1
|
Gül M, Fode M, Urkmez A, Capogrosso P, Falcone M, Sarikaya S, Sokolakis I, Morgado A, Morozov A, Albersen M, Russo GI, Serefoglu EC. A clinical guide to rare male sexual disorders. Nat Rev Urol 2024; 21:35-49. [PMID: 37670085 DOI: 10.1038/s41585-023-00803-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2023] [Indexed: 09/07/2023]
Abstract
Conditions referred to as 'male sexual dysfunctions' usually include erectile dysfunction, ejaculatory disorders and male hypogonadism. However, some less common male sexual disorders exist, which are under-recognized and under-treated, leading to considerable morbidity, with adverse effects on individuals' sexual health and relationships. Such conditions include post-finasteride syndrome, restless genital syndrome, post-orgasmic illness syndrome, post-selective serotonin reuptake inhibitor (SSRI) sexual dysfunction, hard-flaccid syndrome, sleep-related painful erections and post-retinoid sexual dysfunction. Information about these disorders usually originates from case-control trials or small case series; thus, the published literature is scarce. As the aetiology of these diseases has not been fully elucidated, the optimal investigational work-up and therapy are not well defined, and the available options cannot, therefore, adequately address patients' sexual problems and implement appropriate treatment. Thus, larger-scale studies - including prospective trials and comprehensive case registries - are crucial to better understand the aetiology, prevalence and clinical characteristics of these conditions. Furthermore, collaborative efforts among researchers, health-care professionals and patient advocacy groups will be essential in order to develop evidence-based guidelines and novel therapeutic approaches that can effectively address these disorders. By advancing our understanding and refining treatment strategies, we can strive towards improving the quality of life and fostering healthier sexual relationships for individuals suffering from these rare sexual disorders.
Collapse
Affiliation(s)
- Murat Gül
- Department of Urology, Selcuk University School of Medicine, Urology, Konya, Turkey.
| | - Mikkel Fode
- Department of Urology, Copenhagen University Hospital - Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Ahmet Urkmez
- Department of Urology, St. Elizabeth's Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Paolo Capogrosso
- Department of Urology, ASST Sette Laghi, Circolo and Fondazione Macchi Hospital, Varese, Italy
| | - Marco Falcone
- Department of Urology, Molinette Hospital, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Selcuk Sarikaya
- Department of Urology, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Ioannis Sokolakis
- 2nd Department of Urology, Aristotle University of Thessaloniki, Medical School Thessaloniki,Greece, Thessaloniki, Greece
| | - Afonso Morgado
- Department of Urology, Centro Hospitalar São João, Porto, Portugal
| | - Andrey Morozov
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Maarten Albersen
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Giorgio Ivan Russo
- Urology section, Department of Surgery, University of Catania, Catania, Italy
| | - Ege Can Serefoglu
- Department of Urology, Biruni University, School of Medicine, Istanbul, Turkey
| |
Collapse
|
2
|
Morgado A, Tsampoukas G, Sokolakis I, Schoentgen N, Urkmez A, Sarikaya S. Do "testosterone boosters" really increase serum total testosterone? A systematic review. Int J Impot Res 2023:10.1038/s41443-023-00763-9. [PMID: 37697053 DOI: 10.1038/s41443-023-00763-9] [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: 03/22/2023] [Revised: 08/24/2023] [Accepted: 09/04/2023] [Indexed: 09/13/2023]
Abstract
Testosterone boosters are heavily marketed on social media and marketplaces to men with claims to significantly increase testosterone. Lax industry regulation has allowed sales of supplements to thrive in the absence of verification of their purported benefits. Our primary objective was to systematically review all data published in the last two decades on testosterone boosters and determine their efficacy. Our outcome of interest was total testosterone increase versus placebo in four different populations: male athletes, men with late-onset hypogonadism infertile men and healthy men. Following search and screening, 52 studies were included in our review, relating to 27 proposed testosterone boosters: 10 studies of cholecalciferol; 5 zinc/magnesium; 4 Tribulus terrestris and creatine; 3 Eurycoma longifolia and Withania somnifera; 2 betaine, D-aspartic acid, Lepidium meyenii and isoflavones; while the remainder were single reports. Our findings indicate that most fail to increase total testosterone. The exceptions were β-hydroxy β-methylbutyrate and betaine, which can be considered effective for male athletes. Eurycoma longifolia, a blend of Punica granatum fruit rind and Theobroma cacao seed extracts (Tesnor™) and purified Shilajit extract (PrimaVie™) can be considered possibly effective for men with late-onset hypogonadism; Eurycoma longifolia and Withania somnifera possibly effective for healthy men; and a non-hormonal aromatase inhibitor (Novadex XT™) possibly effective for male athletes.
Collapse
Affiliation(s)
- Afonso Morgado
- Serviço de Urologia, Centro Hospitalar Universitário São João, Porto, Portugal.
| | | | - Ioannis Sokolakis
- 2nd Department of Urology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nadja Schoentgen
- Urology Department, University Hospital Center Bichat Claude Bernard, Paris, France
| | - Ahmet Urkmez
- Department of Urology, St. Elizabeth's Medical Center, Boston, MA, USA
| | - Selcuk Sarikaya
- Department of Urology, Gülhane Research and Training Hospital, Ankara, Turkey
| |
Collapse
|
3
|
Urkmez A, Davis JW. Freehand Versus Grid-based Transperineal Prostate Biopsy: A Comparison of Anatomical Region Yield and Complications. Reply. J Urol 2023; 210:249. [PMID: 37163220 DOI: 10.1097/ju.0000000000003547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/11/2023]
Affiliation(s)
- Ahmet Urkmez
- Department of Urology, St Elizabeth's Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - John W Davis
- Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
4
|
Urkmez A, Staskin D. Effect of Pharmacotherapy for Overactive Bladder on the Incidence of and Factors Related to Urinary Tract Infection: A Systematic Review and Meta-analysis. Letter. J Urol 2023; 210:31-32. [PMID: 37126235 DOI: 10.1097/ju.0000000000003508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 04/21/2023] [Indexed: 05/02/2023]
Affiliation(s)
- Ahmet Urkmez
- Division of Urology, St Elizabeth's Medical Center, Steward Health, Boston University School of Medicine, Boston, Massachusetts
| | - David Staskin
- Division of Urology, St Elizabeth's Medical Center, Steward Health, Tufts University School of Medicine, Boston, Massachusetts
| |
Collapse
|
5
|
Urkmez A, Ward JF, Choi H, Troncoso P, Inguillo I, Gregg JR, Altok M, Demirel HC, Qiao W, Kang HC. Temporal learning curve of a multidisciplinary team for magnetic resonance imaging/transrectal ultrasonography fusion prostate biopsy. BJU Int 2021; 127:524-527. [PMID: 33340435 PMCID: PMC10645433 DOI: 10.1111/bju.15325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Ahmet Urkmez
- Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030 USA
| | - John F. Ward
- Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030 USA
| | - Haesun Choi
- Department of Abdominal Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77030 USA
| | - Patricia Troncoso
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Irene Inguillo
- Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030 USA
| | - Justin R. Gregg
- Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030 USA
| | - Muammer Altok
- Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030 USA
| | - Huseyin C. Demirel
- Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030 USA
| | - Wei Qiao
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Hyunseon C. Kang
- Department of Abdominal Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77030 USA
| |
Collapse
|
6
|
Tokuc E, Urkmez A, Gumrukcu G, Orak R, Neselioglu S, Sertkaya Z, Ozturk MI. [Evaluation of ischemia-modified albumin in obstructive renal injury.]. ARCH ESP UROL 2021; 74:427-434. [PMID: 33942731] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVES This study was aimed at assessing the ability of ischemia-modified albumin (IMA) to predict renal injury by associating biochemical, functional, and pathological findings with various degrees of ureteral obstruction. METHODS Twenty-four rats were randomized into three groups, and their blood was sampled to determine the creatinine and IMA values and renal scintigraphy was done at the start and on postoperative day 7. In the sham group, the ureter was untouched; in the partial group, the ureter was gently embedded into the psoas muscle; and in the complete group, the ureter was compathologically, and all parameters were statistically evaluated. RESULTS IMA was significantly associated with functional changes, creatinine values, and pathology scores (r = -0.729, r = 0.771, r = 0.827 respectively; p < 0.001). The postoperative IMA values of the partial and complete group were significantly higher than the respective preoperative values (p < 0.001, p < 0.001; p < 0.05, respectively). Additionally, the postoperative IMA values of the complete group were significantly higher than that of the sham and partial groups (p < 0.001, p = 0.001; p < 0.05, respectively). CONCLUSIONS IMA, which is strongly associated with renal functional and pathological variations, appears to be a valuable parameter for predicting renal injury and may warn clinicians before the irreversible phases of obstructive uropathy occur. More extensive studies with human participants may prove advantageous.
Collapse
Affiliation(s)
- Emre Tokuc
- Sultanbeyli State Hospital. Department of Urology. Istanbul. Turkey
| | - Ahmet Urkmez
- MD Anderson Cancer Center. Department of Urology. Houston. TX. USA
| | - Gulistan Gumrukcu
- SBU Haydarpasa Numune SUAM. Department of Pathology. Istanbul. Turkey
| | - Rahime Orak
- SBU Haydarpasa Numune SUAM. Department of Nuclear Medicine. Istanbul. Turkey
| | - Salim Neselioglu
- Yıldırım Beyazıt University. Department of Biochemistry. Ankara. Turkey
| | - Zulfu Sertkaya
- Esenyurt State Hospital. Department of Urology. Istanbul.Turkey
| | | |
Collapse
|
7
|
Akan S, Ediz C, Sahin A, Tavukcu HH, Urkmez A, Horasan A, Yilmaz O, Verit A. Can the systemic immune inflammation index be a predictor of BCG response in patients with high-risk non-muscle invasive bladder cancer? Int J Clin Pract 2021; 75:e13813. [PMID: 33152142 DOI: 10.1111/ijcp.13813] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 11/02/2020] [Indexed: 12/25/2022] Open
Abstract
AIM We aimed to investigate the predictor role of the systemic immune-inflammation index (SII) on Bacille Calmette-Guerin (BCG) response in patients with high-risk non-muscle invasive bladder cancer (NMIBC). METHODS A total of 96 patients with high-risk NMIBC, who received intravesical BCG, were enrolled in the study. BCG responsive group (group 1) and BCG failure group (group 2) were compared in terms of demographic and pathological data, peripheral lymphocyte, neutrophil and platelet counts, neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), SII, recurrence-free survival (RFS) and progression-free survival (PFS). The SII was calculated as in the formula: SII = neutrophil × platelet/lymphocyte. The prognostic ability of the SII for progression was analysed with multivariate backward stepwise regression models. RESULTS The mean follow-up time 34.635 ± 14.7 months. Group 2 had significantly higher SII, peripheral lymphocyte, neutrophil and platelet counts than group 1. An ROC curve was plotted for the SII to predict the BCG failure and the cut-off point was calculated as 672.75. Effect of the SII to the model was statistically significant (P = .003) and a higher SII increased the progression onefold. A tumour greater than 30 mm in size and a high SII together increased the progression 3.6 folds. CONCLUSIONS The SII might be a successful, non-invasive and low-cost parameter for prediction of BCG failure in patients with high-risk NMIBC. The cut-off value for SII is 672.75 and above this level BCG failure and progression to MIBC might be anticipated. However, these results should be validated in prospective randomised controlled studies with large patient groups.
Collapse
Affiliation(s)
- Serkan Akan
- Department of Urology, University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Caner Ediz
- Department of Urology, University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Aytac Sahin
- Department of Urology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Hasan Huseyin Tavukcu
- Department of Urology, University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Urkmez
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alper Horasan
- Department of Urology, University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Omer Yilmaz
- Department of Urology, University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Ayhan Verit
- Department of Urology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
8
|
Nicolai M, Urkmez A, Sarikaya S, Fode M, Falcone M, Albersen M, Gul M, Hatzichristodoulou G, Capogrosso P, Russo GI. Penile Rehabilitation and Treatment Options for Erectile Dysfunction Following Radical Prostatectomy and Radiotherapy: A Systematic Review. Front Surg 2021; 8:636974. [PMID: 33738297 PMCID: PMC7961076 DOI: 10.3389/fsurg.2021.636974] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/13/2021] [Indexed: 11/13/2022] Open
Abstract
After radical prostatectomy (RP) or radiotherapy (RT) for prostate cancer, erectile dysfunction (ED) is the main complication next to urinary incontinence, affecting quality of life. The pathophysiology of ED after these treatments is believed to include neuropraxia causing reduced oxygenation and structural changes of the tissue in the corpora cavernosa. Next to the option of sparing the nerves during RP, research has been focusing on methods for penile rehabilitation after RP and RT, since it occurs often, even after nerve-sparing techniques were used. In animal studies, the use of phosphodiesterase type 5 inhibitors (PDE5i) after cavernous nerve damage is supported, but results in human studies are contradictory. Non-medical treatment options such as vacuum device therapy, hyperbaric oxygen therapy, yoga, aerobic, or pelvic floor training may be helpful, but evidence is scarce. Clear guidelines for penile rehabilitation are not yet available. However, care and support for ED after RP and RT is highly demanded by a large group of patients, so measures have to be taken even though the evidence is not strong yet. In this systematic review, an overview of the literature for penile rehabilitation and treatment options for ED after RP and RT is provided, using only randomized controlled trials (RCT).
Collapse
Affiliation(s)
- Melianthe Nicolai
- Urology Department, The Netherlands Cancer Institute (NKI), Amsterdam, Netherlands.,Urology Department, Diakonessenhospital, Utrecht, Netherlands
| | - Ahmet Urkmez
- Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | | | - Mikkel Fode
- Urology Department, University of Copenhagen, Copenhagen, Denmark
| | - Marco Falcone
- Urology Department, Molinette Hospital, Turin, Italy
| | - Maarten Albersen
- Urology Department, University Hospitals Leuven, Leuven, Belgium
| | - Murat Gul
- School of Medicine, Selcuk University, Konya, Turkey
| | | | | | | |
Collapse
|
9
|
Abstract
Radical prostatectomy directly affects urinary continence dynamics with incontinence being a major factor in patients’ quality of life, social and psychological status. In order to help maintain continence after robot-assisted radical prostatectomy (RARP), a number of surgical techniques have been described. In the present narrative review, we summarize the surgical techniques that have been applied during RARP and their effects on incontinence rates and time to continence recovery.
Collapse
Affiliation(s)
- Ahmet Urkmez
- Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Weranja Ranasinghe
- Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - John W Davis
- Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
10
|
Abstract
Radical prostatectomy directly affects urinary continence dynamics with incontinence being a major factor in patients' quality of life, social and psychological status. In order to help maintain continence after robot-assisted radical prostatectomy (RARP), a number of surgical techniques have been described. In the present narrative review, we summarize the surgical techniques that have been applied during RARP and their effects on incontinence rates and time to continence recovery.
Collapse
Affiliation(s)
- Ahmet Urkmez
- Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Weranja Ranasinghe
- Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - John W Davis
- Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
11
|
Sahin A, Urkmez A, Yildirim C, Ali Kutluhan M, Topaktaş R, Verit A. Sensitivity and specificity of Briganti nomogram in Turkish patients undergoing radical prostatectomy and pelvic lymph node dissection. Aging Male 2020; 23:836-840. [PMID: 31033371 DOI: 10.1080/13685538.2019.1601176] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
AIM To investigate the accuracy of Briganti nomogram in patients who underwent Pelvic lymph node dissection (PLND). METHODS Hundred and sixty-five patients who underwent radical prostatectomy and PLND between 2012 and 2018 in our clinics were included, and their data were retrospectively screened. RESULTS The mean age of patients was 63.6 ± 5.8 (range: 49-76) years. Hundred and thirty-five (81.8%) patients had a Briganti score of <5, whereas 30 (18.2%) had a Briganti score of ≥5. The preoperative T-PSA levels, biopsy grades and the incidence of T2b and T2c stages in patients with a Briganti score of ≥5 was significantly higher than that in patients with a Briganti score of <5 (p: .026; p: .000; p: .001, respectively). The incidence of lymph node positivity in patients with a Briganti score of ≥5 (76.7%) was significantly higher than that in patients with a Briganti score of <5 (25.2%) (p: .000). The sensitivity of the Briganti score to detect lymph node positivity was 40.35%, specificity was 93.52%, positive predictive value was 76.67% and the negative predictive value was 74.81%. The accuracy of the test was 75.15%. CONCLUSION Nomograms provide useful information regarding prostate cancer. Risk estimates should be carefully considered, and treatment decisions should be given with a patient-specific approach.
Collapse
Affiliation(s)
- Aytac Sahin
- Fatih Sultan Mehmet Egitim ve Arastirma Hastanesi, Istanbul, Turkey
| | - Ahmet Urkmez
- Haydarpasa Numune Egitim ve Arastirma Hastanesi, Istanbul, Turkey
| | - Caglar Yildirim
- Fatih Sultan Mehmet Egitim ve Arastirma Hastanesi, Istanbul, Turkey
| | | | - Ramazan Topaktaş
- Department of Urology, Haydarpasa Training and Research Hospital, Istanbul, Turkey
| | - Ayhan Verit
- Fatih Sultan Mehmet Egitim ve Arastirma Hastanesi, Istanbul, Turkey
| |
Collapse
|
12
|
Abstract
Urogenital cancers are frequently encountered in daily practice. Prostate cancer is the second most common type in adult males, and 2-3% of all adult cancers are renal cell carcinoma. Kaposi's sarcoma originates from vascular endothelial cells and is the most common type of sarcoma observed in HIV-positive patients. However, the development of all these types of cancer in a patient without immunodeficiency is very rare. Incidence of urological malignancies increase with aging. In contrast to normal population, patient who have one urological malignancy have increased risk of getting another urological malignancy in a follow-up. So follow-up of this kind of patients is crucial and needs to be done carefully. In this case report, we aimed to discuss a 68-year-old patient who was diagnosed with concurrent prostate and kidney cancer and developed penile Kaposi's sarcoma in follow-up.
Collapse
Affiliation(s)
| | | | - Aytac Sahin
- Fatih Sultan Mehmet Egitim ve Arastirma Hastanesi, Istanbul, Turkey
| | - Ramazan Topakta
- Department of Urology, Haydarpasa Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Urkmez
- Haydarpasa Numune Egitim ve Arastirma Hastanesi, Istanbul, Turkey
| |
Collapse
|
13
|
Abaza R, Martinez O, Murphy C, Urkmez A, Davis J. Adoption of Single-Port Robotic Prostatectomy: Two Alternative Strategies. J Endourol 2020; 34:1230-1234. [DOI: 10.1089/end.2020.0425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Affiliation(s)
- Ronney Abaza
- Robotic Surgery, OhioHealth Dublin Methodist Hospital, Dublin, Ohio, USA
| | - Oscar Martinez
- Robotic Surgery, OhioHealth Dublin Methodist Hospital, Dublin, Ohio, USA
| | - Christopher Murphy
- Robotic Surgery, OhioHealth Dublin Methodist Hospital, Dublin, Ohio, USA
| | - Ahmet Urkmez
- Division of Surgery, Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - John Davis
- Division of Surgery, Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
14
|
Sahin A, Kutluhan MA, Yildirim C, Urkmez A, Akan S, Verit A. Results of purified micronized flavonoid fraction in the treatment of categorized type III chronic pelvic pain syndrome: a randomized controlled trial. Aging Male 2020; 23:1103-1108. [PMID: 31615318 DOI: 10.1080/13685538.2019.1678581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES The management of chronic pelvic pain syndrome (CPPS) is controversial because of the unclear pathogenesis of this disease. In one theory, prostatitis has been proposed to be associated with pelvic venous diseases such as varicocele and hemorrhoids, dilatation of the Santorini plexus. In this study, we investigated the effect of micronized flavonoid fraction (an agent used in venous insufficiency) in the treatment of type III CPPS. METHODS Patients diagnosed with type III chronic prostatitis were randomized and divided into 3 groups. Group 1 consisted of patients using antibiotics + anti-inflammatory + alpha-blocker (n = 47), Group 2 consisted of patients using antibiotics + anti-inflammatory + purified micronized flavonoid fraction (n = 45), and Group 3 consisted of patients using only purified micronized flavonoid fraction (n = 35). RESULTS The mean age of the patients was 32.93 ± 4.70 (range; 23-44) years. There was a statistically significant difference between the groups in terms of the 6th month NIH-CPSI (National Institute of Health Chronic Prostatitis Symptom Index) total scores (p = .000). Also, it was found that NIH-CPSI total scores at month 12 in Group 3 were significantly higher than those in Group 1 and 2 (p1 = .000, p2 = .002). NIH-CPSI total scores at month 12 in Group 2 were significantly higher than those in Group 1 (p = .000). CONCLUSION The use of purified micronized flavonoid will decrease prostatic inflammation occurring due to increased perineal venous return.it can also be preferred as part of multimodal therapy because of its profile with relatively less side effects and being more affordable compared with alpha-blockers.
Collapse
Affiliation(s)
- Aytac Sahin
- Department of Urology, University of Health Sciences, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
| | - Musab Ali Kutluhan
- Department of Urology, University of Health Sciences, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
| | - Caglar Yildirim
- Department of Urology, Mardin State Hospital, Mardin, Turkey
| | - Ahmet Urkmez
- Department of Urology, University of Health Sciences, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
| | - Serkan Akan
- Department of Urology, University of Health Sciences, Sultan Abdulhamid Han Research and Training Hospital, Istanbul, Turkey
| | - Ayhan Verit
- Department of Urology, University of Health Sciences, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
| |
Collapse
|
15
|
Akan S, Urkmez A. Association between atherogenic dyslipidemia and fournier’s gangrene. Rev Assoc Med Bras (1992) 2020; 66:479-484. [DOI: 10.1590/1806-9282.66.4.479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 11/12/2019] [Indexed: 11/22/2022] Open
Abstract
SUMMARY OBJECTIVE We aimed to determine whether atherogenic dyslipidemia is associated with the disease and morbidity in our patients treated for Fournier’s gangrene (FG). METHODS Sixty-two patients who were treated with the diagnosis of FG at our center between 2012 and 2017 were retrospectively screened. RESULTS The triglyceride values of the patients who required reconstructive surgery were statistically significantly higher than those of the patients for whom wound debridement and primary suturing was sufficient (p:0.001). A total of 65.7% of the patients had normal triglyceride values in the group in which wound debridement and primary suturing was sufficient, while this rate was 22.2% in the group of patients who needed reconstructive surgery; the difference was statistically significant (p: 0.002). The UFGSI score of those with triglyceride values higher than the normal range was statistically significantly higher (p:0.006). The cut-off point for the triglyceride value for which Fournier’s gangrene was more morbid and the probability of reconstructive surgery need was significantly higher, i.e., >233mg. CONCLUSION Our study has demonstrated that atherogenic dyslipidemia, especially hypertriglyceridemia, is an important factor affecting morbidity and associated with high patient care costs after hospitalization and discharge in FG.
Collapse
|
16
|
Rodrigues Pessoa R, Urkmez A, Kukreja N, Baack Kukreja J. Enhanced recovery after surgery review and urology applications in 2020. BJUI Compass 2020; 1:5-14. [PMID: 35474909 PMCID: PMC8988792 DOI: 10.1002/bco2.9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 01/28/2020] [Accepted: 01/28/2020] [Indexed: 02/01/2023] Open
Abstract
Purpose: To explore enhanced recovery after surgery (ERAS) components and their current application to major urologic surgeries, barriers to implementation and maintenance of the associated quality improvement. Data Identification: An English language literature search was done using PubMed. Study Selection: After independent review, 55 of the original 214 articles were selected to specifically address the stated purpose. Data Extraction: Clinical trials were included, randomized trials were prioritized, but robust observational studies were also included. Results of Data Synthesis: Many ERAS components have good data to support usage in radical cystectomy (RC) patients. Most ERAS programs include multidisciplinary teams carrying out multimodal pathways to hasten recovery after a major operation. ERAS components generally include preoperative counseling and medical optimization, venous thromboembolism prophylaxis, ileus prevention, avoidance of fluid overload, normothermia maintenance, early mobilization, pain control and early feeding, all leading to early discharge without increased complications or readmissions. Although there may not be specific data pertaining to other major urologic operations, the principles remain similar and ERAS is easily applicable. Conclusion: The benefits of ERAS programs are well established for RC and principles are easily applicable to other major urology operations. Barriers to implantation and maintenance of ERAS must be recognized to continue to maintain the benefits of these programs.
Collapse
Affiliation(s)
| | - Ahmet Urkmez
- Department of Urology University of Texas MD Anderson Cancer Center Houston TX USA
| | - Naveen Kukreja
- Department of Anesthesia University of Colorado Aurora CO USA
| | | |
Collapse
|
17
|
Urkmez A, Topaktas R, Ozsoy E, Tokuc E, Kutluhan MA, Artuk I, Kayar R, Ozturk MI. Is neutrophil to lymphocyte ratio a predictive factor for recurrence of urethral stricture? ACTA ACUST UNITED AC 2020; 65:1448-1453. [PMID: 31994624 DOI: 10.1590/1806-9282.65.12.1448] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 06/30/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Due to spongiofibrosis and inflammatory processes underlying the pathogenesis of urethral stricture, it is possible that the neutrophil-lymphocyte ratio (NLR) may give essential information about the course of the disease and recurrence possibilities. Our study aims to evaluate the correlation between NLR and recurrence rates. METHODS A total of 512 patients who underwent direct visual internal urethrotomy (DVIU) due to urethral stricture in our clinic between February 2010 and January 2018 were evaluated retrospectively. RESULTS The median follow up for non-recurrent and recurrent groups after DVIU was 30 and 36 months, respectively. During the follow-up, 280 (54.7%) of the patients had recurrences, and 232 (45,3%) had no recurrences. The mean time for recurrence after DVIU was 6,5±1,4 months, with a range of 1-36 months. The mean NLR in the non-recurrence group was 2,02±0,87, with a median of 1.9, and 3,66±2,30, with a median of 3 in the recurrence group. A highly significant statistical difference was observed between two groups in terms of neutrophil count and NLR (p: 0.000 - both). The area under curve value for NLR was 0.767, with a standard error of 0.021 (95% CI 0.727-0.808). The cut-off value of NLR was determined as 2.25, with a 70% sensitivity and 67,7% specificity. CONCLUSION By using NLR, the inflammatory features of the urethral tissue can be predicted, and possible recurrences after surgery can be estimated. Consequently, open urethroplasty techniques can be used in cases with a significant NLR value instead of the recurrent endoscopic procedure.
Collapse
Affiliation(s)
- Ahmet Urkmez
- . Haydarpasa Numune Research & Training Hospital, Dept. of Urology, Istanbul, Turkey
| | - Ramazan Topaktas
- . Haydarpasa Numune Research & Training Hospital, Dept. of Urology, Istanbul, Turkey
| | - Emrah Ozsoy
- . Haydarpasa Numune Research & Training Hospital, Dept. of Urology, Istanbul, Turkey
| | - Emre Tokuc
- . Haydarpasa Numune Research & Training Hospital, Dept. of Urology, Istanbul, Turkey
| | - Musab Ali Kutluhan
- . Fatih Sultan Mehmet Research & Training Hospital, Dept. of Urology, Istanbul, Turkey
| | - Ilker Artuk
- . Haydarpasa Numune Research & Training Hospital, Dept. of Urology, Istanbul, Turkey
| | - Ridvan Kayar
- . Haydarpasa Numune Research & Training Hospital, Dept. of Urology, Istanbul, Turkey
| | - Metin Ishak Ozturk
- . Haydarpasa Numune Research & Training Hospital, Dept. of Urology, Istanbul, Turkey
| |
Collapse
|
18
|
Tokuc E, Urkmez A, Can U, Orak R, Gumrukcu G, Erel O, Kutluhan MA, Sertkaya Z, Ozturk MI. Evaluation of dynamic thiol-disulphide homeostasis in obstructive uropathy. Int Urol Nephrol 2020; 52:821-828. [PMID: 31955364 DOI: 10.1007/s11255-020-02377-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 12/10/2019] [Accepted: 01/03/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the ability of thiol-disulphide homeostasis to predict renal injury in ureteral obstruction by matching renal scintigraphy and pathological findings in an experimental rat model. METHODS 24 rats were randomized and divided into 3 groups as sham, partial and complete. Blood samples for biochemical evaluations and dimercaptosuccinic acid (DMSA) renal scintigraphy were performed at the beginning and on the 7th day postoperatively. Only a midline abdominal incision was done in sham group. Left ureter of partial group was dissected and gently buried into the psoas muscle. In complete group, left ureter was dissected and ligated. RESULTS Statistically significant association was found between left kidney function loss percentage, native thiol, total thiol and creatinine alterations and pathological EGTI (Endothelial, Glomerular, Tubular, Interstitial) scores (r = - 0.867, r = - 0.815, r = 0.745, r = - 0.911; p = 0.000). Statistically significant difference was detected between groups in terms of postoperative native thiol and total thiol values (p = 0.000, p = 0.001). There was also a significant difference in preoperative and postoperative comparisons of these parameters in partial and complete obstruction groups (p = 0.012, p = 0.018). There was a significant difference in terms of postoperative disulphide/native thiol and native thiol/total thiol ratios in complete obstruction group compared to other groups (p1 = 0.011, p2 = 0.040; p1 = 0.015, p2 = 0.028). CONCLUSIONS Association with scintigraphic and pathological results empowers the value of this parameter. Disulphide/native thiol and native thiol/total thiol ratios indicate complete obstruction. These findings may shed light to more comprehensive studies.
Collapse
Affiliation(s)
- Emre Tokuc
- Department of Urology, Sultanbeyli State Hospital, Istanbul, Turkey.
| | - Ahmet Urkmez
- Department of Urology, MD Anderson Cancer Center, Houston, TX, USA
| | - Unal Can
- Department of Nuclear Medicine, SBU Haydarpasa Numune SUAM, Istanbul, Turkey
| | - Rahime Orak
- Department of Nuclear Medicine, SBU Haydarpasa Numune SUAM, Istanbul, Turkey
| | - Gulistan Gumrukcu
- Department of Pathology, SBU Haydarpasa Numune SUAM, Istanbul, Turkey
| | - Ozcan Erel
- Department of Biochemistry, Yıldırım Beyazıt University, Ankara, Turkey
| | | | - Zulfu Sertkaya
- Department of Urology, Memorial Dicle Hospital, Diyarbakır, Turkey
| | | |
Collapse
|
19
|
Akan S, Urkmez B, Artuk I, Urkmez A. Scrotal Lymphedema and its Conservative Treatment: A Rare Complication of Circumcision. J Coll Physicians Surg Pak 2020; 30:94-95. [PMID: 31931942 DOI: 10.29271/jcpsp.2020.01.94] [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] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 04/20/2019] [Indexed: 11/11/2022]
Abstract
Lymphedema is defined as an abnormal accumulation of extracellular fluid in the subcutaneous compartment caused by impaired lymphatic drainage. Scrotal lymphedema is a rare condition characterised by swelling of the scrotal skin due to deterioration in lymphatic drainage. Over time, fibrosis may develop in the scrotum and genital malformations that impair the patient's quality of life. Here, we present the first case in our experience of scrotal lymphedema, which occurred in a 3-year child following circumcision, and subsequently was treated successfully with complex decongestive physiotherapy.
Collapse
Affiliation(s)
- Serkan Akan
- Department of Urology, University of Health Sciences, Sultan Abdulhamid Han Research and Training Hospital, Istanbul, Turkey
| | - Berna Urkmez
- Department of Physical Medicine and Rehabilitation, Bezmialem University Faculty of Medicine, Istanbul, Turkey
| | - Ilker Artuk
- Department of Urology, University of Health Sciences, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| | - Ahmet Urkmez
- Department of Urology, University of Health Sciences, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| |
Collapse
|
20
|
Sahin A, Yildirim C, Yuksel OH, Urkmez A. Treatment of ureteral catheter related symptoms; mirabegron versus tamsulosin/solifenacin combination: A randomized controlled trial. ARCH ESP UROL 2020; 73:54-59. [PMID: 31950924] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVES: The double-J (DJ) stents are commonly used to relieve the ureteral obstruction. Besides several known benefits, some of the patients encounter stent-related morbidities with considerable effects on the quality of life, general health situation, sexual matters, and daily work performance. In this study, we evaluated the effectiveness of tamsulosin/solifenacin combination and mirabegron in reducing DJ stent-related symptoms. MATERIALS AND METHODS: A total of 120 patients with 28cm 4.7fr DJ catheter inserted due to ureteral obstruction were included in this study. Patients were randomly divided into three groups of 40 each; group one received only oral hydration for six weeks; group two received 0.4 mg tamsulosin/10 mg solifenacin, and group three received 50 mg mirabegron. Preoperative and after 6 weeks, the VAPS, OAB-q index, and IPSSs forms were filled. RESULTS: The mean age of the patients was 41.60 ± 12.34 years. There was no significant difference between the groups in terms of preoperative and postoperative VAPS values (p>0.05). There was a significant difference in postop IPSSs values (p:0.001). It was higher in the hydration group than tamsulosin/solifenacin and mirabegron groups. Postoperative IPSS value of the hydration group was 21.78 ± 2.54 while the tamsulosin/ solifenacin and mirabegron groups were 15.6 ± 4.37 and 13.65 ± 4.97, respectively. The use of mirabegron and tamsulosin/solifenacin combination alleviates the LUTSs related with DJ stent. There was also a significant difference between groups in terms of postoperative OAB-q values (p:0.001). Postoperative OAB-q values in the tamsulosin/solifenacin group were significantly higher than the mirabegron group. Postoperative OAB-q value of the hydration group was 29.95 ± 5.21, while the tamsulosin/solifenacin and mirabegron groups were 23.68 ± 4.07 and 18.15 ± 4.1, respectively. Our results also showed that, as a beta-3 adrenergic receptor agonist, mirabegron can improve the OAB-q scores. CONCLUSION: Tamsulosin and solifenacin combination is a significantly good treatment option for reducing LUTS associated with DJ stents. Mirabegron single therapy showed good results in treating LUTS and better results in treating OAB symptoms related with DJ stents than other therapies.
Collapse
Affiliation(s)
- Aytac Sahin
- Department of Urology. Health Sciences University. Fatih Sultan Mehmet Training and Research Hospital. Istanbul. Turkey
| | - Caglar Yildirim
- Department of Urology. Health Sciences University. Fatih Sultan Mehmet Training and Research Hospital. Istanbul. Turkey
| | - Ozgur H Yuksel
- Department of Urology. Health Sciences University. Fatih Sultan Mehmet Training and Research Hospital. Istanbul. Turkey
| | - Ahmet Urkmez
- Department of Urology. Health Sciences University. Haydarpasa Numune Training and Research Hospital. Istanbul. Turkey
| |
Collapse
|
21
|
Kutluhan MA, Urkmez A, Sahin A, Topaktas R, Gumrukcu G, Verit A. Predictive value of ischaemia‐modified albumin in spermatogenesis in an experimental testicular torsion model. Andrologia 2019; 52:e13471. [DOI: 10.1111/and.13471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/01/2019] [Accepted: 10/14/2019] [Indexed: 01/24/2023] Open
Affiliation(s)
- Musab Ali Kutluhan
- Department of Urology Sağlık Bilimleri University Fatih Sultan Mehmet Research & Training Hospital Istanbul Turkey
| | - Ahmet Urkmez
- Department of Urology Sağlık Bilimleri University Fatih Sultan Mehmet Research & Training Hospital Istanbul Turkey
| | - Aytac Sahin
- Department of Urology Sağlık Bilimleri University Fatih Sultan Mehmet Research & Training Hospital Istanbul Turkey
| | - Ramazan Topaktas
- Department of Urology Sağlık Bilimleri University Haydarpasa Numune Research & Training Hospital Istanbul Turkey
| | - Gulistan Gumrukcu
- Department of Pathology Sağlık Bilimleri University Haydarpasa Numune Research & Training Hospital Istanbul Turkey
| | - Ayhan Verit
- Department of Urology Sağlık Bilimleri University Fatih Sultan Mehmet Research & Training Hospital Istanbul Turkey
| |
Collapse
|
22
|
Topaktas R, Aydin C, Altin S, Akkoc A, Aydın ZB, Urkmez A. The Efficacy of Ultra-thin Semi-rigid Ureteroscopy with Holmium Laser Lithotripsy in Pediatric Ureteral Stones: A Single-center Experience. Cureus 2019; 11:e5496. [PMID: 31667032 PMCID: PMC6816524 DOI: 10.7759/cureus.5496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction The aim of this study was to present our results regarding the feasibility and possible complications of 4.5 Fr semi-rigid ureterorenoscopy (URS) treatments in pediatric patients. Methods The files and computer records of a total of 33 pediatric patients (20 males and 13 females), who underwent URS procedures for ureteral stones > 5 mm between January 2013 and June 2017, were retrospectively reviewed. A 4.5 Fr semi-rigid ureteroscope (Ultrathin 4.5/6.5 Fr Ureterorenoscope; Richard Wolf GmbH, Knittlingen, Germany) was used for the URS procedures. For the stone-free rate evaluations, abdominopelvic ultrasound or direct radiography scans were performed one week after the surgery, and low-dose non-contrast computed tomography (CT) was performed during the first month. Results The mean age of the patients was 9.8 ± 2.8 (range 4-16) years old, and the mean ureteral stone size was 8.9 ± 1.4 (range 6-13) mm. The mean surgical duration was 45 ± 21.2 (range 30-75) minutes, and the mean hospital stay length was 1.2 (range 1-4) days. Minor complications occurred in five (15.1%) of the patients. The success rates for the first week and first month were 90.9% and 96.9%, respectively. Conclusion The endoscopic management of pediatric ureteral stones using a 4.5 Fr ureteroscope seems to be a safe and feasible treatment option with high success and low complication rates.
Collapse
Affiliation(s)
- Ramazan Topaktas
- Urology, Haydarpasa Numune Training and Research Hospital, Istanbul, TUR
| | - Cemil Aydin
- Urology, Hitit University Erol Olcok Training and Research Hospital, Corum, TUR
| | - Selcuk Altin
- Urology, Necip Fazıl Training and Research Hospital, Kahramanmaras, TUR
| | - Ali Akkoc
- Urology, Alanya Alaaddin Keykubat University, Antalya, TUR
| | - Zeynep B Aydın
- Radiology, Hitit University Erol Olcok Training and Research Hospital, Çorum, TUR
| | - Ahmet Urkmez
- Urology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, TUR
| |
Collapse
|
23
|
Urkmez A, Yuksel OH, Ozsoy E, Topaktas R, Sahin A, Koca O, Ozturk MI. The effect of urethroplasty surgery on erectile and orgasmic functions: a prospective study. Int Braz J Urol 2019; 45:118-126. [PMID: 30521166 PMCID: PMC6442143 DOI: 10.1590/s1677-5538.ibju.2018.0276] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 06/17/2018] [Indexed: 01/17/2023] Open
Abstract
Objectives: to examine the effects of urethroplasty surgery on sexual functions by taking into account age, location of stenosis, length of stenosis and surgical technique parameters. Materials and Methods: The prospective study was conducted between January 2015 and August 2017 with 60 cases. Patients were categorized according to age groups (19-65 / 65-75 years), surgery technique and stricture localization and length. Before the urethroplasty operation and postoperative 6th month follow-up, the international index of erectile function (IIEF) form (15 questions), was filled, the relevant domains of sexual function; erectile function (Q1,2,3,4,5,15), orgasmic function (Q9,10) and overall satisfaction (Q13,14) were assessed. Results: The mean age of the cases is 54 ± 13. However, preoperative IIEF, sexual satisfaction and orgasmic function averages of patients with a stenosis segment length of 1-3 cm was found to be significantly higher than that of patients with a stenosis segment length of 4-7 cm. Between stenosis segment length groups, there was no statistical difference in terms of preoperative and postoperative sexual functions. And also, there was no statistically significant change in patients’ preoperative and postoperative sexual function scores in terms of localization of stricture and surgery techniques. However, there were statistically significant change in the postoperative IIEF and sexual satisfaction averages according to preoperative averages. Conclusion: Our study suggests that urethroplasty surgery itself does not significantly affect erectile function, orgasmic function, and general sexual satisfaction regardless of the type of surgery, localization and length of stenosis. Besides, there was a significant decrease in erectile function in senior adults.
Collapse
Affiliation(s)
- Ahmet Urkmez
- Department of Urology, University of Health Sciences, Haydarpasa Numune Research & Training Hospital, Istanbul, Turkey
| | - Ozgur H Yuksel
- Department of Urology, University of Health Sciences, Fatih Sultan Mehmet Research & Training Hospital, Istanbul, Turkey
| | - Emrah Ozsoy
- Department of Urology, University of Health Sciences, Haydarpasa Numune Research & Training Hospital, Istanbul, Turkey
| | - Ramazan Topaktas
- Department of Urology, University of Health Sciences, Haydarpasa Numune Research & Training Hospital, Istanbul, Turkey
| | - Aytac Sahin
- Department of Urology, University of Health Sciences, Fatih Sultan Mehmet Research & Training Hospital, Istanbul, Turkey
| | - Orhan Koca
- Department of Urology, University of Health Sciences, Haydarpasa Numune Research & Training Hospital, Istanbul, Turkey
| | - Metin I Ozturk
- Department of Urology, University of Health Sciences, Haydarpasa Numune Research & Training Hospital, Istanbul, Turkey
| |
Collapse
|
24
|
Verit A, Urkmez A, Yuksel OH, Uruc F. Our Results of Laparoscopic Partial Nephrectomies Without Pedicle Dissection: Possible Advantages and Disadvantages. UROLOGY JOURNAL 2019; 16:128-133. [PMID: 30345495 DOI: 10.22037/uj.v0i0.4279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVES This study aimed to document the surgical and oncologic results of nephron sparing of non-ischemic laparoscopic partial nephrectomy without the step of hilus controlling and even without dissecting to expose the main renal vascularity and directly focusing on mass removal. MATERIALS & METHODS The records of the patients who underwent our modified laparoscopic partial nephrectomy technique were evaluated retrospectively. The patients' medical records, including tumor complexity calculated via R.E.N.A.L nephrometry scores, operation time, estimated blood loss, blood transfusions, hospital stay, pre- and postoperative serum creatinine levels, complications via the Clavien classification system, pathological status of surgical margin, and follow-up times, were documented. RESULTS The data of 55 patients with 58 renal units were evaluated. Almost all tumors were in the low complex group (91%), with a mean size of 31.74 ± 7.38 mm (range: 12-46 mm). Mean operation time, estimated blood loss, and transfusion rates were 138.62 ± 38.45 minutes (range: 90-240 min), 242.24 ± 107.12 mL (range: 100-500 mL), and 19%, respectively. The hemoglobin level decreased by a mean of 2.05 ± 0.87 g/dL. Whereas the perioperative complications were Clavien grades I, II, and III (74%, 23%, and 3%, respectively), mean hospital stay and follow-up time were 4.05 ± 1.97 and 19.67 ± 13.57 (ranges: 2-10 days and 1-44 months), respectively. CONCLUSION Present un-controlled results pointed that tumor-focusing nephron-sparing non-ischemic partial laparoscopic nephrectomy may be preferable for small-sized, low-complex renal masses.
Collapse
Affiliation(s)
- Ayhan Verit
- University of Health Sciences, Fatih Sultan Mehmet Hospital, Dept. of Urology, Istanbul, Turkey.
| | - Ahmet Urkmez
- University of Health Sciences, Haydarpasa Numune Hospital, Dept. of Urology, Istanbul, Turkey
| | - Ozgur Haki Yuksel
- University of Health Sciences, Fatih Sultan Mehmet Hospital, Dept. of Urology, Istanbul, Turkey
| | - Fatih Uruc
- University of Health Sciences, Fatih Sultan Mehmet Hospital, Dept. of Urology, Istanbul, Turkey
| |
Collapse
|
25
|
Urkmez A, Ozsoy E, Tokuc E, Kutluhan MA, Topaktas R, Artuk I, Koca O, Ozturk MI. Effect of artificial urinary sphincter implantation on erectile function and sexual satisfaction. Andrologia 2019; 51:e13295. [PMID: 30995702 DOI: 10.1111/and.13295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 02/01/2019] [Revised: 03/06/2019] [Accepted: 03/31/2019] [Indexed: 01/27/2023] Open
Abstract
Artificial urinary sphincter (AUS) implantation is the gold standard treatment in total stress urinary incontinence (SIU). Our aim is to evaluate the effect of AUS implantation on erectile function and sexual satisfaction (SS). Fourteen patients aged 58-73 years (mean: 66.92 ± 4.51 years) who underwent AUS implantation by a perineal approach between May 2015 and April 2018 were included in our study. Patients with neurogenic disease or very low or no erectile function and those who underwent non-nerve-sparing radical prostatectomy were excluded. Erectile function and intercourse satisfaction were evaluated pre-operatively and post-operatively at 6-month follow-up using international index of erectile function (IIEF) questionnaires. After AUS implantation; eight patients were totally dry, four achieved social continence (less than one pad/day), and two still had SUI (two or more pads/day). Mean pre- and post-operative IIEF values of the patients were 16.14 ± 3.18 and 17.42 ± 4.43 respectively. Mean pre- and post-operative SS values were 8.57 ± 1.78 and 8.71 ± 2.19 respectively. There was no statistically significant difference between pre- and post-operative IIEF-5 and intercourse satisfaction scores (p > 0.05). Although we did not see a significant effect of AUS implantation in our study, in SIU patients, coital incontinence or unpleasant odour during intercourse can lead to sexual avoidance and reduced SS, and AUS implantation may improve SS.
Collapse
Affiliation(s)
- Ahmet Urkmez
- Deparment of Urology, University of Health Sciences, Haydarpasa Numune Research & Training Hospital, Istanbul, Turkey
| | - Emrah Ozsoy
- Deparment of Urology, University of Health Sciences, Haydarpasa Numune Research & Training Hospital, Istanbul, Turkey
| | - Emre Tokuc
- Deparment of Urology, University of Health Sciences, Haydarpasa Numune Research & Training Hospital, Istanbul, Turkey
| | - Musab Ali Kutluhan
- Department of Urology, University of Health Sciences, Fatih Sultan Mehmet Research & Training Hospital, Istanbul, Turkey
| | - Ramazan Topaktas
- Deparment of Urology, University of Health Sciences, Haydarpasa Numune Research & Training Hospital, Istanbul, Turkey
| | - Ilker Artuk
- Deparment of Urology, University of Health Sciences, Haydarpasa Numune Research & Training Hospital, Istanbul, Turkey
| | - Orhan Koca
- Department of Urology, Medistate Kavacik Hospital, Istanbul, Turkey
| | - Metin I Ozturk
- Deparment of Urology, University of Health Sciences, Haydarpasa Numune Research & Training Hospital, Istanbul, Turkey
| |
Collapse
|
26
|
Topaktas R, Akyuz M, Kutluhan MA, Kanberoglu H, Koca O, Ozturk MI, Urkmez A. Is minimal invasive technique harmful in treatment of urethral stricture? Niger J Clin Pract 2019; 22:406-409. [PMID: 30837431 DOI: 10.4103/njcp.njcp_145_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objective Our goal was to evaluate the effect of previous history of direct vision internal urethrotomy (DVIU) on success rate of open urethroplasty in patients with bulbar urethral stricture. Patients and Methods We analyzed 133 patients who underwent open urethroplasty for bulbar urethral stricture between January 2008 and May 2017. Patients with penile and fossa navicularis stricture were excluded. We evaluated the effect of previous history of DVIU on success rate of open urethroplasty in patients with urethral stricture. Success of open urethroplasty was defined as disappear of voiding symptoms with maximum flow rate above 15 ml/s. The patients were followed for complications and outcome. Results Mean age was 54.05 ± 16.5 years. Mean length of stricture was 23.74 ± 10.23 mm. Mean follow-up was 39.77 ± 28.0 months. A total of 76 patients (57.1%) had no history of DVIU. On the contrary, 15.8% had history of DVIU once, 12% had twice, and 15.2% had more than twice. Success rate of open urethroplasty in patients who had no history of DVIU was 84%. However, this success rate was 71.4% in patients who had history of DVIU (P = 0.001). Conclusion DVIU is easy, simple, and noninvasive technique in treatment of urethral stricture, so it is frequently used among urologists. However, it could not be an alternative technique to open urethroplasty. Internal urethrotomy can be used in some certain indications. Success rate of open urethroplasty can be affected by previous history of any endoscopic procedures.
Collapse
Affiliation(s)
- R Topaktas
- Department of Urology, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
| | - M Akyuz
- Department of Urology, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
| | - M A Kutluhan
- Department of Urology, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
| | - H Kanberoglu
- Department of Urology, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
| | - O Koca
- Department of Urology, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
| | - M I Ozturk
- Department of Urology, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
| | - A Urkmez
- Department of Urology, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
27
|
Urkmez A, Yuksel OH, Ozsoy E, Topaktas R, Sahin A, Koca O, Ozturk MI. REPLY TO THE AUTHORS: RE: The effect of urethroplasty surgery on erectile and orgasmic functions: a prospective study. Int Braz J Urol 2019; 45:415-416. [PMID: 30735330 PMCID: PMC6541120 DOI: 10.1590/s1677-5538.ibju.2018.0793.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 12/30/2018] [Indexed: 11/22/2022] Open
Affiliation(s)
- Ahmet Urkmez
- Department of Urology, University of Health Sciences, Haydarpasa Numune Research & Training Hospital, Istanbul, Turkey
| | - Ozgur H Yuksel
- Department of Urology, University of Health Sciences, Fatih Sultan Mehmet Research & Training Hospital, Istanbul, Turkey
| | - Emrah Ozsoy
- Department of Urology, University of Health Sciences, Haydarpasa Numune Research & Training Hospital, Istanbul, Turkey
| | - Ramazan Topaktas
- Department of Urology, University of Health Sciences, Haydarpasa Numune Research & Training Hospital, Istanbul, Turkey
| | - Aytac Sahin
- Department of Urology, University of Health Sciences, Fatih Sultan Mehmet Research & Training Hospital, Istanbul, Turkey
| | - Orhan Koca
- Department of Urology, University of Health Sciences, Haydarpasa Numune Research & Training Hospital, Istanbul, Turkey
| | - Metin I Ozturk
- Department of Urology, University of Health Sciences, Haydarpasa Numune Research & Training Hospital, Istanbul, Turkey
| |
Collapse
|
28
|
Urkmez A, Tokuc E, Topaktas R, Sahin A, Yuksel OH. Mirabegron: A Novel and Promising Medical Expulsive Treatment for Ureteral Stones? J Coll Physicians Surg Pak 2019; 29:73-74. [PMID: 30630575 DOI: 10.29271/jcpsp.2019.01.73] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 09/14/2018] [Indexed: 11/11/2022]
Abstract
Medical expulsive therapy (MET) is used especially in distal ureteral stones to reduce colics and decrease the number of endourological surgical interventions. A broad spectrum of agents can be used for the relaxation and the dilatation of the ureter, reducing the intraureteric pressure. Alfa-blockers, calcium channel blockers, phosphodiesterase (PDE) inhibitors, and spasmolytics have been shown as effective in clinical trials on urolithiasis. It is a fact that the urothelium itself, the interstitial cells and the ureteric smooth muscle, have B-beta-2 and beta-3 adrenoreceptors. Stimulation of these receptors results in relaxation of the ureter. A recent beta-3 agonist, mirabegron, is commonly used for overactive bladder nowadays. The mechanism of action is adrenergic agonism that affects with the storage phase of the bladder, without interfering the voiding phase, which is regulated by parasympathetic pathways, commonly muscarinic. Agonism of the beta-3 receptors in the ureter has been shown to decrease the intraluminal pressure. By this mechanism, mirabegron can be thought as an alternative MET agent. Acting through different pathways, and having low adverse effect profile, can be thought as the most striking advantages of mirabegron as a MET. In vitro and in vivo trials should be conducted to support this hypothesis.
Collapse
Affiliation(s)
- Ahmet Urkmez
- Department of Urology, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| | - Emre Tokuc
- Department of Urology, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| | - Ramazan Topaktas
- Department of Urology, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| | - Aytac Sahin
- Department of Urology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
| | - Ozgur H Yuksel
- Department of Urology, Bahcesehir University, VM Medical Park Hospital, Istanbul, Turkey
| |
Collapse
|
29
|
Urkmez A, Akan S, Ozsoy E, Sahin A, Koca O, Ozturk MI. Diagnosis and Treatment of Paratesticular Adenomatoid Tumors. J Coll Physicians Surg Pak 2019; 28:S217-S219. [PMID: 30173704 DOI: 10.29271/jcpsp.2018.09.s217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 03/15/2018] [Indexed: 11/11/2022]
Abstract
Paratesticular adenomatoid tumor (PAT) is the most common paratesticular tumor. It is still a concern for today's urologists because it cannot be distinguished from malignant testicular tumors by clinical symptoms, routine examination and imaging methods. Because of the predominant benign nature of paratesticular masses, testicular preservative treatments get to the foreground. However, the fact that virtually all of the solid scrotal masses are malignant and are treated with radicel ingainel orchiectomy (RIO) remains a cause of concern. In this study, we discuss the diagnosis and treatment of 12 paratesticular adenomatoid tumors treated between 2012 and 2017 in two centres. We suggest that a frozen section should be done with the help of an experienced pathologist; and a meticulous microscopic evaluation should be the gold standard in case of a benign tumor suspicion.
Collapse
Affiliation(s)
- Ahmet Urkmez
- Department of Urology, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| | - Serkan Akan
- Department of Urology, Sultan Abdulhamid Han Research and Training Hospital, Istanbul, Turkey
| | - Emrah Ozsoy
- Department of Urology, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| | - Aytac Sahin
- Department of Urology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
| | - Orhan Koca
- Department of Urology, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| | - Metin Ishak Ozturk
- Department of Urology, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| |
Collapse
|
30
|
Yildirim C, Yuksel OH, Urkmez A, Sahin A, Somay A, Verit A. Protective effects of Tadalafil and darbepoetin against ischemia - reperfusion injury in a rat testicular torsion model. Int Braz J Urol 2018; 44:1005-1013. [PMID: 30130015 PMCID: PMC6237536 DOI: 10.1590/s1677-5538.ibju.2018.0200] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 05/31/2018] [Indexed: 12/03/2022] Open
Abstract
Objectives: To evaluate protective effects of darbepoetin and tadalafil against ischemia-reperfusion injury in ipsilateral and contralateral testicle. Materials and Methods: Thirty 3-month-old adult male Wistar-Albino rats were randomly divided into 5 groups (A-E). Sham operation was performed in the first group. In Group B, rats did not received any medication after creating 720 degrees torsion of the left testis. The rats in Group C, D and E received darbepoetin, tadalafil, and darbepoetin/tadalafil combination 30 minutes after creating 720 degrees torsion of the left testis, respectively. The testes of rats in these three groups were detorsioned at 90 minutes after drug administration. Both testes were removed at 30 minutes after detorsion. Results: There were significant differences between the groups in terms of the degree of histopathological damage, Johnsen score, fibrosis score and caspase-3 immunoreactivity in the torsioned testes (p: 0.000). The results for each parameter in the left testes were significantly better in the darbepoetin / tadalafil combination group. Similarly, there were also significant differences in the contralateral testes (p: 0.000). Conclusion: The active substances darbepoetin and tadalafil that were used as a combination had protective effects on both testes and produced out better results in preserving testicular histology. Especially in cases where it is not possible to rescue the torsioned testis, this result was more noticeable in the contralateral testis.
Collapse
Affiliation(s)
- Caglar Yildirim
- Department of Urology, Fatih Sultan Mehmet Research & Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ozgur H Yuksel
- Department of Urology, Fatih Sultan Mehmet Research & Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ahmet Urkmez
- Department of Urology, Haydarpasa Numune Research & Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Aytac Sahin
- Department of Urology, Fatih Sultan Mehmet Research & Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Adnan Somay
- Department of Pathology, Fatih Sultan Mehmet Research & Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ayhan Verit
- Department of Urology, Fatih Sultan Mehmet Research & Training Hospital, University of Health Sciences, Istanbul, Turkey
| |
Collapse
|
31
|
Urkmez A, Akan S, Ozsoy E. HIV Negative Penile Kaposi's Sarcoma in Circumcised Men. J Coll Physicians Surg Pak 2018; 28:S222-S224. [PMID: 30173706 DOI: 10.29271/jcpsp.2018.09.s222] [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] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 03/20/2018] [Indexed: 11/11/2022]
Abstract
Kaposi's sarcoma (KS) is an inflammatory vascular tumor, which can be seen at multiple areas in the body, especially at skin and extremities, mostly in immunosuppressed patients like organ receivers and AIDS patients. It can also be seen in human immune deficiency virus (HIV) negative, heterosexual, circumcised and non-immunosuppressed patients; and the disease course may be very variable. Herein, we present three patients who were referred to our clinic in the last five years and had a rather different course of disease; they were heterosexual, circumcised, non-immunosuppressed, and HIV negative. KS should be kept in mind in nonspecific penile lesions even if the patient is HIV negative. KS has a high recurrence rate even with any kind of treatment. More studies are needed for determining true recurrence rates, treatment plans and any underlying diseases.
Collapse
Affiliation(s)
- Ahmet Urkmez
- Department of Urology, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| | - Serkan Akan
- Department of Urology, Sultan Abdulhamid Han Research and Training Hospital, Istanbul, Turkey
| | - Emrah Ozsoy
- Department of Urology, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| |
Collapse
|
32
|
Urkmez A, Kutluhan MA, Topaktas R, Gumrukcu G, Erel O, Ozturk MI. Prognostic value of thiol/disulphide homeostasis in predicting testicular ischaemia-reperfusion injury in rats. Andrologia 2018; 50:e13134. [DOI: 10.1111/and.13134] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 07/18/2018] [Accepted: 07/29/2018] [Indexed: 12/14/2022] Open
Affiliation(s)
- Ahmet Urkmez
- Department of Urology; University of Health Sciences, Haydarpasa Numune Research & Training Hospital; Istanbul Turkey
| | - Musab A. Kutluhan
- Department of Urology; University of Health Sciences, Haydarpasa Numune Research & Training Hospital; Istanbul Turkey
| | - Ramazan Topaktas
- Department of Urology; University of Health Sciences, Haydarpasa Numune Research & Training Hospital; Istanbul Turkey
| | - Gulistan Gumrukcu
- Department of Pathology; University of Health Sciences, Haydarpasa Numune Research & Training Hospital; Istanbul Turkey
| | - Ozcan Erel
- Department of Clinical Biochemistry; Yıldırım Beyazıt University School of Medicine; Ankara Turkey
| | - Metin I. Ozturk
- Department of Urology; University of Health Sciences, Haydarpasa Numune Research & Training Hospital; Istanbul Turkey
| |
Collapse
|
33
|
Topaktas R, Akkoc A, Altin S, Aydin C, Urkmez A. Effectiveness of harmonic scalpel in laparoscopic treatment of simple renal cyst. J PAK MED ASSOC 2018; 68:1124-1128. [PMID: 30317318] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We retrospectively evaluated the results of Harmonic Scalpel (Ethicon, Cincinnati, Ohio) used for laparoscopic decortication of simple renal cysts (SRC). Between May 2011 and December 2014, 28 patients with symptomatic SRC (Bosniak type 1) underwent laparoscopic decortication with Harmonic Scalpel, were reviewed. All cysts were evaluated with ultrasonography and abdominal computed tomography. Symptomatic and surgical success was defined as no recurrence on computed tomography imaging and complete pain relief, respectively. The mean age of patients was 51.7±9.6 years and there were 16 female and 12 male. While a transperitoneal approach was preferred in 18 cases, a retroperitoneal approach was chosen in 10 patients. The mean cyst size and duration of operation was 8,8±2,8 (6-12) cm and 72,8±28,4 (50-110) minutes, respectively. A total of three minor complications were observed postoperatively. Mean hospital stay was 1,3±0,9 (1-3) days. After the mean 12,6±3,2 (3-24) months follow-up the radiological and symptomatic successes were 100% and 89,2%, respectively. Our results showed that laparoscopic decortication of SRC using Harmonic Scalpel is consistent with the literature and provides a reasonable complication but increases cost.
Collapse
Affiliation(s)
- Ramazan Topaktas
- Haydarpasa Numune Training and Research Hospital, Clinic of Urology, Istanbul
| | - Ali Akkoc
- Diyarbakir Gazi Yasargil Training and Research Hospital, Clinic of Urology, Diyarbakir, Turkey
| | - Selcuk Altin
- Diyarbakir Gazi Yasargil Training and Research Hospital, Clinic of Urology, Diyarbakir, Turkey
| | - Cemil Aydin
- Diyarbakir Gazi Yasargil Training and Research Hospital, Clinic of Urology, Diyarbakir, Turkey
| | - Ahmet Urkmez
- Haydarpasa Numune Training and Research Hospital, Clinic of Urology, Istanbul
| |
Collapse
|
34
|
Sahin A, Urkmez A, Haki Yuksel O, Verit A. Influence Of Obesity On Gleason Score Inconsistencies Between Biopsy And Radical Prostatectomy Specimens. J Coll Physicians Surg Pak 2018; 28:541-545. [DOI: 10.29271/jcpsp.2018.07.541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 04/20/2018] [Indexed: 11/11/2022]
|
35
|
Akan S, Urkmez A, Tokuc E. Primary Squamous Cell Carcinoma of Renal Pelvis in Non-Functioning Kidneys. J Coll Physicians Surg Pak 2018; 28:S148-S150. [PMID: 29866254 DOI: 10.29271/jcpsp.2018.06.s148] [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] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 02/13/2018] [Indexed: 11/11/2022]
Abstract
Primary renal pelvic squamous cell carcinomas comprise 0.5% of all renal neoplasms and are rare. The most common risk factor is nephrolithiasis. They are diagnosed late due to non-specific imaging and uncertain clinical features. With these two cases, we recommend periodic urine cytology and contrast imaging for chronic nephrolithiasis patients; and if suspected, fine needle aspiration cytology or tru-cut biopsy to be used in order to exclude malignancy that can develop on the basis of chronic pyelonephritis / nephrolithiasis.
Collapse
Affiliation(s)
- Serkan Akan
- Department of Urology, Sultan Abdulhamid Han Research and Training Hospital, Istanbul, Turkey
| | - Ahmet Urkmez
- Department of Urology, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| | - Emre Tokuc
- Department of Urology, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| |
Collapse
|
36
|
Sahin A, Yildirim C, Akan S, Yuksel OH, Urkmez A. A case of seminoma presented with clinical manifestations of testicular torsion. ACTA ACUST UNITED AC 2017; 89:236-237. [PMID: 28969409 DOI: 10.4081/aiua.2017.3.236] [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: 02/02/2017] [Revised: 05/03/2017] [Accepted: 05/05/2017] [Indexed: 11/23/2022]
Abstract
Testicular tumors rarely manifest themselves with clinical picture of testicular torsion. In this presentation of ours, we reported a 30-year-old patient whose post-orchiectomy histopathology report revealed the presence of seminoma. The patient consulted us with acute scrotum whose physical examination and Doppler ultrasonographic findings showed testicular torsion. Though rarely seen patients, in cases who consulted with acute scrotum, the possibility of testicular tumor should not be discarded. For the establishment of differential diagnosis detailed anamnesis and physical examination findings should be supported with laboratory tests and imaging modalities.
Collapse
Affiliation(s)
- Aytac Sahin
- Fatih Sultan Mehmet Research & Training Hospital, Dept. of Urology, Istanbul.
| | | | | | | | | |
Collapse
|
37
|
Sahin A, Urkmez A, Verit A, Yuksel OH, Verit FF. Psychologic and sexual dysfunction in primary and secondary infertile male patients. ACTA ACUST UNITED AC 2017; 89:120-124. [PMID: 28679183 DOI: 10.4081/aiua.2017.2.120] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 04/19/2017] [Accepted: 04/23/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of this study was to compare depression and sexual dysfunctions observed in primary and secondary infertile patients. MATERIAL AND METHOD The study was performed in 39 primary and 31 secondary infertile male patients. Male sexual health was evaluated using the International Index of Erectile Function (IIEF) score and depression with Beck Depression Inventory (BDI). RESULTS Mean age of the participants and their partners were 31.54 ± 5.37 (range, 24-48 yrs), and 28.16 ± 5.58 (range, 20- 46 yrs) years, respectively. Mean duration of their marriage ranged between 1 and 17 years (mean, 5.06 ± 4.15 yrs). A statistically significant intergroup difference was detected between groups as for BDI scores (p = 0.015; p < 0. 05). BDI scores of the primary group were significantly lower than those of the secondary group. A statistically and extremely significant difference was detected between IIEF scores of the groups (p = 0.006; p < 0.01). IIEF scores of the primary infertile group were higher than those of the secondary group. CONCLUSION Our study, frequency of the depression and erectile dysfunction seen in the patients with secondary infertility was seen significantly higher than the patients with primary infertility.
Collapse
Affiliation(s)
- Aytac Sahin
- Fatih Sultan Mehmet Research & Training Hospital, Department of Urology, Istanbul.
| | | | | | | | | |
Collapse
|
38
|
Urkmez A, Ozsoy E, Sahin A, Koca O, Ozturk MI. Prostatic Metastasis of Renal Cell Carcinoma Presenting With Elevated Serum Prostate-specific Antigen Level. Clin Genitourin Cancer 2017; 15:e843-e845. [PMID: 28372980 DOI: 10.1016/j.clgc.2017.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 03/07/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Ahmet Urkmez
- Department of Urology, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey.
| | - Emrah Ozsoy
- Department of Urology, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| | - Aytac Sahin
- Department of Urology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
| | - Orhan Koca
- Department of Urology, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| | - Metin Ishak Ozturk
- Department of Urology, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| |
Collapse
|
39
|
Yuksel OH, Verit A, Sahin A, Urkmez A, Uruc F. White blood cell counts and neutrophil to lymphocyte ratio in the diagnosis of testicular cancer: a simple secondary serum tumor marker. Int Braz J Urol 2017; 42:53-9. [PMID: 27136467 PMCID: PMC4811226 DOI: 10.1590/s1677-5538.ibju.2014.0593] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 03/02/2015] [Indexed: 03/15/2023] Open
Abstract
Purpose The aim of the study was to investigate white blood cell counts and neutrophil to lymphocyte ratio (NLR) as markers of systemic inflammation in the diagnosis of localized testicular cancer as a malignancy with initially low volume. Materials and Methods Thirty-six patients with localized testicular cancer with a mean age of 34.22±14.89 years and 36 healthy controls with a mean age of 26.67±2.89 years were enrolled in the study. White blood cell counts and NLR were calculated from complete blood cell counts. Results White blood cell counts and NLR were statistically significantly higher in patients with testicular cancer compared with the control group (p<0.0001 for all). Conclusions Both white blood cell counts and NLR can be used as a simple test in the diagnosis of testicular cancer besides the well-known accurate serum tumor markers as AFP (alpha fetoprotein), hCG (human chorionic gonadotropin) and LDH (lactate dehydrogenase).
Collapse
Affiliation(s)
- Ozgur Haki Yuksel
- Department of Urology, Fatih Sultan Mehmet Research & Training Hospital, Istanbul, Turkey
| | - Ayhan Verit
- Department of Urology, Fatih Sultan Mehmet Research & Training Hospital, Istanbul, Turkey
| | - Aytac Sahin
- Department of Urology, Fatih Sultan Mehmet Research & Training Hospital, Istanbul, Turkey
| | - Ahmet Urkmez
- Department of Urology, Fatih Sultan Mehmet Research & Training Hospital, Istanbul, Turkey
| | - Fatih Uruc
- Department of Urology, Fatih Sultan Mehmet Research & Training Hospital, Istanbul, Turkey
| |
Collapse
|
40
|
Yuksel OH, Urkmez A, Akan S, Yldirim C, Verit A. Predictive Value of the Platelet-To-Lymphocyte Ratio in Diagnosis of Prostate Cancer. Asian Pac J Cancer Prev 2016; 16:6407-12. [PMID: 26434851 DOI: 10.7314/apjcp.2015.16.15.6407] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To predict prostatic carcinoma using a logistic regression model on prebiopsy peripheral blood samples. MATERIALS AND METHODS Data of a total of 873 patients who consulted Urology Outpatient Clinics of Fatih Sultan Mehmet Training and Research Hospital between February 2008 and April 2014 scheduled for prostate biopsy were screened retrospectively. PSA levels, prostate volumes, prebiopsy whole blood cell counts, neutrophil and platelet counts, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), biopsy results and Gleason scores in patients who had established diagnosis of prostate cancer (PCa) were evaluated. RESULTS This study was performed on a total of 873 cases, with an age range 48-76 years, divided into three groups as for biopsy results. with diagnoses of benign prostatic hyperplasia (BPH) (n=304, 34.8 %), PCa (n=265, 30.4%) and histological prostatitis (n=304; 34.8%). Intra- and intergroup comparative evaluations were performed. White blood cell and neutrophil counts in the histological prostatitis group were significantly higher than those of the BPH and PCa groups (p=0.001; p=0.004; p<0.01). A statistically significant intergroup difference was found for PLR (p=0.041; p<0.05) but not lymphocyte count (p>0.05). According to pairwise comparisons, PLR were significantly higher in the PCa group relative to BPH group (p=0.018, p<0.05, respectively). Though not statistically significant, higher PLR in cases with PCa in comparison with the prostatitis group was remarkable (p=0.067, and p>0.05, respectively). CONCLUSIONS Meta-analyses showed that in patients with PSA levels over 4 ng/ml, positive predictive value of PSA is only 25 percent. Therefore, novel markers which can both detect clinically significant prostate cancer, and also prevent unnecessary biopsies are needed. Relevant to this issue in addition to PSA density, velocity, and PCA3, various markers have been analyzed. In the present study, PLR were found to be the additional predictor of prostatic carcinoma.
Collapse
Affiliation(s)
- Ozgur Haki Yuksel
- Department of Urology, Fatih Sultan Mehmet, Research and Training Hospital, Istanbul, Turkey E-mail :
| | | | | | | | | |
Collapse
|
41
|
Haki Yuksel O, Urkmez A, Verit A. Can perineural invasion detected in prostate needle biopsy specimens predict surgical margin positivity in D'Amico low risk patients? ACTA ACUST UNITED AC 2016; 88:89-92. [PMID: 27377081 DOI: 10.4081/aiua.2016.2.89] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 12/18/2015] [Accepted: 01/08/2016] [Indexed: 11/23/2022]
Abstract
OBJECTIVES In this study, our aim was to estimate the value of perineural invasion (PNI) in prostate needle biopsy (PNB) specimens in the prediction of surgical margin positivity (SMP) and its prognostic significance (upgrade Gleason Score) in patients who had undergone radical retropubic prostatectomy (RRP) with low risk prostate cancer according to D'Amico risk assessment. MATERIALS AND METHODS We retrospectively analyzed the data of 65 patients who were diagnosed as clinical stage T1c prostate cancer (PC) and underwent RRP between January 2010 and June 2013. Pathological specimens of PNB and RRP were separately examined for the parameters of PNI, vascular invasion (VI), Gleason Score (GS) and SMP. RESULTS The patients' mean age was 63.65 ± 4.93 (range 47- 75) years. PNI in PNB specimens were identified in 12 of 65 patients and 11 of 12 patients showed SMP on RRP specimens. While 53 of 65 patients had not PNI on PNB, only 11 of them demonstrated SMP on RRP specimens. SMP was 30.64-fold more frequently encountered in PNB specimens obtained from PNI-positive patients relative to PNI-negative patients. In our study, PNI detected in PNB specimens was statistically significantly associated with SMP on RRP specimens (P = 0.0001). CONCLUSION It is well known that higher PSA values and GS were independent predictors of SMP in clinically localized prostate cancer (CLPC). We think that PNI in PNB specimens may be a useful prognostic factor for predicting SMP in cases with CLPC.
Collapse
Affiliation(s)
- Ozgur Haki Yuksel
- Department of Urology, Fatih Sultan Mehmet Research & Training Hospital, Istanbul.
| | | | | |
Collapse
|
42
|
Haki Yuksel O, Urkmez A, Verit A. The role of Cajal cells in chronic prostatitis. ACTA ACUST UNITED AC 2016; 88:133-5. [PMID: 27377090 DOI: 10.4081/aiua.2016.2.133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Revised: 12/19/2015] [Accepted: 01/08/2016] [Indexed: 11/23/2022]
Abstract
Types of prostatitis can be defined as groups of syndromes in adult men associated with infectious and noninfectious causes characterized frequently by lower abdominal and perineal signs and diverse clinical symptoms and complications. Etiopathogenesis of chronic prostatitis is not well defined. Moreover, its treatment outcomes are not satisfactory. Presence of c-kit positive interstitial cells in human prostate is already known. It has been demonstrated that these cells can be pacemaker cells which trigger spontaneous slow-wave electrical activity in the prostate and can be responsible for the transport of glandular secretion from acinar cells into major and minor prostatic ducts and finally into urethra. In the light of all these data, when presence of a possible inflammatory pathology is thought to involve prostate that secretes and has a reservoir which drains its secretion (for prostate, prostatic urethra), two points are worth mentioning. Impairment of secretion mechanism and collection of secretion within the organ with reflux of the microbial material from its reservoir back into prostate gland. Both of these potential conditions can be explained by ductal neuromuscular mechanism, which induces secretion. We think that in this neuromuscular mechanism interstitial Cajal cells have an important role in chronic prostatitis. Our hypothesis is that curability of prostatitis is correlated with the number of Cajal cells not subjected to apoptosis.
Collapse
Affiliation(s)
- Ozgur Haki Yuksel
- Department of Urology, Fatih Sultan Mehmet Research & Training Hospital, Istanbul.
| | | | | |
Collapse
|
43
|
Yuksel OH, Akan S, Urkmez A, Yildirim C, Sahin A, Verit A. Preoperative Glasgow prognostic score as a predictor of primary bladder cancer recurrence. Mol Clin Oncol 2016; 5:201-206. [PMID: 27330798 DOI: 10.3892/mco.2016.901] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 02/12/2016] [Accepted: 04/27/2016] [Indexed: 11/06/2022] Open
Abstract
The correlation between systemic inflammatory markers and malignancies has been assessed by a number of recent studies. The aim of this study was to prospectively assess preoperative inflammation markers and Glasgow prognostic scores (GPS) in patients who underwent surgery for primary bladder cancer (BC), and evaluate the predictive value of GPS for disease recurrence and progression. A total of 38 patients (mean age, 60.16±9.71 years; range, 33-76 years) who were treated in our department between May, 2014 and August, 2015 were enrolled in the present study. Preoperatively, patient information regarding gender, body mass index, serum C-reactive protein (CRP) and albumin levels, GPS and comorbidities, were collected and recorded. Transurethral resection of the bladder was performed, followed by histopathological evaluation of the resected material. The tumor size, stage and grade and the presence of necrosis were determined. According to the international TNM classification, the results of the histopathological analysis were as follows: Ta low- (n=24) and high-grade (n=4); and T1 low- (n=2) and high-grade (n=8). The median follow-up period was 10.1 months (range, 6-12 months). During this period, recurrence was observed in 10 cases and disease progression was detected in 1 patient. Hypoalbuminemia was encountered in 40% of the cases with recurrence, which was significantly higher compared with that in patients without recurrence (7.1%; P=0.031). In patients who had recurrence, a GPS of 1-2 points and tumor necrosis were more frequently detected compared with those without recurrence (60 vs. 7.1%, P=0.002; and 80 vs. 7.1%, P=0.001, respectively). Excluding a cystectomized case with a diagnosis of muscle-invasive BC, disease progression was not detected in any of the cases with recurrence during follow-up. Therefore, we consider that GPS and serum markers of systemic inflammatory response may be used as predictors of recurrence in patients with transitional cell BC.
Collapse
Affiliation(s)
- Ozgur Haki Yuksel
- Department of Urology, Fatih Sultan Mehmet Research and Training Hospital, TR-34752 Istanbul, Turkey
| | - Serkan Akan
- Department of Urology, Fatih Sultan Mehmet Research and Training Hospital, TR-34752 Istanbul, Turkey
| | - Ahmet Urkmez
- Department of Urology, Haydarpasa Numune Research and Training Hospital, TR-34668 Istanbul, Turkey
| | - Caglar Yildirim
- Department of Urology, Fatih Sultan Mehmet Research and Training Hospital, TR-34752 Istanbul, Turkey
| | - Aytac Sahin
- Department of Urology, Fatih Sultan Mehmet Research and Training Hospital, TR-34752 Istanbul, Turkey
| | - Ayhan Verit
- Department of Urology, Fatih Sultan Mehmet Research and Training Hospital, TR-34752 Istanbul, Turkey
| |
Collapse
|
44
|
Urkmez A, Yuksel OH, Uruc F, Akan S, Yildirim C, Sahin A, Verit A. The effect of asymptomatic histological prostatitis on sexual function and lower urinary tract symptoms. ARCH ESP UROL 2016; 69:185-191. [PMID: 27225056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Prostatitis affects 10-14% of men of all ages and ethnicities. More than 50% of the men experience episodes of prostatitis at one time of their lives. Patients with CP typically have longlasting genitourinary/pelvic pain and obstructive and/or irritative voiding symptoms. Sexual dysfunction and psychological symptoms are frequently added to these symptoms. We also investigated the relationship between sexual functions, and lower urinary system symptoms, and asymptomatic histological prostatitis detected on transrectal ultrasound-guided (TRUS) biopsy performed with the indication of high PSA levels. METHODS Sixty cases compliant with the study criteria among patients who underwent prostate biopsies between September 2014 and June 2015 with the indication of higher PSA levels were included in the study. All patients were requested to complete IIEF-5 and IPSS forms one day previously. Based on histological analysis of biopsy materials, the patients were allocated into groups of BPH (simple BPH without histological prostatitis) (n:30) and histological chronic prostatitis (combination of BPH and histological prostatitis) (n:30). RESULTS Mean age of the cases was 65.73±5.01 (range, 56-75 yrs) years. PSA levels ranged between 4-15 ng/ml. A statistically significant intergroup difference was not found regarding mean age, BMIs, PSA levels, incidence rates of hypertension and coronary artery disease (p>0.05). Prostate volumes of the HCP group were higher than those of the BPH group , with statistically significant differences (p:0.001; p<0.01). Questionnaire forms of the patients included in the study were statistically evaluated, and mean IPSS score of the HCP group was found to be higher when compared with that of the BPH group, with statistically significant differences. (p:0.016; p<0.05). However mean IIEF score of the BPH group was higher than that of the HCP group, with statistically significant differences (p:0.039; p<0.05). DISCUSSION These findings suggested the presence of a correlation between chronic inflammation and lower urinary tract symptoms (LUTS). In addition, statistically significant lower IIEF values in patients with histological chronic prostatitis relative to those without suggested negative effects of even asymptomatic inflammation on sexual functions and mechanism of erection.
Collapse
Affiliation(s)
- Ahmet Urkmez
- Haydarpasa Numune Research and Training Hospital. Istanbul. Turkey
| | - Ozgur Haki Yuksel
- Department of Urology. Fatih Sultan Mehmet Research & Training Hospital. Istanbul. Turkey
| | - Fatih Uruc
- Department of Urology. Fatih Sultan Mehmet Research & Training Hospital. Istanbul. Turkey
| | - Serkan Akan
- Department of Urology. Fatih Sultan Mehmet Research & Training Hospital. Istanbul. Turkey
| | - Caglar Yildirim
- Department of Urology. Fatih Sultan Mehmet Research & Training Hospital. Istanbul. Turkey
| | - Aytac Sahin
- Department of Urology. Fatih Sultan Mehmet Research & Training Hospital. Istanbul. Turkey
| | - Ayhan Verit
- Department of Urology. Fatih Sultan Mehmet Research & Training Hospital. Istanbul. Turkey
| |
Collapse
|
45
|
Yuksel OH, Kivrak M, Sahin A, Akan S, Urkmez A, Verit A. A case of idiopathic diabetes insipidus presented with bilateral hydroureteronephrosis and neurogenic bladder: A pediatric case report and literature review. Can Urol Assoc J 2015; 9:E817-20. [PMID: 26600892 DOI: 10.5489/cuaj.3092] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Diabetes insipidus (DI) is a condition with heterogeneous clinical symptoms characterized by polyuria (urine output >4 mL/kg/hr) and polydipsia (water intake >2 L/m (2)/d). In children, acquired nephrogenic DI (NDI) is more common than central DI (CDI). Diagnosis is based on the presence of high plasma osmolality and low urinary osmolality with significant water diuresis. A water deprivation test with vasopressin challenge, though has limitations, is done to differentiate NDI from CDI and diagnose their incomplete forms. Neonates and young infants are better managed with hydration therapy alone. Older children with CDI are treated with desmopressin (1-deamino-8-D-arginine vasopressin, dDAVP). Its oral form is safe, highly effective and has dosing flexibility. We report a case of an 8-year-old male patient with CDI with severe bilateral non-obstructive hydronephrosis and megaureter. Dramatic clinical and radiological responses to dDAVP treatment were achieved and therapy reduced urine volume and led to marked radiological improvement in hydronephrosis.
Collapse
Affiliation(s)
- Ozgur Haki Yuksel
- Fatih Sultan Mehmet Research and Training Hospital, Department of Urology, Içerenkoy/Atasehir, İstanbul, Turkey
| | | | - Aytac Sahin
- Fatih Sultan Mehmet Research and Training Hospital, Department of Urology, Içerenkoy/Atasehir, İstanbul, Turkey
| | - Serkan Akan
- Fatih Sultan Mehmet Research and Training Hospital, Department of Urology, Içerenkoy/Atasehir, İstanbul, Turkey
| | - Ahmet Urkmez
- Fatih Sultan Mehmet Research and Training Hospital, Department of Urology, Içerenkoy/Atasehir, İstanbul, Turkey
| | - Ayhan Verit
- Fatih Sultan Mehmet Research and Training Hospital, Department of Urology, Içerenkoy/Atasehir, İstanbul, Turkey
| |
Collapse
|
46
|
Yuksel OH, Akan S, Urkmez A, Uruc F, Verit A. Efficacy and safety of semirigid ureteroscopy combined with holmium: YAG laser in the treatment of upper urinary tract calculi: Is it a good alternative treatment option of flexible ureteroscopy for developing countries? J PAK MED ASSOC 2015; 65:1193-1196. [PMID: 26564291] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To assess the success rates of endoscopic management of upper ureteral stones using semirigid ureterorenoscopy and holmium: YAG laser lithotripters. METHODS A total of 74 patients with an established diagnosis of upper ureteric stone and scheduled for endoscopic ureteral stone treatment were retrospectively evaluated. Failure was defined as the inability to contact or fragment the stone, migration of the stone into the renal pelvis and difficulty in visualizing the stone for the second time. Success rates and influencing factors as for stone-free state were investigated. RESULTS Mean age of our patients was 45.99±15.00 (range: 24-82) years. In 14 of 74 patients procedural failure was observed. Double J stents were implanted in 65 % of the patients and ureteral catheterization was performed on 20% of them. The total success rate was 81.1 %. Major complication rate was 1.1 percent. Factors effecting the success rate as gender, age, body mass index, grade of hydronephrosis and stone size were evaluated and only age was found to be statistically significant. CONCLUSIONS Despite some potential risks, semirigid ureterorenoscopic stone extraction and holmium: YAG laser lithotripters are still safe and effective treatment alternatives for management of upper ureteral stones.
Collapse
Affiliation(s)
- Ozgur Haki Yuksel
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, Icerenkoy/Atasehir, Istanbul, Turkey
| | - Serkan Akan
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, Icerenkoy/Atasehir, Istanbul, Turkey
| | - Ahmet Urkmez
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, Icerenkoy/Atasehir, Istanbul, Turkey
| | - Fatih Uruc
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, Icerenkoy/Atasehir, Istanbul, Turkey
| | - Ayhan Verit
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, Icerenkoy/Atasehir, Istanbul, Turkey
| |
Collapse
|
47
|
Uruc F, Yuksel OH, Urkmez A, Sahin A, Aras B, Verit A. A standardized scoring system in the prediction of success and complications of percutaneous nephrolithotomy: Guy's stone scoring system. ARCH ESP UROL 2015; 68:710-717. [PMID: 26530868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVES In this study, our aim was to determine the role of Guy's stone scoring system (GSS) in the prediction of percutaneous nephrolithotomy (PNL) success and its ability to foresee potential complications in consideration of Clavien grading system (CGS). MATERIAL AND METHODS The data of 244 patients who underwent PNL between January 2009 and May 2014 were retrospectively examined. Renal stones were evaluated using GSS with the aid of the patients' preoperative radiological evaluations and their postoperative complications were assessed with CGS. RESULTS Mean age of the patients (men, n=166; 68% and women, n=78; 32%) was 46.50±13.12 years (range, 16-80 yrs). Clinically significant residual stones were not detected in 195 (79.9%) patients, while they were found in 49 (20.1%) patients. Guy's stone scores of 1, 2, 3 and 4 points were estimated in 21.3, 37.7, 29.9, and 11.1% of the cases, respectively. Based on modified Clavien complication grading system, complications were categorized as Clavien grade 1, 2 and 3 in 81.9, 17.2, and 0.8% of the cases, respectively. Clavien Grade 4 and 5 complications were not encountered. A statistically significant correlation was found between Guy's Stone scores and Clavien grades (p<0.02). A statistically and highly significant difference was detected between Guy's stone scores of the cases with respect to residual stones (p=0.001; p<0.01). CONCLUSION Our study findings have revealed that GSS is a successful and easily applicable method for the prediction of success and likelihood of complications of PNL.
Collapse
Affiliation(s)
- Fatih Uruc
- Department of Urology. Fatih Sultan Mehmet Research & Training Hospital. Istanbul. Turkey
| | - Ozgur Haki Yuksel
- Department of Urology. Fatih Sultan Mehmet Research & Training Hospital. Istanbul. Turkey
| | - Ahmet Urkmez
- Department of Urology. Fatih Sultan Mehmet Research & Training Hospital. Istanbul. Turkey
| | - Aytac Sahin
- Department of Urology. Fatih Sultan Mehmet Research & Training Hospital. Istanbul. Turkey
| | - Bekir Aras
- Department of Urology. Dumlupinar University Faculty of Medicine. Kutahya. Turkey
| | - Ayhan Verit
- Department of Urology. Fatih Sultan Mehmet Research & Training Hospital. Istanbul. Turkey
| |
Collapse
|
48
|
Uruc F, Urkmez A, Yuksel OH, Sahin A, Verit A. Androgen secreting giant adrenocortical carcinoma with no metastases: A case report and review of the literature. Can Urol Assoc J 2015; 9:E644-7. [PMID: 26425231 DOI: 10.5489/cuaj.2867] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Functional adrenocortical carcinoma (ACC) is a very rare disease with a poor prognosis. Over half (60%) of ACCs bigger than 6 cm synthesize hormones; hormone-secreting ACCs generally include virilization, feminization or Cushing syndrome. Besides, 82% of ACCs are metastatic at the time of diagnosis. While a 48-year-old female patient was examined for abdominal pain and flushing, we detected a non-metastasizing mass (23 × 18 × 16 cm) in the adrenal lodge. The mass was extracted en bloc during open exploration and its histopathology was reported as ACC. We review the literature and report the largest androgen-producing, clinically silent ACC mass cited in the literature so far.
Collapse
Affiliation(s)
- Fatih Uruc
- Fatih Sultan Mehmet Research and Training Hospital, Department of Urology, Içerenkoy/Atasehir, Istanbul, Turkey
| | - Ahmet Urkmez
- Fatih Sultan Mehmet Research and Training Hospital, Department of Urology, Içerenkoy/Atasehir, Istanbul, Turkey
| | - Ozgur Haki Yuksel
- Fatih Sultan Mehmet Research and Training Hospital, Department of Urology, Içerenkoy/Atasehir, Istanbul, Turkey
| | - Aytac Sahin
- Fatih Sultan Mehmet Research and Training Hospital, Department of Urology, Içerenkoy/Atasehir, Istanbul, Turkey
| | - Ayhan Verit
- Fatih Sultan Mehmet Research and Training Hospital, Department of Urology, Içerenkoy/Atasehir, Istanbul, Turkey
| |
Collapse
|
49
|
Uruc F, Yuksel OH, Sahin A, Urkmez A, Yildirim C, Verit A. Emphysematous pyelonephritis: Our experience in managing these cases. Can Urol Assoc J 2015; 9:E480-3. [PMID: 26279720 DOI: 10.5489/cuaj.2828] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Emphysematous pyelonephritis (EPN) is a rare acute necrotising infection of renal parenchyma. We discuss clinical details and treatment strategies of 8 patients with EPN followed at our clinic. METHODS We retrospectively reviewed the clinical, laboratory, radiological findings and treatment modalities of 8 patients with EPN followed at our urology clinic between 2012 and 2015. RESULTS The mean patient age (female: 5; male: 3) was 62 (range: 51-82) years. Based on computed tomographic findings, EPN was classified as class 1 (n = 3), class 2 (n = 3) and class 3a (n = 2). All patients had fever, flank pain, nausea, and vomiting. Five patients had type 2 diabetes mellitus and 3 diabetic patients also had renal stones. Escherichia coli (n = 6), Klebsiella species (n = 1), and Proteus species (n = 1) were grown in urine cultures. All patients had unilateral involvement. Increased white blood cell counts, sedimentation rate, and C-reactive protein levels were detected in all cases. In addition to medical treatment, 2 patients underwent a nephrostomy catheter placement and another 2 patients underwent nephrectomy upon deterioration of her general health state. After achieving clinical stabilization with medical treatment, 1 patient underwent endoscopic ureteral stone treatment. The remaining 3 cases were treated only with antibiotherapy. All patients were discharged with clinical cure. CONCLUSION Mortality rates of EPN are gradually decreasing. Preservation of renal reserve is possible due to early diagnosis, appropriate antibiotherapy, and drainage.
Collapse
Affiliation(s)
- Fatih Uruc
- Fatih Sultan Mehmet Research and Training Hospital, Istanbul
| | | | - Aytac Sahin
- Fatih Sultan Mehmet Research and Training Hospital, Istanbul
| | - Ahmet Urkmez
- Fatih Sultan Mehmet Research and Training Hospital, Istanbul
| | - Caglar Yildirim
- Fatih Sultan Mehmet Research and Training Hospital, Istanbul
| | - Ayhan Verit
- Fatih Sultan Mehmet Research and Training Hospital, Istanbul
| |
Collapse
|
50
|
Yuksel OH, Urkmez A, Erdogru T, Verit A. The role of steroid treatment in intractable cystitis glandularis: A case report and literature review. Can Urol Assoc J 2015; 9:E306-9. [PMID: 26029302 DOI: 10.5489/cuaj.2636] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Cystitis glandularis is a proliferative disease of the urinary bladder epithelium. It is rare in children. We report a case of a 23-year-old female with intractable macroscopic hematuria and severe irritative bladder symptoms persisting for 13 years. The patient, who had undergone open and endoscopic bladder surgery at various medical centres, is currently being followed up at our clinic. Cystoscopy revealed multiple edematous papillary tumours on the bladder neck, trigone, and lateral wall on both sides and she underwent transurethral resection of the bladder tumour. The pathological diagnosis was cystitis glandularis in accordance with the histopathological reports obtained from the other medical centres. Her condition was resistant to transurethral resection, partial cystectomy, intravesical mitomycin, and bacillus Calmette-Guerin (BCG) treatment; it eventually could have affected the upper urinary tract. Oral steroid treatment was given for 6 months; after treatment, her symptoms improved and the cystoscopy revealed a dramatic improvement in her condition.
Collapse
Affiliation(s)
- Ozgur Haki Yuksel
- Department of Urology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
| | - Ahmet Urkmez
- Department of Urology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
| | - Tibet Erdogru
- Department of Urology, Memorial Atasehir Hospital, Istanbul, Turkey
| | - Ayhan Verit
- Department of Urology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
| |
Collapse
|