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Item 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-4475-2021Objective: 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.Item No Tumor Suppressor Role for LKB1 in Prostate Cancer(2021) Koseoglu, Hikmet; Celebi, Asuman; Galamiyeva, Gunay; Dalay, Nejat; Ozkardes, Hakan; Buyru, Nur; 34370601To elucidate the pathogenesis of prostate diseases, following in silico analysis, the LKB1 gene was selected for further investigation. The LKB1 gene has been associated with poor prognosis and is frequently mutated in different types of cancers. In this study, 50 benign prostatic hyperplasia (BPH) and 57 prostate cancer (PCa) tissues, including matched normal tissue for the patients, were analyzed by qRT-PCR and DNA sequencing for LKB1 expression and the mutation profile, respectively. Expression of LKB1 was increased in 60.7% of the PCa tissues compared with noncancerous tissue samples (p <= 0.001). However, LKB1 expression was lower when compared with normal tissues in BPH (p = 0.920). Four coding sequence alterations were detected in BPH. Three silent mutations were located in codons 9, 32, and 275 and a missense mutation was observed in codon 384. Six alterations were identified in the intronic regions of the LKB1 gene in both PCa and BPH. Five mutations were observed in both patient groups. A new alteration in intron 6 was observed in a patient with PCa. The LKB1 gene may be associated with benign transformations rather than the tumors in prostate pathogenesis when its expression and mutation status are considered. However, the mechanism of LKB1 in PCa needs further studies.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 Predictive values of vascular endothelial growth factor and microvessel-density levels in initial biopsy for prostate cancer(2016) Kervancioglu, Enis; Kosan, Murat; Erinanc, Hilal; Gonulalan, Umut; Oguzulgen, Ahmet Ibrahim; Coskun, Esra Zeynep; Ozkardes, Hakan; 26944325Angiogenesis is an important factor in the development and progression of prostate cancer (PCA). We aimed to investigate the values of vascular-endothelial-growth-factor (VEGF) expression level and microvessel density (MVD) in the prediction of PCA diagnosis at repeated prostate biopsy (re-PBx). We retrospectively evaluated 167 patients with re-PBx according to elevated prostate-specific antigen levels, suspicious digital rectal examination, and the presence of premalignant lesions. Patients with PCA on re-PBx were included in the cancer group (n = 17). Patients with benign prostatic hyperplasia or normal tissues on re-PBx were included in the control group (n = 21). The groups were compared according to the expression level of VEGF and MVD in initial prostate biopsy. There was no statistically significant difference between groups according to age and serum prostate-specific-antigen values. The mean VEGF scores of the cancer and control groups were 232.64 +/- 11.14 and 183.09 +/- 14.56, respectively (p < 0.05). The mean MVD of the biopsy samples in the cancer and control groups were 246.47 +/- 17.59 n/mm(2) and 197.33 +/- 16.26 n/mm(2), respectively (p < 0.05). The cutoff values of VEGF scores and MVD were set as 200 and 215, respectively, for PCA detection in our study. Our results showed that the expression level of VEGF and MVD significantly increased in the initial prostate-biopsy samples of patients with PCA diagnosed with re-PBx. The evaluation of VEGF expression level and MVD might have an important value in the prediction of PCA at re-PBx. The expression level of VEGF and MVD should be kept in mind as PCA-related histopathological changes that indicate the increased angiogenesis in prostatic tissue. Copyright (C) 2015, Kaohsiung Medical University. Published by Elsevier Taiwan LLC.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.