In male infertility, all possible known causes should be carefully evaluated and if detected, tar... more In male infertility, all possible known causes should be carefully evaluated and if detected, targeted treatment options for the cause should be implemented. The known causes of male infertility such as hypogonadotropic hypogonadism, hyperprolactinemia, genital tract infections, disorders of ejaculation, thyroid hormone disorders and varicocele can be treated efficiently by targeted therapies or surgical corrections. Unfortunately, these known causes cover about 20% of male infertility and the rest remains idiopathic. On the other hand, management of idiopathic, unexplained male infertility, in which no etiological factors can be found, is a challenge for both the clinician and couples seeking solutions. In the era of assisted reproductive technology, few medical options in this regard are still available with limited benefits and low scientific foundation based on theoretical concepts but empirical medical therapy continues as a mostly off-label option for obtaining a natural pregn...
Purpose To investigate the effect of platelet-rich plasma (PRP) in reducing renal injury in urete... more Purpose To investigate the effect of platelet-rich plasma (PRP) in reducing renal injury in ureteral obstruction. Methods Twenty-four Wistar Albino rats were randomized and divided into four groups as the donor (n = 6), sham (n = 6), saline (n = 6), and PRP (n = 6). Blood was obtained from the donor group by cardiac puncture and PRP was prepared. 2 cc blood was sampled from other groups to measure blood-urea nitrogen and creatinine levels. Baseline renal scintigraphy was performed. An abdominal midline incision was made and the left ureter was exposed in the sham group. Saline infusion was given to the kidneys of the saline group after left ureteral obstruction, while PRP was given to the PRP group. On postoperative Day 7, control biochemical and scintigraphic evaluations were performed and left nephrectomies were done. Left kidneys were evaluated histopathologically. Results DMSA measurements in the sham group were found to be significantly higher than the saline and PRP groups (p = 0.001 and p = 0.024, respectively). There were no significant differences between the saline and PRP groups (p = 0.525 and p > 0.05, respectively). Histopathologically, no significant difference was observed between the saline and PRP groups (p = 0.320), while the scores of the sham group were significantly higher than the saline and PRP groups (p = 0.02 and p = 0.001, respectively). Conclusion Our study results suggest that PRP may be effective in preventing ureteral obstruction-induced renal injury.
PURPOSE To investigate the relationship between the accuracy of the answers provided by the patie... more PURPOSE To investigate the relationship between the accuracy of the answers provided by the patients to the International Prostate Symptom Score (IPSS) questionnaire and age and level of education. MATERIALS AND METHODS Two hundred and thirty-eight men were given self-administered IPSS questionnaires. After 48 to 96 hours, the IPSS form was completed again with the assistance of a physician. The relationship of the difference between the self-administered IPSS and forms completed with assistance with age and level of education was evaluated through Wilcoxon test. P values less than .05 were considered significant. RESULTS There was not a significant difference between the two IPSS among the high school or university graduates (P = .480). However, the difference was significant among the primary and secondary school graduates (P = .042 and P = 0.34, respectively). Of values obtained from self-administered IPSS forms and those completed with the assistance of a physician, there was a ...
Although testicular cancer (TCa) is rare neoplasm that occurs in young men aged between 18 and 35... more Although testicular cancer (TCa) is rare neoplasm that occurs in young men aged between 18 and 35 years. The risk factors are cryptorchidism, family history, and infertility. The aim of this study was to investigate the diagnostic efficacy of neutrophil to lymphocyte ratio for the diagnosis of TCa. The patients who underwent orchiectomy in our unit reviewed retrospectively. Age of the patients, the laboratory results and pathological reports were recorded. The neutrophil to lymphocyte ratio (NLR) was calculated as the neutrophil counts divided to the lymphocyte counts. The patients were divided into two groups according to the pathology record. The testicular malign neoplasms are included in group 1 and group 2 includes the patients who had cryptorchidism and atrophic testes without any malignancy and inflammation. For statistical analysis, student t test was used for comparing the data between groups and the area under curves were used for NLR, neutrophil and lymphocyte counts in the diagnosis of testicular malign neoplasms.There were 285 patients in the present study. The patients' age was between 10 and 90 with a mean age of 36.87 ± 11.83 and 37.24 ± 20.31 years in groups respectively.The neutrophil, white blood cell counts and NLR were significantly higher in group 1 and lymphocye count was lower in patients with testicular cancer with statistical significance. The area under curve was 0.645, 0.626, 0.578 for NLR, neutrophil and lymphocyte counts for the diagnosis of TCa. Mixed germ cell tumor was the most common histologic subtype with an incidence of 51.58%(n:65 patients) and seminomas were reported 37.30% (n:47 patients) of the patients. Testicular cancer has low incidence when compared the other urologic malignancies. There are only three tumor markers that include alpha-fetaprotein, human chorionic gonadotropin and lactate dehydrogenase for testicular cancer diagnosis. The current study showed Neutrophil to lymphocyte ratio (NLR) may be used as a biomarker for TCa. Further studies are needed to define the assocaiton between NLR and testicular cancer.
SUMMARY INTRODUCTION Due to spongiofibrosis and inflammatory processes underlying the pathogenesi... more SUMMARY INTRODUCTION Due to spongiofibrosis and inflammatory processes underlying the pathogenesis of urethral stricture, it is possible that the neutrophil-lymphocyte ratio (NLR) may give essential information about the course of the disease and recurrence possibilities. Our study aims to evaluate the correlation between NLR and recurrence rates. METHODS A total of 512 patients who underwent direct visual internal urethrotomy (DVIU) due to urethral stricture in our clinic between February 2010 and January 2018 were evaluated retrospectively. RESULTS The median follow up for non-recurrent and recurrent groups after DVIU was 30 and 36 months, respectively. During the follow-up, 280 (54.7%) of the patients had recurrences, and 232 (45,3%) had no recurrences. The mean time for recurrence after DVIU was 6,5±1,4 months, with a range of 1-36 months. The mean NLR in the non-recurrence group was 2,02±0,87, with a median of 1.9, and 3,66±2,30, with a median of 3 in the recurrence group. A hi...
SUMMARY INTRODUCTION Angiomyolipoma is one of the most common benign solid renal tumors. We inves... more SUMMARY INTRODUCTION Angiomyolipoma is one of the most common benign solid renal tumors. We investigated the characteristics of renal angiomyolipomas and the clinical outcomes of patients in the last thirteen years. METHODS The medical records of the patients who underwent nephrectomy were reviewed retrospectively from July 2005 to May 2018. The laboratory data, radiology, and pathology reports were recorded. Patients diagnosed with angiomyolipoma were included in the study. RESULTS A total of 28 patients were included in the study, eight of them male. The mean age of the patients was 55.89+14.49 years. The patients were treated with open and laparoscopic techniques. Partial nephrectomy was performed in 12 patients(42.85%). After pathological examination, 23 patients were diagnosed as fat rich, four patients as fat poor, and one as epithelioid angiomyolipoma. There were no recurrences in the follow-up 91.21+48.31 months. CONCLUSION Angiomyolipoma is a rare renal tumor in daily urolo...
Renal cell carcinomas (RCCs) account 80-85% of all primary renal neoplasms and originate from the... more Renal cell carcinomas (RCCs) account 80-85% of all primary renal neoplasms and originate from the renal cortex. The patients who underwent radical or partial nephrectomy for renal tumour in our unit between January 2005 and 2015 were evaluated retrospectively. The patients were divided into two groups; group 1 includes patients who were treated between January 2005 and December 2009, group 2 those from January 2010 to 2015. There were 103 patients in group 1. The patients were between 21 and 89 years with mean age of 61.46 year. Renal cell carcinomas account 83.4% of the patients, benign renal tumours were 8.7% and transitional cell carcinomas were 7.7% of the patients in group 1. A total of 32.5% RCCs were classified as pT1a, 24.4% as pT1b, 15.1% as pT2a, 11.6% as pT2b, 15.1% as pT3a and 1.1% as pT4. There were 202 patients in group 2 and the patients were between 27 and 81 years with mean age of 58.5 year. Renal cell carcinomas comprised the main bulk of the tumours with 182 nephr...
Efficacy of treatments for benign prostate hyperplasia (BPH) is limited because the disease has c... more Efficacy of treatments for benign prostate hyperplasia (BPH) is limited because the disease has complex etiopathogenesis. Recent studies have demonstrated the presence of phosphodiesterase-5 (PDE-5) receptors in prostate tissue. We investigated efficacy of sildenafil citrate in testosteron - induced BPH in rats. The rats were divided into three groups. Each groups had 7 rats. Group 1 was control group. Testosteron propionate 3 mg/kg/day was injected subcutaneously for two weeks in Group 2. The same procedure was done for Group 3 and sildenafil citrate was added to water at daily doses of 2 mg/kg for two weeks. The rats were euthanized with intraperitoneal pentobarbital. The body weights were measured and the prostates were removed. The mean weights of rats were 288±31.93, 345±23.23 and 294±32.86 g in Groups 1, 2 and 3, respectively. The mean prostate weights of rats were 0.74±0.18, 1.3±0.13 and 0.72±0.24 g in Groups 1, 2, and 3, respectively. Group 2 had statistically significantly ...
The aim of the present study was to evaluate the behavioral and emotional patterns of patients wi... more The aim of the present study was to evaluate the behavioral and emotional patterns of patients with nocturnal enuresis (NE) and compare them with those of healthy subjects. Materials and methods: Thirty-eight children and adolescents with monosymptomatic NE who were admitted to our hospital's pediatric and urologic outpatient clinics and 46 age-matched, healthy subjects were enrolled in this study. To compare behavioral patterns in these patients, the Child Behavior Checklist (CBCL) was used. Patients' ages, occupations, educational, and socioeconomic status, and mothers' age at delivery were compared in the two groups. One-way ANOVA was used for statistical analysis. Results: Enuretic children were found to have more behavioral problems than nonenuretic children with regard to social (P = 0.008) and attention (P = 0.018) problems. There were no significant differences in anxiety or attractiveness problems between the groups (P > 0.05); however, patients with enuresis were more likely to exhibit these behavioral problems than healthy subjects. The demographics of the patients were significantly different in the two groups in favor of the control group. Conclusion: It was shown that patients with enuresis have more social and attention problems than the control group. Treating these patients effectively will increase the likelihood that they will not develop behavioral problems.
International journal of fertility & sterility, 2012
Varicocele, the abnormal dilatation of the veins in the pampiniform plexus is commonly seen in in... more Varicocele, the abnormal dilatation of the veins in the pampiniform plexus is commonly seen in infertile patients. In this study, we aim to examine sperm DNA damage after the creation of experimental varicocele in rats and to observe the change of this damage after a varicocelectomy. In this experimental study, a total of 30 adult male Wistar albino rats were divided into three groups. The 10 rats in group 1 underwent a sham operation, an experimental varicocele was created in both the10 rats in group 2 and the 10 rats in group 3 (a total of 20 rats). While the rats of group 2 were sacrificed after four weeks, the rats in group 3 underwent a varicocelectomy after four weeks and were sacrificed four weeks after the varicocelectomy to observe its effects. Sperm DNA fragmentation was assessed with a Halomax® kit. The DNA Fragmentation Index (DFI) was calculated and the groups were compared according to their DFI. Statistical analysis was performed using the Mann-Whitney U test. Median ...
Varicocele, most treatable pathologic condition in male infertility, exerts unfavorable effects o... more Varicocele, most treatable pathologic condition in male infertility, exerts unfavorable effects on testicular ultrastructure via various mechanisms. In this study we aimed to demonstrate adverse effects of varicocele on both testes. Materials and Methods: Twenty one adult male Albino rats were divided into 3 groups. Sham operation was performed for group 1 (control group), and this group of rats were sacrificed 4 weeks later. Experimental varicocele model was performed for group 2 (varicocele group) and these animals were sacrificed 4 weeks after the operation. In group 3 the rats were varicocelectomized 4 weeks later. This group of rats were sacrificed at 4 weeks postoperatively. The level of testicular damage was examined, and serum testosterone and intratesticular testosterone levels were measured. Results: Mean (±SD) damage scores of the right testes of the sham, varicocele, and varicocelectomy groups were 0, 1.64 ± 1.3, and 1.21 ± 0.3, respectively. There was no statistically significant differences between damage scores of groups 2, and 3 (P = .320), relevant scores of both groups were determined to be significantly higher than group 1 (P = .009, and P = .001). Mean (±) damage scores of the left testes of the three groups were detected to be 0.43 ± 1.13, 2.29 ± 1.15, and 1.78 ± 0.39, respectively. The difference between varicocele, and varicocelectomy groups was not statically significant (P = .112). Conclusion: Unilateral varicocele has deleterious effects on both testes. There was no statistically significant difference as for histopathologic recovery following varicocelectomy.
ABSTRACT bjectives: Ureteropelvic junction (UPJ) obstruction is of critical importance to underst... more ABSTRACT bjectives: Ureteropelvic junction (UPJ) obstruction is of critical importance to understand the histopathology of UPJ obstruction in terms of therapy planning and follow-up. For this purpose, our study was conducted with TNF-α and TGF-β markers to investigate possible underlying problems in intrinsic UPJ obstruction.Methods: Of the patients who had undergone surgery in our clinic, 36 UPJ segments of patients who had undergone dismembered pyeloplasty surgery due to UPJ obstruction and 14 UPJ segments of the patients who had undergone nephrectomy were collected to form 2 groups. All histological sections were examined by applying immunohistochemical transforming growth factor beta 3 (TGF-β3) and tumour necrosis factor alpha (TNF-α) monoclonal antibody dyes. Results: The mean staining values for TNF-α in mucosal tissue and mucosa were 0.53±0.84 and 0.58±0.84, respectively in the obstruction group, whereas the values observed in the control group were 0.86±0.36 and 0.93±0.47, respectively. While the mean staining values in the obstruction group in mucosal tissue and mucosa for TGF-β3 were 1.75±0.73 and 2.17±0.77, respectively, the values established in the control group were 1.14±0.66 and 1.43±0.93, respectively. The difference between the obstruction and control groups were statistically significant for both values (p<0.05).Conclusion: Only a limited number of studies have been carried out on this particular issue. Data from the present study indicate that TGF-β3 and TNF-α may play a role in the histopathogenesis of UPJ obstruction (Tab. 1, Fig. 1, Ref. 18). Keywords: ureteropelvic junction obstruction, TGF-β3, TNF-α, cytokine.
Turkish Journal of Trauma and Emergency Surgery, 2011
Sivil hayatta penise penetran ateşli silah yaralanmaları enderdir. Bu yazıda, acil servise penise... more Sivil hayatta penise penetran ateşli silah yaralanmaları enderdir. Bu yazıda, acil servise penise penetran ateşli silah yaralanması ile başvuran ve daha önce penis protez implantasyonu yapılmış olan 48 yaşındaki erkek hasta sunuldu. Hasarlı implant çıkarıldı ve anterior üretradaki yaralanma primer olarak onarıldı. Bildiğimiz kadarıyla bu yazıda, literatürde penis protezi olup penis ateşli silah yaralanması olan ilk hasta sunuldu.
Türk Üroloji Dergisi/Turkish Journal of Urology, 2014
Objective: Lower urinary tract symptoms (LUTS), which are related to benign prostate hyperplasia ... more Objective: Lower urinary tract symptoms (LUTS), which are related to benign prostate hyperplasia (BPH), are the most commonly encountered diseases in urological practice. In our study, we compared responses to (doxazosin mesylate extended release tablets) treatment. Material and methods: In our study, we included one hundred patients with LUTS who did not receive any medical treatment, and one hundred patients with LUTS who did not respond to alpha-blocker drugs other than doxazosin XL (8 mg). The inclusion criteria for the study were as follows: international prostate symptom score (IPSS)>7, prostate volume >20 cc, Q-max <15 mL/sn, lack of any previous pelvic or prostatic surgery, and /or urethral catheterization. Results: The mean age of the patients was 62.2±7.9 years. No statistically significant differences were detected between the groups with respect to age, prostate volume, and total prostate-specific antigen (PSA) levels. The duration of the follow-up period was calculated as 3-26 (mean 11) months. Significant differences were detected in post-voiding residual urine, IPSS, quality of life and Qmax between pre-and post-treatment values. Similar decreases in the IPSS scores, and increases in Qmax values were detected in both groups. Conclusion: Doxazosin XL (8 mg) treatment was found to be efficient and reliable in primary patients and in patients with severe LUTS who did not respond to medical treatment. Trial of doxazosin XL (8 mg) therapy, before surgery in patients who respond inadequately to other alpha-blocker drugs is a rational approach.
In clinical practice, atypical small acinar proliferation (ASAP) and high-grade prostatic intraep... more In clinical practice, atypical small acinar proliferation (ASAP) and high-grade prostatic intraepithelial neoplasia (HGPIN) are two common findings on prostate biopsies. Knowing the frequency of a prostate cancer diagnosis on repeat biopsies would aid primary treating physicians regarding their decisions in suspicious cases. Materials and Methods: One hundred forty-three patients in whom biopsies revealed ASAP or HGPIN or both were enrolled in the present study; prostate cancer was not reported in the biopsy specimens and at least one repeat biopsy was performed. Age, digital rectal examination findings, prostate volumes, and free and total prostate-specific antigen (PSA) levels and the biopsy results of the patients were recorded. Results: Of the 97 patients with ASAP on the first set of biopsies, prostate cancer was diagnosed in the second and third biopsies of 32 and 6 patients, respectively. Prostate cancer was not detected in the second or third biopsies of the 40 patients with HGPIN in the first biopsy. Of the 6 patients with ASAP+HGPIN in the first biopsy, prostate cancer was detected in 3 patients in the second biopsy and in 1 patient in the third biopsy. Conclusions: The diagnosis of ASAP is a strong risk factor for prostate cancer. A repeat biopsy should be performed for the entire prostate subsequent to the diagnosis of ASAP. In patients with HGPIN according to the biopsy result, the clinical decision should be based on other parameters, such as PSA values and rectal examination, and a repeat biopsy should be avoided if the initial biopsy was performed with multiple sampling.
Objectives: Nocturnal enuresis (NE) is very common and is one of the most common causes for patie... more Objectives: Nocturnal enuresis (NE) is very common and is one of the most common causes for patients to be admitted to urology, pediatrics, child psychiatry and child surgery departments. We aimed to investigate the effect on depression and self-esteem of this disorder that can cause problems on person's social development and human relations. Material and methods: 90 patients who were admitted to our clinic with complaints of nocturnal enuresis were enrolled. Investigations to rule out organic causes were performed in this group of patients. Out of them 38 children and adolescents (age range 8-18 years) with primary monosymptomatic nocturnal enuresis (PMNE) agreed to participate in the study In the same period 46 healthy children and adolescents with a similar age range without bed wetting complaint were included in the study as a control group. The age of the family, educational and socioeconomic level were questioned and Piers-Harris Children's Self-Concept Scale (PHCSCS)...
Background/aims: Extraintestinal manifestations are important causes of mortality and morbidity f... more Background/aims: Extraintestinal manifestations are important causes of mortality and morbidity from inflammatory bowel diseases. However, sexual problems are usually underestimated in these patients in our daily clinical practice. In this study, we aimed to evaluate the prevalence of sexual dysfunction in inflammatory bowel diseases. Methods: The study included sexually active patients who had inflammatory bowel diseases in remission. Sexual activity was defined as at least one sexual intercourse per month. To evaluate sexual function, the Female Sexual Function Index was used for women and the International Index of Erectile Function for men. Results: The study included 21 female and 17 male patients. Sexual dysfunction was present in 54.54% of female patients with inflammatory bowel disease. The prevalence of sexual dysfunction was 69.23% in female patients with Crohnas disease and 33.33% in those with ulcerative colitis. Sexual dysfunction was present in 58.82% of male patients ...
Testis tümörleri erkek malignitelerinin %1-2'sini oluşturmaktadır. Ağrısız testiküler kitle ile k... more Testis tümörleri erkek malignitelerinin %1-2'sini oluşturmaktadır. Ağrısız testiküler kitle ile kendini gösterir. Bazı durumlarda serum parametreleri ile tanı desteklenir. Çalışmamızda testis tümörlü hastaların tam kan parametreleri ile metastaz ve lenfadenopati durumları arasındaki ilişki incelendi. Yöntem ve Gereçler: Kliniğimizde 2007-2014 yılları arasında testis tümörü öntanısı ile radikal orşiektomi ameliyatı yapılmış olan hastaların bilgileri geriye dönük olarak tarandı. Patoloji raporu testis tümörü olarak yorumlanan 108 hasta çalışmaya alındı. Lenfadenopatisi veya metastazı bulunan ve bulunmayan hastaların hemogram parametreleri ile karşılaştırıldı. Bulgular: Çalışmaya alınan hastaların yaş ortalaması 34.6±9.3 olarak hesaplandı. Çalışmaya alınan hastaların 39'unda (%36.11) LAP, 14'ünde (%12.9) metastaz tespit edildi. Metastaz varlığı ile hemotokrit, beyaz küre ve trombosit sayıları arasında istatistiksel anlamlı ilişki tespit edildi. Bu parametrelerden sadece trombosit sayısı ile lenfadenopati varlığı arasında istatistiksel anlamlı korelasyon tespit edildi. Sonuç: Çalışmamızın sonucunda elde edilen veriler ışığında hematolojik parametreler ile metastaz ve lenfadenopati varlığı arasında ilişki tespit edilmiştir. Bu bulguların daha geniş serilerle desteklenmesi durumunda testis kanserli hastaların takibinde kullanılabileceği kanaatindeyiz.
Aim: To assess the efficacy and safety of two different techniques (Percutaneous nephrolithotomy ... more Aim: To assess the efficacy and safety of two different techniques (Percutaneous nephrolithotomy (PNL) vs Retrograde intrarenal surgery (RIRS)) in the management of stones in patients with horseshoe kidneys (HSK). Patients and methods: Departmental files of 88 cases with radiopaque kidney stones in horseshoe kidneys undergoing two different approaches (PNL vs RIRS) were evaluated with respect to the success and complication rates of in a retrospective manner. In addition to the factors related with the procedures (success and complication rates, additional procedures), patient and stone characteristics were all well evaluated. Findings obtained in both groups were evaluated in a comparative manner with respect to the statistical significance. Results: Stone free rates were comparable in both groups after 1-week period (81.6% PNL vs 80% RIRS). As well as 3 months evaluation (84.2% PNL and 82.0% RIRS). The percentage of the cases with residual fragments (> 4 mm) were similar in bot...
In male infertility, all possible known causes should be carefully evaluated and if detected, tar... more In male infertility, all possible known causes should be carefully evaluated and if detected, targeted treatment options for the cause should be implemented. The known causes of male infertility such as hypogonadotropic hypogonadism, hyperprolactinemia, genital tract infections, disorders of ejaculation, thyroid hormone disorders and varicocele can be treated efficiently by targeted therapies or surgical corrections. Unfortunately, these known causes cover about 20% of male infertility and the rest remains idiopathic. On the other hand, management of idiopathic, unexplained male infertility, in which no etiological factors can be found, is a challenge for both the clinician and couples seeking solutions. In the era of assisted reproductive technology, few medical options in this regard are still available with limited benefits and low scientific foundation based on theoretical concepts but empirical medical therapy continues as a mostly off-label option for obtaining a natural pregn...
Purpose To investigate the effect of platelet-rich plasma (PRP) in reducing renal injury in urete... more Purpose To investigate the effect of platelet-rich plasma (PRP) in reducing renal injury in ureteral obstruction. Methods Twenty-four Wistar Albino rats were randomized and divided into four groups as the donor (n = 6), sham (n = 6), saline (n = 6), and PRP (n = 6). Blood was obtained from the donor group by cardiac puncture and PRP was prepared. 2 cc blood was sampled from other groups to measure blood-urea nitrogen and creatinine levels. Baseline renal scintigraphy was performed. An abdominal midline incision was made and the left ureter was exposed in the sham group. Saline infusion was given to the kidneys of the saline group after left ureteral obstruction, while PRP was given to the PRP group. On postoperative Day 7, control biochemical and scintigraphic evaluations were performed and left nephrectomies were done. Left kidneys were evaluated histopathologically. Results DMSA measurements in the sham group were found to be significantly higher than the saline and PRP groups (p = 0.001 and p = 0.024, respectively). There were no significant differences between the saline and PRP groups (p = 0.525 and p > 0.05, respectively). Histopathologically, no significant difference was observed between the saline and PRP groups (p = 0.320), while the scores of the sham group were significantly higher than the saline and PRP groups (p = 0.02 and p = 0.001, respectively). Conclusion Our study results suggest that PRP may be effective in preventing ureteral obstruction-induced renal injury.
PURPOSE To investigate the relationship between the accuracy of the answers provided by the patie... more PURPOSE To investigate the relationship between the accuracy of the answers provided by the patients to the International Prostate Symptom Score (IPSS) questionnaire and age and level of education. MATERIALS AND METHODS Two hundred and thirty-eight men were given self-administered IPSS questionnaires. After 48 to 96 hours, the IPSS form was completed again with the assistance of a physician. The relationship of the difference between the self-administered IPSS and forms completed with assistance with age and level of education was evaluated through Wilcoxon test. P values less than .05 were considered significant. RESULTS There was not a significant difference between the two IPSS among the high school or university graduates (P = .480). However, the difference was significant among the primary and secondary school graduates (P = .042 and P = 0.34, respectively). Of values obtained from self-administered IPSS forms and those completed with the assistance of a physician, there was a ...
Although testicular cancer (TCa) is rare neoplasm that occurs in young men aged between 18 and 35... more Although testicular cancer (TCa) is rare neoplasm that occurs in young men aged between 18 and 35 years. The risk factors are cryptorchidism, family history, and infertility. The aim of this study was to investigate the diagnostic efficacy of neutrophil to lymphocyte ratio for the diagnosis of TCa. The patients who underwent orchiectomy in our unit reviewed retrospectively. Age of the patients, the laboratory results and pathological reports were recorded. The neutrophil to lymphocyte ratio (NLR) was calculated as the neutrophil counts divided to the lymphocyte counts. The patients were divided into two groups according to the pathology record. The testicular malign neoplasms are included in group 1 and group 2 includes the patients who had cryptorchidism and atrophic testes without any malignancy and inflammation. For statistical analysis, student t test was used for comparing the data between groups and the area under curves were used for NLR, neutrophil and lymphocyte counts in the diagnosis of testicular malign neoplasms.There were 285 patients in the present study. The patients' age was between 10 and 90 with a mean age of 36.87 ± 11.83 and 37.24 ± 20.31 years in groups respectively.The neutrophil, white blood cell counts and NLR were significantly higher in group 1 and lymphocye count was lower in patients with testicular cancer with statistical significance. The area under curve was 0.645, 0.626, 0.578 for NLR, neutrophil and lymphocyte counts for the diagnosis of TCa. Mixed germ cell tumor was the most common histologic subtype with an incidence of 51.58%(n:65 patients) and seminomas were reported 37.30% (n:47 patients) of the patients. Testicular cancer has low incidence when compared the other urologic malignancies. There are only three tumor markers that include alpha-fetaprotein, human chorionic gonadotropin and lactate dehydrogenase for testicular cancer diagnosis. The current study showed Neutrophil to lymphocyte ratio (NLR) may be used as a biomarker for TCa. Further studies are needed to define the assocaiton between NLR and testicular cancer.
SUMMARY INTRODUCTION Due to spongiofibrosis and inflammatory processes underlying the pathogenesi... more SUMMARY INTRODUCTION Due to spongiofibrosis and inflammatory processes underlying the pathogenesis of urethral stricture, it is possible that the neutrophil-lymphocyte ratio (NLR) may give essential information about the course of the disease and recurrence possibilities. Our study aims to evaluate the correlation between NLR and recurrence rates. METHODS A total of 512 patients who underwent direct visual internal urethrotomy (DVIU) due to urethral stricture in our clinic between February 2010 and January 2018 were evaluated retrospectively. RESULTS The median follow up for non-recurrent and recurrent groups after DVIU was 30 and 36 months, respectively. During the follow-up, 280 (54.7%) of the patients had recurrences, and 232 (45,3%) had no recurrences. The mean time for recurrence after DVIU was 6,5±1,4 months, with a range of 1-36 months. The mean NLR in the non-recurrence group was 2,02±0,87, with a median of 1.9, and 3,66±2,30, with a median of 3 in the recurrence group. A hi...
SUMMARY INTRODUCTION Angiomyolipoma is one of the most common benign solid renal tumors. We inves... more SUMMARY INTRODUCTION Angiomyolipoma is one of the most common benign solid renal tumors. We investigated the characteristics of renal angiomyolipomas and the clinical outcomes of patients in the last thirteen years. METHODS The medical records of the patients who underwent nephrectomy were reviewed retrospectively from July 2005 to May 2018. The laboratory data, radiology, and pathology reports were recorded. Patients diagnosed with angiomyolipoma were included in the study. RESULTS A total of 28 patients were included in the study, eight of them male. The mean age of the patients was 55.89+14.49 years. The patients were treated with open and laparoscopic techniques. Partial nephrectomy was performed in 12 patients(42.85%). After pathological examination, 23 patients were diagnosed as fat rich, four patients as fat poor, and one as epithelioid angiomyolipoma. There were no recurrences in the follow-up 91.21+48.31 months. CONCLUSION Angiomyolipoma is a rare renal tumor in daily urolo...
Renal cell carcinomas (RCCs) account 80-85% of all primary renal neoplasms and originate from the... more Renal cell carcinomas (RCCs) account 80-85% of all primary renal neoplasms and originate from the renal cortex. The patients who underwent radical or partial nephrectomy for renal tumour in our unit between January 2005 and 2015 were evaluated retrospectively. The patients were divided into two groups; group 1 includes patients who were treated between January 2005 and December 2009, group 2 those from January 2010 to 2015. There were 103 patients in group 1. The patients were between 21 and 89 years with mean age of 61.46 year. Renal cell carcinomas account 83.4% of the patients, benign renal tumours were 8.7% and transitional cell carcinomas were 7.7% of the patients in group 1. A total of 32.5% RCCs were classified as pT1a, 24.4% as pT1b, 15.1% as pT2a, 11.6% as pT2b, 15.1% as pT3a and 1.1% as pT4. There were 202 patients in group 2 and the patients were between 27 and 81 years with mean age of 58.5 year. Renal cell carcinomas comprised the main bulk of the tumours with 182 nephr...
Efficacy of treatments for benign prostate hyperplasia (BPH) is limited because the disease has c... more Efficacy of treatments for benign prostate hyperplasia (BPH) is limited because the disease has complex etiopathogenesis. Recent studies have demonstrated the presence of phosphodiesterase-5 (PDE-5) receptors in prostate tissue. We investigated efficacy of sildenafil citrate in testosteron - induced BPH in rats. The rats were divided into three groups. Each groups had 7 rats. Group 1 was control group. Testosteron propionate 3 mg/kg/day was injected subcutaneously for two weeks in Group 2. The same procedure was done for Group 3 and sildenafil citrate was added to water at daily doses of 2 mg/kg for two weeks. The rats were euthanized with intraperitoneal pentobarbital. The body weights were measured and the prostates were removed. The mean weights of rats were 288±31.93, 345±23.23 and 294±32.86 g in Groups 1, 2 and 3, respectively. The mean prostate weights of rats were 0.74±0.18, 1.3±0.13 and 0.72±0.24 g in Groups 1, 2, and 3, respectively. Group 2 had statistically significantly ...
The aim of the present study was to evaluate the behavioral and emotional patterns of patients wi... more The aim of the present study was to evaluate the behavioral and emotional patterns of patients with nocturnal enuresis (NE) and compare them with those of healthy subjects. Materials and methods: Thirty-eight children and adolescents with monosymptomatic NE who were admitted to our hospital's pediatric and urologic outpatient clinics and 46 age-matched, healthy subjects were enrolled in this study. To compare behavioral patterns in these patients, the Child Behavior Checklist (CBCL) was used. Patients' ages, occupations, educational, and socioeconomic status, and mothers' age at delivery were compared in the two groups. One-way ANOVA was used for statistical analysis. Results: Enuretic children were found to have more behavioral problems than nonenuretic children with regard to social (P = 0.008) and attention (P = 0.018) problems. There were no significant differences in anxiety or attractiveness problems between the groups (P > 0.05); however, patients with enuresis were more likely to exhibit these behavioral problems than healthy subjects. The demographics of the patients were significantly different in the two groups in favor of the control group. Conclusion: It was shown that patients with enuresis have more social and attention problems than the control group. Treating these patients effectively will increase the likelihood that they will not develop behavioral problems.
International journal of fertility & sterility, 2012
Varicocele, the abnormal dilatation of the veins in the pampiniform plexus is commonly seen in in... more Varicocele, the abnormal dilatation of the veins in the pampiniform plexus is commonly seen in infertile patients. In this study, we aim to examine sperm DNA damage after the creation of experimental varicocele in rats and to observe the change of this damage after a varicocelectomy. In this experimental study, a total of 30 adult male Wistar albino rats were divided into three groups. The 10 rats in group 1 underwent a sham operation, an experimental varicocele was created in both the10 rats in group 2 and the 10 rats in group 3 (a total of 20 rats). While the rats of group 2 were sacrificed after four weeks, the rats in group 3 underwent a varicocelectomy after four weeks and were sacrificed four weeks after the varicocelectomy to observe its effects. Sperm DNA fragmentation was assessed with a Halomax® kit. The DNA Fragmentation Index (DFI) was calculated and the groups were compared according to their DFI. Statistical analysis was performed using the Mann-Whitney U test. Median ...
Varicocele, most treatable pathologic condition in male infertility, exerts unfavorable effects o... more Varicocele, most treatable pathologic condition in male infertility, exerts unfavorable effects on testicular ultrastructure via various mechanisms. In this study we aimed to demonstrate adverse effects of varicocele on both testes. Materials and Methods: Twenty one adult male Albino rats were divided into 3 groups. Sham operation was performed for group 1 (control group), and this group of rats were sacrificed 4 weeks later. Experimental varicocele model was performed for group 2 (varicocele group) and these animals were sacrificed 4 weeks after the operation. In group 3 the rats were varicocelectomized 4 weeks later. This group of rats were sacrificed at 4 weeks postoperatively. The level of testicular damage was examined, and serum testosterone and intratesticular testosterone levels were measured. Results: Mean (±SD) damage scores of the right testes of the sham, varicocele, and varicocelectomy groups were 0, 1.64 ± 1.3, and 1.21 ± 0.3, respectively. There was no statistically significant differences between damage scores of groups 2, and 3 (P = .320), relevant scores of both groups were determined to be significantly higher than group 1 (P = .009, and P = .001). Mean (±) damage scores of the left testes of the three groups were detected to be 0.43 ± 1.13, 2.29 ± 1.15, and 1.78 ± 0.39, respectively. The difference between varicocele, and varicocelectomy groups was not statically significant (P = .112). Conclusion: Unilateral varicocele has deleterious effects on both testes. There was no statistically significant difference as for histopathologic recovery following varicocelectomy.
ABSTRACT bjectives: Ureteropelvic junction (UPJ) obstruction is of critical importance to underst... more ABSTRACT bjectives: Ureteropelvic junction (UPJ) obstruction is of critical importance to understand the histopathology of UPJ obstruction in terms of therapy planning and follow-up. For this purpose, our study was conducted with TNF-α and TGF-β markers to investigate possible underlying problems in intrinsic UPJ obstruction.Methods: Of the patients who had undergone surgery in our clinic, 36 UPJ segments of patients who had undergone dismembered pyeloplasty surgery due to UPJ obstruction and 14 UPJ segments of the patients who had undergone nephrectomy were collected to form 2 groups. All histological sections were examined by applying immunohistochemical transforming growth factor beta 3 (TGF-β3) and tumour necrosis factor alpha (TNF-α) monoclonal antibody dyes. Results: The mean staining values for TNF-α in mucosal tissue and mucosa were 0.53±0.84 and 0.58±0.84, respectively in the obstruction group, whereas the values observed in the control group were 0.86±0.36 and 0.93±0.47, respectively. While the mean staining values in the obstruction group in mucosal tissue and mucosa for TGF-β3 were 1.75±0.73 and 2.17±0.77, respectively, the values established in the control group were 1.14±0.66 and 1.43±0.93, respectively. The difference between the obstruction and control groups were statistically significant for both values (p&lt;0.05).Conclusion: Only a limited number of studies have been carried out on this particular issue. Data from the present study indicate that TGF-β3 and TNF-α may play a role in the histopathogenesis of UPJ obstruction (Tab. 1, Fig. 1, Ref. 18). Keywords: ureteropelvic junction obstruction, TGF-β3, TNF-α, cytokine.
Turkish Journal of Trauma and Emergency Surgery, 2011
Sivil hayatta penise penetran ateşli silah yaralanmaları enderdir. Bu yazıda, acil servise penise... more Sivil hayatta penise penetran ateşli silah yaralanmaları enderdir. Bu yazıda, acil servise penise penetran ateşli silah yaralanması ile başvuran ve daha önce penis protez implantasyonu yapılmış olan 48 yaşındaki erkek hasta sunuldu. Hasarlı implant çıkarıldı ve anterior üretradaki yaralanma primer olarak onarıldı. Bildiğimiz kadarıyla bu yazıda, literatürde penis protezi olup penis ateşli silah yaralanması olan ilk hasta sunuldu.
Türk Üroloji Dergisi/Turkish Journal of Urology, 2014
Objective: Lower urinary tract symptoms (LUTS), which are related to benign prostate hyperplasia ... more Objective: Lower urinary tract symptoms (LUTS), which are related to benign prostate hyperplasia (BPH), are the most commonly encountered diseases in urological practice. In our study, we compared responses to (doxazosin mesylate extended release tablets) treatment. Material and methods: In our study, we included one hundred patients with LUTS who did not receive any medical treatment, and one hundred patients with LUTS who did not respond to alpha-blocker drugs other than doxazosin XL (8 mg). The inclusion criteria for the study were as follows: international prostate symptom score (IPSS)>7, prostate volume >20 cc, Q-max <15 mL/sn, lack of any previous pelvic or prostatic surgery, and /or urethral catheterization. Results: The mean age of the patients was 62.2±7.9 years. No statistically significant differences were detected between the groups with respect to age, prostate volume, and total prostate-specific antigen (PSA) levels. The duration of the follow-up period was calculated as 3-26 (mean 11) months. Significant differences were detected in post-voiding residual urine, IPSS, quality of life and Qmax between pre-and post-treatment values. Similar decreases in the IPSS scores, and increases in Qmax values were detected in both groups. Conclusion: Doxazosin XL (8 mg) treatment was found to be efficient and reliable in primary patients and in patients with severe LUTS who did not respond to medical treatment. Trial of doxazosin XL (8 mg) therapy, before surgery in patients who respond inadequately to other alpha-blocker drugs is a rational approach.
In clinical practice, atypical small acinar proliferation (ASAP) and high-grade prostatic intraep... more In clinical practice, atypical small acinar proliferation (ASAP) and high-grade prostatic intraepithelial neoplasia (HGPIN) are two common findings on prostate biopsies. Knowing the frequency of a prostate cancer diagnosis on repeat biopsies would aid primary treating physicians regarding their decisions in suspicious cases. Materials and Methods: One hundred forty-three patients in whom biopsies revealed ASAP or HGPIN or both were enrolled in the present study; prostate cancer was not reported in the biopsy specimens and at least one repeat biopsy was performed. Age, digital rectal examination findings, prostate volumes, and free and total prostate-specific antigen (PSA) levels and the biopsy results of the patients were recorded. Results: Of the 97 patients with ASAP on the first set of biopsies, prostate cancer was diagnosed in the second and third biopsies of 32 and 6 patients, respectively. Prostate cancer was not detected in the second or third biopsies of the 40 patients with HGPIN in the first biopsy. Of the 6 patients with ASAP+HGPIN in the first biopsy, prostate cancer was detected in 3 patients in the second biopsy and in 1 patient in the third biopsy. Conclusions: The diagnosis of ASAP is a strong risk factor for prostate cancer. A repeat biopsy should be performed for the entire prostate subsequent to the diagnosis of ASAP. In patients with HGPIN according to the biopsy result, the clinical decision should be based on other parameters, such as PSA values and rectal examination, and a repeat biopsy should be avoided if the initial biopsy was performed with multiple sampling.
Objectives: Nocturnal enuresis (NE) is very common and is one of the most common causes for patie... more Objectives: Nocturnal enuresis (NE) is very common and is one of the most common causes for patients to be admitted to urology, pediatrics, child psychiatry and child surgery departments. We aimed to investigate the effect on depression and self-esteem of this disorder that can cause problems on person's social development and human relations. Material and methods: 90 patients who were admitted to our clinic with complaints of nocturnal enuresis were enrolled. Investigations to rule out organic causes were performed in this group of patients. Out of them 38 children and adolescents (age range 8-18 years) with primary monosymptomatic nocturnal enuresis (PMNE) agreed to participate in the study In the same period 46 healthy children and adolescents with a similar age range without bed wetting complaint were included in the study as a control group. The age of the family, educational and socioeconomic level were questioned and Piers-Harris Children's Self-Concept Scale (PHCSCS)...
Background/aims: Extraintestinal manifestations are important causes of mortality and morbidity f... more Background/aims: Extraintestinal manifestations are important causes of mortality and morbidity from inflammatory bowel diseases. However, sexual problems are usually underestimated in these patients in our daily clinical practice. In this study, we aimed to evaluate the prevalence of sexual dysfunction in inflammatory bowel diseases. Methods: The study included sexually active patients who had inflammatory bowel diseases in remission. Sexual activity was defined as at least one sexual intercourse per month. To evaluate sexual function, the Female Sexual Function Index was used for women and the International Index of Erectile Function for men. Results: The study included 21 female and 17 male patients. Sexual dysfunction was present in 54.54% of female patients with inflammatory bowel disease. The prevalence of sexual dysfunction was 69.23% in female patients with Crohnas disease and 33.33% in those with ulcerative colitis. Sexual dysfunction was present in 58.82% of male patients ...
Testis tümörleri erkek malignitelerinin %1-2'sini oluşturmaktadır. Ağrısız testiküler kitle ile k... more Testis tümörleri erkek malignitelerinin %1-2'sini oluşturmaktadır. Ağrısız testiküler kitle ile kendini gösterir. Bazı durumlarda serum parametreleri ile tanı desteklenir. Çalışmamızda testis tümörlü hastaların tam kan parametreleri ile metastaz ve lenfadenopati durumları arasındaki ilişki incelendi. Yöntem ve Gereçler: Kliniğimizde 2007-2014 yılları arasında testis tümörü öntanısı ile radikal orşiektomi ameliyatı yapılmış olan hastaların bilgileri geriye dönük olarak tarandı. Patoloji raporu testis tümörü olarak yorumlanan 108 hasta çalışmaya alındı. Lenfadenopatisi veya metastazı bulunan ve bulunmayan hastaların hemogram parametreleri ile karşılaştırıldı. Bulgular: Çalışmaya alınan hastaların yaş ortalaması 34.6±9.3 olarak hesaplandı. Çalışmaya alınan hastaların 39'unda (%36.11) LAP, 14'ünde (%12.9) metastaz tespit edildi. Metastaz varlığı ile hemotokrit, beyaz küre ve trombosit sayıları arasında istatistiksel anlamlı ilişki tespit edildi. Bu parametrelerden sadece trombosit sayısı ile lenfadenopati varlığı arasında istatistiksel anlamlı korelasyon tespit edildi. Sonuç: Çalışmamızın sonucunda elde edilen veriler ışığında hematolojik parametreler ile metastaz ve lenfadenopati varlığı arasında ilişki tespit edilmiştir. Bu bulguların daha geniş serilerle desteklenmesi durumunda testis kanserli hastaların takibinde kullanılabileceği kanaatindeyiz.
Aim: To assess the efficacy and safety of two different techniques (Percutaneous nephrolithotomy ... more Aim: To assess the efficacy and safety of two different techniques (Percutaneous nephrolithotomy (PNL) vs Retrograde intrarenal surgery (RIRS)) in the management of stones in patients with horseshoe kidneys (HSK). Patients and methods: Departmental files of 88 cases with radiopaque kidney stones in horseshoe kidneys undergoing two different approaches (PNL vs RIRS) were evaluated with respect to the success and complication rates of in a retrospective manner. In addition to the factors related with the procedures (success and complication rates, additional procedures), patient and stone characteristics were all well evaluated. Findings obtained in both groups were evaluated in a comparative manner with respect to the statistical significance. Results: Stone free rates were comparable in both groups after 1-week period (81.6% PNL vs 80% RIRS). As well as 3 months evaluation (84.2% PNL and 82.0% RIRS). The percentage of the cases with residual fragments (> 4 mm) were similar in bot...
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