Objective: The pathophysiology of urethral stricture and its recurrence remains vague and one of ... more Objective: The pathophysiology of urethral stricture and its recurrence remains vague and one of the important causes is progressive infl ammation. It has been shown in recent years that the neutrophil / lymphocyte ratio is a marker of systemic infl ammation and is associated with prognosis in many cardiovascular diseases, malignancies and chronic infl ammatory diseases. We assessed simple systemic infl ammation markers preoperatively and surgical techniques for urethral stricture recurrence after urethroplasty. Patients and Methods: After exclusion criteria applied, a total of 117 male cases operated with urethroplasty in our clinic between January 2012 and June 2017 were included in the study and analyzed retrospectively. Localization and length of the strictures of the patients, neutrophil counts and percentages, lymphocyte counts and percentages, and neutrophil / lymphocyte ratios in preoperative peripheral blood samples were statistically analyzed. Recurrent stricture during fi rst 12 months follow-up after the surgery has been assessed as recurrence. Results: The mean age of the patients was 54.12 ± 16.35 and the mean urethral stricture length was 3.44 ± 1.83 cm. Recurrence was observed in 30.1% of cases who received buccal graft, 30% in penile skin applied cases and 26.1% of cases treated with end-to-end anastomosis and there was no statistically signifi cant difference between neutrophil, lymphocyte, neutrophil / lymphocyte ratio and average stricture segment length between recurrent and non-recurrent cases (p > 0.005). Conclusions: We consider that neutrophil, lymphocyte counts and their ratio prior to urethroplasty and the technique performed are not parameters that can be used to predict stricture recurrence. Prospective and randomized new trials with larger patient populations are needed to make more accurate judgments about the role of these infl ammatory parameters.
ARTICLE InfO ______________________________________________________________ _____________________... more ARTICLE InfO ______________________________________________________________ ______________________ Objectives: To evaluate national practice patterns in the treatment of male anterior urethral strictures among Turkish urologists. Materials and Methods: A survey form including 12 questions prepared to determine active Turkish urologists' approach to diagnosis and treatment of the adult urethral stricture (US) were filled out. Based on the survey results, the institutions which 218 urologists work and their years of expertise, methods they used for diagnosis and treatment, whether or not they perform open urethroplasty and timing of open urethroplasty were investigated. Results: Optic internal urethrotomy and dilatation are the most commonly used minimal invasive procedures in treatment of US with the ratios of 93.5% and 63.3% respectively. On the other hand it was seen that urethroplasty was a less commonly used procedure, compared to minimal invasive techniques, with the ratio of 36.7%. Survey results showed us that the number of US cases observed and open urethroplasty procedures performed increases with increasing years of professional experience. Conclusions: As a method demanding special surgical experience and known as a time-consuming and challenging procedure, open urethroplasty will be able to take a greater part in current urological practice with the help of theoretical education and practical courses given by specific centers and experienced authors.
Aims and Scope Eurasian Journal of Medicine (Eurasian J Med) is an international, scientific, ope... more Aims and Scope Eurasian Journal of Medicine (Eurasian J Med) is an international, scientific, open access periodical published by independent, unbiased, and triple-blinded peer-review principles. The journal is the official publication of Atatürk University School of Medicine and published triannually in February, June, and October. The publication language of the journal is English. The aim of the Eurasian Journal of Medicine is to publish original research papers of the highest scientific and clinical value in all medical fields. The Eurasian J Med also includes reviews, editorial short notes and letters to the editor that either as a comment related to recently published articles in our journal or as a case report. The target audience of the journal includes researchers, physicians and healthcare professionals who are interested or working in in all medical disciplines.
Nokturnal enürezis (NE), yaşı ve nörolojik gelişimi itibariyle kuru olması gereken bir çocuğun, u... more Nokturnal enürezis (NE), yaşı ve nörolojik gelişimi itibariyle kuru olması gereken bir çocuğun, uykuda yatağını ıslatması olarak tanımlanmıştır. Bu çalışmada primer enürezis nokturna varlığının ailenin demografik yapısı, sosyo-ekonomik ve eğitim düzeyi ile ilişkisi araştırıldı. Gereç ve Yöntemler: Gece yatak ıslatma şikayeti ile üroloji ve çocuk hastalıkları polikliniğine başvuran ve yaşları 8-18 arası olan 76 enürezis nokturnalı hasta, işeme şikayeti olmayan ve yaş grupları çalışma grubuna eşlenerek seçilen 46 normal çocuk ile karşılaştırıldı. Ayrıntılı anamnez, fizik muayene ve tetkikleri yapılan hasta grubu ile kontrol grubuna, 34 soruluk anket formu doldurtuldu. Bulgular: Toplam 76 hastanın 36'sı (%47.4) kız, 40'ı (%52.6) erkek; kontrol grubunun 26'sı (%56.5) kız, 20'si (%43.5) erkekti. Yaş ortalaması hasta grubunda 10.76 yıl, kontrol grubunda 10.89 yıl idi. Enüretik çocukların % 86.8'i ilk üç çocuktan biri iken geri kalan %13.2 si dördüncü ve daha sonraki çocuktu. Vakaların 32'sinin (% 42.1) annesinde, 22'sinin (%28.9) babasında ve 68'inin (%89.5) anne veya baba tarafından akrabalarında da enürezis olduğu saptandı. Hasta grubu anne yaş ortalaması 34.15 yıl (27-48 yaş), kontrol grubu anne yaş ortalaması 38.28 yıl (27-52 yaş) idi ve aradaki fark istatistiksel olarak anlamlı bulundu (p<0.05). Baba yaşları ortalaması
Objectives: Prostate cancer is the most seen cancer in developed country and second reason of can... more Objectives: Prostate cancer is the most seen cancer in developed country and second reason of cancer related died in this population. We evalutaed the survival of the patients who had Gleason 5 patern on transrectal ultrasoun guided prostate biopsy. Material and Methods: The patients who had Gleason 5 patern underwent transrectal ultrasound guided prostate biopsy between 2005-2010 years included in the study. Seventy-six patients who were followed in our policilinic or died were recorded. Age at diagnosis, time of following, treatments, scores of Gleason, level of PSA’s at diagnosis and last were recorded. Results: Mean age of the patients, PSA levels, prostate volumes and following times are 69.4±8.6, 245.9±517.3 ng/ml, 57.2±30.6 cc and 38.8±12.3 months. Gleason 10,9,8 scores were detected in 6 (%7.9),68(%89.5) and 2(%2.6) patients.26 patients were treated surgical castration,44 patients were treated medical castration. Both radical prostatectomy and medical castration were perform...
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.
Türk Üroloji Dergisi/Turkish Journal of Urology, 2018
Objective: Urethral stricture is a common pathology with different etiologic factors in different... more Objective: Urethral stricture is a common pathology with different etiologic factors in different age groups and societies. In our research, patients who underwent urethroplasty because of urethral stricture were evaluated in terms of etiology, localization, surgical technique and demographic characteristics. Material and methods: One hundred and sixty-three patients with a mean age of 53.43±16.5 years, operated between January 2008 and May 2016 because of urethral stricture were retrospectively included in the study. Diagnosis of the urethral stricture was established based on the complaints of the patient, results of urinalysis, urine culture, uroflowmetry, retrograde urethrography and/or voiding urethrography, and urethroscopy in case of need. Postoperative success for the patients was determined based on urinary flow rate and maximum flow rate of over 15 mL/sec were evaluated as success. Results: Etiologic factors for urethral stricture included trauma in 40 (24.5%), urethral catheterization in 45 (27.6%), endoscopic procedure in 59 (36.2%), infection in 10 (6.2%), idiopathic etiologies in 9 (5.5%) out of 163 patients. Mean length of the stricture was 3.6±1.7 cm. While the indicated number of patients had buccal mucosa graft (n=73, 44.7%), penile skin flap (n=21, 12.8%), Heineke-Mikulicz repair (n=5, 3.0%), and end-to-end anastomosis (n=64, 39.1%). Mean follow-up period was 43.2±33.7 months. Buccal mucosa graft was applied as ventral (n=32, 43.8%), dorsal (n=22, 30.2%), and dorsolateral (n=14, 19.2%) onlay, and transventrally dorsal inlay (n=5, 6.8%) grafts. Average success rates were 83.5% (n=61/73) in buccal mucosa, 76.2% (n=16/21) in penile skin grafts; 85.9% (n=55/64) in end-to-end anastomosis and 80.0% (n=4/5) in Heineke-Mikulicz repair. Conclusion: Our assumption is that urethroplasty procedures have satisfactory long-term results, regardless of the location and size of the stenosis. According to our clinical experience, deciding on the most appropriate surgical technique by assessing each patient individually in experienced centers will increase success rates.
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...
ARTICLE InfO ______________________________________________________________ _____________________... more ARTICLE InfO ______________________________________________________________ ______________________ Objectives: To evaluate national practice patterns in the treatment of male anterior urethral strictures among Turkish urologists. Materials and Methods: A survey form including 12 questions prepared to determine active Turkish urologists' approach to diagnosis and treatment of the adult urethral stricture (US) were filled out. Based on the survey results, the institutions which 218 urologists work and their years of expertise, methods they used for diagnosis and treatment, whether or not they perform open urethroplasty and timing of open urethroplasty were investigated. Results: Optic internal urethrotomy and dilatation are the most commonly used minimal invasive procedures in treatment of US with the ratios of 93.5% and 63.3% respectively. On the other hand it was seen that urethroplasty was a less commonly used procedure, compared to minimal invasive techniques, with the ratio of 36.7%. Survey results showed us that the number of US cases observed and open urethroplasty procedures performed increases with increasing years of professional experience. Conclusions: As a method demanding special surgical experience and known as a time-consuming and challenging procedure, open urethroplasty will be able to take a greater part in current urological practice with the help of theoretical education and practical courses given by specific centers and experienced authors.
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.
Purpose: To investigate the chromosomal changes in patients with benign prostatic hyperplasia (BP... more Purpose: To investigate the chromosomal changes in patients with benign prostatic hyperplasia (BPH). Materials and Methods: A total of 54 patients diagnosed with clinical BPH underwent transurethral prostate resection to address their primary urological problem. All patients were evaluated by use of a comprehensive medical history and rectal digital examination. The preoperative evaluation also included serum prostate-specific antigen (PSA) measurement and ultrasonographic measurement of prostate volume. Prostate cancer was detected in one patient, who was then excluded from the study. We performed conventional cytogenetic analyses of short-term cultures of 53 peripheral blood samples obtained from the BPH patients. Results: The mean (±standard deviation) age of the 53 patients was 67.8±9.4 years. The mean PSA value of the patients was 5.8±7.0 ng/mL. The mean prostate volume was 53.6±22.9 mL. Chromosomal abnormalities were noted in 5 of the 53 cases (9.4%). Loss of the Y chromosome was the most frequent chromosomal abnormality and was observed in three patients (5.7%). There was no statistically significant relationship among age, PSA, prostate volume, and chromosomal changes. Conclusions: Loss of the Y chromosome was the main chromosomal abnormality found in our study. However, this coexistence did not reach a significant level. Our study concluded that loss of the Y chromosome cannot be considered relevant for the diagnosis of BPH as it is for prostate cancer. Because BPH usually occurs in aging men, loss of the Y chromosome in BPH patients may instead be related to the aging process.
Objective: Prostate cancer (PC) is one of the most common cancer and an important reason of cance... more Objective: Prostate cancer (PC) is one of the most common cancer and an important reason of cancer specific death. The incidence of patients who diagnosed at low stage increased because of widespread using Prostate Specific Antigen (PSA) testing. We evaluated the patients who were diagnosed single microscopic focus of adenocarcinoma and treated radical prostatectomy at final pathology. Methods: The patients who underwent transrectal ultrasound guided prostate biopsy between January 2004 and January 2012 were enrolled retrospectively. We extracted the patients who were diagnosed single microscopic focus of adenocarcinoma and treated with RP. Single microscopic adenocarcinoma was defined as one single focus measuring 3 mm or less, well differentiated (Gleason 6) adenocarcinoma. 37 patients were included at the study. Clinical data; including age, serum PSA levels, PSA density and prior biopsy and prostatectomy specimen results were recorded. In pathological examination; high molecular weight cytokeratin (HMW-CK), p63, and alpha-methylacyl-CoA racemase (AMACR) were used for differential diagnosis. Results: The patients' ages were between 42 and 77 with a mean age of 64.9 ± 7.57 years. Mean PSA levels and prostate volumes were 8.03 ± 5.21 ng/ml and 54 ± 25.51 cc. T0, T2a, T2c and T3a were reported in 2 patients, 17 patients, 17 patients and 1 patient after pathological evaluation. According to the Gleason grading system; 6 patients were 7 (3 + 4), one patient was 7 (4 + 3), one patient was 5 (3 + 2) and 27 patients were 6 (3 + 3). Conclusion: Small volume of cancer at prostate biopsy is not necessarily small cancer in radical prostatectomy. The treatment choice may be over or under treatment for some patients, so the patients must be informed when choosing the treatment.
Idiopathic thrombocytopenic purpura (ITP) is an immune thrombocytopenia with a usually benign cli... more Idiopathic thrombocytopenic purpura (ITP) is an immune thrombocytopenia with a usually benign clinical course. Bleedings are mostly of the mucocutaneous type with mild symptoms. Massive bleedings requiring transfusion are rarely seen, unless the number of platelets decreases to extremely low levels. In this case, bilateral perirenal hematoma and bilateral distal ureteral stones were detected on a non-contrast computed tomography scan of a 57-year-old male patient who developed macroscopic hematuria during his treatment in the clinics of internal medicine because of left flank pain and diffuse petechial rashes all over his body. The patient, who had been receiving chronic ITP treatment for 1 year, had a very low platelet count (4,000/mm 3). The patient was prescribed bed rest, and his platelet count increased to a safe level for surgical intervention of above 50,000/mm 3 with administration of prednisolone, intravenous immune globulin, and platelet suspension. A stone-free state was achieved after bilateral ureterorenoscopy and pneumatic lithotripsy. A conservative approach was followed for the perirenal hematoma. Upon regression of the perirenal hematoma, the patient was discharged at 9 weeks postoperatively.
Objective: The pathophysiology of urethral stricture and its recurrence remains vague and one of ... more Objective: The pathophysiology of urethral stricture and its recurrence remains vague and one of the important causes is progressive infl ammation. It has been shown in recent years that the neutrophil / lymphocyte ratio is a marker of systemic infl ammation and is associated with prognosis in many cardiovascular diseases, malignancies and chronic infl ammatory diseases. We assessed simple systemic infl ammation markers preoperatively and surgical techniques for urethral stricture recurrence after urethroplasty. Patients and Methods: After exclusion criteria applied, a total of 117 male cases operated with urethroplasty in our clinic between January 2012 and June 2017 were included in the study and analyzed retrospectively. Localization and length of the strictures of the patients, neutrophil counts and percentages, lymphocyte counts and percentages, and neutrophil / lymphocyte ratios in preoperative peripheral blood samples were statistically analyzed. Recurrent stricture during fi rst 12 months follow-up after the surgery has been assessed as recurrence. Results: The mean age of the patients was 54.12 ± 16.35 and the mean urethral stricture length was 3.44 ± 1.83 cm. Recurrence was observed in 30.1% of cases who received buccal graft, 30% in penile skin applied cases and 26.1% of cases treated with end-to-end anastomosis and there was no statistically signifi cant difference between neutrophil, lymphocyte, neutrophil / lymphocyte ratio and average stricture segment length between recurrent and non-recurrent cases (p > 0.005). Conclusions: We consider that neutrophil, lymphocyte counts and their ratio prior to urethroplasty and the technique performed are not parameters that can be used to predict stricture recurrence. Prospective and randomized new trials with larger patient populations are needed to make more accurate judgments about the role of these infl ammatory parameters.
ARTICLE InfO ______________________________________________________________ _____________________... more ARTICLE InfO ______________________________________________________________ ______________________ Objectives: To evaluate national practice patterns in the treatment of male anterior urethral strictures among Turkish urologists. Materials and Methods: A survey form including 12 questions prepared to determine active Turkish urologists' approach to diagnosis and treatment of the adult urethral stricture (US) were filled out. Based on the survey results, the institutions which 218 urologists work and their years of expertise, methods they used for diagnosis and treatment, whether or not they perform open urethroplasty and timing of open urethroplasty were investigated. Results: Optic internal urethrotomy and dilatation are the most commonly used minimal invasive procedures in treatment of US with the ratios of 93.5% and 63.3% respectively. On the other hand it was seen that urethroplasty was a less commonly used procedure, compared to minimal invasive techniques, with the ratio of 36.7%. Survey results showed us that the number of US cases observed and open urethroplasty procedures performed increases with increasing years of professional experience. Conclusions: As a method demanding special surgical experience and known as a time-consuming and challenging procedure, open urethroplasty will be able to take a greater part in current urological practice with the help of theoretical education and practical courses given by specific centers and experienced authors.
Aims and Scope Eurasian Journal of Medicine (Eurasian J Med) is an international, scientific, ope... more Aims and Scope Eurasian Journal of Medicine (Eurasian J Med) is an international, scientific, open access periodical published by independent, unbiased, and triple-blinded peer-review principles. The journal is the official publication of Atatürk University School of Medicine and published triannually in February, June, and October. The publication language of the journal is English. The aim of the Eurasian Journal of Medicine is to publish original research papers of the highest scientific and clinical value in all medical fields. The Eurasian J Med also includes reviews, editorial short notes and letters to the editor that either as a comment related to recently published articles in our journal or as a case report. The target audience of the journal includes researchers, physicians and healthcare professionals who are interested or working in in all medical disciplines.
Nokturnal enürezis (NE), yaşı ve nörolojik gelişimi itibariyle kuru olması gereken bir çocuğun, u... more Nokturnal enürezis (NE), yaşı ve nörolojik gelişimi itibariyle kuru olması gereken bir çocuğun, uykuda yatağını ıslatması olarak tanımlanmıştır. Bu çalışmada primer enürezis nokturna varlığının ailenin demografik yapısı, sosyo-ekonomik ve eğitim düzeyi ile ilişkisi araştırıldı. Gereç ve Yöntemler: Gece yatak ıslatma şikayeti ile üroloji ve çocuk hastalıkları polikliniğine başvuran ve yaşları 8-18 arası olan 76 enürezis nokturnalı hasta, işeme şikayeti olmayan ve yaş grupları çalışma grubuna eşlenerek seçilen 46 normal çocuk ile karşılaştırıldı. Ayrıntılı anamnez, fizik muayene ve tetkikleri yapılan hasta grubu ile kontrol grubuna, 34 soruluk anket formu doldurtuldu. Bulgular: Toplam 76 hastanın 36'sı (%47.4) kız, 40'ı (%52.6) erkek; kontrol grubunun 26'sı (%56.5) kız, 20'si (%43.5) erkekti. Yaş ortalaması hasta grubunda 10.76 yıl, kontrol grubunda 10.89 yıl idi. Enüretik çocukların % 86.8'i ilk üç çocuktan biri iken geri kalan %13.2 si dördüncü ve daha sonraki çocuktu. Vakaların 32'sinin (% 42.1) annesinde, 22'sinin (%28.9) babasında ve 68'inin (%89.5) anne veya baba tarafından akrabalarında da enürezis olduğu saptandı. Hasta grubu anne yaş ortalaması 34.15 yıl (27-48 yaş), kontrol grubu anne yaş ortalaması 38.28 yıl (27-52 yaş) idi ve aradaki fark istatistiksel olarak anlamlı bulundu (p<0.05). Baba yaşları ortalaması
Objectives: Prostate cancer is the most seen cancer in developed country and second reason of can... more Objectives: Prostate cancer is the most seen cancer in developed country and second reason of cancer related died in this population. We evalutaed the survival of the patients who had Gleason 5 patern on transrectal ultrasoun guided prostate biopsy. Material and Methods: The patients who had Gleason 5 patern underwent transrectal ultrasound guided prostate biopsy between 2005-2010 years included in the study. Seventy-six patients who were followed in our policilinic or died were recorded. Age at diagnosis, time of following, treatments, scores of Gleason, level of PSA’s at diagnosis and last were recorded. Results: Mean age of the patients, PSA levels, prostate volumes and following times are 69.4±8.6, 245.9±517.3 ng/ml, 57.2±30.6 cc and 38.8±12.3 months. Gleason 10,9,8 scores were detected in 6 (%7.9),68(%89.5) and 2(%2.6) patients.26 patients were treated surgical castration,44 patients were treated medical castration. Both radical prostatectomy and medical castration were perform...
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.
Türk Üroloji Dergisi/Turkish Journal of Urology, 2018
Objective: Urethral stricture is a common pathology with different etiologic factors in different... more Objective: Urethral stricture is a common pathology with different etiologic factors in different age groups and societies. In our research, patients who underwent urethroplasty because of urethral stricture were evaluated in terms of etiology, localization, surgical technique and demographic characteristics. Material and methods: One hundred and sixty-three patients with a mean age of 53.43±16.5 years, operated between January 2008 and May 2016 because of urethral stricture were retrospectively included in the study. Diagnosis of the urethral stricture was established based on the complaints of the patient, results of urinalysis, urine culture, uroflowmetry, retrograde urethrography and/or voiding urethrography, and urethroscopy in case of need. Postoperative success for the patients was determined based on urinary flow rate and maximum flow rate of over 15 mL/sec were evaluated as success. Results: Etiologic factors for urethral stricture included trauma in 40 (24.5%), urethral catheterization in 45 (27.6%), endoscopic procedure in 59 (36.2%), infection in 10 (6.2%), idiopathic etiologies in 9 (5.5%) out of 163 patients. Mean length of the stricture was 3.6±1.7 cm. While the indicated number of patients had buccal mucosa graft (n=73, 44.7%), penile skin flap (n=21, 12.8%), Heineke-Mikulicz repair (n=5, 3.0%), and end-to-end anastomosis (n=64, 39.1%). Mean follow-up period was 43.2±33.7 months. Buccal mucosa graft was applied as ventral (n=32, 43.8%), dorsal (n=22, 30.2%), and dorsolateral (n=14, 19.2%) onlay, and transventrally dorsal inlay (n=5, 6.8%) grafts. Average success rates were 83.5% (n=61/73) in buccal mucosa, 76.2% (n=16/21) in penile skin grafts; 85.9% (n=55/64) in end-to-end anastomosis and 80.0% (n=4/5) in Heineke-Mikulicz repair. Conclusion: Our assumption is that urethroplasty procedures have satisfactory long-term results, regardless of the location and size of the stenosis. According to our clinical experience, deciding on the most appropriate surgical technique by assessing each patient individually in experienced centers will increase success rates.
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...
ARTICLE InfO ______________________________________________________________ _____________________... more ARTICLE InfO ______________________________________________________________ ______________________ Objectives: To evaluate national practice patterns in the treatment of male anterior urethral strictures among Turkish urologists. Materials and Methods: A survey form including 12 questions prepared to determine active Turkish urologists' approach to diagnosis and treatment of the adult urethral stricture (US) were filled out. Based on the survey results, the institutions which 218 urologists work and their years of expertise, methods they used for diagnosis and treatment, whether or not they perform open urethroplasty and timing of open urethroplasty were investigated. Results: Optic internal urethrotomy and dilatation are the most commonly used minimal invasive procedures in treatment of US with the ratios of 93.5% and 63.3% respectively. On the other hand it was seen that urethroplasty was a less commonly used procedure, compared to minimal invasive techniques, with the ratio of 36.7%. Survey results showed us that the number of US cases observed and open urethroplasty procedures performed increases with increasing years of professional experience. Conclusions: As a method demanding special surgical experience and known as a time-consuming and challenging procedure, open urethroplasty will be able to take a greater part in current urological practice with the help of theoretical education and practical courses given by specific centers and experienced authors.
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.
Purpose: To investigate the chromosomal changes in patients with benign prostatic hyperplasia (BP... more Purpose: To investigate the chromosomal changes in patients with benign prostatic hyperplasia (BPH). Materials and Methods: A total of 54 patients diagnosed with clinical BPH underwent transurethral prostate resection to address their primary urological problem. All patients were evaluated by use of a comprehensive medical history and rectal digital examination. The preoperative evaluation also included serum prostate-specific antigen (PSA) measurement and ultrasonographic measurement of prostate volume. Prostate cancer was detected in one patient, who was then excluded from the study. We performed conventional cytogenetic analyses of short-term cultures of 53 peripheral blood samples obtained from the BPH patients. Results: The mean (±standard deviation) age of the 53 patients was 67.8±9.4 years. The mean PSA value of the patients was 5.8±7.0 ng/mL. The mean prostate volume was 53.6±22.9 mL. Chromosomal abnormalities were noted in 5 of the 53 cases (9.4%). Loss of the Y chromosome was the most frequent chromosomal abnormality and was observed in three patients (5.7%). There was no statistically significant relationship among age, PSA, prostate volume, and chromosomal changes. Conclusions: Loss of the Y chromosome was the main chromosomal abnormality found in our study. However, this coexistence did not reach a significant level. Our study concluded that loss of the Y chromosome cannot be considered relevant for the diagnosis of BPH as it is for prostate cancer. Because BPH usually occurs in aging men, loss of the Y chromosome in BPH patients may instead be related to the aging process.
Objective: Prostate cancer (PC) is one of the most common cancer and an important reason of cance... more Objective: Prostate cancer (PC) is one of the most common cancer and an important reason of cancer specific death. The incidence of patients who diagnosed at low stage increased because of widespread using Prostate Specific Antigen (PSA) testing. We evaluated the patients who were diagnosed single microscopic focus of adenocarcinoma and treated radical prostatectomy at final pathology. Methods: The patients who underwent transrectal ultrasound guided prostate biopsy between January 2004 and January 2012 were enrolled retrospectively. We extracted the patients who were diagnosed single microscopic focus of adenocarcinoma and treated with RP. Single microscopic adenocarcinoma was defined as one single focus measuring 3 mm or less, well differentiated (Gleason 6) adenocarcinoma. 37 patients were included at the study. Clinical data; including age, serum PSA levels, PSA density and prior biopsy and prostatectomy specimen results were recorded. In pathological examination; high molecular weight cytokeratin (HMW-CK), p63, and alpha-methylacyl-CoA racemase (AMACR) were used for differential diagnosis. Results: The patients' ages were between 42 and 77 with a mean age of 64.9 ± 7.57 years. Mean PSA levels and prostate volumes were 8.03 ± 5.21 ng/ml and 54 ± 25.51 cc. T0, T2a, T2c and T3a were reported in 2 patients, 17 patients, 17 patients and 1 patient after pathological evaluation. According to the Gleason grading system; 6 patients were 7 (3 + 4), one patient was 7 (4 + 3), one patient was 5 (3 + 2) and 27 patients were 6 (3 + 3). Conclusion: Small volume of cancer at prostate biopsy is not necessarily small cancer in radical prostatectomy. The treatment choice may be over or under treatment for some patients, so the patients must be informed when choosing the treatment.
Idiopathic thrombocytopenic purpura (ITP) is an immune thrombocytopenia with a usually benign cli... more Idiopathic thrombocytopenic purpura (ITP) is an immune thrombocytopenia with a usually benign clinical course. Bleedings are mostly of the mucocutaneous type with mild symptoms. Massive bleedings requiring transfusion are rarely seen, unless the number of platelets decreases to extremely low levels. In this case, bilateral perirenal hematoma and bilateral distal ureteral stones were detected on a non-contrast computed tomography scan of a 57-year-old male patient who developed macroscopic hematuria during his treatment in the clinics of internal medicine because of left flank pain and diffuse petechial rashes all over his body. The patient, who had been receiving chronic ITP treatment for 1 year, had a very low platelet count (4,000/mm 3). The patient was prescribed bed rest, and his platelet count increased to a safe level for surgical intervention of above 50,000/mm 3 with administration of prednisolone, intravenous immune globulin, and platelet suspension. A stone-free state was achieved after bilateral ureterorenoscopy and pneumatic lithotripsy. A conservative approach was followed for the perirenal hematoma. Upon regression of the perirenal hematoma, the patient was discharged at 9 weeks postoperatively.
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