; Keles, AnilPurpose: Renal mobility can present challenges for surgeons during stone fragmentation. The respiratory setup of the mechanical ventilator during RIRS might affect renal mobility. This study aimed to evaluate the effect of high ventilation (HV) and standard ventilation (SV) modes on renal mobility during RIRS.Materials and Methods: Patients who underwent RIRS at a single center between November 2020 and November 2021 were retrospectively included in the study. Renal mobility was measured under fluoroscopic view in HV and SV modes during retrograde pyelography. The surgeon, who was blind about mechanical ventilation modes, was asked to assess the renal movement grade. After the ventilation mode was changed, the surgeon reassessed renal mobility. The data and the surgeon's assessment were recorded and compared to each other.Results: A total of 86 patients with a mean age of 48.6 +/- 15.7 years were included in the study. There was a significant difference between the SV and HV modes in terms of renal mobility in fluoroscopic view (17.1 +/- 6.1 mm and 13.6 +/- 5.2mm, respectively; p = 0.007). According to the surgeon's assessments, the grade of renal mobility was found to be significantly higher in the SV group 2.8 +/- 1.1 compared to the HV group 2.2 +/- 0.8 (p = 0.001). Renal movement increased significantly under fluoroscopic vision as the renal grading of the surgeon increased (p = 0.013). This data demonstrated that the surgeon's assessment of renal mobility was significantly correlated with fluoroscopic kidney movement.Conclusion: Kidney movement was decreased significantly in HV mode during RIRS according to both fluoroscopic findings and surgeon assessment. Most surgeries of mobile kidneys were performed in HV mode, due to the surgeon's preference.Öğe The Predictive Factors for the Longer Survival of the Reusable Flexible Ureterorenoscopy(Springer, 2023) Dogan, Cagri; Demir, Aslan; Sahin, Mehmet Fatih; Keles, Anil; Ates, Huseyin; Akgul, Murat; Yazici, Cenk MuratPurposeThe flexible ureterorenoscopy (FURS) is expensive and fragile equipment which easily break down during the surgery. f-URS have yet some problems with their durability that affect survival. One of the most important ways to increase the survival of a device is to improve its use in the right indications. We aimed to investigate whether the durability of the f-URS will be affected due to the volume and location of the stone and some anatomical features of the including infundibulopelvic angle (IPA), and location anomalies.Materials and methodsThe collected data from 705 patients' data including their age, sex, stone location, and stone volume, S-ReSC score, Hounsfield unit (HU) as stone density, IPA, BMI, and the usage time of f-URS using 10f-URS were included to study. Exp(B) values and confidence intervals (95% CIs) of parameters were calculated with COX regression and Roc curve analysis was also used to determine the cut-off value.ResultsRenal malformation, DJstent use, previous ESL application, and UAS use did not affect contrary to expectations stone volume, HU, IPA, and S-ReSC score were among the factors statistically significant affecting the durability of the device. It was observed, Exp(B) values of the affecting factors to be 0.984, 0.268, 0.894, and 0.607, respectively. We found the most appropriate cutoff value for IPA as 41.25 degrees.ConclusionThe mean stone volume broken by each of the subsequent f-URS may increase, while the mean operative time may decrease as time progresses. This result shows us the importance of mastery of the device, such as the deflection maneuver, and the correct use distance of the laser, which improves with the increase in user experience, and makes us interpret that the operation time is shortened with this self-confidence. Factors including stone volume, HU, IPA, S-ReSC score affect the durability of the f-URS device and the as well as manufacturing features.Öğe Urodynamic Findings of the Patients with Parkinson's Disease: A Single Tertiary Center Results(Duzce Univ, Fac Medicine, 2024) Sahin, Mehmet Fatih; Akgul, Murat; Dogan, Cagri; Malak, Arzu; Seramet, Serkan; Yazici, Cenk MuratObjective: In Parkinson's disease (PD), lower urinary tract symptoms (LUTS) are common with a prevalence ranging from 25% to 57%. Patients who are resistant to medical treatment for LUTS may require urodynamic examination and pressure flow study (UDPFS) to better comprehend the bladder's dynamics. To be able to understand the pathophysiology of LUTS, UD-PFS examinations should be performed. In this study, the demographics and clinical properties of PD patients were presented along with their UDPFS examinations. Materials and Methods: The data of 155 patients with PD followed up between 20102020 were retrospectively analyzed. UD-PFS was applied to 42 PD patients resistant to medical treatment of LUTS. Patients' demographic and clinical data with their UD-PFS findings were investigated separately. Results: Twenty-eight of the patients underwent UD-PFS were male, and 14 were female. In UD, the first urinary sensation was 86.00 +/- 68.77cc, and the maximum cystometric capacity was 322.07 +/- 194.25cc. Sixteen patients had a hypo -compliant bladder, 25 (59.5%) had a normo-compliant bladder. In PFS, Q max and peak detrusor pressure during voiding were 12.72 +/- 10.08 mL/sec and 43.93 +/- 15.56 cm-H2O, respectively. Stress -type urinary incontinence was detected in 6 (15%) of the patients. When evaluating the detrusor activity, neurogenic detrusor overactivity was observed in 18 (44%) patients, detrusor areflexia in 8 (19%) and normal UD-PFS in 16 (22%) patients. Conclusions: The majority of the PD patients presented with neurogenic detrusor overactivity accompanied by diminished bladder capacity and hypersensitivity. In the selected PD patients who are resistant to medical treatment with LUTS clinics, UD-PFS provides useful scientific information about the LUTS clinics of patients and may be helpful in treatment management.Öğe Urodynamic Findings of The Patients with Parkinson’s Disease: A Single Tertiary Center Results(2024) Sahin, Mehmet Fatih; Akgul, Murat; Dogan, Cagri; Malak, Arzu; Seramet, Serkan; Yazici, Cenk MuratObjective :In Parkinson’s disease (PD), lower urinary tract symptoms (LUTS) are common with a prevalence ranging from 25% to 57%. Patients who are resistant to medical treatment for LUTS may require urodynamic examination and pressure flow study (UD-PFS) to better comprehend the bladder's dynamics. To be able to comprehend the pathophysiology of LUTS, UD-PFS examinations should be performed. In this study, the demographics and clinical properties of PD patients were presented along with their UD-PFS examinations. Method : The data of 155 patients with PD followed up between 2010-2020 were retrospectively analyzed. UD-PFS was applied to 42 PD patients resistant to medical treatment of LUTS. Patients' demographic and clinical data with their UD-PFS findings were studied separately. Result : Twenty-eight of the patients underwent UD-PFS were male, and 14 were female. In UD, the first urinary sensation was 86.00±68.77cc, and the maximum cystometric capacity was 322.07±194.25cc. Sixteen patients had a hypo-compliant bladder, 25 (59.5%) had a normo-compliant bladder. In PFS, Q max and peak detrusor pressure during voiding were 12.72±10.08 mL/sec and 43.93±15.56 cm-H2O, respectively. Stress-type urinary incontinence was detected in 6 (15%) of the patients. When evaluating the detrusor activity, neurogenic detrusor overactivity in 18 (44%) patients, detrusor areflexia in 8 (19%) and normal UD-PFS in 16 (22%) patients. Conclusion: The majority of the patients presented with neurogenic detrusor overactivity accompanied by diminished bladder capacity and hypersensitivity. In the selected PD patients who are resistant to medical treatment with LUTS clinics, UD-PFS provides useful scientific information about the LUTS clinics of patients and may be helpful in treatment management.Öğe Use of the Systemic Immune-Inflammation Index to Predict Treatment Efficacy in Patients with Bladder Pain Syndrome(Coll Physicians & Surgeons Pakistan, 2024) Sahin, Mehmet Fatih; Eseoglu, Esad; Akgul, Murat; Malak, Arzu; Dogan, Cagri; Yazici, Cenk MuratObjective: To determine the relationship between bladder pain syndrome (BPS) and systemic inflammatory index (SII) and to examine the impact of treatment protocols on it. Study Design: Observational Study. Place and Duration of the Study: Department of Urology, Tekirdag Namik Kemal University, Tekirdag, Turkiye, from January 2017 to December 2022. Methodology: A retrospective analysis was conducted on 30 BPS patients who underwent medical therapy. Upon diagnosis, the patients completed the king's health questionnaire (KHQ), beck depression questionnaire (BDQ), beck anxiety questionnaire (BAQ), and short form (SF -36) quality of life form. Peripheral blood SII was measured. After six months of regular therapy, the SII was recalculated when the patients completed the same forms again. The SII was compared between instances when patients reported more complaints, higher form scores, and instances when they reported fewer and lower scores. Results: The patients had a mean age of 46.1 +/- 13.6 years, with four males and 26 females. The mean follow-up duration was 76.3 +/- 24.5 months. Five patients of KHQ subcategories showed statistically significant decreases following therapy (52 to 39.17, 66.66 to 54.16, 54.40 to 41.07, 75.55 to 58.14, and 60.55 to 40.47). All patients of SF -36 components increased (p = 779, p = 0.393, p = 0.007, p = 0.004, p = 0.008, p = 0.041, p = 0.010, and p = 0.767, respectively). BDQ and BAQ decreased after therapy (11.55 to 11.41 and 11.86 to 11.24, respectively). Lymphocyte count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and SII decreased significantly (p = 0.001, 0.019, 0.002 and 0.039, respectively). Conclusion: SII, lymphocyte count, NLR, and PLR decreased after treatment, similar to BDQ and BAQ. SII is a simple and feasible method for evaluating the treatment efficacy of BPS.Öğe What is the appropriate empirical antibiotic treatment for patients diagnosed with Fournier's gangrene? A single tertiary center experience(Bayrakol Medical Publisher, 2024) Sahin, Mehmet Fatih; Dogan, Cagri; Ates, Huseyin; Koroglu, Muhammed Sencer; Orbegi, Onur; Akgul, Murat; Yazici, Cenk MuratAim: Fournier's gangrene (FG) is a highly destructive condition characterized by necrotizing fasciitis in the perineal, genital, or perianal area. The primary treatment involves fluid resuscitation, surgical debridement, and broad-spectrum antibiotics. However, there is insufficient evidence regarding antibiotic use in FG. This research aims to assess the microbiological characteristics of FG. Material and Methods: This study covered 40 FG patients from 2010 to 2023. In surgery, all necrotic areas were removed until viable tissue was seen. Primary deformity wound care was performed using vacuum-assisted closure (VAC). Patients with significant issues were evaluated, and plastic surgery was performed to repair the afflicted areas. The research examined FG patients' demographics, clinical features, bacterial cultures, and antibiotic susceptibility to establish the best empirical antibiotic therapy. Results: All patients were male and averaged 66.4 +/- 17.5 years old. The average hospital stay was 13.5 +/- 1.7 days. The median debridement number was 2 (1-4). Despite proper FG therapy, 7 (17.5%) patients died due to multiorgan failure. The wound cultures of 35 individuals (87.5%) showed bacterial growth. In 15 cases (37.5%), Escherichia coli was the most prevalent bacterium, followed by Enterococcus sp., Acinetobacter baumannii, and Streptococcus. Amikacin had the most significant bacterial sensitivity (62.5%), followed by ceftriaxone (60%) and carbapenems (imipenem 57.5%, meropenem 55%). Metronidazole has the greatest bacterial sensitivity (52.5%) among anaerobic bacteria. Discussion: The empirical antibiotherapy of amikacin + metronidazole and ceftriaxone/carbapenem antibiotics shows a notable susceptibility rate. Based on the findings of the culture antibiogram, it is recommended that the antibiotic treatment regimen be modified.
