48 results on '"Kılıçarslan, Hakan"'
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2. Reliability of hypo-osmotic swelling test on fresh and frozen-thawed ejaculated or testicular immotile sperm: A sibling oocyte study
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Cakir, Cihan, Kuspinar, Goktan, Ganiyev, Alim, Aslan, Kiper, Kasapoglu, Isil, Kilicarslan, Hakan, Ata, Baris, Uncu, Gurkan, and Avcı, Berrin
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- 2024
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3. Renal stone composition does not affect the outcome of percutaneous nephrolithotomy in children
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Kaygısız, Onur, Türegün, Fethi Ahmet, Satar, Nihat, Özen, Ender, Toksöz, Serdar, Doğan, Hasan Serkan, Pişkin, Mehmet Mesut, İzol, Volkan, Sarıkaya, Şaban, Kılıçarslan, Hakan, Çiçek, Tufan, Öztürk, Ahmet, Tekgül, Serdar, and Önal, Bülent
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- 2018
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4. Penile Plication With or Without Degloving of the Penis Results in Similar Outcomes
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Kadirov, Rustam, Coskun, Burhan, Kaygisiz, Onur, Gunseren, Kadir Omur, Kordan, Yakup, Yavascaoglu, Ismet, and Kilicarslan, Hakan
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- 2017
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5. Comparison of intermediate- and low-frequency shock wave lithotripsy for pediatric kidney stones
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Kaygısız, Onur, Kılıçarslan, Hakan, Mert, Ahmet, Coşkun, Burhan, and Kordan, Yakup
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- 2018
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6. A Retrospective Analysis of 83 Patients with Testicular Mass Who Underwent Testis-Sparing Surgery: The Eurasian Uro-oncology Association Multicenter Study
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Keske, Murat, primary, Canda, Abdullah Erdem, additional, Karadag, Mert Ali, additional, Çiftçi, Halil, additional, Erturhan, Sakip, additional, Kactan, Cagri, additional, Soytas, Mustafa, additional, Özkaya, Fatih, additional, Ozbey, Isa, additional, Ordek, Eser, additional, Atmaca, Ali Fuat, additional, Yildirim, Asif, additional, Sahin, Selcuk, additional, colakoglu, yunus, additional, Boylu, Ugur, additional, Erol, Bulent, additional, Caskurlu, Turhan, additional, Kiremit, Murat Can, additional, Cakici, Ozer Ural, additional, Sonmez, Gokhan, additional, Kılıçarslan, Hakan, additional, Akbulut, Ziya, additional, Kaygısız, Onur, additional, Bedir, Selahattin, additional, Vuruskan, Hakan, additional, Bozkurt, Yunus Erol, additional, Aydin, Hasan Riza, additional, Oguz, Ural, additional, Basok, Erem Kaan, additional, Gumus, Bilal Habes, additional, Tuncel, Altug, additional, Aslan, Yilmaz, additional, Hamidi, Nurullah, additional, Müslümanoğlu, Ahmet Yaser, additional, Dinçer, Murat, additional, Balbay, Derya, additional, Albayrak, Selami, additional, and Laguna, Maria Pilar, additional
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- 2023
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7. Factors predicting postoperative febrile urinary tract infection following percutaneous nephrolithotomy in prepubertal children
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Kaygısız, Onur, Satar, Nihat, Güneş, Ali, Doğan, Hasan Serkan, Erözenci, Ahmet, Özden, Ender, Pişkin, Mehmet Mesut, Demirci, Deniz, Toksöz, Serdar, Çiçek, Tufan, Gürocak, Serhat, Kılıçarslan, Hakan, Nazlı, Oktay, Kefi, Aykut, İzol, Volkan, Beytur, Ali, Sarıkaya, Şaban, Tekgül, Serdar, and Önal, Bülent
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- 2018
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8. Is there a superiority of the stone volume measured in 3-D non-contrast tomography to the stone area in predicting the stone-freeness of the retrograde intrarenal surgery success?
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Kaynak, Yurdaer, Kılıçarslan, Hakan, Okeer, Emre, and Coşkun, Burhan
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KIDNEY stones ,TOMOGRAPHY ,KIDNEY surgery ,MEDICAL records ,MULTIVARIATE analysis - Abstract
Copyright of Pamukkale Medical Journal is the property of Pamukkale Journal of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2023
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9. Factors Affecting Complication Rates of Ureteroscopic Lithotripsy in Children: Results of Multi-Institutional Retrospective Analysis by Pediatric Stone Disease Study Group of Turkish Pediatric Urology Society
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Dogan, Hasan Serkan, Onal, Bulent, Satar, Nihat, Aygun, Cem, Piskin, Mesut, Tanriverdi, Orhan, Gurocak, Serhat, Gunay, Levent Mert, Burgu, Berk, Ozden, Ender, Nazli, Oktay, Erdem, Erim, Yucel, Selcuk, Kefi, Aykut, Demirci, Deniz, Uluocak, Nihat, Aridogan, Ibrahim Atilla, Turunc, Tahsin, Yalcin, Veli, Kilinc, Mehmet, Horasanli, Kaya, Tan, Mustafa Ozgur, Soygur, Tarkan, Sarikaya, Saban, Kilicarslan, Hakan, Turna, Burak, Doruk, Hasan Erdal, and Tekgul, Serdar
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- 2011
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10. 15 and 30 W Holmium:YAG Laser Lithotriptor in Ureteroscopic Lithotripsy: Which One Is More Effective and Safe?
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Kaygısız, Onur, primary, Aydın, Yavuz Mert, additional, Çiçek, Mehmet Çağatay, additional, Çelen, Sinan, additional, Coşkun, Burhan, additional, and Kılıçarslan, Hakan, additional
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- 2021
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11. Laparoscopic ureterolithotomy; an equally effective and a sensible alternative to flexible ureterorenoscopy in the management of large ureteral stones in terms of effectivity and cost.
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Günseren, Kadir, primary, Demir, Aslan, additional, Çiçek, Mehmet, additional, Yavaşcaoğlu, İsmet, additional, and Kılıçarslan, Hakan, additional
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- 2020
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12. A cut‐off value for the operation time and other risk factors in terms of the infection risk for flexible ureterorenoscopy
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Günseren, Kadir Ömür, primary, Demir, Aslan, additional, Celen, Sinan, additional, Çiçek, Mehmet Çağatay, additional, and Kılıçarslan, Hakan, additional
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- 2020
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13. Effect of Hypothyroidism on the NO/cGMP Pathway of Corpus Cavernosum in Rabbits
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Kilicarslan, Hakan, Bagcivan, Ihsan, Yildirim, M. Kemal, Sarac, Bulent, and Kaya, Tijen
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- 2006
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14. A CUT-OFF VALUE FOR THE OPERATION TIME AND THE OTHER RISK FACTORS IN TERMS OF THE INFECTION RISK FOR FURS
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Gunseren, Kadir, primary, Demir, Aslan, additional, Çelen, Sinan, additional, Çiçek, Mehmet Çağatay, additional, and Kılıçarslan, Hakan, additional
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- 2020
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15. LAPAROSCOPIC URETEROLITHOTOMY; AN EQUALLY EFFECTIVE AND A SENSIBLE ALTERNATIVE TO FLEXIBLE URETERORENOSCOPY IN THE MANAGEMENT OF LARGE URETERAL STONES IN TERMS OF EFFECTIVITY AND COST.
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Günseren, Kadir Ömür, Demir, Aslan, Çiçek, Mehmet Cağatay, Yavaşcaoğlu, İsmet, and Kılıçarslan, Hakan
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- 2021
16. A cut‐off value for the operation time and other risk factors in terms of the infection risk for flexible ureterorenoscopy.
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Günseren, Kadir Ömür, Demir, Aslan, Celen, Sinan, Çiçek, Mehmet Çağatay, and Kılıçarslan, Hakan
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Objectives: To investigate the operation time (OT) and ureteral access sheath (UAS) usage with the infection rates and to determine a cut‐off value for OT. Methods: We retrospectively analysed the data of the patients who underwent flexible ureterorenoscopy (FURS) for renal stones larger than 20 mm between 2010 and 2019. The investigated parameters were OT, UAS using, and infection status. The data were analysed by forming two groups according to whether the OT was less than 60 minutes and more, whether the UAS was used and whether an infection occurred. In addition, independent risk factors that may affect postoperative urinary infection development were also investigated by logistic regression analysis. And, a Receiver Operating Characteristic (ROC) curve analysis was applied to determine a cut‐off value in OT terms, where infection rates increase more. Results: A total of 575 patients were enrolled in the study. The rates of the usage of UAS and infection were greater statistically in the group for longer than 60 minutes. OT was longer statistically in the infection group than in the group without infection (94.1 ± 14.2 and 68.01 ± 23.1, for groups 1 and 2, respectively, P <.05, Table 2). OT was statistically longer in the UAS group than the unused one (79.3 ± 24.4 and 66.7 ± 22.4, for groups 1 and 2, respectively, P <.05, Table 3). ROC analyses revealed a cut‐off point of 87.5 min for OT in terms of infection rate. Conclusion: While the infection risk increases when OT exceeds 60 minutes, FURS can be safely performed up to 87.5 minutes with 89% sensitivity and 69% specificity infection risk. [ABSTRACT FROM AUTHOR]
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- 2021
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17. Diode laser in the treatment of benign prostatic enlargement: a preliminary study
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Hakan Kilicarslan, Hakan Vuruşkan, Vuruşkan Hakan, Yavaşcaoğlu İsmet, Oktay Bülent, Kılıçarslan Hakan, Hasan Serkan Dogan, Yakup Kordan, Ismet Yavascaoglu, and Bülent Oktay
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business.industry ,law ,Urology ,Medicine ,Nuclear medicine ,business ,Laser ,Prostatic enlargement ,Diode ,law.invention - Published
- 2011
18. Comparison of intermediate- and low-frequency shock wave lithotripsy for pediatric kidney stones
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Kaygısız, Onur, primary, Kılıçarslan, Hakan, additional, Mert, Ahmet, additional, Coşkun, Burhan, additional, and Kordan, Yakup, additional
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- 2017
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19. Evaluation of Nephrolithiasis Risk Factors in Autosomal Dominant Polycystic Kidney Disease (ADPKD): A Single Center Experience
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Kaygısız, Onur, primary, Coşkun, Burhan, additional, Oruç, Ayşegül, additional, Gedik, Cemil Cihad, additional, Ersoy, Alparslan, additional, Kordan, Yakup, additional, Kılıçarslan, Hakan, additional, and Yıldız, Abdülmecit, additional
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- 2017
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20. Effect of ADMA levels on severity of erectile dysfunction in chronic kidney disease and other risk factors
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Gökçen, Kaan, primary, Kılıçarslan, Hakan, additional, Coşkun, Burhan, additional, Ersoy, Alparslan, additional, Kaygısız, Onur, additional, and Kordan, Yakup, additional
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- 2016
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21. Evaluation of Nephrolithiasis Risk Factors in Autosomal Dominant Polycystic Kidney Disease (ADPKD): A Single Center Experience.
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Kaygısız, Onur, Coşkun, Burhan, Oruç, Ayşegül, Gedik, Cemil Cihad, Ersoy, Alparslan, Kordan, Yakup, Kılıçarslan, Hakan, and Yıldız, Abdülmecit
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POLYCYSTIC kidney disease ,KIDNEY stone risk factors ,GENETIC disorders ,GENETICS - Abstract
Copyright of Okmeydani Tip Dergisi / Medical Journal of Okmeydani Training & Research Hospital is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2018
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22. Proksimale Migrate olan Taşlı Double-J Kateterin Fleksible Üreterorenoskopi ile Tedavisi
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Kılıçarslan, Hakan, primary, Kaygısız, Onur, additional, Çelen, Sinan, additional, and Kanat, Feyzi Mutlu, additional
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- 2015
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23. Comparison of Ureteroscopic Laser Lithotripsy with Laparoscopic Ureterolithotomy for Large Proximal and Mid-Ureter Stones
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Kaygısız, Onur, primary, Coşkun, Burhan, additional, Kılıçarslan, Hakan, additional, Kordan, Yakup, additional, Vuruşkan, Hakan, additional, Özmerdiven, Gökhun, additional, and Yavaşcaoğlu, İsmet, additional
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- 2015
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24. Comparison of patient satisfaction rates for the malleable and two piece-inflatable penile prostheses.
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Kılıçarslan, Hakan, Kaynak, Yurdaer, Gökcen, Kaan, Coşkun, Burhan, and Kaygısız, Onur
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PENILE prostheses , *IMPOTENCE , *TREATMENT of sexual dysfunction , *PATIENT satisfaction , *QUESTIONNAIRES , *DESCRIPTIVE statistics - Abstract
Objective: To compare patient/partner satisfaction with AMS 600-650 and AMS Ambicore penile implants (American Medical Systems, Minneapolis, USA) in patients with erectile dysfunction. Material and methods: The modified Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaires at six months after implantation of 46 patients who underwent AMS 600-650 (n=23) or Ambicore placement (n=23) between 1/1/2008 and 1/1/2013 were analyzed. Results: The percentages of patients with AMS 600-650 who reported to be satisfied, very satisfied and neither satisfied nor dissatisfied with their prostheses were 34.78% (n=8), 30.43% (n=7) and 34.78% (n=8), respectively. For patients with AMS Ambicore, these percentages were 73.91% (n=17), 13.04% (n=3) and 13.04% (n=3), respectively. These overall satisfaction rates were significantly different between patients with AMS 600-650 and Ambicore (p=0.013). For patients with AMS 600-650, the percentages of patients who reported to be very likely, neither likely nor unlikely, or very unlikely to continue using their prosthesis were 30.43% (n=7), 34.78% (n=8), and 34.78% (n=8) while for patients with AMS Ambicore, these percentages were 65.21%, 21.33%, and 13.04%, respectively. These percentages were different between patients with AMS 600-650 and Ambicore (p=0.018). Conclusion: The two-piece inflatable penile prosthesis was found to be more successful in overall satisfaction and more likely for continued use when compared to the malleable penile prosthesis. [ABSTRACT FROM AUTHOR]
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- 2014
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25. Çocuk hastada perkütan nefrolitotomi sırasında oluşan kolon perforasyonu ve tedavisi.
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Doğan, Hasan Serkan, Kılıçarslan, Hakan, and Oktay, Bülent
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- 2009
26. The survival of flexible ureterorenoscopes in terms of the total stone area and total usage time
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Kadir Ömür Günseren, Aslan Demir, Hakan Kilicarslan, Mehmet Çağatay Çiçek, Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı., Günseren, Kadir Ömür, Kılıçarslan, Hakan, Çiçek, Mehmet Çağatay, ABC-9924-2020, and DEMİR, ASLAN
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Adult ,Male ,Ureter stone ,Survival ,Gunseren K. O. , Cicek M. C. , Kilicarslan H., DEMİR A., -The Survival of Flexible Ureterorenoscopes in Terms of the Total Stone Area and Total Usage Time-, JOURNAL OF ENDOUROLOGY, cilt.34, ss.567-572, 2020 ,Urology ,030232 urology & nephrology ,Laser ,Major clinical study ,Kidney ,Nephrolithiasis ,Ultrasonic Lithotripsy ,Percutaneous Nephrolithotomy ,Durability ,Article ,The survival of the flexible ureterorenoscope ,03 medical and health sciences ,0302 clinical medicine ,Urolithiasis ,The durability of the flexible ureterorenoscope ,Tertiary care center ,Statistics ,Ureteroscopy ,Medicine ,Cutoff ,Humans ,Urology & nephrology ,Flexible ureterorenoscope ,Middle aged ,Priority journal ,business.industry ,Patient safety ,Retrospective study ,Sensitivity and specificity ,Correlational study ,030220 oncology & carcinogenesis ,Ureteroscopes ,Kidney calculi ,Cost-effectiveness ,Female ,business ,Human - Abstract
Introduction: We investigated the survival of a flexible ureterorenoscope (FURS) in regard to the total stone area (TSA) and total usage time (TUT) to determine the cutoff values for its survival. Materials and Methods: Data were obtained from 1326 patients who underwent flexible ureterorenoscopy. The stone area and the usage time of the FURS were obtained in each case. The data from each FURS were considered as a group. The TSA was calculated as the sum of the stones for which only one FURS broke, and the TUT was calculated as the sum of the time of use within the body in all cases during the tool's survival. Data from 13 groups of 1258 patients were analyzed in regard to the TSA and TUT. Results: We found a positive correlation of the case number with the TSA and TUT. The Pearson correlation coefficients were 0.983 and 0.937 for the TSA and TUT, respectively (p < 0.05). The mean case number, TSA, and TUT where only one FURS was used were 97.38 +/- 31.34, 11,886 +/- 4567.93 mm(2), and 5160 +/- 1570.52 minutes, respectively. The area under the curve (AUC) of the receiver operating characteristic curve of the FURS survival for the TSA was 91.7% (95% confidence interval [CI]: 0.76-1.07). The best cutoff value for the FURS survival was 6838 mm(2), with a sensitivity of 91%. The results for the AUC and the best cutoff value in regard to the TUT for using only one FURS were 66.7% (95% CI: 0.4-0.93) and 4617 minutes, respectively, with a sensitivity of 66%. If the cutoff value is taken as the average value of the TSA and TUT, the sensitivity rate drops to similar to 58% and 50%, respectively. Conclusion: FURS can be safely used when the stone area and TUT are about 9158 mm(2) and 4617 minutes, respectively, with a sensitivity of 66%.
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- 2020
27. Penile Plication With or Without Degloving of the Penis Results in Similar Outcomes
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Kadir Ömür Günseren, Ismet Yavascaoglu, Hakan Kilicarslan, Burhan Coskun, Yakup Kordan, Onur Kaygisiz, Rustam Kadirov, Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı., Kadirov, Rüstam, Coşkun, Burhan, Kaygısız, Onur, Günseren, Kadir Ömür, Kordan, Yakup, Yavaşçaoğlu, İsmet, Kılıçarslan, Hakan, L-9439-2019, AAH-9704-2021, AAM-9726-2020, and ABC-9924-2020
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Male ,Deformities ,Endocrinology, Diabetes and Metabolism ,030232 urology & nephrology ,lcsh:Medicine ,Behavioral Neuroscience ,0302 clinical medicine ,Endocrinology ,Urologic surgery ,Urology & nephrology ,Original Research ,Priority journal ,Penile Plication ,030219 obstetrics & reproductive medicine ,Degloving plication technique ,Patient satisfaction ,Congenital Penile Curvature ,lcsh:Other systems of medicine ,Medicine, general & internal ,Psychiatry and Mental health ,Retrospective study ,medicine.anatomical_structure ,Operation duration ,Peyronie's disease ,Human ,Peyronie Disease ,Clostridiopeptidase A ,Penis ,Adult ,medicine.medical_specialty ,Foley balloon catheter ,Urology ,Dermatology ,Major clinical study ,Article ,03 medical and health sciences ,Minimally invasive surgery ,Degloving ,medicine ,Peyronie disease ,Postoperative period ,Peyronies-disease ,Tunical plication ,Peyronie's Disease ,Curvature ,business.industry ,Intermethod comparison ,lcsh:R ,Surgical technique ,medicine.disease ,lcsh:RZ201-999 ,Surgery ,Clinical effectiveness ,Reproductive Medicine ,Length of stay ,Penile curvature ,General & internal medicine ,business - Abstract
Background Penile plication techniques with or without degloving offer a minimally invasive option for the treatment of penile curvature. Aim To review the outcomes of penile plication surgery and patient satisfaction with and without degloving of the penis. Methods We conducted a retrospective analysis of 52 patients who underwent penile plication for the treatment of Peyronie disease or congenital penile curvature. Outcomes Surgical success rates, complications, and patient satisfaction determined with the Treatment Benefit Scale were compared between groups. Results The overall surgical success rate was 92.3% at a mean follow-up of 18.84 ± 23.51 months. There were no intraoperative complications. In the degloving group, 42.6% of patients were greatly satisfied and 42.6% had better outcomes; in the without degloving group, 61.5% of patients were greatly satisfied and 30.8% had better outcomes. Comparison of outcomes was not statistically significant between groups. Clinical Implications The results of the present study indicate the two techniques can be used for penile plication. Conclusion With or without degloving, penile plication is safe and effective and provides high patient satisfaction. Kadirov R, Coskun B, Kaygisiz O, et al. Penile Plication With or Without Degloving of the Penis Results in Similar Outcomes. Sex Med 2017;5:e142–e147.
- Published
- 2017
28. The protective effect of L-arginine, tadalafil, and their combination in rat testes after ischemia and reperfusion injury
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Hakan Kilicarslan, Berna Aytaç Vuruşkan, Burhan Coskun, Onur Kaygisiz, Gökhun Özmerdiven, Burak Asiltas, Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı., Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı., Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı., Özmerdiven, Gökhun, Coşkun, Burhan, Kaygısız, Onur, Vuruşkan, Berna Aytaç, Asıltaş, Burak, Kılıçarslan, Hakan, L-9439-2019, AAH-9704-2021, AAH-9746-2021, and AAM-9726-2020
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0301 basic medicine ,Male ,Arginine ,Animal tissue ,Tadalafil ,chemistry.chemical_compound ,0302 clinical medicine ,Nitric-oxide ,Spermatic cordi ,Testicular torsion ,Urology & nephrology ,Original Research ,Protection ,Lipid ,Left Testis ,Schemia/reperfusion injury ,Glutathione ,Reperfusion injury ,Damage ,Oncology ,030220 oncology & carcinogenesis ,Experimental testicular torsion ,medicine.drug ,Adult ,medicine.medical_specialty ,Urology ,Lipid peroxidation ,Article ,Nitric oxide ,03 medical and health sciences ,Internal medicine ,medicine ,Pharmacological approach ,Animal model ,Animal experiment ,Spermatogenesis ,Tissue ,business.industry ,Inhibitors ,Testis torsion ,Contralateral testis ,medicine.disease ,Nonhuman ,Drug effect ,030104 developmental biology ,Endocrinology ,chemistry ,Prepubertal rats ,Rat ,Reperfusion Injury ,Seminiferous Tubules ,Testes ,business ,Controlled study ,Orchiectomy - Abstract
Introduction: Nitric oxide (NO) plays an important role in the ischemia and reperfusion process. In this study, we aimed to examine the effect of L-arginine, tadalafil, and their combination for preventionof the ischemia reperfusion injury after testis torsion in rats.Methods: A total of 40 adult, male Sprague-Dawley rats were allocated into five groups. Three hours of left testicular torsion was performed in each group, excluding the control group. While the ischemia reperfusion (I/R) group had no treatment, I/R + Arg group received L-arginine, I/R + Td group received tadalafil and I/R + Arg + Td group received tadalafil and L-arginine 30 minutes before the detorsion. Then the left testis was untwisted for four hours of reperfusion. After bilateral orchiectomy, lipid peroxidation (LPx) and glutathione (GSH) activities were examined in testicular tissue.Spermatogenesis was evaluated with Johnsen’s score.Results: LPx levels of the I/R group were found to be significantly higher than for groups that received drugs for both testes (p
- Published
- 2017
29. Böbrek taşı tedavisinde flesible üreterorenoskop kullanım süresini etkileyen faktörlerin retrospektif olarak araştırılması
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Günseren, Kadir Ömür, Kılıçarslan, Hakan, and Üroloji Ana Bilim Dalı
- Subjects
Urinary calculi ,Kidney diseases ,Urology ,Üroloji ,Kidney calculi ,Endoscopy ,Kidney - Abstract
Böbrek Taşlarının Tedavisinde Fleksibl ÜreterorenoskopKullanım Süresini Etkileyen Faktörlerin RetrospektifAraştırılmasıFleksibl üreterorenoskop ve lazer enerjisi kullanılarak böbrek taşınınböbreğin içinde kırılması anlamına gelen retrograd intrarenal cerrahi;günümüzde öne çıkan minimal invaziv cerrahi tedavi yöntemlerden birisidir.Böbrek taşlarının cerrahi tedavisinde yüksek etkinlik ve düşükkomplikasyon oranlarına rağmen fleksibl üreterorenoskop'un pahalı vekullanım süresinin kısıtlı bir cihaz olması bu cerrahi tekniğin en önemlidezavantajlarından birisini oluşturmaktadır. Bu çalışmamızda fleksiblüreterorenoskop kullanım süresini etkileyebilecek hastaya ait faktörleriaraştırdık. 2010 ile 2016 yılları arasında kliniğimizde kullanılan 9 adet fleksiblüreterorenoskop ile böbrek taşına müdahale edilen 559 hastanın verileriretrospektif olarak incelendi. Her bir fleksibl üreterorenoskop ile uygulananoperasyonlardaki hastaların taş alanları, taş dansiteleri, operasyon süreleri,taş lokalizasyonları, preoperatif dj stent varlığı değerlendirilerek 9 grupoluşturuldu.Bu 9 grup içinde sırasıyla 22, 17, 18, 56, 111, 90, 96, 76 ve 73operasyon gerçekleştirildi. Gruplar arasında operasyon süreleri, taş alanları,taş dansiteleri ve taş lokalizasyonları açısından farklılıklar saptandı.Sonuçlar değerlendirildiğinde cerrahi deneyimin FURS kullanımömründe önemli bir faktör olduğu bulunmuştur. Yeterli deneyime rağmen altpol lokalizasyonunda bulunan taşların cerrahisinin cihaz ömrünü azalttığısaptandı. Ayrıca kırılan taş alanının artmasının cihaz kullanım süresinietkilediği görüldü. Bununla birlikte taş dansitesinin cihaz ömrü üzerine etkiliolmadığı bulundu.Anahtar kelimeler: böbrek taşı, fleksibl üreterorenoskop Retrograde intra renal surgery (RIRS) is defined as treatment of kidneystones by using a flexible ureteroscope (FURS) and laser energy and it is oneof the most popular minimal invasive treatment methods.It has a high efficiency with lower rates of complications. However,higher cost rates of FURS and it's short durability is one of the importantdisadvantages. In this study we aimed to evaluate the factors that responsiblein durability of FURS. The data of 559 patients in whom RIRS were performedwith 9 separate FURS between 2010 and 2016 were investigatedretrospectively. The mean stone area, mean stone density, mean length ofoperation, stone localizations and presence of preoperative DJ stents werecompared in 9 separate FURS group.A total of 22, 17, 18, 56, 111, 90, 96, 76 and 73 cases were performedin these 9 groups respectively. Difference were obtained regarding length ofoperation, stone area, stone density and stone localizations within groups.The results indicated that surgical experience plays an important rolein durability of the FURS. Despite adequate experience, surgery for lower polemay decrease the durability. Furthermore, an increase in mean stone area caneffect longitivtiy of the device. However, no relation was found with stonedensity on durability.Key words: Kidney stone, flexible ureterorenoscope 46
- Published
- 2016
30. Penil kurvatür bozukluğu olan ve penil plikasyon uygu-lanan hastalarda preoperatif, peroperatif, orta süreli takip sonuçlarının araştırlması
- Author
-
Kadirov, Rustam, Kılıçarslan, Hakan, and Üroloji Ana Bilim Dalı
- Subjects
Penile erection ,Urology ,Üroloji ,Penile diseases ,Patient satisfaction ,Penis - Abstract
Penil plikasyon cerrahileri penil kurvatür tedavisinde minimal invazifve etikili yöntemlerdir. Bu çalışmada kliniğimizde penil plikasyon cerrahisiuygulanmış olan hastaların preoperatif ve peroperatif özelliklerini incelemekve ayrıca postoperatif dönemde karşılaşılan komplikasyonları ve hasta memnuniyetinideğerlendirmeyi retrospektif olarak değerlendirmeyi amaçladık.Toplam 52 hasta çalışmaya dahil edildi. Bu hastaların yarısında penisindeglove edildiği diğer yarısında ise deglove edilmeden plikasyon uygulandığıgörüldü. Genel cerrahi başarı oranı % 92.3 bulundu. Hiçbir hastada peropatifya da erken postop komplikasyon gelişmedi.TFS ile kurvatürün düzelmesi incelendiğinde, operasyon öncesi durumagöre hastaların %53.8'i son derece memnun, % 38.5 daha iyi durumdaolduklarını bildirirken % 7.7'si herhangi bir değişim fark etmediklerini bildirildiOperasyon sonrası erektil fonksiyonlarının TFS ile değerlendirilmesinde hastaların%76.9 'u operasyon öncesi ile penisin sertleşmesi açısından bir farkolmadığını bildirirken, %13.5'i sertleşmenin daha iyi olduğunu, %9.6'sı isekötüleştiğini bildirdi.Deglove işlemi uygulanan ve uygulanmayan gruplar arasında sonuç-lar açısından istatistiksel bir fark saptanmamıştır.Sonuç olarak penil plikasyon cerrahileri yüksek hasta memnuniyetisağlayan etkili yöntemlerdir.Anahtar kelimeler: Penil plikasyon, hasta memnuniyeti, penisin degloveedilmesi Penile plication surgeries are minimaly invasive and effective treatmentoptions. In this study we aimed to review preoperative and peroperativeoutcomes and patient satisfaction. A total of 52 patients were included in thestudy. It was found that the degloving of the penis was performed in half ofthe patients. The overall surgical success was 92.3% and there was earlysurgical complication in any of the patients.Operasyon sonrası erektil fonksiyonlarının TFS ile değerlendirilmesindehastaların %76.9 'u operasyon öncesi ile penisin sertleşmesi açısındanbir fark olmadığını bildirirken, %13.5'i sertleşmenin daha iyi olduğunu,%9.6'sı ise kötüleştiğini bildirdi.While 53.8% of the patients were highly satisfied with the correctionof the curvature, 38.5% declared their satisfaction and 7.7% declared nochange according to the treatment benifit scale .Key words: Penile plication, degloving, penile deviatio 33
- Published
- 2016
31. Effect of ADMA levels on severity of erectile dysfunction in chronic kidney disease and other risk factors
- Author
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Hakan Kilicarslan, Alparslan Ersoy, Yakup Kordan, Onur Kaygisiz, Kaan Gökçen, Burhan Coskun, [Gokcen, Kaan] Cumhuriyet Univ, Dept Urol, Sivas, Turkey -- [Kilicarslan, Hakan -- Coskun, Burhan -- Kaygisiz, Onur -- Kordan, Yakup] Uludag Univ, Dept Urol, Bursa, Turkey -- [Ersoy, Alparslan] Uludag Univ, Dept Nephrol, Bursa, Turkey, Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı., Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı., Kılıçarslan, Hakan, Coşkun, Burhan, Ersoy, Alparslan, Kaygısız, Onur, Kordan, Yakup, AAM-9726-2020, L-9439-2019, AAH-9704-2021, and AAH-5054-2021
- Subjects
Male ,Asymmetric dimethylarginine ,Physiology ,030232 urology & nephrology ,Prehypertension ,chemistry.chemical_compound ,0302 clinical medicine ,Nitric-oxide ,Chronic kidney disease ,Medicine ,Urology & nephrology ,Testosterone ,Erectile dysfunction ,Case Series ,Endothelial dysfunction ,Antihypertensive agent ,030219 obstetrics & reproductive medicine ,Prognosis ,N(g),n(g) dimethylarginine ,Retrospective study ,N(G),N(G) Dimethylarginine ,Arginine ,Dimethylargininase ,Oncology ,Hemodialysis ,Hypertension ,Abnormalities ,Amino acid blood level ,Human ,Adult ,medicine.medical_specialty ,Inhibitor ,Clinical article ,Urology ,Case control study ,Sexual dysfunction ,Hemoglobin blood level ,Article ,Antihypertensive therapy ,Nitric oxide ,03 medical and health sciences ,Internal medicine ,Psychogenic disease ,Hemoglobin ,Erythropoietin ,Disease severity ,Testosterone blood level ,Aged ,business.industry ,Testosterone (patch) ,medicine.disease ,International index of erectile function ,Prolactin ,Prolactin blood level ,Endocrinology ,chemistry ,Dipeptidyl carboxypeptidase inhibitor ,Risk factor ,business ,Controlled study ,Chronic-renal-failure ,Hormone ,Kidney disease - Abstract
WOS: 000373178500009, PubMed ID: 26858787, Introduction: Hormonal, neurogenic, vasculogenic, and psychogenic impairments, as well as endothelial dysfunction may play a role in erectile dysfunction (ED) in patients with chronic kidney disease (CKD). Asymmetrical dimethylarginine (ADMA) is an inhibitor of nitric oxide, which is the key element of ED. ADMA levels are increased in CKD. We aimed to evaluate the effect of serum ADMA, prolactin, testosterone, and hemoglobin levels on erectile function of patients with CKD and control subjects. Methods: A total of 42 men with CKD and 25 age-matched controls were enrolled. The patients with CKD were categorized into group 1 and group 2 based on whether they had ED according to their response to International Index of Erectile Function questionnaire (IIEF-EFD). Group 3 was a control group. Serum ADMA, total testosterone prolactin, and hemoglobin levels of the patients were evaluated. Results: Serum ADMA, testosterone, and hemoglobin levels were similar between group 1 and 2, serum prolactin level was significantly high in group 1 than in group 2 or 3 (control group). There was no correlation between ADMA levels and IIEF-EFD scores of patients with CKD. Conclusions: The results of this study suggest serum ADMA level is not related with ED in patients with CKD. Also, low testosterone and hemoglobin levels were not significant factors. High levels of serum prolactin are related with ED in patients with CKD.
- Published
- 2016
32. Evaluation of arterial stiffness and cardiac function in patients with vascular erectile dysfunction: acute effects of phosphodiesterase-5 inhibitor tadalafil
- Author
-
H. Kilicarslan, Ali Aydinlar, İbrahim Baran, Mesut Keçebaş, Sümeyye Güllülü, Osman Ozdabakoglu, Saim Sağ, Ahmet Tütüncü, Tunay Şentürk, Uludağ Üniversitesi/Tıp Fakültesi/Kardiyoloji Anabilim Dalı., Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı., Özdabakoǧlu, Osman, Güllülü, Sümeyye, Saǧ, Saim, Şentürk, T., Kılıçarslan, Hakan, Tütüncü, Ahmet S., Keçebaş, Mesut, Baran, İbrahim, Aydınlar, Ali, AAI-6632-2021, and AAW-9185-2020
- Subjects
Male ,medicine.drug_mechanism_of_action ,Transthoracic echocardiography ,Glucose blood level ,030232 urology & nephrology ,Low density lipoprotein cholesterol ,030204 cardiovascular system & hematology ,Sexual Health Inventory for men ,Ischemic-heart-disease ,Ventricular Function, Left ,Tadalafil ,0302 clinical medicine ,Heart left ventricle function ,Erectile Dysfunction ,Diastole ,Body surface ,Urology & nephrology ,Phosphodiesterase V inhibitor ,Endothelial dysfunction ,High density lipoprotein cholesterol ,Priority journal ,Men ,Middle Aged ,Impotence ,Phosphodiesterase V Inhibitor ,Cardiovascular disease ,Arterial stiffness ,Pulse pressure ,Clinical trial ,Doppler ultrasonography ,Body mass ,Three dimensional echocardiography ,Cardiology ,Assessment of humans ,Aortic stiffness ,Pulmonary vein ,Phosphodiesterase 5 inhibitor ,medicine.drug ,Human ,Cardiac function curve ,Adult ,medicine.medical_specialty ,Practice guideline ,Systole ,Urology ,Clinical article ,Heart rate ,Case control study ,Triacylglycerol ,Article ,Pulse-wave velocity ,Tonometry ,03 medical and health sciences ,International erectile function index ,Vascular Stiffness ,Internal medicine ,Diastolic blood pressure ,Vascular endothelium ,medicine ,Pressure ,Humans ,Clinical evaluation ,Creatinine blood level ,Drug effects ,business.industry ,Heart function ,Phosphodiesterase 5 Inhibitors ,medicine.disease ,Coronary artery blood flow ,Blood pressure ,Young adult ,Case-Control Studies ,Urea blood level ,Comparative study ,Risk factor ,Endothelium, Vascular ,business ,Controlled study - Abstract
This study aimed to detect endothelial dysfunction in erectile dysfunction (ED) patients free from cardiovascular diseases or atherosclerotic risk factors and to evaluate acute effects of phosphodiesterase-5 inhibitor tadalafil on endothelial dysfunction and cardiac function. Thirty ED patients and 20 healthy male subjects (mean ages: 48.7 +/- 11.7 and 48.3 +/- 8.7 years, respectively) were enrolled. Endothelium functions were assessed by applanation tonometry. Aortic stiffness and cardiac function were evaluated by transthoracic echocardiography. Pulse pressure was greater in the ED group (P < 0.05), whereas aortic strain and aortic distensibility were significantly lower (P < 0.001). Treatment with tadalafil reduced pulse pressure (P = 0.0179), systolic blood pressure (P = 0.001) and diastolic blood pressure (P = 0.054) and increased aortic distensibility (P = 0.001) and aortic strain (P = 0.003) in the ED group. Tadalafil administration also increased large artery and small artery elasticity indices that were reduced in the ED group at baseline (P = 0.02 and 0.003, respectively). Systemic vascular disease and compromised left ventricular diastolic function (LVDF) were present in ED patients with no known atherosclerotic risk factors and cardiac diseases. Tadalafil positively affected arterial stiffness and LVDF.
- Published
- 2014
33. Sıçanlarda testis iskemi/reperfüzyon hasarında nitrik oksit (l-arjinin) ve fosfodiesteraz tip 5 inhibitörünün (tadalafil) etkisi
- Author
-
Özmerdiven, Çağdaş Gökhun, Kılıçarslan, Hakan, and Üroloji Ana Bilim Dalı
- Subjects
Reperfusion injury ,Ischemia ,Urology ,Üroloji ,Reperfusion ,Nitric oxide ,Phosphodiesterase ,Rats ,Tadalafil - Abstract
Çalışmamızda testis torsiyonundan sonra oluşan iskemi/reperfüzyon hasarını önlemede NO prekürsörü L-arjinin ve fosfodiesteraz 5 inhibitörü tadalafilin etkisini sıçan modelinde incelemeyi amaçladık. Kırk adet erkek Sprague Dawley cinsi sıçan randomize bir şekilde 5 gruba ayrıldı. Çalışmaya alınan 40 sıçanın 8'i kontrol grubu, geri kalan 32 tanesi ise çalışma gruplarını oluşturdu. Kontrol grubunda yer alan sıçanlara torsiyon işlemi uygulanmadan testisleri alındı. Çalışma grubundaki sıçanların sol testisinde torsiyon oluşturulduktan sonra, 3 saatlik iskemi oluşturuldu. İkinci gruba ilaç uygulanmadı, 3. gruba detorsiyondan 30 dakika önce intraperitoneal L-arjinin, 4. gruba detorsiyondan 30 dakika önce intraperitoneal tadalafil ve 5. gruba detorsiyondan 30 dakika önce hem tadalafil hem de L-arginin birlikte intraperitoneal olarak verildi. Ardından sol testise detorsiyon uygulanarak, 4 saat reperfüzyon için beklenildi. Yedinci saatin sonunda biyokimyasal ve histopatolojik inceleme için bilateral orşiektomi uygulandı. Biyokimyasal olarak dokuda lipid peroksidasyon (LPx) ve glutatyon (GSH) düzeyleri incelendi. Gruplar kendi aralarında ve kontrol grubuyla karşılaştırıldı.LPx düzeylerine göre incelendiğinde; ipsilateral testiste 2. grubun sonuçları, kontrol ve ilaç verilen gruplardan anlamlı olarak yüksek izlendi. İlaç verilen gruplar arasında anlamlı fark izlenmedi. Kontrol grubu ile 4. ve 5. grup arasından anlamlı fark izlendi. Karşı testis incelendiğinde 2. grubun sonuçları kontrol ve ilaç verilen gruplardan anlamlı olarak yüksek izlendi. Üçüncü ve 4. grup arasında anlamlı fark saptanmazken, 4. grubun sonuçları kontrol ve 5. grubun sonuçlarından anlamlı olarak farklıydı.GSH düzeylerine göre incelendiğinde; ipsilateral testiste 2. grubun sonuçları kontrol ve 5. grubun sonuçlarından anlamlı olarak farklı iken, diğer ikili karşılaştırmalarda anlamlı fark izlenmedi. Karşı testiste ise, 5. grubun sonuçları kontrol ve diğer gruplardan anlamlı olarak yüksek bulundu. 2. ve 4. grup arasında anlamlı fark izlenirken, diğer ikili karşılaştırmalarda anlamlı fark izlenmedi. Histopatolojik olarak incelendiğinde; ipsilateral testiste Johnsen skoruna bakıldığında, kontrol grubunun sonuçları diğer gruplardan anlamlı olarak yüksek olduğu gözlenirken, 2. grubun sonuçlarının ise diğer gruplardan anlamlı olarak düşük olduğu izlendi. Üçüncü ve 4. grup arasında anlamlı fark izlenmezken, 5. grubun sonuçları 3. ve 4. grubun sonuçlarından anlamlı olarak farklı bulundu. Işık mikroskobu ile yapılan incelemede İkinci grupta yüksek oranda nekroz izlenmiştir. İkinci, 3. ve 4. gruplarda yüksek oranda ödem ve konjesyon izlenmesine rağmen, 5. grupta daha az izlenmiştir. Karşı testiste Johnsen skoruna bakıldığında, kontrol grubunun sonuçları diğer gruplardan anlamlı olarak yüksek ve 2. grubunun sonuçları diğer gruplardan anlamlı olarak düşük olduğu görüldü. Beşinci grup ile 4. grup arasında anlamlı fark izlenmesine rağmen 3. ve 5. grup arasında anlamlı fark izlenmedi. Karşı testiste ışık mikroskobu ile yapılan incelemede 2. grupta yüksek oranda nekroz izlendi. Üçüncü, 4. ve 5. gruplarda benzer oranda ödem ve konjesyon izlendi.Sonuç olarak; L-arjinin, tadalafil ve her ikisinin kombine kullanımının, hem torsiyone testiste hem de karşı testiste iskemi/reperfüzyon hasarına karşı koruyucu etkisi olduğu görülmektedir. In our study, we aimed to examine the effect of NO precursor, L-arginine and the phosphodiesterase type 5 inhibitor, tadalafil in the prevention of ischemia reperfusion injury after testis torsion in rats.A total of 40 adult, male Sprague Dawley rats were divided into 5 groups randomly. Of these 40 rats, 8 consisted the control group and the remaining 32 consisted the study groups. Rats in control group were performed bilateral orchiectomy without torsion. In study groups left testis of rats underwent three hours of torsion. No drug was applied in the 2nd group, L-arginine was injected intraperitoneally 30 minutes before the detorsion in the 3th group, tadalafil was injected intraperitoneally 30 minutes before the detorsion in the 4th group, L-arginine and tadalafil were injected together introperitoneally 30 minutes before the detorsion in the 5th group. Then left testis was untwisted for four hours of reperfusion. At the end of 7th hour bilateral testes were removed for histological and biochemical examination. For biochemical examination, lipid peroxidation (LPx) and glutathione (GSH) activities were examined in testicular tissue. Groups were compared with each other and with the control group.When analyzed according to the LPx level; the results of the second group in ipsilateral testis was observed to be significantly higher than the control and drug treated groups. Among the drug treated groups significant difference was not observed. Control group's results were significantly different than the 4th and 5th group's results. When the contralateral testis was examined, the results of the 2nd group were significantly higher than the control group and drug treating groups. No significant difference between 3rd and 4th groups was seen. The result of the 4th group was significantly different than result of the control and the 5th group.When analyzed according to GSH levels, in the ipsilateral testis the results of the 2nd group were significantly different from the results of the control group and the 5th group. Significant difference was not observed in other binary comparisons. The results of the 5th group were significantly higher than other groups in the contralateral testis. Significant difference was observed between the 2nd and 4th groups and no significant difference was observed in other binary comparisons.When examined histopathologically in ipsilateral testis, Johnsen's score of the control group was significantly higher than the other groups and Johnsen's score of the 2nd group was significantly lower than the other groups. No significant difference was seen between Johnsen's score of the 3rd and 4th groups, Johnsen's score of the 5th group was significantly different from Johnsen's score of the 3rd and 4th groups. High rate of necrosis was observed in the 2nd group. High rate of congestion and edema was observed in 3rd and 4th group, but less in 5th group. In contralateral testis, Johnsen's score of the control group was significantly higher than other groups and Johnsen's score of the 2nd group was significantly lower than other groups. No significant difference between the 3rd and 5th groups was seen. Johnsen's score of the 4th group was significantly different than Johnsen's score of the 5th group. In contralateral testis necrosis was seen highly in the 2nd group. Edema and congestion was seen similar rate in the 3rd, 4th and 5th groups.As a result; L-arginine, tadalafil and combined used of both were protective against the effect of ischemia/reperfusion injury in ipsilateral and contralateral testis. 65
- Published
- 2014
34. Transrektal ultrason eşliğinde prostat biyopsisi ve komlikasyonlarının erektil fonksiyonlar üzerine etkisi: İki farklı anestezi yönteminin karşılaştırılması
- Author
-
Serin, Onur, Kılıçarslan, Hakan, and Üroloji Ana Bilim Dalı
- Subjects
Complications ,Penile erection ,Urology ,Biopsy ,Üroloji ,Prostate ,Erectile dysfunction ,Anesthesia ,Prostatic diseases ,Ultrasonography - Abstract
Transrektal ultrasonografi eşliğinde prostat biyopsisi (TRUS-Bx), prostat kanseri şüphesi olan hastalarda tanıya yönelik standart işlemdir. TRUS-Bx poliklnik şartlarında güvenle uygulanabilen bir işlem olmasına rağmen işlemin hematospermi, hematüri, rektal kanama gibi komplikasyonları bulunmaktadır. Literatürde biyopsi sonrası gelişen komplikasyonlar için %22.4 ile 78.2 arasında değişen oranlar bildirilmektedir. Son dönemde TRUS-Bx?in mevcut komplikasyonlar haricinde geçici süreyle erektil disfonksiyonada neden olduğunu belirten çalışmalar yayınlanmıştır. Çalışmamızda, iki farklı anestezi yöntemi ile uygulanan prostat biyopsileri ve bu biyopsiler sırasında gelişen komplikasyonların erektil fonksiyonlar üzerine etkisini inceledik.Potensin değerlendirmesinde IIEF-EFD (Ereksiyon İşlevi Uluslararası Değerlendirme Formu - Erektil Fonksiyon Değerlendirmesi) kullanıldı. Çalışma sonucunda her iki anestezi grubunda işlem öncesi öncesi IIEF-EFD skorları, işlem sonrası skorlarından yüksek olarak bulundu. Ancak bu yükseklik istatistiksel açıdan anlamlı bulunmadı. Yine biyopsiye bağlı gelişen komplikasyonlarla erektil disfonksiyon arasında da ilişki saptanmadı.ilginç olarak; TRUS-Bx patolojisi malign yada şüpheli olarak sonuçlanan hastaların, birinci ay takiplerinde IIEF-EFD skorlarının işlem öncesi ve işlem sonrası birinci haftaya oranla istatistiksel olarak anlamlı düşüşler gösterdiği izlendi. Bu hastaların, eş zamanlı doldurtulan BECK anksiye ölçeği ve BECK depresyon ölçeğinde de IIEF-EFD ile paralellik gösterecek şekilde istatistiksel anlamlı artışlar izlendi. Bu noktadan hareketle biyopsi patolojisi malign veya şüpheli olarak sonuçlanan hastaların benign sonuçlananlara oranla daha depresif ve anksiyeteye sahip oldukları, bu negatif psikolojik durumunda hastalarda geçici süreyle erektil disfonksiyona neden olduğu sonucuna varılmıştır.Sonuç olarak; TRUS-bx uygulanması planlanan hastaların biyopsi öncesi ve sonrası dönemde, erektil fonksiyonlar ve psikolojik durum açısından ayrıntılı şekilde değerlendirilmesi gerekmektedir.Anahtar kelimeler: Ereksiyon, erektil disfonksiyon, prostat biyopsisi. Transrectal ultrasound-guided prostate biopsy (TRUS-Bx), is a standard process of diagnosis to the patients suspected of having prostate cancer. Although TRUS-Bx can be applied safely in outpatient procedure, there are complications such as hematospermia, hematuria and rectal bleeding. In the literature, biopsy complications reported rates ranging from 78.2 to 22.4%. Recently, except for the current complications, TRUS-Bx studies have been published that also cause temporary erectile dysfunction. In this study, we examined the prostate biopsy applied by two different anesthetic method and complications effect on erectile function.IIEF-EFD (International Assessment Form of Erectile Function - Erectile Function Assessment) used in the evaluation of potency. End of the study, in both of the anesthesia group, IIEF-EFD scores before the procedure, were higher than the scores after procedure but this elevation was not statistically significant. In addition, there was no association between erectile dysfunction and the complications due to biopsy.However, interestingly, IIEF-EFD scores in the first month follow-up of patients with malignant or suspicious pathology resulting in the TRUS-Bx was observed that before and after the procedure showed statistically significant decrease compared to the first week of the procedure. Among these patients, BECK anxiety and depression scale simultaneous answered. Results are similar with IIEF-EFD viewed statistically significant. From this viewpoint, patients with biopsy pathology resulting in malignant or suspicious were found to be more depressed and anxious compared to patients resulting in a benign pathology. This negative psychological condition was found to be the cause erectile dysfunction in patients temporarily.As a result, patients treated with TRUS-Bx, should be considered in detail in terms of erectile function and psychological status before and after biopsy period.Key words: Erection, erectile dysfunction, prostate biopsy. 75
- Published
- 2013
35. Management of bleeding in percutaneous nephrolithotomy
- Author
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Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı., Kılıçarslan, Hakan, Kordan, Yakup, Doğan, Hasan Serkan, Gökçen, Kaan, Çelen, Sinan, and ABH-5513-2020
- Subjects
Urology & nephrology - Published
- 2012
36. Kronik renal yetmezlikli hastalarda asimetrik dimetilarjinin (ADMA) seviyesinin erektil disfonksiyon üzerine olan etkisinin değerlendirilmesi
- Author
-
Gökçen, Kaan, Kılıçarslan, Hakan, and Üroloji Ana Bilim Dalı
- Subjects
ADMA ,Urology ,Üroloji ,Erectile dysfunction ,Kidney failure-chronic - Abstract
Asimetrik Dimetilarjinin (ADMA) ; endojen nitrik oksit sentaz (NOS) inhibitörüdür. Gerçekleştirdiği inhibisyon sayesinde azalan NO seviyesi endotel disfonksiyonuna neden olmaktadır. Kronik renal yetmezlik ve erektil disfonksiyon gibi temelinde endotelyal patolojilerin suçlandığı hastalıkların bir belirteci olan ADMA' nın bir prognostik faktör olarak popülaritesi giderek artmaktadır. Kronik renal yetmezlikli hastalardaki ADMA seviyeleri farmakoloji ve biyokimya araştırmacıları tarafından klinik ve moleküler düzeyde araştırılmaya devam etmektedir.Uludağ Üniversitesi Tıp Fakültesi Üroloji Bilim dalında ve Nefroloji Bilim dallarında Ocak 2008 ? Ağustos 2012 yılları arasında hipertansiyon, kronik renal yetmezlik ve erektil disfonksiyon nedeniyle takipli hastalarda ölçülmüş serum ADMA seviyeleri ve International Index of Erectile Function (IIEF) formu ile sorgulanmış olan erektil fonksiyon skorları mevcut 70 hastanın verileri retrospektif olarak değerlendirildi. Yetmiş olgu üç ayrı gruba ayrılmış olup birinci grup kronik renal yetmezliği olan ve erektil disfonksiyonu olan; ikinci grup kronik renal yetmezliği olan ve erektil disfonksiyonu olmayan; üçüncü grup ise kontrol grubu olarak belirlenen kronik renal yetmezliği ve erektil disfonksiyonu olmayan vakalar olarak belirlendi. Erektil fonksiyon durumu 6 sorudan oluşan IIEF-EFD soru anketi ile değerlendirildi.Birinci grup 22; ikinci grup 23, üçüncü grup kontrol grubu olup 25 hastadan oluşmaktadır. Hastaların ortalama yaşı 50.15 ± 1.17 (29-68) olup Ortalama serum ADMA seviyesi 0,60 ± 0,02 ve ADMA median değeri 0,57 (0,27-1,1) olarak hesaplandı.Serum ADMA seviyeleri; KRY'li olgularda kontrol grubuna göre anlamlı olarak yüksek olduğu gözlenirken, KRY grupları içindeki karşılaştırmalı testlerde erektil disfonksiyonun varlığına göre iki grup arasında ADMA seviyeleri arasındaki fark istatistiksel olarak anlamlı bulunmadı.ADMA seviyelerinin, KRY süresi, diyaliz süresi ile pozitif korelasyona; IIEF ve IIEF-EFD skorları ile negatif yönde korelasyona sahip olduğu görüldü (p = 0.008, r = - 0,316). Asymmetric dimethylarginine (ADMA), an endogenous nitric oxide synthase (NOS) inhibitor and performed decreasing NO levels due to inhibition of endothelial dysfunction. On the basis of endothelial pathologies such as chronic renal failure (CRF) and erectile dysfunction (ED) was accused of serum ADMA levels as a marker and prognostic factor increasing in popularity. ADMA levels in patients with chronic renal failure is being explored by researchers.This retrospective study included 70 cases with serum ADMA levels were measured in patients with chronic renal failure, hypertension and erectile dysfunction followed by Urology and Nephrology Departments of Uludag University Medicine Faculty between January 2008 and August 2012. Erectile function was evaluated by the erectile function domain of the international index of erectile function (IIEF-EFD) a validated 15-item self-administered questionnaire. Patients were divided into three groups: group 1(n = 22), patients with CRF and with ED; group 2 (n = 23), patients with CRF and without ED; group 3 (n = 25), control group (patients without CAD or ED). Mean age of patients was 50.15 ± 1.17 (29-68) and the median value of ADMA was calculated 0.57 (0.27 to 1.1).Serum levels of ADMA, was found to be significantly higher in patients with CRF than the control group. CRF groups according to the presence of erectile dysfunction in the comparative tests between the two groups was not statistically significant difference between the levels of ADMA.ADMA had a positive correlations between and duration chronic failure and hemodialysis but there was a negative correlation between IIEF-EFD score (p = 0.008, r = - 0,316). Elevating levels of ADMA is an indepen-dent risk factor for severe of ED. 72
- Published
- 2012
37. Percutaneous nephrolithotomy in children: Does age matter?
- Author
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Sinan Celen, Hakan Kilicarslan, Yakup Kordan, Bülent Oktay, Hasan Serkan Dogan, Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı., Doğan, Hasan Serkan, Kılıçarslan, Hakan, Kordan, Yakup, Çelen, Sinan, Oktay, Bülent, and ABH-5513-2020
- Subjects
Nephrology ,Male ,Complications ,medicine.medical_treatment ,Percutaneous nephrostomy ,Prone position ,Lithotripsy ,Urology & nephrology ,Stone composition ,Treatment outcome ,Child ,Children ,Instrumentation ,Pediatric ,Incidence (epidemiology) ,Renal-calculi ,Incidence ,Equipment Design ,Classification ,Preschool-children ,Management ,Retrospective study ,Female ,Infants ,Age factors ,Human ,medicine.medical_specialty ,Adolescent ,Child, preschool ,Urology ,Nephrolithiasis ,Article ,Postoperative complications ,Age ,Age groups ,Internal medicine ,medicine ,Percutaneous nephrolithotomy ,Humans ,Experience ,Developing-country ,business.industry ,Gender distribution ,Methodology ,Infant ,Retrospective cohort study ,Stone ,Surgery ,Postoperative complication ,Treatment ,Retrospective studies ,Nephrostomy, percutaneous ,Percutaneous Nephrolithotomy ,Urolithiasis ,Ultrasonic Lithotripsy ,Preschool child ,Kidney calculi ,Comparative study ,Complication ,business - Abstract
To compare the outcomes of percutaneous nephrolithotomy (PCNL) in 2 age groups. Fifty-one renal units (RU) of 45 patients were operated between January 2006 and December 2010. In all patients, PCNL was performed by pediatric nephroscope of 17F size through a 20F Amplatz sheath. Patients were examined in 2 groups (Group1: a parts per thousand currency sign5 years, Group 2: > 5 years) and outcomes were compared accordingly. The mean age was 5.95 +/- A 3.63 years and male-to-female ratio was 23/22. The mean stone burden, operative time, and postoperative hospital stay were 4.24 +/- A 2.03 cm(2), 94.30 +/- A 37.28 min, and 5.18 +/- A 2.97 days, respectively. In the postoperative period, 44 renal units (86.2%) were stone-free. Two age groups were similar regarding the postoperative hospital stay, gender distribution, stone location, stone composition, and complication rates. However, stone burden and number of access was less and stone-free rate was higher in younger age group. The stone-free rate in preschool children is at least as good as older children without an increase in complication rates. The older children (> 5 years) have a higher stone burden and need multiple accesses more frequently. The complications are mostly low grade and can be managed conservatively. Our results showed that PCNL in younger children as safe and effective as in the older children and age should not be considered as a limiting factor.
- Published
- 2011
38. Efficacy of levobupivacaine infiltration to nephrosthomy tract in combination with intravenous paracetamol on postoperative analgesia in percutaneous nephrolithotomy patients
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Ozgur Elvan Gokten, Hakan Kilicarslan, Yakup Kordan, Hasan Serkan Dogan, Gurkan Turker, Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı., Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı., Gökten, Özgür Elvan, Kılıçarslan, Hakan, Doǧan, Hasan Serkan, Türker, Gürkan, Kordan, Yakup, AAI-6642-2021, and ABH-5513-2020
- Subjects
Male ,medicine.medical_treatment ,Mobilization ,Treatment response ,Postoperative pain ,Opiate ,Nausea and vomiting ,Medicine ,Urology & nephrology ,Treatment outcome ,Percutaneous Nephrolithotomy ,Staghorn Stone ,Nephrotomy ,Saline ,Percutaneous ,Levobupivacaine ,Priority journal ,Nephrostomy ,Pain, postoperative ,Local anesthetic ,Patient satisfaction ,Bupivacaine ,Hospitalization ,Paracetamol ,Randomized controlled trial ,Anesthesia ,Drug Therapy, Combination ,Female ,Hypotension ,Pethidine ,medicine.drug ,Human ,Adult ,medicine.medical_specialty ,medicine.drug_class ,Visual analogue scale ,Anesthetics, local ,Pain assessment ,Urology ,Analgesic ,Pain ,Injections, intravenous ,Sweating ,Major clinical study ,Side effect ,Unspecified side effect ,Dizziness ,Xerostomia ,Analgesics, non-narcotic ,Article ,Tubeless ,Anesthesia, local ,Postoperative analgesia ,Postoperative period ,Humans ,Percutaneous nephrolithotomy ,Infusion ,Nephrostomy, Percutaneous ,Acetaminophen ,business.industry ,Pruritus ,Lithotomy position ,Surgery ,Drug efficacy ,Drug therapy,combination ,Analgesia ,business - Abstract
Purpose: To evaluate the efficacy of intraoperative local anesthetic infiltration in combination with intravenous paracetamol infusion on postoperative pain management in patients who underwent percutaneus nephrolithotomy (PCNL). Patients and Methods: Sixty adult patients were randomized into three groups with 20 cases in each: Group SP, 20mL saline was infiltrated through the whole nephrostomy tract intraoperatively and this was followed by intravenous paracetamol (4 x 1 g) infusion postoperatively; group LP, 20mL of 0.25% levobupivacaine infiltration to the nephrostomy tract followed by intravenous paracetamol infusion; Group LS, 20mL of 0.25% levobupivacaine infiltration to the nephrostomy tract followed by intravenous saline infusion. In the postoperative period, the pain status of patients was evaluated at postoperative 6 and 24 hours by using the visual analogue scale (VAS). In patients who did not completely respond, meperidine (1mg/kg intramuscularly) was administered as an additional "rescue'' analgesic. Patient satisfaction from the postoperative analgesia management was assessed by a 5 point scale. Results: There was no statistically significant difference between the three groups regarding the demographic characteristics, surgical complications, and postoperative hospital stay. Our findings revealed that in group LP, the amount and frequency of opioid used and related side effects was lesser, VAS score was lower, time to full mobilization was shorter, and the patient satisfaction score was higher when compared with the other two groups. Conclusion: Levobupivacaine infiltration through the nephrostomy tract in combination with intravenous paracetamol infusion was shown to be safe and efficacious as an analgesia method after PCNL.
- Published
- 2011
39. Sıçanlarada ESWL ( Vucut Dışı Şok Dalgası) sonrası oluşan değişikliklerin histopatolojik olarak ve HSP 70 (Heat Shock Protein) ekspresyonu kullanılarak değerlendirilmesi ve fosfodiesteraz tip 5 inhibitörünün (Tadalafil) rolü
- Author
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Danişoğlu, Mahmut Esat, Kılıçarslan, Hakan, and Üroloji Ana Bilim Dalı
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Reperfusion injury ,Heat shock proteins ,Ischemia ,Urology ,Lithotripsy ,Üroloji ,ESWL ,Rats ,Tadalafil - Abstract
Çalışmamızda şok dalga litotripsi (SWL) sonrası oluşan değişikliklerin histopatolojik olarak ve HSP-70 ekspresyonu kullanılarak değerlendirilmesi ve bir fosfodiesteraz tip 5 inhibitörü olan Tadalafilin oluşan hasarı önlemedeki rolünü sıçan modelinde incelenmeyi amaçladık.Kırk adet erişkin erkek Sprague Dawley cinsi sıçan biri kontrol olmak üzere 5 gruba ayrıldı. Çalışmaya alınan 40 sıçanın 8 i sham grubu geri kalan 32 tanesi ise çalışma gruplarını oluşturdu. Otuziki sıçan, SWL uygulanıp 3. ve 7. gün nefrektomi yapılan, öncesinde tadalafil verilip SWL uygulanan ve 3. ve 7. günlerde nefrektomi yapılan gruplar olarak ayrıldı. Tüm sıçanlara laparotomi yapılarak her iki taraf perirenal yağ dokusuna 1 er adet hemoklip yerleştirildi. SWL yerleştirilen hemokliplerin merkezi odaklanarak uygulandı. 1500 şok 14 kV güçte SWL uygulandı. Işık mikroskopu ile proksimal tübülüsler, peritübüler alanda fibrozis, mononükleer hücre infiltrasyonu ve glomerüller incelendi. SWL sonrası böbrekte iskemik hasara cevap olarak oluşan HSP-70 ekspresyonu da araştırıldı. Gruplar kendi aralarında ve kontrol grubuyla karşılaştırıldı.Gruplara göre ışık mikroskopisi altında proksimal tubulus hücreleri, kortikal tubuluslar, medüller kollektör tubuluslardaki değişiklikler ve peritubuler alandaki fibrozis varlığının dağılımına bakıldığında, karşılaştırmada grup 1 ile 5, grup 1 ile 4, grup 2 ile 3, grup 4 ile 5 dışında istatistiksel anlamlı farklılık olduğu saptanmıştır. Glomerülledeki ışık mikroskopisi değişikliklerinin, karşılaştırmasında gruplar arası istatistiksel anlamlı farklılık saptanmamıştır.Gruplara göre kortikal kollektör ve medüller kolektör tubüluslerdeki HSP- 70 boyanma dağılımına bakıldığında karşılaştırmada, grup 1 ile 5, grup 1 ile 4, grup 2 ile 3, grup 4 ile 5 dışında istatistiksel anlamlı farklılık olduğu saptanmıştır. Glomerüllerdeki HSP-70 boyanma dağılımına bakıldığında karşılaştırmada, grup 1 ile 2, grup 1 ile 3, grup 1 ile 5, istatistiksel anlamlı farklılık saptanmıştır. Proksimal tübülüs hücrelerinde hiçbir grupta HSP-70 boyanması olmamıştı.Sonuç olarak; SWL'nin böbrekte iskemi reperfüzyon hasarına neden olabileceği ışık mikroskopisi ve HSP-70 boyama bulgularına dayanarak gösterilmiştir. Bulgularımız, tadalafilin SWL'ye bağlı oluşan bu renal hücre hasarını engelleyebileceğini düşündürmüştürAnahtar kelimeler: Heat Shock Protein, Şok Dalga Litotripsi , İskemi Reperfüzyon Hasarı,Tadalafil Evaluation of the Changes Observed After SWL (Shock Wave Lithotripsy ) Based on Histopathologic Examination and HSP 70 (Heat Shock Protein) Expression in the Rats and the Role of Phosphodiesterase Type 5 (Tadalafil)Our study aimed to evaluate the changes observed after SWL based on histopathologic examination and HSP-70 expression and to examine the role of tadalafin, a phosphodiesterase type 5 inhibitor, in the prevention of the injury in a rat model.A total of 40 adult, male Sprague Dawley rats were divided into 5 groups, one of which was the control. Of these 40 rats, 8 consisted the sham group and the remaining 32 consisted the study groups. Thirty two rats were divided as follows: SWL + nephrectomy at Days 3 and 7; administration of tadalafil followed by SWL; and nephrectomy at Days 3 and 7. All rats underwent laparotomy, during which two hemoclips was placed in the perirenal adipose tissue of the both sides. SWL was given by focusing into the center of the hemoclips placed. SWL was given at 14 kV for 1500 shocks. Proximal tubules, peritubular fibrosis, mononuclear cell infiltration and glomeruli were examined using light microscope. We examined HSP-70 expression, which occurred in response to renal ischemic injury observed after SWL. The groups were compared between each other and with the control group.When proximal tubule cells, cortical tubules, changes of medullar collector tubule and the presence peritubular fibrosis were examined by groups using light microscope, it was seen that there was statistically significant difference, except for the comparisons between Group 1 and 5, Group 1 and 4, Group 2 and 3, Group 4 and 5. When the groups were compared for the changes of glomerulus observed using light microscope, no statistically significant difference was found.When the groups were compared for the distribution of HSP-70 staining in cortical collector and medullar collector tubules, a statistically significant difference was found, except between Group 1 and 5, Group 1 and 4, Group 2 and 3, Group 4 and 5. The comparison of the distribution of HSP-70 staining in the glomeruli revealed a statistically significant difference between group 1 and 2, group 1 and 3 and group 1 and 5. Proximal tubule cells showed HSP-70 staining in none of the groups.Consequently, based on the results of light microscopy and HSP 70 staining, we demonstrated that SWL could cause renal ischemia-reperfusion injury. Our results suggested that tadalafil could prevent this SWL-related renal cell injury.Key words: Heat Shock Protein, Shock Wave Lithotripsy, Ischemia- reperfusion injury, Tadalafil 97
- Published
- 2011
40. Our experience with single session-single access percutaneous nephrolithotomy
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Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı., Kılıçarslan, Hakan, Danışoğlu, Mahmut Esat, Doğan, Hasan Serkan, and Kordan, Yakup
- Subjects
Böbrek taşı ,Percutaneous nephrolithotomy ,Kidney stone ,Perkutan nefrolitotomi - Abstract
Bu çalışmada çoğunluğunu inkomplet staghorn taşlı hastaların oluşturduğu ve tek seans-tek akses PNL uyguladığımız vakaların sonuçlarını sunmaktayız. Nisan 2006-Mart 2008 tarihleri arasında kliniğimizde 138 hastaya tek seans-tek akses PNL uygulandı. Perkütan girişim C kollu floroskopi altında hastaya yüzüstü (prone) pozisyonu verilerek yapıldı. Amplatz dilatatörlerle giriş yolu genişletildi ve 30 F Amplatz sheat yerleştirildi. Perkütan taş kırma ve taşların temizlenmesi 26 F rigid nefroskop ve pnömatik litotriptörle yapıldı. Operasyonun bitiminde 18 F nefrostomi tüpü takıldı. Değerlendirmeye yaş ortalamaları 47.9 (3-76) olan 95 erkek ve 43 kadın olgu alındı. 60 sağ, 78 sol üniteye PNL uygulandı. Ortalama taş boyutu 745,5 mm2, operasyon süresi 99,3 dakikaydı. Taşsızlık oranı 118/138 (%85,5) olarak hesaplandı. Postoperatif dönemde 6 (%4,3) hastaya toplam 7 ünite kan transfüzyonu yapıldı. Cerrahi sırasında ortalama 11,4 lt irrigasyon sıvısı kullanıldı. İki hastada komplike İYE gelişti. Nefrostomi kalış süresi ortalama 2,5 gün, hastanede kalış süresi ortalama 3,7 gündü. Bu bulgular, böbrek taşlarının tedavisinde minimal invaziv bir yöntem olan PNL’nin tek seansta tek akses kullanılarak da etkinlik ve güvenilirliğini koruduğunu göstermektedir. In this study, we present our results with single session-single access PCNL in a group of patients whose most of the stones were incomplete staghorn form. Single session-single access PCNL has been performed in 138 patients between April 2006-March 2008. Percutaneous Access has been established under C-arm fluoroscopic guidance with a prone position. Dilation was made with Amplatz dilators and 30F sheath has been placed. Disintegration has been achieved with 26 F rigid nephroscope and pneumatic lithotripter. 18F nephrostomy tube has been placed at the end of the procedure. There were 95 male and 43 female patients with a mean age of 47.9 (3-76) years. Stones were located at the right side in 60 and left side in 78 patients. Mean stone size was 745.5 mm2, and mean operative time was 99.3 minutes. Stonefree rate was 85.5% (118/138). Six patients (4.3%) received blood transfusion. The mean volume of irrigation fluid used was 11.4 liters. The mean nephrostomy removal day and postoperative hospital stay was 2.5 and 3.7 days, respectively. Our findings reveal that PCNL as a minimally invasive modality preserves its efficiency and safety even in single session and single access technique.
- Published
- 2009
41. Perkütan nefrolitotomide nefrostomi traktına uygulanan levobupivakain infiltrasyonu ve intravenöz parasetamol kombinasyonunun postoperatif analjezi üzerine olan etkilerinin değerlendirilmesi
- Author
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Gökten, Özgür Elvan, Kılıçarslan, Hakan, and Üroloji Ana Bilim Dalı
- Subjects
Urology ,Üroloji - Abstract
Perkütan taş cerrahisi uygulanan hastalarda intraoperatif operasyon bölgesine lokal anestetik infiltrasyonu ve postoperatif intravenöz parasetamol kombinasyonunun ameliyat sonrası ağrı kontrolü üzerine olan etkilerini incelemek. Çalışmaya 18 yaşından büyük 60 hasta dahil edildi. Tüm hastalarda perkütan nefrolitotomi (PNL) operasyonu subkostal ve tek giriş ile gerçekleştirildi. Her birinde 20'şer hasta olmak üzere randomize olarak 3 grup oluşturuldu. 1. gruptaki hastalara (Grup SP) ; İntraoperatif nefrostomi traktına (cilt-ciltaltı ve kas dokusu) 20 ml serum fizyolojik (SF) infiltrasyonu + postoperatif dönemde intravenöz (İV) 4x1 gr parasetamol infüzyonu, 2. gruptaki hastalara (Grup LP) ; İntraoperatif nefrostomi traktına (cilt-ciltaltı ve kas dokusu) 20 ml %0,25 levobupivakain infiltrasyonu + postoperatif dönemde İV 4x1gr parasetamol infüzyonu ve 3. gruptaki hastalara ( Grup LS) İntraoperatif nefrostomi traktına (cilt-ciltaltı ve kas dokusu) 20 ml %0,25 levobupivakain + postoperatif dönemde İV 100 ml SF infüzyonu uygulanandı. Postoperatif dönemde ayılma ünitesinde (0. saat) ve klinikte 2., 4., 6., 8., 12., ve 24. saatlerde vizüel analog skala (VAS) kullanılarak dinlenme ve hareket halindeki ağrısı değerlendirildi. Postoperatif analjezi yöntemine rağmen ağrısı olan (VAS?3) hastalara ? rescue ? analjezik olarak 1mg/kg dozda meperidin intramuskuler verildi. Hastaların postoperatif analjezi memnuniyetleri 5 noktalı skala ile değerlendirildi. Gruplar birbirleriyle ağrı kontrolü ile ilgili parametreler, ağrı tedavisinde kullanılan ajanlara bağlı yan etkiler, cerrahi komplikasyonlar, postoperatif yatış süreleri açısından karşılaştırılmış ve bunlara etki edebilecek faktörler incelenmiştir. Hastaların demografik verileri fark yoktur. Grup LP'deki hastalarda diğer 2 gruba göre kullanılan opiyoid miktarı ve sıklığı daha az, VAS skoru daha düşük, mobilizasyon süreleri daha kısa ve hasta memnuniyet skorları daha yüksek saptanmıştır. Nefrostomi traktına uygulanan levobupivakain infiltrasyonu ve İV parasetamol kombinasyonunun PNL sonrası analjezi yöntemi olarak güvenli ve etkin olduğu görülmektedir. Daha etkili sonuçların verilebilmesi için geniş hasta grupları içeren çalışmalarla desteklenmesi gerekmektedir.Anahtar kelimeler: Perkütan nefrolitotomi, postoperatif ağrı, subkutan infiltrasyon Our aim was to evaluate the efficacy of intraoperative local anesthetic infiltration in combination with intravenous paracetamol infusion on postoperative pain management in patients who underwent percutaneus stone surgery. Sixty patients who were older than 18 years were included into the study. Percutaneus nephrolithotomy (PNL) has been performed via single subcostal access in all patients. Patients were randomized into three groups including 20 cases in each. In the first group (Group SP), 20 ml saline was infiltrated through the whole (cutaneous, subcutaneous and muscle layers) nephrostomy tract intraoperatively and this was followed by intravenous paracetamol (4x1 gr) infusion postoperatively. In the second group (Group LP), 20 ml of 0, 25 % Levobupivacaine infiltration to the nephrostomy tract in a similar manner followed by IV paracetamol infusion. The third group (Group LS) 20 ml of 0, 25 % Levobupivacaine infiltration to the nephrostomy tract in a similar manner followed by IV saline infusion. In the postoperative period, pain status of patients were evaluated in the recovery unit (hour 0) and in the ward at postoperative 2, 4, 6, 8, 12 and 24?Th hours by using the visual analogue scale (VAS). In patients who did not completely respond medication (VAS?3), meperidine 1 mg/kg intramuscular was given as on additional ?rescue?analgesic. The patient satisfaction from the postoperative analgesia management was assessed by 5 points scale. Three groups were compared regarding the demographic features, parameters on pain control, the adverse effects due to agents used in analgesia, surgical complications and postoperative hospital stay. The factors those have impact on these parameters have been analyzed. There was no statistically significant difference between 3 groups regarding the demographic characteristics. Our findings revealed that in group LP, the amount and frequency of opioid used was lesser, VAS score was lower, time period until full mobilization was shorter and patient satisfaction score was higher when compared to the other 2 groups. According to the results our studies, Levobupivacaine infiltration through the nephrostomy tract in combination with intravenous paracetamol infusion was shown to be safe and efficious as an analgesia method following PNL. However, to have more reliable results, this study should be conducted in larger group of patients.Key words: Percutaneous nephrolithotomy, postoperative pain, subcutaneous infiltration. 79
- Published
- 2009
42. Association of vitamin D receptor gene Taq I polymorphism with recurrent urolithiasis in children
- Author
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Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Bölümü., Seyhan, Serkan, Yavaşçaoğlu, İsmet, Kılıçarslan, Hakan, Doğan, Hasan S., Kordan, Yakup, and ABH-5513-2020
- Subjects
Male ,Prostate-cancer ,Adolescent ,Genotype ,Family history ,Hypercalciuria ,Genetic predisposition to disease ,Major clinical study ,Polymorphism, genetic ,Stone disease ,Article ,Disease association ,Urolithiasis ,Recurrence ,Deoxyribonucleases, type II site-specific ,Humans ,Recurrent disease ,Urology & nephrology ,Polymorphism ,Calcium nephrolithiasis ,Child ,Nephrolithiasis ,Kidney Calculi ,Alleles ,Priority journal ,Genetic polymorphism ,Calcium excretion ,Incidence ,Receptors, calcitriol ,Calcium absorption ,Calcium stone ,Gel electrophoresis ,Gene frequency ,Polymerase chain reaction ,Vitamin D receptor ,Female ,Comparative study ,Controlled study ,Human - Abstract
Objective: Urolithiasis has a strong familial component. However, to date, no specific genetic abnormality has been identified. It has been reported that allelic variation in the vitamin D receptor (VDR) gene may affect calcium absorption and excretion. Urolithiasis is a multifactorial disease in which both genetic and environmental factors have an effect on onset and severity of disease. In the present study, the role of Taq I polymorphism of vitamin D receptor gene in urolithiasis was studied. Methods: Eighty children with calcium stone disease (40 with single episode of stone disease and 40 with recurrence) and 40 controls were enrolled. Polymorphic sites were amplified by polymerase chain reaction, digested with Taq I restriction enzymes and analyzed by gel electrophoresis. Allelic or genotypic frequencies were calculated and associations between them and the presence of hypercalciuria, family history and stone recurrence were evaluated. Results: Incidence of Taq I tt genotypes was significantly higher in patients with recurrent calcium-stone disease compared to the controls. In addition, the frequency of the 't' allele was higher in recurrent calcium-stone formers. Taq I t allele was found to be associated with increased risk of recurrence. No association between Taq I polymorphism and a positive family history was found in the present study. The frequency of hypercalciuria was higher in patients with the 'tt' genotype. Conclusion: Taq I t allele of the VDR gene may be a risk factor for severe urolithiasis and recurrent stone disease.
- Published
- 2007
43. Pubovaginal sling with autologous rectus fascia for the management of all types of stress urinary incontinence in females
- Author
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Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı., Kılıçarslan, Hakan, Vuruşkan, Hakan, and Doğan, Hasan Serkan
- Subjects
Surgical treatment ,Sling ,Stress urinary incontinence ,Stres üriner inkontinans ,Cerrahi tedavi - Abstract
Kadın üriner inkontinansı sıklıkla sosyal veya hijyenik bir problemdir. Sling cerrahisi, kadın üriner inkontinansının tedavisi için 20. yüzyılın başından beri kullanılagelmiştir. Pubovajinal sling, etkili ve kalıcılığı olan bir işlemdir. Bu yayında pubovajinal sling ameliyatı yapılan 58 hastamızdaki tecrübemiz aktarılmaktadır. Ürodinamik olarak stres üriner inkontinansı olduğu ortaya konulmuş 58 hasta çalışmaya dahil edilmiştir. Hastaların ameliyat öncesi değerlendirmelerinde hikaye, fizik muayene, stres testi, 24 saatlik ped testi, idrar kültürü, 7 günlük işeme günlüğü ve urodinamik inceleme kullanılmıştır. Ameliyat sonrası değerlendirmede ameliyat süresi, intra ve postoperatif komplikasyonlar, işeme problemleri ve diğer komplikasyonlar göz önünde bulundurulmuştur. Ortalama ameliyat süresi 35 dakika ve ortanca postoperatif yatış süresi 1 gün olarak tespit edilmiştir. Ortalama 30,2 aylık takip süresi içinde 48 hastada tam olarak kür veya iyileşme sağlanmıştır. Geriye kalan 10 hastada (%17,3) ise başarılı sonuç elde edilememiştir. Hiçbir major intraoperatif komplikasyon yaşanmamıştır. Rektus fasyası kullanılarak yapılan sling girişimi, tüm kadın stres üriner inkontinansı tiplerinde yüksek başarı oranlarıyla komplikasyonsuz olarak uygulanabilen bir yöntemdir. Female urinary incontinence is mostly a social or hygienic problem. Sling procedures have been used for the treatment of urinary incontinence in women since the beginning of the 20th century. The pubovaginal sling is an effective and durable operation for stress urinary incontinence. We present our experience with 58 female patients who underwent pubovaginal fascial sling operations. Fifty-eight women with urodynamic stress incontinence were enrolled consecutively for this study. Preoperative evaluation of all women included a standardized history and physical examination, stress test, 24-hour pad weighing test, urine culture, a 7-day urinary diary and urodynamic evaluation. The postoperative evaluation also included examination of the case notes with regard to operating time, intra- and postoperative complications, voiding problems and other complications. Recorded mean operation time was 35 minutes and median postoperative hospital stay was 1 day. Forty-eight patients were considered to have successfully cured or improved outcome for their incontinence with a mean follow up of 30.2 months. The outcomes of remaining 10 patients (17.3%) were considered failure after surgery. There were no major intra-operative complications. The autologous rectus fascial sling procedure appears to be effective in the management of all types of stress urinary incontinence in female with a success rate of 82.7%.
- Published
- 2007
44. Effect of hypothyroidism on the NO/cGMP pathway of corpus cavernosum in rabbits
- Author
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Bülent Saraç, Ihsan Bagcivan, Hakan Kilicarslan, M. Kemal Yildirim, Tijen Kaya, Uludağ Üniversitesi/Tıp Fakültesi., Kılıçarslan, Hakan, and Uludag Univ, Fac Med, Dept Urol, TR-16059 Bursa, Turkey -- Cumhuriyet Univ, Fac Med, Sivas, Turkey
- Subjects
Male ,Relaxation ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Muscle Relaxation ,Vasodilator Agents ,Thyrotropin ,Stimulation ,Rabbit ,YC-1 ,Parathyroid hormone ,Thyrotropin blood level ,Muscle, Smooth, Vascular ,Liothyronine ,chemistry.chemical_compound ,Endocrinology ,Nitric-oxide ,Cyclic-nucleotide phosphodiesterase ,Soluble guanylyl cyclase ,Papaverine ,Electric field ,Urology & nephrology ,Pharmacologic studies in sexual function ,Cyclic GMP ,Priority journal ,Parathyroid hormone blood level ,Triiodothyronine ,Penile erection ,Calcium blood level ,animal models ,Animal models ,Psychiatry and Mental health ,medicine.anatomical_structure ,Thyroidectomy ,pharmacologic studies in sexual function ,Rabbits ,hormones, hormone substitutes, and hormone antagonists ,medicine.drug ,Nitroprusside ,medicine.medical_specialty ,endocrine system ,Impotence ,Penis Erection ,Corpus ,Carbachol ,Endothelium ,Urology ,Concentration response ,Nitric Oxide ,Article ,Impotence, Vasculogenic ,Hypothyroidism ,Internal medicine ,medicine ,Animals ,Animal model ,Animal experiment ,Cyclic guanosine monophosphate ,Endocrinologic studies of sexual function ,business.industry ,Tissue in-vitro ,Synergistic activation ,Body weight ,Smooth-muscle tone ,Nonhuman ,Prolactin ,Electric Stimulation ,Thyroxine ,Disease Models, Animal ,Corpus cavernosum ,Reproductive Medicine ,chemistry ,endocrinologic studies of sexual function ,Calcium ,business ,Controlled study ,Hormone ,Noncholinergic neurotransmission ,Penis - Abstract
WOS: 000239941600013, PubMed ID: 16942528, Introduction. The incidence of hormonal dysfunction as a cause of impotence remains controversial. However, several recent studies have reported evidence of hormonal abnormalities in 25-35% of impotent men. Hypothyroidism has been reported to occur in 6% of impotent men. There is some evidence suggesting that hypothyroidism may be a cause of impotence. Aim. We aimed to investigate the nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) pathway in hypothyroidism in an experimental rabbit model and compared hypothyroid rabbits with controls to evaluate the possible involvement of the NO/cGMP pathway. Methods. The study comprised 20 male New Zealand white rabbits. The rabbits were divided into two equal groups. The first group had hypothyroidism induced surgically by thyroidectomy for 6 weeks. The second group underwent a sham operation. Results. There was no significant change in the mean body weight of hypothyroid rabbits and controls. Triiodothyronine and thyroxine levels were significantly lower in hypothyroid rabbits. Plasma thyroid-stimulating hormone and prolactin levels were significantly higher in hypothyroid rabbits. Plasma total calcium and parathormone levels remained in the normal range in both groups. Main Outcome Measures. Papaverine-induced concentration-dependent relaxations were similar in both groups. Carbachol-induced relaxation responses decreased in hypothyroid rabbits. There were significant differences between control and hypothyroid rabbits in frequency-dependent relaxations induced by electrical-field stimulation (EFS). YC-1-induced relaxation responses did not change significantly in hypothyroid rabbits. Concentration-dependent relaxations induced by diethylamine (DEA)/NO were similar in both groups. Amrinone-induced relaxation responses did not change significantly in hypothyroid rabbits. Conclusion. Reductions of relaxant responses to EFS and carbachol in hypothyroid rabbits can depend on the decrease of released or synthesized NO from nitrergic nerves and endothelium.
- Published
- 2006
45. Treatment of detrusor sphincter dyssynergia with baclofen and doxazosin
- Author
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Hakan Kilicarslan, Gökhan Gökçe, Semih Ayan, E.Y. Gultekin, Hakan Vuruşkan, Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı., Kılıçarslan, Hakan, Vuruşkan, Hakan, and Uludag Univ, Sch Med, Dept Urol, TR-58140 Bursa, Turkey -- Cumhuriyet Univ, Dept Urol, Sch Med, Sivas, Turkey
- Subjects
Neurologic disease ,Baclofen ,Complications ,Overactive Bladder ,Incobotulinumtoxina ,Intravesical Drug Administration ,Clinical examination ,urologic and male genital diseases ,Diagnosis ,Urethral Diseases ,Urology & nephrology ,Symptomatology ,Treatment outcome ,Cholinergic receptor blocking agent ,medicine.diagnostic_test ,Muscle Relaxants, Central ,Cystometry ,Spinal-cord injury ,Middle Aged ,Upper tract deterioration ,Nephrology ,Anesthesia ,Female ,Tolterodine ,Urinary-tract ,Hyperreflexia ,Detrusor sphincter dyssynergia ,medicine.drug ,Human ,Muscle Contraction ,Adult ,medicine.medical_specialty ,Adolescent ,medicine.drug_class ,Urology ,Clinical article ,Bladder outlet obstruction ,Urethra pressure ,Multiple sclerosis ,Micturition ,Health care organization ,medicine ,Doxazosin ,Anticholinergic ,Humans ,Women ,Adrenergic alpha-Antagonists ,Aged ,business.industry ,Urethral sphincter ,Electromyogram ,Detrusor dyssynergia ,Urodynamics ,Drug efficacy ,Lioresal ,business ,Controlled study ,Conservative treatment - Abstract
WOS: 000245215800033, PubMed ID: 17124622, Detrusor sphincter dyssynergia (DSD) is an involuntary contraction of the external urethral sphincter during detrusor contraction. A high proportion of patients needing repeat surgery and long term failure have both been described in the literature. In the present study, we evaluated clinical characteristics, underlying disorders and outcomes of conservative medical treatment in 21 female patients. Two patients were newly diagnosed multiple sclerosis. Urodynamic studies were performed in all symptomatic patients, and consisted of measurement of post-micturition residuals, urethral pressure profilometry and EMG cystometry according to the criteria of the International Continence Society. All patients were treated with baclofen 15 mg/day and doxazosin 4 mg/day. Seven patients received tolterodine 4 mg/day in addition to baclofen and doxazocin because they had detrusor hyperreflexia (DH). In conclusion, treatment with either combined baclofen and doxazosin or anticholinergic agent tolterodine appeared to be effective. In addition, it should be kept in mind that DSD could be the first sign to any neurologic diseases.
- Published
- 2006
46. Çocuklarda ürokinaz 3'-UTR T/C gen polimorfizmi ile tekrarlayan taş hastalığı arasındaki ilişki
- Author
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Öztürk, Murat, Kılıçarslan, Hakan, and Üroloji Ana Bilim Dalı
- Subjects
Urology ,Üroloji - Abstract
ÖZETAmaç: Ürokinaz böbrek, pnömositler ve fagositler gibi değişik hücrelerdensentezlenir. Plazminojeni plazmine dönüştürerek fibrinolizisi uyarır. Ürokinaztaş yapısındaki matriks proteinini parçalayarak taş oluşumunu ve büyümesiniönler. Tekrarlayan taş hastalığı olanlarda ürokinaz konsantrasyonu düşükbulunurken, ürokinaz 3'-UTR T/C gen polimorfizmi yüksek olarakbulunmuştur. Bu çalışmanın amacı ürokinaz 3'-UTR T/C gen polimorfizmininçocuklarda rekürren taş hastalığındaki rolünü araştırmaktır.Gereç ve Yöntem: Çalışmaya taş hikayesi olmayan 40 sağlıklı çocuk(ortalama yaş 10,5 ± 4,2) kontrol grubu olarak (grup 3), ilk kez taş hastalığıolan 40 çocuk (ortalama yaş 10,5 ± 4,33) (grup 1) ve tekrarlayan taş hastalığıolan 40 çocuk (ortalama yaş 11,2 ± 3,8) (grup 2) dahil edildi. Gruplar yaş,cinsiyet ve ürokinaz 3'-UTR T/C gen polimorfizmi açısından karşılaştırıldı.Ürokinaz geni T/C polimorfizmini belirlemek için polimeraz zincir reaksiyonubazlı restriksiyon analizleri kullanıldı.Bulgular: Yaş ve cinsiyet açısından 3 grup arasında anlamlı fark görülmedi.Ürokinaz gen 3'-UTR T/C polimorfizmi 2.grupta 4 olguda (%10) görüldü. 1 ve3. gruplarda T/C gen polimorfizmli olgu görülmedi.Sonuç: Ürokinaz 3'-UTR T/C gen polimorfizmi tekrarlayan taş hastalığı olançocuklarda, sağlıklı ve ilk kez taş hastalığı olan olgularda daha yaygındır. Bubulgular bize çocukluk çağı tekrarlayan taş hastalığında ürokinaz gen 3'-UTRT/C polimorfizminin rolü olabileceğini düşündürmektedir.Anahtar kelimeler: Ürokinaz, ürolityazis, polimorfizm.i SUMMARYASSOCIATION OF UROKINASE GENE 3'-UTR T/C POLYMORPHISMWITH RECURRENT UROLITHIASIS IN CHILDRENPurpose: Urokinase is synthesized by various cells such as kidney,pneumocytes, phagocytes. It cleaves plasminogen to plasmin and hencestimulates fibrinolysis. Urokinase breaks down the matrix protein within thestone thus prevents stone formation and growth. Urokinase concentrationswere found lower and urokinase gene 3?-UTR T/C polymorphism was higherin recurrent stone patients. Our aim was to investigate the role of urokinasegene 3?-UTR T/C polymorphism in childhood recurrent stone disease.Materials and Methods: A control group of 40 healthy children having nohistory of stone formation (group 3) (mean age 10,5 ± 4,2), 40 children(mean age 10,5 ± 4,33) who were first time stone formers (group 1) and 40patients (mean age 11,2 ± 3,8) with recurrent stone disease (group 2) wereincluded into the study. Groups were compared in respect to age, sex andurokinase gene 3?-UTR T/C polymorphism. Polimerase chain reaction basedrestriction analysis was used to identify C/T polymorphism of the urokinasegene.Outcomes: No significant difference was observed between 3 groups inrespect to age and sex. While urokinase 3?-UTR T/C gene polymorphismwas observed in 4 patients (10%) from group 2. In group 1 and 3 there wasno patient with T/C polymorphism.Conclusion: Urokinase 3?-UTR T/C gene polymorphism more commonly inchildren with recurrent stone disease than healthy and first time stoneformers. This results suggests that urokinase 3?-UTR T/C gene polymorphismmight play a role in childhood recurrent stone disease.Key words: Urokinase, urolithiasis, polymorphismi 37
- Published
- 2006
47. Stres üriner inkontinans tedavisinde uygulanan pubovajinal fasyal sling ve vajinal wall sling operasyonlarının sonuçlarının karşılaştırılması
- Author
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Kayacan, Ertan, Kılıçarslan, Hakan, and Üroloji Ana Bilim Dalı
- Subjects
Urology ,Üroloji - Abstract
IV ÖZET Sosyal, hijyenik problem haline gelen ve objektif olarak gösterilebilen stres üriner inkontinans detrusor kontraksiyonu veya mesanenin aşın distansiyonu olmaksızın, karın içindeki basınç artışına bağlı idrar kaçırmadır. Pubovajinal fasyal sling operasyonu uyguladığımız 38 hasta ile vajinal wall sling operasyonu uyguladığımız 58 hastanın sonuçlan karşılaştmldı. Pubovajinal fasyal sling operasyonu yapılan hastaların yaşlan 25 ile 80 yıl arasında değişmekte olup (ortalama 44.5 yıl), doğum sayısı 1-8 (ortalama 4.7) ve takip süresi 14-32 ay (ortalama 26.7 ay), operasyon süresi 30-70 dakika (ortalama 46 dakika) olup hiçbir hastada komplikasyon görülmedi. Üretral kateteri 3-10 gün sonra (ortalama 7.1 gün) çekilen hastalar, 3-10 gün (ortalama 6.5 gün) sonra taburcu edildi. Vajinal wall sling operasyonu yapılan 58 hastanın yaşlan 41 ile 71 arasında (ortalama 52.3 yıl) değişmekte, doğum sayısı 1-7 (ortalama 5.6) ve takip süresi 16-34 ay (ortalama 26 ay), operasyon süresi 30-70 dakika (ortalama 47.9 dakika) olup hiçbir hastada komplikasyon görülmedi. Üretral kateteri 3-10 gün sonra (ortalama 7.7 gün) çekilen hastalar, 3-10 gün (ortalama 7 gün) sonra taburcu edildi. înkontinans cerrahi tedavisinde uygulanan diğer yöntemlere göre komplikasyon oranı düşük olan pubovajinal fasyal sling ve vajinal wall sling operasyonlarının etkili bir yöntem olduğu ve cerrahi tedavide uygulanması gerektiğini söyleyebiliriz. Anahtar kelimeler: Stres üriner inkontinans, sistosel, cerrahi, tedavi ABSTRACT Stress urinary incontinence, which can be demonstrated objectively, is ` involuntary urine leakage due to the increase in intraabdominal pressure in the absence of detrusor contraction or bladder distention. It can be a social and hygene problem. In this study we compared the outcomes of 38 patients who underwent pubovaginal facial sling operation with 58 patients who underwent vaginal wall sling operation. The ages of the patients treated with pubovaginal facial sling ranged 25-80 years with a mean age of 44.5 years. These patients characteristics were as follows : number of giving births 1-8 (mean number 4.7), follow-up time 14-32 months ( mean time 26.7 month), operation time 30-70 minutes (mean time 46 minutes). None of the patients had a complication during the operation. Urethral catheterization period ranged 3-10 days (mean time 7.1 days) and the patients were discharged between 3-10 days, (mean time 6.5 days after operation). The ages of the patients treated with vaginal wall sling ranged 41-71 years with a mean age of 52.3 years. These patients characteristics were as follows : number of giving births 1-7 (mean number 5.6), follow-up time 16-34 months ( mean time 26 month), operation time 30-70 minutes (mean time 47.9 minutes). None of the patients had a complication during the operation. Urethral catheterization period ranged 3-10 days (mean time 7.7 days) and the patients were discharged between 3-10 days (mean time 7days after operation). We concluded that pubovaginal facial sling and vaginal wall sling operations were effective procedures with low complication rates compared with other procedures and should be used in incontinence surgery. Key Words: Stres urinary incontinence, cystocell, surgery, treatment 62
- Published
- 2005
48. Mesane kanserli hastaların tanı ve takibinde üriner NMP22 testinin önemi
- Author
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Arikan, Yilmaz, Kılıçarslan, Hakan, and Üroloji Ana Bilim Dalı
- Subjects
Oncology ,Urology ,Üroloji ,Onkoloji - Abstract
24 Özet Bu çalışma Ağustos 1999-Ekim 2000 tarihleri arasında Cumhuriyet Üniversitesi Tıp Fakültesi Üroloji Anabilim Dalı'nda yapıldı. Çalışmaya yaşları 19 ile 95 arasında olan 103 hasta dahil edilerek, iki gruba ayrıldı. Birinci grubu daha önce mesane kanseri tanısı olan, rekürrens açısından takip edilen 34 hasta, ikinci grubu ise makroskopik hematüri nedeniyle mesane kanserinden şüphelenilen 69 hasta oluşturmaktaydı. Kanser tespit edilen hastalar kanserin evresine, odak sayısına ve büyüklüğüne göre gruplandırılarak üriner NMP22 sonuçları değerlendirildi. Birinci gruptaki hastalarda üriner NMP22 testinin duyarlılığı %73.33, özgüllüğü %73.68 olarak bulundu. İkinci gruptaki hastalarda üriner NMP22 testinin duyarlılığı %58.62, özgüllüğü ise %60 olarak bulundu. Yüzeyel kanseri olan 31 hastanın 15 'inde (%48.38) üriner NMP22 testi pozitif, median değer 8.20 U/ml idi. İnvaziv kanseri olan 13 hastanın hepsinde üriner NMP22 testi pozitif, median değer 70.90 U/ml idi. İki grup arasındaki üriner NMP22 değerleri arasındaki fark istatistiksel olarak anlamlı bulundu (p=0.037; p0.05). Birinci grupta 5 yalancı pozitif üriner NMP22 değeri vardı. Bu hastaların 2'sinde intrakaviter immün BCG, 2'sinde intrakaviter mitomycin-C kullanımı, 1 hastada üriner enfeksiyon vardı. İkinci grupta 16 yalancı pozitif üriner NMP22 değeri vardı. Bunların 2'sinde üriner enfeksiyon, 2'sinde BPH, 3'ünde üriner enfeksiyonla beraber BPH, 2'sinde RHK, 2'sinde ürolitiyazis 1 hastada mesaneye fistülize olmuş sigmoid kolon adenokanseri, 1 hastada renal tüberküloz saptanırken, 3'ünde hiçbir neden bulunamadı. Kanser belirleyicilerinin klinikte uygulanışının pratik olması en önemli özelliklerinden birisidir. Yanlış pozitif sonuçlara neden olan etkenleri ortadan kaldırmak mümkün olmakla birlikte, başka kanser varlığı gibi etkenleri gidermek olanaksızdır. Üriner kanser belirleyicilerinin duyarlılığı %100 olmadığı sürece, sistoskopinin zaman aralığının uzatılması önerilemez. Üriner kanser belirleyici testlerin özellikle yüzeyel mesane kanserlerinde düşük duyarlılık göstermeleri ve yalancı pozitiflikleri dezavantajlarıdır. Noninvaziv kanser belirleyicileri, invaziv bir yöntem olması nedeniyle sistoskopiye göre avantajlıdır, fakat güvenilirlikleri tam olana kadar mesane kanserinin izlenmesinde sistoskopiye yardımcı olarak kalacaklardır. 33
- Published
- 2001
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