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Öğe Association of ring box-1 protein overexpression with clinicopathologic prognostic parameters in prostate carcinoma(ELSEVIER SCIENCE INC, 2016) Celik, Zeliha Esin; Kaynar, Mehmet; Dobur, Fatma; Karabagli, Pinar; Goktas, SerdarAim: To determine the expression of Ring Box-1 (RBX-1) protein in prostate carcinoma (PCa) and the association between RBX-1 expression and clinicopathologic prognostic parameters. Material and methods: Relevant data such as age, preoperative serum PSA values, and tumor stage were obtained from 51 patients' with PCa record who underwent radical prostatectomy between January 2010 and March 2014. Hematoxylin-eosin stained pathology slides were evaluated by 2 pathologists blinded to patients' data in order to determine Gleason grade groups, tumor stage, tumor volume, capsule invasion, lymphovascular invasion, perineural invasion, and seminal vesicle invasion Immunoreactivity scoring system (IRS) was used to determine RBX-1 expressions. Results: A statistically significant difference was determined in terms of RBX-1 expression between non tumoral prostate tissue, high grade prostatic intraepithelial neoplasia (H-PIN) and carcinoma foci (P = 0.001). RBX-1 expression in the Gleason pattern 4 was higher than the Gleason pattern 3 and H-PIN foci as well as non tumoral prostate tissue. Likewise, in cases with PSA levels of > 10.1 ng/ml, RBX-1 expression was higher than those <= 10 ng/ml. Moreover, RBX-1 expression of stage II cases was higher than stage I (P = 0.019), RBX-1 expression of stage III higher than stage I cases (P = 0.044). However, RBX-1 expression was not related with clinicopathologic parameters including patient age, tumor volume, lymphovascular invasion, perineural invasion, seminal vesicle invasion, or capsule invasion. Conclusions: RBX-1 protein is overexpressed in PCa and associated with clinicopathologic prognostic parameters related with biological potential of the aggressive disease. Further studies of basic and molecular science are needed to reveal clinical and therapeutic implications of RBX-1 in PCa. (C) 2016 Elsevier Inc. All rights reserved.Öğe Benign Prostat Hiperplazisi ve Antimuskarinik Tedavi(2016) Kaynar, Mehmet; Altıntaş, Emre; Göktaş, SerdarAlt üriner sistem semptomları (AÜSS) terimi; üriner sistem semptomlarına sahip erkek hastaları değerlendirmede kullanılan prostatizm, semptomatik benign prostat hiperplazisi (BPH) ve klinik BPH terimlerinin yerini almaktadır. BPH, aşırı aktif mesane (AAM), nokturnal poliüri, üriner sistem enfeksiyonları, distal üreter taşları ve mesane tümörleri gibi birçok sağlık sorunu AÜSS'ye neden olabilir. Yaygın kullanılan bir terim olan AÜSS kapsamına giren semptomlar; depolama (acil idrar yapma hissi, sık idrara çıkma, gece idrar yapmak için uyanma ve urge inkontinans), işeme (işeme gücünde azalma, idrarı başlatmakta gecikme, kesik kesik idrar yapma) ve işeme sonrası (işeme sonrası damlama, yetersiz boşaltım hissi) ile ilgili semptomlar olarak üç alt grupta toplanmıştır. Günümüzde BPH için uygulanan en yaygın ve standart tıbbi tedavide ?1-adrenerjik reseptör antagonistleri kullanılmaktadır. Bu tedavinin yetersiz kaldığı düşünülen durumlar için alternatif tedavi arayışları halen sürmektedir. Bu çalışmalar sonucunda, BPH'nin tedavisinde ?1blokerler ile birlikte kullanılan antimuskarinik ilaçlar, bir kombine tedavi olarak literatürdeki yerini almıştır. Bu derlemede; BPH'den muzdarip hastalarda antimuskarinik tedavilerinin etkinliği ve güvenilirliği değerlendirilmiştirÖğe Benign prostatic hyperplasia and prostate cancer differentiation via platelet to lymphocyte ratio(IOS PRESS, 2015) Kaynar, Mehmet; Yildirim, Mehmet Erol; Gul, Murat; Kilic, Ozcan; Ceylan, Kadir; Goktas, SerdarBACKGROUND: The aim of the current study is to evaluate NLR and PLR inflammation markers in PCa and BPH. METHODS: Clinical and pathological data such as age, prostate volume, PSA, NLR, and PLR levels of 201 patients were retrospectively reviewed. Pathological sample results of these patients were categorized either as benign or malign. The benign group consisted of chronic prostatitis and BPH and the malign group of PCa. The PSA levels were divided into three categories as PSA: 0-4 ng/ml, PSA: 4-10 ng/ml, and 10 ng/ml and above. RESULTS: In the benign category, the mean PLR values for PSA: 0-4 ng/ml is 131.8 +/- 31.2, for PSA: 4-10 ng/ml 124.7 +/- 83.9 and 10 ng/ml and above 124 +/- 53 in chronic prostatitis group and in the BPH group for PSA: 4-10 ng/ml 120.3 +/- 45.1, for PSA: 4-10 ng/ml 126 +/- 54,2, and 10 ng/ml and above 191.4 +/- 176.1. In the malign category, the mean PLR values of PCa patients is for PSA: 0-4 ng/ml 122.8 +/- 43.8, for PSA: 4-10 ng/ml 123 +/- 43.8, and above 10 ng/ml 179.1 +/- 94. Related to the variables of age, NLR, and mean prostate volume, there were no statistically significant differences. Statistically significant differences were observed in the mean PLR values only if the PSA level was 10 ng/ml and above (p: 0.044) in the BPH and PCa groups. The correlation of the PCa Gleason score and PSA, NLR and PLR parameters in the malign category revealed no statistically significant differences (P > 0.05). CONCLUSION: Effective malign and benign differentiation of prostate pathologies based on noninvasive inflammation biomarkers such NLR and PLR necessitate clinical studies with larger patient series.Öğe Bladder cancer invasion predictability based on preoperative neutrophil-lymphocyte ratio(SAGE PUBLICATIONS LTD, 2014) Kaynar, Mehmet; Yildirim, Mehmet Erol; Badem, Huseyin; Cavis, Mucahit; Tekinarslan, Erdem; Istanbulluoglu, Mustafa Okan; Karatas, Omer FarukAn increased pretreatment neutrophil-lymphocyte ratio (NLR) is associated with poor prognosis in colorectal, gastric, and ovarian cancer; malignant mesothelioma; and renal cell carcinoma. The present study aims to define the predictive value of preoperative peripheral blood count NLR in non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive disease (MIBC) patients. There were in total 291 patients, 241 males and 50 females. Out of these, 156 male and 36 female patients were in the NMIBC group and 85 male and 14 female patients in the MIBC group. In the NMIBC group, 172 patients had low-grade and 20 high-grade papillary urothelial carcinoma. The mean age of the patients in the NMIBC group was 64 +/- 13, ranging from 27 to 97. The mean age of the patients in MIBC group was 70.5 +/- 10, ranging from 27 to 95. A statistically significant relation between patient ages and tumor invasiveness was determined (p = 0.023, 95 % confidence interval (CI) 63.3-66.7). The mean tumor size of the NMIBC group was 2.1 +/- 1.09 (cm) (range 0.5-8), and of MIBC group 3.6 +/- 1.5 (cm) (range 0.8-9). There was a statistically significant relation between the tumor size and invasiveness (p = 0.002, 95 % CI 2.8-4.4). In the NIMBC group, 149 (77.6 %) of them have NLR a parts per thousand currency signaEuro parts per thousand 2.5 and 43 (22.4 %) have NLR > 2.5. Also, in MIBC, 67 (67.7 %) of them have NLR a parts per thousand currency signaEuro parts per thousand 2.5 and 32 (32.3 %) have NLR > 2.5. The mean NLR in the NMIBC group was 2.4 +/- 0.1 (range 0.08-6.49, 95 % CI 1.52-2.71) and in the MIBC 2.9 +/- 0.2 (range 0.08-16.72, 95 % CI 1.67-2.97). In terms of NLR, there was a statistically significant difference between the NMIBC and MIBC groups (p = 0.028). Platelet-lymphocyte ratio (PLR) of the two groups was also analyzed. The PLR of the NMIBC group was 12.8 +/- 15.1 (range 3.38-19.1) and of the MIBC 13.6 +/- 8.78 (range 0.18-63), yet there was not any statistically significant difference (p = 0.810, 95 % CI 11.4-14.8) (Table 1). The correlation tests revealed a positive correlation between the age (r = 0.144, p = 0.024), tumor size (r = 0.193, p = 0.02), and tumor invasiveness NLR (r = 0.138, p = 0.031). NLR can be used to determine tumor invasiveness as a cost-effective, common, and simple biomarker in bladder cancer (BC).Öğe Böbrek ve mesane tümörlerinde aşı tedavileri(2016) Sönmez, Mehmet Giray; Kara, Cengiz; Kaynar, MehmetGenel olarak aşı tedavisi çeşitli kanserlerin tedavisinde kullanılabilir. Ancak tüm araştırmalara rağmen henüz pek çok kanser türünde başarılı olunamamıştır. Aşı tedavisinin uygulanabilmesi için; kanserin immünojenik olması ve dokuya özgü proteinler içermesi, yavaş ilerlemesi, tedavilerin uygulanabilir olması gereklidir. Bu nedenle, ürolojik kanserler içinde çoğu faz 1/2 ve faz 3 olmak üzere çalışmalar böbrek ve prostat, daha az miktarda da mesane üzerine yoğunlaşmıştır (1,2). Testis kanserlerinde aşı çalışmalarının olmaması hızlı yayılım ve metastaz göstermesi, çeşitli olması ve genellikle mix tümörler halinde izlenmesi, kantestis bariyerinin olması olarak açıklanabilir.Aşı tedavisinin kullanımında amaç; tümörün tetiklediği toleransı yenerek, malign hücrelere karşı oluşan immun cevabı aktive etmektir. Bu tedaviler kansere karşı immun cevabı kullanarak etki göstermektedir. Literatür de yayınlanan ilk onkolojik aşı tedavisi 1893 yılında Coley tarafından yayınlanmıştır. Bu çalışmada inoperable yumuşak doku sarkomlarının streptokokal toksinler ile non-spesifik immün cevap oluşturulurak regrese olduğu gösterilmiştir (3). Üroonkolojide kullanılan aşılar; tümör hücreleri (otolog ve allojenik), dentritik hücre, DNA viral vektör, protein/peptid, immün düzenleyiciler olmak üzere ana başlıklar halinde sayılabilir (4). Böbrek ve mesane tümörlerinde aşı tedavilerinin uygulanmasına ait geçmiş çalışmalar olmasına rağmen özellikle araştırmalar son dönem de yoğunlaşmıştır. Biz de bu derlemede üroloji hekimlerinin çok aşina olmadığı, güncel literatür eşliğinde böbrek ve mesane tümörlerinde kullanılan aşı tedavilerinden bahsedeceğiz.Öğe Comparison of Anesthesia Methods in Treatment of Staghorn Kidney Stones with Percutaneous Nephrolithotomy(UROL & NEPHROL RES CTR-UNRC, 2016) Buldu, Ibrahim; Tepeler, Abdulkadir; Kaynar, Mehmet; Karatag, Tuna; Tosun, Muhammed; Umutoglu, Tarik; Tanriover, HakanPurpose: To compare the efficacy and safety of percutaneous nephrolithotomy (PNL) in the treatment of staghorn calculi (SC) under spinal anesthesia (SA) versus general anesthesia (GA). Materials and Methods: Patients with SC who treated with PNL from 2011 to 2014 were retrospectively reviewed. In total, 100 patients mere divided into 2 groups according to anesthesia type: SA (group 1, n = 47) and GA (group 2, n = 53). Demographics, perioperative parameters, and postoperative analgesic requirements were compared between the two groups. Results: There was no significant difference in terms of age, sex, American Society of Anesthesiologists score, body mass index, or stone size between the two groups (P = .40, .30, .18, .20, and .50, respectively). The mean procedure times were 84.7 and 87.5 min in the SA and GA groups, respectively (P = .68). The complication rates were similar in the SA and GA groups (19.1% vs. 13.2%, respectively; P = .421). The stone-free rates were also similar in the SA and GA groups (61.7% vs. 52.8%, respectively; P = .374). No statistically significant difference was found in analgesic requirements. Conclusion: SA is a safe method without the risks of GA and may be used for conditions in which GA is contraindicated or in patients with concerns about GA. Our outcomes indicated that SC can be treated safely and effectively under SA.Öğe Comparison of diagnostic performance of PI-RADS V2 and V2.1 and interobserver agreement in both versions(Selçuk Üniversitesi, 2024) Baytok, Ahmet; Koplay, Mustafa; Özer, Halil; Topaloğlu, Ömer Faruk; Kaynar, Mehmet; Göktaş, Serdar; Batur, Ali FurkanObjective: To compare the diagnostic performance for the detection of clinically significant prostate cancers and interobserver agreement between PI-RADS v2 and v2.1 Material and Method: The mpMRI images of 258 patients and 394 nodüles included in this retrospective study were obtained on 3T MR and evaluated by two radiologists according to PIRADS v2 and v2.1. Sensitivity and specificity between v2 and v2.1 were compared. Detection rates for clinically significant prostate cancers were evaluated. Interobserver agreement was evaluated using κ statistics. Results: PI-RADS v2.1 and v2 had higher sensitivity and lower specificity (100%, 52.38%) in the peripheral zone, and showed higher sensitivity and specificity (92.86%, 98.79%) in the transition zone for category ≥4 lesions to estimate csPCa, but no remarkable difference was found between the two versions. Interobserver agreement was statistically significant and very weak in the transition zone (κ=0.383, κ=0.279, respectively), very strong in the peripheral zone (κ=0.869) according to both classifications and they were similar. Conclusion: The diagnostic performance of PI-RADS v2 and v2.1 were found similar in the determination of clinically significant cancers and all cancers in both zones. The clinically significant cancer detection rate in category 2+1 lesions in the transition zone was higher than in category 2 lesions but it was not statistically significant. Interobserver agreement was low in the transition zone and very strong in the peripheral zone in both versions.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 Comparison of the efficacy of diclofenac, acupuncture, and acetaminophen in the treatment of renal colic(W B SAUNDERS CO-ELSEVIER INC, 2015) Kaynar, Mehmet; Koyuncu, Ferudun; Buldu, Ibrahim; Tekinarslan, Erdem; Tepeler, Abdulkadir; Karatag, Tuna; Istanbulluoglu, Mustafa OkanObjective: The objective is to compare the analgesic effects of diclofenac, acetaminophen, and acupuncture in urolithiasis-driven renal colic pain relief. Methods: Renal colic patients were divided randomly into 3 groups. Patients in group I (n = 40) were treated with intravenous acetaminophen, those in group II (n = 41) with acupuncture, and those in group III (n = 40) with a 75-mg intramuscular injection diclofenac sodium. Visual analogue scale (VAS) and verbal rating scale (VRS) were used to assess pain intensity after 10, 30, 60, and 120 minutes. Results: No significant differences in baseline VAS or VRS were found with regard to age or sex. After 10 minutes, all 3 groups experienced a significant decrease in VAS and VRS scores, with the most drastic decrease occurring in group II. After 30 minutes, there was a significantly higher decrease in group III than in group I (P=.001). After 60 minutes, mean VAS scores of groups I and III (P=.753) were similar. The mean VAS score of group III was lower than that of group II (P=.013). After 120 minutes, the difference in the VAS scores was (P=.000) between groups I and II and between groups II and III. Yet, the VAS evaluation made after 120 minutes revealed statistically similar outcomes for groups I and III (P=.488). The statistical findings for VRS evaluations made after 10, 30, 60, and 120 were similar to those for VAS. Conclusions: In renal colic patients with a possible nonsteroidal anti-inflammatory drug and acetaminophen side effect risk, acupuncture emerges as an alternative treatment modality. (C) 2015 Elsevier Inc. All rights reserved.Öğe Comparison of the Therapeutic Effects of Diclofenac Sodium, Prednisolone and an Alpha Blocker for the Treatment of Renal Colic(2012) Sümer, Alpay; Kaynar, Mehmet; Topbaş, Emrah; Hassan, Mustafa Aziz; Gürbüz, RecaiObjective: In this study, we compare the efficacy of diclofenac sodium, methylprednisolone and alphablockers for the treatment of renal colic treatment. Material and methods: A total of 30 patients between the ages of 18-70 were included in this study. Patients were referred to the Meram Medical Faculty Urology Department or Department of Emergency Medicine at Selcuk University between October 2008 and January 2009. This prospective study was approved by the Selcuk University Meram Medical Faculty Ethics Committee. Patients were randomly divided into 3 cohorts of 10 patients each. The first group consisted of patients receiving diclofenac sodium and an alpha blocker, the second group of patients received diclofenac sodium and prednisolone, and the third group of patients received diclofenac sodium alone. Each patient was diagnosed and evaluated by the same clinician. Evaluation was based on the Numerical Classification Score (NCS) and the Renal Colic Symptom Score (RCSS). Pain intensity was evaluated prior to medication administration and 5, 10, 15, 20, and 30 hours thereafter. Statistical analysis was performed using chi-squared analysis and the Kruskal-Wallis test. Pvalue of ?0.05 were considered statistically significant. Results: Symptoms immediatiely prior to medication administration and after 5, 10, 15, 20 and 30 hours are evaluated. There are no significant differences between the groups (p>0.05). In group 1, stone expulsion occured in 4 patients (40%), a finding that is statistically significant (p=0.01). No adverse events occurred in any group during this study. Conclusion: Comparison of the therapeutic response among the 3 groups revealed no statistically significant difference. The most important aspects to consider in regard to a treatment modality include diminishing pain, dissolving blockage, a preservation of renal function and minimizing the side effects.Öğe Controversies in Radical Cystectomy: Meta-Analysis and Systemic Comparison of Open Surgery with Laparoscopic and Robotic Surgery(GALENOS YAYINCILIK, 2016) Kaynar, Mehmet; Goktas, SerdarOpen radical cystectomy (ORC) is the standard treatment modality in high-risk non-muscle-invasive and invasive bladder carcinoma. Although it has some advantages, oncologic outcomes of ORC are associated with high morbidity and mortality risks. In line with recent developments in urotechnology, the minimally invasive treatment modalities, such as laparoscopic radical cystectomy (LRC) and robotic-assisted radical cystectomy (RARC) have emerged as an alternative to ORC. Compared to ORC, both treatment modalities have effective surgical and similar oncological outcomes as reported in various studies. However, due to inherent difficulties in the practice of LRC and high costs of RRC have hindered these two treatment modalities to become widespread. Considering the results obtained in experienced centers as well as long-term oncologic outcomes of large patient series forming samples of the whole population, changes in the standard treatment modality of invasive bladder tumors seem to be unavoidable.Öğe Does the presence of hydronephrosis have effects on micropercutaneous nephrolithotomy?(SPRINGER, 2015) Karatag, Tuna; Buldu, Ibrahim; Kaynar, Mehmet; Inan, Ramazan; Istanbulluoglu, Mustafa OkanTo evaluate the effects of presence of hydronephrosis on micropercutaneous nephrolithotomy (micro-PNL) surgery. A retrospective analysis of 112 patients who underwent microperc surgery between December 2012 and April 2014 was performed. Patients were evaluated in two groups according to whether the presence of hydronephrosis. Stone size and location, fluoroscopy and operation time, stone-free rates and patient-related parameters were prospectively recorded into a centralized computer-generated system. A total of 58 patients in Group 1 with hydronephrosis and 54 patients in Group 2 with no hydronephrosis were analyzed. There was no statistically significant difference in terms of stone sizes and body mass indexes (BMI) in comparison of groups (155.2 +/- A 93.06 vs. 143.70 +/- A 70.77 mm(2), p = 0.856 and 27.6 +/- A 4.2 vs. 26.7 +/- A 3.2 kg/m(2), p = 0.625). The success rates were similar (91.3 vs. 92.5 %, p = 0.341). While the mean operation time and fluoroscopy time in Group 1 were 44.2 +/- A 23.62 min and 105.3 +/- A 47 s, it was 38.8 +/- A 26.4 min and 112.53 +/- A 68.3 s in Group 2, but there was no statistical difference in comparison of both groups. The mean attempts of percutan puncture were 1.35 +/- A 0.47 in Group 1 and 1.76 +/- A 0.31 in Group 2 (p = 0.185). We also found no statistical differences regarding mean hemoglobin change and hospitalization time, respectively (p = 0.685 and p = 0753). In comparison of grades of hydronephrosis, there was no statistically significant difference in subgroups analysis. The presence of hydronephrosis does not affect success rates and operative time in micro-PNL procedures significantly. Micropercutaneous nephrolithotomy is technically feasible and efficacious both in hydronephrotic and non-hydronephrotic kidneys.Öğe DRUG RESISTANCE RESTRICTS THE EFFICACY OF SHORT TERM LOW DOSE MITOMYCIN-C TREATMENT IN UMUC-3 BLADDER CANCER CELLS(INIESTARES, S.A., 2018) Gul, Murat; Goktas, Serdar; Kars, Meltem Demirel; Kaynar, MehmetOBJECTIVE: Mitomycin-c (MMC) is the most used intravesical adjuvant agent in non-muscle invasive bladder cancer to prevent recurrence. However, a consensus on about appropriate dosage and treatment schedule of MMC is lacking. We, therefore, aimed to evaluate the most appropriate MMC dosage using an in vitro model of high-grade human bladder cancer. METHODS: UMUC-3 cells, a model for high-grade bladder cancer, were exposed to MMC in different time courses to assess its toxicological effects. XTT cell proliferation kit was used to evaluate the effect of MMC on the proliferation of UMUC-3 cell line. Gene expression analysis for the MDR1, BCL2 and ANXA5 genes was performed by Real-time PCR and flow cytometry analysis were conducted to evaluate the cell death mechanism and acquired resistance after MMC exposure. An ANXA5 kit was used to detect apoptotic cells, and 7-AAD was used to detect necrotic cells. RESULTS: Cell proliferation was prevented to a large extent (IC50, 0.175-0.081 mg/mL) and cytotoxic effects were observed after 5 mu g/mL and 10 mu g/mL MMC administrations for 1 and 2-h, after the 4th and 2nd dose cycles, respectively. Moreover, cell death was observed at 5 mu g/mL and 10 mu/mL MMC applications for 1-h and 2-h by the sixth and second week, respectively. Flow cytometry exhibits increased subpopulation of drug-extruding UMUC-3 cells after a single dose of MMC for 1-h. MMC did not increase the number of apoptotic or necrotic cells; yet, MDR1 (multiple drug resistance) and ANXA5 (apoptotic) expression levels were increased and BCL2 (anti-apoptotic) expression was decreased. Limitations: In-vitro nature of the study and working with only one cell culture are inherit limitations of this project. CONCLUSION: A single dose of MMC administration for 1 or 2-h results in drug-resistance. If maintenance treatment is administered for one hour, it should be continued throughout a 6-week period.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 Effective radiation exposure evaluation during a one year follow-up of urolithiasis patients after extracorporeal shock wave lithotripsy(POLISH UROLOGICAL ASSOC, 2015) Kaynar, Mehmet; Tekinarslan, Erdem; Keskin, Suat; Buldu, Ibrahim; Soenmez, Mehmet Giray; Karatag, Tuna; Istanbulluoglu, Mustafa OkanIntroduction To determine and evaluate the effective radiation exposure during a one year follow-up of urolithiasis patients following the SWL (extracorporeal shock wave lithotripsy) treatment. Material and methods Total Effective Radiation Exposure (ERE) doses for each of the 129 patients: 44 kidney stone patients, 41 ureter stone patients, and 44 multiple stone location patients were calculated by adding up the radiation doses of each ionizing radiation session including images (IVU, KUB, CT) throughout a one year follow-up period following the SWL. Results Total mean ERE values for the kidney stone group was calculated as 15, 91 mSv (5.10-27.60), for the ureter group as 13.32 mSv (5.10-24.70), and in the multiple stone location group as 27.02 mSv (9.41-54.85). There was no statistically significant differences between the kidney and ureter groups in terms of the ERE dose values (p = 0.221) (p >0.05). In the comparison of the kidney and ureter stone groups with the multiple stone location group; however, there was a statistically significant difference (p = 0.000) (p <0.05). Conclusions ERE doses should be a factor to be considered right at the initiation of any diagnostic and/or therapeutic procedure. Especially in the case of multiple stone locations, due to the high exposure to ionized radiation, different imaging modalities with low dose and/or totally without a dose should be employed in the diagnosis, treatment, and follow-up bearing the aim to optimize diagnosis while minimizing the radiation dose as much as possible.Öğe The effectiveness of local steroid injection after internal urethrotomy to avoid recurrence(PAGEPRESS PUBL, 2015) Yildirim, Mehmet Erol; Kaynar, Mehmet; Ozyuvali, Ekrem; Badem, Huseyin; Cakmak, Muzaffer; Kosem, Bahadir; Cimentepe, ErsinObjective: Local steroid injection to the stricture region after internal urethrotomy (IU) is a promising technique to avoid the recurrence, although the effectiveness and safety of this technique is still controversial. We aimed to determine the efficacy and safety of local steroids as applied with the IU procedure. Material-Method: A total of 83 patients data with urethral stricture in men were examined retrospectively. Patients classified in two groups who had steroid injection with internal urethrotomy or not. Metil prednisolone 40 mg was injected with transurethral injection needle in the stricture region at the 5, 7 and 12 o'clock sites at the same session with internal urethrotomy. Procedure was considered successful if patient did not report any voiding difficulty and maximum flow rate > 15 mL/second for a voided volume of at least 150 mL after removal of the catheter. Patient's age, time to recurrence, previous recurrences were evaluated. Results: The mean age was 56.4 (18-83) years. Of those patients 33/83 had recurrent stenosis. Nineteen out of these 33 recurrent stenosis patients were treated with local steroid injection and 14/33 had no injection. Only two patients of the steroid treated group had recurrence. Despite that 12 patients had recurrence in the steroid non-treated group. Also the primary stenosis patients showed no recurrence at the steroid+ IU group. Conclusions: The use of local steroids with IU seems to decrease the high stricture recurrence rate following IU. When local steroids were administered with complementary intention, the disease control outcomes are encouraging. Further robust comparative effectiveness studies are now required.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 Ileo-Cavernosal Fistula after Radiotherapy: A Case Report and Review of the Literature(UROL & NEPHROL RES CTR-UNRC, 2015) Gul, Murat; Islamoglu, Necat; Kaynar, Mehmet; Koplay, Mustafa; Goktas, Serdar[Abstract not Available]Öğe Necessity of routine histopathological evaluation subsequent to bladder neck contracture resection(POLISH UROLOGICAL ASSOC, 2016) Kaynar, Mehmet; Gul, Murat; Kucur, Mustafa; Celik, Esin; Bugday, M. Serdar; Goktas, SerdarIntroduction Bladder neck contracture is a well-known complication following some urologic surgical procedures. Regardless of the surgical procedure, any specimen resected should be submitted for histopathological evaluation worldwide. However, the charges of histopathological evaluation may bring a heavy burden to the hospital and health care system. Also, waiting the period of the pathological evaluation process can be an anxious time for patients. Hence, we aimed to investigate the necessity of routine histopathological evaluation of bladder neck contracture bladder neck contraction specimens. Material and methods Patients undergoing bladder neck contraction resection, from 2010 to 2015 were identified. Patient demographics, type of surgery and histopathological diagnosis and cost of histopathological analyses of the specimens were recorded and analyzed. Results Findings of the histopathologic evaluations of 340 bladder neck specimens were reviewed. Out of these, 294 had underwent transurethral resection of the prostate, 38 open prostatectomy, and 8 radical prostatectomy. Evidence of malignant disease involving prostate cancer was present in only 2 specimens. Both of the specimens had a known preexisting history of malignant disease. The remaining 338 specimens showed chronic inflammation (n = 176), chronic active inflammation (n = 64), adenomatous hyperplasia (n = 78) or cystitis (n = 20). Conclusions Our results indicate that routine histopathological examination of bladder neck contraction specimens is clinically unnecessary. We recommend that the surgeon should decide the need for histological examination on individual basis, depending on known preoperative risk factors.Öğe Neutrophil-to-lymphocyte ratio predicts progression and recurrence of non-muscle-invasive bladder cancer(ELSEVIER SCIENCE INC, 2015) Kaynar, Mehmet; Goktas, Serdar[Abstract not Available]
