Wos Açık Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10754
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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 Surgical Treatment Options for High Risk Patients with Benign Prostatic Hyperplasia(2015) Hasirci, Eray; Dirim, Ayhan; Ozkardes, HakanLower 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.Item Synchronous and Metachronous Secondary Tumors of Bladder Cancer Patients(2016) Dirim, Ayhan; Ozkardes, Hakan; Hasirci, ErayThe 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.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.Item 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-4475-2021Adrenal 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.