Mustafa Kadihasanoglu - Academia.edu (original) (raw)

Papers by Mustafa Kadihasanoglu

Urology journal, 2015

PURPOSE The physiology and anatomy of pregnant women change during pregnancy. Pregnancy is an ana... more PURPOSE The physiology and anatomy of pregnant women change during pregnancy. Pregnancy is an anatomically and physiologically amended process experienced by women and as a result of these changes, sexual life of pregnant women alters during pregnancy. We aimed to compare sexual functions of pregnant and non-pregnant women. MATERIALS AND METHODS Sexually active 246 pregnant women were included into this cross-sectional controlled study. A total of 210 non-pregnant women were served as control. Both groups were compared in terms of age, gestational age, presence of urinary incontinence, body mass index, and obstetrical history. Sexual functions of the women were evaluated with Female Sexual Function Index (FSFI). Data were analyzed using chi-square, Mann-Whitney U, Fisher's Exact, Shapiro Wilk, Kruskal Wallis and Dunnett's tests where appropriate. The Pvalues < .05 were considered statistically significant. RESULTS Mean age in both groups were comparable (P = .053). Median...

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2017

OBJECTIVE To compare the effectiveness of laser lithotripsy (LL) and pneumatic lithotripters (PL)... more OBJECTIVE To compare the effectiveness of laser lithotripsy (LL) and pneumatic lithotripters (PL) in calcium oxalate (CaOx) and calcium phosphate (CaP) stones and assess whether these stone compositions affect the outcomes of LL and PL. STUDY DESIGN Comparative, descriptive study. PLACE AND DURATION OF STUDY Istanbul Training and Research Hospital, Turkey, from August 2010 to August 2015. METHODOLOGY A total of 114 patients underwent ureteroscopy using LL and PL. Fifty-eight (50.9%) had CaOx stones and 56 (49.1%) had CaP stones. The lithotripters were compared in stone composition groups, and stone compositions were compared in lithotripter groups. Patient characteristics, perioperative parameters, and postoperative complications were compared. RESULTS The baseline patient and stone characteristics were similar in all groups. The operation time of the PL and LL for the patients with CaP stones (68.75 ±32.88 and 44.48 ±34.37 minutes, respectively) was significantly shorter than the o...

Urology journal, 2020

PURPOSE The aim of the study was to evaluate the predictive value of nephrolithometric scoring sy... more PURPOSE The aim of the study was to evaluate the predictive value of nephrolithometric scoring systems used to predict the complexity of renal stones for the outcomes of retrograde intrarenal surgery (RIRS). MATERIALS AND METHODS A total of 81 patients who underwent RIRS for nephrolithiasis between January 2013 and October 2017 were reviewed in this retrospective study. Guy's Stone Score (GSS), the S.T.O.N.E., Clinical Research Office of the Endourologic Society (CROES), and Seoul National University Renal Stone Complexity (S-ReSC) nephrolithometry scores were assessed by same researcher for each patient from preoperative non-contrast enhanced computed tomography scans. These nephrolithometric scores, stone characteristics and complications were compared in patients with/without residual stone. RESULTS The median (IQR) age of patients (37 female/44 male) was 45 (20) years. The median (IQR) stone burden was 139.4 (125.4) mm2 and the mean Hounsfield unit (HU) value was 1034.46±239...

Urology journal, 2014

PURPOSE To evaluate the effect of stone localization on the success and complication rates of the... more PURPOSE To evaluate the effect of stone localization on the success and complication rates of the percutaneous nephrolithotomy (PNL) procedure. MATERIALS AND METHODS Five hundred seventy-eight PNL procedures that were performed in our clinic were retrospectively evaluated. The patients were divided into seven groups according to the localization of the renal stones as: group 1, patients having stones only in the upper calyx; group 2, patients having stones only in the pelvis; group 3, patients having stones only in the lower calyx; group 4, patients having partial staghorn stones; group 5, patients having multiple calyx stones; group 6, patients having stones in both the pelvis and lower calyx and group 7, patients having complete staghorn stones. The first three groups were defined as simple stones, and the other four groups were defined as complex stones. RESULTS The mean stone clearance rate was 77% in simple stones and 53% in complex stones (P = .005). The complication rate was ...

Urology journal, 2012

PURPOSE To revise the predictive factors for intra-operative complications of rigid ureteroscopy ... more PURPOSE To revise the predictive factors for intra-operative complications of rigid ureteroscopy in the treatment of ureteral calculi. MATERIALS AND METHODS During a 15-year period (1993 to 2008), a total of 1496 consecutive patients who had undergone 1660 ureteroscopy procedures were retrospectively reviewed. After exclusion of the cases for diagnostic purposes, diseases other than ureteral calculi, and repeated ureteroscopy procedures, 1189 patients were left as the study population. Those patients were then divided into two groups based on the presence of the complications: complication-positive (group 1, n = 57) and complication-negative (group 2, n = 1132). Both groups were statistically compared regarding patients' age and gender, stone surface area, lateralization and localization of the stone, impaction of the stone, type of the ureteroscope, necessity of ureteral orifice dilation, and use of a catheter during and after the procedure. Furthermore, the effect of leaving t...

Andrologia, 2021

In December 2019, China reported a group of pneumonia cases of unknown aetiology to the World Hea... more In December 2019, China reported a group of pneumonia cases of unknown aetiology to the World Health Organization (WHO). A novel beta-coronavirus was detected in samples taken from the patients' lower respiratory tract (Zhu et al., 2020). Due to the similarity of its genomic structure with severe acute respiratory syndrome coronavirus (SARS-CoV), it was named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Gralinski & Menachery, 2020). The highly contagious coronavirus disease 2019 (COVID-19) spread rapidly, causing a pandemic. SARS-CoV-2 infects host cells through angiotensin-converting enzyme 2 (ACE2) receptors (Bourgonje et al., 2020). In addition, transmembrane serine protease 2 (TMPRSS2) plays a major role in the entry of SARS-CoV-2 into the host cell. ACE2 and TMPRSS have been shown to be highly expressed in spermatogonia and Sertoli and Leydig cells (Wang & Xu, 2020). SARS-CoV-2 causes the downregulation of ACE2 expression after entering the host cell, resulting in excessive angiotensin production (Dijkman et al., 2012; Gurwitz, 2020). Overproduction of angiotensin leads to apoptosis by increasing reactive oxygen species (Aitken, 2021). In addition, excessive production of proinflammatory cytokines induced by SARS-CoV-2 infection may adversely affect spermatogenesis by increasing autoimmune response and leucocyte infiltration in the testis (Hedger

The Journal of Sexual Medicine, 2021

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

International braz j urol, 2019

Objective: We aimed to evaluate the results of laparoscopic pyeloplasty with concomitant pyelolit... more Objective: We aimed to evaluate the results of laparoscopic pyeloplasty with concomitant pyelolithotomy and compare results with a cohort of patients undergoing laparoscopic pyeloplasty without pyelolithotomy. Materials and Methods: We retrospectively reviewed records of 43 patients undergoing transperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty between December 2012 and July 2018 at our department. Eighteen patients (42%) underwent laparoscopic pyeloplasty with concomitant pyelolithotomy. The results of patients with renal stones were compared with 25 matched patients undergoing laparoscopic pyeloplasty without concomitant renal stones. Demographic data, operative and stone parameters were compared between the groups. Results: The groups were similar regarding to demographic characteristics. All operations were completed laparoscopically with no conversions to open surgery. In 3 cases without renal stones and 15 cases with renal stones, transposition of the ureter due to crossing vessels was performed. The mean stone size was 13±5.24 mm, and the median number of stones was 1 (1-18). The success of laparoscopic pyeloplasty with and without pyelolithotomy was 93.3% and 92.9%, respectively, as confi rmed by negative diuretic renogram at postoperative 3rd months. Overall stone-free rate after laparoscopic pyelolithotomy was 93.3%. Mean operative time was 222.6765.71 minutes vs. 219.11±75.63 minutes for the pyeloplasty with concomitant pyelolithotomy vs. pyeloplasty, respectively (p=0.88). Conclusions: Laparoscopic pyeloplasty with concomitant pyelolithotomy is a safe and effective intervention with associated good cosmetic results and high stone-free rates without signifi cant increase in operative time or complications.

Aktuelle Urologie, 2019

Introduction To evaluate the efficacy of tamsulosin and deflazacort in the spontaneous expulsion ... more Introduction To evaluate the efficacy of tamsulosin and deflazacort in the spontaneous expulsion of distal ureteral stones when applied in an independent or combined manner. Methods 134 patients with distal ureteral stones (4 – 10 mm) were included in tothe study. All patients were randomized into four groups: group 1 (n = 37) patients receiving tamsulosin (0.4 mg/day); group 2 (n = 26) patients receiving deflazacort (30 mg/day); group 3 (n = 37) patients receiving combined treatment (tamsulosin and deflazacort) with the same dosages; and group 4, control group cases (n = 34), receiving paracetamol on demand. Although deflazacort treatment was limited to 10 days due to the possible associated side effects, α-blocker and paracetamol lasted up to four weeks. Patients were followed up on a weekly basis and at the end of four weeks all groups were compared primarily with respect to the stone expulsion rates. Results No statistically significant difference was noted between all groups re...

Turkish journal of urology, 2017

To determine the predictive value of free and bioavailable testosterone levels on the detection o... more To determine the predictive value of free and bioavailable testosterone levels on the detection of high-grade prostate cancer proven by histopathological examination of transrectal prostate biopsy specimens. A total of 405 patients who underwent transrectal prostate biopsy due to high prostatic specific antigen (PSA) (>2.5 ng/mL) and/or abnormal findings at digital rectal examination were included in this study. Blood free and bioavailable testosterone levels were calculated by the formula recommended by International Society for the Study of the Aging Male (ISSAM). The patients were stratified according to the D'Amico classification based on PSA levels and histological outcomes of prostate biopsies as benign, low, intermediate and high-risk prostate cancer. Patients were also divided into five groups according to the percentage of cancerous cores. Prostate cancer was detected in 160 of 405 (39.5%) patients. Total, free and bioavailable testosterone levels did not differ sign...

Research and Reports in Urology, 2016

Background: Multiple endoscopic surgical options exist to treat benign prostatic hyperplasia (BPH... more Background: Multiple endoscopic surgical options exist to treat benign prostatic hyperplasia (BPH), including holmium laser enucleation of the prostate (HoLEP). HoLEP alleviates obstructive prostatic tissue via enucleation, both bluntly with a resectoscope and by cutting tissue with the holmium laser, and removal of adenoma via morcellation. This article reviews patient selection for HoLEP in order to optimize outcomes, costs, and patient satisfaction. Methods: A literature review of all studies on HoLEP was conducted. Studies that focused on outcomes in regard to patient and procedural factors were closely reviewed and discussed. Results: Various studies found that men with large or small prostates, on antithrombotic therapy, in urinary retention, with bladder hypocontractility, with prostate cancer, undergoing retreatment for BPH, or in need of concomitant surgery for bladder stones and other pathologies do well with HoLEP, as demonstrated by excellent functional and symptomatic outcomes as well as low complication rates. There is a 74-78% rate of retrograde ejaculation following HoLEP. Techniques to preserve ejaculatory function following enucleative techniques have not been able to demonstrate a significant improvement. Conclusion: Patient selection for HoLEP can include most men with bothersome BPH who have evidence of bladder outlet obstruction and are healthy enough to undergo surgery. The ability to safely perform concomitant surgery with HoLEP benefits the patient by sparing them an additional anesthetic and also decreases costs. Patients should be made aware of the risk of retrograde ejaculation following HoLEP and counseled on treatment alternatives if maintaining ejaculatory function is desired.

The Journal of Urology, 2016

control among Diabetics and those with the metabolic syndrome. It is not known, however, if uric ... more control among Diabetics and those with the metabolic syndrome. It is not known, however, if uric acid nephrolithiasis can also be a presenting sign of undiagnosed diabetes mellitus. In this multi-institutional pilot study, we seek to determine the prevalence of undiagnosed diabetes and pre-diabetes amongst uric acid stone formers. METHODS: Data from prospectively maintained clinical databases of stone formers were retrospectively acquired from 2008 onward by participating institutions. Patients forming 50% uric acid stones were identified and charts were assessed for a diagnosis of diabetes at the time of initial urologic encounter for stones. Those non-diabetic patients who underwent Hemoglobin A1c testing within 24 months form the study group. Patients were categorized as "Pre-diabetic" or "Diabetic" based upon an A1c value of 5.7-6.4 or >6.4 respectively. RESULTS: 78 Uric acid stone formers were identified, of which 45 were non-diabetic and 33 diabetic. 25 non-diabetic patients underwent Hemoglobin A1c testing within 24 months of their stone event, with a mean value of 7.4 months (0-19; 6.7 range; SD). Mean age was 60 years (37-84; 13.0), BMI was 31 kg/m 2 (25-45.7; 4.5) and A1c was 6.3%(4.6-14.3; 1.8). Of these patients, 14 (56%) were categorized as "Pre-diabetic" and 5 (20%) as "Diabetic" based upon A1c alone. Two patients in this subgroup had gout: one was "Pre-diabetic" and the other "Diabetic" by A1c. CONCLUSIONS: We identified a 76% rate of undiagnosed prediabetes and diabetes amongst a population of non-diabetic uric acid stone formers. Uric acid stone formation may be a harbinger of diabetes mellitus and further work is needed to determine if screening for diabetes is appropriate in this population. The passage of a uric acid stone may be a critical opportunity for intervention and diabetes prevention.

Istanbul Medical Journal, 2016

This new method not only avoids dilation, which may cause complications such as hemorrhage and pe... more This new method not only avoids dilation, which may cause complications such as hemorrhage and perforation, but also shortens operation and fluoroscopy times (14). Micropercutaneous Nephrolithotomy: First 66 Cases Experience Objective: To present the initial experience with micro-percutaneous nephrolithotomy (micro-PNL) in patients with kidney stones. Methods: Medical records of 66 patients with kidney stones who underwent micro-PNL between December 2012 and March 2015 were retrospectively reviewed. The demographic data; stone side, location and size; operation and fluoroscopy time; intraoperative and postoperative complications; preoperative and postoperative hemoglobin levels and hematocrit; and operation success of the patient were evaluated. Results: The mean age of the patients was 46.62±13.94 years, and their mean body mass index was 25.77±2.62 kg/m 2. The mean stone size was 186.7±34.23 mm 2. The mean operation and fluoroscopy times were 80.46±43.67 min and 10.78±7.14 min, respectively. The mean hemoglobin drop was 0.86 g/dL. Twenty-four intraoperative and 17 postoperative complications were observed. An overall success rate of 95% (including clinically insignificant residual fragments) was achieved. Conclusion: Micro-PNL is a feasible, safe, and effective minimally invasive treatment modality for patients with small kidney stones.

Istanbul Medical Journal, 2016

Erectile dysfunction (ED) is the second most common sexual dysfunction in men after premature eja... more Erectile dysfunction (ED) is the second most common sexual dysfunction in men after premature ejaculation (1) and is defined as "the inability of a man to have and/or maintain adequate penile erection for sexual intercourse for at least 6 months" (2). In a community-based study conducted by the Turkish Society of Andrology on the prevalence of ED, its prevalence was found to be 69.2% (33.2% as mild, 27.5% as moderate, and 8.5% as advanced ED) (3). According to the findings of the Massachusetts Male Aging Study (MMAS), which is accepted to be a reference as one of the most important international epidemiological studies, of male patients between the ages of 40 and 70 years, 17% had mild ED, 25% had moderate ED, and 10% had severe ED (4). Based on these findings, it is estimated that the number of ED patients will increase to approximately 322 million worldwide in 2015 (5). It has been demonstrated that frequent ED can seriously affect the quality of life of the spouse as well as the patient (4). In basic scientific and clinical studies conducted on the physiology and pathophysiology of erection, it has been revealed that ED is a vascular pathology associated with risk factors, such as cardiovascular diseases, hypertension, atherosclerosis, lipid disorders, smoking, diabetes mellitus, obesity, metabolic syndrome, and a sedentary lifestyle (2, 6). Apart from the abovementioned medical problems, iatrogenic factors, such as pelvic surgeries, particularly radical prostatectomy where even bilateral neuroprotective is applied, are also among the important factors that play a role in the occurrence of ED (7). Currently, lifestyle changes and primary and secondary care conservative therapies, including medical treatment choices applied orally or through intracavernous injection, are the first techniques performed for patients with ED. Phosphodiesterase type-5 inhibitors, intracavernous injections, intraurethral alprostadil, and vacuum devices can fail in approximately 80% of patients because they discontinue the treatment (8, 9). In such a situation or in ED patients, particularly in the case of ED with an organic origin, with no adequate response to the treatment, despite invasive and costly intervention, flexible or inflatable penile prosthesis implantation, which has been

European Journal of Hospital Pharmacy: Science and Practice, 2015

Objectives To investigate the effect of furosemide given before shock wave lithotripsy (SWL) in p... more Objectives To investigate the effect of furosemide given before shock wave lithotripsy (SWL) in patients with renal stones. Methods Two-hundred patients with renal stones measuring 6–20 mm in diameter were prospectively included in this study. The treatment group (n=100 patients) received 40 mg furosemide 30 min before SWL plus 1000 mL 0.9% sodium chloride, infused during the procedure. Standard SWL alone was used for the control group (n=100 patients). The effectiveness of SWL was compared between the two groups. Results No statistically significant difference was found between the groups in age, stone size, Hounsfield units, urinary pH, stone density, average number of sessions, average number of pulses or mean energy used. The stone-free rate was 69% in the control group and 71% in the treatment group (p=0.758). Conclusions Although it is an easy and safe application, no positive effects of furosemide and hydration were found.

European Urology Supplements, 2009

European Urology Supplements, 2009

European Urology Supplements, 2009

eau 9th central european meeting (cem) / european urology supplements 8 (2009) 657-702 in various... more eau 9th central european meeting (cem) / european urology supplements 8 (2009) 657-702 in various age groups, as well as the late outcome of the interventions. Material and Methods: A total of 120 operations were performed on 114 children (6 children underwent bilateral operations) between the 1 st of January 2000 and the 31 st of May 2006. The cause of obstruction was congenital pyeloureteral stenosis in 75, a crossing vessel in 45 cases. Patients were divided into three age groups (I: <1 year, II: 1-5 years, III: >5 years). Long term follow-up (more than 3 years) including abdominal ultrasonography, intravenous urography and radioisotopic examinations was performed. Results: The incidence of crossing vessel increased with age (Group I: 12%, Group II 43% Group III 53%). An Anderson-Hynes pyeloplasty was performed in 105 cases. Transection, transposition or hitch of the crossing vessel without pyeloplasty was sufficient in 7. Nephrectomy was done in eight children. Improvement in hydronephrosis and drainage occurred in 105 kidneys out of 112 (93.8%). Secondary nephrectomy or reoperation was required in 1 case, each. Transection of the lower pole artery did not result in significant loss of parenchyma according to follow-up investigations. Conclusions: Neonatally or postnatally diagnosed hydronephrosis is caused by pyeloureteral stenosis in the majority of cases. Therefore, a negative ultrasonography of the infant does not preclude the possibility of a childhood hydronephrosis due to crossing vessels. In older children more than 50% of all hydronephrosis are caused by crossing vessels. This should be considered when the surgical plan is devised. In our opinion, vascular surgery without pyeloplasty is appropriate only in selected cases. Crossing vessels often lead to so-called "intermittent hydronephrosis", therefore in case of recurrent pain control abdominal ultrasonography is required when symptoms appear.

European Urology Supplements, 2009

Urology journal, 2015

PURPOSE The physiology and anatomy of pregnant women change during pregnancy. Pregnancy is an ana... more PURPOSE The physiology and anatomy of pregnant women change during pregnancy. Pregnancy is an anatomically and physiologically amended process experienced by women and as a result of these changes, sexual life of pregnant women alters during pregnancy. We aimed to compare sexual functions of pregnant and non-pregnant women. MATERIALS AND METHODS Sexually active 246 pregnant women were included into this cross-sectional controlled study. A total of 210 non-pregnant women were served as control. Both groups were compared in terms of age, gestational age, presence of urinary incontinence, body mass index, and obstetrical history. Sexual functions of the women were evaluated with Female Sexual Function Index (FSFI). Data were analyzed using chi-square, Mann-Whitney U, Fisher's Exact, Shapiro Wilk, Kruskal Wallis and Dunnett's tests where appropriate. The Pvalues < .05 were considered statistically significant. RESULTS Mean age in both groups were comparable (P = .053). Median...

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2017

OBJECTIVE To compare the effectiveness of laser lithotripsy (LL) and pneumatic lithotripters (PL)... more OBJECTIVE To compare the effectiveness of laser lithotripsy (LL) and pneumatic lithotripters (PL) in calcium oxalate (CaOx) and calcium phosphate (CaP) stones and assess whether these stone compositions affect the outcomes of LL and PL. STUDY DESIGN Comparative, descriptive study. PLACE AND DURATION OF STUDY Istanbul Training and Research Hospital, Turkey, from August 2010 to August 2015. METHODOLOGY A total of 114 patients underwent ureteroscopy using LL and PL. Fifty-eight (50.9%) had CaOx stones and 56 (49.1%) had CaP stones. The lithotripters were compared in stone composition groups, and stone compositions were compared in lithotripter groups. Patient characteristics, perioperative parameters, and postoperative complications were compared. RESULTS The baseline patient and stone characteristics were similar in all groups. The operation time of the PL and LL for the patients with CaP stones (68.75 ±32.88 and 44.48 ±34.37 minutes, respectively) was significantly shorter than the o...

Urology journal, 2020

PURPOSE The aim of the study was to evaluate the predictive value of nephrolithometric scoring sy... more PURPOSE The aim of the study was to evaluate the predictive value of nephrolithometric scoring systems used to predict the complexity of renal stones for the outcomes of retrograde intrarenal surgery (RIRS). MATERIALS AND METHODS A total of 81 patients who underwent RIRS for nephrolithiasis between January 2013 and October 2017 were reviewed in this retrospective study. Guy's Stone Score (GSS), the S.T.O.N.E., Clinical Research Office of the Endourologic Society (CROES), and Seoul National University Renal Stone Complexity (S-ReSC) nephrolithometry scores were assessed by same researcher for each patient from preoperative non-contrast enhanced computed tomography scans. These nephrolithometric scores, stone characteristics and complications were compared in patients with/without residual stone. RESULTS The median (IQR) age of patients (37 female/44 male) was 45 (20) years. The median (IQR) stone burden was 139.4 (125.4) mm2 and the mean Hounsfield unit (HU) value was 1034.46±239...

Urology journal, 2014

PURPOSE To evaluate the effect of stone localization on the success and complication rates of the... more PURPOSE To evaluate the effect of stone localization on the success and complication rates of the percutaneous nephrolithotomy (PNL) procedure. MATERIALS AND METHODS Five hundred seventy-eight PNL procedures that were performed in our clinic were retrospectively evaluated. The patients were divided into seven groups according to the localization of the renal stones as: group 1, patients having stones only in the upper calyx; group 2, patients having stones only in the pelvis; group 3, patients having stones only in the lower calyx; group 4, patients having partial staghorn stones; group 5, patients having multiple calyx stones; group 6, patients having stones in both the pelvis and lower calyx and group 7, patients having complete staghorn stones. The first three groups were defined as simple stones, and the other four groups were defined as complex stones. RESULTS The mean stone clearance rate was 77% in simple stones and 53% in complex stones (P = .005). The complication rate was ...

Urology journal, 2012

PURPOSE To revise the predictive factors for intra-operative complications of rigid ureteroscopy ... more PURPOSE To revise the predictive factors for intra-operative complications of rigid ureteroscopy in the treatment of ureteral calculi. MATERIALS AND METHODS During a 15-year period (1993 to 2008), a total of 1496 consecutive patients who had undergone 1660 ureteroscopy procedures were retrospectively reviewed. After exclusion of the cases for diagnostic purposes, diseases other than ureteral calculi, and repeated ureteroscopy procedures, 1189 patients were left as the study population. Those patients were then divided into two groups based on the presence of the complications: complication-positive (group 1, n = 57) and complication-negative (group 2, n = 1132). Both groups were statistically compared regarding patients' age and gender, stone surface area, lateralization and localization of the stone, impaction of the stone, type of the ureteroscope, necessity of ureteral orifice dilation, and use of a catheter during and after the procedure. Furthermore, the effect of leaving t...

Andrologia, 2021

In December 2019, China reported a group of pneumonia cases of unknown aetiology to the World Hea... more In December 2019, China reported a group of pneumonia cases of unknown aetiology to the World Health Organization (WHO). A novel beta-coronavirus was detected in samples taken from the patients' lower respiratory tract (Zhu et al., 2020). Due to the similarity of its genomic structure with severe acute respiratory syndrome coronavirus (SARS-CoV), it was named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Gralinski & Menachery, 2020). The highly contagious coronavirus disease 2019 (COVID-19) spread rapidly, causing a pandemic. SARS-CoV-2 infects host cells through angiotensin-converting enzyme 2 (ACE2) receptors (Bourgonje et al., 2020). In addition, transmembrane serine protease 2 (TMPRSS2) plays a major role in the entry of SARS-CoV-2 into the host cell. ACE2 and TMPRSS have been shown to be highly expressed in spermatogonia and Sertoli and Leydig cells (Wang & Xu, 2020). SARS-CoV-2 causes the downregulation of ACE2 expression after entering the host cell, resulting in excessive angiotensin production (Dijkman et al., 2012; Gurwitz, 2020). Overproduction of angiotensin leads to apoptosis by increasing reactive oxygen species (Aitken, 2021). In addition, excessive production of proinflammatory cytokines induced by SARS-CoV-2 infection may adversely affect spermatogenesis by increasing autoimmune response and leucocyte infiltration in the testis (Hedger

The Journal of Sexual Medicine, 2021

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

International braz j urol, 2019

Objective: We aimed to evaluate the results of laparoscopic pyeloplasty with concomitant pyelolit... more Objective: We aimed to evaluate the results of laparoscopic pyeloplasty with concomitant pyelolithotomy and compare results with a cohort of patients undergoing laparoscopic pyeloplasty without pyelolithotomy. Materials and Methods: We retrospectively reviewed records of 43 patients undergoing transperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty between December 2012 and July 2018 at our department. Eighteen patients (42%) underwent laparoscopic pyeloplasty with concomitant pyelolithotomy. The results of patients with renal stones were compared with 25 matched patients undergoing laparoscopic pyeloplasty without concomitant renal stones. Demographic data, operative and stone parameters were compared between the groups. Results: The groups were similar regarding to demographic characteristics. All operations were completed laparoscopically with no conversions to open surgery. In 3 cases without renal stones and 15 cases with renal stones, transposition of the ureter due to crossing vessels was performed. The mean stone size was 13±5.24 mm, and the median number of stones was 1 (1-18). The success of laparoscopic pyeloplasty with and without pyelolithotomy was 93.3% and 92.9%, respectively, as confi rmed by negative diuretic renogram at postoperative 3rd months. Overall stone-free rate after laparoscopic pyelolithotomy was 93.3%. Mean operative time was 222.6765.71 minutes vs. 219.11±75.63 minutes for the pyeloplasty with concomitant pyelolithotomy vs. pyeloplasty, respectively (p=0.88). Conclusions: Laparoscopic pyeloplasty with concomitant pyelolithotomy is a safe and effective intervention with associated good cosmetic results and high stone-free rates without signifi cant increase in operative time or complications.

Aktuelle Urologie, 2019

Introduction To evaluate the efficacy of tamsulosin and deflazacort in the spontaneous expulsion ... more Introduction To evaluate the efficacy of tamsulosin and deflazacort in the spontaneous expulsion of distal ureteral stones when applied in an independent or combined manner. Methods 134 patients with distal ureteral stones (4 – 10 mm) were included in tothe study. All patients were randomized into four groups: group 1 (n = 37) patients receiving tamsulosin (0.4 mg/day); group 2 (n = 26) patients receiving deflazacort (30 mg/day); group 3 (n = 37) patients receiving combined treatment (tamsulosin and deflazacort) with the same dosages; and group 4, control group cases (n = 34), receiving paracetamol on demand. Although deflazacort treatment was limited to 10 days due to the possible associated side effects, α-blocker and paracetamol lasted up to four weeks. Patients were followed up on a weekly basis and at the end of four weeks all groups were compared primarily with respect to the stone expulsion rates. Results No statistically significant difference was noted between all groups re...

Turkish journal of urology, 2017

To determine the predictive value of free and bioavailable testosterone levels on the detection o... more To determine the predictive value of free and bioavailable testosterone levels on the detection of high-grade prostate cancer proven by histopathological examination of transrectal prostate biopsy specimens. A total of 405 patients who underwent transrectal prostate biopsy due to high prostatic specific antigen (PSA) (>2.5 ng/mL) and/or abnormal findings at digital rectal examination were included in this study. Blood free and bioavailable testosterone levels were calculated by the formula recommended by International Society for the Study of the Aging Male (ISSAM). The patients were stratified according to the D'Amico classification based on PSA levels and histological outcomes of prostate biopsies as benign, low, intermediate and high-risk prostate cancer. Patients were also divided into five groups according to the percentage of cancerous cores. Prostate cancer was detected in 160 of 405 (39.5%) patients. Total, free and bioavailable testosterone levels did not differ sign...

Research and Reports in Urology, 2016

Background: Multiple endoscopic surgical options exist to treat benign prostatic hyperplasia (BPH... more Background: Multiple endoscopic surgical options exist to treat benign prostatic hyperplasia (BPH), including holmium laser enucleation of the prostate (HoLEP). HoLEP alleviates obstructive prostatic tissue via enucleation, both bluntly with a resectoscope and by cutting tissue with the holmium laser, and removal of adenoma via morcellation. This article reviews patient selection for HoLEP in order to optimize outcomes, costs, and patient satisfaction. Methods: A literature review of all studies on HoLEP was conducted. Studies that focused on outcomes in regard to patient and procedural factors were closely reviewed and discussed. Results: Various studies found that men with large or small prostates, on antithrombotic therapy, in urinary retention, with bladder hypocontractility, with prostate cancer, undergoing retreatment for BPH, or in need of concomitant surgery for bladder stones and other pathologies do well with HoLEP, as demonstrated by excellent functional and symptomatic outcomes as well as low complication rates. There is a 74-78% rate of retrograde ejaculation following HoLEP. Techniques to preserve ejaculatory function following enucleative techniques have not been able to demonstrate a significant improvement. Conclusion: Patient selection for HoLEP can include most men with bothersome BPH who have evidence of bladder outlet obstruction and are healthy enough to undergo surgery. The ability to safely perform concomitant surgery with HoLEP benefits the patient by sparing them an additional anesthetic and also decreases costs. Patients should be made aware of the risk of retrograde ejaculation following HoLEP and counseled on treatment alternatives if maintaining ejaculatory function is desired.

The Journal of Urology, 2016

control among Diabetics and those with the metabolic syndrome. It is not known, however, if uric ... more control among Diabetics and those with the metabolic syndrome. It is not known, however, if uric acid nephrolithiasis can also be a presenting sign of undiagnosed diabetes mellitus. In this multi-institutional pilot study, we seek to determine the prevalence of undiagnosed diabetes and pre-diabetes amongst uric acid stone formers. METHODS: Data from prospectively maintained clinical databases of stone formers were retrospectively acquired from 2008 onward by participating institutions. Patients forming 50% uric acid stones were identified and charts were assessed for a diagnosis of diabetes at the time of initial urologic encounter for stones. Those non-diabetic patients who underwent Hemoglobin A1c testing within 24 months form the study group. Patients were categorized as "Pre-diabetic" or "Diabetic" based upon an A1c value of 5.7-6.4 or >6.4 respectively. RESULTS: 78 Uric acid stone formers were identified, of which 45 were non-diabetic and 33 diabetic. 25 non-diabetic patients underwent Hemoglobin A1c testing within 24 months of their stone event, with a mean value of 7.4 months (0-19; 6.7 range; SD). Mean age was 60 years (37-84; 13.0), BMI was 31 kg/m 2 (25-45.7; 4.5) and A1c was 6.3%(4.6-14.3; 1.8). Of these patients, 14 (56%) were categorized as "Pre-diabetic" and 5 (20%) as "Diabetic" based upon A1c alone. Two patients in this subgroup had gout: one was "Pre-diabetic" and the other "Diabetic" by A1c. CONCLUSIONS: We identified a 76% rate of undiagnosed prediabetes and diabetes amongst a population of non-diabetic uric acid stone formers. Uric acid stone formation may be a harbinger of diabetes mellitus and further work is needed to determine if screening for diabetes is appropriate in this population. The passage of a uric acid stone may be a critical opportunity for intervention and diabetes prevention.

Istanbul Medical Journal, 2016

This new method not only avoids dilation, which may cause complications such as hemorrhage and pe... more This new method not only avoids dilation, which may cause complications such as hemorrhage and perforation, but also shortens operation and fluoroscopy times (14). Micropercutaneous Nephrolithotomy: First 66 Cases Experience Objective: To present the initial experience with micro-percutaneous nephrolithotomy (micro-PNL) in patients with kidney stones. Methods: Medical records of 66 patients with kidney stones who underwent micro-PNL between December 2012 and March 2015 were retrospectively reviewed. The demographic data; stone side, location and size; operation and fluoroscopy time; intraoperative and postoperative complications; preoperative and postoperative hemoglobin levels and hematocrit; and operation success of the patient were evaluated. Results: The mean age of the patients was 46.62±13.94 years, and their mean body mass index was 25.77±2.62 kg/m 2. The mean stone size was 186.7±34.23 mm 2. The mean operation and fluoroscopy times were 80.46±43.67 min and 10.78±7.14 min, respectively. The mean hemoglobin drop was 0.86 g/dL. Twenty-four intraoperative and 17 postoperative complications were observed. An overall success rate of 95% (including clinically insignificant residual fragments) was achieved. Conclusion: Micro-PNL is a feasible, safe, and effective minimally invasive treatment modality for patients with small kidney stones.

Istanbul Medical Journal, 2016

Erectile dysfunction (ED) is the second most common sexual dysfunction in men after premature eja... more Erectile dysfunction (ED) is the second most common sexual dysfunction in men after premature ejaculation (1) and is defined as "the inability of a man to have and/or maintain adequate penile erection for sexual intercourse for at least 6 months" (2). In a community-based study conducted by the Turkish Society of Andrology on the prevalence of ED, its prevalence was found to be 69.2% (33.2% as mild, 27.5% as moderate, and 8.5% as advanced ED) (3). According to the findings of the Massachusetts Male Aging Study (MMAS), which is accepted to be a reference as one of the most important international epidemiological studies, of male patients between the ages of 40 and 70 years, 17% had mild ED, 25% had moderate ED, and 10% had severe ED (4). Based on these findings, it is estimated that the number of ED patients will increase to approximately 322 million worldwide in 2015 (5). It has been demonstrated that frequent ED can seriously affect the quality of life of the spouse as well as the patient (4). In basic scientific and clinical studies conducted on the physiology and pathophysiology of erection, it has been revealed that ED is a vascular pathology associated with risk factors, such as cardiovascular diseases, hypertension, atherosclerosis, lipid disorders, smoking, diabetes mellitus, obesity, metabolic syndrome, and a sedentary lifestyle (2, 6). Apart from the abovementioned medical problems, iatrogenic factors, such as pelvic surgeries, particularly radical prostatectomy where even bilateral neuroprotective is applied, are also among the important factors that play a role in the occurrence of ED (7). Currently, lifestyle changes and primary and secondary care conservative therapies, including medical treatment choices applied orally or through intracavernous injection, are the first techniques performed for patients with ED. Phosphodiesterase type-5 inhibitors, intracavernous injections, intraurethral alprostadil, and vacuum devices can fail in approximately 80% of patients because they discontinue the treatment (8, 9). In such a situation or in ED patients, particularly in the case of ED with an organic origin, with no adequate response to the treatment, despite invasive and costly intervention, flexible or inflatable penile prosthesis implantation, which has been

European Journal of Hospital Pharmacy: Science and Practice, 2015

Objectives To investigate the effect of furosemide given before shock wave lithotripsy (SWL) in p... more Objectives To investigate the effect of furosemide given before shock wave lithotripsy (SWL) in patients with renal stones. Methods Two-hundred patients with renal stones measuring 6–20 mm in diameter were prospectively included in this study. The treatment group (n=100 patients) received 40 mg furosemide 30 min before SWL plus 1000 mL 0.9% sodium chloride, infused during the procedure. Standard SWL alone was used for the control group (n=100 patients). The effectiveness of SWL was compared between the two groups. Results No statistically significant difference was found between the groups in age, stone size, Hounsfield units, urinary pH, stone density, average number of sessions, average number of pulses or mean energy used. The stone-free rate was 69% in the control group and 71% in the treatment group (p=0.758). Conclusions Although it is an easy and safe application, no positive effects of furosemide and hydration were found.

European Urology Supplements, 2009

European Urology Supplements, 2009

European Urology Supplements, 2009

eau 9th central european meeting (cem) / european urology supplements 8 (2009) 657-702 in various... more eau 9th central european meeting (cem) / european urology supplements 8 (2009) 657-702 in various age groups, as well as the late outcome of the interventions. Material and Methods: A total of 120 operations were performed on 114 children (6 children underwent bilateral operations) between the 1 st of January 2000 and the 31 st of May 2006. The cause of obstruction was congenital pyeloureteral stenosis in 75, a crossing vessel in 45 cases. Patients were divided into three age groups (I: <1 year, II: 1-5 years, III: >5 years). Long term follow-up (more than 3 years) including abdominal ultrasonography, intravenous urography and radioisotopic examinations was performed. Results: The incidence of crossing vessel increased with age (Group I: 12%, Group II 43% Group III 53%). An Anderson-Hynes pyeloplasty was performed in 105 cases. Transection, transposition or hitch of the crossing vessel without pyeloplasty was sufficient in 7. Nephrectomy was done in eight children. Improvement in hydronephrosis and drainage occurred in 105 kidneys out of 112 (93.8%). Secondary nephrectomy or reoperation was required in 1 case, each. Transection of the lower pole artery did not result in significant loss of parenchyma according to follow-up investigations. Conclusions: Neonatally or postnatally diagnosed hydronephrosis is caused by pyeloureteral stenosis in the majority of cases. Therefore, a negative ultrasonography of the infant does not preclude the possibility of a childhood hydronephrosis due to crossing vessels. In older children more than 50% of all hydronephrosis are caused by crossing vessels. This should be considered when the surgical plan is devised. In our opinion, vascular surgery without pyeloplasty is appropriate only in selected cases. Crossing vessels often lead to so-called "intermittent hydronephrosis", therefore in case of recurrent pain control abdominal ultrasonography is required when symptoms appear.

European Urology Supplements, 2009