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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 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 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 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 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 Prognostic value of preoperative neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios, and multiphasic renal tomography findings in histological subtypes of renal cell carcinoma(Bmc, 2014) Keskin, Suat; Keskin, Zeynep; Taskapu, Hakan Hakki; Kalkan, Havva; Kaynar, Mehmet; Poyraz, Necdet; Toy, HaticeBackground: To determine the relationship between renal cell carcinoma subtypes and the associated mortality and biochemical parameters. An additional aim was to analyze multiphasic multidetector computed tomography findings. Methods: This study is a hospital-based retrospective investigation, using 211 patients with a diagnosis of renal cell carcinoma upon computed tomography examination. The histological subtypes included clear cell in 119 patients, chromophobe cell in 30 patients, papillary cell in 25 patients, mixed cell in 32 patients, and sarcomatoid cell in 4 patients. Results: The mean age of the patients participating in this study was 61.18 +/- 11.81 years, and the mortality rate was 10.4% (n = 22) through the 2-year follow-up. The ratios of both the neutrophil-to-lymphocyte upon admission to the hospital and platelet-to-lymphocyte of the non-surviving group were significantly higher than those of the surviving group (p < 0.05). When the analysis of the 2-year survival of the patients was examined according to the median platelet-to-lymphocyte ratio values, the Kaplan-Meier survival curves were significantly different between the surviving and non-surviving groups (p = 0.01). In two-way analysis of variance test, statistically significant results which were influenced by mortality (p = 0.028) and were found between renal cell carcinoma subtypes in the computed tomography density of corticomedullary phase (p = 0.001). Conclusions: The neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio may represent widely available biomarkers in renal cell carcinoma, and the logistic regression model indicated that neutrophil-to-lymphocyte ratio was a significant predictor for mortality. According to the median platelet-to-lymphocyte ratio values, the Kaplan-Meier survival curves were significantly different between the surviving and non-surviving groups.Öğe A rare case in literature: Isochromosome Xq in Klinefelter syndrome(Wiley, 2019) Simsek, Levent; Zamani, Ayse Gul; Taskapu, Hakan Hakki; Yildirim, Mahmut SelmanBackground: Klinefelter syndrome(KS), affecting 1 in 500-1,000 newborn males, is the most common sex chromosome aneuploidy among males with primary hypogonadism. Isochromosome Xq on the other hand is a rare variant of Klinefelter syndrome, accounting approximately 0.3% of all KS and associated with normal height and androgenisation compared to classical KS. Here, we present a case of isochromosome Xq variant of KS with similar clinical and cytogenetic findings with the few cases reported before. Materials and Methods: A 25-year-old male patient referred to our clinic with complaint of infertility. He is the son of a consanguineous couple who are first cousins and there was no family history of reproductive difficulty. In physical examination synophrys, prominent ear and small testicles noted. The patient's spermiogram showed azoospermia and scrotal USG revealed testicular atrophy. Results: Karyotype analysis using G-banding resulted as 47, X, i(X)(q10), Y, and STR analysis showed no deletion in AZF and SRY loci of interest. Conclusion: Although several isochromosome Xq variant of KS cases can be found in literature, it is our duty to emphasise the importance of karyotyping for patients with reproductive difficulty who may not have all features of classical Klinefelter syndrome.