59 results on '"Ahmet Urkmez"'
Search Results
2. Effect of Pharmacotherapy for Overactive Bladder on the Incidence of and Factors Related to Urinary Tract Infection: A Systematic Review and Meta-analysis. Letter
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Ahmet Urkmez and David Staskin
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Urology - Published
- 2023
3. Temporal learning curve of a multidisciplinary team for magnetic resonance imaging/transrectal ultrasonography fusion prostate biopsy
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Hyunseon C. Kang, Justin R. Gregg, Muammer Altok, Haesun Choi, Ahmet Urkmez, Wei Qiao, Hüseyin Cihan Demirel, Patricia Troncoso, Irene A. Inguillo, and John F. Ward
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Image-Guided Biopsy ,Male ,medicine.medical_specialty ,Prostate biopsy ,Urology ,030232 urology & nephrology ,urologic and male genital diseases ,Multidisciplinary team ,Multimodal Imaging ,Endosonography ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Prostate ,Image Processing, Computer-Assisted ,medicine ,Humans ,Aged ,Patient Care Team ,medicine.diagnostic_test ,business.industry ,Ultrasound ,Rectum ,Prostatic Neoplasms ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Transrectal ultrasonography ,Radiology ,Temporal learning ,business ,Learning Curve - Abstract
Both transperineal and transrectal ultrasound (TRUS)-guided systematic biopsy are accepted methods to diagnose prostate cancer (PCa). However, systematic sampling misses up to 47% of tumors 0.5 mL or larger and under-represents the tumor grade in 38% of cases [1,2]. These shortcomings result in underestimated risk and repeat prostate biopsies.
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- 2021
4. Evaluation of dynamic thiol-disulphide homeostasis in obstructive uropathy
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Zülfü Sertkaya, Gulistan Gumrukcu, Musab Ali Kutluhan, Rahime Orak, Metin İshak Öztürk, Ozcan Erel, Unal Can, Emre Tokuç, and Ahmet Urkmez
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Male ,Nephrology ,medicine.medical_specialty ,Urology ,030232 urology & nephrology ,030204 cardiovascular system & hematology ,Scintigraphy ,Random Allocation ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,Animals ,Homeostasis ,Medicine ,Disulfides ,Sulfhydryl Compounds ,Rats, Wistar ,Hydronephrosis ,Obstructive uropathy ,chemistry.chemical_classification ,Creatinine ,Kidney ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Rats ,medicine.anatomical_structure ,chemistry ,Dimercaptosuccinic acid ,Thiol ,Kidney Diseases ,business ,Ureteral Obstruction ,medicine.drug - Abstract
To evaluate the ability of thiol-disulphide homeostasis to predict renal injury in ureteral obstruction by matching renal scintigraphy and pathological findings in an experimental rat model. 24 rats were randomized and divided into 3 groups as sham, partial and complete. Blood samples for biochemical evaluations and dimercaptosuccinic acid (DMSA) renal scintigraphy were performed at the beginning and on the 7th day postoperatively. Only a midline abdominal incision was done in sham group. Left ureter of partial group was dissected and gently buried into the psoas muscle. In complete group, left ureter was dissected and ligated. Statistically significant association was found between left kidney function loss percentage, native thiol, total thiol and creatinine alterations and pathological EGTI (Endothelial, Glomerular, Tubular, Interstitial) scores (r = − 0.867, r = − 0.815, r = 0.745, r = − 0.911; p = 0.000). Statistically significant difference was detected between groups in terms of postoperative native thiol and total thiol values (p = 0.000, p = 0.001). There was also a significant difference in preoperative and postoperative comparisons of these parameters in partial and complete obstruction groups (p = 0.012, p = 0.018). There was a significant difference in terms of postoperative disulphide/native thiol and native thiol/total thiol ratios in complete obstruction group compared to other groups (p1 = 0.011, p2 = 0.040; p1 = 0.015, p2 = 0.028). Association with scintigraphic and pathological results empowers the value of this parameter. Disulphide/native thiol and native thiol/total thiol ratios indicate complete obstruction. These findings may shed light to more comprehensive studies.
- Published
- 2020
5. Is neutrophil to lymphocyte ratio a predictive factor for recurrence of urethral stricture?
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Emrah Özsoy, Metin İshak Öztürk, Ahmet Urkmez, Ramazan Topaktaş, Emre Tokuç, Musab Ali Kutluhan, Ilker Artuk, and Ridvan Kayar
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Adult ,medicine.medical_specialty ,Medicine (General) ,Time Factors ,Urologic Surgical Procedures, Male ,Procedimentos cirúrgicos urológicos masculinos ,Urethra/surgery ,Neutrophils ,Urethral stricture ,Urethroplasty ,medicine.medical_treatment ,030232 urology & nephrology ,Statistical difference ,Urology ,Estreitamento uretral ,Statistics, Nonparametric ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,R5-920 ,Urethra ,Median follow-up ,Recurrence ,medicine ,Humans ,Lymphocyte Count ,Neutrophil to lymphocyte ratio ,Aged ,Retrospective Studies ,Inflammation ,business.industry ,fungi ,Uretra/cirurgia ,General Medicine ,Middle Aged ,medicine.disease ,Predictive factor ,Inflamação ,Treatment Outcome ,Standard error ,ROC Curve ,030220 oncology & carcinogenesis ,Absolute neutrophil count ,business ,Recidiva ,Follow-Up Studies - Abstract
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 highly significant statistical difference was observed between two groups in terms of neutrophil count and NLR (p: 0.000 – both). The area under curve value for NLR was 0.767, with a standard error of 0.021 (95% CI 0.727-0.808). The cut-off value of NLR was determined as 2.25, with a 70% sensitivity and 67,7% specificity. CONCLUSION By using NLR, the inflammatory features of the urethral tissue can be predicted, and possible recurrences after surgery can be estimated. Consequently, open urethroplasty techniques can be used in cases with a significant NLR value instead of the recurrent endoscopic procedure. RESUMO INTRODUÇÃO Devido à espongiofibrose e processos inflamatórios subjacentes à patogênese da estenose uretral, pode-se pensar que a relação de linfócitos neutrofílicos (NLR) pode fornecer informações essenciais sobre o curso da doença e as possibilidades de recorrência. O objetivo do nosso estudo é avaliar a correlação entre NLR e taxas de recorrência. MÉTODOS Quinhentos e doze pacientes submetidos à uretrotomia interna visual direta (DVIU) devido à estenose uretral em nossa clínica entre as datas de fevereiro de 2010 e janeiro de 2018 foram avaliados retrospectivamente. RESULTADOS A mediana de acompanhamento para os grupos não recorrentes e recorrentes após a DVIU foi de 30 e 36 meses, respectivamente. Durante o seguimento, 280 (54,7%) dos pacientes tiveram recidivas e 232 (45,3%) não tiveram recidivas. O tempo médio de recorrência após a DVIU foi de 6,5±1,4 mês, com variação de 1-36 meses. A média da RNL no grupo sem recorrência foi de 2,02±0,87 com mediana de 1,9 e 3,66±2,30 com mediana de 3 no grupo com recidiva. Uma diferença estatística altamente significativa foi observada entre dois grupos em termos de contagem de neutrófilos e NLR (p: 0,000 - ambos). A área sob o valor da curva para NLR foi de 0,767 com um erro padrão de 0,021 (IC 95% 0,727-0,808). Valor de corte de NLR determinado como 2,25 com uma sensibilidade de 70%, especificidade de 67,7%. CONCLUSÃO Ao utilizar a RNL, as características inflamatórias do tecido uretral podem ser previstas e possíveis recidivas após a cirurgia podem ser estimadas. Dessa forma, técnicas de uretroplastia aberta podem ser usadas em casos com valor significativo de NLR em vez de procedimento endoscópico recorrente.
- Published
- 2020
6. PD56-01 FREEHAND VERSUS GRID-BASED TRANSPERINEAL PROSTATE BIOPSY: A COMPARISON OF ANATOMIC REGION YIELD AND COMPLICATIONS
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Ahmet Urkmez, Cihan Demirel, Muammer Altok, Bathala Tharakeswara, Daniel Shapiro, and John Davis
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Urology - Published
- 2021
7. Freehand versus Grid-Based Transperineal Prostate Biopsy: A Comparison of Anatomical Region Yield and Complications
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Muammer Altok, Ahmet Urkmez, Cihan Demirel, Tharakeswara K. Bathala, John W. Davis, and Daniel D. Shapiro
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Image-Guided Biopsy ,Male ,medicine.medical_specialty ,Urology ,Magnetic Resonance Imaging, Interventional ,Perineum ,Prostate cancer ,Postoperative Complications ,Fiducial Markers ,medicine ,Humans ,Prospective Studies ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Transperineal biopsy ,Prostate ,Prostatic Neoplasms ,Middle Aged ,medicine.disease ,Grid based ,Transperineal Prostate Biopsy ,Radiology ,Biopsy, Large-Core Needle ,business - Abstract
The freehand (FH) technique of transperineal prostate biopsy using commercialized needle access systems facilitates a reduction in anesthesia requirements from general to local or local/sedation. We sought to compare the efficacy and complication rates of the FH method with those of the standard grid-based (GB) method.The GB method was performed from 2014 to 2018, and the updated FH technique was performed from 2018 to 2020, yielding comparative cohorts of 174 and 304, respectively.The FH and GB techniques demonstrated equivalent yields of ≥Gleason grade group (GGG)-2 prostate cancer (PCa). The FH group had a significantly higher mean number of cores with ≥GGG-2 PCa involvement (p=0.011) but a significantly lower mean number of biopsy samples (p0.01). The urinary retention rate of the GB group (10%) was significantly higher than that of the FH group (1%; p0.01). The rates of ≥GGG-2 PCa involvement in the anterior (GB, 31%) and anteromedial (FH, 22%) sectors were higher than those in other sectors (range, 0%-9%). For multiparametric magnetic resonance imaging, the rate of ≥GGG-2 PCa detection in the anteromedial prostate (23%) was nearly half that in other locations (range, 38%-55%).Compared with GB transperineal biopsy, FH transperineal biopsy demonstrates an equivalent cancer yield with no risk of sepsis, a significantly reduced risk of urinary retention, and reduced anesthesia needs. The higher number of cores with ≥GGG-2 PCa involvement in the FH group suggests that FH transperineal biopsy can sample the prostate better than GB-transperineal biopsy can.
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- 2021
8. Penile Rehabilitation and Treatment Options for Erectile Dysfunction Following Radical Prostatectomy and Radiotherapy: A Systematic Review
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Melianthe Nicolai, Ahmet Urkmez, Selcuk Sarikaya, Mikkel Fode, Marco Falcone, Maarten Albersen, Murat Gul, Georgios Hatzichristodoulou, Paolo Capogrosso, and Giorgio Ivan Russo
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medicine.medical_specialty ,intracavernosal injection ,erectile dysfunction ,medicine.medical_treatment ,vacuum devices ,030232 urology & nephrology ,Urology ,lcsh:Surgery ,Urinary incontinence ,law.invention ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Randomized controlled trial ,Quality of life ,law ,medicine ,pelvic floor therapy ,Pelvic floor ,Science & Technology ,penile rehabilitation ,Prostatectomy ,business.industry ,lcsh:RD1-811 ,medicine.disease ,Radiation therapy ,Erectile dysfunction ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Surgery ,Systematic Review ,medicine.symptom ,business ,Life Sciences & Biomedicine ,phosphodiesterase 5 (PDE 5) inhibitors - Abstract
After radical prostatectomy (RP) or radiotherapy (RT) for prostate cancer, erectile dysfunction (ED) is the main complication next to urinary incontinence, affecting quality of life. The pathophysiology of ED after these treatments is believed to include neuropraxia causing reduced oxygenation and structural changes of the tissue in the corpora cavernosa. Next to the option of sparing the nerves during RP, research has been focusing on methods for penile rehabilitation after RP and RT, since it occurs often, even after nerve-sparing techniques were used. In animal studies, the use of phosphodiesterase type 5 inhibitors (PDE5i) after cavernous nerve damage is supported, but results in human studies are contradictory. Non-medical treatment options such as vacuum device therapy, hyperbaric oxygen therapy, yoga, aerobic, or pelvic floor training may be helpful, but evidence is scarce. Clear guidelines for penile rehabilitation are not yet available. However, care and support for ED after RP and RT is highly demanded by a large group of patients, so measures have to be taken even though the evidence is not strong yet. In this systematic review, an overview of the literature for penile rehabilitation and treatment options for ED after RP and RT is provided, using only randomized controlled trials (RCT). ispartof: FRONTIERS IN SURGERY vol:8 ispartof: location:Switzerland status: published
- Published
- 2021
9. Renoprotective effect of platelet-rich plasma in obstructive uropathy
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Gulistan Gumrukcu, Emrah Özsoy, Metin İshak Öztürk, Ahmet Urkmez, Emre Tokuç, Musab Ali Kutluhan, and Mehmet Akyüz
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Nephrology ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,030204 cardiovascular system & hematology ,Scintigraphy ,Nephropathy ,03 medical and health sciences ,chemistry.chemical_compound ,Random Allocation ,0302 clinical medicine ,Internal medicine ,medicine ,Animals ,Rats, Wistar ,Saline ,Hydronephrosis ,Obstructive uropathy ,Creatinine ,medicine.diagnostic_test ,business.industry ,Platelet-Rich Plasma ,medicine.disease ,Rats ,chemistry ,Platelet-rich plasma ,Kidney Diseases ,business ,Ureteral Obstruction - Abstract
To investigate the effect of platelet-rich plasma (PRP) in reducing renal injury in ureteral obstruction. 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. 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). Our study results suggest that PRP may be effective in preventing ureteral obstruction-induced renal injury.
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- 2020
10. Adoption of Single-Port Robotic Prostatectomy: Two Alternative Strategies
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Ronney Abaza, Christopher Murphy, John J. Davis, Oscar Martinez, and Ahmet Urkmez
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Male ,Prostatectomy ,medicine.medical_specialty ,business.industry ,Urology ,General surgery ,technology, industry, and agriculture ,Prostatic Neoplasms ,Robotics ,body regions ,surgical procedures, operative ,Port (medical) ,Robotic Surgical Procedures ,Laparoscopic Prostatectomy ,medicine ,Humans ,Robotic surgery ,Laparoscopy ,Prospective Studies ,Robotic prostatectomy ,business ,human activities - Abstract
Objective: To demonstrate two distinct methods for adopting the single-port (SP) robotic surgery system for robotic-assisted laparoscopic prostatectomy (RALP) by two experienced robotic surgeons (J...
- Published
- 2020
11. Effects of platelet-rich plasma on spermatogenesis and hormone production in an experimental testicular torsion model
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Aytac Sahin, Musab Ali Kutluhan, Emrah Özsoy, Ahmet Urkmez, Ayhan Verit, Tuncay Toprak, Gulistan Gumrukcu, and Ramazan Topaktaş
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Male ,medicine.medical_specialty ,Urology ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Ischemia ,Testicle ,Sham group ,03 medical and health sciences ,Random Allocation ,0302 clinical medicine ,Endocrinology ,Internal medicine ,Testis ,medicine ,Testicular torsion ,Animals ,Orchiectomy ,Rats, Wistar ,Gonadal Steroid Hormones ,Spermatogenesis ,Saline ,Spermatic Cord Torsion ,030219 obstetrics & reproductive medicine ,business.industry ,Platelet-Rich Plasma ,medicine.disease ,Disease Models, Animal ,medicine.anatomical_structure ,Reproductive Medicine ,Platelet-rich plasma ,business ,Hormone - Abstract
Background Platelet-rich plasma is a biological instrument rich in growth factors and cytokines. Objectives The aim of this study was to investigate the effect of platelet-rich plasma on spermatogenesis and hormone production in an experimental testicular torsion model. Materials and methods The rats were randomly divided into three groups, including six rats in each group as follows: the first group as the sham group; the second group as the ischemia/reperfusion + Saline group and the third group as the ischemia/reperfusion + platelet-rich plasma group. The left testicles of the ischemia/reperfusion + Saline and ischemia/reperfusion + platelet-rich plasma group were kept in four-hour torsion. Then, the left testicles of ischemia/reperfusion + Saline and ischemia/reperfusion + platelet-rich plasma groups were detorsioned, and intra-testicular 1 cc saline (ischemia/reperfusion + Saline) and 1 cc platelet-rich plasma (ischemia/reperfusion + platelet-rich plasma) were injected. At one month, blood samples were taken from all groups for hormonal evaluation and left orchiectomy was performed. Results The mean follicle-stimulating hormone level of ischemia/reperfusion + Saline group was significantly higher than ischemia/reperfusion + platelet-rich plasma group (7.78 ± 0.23 vs 6.18 ± 0.28 nmol/l, respectively, P = .004). The mean LH level of ischemia/reperfusion + platelet-rich plasma group was significantly lower than ischemia/reperfusion + Saline group (3.63 ± 0.28 vs 5.68 ± 0.21 nmol/l, respectively, P = .004). The mean total testosterone level of ischemia/reperfusion + platelet-rich plasma group was significantly higher than ischemia/reperfusion + Saline group (8.05 ± 0.24 vs 5.78 ± 0.23 nmol/l, respectively, P = .004). The mean Johnsen scores of ischemia/reperfusion + platelet-rich plasma group were significantly higher than ischemia/reperfusion + Saline group (5.85 ± 0.58 vs 3.93 ± 0.65, respectively, P = .004). The mean Johnsen score of the sham group was significantly higher than ischemia/reperfusion + platelet-rich plasma and ischemia/reperfusion + Saline groups (P = .003 and P = .003, respectively). Discussion and conclusion The platelet-rich plasma has beneficial effects on spermatogenesis and reproductive hormone production in testicular torsion. It is easily accessible and applicable. In the future, intra-testicular platelet-rich plasma injection may be used in testicular torsion after detorsion. However, further experimental and large-scale prospective clinical studies are needed to establish a definitive conclusion on this topic.
- Published
- 2020
12. MP81-05 COMPARATIVE OUTCOMES OF 2 DIFFERENT TRANSPERINEAL PROSTATE BIOPSY TECHNIQUES
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Ahmet Urkmez, Muammer Altok, John M. Davis, and Cihan Demirel
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medicine.medical_specialty ,Prostate biopsy ,genetic structures ,medicine.diagnostic_test ,business.industry ,Urology ,medicine.medical_treatment ,Brachytherapy ,medicine ,Transperineal Prostate Biopsy ,Radiology ,business - Abstract
INTRODUCTION AND OBJECTIVE:Transperineal (TP) prostate biopsy has traditionally been described using a brachytherapy style grid and often using general anesthesia due to the large number of transcu...
- Published
- 2020
13. MP10-02 A NOVEL METHOD PREDICTING OBSTRUCTIVE RENAL INJURY: THIOL-DISULPHIDE HOMEOSTASIS
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Metin İshak Öztürk, Unal Can, Rahime Orak, Gulistan Gumrukcu, Ozcan Erel, Musab Ali Kutluhan, Ahmet Urkmez, and Emre Tokuç
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medicine.medical_specialty ,Endocrinology ,medicine.anatomical_structure ,Renal injury ,business.industry ,Urology ,Internal medicine ,medicine ,food and beverages ,Nephron ,urologic and male genital diseases ,business ,Thiol disulphide homeostasis - Abstract
INTRODUCTION AND OBJECTIVE:Obstructive uropathies can lead to progressive nephron loss at all ages. Renin-angiotensin system and other pathways induced by the increase of intraglomerular pressure d...
- Published
- 2020
14. MP06-02 ASSESMENT OF ANOGENITAL DISTANCE AS A MARKER IN BENIGN PROSTATE HYPERPLASIA RELATED LOWER URINARY TRACT SYMPTOMS
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Musab Ali Kutluhan, Aytac Sahin, Tuncay Toprak, Ayhan Verit, and Ahmet Urkmez
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medicine.medical_specialty ,Lower urinary tract symptoms ,business.industry ,Urology ,Anogenital distance ,medicine ,Hyperplasia ,medicine.disease ,business ,Benign prostate - Published
- 2020
15. Patterns of sexual behavior and psychological processes in asexual persons: a systematic review
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Ahmet Urkmez, Joana Carvalho, Leonor de Oliveira, Selçuk Sarıkaya, Andrea Salonia, Giorgio Ivan Russo, de Oliveira, L., Carvalho, J., Sarikaya, S., Urkmez, A., Salonia, A., and Russo, G. I.
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Biopsychosocial model ,030219 obstetrics & reproductive medicine ,business.industry ,Sexual attraction ,Sexual Behavior ,Urology ,030232 urology & nephrology ,Human sexuality ,Interpersonal communication ,Asexuality ,Developmental psychology ,Sexual Dysfunction, Physiological ,03 medical and health sciences ,0302 clinical medicine ,Attitude ,Cultural diversity ,Humans ,Medicine ,business ,Sexuality ,Heteronormativity ,Qualitative Research ,Qualitative research - Abstract
Asexuality is commonly regarded as lack of sexual attraction. Research in asexuality grew progressively in the past two decades. However, asexuals’ patterns of sexual behavior and psychological processes were not yet systematized. This review searched for articles that could potentially help establishing these patterns. Articles published in English until December 31st 2019 were retrieved from Medline, Embase, Cochrane, EBSCO, PubMed, Scopus, and PsycARTICLES. A systematic search was conducted using an exhaustive list of key terms regarding asexuality and sexual behavior following PRISMA guidelines. Of the 195 initially retrieved, only 23 were considered for this review. Of the 23 articles, 16 were quantitative studies, 5 were qualitative studies, and 2 comprised quantitative and qualitative studies. Overall, current findings suggest that asexuals present great heterogeneity of sexual behaviors and psychological processes regarding sexuality, including different aspects and types of interpersonal and romantic relationships, sexual attitudes or fantasies. Conversely, data did not find support for the claim that asexuals present impaired sexual functioning. The little geographic and cultural diversity of thesamples is a major limitation in thesestudies, preventing the properly representation of asexuals. Furthermore, asexuals may benefit from evidence on the biopsychosocial factors shaping sexual, emotional, and relationship well-being, as far as such evidence is built upon asexuals’ lenses, rather than on heteronormativity criteria.
- Published
- 2020
16. The relationship between anogenital distance and benign prostate hyperplasia-related lower urinary tract symptoms
- Author
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Tuncay Toprak, Zülfü Sertkaya, Ramazan Topaktaş, Aytac Sahin, Ayhan Verit, Musab Ali Kutluhan, Korhan Akgul, and Ahmet Urkmez
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Male ,medicine.medical_specialty ,medicine.drug_class ,Urology ,030232 urology & nephrology ,Prostatic Hyperplasia ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Lower Urinary Tract Symptoms ,Prostate ,Lower urinary tract symptoms ,medicine ,Humans ,030219 obstetrics & reproductive medicine ,Hyperplasia ,urogenital system ,business.industry ,Anogenital distance ,General Medicine ,Androgen ,Anus ,medicine.disease ,medicine.anatomical_structure ,International Prostate Symptom Score ,business ,Body mass index ,Biomarkers - Abstract
Anogenital distance (AGD) is the length between the genitals and anus which shows an androgenic activity in the evolution of the reproductive system in the uterine life. For prostatic evolution and development during the embryological stage, androgen exposure is required. In this study, we aimed to investigate the relationship between AGD and benign prostate hyperplasia (BPH)-related lower urinary tract symptoms (LUTS). A total of 70 patients who were admitted to our urology clinics with LUTS due to BPH (LUTS group) and 70 patients without LUTS (control group) were included. All patients were administered an International Prostate Symptom Score form. Data including height, weight, body mass index, total prostate-specific antigen, prostate volume and uroflowmetry Qmax values of all patients were evaluated. The AGD of the LUTS and control groups was measured. The mean AGDAS values of the LUTS group were significantly lower than the control group (p = .013). There was no statistically significant difference between the two groups in terms of the mean adjusted AGDAP values (p = .241). However, the mean adjusted AGDAS values were significantly lower in the LUTS group than the control group (p = .002). Our study results suggest that AGD may be a useful marker in BPH-related LUTS.
- Published
- 2019
17. Predictive value of ischaemia‐modified albumin in spermatogenesis in an experimental testicular torsion model
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Gulistan Gumrukcu, Musab Ali Kutluhan, Ayhan Verit, Aytac Sahin, Ahmet Urkmez, and Ramazan Topaktaş
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Male ,medicine.medical_specialty ,Urology ,030232 urology & nephrology ,Ischemia ,Serum Albumin, Human ,Testicular Diseases ,Random Allocation ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Predictive Value of Tests ,Testis ,medicine ,Animals ,Testicular torsion ,Orchiectomy ,Rats, Wistar ,Spermatogenesis ,Spermatic Cord Torsion ,030219 obstetrics & reproductive medicine ,business.industry ,Albumin ,General Medicine ,Venous blood ,medicine.disease ,Reperfusion Injury ,Complication ,business ,Reperfusion injury ,Biomarkers - Abstract
Our aim was to measure the ability of ischaemia-modified albumin (IMA) to predict testicular histopathological damage in the testes of rats with short- and long-term ischaemia using experimental testicular torsion and subsequent reperfusion via detorsion.21 Wistar Albino rats were randomized into three groups. The sham group was subjected to a mid-scrotal incision only. The 4- and 8-hr T/D (Torsion/Detorsion) groups were subjected to left testicular torsion by twisting the testes by 720 degrees counterclockwise. 2 cc venous blood samples were taken from the sham group after the mid-scrotal incision, and from the 4- and 8-hr T/D groups after 4 and 8 hr respectively. After that, the 4- and 8-hr T/D groups were subjected to detorsion. Two days later, orchiectomy was performed. Ischaemia-modified albumin levels were significantly different among the groups at 48 hr prior to orchiectomy (reperfusion; p = .003). Based on the results of the paired comparisons, it was found that IMA levels of the sham group were significantly higher than those of the 4- and 8-hr T/D groups (p = .002 and .009 respectively). Our study has showed that IMA may be used to predict ischaemia/reperfusion injury, which is another complication that may occur following detorsion in testicular torsion.
- Published
- 2019
18. Influence Of Obesity On Gleason Score Inconsistencies Between Biopsy And Radical Prostatectomy Specimens
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Özgür Haki Yüksel, Aytac Sahin, Ahmet Urkmez, and Ayhan Verit
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Male ,medicine.medical_specialty ,Prostate biopsy ,Turkey ,Biopsy ,medicine.medical_treatment ,Urology ,urologic and male genital diseases ,Body Mass Index ,Cohort Studies ,Prostate cancer ,Prostate ,medicine ,Humans ,Obesity ,Prostatectomy ,medicine.diagnostic_test ,business.industry ,Prostatic Neoplasms ,General Medicine ,Middle Aged ,Prostate-Specific Antigen ,Nomogram ,medicine.disease ,Prostate-specific antigen ,medicine.anatomical_structure ,Neoplasm Grading ,business ,Body mass index - Abstract
OBJECTIVE To evaluate the association of obesity with Gleason scores determined in biopsy and radical prostatectomy specimens. STUDY DESIGN Cohort study. PLACE AND DURATION OF STUDY Urology Department, Fatih Sultan Mehmet Research Hospital, Istanbul, Turkey from 2007 to 2015. METHODOLOGY A total of 111 patients, younger than 65 years who underwent radical prostatectomy (RP) with the diagnosis of prostate cancer, were included in the study. Histopathology reports of the surgical, and TRUS-guided prostate biopsy specimens were analysed. Body mass index (BMI) and prostate specific antigen (PSA) levels were also evaluated. RESULTS Mean age of the patients was 59.06 ±4.10 (range = 47-64 years) years. Mean BMI of the patients was 25.59 ±3.24 kg/m2 (range = 19-35 kg/m2). In patients whose BMI measurements were equal or above 25 kg/m2; a significant difference was found between Gleason scores of the needle biopsy and RP specimens (p=0.001). CONCLUSION BMI and PSA, which are known to be the most important parameters effecting Gleason score, were evaluated in combination. Regarding non-concordance with Gleason scores, it has been observed that as a predisposing factor, obesity can explain these incompatibilities similarly to PSA.
- Published
- 2018
19. Psychologic and sexual dysfunction in primary and secondary infertile male patients
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Aytac Sahin, Ayhan Verit, Fatma Ferda Verit, Ahmet Urkmez, and Özgür Haki Yüksel
- Subjects
Adult ,Male ,Infertility ,medicine.medical_specialty ,Urology ,Secondary infertile man ,lcsh:RC870-923 ,Secondary infertility ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Erectile Dysfunction ,Internal medicine ,medicine ,Humans ,Infertility, Male ,Depression (differential diagnoses) ,Gynecology ,030219 obstetrics & reproductive medicine ,business.industry ,Depression ,Male sexual dysfunction ,Beck Depression Inventory ,Mean age ,Middle Aged ,medicine.disease ,lcsh:Diseases of the genitourinary system. Urology ,Sexual dysfunction ,Erectile dysfunction ,Male patient ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Objective: The aim of this study was to compare depression and sexual dysfunctions observed in primary and secondary infertile patients. Material and method: The study was performed in 39 primary and 31 secondary infertile male patients. Male sexual health was evaluated using the International Index of Erectile Function (IIEF) score and depression with Beck Depression Inventory (BDI). Results: Mean age of the participants and their partners were 31.54 ± 5.37 (range, 24-48 yrs), and 28.16 ± 5.58 (range, 20- 46 yrs) years, respectively. Mean duration of their marriage ranged between 1 and 17 years (mean, 5.06 ± 4.15 yrs). A statistically significant intergroup difference was detected between groups as for BDI scores (p = 0.015; p < 0. 05). BDI scores of the primary group were significantly lower than those of the secondary group. A statistically and extremely significant difference was detected between IIEF scores of the groups (p = 0.006; p < 0.01). IIEF scores of the primary infertile group were higher than those of the secondary group. Conclusion: Our study, frequency of the depression and erectile dysfunction seen in the patients with secondary infertility was seen significantly higher than the patients with primary infertility.
- Published
- 2017
20. Assesment of anogenital distance as a marker in diagnosis of prostate cancer
- Author
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Yasin Vural, Aytac Sahin, Musab Ali Kutluhan, Serkan Akan, Ayhan Verit, Tuncay Toprak, and Ahmet Urkmez
- Subjects
Male ,medicine.medical_specialty ,medicine.drug_class ,Urology ,030232 urology & nephrology ,Anal Canal ,Genitalia, Male ,lcsh:RC870-923 ,urologic and male genital diseases ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Benign prostate hyperplasia ,Scrotum ,Biopsy ,Humans ,Medicine ,Body Weights and Measures ,Sex organ ,Aged ,Aged, 80 and over ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,business.industry ,Anogenital distance ,Prostatic Neoplasms ,Middle Aged ,Hyperplasia ,lcsh:Diseases of the genitourinary system. Urology ,medicine.disease ,Androgen ,Anus ,medicine.anatomical_structure ,Androgens ,business - Abstract
Objectives: Anogenital distance (AGD), the distance from the sexual organs to the anus, is a sexually dimorphic feature in mammals. In this study, we investigated the relationship between anogenital distance and prostate cancer (PCa). Methods: 52 patients diagnosed with PCa and 60 patients with benign prostate hyperplasia as a control group were included in the study. AGDAP (cephalad insertion of the penis to the center of the anus) and AGDAS (posterior base (first fold) of the scrotum to the center of the anus) measurements of patients were done and noted before biopsy. Results: The mean ages of 52 patients diagnosed with PCa and 60 patients with benign prostatic hyperplasia (BPH) were 67.70 ± 7.74 and 67.03 ± 7.89, respectively. There was no statistically significant difference in terms of age and serum testosterone levels of the patients diagnosed with prostate cancer or BPH (p > 0.05). Mean PSA values of patients diagnosed with prostate cancer wto be statistically higher than patients with BPH (p = 0.000). The mean AGDAP measurements of patients diagnosed with prostate cancer were statistically higher than those diagnosed with BPH (p = 0.000) and there was no significant difference in AGDAS measurements.(p = 0.823; p > 0.05). Conclusions: Androgen exposure is thought to play a role in the development PCa. Also AGD may be an indicator of prenatal androgen activity. In our study, we found a direct correlation between AGDAP and PCa. In order to reach a definitive conclusion, randomized controlled trials with larger sample number are needed.
- Published
- 2019
21. The Efficacy of Ultra-thin Semi-rigid Ureteroscopy with Holmium Laser Lithotripsy in Pediatric Ureteral Stones: A Single-center Experience
- Author
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Ramazan Topaktaş, Cemil Aydin, Zeynep Banu Aydın, Ahmet Urkmez, Ali Akkoç, Selcuk Altin, Aydın, Cemil, Aydın, Zeynep Banu, ALKÜ, and 0-belirlenecek
- Subjects
medicine.medical_specialty ,pediatrics ,medicine.medical_treatment ,Radiography ,Urology ,Ureteral stone ,030204 cardiovascular system & hematology ,Lithotripsy ,Single Center ,03 medical and health sciences ,0302 clinical medicine ,Pediatric Surgery ,medicine ,Ureteroscopy ,medicine.diagnostic_test ,business.industry ,Ultrasound ,General Engineering ,Laser lithotripsy ,Surgery ,ureteral stone ,laser lithotripsy ,ureteroscopy ,Complication ,business ,030217 neurology & neurosurgery - Abstract
Aydin, Cemil/0000-0002-7271-5748; Topaktas, Ramazan/0000-0003-3729-3284 WOS: 000484762600001 PubMed: 31667032 Introduction The aim of this study was to present our results regarding the feasibility and possible complications of 4.5 Fr semi-rigid ureterorenoscopy (URS) treatments in pediatric patients. Methods The files and computer records of a total of 33 pediatric patients (20 males and 13 females), who underwent URS procedures for ureteral stones > 5 mm between January 2013 and June 2017, were retrospectively reviewed. A 4.5 Fr semi-rigid ureteroscope (Ultrathin 4.5/6.5 Fr Ureterorenoscope; Richard Wolf GmbH, Knittlingen, Germany) was used for the URS procedures. For the stone-free rate evaluations, abdominopelvic ultrasound or direct radiography scans were performed one week after the surgery, and low-dose non-contrast computed tomography (CT) was performed during the first month. Results The mean age of the patients was 9.8 +/- 2.8 (range 4-16) years old, and the mean ureteral stone size was 8.9 +/- 1.4 (range 6-13) mm. The mean surgical duration was 45 +/- 21.2 (range 30-75) minutes, and the mean hospital stay length was 1.2 (range 1-4) days. Minor complications occurred in five (15.1%) of the patients. The success rates for the first week and first month were 90.9% and 96.9%, respectively. Conclusion The endoscopic management of pediatric ureteral stones using a 4.5 Fr ureteroscope seems to be a safe and feasible treatment option with high success and low complication rates.
- Published
- 2019
22. Increased neutrophil/lymphocyte ratio in testicular cancer
- Author
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Tuncay Toprak, Musab Ali Kutluhan, Yasin Vural, Ayhan Verit, Aytac Sahin, and Ahmet Urkmez
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Neutrophils ,Urology ,Lymphocyte ,Varicocele ,030232 urology & nephrology ,Inflammation ,Physical examination ,lcsh:RC870-923 ,Gastroenterology ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Testicular Neoplasms ,Internal medicine ,Testis ,Biomarkers, Tumor ,medicine ,Humans ,Platelet ,Neutrophil/lymphocyte ratio (NLR) ,Lymphocytes ,Mean platelet volume ,Child ,Testicular cancer ,Cancer ,Aged ,Neoplasm Staging ,Retrospective Studies ,Aged, 80 and over ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,business.industry ,Infant ,Retrospective cohort study ,Middle Aged ,lcsh:Diseases of the genitourinary system. Urology ,medicine.disease ,Cross-Sectional Studies ,medicine.anatomical_structure ,Child, Preschool ,medicine.symptom ,business ,Mean Platelet Volume ,Mean platelet volume (MPV) - Abstract
Objective: Testicular cancers, which are less common than other cancers, are important in terms of being seen in young people. Physical examination, imaging, laboratory and tumor markers are used for diagnosis. There are some studies of some blood parameters that can be involved in inflammation and tumorogenesis. We retrospectively compared hematological values measured in our patients who were diagnosed with testicular tumor in comparison with patients with similar age group who underwent varicocelectomy repair. Materials and methods: This cross-sectional retrospective study included 120 patients who underwent radical inguinal orchiectomy for testicular tumor between January 2010 and December 2018, and 171 patients who underwent varicocelectomy as a control group. Patients with an active infection and hematological disorders were excluded from the study. We evaulated hematological parameters including neutrophil (NEU), lymphocyte (LYM), platelet (PLT) count, and mean platelet volume. The study was conducted on 291 patients. divided in two groups: tumor (n = 120) and varicocele (n = 171). Results: There was no statistically significant difference between the groups in terms of PLT / lymphocyte ratio and mean platelet volume (MPV) levels (p > 0.05). The neutrophil /lymphocyte ratio (NLR) of the tumor group was significantly higher than the varicocele group (p = 0.001; p < 0.05). There was a statistically significant difference between the tumor stages in terms of PLT / Lymphocyte ratios (p = 0.006; p < 0.05). Conclusions: There was only a statistically significant increase in NLR values in the testicular tumor group compared to the varicocele group. Larger, randomized controlled studies are needed at this field.
- Published
- 2019
23. REPLY TO THE AUTHORS: Re: The effect of urethroplasty surgery on erectile and orgasmic functions: a prospective study
- Author
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Metin İshak Öztürk, Ramazan Topaktaş, Aytac Sahin, Emrah Özsoy, Orhan Koca, Özgür Haki Yüksel, and Ahmet Urkmez
- Subjects
Adult ,Male ,medicine.medical_specialty ,Urologic Surgical Procedures, Male ,Urology ,media_common.quotation_subject ,Urethroplasty ,medicine.medical_treatment ,MEDLINE ,Orgasm ,lcsh:RC870-923 ,Urethra ,Erectile Dysfunction ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Letter to the Editor ,media_common ,Aged ,Urethral Stricture ,business.industry ,Penile Erection ,Middle Aged ,lcsh:Diseases of the genitourinary system. Urology ,Surgery ,medicine.anatomical_structure ,business - Abstract
To examine the effects of urethroplasty surgery on sexual functions by taking into account age, location of stenosis, length of stenosis and surgical technique parameters.The prospective study was conducted between January 2015 and August 2017 with 60 cases. Patients were categorized according to age groups (19-65 / 65-75 years), surgery technique and stricture localization and length. Before the urethroplasty operation and postoperative 6th month follow-up, the international index of erectile function (IIEF) form (15 questions), was filled, the relevant domains of sexual function; erectile function (Q1,2,3,4,5,15), orgasmic function (Q9,10) and overall satisfaction (Q13,14) were assessed.The mean age of the cases is 54 ± 13. However, preoperative IIEF, sexual satisfaction and orgasmic function averages of patients with a stenosis segment length of 1-3 cm was found to be significantly higher than that of patients with a stenosis segment length of 4-7 cm. Between stenosis segment length groups, there was no statistical difference in terms of preoperative and postoperative sexual functions. And also, there was no statistically significant change in patients' preoperative and postoperative sexual function scores in terms of localization of stricture and surgery techniques. However, there were statistically significant change in the postoperative IIEF and sexual satisfaction averages according to preoperative averages.Our study suggests that urethroplasty surgery itself does not significantly affect erectile function, orgasmic function, and general sexual satisfaction regardless of the type of surgery, localization and length of stenosis. Besides, there was a significant decrease in erectile function in senior adults.
- Published
- 2019
24. Effect of artificial urinary sphincter implantation on erectile function and sexual satisfaction
- Author
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Metin İshak Öztürk, Musab Ali Kutluhan, Ilker Artuk, Orhan Koca, Ahmet Urkmez, Emre Tokuç, Emrah Özsoy, and Ramazan Topaktaş
- Subjects
Male ,medicine.medical_specialty ,Urinary Incontinence, Stress ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Urinary incontinence ,Prosthesis Implantation ,Artificial urinary sphincter ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Erectile Dysfunction ,medicine ,Humans ,Orgasm ,Aged ,Prostatectomy ,030219 obstetrics & reproductive medicine ,business.industry ,Penile Erection ,Coital incontinence ,Significant difference ,Perineal approach ,General Medicine ,Middle Aged ,Erectile function ,medicine.disease ,Treatment Outcome ,Erectile dysfunction ,Patient Satisfaction ,Urinary Sphincter, Artificial ,medicine.symptom ,business ,Follow-Up Studies - Abstract
Artificial urinary sphincter (AUS) implantation is the gold standard treatment in total stress urinary incontinence (SIU). Our aim is to evaluate the effect of AUS implantation on erectile function and sexual satisfaction (SS). Fourteen patients aged 58-73 years (mean: 66.92 ± 4.51 years) who underwent AUS implantation by a perineal approach between May 2015 and April 2018 were included in our study. Patients with neurogenic disease or very low or no erectile function and those who underwent non-nerve-sparing radical prostatectomy were excluded. Erectile function and intercourse satisfaction were evaluated pre-operatively and post-operatively at 6-month follow-up using international index of erectile function (IIEF) questionnaires. After AUS implantation; eight patients were totally dry, four achieved social continence (less than one pad/day), and two still had SUI (two or more pads/day). Mean pre- and post-operative IIEF values of the patients were 16.14 ± 3.18 and 17.42 ± 4.43 respectively. Mean pre- and post-operative SS values were 8.57 ± 1.78 and 8.71 ± 2.19 respectively. There was no statistically significant difference between pre- and post-operative IIEF-5 and intercourse satisfaction scores (p > 0.05). Although we did not see a significant effect of AUS implantation in our study, in SIU patients, coital incontinence or unpleasant odour during intercourse can lead to sexual avoidance and reduced SS, and AUS implantation may improve SS.
- Published
- 2019
25. Hematologic parameters and Neutrophil / Lymphocyte ratio in the prediction of urethroplasty success
- Author
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Musab Ali Kutluhan, Mehmet Akyüz, Ramazan Topaktaş, Emre Tokuç, and Ahmet Urkmez
- Subjects
Adult ,Male ,medicine.medical_specialty ,Urologic Surgical Procedures, Male ,Adolescent ,Urethral stricture ,Neutrophils ,Urology ,Lymphocyte ,Urethroplasty ,medicine.medical_treatment ,030232 urology & nephrology ,Inflammation ,Anastomosis ,lcsh:RC870-923 ,Systemic inflammation ,Gastroenterology ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Urethra ,Internal medicine ,medicine ,Humans ,Lymphocyte Count ,Aged ,Retrospective Studies ,Aged, 80 and over ,Urethral Stricture ,business.industry ,Middle Aged ,lcsh:Diseases of the genitourinary system. Urology ,Prognosis ,medicine.disease ,Pathophysiology ,Peripheral blood ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Original Article ,Inflammation Mediators ,medicine.symptom ,business ,Biomarkers - Abstract
Objective: The pathophysiology of urethral stricture and its recurrence remains vague and one of the important causes is progressive inflammation. It has been shown in recent years that the neutrophil / lymphocyte ratio is a marker of systemic inflammation and is associated with prognosis in many cardiovascular diseases, malignancies and chronic inflammatory diseases. We assessed simple systemic inflammation 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 first 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 significant 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 inflammatory parameters.
- Published
- 2019
26. Prostatic Metastasis of Renal Cell Carcinoma Presenting With Elevated Serum Prostate-specific Antigen Level
- Author
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Orhan Koca, Emrah Özsoy, Metin İshak Öztürk, Aytac Sahin, and Ahmet Urkmez
- Subjects
Image-Guided Biopsy ,Male ,PCA3 ,medicine.medical_specialty ,Urology ,030232 urology & nephrology ,Metastasis ,Elevated serum ,03 medical and health sciences ,Fatal Outcome ,0302 clinical medicine ,Renal cell carcinoma ,Carcinoma ,medicine ,Humans ,Carcinoma, Renal Cell ,Aged ,Ultrasonography ,business.industry ,Prostatic Neoplasms ,Laparoscopic nephrectomy ,Prostate-Specific Antigen ,medicine.disease ,Kidney Neoplasms ,Prostate-specific antigen ,Oncology ,030220 oncology & carcinogenesis ,Cancer research ,business - Published
- 2017
27. Vesicourethral anastomosis including rhabdosphincter in retropubic radical prostatectomy: Technique and results
- Author
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Sinasi Yavuz Onol, Musab Ali Kutluhan, Ramazan Topaktaş, Ahmet Urkmez, and Ismail Basibuyuk
- Subjects
Male ,medicine.medical_specialty ,Prostate biopsy ,Time Factors ,Urology ,Biopsy ,Urinary Bladder ,030232 urology & nephrology ,Anastomosis ,lcsh:RC870-923 ,03 medical and health sciences ,0302 clinical medicine ,Urethra ,medicine ,Humans ,Rhabdosphincter ,Prospective Studies ,Vicryl ,Retropubic radical prostatectomy ,Aged ,Prostatectomy ,Incontinence ,030219 obstetrics & reproductive medicine ,Pelvic floor ,Vesicourethral anastomosis ,Urinary continence ,medicine.diagnostic_test ,business.industry ,Anastomosis, Surgical ,Prostatic Neoplasms ,Pelvic cavity ,Length of Stay ,Middle Aged ,Prostate-Specific Antigen ,lcsh:Diseases of the genitourinary system. Urology ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Urinary Incontinence ,Neoplasm Grading ,business ,Follow-Up Studies - Abstract
Objective: Retropubic radical prostatectomy (RRP) is still widely used in clinical practice in localized prostate cancer because of its high oncological success. The aim of this study was to define the continence status in patients where rhabdosphincter was included in the vesicourethral anastomosis. Materials and methods: Between November 2004 and September 2010, 90 cases who underwent RRP by the same surgeon in our clinic were taken into the study. In all cases vesicourethral anastomosis was performed include the rhabdosphincter. The anastomosis was performed with mean 2.9 (0-7) interrupted no 2-0 vicryl sutures, depending on the angulation of symphysis pubis and pelvic cavity. Pad test was performed to all patients at 1, 3, 6 and 12 months postoperatively. We defined patients as ‘continent’ when they no need pad, as ‘mild incontinence’ when they use only one pad daily, as ‘moderate incontinence’ when they use two or three pads daily and as ‘severe incontinence’ when they use more than three pads daily. Results: Preoperative total PSA value was 12.2 ng/ml (range: 2.7-84 ng/ml). Preoperative prostate biopsy results were found that Gleason scores were 5, 6, 7 and 8 in 7, 53, 21, 9 patients, respectively. Mean operation and urethral catheter removal time was 103 minutes (60-200) and 14,6 days (9-28), respectively. Mean hospital stay was 4.6 days (2-20). According to results of postoperative pad tests, 38 (42.2%), 48 (53.3%), 55 (61.1%) and 75 (83.3%) patients were defined as continent in first, third, sixth and twelfth months, respectively. Conclusions: We think that, our novel technique of vesicourethral anastomosis in standard RRP provides more optimal urethral position during fixation of pelvic floor and urethra, protect caudal retraction, preserve functional urethral length. Also strong full thickness stitch on urethra provides better urinary continence by hanging urethra in our patients. Although our early continence rate is better, our long term continence rate is similar to literature.
- Published
- 2018
28. Comparison of translabial ultrasonographic and urodynamic data of female patients with urinary incontinence: Importance of translabial ultrasonography in the diagnosis of incontinence
- Author
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Serkan Akan, Halide Yüksel, Aytac Sahin, Özgür Haki Yüksel, Ahmet Urkmez, Burcu Seher Anıl, and Ayhan Verit
- Subjects
Stress incontinence ,Mixed urinary incontinence ,medicine.medical_specialty ,Female Urology ,business.industry ,Urology ,Mixed type ,Urinary incontinence ,medicine.disease ,Neck of urinary bladder ,Female patient ,medicine ,Ultrasonography ,medicine.symptom ,business ,Body mass index - Abstract
Objective To explore the diagnostic importance of translabial ultrasonographic data in incontinence, for comparison with urodynamic data. Material and methods The study was performed between January and May 2017 on 64 patients aged between 40 and 65 years with complaints of mixed type incontinence. The patients were separated into two groups according to their urodynamic data. Translabial ultrasonography was performed in both groups. Results Mean age of the patients was 51.19±7.01 years, and mean body mass index was 26.69±2.02 kg/m2. The patients were separated into two groups as those with (n=33) or without (n=31) stress urinary incontinence based on urodynamic findings (despite the presence of mixed urinary incontinence complaints, stress urinary incontinence and detrusor overactivity associated with incontinence could not be detected in the urodynamic study). Average x descend, y descend and bladder neck mobilization values detected with translabial ultrasonography were found to be statistically significantly higher in the urodynamic stress incontinence group. There was an opposite-directional, 37.6% and statistically significant relation between maximum cystometric capacity and x descend parameters. Y descend values and bladder neck mobilization of females with negative Q-tip test were found to be statistically significantly lower than females with positive Q-tip test. Conclusion As a complementary examination tool in the evaluation of urinary incontinence translabial ultrasonography may become one of the main diagnostic evaluation tools in the future.
- Published
- 2018
29. Is sulfonamide group of tamsulosin main factor in the pathophysiology of floppy iris syndrome?
- Author
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Ahmet Urkmez
- Subjects
chemistry.chemical_classification ,medicine.medical_specialty ,chemistry ,Tamsulosin ,business.industry ,medicine ,Urology ,Floppy iris syndrome ,business ,Pathophysiology ,Sulfonamide ,medicine.drug - Published
- 2018
30. The history of establishment and evaluation period of Ottoman-Turkish urology inside the surgical science
- Author
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Ayhan Verit, S Tellaloğlu, and Ahmet Urkmez
- Subjects
Main branch ,medicine.medical_specialty ,Turkish ,business.industry ,Pasha ,Medical school ,Urology clinic ,language ,Urology ,medicine ,business ,General Economics, Econometrics and Finance ,language.human_language - Abstract
The first urological international organization occurred in Paris in 1908, and three Ottoman urologists were present among a total of 29. In that year, the Ottoman Urological society had only nine urologists, and almost all were from the Ottoman minorities with the exception of two under the main branch of General Surgery. Among them, Cemil Pasha who was the first dean and department chief of Surgery and Urology of the Medical School in a modern manner (1909) was the most dominant pioneer of the Turkish Surgery-Urology. Four beds out of 20 were separated for the urology clinic.
- Published
- 2018
31. Mirabegron: A Novel and Promising Medical Expulsive Treatment for Ureteral Stones?
- Author
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Emre Tokuç, Aytac Sahin, Özgür Haki Yüksel, Ramazan Topaktaş, and Ahmet Urkmez
- Subjects
Agonist ,medicine.medical_specialty ,Ureteral Calculi ,medicine.drug_class ,Muscle Relaxation ,030231 tropical medicine ,030232 urology & nephrology ,Urology ,Adrenergic beta-3 Receptor Agonists ,Stimulation ,03 medical and health sciences ,0302 clinical medicine ,Ureter ,Muscarinic acetylcholine receptor ,medicine ,Humans ,Urothelium ,business.industry ,General Medicine ,medicine.disease ,Thiazoles ,medicine.anatomical_structure ,Mechanism of action ,Overactive bladder ,Acetanilides ,medicine.symptom ,Mirabegron ,business ,medicine.drug - Abstract
Medical expulsive therapy (MET) is used especially in distal ureteral stones to reduce colics and decrease the number of endourological surgical interventions. A broad spectrum of agents can be used for the relaxation and the dilatation of the ureter, reducing the intraureteric pressure. Alfa-blockers, calcium channel blockers, phosphodiesterase (PDE) inhibitors, and spasmolytics have been shown as effective in clinical trials on urolithiasis. It is a fact that the urothelium itself, the interstitial cells and the ureteric smooth muscle, have B-beta-2 and beta-3 adrenoreceptors. Stimulation of these receptors results in relaxation of the ureter. A recent beta-3 agonist, mirabegron, is commonly used for overactive bladder nowadays. The mechanism of action is adrenergic agonism that affects with the storage phase of the bladder, without interfering the voiding phase, which is regulated by parasympathetic pathways, commonly muscarinic. Agonism of the beta-3 receptors in the ureter has been shown to decrease the intraluminal pressure. By this mechanism, mirabegron can be thought as an alternative MET agent. Acting through different pathways, and having low adverse effect profile, can be thought as the most striking advantages of mirabegron as a MET. In vitro and in vivo trials should be conducted to support this hypothesis.
- Published
- 2019
32. Predictive Value of the Platelet-To-Lymphocyte Ratio in Diagnosis of Prostate Cancer
- Author
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Özgür Haki Yüksel, Ayhan Verit, Caglar Yldirim, Serkan Akan, and Ahmet Urkmez
- Subjects
Male ,PCA3 ,Cancer Research ,medicine.medical_specialty ,Prostate biopsy ,Neutrophils ,Epidemiology ,Biopsy ,Prostatic Hyperplasia ,Urology ,Prostatitis ,urologic and male genital diseases ,Prostate cancer ,Predictive Value of Tests ,Prostate ,Humans ,Medicine ,Outpatient clinic ,Lymphocyte Count ,Neutrophil to lymphocyte ratio ,Aged ,Retrospective Studies ,Gynecology ,medicine.diagnostic_test ,Platelet Count ,business.industry ,Public Health, Environmental and Occupational Health ,Prostatic Neoplasms ,Middle Aged ,Prostate-Specific Antigen ,medicine.disease ,Prostate-specific antigen ,medicine.anatomical_structure ,Oncology ,Neoplasm Grading ,business - Abstract
To predict prostatic carcinoma using a logistic regression model on prebiopsy peripheral blood samples.Data of a total of 873 patients who consulted Urology Outpatient Clinics of Fatih Sultan Mehmet Training and Research Hospital between February 2008 and April 2014 scheduled for prostate biopsy were screened retrospectively. PSA levels, prostate volumes, prebiopsy whole blood cell counts, neutrophil and platelet counts, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), biopsy results and Gleason scores in patients who had established diagnosis of prostate cancer (PCa) were evaluated.This study was performed on a total of 873 cases, with an age range 48-76 years, divided into three groups as for biopsy results. with diagnoses of benign prostatic hyperplasia (BPH) (n=304, 34.8 %), PCa (n=265, 30.4%) and histological prostatitis (n=304; 34.8%). Intra- and intergroup comparative evaluations were performed. White blood cell and neutrophil counts in the histological prostatitis group were significantly higher than those of the BPH and PCa groups (p=0.001; p=0.004; p0.01). A statistically significant intergroup difference was found for PLR (p=0.041; p0.05) but not lymphocyte count (p0.05). According to pairwise comparisons, PLR were significantly higher in the PCa group relative to BPH group (p=0.018, p0.05, respectively). Though not statistically significant, higher PLR in cases with PCa in comparison with the prostatitis group was remarkable (p=0.067, and p0.05, respectively).Meta-analyses showed that in patients with PSA levels over 4 ng/ml, positive predictive value of PSA is only 25 percent. Therefore, novel markers which can both detect clinically significant prostate cancer, and also prevent unnecessary biopsies are needed. Relevant to this issue in addition to PSA density, velocity, and PCA3, various markers have been analyzed. In the present study, PLR were found to be the additional predictor of prostatic carcinoma.
- Published
- 2015
33. The role of physical activity in the treatment of erectile dysfunction
- Author
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Özgür Haki Yüksel, İlknur Aktaş, Özge Gülsüm Memetoğlu, Ahmet Urkmez, and Ayhan Verit
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,Physical exercise ,medicine.disease ,Erectile dysfunction ,Reproductive Medicine ,Quality of life ,medicine ,Physical therapy ,Outpatient clinic ,Aerobic exercise ,Prospective cohort study ,business ,Body mass index ,Depression (differential diagnoses) - Abstract
Objective To compare the effect of phosphodiesterase inhibitors and physical exercise alone in patients with erectile dysfunction (ED). Materials and methods A total of 60 patients with a satisfactory cardiopulmonary performance who consulted the outpatient clinics of Urology and Physical Therapy and Rehabilitation were included in the prospective study. In the study, 30 patients were scheduled for 6 weeks of vigorous aerobic exercise program to be carried out for 75 min a day, 3 days a week. The remaining 30 patients received only an oral form of a phosphodiesterase inhibitor. All patients completed International Index of Erectile Function (IIEF) and quality of life (SF-36) forms before and after the treatment. Results Median age of the patients was 55.63 ± 12.93 years with body mass index ranging between 18.99 and 35.86 kg/m2. A statistically significant increase has been observed for IIEF-5 and SF-36 scores both in the physical exercise and medical treatment groups. However, in the medical treatment group post-treatment variation in IIEF-5 and SF-36 mental scores in the medical treatment group were statistically significantly higher when compared with the physical exercise group. Increase in physical SF-36 scores in the physical exercise group was more prominent without any statistically significant difference between groups. Conclusion Emerging evidence indicates that exercise has a positive effect for improving many factors in men with erectile dysfunction including changes in body composition, physical function, risk of comorbid conditions, depression, quality of life and an increase in pelvic oxygenation and penile blood flow, and thus before or during the treatment with a phosphodiesterase inhibitor, regular physical activity should be recommend for all ED patients.
- Published
- 2015
34. What is the correct staging and treatment strategy for locally advanced prostate cancer extending to the bladder?
- Author
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Özgür Haki Yüksel, Ahmet Urkmez, and Ayhan Verit
- Subjects
Male ,Oncology ,medicine.medical_specialty ,Staging ,Bladder neck invasion ,Urology ,medicine.medical_treatment ,Pain ,Hydronephrosis ,Cystectomy ,lcsh:RC870-923 ,Cystoprostatectomy ,Androgen deprivation therapy ,Prostate cancer ,Locally advanced prostate cancer ,Internal medicine ,medicine ,Humans ,Neoplasm Invasiveness ,Survival analysis ,Neoplasm Staging ,Prostatectomy ,Urinary retention ,business.industry ,Prostatic Neoplasms ,Urinary Retention ,medicine.disease ,lcsh:Diseases of the genitourinary system. Urology ,Survival Analysis ,Radical prostatectomy ,Neck of urinary bladder ,Treatment Outcome ,Urinary Bladder Neoplasms ,Quality of Life ,medicine.symptom ,business - Abstract
In locally advanced prostate cancer with bladder invasion, frequently encountered problems such as bleeding, urinary retention, hydronephrosis, and pain create distress for the patients. Therefore patients’ quality of life is disrupted and duration of hospitalization is prolonged. Relevant literature about accurate staging and treatment of locally advanced prostate cancer with bladder invasion was investigated. Locally advanced prostate cancer can present as a large-volume aggressive tumor extending beyond boundaries of prostate gland, and involving neighboring structures which can be involved as recurrence(s) following initial local therapy. Survival times of these patients can range between 5 and 8 years. Their common characteristics are adverse and severe local symptoms unfavorably affecting quality of life Control of local symptoms and their effective palliation are independent clinical targets influencing survival outcomes of these patients. The treatment outcomes of locally advanced prostate cancer into the bladder are currently debatable. Although in the current TNM classification, it is defined in T4a, we think that this may be categorized as a subgroup of T3 and thus encourage surgeons for the indication of radical surgeries (radical prostatectomy, radical cystoprostatectomy) in selected patient populations after discussing issues concerning consequences of the treatment alternatives, and expectations with the patients. Cystoprostatectomy followed by immediate androgen deprivation therapy may be a feasible option for selected patients with previously untreated prostate cancer involving the bladder neck because of excellent local control and long term survival.
- Published
- 2015
35. The role of Cajal cells in chronic prostatitis
- Author
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Özgür Haki Yüksel, Ayhan Verit, and Ahmet Urkmez
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,Urology ,030232 urology & nephrology ,Prostatitis ,Apoptosis ,lcsh:RC870-923 ,03 medical and health sciences ,symbols.namesake ,0302 clinical medicine ,Prostate ,Prostatic urethra ,medicine ,Animals ,Humans ,Secretion ,business.industry ,Interstitial Cells of Cajal ,medicine.disease ,lcsh:Diseases of the genitourinary system. Urology ,Interstitial cell of Cajal ,medicine.anatomical_structure ,Urethra ,Cajal cells ,030220 oncology & carcinogenesis ,Chronic Disease ,symbols ,Mast cells ,Glandular secretion ,business - Abstract
Types of prostatitis can be defined as groups of syndromes in adult men associated with infectious and noninfectious causes characterized frequently by lower abdominal and perineal signs and diverse clinical symptoms and complications. Etiopathogenesis of chronic prostatitis is not well defined. Moreover, its treatment outcomes are not satisfactory. Presence of c-kit positive interstitial cells in human prostate is already known. It has been demonstrated that these cells can be pacemaker cells which trigger spontaneous slow-wave electrical activity in the prostate and can be responsible for the transport of glandular secretion from acinar cells into major and minor prostatic ducts and finally into urethra. In the light of all these data, when presence of a possible inflammatory pathology is thought to involve prostate that secretes and has a reservoir which drains its secretion (for prostate, prostatic urethra), two points are worth mentioning. Impairment of secretion mechanism and collection of secretion within the organ with reflux of the microbial material from its reservoir back into prostate gland. Both of these potential conditions can be explained by ductal neuromuscular mechanism, which induces secretion. We think that in this neuromuscular mechanism interstitial Cajal cells have an important role in chronic prostatitis. Our hypothesis is that curability of prostatitis is correlated with the number of Cajal cells not subjected to apoptosis.
- Published
- 2016
36. A case of Fournier's gangrene after inguinal hernia repair
- Author
-
Serkan Akan, Ahmet Urkmez, Özgür Haki Yüksel, and Ayhan Verit
- Subjects
Gangrene ,medicine.medical_specialty ,Polymicrobial infection ,business.industry ,Urology ,General surgery ,medicine.disease ,Surgery ,03 medical and health sciences ,Inguinal hernia ,0302 clinical medicine ,Reproductive Medicine ,Fournier s gangrene ,030220 oncology & carcinogenesis ,Rare case ,medicine ,030212 general & internal medicine ,business ,Fasciitis - Abstract
Fournier's gangrene is a polymicrobial infection of perineal and scrotal regions that manifests as a rapidly progressive necrotizing fasciitis. Fournier's gangrene following a surgical procedure is not frequently seen. We report a very rare case of Fournier's gangrene following inguinal hernia repair.
- Published
- 2016
37. A case of seminoma presented with clinical manifestations of testicular torsion
- Author
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Aytac Sahin, Ahmet Urkmez, Özgür Haki Yüksel, Caglar Yildirim, and Serkan Akan
- Subjects
Adult ,Male ,endocrine system ,medicine.medical_specialty ,Testicular torsion ,endocrine system diseases ,Urology ,Physical examination ,Acute scrotum ,lcsh:RC870-923 ,urologic and male genital diseases ,Diagnosis, Differential ,Testicular Neoplasms ,medicine ,Humans ,Orchiectomy ,Spermatic Cord Torsion ,Anamnesis ,medicine.diagnostic_test ,urogenital system ,business.industry ,Ultrasonography, Doppler ,Seminoma ,lcsh:Diseases of the genitourinary system. Urology ,medicine.disease ,Scrotum ,Radiology ,Differential diagnosis ,Presentation (obstetrics) ,business - Abstract
Testicular tumors rarely manifest themselves with clinical picture of testicular torsion. In this presentation of ours, we reported a 30-year-old patient whose post-orchiectomy histopathology report revealed the presence of seminoma. The patient consulted us with acute scrotum whose physical examination and Doppler ultrasonographic findings showed testicular torsion. Though rarely seen patients, in cases who consulted with acute scrotum, the possibility of testicular tumor should not be discarded. For the establishment of differential diagnosis detailed anamnesis and physical examination findings should be supported with laboratory tests and imaging modalities.
- Published
- 2017
38. Circumcision and its potential effects on children's mental health state
- Author
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M. Yasin Irmak, Fatih Uruç, Ayhan Verit, Aytac Sahin, Bekir Aras, Caglar Yildirim, Ahmet Urkmez, Omer Yanartas, and O. Haki Yuksel
- Subjects
medicine.medical_specialty ,Pediatrics ,business.industry ,Depression ,Urology ,Strengths and Difficulties Questionnaire ,Anxiety ,Mental health ,Childhood ,03 medical and health sciences ,0302 clinical medicine ,Reproductive Medicine ,Circumcision ,Anxiety sensitivity ,Medicine ,Premedication ,030212 general & internal medicine ,medicine.symptom ,business ,Prospective cohort study ,Psychiatry ,Socioeconomic status ,030217 neurology & neurosurgery ,Depression (differential diagnoses) - Abstract
WOS: 000413061800001, Objectives: Circumcision is one of the oldest elective surgical interventions in the history of mankind. Though many studies have been conducted on the surgical complications of circumcision, the potential effects on the mental state of the children has not been satisfactorily reviewed. In this prospective study, we analyzed potential effects of circumcision on their mental state, anxiety levels and moods using updated scales. Material and methods: One hundred and two male children aged between 6 and 8 and their families were included in the study. Children with their families completed sociodemographic data form Anxiety Sensitivity Index For Children, the Strengths and Difficulties Questionnaire (SDQ), Depression Scale for Children during the preoperative period. All children received oral 0.5 mg/kg midazolam as a premedication before circumcision procedure. Circumcisions were performed under general anesthesia in the operating room. During the 6th week of the postoperative period, the children and their families were returned to the facility and parents were asked to complete the questionnaire again. Results: Mean score of the preoperative depression scale was statistically and significantly higher than the mean postoperative depression scale score (P=0.001; P
- Published
- 2017
39. Prognostic value of thiol/disulphide homeostasis in predicting testicular ischaemia-reperfusion injury in rats
- Author
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Metin İshak Öztürk, Gulistan Gumrukcu, Ramazan Topaktaş, Ozcan Erel, Ahmet Urkmez, and Musab Ali Kutluhan
- Subjects
Male ,medicine.medical_specialty ,Ischaemia-reperfusion injury ,Urology ,030232 urology & nephrology ,Ischemia ,Sham group ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Predictive Value of Tests ,Internal medicine ,Testis ,medicine ,Animals ,Humans ,Testicular torsion ,Disulfides ,Sulfhydryl Compounds ,Rats, Wistar ,Thiol disulphide homeostasis ,Spermatic Cord Torsion ,chemistry.chemical_classification ,030219 obstetrics & reproductive medicine ,business.industry ,General Medicine ,Venous blood ,Prognosis ,medicine.disease ,Rats ,Disease Models, Animal ,chemistry ,Reperfusion Injury ,Thiol ,business ,Homeostasis - Abstract
Testicular torsion is a surgical emergency and the testicular salvage rate through surgical detorsion ranges from 42% to 88%. However, it is not known to what extent spermatogenic function is preserved in these testes. The purpose of the study was to demonstrate the prognostic value of thiol/disulphide homeostasis in rats for testicular ischaemia and ischaemia-reperfusion injury during early and late stages. A total of 21 Wistar albino rats were randomly divided into three groups. The 4 and 8-hr T/D (torsion/detorsion) groups were subjected to left testicular torsion by twisting the testes by 720° counterclockwise direction. The 2 cc venous blood samples were also collected from the 4 and 8-hr T/D groups after 4 and 8 hr respectively. It was determined that the native thiol, total thiol and disulphide values of 4 and 8-hr T/D group before detorsion were significantly lower than those of the sham group (p: 0.006; p: 0.003; p: 0.003). In the 8-hr T/D group, there was a positive statistically significant relationship at an 88.3% level between Johnsen's score and total thiol values before detorsion (p: 0.008). Our study showed that thiol/disulphide homeostasis may be a haematologic parameter in predicting testicular ischaemia and histopathologic injury in the testes following ischaemia-reperfusion.
- Published
- 2018
40. Parameters that affect the outcome of patients undergoing microTESTE because of infertility
- Author
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Orhan Koca, Metin İshak Öztürk, N. Delikara, S. Karabulut, Musab Ali Kutluhan, and Ahmet Urkmez
- Subjects
Infertility ,medicine.medical_specialty ,business.industry ,Urology ,Internal medicine ,Medicine ,business ,Affect (psychology) ,medicine.disease ,Outcome (game theory) - Published
- 2017
41. Contralateral tumor seeding of renal cell carcinoma mimicking late metastasis of liver after laparoscopic nephrectomy: A case report with review of the literature
- Author
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Serkan Akan, Ahmet Urkmez, Caglar Yildirim, Ayhan Verit, and Özgür Haki Yüksel
- Subjects
Laparoscopic surgery ,Male ,Reoperation ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Laparoscopic radical nephrectomy ,Neoplasm Seeding ,lcsh:RC870-923 ,Nephrectomy ,Metastasis ,Tumor seeding ,Peritoneal Neoplasm ,Peritoneal implant ,Renal cell carcinoma ,medicine ,Humans ,Laparoscopy ,Carcinoma, Renal Cell ,Peritoneal Neoplasms ,Aged ,Neoplasm Staging ,Renal cell cancer ,medicine.diagnostic_test ,business.industry ,Liver Neoplasms ,lcsh:Diseases of the genitourinary system. Urology ,medicine.disease ,Kidney Neoplasms ,Surgery ,Treatment Outcome ,Neoplasm Grading ,business - Abstract
Laparoscopic surgery has been increasingly used every day in the management of urologic malignancies. Even though it seems as a minimally invasive surgery, during these interventions tumor seeding, as seen in open surgery, confronts us as a rarely seen serious risk. Herein, we have reported a case who demonstrated peritoneal tumor implantation at 12 month postoperative follow up after laparoscopic radical nephrectomy (LRN) performed for Furhman grade 1 (T2N0M0) renal cell cancer.
- Published
- 2015
42. Emphysematous pyelonephritis: Our experience in managing these cases
- Author
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Caglar Yildirim, Ayhan Verit, Ahmet Urkmez, Aytac Sahin, Fatih Uruç, and Özgür Haki Yüksel
- Subjects
medicine.medical_specialty ,business.industry ,Nausea ,Urology ,Mortality rate ,medicine.medical_treatment ,Type 2 Diabetes Mellitus ,Urine ,Nephrectomy ,Surgery ,medicine.anatomical_structure ,Oncology ,Percutaneous nephrostomy ,White blood cell ,medicine ,Vomiting ,Case Series ,medicine.symptom ,business - Abstract
Introduction: Emphysematous pyelonephritis (EPN) is a rare acute necrotising infection of renal parenchyma. We discuss clinical details and treatment strategies of 8 patients with EPN followed at our clinic.Methods: We retrospectively reviewed the clinical, laboratory, radiological findings and treatment modalities of 8 patients with EPN followed at our urology clinic between 2012 and 2015.Results: The mean patient age (female: 5; male: 3) was 62 (range: 51–82) years. Based on computed tomographic findings, EPN was classified as class 1 (n = 3), class 2 (n = 3) and class 3a (n = 2). All patients had fever, flank pain, nausea, and vomiting. Five patients had type 2 diabetes mellitus and 3 diabetic patients also had renal stones. Escherichia coli (n = 6), Klebsiella species (n = 1), and Proteus species (n = 1) were grown in urine cultures. All patients had unilateral involvement. Increased white blood cell counts, sedimentation rate, and C-reactive protein levels were detected in all cases. In addition to medical treatment, 2 patients underwent a nephrostomy catheter placement and another 2 patients underwent nephrectomy upon deterioration of her general health state. After achieving clinical stabilization with medical treatment, 1 patient underwent endoscopic ureteral stone treatment. The remaining 3 cases were treated only with antibiotherapy. All patients were discharged with clinical cure.Conclusion: Mortality rates of EPN are gradually decreasing. Preservation of renal reserve is possible due to early diagnosis, appropriate antibiotherapy, and drainage.
- Published
- 2015
43. Extraintestinal gastrointestinal stromal tumor of undetermined origin: Is the mass resection a wrong approach? A case report and review of the literature
- Author
-
Ayhan Verit, Serkan Akan, Ahmet Urkmez, Caglar Yildirim, and Özgür Haki Yüksel
- Subjects
Male ,Pathology ,medicine.medical_specialty ,Gastrointestinal Stromal Tumors ,Urology ,Antineoplastic Agents ,Gastrointestinal system ,lcsh:RC870-923 ,Mass extirpation ,Piperazines ,Resection ,Prostate ,medicine ,Humans ,Radical surgery ,Stromal tumor ,Aged ,Pelvic Neoplasms ,Postoperative Care ,Prostatectomy ,GiST ,business.industry ,Gallbladder ,Prostatic Neoplasms ,lcsh:Diseases of the genitourinary system. Urology ,medicine.anatomical_structure ,Pyrimidines ,Treatment Outcome ,Male patient ,Benzamides ,Imatinib Mesylate ,Extragastrointestinal stromal tumor ,business - Abstract
Gastrointestinal stromal tumor (GIST) was first defined by Mazur et al. in 1983. GIST is evaluated among tumoral lesions that can be acquired or congenital. Those not associated with gastrointestinal system are termed as extragastrointestinal stromal tumor (EGIST). EGISTs can develop on intraperitoneal spaces as omentum, mesenterium and gallbladder and they can occur on retroperitoneum, extraperitoneal (prostate) and intrapelvic organs. Herein, we present a case with EGIST in a 65-year-old male patient located in intrapelvic and retroprostatic area which had no connection with gastrointestinal system as assessed by radiological methods and we discuss its treatment. We reviewed the literature and observed that ours is the first case report on a patient in which the mass was only extirpated rather than performing radical surgery. He is still at the 2. year of his follow-up period without any disease recurrence.
- Published
- 2015
44. Lower pole renal cut injury due to the iliac wing fracture: A rare case report
- Author
-
Ayhan Verit, Serkan Akan, Özgür Haki Yüksel, Ahmet Urkmez, and Caglar Yildirim
- Subjects
Adult ,medicine.medical_specialty ,Urology ,Wounds, Penetrating ,Lower pole renal trauma ,lcsh:RC870-923 ,Kidney ,Wounds, Nonpenetrating ,Body Mass Index ,Ilium ,Fractures, Bone ,Blunt ,Fatal Outcome ,Rare Diseases ,Risk Factors ,Rare case ,medicine ,Humans ,Obesity ,Pelvic Bones ,Left kidney ,Fractures, Comminuted ,Iliac wing fracture ,Genitourinary system ,business.industry ,Multiple Trauma ,Lower pole ,Shock ,lcsh:Diseases of the genitourinary system. Urology ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Iliac wing ,Pelvic fracture ,Accidental Falls ,Female ,business - Abstract
The most frequent causes of blunt genitourinary injuries are falls from heights, motor vehicle accidents and sports injuries. Firearm injuries and penetrating stab wounds are also frequently encountered. Skeletal system traumas in the vicinity of the urogenital system can cause urological organ injuries. Though rarely, renal traumas can be dependent on the kinetic energy of the trauma and the retroperitoneal movement capacity of the kidneys and cannot be explained with the proximity of the kidney to the skeletal system. In cases with high-energy decelerations, renal pedicle and ureteropelvic junction traumas are more frequently observed. Herein, we presented a grade 3 left kidney lower pole injury developed secondary to A2 type pelvic fracture following a high energy deceleration trauma. It should not be forgotten that especially in this type of fractures, injuries of the lower renal pole can occur.
- Published
- 2015
45. The role of steroid treatment in intractable cystitis glandularis: A case report and literature review
- Author
-
Ayhan Verit, Ahmet Urkmez, Tibet Erdogru, and Özgür Haki Yüksel
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Urology ,medicine.medical_treatment ,Case Report ,Cystoscopy ,Urinary bladder epithelium ,medicine.disease ,Surgery ,Cystectomy ,Neck of urinary bladder ,Oncology ,Medicine ,Trigone of urinary bladder ,business ,Hydronephrosis ,Cystitis glandularis ,Upper urinary tract - Abstract
Cystitis glandularis is a proliferative disease of the urinary bladder epithelium. It is rare in children. We report a case of a 23-yearold female with intractable macroscopic hematuria and severe irritative bladder symptoms persisting for 13 years. The patient, who had undergone open and endoscopic bladder surgery at various medical centres, is currently being followed up at our clinic. Cystoscopy revealed multiple edematous papillary tumours on the bladder neck, trigone, and lateral wall on both sides and she underwent transurethral resection of the bladder tumour. The pathological diagnosis was cystitis glandularis in accordance with the histopathological reports obtained from the other medical centres. Her condition was resistant to transurethral resection, partial cystectomy, intravesical mitomycin, and bacillus Calmette-Guerin (BCG) treatment; it eventually could have affected the upper urinary tract. Oral steroid treatment was given for 6 months; after treatment, her symptoms improved and the cystoscopy revealed a dramatic improvement in her condition.
- Published
- 2015
46. Androgen secreting giant adrenocortical carcinoma with no metastases: A case report and review of the literature
- Author
-
Fatih Uruç, Özgür Haki Yüksel, Ayhan Verit, Aytac Sahin, and Ahmet Urkmez
- Subjects
medicine.medical_specialty ,Pathology ,Abdominal pain ,medicine.drug_class ,business.industry ,Urology ,Virilization ,Case Report ,Androgen ,medicine.disease ,behavioral disciplines and activities ,Cushing syndrome ,stomatognathic diseases ,Oncology ,nervous system ,medicine ,Adrenocortical carcinoma ,Histopathology ,Mitotane ,medicine.symptom ,business ,human activities ,psychological phenomena and processes ,Rare disease ,medicine.drug - Abstract
Functional adrenocortical carcinoma (ACC) is a very rare disease with a poor prognosis. Over half (60%) of ACCs bigger than 6 cm synthesize hormones; hormone-secreting ACCs generally include virilization, feminization or Cushing syndrome. Besides, 82% of ACCs are metastatic at the time of diagnosis. While a 48-year-old female patient was examined for abdominal pain and flushing, we detected a non-metastasizing mass (23 × 18 × 16 cm) in the adrenal lodge. The mass was extracted en bloc during open exploration and its histopathology was reported as ACC. We review the literature and report the largest androgen-producing, clinically silent ACC mass cited in the literature so far.
- Published
- 2015
47. The relationships between metabolic syndrome, erectile dysfunction and lower urinary tract symptoms associated with benign prostatic hyperplasia
- Author
-
Bekir Aras, Mithat Kivrak, Sabahattin Aydin, Fatih Uruç, Ahmet Urkmez, Aytac Sahin, Numan Doğu Güner, and Yunus Doğan
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,medicine.disease ,Metabolic syndrome ,Andrology ,symbols.namesake ,Üroloji ve Nefroloji ,Erectile dysfunction ,Lower urinary tract symptoms ,medicine ,symbols ,Outpatient clinic ,International Prostate Symptom Score ,Analysis of variance ,business ,National Cholesterol Education Program ,Fisher's exact test - Abstract
Amaç: Benign prostat hiperplazisi (BPH) nedeni ile alt üriner sistem semptomları (AÜSS) olan hastalarda, erektil disfonksiyon (ED) ve metabolik sendrom (MetS) arasındaki ilişkinin belirlenmesi amaçlanmıştır. Gereç ve yöntemler: Polikliniğimize BPH’ya bağlı AÜSS nedeniyle başvuran 40 yaş üstü 78 hasta çalışma- ya kabul edildi. Hastalara AÜSS ve ED değerlendirilmesi için sırası ile uluslararası prostat semptom skoru (IPSS), Uluslararası erektil fonksiyon indeksi (IIEF-5) formları dolduruldu. MetS tanısı için the National Cholesterol Education Program Adult Treatment Panel III kriteri kullanıldı. AÜSS, IPSS’a göre hafif, orta ve şiddetli olarak, ED ise IIEF-5 skoruna göre ise hafif, orta-hafif, orta, şiddetli gruplarına ayrılarak incelendi. Bu üç durumun birbirleri ile ve yaşa göre ilişkilerin değerlendirilmesinde Student’s t test, Mann-Whitney U, ANOVA, ki-kare, Fisher Exact testi ve Pearson korelasyon analizi kullanıldı. P, Objective: To determine the relationship between erectile dysfunction and metabolic syndrome (MetS) in patients with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). Material and methods: Seventy-eight patients who were admitted to our outpatient clinic because of BPH- related LUTS over 40 years of age were included in the study. Patients with LUTS and erectile dysfunction (ED) were evaluated by International Prostate Symptom Score (IPSS) and International Index of Erectile Function-5 (IIEF-5) forms. The National Cholesterol Education Program Adult Treatment Panel III criteria was used for the diagnosis of MetS. LUTS were classified as mild, moderate, and severe according to IPSS and ED was classified as mild- moderate, moderate, and severe according to the IIEF-5. For the evaluation of data, descriptive statistical methods (mean, standard deviation, median, frequency, ratio, minimum, and maximum) and also for the comparison of the variables with non-normal distribution in 3 or more than 3 groups Student’s t test, Mann-Whitney U, ANOVA, chi-square, Fisher Exact tests, and Pearson correlation analysis were used. P0.05). There was a positive correlation with age and severity of LUTS but this relationship was not found to be sta- tistically significant (p>0.05). Mean age of the patients with ED was significantly higher than those without (p
- Published
- 2015
48. Is it possible to distinguish testicular torsion from other causes of acute scrotum in patients who underwent scrotal exploration? A multi-center clinical trial
- Author
-
Fatih Uruç, Muammer Altok, Muzaffer Oğuz Keleş, Zülfü Sertkaya, Mehmet Akyüz, Ercan Baş, Ahmet Urkmez, Cemal Selcuk İşoğlu, Mustafa Güneş, Mehmet Umul, and Bekir Aras
- Subjects
medicine.medical_specialty ,endocrine system ,Urology ,Physical examination ,urologic and male genital diseases ,Statistical significance ,medicine ,Testicular torsion ,epididymoorchitis ,Orchiectomy ,Original Paper ,medicine.diagnostic_test ,business.industry ,urogenital system ,General Medicine ,Testicular trauma ,medicine.disease ,Pyuria ,testicular torsion ,Surgery ,Clinical trial ,torsion of testicular appendages ,acute scrotum ,medicine.symptom ,Differential diagnosis ,business - Abstract
Introduction To assess the clinical presentation of patients who underwent surgical exploration for acute scrotum and to investigate the potentially related factors for differential dignosis. Material and methods We retrospectively analyzed the medical records of 97 patients who underwent surgical exploration for acute scrotum between May 2007 and July 2013. The patients were divided into two groups as follows: Group1 included patients with testicular torsion (TT) and Group 2 contained patients with acute scrotal pathologies other than TT, including torsion of the testicular appendage, epid-idymo-orchitis, trauma and Henoch-Schönlein purpura. The physical examination findings, colour Doppler ultrasound (CDUS) and laboratory findings for the groups were compared. Results In total, 97 scrotal explorations were carried out for acute scrotum. Group 1 included 72 patients (74.2%) and Group 2 included 25 patients (25.8%). Group 2 was comprised of patients with torsion of the testicular appendage (n = 13), epididymo-orchitis (n = 8), testicular trauma (n = 2) and Henoch-Schönlein purpura (n = 2). In Group 1, 32 cases (44.4%) presented to a hospital less than 6 hours after onset of pain.More than half (64%) of Group 2’s cases presented more than 24 hours after pain onset. Fever and pyuria appeared more frequently in Group 2 than in Group 1 and the results reached statistical significance (p = 0.001 and p = 0.044, respectively). Group 1 had more testicular tenderness than Group 2 (p
- Published
- 2015
49. Can perineural invasion detected in prostate needle biopsy specimens predict surgical margin positivity in D’Amico low risk patients?
- Author
-
Ayhan Verit, Ahmet Urkmez, and Özgür Haki Yüksel
- Subjects
Male ,medicine.medical_specialty ,Surgical margin ,Prostate needle biopsy ,Lymphovascular invasion ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Perineural invasion ,lcsh:RC870-923 ,Risk Assessment ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Prostate adenocarcinoma ,Biopsy ,Humans ,Medicine ,Neoplasm Invasiveness ,Aged ,Retrospective Studies ,Positive surgical margins ,Prostatectomy ,medicine.diagnostic_test ,business.industry ,Biopsy, Needle ,Margins of Excision ,Prostatic Neoplasms ,Middle Aged ,Prostate-Specific Antigen ,lcsh:Diseases of the genitourinary system. Urology ,Prognosis ,medicine.disease ,Surgery ,Prostate-specific antigen ,030220 oncology & carcinogenesis ,Neoplasm Grading ,business ,Radical retropubic prostatectomy - Abstract
Objectives: In this study, our aim was to estimate the value of perineural invasion (PNI) in prostate needle biopsy (PNB) specimens in the prediction of surgical margin positivity (SMP) and its prognostic significance (upgrade Gleason Score) in patients who had undergone radical retropubic prostatectomy (RRP) with low risk prostate cancer according to D’Amico risk assessment. Materials and Methods: We retrospectively analyzed the data of 65 patients who were diagnosed as clinical stage T1c prostate cancer (PC) and underwent RRP between January 2010 and June 2013. Pathological specimens of PNB and RRP were separately examined for the parameters of PNI, vascular invasion (VI), Gleason Score (GS) and SMP. Results: The patients’ mean age was 63.65 ± 4.93 (range 47- 75) years. PNI in PNB specimens were identified in 12 of 65 patients and 11 of 12 patients showed SMP on RRP specimens. While 53 of 65 patients had not PNI on PNB, only 11 of them demonstrated SMP on RRP specimens. SMP was 30.64-fold more frequently encountered in PNB specimens obtained from PNI-positive patients relative to PNI-negative patients. In our study, PNI detected in PNB specimens was statistically significantly associated with SMP on RRP specimens (P = 0.0001). Conclusion: It is well known that higher PSA values and GS were independent predictors of SMP in clinically localized prostate cancer (CLPC). We think that PNI in PNB specimens may be a useful prognostic factor for predicting SMP in cases with CLPC.
- Published
- 2016
50. 374 The history of establishment of Ottoman urological society in connection with European ones
- Author
-
Ahmet Urkmez, S. Tellaloglu, and Ayhan Verit
- Subjects
business.industry ,Urology ,Law ,Medicine ,business ,Connection (mathematics) - Published
- 2016
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