Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Prostatic Melanosis: A Case Report(2014) Cicek, Tufan; Erinanc, Hilal; Gonulalan, Umut; Sen, Erhan; Ozturk, Bulent; 0000-0003-1944-1722; 0000-0003-1401-6356; AAJ-8576-2021; AAL-1268-2021Prostatic melanosis is characterized by melanocytic proliferation in prostatic stroma and the epithelium. The pathogenesis of the lesion is uncertain. In literature it has been reported as a case associated with prostatic adenocarcinoma before. Primary and metastatic malignant melanoma should be considered in differantial diagnosis of the lesion.Item Renal Pseudoaneurysm after Micropercutaneous Nephrolithotomy(2014) Cicek, Tufan; Istanbulluoglu, Okan; Yildirim, Erkan; Buldu, Ibrahim; Kaynar, Mehmet; Ulas, Huseyin; 0000-0002-9057-722X; 0000-0002-6957-9060; ABI-3856-2020Postoperative bleeding due to pseudoaneurysm formation is the major cause of percutaneous kidney interventions. Micro percutaneous nephrolithotomy is a one step procedure that used mostly lower pole stones. There are small series that reports technical feasibility and safety of microperc using the All-seeing needle. Here we state the first report of pseudoaneurysm and its treatment after microperc in the literature.Item Re: Cicek et al.: Spinal Anesthesia Is an Efficient and Safe Anesthetic Method for Percutaneous Nephrolithotomy (Urology 2013;83:50-55) Reply(2014) Gonulalan, Umut; Cicek, Tufan; Kosan, Murat; https://orcid.org/0000-0002-0784-9926; 24581537Item Urethral Duplication: A Rare Cause of Recurrent Urinary Infection(2015) Cicek, Tufan; Kizilkan, Yalcin; Coban, Gokcen; Kosan, Murat; 0000-0002-4729-0100; 0000-0002-0784-9926; 25831685; P-7533-2014; ADD-5305-2022Urethral duplication is quite a rare congenital anomaly with ill-defined aetiology. Patients often present with penile deformity, recurrent urinary infections, urinary incontinence, serosal discharge from the accessory urethra, and difficulty in urinating. Urethral duplication is most commonly grouped according to the Efmann classification. It has 3 main types as Type I, II, and III. There is no consensus on its therapy. There are non-surgical solutions, including follow-up without therapy, as well as many surgical options, including urethral reconstruction. Anatomical urethra and the external sphincter should absolutely be delineated when a surgery is contemplated. We herein report the case of a two-year-old male patient referred to our clinic with recurrent urinary infection, bilateral hydronephrosis and difficulty in urinating who was diagnosed with urethral duplication. We discuss our findings with review of the relevant literature.Item Skin-to-Stone Distance Has No Impact on Outcomes of Percutaneous Nephrolithotomy(2014) Gonulalan, Umut; Akand, Murat; Coban, Gokcen; Cicek, Tufan; Kosan, Murat; Goktas, Serdar; Ozkardes, Hakan; https://orcid.org/0000-0002-4010-2883; https://orcid.org/0000-0002-0784-9926; https://orcid.org/0000-0002-7277-449X; 24481206; P-7533-2014; AAH-1052-2020Objective: Skin-to-stone distance (SSD) is a stronger factor than body mass index in predicting the success of shock wave lithotripsy. We aimed to evaluate the impact of SSD on outcomes of percutaneous nephrolithotomy (PCNL). Materials and Methods: The medical records of 1,280 patients who had undergone PCNL between April 2007 and February 2012 were evaluated retrospectively. 192 patients who had had preoperative non-contrasted computed tomography and single renal access were included the study. According to this median SSD value, patients were divided into two groups: group 1 (SSD <= 94 mm) (n = 92) and group 2 (SSD >94 mm) (n = 90). The groups were compared according to operative and postoperative parameters. Results: We found no significant differences between the two groups with regard to stone-free rate, operation time, fluoroscopy time, hospitalization time, visual analog score of pain, stone burden, transfusion rates and complication rates. On the other hand, the mean body mass index of group 1 was significantly lower than that of group 2 (p < 0.05). Conclusions: In this retrospective review of patients undergoing PCNL, we found that SSD has no impact on operative and postoperative outcomes. These results were in accordance with the safety of PCNL in obese patients. (c) 2014 S. Karger AG, BaselItem The Diagnostic Value of Magnetic Resonance Urography Using A Balanced Turbo Field Echo Sequence(2016) Cifci, Egemen; Coban, Gokcen; Cicek, Tufan; Gonulalan, Umut; 26984432The aim of the study was to compare the inter-observer variability and the accuracy of magnetic resonance urography (MRU) using a thin sectional balanced-turbo field echo (B-TFE) sequence for detecting ureteral calculi and to determine the effect of additional factors (size, density and location of the calculus) on the sensitivity and specificity of the MRU. MRU and CT images were evaluated independently by two radiologists according to presence, density and localization of calculi. The degrees of inter-rater agreement for categorical items were evaluated by the Kappa coefficient. According to the 1st and 2nd observers, the sensitivity of MRU was 65.9 %, 71.8 % and the specificity of MRU was 95.9 %, 100 %, respectively. Inter-observer agreement was 84.6 % for stone detection. The larger size had a better effect on detectability (p < 0.05). Also, the higher density had a better impact on detectability (p < 0.05). Our study has shown that B-TFE MRU was useful to detect ureteral calculi. However, B-TFE MRU has low sensitivity and high specificity in comparison with CT images. MRU is a reasonable alternative imaging technique for follow-up periods of selective groups like patients with large urinary stones, children or pregnant patients when ionizing radiation is undesirable. aEuro cent According to 1st and 2nd observers, sensitivity of MRU was 65.9 %, 71.8 %, respectively. aEuro cent According to 1st and 2nd observers, MRU specificity was 95.9 %, 100 %, respectively. aEuro cent Interobserver agreement was found to be over 84 % for stone detection. aEuro cent B-TFE sequence provides calculus follow-up without radiation. aEuro cent Larger calculi and more dense calculi individually have the better effect on detectability.Item Renal Stone Composition Does not Affect The Outcome of Percutaneous Nephrolithotomy in Children(2018) Kaygisiz, Onur; Turegun, Fethi Ahmet; Satar, Nihat; Ozen, Ender; Toksoz, Serdar; Dogan, Hasan Serkan; Piskin, Mehmet Mesut; Izol, Volkan; Sarikaya, Saban; Kilicarslan, Hakan; Cicek, Tufan; Ozturk, Ahmet; Tekgul, Serdar; Onal, Bulent; 29761226Purpose We sought to investigate the association between renal stone composition and percutaneous nephrolithotomy outcomes in pediatric patients and define the characterization of the stone composition. Methods The data of 1157 children who underwent percutaneous nephrolithotomy between 1991 and 2012 were retrieved from the multicenter database of the Turkish Pediatric Urology Society. The study population comprised 359 children (160 girls, 199 boys) with stone analyses. Patients were divided into five groups according to the stone composition [group 1: calcium oxalate; group 2: calcium phosphate; group 3: infection stones (magnesium ammonium phosphate, ammonium urate); group 4: cystine; group 5: uric acid, xanthine stones]. Results Patient characteristics, perioperative, postoperative, and stone characteristics were compared considering the stone composition. There were no significant differences between the groups concerning age, sex, side involved, preoperative hematocrit levels, and solitary renal unit. Patients with cystine stones were more likely to have a history of stone treatment. Groups 2 and 5 had mostly solitary stones. However, group 3 had staghorn stone more often, and group 4 frequently had multiple stones. Overall stone-free rate (79.4%) was similar among the groups. Although stone composition was related to blood transfusion and prolonged operative and fluoroscopy screening times on univariate analysis, it was not a significant predictor of them on multivariate analysis. Conclusions Stone composition was not a predictor of outcomes of pediatric percutaneous nephrolithotomy. However, cystine and infection stones, which are larger and filled multiple calyxes due to the nature of stone forming, were more challenging cases that need multiple tracts.Item Factors Predicting Postoperative Febrile Urinary Tract Infection Following Percutaneous Nephrolithotomy in Prepubertal Children(2018) Kaygisiz, Onur; Satar, Nihat; Gunes, Ali; Dogan, Hasan Serkan; Erozenci, Ahmet; Ozden, Ender; Piskin, Mehmet Mesut; Demirci, Deniz; Toksoz, Serdar; Cicek, Tufan; Gurocak, Serhat; Kilicarslan, Hakan; Nazli, Oktay; Kefi, Aykut; Izol, Volkan; Beytur, Ali; Sarikaya, Saban; Tekgul, Serdar; Onal, Bulent; 29779995Predictive tables and scoring systems can predict stone clearance. However, there is a paucity of evidence regarding the prediction of complications during percutaneous nephrolithotomy (PCNL), particularly in children, which remains under-researched. To our knowledge, no studies have evaluated the risk factors for febrile urinary tract infection (FUTI) after pediatric PCNL. Objectives To assess the predictive factors of FUTI in prepubertal children after PCNL and determine whether any prophylactic cephalosporins are superior for decreasing the FUTI rate. Study design Data from 1157 children who underwent PCNL between 1991 and 2012 were retrieved from the multicenter database of the Turkish Pediatric Urology Society. Children >12 years of age were excluded, leaving 830 children (364 girls, 466 boys). Data were analyzed according to the presence of FUTI and compared between the FUTI and non-FUTI groups. Results Mean age was 6.46 +/- 3.38 years. Twenty-nine (3.5%) children had FUTI which was confirmed by urine culture. FUTI Table Predictive factors for FUTI. occurred more frequently in young children (5.5%) than school-age children (2.4%). In univariate analysis, there were significant differences between the FUTI and non-FUTI groups regarding age, cephalosporin subgroup (first, second and third generation cephalosporin), side of PCNL, staghorn stones, tract size, operative time, postoperative ureteral catheter usage, perioperative complications (SATAVA), and blood transfusion. Multivariate analysis revealed that age, side of PCNL, staghorn stones, tract size, operative time, and blood transfusion were independent predictors of FUTI. Discussion The smaller tract size could cause FUTI with poor fluid drainage that may lead to elevate renal pelvic pressure and trigger bacteremia-causing pyelovenous backflow. Filling the calyx and renal pelvis by a staghorn stone and the resulting obstruction of fluid drainage may elevate intrarenal pelvis pressure. Longer operative time is likely to increase renal pelvic pressure over longer periods, which may account for FUTI after pediatric PCNL. Conclusions Younger age, right-sided PCNL, staghorn stones, mini-PCNL, longer operative time, and blood transfusion are risk factors for FUTI. First-, second-, and third-generation cephalosporins are equally effective for prophylaxis in prepubertal children undergoing PCNL.Item Ecchymosis and Coldness in Peripheral Varicose Vein Patients: Observations From VEIN-TURKEY Study(2020) Ozturk, Selcuk; Akbaba, Kagan Turker; Kilic, Suleyman; Cicek, Tufan; Peskircioglu, Levent; Tandogan, Izzet; Gurlek, Ahmet; Aydemir, Ozbay; Ileri, Mehmet; Yetkin, Ertan; 32356471The purpose of this subgroup analysis is to investigate and analyze the venous leg symptoms including sense of coldness and sign of ecchymosis in patients with or without peripheral varicose veins (PVVs) from VEIN-TURKEY study population. A total of 600 patients, who were enrolled to VEIN-TURKEY study recently, were included in this subgroup analysis. Patients were examined clinically for the presence and severity of PVV and varicocele. Patients were asked to answer the VEINES-Sym questionnaire consisting of 10 parts and questions about ecchymosis and coldness in their legs. Frequency of symptoms present in the VEINES-Sym instrument, coldness (16.6%, 6.5%, P = .002, respectively), and ecchymosis (16.6%, 2.7%, P < .001, respectively) were significantly higher in patients with PVV compared to patients without PVV. Mean score of each symptom was significantly lower in PVV (+) patients including scores of ecchymosis and coldness. Total VEINES-Sym score was also correlated with the scores of ecchymosis (r = 0.18, P < .001) and coldness (r = 0.35, P < .001). Logistic regression analysis revealed that heavy legs, aching legs, night cramps, and ecchymosis are significantly and independently associated with PVV. In conclusion, sign of ecchymosis and coldness are significantly higher in patients with PVV compared to patients without PVV in a population recruited from the urology clinics. In clinical evaluation, presence or sign of ecchymosis and coldness in legs should be considered to be compatible with PVV in the absence of trauma, hematologic pathologies including antiplatelet treatment, and arterial stenosis or obstruction.Item Venous leg symptoms in patients with varicocele: A multicenter assessment study (VEIN-TURKEY study)(2019) Ozturk, Selcuk; Akbaba, Kaan Turker; Kilic, Suleyman; Cicek, Tufan; Peskircioglu, Levent; Tandogan, Izzet; Gurlek, Ahmet; Aydemir, Ozbay; Ileri, Mehmet; Yetkin, Ertan; 29793400Objective The aim of this study is to evaluate chronic venous disease symptoms by using the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms (VEINES-QoL/Sym) questionnaire in varicocele patients. Material and methods The study was designed as a prospective, case controlled study and conducted in four hospitals from Turkey. A total of 600 patients who admitted to urology outpatient clinic were enrolled to the study. After the exclusion of 44 patients who do not match the inclusion criteria, the remaining 556 patients were examined for the presence and grade of varicocele and subsequently examined clinically for the presence of chronic venous disease findings. Finally, patients were asked to answer the VEINES-Sym questionnaire consisting of 10 items. All patients' demographic parameters, cardiovascular risk factors, other co-morbid diseases and drug usage were noted. Results Patients were classified into two groups: varicocele (+) group (n=269) and varicocele (-) group (n=287). VEINES-Sym scores of varicocele patients were lower compared to patients without varicocele (41.415.21, 43.19 +/- 3.22, respectively, p<0.001). Grades of varicocele significantly but inversely correlated with VEINES-Sym score (r=0, -206, p=0.001). Logistic regression analysis revealed that presence of varicocele irrespective of grading significantly and independently associated with the presence of aching (odds ratio: 2.054, 95% confidence interval: 1.265-3.338, p=0.004) and throbbing (odds ratio: 2.586, 95% confidence interval: 1.353-4.943, p=0.004). Conclusion Varicocele patients have lower VEINES-Sym scores compared to patients without varicocele and this finding is inversely correlated with the degree of the varicocele. This association supports the hypothesis that there may be a systemic vessel wall abnormality in venous disease patients. Patients with symptoms related to vascular dilatation in any territory may deserve to be assessed systematically with the support of further clinical studies.