Browsing by Author "Aslan, Rahmi"

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46 Xx Testiküler Bozukluk Sendromu Olgusu
(2019) Eryılmaz, Recep; Demir, Murat; Aslan, Rahmi
‘’46 XX testiküler bozukluk’’ hastalığı genotip olarak 46 XX olup fenotip olarak erkekolan hastaları tanımlamaktadır. Bu hastalardanormal genital yapıdan ambiguus genitalyayakadar uzanan genital yapı farklılığı ile kendinigösterebilir. Bu olgumuzda infertilite nedeniyle tarafımıza başvuran 46 XX testiküler bozukluk sendromu olgusunu sunmayı amaçladık.
Benign ve Malign Böbrek Kitlelerinin Enflamasyon Markerlarıyla Ayrımı
(2021) Taken, Kerem; Ertaş, Kasım; Aslan, Rahmi; Eryılmaz, Recep; Demir, Murat
Amaç: Görüntüleme yöntemlerindeki son gelişmelere rağmen, böbrek kitlelerinin patolojisini tahmin etmede hala %10-20 oranı yetersizdir. Bu nedenle, hematolojik enflamatuvar belirteçlerin patoloji sonucunu tahmin etmede yararlı olup olmadığını incelemeyi amaçladık. Yöntem: Ocak 2010 ile Ekim 2020 tarihleri arasında böbrek kitlesi nedeniyle opere edilen 116 hasta çalışmaya dahil edildi. Retrospektif olarak preoperatif trombosit, nötrofiller, lenfosit sayıları ve oranları patoloji sonuçları ile karşılaştırıldı. Bulgular: Çalışmaya alınan 116 hastanın yaş ortalaması 55,36±13,93 yıl idi. Yirmi altı (%22,4) hastanın patoloji sonuçları benign iken 90’ı (%77,6) malign idi. Nötrofil sayısı ve nötrofil lenfosit oranı benign grupta anlamlı olarak daha düşüktü. Renal hücreli karsinomlu hastalarda yüksek Fuhrman derecelerinde trombosit sayısı ve trombosit lenfosit oranı daha yüksek iken lenfosit sayısı ise daha düşüktü. Sonuç: Hematolojik enflamatuvar belirteçler, ameliyattan öncesi böbrek kitlelerinin patoloji sonucunu tahmin etmede yararlıdır
Böbrek Kitlelerinin Benign-malign Ayırıcı Tanısında Bilgisayarlı Tomografi Dansite Değerlerinin Etkinliği
(2021) Özgökçe, Mesut; Kankılıc, Nazım A; Aslan, Rahmi; Gul, Abdullah; Özkaçmaz, Sercan; Dündar, İlyas
Amaç: Benign ve malign böbrek kitlelerinin ayrımında kontrastlı ve kontrastsız Bilgisayarlı Tomografi imajlar üzerinde lezyonlardan ölçülen ortalama Hounsfield Unit (HU) değerinin rolünü araştırmayı amaçladık.Araçlar ve Yöntem: Bu retrospektif çalışmada böbrekte kitle nedeniyle biyopsi yapılan hastaların histopatolojik sonuçları, demografik özellikleri ve Bilgisayarlı Tomografi incelemeleri hastane veritabanından tarandı. Hastaların patoloji sonuçları benign ve malign olarak gruplara ayrıldı. Kontrastlı ve kontrastsız bilgisayarlı tomografi imajlarda lezyonlardan ortalama dansiteler HU olarak ölçüldü. Benign ve malign gruplar arasında ölçülen HU değerleri açısından student t testi ile karşılaştırmalar yapıldı.Bulgular: Kontrastlı BT’si olan ve histopatoloji sonucu malign çıkan hastaların (17 erkek,11 kadın hasta) ölçülen HU değerlerinin ortalaması 83,7± 39,4 benign çıkanların (5 erkek,4 kadın) ortalaması ise 81,0± 52,9 olup iki grup arasında anlamlı farklılık saptanmadı (p:0.8704). Kontrastsız BT’si olup histopatoloji sonucu malign çıkan hastaların (12 erkek,9 kadın hasta) ölçülen HU değerlerinin ortalaması 29,3± 8,1, benign çıkanların (1 erkek, 4 kadın) ortalaması ise 9,4± 42,0 olup benign grupta HU değeri anlamlı olarak düşük bulundu. (p:0.0426). Sonuç: Kontrastlı BT imajlarında (70. Saniye) renal kitlelerden ölçülen ortalama HU değerlerinin çalışmamızda malign-benign kitle ayrımına katkı sağlamadığı saptanmıştır ancak kontrastsız imajlarda ölçülen değerler bu ayrım için faydalı olabilir.
Comparative Evaluation of Bilateral Pudendal Nerve Blockade and Periprostatic Nerve Block in Transrectal Ultrasound Guided Prostate Biopsy: a Prospective Randomised Trial
(Polish Urological Assoc, 2020) Aslan, Rahmi; Erbin, Akif; Eryilmaz, Recep; Taken, Kerem
Introduction Although the periprostatic nerve block (PNB) is accepted as the standard method for local anesthesia prior to transrectal ultrasound (TRUS)-guided prostate biopsy, it is not the most ideal method. We aimed to analyze the effectiveness and safety of bilateral pudendal nerve blockage (PuNB) by comparing with PNB. Material and methods Between June 2019 and October 2019, a total of 108 patients with elevated serum prostate specific antigen values (PSA >= 4 ng/ml) and/or abnormal digital rectal examination findings were included in the study. After exclusion criteria, the remaining 91 patients were randomly divided into two groups as PuNB (n = 46) and PNB (n = 45). Pain during local anesthesia application was recorded as a visual analog scale (VAS) 1, pain during placement of the rectal probe and manipulation was recorded as VAS 2 and pain during needle penetration into prostate tissue and sampling was recorded as VAS 3. Results No significant difference was found between the two groups with regard to age, body mass index, serum PSA, prostate volume and prostate cancer rates. Mean VAS-2 score was significantly lower in the PuNB group when compared with the PNB group. There was no significant difference in terms of VAS-1 and VAS-3 scores. There was no significant difference between the groups in terms of mild and severe complications. Conclusions Both techniques are safe for TRUS-guided prostate biopsy; however, PuNB provided more effective pain control compared to PNB especially during placement of rectal probe and manipulation.
Comparison of Ceftriaxone and Cefazolin Sodium Antibiotic Prophylaxis in Terms of Sirs/Urosepsis Rates in Patients Undergoing Percutaneous Nephrolithotomy
(Galenos Yayincilik, 2019) Taken, Kerem; Asik, Alper; Eryilmaz, Recep; Aslan, Rahmi; Donmez, Muhammet Irfan; Gunes, Mustafa
Objective: The aim of this study is to compare ceftriaxone and cefazoline sodium antibiotic prophylaxis in terms of development of Systemic Inflammatory Response syndrome (SIRS)/urosepsis in patients undergoing percutaneous nephrolithotomy (PCNL). Materials and Methods: Patients who underwent PCNL between June 2015 and October 2015 in our hospital were prospectively randomized to ceftriaxone (n=30) and cefazoline sodium (n=32) antibiotic prophylaxis groups. Patients with predisposing conditions to SIRS were excluded. Intraoperative urine cultures from renal pelvis and stone cultures were obtained from all patients. Clinical and laboratory findings of the patients who developed postoperative fever were evaluated. SIRS and urosepsis rates were compared between two groups. Results: There were 7 patients in ceftriaxone group (23.3%) and 4 patients in cefazoline sodium group (12.5%) who developed SIRS (p=0.264). Sepsis was observed in 2 patients in both groups (p=0.826). Prolonged duration of surgery in ceftriaxone group and renal pelvis urine culture positivity in cefazoline group were found to be statistically significant in patients who developed SIRS (p=0.02, p=0.015, respectively). Conclusion: There was no significant difference between two groups in terms of SIRS and sepsis following PCNL. Therefore, cefazoline, which has a narrower antimicrobial spectrum, may be preferred for prophylaxis.
Comparison of Complications Following Laparoscopic Radical and Simple Nephreoctomy Using the Clavien-Dindo Clasification
(Galenos Yayincilik, 2019) Eryilmaz, Recep; Aslan, Rahmi; Taken, Kerem; Gunes, Mustafa
Aim: In this article, we aimed to compare the complications occurring after laparoscopic radical (LRN) and simple nephrectomy (LSN). Methods: After obtaining local ethics committee approval, we analyzed the records of a total of 98 patients, who underwent transperitoneal laparoscopic nephrectomy. LSN and LRN were performed in 64 and 34 patients, respectively. The Clavien-Dindo classification was used for evaluating complications. Pneumoperitoneum was created using a Veress needle. Intraabdominal carbon dioxide pressure was 18 mmHg while three 10 mm trocars were inserted and then one 5 mm trocar was inserted if needed. Results: The mean age of the LSN and LRN patients was 38.8 +/- 18.43 and 55.7 +/- 14.75 years, respectively. Five patients who underwent LSN developed postoperative minor complications (fever in one patient, nausea and vomiting in four patient). In addition, one patient who underwent LSN died postoperatively (vascular injury). Minor complications (fever in two patients, nausea and vomiting two, and ileus in one patient) developed postoperatively in five of 34 patients in LRN group. Conclusion: The rate of complication after LRN was found to be statistically significantly higher than that after LSN.
Comparison of Laser and Pneumatic Lithotripters Used in the Ureterorenoscopi̇c Treatment of Proximal Ureter Stones
(2019) Araz, Şeyhmuz; Aslan, Rahmi
Amaç: Proximal üreter taşı olan hastalarda Üreteroskopik LL ve PL tedavi yöntemlerinin etkinliklerinin ve güvenirliğinin araştırılması amaçlandı. Gereç ve yöntem: 1 ekim 2013 ile 1 ekim 2018 tarihleri arasında kliniğimizde proximal üreter taşı nedeniyle Üreteroskopik LL ve PL tedavisi uygulanan 244(LL:139, PL:105) hastanın dosyaları retrospektif olarak incelendi. Sonuçlar tedaviden 1 gün sonra ve 1 ay sonra yapılan direkt üriner sistem grafisi, üriner ultrasonografi, kontrastsız bilgisayarlı tomografi veya intravenöz ürografi ile değerlendirildi. Üreteroskopik LL ve PL tedavi yöntemlerinin ameliyat süreleri, hastanede yatış süreleri, taşsızlık oranları ve komplikasyon oranları karşılaştırıldı. Bulgular: Bu çalışmaya LL grubuna 139, PL grubuna 105 hasta olmak üzere toplam 244 hasta dahil edildi. LL grubunda 101 (%72.6) erkek, 38 (%27.42) bayan hasta, PL grubunda ise 79 (%75.2) erkek, 26 (%24.8) bayan hasta mevcuttu. LL grubuna alınan hastaların yaş ortalaması 44.47 ±15.702 yıl, PL grubuna alınan hastaların yaş ortalaması ise 41.24±13.723 yıl olarak saptandı. LL grubunda taş boyutları ortalaması 11.26±3,752 mm, PL grubunda ise 10.98± 4,572 mm olarak saptandı. LL grubunda taşların taraf dağılımı sağ %57.6 sol %42.4, PL grubunda ise sağ %43.8 sol %56.2 olarak saptandı. Majör Komplikasyon oranları sırasıyla %6.4 ve %9.4 olarak tespit edildi(P >0,05). Postop 1. Ay Taşsızlık oranları LL grubunda %87.1 , PL grubunda ise %81 olarak izlendi(P >0,05). Postop hastanede yatış süreleri LL grubu 17.12±4,511 saat, PL grubunda ise 25.26±29,657 saat olarak tespit edildi(P <0.05). ameliyat süreleri LL grubu 41.29±12,119 dakika, PL grubunda ise 36.10±12,972 dakika olarak hesaplandı(P <0.05). Sonuç: Proximal üreter taşı tedavisinde yüksek taşsızlık oranları ve düşük komplikasyon oranları nedeniyle her iki litotripsi yöntemi etkili ve güvenli bir şekilde kullanılabilir..
Comparison of Retrograde Intrarenal Surgery, Mini Percutaneous and Super Mini Percutaneous in the Treatment of <2cm Renal Lower Pole Stones
(2020) Taken, Kerem; Duran, Mehmet Arif; Md, Kasim Ertas; Eryilmaz, Recep; Aslan, Rahmi
Renal lower pole stones are a common disorder in the community. In this study, we aimed to compare Retrograde intrarenal surgery (RIRS), Mini PCNL(percutaneous nephrolithotomy) and Super Mini PCNL treatments in the treatment of lower pole stones. Patients who had lower pol renal stones with <20 mm stone sizes were en-rolled in the study. Preoperatively, renal stone and kidney characteristics were evaluated renal ultrasonography, intravenous pyelography and/or non-contrast abdominal computed tomography (CT). RIRS, Mini PCNL and Super Mini PCNL surgery methods were performed. Holmium laser and pneumatic lithotriptor were used for stone lithotripsy. The mean age of the patients in the RIRS group was 35 ± 5.23 years, the mean age in the Mini PCNL group was 38.3 ± 6.47 years and the mean age in the Super Mini PCNL group was 34.12 ± 3.56 years. RIRS were performed in 43 patients, Mini PCNL 37 patients and Supper Mini PCNL 35 patients.Stone free in RIRS was 74.3% Mini PCNL was 93.3% Super Mini PCNL was 94.6 %. According to clavien dindo classification postop grade2-3 complication , in RIRS was 4,6%Mini PCNL was 8,1% .But no grade2-3 complication was seen in Super Mini PCNL group. Hospital stay of RIRS was 1.59± 2.03 mini pnl was 3.73±1.76 and Super Mini PCNL was 2.3±1.55.Cost analysis respectively ,RIRS group, $801.52 ± 25.32; Mini PCNL group, $698.33 ± 22.37; Super Mini PCNL group,$703.13±62. In lower pole stones, RIRS is minimally invasive and have less hospital stay.Stone free rates were higher in Mini PCNL and Super Mini PCNL than RIRS. Super Mini PCNL has short hospital stay and less postoperative complication rate than Mini PCNL. RIRS is more expensive than Mini PCNL and SMP.
Comparison of Supine-Prone Percutaneous Nephrolithotomy Methods in the Treatment of Kidney Stones in Pediatric Patients: Prospective Randomized Study
(Springer, 2024) Eryilmaz, Recep; Ertas, Kasim; Aslan, Rahmi; Sevim, Mehmet; Keles, Muhammed Fatih; Taken, Kerem
Mini-PCNL is one of the most effective surgical methods in the treatment of kidney stones in pediatric patients. In this study, we aimed to compare PCNL in the supine-prone position in pediatric patients (especially operation time, postop complications, hospital stay and stone-free rates).We conducted our study in a randomized and prospective manner. Patients with lower pole stones larger than 1 cm, stones larger than 1.5 cm in the pelvis, upper pole, midpole or multiple locations, and patients who did not respond to ESWL or whose family that preferred mini-PCNL to be the primary treatment were included in the study. Patients with any previous kidney stone surgery, patients with coagulation disorders and patients with retrorenal colon were excluded from the study. Between 2021 and 2023, a total of 144 patients underwent PCNL. 68 of these patients had supine PCNL and 76 prone PCNL. Postoperative Clavien grade1 complication occurred in a total of 7 patients in the prone position; Clavien grade1 complication occurred in 1 patient in the supine position. The mean operation time for prone PCNL was 119.88 +/- 28.32 min, and the mean operative time for supine PCNL was 98.12 +/- 14.97 the mean hospitalization time in prone PCNL was 3.56 +/- 1.12 days, and 3.00 +/- 0.85 days in supine PCNL. In conclusion, supine PCNL is a safe and effective method in the treatment of pediatric kidney stones and postoperative complications were observed to be less; the operation time and hospital stay were shorter in supine PCNL.
Comparison of Transrectal Ultrasound Achieved Prostate Biopsy and Index Tumor Detection Rate and Consistence of Biopsy and Radical Prostatectomy Gleason Score
(2022) Kırmızıtoprak, Şevder; Aslan, Rahmi
Radikal prostatektomi yapılan hastalarda bulunan Gleason skoru ile transrektal ultrasonografi eşliğinde prostat biyopsisinde elde edilen Gleason skoru ve D'Amigo risk sınıflamasının korelasyonunu araştırmaktır. Materyal metod: Bu çalışma, Nisan 2017- Ocak 2022 yılları arasında prostat kanseri tanısı konulmuş ve radikal prostatektomi operasyonu yapılmış hasta dosyaları retrospektif olarak incelendi. Hastaların yaşları, TRUS Bx öncesi PSA değerleri, TRUS Bx GS, RP spesmeni GS, invazyon derecesi (TNM sınıflaması), D'Amico risk sınıflamasına göre risk sınıfı, postop komplikasyonları, izlem süresi (AY), RP sonrası ek tedavi gereksinimi kaydedildi. Bulgular: Çalışmaya alınan 39 hastanın yaş ortalaması 65,72±5,93 yıl, pre op PSA değeri 11,77±7,53 ng/ml, post op takip süreleri (ay) ortalama 21,23±17,53 olarak elde edildi. TRUS Bx örneklerinin GS ile RP örneklerinin GS hastaların 30 (%76,9)'unda uyumlu izlendi. TRUS Bx örneklerinde hastaların 5 (%12,9)'ünde düşük derecelendirme, 4 (%10,2)'inde ise yüksek derecelendirme yapıldığı görüldü. Toplam 27 (%69,2) hastanın D'Amico risk sınıflaması pre op ve post op uyumlu olarak bulunmuştur. 9 (%23) hastanın post op D'Amico sınıflaması pre op sonuçlarına göre düşük riskli bulunmuş olup 3 (%7,8) hastanın post op D'Amico sınıflaması yüksek riskli bulunmuştur. Gleason skorları ve D'Amico risk sınıflaması arttıkça post op tedavi ihtiyacı ve persistan PSA oranının arttığı izlendi. Sonuç: TRUS Bx spesmenlerinin GS'ları ile RP spesmenlerinin GS'ları yüksek derecede uyumlu olduğu görüldü. Aynı zamanda D'Amico sınıflaması pre op ve post uyumu yüksek derecede izlendi. Hastaların önemli bir kısmında post op D'Amico sınıflaması pre op sonucuna göre daha düşük bulundu. TRUS Bx GS'nin ve D'Amico sınıflamasının güvenirliği ve etkinliği tedavi modalitesine karar vermede etkin birer yöntemlerdir. Hekimlerin daha sağlıklı kararlar verebilmeleri için, biyopsi sonrasında patoloji sonuçlarını ele alırken GS'de alınacak hata payı olasılığını akılda tutulması gerekir.
The Diagnostic Value of Ischemia-Modified Albumin in Prostate Cancer
(Galenos Yayincilik, 2020) Aslan, Rahmi; Eryilmaz, Recep; Sevim, Mehmet; Demir, Murat; Taken, Kerem
Aim: The aim of this study was to investigate whether serum ischemia-modified albumin (IMA) levels have a diagnostic value in prostate cancer (Pca). Methods: Thirty primary Pca patients and 30 age-matched healthy male subjects were included in this prospective case-control study. The patients were selected from the urology clinic of a tertiary university hospital. Healthy men included in the control group were selected from hospital staff and patient relatives. Patients with severe chronic diseases and other malignancies were excluded. Serum IMA level was measured using the colorimetric method. The results were reported in absorbance unit (ABSU). Results: Serum IMA levels were significantly higher in the study group when compared to the control group (0.843 +/- 0.76 and 0.443 +/- 0.49 ABSU, respectively; p=0.002). The mean IMA value in patients with a Gleason score >= 7 (1.08 +/- 0.053 ABSU) was significantly higher than in patients with Gleason score <= 6 (IMA 0.418 +/- 0.64 ABSU). According to the receiving operating characteristic (ROC) analysis, when the cut-off value was ABSU=0.57, the sensitivity and specificity were 80% and 56.7%, respectively. Conclusion: Serum concentrations of IMA are significantly elevated especially in clinically significant Pca patients. Its high sensitivity (80%) in ROC analysis suggests that IMA can be used an ancillary biomarker in diagnosis.
Does Tamsulosin Use Before Ureteroscopy Increase the Success of the Operation
(Coll Physicians & Surgeons Pakistan, 2022) Demir, Murat; Ertas, Kasim; Aslan, Rahmi; Eryilmaz, Recep; Sevim, Mehmet; Taken, Kerem
Objective: To investigate the effect of preoperative tamsulosin use on the success and complications rates of ureteroscopy for ureteral stone removal. Study Design: A randomised clinical trial. Place and Duration of Study: Department of Urology, Dursun Odabas Medical Center, Van Yuzuncu Yil University, Turkey, from December 2020 to June 2021. Methodology: Patients were scheduled for ureteroscopy due to ureteral stones, and were randomly divided into two groups; 67 patients preoperatively were given 0.4 mg tamsulosin for 7 days and 70 patients were not given tamsulosin. Each patient's intraoperative surgical complications, preoperative and postoperative pain, postoperative fever, need for analgesia, stone-free rate, and double J ureteral stent (DJ) insertion rates were recorded and evaluated. Results: A total of 137 patients, 103 (75.1%) males, and 34 (24.8%) females, were included. In 70 (51.1%) of these patients, the stone was on the right side, while in 67 (48.9%) the stone was on the left side. The stone was in the distal ureter in 47 (34.3%) patients, in the middle in 38 (27.7%) patients, and the proximal in 52 (37.9%) patients. The patients who were given tamsulosin had lower preoperative visual analog scale (p=0.02), operation time (p=0.003), post-ureteroscopic lesion scale (p=0.01), postoperative 24th-hour visual analog scale (p=0.03), fever (p=0.02), and analgesic need (p=0.04), while their rate of accessing the stone (p=0.02); and their stone-free rates (p=0.02) was higher. Conclusion: Preoperative tamsulosin use increases the success of the operation and reduces complications.
Effect of Combined Use of Tolterodine and Continuous Positive Airway Pressure Vs Continuous Positive Airway Pressure Only Treatment on Overactive Bladder Symptoms in Women With Moderate-To Obstructive Sleep Apnea Syndrome: a Randomized Clinical Trial
(Springer London Ltd, 2022) Ertas, Kasim; Yildiz, Hanifi; Demir, Murat; Aslan, Rahmi; Eryilmaz, Recep; Kirmizitoprak, Sevder; Taken, Kerem
Introduction and hypothesis Obstructive sleep apnea syndrome is associated with urological symptoms, including overactive bladder (OAB). This study aims to determine whether combined tolterodine and CPAP therapies are more effective for patients with OSAS than CPAP treatment only. Methods Women who underwent polysomnography test and were diagnosed with moderate-to-severe OSAS with apnea-hypopnea index (AHI) were included in the study. Data were collected on AHI, OAB awareness-8-item tool (OAB-V8), incontinence questionnaire-urinary incontinence short form (ICIQ-UI-SF), total daily urine volume (DUV), and the Benefit, satisfaction with treatment and willingness (BSW) tool. Eligible patients were randomized to receive either CPAP treatment only or combined CPAP and tolterodine treatment for 3 months. Results Among 103 participants, a total of 60 were included. Patients in both treatment arms showed significant improvements in OAB-V8, ICIQ-UI-SF, and total DUV compared to their baseline. The mean OAB-V8 was 15.7 at baseline and 5.6 at 3 months for the combined treatment arm and 16.6 and 7.6 at 3 months for the CPAP group only (mean baseline-adjusted between-group difference -1.1 [95% CI, -12.3 to -7.4]; p < 0.001). The improvement in the mean ICIQ-UI-SF was also statistically more significant in the combined therapy group than in the CPAP only arm (mean baseline-adjusted between-group difference -3.27 [95% CI, -4.6 to -1.59]; p < 0.001). No statistical significance was found in the improvement of total DUV between the groups. Conclusions In this study, combined use of tolterodine with CPAP provides beneficial effects to CPAP treatment only regarding OAB symptoms. Further research is required to confirm these findings in a large cohort.
The Effect of Plasma Rich Platelet Graft on Post-Operative Complications in Mid-Penile Hypospadias
(Wiley, 2020) Eryilmaz, Recep; Simsek, Metin; Aslan, Rahmi; Beger, Burhan; Ertas, Kasim; Taken, Kerem
Hypospadias is one of the most common penile congenital anomalies, which often requires a surgical approach. After the hypospadias is repaired, urethral fistula can occur in around 20% of patients. In this study, we used platelet-rich plasma (PRP) to reduce the urethral fistula and other post-operative complications after hypospadias repair. Only patients with primary mid-penile hypospadias were included study. Patients with forms other than mid-penile hypospadias and cases with previous hypospadias surgery were excluded from the study. A total of 40 hypospadias patients were included in this study. These patients were divided into groups A and B with 20 patients in each group. Hypospadias repair was performed with the Snodgrass TIPU technique on both groups. PRP was used with group A, and PRP was not use with group B. These two groups were compared in terms of early and long-term post-operative complications. Both early and long-term post-operative UCF, urethral stenosis and post-operative infection rates were lower in the group using PRP, group A. PRP has the potential to prevent post-operative complications occurring after hypospadias repair, particularly post-operative infection.
The Efficiency of Acoustic Radiation Force Impulse (Arfi) Elastography in the Differentiation of Renal Cell Carcinoma and Oncocytoma
(Bentham Science Publ Ltd, 2024) Ozgokce, Mesut; Dundar, Ilyas; Durmaz, Fatma; Ozkacmaz, Sercan; Kankilic, Nazim A.; Aslan, Rahmi; Akinci, M. Bilal
Purpose This study is to investigate the effectiveness of Acoustic Radiation Force Impulse (ARFI) elastography in differentiating radiologically similar renal cell carcinoma (RCC) and oncocytoma in solid masses of the kidney. Methods The patients with solid renal mass histopathological diagnosed after excision or tru-cat biopsy who underwent a preoperative ARFI elastography of the lesion during a 4-year period were included in this study. Preoperative shear wave velocity (SWV) values were measured in all the lesions. SWV results of RCCs and oncocytomas were compared by an independent t-test, and cut-off, sensitivity and specificity values were calculated. Results Forty-two of the 60 patients included in the study were men (70%) and, 18 were women (30%), and the mean age was 59.7 +/- 14 (27-94) years. Among 46 RCCs (76.6%), 23 and 14 oncocytomas, 5 (23.4%) were located in the right kidney (p:0.34722). Mean SWV values were found to be significantly higher in RCCs (2.87 +/- 0.74 (0.96-4.14) m/s) than oncocytomas (1.83 +/- 0.78 (0.80-3.76) m/s) (p <0.001). In the ROC analysis, a cut-off value of 2.29 m/s was found to havean 80.4% sensitivity and a 78.6% specificity for the discrimination of RCCs from oncocytomas. Conclusion ARFI elastography measurements may be useful in distinguishing RCC and oncocytomas that may have similar solid radiological imaging features.
Evaluation of Hemorrhoidal Disease and Lower Extremity Venous Insufficiency in Primary Adult Varicocele: a Prospective Controlled Study
(Sage Publications inc, 2019) Aslan, Rahmi; Erbin, Akif; Celik, Sebahattin; Ucpinar, Burak; Sahinalp, Sahin; Yildizhan, Murat; Taken, Kerem
Background The study investigated the association between varicocele, lower extremity venous insufficiency and hemorrhoidal disease. Methods The study included 62 patients with varicocele and 60 voluntary subjects with no varicocele. Patients who were diagnosed as having varicocele on physical examination and Doppler ultrasonography were included in the study group. Examination of lower extremity venous insufficiency was performed by physical examination and Doppler ultrasonography. Examination of hemorrhoidal disease was performed by a general surgery specialist. Results The patients with varicocele had a statistically significant (p < 0.05) higher rates of venous insufficiency of the lower extremities and had a borderline significant difference of higher hemorrhoidal disease rates (p = 0.05). Therewithal incidences of hemorrhoidal disease and lower extremity venous insufficiency were significantly higher in body mass index > 25 and age > 30 years of varicocele patients. Conclusion There is a statistically significant relation between varicocele, lower extremity venous insufficiency, and hemorrhoidal disease. In particular, varicocele patients who are aged over 30 years and overweight are at higher risk.
Examining Changes on Testicular Structure and Sperm Analysis of Covid-19 Patients
(Wiley, 2022) Ertas, Kasim; Eryilmaz, Recep; Yokus, Adem; Korpe, Kadir; Geduk, Nurullah; Ozkan, Mazlum; Aslan, Rahmi
This study aimed to examine the testicular functions with sperm analysis of patients with COVID-19. The study was carried out with male patients aged between 18 and 50 years with positive RT-PCR test and SARS-CoV-2 virus between December 2020 and April 2021. A total of 103 participants were included in the study. The mean age was 31.24 +/- 5.67 (19-45) years and the mean body mass index of the participants was 28.41 +/- 4.68 kg/m(2). The patients were divided into two groups, group-1 was patients who had COVID-19, group-2 was healthy men. A semen analysis of both groups was performed, and the serum total testosterone, FSH, LH, anti-mullerian hormone and Inhibin-B tests were analysed and recorded. The testicular dimensions and testicular densities were examined by ultrasound and elastography for both groups. Comparing the patient and control groups results, this study found that the sperm count per 1 cc (p = 0.01) and total motility (p = 0.01) in group-1 was lower than in the control group, the testicular dimensions decreased (for right testis group-2 was 15.39 +/- 4.78 ml versus group-1 was 12.11 +/- 4.62 cm(3) p < 0.01, for left testis group-2 was 16.01 +/- 5.12 versus group-1 was 11.92 +/- 4.78 cm(3); p < 0.01), and the shear wave velocities were significantly higher in group-1 patients. In conclusion, sperm parameters deteriorate in men who have symptomatic disease with SARS-CoV-2 infection. The fact that the cause of this deterioration is characterized by changes at the cellular level in the testis raises doubts about the persistence of this condition.
Levels of Serum Trace Elements in Patients With Peyronie
(Taylor & Francis Ltd, 2020) Gunes, Mustafa; Aslan, Rahmi; Eryilmaz, Recep; Demir, Halit; Taken, Kerem
Aim: The etiology of the disease of Peyronie is not certainly known. However, penile micro traumas are thought to be important in the pathogenesis of Peyronie's disease (PD) in genetically predisposed individuals. In this study, we aimed to determine the relationship of some trace element and heavy metals with PD. Material and methods: Thirty Peyronie patients and 26 healthy volunteers were included in the study. In individuals in both groups, levels of serum trace elements (Manganese [Mn], Cu, Cobalt (Co), zinc [Zn], Cd, and iron [Fe]) were determined separately by Atomic Absorption Spectrophotometer method in Yuzuncu Yil University Central Research Laboratory. Results: Mn, Cu, Zn, and Fe levels in Peyronie patients were statistically significantly lower when compared to the healthy control group (p < .05). Cd and Co levels were similar for both groups but not statistically significant (p > .05). Conclusions: The changes in trace element levels are related to the etiopathogenesis of PD. We think that our study is the first from this aspect.
Mesane Kanseri Hastalarında de Ritis Oranının Önemi
(2020) Demir, Murat; Aslan, Rahmi; Taken, Kerem; Eryılmaz, Recep; Ertaş, Kasım
Amaç:Çoksayıdaçalışmadabelirtildiğiüzere,serumaspartattransaminaz/alanin transaminaz (AST/ALT) oranı (De Ritis Oranı) ile kanser olguları arasında ilişki bulunmaktadır. Ancak araştırmacıların elde ettikleri sonuçlar tartışmalıdır ve çoğu bilimsel makalede farklı sonuçlar bulunmaktadır. Ürotelyal karsinoma hastalarında De Ritis oranının arttığını gösterenaraştırmalarmevcuttur.Buçalışmadadiğeraraştırmalarlabenzer bir biçimde De Ritis oranı ile mesane kanseri arasındaki ilişki araştırılmıştır. Yöntem: Bu çalışma hastanemizin 20/07/2018 tarihli ve 2018/12 belge no’luetikkuruluonayımüsaadesincegerçekleştirilmiştir.Çalışmayamesane kanserinden ameliyat edilen 172 hasta ve 68 sağlıklı bireyden oluşan kontrol grubu dahil edilmiştir. Bu hastaların AST/ALT değerleri ile tümör evreleri, patolojileri arasında bir ilişki olup olmadığı değerlendirilmiş, ayrıca De Ritis oranının sağlıklı ve hasta bireyler arasında farklılık gösterip göstermediği retrospektif olarak araştırılmıştır.Bulgular: Yüz yetmiş iki hasta ve 68 kontrol grubu olmak üzere toplamda 240 kişinin değerlendirildiği bu çalışmada, AST/ALT oranı ile tümör evresi, tümör patolojisi, ultrason bulguları, tümör boyutu arasında herhangi bir istatistiksel anlamlılık gözlenmemiş, buna karşın kontrol grubu ile mesane kanseri hastaları arasında AST/ALT oranı bakımından istatistiksel olarak farklılık gözlenmiştir. Mesane kanseri hastalarında De Ritis oranı (AST/ALT) kontrol grubuna göre yüksek bulunmuştur (ortalama: 1,18/0,91). Sonuç: Bu çalışmanın bulgularına göre, mesane tümörü hastalarında AST/ALT oranı kontrol grubu ile karşılaştırıldığında farklılık göstermektedir. Bu nedenle, De Ritis oranının bu hastaların değerlendirilmesind
Mikroperkütan Nefrolitotomide İlk Deneyimlerimiz
(2016) Ergün, Müslüm; Teken, Kerem; Gunes, Mustafa; Aslan, Rahmi; Eryılmaz, Recep; Geçit, İlhan
Amaç: İlk mikro-Perkütan nefrolitotomi (mikro-PNL) deneyimlerimizi değerlendirmeyi amaçladık.Gereç ve Yöntemler: Bu çalışmada, Ağustos 2014 ile Ocak 2015 tarihleri arasında Yüzüncü Yıl Üniversitesi Tıp Fakültesi Hastanesi üroloji kliniğinde böbrek taşınedeniyle Mikro- Perkütan Nefrolitotomi yapılan ilk 10 hasta değerlendirildi. İşlem genel anestezi altında, pron pozisyonunda uygulandı. Çalışmada 4.85 Fr microperc sistem kullanıldı. Fragmantasyonda 200 mikron veya 270 mikronlazerfiberi[8Hz(6.4W)0.8J]kullanıldı. Postoperatif nefrostomi tüpü bırakılmadı. Tüm hastalar ameliyat sonrası 1.gün ve 1.ayda DÜSG ve USG ile değerlendirildi. Rezidü taş kaldığı düşünülen hastalar BT ile değerlendirildi. Bulgular: Çalışmamızda hastaların ortalama yaşı 26.7 ± 20.6 (3-43) yıl, ortalama taş boyutu 13.1 ± 5.15 (0.9-22) mm ve ortalama cerrahi süresi 38 (24-58) dk olarak hesaplandı. Ortalama hastanede kalış süresi 1.76 ± 0.65 (1-5) gün, ortalama hemoglobinde düşme seviyesi 0.82 ± 0.84 (0-1.3) mg/dL olduğu izlendi. Hiçbir hastaya kan transfüzyonu yapılmadı. Hastaların 4 (%40)' üne DJ stent uygulandı. Hastaların birinde postoperatif dönemde renal kolik izlendi ve 3 yaşında olan bir hastada ise abdominal distansiyon izlendi. Bu hastalar konservatif olarak tedavi edildiler.Ayrıca bir hastada ise ateş izlendi. Bir hastada rezidü taş olduğu BT ile saptandı. Sonuç: Mikroperkütan nefrolitotomi, düşük-orta büyüklüktekiböbrektaşlarınıntedavisindegüvenliveetkin bir tedavi yöntemidir.