Ekrem Güner - Academia.edu (original) (raw)

Papers by Ekrem Güner

European urology open science, Jul 1, 2020

Retroperitoneal liposarkom (RPLS), retroperitonda ortaya cikan yumusak doku sarkomlari arasinda e... more Retroperitoneal liposarkom (RPLS), retroperitonda ortaya cikan yumusak doku sarkomlari arasinda en yaygin olanidir. Bu tumorler retroperitonda semptom vermemesi sebebiyle tani aninda buyuk boyutlara erisirler. Primer RPLS’nin definitif tedavisi tumorun komplet cerrahi rezeksiyonudur fakat kritik anatomik organlara yakinligi sebebiyle tumorun komplet cerrahi rezeksiyonu zordur. Ayni zamanda yuksek rekurrens orani tedaviyi zorlastiran onemli bir faktordur. Biz bu olgu sunumunda 20×18×19 cm capinda RPLS vakasini sunuyoruz. Karinda sislik sikayetiyle basvuran 49 yasinda erkek hastada RPLS tespit edildi. Dalak, sol bobrek ve sol surrenal gland ile birlikte tumorun komplet cerrahi rezeksiyonu gerceklestirilmesine ragmen rekurrens gelisti. Biz, rekurren tumore de komplet cerahi rezeksiyon uyguladik. Hastanin 1 yillik takibinde rekurrens gelismedi.

The Journal of International Social Research, Apr 30, 2019

Journal of Urological Surgery, Dec 1, 2022

What's known on the subject? and What does the study add? The multidisciplinary evaluation is kno... more What's known on the subject? and What does the study add? The multidisciplinary evaluation is known be an essential component of today's medical practice. The urology department requires to be in communication with other surgical branches throughout the preoperative, intraoperative and postoperative periods due to the close neighboring of numerous organs and iatrogenic injuries. This is the first study in the literature to present a review of cases in which multidisciplinary surgeries were performed with the involvement of urology and other surgical specialties.

Actas urológicas españolas, Sep 1, 2020

Introduction and objectives: In recent years, the incidence of testicular cancer has increased, b... more Introduction and objectives: In recent years, the incidence of testicular cancer has increased, but mortality rates have decreased thanks to the improvements in treatment. Although primary tumor characteristics and serum tumor markers are associated with metastasis and relapse, their predictive value is not reliable. Therefore, there is a need for new biomarkers that predict prognosis. In this study, we aimed to investigate the role of preoperative albumin to globulin ratio (AGR) in predicting retroperitoneal lymph node (GLRP) involvement, distant metastasis and prognosis in testicular cancer. Material and methods: We retrospectively analyzed the medical records of all patients that underwent radical inguinal orchiectomy at our hospital between 2008 and 2018. AGR was calculated using the equation: AGR = serum albumin/(serum total protein-serum albumin). The predictive value of AGR for GLRP involvement and distant metastasis was evaluated using receiver operating characteristic analysis and its prognostic value was evaluated using Kaplan-Meier survival analysis. Results: A total of 115 patients with a mean age of 33.4 ± 7.7 years were included the study. In multivariate analysis, AGR less than 1.47 and the presence of lymphovascular invasion were detected as the factors predicting GLRP involvement and distant metastasis. The AGR of patients who had died was significantly lower than AGR of those who were alive, 1 ± 0.2 versus 1.6 ± 0.3 (P = .001). In Kaplan-Meier survival analysis, the mean survival of patients with higher AGR (>1.47) was found longer than patients with lower AGR (<1.47). Conclusions: Preoperative AGR is a biomarker that may be used in predicting GLRP involvement, distant metastasis and prognosis in testicular cancer.

Yeni Üroloji Dergisi

Objective: This study aimed to investigate the safety and effectiveness of open simple prostatect... more Objective: This study aimed to investigate the safety and effectiveness of open simple prostatectomy (OSP) in patients older than 80 (i.e., octogenarians). Materials and Methods: Patients who underwent OSP in our center between January 2012 and January 2018 constituted this study's target population. The patients were evaluated by dividing the entire cohort into three age groups: 50-64, 65-79, and ≥80. The study groups were compared regarding demographic features, preoperative clinical data, operative parameters, postoperative first-month and third-month uroflowmetric data, and short-term complication rates. Results: Preoperative persistent acute urinary retention and urethral catheterization rates were significantly higher in octogenarians than in the other patients. The groups were similar concerning intraoperative estimated blood loss, blood transfusion, Clavien-Dindo Class≥3 complication rates and the general complication rate statistically. The comparative analysis revealed...

The New Journal of Urology, Oct 1, 2018

Retroperitoneal liposarkom (RPLS), retroperitonda ortaya çıkan yumuşak doku sarkomları arasında e... more Retroperitoneal liposarkom (RPLS), retroperitonda ortaya çıkan yumuşak doku sarkomları arasında en yaygın olanıdır. Bu tümörler retroperitonda semptom vermemesi sebebiyle tanı anında büyük boyutlara erişirler. Primer RPLS'nin definitif tedavisi tümörün komplet cerrahi rezeksiyonudur fakat kritik anatomik organlara yakınlığı sebebiyle tümörün komplet cerrahi rezeksiyonu zordur. Aynı zamanda yüksek rekürrens oranı tedaviyi zorlaştıran önemli bir faktördür. Biz bu olgu sunumunda 20×18×19 cm çapında RPLS vakasını sunuyoruz. Karında şişlik şikayetiyle başvuran 49 yaşında erkek hastada RPLS tespit edildi. Dalak, sol böbrek ve sol sürrenal gland ile birlikte tümörün komplet cerrahi rezeksiyonu gerçekleştirilmesine rağmen rekürrens gelişti. Biz, rekürren tümöre de komplet cerahi rezeksiyon uyguladık. Hastanın 1 yıllık takibinde rekürrens gelişmedi.

Actas Urológicas Españolas (English Edition), 2022

OBJECTIVE To combine non-contrast computerized tomography (NCCT)-based parameters with stone and ... more OBJECTIVE To combine non-contrast computerized tomography (NCCT)-based parameters with stone and patient characteristics that are already known to affect shock wave lithotripsy (SWL) success and assess this novel model's effectiveness in predicting SWL success for single ureteral stones in different locations. MATERIALS AND METHODS Data of patients treated by SWL for a single ureteral stone between January 2017 and January 2019 were retrospectively reviewed. Demographic parameters of patients and stone characteristics were combined with NCCT-based parameters. NCCT-based parameters included the presence or absence of hydronephrosis, perinephric stranding, periureteral edema, diameter of the proximal ureter, ureteral wall thickness (UWT) at ureteral stone site. The logistic regression method was used for the development of a useful predictive model. Subsequently, the receiver operating curve was used to determine cut-off levels, and a scoring system was developed for prediction of SWL success. RESULTS Stone-free rate was 77,1% (267/346) in the entire cohort. Univariate analysis revealed that age, stone volume, density, perinephric stranding, diameter of proximal ureter, and UWT, were associated with SWL success. In multivariate analysis, proximal ureteral stone location, stone volume, density, and UWT were independent predictors of SWL success. The formula used during logistic regression analysis was: 1/[1 + exp {-8.856 + 0.008 (stone volume) + 0.002 (stone density) + 0.673 (UWT) + 1026 (proximal ureteral stone)}]. The scores of 0, 1, 2, 3 and 4 were associated with 97,8%, 83,4%, 60,8%, 33,2% and 11,1% success rates, respectively, in the prediction model based on these parameters. CONCLUSION We conclude that our model can facilitate decision-making for SWL treatment of ureteral stones in different locations.

Der Urologe, 2020

Im Polytheismus waren viele Bereiche des menschlichen Lebens Gottheiten zugeordnet. In dieser Epo... more Im Polytheismus waren viele Bereiche des menschlichen Lebens Gottheiten zugeordnet. In dieser Epoche entstand ein institutionalisiertes Modell, das v. a. unter dem Einfluss der griechischen Götterwelt stand. Die Menschen besuchten Tempel verschiedener Gottheiten, von denen sie annahmen, dass sie Heilung bringen könnten. Menschen, die eine Heilung für ihre Krankheit suchten, präsentierten verschiedene anatomische Votive, die die befallenen Organe zum Ausdruck brachten und die Aufmerksamkeit der Götter auf sich ziehen sollten (. Abb. 1a).

European Urology Supplements, 2018

Aktuelle Urologie, 2020

Objective There are a few studies in the literature investigating the effect of preoperative duta... more Objective There are a few studies in the literature investigating the effect of preoperative dutasteride use on bleeding in open simple prostatectomy. We aimed to evaluate the effect of preoperative dutasteride use on perioperative bleeding during open simple prostatectomy. Methods We retrospectively analyzed the medical records of all patients who underwent transvesical open prostatectomy due to benign prostatic hyperplasia in our institution between 2008 and 2018. Patients were divided into 2 groups regarding the use of dutasteride prior to surgery as group 1 = received dutasteride during at least six weeks prior to surgery; group 2 = dutasteride naive.Results: A total of 167 patients who met the inclusion criteria were included in the study. The mean operative time was 86.5±18.7 min while the estimated blood loss was 640.7±55.7 ml. There was no statistically significant difference in operative time, estimated blood loss, hemoglobin, and hematocrit decrease among the two groups. C...

British Journal of Urology, 1996

Objective To investigate the urodynamic variables of the patients with renal, upper and lower ure... more Objective To investigate the urodynamic variables of the patients with renal, upper and lower ureteric stones and compare the results according to the location of the stone.Patients and methods Pre‐operatively, 49 patients with kidney, upper and lower ureteric stones were evaluated to determine bladder capacity, compliance and urine volume at first sensation. Patients with urinary tract infection, neurogenic pathology and bladder outlet obstruction were excluded. The patients were divided into two groups; 20 patients with kidney and upper ureteric stones and 29 patients with lower ureteric stones.Results The mean bladder compliance, bladder capacity and volume at first sensation were all significantly lower in patients with lower ureteric stones (P=0.026, P=0.005 and P=0.042, respectively). These patients also had more prominent irritative symptoms, urgency and frequency. However, the mean values of bladder capacity, compliance and volume at first sensation were within normal limits...

Archivio italiano di urologia, andrologia : organo ufficiale [di] Società italiana di ecografia urologica e nefrologica / Associazione ricerche in urologia, 1997

Rapid advances in the basic understanding of the anatomy, physiology and pharmacology of penile e... more Rapid advances in the basic understanding of the anatomy, physiology and pharmacology of penile erection have drastically changed the clinical approach to patients with erectile dysfunction. To evaluate the value of microscopic architecture of the corpora cavernosa, we examined cavernous body biopsies taken during penile prosthesis implants. We studied on 12 impotent patients 25 to 67 years old who underwent implantation of a penile prosthesis. The biopsy was stained with H&E (Hematoxylin and Eosin) for general architecture, Masson Trichrome for collagen distribution and EVG for elastic fibers. Except 3 cases no pathological changes were determined at H&E staining. At collagen staining, roughly increased collagen distribution was determined in all cases. There were no appreciable differences in distribution of elastic fibers. In conclusion our data demonstrate that cavernous body biopsy is of limited value to determine etiologic factors in patients with erectile dysfunction.

International Urology and Nephrology, 1996

Urodynamic evaluation was done in 28 patients with various staged bladder turnouts. In 12 patient... more Urodynamic evaluation was done in 28 patients with various staged bladder turnouts. In 12 patients with superficial bladder tumours all urodynamic parameters were in normal range. Thirteen patients of 16 with invasive bladder tumours had low capacity of bladder and 5 of them also had involuntary contractions. In this study we suggest that urodynamic parameters in patients with bladder tumour became significantly abnormal when the first tumour invasion is seen at the muscular layer of the bladder (p<0.05); so compliance significantly decreased and the other pathological conditions were followed (p<0.05).

International Urology and Nephrology, 1997

A variety of indications have made the use of double J stents routine in urology. Minimal and mod... more A variety of indications have made the use of double J stents routine in urology. Minimal and moderate side effects of ureteral stent are common, when the indwelling time exceeds 6 weeks the incidence of severe complications, like fragmentation increase. We report a case of stent fragmentation after an indwelling period of 12 months. Despite the variety of complications the severity requires close monitorhag of the patient.

Actas Urológicas Españolas, 2020

Resumen Introduccion y objetivos La incidencia del cancer testicular ha aumentado en los ultimos ... more Resumen Introduccion y objetivos La incidencia del cancer testicular ha aumentado en los ultimos anos, pero gracias a las mejoras en el tratamiento las tasas de mortalidad han disminuido. Aunque las caracteristicas primarias del tumor y los marcadores tumorales sericos son relevantes en terminos de metastasis y recurrencia, su valor predictivo no es fiable. Por lo tanto, se requieren nuevos biomarcadores predictivos y pronosticos. El objetivo de nuestro estudio fue investigar el rol del valor preoperatorio de la relacion albumina/globulina (RAG) en la prediccion de la propagacion a los ganglios linfaticos retroperitoneales (GLRP) y la metastasis a distancia, asi como en el pronostico del cancer testicular. Material y metodos Analizamos retrospectivamente los expedientes medicos de todos los pacientes que recibieron orquiectomia inguinal radical en nuestro hospital entre 2007 y 2018. La RAG se calculo mediante la ecuacion: RAG = albumina serica / (proteina serica total − albumina serica). El valor predictivo de la RAG para la propagacion de los GLRP y la metastasis a distancia se evaluo mediante el analisis de las caracteristicas operativas del receptor y su valor pronostico se evaluo mediante el analisis de supervivencia de Kaplan-Meier. Resultados Un total de 115 pacientes fueron incluidos en el estudio, con una media de edad de 33,4 ± 7,7 anos. En el analisis multivariante se detectaron valores de la RAG inferiores a 1,47 y la presencia de invasion linfovascular como factores predictivos de la diseminacion a los GLRP y la metastasis a distancia. El valor de la RAG de los pacientes fallecidos era significativamente menor que el de la RAG de los que seguian vivos: 1 ± 0,2 vs. 1,6 ± 0,3 (p = 0,001). En el analisis de supervivencia de Kaplan-Meier el tiempo medio de supervivencia de los pacientes con mayor RAG (> 1,47) fue mayor que el de los pacientes con menor RAG ( Conclusiones El valor preoperatorio de la RAG puede usarse como biomarcador para predecir la propagacion a los GLRP y la metastasis a distancia y para el pronostico del cancer testicular.

Bakirkoy Tip Dergisi / Medical Journal of Bakirkoy

Objective: There is a need for additional predictive factors for the malignant/benign differentia... more Objective: There is a need for additional predictive factors for the malignant/benign differentiation to prevent overtreatment in intratesticular mass lesions with negative tumor markers. In this study, we evaluated the usability of systemic inflammatory markers, neutrophil-to-lymphocyte ratio (NLR), and tumor in the preoperative differentiation of benign and malignant intratesticular mass lesions. Methods: The records of patients who underwent radical inguinal orchiectomy with a preliminary diagnosis of testicular tumor between August 2007 and September 2020 were retrospectively reviewed. Patients with a malignant specimen histopathology result after radical orchiectomy were classified as group 1, and those with a benign pathology result were classified as group 2. The demographic data, tumor diameters, preoperative systemic inflammatory markers, and NLRs were statistically compared between the two groups. NLR was calculated by dividing the neutrophil count by the lymphocyte count. Results: The study included a total of 78 patients, of whom 47 (60.3%) were in group 1 and 31 (39.7%) were in group 2. The mean tumor sizes of groups 1 and 2 were 3.74±2.24 cm and 1.87±1.30 cm, respectively, being significantly higher in group 1 (p<0.001). For groups 1 and 2, the mean white blood cell (WBC) counts were determined as 8.60±2.23 and 7.54±2.02 µ/L, respectively; the mean neutrophil counts as 5.30±1.77 and 4.34±1.40 µ/L, respectively; the mean neutrophil ratios as 63.0±8.22 and 56.9±7.28%, respectively; the mean lymphocyte ratios as 26.2±6.69 and 31.9±6.05%, respectively; and the mean NLR values as 2.72±1.44 and 1.87±0.54, respectively. The mean WBC count, neutrophil count, neutrophil ratio, and NLR were significantly higher in group 1 (p=0.037, p=0.014, p<0.001, and p=0.002, respectively), and the mean lymphocyte ratio was significantly higher in group 2 (p<0.001). The analysis of the pathological results showed that malignancy correlated positively with tumor size, WBC count, neutrophil count, neutrophil ratio, and NLR, and a negative correlation with the lymphocyte ratio. Conclusion: Tumor diameter, WBC count, neutrophil count, neutrophil ratio, lymphocyte ratio, and NLR can be used as predictive factors in the differentiation of benign-malignant intratesticular masses with negative testicular cancer markers before radical orchiectomy to prevent overtreatment. While the increased values of tumor diameter, WCB count, neutrophil count, neutrophil ratio, and NLR correlate with the possibility of malignancy, a decreased lymphocyte ratio can be evaluated in favor of malignancy.

Actas Urológicas Españolas (English Edition)

OBJECTIVE To identify the preoperative and intraoperative factors that might cause systemic infla... more OBJECTIVE To identify the preoperative and intraoperative factors that might cause systemic inflammatory response syndrome (SIRS) after retrograde intrarenal surgery (RIRS), and to investigate the effect of time elapsed between the date of performing preoperative bladder urine culture (PBUC) and surgery date on postoperative SIRS. MATERIALS AND METHODS Four hundred sixty-seven patients who had RIRS between January 2013 and June 2020 constituted the target population of this study. PBUC were obtained from all patients before undergoing surgery. Postoperatively, patients were closely monitored for fever and other signs of SIRS. Univariate and multivariate logistic regression analysis were performed to reveal the predictive factors for SIRS after RIRS. RESULTS The entire study cohort consisted of 467 patients. The rate of SIRS was 5.6%. In univariate analysis, the rate of DM, recurrent urinary tract infection (UTI) history, surgical time, and stone burden were significant predictive factors for SIRS. In multivariate analysis, the rate of recurrent UTI history, surgical time and stone burden were observed to be statistically significant predictive factors. Time elapsed between the date of performing PBUC and surgery date was not different between the SIRS group and the normal group. CONCLUSION We conclude that the time between the date of performing PBUC and surgery date is not an influential factor for SIRS. Clarifying this issue with prospective studies may be useful, as endourologists frequently encounter this situation in daily practice.

Actas Urológicas Españolas, 2022