Mehmet Kaynar

Konya Training and Research Hospital, Conia, Konya, Turkey

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Publications (49)47.45 Total impact


  • No preview · Article · Feb 2016
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    ABSTRACT: Objective: Local steroid injection to the stricture region after internal urethrotomy (IU) is a promising technique to avoid the recurrence, although the effectiveness and safety of this technique is still controversial. We aimed to determine the efficacy and safety of local steroids as applied with the IU procedure. Material-Method: A total of 83 patients data with urethral stricture in men were examined retrospectively. Patients classified in two groups who had steroid injection with internal urethrotomy or not. Metil prednisolone 40 mg was injected with transurethral injection needle in the stricture region at the 5, 7 and 12 o’clock sites at the same session with internal urethrotomy. Procedure was considered successful if patient did not report any voiding difficulty and maximum flow rate > 15 mL/second for a voided volume of at least 150 mL after removal of the catheter. Patient’s age, time to recurrence, previous recurrences were evaluated. Results: The mean age was 56.4 (18-83) years. Of those patients 33/83 had recurrent stenosis. Nineteen out of these 33 recurrent stenosis patients were treated with local steroid injection and 14/33 had no injection. Only two patients of the steroid treated group had recurrence. Despite that 12 patients had recurrence in the steroid non-treated group. Also the primary stenosis patients showed no recurrence at the steroid+ IU group. Conclusions: The use of local steroids with IU seems to decrease the high stricture recurrence rate following IU. When local steroids were administered with complementary intention, the disease control outcomes are encouraging. Further robust comparative effectiveness studies are now required.
    Preview · Article · Jan 2016 · Archivio italiano di urologia, andrologia: organo ufficiale [di] Società italiana di ecografia urologica e nefrologica / Associazione ricerche in urologia
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    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. Results: 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). Conclusions: 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.
    Full-text · Article · Nov 2015 · Central European Journal of Urology
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    Full-text · Article · Nov 2015 · Urology journal
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    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.
    Full-text · Article · Sep 2015 · The Kaohsiung journal of medical sciences
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    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. Methods: 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. Results: 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). Conclusion: 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.
    Full-text · Article · Jul 2015 · Journal of endourology / Endourological Society
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    DESCRIPTION: http://dx.doi.org/10.1155/2015/187831
    Full-text · Research · Jun 2015
  • Mehmet Kaynar · Serdar Goktas

    No preview · Article · Jun 2015 · Urologic Oncology

  • No preview · Article · Jun 2015
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    Mehmet Kaynar · Murat Akand · Murat Gül · Serdar Göktaş
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    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.
    Full-text · Article · Jun 2015
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    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.
    Full-text · Article · Apr 2015
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    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
    Full-text · Conference Paper · Apr 2015
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    Full-text · Conference Paper · Apr 2015
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    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
    Full-text · Conference Paper · Apr 2015
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    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.
    Full-text · Conference Paper · Apr 2015
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    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.
    Full-text · Article · Apr 2015 · World Journal of Surgical Oncology
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    ABSTRACT: To investigate the effect of the bladder sensation grade on uroflowmetry parameters. Methods Fifty healthy volunteering young men were enrolled in the present study. In total, three uroflowmetry evaluations were made. Qmax , Qave , VV, and PVR urine was obtained three times in three described bladder sensation grades, nearly at the same time of the day. Results The mean age of the participants in the present study is 29.08 ± 3.8 years. The mean Qmax values of the volunteers were 17.4 ± 4.8 ml/s, 24.1 ± 6.0 ml/s, and 29.6 ± 6.5 ml/s in the first, second, and third, voiding desire grades, respectively. The mean Qave values were 9.9 ± 2.1 ml/s, 12.9 ± 2.9 ml/s, and 15.9 ± 4.0 ml/s for each of the voiding desire grades mentioned. A statistically significant difference was obvious for all three bladder sensation grades in terms of Qmax and Qave values (P = 0.000). However, no statistically significant difference was seen regarding the PVR urine volumes. The mean voided volume in the first, second and third uroflowmetry were 140 ± 42 ml, 245 ± 64 ml, and 449 ± 105 ml, respectively. The highest Qmax and Qave values were obtained when the desire to void was urgent. Conclusions The findings of the study show that, uroflowmetry evaluations are to be made if the patients have a strong desire to void. Only thus the highest Qmax values can be obtained; yet, the degree of perceived bladder sensation does not have a statistically significant impact on PVR quantity. Neurourol. Urodynam. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.
    Full-text · Article · Apr 2015 · Neurourology and Urodynamics
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    ABSTRACT: The objective is to compare the analgesic effects of diclofenac, acetaminophen, and acupuncture in urolithiasis-driven renal colic pain relief. Renal colic patients were divided randomly into 3 groups. Patients in group I (n = 40) were treated with intravenous acetaminophen, those in group II (n = 41) with acupuncture, and those in group III (n = 40) with a 75-mg intramuscular injection diclofenac sodium. Visual analogue scale (VAS) and verbal rating scale (VRS) were used to assess pain intensity after 10, 30, 60, and 120 minutes. No significant differences in baseline VAS or VRS were found with regard to age or sex. After 10 minutes, all 3 groups experienced a significant decrease in VAS and VRS scores, with the most drastic decrease occurring in group II. After 30 minutes, there was a significantly higher decrease in group III than in group I (P = .001). After 60 minutes, mean VAS scores of groups I and III (P = .753) were similar. The mean VAS score of group III was lower than that of group II (P = .013). After 120 minutes, the difference in the VAS scores was (P = .000) between groups I and II and between groups II and III. Yet, the VAS evaluation made after 120 minutes revealed statistically similar outcomes for groups I and III (P = .488). The statistical findings for VRS evaluations made after 10, 30, 60, and 120 were similar to those for VAS. In renal colic patients with a possible nonsteroidal anti-inflammatory drug and acetaminophen side effect risk, acupuncture emerges as an alternative treatment modality. Copyright © 2015. Published by Elsevier Inc.
    Full-text · Article · Feb 2015 · The American journal of emergency medicine
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    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. Conclusion We think that non-metastatic primary multiple cancers can be cured separately with a proper management.
    Full-text · Conference Paper · Feb 2015
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    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. Materials 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. Results 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) Conclusion 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
    Full-text · Conference Paper · Jan 2015

Publication Stats

69 Citations
47.45 Total Impact Points

Institutions

  • 2013-2015
    • Konya Training and Research Hospital
      Conia, Konya, Turkey
  • 2008-2015
    • Selcuk University
      • Department of Urology
      Conia, Konya, Turkey