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Öğe Body mass index based evaluation of 6-year outcomes after transobturator tension-free vaginal tape for female urinary incontinence(Sage Publications Ltd, 2017) Salvarci, Ahmet; Gurbuz, RecaiIntroduction: The long-term results will be presented according to the body mass index (BMI) rates for transobturator tension-free vaginal. Methods: Three hundred nineteen female patients were evaluated (2008-2014). Their incontinence was classified according to the Stamey classification. The International Consultation on Incontinence Questionnaire-Short form was filled in before and after surgery. The Pelvic Organ Prolapse quantification system was utilized. The Female Sexual Function Index and the International Index of Erectile Functions were asked to be filled in. Their satisfaction level was assessed in the sixth year with the modified Clavien classification system. BMI cut-off points for public health action for the Asian population were adopted in the present study as follows: 18.5-23.0 kg/m(2) (normal), 23.1-27.4 kg/m(2) (high) and at least 27.5 kg/m(2) (obese), respectively. Results: The median success rate on the 12th month was calculated as 81.25% in the follow-ups after TOT; it was observed that the median success rate after 72 months decreased to 79.15%. Significant improvements were observed in the Female Sexual Function Index and the Index of Erectile Dysfunction. The objective cure rates detected according to normal, high and obese BMI rates, respectively, were 93.1%, 75.9% and 81.4%, while the patient satisfaction rates were 83.3%, 81.3% and 83.1%, respectively. Conclusions: It was observed that the objective and subjective patient satisfaction rates were very good in the long term in all BMI groups. No statistically significant differences were observed in perioperative complication rate, 6-year success rates and patient satisfaction among the three different BMI groups in the long term.Öğe Comparison of Non-Hilar Clamping Simple Enucleation and Enucleo-Resection of Exophytic Renal Tumors(Urol & Nephrol Res Ctr-Unrc, 2015) Balasar, Mehmet; Durmus, Emrullah; Piskin, Mehmet Mesut; Karalezli, Giray; Gurbuz, Recai; Kilinc, MehmetPurpose: To retrospectively evaluate our institutional experience with non-hilar-clamping simple enucleation (SE) and enucleoresection (ER) for the treatment of exophytic renal tumors regarding their oncological outcomes. Materials and Methods: We retrospectively evaluated patients treated between 2006 and 2013 for clinical exophytic T1-T2a renal tumors using open nephron-sparing surgery. Results: A total of 33 patients underwent SE and 39 underwent ER. The mean tumor size was 38.7 mm. None of the patients had positive surgical margins. No local recurrences were observed during the postoperative follow-up period (mean 40.7 +/- 23.4 months); however, ipsilateral adrenal and contralateral kidney metastasis was detected in one of the patients. There was no statistically significant difference in the R.E.N.A.L Nephrometry Score, operative time, or intraoperative blood loss in the non-hilar-clamping SE and ER groups (P > .05). During the third postoperative month, the estimated glomerular filtration rate (eGFR) levels in the SE group were significantly reduced compared with the preoperative eGFR levels (P = .046). Conclusion: SE and ER with non-hilar clamping are safe, acceptable approaches for treating exophytic renal tumors.Öğe Complete treatment with partial cystectomy in giant xanthogranulomatous cystitis case imitating bladder tumor(Medknow Publications & Media Pvt Ltd, 2017) Balasar, Mehmet; Sonmez, Mehmet Giray; Oltulu, Pembe; Kandemir, Abdlkadir; Kilic, Mehmet; Gurbuz, RecaiXanthogranulomatous cystitis (XC) is a very rare chronic benign inflammatory disease of the bladder. It may cause local invasion although it is not a malign lesion and may occur together with malign lesions. It has a clinical importance as the distinction from malign lesions is difficult clinically and pathologically. Sharing a 37-year-old female case with giant XC imitating bladder tumor referring to the hospital with hematuria and stomach ache, together with current literature, we wanted to present that the disease can be treated with bladder-preserving approaches instead of radical approaches even though the mass is big in these cases. Application of basic excision and partial resection for small masses and radical cystectomy for large masses was reported in literature. We think that our case may provide a contribution to literature in treatment approach since we provided surgical cure with partial resection in a big mass with dimensions of 9 cm x 8 cm which is different from the present literature. Even though XC is a rare disease, it should be considered in prediagnosis for especially big dimensioned masses, and treatment should be planned according to the pathology result after together with cystoscopy in suitable patients.Öğe Investigation of granulomatous prostatitis incidence following intravesical BCG therapy(E-Century Publishing Corp, 2014) Balasar, Mehmet; Dogan, Metin; Kandemir, Abdulkadir; Taskapu, Hakan Hakki; Cicekci, Faruk; Toy, Hatice; Gurbuz, RecaiIn the present manuscript, we studied the incidence of granulomatous prostatitis in the prostatectomy specimen of the patients who underwent transurethral resection of the prostate (TURP) after superficial bladder cancer treatment with intravesical Bacillus Calmette-Guerin (BCG) and were diagnosed with benign prostate hyperplasia (BPH). The clinical data and histopathological specimen records of 472 patients who underwent TUR-P due to BPH diagnosis, obtained over a period of 6 years in the urology department of Private Konya Hospital, Konya, Turkey, were studied retrospectively. The cases were divided into two groups as (Group I) who did not undergo any treatment and as (Group II) who underwent BCG treatment. The frequency and the clinical course of the cases with granulomatous prostatitis were studied histopathologically. There were in total 472 patients who underwent TUR-P. Out of the 459 patients who did not undergo BCG treatment (Group I), the histopathological specimen records of 262 (57%) was BPH, of 197 (43%) BPH + chronic prostatitis. Of the second group, 13 cases underwent intravesical BCG treatment before surgical intervention due to superficial bladder CA diagnosis. In this group 4 of the cases were diagnosed as (30%) BPH, 9 as (70%) chronic prostatitis + BPH. 6 out of the 9 chronic prostatitis cases were chronic prostatitis, 2 caseous granulomatous prostatitis, 1 non-caseous granulomatous prostatitis. Granulomatous prostatitis cases should require no specific therapy. Conclusion: In patients with obstruction complaints following intravesical BCG treatment, granulomatous prostatitis should also be considered and treatment plans should be made accordingly.Öğe A prospective randomized comparison of micropercutaneous nephrolithotomy (Microperc) and retrograde intrarenal surgery (RIRS) for the management of lower pole kidney stones(Springer, 2017) Kandemir, Abdulkadir; Guven, Selcuk; Balasar, Mehmet; Sonmez, Mehmet Giray; Taskapu, Hakan; Gurbuz, RecaiTo make a comparison between the safety and efficacy of micropercutaneous nephrolithotomy (microperc) and retrograde intrarenal surgery (RIRS) for the management of lower pole kidney stones up to 15 mm. 60 patients presenting with solitary lower pole kidney stones up to 15 mm were included in the study between March 2013 and December 2015. Patients were randomized into Microperc or RIRS groups with computer-generated numbers. The mean stone size was 10.6 (5-15) and 11.5 (7-15) mm for Microperc and RIRS groups, respectively (P = 0.213). In the Microperc group, the scopy time was 158.5 s, while in the RIRS group, the scopy time was 26.6 s (P = 0.001). The hospitalization period in the Microperc group was 542 h, while it was 19 h in the RIRS group (P = 0.001). No statistical differences were observed during the operating time, pre-operative-post-operative hemoglobin (Hb), serum creatinine, and estimated glomerular filtration speed (e-GFR) values and stone-free rates. No intraoperative complications were observed in either of the groups, while post-operative complications were observed in six patients in Microperc Group and five patients belonging to the RIRS Group (P = 0.922). Both Microperc and RIRS are safe and effective alternatives, and have similar stone clearance and complication rates for the management of lower pole kidney stones up to 15 mm in diameter. However, prolonged hospital stay and scopy times are the main disadvantages of Microperc and further research is needed to evaluate the renal tubular damages caused by both of these methods.
