Browsing by Author "Hasirci, Eray"

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Adrenal Myelolipoma: A Case Presentation
(2018) Kervancioglu, Enis; Hasirci, Eray; Dirim, Ayhan; Aygun, Yuksel Cem; 0000-0002-6232-4313; 0000-0002-4147-2966; 0000-0003-3465-9092; AAM-3015-2021; AAI-7997-2021; AAM-4475-2021
Adrenal myelolipomas are non-functional benign tumors of hematopoietic and mature adipose tissue. Adrenal myelolipomas, which are generally detected in post-mortem examinations, have become more detectable thanks to evolution and frequent use of imaging techniques. This presentation elaborates on a case of 35-year old male patient presenting with no complaint but diagnosed with adrenal myelolipoma in histopathological examination following surrenalectomy operation for an adrenal mass incidentally detected on ultrasonography and computed tomography work-up.
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.
Complications and specimen quality in transrectal ultrasound guided prostate biopsy: Comparison of 16G and 18G needles
(2020) Bayraktar, Ahmet Murat; Olcucuoglu, Erkan; Hasirci, Eray; Nalbant, Ismail; Yesil, Suleyman; 0000-0002-4147-2966; AAI-7997-2021
Objectives: To evaluate specimen quality, pathological results, complications and pain in transrectal ultrasound (TRUS) guided prostate biopsy using 16 gauge (G) or 18G biopsy needles Design: Retrospective study Setting: Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey Subjects: Retrospective analysis of 243 TRUS guided prostate biopsies between March 2011 and April 2016 Interventions: Group 1 (n=121) underwent TRUS guided prostate biopsy using a 16 G needle and Group 2 (n=122) underwent TRUS guided prostate biopsy with an 18 G-needle. Main outcome measures: We compared two biopsy needle sizes (16G vs 18G) in relation to sample quality, prostate cancer detection rate, pain, bleeding and infection rates in 243 patients. Core fragmentation and short specimen length (<10mm) rate were the sample quality criteria. Pain was evaluated using visual analog scale (VAS). Results: There were no statistically significant differences in mean patient ages, prostate-specific antigen values and prostate volumes between groups 1 and 2. Sixteen gauge needles caused significantly less fragmentation of the biopsy cores when compared to 18G needles (p=0.00), but no statistically significant difference between two groups was recorded for pathological results (p=0.72) and shorter specimen length (p=0.567). Haematuria, rectal bleeding and infection were similar in both groups. Mean VAS score of group 1 was significantly greater than that of group 2 (3.19 vs 2.66;p=0.027). Conclusion: Though thicker needles provided better sampling quality, the cancer detection rate was not altered by the needle size. Also, even though complication rates were similar for different needle sizes, the 18G needles were better tolerated.
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.
Does Bipolar Transuretral Resection of Prostate Increase the Incidence of Urethral Stricture?
(2021) Hasirci, Eray; Kervancioglu, Enis; Ozkardes, Hakan; 0000-0002-4147-2966; 0000-0003-3465-9092; AAI-7997-2021; AAM-4475-2021
Objective: Transurethral resection of the prostate (TURP) remains the gold standard surgical method for patients with benign prostate obstruction. The aim of this study was to compare the efficacy and complication rates of bipolar TURP applied with saline and monopolar TURP applied with glycine, performed by the same surgeon. Design: Retrospective study Setting: Department of Urology, Baskent University, Ankara, Turkey Subjects: Ninety-two patients who were scheduled for monopolar and bipolar TURP Intervention: All the surgical procedures were applied under spinal anesthesia and the procedure was done by the same surgeon. The cases were compared in respect of the time of the procedure, the amount of resected tissue, the speed of resection, length of hospital stay, irrigation duration, changes in serum haemoglobin, changes in maximum flow rate, changes in amount of post-voiding residual urine and complications. Main Outcome Measure: Urethral stricture Results: The operating time was longer in the bipolar group and associated with that, the resection speed was lower. Urethral stricture was found to be greater in the bipolar group (11 cases of the 58 bipolar TURP patients (18.96%) and in 2 cases of the 34 monopolar TURP patient (5.88%), P=.045). Conclusions: Bipolar TURP is as effective a technique as conventional TURP. However, urethral strictures significantly exist in bipolar group, even if it was done by the same surgeon.
Does the sexual function of the spouses change after the TOT procedure?
(2021) Turgut, Hasan; Hasirci, Eray; https://orcid.org/0000-0002-4147-2966; 33386954; AAI-7997-2021
Aim This prospective study aimed to evaluate sexual function in women who underwent transobturator tape (TOT) sling surgery and their male sexual partners compared to before the procedure. Materials and methods The study included a total of 202 women with stress urinary incontinence who underwent the TOT procedure between April 2018 and February 2020, and their partners. All of the women completed the Incontinence Impact Questionnaire (IIQ-7), Urogenital Distress Inventory (UDI-6), and Female Sexual Function Index (FSFI) questionnaire while their partners completed the International Index of Erectile Function (IIEF-5) questionnaire before and 6 months after the procedure. Results Mean IIQ-7 and UDI-6 scores were significantly lower at postoperative month 6 compared to preoperative values (p < 0.001). Mean FSFI scores were 22.5 +/- 1.7 preoperatively and 27.8 +/- 1.6 at postoperative month 6 (p < 0.001). Pain score did not change significantly (p = 0.4), but there were significant increases in the other FSFI domains of desire, arousal, lubrication, and satisfaction (p < 0.001, p < 0.001, p < 0.001, p < 0.001). The partners' mean IIEF score was 50.05 +/- 5.4 preoperatively and increased to 59.7 +/- 6.8 postoperatively (p < 0.001). No significant differences were detected in erectile or orgasmic function (p = 0.16, p = 0.67), whereas desire, intercourse satisfaction, and overall satisfaction scores increased significantly (p < 0.001, p < 0.001, p < 0.001). Conclusion TOT surgery improves sexual function not only in women but also their partners.
Expression of maspin in testis tumors with germ cells and its relation with angiogenesis factors
(2016) Celik, Huseyin; Turunc, Tahsin; Bal, Nebil; Hasirci, Eray; Akay, Alaaddin; Pekircioglu, Cetin Levent; 27513425
Background/aim: We aimed to evaluate the importance of maspin expression in testicular tumors with germ cells, its effect on prognosis, and the relation with angiogenesis factors. Materials and methods: The paraffin blocks of the orchiectomy materials of 32 patients who had undergone orchiectomy due to testicular tumors were taken within the scope of the study. The specimens of the cases included in the study group were reexamined under light microscope. Results: While just one maspin-positive sample was found in the seminoma cases, maspin stained positively in 6 of the nonseminoma germ cell tumors (NSGCTs). No statistical difference was found between maspin and tumor stage, size, alpha fetoprotein values, vascular endothelial growth factor, Ki-67, and CD31. A statistically positive correlation was only determined between maspin and p53 (P < 0.001). Conclusion: Maspin protein, whose expression in some tumors is accepted as a poor prognostic factor, is also expressed in testicular tumors with germ cells. However, according to our study, it is difficult to say whether this protein is a favorable or poor prognostic factor in testicular tumors and to understand how the effect mechanism works. The positive correlation between maspin and p53 in the NSGCTs makes us think that maspin might have displayed an effect on the p53 pathway.
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
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.
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.
The relationship between serum irisin levels and erectile dysfunction in diabetic men (irisin and erectile dysfunction in diabetic patients)
(2021) Kumsar, Sukru; Cigerli, Ozlem; Hasirci, Eray; Akay, Ali F.; Peskircioglu, Levent; https://orcid.org/0000-0003-3700-4104; https://orcid.org/0000-0002-4147-2966; https://orcid.org/0000-0003-0389-9472; 33400308; AAD-5584-2021; AAI-7997-2021; S-4494-2019
Irisin is an exercise-induced myokine that alleviates endothelial dysfunction and reduces insulin resistance in type 2 diabetes mellitus. We conducted this cross-sectional prospective study to determine the association of serum irisin levels and erectile dysfunction in type 2 diabetic patients. We compared 34 diabetic patients with erectile dysfunction with 30 diabetic patients without erectile dysfunction. In our study, serum irisin levels were found to be statistically significantly higher in diabetic patients without erectile dysfunction compared to those with erectile dysfunction (p = .016) and according to correlation analysis, irisin levels had a significantly negative correlation with the serum HbA1C value (r = -.294, p = .018). Based on the results of our study, we think that this molecule can be used in the diagnosis or treatment of erectile dysfunction in diabetic patients, if these findings are supported by larger studies.
Surgical Treatment Options for High Risk Patients with Benign Prostatic Hyperplasia
(2015) Hasirci, Eray; Dirim, Ayhan; Ozkardes, Hakan
Lower urinary tract symptoms due to benign prostatic hyperplasia (BPH) are a complex symptoms that almost every man will somehow experience in some part of his life. Today, treatment of BPH can be successfully achieved in most of the cases. However, surgical therapies may become inevitable in a group of non-complient patients or in those who have failed medical therapy. The increasing incidence of systemic diseases with age may cause difficulty in decision making for surgey in high-risk patients. In this review, different treatment options such as bipolar resection, laser prostatectomy, microwave thermotherapy, ethanol ablation and radiofrequency ablation in addition to conventional transurethral resection of prostate are compared in high risk patients with BPH. Although treatment options appear to achieve comparable outcome, differences between methods are hidden in side the effects. Choosing the most appropriate method for a particular high-risk case should be based on surgeon's experience, possible side effects of the procedure and severity of comorbidities.
Synchronous and Metachronous Secondary Tumors of Bladder Cancer Patients
(2016) Dirim, Ayhan; Ozkardes, Hakan; Hasirci, Eray
The improvements in cancer treatment prolonged survival in patients. Despite this survival benefit, chemotherapies, radiotherapies or combination therapies, and continuing exposure to the same carcinogenic agents may lead to secondary cancers. Multiple primary neoplasm is described as multiple tumors in a single patient posing distinct individual malignant characteristics with definite exclusion of one tumor is the metastasis of the other. According to the time of onset, these are considered to be synchronous or metachronous tumors. While synchronous tumors often occur due to carcinogen exposure, metachronous tumors often develop after treatments such as radiotherapy. Although the cause and developmental mechanisms of multiple primary tumors are not clear, several factors including immune deficiency, genetic instability, increased use of systemic chemotherapy and radiotherapy, increased survival, elderliness, and smoking have been implicated. The two developmental hypotheses in development of multiple primary tumors appear as field cancerization and common clonal origin. Multiple primary tumors often involve respiratory, gastrointestinal, and genitourinary systems. Transitional cell carcinoma of the urinary bladder may also rise as part of synchronous or metachronous multiple tumors. We still lack large scale studies relevant to the treatment of multiple primary cancers. Close follow-up in primary malignant tumor patients is of extreme importance for the risk of secondary cancers.
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.