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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 Urinary KIM-1 and NGAL Predict Management Endoscopic Surgery in Acute Unilateral Obstructive Stone Disease? Results from a Prospective Cohort Study(Karger, 2021) Goger, Yunus Emre; Ozkent, Mehmet Serkan; Topcu, Cemile; Atici, Ahmet; Sonmez, Mehmet Giray; Balasar, Mehmet; Gurbilek, MehmetIntroduction: Kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) are the leading novel biomarkers used efficiently in acute kidney injury (AKI). The levels of these biomarkers increase especially in the early period of nephrotoxic and ischemic renal damage. In this study, we aimed to investigate the clinical importance of NGAL and KIM-1 biomarkers used in the effective evaluation of kidney functions in patients with acute unilateral obstructive stone disease (AUOSD) in the management of endoscopic surgery. Materials and Methods: We prospectively included patients who underwent endoscopic surgery due to AUOSD between January 2018 and December 2019. Urine KIM-1 and NGAL values of the patients were measured preoperative period, postoperative 4th h, and postoperative 7th day. The patients were evaluated according to the location and size of the stone, the degree of renal hydronephrosis, the duration of the operation, complications, and JJ stent placement. Results: The study enrolled 50 patients. Urinary KIM-1/Cr and urinary NGAL/Cr ratios were higher in postoperative 4th h than in others (p < 0.001). Also, we found that urinary KIM-1/Cr and urinary NGAL/Cr ratios with Grade 2 and higher hydronephrosis were statistically higher than Grade 0-1 hydronephrosis (p < 0.001 and p: 0.042, respectively). Additionally, a preoperative urinary KIM-1 value of 1.24 ng/mL had a sensitivity of 78% and a specificity of 63% to predict the presence of hydronephrosis. When urine KIM-1 and NGAL results were compared with surgery time, stone size and location, serum creatinine (sCr) value, and Post-Ureteroscopic Lesion Scale grade, the difference was not statistically significant. Postoperative 7th day NGAL/Cr and KIM-1/Cr ratios were statistically higher in those with JJ stents placed (p: 0.03 and p: 0.004, respectively). Conclusion: KIM-1 and NGAL can be used in our assessment of renal function in patients with AUOSD, even if sCr is normal. Also, these biomarkers can predict the presence of hydronephrosis. It can be helpful in determining the time of surgical treatment, as well as providing information in the follow-up of patients with JJ stents after treatment.Öğe Comparison of Oral Sodium Bicarbonate and Solifenacin Treatment in Female Overactive Bladder Patients With Acidic Urine pH(Lippincott Williams & Wilkins, 2020) Sonmez, Mehmet Giray; Ecer, Gokhan; Atici, Ahmet; Ozkent, Mehmet Serkan; Iyisoy, Mehmet Sinan; Ozturk, AhmetObjective In this study, we planned to compare the effects of oral sodium bicarbonate (NaHCO3) and anticholinergic (solifenacin) treatments in women with overactive bladder (OAB) and acidic urine pH values (<6). Methods According to the referral order of OAB patients, 8 g/d oral NaHCO3(group 1) or 5 mg/d solifenacin succinate (group 2) was given to the patients. Both treatment regimens were applied one at a time for 12 weeks in total. Laboratory values, bladder diary, Patient Perception of Bladder Condition score, Patient Perception of Intensity of Urgency Scale, Overactive Bladder-Validated 8-Question Awareness Tool, and the King's Health Questionnaire (KHQ) scores before and after treatment were compared. Results A total of 59 patients were evaluated. Thirty-one patients were included in group 1, and 28 patients were included in group 2. No difference was detected in pretreatment and posttreatment laboratory values other than urine pH values in both groups. Whereas there was no difference in pretreatment urine pH values among the 2 groups, posttreatment urine pH values were significantly higher in group 1 compared with group 2 (P= 0.08,P< 0.001, respectively). There was a significant amelioration in the bladder diary parameters, symptom scores, and KHQ values measured after treatment in both groups. However, degree of amelioration in posttreatment outcomes was similar among the groups. Conclusions It was demonstrated that urinary alkalization made with oral NaHCO(3)in female OAB patients with acidic urine pH had a significantly positive effect on symptoms and symptom scores, and these results are similar to the results of solifenacin treatment.Öğe Digitalization and Urological Diseases: Severity of Cyberchondria and Level of Health Anxiety in Patients Visiting Outpatient Urology Clinics(Mary Ann Liebert, Inc, 2023) Ozkent, Mehmet Serkan; Kilinc, Muzaffer Tansel; Hamarat, Mustafa Bilal; Yilmaz, Burak; Goger, Yunus Emre; Ozkent, Yasemin; Piskin, Mehmet MesutThis study aimed to evaluate the cyberchondria levels of patients who applied to the urology outpatient clinic. The second goal of this study was to evaluate the relationship between cyberchondria severity and health anxiety in these patients. The present prospective observational study was conducted at the urology outpatient clinic of two tertiary centers in our city between September and December 2021. Eligible patients were the adult patients (>18 and <= 60 years) who used the Internet for health purposes and had no self-reported psychological or mental disease. The patients were divided into following groups according to their complaints: general urology, uro-oncology, andrology, functional urology, and endourology (stone disease). The level of cyberchondria and health anxiety was evaluated for these patients by using the Short Health Anxiety Inventory (SHAI) and a short-form version of the Cyberchondria Severity Scale (CSS-12). This study enrolled 578 patients (190 female, 388 male). The mean age of patients was 43.4 +/- 13.3 years (18-60 years). The mean CSS-12 was 28.1 +/- 12.1, and the mean value of SHAI was 18.9 +/- 13.6. The patients had andrological symptoms, is uniquely related to higher CSS and health anxiety, and followed by uro-oncological diseases. However, the least relationship was observed in patients with functional urological diseases (analysis of variance [ANOVA], p < 0.001 for CSS-12; p < 0.001 for SHAI). In addition, a positive correlation was observed between the CSS and SHAI (Pearson's correlation = 0.782). The increased level of cyberchondria causes increased health anxiety and an increased disease burden in these patients. Therefore, physicians should consider this increased treatment burden during the treatment of patients.Öğe Effects of urine alkalinization with sodium bicarbonate orally on lower urinary tract symptoms in female patients: a pilot study(Springer London Ltd, 2018) Sonmez, Mehmet Giray; Goger, Yunus Emre; Ecer, Gokhan; Atici, Ahmet; Ozkent, Mehmet Serkan; Ozturk, AhmetIn this study, we planned to explore the effects of sodium bicarbonate orally (NaHCO3) treatment on female patients with lower urinary tract symptoms (LUTS) who have acidic urine pH values (< 6). NaHCO3 was given orally to 33 female patients for 4 weeks at a dose of 2 x 4 g/day. Laboratory values, bladder diary, the Patient Perception of Bladder Condition Score (PPBC), Patient Perception of Intensity of Urgency Scale (PPIUS), Overactive Bladder-Validated 8-question Awareness tool (OAB-V8), Pelvic Pain and Urgency & Frequency Patient Symptom Scale tests (PUFSS), and the King's Health Questionnaire (KHQ) scores before and after treatment were compared. A significant increase was detected in urine pH values measured after treatment (5.31 +/- 0.52 to 7.2 +/- 0.66, p < 0.001), but not in blood pH values (7.369 +/- 0.33 to 7.384 +/- 0.28, p = 0.14). After treatment, a significant decrease was detected in daily frequency, nocturia, urgency, and urge incontinence prevalence (p < 0.001,p = 0.003, p < 0.001, p = 0.002, respectively) and PPBC, PPIUS, PUFSS, and OAB-V8 symptom scores (p = 0.004, p = 0.002, p < 0.001, p < 0.001, respectively). A significant decrease was detected in all KHQ subunit scores. Urine alkalinization with NaHCO3 orally in female patients with LUTS and acidic urine pH has a significant level of positive effects on symptoms and symptom scores. Our results show that this new treatment modality-which is inexpensive, easy to use, and has a low side-effect profile is effective in this chronic patient group.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 Evaluation of parental sociocultural background and education level in response to pediatric testis torsion(Elsevier Sci Ltd, 2020) Goger, Yunus Emre; Ozkent, Mehmet Serkan; Unlu, Mahmud Zahid; Kocaoglu, Canan; Madenci, Hasan; Piskin, Mehmet MesutIntroduction Acute scrotal pain (ASP) remains one of the most common male urologic emergencies in the pediatric age group. The most concerning outcome of testicular torsion (TT) is the need for orchiectomy, which has a negative impact on the child's development in general and on sexual development and psychology in particular. Time is the most important factor in the treatment of TT. Parental awareness of ASP indicating the possibility of TT is a significant factor in children's hospital admission time. Sociocultural background may be an indicator in parental awareness. Objective This study sought to determine if parental sociocultural and education level is associated with delayed treatment for TT. Study design This retrospective study evaluated data for patients with scrotal or abdominal pain and TT at two hospitals in Konya, Turkey from 2012 to 2020. Study participants were the parents of the patients treated for TT. Participants were contacted by telephone and asked about their educational background. The study population was divided into 2 groups based on parent characteristics. Group 1 parents had an education level less than high school, had no health insurance, were in need of state aid, and had a low sociocultural background. Group 2 parents had an education level of at least high school or higher and had health insurance. Symptom duration (time between symptom onset and hospital admission) and surgical procedures for the patients were compared between the 2 parent groups. Results Of the 140 patients who received a diagnosis of TT, 77 were in Group 1 and 63 in Group 2. Mean patient age was 12.7 +/- 2.7 (5-16) years Median symptom duration was 7 (1-120) hours. Symptom duration was higher in Group 1, but no statistically significant differences were noted between groups (Group 1 duration was 8h vs. Group 2 duration of 6h; p = 0.331). Orchiectomy was performed for 62 (44.3%) patients and testicular-sparing surgery for 78 (55.7%). Orchiectomy rates between groups were statistically significant and higher in Group 1 with 41 (53.2%) versus 21 (33.3%) in Group 2. Conclusion Factors such as low sociocultural family background and low parental education level increase the risk of orchiectomy for their children. Awareness of the symptoms of TT may minimize the possibility of testicular loss. [GRAPHICS] .Öğe Is erectile dysfunction related to self-esteem and depression? A prospective case-control study(Wiley, 2021) Ozkent, Mehmet Serkan; Hamarat, Mustafa Bilal; Taskapu, Hakan Hakki; Kilinc, Muzaffer Tansel; Goger, Yunus Emre; Sonmez, Mehmet GiraySexual activity is important role in life of men. Decreased sexual function has a negative impact on the quality of life of the patients and their partners. In this study, we aimed to evaluate the relationship of erectile dysfunction (ED) with self-esteem, symptom severity and depression. The 80 patients were evaluated prospectively. Group 1 (cases group) included 40 patients who with ED an age range of up to 18-70 years. Group 2 (healthy control group) included 40 patients who apply to the urology clinic for various reasons without ED. All patients were filled international index of erectile function-5 (IIEF-5), Beck Depression questionnaire (BDI-2) and Rosenberg self-esteem questionnaires (RESQ). Demographic characteristics and inventory results of the patients were compared between the two groups. Significant differences were found between the two groups in IIEF-5, RESQ and BDI-2 scores. In Group 1, IIEF-5 score was low, RESQ, BDI-2 scores were significantly higher (All scores p < 0.001). As a result people significantly reflect their sexual satisfaction in their social life. The patients with mild ED are not entirely satisfied in spite of normal sexual frequency. This situation causes significantly low the self-esteem of men. Prevention of ED will contribute to increased self-esteem and happy lives.Öğe Is Retrograde Intrarenal Surgery as Safe for Children as It Is for Adults?(Karger, 2021) Ozkent, Mehmet Serkan; Piskin, Mehmet Mesut; Balasar, Mehmet; Goger, Yunus Emre; Sonmez, Mehmet GirayIntroduction: The primary aim of this study is to compare the efficacy and safety of retrograde intrarenal surgery (RIRS) among the children and adults with similar stone burdens and locations. Also, the secondary aim of this study is to identify the factors affecting the stone-free rates (SFRs) of RIRS. Methods: We retrospectively compared perioperative results, SFRs, and complication rates (CRs) between pediatric (group 1, n: 55) and adult (group 2, n: 220) age groups diagnosed with kidney stones and treated by flexible ureterorenoscopy using the same instruments. Furthermore, multivariate analysis was performed to determine the factors affecting the SFR. Results: A total of 275 patients (pediatric group: 55; adult group: 220) were included in this study. The mean age of pediatric and adult groups was 7.2 +/- 5.3 and 43.9 +/- 15.1, respectively. The mean stone size was 13.9 +/- 6.6 mm in the pediatric group compared to 14.8 +/- 6.7 mm in the adult group (p = 0.35). Stone localizations and number were similar. JJ stenting for passive dilatation and use of UAS were higher in the pediatric group (p = 0.002; p = 0.017). However, postoperative double pigtail stenting rate was higher in the adult group (p < 0.001). Total CR was 13.8% and mostly Clavien I-II, and no difference was observed between the 2 groups (p = 0.541). The SFRs between the groups were similar (pediatric group: 81.8%; adult group: 78.2%; p = 0.554). On multivariate analysis, stone size (p < 0.001) and lower calyx stone (p < 0.001) were the negative predictive factors for SFR. Conclusion: There are small technical differences between pediatric patients and adult patients in our study, but RIRS in children is as safe and efficient as it is in adults.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 New surgical technique applied with urological instruments in bilobar multiple hepatolithiasis: Ultra-mini percutaneous hepatolithotomy(Aves, 2017) Ozturk, Ahmet; Sonmez, Mehmet Giray; Bakdik, Suleyman; Goger, Yunus Emre; Ozkent, Mehmet Serkan; Aksoy, Faruk; Belviranli, MetinIntrahepatic bile duct stones may emerge with manifestations as chronic stomach ache, cholestasis, cholangitis, abscess, post-obstructive atrophy and liver cirrhosis presentation may occur. Thus the treatment of symptomatic hepatolithiasis patients should be provided. Different methods such as biliary decompression, endoscopic, percutaneous or open surgery are recommended for the treatment of patients with intrahepatic gallstones. The aim of the treatment is to extract the stones and regain biliary drainage. But the treatment regimen to be applied should be determined after examining the age, performance condition, general condition of the patient and location of the stone carefully. In this case, we presented a young female patient who had many unsuccessful surgical interventions due to coledochal cyst and congenital malformation in bile ducts, had large stones in right and left intrahepatic bile ducts and in whom we provided complete stone-free condition through Ultra-Mini Percutaneous Hepatolithotomy (UM-PHL) using urological instruments.Öğe Observation and comparison of gas formation during holmium:YAG laser lithotripsy of cystine, uric acid, and calcium oxalate stones: a chromatographic and electron microscopic analysis(Springer, 2024) Kilinc, Muzaffer Tansel; Ozkent, Mehmet Serkan; Goger, Yunus EmreThe primary aim of the present in vitro study is to analyze the chemical content of the bubbles occurring during the fragmentation of cystine stones with both the high-power and low-power holmium:YAG (Ho:YAG) lasers. The secondary aim is to discuss their clinical importance. Three types of human renal calculi calcium oxalate monohydrate (COM), cystine, and uric acid were fragmented with both low-power and high-power Ho:YAG lasers in separate experimental setups at room temperature, during which time it was observed whether gas was produced. After laser lithotripsy, a cloudy white gas was obtained, after the fragmentation of cystine stones only. A qualitative gas content analysis was performed with a gas chromatography-mass spectrometry (GC-MS) device. The fragments in the aqueous cystine calculi setup were dried and taken to the laboratory to be examined by scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM-EDX) and X-ray diffraction analysis. No gas production was observed after fragmentation in the COM and uric acid stones. Free cystine, sulfur, thiophene, and hydrogen sulfide gas were produced by both low-power and high-power Ho:YAG laser lithotripsy of the cystine stones. In the SEM-EDX mapping analysis, a free cystine molecule containing 42.8% sulfur (S), 21% oxygen (O), 14.9% carbon (C), and 21% nitrogen (N) atoms was detected in the cystine stone experimental setup. The evidence obtained, which shows that hydrogen sulfide emerges in the gaseous environment during Ho:YAG laser fragmentation of cystine stones, indicates that caution is required to prevent the risk of in vivo production and toxicity.Öğe Prognostic Value of Systemic Immune-Inflammation Index in Patients with Testicular Cancer: A Retrospective Case-Control Study(Galenos Publ House, 2021) Goger, Yunus Emre; Ozkent, Mehmet Serkan; Karaagac, Mustafa; Ucmak, Harun; Artac, MehmetObjective: The primary aim of this study was to evaluate the correlation between the systemic immune-inflammation index (SII) and clinicopathological outcomes of patients with testicular cancer (TCa). The secondary aim was to evaluate the relation of SII with overall survival (OS). Materials and Methods: A total of 244 patients were included in the study. Patients were divided into the testicular tumor (group 1, n=184) and control group (group 2, n=60). Preoperative complete blood count, tumor markers, and imaging tests of the patients in group 1 were recorded. A subgroup analysis was performed according to the clinical stage, pathological stage, tumor type, and tumor size. Then, the effectiveness of TCa on SII was evaluated among the groups. Results: A significant difference was observed between the SII, neutrophil, and neutrophil-to-lymphocyte ratios between groups 1 and 2. The median SII was 719.92 in group 1 and 510.93 in group 2 (p<0.001). In the subgroup analysis, the median SII value was higher in patients with advanced disease stage and metastasis (p<0.001). In the receiver operating characteristics curve analysis, the area under the curve was 0.784, and the SII cut-off point was 719, with a sensitivity of 81% and specificity of 65.4%. The median follow-up time was 55 (interquartile range, 8-132) months. Ten patients died of TCa. In the multivariable analysis, SII (7.6-fold increase; p=0.005) and presence of metastasis (4.3-fold increase; p=0.001) were independent predictors of OS. Conclusion: SII can be an important marker in the diagnosis and follow-up of TCa. However, SII needs to be evaluated using larger data, especially in the risk assessment in TCa.Öğe A randomised-controlled, prospective study on the effect of dorsal penile nerve block after TURP on catheter-related bladder discomfort and pain(Wiley, 2021) Goger, Yunus Emre; Ozkent, Mehmet Serkan; Goger, Esra; Kilinc, Muzaffer Tansel; Ecer, Gokhan; Piskin, Mehmet Mesut; Erol, AtillaPurpose: In the present study, the impact of penile nerve block (PNB) on postoperative pain and Catheter-Related Bladder Discomfort (CRBD) in the transurethral resection of prostate(TURP) patients were evaluated. Methods: Participants of the present study were selected from patients who performed TURP under spinal anaesthesia for benign prostatic hyperplasia (BPH) between January 2018 and July 2020. The present study was planned as a single-centre, randomised-controlled prospective study in which the patients were divided into two groups. Group 1 was administered Control (n:40), and Group 2 ultrasonography(USG) guided PNB (n:40). The patients were included in the Groups, respectively. Visual analogue scale (VAS) scores were questioned and recorded in order to evaluate the postoperative pain complaints of the patients after the operation. In addition, in order to evaluate the CRBD, VAS scores were questioned and recorded as 0th, 0-1th hour, 1st-2nd hour, 2nd-4th hour, 4th-8th hour, 8th-12th hour, and 12th-24th hour. In addition, postoperative pain and need for analgesic drug were recorded. Tramadol was given to patients with moderate to severe CRBD. The findings were compared between the Groups. Results: There was no statistical difference demographic and per-operative data between Group 1 and Group 2. The CRBD and pain-related VAS scores were significantly higher in Group 1 between the 0 and 8th hours. There was no difference between VAS scores in the postoperative 8-24th hours. In total 24 hours, Group 2's need for tramadol was significantly less than Group 1. On examining the factors affecting CRBD in the multivariate analysis, age, body mass index(BMI), prostate volume, operation time do not affect CRBD statistically, and only PNB reduces CRBD (P: .029). While less drug-related complications were observed in Group 2, no serious complications related to PNB were observed. Conclusion: Penile nerve block is an effective method for the decrease pain and CRBD after urological surgery. It will also reduce the need for analgesics, and provide painless patients in the postoperative period.Öğe The Role of Acidic Urine on Detrusor Pressure in Patients with Overactive Bladder: A Urodynamic Evaluation(Iniestares, S.A., 2022) Ozkent, Mehmet Serkan; Goger, Yunus Emre; Atici, Ahmet; Kilinc, Muzaffer Tansel; Ucmak, Harun; Sonmez, Mehmet GirayObjectives: To evaluate the relationship between urine pH value and urodynamic parameters in patients with overactive bladder. Methods: The patients' data whose underwent standard urodynamic study at two tertiary centers in our city. The period between January 2015-January 2021 was reviewed retrospectively. The inclusion criteria were the patients with overactive bladder, over 18 years of age, and with urine analysis before urodynamic study. Patients were divided into two groups as those with acidic urine pH (Group 1) and without (Group 2). The detrusor pressures obtained from filling cystometry were compared between the groups. In addition, the correlation between detrusor pressure and urine pH was examined. Results: The data from 211 patients (109 females, 102 males) were analyzed during the screening period. Eighty-two patients were in Group 1 and 129 patients in Group 2. The mean age was similar between the groups (p = 0.244). The bladder volume at first sensation of filling and urodynamic maximal bladder capacity was lower in Group 1 than Group 2 (p = 0.004; p < 0.001, respectively). The maximum detrusor pressure was higher in the acidic urine pH group (Group 1, 55.8 +/- 20.6) than non-acidic urine pH group (Group 2, 14.5 +/- 10.2), and it was statistically significant (p < 0.001). In addition, a significant negative correla-tion was observed between urine pH level and detrusor pressure (p < 0.001). Conclusions: The presence of acidic urinalysis is associated with many urodynamic findings. Significantly, the patients with de-trusor overactivity had more acidic urine than without detrusor overactivity. Therefore, for patients with high detrusor pressure, urinalysis should be evaluated carefully.Öğe Which Endoscopic Methods in Prepubertal Patients with 10-20mm Bladder Stones: Transurethral Cystolithotripsy or Percutaneous Cystolithotripsy?(Mary Ann Liebert, Inc, 2021) Piskin, Mehmet Mesut; Ozkent, Mehmet Serkan; Kilinc, Muzafffer Tansel; Goger, Yunus Emre; Sonmez, Mehmet Giray; Balasar, MehmetBackground: The aim of this study was to evaluate the efficacy and safety of transurethral cystolithotripsy (TUC) and percutaneous cystolithotripsy (PCC) in prepubertal patients with 10-20mm bladder stones. Materials and Methods: The files of patients aged 12 years and under who were admitted to our clinic for bladder stones from January 2007 to January 2021 were reviewed retrospectively. Inclusion criteria were patients who were 12 years of age and under with 10-20mm bladder stones, and who underwent endoscopic surgery (TUC or PCC). None of the patients had prior bladder or stone surgery. The patients were divided into two groups (Group 1: PCC group, and Group 2: TUC group) and collected data (preoperative, intraoperative, and postoperative characteristics) were compared between the groups. Results: This study was enrolled 51 patients (21 patients in Group 1 and 30 patients in Group 2). The mean ages of the groups were similar (Group 1: 4.73.6; Group 2: 4.6 +/- 3.2; p=0.936). The mean stone size was 15.8 +/- 3.5 in Group 1, and 12.1 +/- 2.4mm in Group 2. It was higher in the PCC group than TUC group (p<0.001). The operative time was lower in Group 1 than Group 2 (36.412.9 vs 42.7 +/- 16.3 minutes, respectively), but there was no statistically significant difference between the groups (p=0.117). We achieved stone-free rate (SFR) for all the patients in both groups. Complications were observed in 4 (7.7%) cases. One female patient was in Group 1 and three male patients were in Group 2. There was no difference for complication rates between the groups (p=0.634). Conclusions: Endoscopic surgeries have almost become a routine method in the treatment of bladder stones. Despite larger stone size, PCC provides similar SFR compared with TUC along with a tendency of shorter operative time. However, the use of the TUC method in male toddlers could increase the risk of postoperative urinary retention. Hence, stone size and patient age should be considered in the selection of a surgical approach.