[Show abstract][Hide abstract] ABSTRACT: Introduction:
To determine and evaluate the effective radiation exposure during a one year follow-up of urolithiasis patients following the SWL (extracorporeal shock wave lithotripsy) treatment.
Material and methods:
Total Effective Radiation Exposure (ERE) doses for each of the 129 patients: 44 kidney stone patients, 41 ureter stone patients, and 44 multiple stone location patients were calculated by adding up the radiation doses of each ionizing radiation session including images (IVU, KUB, CT) throughout a one year follow-up period following the SWL.
Total mean ERE values for the kidney stone group was calculated as 15, 91 mSv (5.10-27.60), for the ureter group as 13.32 mSv (5.10-24.70), and in the multiple stone location group as 27.02 mSv (9.41-54.85). There was no statistically significant differences between the kidney and ureter groups in terms of the ERE dose values (p = 0.221) (p >0.05). In the comparison of the kidney and ureter stone groups with the multiple stone location group; however, there was a statistically significant difference (p = 0.000) (p <0.05).
ERE doses should be a factor to be considered right at the initiation of any diagnostic and/or therapeutic procedure. Especially in the case of multiple stone locations, due to the high exposure to ionized radiation, different imaging modalities with low dose and/or totally without a dose should be employed in the diagnosis, treatment, and follow-up bearing the aim to optimize diagnosis while minimizing the radiation dose as much as possible.
Central European Journal of Urology 11/2015; 68(3):348-352. DOI:10.5173/ceju.2015.547
[Show abstract][Hide abstract] ABSTRACT: In this study, we aimed to assess the potential harmful effects of radiofrequency-electromagnetic radiation on sperm parameters. We requested semen for analyses from the male patients coming to our infertility division and also asked them to fill out an anonymous questionnaire. We queried their mobile phone and wireless internet usage frequencies in order to determine their radiofrequency-electromagnetic radiation exposure. A total of 1082 patients filled the questionnaire but 51 of them were excluded from the study because of azoospermia. There was no significant difference between sperm counts and sperm morphology excluding sperm motility, due to mobile phone usage period, (p = 0.074, p = 0.909, and p = 0.05, respectively). The total motile sperm count and the progressive motile sperm count decreased due to the increase of internet usage (p = 0.032 and p = 0.033, respectively). In line with the total motile sperm count, progressive motile sperm count also decreased with wireless internet usage compared with the wired internet connection usage (p = 0.009 and p = 0.018, respectively). There was a negative correlation between wireless internet usage duration and the total sperm count (r = -0.089, p = 0.039). We have also explored the negative effect of wireless internet use on sperm motility according to our preliminary results.
The Kaohsiung journal of medical sciences 09/2015; 31(9):480-4. DOI:10.1016/j.kjms.2015.06.006 · 0.80 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Purpose:
To evaluate the use of spinal anesthesia by reducing anesthetic agent dose to provide better analgesia with minimal side effects without sacrificing the outpatient setting for prostate biopsy. In this study, efficacy and tolerability of selective low-dose spinal anesthesia versus intrarectal local anesthesia (IRLA) plus periprostatic nerve blockade (PPNB) were compared.
Between September 2012 and April 2013, 100 patients, aged 40 to 80 years, prostate-specific antigen (PSA) ≥4 ng/mL, abnormal digital rectal examinations, and enrolled for biopsy were included in the present study. Ensuring double blindness, pain was assessed using the visual analog scale (VAS). Anal sphincter relaxation, patient satisfaction with the anesthesia technique, and motor response were evaluated.
Differences between the two groups, considering age, American Society of Anesthesiologist score, total PSA, prostate volume, anesthesia duration, and cancer presence, were not statistically significant. Pain experienced during probe insertion, biopsy, and 30 minutes after biopsy was significantly lower in the low-dose spinal anesthesia group (P < 0.0001). Anal sphincter relaxation degree was significantly higher in the spinal group (P < 0.001). Patient procedure-related overall satisfaction level was significantly higher in the spinal anesthesia group (P < 0.001). In the spinal anesthesia group, no motor blockade was observed. Between the two groups, no statistically significant difference was seen with regard to complications (P > 0.05).
Selective low-dose spinal anesthesia provides better pain relief than PPNB plus IRLA without sacrificing the day case setting in ambulatory practice. It is also associated with high patient satisfaction and willingness for a repeated biopsy without differences in procedure duration, tolerance, and complications.
Journal of endourology / Endourological Society 07/2015; DOI:10.1089/end.2015.0450 · 1.71 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The common soft tissue tumor Liposarcoma that located in paratesticular area is quite rare. These tumors originating from the retro- peritoneal adipose tissue often continue to distal with the fat of the cords It is usually diagnosed by histopathological examination af- ter intraoperative suspicion. In this paper we presented an operated case with testicular inguinal hernia and paratesticular liposarcom.
[Show abstract][Hide abstract] ABSTRACT: We present the treatment of lower pole stones of a 62-year-old male patient with a history of open partial nephrectomy due to renal angiomyolipoma and renal stones. He was successfully treated with micropercutaneous nephrolithotomy technique under spinal anesthesia in spite of fibrotic and scar tissue due to previous open surgery. The patient was stone-free and was discharged after a 24-hour hospitalization period. There is not any published report of micropercutaneous nephrolithotomy in a partial nephrectomized kidney before. In this report, we suggest that microperc technique may be considered for challenging conditions in case of failed retrograde intrarenal surgery.
[Show abstract][Hide abstract] ABSTRACT: Cerrahi eksizyon sonrası histopatolojik değerlendirme ülkemizde rutin bir hal almıştır. Ancak histopatolojik değerlendirmelerin sonucunun beklenmesi hasta üzerinde ciddi anksiyete oluştururken hekimlere ve hastanelere ciddi maliyet ve iş yükü oluşturmaktadır. Mesane boynu darlığı ile mesane boynu rezeksiyonu yapılan hastaların rutin histopatolojik analizi hakkında literatürde belirlenmiş bir konsensus yoktur. Bu nedenle bu çalışmamızda mesane boynu darlığı nedeni ile TUR yapılan hastalarda rutin histopatolojik değerlendirilmenin gerekliliği araştırılmıştır
[Show abstract][Hide abstract] ABSTRACT: Mesane fistülleri genellikle deri , gastrointestinal sistem ya da kadın genital sistemine açılırlar. Nedenleri arasında divertikülit, kolon kanseri ve Chron hastalığı gibi primer intestinal hastalıklar; zor doğuma bağlı basınç nekrozu ve serviks kanseri gibi jinekolojik hastalıklar; pelvik radyoterapi ve travma sayılmaktadır.
Erişkinlerde vezikokütanöz fistül genellikle geçirilmiş ürogenital enfeksiyon, ürolojik cerrahi, pelvik radyoterapi veya iatrojenik olarak ortaya çıkar ve yaşam kalitesini ciddi derecede bozmaktadır. Tisseel® (Fibrin Sealant) ajan ile uyluk iç kısmına açılan veziko-kütanöz fistül tedavisi uygulanan olgu sunulmuştur
[Show abstract][Hide abstract] ABSTRACT: Endoürolojik yöntemlerin yaygınlaşması ve DJ stent kullanımı artmakla birlikte takılan stentin unutularak uzun süre vücütta kalması sonucu enkrustasyon , migrasyon , taşlaşma , üriner obstruksiyon sonucu hidronefroz ,renal kayıp ve ürosepsis gibi ciddi komplikasyonlar gelişebilmektedir. 10 yıllık unutulmuş DJ'si olan olgunun sistolitotomi, PNL ve üreterenoskopi ile endoskopik çıkarılması sunulmuştur.
[Show abstract][Hide abstract] ABSTRACT: Retroperitoneal tumors (RTs) develop insidiously and are generally seen as large masses, and 50% of RTs are larger than 20 cm at the time of diagnosis. In this article, we share our experience of 5 years of surgical management of RTs.
We evaluated 28 RT cases operated on in three education hospitals in Turkey from January 2008 onwards, with regard to patients' demographic characteristics, complaints, weight loss figures, the location and size of the tumor, blood transfusion, intra-operational time, metastases (in malignant cases), additional organ resection, histological grade, local recurrences, average life expectancy, and post-operative treatment methods.
The mean age of the patients was 49 years (range, 18 to 78 years). Twenty (71.43%) were female, and 8 (28.57%) were male. The primary complaint was abdominal pain in 18 patients (64.28%). CT scans were performed in 17 (61%) patients, 10 (35.4%) underwent abdominal MR imaging, and 1 (3.6%) underwent both abdominal CT and abdominal MR imaging. A mass was palpated in the pelvis (suprapubic region) in seven (25%) of the patients during physical examination. The largest tumors were detected in the left lumbar area. The mean tumor size was 12.78 cm (range, 2 to 30 cm). The mean intra-operational time was 192 min (range, 70 to 380 min). The mean hospitalization period was 11 days (range, 8 to 23 days). Seven (25%) patients were reported to have benign tumors, while 21 (75%) were reported to have malignant tumors. The most frequently seen malignant pathology was liposarcoma (eight cases; 38.09%) followed by leiomyosarcoma (five cases; 23.8%) and malignant fibrous histiocytoma (four cases; 19.04%). The earliest local recurrence was detected in the 12th month and the latest in the 28th month. A total of 11 (52.3%) of the total of 21 malignant cases experienced local recurrence within 3 years. The 3-year average life expectancy was 85.7% in the 18 malignant cases.
Due to the low response rate of all but two types of RT to chemotherapy, the best remaining treatment option is surgery with wide resection margins, whereby all macroscopic traces of tumor are removed.
World Journal of Surgical Oncology 04/2015; 13(1):143. DOI:10.1186/s12957-015-0548-z · 1.41 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective
A cas e of s ynchronous prim ary lung and pros tate adenocarcinom a is reported. To our knowledge it is the firs t cas e of synchronized primary lung and prostate adenocarcinoma
Methods and Case
A 66-year-old man had been complaining of lower urinary symptoms was admitted to our clinic. His laboratory
res ults s howed an elevated PSA levels (6.36 ng/m l). It is decided to perform pros tate biops y by trans rectal
ultras onography. Pathological analys is of pros tate biops y revealed a adenocarcinom a with Gleas on Score: 3+3 (Figure 1). Bone scintigraphy gave evidence of suspected T8 metastasis. To confirm this metastasis, positron emission tomography performed and it revealed a 42x43 mm sized solid lesion on left lung lobe. (Figure 2). Despite of benign cytology, lung biopsy was taken from the patient's masses and pathology gave a result of
invas ive adenocarcinom a (Figure 3). Patient had left lobectom y with thoracic s urgery and the final pathology report came as bronchial adenocarcinoma (Figure 4). After these procedures patient redirected to our clinic for the management of prostate cancer. We now plan to radical prostatectomy for his prostate cancer.
We think that non-metastatic primary multiple cancers can be cured separately with a proper management.
6. Avrasya Üroonkoloji Kış Kongresi ve Kursu, Bakü / Azerbaycan; 02/2015
[Show abstract][Hide abstract] ABSTRACT: Objective
The current study aims to evaluate NLR and PLR inflammation markers in the differentiation of PCa, BPH, in patients with differing PSA levels.
Clinical and pathological data such as age, prostate volume, PSA, NLR, and PLR levels of 201 patients were
retros pectively reviewed. Pathological s am ple res ults of thes e patients were categorized either as benign or malign. The PSA levels were divided into three categories as PSA: 0-4 ng/ml, PSA: 4-10 ng/ml., and 10 ng/ml and above.
Total of 201 patients, 15 patients were in the chronic prostatitis, 110 in the BPH, and 76 in the PCa group. The mean age, prostate volume and serum levels of PSA are given in Table 1. In terms of age, NLR, and mean prostate volume, no statistically significant differences were observed among the groups.
Statistically significant differences were observed in the PLR if the PSA levels were above 10 ng/ml (p: 0,044). On com paring the groups , s tatis tically s ignificant differences were s een in the BPH and PCa groups for PSA> 10 ng/m l levels (p: 0,032).The other PSA levels revealed no s ignificant differences (P > 0.05). No s tatis tically s ignificant difference resulted from the correlation of the PCaGleason score and PSA, NLR and PLR parameters (P > 0.05). A positive correlation was evident regarding age and Gleason score (r: 0,388 p: 0,002)
There is a great demand for noninvasive inflammatory biomarker such us PLR, NLR clinical studies with larger patient series for the differentiation between BPH, PCa
6. Avrasya Üroonkoloji Kış Kongresi ve Kursu, Bakü / Azerbaycan; 01/2015
[Show abstract][Hide abstract] ABSTRACT: The aim of the current study is to evaluate NLR and PLR inflammation markers in PCa and BPH.
Clinical and pathological data such as age, prostate volume, PSA, NLR, and PLR levels of 201 patients were retrospectively reviewed. Pathological sample results of these patients were categorized either as benign or malign. The benign group consisted of chronic prostatitis and BPH and the malign group of PCa. The PSA levels were divided into three categories as PSA: 0-4 ng/ml, PSA: 4-10 ng/ml, and 10 ng/ml and above.
In the benign category, the mean PLR values for PSA: 0-4 ng/ml is 131.8 ± 31.2, for PSA: 4-10 ng/ml 124.7 ± 83.9 and 10 ng/ml and above 124 ± 53 in chronic prostatitis group and in the BPH group for PSA: 4-10 ng/ml 120.3 ± 45.1, for PSA: 4-10 ng/ml 126 ± 54,2,and 10 ng/ml and above 191.4 ± 176.1. In the malign category, the mean PLR values of PCa patients is for PSA: 0-4 ng/ml 122.8 ± 43.8, for PSA: 4-10 ng/ml 123 ± 43.8, and above 10 ng/ml 179.1 ± 94. Related to the variables of age, NLR, and mean prostate volume, there were no statistically significant differences. Statistically significant differences were observed in the mean PLR values only if the PSA level was 10 ng/ml and above (p: 0.044) in the BPH and PCa groups. The correlation of the PCa Gleason score and PSA, NLR and PLR parameters in the malign category revealed no statistically significant differences (P > 0.05).
Effective malign and benign differentiation of prostate pathologies based on noninvasive inflammation biomarkers such NLR and PLR necessitate clinical studies with larger patient series.
Cancer biomarkers: section A of Disease markers 01/2015; 15(3). DOI:10.3233/CBM-150458 · 1.72 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Purpose:
To evaluate the effects of presence of hydronephrosis on micropercutaneous nephrolithotomy (micro-PNL) surgery.
Patients and methods:
A retrospective analysis of 112 patients who underwent microperc surgery between December 2012 and April 2014 was performed. Patients were evaluated in two groups according to whether the presence of hydronephrosis. Stone size and location, fluoroscopy and operation time, stone-free rates and patient-related parameters were prospectively recorded into a centralized computer-generated system.
A total of 58 patients in Group 1 with hydronephrosis and 54 patients in Group 2 with no hydronephrosis were analyzed. There was no statistically significant difference in terms of stone sizes and body mass indexes (BMI) in comparison of groups (155.2 ± 93.06 vs. 143.70 ± 70.77 mm(2), p = 0.856 and 27.6 ± 4.2 vs. 26.7 ± 3.2 kg/m(2), p = 0.625). The success rates were similar (91.3 vs. 92.5%, p = 0.341). While the mean operation time and fluoroscopy time in Group 1 were 44.2 ± 23.62 min and 105.3 ± 47 s, it was 38.8 ± 26.4 min and 112.53 ± 68.3 s in Group 2, but there was no statistical difference in comparison of both groups. The mean attempts of percutan puncture were 1.35 ± 0.47 in Group 1 and 1.76 ± 0.31 in Group 2 (p = 0.185). We also found no statistical differences regarding mean hemoglobin change and hospitalization time, respectively (p = 0.685 and p = 0753). In comparison of grades of hydronephrosis, there was no statistically significant difference in subgroups analysis.
The presence of hydronephrosis does not affect success rates and operative time in micro-PNL procedures significantly. Micropercutaneous nephrolithotomy is technically feasible and efficacious both in hydronephrotic and non-hydronephrotic kidneys.
International Urology and Nephrology 01/2015; 47(3). DOI:10.1007/s11255-014-0907-7 · 1.52 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Liposarcoma of common soft tissue tumor is very rare placement in paratesticular area. These tumors often originate from extraperitoneal fat distally with the courts of the fatty tissue continues. Diagnosis; usually is made by histopathological examination after suspected during the operation. In this paper, due to testicular mass was operated along the left paratesticular liposarcoma, and was presented with an inguinal hernia.
6. Avrasya Üroonkoloji Kış Kongresi ve Kursu, Bakü / Azerbaycan; 01/2015