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Öğe Assessment and Cost Analysis for Patients Admitted to Emergency Department with Macroscopic Hematuria(Galenos Publ House, 2023) Sonmez, Leyla Ozturk; Turaliev, Nurmanbet; Ayranci, Mustafa Kursat; Ozturk, Esma Erdemir; Aydin, ArifAim: This study examined the etiological causes and their cost analysis in patients admitted and hospitalized with macroscopic hematuria (MH).Materials and Methods: Hemograms, urine, and biochemistry results of patients with MH, radiological images and pathology results, hospitalization need, hospitalization durations, and hematuria causes acquired following hospitalization, and the expenditures during this phase were registered for the patients. Laboratory values for the detected hematuria causes were compared and examined statistically.Results: Seventy-eight patients admitted to the emergency department with MH were evaluated. The most common underlying pathologies were bladder cancer (34.6%, n=27), prostate pathologies (24.3%, n=19), kidney stone (8.9%, n=7), urethral stone (7.7%, n=6), kidney cancer (7.7%, n=6), bladder stone (6.4%, n=5), urinary infection (6.4%, n=5), kidney laceration (2.6%, n=2) and arteriovenous malformation (1.3%, n=1) respectively. The mean invoice amount covering the management starting from admission with MH was 6647 +/- 10200 for each patient. In operated patients (n=54), hospitalization duration, catheterization duration, and invoice amount were found to be higher; in patients with malignancy (n=34) age, hospitalization duration, catheterization duration, and invoice amount were higher (p<0.05, all parameters).Conclusion: Among patients with MH, those with indications for surgery and malignancy have a greater impact on health expenditure. We can conclude that it will be beneficial for both the patient and the economy to start the diagnosis and treatment process before the onset of MH with prevention and early screening workups.Öğe The Benign Renal Masses that Were Exposed after Nephron-Sparing Surgery: Postsurgical Fatty Tumor. Is It Related to the Surgical Technique?(Codon Publications, 2022) Balasar, Mehmet; Ozkent, Mehmet Serkan; Aydin, Arif; Taskapu, Hakan Hakki; Atici, Ahmet; Ecer, Gokhan; Sonmez, Mehmet GirayAfter nephron-sparing surgery (NSS), postsurgical fatty tumor could be mistakenly reported as angiomyolipoma during radiologic imaging of some patients. In the present paper, we studied the postsurgical fatty tumor detected after NSS but not covered before in the literature. In addition, we also evaluated whether the postsurgical fatty tumor was related to the surgical technique employed. Patients admitted to the urology department of our university hospital from 2014 to 2019 and operated with open NSS were evaluated retrospectively. We detected those 156 patients were operated with NSS. Nine patients with angiomyolipoma as primary pathology and four patients with surgical border positivity were excluded from the study. The patients were divided into two groups based on the repair of tumor extraction region. In Group 1, fatty tissue was used for repair, and Group 2 is the primary repair group. In all, 143 patients (Group 1 = 79, and Group 2 = 64) were included in the study. No demographic and radiologic differences, such as number of patients, age, gender, positioning of tumor, mass localization, tumor diameter, and RENAL nephrometry scoring system, were detected between the two groups. Postsurgical fatty tumors were detected in 28 patients in Group 1 and in two patients in Group 2 (P < 0.001). In patients with negative surgical margins after partial nephrectomy, lesions that were radiologically detected mimicking as angiomyolipoma were defined as postsurgical fatty tumor. This mass containing adipose tissue only neither depicted vascularization and enhancement nor increase in size for at least 1 year. We assumed that these lesions must be followed as benign lesions not requiring additional treatment.Öğe The Benign Renal Masses that Were Exposed after Nephron-Sparing Surgery: Postsurgical Fatty Tumor. Is It Related to the Surgical Technique?(Codon Publications, 2022) Balasar, Mehmet; Ozkent, Mehmet Serkan; Aydin, Arif; Taskapu, Hakan Hakki; Atici, Ahmet; Ecer, Gokhan; Sonmez, Mehmet GirayAfter nephron-sparing surgery (NSS), postsurgical fatty tumor could be mistakenly reported as angiomyolipoma during radiologic imaging of some patients. In the present paper, we studied the postsurgical fatty tumor detected after NSS but not covered before in the literature. In addition, we also evaluated whether the postsurgical fatty tumor was related to the surgical technique employed. Patients admitted to the urology department of our university hospital from 2014 to 2019 and operated with open NSS were evaluated retrospectively. We detected those 156 patients were operated with NSS. Nine patients with angiomyolipoma as primary pathology and four patients with surgical border positivity were excluded from the study. The patients were divided into two groups based on the repair of tumor extraction region. In Group 1, fatty tissue was used for repair, and Group 2 is the primary repair group. In all, 143 patients (Group 1 = 79, and Group 2 = 64) were included in the study. No demographic and radiologic differences, such as number of patients, age, gender, positioning of tumor, mass localization, tumor diameter, and RENAL nephrometry scoring system, were detected between the two groups. Postsurgical fatty tumors were detected in 28 patients in Group 1 and in two patients in Group 2 (P < 0.001). In patients with negative surgical margins after partial nephrectomy, lesions that were radiologically detected mimicking as angiomyolipoma were defined as postsurgical fatty tumor. This mass containing adipose tissue only neither depicted vascularization and enhancement nor increase in size for at least 1 year. We assumed that these lesions must be followed as benign lesions not requiring additional treatment.Öğe Can Eosinophil Count, Platelet Count, and Mean Platelet Volume Be a Positive Predictive Factor in Penile Arteriogenic Erectile Dysfunction Etiopathogenesis?(Sage Publications Inc, 2017) Sonmez, Mehmet Giray; Goger, Yunus Emre; Sonmez, Leyla Ozturk; Aydin, Arif; Balasar, Mehmet; Kara, CengizBlood count parameters of patients referring with erectile dysfunction (ED) were examined in this study and it was investigated whether eosinophil count (EC), platelet count (PC), and mean platelet volume values among the suspected predictive parameters which may play a role in especially penile arteriogenic ED etiopathogenesis had a contribution on pathogenesis. Patients referring with ED complaint were evaluated. Depending on the medical story, ED degree was determined by measuring International Index of Erectile Function. Penile Doppler ultrasonography was taken in patients suspected to have vasculogenic ED. According to penile Doppler ultrasonography result, patients with arterial deficiency were included in the penile arteriogenic ED group and the patients with normal results were included in the nonvasculogenic ED group. A total of 36 patients participated in the study from the penile arteriogenic ED group and 32 patients from the nonvasculogenic ED group. Compared with the nonvasculogenic ED group, the penile arteriogenic ED group's low International Index of Erectile Function score, high EC, mean platelet volume and PC values were detected to be statistically significant (p < .001, p = .021, p = .018, p = .034, respectively). No statistically significant difference was observed among the two groups when age, white blood cells, red blood cells, and hemoglobin values were considered. Pansystolic volume velocities were detected as statistically significantly low compared with the nonvasculogenic ED group in the measurements made in 5th, 10th, 15th, and 20th minutes on the right and left sides in the penile arteriogenic ED group. High MPV value and PC is a significant predictive factor for penile arteriogenic ED and vasculogenic ED and high EC is specifically predictive of arteriogenic ED.Öğe Clinical efficacy and safety of transcatheter embolization for vascular complications after percutaneous nephrolithotomy(Termedia Publishing House Ltd, 2017) Poyraz, Necdet; Balasar, Mehmet; Gokmen, Ibrahim Erdem; Koc, Osman; Sonmez, Mehmet Giray; Aydin, Arif; Goger, Yunus EmreIntroduction: Percutaneous nephrolithotomy (PNL) is the preferred procedure for safe and effective surgical treatment of kidney stones. Hemorrhage is the most serious complication of PNL, resulting from pseudoaneurysm (PA) or arteriovenous fistula (AVF), and can usually be controlled with conservative treatment. Aim: To evaluate endovascular treatments and outcomes of vascular complications observed after PNL. Material and methods: We retrospectively reviewed data on 19 patients who underwent renal embolization due to post-PNL renal artery bleeding between March 2005 and September 2016. Embolization materials included embolization coils and glue. The incidence of post-PNL vascular complications and their endovascular treatments, outcomes, and the follow-up data were analyzed. Results: Nineteen (1.1%) of 1,609 patients (mean age: 44.9 years, range: 19-75 years) underwent angiography and subsequent transcatheter embolization to control bleeding. The mean time to onset of hemorrhage was 7.2 days after PNL (range: 3-18 days). The PNL entry site was the lower calyx in 15 patients, the middle calyx in 3, and the upper calyx in 1. PA, AVF, and PA plus AVF occurred in 14, 5, and 3 of the 19 renal angiography patients, respectively. Embolization of the affected vessels was successful in all 19 patients. The embolization materials of coil, glue, and coil plus glue were used in 16, 3, and 2 patients, respectively. Conclusions: Severe hematuria is a rare complication of PNL and can be successfully treated with transcatheter embolization.Öğe Comparison of early period sexual function parameters between surgical repair and conservative treatment after penile fracture(Elsevier Espana Slu, 2023) Taskapu, Hakan Hakki; Sonmez, Mehmet Giray; Ecer, Gokhan; Ucmak, Harun; Aydin, Arif; Balasar, MehmetIntroduction and objectives: Comparison of early period sexual function parameters in patients who had surgical repair and conservative follow-up after penile fracture and the evaluation of surgical intervention time on these parameters were planned in this study. Materials and methods: Total of 26 patients who were treated for penile fracture were evaluated. 19 patients had surgical repair and 7 patients had conservative treatment.Sexual function and erectile dysfunction (ED) degree of the patients before penile fracture and in the 12th week after fracture were evaluated with 5-question International Index of Erectile Function (IIEF-5) questionnaire, Erection Hardness Score (EHS), Sexual Encounter Pro-file(SEP) 2 and SEP 3. Parameters showing sexual function before and after the fracture were compared. Results: In both groups, a significant change was detected in IIEF-5 score, EHS, SEP-2 and SEP-3 parameters of the patients measured after penile fracture compared to the values before the fracture (all parameters, p < 0.05). No difference was detected in the parameters measured before and after the fracture among surgical repair and conservative treatment groups (all parameters p > 0.05). Mean time passing until the surgery after fracture was measured as 9.6 & PLUSMN; 6.85 h in 19 patients who had surgery. Conclusion: A difference wasn't detected in sexual parameters in conservative treatment and surgical repair groups in this study. As a significant decrease was observed in sexual function parameters even in conservative treatment cases without sudden detumescence and tunica albuginea rupturing, we think that quick surgical exploration would be useful in cases considered to have penile fracture. (c) 2022 Asociacion Espanola de Andrologia, Medicina Sexual y Reproductiva. Published by Elsevier Espana, S.L.U. All rights reserved.Öğe Complications and prostate cancer diagnosis rate of TRUS prostate biopsies using 16 and 18G needles by Clavien scoring(Wichtig Publishing, 2017) Ozcan, Serkan; Diri, Mehmet Akif; Bagcioglu, Murat; Karakan, Tolga; Aydin, ArifAim: We aimed to compare the 18 and 16-Gauge (G) needles used in transrectal ultrasonography (TRUS)-guided needle biopsy for cancer detection rates and complications using the Clavien Scoring System. Materials and methods: The 80 patients who were included in the study were randomized and divided into two groups. Group 1 (n = 36) had a TRUS-guided prostate biopsy with an 18G needle and Group 2 had a 16G needle (n = 44). The hematuria, bleeding assessment, and infection events were evaluated on a daily basis. These complications were graded according to the Clavien Scoring. Results: In Group 1, only five (13%) patients were diagnosed with prostate cancer, and three patients were reported to have atypical small acinar proliferation (ASAP). In Group 2, 16 (36%) patients were diagnosed with prostate cancer and one patient was reported to have ASAP. The difference in the prostate cancer detection rate between the groups was statistically significant. According to the Clavien grading system, the complications were at the Grade 1 level in 25 people in Group 1 in 29 people in Group 2. Grade 2 level complications were not observed in either group. While one person was Grade 3 in Group 1, two people in Group 2 had this rate. There were no significant differences between the groups. Conclusions: We found that cancer detection rate increased by increasing the thickness of the needle used in TRUS-guided prostate biopsy without any increase in the complications.Öğe Cystocele Repair with Platelet-Rich Plasma(Springer India, 2021) Atilgan, Adeviye Elci; Aydin, ArifCystocele is the most common vaginal wall prolapse with high incidence of recurrence after operation. Our aim in this study was to show the effectiveness of using platelet-rich plasma with cystocele repair. Patients were assigned to 2 groups: (1) cystocele repair only and (2) cystocele repair with platelet-rich plasma injection. Each group consisted of 28 patients. There were no significant differences between the groups in terms of demographics features. They were re-assessed 4 weeks later, 6 months later and annually with the standard Pelvic Organ Prolapse Quantification system to detect anatomic recurrence, the Pelvic Floor Distress Inventory for assessment of symptomatic recurrence and Patient Impression of Global Improvement questionnaire for assessment of subjective success. At the end of the 48-month follow-up period, the results were compared between the groups. The main outcome was low recurrence rate with platelet-rich plasma administration and secondary outcome was lower Pelvic Floor Distress Inventory scale score and higher Patient Impression of Global Improvement questionnaire results. The decrease in prolapse symptoms ascertained with the Pelvic Floor Distress Inventory scale was more significant in group 2 (6 vs. 2,p = 0.002), reoperation rate for symptomatic cystocele recurrence was significantly lower in group 2 (5 (17.8%) vs. 1 (3.5%),p = 0.001) and also subjective success evaluated with Patient Impression of Global Improvement scale was significantly higher in group 2 (21 vs. 25,p = 0.012). Considering mesh complications, platelet-rich plasma administration may be a good alternative to prevent cystocele recurrence. However, further research is needed to evaluate the safety and efficacy of this treatment.Öğe Early kidney injury in immunoglobulin A vasculitis: Role of renal biomarkers(Wiley, 2021) Ture, Esra; Yazar, Abdullah; Akin, Fatih; Topcu, Cemile; Aydin, Arif; Balasar, Mehmet; Atas, BulentBackground We aimed to determine whether urine kidney injury molecule 1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) can be used as early noninvasive biomarkers of kidney injury in immunoglobulin A vasculitis. Methods Patients who were diagnosed with immunoglobulin A vasculitis were included in the study. Urine samples were collected for determination of urine KIM-1 and NGAL levels. The control group consisted of age-matched healthy children. Results Sixty-one patients who were diagnosed with immunoglobulin A vasculitis were included in the study; 37.7% of these patients were determined to have renal involvement. Median KIM-1 was found to be significantly higher in the patient group (69.59 pg/mL) than the control group (40.84 pg/mL) (P = 0.001). Median NGAL was determined to be statistically significantly higher in the patient group (59.87 ng/mL) compared with the control group (44.87 ng/mL) (P = 0.013). In 23.6% of the patients without renal involvement at admission renal involvement developed within the following 6 months. When median KIM-1 and NGAL at admission of these patients were compared with the control group, they were determined to be statistically significantly higher (P = 0.001, P = 0.003). Conclusions The fact that our patients with late-term nephropathy had no hematuria and / or proteinuria and that KIM-1 and NGAL levels were determined to be high indicates that these biomarkers might be potentially reliable, noninvasive and early determinants of kidney injury.Öğe The effects of pelvic floor muscle training combined with Kinesio taping on bladder symptoms, pelvic floor muscle strength, and quality of life in women with overactive bladder syndrome: A randomized sham-controlled trial(Taylor & Francis Inc, 2022) Celenay, Seyda Toprak; Korkut, Zehra; Oskay, Kemal; Aydin, ArifBackground: There is insufficient study using Kinesio taping (KT) in bladder problems. Objectives: To investigate the effects of pelvic floor muscle training (PFMT) combined with KT on bladder symptoms, pelvic floor muscle strength, and quality of life in women with overactive bladder (OAB) syndrome and compare this combination with PFMT plus sham tape (ST). Methods: Women with OAB were randomly allocated into PFMT+KT and PFMT+ST groups. All patients were given PFMT for 6 weeks and applied taping according to groups. Before and after treatment, the OAB symptoms with the Overactive Bladder Assessment Form (OAB-V8) and Patients' Perception of Intensity of Urgency Scale (PPIUS), bladder function with a 3-day voiding diary, pelvic floor muscle strength with the Modified Oxford Scale, and quality of life with the King's Health Questionnaire (KHQ) were assessed. Results: OAB-V8, PPIUS, and KHQ scores decreased and the MOS improved in both groups (P < .05) after treatment. The intergroup comparisons revealed a further decrease in voids/day, voids/night, incontinence episodes/day, and personal limitation scores of the KHQ in the PFMT+KT group compared to the PFMT+ST group (P < .05). Conclusion: PFMT+KT was more effective in reducing the OAB symptoms compared to PFMT+ST. KT could be a complementary application for reducing symptoms in OAB.Öğe Efficiency of intracavernosal alprostadil and oral clomiphene citrate combination treatment in penile vasculogenic erectile dysfunction patients accompanied by late-onset hypogonadism(Wiley, 2020) Taskapu, Hakan Hakki; Sonmez, Mehmet Giray; Kilinc, Muzaffer Tansel; Altinkaya, Nurullah; Aydin, Arif; Balasar, MehmetIn this study, the efficiency of intracavernosal alprostadil + oral clomiphene citrate (CC) treatment in late-onset hypogonadism (LOH) accompanied by penile vasculogenic erectile dysfunction (PVED) in patients irresponsive to phosphodiesterase type 5 inhibitor treatment was evaluated. A total of 31 patients with concurrent PVED and LOH were included in the study. The patients were given intracavernosal alprostadil (10-20 mu g) and oral CC (50 mg) every day for 12 weeks. Before and after treatment, a 15-question International Index of Erectile Function (IIEF-15) questionnaire, Erection Hardness Score (EHS), Sexual Encounter Profile (SEP)2 and SEP3 levels were analysed, and follicle stimulating hormone (FSH), luteinising hormone (LH), total testosterone and prostate-specific antigen (PSA) levels were measured. In all, 41.9% of patients had pure arterial deficiency, 19.3% had pure venous deficiency, and 38.7% had arterial + venous (mixed) deficiency. A significant increase was detected in total testosterone, FSH, LH and PSA values after treatment when compared to values before treatment (p < .001,p < .001,p p = .034 respectively). A significant recovery was observed in IIEF-15 subscores, EHS and SEP2-SEP3 results. In PVED patients accompanied by LOH, intracavernosal alprostadil and oral CC combination is an efficient, low cost, safely applicable and tolerable treatment.Öğe Efficiency of retrograde intrarenal surgery in lower pole stones: disposable flexible ureterorenoscope or reusable flexible ureterorenoscope?(Springer, 2021) Goger, Yunus Emre; Ozkent, Mehmet Serkan; Kilinc, Muzaffer Tansel; Taskapu, Hakan Hakki; Goger, Esra; Aydin, Arif; Sonmez, Mehmet GirayPurpose The primary aim of this study to comparison of reusable and disposable flexible ureterorenoscope (fURS) efficiency in lower pole renal stone disease management. In addition, the secondary goal of this study was to evaluate the factors affecting stone-free rates (SFR) in lower pole stones. Materials and methods A prospective case-control study utilizing data from 122 consecutive ureteroscopic cases. The patients were divided into two groups according to the ureterorenoscope employed in the surgical intervention as disposable fURS (Group1, n:52) and reusable fURS (Group 2, n:70). Demographic characteristics, stone size, infundibulopelvic angle (IPA), SFR, hospitalization time, intraoperative complication rate (CR), operative time, preoperative or postoperative JJ stenting, and postoperative CR were analyzed. Results There was no statistical difference between the demographic and renal stone-related data between the groups. Likewise, no difference is observed in term of intraoperative and postoperative outcomes such as fluoroscopy time, CR, and hospitalization time between the groups. Although SFR was higher in the disposable fURS group, there was no difference statistically. However, the operative time was longer in reusable fURS Group (47.02 +/- 9.91 min in Group 1, and it was 57.97 +/- 14.28 in Group 2) (p: 0.001). The multivariate regression analysis result to evaluate the factors of effect to operative time; the use of disposable fURS was associated with a 10.95-min decrease in procedure duration (p < 0.001). Conclusions Disposable fURS and reusable fURS have similar clinical efficiency and complication rates in the treatment of lower calyceal stones with RIRS. Nevertheless, disposable fURS is a useful treatment option for increased stone volume due to the advantages such as shorter operative time.Öğe Investigation of bone biomechanics in rats with traumatic kidney injury(Wolters Kluwer Medknow Publications, 2023) Nalbant, Asrin; Saygin, Duygu Akin; Aydin, Arif; Aydin Kabakci, Anil DidemObjective: Mineral metabolism disorders are common in chronic kidney disease (CKD) and increase the risk of fractures. It has been confirmed by animal models that these changes in bone also cause negative results in the mechanical properties of bone. Although there are many available methods for diagnosing metabolic bone disorders and estimating fracture risk, it has been suggested that biomechanical tests that provide information about bone's structural and material properties are most appropriate, particularly in small rodents with CKD. Therefore, this study aimed to investigate the effects of trauma-induced kidney damage on bone biomechanical properties. Materials and Methods: In this study, we used 16 adult Wistar Albino rats, 200-300 g, 4-5 months old. The animals were examined under two groups: kidney control (n = 9) and healty kidney control group and kidney damage group (n = 7). In the control group, the rats were fixed by laparotomy, and the kidneys were closed without suturing. However, the kidney damage group was approached by suturing. Results: When the bone biomechanical properties of the control and kidney-damaged groups were compared, a statistically significant difference was found between the displacement at maximum load, duration, and young's modulus groups (P < 0.005). Conclusion: The study showed that the bone biomechanical properties of rats with trauma-induced kidney damage changed, and there was an increased fracture risk.Öğe Is There A Relation Between Serum Uric Acid Values and Prostatic Calculi Presence?(Karger, 2019) Balasar, Mehmet; Sonmez, Mehmet Giray; Aydin, Arif; Goger, Yunus Emre; Ozkent, Mehmet Serkan; Poyraz, NecdetObjective: We planned to examine the connection between serum uric acid (UA) values and prostatic calculi (PCal) presence and to evaluate the relation between PCal and other etiological factors. Methods: Patients between 20 and 60 years of age who were referred to the clinic with any reason and had non-contrast abdominal tomography (NCACT) for PCal were included in the study. While the patients were separated into 2 groups based on their serum UA level as >= 7 mg/dL (Group 1) and <7 mg/dL (Group 2), NCACT was also divided into 2 groups as PCal presence (PCal+) and lack (PCal-) serum UA, calcium, phosphorus, sodium, prostate-specific antigen levels and urinary analysis results of the patients were evaluated and compared. Results: PCal were detected in 38 of 169 patients (22%). PCal presence was detected to be significantly high in Group 1 (p = 0.015). While Type A localization PCal were present both in Groups 1 and 2. Based on PCal presence, UA level was detected to be significantly high in PCal+ patients (p = 0.01). No significant difference was detected among the groups in biochemical parameters and urine-related parameters other than UA. Conclusion: A significant relation was found between high UA value and PCal in this study. These results may show that UA plays an active role in PCal etiology. (C) 2018 S. Karger AG, BaselÖğe Is there a relationship between penile vasculogenic erectile dysfunction, platelet functions and eosinophil count?(Elsevier Espana Slu, 2017) Sonmez, Mehmet Giray; Sonmez, Leyla Ozturk; Goger, Yunus Emre; Aydin, Arif; Demirelli, Erhan; Boga, Mehmet Salih; Kara, CengizPurpose: Blood count parameters of patients referring with penile vasculogenic erectile dysfunction (ED) were examined in this study. It was investigated whether eosinophil count (EC), platelet count (PC) and mean platelet volume (MPV), values among the suspected predictive parameters which may affect vascular functions, have a contribution on ED pathology or not. Materials and methods: Patients referring erectile dysfunction complaint were evaluated. Depending on the medical story, ED degree was determined by measuring International Index of Erectile Function (IIEF). Values such as hormones, complete blood count and other laboratory markers were examined. Penile doppler ultrasonography (PDU) was performed in patients suspected to have vasculogenic ED. According to PDU result, patients with vascular deficiency were included in the penile vasculogenic ED group and patients with normal results were included in the control group. 49 patients participated in the study from the penile vasculogenic ED group and 30 patients from the control group. Intergroup comparisons were performed using the Mann-Whitney U test and the chi-square (chi(2)) test was used to assess the relationship between categorical variables within the patient groups. Results: Low IIEF score in vasculogenic ED group compared to the control group and high EC, MPV and PC values were detected to be statistically significant (p < 0.001, p = 0.026, p = 0.009, p = 0.029, respectively). No statistically significant difference was observed among the two groups when age, white blood cells, red blood cells or hemoglobin values are considered (p = 0.332, p = 0.235, p = 0.127, p = 0.696, respectively). Conclusion: High MPV value and platelet count showing the platelet functions and high eosinophil count are important factors which may play a role in penile vasculogenic ED etiopathogenesis. (C) 2016 Asociacion Espanola de Andrologia, Medicina Sexual y Reproductiva. Published by Elsevier Espana, S.L.U. All rights reserved.Öğe Long-term outcomes of minimally invasive surgeries in partial nephrectomy. Robot or laparoscopy?(Wiley, 2021) Boga, Mehmet Salih; Sonmez, Mehmet Giray; Karamik, Kaan; Ozsoy, Cagatay; Aydin, Arif; Savas, Murat; Ates, MutluBackground To compare long-term oncological and renal functional outcomes of laparoscopic and robotic partial nephrectomy for small renal masses. Methods A total of 103 patients who underwent laparoscopic (n = 31) and robotic (n = 72) partial nephrectomy between April 2015 and November 2018 were included in the study. Perioperative parameters, long-term oncological and functional outcomes were compared between the laparoscopic and robotic groups. Results No significant differences were found in terms of age, tumour size, RENAL and PADUA scores, pre-operative estimated glomerular filtration rate (eGFR), and presence of chronic hypertension and diabetes (P = .479, P = .199, P = .120 and P = .073, P = .561, and P = .082 and P = .518, respectively). Only estimated blood loss was significantly higher in the laparoscopic group in operative parameters (158.23 +/- 72.24 mL vs. 121.11 +/- 72.17 mL; P = .019), but transfusion rates were similar between the groups (P = .33). In the laparoscopic group, two patients (6.5%) required conversion to open, while no conversion was needed in the robotic group (P = .89). There were no differences in terms of positive surgical margin and complication rates (P = .636 and P = .829, respectively). No significant differences were observed in eGFR changes and post-operative new-onset chronic kidney disease at 1 year after the surgery (P = .768, P = .614, respectively). The overall mean follow-up period was 36.07 +/- 13.56 months (P = .007). During the follow-up period, no cancer-related death observed in both group and non-cancer-specific survival was 93.5% and 94.4% in laparoscopic and robotic groups, respectively (P = .859). Conclusions In this study, perioperative and long-term oncological and functional outcomes seems to be comparable between laparoscopic and robotic partial nephrectomies.Öğe Management of War-related Genitourinary Injuries(Galenos Yayincilik, 2021) Aydin, Arif; Ozbay, Engin; Durmus, Emrullah; Oncel, Halil Ferat; Karlidag, Ismail; Salar, Remzi; Sonmez, Mehmet GirayObjective: This study aimed to share the diagnosis and treatment results of patients who received genitourinary system interventions or surgeries for injuries sustained during the Syrian Civil War. Materials and Methods: Patients who underwent surgery for firearm injury-related urological trauma and other system injuries accompanied by urological trauma in a border city hospital urology department between October 2012 and May 2016 were evaluated. In addition, patients were classified according to trauma area and presence of accompanying non-genitourinary trauma. Results: Isolated genitourinary injuries were present in 7 of 37 patients (18.9%) who were brought to the emergency service due to war injuries. The most common accompanying damage to the genitourinary system was abdominal injury (56.7%), and 15 (40.5%) patients had intervention after intraoperative consultation. When urological injuries were classified, there were 19 (51.3%) major renal injuries, 3 (8.1%) ureteral injuries, 7 (18.9%) bladder injuries, 4 (10.9%) posterior urethral injuries, 3 (8.1%) testicular injuries, and 3 (8.1%) external genital organ injuries. The most common urological surgical procedure was nephrectomy, and the second was bladder perforation repair. Conclusion: This study demonstrates the necessity of a multidisciplinary approach especially for patients with war-related injuries. Moreover, important information is given about the classification and type of genitourinary system injuries.Öğe An overlooked complication of the clean intermittent catheters: prostate calculi(Springer, 2023) Ecer, Gokhan; Aydin, Arif; Sonmez, Mehmet Giray; Kilinc, Muzaffer Tansel; Guven, Selcuk; Balasar, MehmetObjective Although the clinical importance of prostate calculi has been understood over time, it is a urinary system disease that can cause different symptoms and can be ignored by urologists sometime. Clean intermittent catheter (CIC) is the gold standard method for bladder rehabilitation and urinary drainage in patients with neurogenic bladder. The aim of this study was to compare the incidence of prostate calculi and related pathologies between patients using CIC and not using CIC. Material-method A total of 314 neurogenic bladder patients who were followed up and treated in our urology clinic were included in this study. The patients were divided into two groups as patients non-using CIC (Group-1, n:154) and patients using CIC (Group-2, n:160). Presence of prostate calculi, the number of CIC used per/day, plasma uric acid levels, urine parameters, mean-stone-density (MSD) and calculi sizes were retrospectively scanned from patient records. Results In this study, no significant difference was observed between the parameters such as age, uric acid level, MSD, urine parameters, and other electrolyte levels (Table 1) While the incidence of prostate calculi in Group 1 was 23.4%; The incidence of prostate calculi in group 2 was 37.5(p = 0.007) (Fig. 2). Conclusion In this study, it was tried to show the relationship between the use of CIC and prostate calculi that cause LUTS and dysuria, which are generally ignored in clinical evaluation but do not pass in patients. As a result of this study, it was determined that the incidence of prostate calculi increased in patients using CIC.Öğe Prostate incidentaloma on 18F-fluorodeoxyglucose positron emission tomography: Diagnostic value of volumetric positron emission tomography parameters(Georg Thieme Verlag Kg, 2021) Sahin, Ozlem; Kaya, Bugra; Aydin, Zeynep; Sen, Ahmet Eren; Iyisoy, Mehmet Sinan; Aydin, ArifObjective To evaluate whether volumetric PET parameters such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG) contributed to maximum standardized uptake value (SUVmax) in predicting prostate carcinoma in the prostate incidentalomas (PI) in 18F-FDG PET/CT. Materials and methods This retrospective study comprised 107 patients with PI of 4723 male patients who had undergone 18F-FDG PET/CT. SUVmax and volumetric PET parameters of PIs were assessed. MTV and TLG were acquired with each SUV threshold as 2.5, 3.0, 3.5, 4.0, 4.5, and 5.0. Results The PI incidence was 2.3 %, and the malignancy ratio of PI was 15.9 %. According to further analysis results, 17 patients were in the malignant group, and 46 patients were in the benign group. Malignant PIs had higher SUVmax (10.6 vs. 6.4 and p < 0.01), MTV (all p < 0.01) and TLG (all p < 0.01) than benign incidentalomas. All volumetric PET parameters had higher area under the curve (AUC) than SUVmax. SUVmax AUC was 0.835 [95 % confidence interval (CI): 0.728-0.942]. MTV 2.5 and TLG 2.5 had the highest performance for predicting malignant PI. MTV2.5 AUC was 0.871 (95 % CI: 0.775-0.968), and TLG2.5 AUC was 0.882 (95 % CI: 0.797-0.967). Using TLG 2.5 greater than 29.8 as the cut-off point, the sensitivity and specificity for malignancy prediction were 94.1 % and 82.6 %, respectively. Conclusion In this study, in which the effectiveness of volumetric parameters in the diagnosis of PI was evaluated for the first time, it was shown that they could potentially have clinical value along with SUVmax.Öğe Single-center experience of robot-assisted radical cystectomy (RARC) and extended pelvic lymph node dissection(Aves, 2020) Boga, Mehmet Salih; Ozsoy, Cagatay; Aktas, Yasin; Aydin, Arif; Savas, Murat; Ates, MutluObjective: To report the outcomes of robot-assisted radical cystectomy (RARC) and extended pelvic lymph node dissection (ePLND) series for bladder cancer. Material and methods: Between October 2016 and June 2019, overall 57 patients (50 men, 7 women) were included in the study. Patient demographics, operative data, and postoperative pathological outcomes were evaluated. Patients who had a history of pelvic or intraabdominal surgery due to other concurrent malignancy, radiation therapy, or lacked data were excluded from the study. Results: The mean age of the patients was 64.72 +/- 9.09 years. The mean operation time, intraoperative estimated blood loss, and hospitalization time were 418.58 +/- 85.66 minutes, 313.00 +/- 79.16mL, and 13.44 +/- 5.25 days, respectively. The postoperative pathological stages were reported as pT0 (n=8), pTis (n=4), pT1 (n=4), pT2 (n=22), pT3a (n=11), pT3b (n=2), pT4a (n=4), pT4b (n=1), and other (n=1). The mean lymph node (LN) yield was 23.45 +/- 943. Positive LNs were found in 16 (28.1%) patients. Surgical margins were positive in 3 (5.26%) patients. The mean follow-up period was 15.42 +/- 8.31 months. According to the modified Clavien-Dindo system, minor (Clavien 1-2) and major (Clavien 3-5) complications occurred in 18 (31.58%) and 9 (15.78%) patients during the early (0-30 days) period and in 4 (7.02%) and 5 (8.77%) patients in the late (31-90 days) period. Conclusion: RARC and ePLND are complex but safe procedures with acceptable morbidity and excellent surgical and oncologic outcomes in muscle-invasive or high-risk bladder tumors.
