Wos İndeksli Yayınlar Koleksiyonu
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Item 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-2513-2020Introduction: 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.Item 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-8394-2021We 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.Item Parameters predicting sperm retrieval rates during microscopic testicular sperm extraction in nonobstructive azoospermia(2019) Kizilkan, Yalcin; Toksoz, Serdar; Turunc, Tahsin; Ozkardes, Hakan; 0000-0002-7277-449X; 31583760; AAH-1052-2020The aim of this study was to investigate the predictive value of the parameters that might have an effect on the success of microscopic testicular sperm extraction (micro-TESE) in infertile patients with nonobstructive azoospermia (NOA). Between 2003 and 2014, 860 patients with NOA were retrospectively analysed. The effect of age, infertility duration, history of varicocelectomy, herniorrhaphy or orchiopexy, presence of solitary testis, tobacco use, previous testicular biopsy results, history of orchitis, usage of human chorionic gonadotropin in the past three months, presence of undescended or retractile testis, presence of varicocele, testicular volume, levels of serum follicle-stimulating hormone, luteinising hormone, and testosterone, presence of Klinefelter syndrome and micro-deletion of Y chromosome on sperm retrieval rates were evaluated. In 45.8% (n = 394) of the patients who underwent micro-TESE, spermatozoon was adequately obtained. Multiple logistic regression analysis demonstrated that previous successful testicular biopsy (OR = 15.346; GA = 5.45-43.16; p < .001) and higher testicular volumes significantly increase sperm retrieval rate in micro-TESE. The testicular volume cut-off as 11 ml was found to be the most significant factor. Although currently testicular biopsy result is not being used as a diagnostic method, it is significantly associated with micro-TESE result.Item Comparison of Cajal-like cells in pelvis and proximal ureter of kidney with and without hydronephrosis(2015) Balikci, Omer; Turunc, Tahsin; Bal, Nebil; Celik, Huseyin; Ozkardes, Hakan; 26742978Objectives: To evaluate effects of Cajal-like cells on human renal pelvis and proximal ureter on peristalsis. Materials and Methods: 63 patients submitted to nephrectomy due to atrophic non- functional kidney associated with hydroureteronephrosis were included as study group and 30 cases with nephrectomy due to other reasons were included as control group. Samples from renal pelvis and proximal ureters were obtained and sections of 5 mu form paraffin blocks of these samples were prepared; layers of lamina propria and muscularis mucosa were examined by immune-histochemistry using CD117 in order to determine count and distribution of Cajal-like cells. Results: During immune-histochemical examinations of sections, obtained from renal pelvis and proximal ureter of hydronephrotic kidneys by CD117, Cajal-like cells number determined in lamina propria and muscularis propria was statistically significantly lower compared to control group (p<0.001). Distribution of Cajal-like cells in renal pelvis and proximal tubulus was similar under examination by light microscope, and also both groups were not different from each other regarding staining intensity of Cajal-like cells by c-kit. Conclusion: Significantly reduced number of Cajal-like cells in study group compared to control group, shows that these cells may have a key role in regulation of peristalsis at level of renal pelvis and proximal ureter in urinary system.Item The Effect of Human Chorionic Gonadotropin Treatment Before Testicular Sperm Extraction in Non-Obstructive Azoospermia(2016) Gul, Umit; Turunc, TahsinAim: 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.Item Is Learning Curve Short for MicroTESE Operation in Nonobstructive Azoospermic Patients?(2016) Turunc, Tahsin; Kuzgunbay, BarisAim: To evaluate learning curve in microdissection testicular sperm extraction (microTESE) surgery performed in non-obstructive azoospermia patients. Material and Method: The study included 300 non-obstructive azoospermic (NOA) patients, who underwent microTESE surgery performed by a single urologist. The patients were divided into three groups (the first 100 patients, the second 100 patients, and the third 100 patients) and these groups were compared in terms of sperm retrieval rate (SRR) and other clinical parameters. It was planned to compare the patients in first 99 patients between themselves in case there is no difference between the groups in terms of SRR. Results: The overall SRR was 47% in 300 NOA patients. No significant difference was determined between the three groups in terms of SRR (49%, 46%, and 46%, respectively). Accordingly, the first 99 patients were re-compared in terms of SRR (the first 33 patients, the second 33 patients, and the third 33 patients). It was observed that there is also no significant difference between these groups in terms of SRR (54.5%, 42.4%, and 51.5%, respectively). Moreover, no significant difference was determined between all of the groups in terms of patient age, testis volume, and serum follicle-stimulating hormone and testosterone levels. It was observed that duration of surgery has been significantly shortened in all groups as the number of surgical procedures increased. Discussion: Learning curve in microTESE surgery is shorter according to learning curves in other urological surgeries.Item Percutaneous Nephrolithotomy for Kidney Stones in Patients with Hematological Malignancy(2016) Kuzgunbay, Baris; Turunc, TahsinTo define the alterations in the outcomes of percutaneous nephrolithotomy (PNL) operations for kidney stones in patients with history of hematological malignancy (HM). Material and Method: Between 2000 and 2013, 1700 adult patients underwent PNL for the treatment of kidney stones in our institution. Four of these patients had a history of HM and considered to be HM group (n=4). Ten elderly (>65 years) patients who had no history of operation, HM or any other co-morbide diseases were chosen as the control group (n=10). Surgical parameters, success rates, additional treatments and complications were evaluated. Results: Statistical analyses showed no significant differences between HM and control group according to stone area, operation time, fluoroscopy time, hospitalization time,Delta Hb, blood transfusion rates and INR values (p>0.05). Statistical analyses revealed no significant differences between HM and control groups according to the success rates (p=0.470). Statistical analyses revealed no significant difference between groups for additional treatment requirements (p=0.882). No major perioperative complication was seen in both of the groups. Discussion: The treatment of kidney stone disease by PNL in patients with hematological malignancy is feasible, safe and effective. However, close cooperation with the Hematology Department before the operation is mandatory.Item 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; 27513425Background/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.Item 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-4475-2021We 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.