Öner M Şanlı - Academia.edu (original) (raw)
Papers by Öner M Şanlı
PubMed, Apr 1, 2016
Objective: Evaluation of retrospective results of treatment of patients with kidney cancer, who h... more Objective: Evaluation of retrospective results of treatment of patients with kidney cancer, who have undergone a laparoscopic or a retroperitoneoscopic radical nephrectomy. Materials and methods: We have conducted a retrospective analysis of 185 patients with kidney tumour, who have undergone a laparoscopic or a retroperitoneoscopic radical nephrectomy during 2010-2015. Amongst the participants there were 116 men (62.7%) and 69 women (37.3%) aged 29-86 (average age of 58.1 years). 150 patients (81.1%) have performed radical nephrectomy by transperitoneal access, while 30 patients (16.2%) experienced identical process through retroperitoneal access. 5 cases (2.7%) hybrid technique was utilized. 97 patients performed nephrectomy on the right side, 88 patients on the left side. 178 patients (96.2%) had a single kidney tumours, while 7 (3.8%) had multiple tumours ranging between 2-8. 15 patients, who experienced a laparoscopic radical nephrectomy, had a thrombus in kidney vein (level 1 under Mayo classification). 1 patient had a thrombus in vena cava (level 2). Results: Only one of the patients suffered a fatal outcome. 12 patients (6.5%) had a conversion. The duration of operation ranged between 50-215 minutes (average of 104.3 minutes), time of insufflation ranged between 36-205 minutes (average of 96.2 minutes). Average intraoperative blood loss constituted 147.8 ml. Patients spent 2-18 days (average 4.1 days) in the hospital after the surgery. Conclusion: There is an obvious advantage to utilizing a laparoscopic or a retroperitoneoscopic intervention in order to treat kidney cancer. The process constitutes minimal invasiveness, low death rates, minimal intraoperative blood loss and fast rehabilitation of the patients. 72% of patients who have who have experienced surgical intervention, such as radical nephrectomy, spent only 3-4 days in the hospital.
PubMed, Oct 1, 2016
Aim - retrospective comparative analysis of results of laparoscopic partial nephrectomy (LPN) dep... more Aim - retrospective comparative analysis of results of laparoscopic partial nephrectomy (LPN) depending on the type of access and the size of the tumor. The study included 170 patients undergoing LPN during the period from 2010 to 2015 years. Among the patients was 108 males (63.5%) and 62 women (36.5%) ranging in age from 17 to 80 years (average age 56,6±0.9 years). Depending on the type of access and the size of the tumor patients divided into 4 subgroups-154 patients who performed transperitoneal LRP, 16 patients undergoing retroperitoneal partial nephrectomy, 117 patients with tumor less than 4 cm and 53 patients with tumor more than 4 cm. There were no fatalities in 170 patients undergoing LRN, 3 (1.8±1.0%) patients had conversion, two of which involved open partial nephrectomy and one case involved radical nephrectomy. The duration of the surgery ranged 50-250 min (115.4±2.3 min on average), while time of insufflation ranged 40-240 min (103.8±2.2 min on average). Average intraoperative blood loss constituted 120.6±6.3 ml (15-400 ml), average time of warm ischemia was 22.01±0.83 min. Different intraoperative complications were observed in 4 patients (2.4%), in the postoperative period in 25 patients (14.7±2.7%). Patients spent 2-16 days (average 4.11±0.16 days) in the hospital after surgery. LRP can perform as transperitoneal а retroperitoneal approaches. The large size of kidney tumour, are not a contraindication for laparoscopic organ-preserving surgery and can successfully performed in experienced hands and specialized centres.
Urologiâ, Mar 13, 2018
AIM To investigate the results of laparoscopic management of patients with ureterolithiasis, depe... more AIM To investigate the results of laparoscopic management of patients with ureterolithiasis, depending on the type of laparoscopic approach and location of the stone. MATERIALS AND METHODS This study is a retrospective analysis of 30 ureterolithiasis patients who underwent laparoscopic ureterolithotomy from 2010 to 2015. Patients were divided into four subgroups depending on the type of laparoscopic approach - transperitoneal (n=17) and retroperitoneal (n=13) and on location of stones - upper ureteral stone (n=20) and mid ureteral stone (n=10). The patients comprised 23 (76.7%) men and 7 (23.3%) women aged from 18 to 68 years (mean age 46.2+/-2.3 years). 15 patients had stones in the right and 15 in left ureters. The groups were comparable by sex, age, the severity of hydronephrosis, body mass index, duration of urolithiasis, comorbidities and previous surgeries (p>0.05). RESULTS There were no deaths, conversion to open surgery or intraoperative complications. The only statistically significant difference between transperitoneal and retroperitoneal approaches was the absence of postoperative complications (p<0.05). The duration of drainage and hospital stay was significantly shorter in patients with mid ureteral stone than in patients with upper ureteral stone (p<0.05). CONCLUSION Surgical management of patients with ureterolithiasis of various locations using laparoscopic ureterolithotomy by different approaches showed positive results of in all cases thus indicating high clinical effectiveness of this method.
International braz j urol : official journal of the Brazilian Society of Urology
To evaluate the importance of preoperative neutrophil lymphocyte ratio (NLR) predicting malignanc... more To evaluate the importance of preoperative neutrophil lymphocyte ratio (NLR) predicting malignancy in patients who undergo partial nephrectomy due to renal mass. Seventy nine patients who underwent open partial nephrectomy for renal masses were included in this retrospective study. In preoperative routine blood tests, renal ultrasonography and contrast-enhanced computed tomography were performed for all patients. Preoperative neutrophil lymphocyte ratio were compared in patients with clear cell renal cell carcinoma (Group1, 65 patients) and benign lesions (Group 2, 14 patients). The predictive ability of NLR was analyzed by ROC curves and Youden Index method was used to identify the cut-off value for NLR. The mean age of patients was 59.8±11.7 years in Group1 and 57.4±12.6 years in Group 2 (p=0.493). The mean tumor size was 3.8±1.2 cm in Group 1 and 3.3±1.0 cm in Group 2 (p=0.07). The median NLR was 2.48 (1.04) in Group 1 and 1.63 (0.96) in Group 2 (p<0.001). The area under a ROC...
Turkiye Klinikleri Geriatrics - Special Topics, 2018
The Journal of Urology, Apr 1, 2008
Only a few studies have investigated the association between the severity of Peyronie disease (PD... more Only a few studies have investigated the association between the severity of Peyronie disease (PD) and clinical parameters such as age and associated comorbidities. The aim of this study was to report the relationship between the degree of curvature of the penis and the clinical parameters among patients with PD. A total of 1001 patients with PD were evaluated retrospectively in terms of penile deformity, erectile status, and risk factors for systemic vascular diseases. The degree of curvature was assessed with a protractor during maximum erection in response to a combined injection and stimulation test and/or vacuum device. A modified Kelami classification was used to categorize penile deformities as follows: patients with deformities without curvature (notching, hourglass, and swan neck deformity, group 1), with mild curvature (≤ 30 degrees, group 2), with moderate curvature (31-60 degrees, group 3), or with severe curvature (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 60 degrees, group 4). Chi-square tests, 1-way analysis of variance, and univariate and multiple ordinal regression analyses were used for statistical analysis. Penile deformity without curvature was detected in 12.3% of the patients, whereas the curvature was less than 30 degrees in 39.5%, 30 to 60 degrees in 34.5%, and more than 60 degrees in 13.5% of the patients. Multiple ordinal regression analysis identified age (P = .013), side of deformity (P = .007), erectile dysfunction (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .0001), and diabetes mellitus (P = .001) as significant independent predictors of the severity of penile curvature. In conclusion, patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; age, side of deformity, erectile function, and diabetes were significantly associated with the degree of curvature.
Fertility and Sterility, Sep 1, 2009
Objective: To compare transrectal ultrasonography (TRUS) and TRUS-guided seminal vesicle aspirati... more Objective: To compare transrectal ultrasonography (TRUS) and TRUS-guided seminal vesicle aspiration in the diagnosis of ejaculatory duct obstruction (EDO). Design: A retrospective case-controlled study comparing the findings of TRUS and TRUS-guided seminal vesicle (SV) aspiration. Setting: Clinics of Urology and Radiology. Patient(s): Seventy patients with suspected EDO (complete in 10, partial in 60 patients) on clinical evaluation. Intervention(s): Each SV was punctured transrectally using a 20-gauge Chiba needle within 2 hours after ejaculation. Main outcome measure(s): In SV aspirates, greater than three sperm per high-power microscopic field was considered a positive result for EDO. Result(s): Fifty-five (78.6%) patients had evidence of EDO on diagnostic TRUS. However, obstruction on TRUS was confirmed in 49.1% (27 of 55) of the patients with SV aspiration. Higher sperm positivity rates were achieved in patients with SV dilation (11 of 13, 84.6%) and prostatic midline/ED cyst (12 of 16, 75.0%). Stepwise logistic regression analysis revealed that the incidence of SV dilation was significantly higher, whereas that of chronic inflammatory findings in the prostate was significantly lower in the positive SV aspirate group. Conclusion(s): TRUS alone is not a reliable tool for the diagnosis of EDO. For this reason, SVaspiration should be used as an adjunctive technique in patients with SV dilation or a prostatic midline/ED cyst to confirm the diagnosis before surgery. (Fertil Steril Ò 2009;92:964-70. Ó2009 by American Society for Reproductive Medicine.
Nature Reviews Disease Primers, Apr 13, 2017
Turkiye Klinikleri Urology - Special Topics, 2019
The Italian journal of urology and nephrology, Dec 1, 2010
Aim: The aim of this study was to investigate the significance of microscopic venous invasion (MV... more Aim: The aim of this study was to investigate the significance of microscopic venous invasion (MVI) as a prognostic factor for patients with renal cell carcinoma (RCC). Methods: The present study included 220 patients with non-metastatic RCC who underwent radical nephrectomy (RN). MVI was defined by the presence of a cancer cell in blood vessels based on microscopic examination of hematoxylin-eosin stained specimens. The impact of MVI on disease progression and survival after 37 (6-190) months of median follow-up and its correlation with known clinicopathological features were studied. Survival analyses using Kaplan-Meier and log-rank models for univariate comparisons and Cox proportional hazards model for multivariate analyses were performed. Results: MVI was found in 68 patients (30.8%), and of these, 26 (38.2%) developed a tumor recurrence and 16 (23.5%) died of cancer progression, whereas only 18 (11.8%) of the remaining 152 patients without MVI presented with disease-recurrence and 8 (5.3%) died of cancer. In the multivariate analysis, MVI (P=0.014) Fuhrman's grade (P=0.028), and sarcomatoid differentiation (SD) (P=0.01) were the factors predicted a decreased disease-free survival (DFS). Meanwhile, MVI (P=0.04) and SD (P=0.029) were also found to be predictor of cancer specific survival (CSS) with necrosis (P=0.037) in multivariate analysis. Conclusion: The present study showed that MVI is associated with the vast majority of the adverse pathological features related with RCC. Furthermore, it was found to be an independent clinical prognostic factor for DFS and CSS.
Journal of Clinical Oncology, Feb 20, 2018
586 Background: Targeted therapy (TT) is the first-line option for metastatic renal cell carcinom... more 586 Background: Targeted therapy (TT) is the first-line option for metastatic renal cell carcinoma (mRCC) however, it is not curative and associated with a high-cost and adverse events. Preliminary data suggests TT may be safely delayed in appropriately selected patient, however the utilization and impact of delayed TT has not been evaluated on larger-scale. Methods: The National Cancer Database (NCDB) was queried from 2006-2012 for patients with mRCC treated with cytoreductive nephrectomy and TT. Time to initiation of TT was defined as ‘early’ (within 2 months), ‘moderately delayed’ (2-4 months), and ‘delayed’ (4-6 months), and ‘late’ ( &amp;amp;gt; 6 months) based on time from diagnosis to initiation of therapy. Multivariable logistic regression was performed to determine factors associated with delayed TT. The impact time to initiation of TT on OS was estimated by Kaplan-Meier and Cox multivariable survival analysis. Results: For2,716 patients in the analysis, the median (interquartile range [IQR]) follow-up was 18.8 (9.1-32.9) months, and 71.8% of patients had died at last follow-up. The median (IQR) time from diagnosis to initiation of TT was 2.1 (1.3-3.23) months, with the longest delay being 20.1 months. 1,255 patients (46.2%) had early TT, 1,072 patients (39.5%) had moderately delayed TT, 284 patients (10.5%) had delayed TT, and 105 patients (3.9%) had late TT. Delay in TT was not found to be a predictor of mortality in multivariable analysis; early TT (reference), moderately delayed TT (HR 0.98, p = 0.74), delayed TT (HR 0.95, p = 0.51), and late TT (HR 0.86, p = 0.20). Time from diagnosis to initiation of TT and time from initiation of TT to patient death were not correlated after control for covariates ( r= 0.04, p = 0.08). Conclusions: Delay in initiation of TT for mRCC was not an independent predictor of worse OS. Although this study is subject to limitations of observation study design and selection bias, the results are consistent with the notion that in carefully selected patients, outcomes might not be compromised with initial observation. Prospective, randomized evaluation is warranted.
Turk Uroloji Dergisi, Sep 5, 2003
Turk Uroloji Dergisi, Jun 2, 2005
Journal of Investigative Surgery, 2021
Abstract Introduction We aimed to evaluate the impact of the resection technique (tumor enucleati... more Abstract Introduction We aimed to evaluate the impact of the resection technique (tumor enucleation (TE) or standard partial nephrectomy (SPN)) on trifecta outcomes in patients having undergone partial nephrectomy (PN). Materials and Methods We retrospectively analyzed the clinical and pathologic parameters in patients with localized renal cell carcinoma (pT1–2N0M0) who had undergone PN between January 2001–December 2018 at one of 15 different tertiary referral centers. Multivariable logistic regression analysis was applied to investigate independent predictors of trifecta failure, decreased postoperative renal functions (decreased estimated glomerular filtration rate (eGFR) > 10%), perioperative complications (Clavien–Dindo > 1), and positive surgical margins. Results A total of 1070 patients with a mean age 56.11 ± 11.88 years were included in our study. PN was performed with TE in 848 (79.25%) and SPN in 222 (20.75%) patients. Trifecta failure rate was 56.2% for TE and 64.4% for SPN (p = 0.028). On multivariable analysis, TE was associated with less trifecta failure (p = 0.025) and eGFR decrease >10% rates (p = 0.024). On the other hand, there was no statistically significant difference between TE and SPN according to positive surgical margins (p = 0.450) and complication > Clavien-Dindo grade 1 (p = 0.888) rates. The only independent predictive factor for complications > Clavien–Dindo 1 was the Charlson comorbidity index (CCI) (p = 0.001). Conclusion TE is associated with less trifecta failure than SPN. This result is mainly due to better preservation of renal function with TE.
Marmara Medical Journal, 2002
Lymphangiomas of the urinary tract are rare lesions and those of the penis are even rarer. Herein... more Lymphangiomas of the urinary tract are rare lesions and those of the penis are even rarer. Herein we report a case of cutaneous lymphangioma of glans penis in a 35-year-old man and its surgical treatment. Preoperative MRI imaging defined the mass on the glans as hemangioma but the histopathologic examination revealed cutaneous lymphangioma of glans penis. The lesion was successfully treated surgically. Key Words: Penis, Lymphangioma, Neodymium: Yag laser
Diagnostic and Interventional Radiology, 2018
rolithiasis is an important public health problem worldwide owing to its high prevalence and recu... more rolithiasis is an important public health problem worldwide owing to its high prevalence and recurrence rates as high as 50%. It is more common in men, and it affects nearly 5%-10% of the European and North American population, although it may be more prevalent in other regions of the world (1). Radiologic imaging techniques have an important role in the diagnosis, treatment, and follow-up of urolithiasis. Abdominal X-ray, intravenous pyelography (IVP), sonography, and computed tomography (CT) have long been used as the primary imaging modalities (2) .Thin-section unenhanced abdominal CT is regarded as the gold standard imaging modality for the diagnosis of urinary system calculi due to high specificity and sensitivity values (2). Nevertheless, there is a growing concern about radiation exposure and associated cancer risk with the use of CT examinations (3). Despite many advantages of CT in the diagnosis of calculi, it has some important limitations including repeated radiation exposure, increased sensitivity to radiation's harmful effects in pregnancy and childhood, relatively high cost, and limited availability (4). Ultrasonography (US), a widely available and reliable imaging modality, has some disadvantages in the diagnosis of urinary calculi due to certain factors such as obesity, intes-From the Departments of Radiology (A.
PubMed, Apr 1, 2016
Objective: Evaluation of retrospective results of treatment of patients with kidney cancer, who h... more Objective: Evaluation of retrospective results of treatment of patients with kidney cancer, who have undergone a laparoscopic or a retroperitoneoscopic radical nephrectomy. Materials and methods: We have conducted a retrospective analysis of 185 patients with kidney tumour, who have undergone a laparoscopic or a retroperitoneoscopic radical nephrectomy during 2010-2015. Amongst the participants there were 116 men (62.7%) and 69 women (37.3%) aged 29-86 (average age of 58.1 years). 150 patients (81.1%) have performed radical nephrectomy by transperitoneal access, while 30 patients (16.2%) experienced identical process through retroperitoneal access. 5 cases (2.7%) hybrid technique was utilized. 97 patients performed nephrectomy on the right side, 88 patients on the left side. 178 patients (96.2%) had a single kidney tumours, while 7 (3.8%) had multiple tumours ranging between 2-8. 15 patients, who experienced a laparoscopic radical nephrectomy, had a thrombus in kidney vein (level 1 under Mayo classification). 1 patient had a thrombus in vena cava (level 2). Results: Only one of the patients suffered a fatal outcome. 12 patients (6.5%) had a conversion. The duration of operation ranged between 50-215 minutes (average of 104.3 minutes), time of insufflation ranged between 36-205 minutes (average of 96.2 minutes). Average intraoperative blood loss constituted 147.8 ml. Patients spent 2-18 days (average 4.1 days) in the hospital after the surgery. Conclusion: There is an obvious advantage to utilizing a laparoscopic or a retroperitoneoscopic intervention in order to treat kidney cancer. The process constitutes minimal invasiveness, low death rates, minimal intraoperative blood loss and fast rehabilitation of the patients. 72% of patients who have who have experienced surgical intervention, such as radical nephrectomy, spent only 3-4 days in the hospital.
PubMed, Oct 1, 2016
Aim - retrospective comparative analysis of results of laparoscopic partial nephrectomy (LPN) dep... more Aim - retrospective comparative analysis of results of laparoscopic partial nephrectomy (LPN) depending on the type of access and the size of the tumor. The study included 170 patients undergoing LPN during the period from 2010 to 2015 years. Among the patients was 108 males (63.5%) and 62 women (36.5%) ranging in age from 17 to 80 years (average age 56,6±0.9 years). Depending on the type of access and the size of the tumor patients divided into 4 subgroups-154 patients who performed transperitoneal LRP, 16 patients undergoing retroperitoneal partial nephrectomy, 117 patients with tumor less than 4 cm and 53 patients with tumor more than 4 cm. There were no fatalities in 170 patients undergoing LRN, 3 (1.8±1.0%) patients had conversion, two of which involved open partial nephrectomy and one case involved radical nephrectomy. The duration of the surgery ranged 50-250 min (115.4±2.3 min on average), while time of insufflation ranged 40-240 min (103.8±2.2 min on average). Average intraoperative blood loss constituted 120.6±6.3 ml (15-400 ml), average time of warm ischemia was 22.01±0.83 min. Different intraoperative complications were observed in 4 patients (2.4%), in the postoperative period in 25 patients (14.7±2.7%). Patients spent 2-16 days (average 4.11±0.16 days) in the hospital after surgery. LRP can perform as transperitoneal а retroperitoneal approaches. The large size of kidney tumour, are not a contraindication for laparoscopic organ-preserving surgery and can successfully performed in experienced hands and specialized centres.
Urologiâ, Mar 13, 2018
AIM To investigate the results of laparoscopic management of patients with ureterolithiasis, depe... more AIM To investigate the results of laparoscopic management of patients with ureterolithiasis, depending on the type of laparoscopic approach and location of the stone. MATERIALS AND METHODS This study is a retrospective analysis of 30 ureterolithiasis patients who underwent laparoscopic ureterolithotomy from 2010 to 2015. Patients were divided into four subgroups depending on the type of laparoscopic approach - transperitoneal (n=17) and retroperitoneal (n=13) and on location of stones - upper ureteral stone (n=20) and mid ureteral stone (n=10). The patients comprised 23 (76.7%) men and 7 (23.3%) women aged from 18 to 68 years (mean age 46.2+/-2.3 years). 15 patients had stones in the right and 15 in left ureters. The groups were comparable by sex, age, the severity of hydronephrosis, body mass index, duration of urolithiasis, comorbidities and previous surgeries (p>0.05). RESULTS There were no deaths, conversion to open surgery or intraoperative complications. The only statistically significant difference between transperitoneal and retroperitoneal approaches was the absence of postoperative complications (p<0.05). The duration of drainage and hospital stay was significantly shorter in patients with mid ureteral stone than in patients with upper ureteral stone (p<0.05). CONCLUSION Surgical management of patients with ureterolithiasis of various locations using laparoscopic ureterolithotomy by different approaches showed positive results of in all cases thus indicating high clinical effectiveness of this method.
International braz j urol : official journal of the Brazilian Society of Urology
To evaluate the importance of preoperative neutrophil lymphocyte ratio (NLR) predicting malignanc... more To evaluate the importance of preoperative neutrophil lymphocyte ratio (NLR) predicting malignancy in patients who undergo partial nephrectomy due to renal mass. Seventy nine patients who underwent open partial nephrectomy for renal masses were included in this retrospective study. In preoperative routine blood tests, renal ultrasonography and contrast-enhanced computed tomography were performed for all patients. Preoperative neutrophil lymphocyte ratio were compared in patients with clear cell renal cell carcinoma (Group1, 65 patients) and benign lesions (Group 2, 14 patients). The predictive ability of NLR was analyzed by ROC curves and Youden Index method was used to identify the cut-off value for NLR. The mean age of patients was 59.8±11.7 years in Group1 and 57.4±12.6 years in Group 2 (p=0.493). The mean tumor size was 3.8±1.2 cm in Group 1 and 3.3±1.0 cm in Group 2 (p=0.07). The median NLR was 2.48 (1.04) in Group 1 and 1.63 (0.96) in Group 2 (p<0.001). The area under a ROC...
Turkiye Klinikleri Geriatrics - Special Topics, 2018
The Journal of Urology, Apr 1, 2008
Only a few studies have investigated the association between the severity of Peyronie disease (PD... more Only a few studies have investigated the association between the severity of Peyronie disease (PD) and clinical parameters such as age and associated comorbidities. The aim of this study was to report the relationship between the degree of curvature of the penis and the clinical parameters among patients with PD. A total of 1001 patients with PD were evaluated retrospectively in terms of penile deformity, erectile status, and risk factors for systemic vascular diseases. The degree of curvature was assessed with a protractor during maximum erection in response to a combined injection and stimulation test and/or vacuum device. A modified Kelami classification was used to categorize penile deformities as follows: patients with deformities without curvature (notching, hourglass, and swan neck deformity, group 1), with mild curvature (≤ 30 degrees, group 2), with moderate curvature (31-60 degrees, group 3), or with severe curvature (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 60 degrees, group 4). Chi-square tests, 1-way analysis of variance, and univariate and multiple ordinal regression analyses were used for statistical analysis. Penile deformity without curvature was detected in 12.3% of the patients, whereas the curvature was less than 30 degrees in 39.5%, 30 to 60 degrees in 34.5%, and more than 60 degrees in 13.5% of the patients. Multiple ordinal regression analysis identified age (P = .013), side of deformity (P = .007), erectile dysfunction (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .0001), and diabetes mellitus (P = .001) as significant independent predictors of the severity of penile curvature. In conclusion, patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; age, side of deformity, erectile function, and diabetes were significantly associated with the degree of curvature.
Fertility and Sterility, Sep 1, 2009
Objective: To compare transrectal ultrasonography (TRUS) and TRUS-guided seminal vesicle aspirati... more Objective: To compare transrectal ultrasonography (TRUS) and TRUS-guided seminal vesicle aspiration in the diagnosis of ejaculatory duct obstruction (EDO). Design: A retrospective case-controlled study comparing the findings of TRUS and TRUS-guided seminal vesicle (SV) aspiration. Setting: Clinics of Urology and Radiology. Patient(s): Seventy patients with suspected EDO (complete in 10, partial in 60 patients) on clinical evaluation. Intervention(s): Each SV was punctured transrectally using a 20-gauge Chiba needle within 2 hours after ejaculation. Main outcome measure(s): In SV aspirates, greater than three sperm per high-power microscopic field was considered a positive result for EDO. Result(s): Fifty-five (78.6%) patients had evidence of EDO on diagnostic TRUS. However, obstruction on TRUS was confirmed in 49.1% (27 of 55) of the patients with SV aspiration. Higher sperm positivity rates were achieved in patients with SV dilation (11 of 13, 84.6%) and prostatic midline/ED cyst (12 of 16, 75.0%). Stepwise logistic regression analysis revealed that the incidence of SV dilation was significantly higher, whereas that of chronic inflammatory findings in the prostate was significantly lower in the positive SV aspirate group. Conclusion(s): TRUS alone is not a reliable tool for the diagnosis of EDO. For this reason, SVaspiration should be used as an adjunctive technique in patients with SV dilation or a prostatic midline/ED cyst to confirm the diagnosis before surgery. (Fertil Steril Ò 2009;92:964-70. Ó2009 by American Society for Reproductive Medicine.
Nature Reviews Disease Primers, Apr 13, 2017
Turkiye Klinikleri Urology - Special Topics, 2019
The Italian journal of urology and nephrology, Dec 1, 2010
Aim: The aim of this study was to investigate the significance of microscopic venous invasion (MV... more Aim: The aim of this study was to investigate the significance of microscopic venous invasion (MVI) as a prognostic factor for patients with renal cell carcinoma (RCC). Methods: The present study included 220 patients with non-metastatic RCC who underwent radical nephrectomy (RN). MVI was defined by the presence of a cancer cell in blood vessels based on microscopic examination of hematoxylin-eosin stained specimens. The impact of MVI on disease progression and survival after 37 (6-190) months of median follow-up and its correlation with known clinicopathological features were studied. Survival analyses using Kaplan-Meier and log-rank models for univariate comparisons and Cox proportional hazards model for multivariate analyses were performed. Results: MVI was found in 68 patients (30.8%), and of these, 26 (38.2%) developed a tumor recurrence and 16 (23.5%) died of cancer progression, whereas only 18 (11.8%) of the remaining 152 patients without MVI presented with disease-recurrence and 8 (5.3%) died of cancer. In the multivariate analysis, MVI (P=0.014) Fuhrman's grade (P=0.028), and sarcomatoid differentiation (SD) (P=0.01) were the factors predicted a decreased disease-free survival (DFS). Meanwhile, MVI (P=0.04) and SD (P=0.029) were also found to be predictor of cancer specific survival (CSS) with necrosis (P=0.037) in multivariate analysis. Conclusion: The present study showed that MVI is associated with the vast majority of the adverse pathological features related with RCC. Furthermore, it was found to be an independent clinical prognostic factor for DFS and CSS.
Journal of Clinical Oncology, Feb 20, 2018
586 Background: Targeted therapy (TT) is the first-line option for metastatic renal cell carcinom... more 586 Background: Targeted therapy (TT) is the first-line option for metastatic renal cell carcinoma (mRCC) however, it is not curative and associated with a high-cost and adverse events. Preliminary data suggests TT may be safely delayed in appropriately selected patient, however the utilization and impact of delayed TT has not been evaluated on larger-scale. Methods: The National Cancer Database (NCDB) was queried from 2006-2012 for patients with mRCC treated with cytoreductive nephrectomy and TT. Time to initiation of TT was defined as ‘early’ (within 2 months), ‘moderately delayed’ (2-4 months), and ‘delayed’ (4-6 months), and ‘late’ ( &amp;amp;gt; 6 months) based on time from diagnosis to initiation of therapy. Multivariable logistic regression was performed to determine factors associated with delayed TT. The impact time to initiation of TT on OS was estimated by Kaplan-Meier and Cox multivariable survival analysis. Results: For2,716 patients in the analysis, the median (interquartile range [IQR]) follow-up was 18.8 (9.1-32.9) months, and 71.8% of patients had died at last follow-up. The median (IQR) time from diagnosis to initiation of TT was 2.1 (1.3-3.23) months, with the longest delay being 20.1 months. 1,255 patients (46.2%) had early TT, 1,072 patients (39.5%) had moderately delayed TT, 284 patients (10.5%) had delayed TT, and 105 patients (3.9%) had late TT. Delay in TT was not found to be a predictor of mortality in multivariable analysis; early TT (reference), moderately delayed TT (HR 0.98, p = 0.74), delayed TT (HR 0.95, p = 0.51), and late TT (HR 0.86, p = 0.20). Time from diagnosis to initiation of TT and time from initiation of TT to patient death were not correlated after control for covariates ( r= 0.04, p = 0.08). Conclusions: Delay in initiation of TT for mRCC was not an independent predictor of worse OS. Although this study is subject to limitations of observation study design and selection bias, the results are consistent with the notion that in carefully selected patients, outcomes might not be compromised with initial observation. Prospective, randomized evaluation is warranted.
Turk Uroloji Dergisi, Sep 5, 2003
Turk Uroloji Dergisi, Jun 2, 2005
Journal of Investigative Surgery, 2021
Abstract Introduction We aimed to evaluate the impact of the resection technique (tumor enucleati... more Abstract Introduction We aimed to evaluate the impact of the resection technique (tumor enucleation (TE) or standard partial nephrectomy (SPN)) on trifecta outcomes in patients having undergone partial nephrectomy (PN). Materials and Methods We retrospectively analyzed the clinical and pathologic parameters in patients with localized renal cell carcinoma (pT1–2N0M0) who had undergone PN between January 2001–December 2018 at one of 15 different tertiary referral centers. Multivariable logistic regression analysis was applied to investigate independent predictors of trifecta failure, decreased postoperative renal functions (decreased estimated glomerular filtration rate (eGFR) > 10%), perioperative complications (Clavien–Dindo > 1), and positive surgical margins. Results A total of 1070 patients with a mean age 56.11 ± 11.88 years were included in our study. PN was performed with TE in 848 (79.25%) and SPN in 222 (20.75%) patients. Trifecta failure rate was 56.2% for TE and 64.4% for SPN (p = 0.028). On multivariable analysis, TE was associated with less trifecta failure (p = 0.025) and eGFR decrease >10% rates (p = 0.024). On the other hand, there was no statistically significant difference between TE and SPN according to positive surgical margins (p = 0.450) and complication > Clavien-Dindo grade 1 (p = 0.888) rates. The only independent predictive factor for complications > Clavien–Dindo 1 was the Charlson comorbidity index (CCI) (p = 0.001). Conclusion TE is associated with less trifecta failure than SPN. This result is mainly due to better preservation of renal function with TE.
Marmara Medical Journal, 2002
Lymphangiomas of the urinary tract are rare lesions and those of the penis are even rarer. Herein... more Lymphangiomas of the urinary tract are rare lesions and those of the penis are even rarer. Herein we report a case of cutaneous lymphangioma of glans penis in a 35-year-old man and its surgical treatment. Preoperative MRI imaging defined the mass on the glans as hemangioma but the histopathologic examination revealed cutaneous lymphangioma of glans penis. The lesion was successfully treated surgically. Key Words: Penis, Lymphangioma, Neodymium: Yag laser
Diagnostic and Interventional Radiology, 2018
rolithiasis is an important public health problem worldwide owing to its high prevalence and recu... more rolithiasis is an important public health problem worldwide owing to its high prevalence and recurrence rates as high as 50%. It is more common in men, and it affects nearly 5%-10% of the European and North American population, although it may be more prevalent in other regions of the world (1). Radiologic imaging techniques have an important role in the diagnosis, treatment, and follow-up of urolithiasis. Abdominal X-ray, intravenous pyelography (IVP), sonography, and computed tomography (CT) have long been used as the primary imaging modalities (2) .Thin-section unenhanced abdominal CT is regarded as the gold standard imaging modality for the diagnosis of urinary system calculi due to high specificity and sensitivity values (2). Nevertheless, there is a growing concern about radiation exposure and associated cancer risk with the use of CT examinations (3). Despite many advantages of CT in the diagnosis of calculi, it has some important limitations including repeated radiation exposure, increased sensitivity to radiation's harmful effects in pregnancy and childhood, relatively high cost, and limited availability (4). Ultrasonography (US), a widely available and reliable imaging modality, has some disadvantages in the diagnosis of urinary calculi due to certain factors such as obesity, intes-From the Departments of Radiology (A.