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Baran C, Culha MG, Bayraktarli RY, Ozgur BC, Bayraktar AB, Oktem C, Cek HM, Akgul B, Alkan A, Aglamis E, Ogras MS, Kacan T, Kaya C, Aydin ME, Ergun KE, Yoldas M, Cakan M, Durak HM, Gonultas S, Bulut B, Dogan K, Efiloglu O, Akalin MK, Yildirim A, Danacioglu YO, Demirelli E, Balci MBC, Gezmis CT, Tuncer M, Can M, Kirdag MK, Aydin M, Yazar S, Calik G, Guzelburc V, Guzel A, Otunctemur A, Kadioglu A. The prevalence and topographic distribution of penile calcification in a large cohort: a retrospective cross-sectional study. Int J Impot Res 2023:10.1038/s41443-023-00758-6. [PMID: 37660216 DOI: 10.1038/s41443-023-00758-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 08/18/2023] [Indexed: 09/04/2023]
Abstract
The prevalence of penile calcification in the population remains uncertain. This retrospective multicenter study aimed to determine the prevalence and characteristics of penile calcification in a large cohort of male patients undergoing non-contrast pelvic tomography. A total of 14 545 scans obtained from 19 participating centers between 2016 and 2022 were retrospectively analyzed within a 3-months period. Eligible scans (n = 12 709) were included in the analysis. Patient age, penile imaging status, presence of calcified plaque, and plaque measurements were recorded. Statistical analysis was performed to assess the relationships between calcified plaque, patient age, plaque characteristics, and plaque location. Among the analyzed scans, 767 (6.04%) patients were found to have at least one calcified plaque. Patients with calcified plaque had a significantly higher median age (64 years (IQR 56-72)) compared to those with normal penile evaluation (49 years (IQR 36-60) (p < 0.001). Of the patients with calcified plaque, 46.4% had only one plaque, while 53.6% had multiple plaques. There was a positive correlation between age and the number of plaques (r = 0.31, p < 0.001). The average dimensions of the calcified plaques were as follows: width: 3.9 ± 5 mm, length: 5.3 ± 5.2 mm, height: 3.5 ± 3.2 mm, with an average plaque area of 29 ± 165 mm² and mean plaque volume of 269 ± 3187 mm³. Plaques were predominantly located in the proximal and mid-penile regions (44.1% and 40.5%, respectively), with 77.7% located on the dorsal side of the penis. The hardness level of plaques, assessed by Hounsfield units, median of 362 (IQR 250-487) (range: 100-1400). Patients with multiple plaques had significantly higher Hounsfield unit values compared to those with a single plaque (p = 0.003). Our study revealed that patients with calcified plaques are older and have multiple plaques predominantly located on the dorsal and proximal side of the penis.
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Affiliation(s)
- Caner Baran
- Department of Urology, University of Health Science, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey.
| | - Mehmet Gokhan Culha
- Department of Urology, University of Health Science, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Recep Yilmaz Bayraktarli
- Department of Radiology, University of Health Science, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Berat Cem Ozgur
- Department of Urology, University of Health Science, Ankara Education and Research Hospital, Ankara, Turkey
| | - Arif Bedirhan Bayraktar
- Department of Urology, University of Health Science, Ankara Education and Research Hospital, Ankara, Turkey
| | - Cagri Oktem
- Department of Urology, University of Health Science, Ankara Education and Research Hospital, Ankara, Turkey
| | - Hakki Mete Cek
- Department of Urology, Trakya University Faculty of Medicine, Edirne, Turkey
| | - Burak Akgul
- Department of Urology, Trakya University Faculty of Medicine, Edirne, Turkey
| | - Aykut Alkan
- Department of Radiology, Trakya University Faculty of Medicine, Edirne, Turkey
| | - Erdogan Aglamis
- Department of Urology, University of Health Science, Elazig Fethi Sekin City Hospital, Elazig, Turkey
| | - Mehmet Sezai Ogras
- Department of Urology, University of Health Science, Elazig Fethi Sekin City Hospital, Elazig, Turkey
| | - Turgay Kacan
- Department of Urology, Ankara City Hospital, Ankara, Turkey
| | - Coskun Kaya
- Department of Urology, Eskisehir City Hospital, Ankara, Turkey
| | | | - Kasim Emre Ergun
- Department of Urology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Mehmet Yoldas
- Department of Urology, Tepecik Education and Research Hospital, İzmir, Turkey
| | - Murat Cakan
- Department of Urology, University of Health Science, Diskapi Education and Research Hospital, Ankara, Turkey
| | - Huseyin Mert Durak
- Department of Urology, University of Health Science, Diskapi Education and Research Hospital, Ankara, Turkey
| | - Serkan Gonultas
- Department of Urology, Gaziosmanpasa Education and Research Hospital, İstanbul, Turkey
| | - Berk Bulut
- Department of Urology, Gaziosmanpasa Education and Research Hospital, İstanbul, Turkey
| | - Kazim Dogan
- Department of Urology, Gaziantep Private Liv Hospital, Gaziantep, Turkey
| | - Ozgur Efiloglu
- Department of Urology, Istanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Mustafa Kaan Akalin
- Department of Urology, Istanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Asif Yildirim
- Department of Urology, Istanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Yavuz Onur Danacioglu
- Department of Urology, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | - Erhan Demirelli
- Department of Urology, Giresun University Faculty of Medicine, Giresun, Turkey
| | - Mustafa Bahadir Can Balci
- Department of Urology, University of Health Science, Istanbul Taksim Health Application and Research Center, Istanbul, Turkey
| | - Cem Tugrul Gezmis
- Department of Urology, University of Health Science, Istanbul Taksim Health Application and Research Center, Istanbul, Turkey
| | - Murat Tuncer
- Department of Urology, University of Health Science, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
| | - Murat Can
- Department of Urology, University of Health Science, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
| | | | - Mustafa Aydin
- Department of Urology, Samsun Education and Research Hospital, Samsun, Turkey
| | - Selim Yazar
- Department of Urology, Recep Tayyip Erdogan University Education and Research Hospital, Rize, Turkey
| | - Gokhan Calik
- Istanbul Medipol University, Faculty of Medicine, Istanbul, Turkey
| | - Vahit Guzelburc
- Istanbul Medipol University, Faculty of Medicine, Istanbul, Turkey
| | - Ahmet Guzel
- Department of Urology, Aydin State Hospital, Aydin, Turkey
| | - Alper Otunctemur
- Department of Urology, University of Health Science, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Ates Kadioglu
- Department of Urology, Section of Andrology, Istanbul Faculty of Medicine, Istanbul, Turkey
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Kalkanli A, Sönmez SZ, Guvel M, Aglamis E, Araz S, Asfuroglu A, Avci HK, Aydin M, Aydos M, Balci U, Baran C, Bastug Y, Baydilli N, Bayrak O, Benlioglu C, Halil Bozkurt I, Bursali K, Can U, Coser S, Caglar Cakici M, Calik G, Cift A, Cilesiz NC, Demir DO, Demir M, Cihan Demirel H, Dursun M, Demirelli E, Ekenci BY, Eksi M, Ergin G, Ergin IE, Erkan A, Fikri O, Tugrul Gezmis C, Gül A, Guzelsoy M, Ibis MA, Inkaya A, Ipekci T, Karakeci A, Karkin K, Kaya C, Kazan O, Koray Kirdag M, Cagri Kizilcay Y, Koseoglu B, Kucuk E, Gonultas S, Ogras MS, Olgun A, Ordek E, Ozbey I, Sarier M, Senel S, Tahra A, Toprak T, Yigit Yalcin M, Hizir Yavuzsan A, Yazar S, Hacıbey İ, Yildirim K, Yilmaz K, Yilmaz S, Yoldas M, Yuce A, Ozgur Yucel M, Nedim Yuceturk C, de la Rosette J, Kadioglu A. Management of Priapism: Results of a Nationwide Survey and Comparison with International Guidelines. Urol Res Pract 2023; 49:225-232. [PMID: 37877823 PMCID: PMC10544432 DOI: 10.5152/tud.2023.22209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 04/06/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVE The aim of this study is to evaluate current urologic practice regarding the management of priapism in Turkey and compare with international guidelines. METHODS Urologists and urology residents were invited to an online survey consisting of 30 multiple-choice questions on priapism-related clinical practices that were consid- ered most important and relevant to practices by using Google Forms. RESULTS Total number of responses was 340. Respondents reported that they recorded a detailed patient's medical history and physical examination findings (n = 340, 100%) and laboratory testing, which includes corporal blood gas analysis (n=323, 95%). Participants announced that they performed Doppler ultrasound for 1/4 cases (n = 106, 31%), but 22% of the participants (n=75) replied that they performed in >75% of cases. Participants (n=311, 91%) responded that the first-line treatment of ischemic priapism is decompression of the corpus cavernosum. Moreover, most respondents (n = 320, 94%) stated that sympathomimetic injection drugs should be applied as the second step. About three-quarters of respondents (n = 247, 73%) indicated adrenaline as their drug of choice. Phosphodiesterase type 5 inhibitors seems to be the most pre- ferred drug for stuttering priapism (n=141, 41%). Participants (n=284, 84%) replied that corpora-glanular shunts should be preferred as the first. A large number of par- ticipants (n = 239, 70%) declared that magnetic resonance imaging can be performed in cases with delayed (>24 hours) priapism to diagnose corporal necrosis. Most of the participants (84%) responded that penile prosthesis should be preferred to shunts in cases with delayed (>48 hours) priapism. CONCLUSION It would be appropriate to improve the training offered by professional associations and to give more training time to the management of priapism during residency.
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Affiliation(s)
- Arif Kalkanli
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Salih Zeki Sönmez
- Department of Urology, Bağcılar Education and Research Hospital, Istanbul, Turkey
| | - Mine Guvel
- Istanbul Provincial Health Directorate, Istanbul, Turkey
| | | | - Seyhmuz Araz
- Department of Urology, Esenyurt Necmi Kadıoğlu State Hospital, Istanbul, Turkey
| | | | - Huseyin Kursad Avci
- Department of Urology, Ankara Gülhane Training and Research Hospital, Ankara, Turkey
| | - Memduh Aydin
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Murat Aydos
- Department of Urology, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Ugur Balci
- Department of Urology, Katip Çelebi University, School of Medicine, Izmir, Turkey
| | - Caner Baran
- Department of Urology, Okmeydanı Education and Research Hospital, Istanbul, Turkey
| | - Yavuz Bastug
- Department of Urology, Haydarpaşa Education and Research Hospital, Istanbul, Turkey
| | - Numan Baydilli
- Department of Urology, Erciyes University, School of Medicine, Kayseri, Turkey
| | - Omer Bayrak
- Department of Urology, Gaziantep University, School of Medicine, Gaziantep, Turkey
| | - Can Benlioglu
- Department of Urology, Adıyaman University, School of Medicine, Adiyaman, Turkey
| | | | - Kerem Bursali
- Department of Urology, Şişli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Utku Can
- Department of Urology, Kartal Dr Lütfi Kırdar Training and Research Hospital, Istanbul, Turkey
| | - Seref Coser
- Department of Urology, Evliya Çelebi Training and Research Hospital, Kütahya, Turkey
| | - Mehmet Caglar Cakici
- Department of Urology, Göztepe Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Gokhan Calik
- Department of Urology, Medipol University, School of Medicine, Istanbul, Turkey
| | - Ali Cift
- Department of Urology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Nusret Can Cilesiz
- Department of Urology, Biruni University, School of Medicine, Istanbul, Turkey
| | | | - Murat Demir
- Department of Urology, Van YY University, School of Medicine, Van, Turkey
| | | | - Murat Dursun
- Department of Urology, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey
| | - Erhan Demirelli
- Department of Urology, Giresun University, School of Medicine, Giresun, Turkey
| | - Berk Yasin Ekenci
- Department of Urology, Dışkapı Training and Research Hospital, Ankara, Turkey
| | - Mithat Eksi
- Department of Urology, Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Giray Ergin
- Department of Urology, Koru Hospital, Ankara, Turkey
| | - Ismail Emre Ergin
- Department of Urology, Cumhuriyet University, School of Medicine, Sivas, Turkey
| | - Anil Erkan
- Department of Urology, Katip Çelebi University, School of Medicine, Izmir, Turkey
| | - Onur Fikri
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Cem Tugrul Gezmis
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Abdullah Gül
- Department of Urology, Bursa Education and Research hospital, Bursa, Turkey
| | - Muhammet Guzelsoy
- Department of Urology, Katip Çelebi University, School of Medicine, Izmir, Turkey
| | - Muhammed Arif Ibis
- Department of Urology, Keçiören Training and Research Hospital, Ankara, Turkey
| | - Abdurrahman Inkaya
- Department of Urology, Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Tumay Ipekci
- Department of Urology, Bahceşehir University, School of Medicine, Istanbul, Turkey
| | - Ahmet Karakeci
- Department of Urology, Fırat University, School of Medicine, Elazığ, Turkey
| | - Kadir Karkin
- Department of Urology, Adana City Hospital, Adana, Turkey
| | - Coskun Kaya
- Department of Urology, Eskişehir City Hospital, Eskişehir, Turkey
| | - Ozgur Kazan
- Department of Urology, Göztepe Medeniyet University, School of Medicine, Istanbul, Turkey
| | | | - Yigit Cagri Kizilcay
- Department of Urology, Balıkesir University, School of Medicine, Balıkesir, Turkey
| | - Burak Koseoglu
- Department of Urology, Ankara City Hospital, Ankara, Turkey
| | - Emrah Kucuk
- Department of Urology, Akçakale State Hospital, Şanlıurfa, Turkey
| | - Serkan Gonultas
- Department of Urology, aziosmanpaşa Training and Research Hospital, Istanbul, Turkey
| | | | - Ahmet Olgun
- Department of Urology, Elazığ City Hospital, Elazığ, Turkey
| | - Eser Ordek
- Department of Urology, Gazi University, School of Medicine, Ankara, Turkey
| | - Isa Ozbey
- Department of Urology, Kahta State Hospital, Adıyaman, Turkey
| | - Mehmet Sarier
- Department of Urology, Atatürk University, School of Medicine, Erzurum, Turkey
| | - Samet Senel
- Department of Urology, Ankara City Hospital, Ankara, Turkey
| | - Ahmet Tahra
- Department of Urology, Medipol University, School of Medicine, Istanbul, Turkey
| | - Tuncay Toprak
- Department of Urology, Istinye University, School of Medicine, Istanbul, Turkey
| | | | - Abdullah Hizir Yavuzsan
- Department of Urology, Kartal Dr Lütfi Kırdar Training and Research Hospital, Istanbul, Turkey
| | - Selim Yazar
- Department of Urology, Şanlıurfa Training and Research Hospital, Şanlıurfa, Turkey
| | - İbrahim Hacıbey
- Department of Urology, Rize Training and Research Hospital, Rize, Turkey
| | - Kadir Yildirim
- Department of Urology, Medical Park Hospital, Elazığ, Turkey
| | - Kemal Yilmaz
- Department of Urology, Malatya Training and Research Hospital, Malatya, Turkey
| | - Sercan Yilmaz
- Department of Urology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Mehmet Yoldas
- Department of Urology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ahmet Yuce
- Department of Urology, Darende State Hospital, Malatya, Turkey
| | - Mehmet Ozgur Yucel
- Department of Urology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Cem Nedim Yuceturk
- Department of Urology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Jean de la Rosette
- Department of Urology, Medipol University, School of Medicine, Istanbul, Turkey
| | - Ates Kadioglu
- Department of Urology, Section of Andrology, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey On Behalf of Turkish Urology Academy
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Kalkanli A, Gezmis CT, Fikri O, Cilesiz NC, Ozkan A, Eroglu A, Aydin M. The effect of plasma melatonin levels in the treatment of lifelong premature ejaculation with selective serotonin reuptake inhibitors. Andrologia 2020; 52:e13785. [PMID: 32816318 DOI: 10.1111/and.13785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/22/2020] [Accepted: 07/07/2020] [Indexed: 11/27/2022] Open
Abstract
The aim of our study was to compare melatonin levels of patients with lifelong premature ejaculation (LPE) (n:60) with healthy controls (n:30) and to investigate the changes of melatonin levels in the treatment with dapoxetine and sertraline. Age, body mass index, duration of marriage, weekly intercourse number, International Index of Erectile Function scores, Intravaginal Ejaculation Latency Time (IELT) and melatonin levels were recorded. LPE patients were divided into two treatment groups. The first group was included 30 patients, who received 60 mg dapoxetine for six weeks, twice a week, an hour before intercourse. The second group received 50 mg of sertraline daily, for six weeks. IELT and melatonin measures were repeated after the treatment. IELT (dapoxetine group: 41.22 ± 21.3 s, sertraline group: 48 ± 23.11 s, control group: 195.54 ± 84.14 s; p < .001) and melatonin levels (dapoxetine group: 5.75 ± 2.04 pg/mL, sertraline group: 5.49 ± 2.88 pg/mL, control group: 13.4 ± 12.09 pg/mL; p < .001) of both LPE groups were significantly lower than control group. Following the six-week sertraline (before: 48 ± 23.11 s, after: 101.01 ± 59.55 s; p < .001) and dapoxetine (before: 41.22 ± 21.3 s, after: 97.39 ± 44.1 s; p < .001) treatments, IELT increased. The melatonin levels increased in the sertraline group (before: 5.49 ± 2.88 pg/mL, after: 10.6 ± 7.37 pg/mL; p < .001). Our results indicate that melatonin levels of LPE patients are lower than levels of healthy volunteers. Furthermore, we found a significant increase in melatonin levels following sertraline treatment.
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Affiliation(s)
- Arif Kalkanli
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Cem Tugrul Gezmis
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Onur Fikri
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Nusret Can Cilesiz
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Arif Ozkan
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Ali Eroglu
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Memduh Aydin
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
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Kalkanli A, Cilesiz NC, Fikri O, Ozkan A, Gezmis CT, Aydin M, Tandoğdu Z. Impact of Anterior Kidney Calyx Involvement of Complex Stones on Outcomes for Patients Undergoing Percutaneous Nephrolithotomy. Urol Int 2020; 104:459-464. [PMID: 32155628 DOI: 10.1159/000505822] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 01/07/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION A number of factors that can impact the outcomes of percutaneous nephrolithotomy (PCNL) procedures have previously been investigated. Complex stones that extend to the anterior calyx could affect the success and complication rates of PCNL. OBJECTIVE We analyzed the effect of anterior calyx involvement on the outcomes of patients with complex stones treated with PCNL. METHODS A total of 132 consecutive patients who underwent PCNL due to complex stones (multiple, partial staghorn, or staghorn stones) between 2015 and 2017 were enrolled in this study. They were stratified into two groups based on whether the stone extended to the anterior calyx (group 1, n = 45) or not (group 2, n = 87). The stratification was achieved through contrast-enhanced computerized tomography (CT). Demographics, laboratory tests, and peri- and postoperative findings (operation and fluoroscopy duration, hospital stay, utilization of flexible instruments, access numbers, total blood count change, stone-free rate [SFR], and complications) were compared between the groups. The SFR was evaluated by plain kidney-ureter-bladder radiography or CT. RESULTS The demographics, operation and fluoroscopy duration, access number, and hospital stay were similar between the groups (p < 0.05). A higher drop in the hemoglobin level in group 1 was identified (group 1 [2.14 ± 1.49 g/dL] vs. group 2 [1.43 ± 1.31 g/dL]) (p = 0.006). The SFR among the patients with extension to the anterior calyx was 60%, compared to 77% among the patients with no extension to the anterior calyx (p = 0.041). Flexible instruments were utilized in 60% of the patients of group 1, which was a higher rate than for group 2 (36%) (p = 0.007). Complication rates were similar in the two groups according to the Clavien-Dindo classification (p > 0.05). CONCLUSIONS Our study demonstrated that complicated stones with extension to the anterior calyx are more challenging than cases without extension to the anterior calyx. This was noted by a lower SFR, a more prominent drop in total blood count, and more frequent utilization of flexible scopes.
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Affiliation(s)
- Arif Kalkanli
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey,
| | - Nusret Can Cilesiz
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Onur Fikri
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Arif Ozkan
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | | | - Memduh Aydin
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Zafer Tandoğdu
- Department of Urology, Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, United Kingdom
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