Yazar "Akand, Murat" seçeneğine göre listele
Listeleniyor 1 - 20 / 33
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Aşırı aktif mesanede farmakoterapiye güncel bakış(2014) Çelik, Orçun; Karadağ, Mert Ali; Akand, Murat; Çeçen, Kürşat; Demir, Aslan; Kocaaslan, RamazanAşırı aktif mesane (AAM) hayat kalitesi üzerine belirgin etkisi olan yaygın bir tıbbi durumdur. Tedavi yaklaşımı davranışsal ve farmakolojiktir. İlk farmakolojik tedavi alternatifi tolerabilitesi, etkinliği ve uzun dönem komplians gibi sınırlayıcı faktörleri olan antikolinerjik ajanlardır. AAM' nin patofizyolojisinin anlaşılması ve farmakolojik tedavideki alternatif ajan arayışı, bu durumun tedavisi için yeni moleküllerin geliştirilmesini sağlamıştır. Bu moleküllerin antikolinerjik ilaçlarla benzer etkileri olup, yan etkilerinden kaçınmaktadırlar.Öğe Color Doppler ultrasound characteristics after subinguinal microscopic varicocelectomy(SOC ROMANA ULTRASONOGRAFE MEDICINA BIOLOGIE-SRUMB, 2017) Akand, Murat; Koplay, Mustafa; İslamoğlu, Necat; Altıntaş, Emre; Kılıç, Özcan; Gül, Murat; Kulaksızoğlu, HalukAim: The present study evaluated the effect of differences in the peak systolic velocity (PSV) and resistive index (RI) in the testicular artery (TA), capsular artery (CA), and intratesticular artery (ITA) after microscopic subinguinal varicocelectomy (MSV) on postoperative pain and semen parameters. Patients and methods: Scrotal color Doppler ultrasound (CDUS) measurements were made in 33 patients (age 18-31 years) prior to MSV and 3 and 6 months after MSV. Pain was recorded using a visual analog scale and sperm concentration was determined to analyze the predictive value of the CDUS parameters regarding surgical outcome. Results: A significant decrease in pain scores was observed in most patients at both follow-ups. The first postoperative CDUS revealed a significant increase in the TA-PSV (p<0.001) and a decrease in the TA-RI (p=0.002) and CARI (p=0.006). The second postoperative CDUS also revealed a significant increase in the TA-PSV and a decrease in the TA-RI, and the PSV in the ITA and CA and RI in the ITA and CA were significantly different from the values obtained pre-operatively and at the first follow-up. A negative correlation was found between the pain level and TA-PSV (r=-0.433, p=0.012), whereas sperm concentration positively correlated with both the TA-PSV and CA-PSV (r=0.534, p=0.001 and r=0.455, p=0.008, respectively). Conclusions: The PSV and RI are useful parameters for detecting changes in testicular microhemodynamics after MSV. In addition, the TA-PSV and CA-PSV can be used to predict improvements in pain and sperm concentration.Öğe Does previous video game experience affect laparoscopic skills? Evaluation of non-medical school students with a novel laparoscopic training box(E-CENTURY PUBLISHING CORP, 2016) Akand, Murat; Altıntaş, Emre; Kılıç, Özcan; Gül, Murat; Erdoğdu, Merter B.Background and objectives: Training is important to master skills in laparoscopic surgery. Various laparoscopic skills curricula have been developed to accelerate the learning curve of the trainees in a safer setting. Video games have become an integral part of daily life, and they have also begun to be used in medical education. We aimed to compare the laparoscopic skills of university students with or without history of video game playing with previously validated laparoscopic tasks on a newly developed laparoscopic training box. Materials and methods: A total of 60 university students were recruited from different faculties of Selcuk University other than medical school, and were divided equally into two groups according to their previous video game experience. The students were asked to perform seven different laparoscopic tasks. The performance durations for each task as well as the overall durations were evaluated according to the video game experience of the students. Results: Except for Task-6, all durations were statistically significantly shorter in the group with video game experience. The total duration was also shorter in this group. No difference was observed for the durations between male and female students in each group. Conclusions: Experience of playing video games seems to have a positive effect on laparoscopic skills. This can be due to improved hand-eye coordination and visual selective attention capacity, and decrease in response time to visual stimuli. This novel training box seems to be useful in general laparoscopic skills training.Öğe DOES SKIN-TO-STONE DISTANCE HAVE ANY IMPACT ON OUTCOMES OF PERCUTANEOUS NEPHROLITHOTRIPSY?(MARY ANN LIEBERT INC, 2012) Gonulalan, Umut; Akand, Murat; Coban, Gokcen; Cicek, Tufan; Kosan, Murat; Goktas, Serdar; Ozkardes, Hakan[Abstract not Available]Öğe The effect of bladder sensation on uroflowmetry parameters in healthy young men(WILEY, 2016) Kaynar, Mehmet; Kucur, Mustafa; Kilic, Ozcan; Akand, Murat; Gul, Murat; Goktas, SerdarAimsTo investigate the effect of the bladder sensation grade on uroflowmetry parameters. MethodsFifty healthy volunteering young men were enrolled in the present study. In total, three uroflowmetry evaluations were made. Q(max), Q(ave), VV, and PVR urine was obtained three times in three described bladder sensation grades, nearly at the same time of the day. ResultsThe mean age of the participants in the present study is 29.083.8 years. The mean Q(max) values of the volunteers were 17.4 +/- 4.8ml/s, 24.1 +/- 6.0ml/s, and 29.6 +/- 6.5ml/s in the first, second, and third, voiding desire grades, respectively. The mean Q(ave) values were 9.9 +/- 2.1ml/s, 12.9 +/- 2.9ml/s, and 15.9 +/- 4.0ml/s for each of the voiding desire grades mentioned. A statistically significant difference was obvious for all three bladder sensation grades in terms of Q(max) and Q(ave) values (P=0.000). However, no statistically significant difference was seen regarding the PVR urine volumes. The mean voided volume in the first, second and third uroflowmetry were 140 +/- 42ml, 245 +/- 64ml, and 449 +/- 105ml, respectively. The highest Q(max) and Q(ave) values were obtained when the desire to void was urgent. ConclusionsThe findings of the study show that, uroflowmetry evaluations are to be made if the patients have a strong desire to void. Only thus the highest Q(max) values can be obtained; yet, the degree of perceived bladder sensation does not have a statistically significant impact on PVR quantity. Neurourol. Urodynam. 35:622-624, 2016. (c) 2015 Wiley Periodicals, Inc.Öğe Effectiveness of pelvic floor muscle training on symptoms and uroflowmetry parameters in female patients with overactive bladder(TUBITAK SCIENTIFIC & TECHNICAL RESEARCH COUNCIL TURKEY, 2015) Kulaksizoglu, Haluk; Akand, Murat; Cakmakci, Evrim; Gul, Murat; Seckin, BedreddinBackground/aim: To evaluate the effects of pelvic floor muscle training (PFMT) on symptoms of overactive bladder (OAB) as well as uroflowmetry parameters and functional bladder capacity. Materials and methods: Fifty-nine female patients with OAB symptoms were included. Patients were assessed by SEAPI-QMM, uroflowmetry, and abdominal ultrasound. A specially designed PFMT program using a Pilates ball was generated for patients. The training period was 1-h sessions twice a week for 6 weeks and aerobic home exercises to be performed at home 4 or 5 times every other day. Following training, subjects were reevaluated for body mass index, SEAPI questionnaire, and uroflowmetry. Results: Initial mean SEAPI score, mean maximum and average flow rates, and mean voided volume were 9.8 +/- 7.2, 29.8 +/- 16.4 mL/s, 16.3 +/- 8.7 mL/s, and 211.6 +/- 173.5 mL, respectively. After completion of the training program, SEAPI scores improved significantly to 3.4 +/- 6.4 (P < 0.05). Maximum and average flow rate results did not show significant changes, whereas voided volume seemed to have improved in conjunction with patients' symptom scores (Pearson correlation coefficient: 0.86). Conclusion: According to our results, we think that proper PFMT results in increase of functional bladder capacity as well as improvement in OAB symptoms and can be recommended as first-line therapy or in conjunction with medical therapy in severe cases.Öğe Effectiveness of pelvic foor muscle training on symptoms and urofowmetry parameters in female patients with overactive bladder(2015) Kulaksızoğlu, Haluk; Akand, Murat; Çakmakçı, Evrim; Gül, Murat; Seçkin, BedreddinBackground/aim: To evaluate the efects of pelvic foor muscle training (PFMT) on symptoms of overactive bladder (OAB) as well as urofowmetry parameters and functional bladder capacity. Materials and methods: Fify-nine female patients with OAB symptoms were included. Patients were assessed by SEAPI-QMM, urofowmetry, and abdominal ultrasound. A specially designed PFMT program using a Pilates ball was generated for patients. Te training period was 1-h sessions twice a week for 6 weeks and aerobic home exercises to be performed at home 4 or 5 times every other day. Following training, subjects were reevaluated for body mass index, SEAPI questionnaire, and urofowmetry. Results: Initial mean SEAPI score, mean maximum and average fow rates, and mean voided volume were 9.8 ± 7.2, 29.8 ± 16.4 mL/s, 16.3 ± 8.7 mL/s, and 211.6 ± 173.5 mL, respectively. Afer completion of the training program, SEAPI scores improved signifcantly to 3.4 ± 6.4 (P < 0.05). Maximum and average fow rate results did not show signifcant changes, whereas voided volume seemed to have improved in conjunction with patients symptom scores (Pearson correlation coefcient: 0.86). Conclusion: According to our results, we think that proper PFMT results in increase of functional bladder capacity as well as improvement in OAB symptoms and can be recommended as frst-line therapy or in conjunction with medical therapy in severe cases.Öğe Eosinophilic Cystitis: A Rare Cause of Nocturnal Enuresis in Children(KOWSAR PUBL, 2016) Kilic, Ozcan; Akand, Murat; Gul, Murat; Karabagli, Pinar; Goktas, SerdarIntroduction: Eosinophilic cystitis (EC) is a rare and poorly understood inflammatory condition, characterized by eosinophilic infiltration of all layers of the bladder wall, which mimics bladder tumors. EC may present with symptoms such as increased urination frequency, dysuria, gross/microscopic hematuria, suprapubic pain and urinary retention. Case Presentation: We present a 17-year-old male patient, who was continent night and day in his childhood, and was admitted to our clinic for complaints of hematuria and nocturnal enuresis for the past six months. His history and physical examination were unremarkable, and routine hematological and biochemical tests were normal. Cystoscopy revealed a 4 x 3 cm erythematous, polypoidal, solid lesion on the bladder dome. Histopathological examination of the lesion revealed transitional epithelium with stromaledema, where diffuse, dense infiltration of lamina propria by eosinophils and lymphocytes was also seen. According to these findings, a histopathological diagnosis of EC was made, and the patient was treated with corticosteroids, antimicrobial agents and antihistamines. His symptoms dramatically improved and nocturnal enuresis also recovered after treatment. Conclusions: Although it is a rare entity, EC should be kept in mind in the differential diagnosis of patients presenting with dysuria, hematuria and any kind of acquired voiding dysfunction, including frequency, pollakiuria and incontinence.Öğe Evaluation of conservative approach in the management of ureteroenteric strictures following radical cystectomy with Bricker ileal conduit: a single-center experience(TAYLOR & FRANCIS LTD, 2016) Baten, Evert; Akand, Murat; Floyd, Michael S., Jr.; Van Cleynenbreugel, Ben; Albersen, Maarten; Everaerts, Wouter; Van Poppel, HendrikObjective: The aim of this study was to evaluate the risk factors and treatment options for ureteroenteric strictures (UES) following radical cystectomy (RC) and ileal conduit (IC) formation, and specifically to comment on the conservative management of UES in asymptomatic patients. Materials and methods: The datasheets were reviewed of 304 consecutive patients who were treated with an RC and IC between January 2001 and May 2011 in a Belgian tertiary center and who followed a strict follow-up protocol. Long-term treatment outcomes were retrospectively analyzed. Results: Twenty-two patients (7.2%) were diagnosed with UES (affecting 27 ureters in total), when a new-onset hydroureteronephrosis or increase of the pre-existing hydroureteronephrosis was detected by ultrasound or computed tomography. A retrograde loopogram was then performed to confirm the UES. The mean follow-up time was 33 months. A decline in renal function, the presence of flank pain and urinary tract infections were indications for interventional treatment. Six patients underwent double-J stent placement, two patients received percutaneous nephrostomies as a definitive treatment and two patients underwent ureterointestinal reimplantation. Asymptomatic patients with a UES and a favorable renal function were conservatively managed. They remained asymptomatic during follow-up and required no active treatment. Conclusions: No clinical variable was independently associated with an increased risk of UES. These long-term data suggest that a selected patient population of asymptomatic patients with good renal function at the time of UES diagnosis can be safely managed conservatively.Öğe Expression of Ring Box-1 protein and its relationship with Fuhrman grade and other clinical-pathological parameters in renal cell cancer(ELSEVIER SCIENCE INC, 2020) Altıntaş, Emre; Kaynar, Mehmet; Çelik, Zehra Esin; Çelik, Murat; Kılıç, Özcan; Akand, Murat; Göktaş, SerdarObjective: To determine the relationship between RING-box protein 1 (RBX-1) expression and renal cell carcinoma (RCC) with prognostic factors. Methods: A total of 88 patients who underwent radical/partial nephrectomy between January 2009 and January 2016 have been included in our study. The age, gender, tumor location, tumor size, and tumor-node-metastasis stage of each patient was evaluated. From the best sections in hematoxylin-eosin stained pathology preparations, tumor histological subtype, Fuhrman nuclear grade, lymphovascular invasion, renal artery/vein invasion, capsule invasion, perirenal fatty tissue invasion, and tumor grade were evaluated. Participants were divided into 2 groups according to Fuhrman grade. Fuhrman grades 1 to 2 comprised Group 1, and Fuhrman grades 3 to 4 comprised Group 2. An immunoreactivity scoring system was used to evaluate RBX-1 expression. Results: Upon examining all histological subtypes together, it was observed that RBX-1 expression was statistically higher in Group 2 compared to Group 1 (P < 0.008). Upon examining clear RCC cases, it was observed again that Group 2 had a higher RBX-1 expression than Group 1 (P < 0.009). RBX-1 expression was not associated with clinical-pathological parameters including tumor grade, lymphovascular invasion, capsule invasion, or perirenal invasion. Conclusion: RBX-1 expression is closely associated with a highly important prognostic factor in RCC-Fuhrman grade-and it shows promise as a prognostic marker. Further studies are required to reveal the importance of RBX-1 in RCC prognosis and treatment. (C) 2019 Elsevier Inc. All rights reserved.Öğe Feasibility of a novel technique using 3-dimensional modeling and augmented reality for access during percutaneous nephrolithotomy in two different ex-vivo models(SPRINGER, 2019) Akand, Murat; Civcik, Levent; Büyükaslan, Ahmet; Altıntaş, Emre; Koçer, Erdinç; Koplay, Mustafa; Erdoğru, TibetPurposeWe describe a novel technique that uses mathematical calculation software, 3-dimensional (3D) modeling and augmented reality (AR) technology for access during percutaneous nephrolithotomy (PCNL) and report our first preliminary results in two different ex-vivo models.MethodsNovel software was created in order to calculate access point and angle by using pre-operative computed tomography (CT) obtained in 50 patients. Two scans, 27s and 10min after injection of contrast agent, were taken in prone PCNL position. By using DICOM objects, mathematical and software functions were developed to measure distance of stone from reference electrodes. Vectoral 3D modeling was performed to calculate the access point, direction angle and access angle. With specific programs and AR, 3D modeling was placed virtually onto real object, and the calculated access point and an access needle according to the calculated direction angle and access angle were displayed virtually on the object on the screen of tablet.ResultsThe system was tested on two different modelsa stone placed in a gel cushion, and a stone inserted in a bovine kidney that was placed in a chickenfor twice, and correct access point and angle were achieved at every time. Accuracy of insertion of needle was checked by feeling crepitation on stone surface and observing tip of needle touching stone in a control CT scan.ConclusionsThis novel device, which uses software-based mathematical calculation, 3D modeling and AR, seems to ensure a correct access point and angle for PCNL. Further research is required to test its accuracy and safety in humans.Öğe First experience with a new form of orthotopic ileal neobladder (Leuven N-Pouch) following radical cystectomy(AVES, 2019) Akand, Murat; Kilic, Ozcan; Bocu, Kadir; Harmankaya, Ismail; Aydogan, Muhammed FurkanBladder cancer is the most common malignancy of the urinary tract. Radical cystectomy with pelvic lymph node dissection and a urinary diversion (UD) is the gold standard treatment of non-metastatic muscle-invasive bladder cancer (MIBC). Although ileal conduit is the standard and most commonly performed type of UD, more number of centers have recently started to perform orthotopic ileal neobladder (OIN). A novel OIN has been described in 2005 as the so-called "Leuven N-pouch", which combines the features of the commonly used Hautmann and Studer neobladders. Herein, we report our first experience with a case of Leuven N-pouch in our department, which was performed for a male patient with MIBC.Öğe Hemostatic Efficacy and Histopathological Effects of Ankaferd Blood Stopper in an Experimental Rat Model of Cyclophosphamide-induced Hemorrhagic Cystitis(ELSEVIER SCIENCE INC, 2016) Kilic, Ozcan; Akand, Murat; Karabagli, Pinar; Piskin, Mehmet MesutOBJECTIVE To evaluate the hemostatic efficacy and histopathological effects of Ankaferd Blood Stopper (ABS) in an experimental rat model of cyclophosphamide-induced (CYP) hemorrhagic cystitis (HC). MATERIALS AND METHODS Forty male Sprague-Dawley rats were included in the study. Firstly, 10 rats were divided equally into 2 groups where the first group was administered only an intraperitoneal (i.p.) injection of normal saline to constitute the negative control group (CON). The remaining 5 rats were administered only a single i.p. injection of CYP (without any further treatment) for induction of HC to constitute the positive control group (HC). Subsequently, the remaining 30 rats, which also received i.p. CYP for induction of HC, were divided into 3 groups to which intravesical saline (SAL group), epinephrine (EPN group), and ABS (ANK group) were administered for 3 consecutive days. Ten days after the third instillation, cystectomy was performed for histopathological examination. Specimens were evaluated for presence of congestion, edema, necrosis, ulceration, and regenerated epithelium, and scores were given for each parameter according to the severity. RESULTS No statistically significant difference was observed for congestion, edema, necrosis, and ulceration between HC-SAL, and also between CON-ANK groups (all P values > .05). There was a significant difference for total scores between EPN and ANK groups (P = .009). There was statistically significant difference for regenerating epithelium between CON-EPN, CON-ANK, HCANK, and SAL-ANK groups. CONCLUSION Intravesical administration of ABS is at least as efficacious as EPN in terms of congestion, edema, necrosis, and ulceration. Moreover, ABS can be considered as a better option in inducing regenerating epithelium than EPN. (C) 2016 Elsevier Inc.Öğe Impact of neoadjuvant chemotherapy on short-term complications and survival following radical cystectomy(SPRINGER, 2019) Milenkovic, Uros; Akand, Murat; Moris, Lisa; Demaegd, Liesbeth; Muilwijk, Tim; Bekhuis, Youri; Laenen, Annouschka; Cleynenbreugel, Ben Van; Everaerts, Wouter; Poppel, Hein Van; Dumez, Herlinde; Albersen, Maarten; Joniau, StevenObjectives To compare perioperative and short-term postoperative complication rates between patients receiving radical cystectomy (RC) after neoadjuvant chemotherapy (NAC) and patients undergoing RC alone. Secondary objectives were to compare overall survival (OS) and cancer-specific survival (CSS). Materials and methods Clinico-pathological data of all patients who received RC between 1996 and 2015 were retrospectively collected. Only patients with RC for muscle-invasive bladder cancer were included in the final analysis. Short-term (30-day) postoperative complications were assessed by registering the Clavien-Dindo classification (CDC) and dividing into sub-groups: low-grade (LGC) CDC 1-2 and high-grade (HGC) CDC 3-5. To compare populations with similar age, comorbidities and preoperative creatinine, we used a propensity score-adjusted statistical model. Pre- and perioperative predictors of short-term complications were identified using uni- and multivariable models. Survival was assessed using Kaplan-Meier analysis. Results A total of 491 patients undergoing RC were included, of whom 102 (20.8%) received NAC. After propensity score covariate adjustment, there was no significant difference in postoperative complications between patients undergoing NAC plus RC and RC alone with an overall complication rate of 69% and 66%, respectively. No significant differences in the 30-day HGC rates (11.76% and 11.83%, respectively) were observed. NAC plus RC patients had worse prognostic factors at baseline; nevertheless, after correction for group differences OS and CSS did not differ from RC only group (5-year OS 61.3% vs. 50.2%, and 5-year CSS 61.8% vs. 57.9% respectively, p > 0.05 for all). Conclusion In appropriately selected patients, exposure to NAC is not associated with increased short-term complications.Öğe Intravenous paracetamol for relief of pain during transrectal-ultrasound-guided biopsy of the prostate: A prospective, randomized, double-blind, placebo-controlled study(ELSEVIER TAIWAN, 2015) Kilic, Ozcan; Akand, Murat; Kulaksizoglu, Haluk; Haliloglu, Ahmet H.; Tanidik, Seher; Piskin, Mehmet M.; Yurdakul, TalatTransrectal-ultrasound-guided prostate biopsy (TRUS-PBx) is the standard procedure for diagnosing prostate cancer. The procedure does cause some pain and discomfort; therefore, an adequate analgesia is necessary to ensure patient comfort, which can also facilitate good-quality results. This prospective, randomized, double-blinded, placebo-controlled study aimed to determine if intravenous (IV) paracetamol can reduce the severity of pain associated with TRUS-PBx. The study included 104 patients, scheduled to undergo TRUS-PBx with a suspicion of prostate cancer, that were prospectively randomized to receive either IV paracetamol (paracetamol group) or placebo (placebo group) 30 minutes prior to TRUS-PBx. All patients had 12 standardized biopsy samples taken. Pain was measured using a 10-point visual analog pain scale during probe insertion, during the biopsy procedure, and 1 hour postbiopsy. All biopsies were performed by the same urologist, whereas a different urologist administered the visual analog pain scale. There were not any significant differences in age, prostatespecific antigen level, or prostate volume between the two groups. The pain scores were significantly lower during probe insertion, biopsy procedure, and 1 hour postbiopsy in the paracetamol group than in the placebo group. In conclusion, the IV administration of paracetamol significantly reduced the severity of pain associated with TRUS- PBx. Copyright (C) 2015, Kaohsiung Medical University. Published by Elsevier Taiwan LLC. All rights reserved.Öğe Laparoscopic Radical Prostatectomy Alone or With Laparoscopic Herniorrhaphy(SOC LAPAROENDOSCOPIC SURGEONS, 2015) Celik, Orcun; Akand, Murat; Ekin, Gokhan; Duman, Ibrahim; Ilbey, Yusuf Ozlem; Erdogru, TibetBackground and Objectives: Prostate cancer and inguinal hernia are common health issues in men aged more than 50 years. Recently, more data are accumulating that laparoscopic radical prostatectomy (LRP) and laparoscopic inguinal hernia repair (LIHR) can be performed in the same operation. The purpose of this study was to compare patients who underwent simultaneous extraperitoneal LRP (E-LRP) and LIHR with control patients who underwent only E-LRP in a matched-pairs design. Methods: Medical records of 215 patients were evaluated, and 20 patients who underwent E-LRP + LIHR were compared with 40 patients who underwent only E-LRP in a matched-pairs analysis. Preoperative clinical parameters (age, body mass index, prostate-specific antigen, clinical stage, Gleason score of the prostate biopsy, and prostate volume) and operative data (operation time, duration of catheterization, length of hospital stay, estimated blood loss, time to perform the anastomosis and its quality, and the percentage of patients with bilateral lymphadenectomy) were evaluated, as well as postoperative parameters (pathological stage, Gleason score, specimen weight, follow-up duration, biochemical recurrence, complication rates, and duration of postoperative analgesic treatment). Results: No statistically significant differences were found in the preoperative and operative parameters between the 2 study groups. Pathological parameters and the follow-up period and complication rates were similar between the 2 groups. Conclusion: Performing LIHR and E-LRP during the same operation is safe and feasible in the treatment of patients with prostate cancer and inguinal hernia.Öğe Laparoscopic Stepwise-Cut Double Initial Stay Suture Pyeloplasty: Our Novel Surgical Technique(MARY ANN LIEBERT, INC, 2015) Ateş, Mutlu; Özgök, Yaşar; Akın, Yiğit; Arslan, Murat; Akand, Murat; Hoşcan, Mustafa BurakObjective: To describe a novel surgical technique, laparoscopic stepwise-cut double initial stay suture (LASDISS) pyeloplasty for ureteropelvic junction obstruction (UPJO). Additionally, we evaluated the safety and short-term results. Materials and Methods: This was a nonrandomized study with a series of 6 patients with UPJO, operated on between March 2012 and August 2013. Perioperative and short-term outcomes were evaluated. In brief, a "T shape cut" was performed from the dilated pelvis to the ureter. The initial stay suture was placed between the lower edge of the pelvis and the distal end of the spatulated anterolateral part of the ureter. The pelvis was closed with a continuous suture starting from the opened upper edge of the pelvis that was secured after leaving enough space for ureteral anastomosis. The second initial stay suture was placed after passing the ureter and pelvis two times. The dilated part of the renal pelvis and the stenotic segment were excised. A double-J stent was inserted. The remaining space between the two initial sutures was closed with these continuous sutures. Results: We performed the LASDISS pyeloplasty technique in all cases. Median operation time was 177 minutes (range, 100-290 minutes). Mean follow-up was 7.5 months (range, 3-18 months). The mean pre- and postoperative split renal function on diuretic renography was 33% (range, 25%-56%) and 42% (range, 30%-52%), respectively. Conclusions: The LASDISS pyeloplasty surgical technique represents a safe and effective option in surgical treatment of UPJO.Öğe The N-shaped orthotopic ileal neobladder: functional outcomes and complication rates in 119 patients(SPRINGER INTERNATIONAL PUBLISHING AG, 2016) De Sutter, Thomas; Akand, Murat; Albersen, Maarten; Everaerts, Wouter; Van Cleynenbreugel, Ben; De Ridder, Dirk; Goethuys, HansBackground: We report our long-term experience with 119 cases of N-shaped orthotopic ileal neobladder. Methods: Between March 1996 and July 2013, a total of 119 patients (102 men, 17 women) underwent cystectomy with creation of an N-shaped orthotopic ileal neobladder. The Clavien-Dindo classification score was used for grading early (<3 months postoperative), late, and pouch-related and non-pouch-related complications. Daytime and nighttime continence were evaluated for male and female patients separately, with patients subdivided in three groups: completely continent, use of <= 1 pad, and use of >1 pad. Results: Median follow-up was 75 months (range 3-204). Early complications (15 major, 54 minor) occurred in 39.5 % of 119 patients whereas 53.1 % presented with late complications (56 major, 39 minor; 111 patients evaluated). Urinary infection and outlet obstruction were both the most frequent early and late pouch-related complications; early non-pouch-related complications were mainly infectious and gastrointestinal, and the most common late non-pouch-related problem was wound herniation. At 12 months, 96 and 60 % of the men and 84.6 and 66.7 % of the women respectively achieved daytime and nighttime continence. Conclusion: Complication rates of the N-shaped orthotopic ileal neobladder were relatively high, probably because of meticulous recording and follow-up. Daytime continence rates were better than nighttime rates. N-shaped orthotopic ileal neobladder can be a good option for urinary diversion in selected patients who undergo radical cystectomy.Öğe No survival difference between super extended and standard lymph node dissection at radical cystectomy: what can we learn from the first prospective randomized phase III trial?(AME PUBL CO, 2019) Muilwijk, Tim; Akand, Murat; Gevaert, Thomas; Joniau, Steven[Abstract not Available]Öğe A novel cannulation technique for difficult urethral catheterization(PAGEPRESS PUBL, 2016) Kaynar, Mehmet; Akand, Murat; Goktas, SerdarIntroduction: To propose a novel cannulation technique for difficult urethral catheterization procedures. Technique: The sheath tip of an intravenous catheter is cut off, replaced to the needle tip and pushed through the distal drainage side hole to Foley catheter tip, and finally withdrawn for cannulation. In situations making urethral catheterization difficult, a guide wire is placed under direct vision. The modified Foley catheter is slid successfully over the guide wire from its distal end throughout the urethral passage into the bladder. Results: The modified Foley catheter was used successfully in our clinic in cases requiring difficult urethral catheterization. Conclusions: This easy and rapid modification of a Foley catheter may minimize the potential complications of blind catheter placement in standard catheterization.
