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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 Comparison of Post Biopsy Pathology and Post Radical Prostatectomy Pathology in Patients with Prostate Cancer Detected After Fusion Biopsy(Selçuk Üniversitesi, 2023 Ekim) Altıntaş, Emre; Kaynar, Mehmet; Kılıç, Özcan; Batur, Ali Furkan; Gül, Murat; Özer, Halil; Çelik, Murat; Göktaş, SerdarAims: To compare the post-radical prostatectomy (RP) final pathologies and post-biopsy pathologies of the patients diagnosed with prostate cancer (PCa) after fusion biopsy according to the International Society of Urological Pathology (ISUP) grading system. Material and Methods: In this retrospective study, data of 182 patients who underwent fusion biopsy and concomitant systematic biopsy between January 2020 and August 2022 was reviewed. All these patients were biopsy naive with PIRADS-3 lesions according to the multiparametric MRI (mpMRI) imaging. A total of 89 patients with PCa detected by biopsy were included in the study. Age, PSA, PSA density, and lesion grades according to PI-RADS were analyzed. The post-biopsy (fusion and systematic biopsy) pathology results of 60 patients who underwent RP were compared with the final pathology results after RP. Results: Pathological results after fusion biopsy and RP were compared. The individual agreement between RP and fusion biopsy for each ISUP grade was moderate to almost excellent (0.558 to 0.848). When the overall agreement between RP and fusion biopsy was evaluated, the weighted kappa was calculated as 0.721 (95% CI: 0.577 to 0.865), which was determined as substantial significant agreement. On the other hand, the overall agreement between systematic biopsy and pathology results after RP was calculated as weighted kappa 0.544 (95% CI: 0.405 to 0.683) and this agreement was determined as moderate agreement. Conclusion: Our study showed that the concordance between the pathology result after fusion biopsy and the final pathology after RP was higher than the standard TRUS prostate biopsy. We think this compliance is crucial in the regulation and follow-up of the treatment of the patients.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 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 Pleyistosen-güncel gevşek çökeller üzerinde yapılaşmanın jeoteknik açıdan değerlendirilmesi: Mersin ili örneği(Selçuk Üniversitesi Mühendislik-Mimarlık Fakültesi, 2007) Çobanoğlu, İbrahim; Özbek, Ahmet; Gül, MuratGünümüzde ve geçmişte birçok yerleşim yeri litolojik, topoğrafik özellikleri ve konumları nedeniyle Pleyistosen-Güncel yaşlı gevşek çökeller üzerinde inşaa edilmiştir ve edilmeye devam edilmektedir. Bununla birlikte genel olarak mühendislik problemlerinin büyük çoğunluğu da bu çökeller için tipik olmaktadır. Bu tür alanlara örneklerden biri de Mersin il merkezi ve çevresidir. Bu alanlarda akarsular tarafından oluşturulmuş eski ve yeni alüvyon çökelleri, kıyı kumulları, kaliş ve çeşitli renkteki toprak oluşumları bulunmaktadır. Bu çalışmada Mersin ili Mezitli Beldesi yerleşim alanı içinde yer alan gevşek çökellerin fiziksel ve mekanik özellikleri araştırılmış ve elde edilen parametreler ışığında mevcut yapılaşmanın durumu değerlendirilmiştir. İnceleme alanının sahile oldukça yakın olması ve buna bağlı olarak yeraltı su seviyesinin yüzeye yakınlığı, çökellerin gevşek ve kazılan yüzeysel temellerin oldukça sığ olması yapılaşma açısından oldukça büyük risk oluşturmaktadır. Nitekim, incelenen kazı çukurlarında, sudan dolayı temellerde çalışmaların imkansız hale geldiği aynı nedenle kazı derinliklerinin artırılamadığı görülmüştür. Pleyistosen-Güncel yaşlı birimlerin heterojen dağılım sunması, düşük dayanım değerleri göstermesi, yüksek derecede sıkışabilir olması ve insan aktiviteleri nedeniyle üzerine gelen statik yükün sürekli artması, binalarda kırılma, çatlama ve oturma gibi problemlere neden olmaktadır. Bu çalışmanın temel amacı da, incelenen bu litolojiye ait parametrelerin görünen olumsuz duruma ne derece uyum sağladığının belirlenmesidir. Bu alandaki zeminin özellikleri önceden yapılmış zemin etüt çalışmaları ile birlikte bu çalışma kapsamında yapılmış araştırma çukurları ve arazi gözlemleri kullanılarak belirlenmeye çalışılmıştır. Elde edilen örselenmiş ve örselenmemiş zemin örnekleri üzerinde zeminin temel fiziksel ve mekanik özelliklerini belirlemeye yönelik deneyler yapılmıştır. Yapılan drenajlı kesme kutusu deneyleri ile kum boyutundaki iri taneli çökellerin kayma dayanımı parametreleri elde edilmiştir. SP zemin grubunda yer alan bu gevşek çökellerin sıvılaşma potansiyellerinin yüksek olması yapılaşma yapılaşma açısından risk taşıyan bölgeler olduğunu ortaya koymuştur. Bununla birlikte bölgede çok katlı yapılaşmanın hızla devam ettiği gözlenmektedir.Öğe The predictive value of platelet to lymphocyte and neutrophil to lymphocyte ratio in determining urethral stricture after transurethral resection of prostate(AVES, 2017) Gül, Murat; Altıntaş, Emre; Kaynar, Mehmet; Buğday, Muhammet Serdar; Göktaş, SerdarObjective: The pathology of urethral stricture disease is still unclear however progressive inflammation may contribute to the development of urethral stricture. The platelet-to-lymphocyte ratio (PLR) is a new and simple marker that indicates inflammation. In this study we aimed to investigate the predictive value of neutrophil to lymphocyte ratio (NLR) and PLR in patients with urethral stricture who underwent transurethral resection of prostate (TURP). Material and methods: A total of 208 patients who underwent bipolar-TURP were included in this study. Patients who had previously undergone surgery due to any urethral pathology, posterior urethral strictures, previous or ongoing treatment for any cancer, hematologic disorders, presence of an active infection at the time of surgical intervention, and prior blood transfusion were excluded. PLR, NLR and red cell distribution width (RDW) levels were measured. In order to investigate the predictive values of NLR and PLR variables, binary logistic regression analysis was performed. Results: No statistically significant differences were observed between the groups in terms of age, NLR, RDW, prostate size and operative times. Statistically significant differences were presented only in the median PLR-values. For predicting urethral stricture, the optimal cut-off value was 112.5, (sensitivity: 0.84, specificity: 0.64; AUC=0.762, 95% CI 0.684-0.84). Conclusion: In this study we showed that PLR can be used to determine urethral stricture as a cost-effective, common, and simple biomarker in patients after TURP.Öğe Prostate myths: What is the prostate awareness in the general male population in Turkey?(2014) Kulaksızoğlu, Haluk; Akand, Murat; Kılıç, Özcan; Gül, Murat; Kucur, Mustafa; Göktaş, SerdarObjective: The aim of the study was to evaluate prostate awareness in the general male population and discover the common misinformation about prostate diseases (PDs). Material and methods: A cross-sectional population sampling was performed in the general population for men between the ages of 18-70 with a survey conducted by medical students. The survey consisted of 15 questions addressing different aspects of PDs and common misinformation in the general population. All participants were stratifed according to age, degree of education, occupation and whether the person himself or a close relative had visited a urologist for PDs. All questionnaires were anonymous, and patients were informed about the confdentiality of the results. Results: A total of 1004 men between the ages of 18-70 were included in the study (mean age 38.0±12.9 years). Of those included, 20.2% were primary school graduates, 8.6% were secondary school graduates, 25.5% were high school graduates, 39.8% were university graduates, and 5.8% had a doctorate or higher education. Of all 1004 men, 31.5% had seen a urologist or attended an interview with a close relative for a PDs-related visit in a urologists offce; 56.2% reported prostate as a disease and only 16.5% as an organ. In terms of beliefs, 50.2% believed that all men had a prostate, 5.4% said that sexual activity would cause PDs, 13% thought that sexual activity would prevent PD, 24.9% reported that a rectal exam would affect sexual activity, and 63.5% believed that urinating when squatting would prevent prostate hyperplasia. Prostate cancer transmission to sexual partners was marked as true by 5% of the men. As many as 41.3% of the participants believed that early prostate surgery for BPH would prevent prostate cancer, and 13% reported that sexual activity ceases with prostate surgery and that retrograde ejaculation or anejaculation is the end of sexual activity in men. Conclusion: The survey clearly showed that prostate awareness is still very unsatisfactory in the Turkish male population and that urologists need to better inform the general population. PD knowledge is still lacking throughout all education levels. This is a unique study showing a cross-sectional analysis of the Turkish community; however, the applicability of these results to other communities should be evaluated.Öğe Retrograt intrarenal cerrahi geriatrik erkek hastalarda böbrek taşı tedavisinde etkin ve güvenilir bir seçenek midir?(Selçuk Üniversitesi, 2021) Batur, Ali Furkan; Gülmen, Mustafa; Böcü, Kadir; Böcü, Kadir; Altınaş, Emre; Gül, Murat; Kaynar, Mehmet; Kılıç, Özcan; Göktaş, SerdarAmaç: Bu çalışmada böbrek taşı tedavisi için kliniğimizde retrograt intrarenal cerrahi(RİRC) uygulanılan geriatrik yaş grubu erkek hastaların etkinlik ve güvenlik sonuçlarının, daha genç yaş hasta grubu ile karşılaştırılarak sunulması amaçlanmıştır. Gereç ve Yöntem: Kliniğimizde böbrek taşı nedeniyle RİRC uygulanmış olan, 40 yaş üzeri erkek hastaların verileri retrospektif olarak değerlendirildi. Hastalar yaşlarına göre iki gruba ayrıldı: 40-64 yaş (Grup 1) ve 65 yaş ve üzeri (Grup 2). Komorbidite değerlendirilmesi için anestezi risk skoru (ASA) ve modifiye Charlson komorbidite indeksi (MCKİ) kullanıldı. Hastanenin kayıt sisteminden ve hastaların dosyalarından genel bilgiler, komplikasyon bilgileri, renal anormallik varlığı, taşın bulunduğu böbrek ve lokalizasyonu, taşın dansitesi, taşın boyutu, taş sayısı verileri ve postoperatif taş temizlenme verileri elde edildi. Bulgular: Çalışmaya 233 tanesi Grup 1 (40-64 yaş) ve 61 tanesi Grup 2 (65 yaş ve üstü) olmak üzere toplam 294 hasta alınmıştır. ASA ve MCKİ skorları bakımından Grup 2’de yer alan hastaların skorları Grup 1’e göre istatistiksel olarak anlamlı olarak daha yüksek olarak bulunmuştur (sırasıyla p<0.001, p<0.001). Gruplar arasında taş dansitesi, taş boyutu, taş hacmi, operasyon süresi, hastanede yatış süreleri ve postoperatif taşsızlık oranları bakımından fark bulunmamıştır. Grup 1’de toplam 25 (%10.7) hastada ve Grup 2’de toplam 10 (%16.4) hastada komplikasyon geliştiği tespit edilmiştir ve gruplar arasında genel komplikasyon oranları açısından istatistiki fark bulunmamıştır (p=.265). Sonuç: Dünya nüfusunun giderek yaşlanması ile beraber bu hasta grubunun hastalıklarının da en uygun tedavi metodlarıyla tedavi edilmesinin önemi artmıştır. Çalışmamızda RİRC yöntemi ile böbrek taşı tedavisi yaşlı hasta grubunda da güvenli ve etkili olarak çıkmıştır.Öğe Testiküler kitlenin nadir sebebi: Fıtık eşliğinde paratestiküler liposarkom(2015) Kaynar, Mehmet; Akand, Murat; Gül, Murat; Göktaş, SerdarYumuşak dokunun sık gözlenen tümörü olan liposarkomun paratestiküler yerleşimi oldukça nadir görülmektedir. Sıklıkla ekstrape- ritoneal yağ dokusundan köken alan bu tümörler distale doğru korda ait yağ dokusuyla devam etmektedir. Tanı; genellikle operasyon sırasında şüphe üzerine histopatolojik değerlendirme ile konur. Bu yazıda testiküler kitle nedeni ile opere edilen paratestiküler lipo- sarkom ve beraberinde inguinal hernisi olan olgu sunulmuştur
