Browsing by Author "Taken, K."

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Approaches in the Treatment of Urethral Strictures
(Yuzuncu Yil Universitesi Tip Fakultesi, 2019) Demir, M.; Taken, K.
Urethral strictures are defined as the narrowing of the anterior urethral lumen or as corpus spongiosum fibrosis. Anterior urethral strictures can be divided as iatrogenic, inflammatory, idiopathic, and traumatic based on their etiology. Lower urinary tract septomas develop as a result of this disease. Many complications may occur in untreated patients.Cystoscopy, retrograde urethrography and ultrasonography can be used to diagnose the disease.Treatment methods are endoscopic and open surgery.Endoscopic treatment methods include dilatation, cold knife and laser internal uretrotomy. Recurrent bulbar urethral strictures; ”End-to-end anastomosis urethroplasty“ technique for short stenosis shorter than 2 cm. The technique of like ogmented anastomosis urethroplasty an with buccal graft is used for longer or complicated stenosis. © 2019, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Can the Irisin Be a Biomarker for Prostate Cancer? a Case Control Study
(Asian Pacific Organization for Cancer Prevention, 2020) Aslan, R.; Alp, H.H.; Eryılmaz, R.; Huyut, Z.; Sevim, M.; Araz, S.; Taken, K.
Aim: There is much evidence of an association between cancer and irisin that is an adipokine. This study researched on the relationship between prostate cancer (PCa) and irisin levels, and whether irisin can be used as a biomarker in the diagnosis of PCa. Materials and Methods: For the study groups, 50 primary PCa patients and 30 healthy male subjects were included in the PCa and healthy control groups, respectively. All volunteers in the healthy control group were screened for prostate cancer and other malignancies and chronic diseases. Volunteers who were determine to be completely healthy were included for healthy control group. In the serum samples of the subjects were measured free PSA, total PSA and irisin levels. Irisin levels were compared separately in terms of the Gleason scores and T stage. In addition to intergroup comparisons, the ROC curve for the irisin was plotted and power analysis was performed. Results: Free and total PSA levels in the PCa group were significantly higher compared to the healthy control group (p<0.05). In addition, irisin levels in the PCa group were significantly lower than in the healthy control group (p<0.05). There was no significant difference between irisin levels in the groups classified in terms of Gleason scores (p>0.05). When the cut-off value was taken as 8.1, the sensitivity and specificity of irisin for PCa were as 80.5% and 90%, respectively. Conclusion: The results of this study indicate that the levels of irisin in the PCa group are considerably reduced and irisin may be used as a biomarker as well as free and total PSA. © This work is licensed under a Creative Commons Attribution Non Commercial 4.0 International License.
Clinicopathological Features and Survival Data of Localized Renal Masses in Young Adults
(Asian Pacific Organization for Cancer Prevention, 2018) Aslan, R.; Taken, K.; Eryilmaz, R.
Purpose: Renal tumors are rarely seen in young adults. In this study, was aimed to report the data of 18-40 years old patients with Renal Cell Carcinoma (RCC) whom we operated. Material and Method: We retrospectively reviewed the data of patients between the ages of 18 and 40 years old patients who have renal masses. All patients were evaluated with chest X-ray, Computed tomography (CT) and/or MRI. Radical or partial nephrectomy was performed for clinical localized masses with malignancy suspicion. Clinicopathological features and survival data of all the patients were recorded. In the follow-up protocol routine blood tests, chest X-ray and abdominal CT were used. Results: A total of 42 patients, [22 (52.4%) male and 20 (47.6%) female], with a mean age of 34.48 (range 18 to 40) were included in the study. Of these, 32 (%76) had RCC and 10 (24%) had benign pathologies. Female patients had more benign pathology (35% vs 13.6%). The most commonly subtype of RCC (n = 22% 69) was clear cell RCC (cRCC), while the most common benign mass was oncocytoma (n = 4% 40). At the mean follow-up period of 42.34 months, overall survival rate was found to be 93.8%. Conclusion: Young adults with localized renal mass have benign pathology in a considerable rate. All of the malign masses in this population have low Furhman grade (1 or 2). © 2018 Asian Pacific Organization for Cancer Prevention.
Comparison of Cystoscopy With Diffusion-Weighted Magnetic Resonance Images Used in the Diagnosis and Follow-Up of Patients With Bladder Tumor
(Elsevier Science Bv, 2010) Ceylan, K.; Taken, K.; Gecit, I; Pirincci, N.; Gunes, M.; Karaman, M.
Comparison of Focused and Unfocused Eswt in Treatment of Erectile Dysfunction
(Taylor and Francis Ltd., 2020) Eryilmaz, R.; Kaplan, Ş.; Aslan, R.; Demir, M.; Taken, K.
Recently, extracorporeal shock wave therapy (ESWT) is more commonly used in noninvasive treatment of erectile dysfunction (ED). There is no definitive treatment protocol on the use of ESWT. In this study, we aimed to compare focused and unfocused ESWT in ED. We created two groups, each including 20 patients with similar demographics. Focused ESWT is performed in one group, while unfocused ESWT is performed for the other group. Patients are assessed with IIEF-5 and EHS. Mean score of IIEF-5 was increased by 6.3 ± 3.3 (p <.05) from 9.6 ± 2.9 to 15.0 ± 5.0 in 3-month follow-up in the unfocused group. In the focused group, IIEF-5 score increased by 5.34 in average from 10.01 ± 2.5 to 15.4 ± 3.1. In conclusion, IIEF-5 score was significantly higher in the unfocused ESWT group than the focused ESWT group. © 2019 Informa UK Limited, trading as Taylor & Francis Group.
Could Bladder Wall Elastography Be Used as an Indicator for the Diagnosys of Bladder Outlet Obstruction by Benign Prostate Hyperplasia
(Yuzuncu Yil Universitesi Tip Fakultesi, 2020) Eryılmaz, R.; Aslan, R.; Arslan, H.; Demir, M.; Türkoğlu, S.; Araz, Ş.; Taken, K.
Benign prostatic hyperplasia (BPH) is one of the most common causes of bladder outlet obstruction in men. In this study we aimed to evaluate the elasticity of the bladder by Acoustic Radiation Force Impulse (ARFI) elastography in BPH patients. Fifty benign prostate patients were included in the study. After evaluation of patients in the outpatient clinic. A RFI elastography was performed with full bladder. Elastography was performed separately on the anterior, right and left walls of the bladder. Then the patient underwent uroflowmetry. The maximum flow rate and post-mix residual values in uroflowmetry were recorded. The mean age of the patients was 45.6 ± 3.77 The average of bladder anterior wall elasticity 3.39 ± 0.89, Bladder left wall elasticity 2,69 ± 0,82 and Bladder right wall elasticity was 3.69 ± 0.89.The mean prostate size 52.58 ± 24.16 The average of Qmax11.96 ± 4.85 The mean of PMR 77.8 ± 59.6 and mean of prostate elasticity was 2.97 ± 1.1 Urinary bladder wall elasticity with ARFI can be a diagnostic indicator for bladder outlet obstruction due to BPH. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Do the Medical Treatment Reduces the Rate of Surgical Treatment in Suspected Cases of Chronic Prostatitis Before Prostatectomy
(verduci Publisher, 2013) Gunes, M.; Gecit, I.; Pirincci, N.; Cecen, K.; Taken, K.; Ceylan, K.; Ozunver, H.
AIM: Our aim is to investigate how the chronic intraprostatic inflammation affect the course of the BPH (benign prostatic hyperplasia). PATIENTS AND METHODS: Between the dates of 2007-2011, the files of the patients who had TUR-P (transurethral resection of the prostate) and underwent open surgery were retrospectively reviewed because of BPH, and the patients were divided into two groups who were operated due to AUR (acute urinary retention) or LUTS (lower urinary tract symptoms) and the clinical data and pathology results of the two groups were compared in terms of chronic intraprostatic inflammation. RESULTS: There were evaluable data of 130 of 150 patients. The age range of the patients was 50-88. 52 of the 130 patients due to AUR and 78 of them due to LUTS underwent surgery. While there was chronic inflammation in 59 of the 130 patients, there was not in 71. The volume of the prostate and the average age of those who had chronic prostatitis with the combination of AUR were greater compared to the LUTS. CONCLUSIONS: It seems that chronic prostatitis is a factor which is often accompanied by BPH and affects the progression and pathology of the disease. The risk of acute urinary retention is more frequent in patients with chronic inflammation than in those who lack. In the future, related clinical trials with the relationship between the intraprostatic inflammation and BPH treatment are necessary and should include more cases and longer period of follow-up for these studies.
The Effectiveness of Extracorporeal Shock Wave Lithotripsy in the Treatment of Ureteral Stones in Children
(verduci Publisher, 2012) Pirincci, N.; Gecit, I.; Bilici, S.; Taken, K.; Tanik, S.; Ceylan, K.
PURPOSE: In our study, we evaluated retrospectively the efficacy of extracorporeal shock wave lithotripsy (ESWL) in the treatment of ureteral stones in children. MATERIALS AND METHODS: Between the dates of 2005-2010, 62 children who were applied ESWL due to the ureteral stone in our Clinic and consisted of 42 males and 20 girls whose mean age was 6.6 +/- 3.1 were evaluated. 31(50%) of the patients were upper ureteral stone, 10 (16.1%) of them were middle ureteral stone and 21(33.9%) of them were lower ureteral stone. The sizes of the stones were 4 to 17 mm, the average was 7.1 mm. ESWL was performed in the supine position for upper ureteral stones, in the supine/prone position for middle and lower ureteral stones. RESULTS: Stone-free rate was determined as 93.5% in three-month follow-up of the patients. Re-treatment was done at 14.5% of the patients. The implementation of ESWL was ended unsuccessfully at 4 children (6.5%). A significant difference was not detected between three-month stone-free rates in terms of the size of the stones and location. There was not any serious complication at any of the patients. CONCLUSIONS: According to these findings ESWL with its high stone-free rates and negligible complications is the first method to be refered in the treatment of ureteral stones in children.
Evaluation of Patients Who Underwent Radical Nephrectomy Due To Renal Tumor
(2013) Gunes, M.; Gecit, I.; Princci, N.; Taken, K.; Ceylan, K.; Reşit Öncü, M.
The aim of the present study was to evaluate the results of the cases that underwent radical nephrectomy due to renal cell carcinoma (RCC) and to discuss the results together with the literature. Eighty-three patients (51 males), who underwent radical or partial nephrectomy because of renal tumor between 2005 and 2011 were retrospectively evaluated 70 patients underwent open radical nephrectomy and 13 patients underwent open partial nephrectomy. With regard of tumor localization, 50 were localized in the left and 33 were localized in the right kidney. Tumor sizes varied between 2 cm to 16 cm. According to the subtypes of RCC, five-year survival rate was 72% for clear cell, 80% for papillary carcinoma, 66.6% for chromophobe, and 71.4% for other malignant lesions. Five-year disease specific survival rates of the patients with T1, T2, T3, and T4 renal carcinoma were 91.3%, 87.5%, 50%, and 0%, respectively. Radical nephrectomy is the standard method for the treatment of RCC. Survival rate in the patients with renal tumor is directly associated with the tumor stage.
Evaluation of Renal Colic Patients Attending the Emergency Department When the Covid 19 Pandemic Was First Announcement
(Yuzuncu Yil Universitesi Tip Fakultesi, 2022) Ertaş, K.; Gizli, G.; Demir, M.; Sevim, M.; Eryılmaz, R.; Aslan, R.; Taken, K.
Renal colic cases, which have an important place among patients presenting to the emergency department with pain complaints, have an important place in urological emergencies. In this study, patients who applied to the emergency department with suspected renal colic diagnosis during the Covid-19 pandemic were compared with those in the pre-pandemic period. Patients who applied to the Emergency Department with the colic type flank pain between March 2020 and May 2020 were included in the study. Diagnostic and treatment parameters of 1699 patients, inclu ding 199 pandemic and 1500 pre-pandemic control group, were evaluated in this study. As a result of the evaluation made, it was seen that emergency physicians preferred ultrasonography less during the pandemic period, and mostly resorted to computer tomography method, and in this period, a decrease in the rate of observed kidney stones, an increase ureter stones were observed. During the pandemic period, there has been a considerable decrease in the rate of hospital admissions As a result of postponing treatment of patients with urinary system stones, secondary pyonephrosis and pyelonephritis rates increased approximately 10 times compared to the pre-pandemic period. © 2022, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Fluoroscopy Free Flexible Ureteroscopy: the Report of 248 Cases
(Yuzuncu Yil Universitesi Tip Fakultesi, 2023) Taken, K.; Eryilmaz, R.; Aslan, R.; Ertaş, K.; Demir, M.; Deniz, B.; Duran, A.M.
The goal of this study was to assess the results of 248 patients who underwent fluoroscopy-free retrograde intrarenal surgery. Between January 2017 and March 2020, 248 cases of retrograde intrarenal surgery (RIRS) were conducted using an access sheath and guidewire. Using ureteroscopy, two hydrophilic guide wires were inserted into the renal pelvis under direct eyesight (URS). When the ureter could not be entered with the 9.5 Fr URS, the ureter was first entered using the 7.5 Fr URS. Then, without flouroscopy, an access sheath was pushed u p to the proximal ureter while examining the opening with URS. When an access sheath could not be placed, a double J stent was implanted. The operation was repeated after 3 weeks. The procedure's success rate was determined by the absence of stones or the presence of leftover fragments smaller than 3 mm. The study included 161 (64.9%) male and 87 (35.1%) female patients with a mean age of 44.03 (± 16.04), (range 18-81) years. Mean stone size was 14.7 (± 3.7) mm. The mean operation time was 62.34 (± 8.2) minutes. Stone-free rate was 88.7% (n: 220). 28 of the patients had residual stone. Twenty patients (8%) had minor complications, including hematuria and fever and in 2 patients (0.8%) subcapsular hematoma was developed. Kidney stones can be treated successfully with minimal morbidity and mortality. The insertion of an access sheath under urs guidance is possible without the need of fluoroscopy. Patients and surgeons are exposed to less radiation as a result of this procedure. © 2023, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Is Accompanying Organ Damage Related With Mortality in Renal Trauma
(Yuzuncu Yil Universitesi Tip Fakultesi, 2018) Eryılmaz, R.; Demir, M.; Aslan, R.; Taken, K.
Our aim in this study was to retrospectively review the accompanying organ damage, treatment and follow-up processes of patients in our clinic who had had renal trauma within the last five years. 78 patients who were followed due to renal injury were retrospectively reviewed. The cases were evaluated in terms of age, sex, trauma mechanism, accompanying injuries, injury severity, hematuria, treatment type, blood transfusion, hospitalization duration and results. Of the 78 patients, renal injury was observed in 33 (42.3%) patients due to a motor vehicle accident and in 16 (20.5%) patients due to falling. Conservative treatment was applied for 77% (n=60) of the patients, while 23% (n=18) of the patients underwent nephrectomy. The most common intra-abdominal injury was observed as a hepatic injury in 18 (23%) patients. In our study, six (7.7%) of the 78 patients had died. Accompanying organ damage was observed in all patients who died, and all of them had high grade renal injury. Conservative treatment is still important today regardless of the severity of the renal trauma after providing hemodynamic stability. High-grade renal injury and accompanying organ damage are important risk factors in terms of mortality. © 2018, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Laparoscopic Transperitoneal Nephrectomy in Non-Functioning Inflammatory Kidneys With or Without Renal Stone
(verduci Publisher, 2015) Kaba, M.; Pirincci, N.; Taken, K.; Gecit, I.; Demiray, O.; Eren, H.
OBJECTIVE: To compare our laparoscopic simple nephrectomy results in non-functioning inflammatory kidneys with or without renal stones. PATIENTS AND METHODS: Patients, who underwent laparoscopic transperitoneal nephrectomy for non-functioning kidney between June, 2010 and October, 2014 were included to study. Overall, data of 32 patients including 15 patients with renal stone (Group 1) and 17 patients without renal stone (Group 2) were retrospectively reviewed. RESULTS: Mean age was 44.4 +/- 18.5 years (10-71) in group 1 and 35.2 +/- 21 years (9-77) in group 2. Mean operation time was 95.0 +/- 25.9 minutes (70-175) in group 1 and 86.7 +/- 15.1 minutes (70-125) in group 2. Mean estimated blood loss was found to be 64.13 +/- 26.67 ml (30-120) in group 1 and 58.94 +/- 24.24 ml (30-100) in group 2. Both groups had inflammatory findings in pathological analysis. There was no significant difference between groups regarding estimated blood loss, operation time, pre-operative and post-operative hemoglobin values, percent hemoglobin decrease, complications and hospitalization times (p > 0.05). CONCLUSIONS: Non-functioning kidney with or without renal stone could be operated safely with comparable complication rates and success via laparoscopy in experienced hands.
The Management of the Congenital Anterior Urethral Diverticula With Calculi Which Is the Cause of Acute Urinary Retention (Globe Vesicale): a Case Report
(Yuzuncu Yil Universitesi Tip Fakultesi, 2011) Pirinççi, N.; Geçit, I.; Güneş, M.; Taken, K.; Tanik, S.; Ceylan, K.
Congenital urethral diverticula with calculi has a low incidence as reported in the literature. Congenital diverticula have been seen % 10-20 in all urethral diverticula. The etiology of urethral stones are urethra and bladder stones, urethral diverticula, foreign matters, urethral stenosis and urethral trauma. Management of treatment urethral stones is surgery and endoscopy. Our case was a three years old boy who referred to our clinic due to globe vesicale. Diagnosis was performed with cystoscopy and the presence of a stone in the urethral diverticula.
A Novel Indicator for Erectile Dysfunction: S100a4
(Yuzuncu Yil Universitesi Tip Fakultesi, 2024) Demir, M.; Huyut, Z.; Huyut, M.T.; Ertaş, K.; Aslan, R.; Eryılmaz, R.; Taken, K.
This study aimed whether S100A4 would be useful in predicting Erectile Dysfunction (ED) and ED severity. This prospective study included 88 male volunteers aged 18-80 years. The control group consisted of 44 healthy patients and the diabetic group consisted of 44 patients with type-2 diabetes (T2DM). Age, body mass index, smoking status, hypertension status, International Index of Erectile Function 1-5 scores of all the volunteers were evaluated, and also glucose, HbA1c, cholesterol, testosterone, prolactin and S100A4 levels were measured in the serum samples. The relationships between S100A4 and erectile functions were investigated with appropriate statistical analyzes. The mean age of the T2DM group was 51.98 ±10.91 years, while the control group’s mean age was 53.77 ±12.46 years and there was no significant difference between them (p=0.31). Glucose, HbA1c, mean ED severity and S100A4 levels in the T2DM group were higher than in the control group, while testosterone level was lower than in the control (p≤0.05). In addition, it was found that S100A4 levels increased due to the increase in ED severity in both groups (p<0.001). In addition to ED severity, smoking and hypertension were seen as the factors that most affected S100A4. The results indicated that S100A4 may be a useful biomarker in determining ED and ED severity. © 2024, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
A Prospective Analysis of the Efficacy and Safety of Caudal Block for Transrectal Ultrasound Guided Prostate Biopsy in Patients With Anorectal Disorders
(Yuzuncu Yil Universitesi Tip Fakultesi, 2024) Aslan, R.; Günes, H.Y.; Erbin, A.; Eryilmaz, R.; Sevim, M.; Ertaş, K.; Taken, K.
In this study, the efficacy and safety of the caudal block technique for transrectal ultrasonography-guided biopsy (Trus-guided biopsy) in patients with anorectal problems were investigated. A total of 31 consecutive patients with anal-rectal problems underwent prostate needle biopsy. All patients included in the study were examined by an experienced general surgeon, and the presence of anorectal problems was confirmed. The majority of patients (61%) were referred from the outer center to our clinic beca use a biopsy could not be performed due to severe pain felt during rectal probe insertion despite local anesthesia (topical prilocaine or lidocaine cream). A 12-core biopsy protocol was applied to all patients under the caudal block. Pain perception was se parately assessed during caudal anesthesia, probe insertion, and sampling stages using a visual analog scale (VAS) score. The mean age was 64.1 ± 9.1 years. The mean VAS score during caudal anesthesia was 1.8 ± 0.81. At probe insertion, the mean VAS score was 1,44 ± 012. During the needle penetration into prostate tissue and sampling, the mean VAS score was 2.44± 013. All of the patients did not state any bothersome pain at any stage. We did not find any complications related to the anesthesia method. Topical creams and/or periprostatic nerve block (PNB) do not provide adequate analgesia in patients with anorectal disorders undergoing Trus-guided biopsy. Caudal block technique can be performed effectively and reliably in this selected patient group. © 2024, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Protective Effect of Curcumin on Priapism and Ischemia-Reperfusion Injury in Rats
(verduci Publisher, 2015) Yilmaz, Y.; Taken, K.; Atar, M.; Ergun, M.; Soylemez, H.
OBJECTIVE: We aimed to identify the oxidative stress effects of the ischemic priapism on cavernosal tissues and to assess the biochemical and histopathological effects of curcumin in rats. MATERIALS AND METHODS: 26 adult male Sprague Dawley rats were randomly divided into three groups. Group 1 (Control, n = 8): only penectomy was performed and 3 ml blood samples were obtained from the vena cava inferior (VCI). Group 2 (ischemia-reperfusion group; n=8): penectomy was performed after 1 hour ischemic priapism + 30 min reperfusion and 3 ml blood samples were obtained from the VCI. Group I I I (IR + CURC group, n = 10) : 200 mg/kg/day curcumin per orally before surgery for 7 days + penectomy after 1 hour ischemic priapism + 30 min reperfusion and 3 ml blood samples from the VCI. Total oxidant status (TAS), total ant ioxidant status (TAS) and paraoxonase (PON1) levels were measured. Tissue samples were investigated and scored histopathologically in terms of bleeding, edema and necrosis. RESULTS: TOS levels were higher (p = 0.002), and TAS levels were lower (p = 0.001) in the IR group compared to the control group. As a result of curcumin treatment, TAS levels were increased (p = 0.003), and TOS levels were decreased (p = 0.004) in the IR + CURC group compared to the IR group. In the treatment group (IR + CURC) TAS and TOS levels were similar to levels in the control group. PON1 levels were increased with ischemia-reperfusion (p = 0.21) and decreased with curcumin treatment (p = 0.53), however these changes were not statistically significant. There was no significant difference in the effects of curcumin on histopathological changes. CONCLUSIONS: This study showed that curcumin has preventive effects on oxidative stress parameters against ischemia-reperfusion injury.
Retroperitoneal Abscesses: Origin, Ethiology and Percutaneous Treatment
(Yuzuncu Yil Universitesi Tip Fakultesi, 2018) Aslan, R.; Özgökçe, M.; Eryılmaz, R.; Duran, M.A.; Yıldızhan, M.; Taken, K.
Retroperitoneal abscess is a rare clinical condition that can cause mortality if not properly treated. In our study, we aimed to report the data of retroperitoneal abscess cases which performed percutaneous drainage in the first step treatment. A retrospective study was made of 81 patients with retroperitoneal abscesses treated at our hospital from June 2010 to December 2017 for the purpose of analyzing the diagnosis and treatment of these rare infections. In each case, we analyzed patient characteristics, abscess location and origin, predisposing factors, c linical presentation, microbiology, radiographic findings, treatment, and outcome. 81 cases were identified as 11 (14%) primary and 70 (86%) as secondary. The majority (63%) of these abscesses were originated from Urinary System, while others were found to be originated from psoas, vertebral and Gastrointestinal system (GIS). Urolithiasis, previous surgery, and other Urinary system anomalies were determined to be the most common predisposing factors. Escherichia coli (E. coli) was the most commonly seen pathogen in abscess culture. In all patients, percutaneous drainage catheter was successfully placed in the abscess lodge. No serious complications occurred in patients during and after the procedure. 78/81 (96%) clinical success was achieved. In 12 months fo llow-ups, recurrence was seen in only 5 patients. Percutaneous abscess drainage should be preferred in the treatment of retroperitoneal abscesses as easy to perform, cost effective, low complication risk and high success rate. © 2018, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
The Role of the Virtual Touch Tissue Quantification Technique in Differentiating Between Benign Prostatic Hyperplasia and Prostatic Carcinoma
(Yuzuncu Yil Universitesi Tip Fakultesi, 2023) Akdemir, Z.; Yokuş, A.; Taken, K.; Alpaslan, M.; Arslan, H.; Akdeniz, H.
Virtual Touch Tissue Quantification (VTTQ) is a promising new implementation of the acoustic radiation force pulsed ultrasound technique that has gained popularity in recent years. The present study compares the performance of the VTTQ technique in distinguishing between prostate cancer (PCa) and benign prostatic hyperplasia (BPH). VTTQ was performed on 91 prostate nodular lesions in 72 patients with BPH and suspected PCa prior to a prostate histopathologic examination, while 35 healthy volunteers were included in the study as controls. The mean shear wave velocity (SWV) values of the central and peripheral prostate zone were measured in the healthy volunteers, with the SWV at each nodular lesion quantified through the implementation of an acoustic radiation force impulse (ARFI). The performance of VTTQ in discriminating between PCa and BPH was compared, and the diagnostic value of VTTQ for PCa was evaluated in terms of sensitivity, specificity and cut-off value. Histopathological examinations detected PCa in 21 of the 91 nodular lesions and BPH in 70. The SWV values (m/s) were significantly higher in prostate cancer than in the BPH and central-peripheral prostate zones (3.85±0.78, 2.29±1.03, 1.65 ±0.95, 1.14±0.56). The mean SWV values of the central-peripheral prostate zones were found to be significantly different from each other. We determined an SWV cut-off value of 3.09 m/s for differentiating between benign and malignant nodules, with a sensitivity and specificity of 90.5% and 80%, respectively. VTTQ can effectively determine the stiffness of prostate nodular lesions, with significantly higher performance discrimination between PCa and BPH. © 2023, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Should Ureteroscopy Be Considered as the First Choice for Proximal Ureter Stones of Children
(verduci Publisher, 2013) Gecit, I.; Pirincci, N.; Gunes, M.; Bilici, S.; Taken, K.; Goktas, U.; Ceylan, K.
OBJECTIVES: In this study, we aimed to analyze the ureter stones that had been treated using rigid ureteroscopy and pneumatic lithotripsy without mechanically dilating the ureteral orifice. PATIENTS AND METHODS: Records of 110 patients who had undergone rigid ureteroscopy and pneumatic lithotripsy due to ureteral stone between February 2005 and May 2011 were retrospectively analyzed. The location and size of the stone and additional anomalies in the urinary tract on the preoperative direct urinary system (DUS) X-Ray, urinary system ultrasonography (USG), intravenous pyelography (IVP) if performed, and computed tomography (CT), were found from the records of the patients. RESULTS: The mean age of the patients was 5.2 (range 1-17 years). 74 (67.2%) of the patients were males and 36 (32.8%) were females. A total of 115 rigid ureteroscopies were performed on 110 patients. 72 (65%) of the stones were located in the lower ureter, 21 (19%) were located in the middle part of the ureter, and 17 (15.4%) were located in the upper ureter. The mean stone size was determined as 7.5 mm (range 5-15). The mean stone size was determined as 7.4 mm in the lower ureter, as 8.3 mm in the middle ureter, and 8.4 mm in the upper ureter. No difference was found between the sizes of the stones in different locations (p = 0.121). The stone free rate was found as 92.2% for all ureteral stones. The total stone free rate according to the location of the stones was determined as 79.2% in the upper ureter, as 94.4% in the middle ureter and 93,8% in the lower ureter (p = 0.022). The total complication rate was 7.6%. Complication rates were 7.2%, 4.1% and 10.7% for the lower, middle and upper ureter, respectively (p = 0.411) (Table I). No difference was found in terms of complication rates according to location of the stone in the ureter. No major perioperative or postoperative complications developed. A double J stent was inserted in 36 (32%) patients for 2-3 weeks. CONCLUSIONS: We suggest that rigid ureteroscopy may be considered as the first choice for treatment of not only distal-middle ureter stones, but also for proximal ureter stones.