ali tekin | Ege University (original) (raw)
Papers by ali tekin
Journal of Surgery and Medicine
All procedures in this study involving human participants were performed in accordance with the 1... more All procedures in this study involving human participants were performed in accordance with the 1964 Helsinki Declaration and its later amendments.
Turkish Association of Pediatric Surgeons, 2016
Alt ıslatma pek çok çocuğu ilgilendiren bir sağlık sorunudur. Yalnızca sosyal sorunlere neden ola... more Alt ıslatma pek çok çocuğu ilgilendiren bir sağlık sorunudur. Yalnızca sosyal sorunlere neden olabilecek monosemptomatik enürezise bağlı gelişebileceği gibi, üst üriner sistemi tehdit edebilecek önemli alt üriner sistem fonksiyon bozukluklarının da belirtisi olabilir. Tanı ve tedavi gamının geniş olması olguların iyi değerlendirilmesini gerektirir. Bu çalışmada altını ıslatan çocuğun tanı ve tedavisine dair ipuçları mevcuttur.
DergiPark (Istanbul University), Dec 1, 2008
Practical Tips in Urology, 2016
Parents of the pediatric stone formers ask the physicians what they should give attention to or w... more Parents of the pediatric stone formers ask the physicians what they should give attention to or what the doctors recommend, in order to prevent the recurrence of stone disease. Answering these questions is always difficult in clinical practice. In this chapter we aim to clarify this relatively unexplored subject.
The Journal of Pediatric Research, 2021
Materials and Methods The hospital records of those patients with grade 4-5 VUR and breakthrough ... more Materials and Methods The hospital records of those patients with grade 4-5 VUR and breakthrough urinary tract infections (UTIs) who had undergone endoscopic subureteric injection in the
Turkish Association of Pediatric Surgeons, 2016
İşeme eylemi oldukça karmaşık bir işlem süreci sonucu ortaya çıkan bir eylemdir. İşlemin karmaşık... more İşeme eylemi oldukça karmaşık bir işlem süreci sonucu ortaya çıkan bir eylemdir. İşlemin karmaşık ve kırılgan yapısı nöropatolojilerin değerlendirme ve takibi açısından önemli bir ölçüt olarak da kullanılmasını sağlamıştır. Bu makalenin işeme eyleminin fizyolojisi ortaya konularak derginin diğer bölümlerinde anlatılacak patolojilerin daha iyi anlaşılabilmesini sağlayacağını düşünüyoruz.
Journal of Pediatric Urology, 2016
We herein report a 17-year-old boy who presented with acute urinary retention due to BPH and was ... more We herein report a 17-year-old boy who presented with acute urinary retention due to BPH and was treated with endoscopic transurethral resection of the prostate (TUR-P).
Turkish Association of Pediatric Surgeons, 2016
Ultrasonun prenatal dönemde tarama amacıyla kullanılması antenatal hidronefrozu en sık saptanan a... more Ultrasonun prenatal dönemde tarama amacıyla kullanılması antenatal hidronefrozu en sık saptanan anomali hâline getirmiştir. Yüksek oranda spontan rezolüsyon beklenmekle birlikte, cerrahi gerektiren obstrüktif durumlar gelişebilir. Bu nedenle prenatal ve postnatal görüntüleme yöntemleri ile cerrahi gerekebilecek hastaların ayrımı önemli ve karmaşık bir konudur. Bu çalışmada, antenatal hidronefrozun görüntüleme yöntemleri ile bu yöntemlerin ortaya çıkardığı sonuçlara göre hasta yönetimi kısaca anlatılmaya çalışılmıştır.
Journal of Pediatric Urology, 2014
Objective: Urethrocutaneous fistula is the most common complication of hypospadias repair. Tubula... more Objective: Urethrocutaneous fistula is the most common complication of hypospadias repair. Tubularized incised plate urethroplasty (TIPU) has been used for the management of distal fistulas. This study reports the usage of TIPU in the treatment of large penile fistulas. Materials and methods: Between April 2002 and September 2012, 15 patients with large penile fistulas who were managed with TIPU were included in the study. The fistulas were sited along the penile shaft from proximal to distal penile localization. Glanular and coronal fistulas were excluded. The surgical technique was completed according to the standard TIPU technique. The surrounding scar tissue of the fistula was circumferentially excised, and the urethral plate at the level of the fistula was incised to provide performance of loose urethral tubularization. A urethral stent was kept for 5e7 days. Results: The mean age of the patients was 7.3 AE 3.1 years. Primary operation of these patients was tubularized preputial island flap (n Z 6), on-lay preputial island flap (n Z 4), and TIPU (n Z 5). The sites of the hypospadias fistulas were as follows; penoscrotal (three), midpenile (eight) and subcoronal (four). Fistulas recurred in two patients after fistula repair. The postoperative follow up of the patients was 12.4 AE 7.7 months. Conclusion: TIPU may be used safely for the treatment of fistulas after hypospadias repair.
Endouroloji Bulteni, 2015
Journal of clinical research in pediatric endocrinology, Jul 29, 2018
Objective: "Disorders of sex development (DSD)" is a nomenclature proposed to defeat the discomfo... more Objective: "Disorders of sex development (DSD)" is a nomenclature proposed to defeat the discomfort of families and patients and has found worldwide usage. The aim of this study is addressing the perception and usage of terminology among the parents of DSD patients in a tertiary center in western Turkey. Methods: The records of the DSD council between years 2008-2015 were reviewed retrospectively and data including details of the management process, patient characteristics and follow-up details were noted. Then inquiries reflecting parental perception about terminology were implemented. Results: In total, 121 patients were evaluated in monthly meetings of DSD council and 79 inquiries were completed. About half of the families admitted knowing the terms; DSD, ambiguous genitalia, dubious genitals (translated from its proxy in Turkish), and intersex; however, only 2% preferred using DSD, 6% intersex, and 14% ambiguous genitalia. Fifty-two percent of the parents used a disease name in Latin (mostly hypospadias) addressing the disorder. Sixty-nine percent who were familiar with the name dubious genitals were diagnosed in the neonatal period. The department mostly involved in the management was related to the terms referring the disease. Conclusion: Each country has its own social norms; therefore, local committees should be employed to develop proper terminology.
Turkish journal of urology, 2016
Myelomeningocele (MMC) is one of the most common reason of neurogenic bladder dysfunction in chil... more Myelomeningocele (MMC) is one of the most common reason of neurogenic bladder dysfunction in children. Although neurogenic bladder dysfunction occurrence is related with bladder innervation, also there are some changes seen in the smooth muscle and neural cells of the bladder. Interstitial cells of Cajal (ICC) are the pacemaker cells found in organs with peristaltic activity. Although it has been shown that ICC are diminished in the rat urinary bladder with traumatic spinal cord injury, there is no data about ICC in fetal rat bladders with MMC. This study has been conducted to investigate the ICC in the bladders of fetal rats with retinoic acid induced MMC. Time dated pregnant Wistar albino rats were divided into 3 groups. In MMC group, dams were fed with gavage solution containing 60 mg/kg all-trans retinoic acid dissolved in olive oil on 10. embryologic day. Sham group animals were fed only olive oil. Control group dams were fed with standard rat chow. Fetuses were delivered by ce...
Journal of Pediatric Urology, 2016
Various graft and flap techniques have been proposed for urethral reconstruction in proximal hypo... more Various graft and flap techniques have been proposed for urethral reconstruction in proximal hypospadias repair. The Bracka repair involving the transfer of inner prepuce like a Wolfe graft mostly results in satisfactory results besides a high fistula rate. The aim was to decrease the high fistula rate with Bracka repair; we wanted to use the advantages of vascularized skin in the Bracka method. The aim of this study was to evaluate our results with this modification. Our modification involves using a flap instead of a graft. In the first stage, chordee was corrected by transection of the urethral plate and dorsal midline plication when necessary. Instead of a graft as suggested by Bracka, inner preputial skin with ample blood supply was transferred and stitched to the denuded ventral penile surface. In the second stage after 6 months, this flap was tubularized in the Thiersch-Duplay fashion. Hospital records of patients who had undergone two stage modified Bracka repair between June 2007 and July 2012 were reviewed, including complaints, complications, and need for interventions. Thirty-eight patients had undergone this operation. Four patients were lost to follow-up. The main complaint was obstructed urinary flow. Voiding symptoms were first attributed to urethral stenosis, but were, however, found to be due to diverticulum and vortex of the urine in the dilated urethra. Twenty-one patients (61%) had voiding problems and 10 patients (29%) had urinary tract infections. Fistula was observed in 23 and diverticula were observed in 24 patients. Of these, 16 patients had both fistula and diverticula. Only two patients (5%) were free of complications and totally satisfied with the operation, and 23 of the 34 patients had complications requiring intervention (Figure). Inner preputial flaps used in proximal hypospadias repairs are prone to diverticula formation. They become redundant in time requiring reoperation, thus decreasing the success rate. Careful fixation of the flap to the corpora and allowing time for additional attachment of the urethral plate substitution through fibrotic activity could not overcome this complication. Our modification of the Bracka technique using a flap for the plate resulted in a high rate of complications (in particular diverticulum formation) and was therefore abandoned. We recommend careful use of flaps in hypospadias surgery and long-term follow-up studies to evaluate actual functional and cosmetic results.
Urolithiasis, Jan 30, 2015
There is a lack of literature on children compared to adults regarding the long-term effects of e... more There is a lack of literature on children compared to adults regarding the long-term effects of extracorporeal shock wave lithotripsy (SWL), specifically in infants. The aim of the present study was to analyze the efficacy and safety of SWL in infants and also evaluate its potential adverse effects in the mid-term. Between May 1999 and December 2013, 36 infants with 39 renal units underwent SWL treatment for kidney stones with an electrohydraulic lithotripter (Dornier MPL 9000/ELMED Multimed Classic). All children were less than 12-month old. The mid-term effects of SWL were examined at the last follow-up by measuring arterial blood pressure, random blood glucose level and ipsilateral kidney size. Evaluation of treatment and its consequences was based on clinical examination, blood tests and conventional imaging (plain abdominal radiography and ultrasound). Overall stone-free rate was 84.6 % after 3-month follow-up without any major complications. Mid-term follow-up was available in...
Revista da Sociedade Brasileira de Medicina Tropical, 2014
International braz j urol : official journal of the Brazilian Society of Urology, Jan 15, 2018
Various bulking agents were utilized for endoscopic correction of VUR. A study reviewing multi-in... more Various bulking agents were utilized for endoscopic correction of VUR. A study reviewing multi-institutional data showed that the amount of injection material has increased over time with the purpose of improving success rates, which also resulted in costs. We noticed an opposite trend in our center since we started using a new bulking agent. The aim of this study was to evaluate evolution of our practice with different bulking agents. Records of VUR patients who underwent subureteric injection with polyacrylate polyalcohol copolymer (PPC) and dextronomere hyaluronic acide (DxHA) between 2005 and 2014 were reviewed. Variation of different parameters throughout the study period was evaluated along with the success rate. Success was defined as complete resolution of reflux. A total of 260 patients with 384 refluxing units were included. The success rate was higher in PPC group compared to DxHA group. There was no statistically significant difference between years regarding distributio...
Journal of Surgery and Medicine
All procedures in this study involving human participants were performed in accordance with the 1... more All procedures in this study involving human participants were performed in accordance with the 1964 Helsinki Declaration and its later amendments.
Turkish Association of Pediatric Surgeons, 2016
Alt ıslatma pek çok çocuğu ilgilendiren bir sağlık sorunudur. Yalnızca sosyal sorunlere neden ola... more Alt ıslatma pek çok çocuğu ilgilendiren bir sağlık sorunudur. Yalnızca sosyal sorunlere neden olabilecek monosemptomatik enürezise bağlı gelişebileceği gibi, üst üriner sistemi tehdit edebilecek önemli alt üriner sistem fonksiyon bozukluklarının da belirtisi olabilir. Tanı ve tedavi gamının geniş olması olguların iyi değerlendirilmesini gerektirir. Bu çalışmada altını ıslatan çocuğun tanı ve tedavisine dair ipuçları mevcuttur.
DergiPark (Istanbul University), Dec 1, 2008
Practical Tips in Urology, 2016
Parents of the pediatric stone formers ask the physicians what they should give attention to or w... more Parents of the pediatric stone formers ask the physicians what they should give attention to or what the doctors recommend, in order to prevent the recurrence of stone disease. Answering these questions is always difficult in clinical practice. In this chapter we aim to clarify this relatively unexplored subject.
The Journal of Pediatric Research, 2021
Materials and Methods The hospital records of those patients with grade 4-5 VUR and breakthrough ... more Materials and Methods The hospital records of those patients with grade 4-5 VUR and breakthrough urinary tract infections (UTIs) who had undergone endoscopic subureteric injection in the
Turkish Association of Pediatric Surgeons, 2016
İşeme eylemi oldukça karmaşık bir işlem süreci sonucu ortaya çıkan bir eylemdir. İşlemin karmaşık... more İşeme eylemi oldukça karmaşık bir işlem süreci sonucu ortaya çıkan bir eylemdir. İşlemin karmaşık ve kırılgan yapısı nöropatolojilerin değerlendirme ve takibi açısından önemli bir ölçüt olarak da kullanılmasını sağlamıştır. Bu makalenin işeme eyleminin fizyolojisi ortaya konularak derginin diğer bölümlerinde anlatılacak patolojilerin daha iyi anlaşılabilmesini sağlayacağını düşünüyoruz.
Journal of Pediatric Urology, 2016
We herein report a 17-year-old boy who presented with acute urinary retention due to BPH and was ... more We herein report a 17-year-old boy who presented with acute urinary retention due to BPH and was treated with endoscopic transurethral resection of the prostate (TUR-P).
Turkish Association of Pediatric Surgeons, 2016
Ultrasonun prenatal dönemde tarama amacıyla kullanılması antenatal hidronefrozu en sık saptanan a... more Ultrasonun prenatal dönemde tarama amacıyla kullanılması antenatal hidronefrozu en sık saptanan anomali hâline getirmiştir. Yüksek oranda spontan rezolüsyon beklenmekle birlikte, cerrahi gerektiren obstrüktif durumlar gelişebilir. Bu nedenle prenatal ve postnatal görüntüleme yöntemleri ile cerrahi gerekebilecek hastaların ayrımı önemli ve karmaşık bir konudur. Bu çalışmada, antenatal hidronefrozun görüntüleme yöntemleri ile bu yöntemlerin ortaya çıkardığı sonuçlara göre hasta yönetimi kısaca anlatılmaya çalışılmıştır.
Journal of Pediatric Urology, 2014
Objective: Urethrocutaneous fistula is the most common complication of hypospadias repair. Tubula... more Objective: Urethrocutaneous fistula is the most common complication of hypospadias repair. Tubularized incised plate urethroplasty (TIPU) has been used for the management of distal fistulas. This study reports the usage of TIPU in the treatment of large penile fistulas. Materials and methods: Between April 2002 and September 2012, 15 patients with large penile fistulas who were managed with TIPU were included in the study. The fistulas were sited along the penile shaft from proximal to distal penile localization. Glanular and coronal fistulas were excluded. The surgical technique was completed according to the standard TIPU technique. The surrounding scar tissue of the fistula was circumferentially excised, and the urethral plate at the level of the fistula was incised to provide performance of loose urethral tubularization. A urethral stent was kept for 5e7 days. Results: The mean age of the patients was 7.3 AE 3.1 years. Primary operation of these patients was tubularized preputial island flap (n Z 6), on-lay preputial island flap (n Z 4), and TIPU (n Z 5). The sites of the hypospadias fistulas were as follows; penoscrotal (three), midpenile (eight) and subcoronal (four). Fistulas recurred in two patients after fistula repair. The postoperative follow up of the patients was 12.4 AE 7.7 months. Conclusion: TIPU may be used safely for the treatment of fistulas after hypospadias repair.
Endouroloji Bulteni, 2015
Journal of clinical research in pediatric endocrinology, Jul 29, 2018
Objective: "Disorders of sex development (DSD)" is a nomenclature proposed to defeat the discomfo... more Objective: "Disorders of sex development (DSD)" is a nomenclature proposed to defeat the discomfort of families and patients and has found worldwide usage. The aim of this study is addressing the perception and usage of terminology among the parents of DSD patients in a tertiary center in western Turkey. Methods: The records of the DSD council between years 2008-2015 were reviewed retrospectively and data including details of the management process, patient characteristics and follow-up details were noted. Then inquiries reflecting parental perception about terminology were implemented. Results: In total, 121 patients were evaluated in monthly meetings of DSD council and 79 inquiries were completed. About half of the families admitted knowing the terms; DSD, ambiguous genitalia, dubious genitals (translated from its proxy in Turkish), and intersex; however, only 2% preferred using DSD, 6% intersex, and 14% ambiguous genitalia. Fifty-two percent of the parents used a disease name in Latin (mostly hypospadias) addressing the disorder. Sixty-nine percent who were familiar with the name dubious genitals were diagnosed in the neonatal period. The department mostly involved in the management was related to the terms referring the disease. Conclusion: Each country has its own social norms; therefore, local committees should be employed to develop proper terminology.
Turkish journal of urology, 2016
Myelomeningocele (MMC) is one of the most common reason of neurogenic bladder dysfunction in chil... more Myelomeningocele (MMC) is one of the most common reason of neurogenic bladder dysfunction in children. Although neurogenic bladder dysfunction occurrence is related with bladder innervation, also there are some changes seen in the smooth muscle and neural cells of the bladder. Interstitial cells of Cajal (ICC) are the pacemaker cells found in organs with peristaltic activity. Although it has been shown that ICC are diminished in the rat urinary bladder with traumatic spinal cord injury, there is no data about ICC in fetal rat bladders with MMC. This study has been conducted to investigate the ICC in the bladders of fetal rats with retinoic acid induced MMC. Time dated pregnant Wistar albino rats were divided into 3 groups. In MMC group, dams were fed with gavage solution containing 60 mg/kg all-trans retinoic acid dissolved in olive oil on 10. embryologic day. Sham group animals were fed only olive oil. Control group dams were fed with standard rat chow. Fetuses were delivered by ce...
Journal of Pediatric Urology, 2016
Various graft and flap techniques have been proposed for urethral reconstruction in proximal hypo... more Various graft and flap techniques have been proposed for urethral reconstruction in proximal hypospadias repair. The Bracka repair involving the transfer of inner prepuce like a Wolfe graft mostly results in satisfactory results besides a high fistula rate. The aim was to decrease the high fistula rate with Bracka repair; we wanted to use the advantages of vascularized skin in the Bracka method. The aim of this study was to evaluate our results with this modification. Our modification involves using a flap instead of a graft. In the first stage, chordee was corrected by transection of the urethral plate and dorsal midline plication when necessary. Instead of a graft as suggested by Bracka, inner preputial skin with ample blood supply was transferred and stitched to the denuded ventral penile surface. In the second stage after 6 months, this flap was tubularized in the Thiersch-Duplay fashion. Hospital records of patients who had undergone two stage modified Bracka repair between June 2007 and July 2012 were reviewed, including complaints, complications, and need for interventions. Thirty-eight patients had undergone this operation. Four patients were lost to follow-up. The main complaint was obstructed urinary flow. Voiding symptoms were first attributed to urethral stenosis, but were, however, found to be due to diverticulum and vortex of the urine in the dilated urethra. Twenty-one patients (61%) had voiding problems and 10 patients (29%) had urinary tract infections. Fistula was observed in 23 and diverticula were observed in 24 patients. Of these, 16 patients had both fistula and diverticula. Only two patients (5%) were free of complications and totally satisfied with the operation, and 23 of the 34 patients had complications requiring intervention (Figure). Inner preputial flaps used in proximal hypospadias repairs are prone to diverticula formation. They become redundant in time requiring reoperation, thus decreasing the success rate. Careful fixation of the flap to the corpora and allowing time for additional attachment of the urethral plate substitution through fibrotic activity could not overcome this complication. Our modification of the Bracka technique using a flap for the plate resulted in a high rate of complications (in particular diverticulum formation) and was therefore abandoned. We recommend careful use of flaps in hypospadias surgery and long-term follow-up studies to evaluate actual functional and cosmetic results.
Urolithiasis, Jan 30, 2015
There is a lack of literature on children compared to adults regarding the long-term effects of e... more There is a lack of literature on children compared to adults regarding the long-term effects of extracorporeal shock wave lithotripsy (SWL), specifically in infants. The aim of the present study was to analyze the efficacy and safety of SWL in infants and also evaluate its potential adverse effects in the mid-term. Between May 1999 and December 2013, 36 infants with 39 renal units underwent SWL treatment for kidney stones with an electrohydraulic lithotripter (Dornier MPL 9000/ELMED Multimed Classic). All children were less than 12-month old. The mid-term effects of SWL were examined at the last follow-up by measuring arterial blood pressure, random blood glucose level and ipsilateral kidney size. Evaluation of treatment and its consequences was based on clinical examination, blood tests and conventional imaging (plain abdominal radiography and ultrasound). Overall stone-free rate was 84.6 % after 3-month follow-up without any major complications. Mid-term follow-up was available in...
Revista da Sociedade Brasileira de Medicina Tropical, 2014
International braz j urol : official journal of the Brazilian Society of Urology, Jan 15, 2018
Various bulking agents were utilized for endoscopic correction of VUR. A study reviewing multi-in... more Various bulking agents were utilized for endoscopic correction of VUR. A study reviewing multi-institutional data showed that the amount of injection material has increased over time with the purpose of improving success rates, which also resulted in costs. We noticed an opposite trend in our center since we started using a new bulking agent. The aim of this study was to evaluate evolution of our practice with different bulking agents. Records of VUR patients who underwent subureteric injection with polyacrylate polyalcohol copolymer (PPC) and dextronomere hyaluronic acide (DxHA) between 2005 and 2014 were reviewed. Variation of different parameters throughout the study period was evaluated along with the success rate. Success was defined as complete resolution of reflux. A total of 260 patients with 384 refluxing units were included. The success rate was higher in PPC group compared to DxHA group. There was no statistically significant difference between years regarding distributio...