Bozlu M. | Akduman B. | Mungan U. | Özen H. | Baltaci S. | Türkeri L. | Kirkali Z.
Article | 2007 | Turk Uroloji Dergisi33 ( 3 ) , pp.266 - 271
Introduction: Ultrasound-guided prostate biopsy is the standard method for the diagnosis of prostate cancer. The aim of the present survey is to assess the variability in patient preparation and technique of ultrasound-guided prostate biopsy among Turkish Urologists. Materials and Methods: In July 2004, a questionnaire was sent out to e-mail addresses of the members of Urooncological Association, asking about the details of prostate biopsy protocol of the members. The survey consisted of multiple choice questions about the patient preparation and prostate biopsy technique. Responses were acquired via e-mail and analyzed in detail. R . . .esults: Thirty two urologists from 24 centers responded. The biopsy procedure was performed by the urologist only in 54.16% of the centers, both urologist and radiologist in 37.5%, and radiologist only in 8.33%. Transrectal route was the most common method for ultrasound-guided prostate biopsy. A half of the responders performed biopsy when PSA was greater than 4 ng/ml. All of the centers administered antibiotic and a half of them used enema before the procedure. Approximately 37% of responders did not administer any type of analgesia, but 29.1% of all responders administered a periprostatic nerve block for reducing pain during the procedure. Most urologists obtained 10 or 12 biopsy cores and only 20.8% of them obtained routine transitional zone biopsy during the initial biopsy session. Conclusion: This survey demonstrated that patient preparation and technique of ultrasound-guided prostate biopsy is not standardized among Turkish Urologists, and a guideline on prostate biopsy is needed Daha fazlası Daha az
Irkilata L. | Sözen S. | Tokgöz H. | Kordan Y. | Kiraç M. | Onaran M. | Alkibay T.
Article | 2010 | Turk Uroloji Dergisi36 ( 2 ) , pp.103 - 107
Objective: This study aimed to evaluate the sensitivity and specificity of radiological diagnostic methods, urinary biomarkers and urine cytology for patients with microscopic hematuria in the diagnosis of bladder cancer. Materials and methods: A total of 150 patients with the initial diagnosis of microscopic hematuria were included in the study. Patients were prospectively evaluated in terms of urinary symptomatology, physical examination, smoking habits, intravenous pyelography (IVP), abdominal ultrasonography (USG), Nuclear Matrix Protein 22 (NMP22), urine cytology and NMP22 BladderChek® test. The cut-off point for NMP22 test was . . . accepted as 10 U/mL. Results: Mean age of the study population was 49.8±10.79 years with a male to female ratio of 1.08 (78/72). Overall, 10.7% (n=16) of patients had pathological diagnosis of bladder cancer, whereas 89.5% of the study population had no etiology for microhematuria. IVP was considered as the most sensitive and specific test in the diagnosis of bladder cancer. However, voided urine cytology was the least sensitive test, although it has the same specificity with IVP. The best sensitivity and specificity values were demonstrated when NMP22 and abdominal USG were used in double-test combinations. Conclusion: In microscopic hematuria, the combination of radiological methods with tumor markers such as NMP22 BladderChek® test, provides 100% sensitivity, and protects nearly half of cases from unnecessary cystoscopies Daha fazlası Daha az
Bozlu M. | Akduman B. | Mungan U. | Özen H. | Baltaci S. | Türkeri L. | Kirkali Z.
Article | 2007 | Turk Uroloji Dergisi33 ( 2 ) , pp.145 - 150
Introduction: Ultrasound-guided prostate biopsy is the standard method for the diagnosis of prostate cancer. The aim of the present survey is to assess the variability in patient preparation and technique of ultrasound-guided prostate biopsy among Turkish Urologists. Materials and Methods: In July 2004, a questionnaire was sent out to e-mail addresses of the members of Urooncological Association, asking about the details of prostate biopsy protocol of the members. The survey consisted of multiple choice questions about the patient preparation and prostate biopsy technique. Responses were acquired via e-mail and analyzed in detail. R . . .esults: Thirty two urologists from 24 centers responded. The biopsy procedure was performed by the urologist only in $4.16% of the centers, both urologist and radiologist in 37.5%, and radiologist only in 8.33%. Transrectal route was the most common method for ultrasound-guided prostate biopsy. A half of the responders performed biopsy when PSA was greater than 4 ng/ml. All of the centers administered antibiotic and a half of them used enema before the procedure. Approximately 37% of responders did not administer any type of analgesia, but 29.1% of all responders administered a periprostatic nerve block for reducing pain during the procedure. Most urologists obtained 10 or 12 biopsy cores and only 20.8% of them obtained routine transitional zone biopsy during the initial biopsy session. Conclusion: This survey demonstrated that patient preparation and technique of ultrasound-guided prostate biopsy is not standardized among Turkish Urologists, and a guideline on prostate biopsy is needed Daha fazlası Daha az
Erol B. | Dönmez I. | Mungan G. | Cam M. | Tokgöz H. | Mungan N.A.
Article | 2008 | Turk Uroloji Dergisi34 ( 3 ) , pp.295 - 299
Introduction: In this study, we aimed to evaluate TNF-? and IL-8 levels in patient with prostate cancer as diagnostic tools additional to PSA. Materials and Methods: In this current study, we included a total of 37 patients who were planned to undergo prostate biopsies in Department of Urology of Zonguldak Karaelmas University due to having high PSA levels between January and December 2005. Two samples of serum each containing 100 µL plasma were collected from each patient in order to measure TNF-? and IL-8 levels by using Immulite® IL8 and Immulite® TNF-? immunometric assays and results were given in pg/mL unit. TNF-? and IL-8 leve . . .ls were compared in groups of BPH and prostate cancer. Additionally, Gleason score and those parameters were compared within prostate cancer group. Results: IL-8 levels were between 5.0 pg/mL to 46.2 pg/ml and mean IL-8 level was 12.1 pg/ml; TNF-? levels were between 4.0 pg/ml to 10 pg /mL and mean TNF-? level was 5.64 pg/ml in prostate cancer group (n=20). IL-8 levels were between 5.0 pg/ml to 27.4 pg/ml and mean IL-8 level was 9.094 pg/ml; TNF-? levels were between 4.0 pg/ml to 9 pg /mL and mean TNF-? level was 5.46 pg/ml in BPH group (n = 17) (p>0.05). There was no statistical corelation detected between Gleason score and those parameters. Conclusion: There were not any significant statistical difference in TNF-? and IL-8 levels between patients with BPH and prostate cancer. IL-8 and TNF-? do not seem to diagnostic value in patients with prostate cancer. However, the role of TNF-? and IL-8 in prostate cancer etiology and their roles in diagnosing prostate cancer and prognosis of prostate cancer should be investigated in larger series Daha fazlası Daha az
Özdiler E. | Yaman Ö. | Soyupek S. | Seçkiner I. | Bozlu M. | Tükel O.
Article | 2003 | Turk Uroloji Dergisi29 ( 4 ) , pp.481 - 485
Introduction: The aim of our study was to compare the results of conventional transurethral electroresection of the prostate (TURP) and transurethral vaporization and resection of the prostate (TUVRP) operations in patients with symptomatic bladder outlet obstruction due to prostatic enlargement. Materials and Methods: 59 consecutive patients with symptomatic bladder outlet obstruction due to prostatic enlargement and prostate size between 20-60 g were prospectively randomized to two treatment groups; one group underwent standard TURP and the other TUVRP. Eligibility criteria included IPSS result 8 or grater, Qmax
Karakaş H.B. | Çiçekbilek İ. | Tok A. | Alışkan T. | Akduman B.
Article | 2016 | Turk Uroloji Dergisi42 ( 3 ) , pp.162 - 167
Objective: In this study we aimed to evaluate intraoperative and postoperative complications which developed according to pre-operative American Society of Anesthesiologists (ASA) risk criteria in patients who had undergone percutaneous nephrolithotomy (PNL). Material and methods: Five hundred and sixty patients who had undergone PNL between 2002 and 2014 were included in the study. Patients operated on the ipsilateral kidney, those with solitary kidney or the cases who had previously undergone more than one access were excluded from this study. Preoperative anesthesia risks were determined according to preoperative classification d . . .eveloped by ASA. Postoperative complications were evaluated using Clavien Complication Grading Scale. Results: The mean age of the cases was 47±14 years. The 57% (n=319) of the cases were male, 241 (43%) of them were female. The average indwell time of nephrostomy catheter was 2.88±1.00 (1-8), and length of hospital stay was 4.91±1.54 (2-17) days. When the cases were assessed according to ASA risk groups, intraoperative complications were observed in 9 (5.5%) ASA I, 27 (8.6%) ASA II, and 18 (22%) ASA III patients and and distribution of the patients was statistically significant ( Daha fazlası Daha az
Mungan A. | Müezzinoglu T.
Article | 2007 | Turk Uroloji Dergisi33 ( 4 ) , pp.435 - 437
[No abstract available]
Tezer H.M. | Güven S. | Ersay A. | Erol B. | Kadioglu A.
Review | 2006 | Turk Uroloji Dergisi32 ( 3 ) , pp.319 - 326
Introduction: The aim of infertile male evaluation is to unveil the etiology of infertility and plan the specific treatment according to the etiology. In case there is not a specific treatment the aim is to refer to assisted reproductive techniques. However the etiology specific treatment of male infertility, compared to the assisted reproductive techniques is more cost effective and it does not have the risks of assisted reproductive techniques. Materials and Methods: The obstruction of the sperm ducts is one of the correctable causes of male infertility and the treatment varies according to the localization of obstruction. When th . . .ere is distal ejaculatory duct pathology the treatment choice is TUR-ED while in proximal ejaculatory duct patologies reconstructive treatment is the preferred choice (vasovasostomy/epididymovasostomy). Peroperative semen freezing is offered to the patient as there is a risk of recurrence. Results: The reconstructive surgery of ductal system has been improved through years and so has the operation success. The success of the operation is to provide a ductal patency and pregnancy. The milestone of operative technique is the use of the microscope. With the use of the microscope the obstruction is localized more effectively and the anastomoses are made according to the anatomy. Consecuently, the success of the operation is higher. Conclusion: The success rate of the operation, on behalf of the development of the operational technique, depends on the choice of the right patient. In order to predict the success of the operation some parameters were tried to be established in some studies. It was stated that some preoperative and peroperative parameters have predictive importance Daha fazlası Daha az
Akduman B. | Erdem O. | Yeşilli Ç. | Erdem Z. | Seçkiner I. | Mungan N.A.
Article | 2004 | Turk Uroloji Dergisi30 ( 2 ) , pp.182 - 186
Introduction: Transrectal ultrasound guided prostate biopsy is the method of choice for prostate biopsy guidance. It was demonstrated that most prostate cancers in peripheral zone showed hypervascularization, in contrasts to hypovascularization of the normal peripheral zone. Color Doppler ultrasonography or power Doppler sonography may be of help in differentiating prostate cancer from benign prostatic disease by demonstrating local blood flow changes in the lesion compared to signals from surrounding tissue. Power Doppler is more sensitive to slow flow and is less angle-dependent than color Doppler imaging. In this prospective stud . . .y, the role of power Doppler ultrasonography in addition to systematic 10 cores biopsy for the detection of prostate cancer was assessed. Materials and Methods: Between July 2002 and April 2003, 52 patients who have serum PSA level greater than 2.5 ng/mL or abnormal digital rectal examination included the study. All patients were examined with the 7.5 MHz end-firing probe (Hitachi EUB 525, Tokyo, Japan). Biopsies were directed into hypervascularized area detected by power doppler ultrasonography before systematic 10 cores needle biopsies were performed. No major complication during or after the procedure was seen. The impact of power Doppler, directed biopsies to prostate cancer detection rate, was analyzed using chi-square test. Mean age of patients was 63.1 (42-82). Results: In addition to 520 systematic biopsy sites from 52 patients, 73 suspicious areas detected by power Doppler ultrasonography were also biopsied. A total of 65 biopsy sites in 11 patients turned out to be adenocarcinoma of the prostate. With the use of power Doppler ultrasonography, cancer detection rate was increased to 11.0% (65/593) from 10.2% (53/520). This increase was statistically insignificant (p=0.75). In 2 patients, prostate cancer was diagnosed only in the suspicious areas detected by power Doppler ultrasonography. The contribution of power Doppler ultrasonography in that regard was also statistically insignificant (p=0.80). In a patient with prostate cancer diagnosed with systematic 10 cores needle biopsy, power Doppler ultrasonography could not detect any suspicious areas. In contrasts to suspicious areas detected with power Doppler ultrasonography, prostate cancer was diagnosed in a patient in the areas taken by systematic 10 cores needle biopsy technique. Conclusion: Targeted biopsy performed on the basis of power Doppler ultrasonography findings does not increase the detection rate of prostate cancer compared to systematic 10 cores needle biopsy technique. A second set systematic 10 cores needle biopsy seems the most reliable method in patients with high serum PSA level or suspicious digital rectal examination and negative biopsy result in the first set of biopsy Daha fazlası Daha az
Yencilek F. | Erturhan S. | Cangüven Ö. | Erol B. | Koyuncu H. | Göktaş C. | Sarica K.
Article | 2009 | Turk Uroloji Dergisi35 ( 4 ) , pp.298 - 303
Objective: The aim of this study was to determine the effect of indomethacin, an anti-inflammatory agent, on apoptosis and crystal deposition developing as a consequence of tubular cell injury induced by hyperoxaluria in an animal model. Materials and methods: Fifty New Zealand rabbits were divided into 3 groups. The first 2 groups were fed with hyperoxaluric diet and Group 3 was the control group with no supplementary procedure or treatment. While the animals in Group 1 were given only hyperoxaluric diet, Group 2 animals was applied indomethacin in addition to the hyperoxaluric diet. Animals were sacrificed at the early (7th day) a . . .nd late (28th day) periods and renal tis-sue specimens were sent for the pathological analysis of crystal deposition and apoptosis. Results: The presence and degree of crystal deposition were significantly less in the specimens obtained from indomethacin-treated group during both the early and late periods ( Daha fazlası Daha az
Bayar D. | Erol B. | Altinel M. | Dönmez I. | Özgök Y.
Article | 2008 | Turk Uroloji Dergisi34 ( 3 ) , pp.340 - 344
Introduction: Transition Zone Index (TZI) is a parameter for diagnosis and evaluation of symptoms in patients with Benign Prostatic Hyperplasia (BPH). The aim of this study is to evaluate the role of measuring transition zone index in patients with lower urinary tract symptoms (LUTS) and to asses the correlation between International Prostate Symptom Score (IPSS), peak urine flow (PUF), age and PSA. Materials and Methods: The study included 81 patients with LUTS. Age, IPSS, PUF and PSA were determined in all patients and these parameters were evaluated for the correlation with TZI. Additionally, age, IPSS and PSA values were grouped . . . and each one was statistically analyzed with TZI. Afterwards TZI was fixed and statistical analyses were carried out between the groups. Results: The mean age of the patients was 62.6±8. There was statistically significant positive correlation between TZI values and age, IPSS score and PSA values and statistically significant negative correlation between TZI and PUF ( Daha fazlası Daha az
Akduman B. | Crawford E.D.
Review | 2010 | Turk Uroloji Dergisi36 ( 1 ) , pp.25 - 32
Over the past decade, a significant number of modifications have been made to the technique for prostate biopsy. In this report, we reviewed the literature regarding transrectal ultrasound-guided prostate biopsy (TRUS-BX) in terms of the various techniques of prostate biopsy, number of cores, prophylactic antibiotic selection and use, patient preparation and pain-controlling techniques applied before the procedure. The proposed advantages/ disadvantages of transitional zone and seminal vesicle biopsies were also summarized. According to the literature, TRUS-BX rather than transperineal approach should be preferred as the technique o . . .f choice in most men undergoing a prostate biopsy. The laterally directed sextant biopsy and extended biopsy approaches decrease the false-negative rate that occurs with the conventional sextant biopsy approach. As a conclusion, considering the baseline biopsy protocol, the current advice is the use of an extended biopsy scheme (12 biopsy cores without transitional zone). Laterally directed biopsies from the anterior horn should be included. Repeat as well as saturation biopsies should include the transitional zone. Local anesthesia using transrectal ultrasound-guided lidocaine injection provides adequate periprostatic nerve blockage and is recommended to reduce the pain associated with prostate biopsy. Broad-spectrum antibiotic therapy should be administered to reduce the risk of infection Daha fazlası Daha az