Browsing by Author "Goren, Mehmet Resit"

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Author response: Papillary RCC and oncocytoma: Longer follow-up reported
(2015) Ozer, Cevahir; Goren, Mehmet Resit; Egilmez, Tulga; Bal, Nebil; 26085864
Bilateral renal leiomyoma with 5 year follow-up: Case report
(2015) Goren, Mehmet Resit; Erbay, Gurcan; Ozer, Cevahir; Goren, Vinil; Bal, Nebil; 26664510
Renal leiomyomas are exceptionally rare benign tumours of the kidney. Although the renal leiomyomas usually do not metastasize, the differential diagnosis between renal leiomyomas and malign lesions (leiomyosarcoma or renal cell carcinoma) cannot be done by radiological examinations, but is possible by histological examination. Surgery is the preferred treatment. After surgery, the prognosis is excellent without recurrence. Although uterine leiomyomas can be multicentric, renal leiomyomas have been single lesions. We report an incidentally detected case of bilateral renal leiomyoma in a 50-year-old woman with a 5-year follow-up. We also review the literature and discuss clinical, radiological and histological features of renal leiomyomas.
Can We Predict the Outcome of Varicocelectomy Based on the Duration of Venous Reflux?
(2016) Goren, Mehmet Resit; Erbay, Gurcan; Ozer, Cevahir; Kayra, Mehmet Vehbi; Hasirci, Eray; https://orcid.org/0000-0002-2001-1386; https://orcid.org/0000-0002-1706-8680; https://orcid.org/0000-0001-6037-7991; https://orcid.org/0000-0002-7349-9952; https://orcid.org/0000-0002-4147-2966; 000373464600021; Y-6143-2019; AAK-5370-2021; AAK-8372-2021; AAI-7997-2021
OBJECTIVE To investigate the outcome of varicocelectomy based on the duration of venous reflux (DVR) of the pampiniform plexus veins. MATERIALS AND METHODS In total, 138 patients with clinically palpable varicoceles were evaluated for DVR with color Doppler ultrasonography from May 2009 to August 2014. The DVR was defined as the DVR of a varicocele in the supine position during the Valsalva maneuver. Patients with bilateral, recurrent, or subclinical varicoceles; hormonal imbalances involving follicle-stimulating hormone, luteinizing hormone, or total testosterone; azoospermia; and intraoperative or postoperative complications were excluded. Of the 138 patients, 76 met the inclusion criteria. All patients were treated with subinguinal microscopic varicocelectomy. Restoration of all three semen parameters (concentration, motility, and morphology) to normal values 6 months postoperatively was considered to indicate treatment success. The patients were divided into those with a DVR of <4.5 seconds (Group 1) and >= 4.5 seconds (Group 2). RESULTS The mean age of the patients was 29.39 (+/- 6.03) years. No statistically significant relationship was found between the success rate and varicocele grade. The cutoff DVR value was calculated as 4.5 seconds using a receiver operating characteristics curve according to patients who underwent successful treatment. The success rates of Groups 1 and 2 were 40.0% and 88.2%, respectively (P = .0001). CONCLUSION The results of this analysis indicate that a DVR of >= 4.5 seconds predicts better outcomes of varicocelectomy. (C) 2016 Elsevier Inc.
Catheterized Uroflowmetry as a Noninvasive Test for Detrusor Acontractility
(2014) Egilmez, Tulga; Goren, Mehmet Resit; https://orcid.org/0000-0001-5644-5672; https://orcid.org/0000-0002-2001-1386; 24642885; AAK-9166-2021; Y-6143-2019
Objective: To evaluate the efficacy of uroflowmetry performed through an indwelling catheter on the differential diagnosis of detrusor acontractility. Patients and Methods: 50 men aged between 51 and 85 years (mean 66 years) presenting to the outpatient urology department with indwelling catheters due to urinary retention were included in the study. In the supine position, 300 ml of saline was instilled into the bladder and the catheter was blocked; with the patient standing by the flowmeter, the catheter was opened, allowing the patient to void through the catheter. The evaluation continued with a cystometry and pressure-flow study (PFS). The patients were separated into two groups according to the results of the PFS-group 1 with positive detrusor pressure and group 2 with negative detrusor pressure (detrusor acontractility)-and the catheterized uroflow and PFS data were compared. Results: Statistical significance was seen between detrusor acontractility and peak flow rate (Q(max)) on catheterized uroflow when Q(max) <10 ml/s was taken as a threshold value (p = 0). Conclusion: A quick, noninvasive and inexpensive means of assessing lower urinary tract function would improve the management of men needing PFS. This study reveals that catheterized uroflow is a very easy and useful test if the question is whether the bladder is acontractile or not. (C) 2014 S. Karger AG, Basel
The Course of Renal Function After Radical Cystectomy with Ileal Conduit Diversion for Bladder Cancer
(2019) Oze, Cevahir; Goren, Mehmet Resit; Egilmez, Tulga; Kilinc, Ferhat; Guvel, Sezgin; 0000-0002-7850-6912; 0000-0002-2001-1386; 0000-0001-6037-7991; AAM-2222-2020; Y-6143-2019
Objective: We evaluated the course of the renal function and potential risk factors for renal deterioration in patients who had undergone radical cystectomy with ileal conduit diversion. Materials and Methods: A retrospective study evaluated 121 patients, including 114 male and 7 female who underwent radical cystectomy with ileal conduit diversion. Estimated glomerular filtration rate (eGFR) was calculated and postoperative changes in renal function were reviewed. The clinical variables influencing renal function were evaluated. Results: The median follow-up period was 35.6 months (range, 12.2 to 139.6 months). The mean eGFR was 78.37 +/- 27.58 mL/min/1.73 m(2) before surgery and 90.14 +/- 29.68 mL/min/1.73 m(2) at 5 years postoperatively. The comparison of preoperative eGFR and the last follow-up eGFR showed the no statistically significant difference (p=0.195). Statistical analysis showed that development of postoperative urinary tract obstruction and postoperative urinary tract infection were significant adverse factors (p=0.008, p=0.026, respectively). Conclusion: Thirty two patients (53.3%) developed renal deterioration during the follow-up period. Development of urinary tract obstruction and urinary tract infection in the postoperative period were found to be significant adverse factors affecting renal function.
Distribution and number of Cajal-like cells in testis tissue with azoospermia
(2017) Hasirci, Eray; Turunc, Tahsin; Bal, Nebil; Goren, Mehmet Resit; Celik, Huseyin; Kervancioglu, Enis; Dirim, Ayhan; Tekindal, Mustafa Agah; Ozkardes, Hakan; 0000-0002-7936-2172; 0000-0003-2898-485X; 0000-0002-2001-1386; 0000-0002-7277-449X; 0000-0002-4060-7048; 0000-0002-4147-2966; 0000-0003-3465-9092; 28359405; ABD-4332-2020; AAJ-5689-2021; Y-6143-2019; AAH-1052-2020; U-9270-2018; AAI-7997-2021; AAA-3033-2021; AAM-4475-2021
We investigated the number and distribution of Cajal-like cells in patients with azoospermia. A total of 99 patients with non-obstructive azoospermia were divided into subgroups [19 patientsin hypospermatogenesis group (S1), 40 patients in maturation arrest group (S2), 20 patients in a Sertoli cell-only syndrome (S3), and 20 patients in a testicular atrophy and fibrosis group (S4)], and 20 patients with obstructive azoospermia group (SO). Sections stained with a c-kit antibody were studied by light microscopy to determine the number and distribution of Cajal-like cells in peritubular and perivascular areas of testis. The number of Cajal-like cells were higher in all the non-obstructive groups than in the obstructive group (S0: 2.43 cells/mm(2), S1: 3.14 cells/mm(2), S2: 4.00 cells/mm(2), S3: 4.57 cells/mm(2), S4: 3.86 cells/mm(2)) but statistically significantly different (p < 0.05) in the S2 and S3 subgroups only. Distribution of Cajal-like cells were similar in all groups. The number and distribution of Cajal-like cells in non obstructive groups suggest that these cells may affect spermatogenesis. This cellular type can be responsible for the regulation of cellular motility or spermatogenesis. Electrophysiological and electron microscopic studies are needed to better define morphology and function of Cajal-like cells in the testis, especially totally the normal testis tissue. Copyright (C) 2017, Kaohsiung Medical University. Published by Elsevier Taiwan LLC.
Fever and Systemic Inflammatory Response Syndrome Seen After Percutaneous Nephrolithotomy: Review of 1290 Adult Patients
(2015) Egilmez, Tulga; Goren, Mehmet Resit
Aim: Although accepted as minimally invasive, percutaneous nephrolithotomy (PCNL) still poses a significant risk of complications. Recent studies suggest that the incidence of sepsis may be higher than previously reported. The systemic inflammatory response syndrome (SIRS) seen in the subset of patients with or without bacteremia, is a life threatening complication and the purpose of this study is to give an insight to the relation between a post-operative fever episode and the risk of developing SIRS. Material and Method: Medical files of 1646 adult patients to whom a PCNL operation was performed were reviewed. A total of 1290 patients fulfilled the needed criteria and were included in the study. Study variables were recorded from the medical files for statistical analysis. Results: Stone burden had a statistically significant correlation with SIRS (p<0.05) but not with fever. Comorbidities of the patients alone did not have a correlation with fever or SIRS. But ASA score 3 and 4 showed statistically significant correlations with SIRS (p<0.05). Majority of the 288 complications encountered were Clavian grade 2 and grade >= 2 complications were seen to increase the hospitalization period (p<0.05). Operation time >= 120 min. was the only operative variable that had correlation with both fever and SIRS (p<0.05). Blood loss >2 g/dl (Delta haemoglobin-Hb) and Clavian 5 complications had statistically significant correlations with fever. ASA score >= 3, operation time >120 min. Delta Hb > 2 gr/dl, stone size and Clavian 5 complications had statistically significant correlations with the development of SIRS. The incidence of a fever episode, which was seen in 181 patients (14%), to progress to SIRS, which leaded to death, was found to be 1.6%. Discussion: Postoperative fever has a low risk of progressing to a life threatening condition. But special attention should be given to patients that also have the other SIRS criteria; blood loss more than 2 g/dl and/or operation time more than 120 minutes. Although only encountered in a small subset of patients, multiple organ dysfunctions can develop leading to death.
Nocturnal Vaginal pH Monitoring: A Possible New Assessment Method for Female Sexual Function
(2023) Goren, Mehmet Resit; Ozer, Cevahir; Oguzulgen, Ibrahim; 0000-0002-2001-1386; 0000-0002-7850-6912; Y-6143-2019; AAM-2222-2020
Objective: The aim of this preliminary study was to investigate whether women have nocturnal vasocongestion episodes like men and whether nocturnal vaginal pH (NVpH) monitoring can be used for female sexual function assessment-like nocturnal penile tumescence and rigidity (NPTR) test in men. Materials and Methods: Twelve premenopausal volunteers were included in the study. All women were within sexually active age and had normal hormonal profiles. NVpH was performed in an ambulatory manner on the same day and phase of the menstrual cycle. Female sexual function index (FSFI) scores, lubrication scores, and clitoral artery peak systolic velocity (PSV) were recorded. The volunteers were grouped according to the number of elevated pH episodes (EPE). Results: Four women had four or more EPEs and constituted group 1. Eight women had 3 or less EPEs and constituted group 2. Group 2 had statistically significantly lower FSFI scores and clitoral artery PSV (p=0.001 and p=0.014, respectively). However, there was no statistically significant difference between the groups for lubrication scores and age. Conclusion: The results of this preliminary study suggested that women and men has the same nocturnal vasocongestion episodes and NVpH measurement in women might be considered as analogous to NPTR in men.
Papillary renal cell carcinoma within a renal oncocytoma: Case report of very rare coexistence
(2014) Ozer, Cevahir; Goren, Mehmet Resit; Egilmez, Tulga; Bal, Nebil; 25553171
Renal oncocytomas accounts for 3% to 9% of primary renal neoplasms. The coexistence of renal cell carcinoma (RCC) within the oncocytoma is extremely rare. We report the case of an asyptomatic 74-year-old man with papillary RCC within oncocytoma managed with left radical nephrectomy.
Predicting Surgical Outcome of Percutaneous Nephrolithotomy: Validation of the Guy's Stone Score and Nephrolithometric Nomogram in Terms of Success and Complications
(2015) Egilmez, Tulga; Goren, Mehmet Resit
This single institution retrospective study aims to validate the ability of Guy's stone score and the nephrolithometric nomogram to predict the success of PCNL and to assess the correlation of the scoring systems with the complications encountered. Material and Method: Medical files of 1646 adult patients to whom a PCNL operation was performed were reviewed. A total of 1325 patients fulfilled the needed criteria and were included in the study. Study variables were recorded from the medical files for statistical analysis. Results: Stone burden was the only pre-operative, operative and post-operative variable that had a statistically significant correlation both with success and also with the complications encountered (p< 0.05). Guy's stone score grade 1 and 2 were associated with success and grade 3 and 4 were associated with complications (p< 0.05). ASA score 3 and 4 were seen to be associated with complications (p< 0.05). Operation time > 120 minutes, presence of a staghorn stone, intra-and post-operative blood transfusion, duration of the nephrostomy catheter, Delta Hg more than 2 gr/dl and and positive post-operative urine/blood culture were the other associated variables related to the complications encountered (p< 0.05). ROC curve analysis performed to the nephrolithometric nomogram data showed that with a cut of value of 80.5% for success, the nomogram has a sensitivity of 71% and specificity of 74% (ROC AUC= 80%). The nomogram was further analyzed for an association between the complications encountered and showed that the association is not strong enough to predict a possible complication (ROC AUC= 67%). Discussion: This study shows that the nephrolithometric nomogram has a good predictive accuracy for success (AUC= 0.80) and the Guys's stone score has a good correlation both with success and with complications (p< 0.05) and can be used for pre-operative counseling and decision making.
Predictive Factors Affecting the Success of Nephrectomy for the Treatment of Nephrogenic Hypertension: Multicenter Study
(2021) Vuruskan, Ediz; Ercil, Hakan; Unal, Umut; Alma, Ergun; Anil, Hakan; Sumbul, Hilmi Erdem; Deniz, Mehmet Eflatun; Goren, Mehmet Resit; 33873196
Introduction: The aim of our study is to evaluate the predictive factors affecting the success of treatment with nephrectomy in patients with poorly functioning kidney and nephrogenic hypertension. Methods: Data for patients who underwent nephrectomy with a diagnosis of nephrogenic hypertension in 3 centers between May 2010 and January 2020 were analyzed. In the postoperative period, if the blood pressure (BP) was below 140/90 mm Hg without medical treatment, it was accepted as complete response; if the arterial BP was below 140/90 mm Hg with medical treatment or less medication, it was accepted as partial response; and if BP did not decrease to normal values, it was accepted as unresponsive. Demographic characteristics, duration of hypertension, preoperative and postoperative BP values, and presence of metabolic syndrome were statistically evaluated. Results: Our study consisted of 91 patients with a mean preoperative hypertension duration of 23.3 +/- 12.1 months. Among patients, 42 (46.2%) had complete response, 18 (19.8%) had partial response, and 31 (34.0%) had no response. Preoperative systolic and diastolic BP values were not effective on treatment success (p = 0.071, p = 0.973, respectively), but the increase in age and hypertension duration (p = 0.030 and p < 0.001, respectively) and the presence of metabolic syndrome (p = 0.002) significantly decreased the complete response rates. Conclusions: Preoperative hypertension duration, advanced age, and presence of metabolic syndrome are predictive factors affecting the response to treatment in patients who undergo nephrectomy due to nephrogenic hypertension.
A Rare Cause of the Rare Condition: Paratesticular Fibrous Pseudotumor
(2015) Goren, Mehmet Resit
Benign fibrous proliferations of the spermatic cord are uncommon and mostly arise from the paratesticular region. Although benign, they often clinically mimic malignancy and usually remain undiagnosed preoperatively. Here, we report a case of fibrous pseudotumor arising from the right spermatic cord encountered in a 26-year-old male who presented with a palpable right inguinal mass.
Retroperitoneal Schwannoma: A Case Report
(2017) Ozer, Cevahir; Goren, Mehmet Resit; Hasbay, Bermal; Erbay, Gurcan; 0000-0002-7850-6912; 0000-0002-2001-1386; 0000-0002-1706-8680; AAM-2222-2020; Y-6143-2019; AAK-5370-2021
Schwannomas are benign tumors originating from Schwann cells of the neural sheaths. Only 0.3% to 3% of the schwannomas are located the retroperitoneal space. Most schwannomas are asymptomatic and often found incidentally. The ideal treatment is complete surgical excision. Here, we report a case of a 49-year-old woman with retroperitoneal schwannoma.
Transurethral Resection of Ejaculatory Duct in Primary Infertile Men with Distal Ejaculatory Duct Obstruction
(2019) Ozer, Cevahir; Goren, Mehmet Resit; 0000-0001-6037-7991; 0000-0002-7850-6912; 0000-0002-2001-1386; AAM-2222-2020; Y-6143-2019
Objective: We evaluated the outcome of transurethral resection for the treatment of distal ejaculatory duct obstruction with primary infertile men. Materials and Methods: We retrospectively evaluated 23 primary infertile men, who had distal ejaculatory duct obstruction, between June 2006 and July 2018. All patients were treated by transurethral resection of the ejaculatory duct. Results: The mean age of the patients was 31.82 +/- 5.01 years. Preoperative and postoperative seminal parameters were compared. There was a statistically significant increase in ejaculate volume, sperm concentration, sperm motility and total motile sperm count. Conclusion: Transurethral resection of the ejaculatory duct improved sperm parameters in most of the primary infertile men with distal ejaculatory duct obstruction. Transurethral resection may also decrease the need for assisted reproduction methods and allow in-vitro fertilization/intracytoplasmic sperm injection with ejaculated sperm in some azoospermic patients.
Treatment of Moderate Sized Renal Pelvis Calculi: Stone Clearance Time Comparison of Extracorporeal Shock Wave Lithotripsy and Retrograde Intrarenal Surgery
(2016) Ercil, Hakan; Alma, Ergun; Bas, Okan; Sener, Nevzat Can; Vuruskan, Ediz; Kuyucu, Faruk; Unal, Umut; Goren, Mehmet Resit; Evliyaoglu, Yalcin; https://orcid.org/0000-0002-2001-1386; 26945652; Y-6143-2019
Purpose: To compare the stone clearance times in patients undergoing extracorporeal shock wave lithotripsy (SWL) or retrograde intrarenal surgery (RIRS) for single radiopaque renal pelvis stones 10-20 mm in size. The results of this study may guide urologists and patients and aid in selecting the optimal preoperative treatment. Materials and Methods: Between January 2013 and February 2015, we conducted a retrospective study and collected data from 333 patients treated with SWL (n = 172) or RIRS (n = 161). We included successfully treated patients with a single radiopaque renal pelvis stone 10-20 mm in size to calculate stone clearance times. Results: The average stone size for the SWL group was 14.62 +/- 2.58 mm and 14.91 +/- 2.92 mm for the RIRS group. The mean Hounsfield unit (HU) of the patients was 585.40 +/- 158.39 HU in the SWL group and 567.74 +/- 186.85 HU in the RIRS group. Following full fragmentation, the mean stone clearance time was 26.55 +/- 9.71 days in the SWL group and 11.59 +/- 7.01 days in the RIRS group (P <.001). Conclusion: One of the most overlooked parameters in urinary stone treatments is stone clearance. We believe this study will shed light for those who aim to conduct larger randomized prospective studies.
Ultrasound-Guided Shockwave Lithotripsy Reduces Radiation Exposure and Has Better Outcomes for Pediatric Cystine Stones
(2017) Goren, Mehmet Resit; Goren, Vinil; Ozer, Cevahir; https://orcid.org/0000-0002-2001-1386; https://orcid.org/0000-0001-6037-7991; 27160372; Y-6143-2019
Background/Aims/Objectives: To evaluate the outcomes and ionizing radiation (IR) exposure of children with cystine stones (CS) using different shockwave lithotripsy (SWL) guidance modalities. Methods: Data from pediatric patients with renal stones treated between January 2009 and August 2015 were retrospectively reviewed. Outcome results and IR exposure in patients undergoing fluoroscopy (FL)-guided SWL and ultrasonography (US)-guided SWL were compared. First-time stone formers and those treated with SWL and with complete follow-up data, including post-treatment stone analysis confirming CS were included. Results: Forty-four patients (16 girls and 28 boys) met the inclusion criteria. Results of SWL performed in 51 kidneys were analyzed. After the SWL, 41 (80.4%) of 51 kidneys were stone free, and 10 (19.6%) had clinically insignificant residual fragments (<= 3 mm) or unfragmented stones. The success rates differed between patients in Group-FL (60%) and Group- US (93.5%) (p = 0.008). Single-session success rates were higher, and prospects of retreatment were lower in Group-US ( p = 0.000 and p = 0.002, respectively). In addition, overall complications were significantly lower in Group-US ( p = 0.042). Overall IR exposure was higher in Group-FL ( p = 0.013). Conclusions: US-guided SWL is more effective for pediatric CS and should be considered a preferred treatment to reduce IR doses in children. (C) 2016 S. Karger AG, Basel
Use of Histogram Analysis in Diffusion-Weighted Magnetic Resonance Imaging for Differentiation of Renal Tumor Subgroups
(2021) Erbay, Gurcan; Goren, Mehmet Resit; Karadeli, Elif; Koc, Zafer; 0000-0002-0352-8818; 0000-0002-2001-1386; AAK-5399-2021; Y-6143-2019
Background: The histopathological differentiation of renal neoplasms can be challenging via imaging. Objectives: To evaluate differences in histogram parameters on apparent diffusion coefficient (ADC) maps and to investigate the efficacy of histogram analysis in differentiation of oncocytomas from malignant renal neoplasm (MRN) subgroups. Patients and Methods: In this cross-sectional, retrospective study, the texture parameters of diffusion-weighted magnetic resonance images (DW-MRI) were evaluated in 65 patients with renal tumors (nine cases of oncocytoma and 59 cases of MRN) for a Results: A total of 68 lesions from 50 male and 15 female patients, with a median age of 55.4 years, were examined in this study. There were significant differences in the mean, median, and peak ADC values, as well as ADC percentiles, between the oncocytoma and MRN subgroups. Regarding the histopathological features of the lesions, 9 (11.5%) cases of oncocytomas, 23 (29.5%) cases of clear cell renal carcinoma (ccRCC), 14 (17.9%) cases of papillary renal cell carcinoma (pRCC), 12 (15.4%) cases of chromophobe renal cell carcinoma (chRCC), and 10 (12.8%) other tumors (including four cases of transitional cell carcinoma, four cases of non-Hodgkin's lymphoma, and two cases of primitive neuroectodermal tumor) were identified. Significant differences were found in the mean and median ADC values between the oncocytoma, pRCC, chRCC, and other MRN subgroups. Moreover, significant differences were found in the mean and median ADC values between the ccRCC, pRCC, and chRCC subgroups. There were also significant differences in the percentiles of mean and median ADCs between oncocytomas and pRCC, chRCC, and other MRN subgroups. However, there were no significant differences in the mean and median ADCs (including the percentile histogram analysis) or the peak ADC between the oncocytoma and ccRCC groups. The mean, median, and percentile of ADC for renal masses were superior to kurtosis, skewness, and entropy. Conclusion: Although differentiation between ccRCC and oncocytoma was not possible by only measuring the mean, median, and peak ADC values, the histogram analysis of ADCs may improve differentiation between the MRN subgroups. Clearly, ADC cannot be used to differentiate between oncocytomas and MRNs.