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Yayın Are Hounsfield densities of ureteral stones a predictive factor for effectiveness of extracorporeal shock wave lithotripsy?(E-CENTURY PUBLISHING CORP, 2014) Cakiroglu, Basri; Eyyupoglu, S. Erkan; Tas, Tuncay; Balci, M. B. Can; Hazar, Ismet; Aksoy, S. Hilmi; Sinanoglu, OrhunExtracorporeal Shock Wave Lithotripsy (SWL) has long been used successfully to dissolve ureteral stones. We researched whether Hounsfield values of ureteral stones is a factor that affects the success of SWL. Methods: Data from 144 patients who had diagnoses of ureteral stones and underwent SWL, were retrospectively reviewed between January 2011 and December 2012. Urinary tomography of patients was processed and classified into 3 groups by Hounsfield units (Group 1, < 500 HU; Group 2, 500-1000 HU; and Group 3, > 1000 HU) and 2 groups by stone size (Group A; < 1 cm, Group B; > 1 cm). SWL success was analyzed for both of these group types. Failure was defined as any fragments of the stone that remained within the ureter. Results were analyzed by evaluating the predictive factors in both groups. Results: The study included 144 patients (100 men, 44 women) who fit the inclusion criteria. In Hounsfield unit Group 1 (12 women and 44 men), the mean age was 37.2 +/- 13.2, stone size was 8.5 +/- 2.5 mm, number of shocks was 3240 +/- 1414 (1200-7500) and number of treatments was 1.4 +/- 0.6. In Group 2 (26 women and 32 men), the mean age was 33.6 +/- 7.6, stone size was 9.6 +/- 3.1 mm, process number was 3375 +/- 2103 (1200-8750) and shock amount was 1.6 +/- 0.8. In Group 3 (6 women and 24 men), the mean age was 42.2 +/- 13.6, stone size was 11.7 +/- 3.0 mm, number of shocks was 4513 +/- 2458 (1300-8700) and number of treatments was 2.1 +/- 1.2. In size Group 1 (28 women and 74 men), the mean age was 35.8 +/- 10.6, stone size was 8.1 +/- 1.4 mm, process number was 3105 +/- 1604, shock amount was 1.4 +/- 0.5 and HU value was 580 +/- 297. In Group 2 (16 women and 26 men), the mean age was 39.9 +/- 14.2, stone size was 13.9 +/- 2.4 mm, number of shocks was 4722 +/- 2467, number of treatments was 2.3 +/- 1.1 and HU value was 912 +/- 270. Conclusion: Although stone density predicted the failure of SWL, size of the stone is more important criterion for successful lithotripsy of ureteral stones.Yayın Bladder Neck Collagen Injection in the Treatment of Congenital Retrograde Ejaculation: A Case Report(CUREUS INC, 2017) Cakiroglu, Basri; Sinanoglu, Orhun; Arda, ErsanThe present study describes the first successful treatment of a congenital retrograde ejaculation case with a submucosal collagen injection to the bladder neck. A 28-year-old male (height 170 cm, weight 80 kg) attended to the urology outpatient clinic with complaints of scattered urine stream and absence of ejaculation. The laboratory tests, including hormone profile (follicle stimulating hormone, luteinizing hormone, and testosterone) and the routine blood count were within normal ranges, whereas semen analysis demonstrated a total absence of ejaculation. The analysis of post-ejaculate urine specimens revealed an elevated sperm concentration indicative of retrograde ejaculation. The cystoscopy was performed; the prostatic urethra was normal, the verumontanum was in the orthotopic position, and the bladder neck was wide opened. Dextranomer/hyaluronic acid copolymer (Deflux, 8 ml) was injected into the bladder neck at clock positions of one, five, seven, and 11 o'clock. During the same procedure, the large opening in the vesical collum was obliterated. During the first followup (four weeks after surgery), the patient was able to produce a normal (2.8 ml) ejaculation volume. The sperm analysis revealed normozoospermia, with 25 million spermatozoa/ml, 26% (a) and 57% (a + b) motility, and 14% normal morphology. The submucosal bladder neck collagen injection is a minimally invasive technique that quickly restores anterograde ejaculation and should be considered in the patients with congenital or acquired retrograde ejaculation and for those who did not respond to the medical treatment.Yayın The comparative evaluation of apoptosis produced by leuprolide or orchiectomy on rat prostate tissue(PAGEPRESS PUBL, 2015) Cakiroglu, Basri; Hazar, Aydin Ismet; Eyyupoglu, Seyit Erkan; Balci, Mustafa Bahadir Can; Sinanoglu, Orhun; Tuzlali, PinarIntroduction: Organisms are constantly in a balance meaning that while new cells are produced, some of the older ones die which takes place in 2 ways: necrosis or apoptosis. Apoptosis is the programmed cellular death triggered by intrinsic or extrinsic stimuli. In this study we have evaluated the apoptosis of prostate tissue generated by surgical or medical orchiectomy. Material and Method: In this experimental study, we used 36 adult male rats that were evaluated in 3 groups. The first group (Group 1) consisted of 12 rats that had bilateral orchiectomy; the second group (Group 2) included 12 rats that were given leuprolide acetate and the third group (Group 3) consisted of 12 control rats. Immunohistochemical staining of the prostate of all rats was performed and the presence of glandular atrophy and apoptosis were evaluated in the three groups. The statistical differences between the two groups were evaluated by the Fisher exact test. Results: Glandular atrophy was not determined in any rat of the control group, and the apoptotic staining was in the normal limits in all the control rats. In Leuprolide group, glandular atrophy was mild in 7 cases, and moderate in 3 rats. In 2 rats of the Leuprolide group, atrophy was not demonstrated. In surgical orchiectomy group, glandular atrophy was present in all cases. Atrophy was observed as cystic atrophy. Statistical analysis with the Fisher exact test revealed that glandular atrophy was statistically significantly more common in surgical orchiectomy group compared with Leuprolide group (p = 0,012). Conclusion: If the aim of treatment in androgen dependent prostatic adenocarcinoma or benign prostate hypertrophy is the construction of a robust apoptosis, bilateral orchiectomy generates a more powerful apoptosis compared with Leuprolide.Yayın Comparison of conventional radiography combined with ultrasonography versus nonenhanced helical computed tomography in evaluation of patients with renal colic(SPRINGER, 2012) Ekici, Sinan; Sinanoglu, OrhunThe aim of this study is to determine whether kidneys ureters bladder X-ray (KUB) film combined with ultrasound (US) can be effectively used in evaluation of renal colic and miss stones with clinically significant size identified on nonenhanced computed tomography (NECT) in patients with urolithiasis. This retrospective study evaluated the clinical and radiological records of 300 patients at our institution undergoing KUB and/or US and/or NECT for the evaluation of renal colic from June 2007 to December 2010. Of patients with negative findings on KUB and/or US, 22 had renal stones on NECT (mean size 4.4 mm, range 3-8), 3 had lower ureteral stone (mean size 3.3 mm, range 2-5). In patients with isolated suspicious renal ectasia without stone image, two had renal stone on NECT (mean size 4 mm, range 2-6), 5 had upper ureteral stone (mean size 4.4 mm, range 4-6), 7 had middle ureteral stone (mean size 3.7 mm, range 3-4) and 14 had lower ureteral stone (mean size 4 mm, range 2-6). The cost-effective and almost radiation-free combination of KUB and US should be preferred for diagnosis of urolithiasis, as it detects most of the ureteral and renal calculi which are clinically significant.Yayın COMPARISON OF HOUNSFIELD UNITS OF THE RENAL PAPILLAE IN KIDNEY STONE FORMERS AND NON STONE FORMERS(NOBEL ILAC, 2014) Sinanoglu, Orhun; Ekici, Sinan; Cakiroglu, Basri; Cubuk, Rahmi; Aksoy, Suleyman HilmiObjective: To investigate whether renal papillae of patients with nephrolithiasis are more radiodense than that of control patients and to evaluate the predictibility of urolithiasis events using papillary density differences between stone and non stone formers. Material and Method: Hounsfield unit (HU) values of the papillae of 212 patients with unilateral nephrolithiasis and 108 patients in the control group at the level of the upper pole, middle region and lower pole of both kidneys were evaluated. Results: Mean HU density of all papillae of kidneys with stones was higher than that of stone free kidneys in nephrolithiasis patients (27.21 +/- 2.83 vs 25.66 +/- 2, p=0.000). Mean HU density of renal papillae of stone patients in calyces with stones was significantly higher than that of all papillae in control patients (25,82 +/- 1.97 vs 30,25 +/- 4,03, p<0,001). Mean HU density of all papillae in stone-free kidneys of nephrolithiasis patients was not significantly different from that of control patients (25.82 +/- 1.97 vs 25.66 +/- 2.57, p=0.642). When the values for control and patient groups according to stone laterality was evaluated, the difference was significant only between right upper and right lower calyces for the right nephrolithiasis and the left middle region for the left nephrolithiasis. (26.32 +/- 3.30 vs. 27.90 +/- 3.92 and 25.10 +/- 3.34 vs. 26.95 +/- 4.73, p=0.003 and p=0.009 and 25.70 +/- 3.67 vs 27.15 +/- 3.77 p=0.001, respectively). Conclusion: Only the kidneys with stones and especially the patients with papillae facing the stones in nephrolithiasis have higher renal papillary HU. This fact implies the impossibility of HU per se in predicting future urolithiasis events and/or patients; opposing to the findings of a few previous studies.Yayın Comparison of Intravesical Application of Chondroitin Sulphate and Colchicine in Rat Protamine/Lipopolysaccharide Induced Cystitis Model(UROL & NEPHROL RES CTR-UNRC, 2014) Sinanoglu, Orhun; Ekici, Isin Dogan; Ekici, SinanPurpose: To investigate beneficial effect of the readily available colchicine through its intravesical application on protamine/lipopolysaccharide induced interstitial cystitis model in rat and to compare its efficacy to the chondroitin sulphate available for clinical use. Materials and Methods: Twenty-four Wistar female rats were assigned to control (C), interstitial cystitis (IC), chondroitin sulphate (CS) and colchicine (Col) groups. IC, CS and Col groups received protamine sulphate and lipopolysaccharide (PS/LPS) instillation. Testing agents CS and Col were administered a day after PS/LPS inoculation into the bladders. Rats in Group C received saline solution. CS and Col groups received 1 mL CS (0.2%) and 1 mL Col (0.05 mg/mL). The treatment agents were left in bladders for one hour's duration. Animals were sacrificed 5 days after the inoculation and the bladder tissues were examined histologically to evaluate the amount of extravasated leucocytes, mast cell concentration (by counting total number of cells per 10 high power field (hpf; 1 hpf = x400 magnification) as well as interstitial tissue edema for each bladder. Results: Intravesical application of CS reduced significantly the leucocyte and mast cell infiltration as well as interstitial edema compared to group C. The level of reduction in leucocyte and mast cell infiltration in Col group was comparable to that of CS, although the interstitial edema was not resolved. Conclusion: Intravesical administration of Col decreased leucocyte and mast cell infiltration to the same extent of CS in PS/LPS induced bladder inflammation in rat. Col may be an alternative to other treatment modalities for painful bladder conditions such as IC.Yayın Comparison of Melatonin and Ozone in the Prevention of Reperfusion Injury Following Unilateral Testicular Torsion in Rats(ELSEVIER SCIENCE INC, 2012) Ekici, Sinan; Ekici, A. Isin Dogan; Ozturk, Guler; Aksungar, Fehime Benli; Sinanoglu, Orhun; Turan, Guven; Luleci, NurettinOBJECTIVE To compare the efficacy of ozone with melatonin, shown as the most powerful antioxidant in attenuation of testicular ischemia/reperfusion injury, in an experimental rat model of testicular torsion/detorsion. METHODS Twenty-four male Wistar rats were divided into 4 groups: sham-operated, torsion/detorsion, torsion/detorsion plus melatonin, and torsion/detorsion plus ozone. Melatonin (10 mg/kg) and ozone (4 mg/kg) were intraperitoneally injected daily beginning 15 minutes before detorsion for the following 7 days. At the seventh day, blood and tissue samples were obtained. Johnsen score, malondialdehyde, inhibin B, glutathione plasma total sulfhydryl group (RSH) levels, and total nitric oxide were studied. RESULTS Torsion/detorsion caused increase in tissue malondialdehyde and total nitric oxide along with a decrease in Johnsen score, tissue and plasma inhibin B, RSH, and glutathione levels. Melatonin prevented the rise in malondialdehyde and total nitric oxide levels and improved Johnsen score, tissue and plasma inhibin B, and tissue glutathione levels, along with a decrease in plasma RSH level. Ozone showed similar results except for the total nitric oxide level. Concomitantly, in contralateral testis, melatonin and ozone induced similar changes for Johnsen score, malondialdehyde, and inhibin B (not significant) and in glutathione (significant). Melatonin decreased the total nitric oxide level in both testes and ozone increased the same parameter. CONCLUSION On different pathways, ozone was comparable with melatonin in the amelioration of ischemia/reperfusion injury. Protective effects of ozone were associated with nitrous oxide. The potential for ozone as a treatment for torsion/detorsion therefore deserves to be further elucidated. UROLOGY 80: 899-906, 2012. (C) 2012 Elsevier Inc.Yayın Comparison of transurethral incision of the prostate and silodosin in patients having benign prostatic obstruction in terms of retrograde ejaculation(PAGEPRESS PUBL, 2017) Cakiroglu, Basri; Hazar, Aydin Ismet; Sinanoglu, Orhun; Arda, Ersan; Ekici, SinanBackground: To compare the functional outcomes and retrograde ejaculation (RE) after transurethral incision of the prostate (TUIP) or silodosin in bladder outlet obstruction (BOO) secondary to a small prostate. Methods: Prospectively collected data from December 2011 through December 2014 of 192 LUTS patients having fertility concerns with prostate volume smaller than 40 ml receiving either TUIP or silodosin treatment were prospectively reviewed. The treatment outcomes were evaluated and compared. Results: TUIP was performed in 96 cases and silodosin 8 mg was prescribed in 96 cases. At 12th months after TUIP or continuous silodosin treatment, the decrease in mean International Prostate Symptom Score (IPSS) and postvoiding residual urine (PVR) and the improvement of mean maximal flow rate (Q(max)) were significant (p = 0.000). The improvement in IPPS and Qmax was significantly higher in TUIP group compared to silodosin group (p = 0.005, p = 0.000) with a lower rate of retrograde ejaculation (RE) in TUIP group. (11/96 vs 33/96) (p = 0.000) Conclusions: Both TUIP and silodosin ensures comparable improvement in PVR, IPSS and Q(max) with a lower rate of RE on the TUIP group in prostates weighing less than 40 grams suggesting that TUIP is a better choice in younger patiens seeking preservation of ejaculation with fertility concerns.Yayın Does Mild Hydronephrosis Induced by Full-Bladder Improve Outcomes in Patients Undergoing Shock Wave Lithotripsy for Lower Calyceal Stones?: A Prospective Randomized Study(UROL & NEPHROL RES CTR-UNRC, 2018) Hazar, Ismet Aydin; Cakiroglu, Basri; Sinanoglu, Orhun; Akgun, Feride Sinem; Arda, Ersan; Yuksel, Ilkan; Akdere, HakanPurpose: To compare the outcomes, sessions and shock wave numbers in patients undergoing standard procedure shock wave lithotripsy (SWL) and patients undergoing SWL with mild hydronephrosis induced by full-bladder following oral hydration before SWL procedure for lower calyceal stones. Materials and Methods: Between January 2014-January 2016 a total of 371 patients who underwent SWL, for lower pole calyceal stones 2 cm, were included into the study. 127 patients were treated in the supine position (Group A), 123 in the prone position (Group B) and 121 in the prone position with full bladder and mild hydronephrosis checked by ultrasound before procedure (Group C). There were 286 men and 85 women with a mean SD age of 36 11 years Results: The mean (SD) stone sizes within the group A, group B and group C were 11 mm (+/- 3 mm), 12 mm (+/- 4.1 mm) and 11 mm ( +/- 3.8 mm) respectively. No significant difference was found in age (P =.18) and stone size between 3 groups (P =.07). The median interquartile range (IQR) number of shocks within the group A, group B and group C were 7600 (3855), 6500 (4300) and 6700 (4915) respectively. Significant difference was found in number of shock waves among 3 groups (P <.01). The difference between groups according to stone expulsion rate was found significant in all sessions (P =.01). Conclusion: The present study suggests that mild hydronephrotic status induced by full-bladder before SWL can lower cost and patient discomfort by decrease in number of sessions and increase in stone clearance.Yayın Ectopic Ureterocele: An Infrequent Cause of Retrograde Ejaculation and Its Diagnosis: Case Report(ORTADOGU AD PRES & PUBL CO, 2011) Ekici, Sinan; Sinanoglu, Orhun; Cubuk, RahmiRetrograde ejaculation is an uncommon cause of infertility. It may be congenital, acquired or idiopathic. It can be very rarely a consequence of an ectopic ureterocele. Herein, we present an infertile patient with retrograde ejaculation due to ectopic ureterocele and emphasize the role of magnetic resonance imaging in diagnosis. Only three similar cases have been reported in the literature. The pathogenesis of retrograde ejaculation due to ureterocele remains unclear. It is postulated that dilated ectopic ureter in some way affected the development of the innervation of the bladder neck. Ectopic ureterocele should be kept in mind in the differential diagnosis of patients with retrograde ejaculation.Yayın The effect of inclined position on stone free rates in patients with lower caliceal stones during SWL session(PAGEPRESS PUBL, 2015) Cakiroglu, Basri; Sinanoglu, Orhun; Tas, Tuncay; Hazar, Ismet Aydin; Balci, Mustafa Bahadir CanObjective: To compare the outcomes of shock wave lithotripsy (SWL) combined with inclined position and SWL alone in patients with lower pole calyx stones. Methods: Seven hundred forty patients who underwent SWL treatment for lower pole renal stones with a total diameter of 2 cm or less were prospectively randomized into two groups. They were comparable in terms of age, sex, and stone diameters. Patients with lower calyceal stones (4-20 mm) were randomized to SWL (368 patients) or SWL with simultaneous inclination (372 patients) with 30o head down Trendelenburg position). Shock wave and session numbers were standardized according to stone size. Additional standardized shock waves were given to patients with stone fragments determined by kidney urinary bladder film and ultrasound at weeks 1, 4, 10. Results: The overall stone free rate (SFR) was 73% (268/368) in patients with SWL alone and 81% (300/372) in SWL with inclination at the end of 12th week (p = 0.015). No significant adverse events were noted in both treatment groups. Conclusion: Simultaneous inclination of patients during SWL session increase SFR in lower caliceal stones significantly compared to SWL treatment alone.Yayın The histology and the proapoptotic control in the ipsilateral and the contralateral testes following unilateral vasectomy(PAGEPRESS PUBL, 2015) Hazar, Aydin Ismet; Cakiroglu, Basri; Sakalli, Ertan; Balci, Mustafa Bahadir Can; Eyyupoglu, Erkan; Tas, Tuncay; Sinanoglu, Orhun; Tuzlali, Pinar; Cilesiz, Nusret CanObjective: The aim of this study was to enlighten both the testicular histology and the genetic aspects of the apoptotic process. Thus an experimental study was designed with a model of unilateral vasectomy. Methods: Twenty-two adult male rats were used and 4 main groups were formed. The first (A), the second (B), the third (C), and the fourth group (D) consisted of 4, 4, 4 and 10 rats respectively. Rats in group A had sham operation while rats in other groups (B, C, D) underwent left vasectomy operation including binding of ductus deferens with a 3/0 silk and cutting a minimum of 1 cm part while preserving the vascular structure under 9x magnification. Rats undergoing unilateral vasectomy were sacrificed at the 1st, 2nd and 8th weeks and their testicular structure and proapoptotic gene proteins were compared with that of the control group undergoing sham operation. Results: We found that vasectomy gradually caused destruction and both ipsilateral and contralateral testicles were affected showing initial apoptosis. Conclusion: The procedure causes destruction in the testicular structure by causing bilateral intratubular germ cell necrosis, unilateral obstruction, increase in the tubular pressure and processes that are aggravated by some probable autoimmune reactions.Yayın Ipsilateral Testicular Catch-Up Growth Rate Following Microsurgical Inguinal Adolescent Varicocelectomy(HINDAWI PUBLISHING CORPORATION, 2012) Sinanoglu, Orhun; Eyyupoglu, Seyit Erkan; Ekici, SinanObjective. To evaluate the ipsilateral catch-up growth rates compared to contralateral testicular growth in adolescents with varicocele undergoing microsurgical inguinal varicocelectomy. Materials and Methods. Between December 2005 and May 2007, 39 adolescent patients with grade 2-3 varicocele admitted to our clinic with complaints of pain and/or testicular asymmetry were operated. Preoperative mean age was 14.5 +/- 1.96 (9 17). Testicular volumes were assessed with ultrasound every 3 months. The available followup was 39 months. Results. In our series, mean testicular preoperative volumes were 9.07 +/- 3.19 mL for the right and 5.90 +/- 1.74 mL for the left. Mean testicular volumes at the end of follow up were 13.97 +/- 3.42 mL for the right and 12.20 +/- 4.05 mL for the left. The testicular catch-up growth approximately begins after the 9th month and significant catch-up occurred in the 12 24 months (P < 0.05). Conclusion. Since testicular volume is the primary method of assessing testicular function in adolescents, testicular size can predict future fertility status significantly 9 months after surgical varicocele correction.Yayın Long-term Effect of Colchicine Treatment in Preventing Urethral Stricture Recurrence After Internal Urethrotomy(UROL & NEPHROL RES CTR-UNRC, 2018) Sinanoglu, Orhun; Kurtulus, Fatih Osman; Akgun, Feride SinemPurpose: Urethral stricture, known as a scar formation leading to urethral lumen stricture in sub-epithelial tissue, is the most common late complication of transurethral prostate resection (TURP). The aim of study is to evaluate efficacy of colchicine treatment in preventing urethral stricture recurrence in patients after internal urethrotomy, and to determine whether colchicine treatment had a sustained effect in decreasing stricture recurrences in patients with concomitant diseases. Methods: Patient data with weak urine stream and/or voiding difficulty, and who had internal urethrotomy in Urology Department of Maltepe University Hospital between dates 01 January 2011 and December 2016 were collected. They were randomized to colchicine receiving, and non-receiving arms. Colchicine was given 1 g/day orally for two months, and primary efficacy point was defined as urethral stricture development in 3, 6, and 12 months after internal urethrotomy. Results: The study was conducted on 84 males with the mean age of 67.7 +/- 7.5 years. The mean ages of colchicine receivers and non-receivers were 68.2 +/- 7.6 and 67.1 +/- 7.6 years, respectively. Recurrence rate of urethral stricture was significantly lower in colchicine receivers (P = .044) than non-receivers. In overall evaluation, recurrence rate of urethral stricture was significantly low, if there was only one comorbidity (P = .006), but rates were significantly higher in presence of three (P = .010) and four (P = .040) comorbidities. No significant difference in recurrence rates was determined in patients without comorbidities or with two comorbidities (P > .05). Conclusion: Combination of oral colchicine with internal urethrotomy reduces recurrence rates of urethral stricture significantly.Yayın Melatonin with 1,25-Dihydroxyvitamin D3 Protects against Apoptotic Ischemia-Reperfusion Injury in the Rat Kidney(INFORMA HEALTHCARE, 2012) Sinanoglu, Orhun; Sezgin, Gulbuz; Ozturk, Guler; Tuncdemir, Matem; Guney, Sevin; Aksungar, Fehime Benli; Yener, NeseThis study was designed to evaluate the preventive role of melatonin (Mel) and 1,25-dihydroxyvitamin D3 (VD3) in biochemical and apoptotic events leading to tissue injury and renal dysfunction after ischemia-reperfusion (I/R). Thirty male Wistar rats were divided into five groups: sham-operated, I/R, Mel + I/R, VD3 + I/R, and Mel + VD3 + I/R. The rats were intraperitoneally administered with Mel (10 mg/kg), VD3 (0.5 mu g/kg), or Mel (10 mg/kg) plus VD3 (0.5 mu g/kg) each day at 1 week prior to ischemia. Right nephrectomy was initially performed and left renal I/R injury was induced by 45 min of bilateral renal ischemia followed by 45 min of reperfusion. After reperfusion, kidneys and blood were obtained for histopathologic and biochemical evaluation. Mel and VD3 had an ameliorative effect on biochemical parameters such as serum creatinine, blood urea nitrogen, alanine aminotransferase, aspartate aminotransferase, and apoptosis (caspase-3 and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling staining) in the kidneys against renal I/R injury in rats. Additionally, VD3 combined with Mel significantly reduced apoptotic and histological alterations when compared with Mel or VD3 alone. This preventive effect on renal tubular apoptosis was remarkable when Mel was combined with VD3.Yayın Monosymptomatic nocturnal enuresis caused by seasonal temperature changes(E-CENTURY PUBLISHING CORP, 2014) Tas, Tuncay; Cakiroglu, Basri; Hazar, Aydin Ismet; Balci, Mustafa Bahadir Can; Sinanoglu, Orhun; Nas, Yunus; Yilmazer, FazliBackground: Primary nocturnal enuresis is the most frequent urologic complaint among pediatric patients. Enuresis is believed to have a complex etiology involving genetic, somatic, and behavioral factors. We study the relationship between seasonal temperature changes effect and monosymptomatic nocturnal enuresis (MNE). Methods: Between 2011 and 2012, a total of 75 children with primary MNE selected from urology and pediatry clinics were included in this study. All of the children underwent physical examinations, urine analyses, urinary ultrasounds, and direct urinary graphs. We evaluated the enuresis ratio for the summer (the hot season from June to September) and winter (the cold season from December to March) months in nightly, weekly, and monthly intervals via prepared questionnaires. Results: Of the 75 study participants, 45 were boys (60%) and 30 were girls (40%). The age range was 6-16 years (mean 10.3 +/- 2.0 years). We observed a difference in the ratio of enuresis data between the summer and winter months in 29 males and 19 females, which totals 48 of the 75 MNE patients evaluated in this study. There was a statistically significant difference noted in monthly enuresis ratio in the summer and winter (p<0.0001). We observed a significant difference in quality of life, and this difference caused considerable emotional discomfort for the patients. Conclusion: In the winter months, the nightly, weekly, and monthly ratios are higher in children with MNE. This increase causes a decrease in the quality of life of these children.Yayın MRI in Stress Urinary Incontinence Endovaginal MRI With an Intracavitary Coil and Dynamic Pelvic MRI(UROL & NEPHROL RES CTR-UNRC, 2012) Tasali, Nuri; Cubuk, Rahmi; Sinanoglu, Orhun; Sahin, Kemal; Saydam, BulentPurpose: To evaluate both morphology of the urethra and its supporting structures using endovaginal magnetic resonance imaging (EV-MRI) and the grade of the bladder neck prolapsus using dynamic pelvic MRI (DP-MRI) in women with stress urinary incontinence (SUI). Materials and Methods: We compared 25 women with SUI and 8 controls according to the different layers of the urethra, the degree of distortion in the periurethral, paraurethral, and pubourethral ligaments, the vesicourethral angle, the retropubic space, and the thickness of the puborectal muscle. The SUI group was also evaluated according to the number of deliveries and degree of the bladder neck prolapsus. Results: Significant differences were found in the thickness of each three layers of the urethra between the two groups (P < .05). There was a significantly higher pubourethral ligament distortion (P = .024) and larger vesicourethral angle (P = .000) in women with SUI. In women with SUI, there was no significant relationship between the number of deliveries and the degree of the bladder neck prolapsus (P > .05). Conclusion: The combined usage of the EV-MRI and DP-MRI can provide complementary information concerning certain structural abnormalities with specific dysfunction, such as vesicourethral angle increase and pubourethral ligament distortion in patients with SUI.Yayın Outcome of buccal mucosa urethroplasty in the management of urethral strictures(PAGEPRESS PUBL, 2017) Cakiroglu, Basri; Sinanoglu, Orhun; Arda, ErsanObjective: The objective of the study is to report the outcome of buccal mucosal urethroplasty. Materials and methods: The follow up data of 15 patients undergoing single stage urethroplasty from September 2010 to September 2015 were retropectively reviewed. They received buccal mucosa graft for urethroplasty. The patients were followed for complications and outcome. Results: Mean age was 53.7 +/- 13.6 The stricture length ranged from 3 to 6 cm (mean 4.4 +/- 0.8). The success rate for buccal mucosa urethroplasty (BMU) was 67.7% at 12th month. Three patients presenting with voiding difficulty in the 3rd month and one in the next 12 months, had urethral restenosis. One patient had fistula formation at 6th month postoperatively. Five patients underwent retreatment procedures such as internal urethrotomy, urethroplasty and/or internal urethrotomy. Conclusions: The buccal mucosa is easy to obtain and handle, therefore BMU can be safely and effectively managed outside high volume institutions.Yayın Penile Mondor's Disease Induced by Vigorous Sexual Activity: Two Cases, Two Different Approaches(ORTADOGU AD PRES & PUBL CO, 2012) Aydin, Memduh; Tas, Tuncay; Gursoy, Gokhan; Sinanoglu, Orhun; Balci, Mustafa Bahadir Can; Hazar, Aydin Ismet; Nuhoglu, BarisPenile Mondor's disease is a painless superficial induration due to thrombosis of penile superficial dorsal vein. Etiological factors for superficial dorsal penile vein thrombosis include trauma, vigorous sexual activity, pelvic tumors and a distended bladder. Doppler ultrasonographic evidence of thrombotic dorsal penile vein is diagnostic for penile Mondor's disease. Two cases with Mondor's disease of the penis due to brutal sexual intercourse are reported here. The first patient's thrombosis resolved spontaneously whereas in the second one anti-inflammatory and heparinoid agents were applied. The treatment should primarily be based on temporary sexual abstinence, and in case of no response treatment with non-steroid anti-inflammatory agents, local anticoagulants should be administered. Larger series are needed to determine whether initial observation is appropriate for all patients with penile Mondor's disease.Yayın Postoperative Outcomes of Plasmakinetic Transurethral Resection of the Prostate Compared to Monopolar Transurethral Resection of the Prostate in Patients With Comorbidities(ELSEVIER SCIENCE INC, 2012) Sinanoglu, Orhun; Ekici, Sinan; Tatar, M. Naci; Turan, Gueven; Keles, Ahmet; Erdem, ZekiOBJECTIVE To compare the 12-month postoperative clinical data in patients with comorbidities undergoing plasmakinetic enucleation of the prostate (PK-TURP) and monopolar transurethral resection of the prostate (M-TURP) for symptomatic benign prostatic hyperplasia (BPH). METHODS The data of 165 patients undergoing either PK-TURP or M-TURP from September 2006 to December 2010 were retrospectively evaluated in terms of erectile function. Decrease in Hb level at 24-hour follow-up, variations in serum Na+ at 2-hour follow-up, and 12 month postoperative International Prostate Symptom Score (IPSS), Q(max.), postoperative International Index of Erectile Function (IIEF) scores and urethral stricture rates were evaluated. RESULTS A total of 85 patients underwent M-TURP and 80 patients PK-TURP. In all, 62 patients in M-TURP group and 71 patients in PK-TURP group had one or more comorbidities (P = .01). The operative times were 59.8 +/- 17.8 versus 60.3 +/- 23.8 (P = 0.539). The postoperative 12-month IIEF scores of PK-TURP patients were significantly higher than those of M-TURP patients (M-TURP; 14.5 +/- 6.9, PK-TURP; 17.4 +/- 8.9, P = .04). IPSS and Q(max.) were similar in both the M-TURP and PK-TURP treatment arms (10.9 +/- 8.1 versus 9 +/- 7.9, P = .187 and 18.9 +/- 4.8 versus 18.8 +/- 6.4, P = .905). Urethral stricture rate was 3/62 in M-TURP versus 8/71 in PK-TURP treatment arm, P = .171). CONCLUSION Both modalities yielded similar results with respect to IPSS and Q(max.). The postoperative IIEF in BPH patients with comorbidities appeared to be significantly higher in the PK-TURP group. Although urethral stricture rates seemed higher in the PK-TURP arm, the difference was not statistically significant. UROLOGY 80: 402-407, 2012. (c) 2012 Elsevier Inc.
