Browsing by Author "Gul, Umit"

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A Case of Renal Hydatid Cyst Mimicking a Non-opaque Kidney Stone
(2018) Kayra, Mehmet Vehbi; Gul, Umit; 0000-0002-7349-9952; 0000-0003-3249-0895; AAK-8372-2021; AAK-8394-2021
Hydatid cyst is an endemic disease in several regions of the world. Renal involvement is rare. Association with kidney stones is even less likely. We report a case with isolated renal hydatid disease mimicking a non-opaque kidney stone.
Changing Aspects of Male Sexual Functions Accompanying Treatment of Benign Prostatic Hyperplasia With Silodosin 8 mg Per Day
(2020) Cihan, Ahmet; Kazaz, Ilike Onur; Yildirim, Omer; Deliktas, Hasan; Ongun, Sakir; Gul, Umit; Sahin, Bahadir; Ure, Iyimser; Ozkara, Hamdi; 0000-0003-3249-0895; 32217036; AAK-8394-2021
Background: Alpha-adrenergic antagonist treatment for benign prostatic hyperplasia (BPH) and drug-related sexual side effects are frequent in aging men. Aim: To investigate functional changes in erectile and ejaculatory aspects of male sexuality under Silodosin 8 mg per day treatment for BPH. Methods: Sexually active patients diagnosed with BPH and who initiated Silodosin treatment were the subjects of the study. The International Prostate Symptom Score, premature ejaculation patient profile (PEP-male) questionnaire, Sexual Health Inventory for Men (SHIM) questionnaire, and estimated intravaginal ejaculation latency time (IELT) values of the participants were used to evaluate sexual functions. Data evaluation was performed in 8 urology clinics retrospectively. Outcomes: Participant ratings for SHIM, PEP, and estimated IELT were the primary outcome measures in the study. Results: Among 187 recruited patients, data of 98 patients, who completed the trial period in the study, were eligible. The median age of the eligible participants who completed the trial period for 3 months was 59.5 years (range 45-82). 16 patients of 187 (8%) reported a desire for drug withdrawal for anejaculation during the recruitment period. 46 (46.9%) and 49 (50%) patients reported anejaculation in the first and third month of the treatment, respectively. De novo erectile dysfunction was noticed in 15 patients (15.3%). There was a significant increase in the estimated IELT of subjects in both the first (P = .01) and third ( P = .002) month. SHIM-1 (P = .008), SHIM-total (P = .009), and PEP scores (P = .008) were also improved in the third month of the treatment. Neither baseline patient characteristics nor changes in the International Prostate Symptom Score after treatment predicted final outcomes with multivariable analysis. The subgroup analysis of participants who reported "anejaculation" also revealed better outcomes compared with participants ejaculating naturally in the third month as per SHIM ratings. Clinical Implications: Despite several male patients having dry orgasms due to Silodosin-induced anejaculation, the majority experienced improved erectile function. Strengths & Limitations: The present study demonstrated pioneering results while investigating both erectile and ejaculatory dimensions of the male sexual function during Silodosin treatment for BPH. However, lack of partner evaluation, low follow-up rates, and lack of knowledge about reasons why subjects are lost to follow-up after drug initiation have limited our interpretation. Conclusion: Most patients using Silodosin 8 mg per day for BPH treatment experienced improvement in their erectile function, estimated IELT, and premature ejaculation profile in the third month of the treatment. Underlying mechanisms and reasons for individual differences necessitate further investigation. Copyright (C) 2020, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.
The Diagnosis and Treatment of Retroperitoneal Mass
(2015) Gul, Umit
Retroperitoneal masses are extremely rare. They may be primary malignant, benign or metastatic. The majority of them are malignant. Possible causes that may reveal the etiology of these masses have not been clarified yet. However some predisposing factors have been identified. These masses are classified according to their histological types. Clinical signs are presence of abdominal mass and abdominal pain. A multidisciplinary approach for diagnosis and treatment in high-volume referral centers is ideal. Retroperitoneal masses are treated surgically as much as possible. It is important to achieve negative surgical margins. Optimal treatment approaches have not been standardized as of today. Anthracycline chemotherapy which may be combined with radiotherapy forms the basis of therapy. Developments related to targeted therapies are particularly promising.
The Effect of Human Chorionic Gonadotropin Treatment Before Testicular Sperm Extraction in Non-Obstructive Azoospermia
(2016) Gul, Umit; Turunc, Tahsin
Aim: To investigate our experience on empirical hCG treatment of patients with idiopathic non-obstructive azoospermia (NOAT Material and Method: hCC group consisted of 34 patients who were empirically treated with hCG despite normal serum FSH and LH levels and normal testicular volumes. KG was administered as 2500 IU twice weekly subcutaneous injections for 10 to 14 weeks prior to testicular sperm extraction (TESE). Control group consisted of 49 age and spouse age matched patients who underwent TESE in the same time period. Sperm retrieval rate (SRR), and follicle stimulating hormone (FSH), lutenizing hormone (LH) and testosterone levels, volume of testicles, fertilization rate (FR), implantation rate (IR), pregnancy rate (PR), live birth rate (LBR) and cancel rate (CR) and surgical technique were compared between the two groups. Results: Conventional technique was used in 14 of the 17 patients (82.30/:) with successful sperm retrieval in the KG group, and 18 of the 28 patients (64,390) in the control group (p=0,170). There were no differences between groups in terms of SRR (p=0.338). There were no significant differences in patient age, mean infertility period, mean values of FSH. LH, testosterone, estradiol levels, and testis volume between the two groups (pa0.05). There were no statistically significant differences for FR, IR, PR. LBR between the tuvo groups (p>0.05). Discussion: Empirical hCG treatment in patients with idiopathic NOA did not result in improved SRR. hCG treatment did not have any effect on the success of ICSI.
Frequency of Poor Sleeping and Determinants of Sleep Quality Among Erectile Dysfunction Sufferers
(2022) Cihan, Ahmet; Baser, Aykut; Duran, Mesut B.; Yildirim, Omer; Kizilkan, Yalcin; Gul, Umit; Hasirci, Eray; Turunc, Tahsin; Cam, Halil, I; Sahin, Bahadir; Akkus, Kadir E.; 0000-0002-4147-2966; AAI-7997-2021
How do testosterone and prostate-specific antigen levels affect the prostate volume in patients with spinal cord injury?
(2019) Gul, Umit; 30762894
Inflammatory Myofibroblastic Tumor of the Prostate
(2016) Kocer, Nazim Emrah; Bal, Nebil; Gul, Umit; Aydin, Hakan
Inflammatory myofibroblastic tumors (IMT) of the prostate are very rare lesions that may mimic sarcomas and spindle carcinomas both clinically and histopathologically. The case presented here is a 63-year-old patient, with normal prostate specific antigen levels and a chronic history of complaints, who underwent to suprapubic prostatectomy due to the infravesical obstruction symptoms that are resistant to medical therapy. Histopathological examination of the excision material revealed a well demarcated spindle cell lesion with focal nuclear polymorphism, hyperchromasia, mononuclear inflammatory infiltration and myxoid areas. Mitosis was rare. Immunohistochemically smooth muscle actin and vimentin were positive, anaplastic lymphoma kinase-1 was focal positive, S-100 and pancytokeratin were negative. The lesion was diagnosed as an inflammatory pseudotumor. Differential diagnosis of the IMT from malignant spindle cell tumors of the prostate is crucial to prevent overtreatment.
Isolated Tuberculous Epididymoorchitis Developing After Allogeneic Haematopoietic Stem Cell Transplantation: A Case Report
(2017) Yeral, Mahmut; Demiroglu, Yusuf Ziya; Gul, Umit; Aytan, Pelin; 0000-0002-2553-7715; 0000-0003-3249-0895; 0000-0002-9866-2197; AAE-3833-2019; AAK-8394-2021; AAZ-9711-2021; ABC-4148-2020
We report a case of isolated tuberculous epididymoorchitis developing in a patient after haematopoietic stem cell transplantation (HSCT). Forty-four-year-old male was admitted to the hospital with scrotal pain and swelling 6 months after an allogeneic HSCT using a fullymatched sibling donor because of his acute myeloid leukemia. There were scrotal tenderness, thickening and erythema on the right side. Brucella standard tube agglutination test was negative. Increased scrotal skin thickening, edema in the right epididymis and increased testicular vascularization were detected on ultrasonography. He was readmitted to our hospital with recurrent scrotal pain after 3 months of partial improvement with oral ciprofloxacin administered for a diagnosis of right epididymoorchitis. Pelvic magnetic resonance imaging revealed bilateral epididymoorchitis and scrotal abscess. Acid fast bacilli were detected on Ehrlich-Ziehl-Neelsen staining of the content of abscesses drained under local anesthesia. Mycobacterium tuberculosis complex was isolated on the 24th day of quadruple anti-tuberculosis therapy. Scrotal fistula developed on the first month of therapy which healed spontaneously after discontinuation of immunosuppressive agents. Full recovery was achieved after six months of antituberculosis therapy. As a result, tuberculous epididymoorchitis should be kept in mind in the presence of chronic epididymoorchitis developing in patients receiving immunosuppressive therapy.
Prevalence of Poor Sleep Quality and Its Determinants Among Men Suffering from Erectile Dysfunction
(2023) Cihan, Ahmet; Kazaz, Ilke Onur; Duran, Mesut Berkan; Yildrim, Omer; Baser, Aykut; Gul, Umit; Hasirci, Eray; Kizilkan, Yalcin; Turunc, Tahsin; Cam, Halil Ibrahim; Sahin, Bahadir; Akkus, Kadir Emre; 0000-0002-4147-2966; AAI-7997-2021
Objective: Recent findings implicate a higher prevalence of erectile dysfunction (ED) among men with sleep disorders. We investigated sleep quality among men with ED. Materials and Methods: A prospective study was conducted at 12 different andrology outpatient clinics among men with complaints of insufficient erections. The subjective quality of sleep was measured using the Pittsburgh Sleep Quality Inventory. Erectile function and its dimensions were measured using the International Index of Erectile Function (IIEF) questionnaire. The age-adjusted Charlson comorbidity index and Beck Depression Inventory were used to evaluate interrelations with comorbid disease severity and depression of the subjects consecutively in the study. Results: Among 431 eligible men, the median age of the participants and their erectile function scores in the IIEF were 51 [interquartile range (IQR)=43-59] and 16 (IQR=11-19), respectively. Poor sleep was observed in 192 of 431 (44.5%) subjects. Multivariable analysis revealed that younger age [odds ratio (OR)=0.95, p=0.01], lower body mass (OR=0.86, p=0.01), lower serum high-density lipoprotein cholesterol (OR=0.95, p=0.02), and higher severity of depression (0R=2.1, p=0.0001) were predictors of poor sleep quality among men with ED. Conclusion: Nearly half of the men with ED also suffer from poor sleep. Younger age, lean body mass, and severe depression were the main predictors of poor sleep quality among ED sufferers.
Pseudotumoral Cystitis Cystica of the Bladder
(2015) Gul, Umit; Cystica, Cystitis
A Rare Complication of Brucellosis: Testicular Abscess
(2015) Gul, Umit; Demiroglu, Yusuf Ziya; Erbay, Gurcan; Kocer, Nazim Emrah
Brucellosis is a zoonosis caused by Brucella species. Brucella epididymo-orchitis had been reported in up to 20% of patients with brucellosis. This case was a male patient who developed Brucella epidiymo-orchitis and testicular abscess. He had fever, arthralgia and his right epididymis and right testicle were enlarged and tender. Ultrasound evaluation showed hypertrophy of the right epididymis and testis and moreover hypoechoic area within the testis. Brucella serology was positive and the patient did not respond completely to treatment with streptomycin, doxycycline, and rifampicina. Unilateral orchidectomy was decided. In areas where brucella infection is endemic brucella epididymo-orchitis should be considered in the differential diagnosis. Effective and rapid treatment is important. It should be noted that these patients may develop testicular abscess.
The relationship between premature ejaculation and the timing of pre-adult circumcision
(2021) Ongun, Sakir; Esen, Emre Cem; Ozer, Muhammed Selcuk; Yildirim, Omer; Hasirci, Eray; Sah, Cem; Sahin, Bahadir; Duran, Mesut Berkan; Cinar, Onder; Cihan, Ahmet; Kazaz, Ilke Onur; Gul, Umit; Deliktas, Hasan; Kizilkan, Yalcin; Altunkol, Adem; Kurt, Hasan Anil; Tosun, Cagatay; Bozkurt, Ozan; Turunc, Tahsin; Akkus, Emre; 0000-0002-4147-2966; 0000-0003-3249-0895; 33709439; AAI-7997-2021; AAK-8394-2021
We aimed to investigate the relationship between premature ejaculation and the age when men had been circumcised before adulthood. A total of 2,768 sexually active male patients aged between 18 and 65 years were included in this study. A multicentre study was conducted prospectively with the participation of 20 centres. A survey consisting of 12 questions prepared by the researchers, as well as the validated Turkish versions of the five-item Premature Ejaculation Diagnostic Tool, was administered to all participants. The study included 1,603 participants who met the inclusion criteria. There was no significant difference in the Premature Ejaculation Diagnostic Tool and self-reported ejaculation time between the participants who had been circumcised at different ages during childhood. Remembering circumcision experience with fear or anxiety did not increase the risk of sexual dysfunction compared to the participants who described their experience with happiness or with no particular emotion. There was no significant difference in Premature Ejaculation Diagnostic Tool scores or the self-reported ejaculation time of the participants circumcised at different ages. The age of childhood circumcision, having a fearful or anxious circumcision experience, does not affect the risk of premature ejaculation in adult life.
Risk Factors for Urothelial Cancers
(2016) Kuzgunbay, Baris; Gul, Umit; 0000-0003-3249-0895; AAK-8394-2021
Urothelial cancers affect renal pelvis and ureters in the upper urinary tract, however they affect bladder and urethra in the lower urinary tract. The rate of the urothelial carcinoma makes up 3% pf cancers in the world. Although urothelial cancer locations and frequencies show difference, their etiology are similar. Environmental factors are responsible for most urothelial cancer cases. Major risk factors are smoking and chemical carcinogens. Other important factors include radiotherapy, alcohol, coffee consumption, artificial sweeteners, arsenic exposure, schistomiasis, cronical cystitis, urolithiasis, analgesics, cyclophosphamide and genetic predisposition. Identification of these factors and avoiding them are important for the prevention of the disease. The evaluation and follow up of the whole urothelium is critical since the urothelial cancers are a kind of panurethelial diseases.
Variations in the Number of Patients Presenting With Andrological Problems During the Coronavirus Disease 2019 Pandemic and the Possible Reasons for These Variations: A Multicenter Study
(2021) Duran, Mesut Berkan; Yildirim, Omer; Kizilkan, Yalcin; Tosun, Cagatay; Cirakoglu, Abdullah; Gultekin, Mehmet Hamza; Gul, Umit; Altan, Mesut; Sah, Cem; Hasirci, Eray; Ceyhan, Erman; Ongun, Sakir; Turunc, Tahsin; 0000-0003-3249-0895; 0000-0002-4147-2966; 0000-0001-8223-6399; 33318798; AAK-8394-2021; AAI-7997-2021; ABI-2513-2020
Introduction: Coronavirus disease 2019 (COVID-19) pandemic caused unprecedented restrictions in outpatient services and surgical practices in urology as in other medical branches as well as in all areas of life. Aim: To investigate whether there have been variations in the presentations of male patients with sexual and reproductive health problems to the outpatient urology clinics during the COVID-19 pandemic and to understand the underlying factors for these variations, if any. Methods: Male patients aged >= 18 years who presented to the outpatient urology clinics in 12 centers across Turkey from February 1, 2020 to June 1, 2020 were retrospectively evaluated. The patients were divided into 2 groups: those who presented to the outpatient clinic from February 1, 2020 to March 11, 2020 comprised the "pre-COVID-19 pandemic period" group, whereas those who presented to the outpatient clinic from March 12, 2020 to June 1, 2020 comprised the "COVID-19 pandemic period" group and compared with each other. Main Outcome Measures: The main outcome of this study was the number and diagnose of patients presented to urology outpatient clinics. Results: Andrological problems were detected in 721 of 4,955 male patients included in the study. During the COVID-19 pandemic period, there was a significant increase in andrological diagnosis in these patients compared with the pre-COVID-19 pandemic period (n = 293 [17%] vs n = 428 [13.2%], P < .001, respectively). Similarly, there was a statistically significant increase in the number of patients diagnosed with male reproductive or sexual health problems during the COVID-19 pandemic period (n = 107 [6.2%] vs n = 149 [4.6%], P = .016 and n = 186 [10.8%] vs n = 279 [8.6%], P = .013, respectively). The number of patients diagnosed with erectile dysfunction during the pandemic was also significantly higher than the pre-COVID-19 pandemic period (n = 150 [8.7%] vs n = 214 [6.6%], P = .008). Conclusion: Presentations to the outpatient urology clinics owing to andrological problems markedly increased during the pandemic period. Although these problems are of multifactorial origin, psychogenic factors are also considered to significantly trigger these problems. Copyright (C) 2020, The Authors. Published by Elsevier Inc. on behalf of the International Society for Sexual Medicine.
Varicocelectomy in Patients with Non-obstructive Azoospermia
(2019) Ozer, Cevahir; Goren, Mehmet Rasit; Gul, Umit; Tunc, Tahsin; Guvel, Sezgin; 0000-0001-6037-7991; AAM-2222-2020
Objective: We evaluated the outcomes of varicocelectomy in men with non-obstructive azoospermia (NOA) and a palpable varicocele. Materials and Methods: We retrospectively evaluated 25 male patients with NOA having a palpable varicocele, between May 2006 and December 2018. Age, duration of infertility, testicular volume, grade and side of varicocele, varicocelectomy technique, and serum follicle-stimulating hormone, serum luteinizing hormone and serum testosterone levels were analyzed. Results: The mean age of the patients was 30.68 +/- 3.91 years. Of the 25 patients, 5 (20%) had motile sperm in the ejaculate in the postoperative semen analysis. There were no predictive factors affecting the appearance of the sperm in the ejaculate. Conclusion: Varicocelectomy should be considered a treatment option for men with NOA having a palpable varicocele.