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    Penis replantation after self-mutilation
    (SPRINGER, 2009) Ozturk, Ahmet; Kilinc, Mehmet; Guven, Selcuk; Gormus, Niyazi; Belviranli, Metin; Kaynar, Mehmet; Arslan, Mehmet
    In this case report, the procedure of penis replanting and its complications after genital self-mutilation in a male adult are explained.
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    Percutaneous injection sclerotherapy with tetracycline hydrochloride in simple renal cysts
    (SPRINGER, 2008) Kilinc, Mehmet; Tufan, Osman; Guven, Selcuk; Odev, Kemal; Gurbuz, Recai
    Objectives Symptomatic simple renal cysts can be treated by combination of percutaneous aspiration and sclerotherapy. A number of sclerosing agents including glucose, phenol, iophendylate, polidocanol, minocycline and pantopaque have been used in the past to prevent reformation of cyst. In this study, tetracycline HCL solution is evaluated as a sclerosant for treatment of simple renal cysts. Methods Our study treated 76 cysts in 70 patients with symptomatic renal cysts. Aspiration and sclerotherapy was performed on 56 cysts, and 20 cysts aspirated without sclerotherapy as a control group. Treatment was performed under local anesthesia and punctured under ultrasound guidances with an 18-gauge needle. Tetracycline HCL (20%) was injected into the cystic cavity according to cyst diameter. All patients were followed up with an ultrasound examination at 3 months, 6 months, and then at yearly intervals. The reduction rate was estimated by a comparison of the volume of the cyst before and after treatment. A cyst reduction of 50% or greater in diamater was considered as a successful treatment. Results The average follow-up period was 9.8 months in the sclerotherapy group and 9.9 months in the control group. The success rate was 85.7% in the sclerotherapy group. There was a significant difference in the reduction rate of tetracycline HCL sclerotherapy group and control group. No major complications were encountered.
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    Simultaneous Bilateral Percutaneous Nephrolithotomy in Children: No Need to Delay
    (MARY ANN LIEBERT INC, 2011) Guven, Selcuk; Ozturk, Ahmet; Arslan, Mehmet; Istanbulluoglu, Okan; Piskin, Mesut; Kilinc, Mehmet
    Background and Purpose: Children with bilateral kidney stones are generally treated using staged percutaneous nephrolithotomy (PCNL). Reports related to simultaneous bilateral PCNL (SBPCNL) in children are scarce. We aimed to evaluate the efficacy and safety of SBPCNL in children. Patients and Methods: The children who underwent SBPCNL applications between January 2007 and February 2010 in our clinic were evaluated. Patient data were collected from the retrospective reviews of hospital records. Results: SBPCNL was conducted in five patients for bilateral renal stones. The mean age of the patients was 6.28 years (range 0.75-15 y), and the mean follow-up was 10.6 months (range 1-36 mos). The mean renal stone burden was 19 mm (range 11-22 mm). Four children underwent bilateral standard PCNL, and one child underwent bilateral tubeless PCNL. The mean duration of SBPCNL was 75 minutes (range 55-120 min), and the hospitalization time was 4 days (range 2-5 d). No blood transfusion was necessary in any patient. Except for the patient with complex renal stones, all patients were stone free after the intervention, and none needed a conversion to open surgery. Conclusion: SBPCNL is a safe and effective procedure in children if they are selected properly and if the surgeon has sufficient experience with the procedure. More studies with a higher number of participants are needed, however, for further evaluation of the procedure.
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    Temporary Cavernosal-Cephalic Vein Shunt in Low-Flow Priapism Treatment
    (ELSEVIER SCIENCE BV, 2009) Kilinc, Mehmet
    Background: Surgical shunting might be considered as the only option in the treatment of extended ischemic priapism that does not respond to aspiration and medication. Objective: A modified, simple, minimally invasive, and easily applicable artificial cavernosal-venous shunt technique for treating priapism is described in this report. Design, setting, and participants: A total of 15 patients with extended and non-responsive low-flow priapism were treated with this technique between January 1998 and February 2007. Intervention: When the conservative treatment of low-flow priapism does not yield the expected results, then the temporary cavernosal-cephalic vein shunt should be applied. The standard equipment required for this modified technique includes three angiocaths, two shorn blood serum sets, and saline solution with heparin. The blood in the cavernosa and the saline solution infusion are incorporated into the systemic circulation with the aid of serum sets and angiocaths. Measurements: Priapism duration, history, causes, its relation with sexual stimulation, pain, and any prior management of priapism were assessed in all patients. A complete blood count and blood gases assessment were conducted in corporal aspirates, and duplex penile ultrasonography was performed, which showed attenuated blood flow in the cavernosal artery. Results and limitations: This technique was applied in 15 patients. Complete detumescence was achieved in 13. In the two cases in whom the technique did not yield the expected results, there was a need for a sapheno-cavernosal shunt. These patients later complained of erectile dysfunction and penile pain that continued for 6 mo. Of the 13 patients in whom detumescence was achieved, 3 reported erectile dysfunction according to International Index of Erectile Function (IIEF) scores at the 12-mo follow-up. Conclusions: Artificial cavernosal-cephalic vein shunt in the treatment of priapism is simple, safe, effective, easily applicable, and warrants primary consideration when the second-line treatment of priapism is initiated. (C) 2008 European Association of Urology. Published by Elsevier B.V. All rights reserved.
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    Topical and Long-Acting Local Anesthetic for Prostate Biopsy: A Prospective Randomized Placebo-Controlled Study
    (KARGER, 2009) Yurdakul, Talat; Taspinar, Bulent; Kilic, Ozcan; Kilinc, Mehmet; Serarslan, Alparslan
    Objective: To determine the efficacy of intrarectal lidocaine gel alone and a combination of lidocaine gel with 2 different longer-acting local anesthetic (LA) agents that were injected into the periprostatic area before transrectal ultrasound-guided prostate biopsy. Patients and Methods: One hundred patients undergoing transrectal prostate biopsy were randomized into 4 groups of 25 patients each. Before the biopsy, group 1 received no local anesthesia, group 2 received 2% lidocaine gel intrarectally, group 3 received intrarectal lidocaine gel and 5 ml bupivacaine (0.25%) injected into periprostatic area, and group 4 received lidocaine gel intrarectally and a 5-ml ropivacaine injection (0.25%) in the same location as group 3. Pain levels during and after the biopsy were assessed by using a 10-point linear visual analog scale (VAS). Results: Patients in groups 3 and 4 had significantly lower VAS scores than those in groups 1 and 2, both during and 1 h after biopsy. There were no differences in the pain scores between groups 1 and 2. Conclusion: The combination of intrarectal lidocaine gel and periprostatic longer-acting LA agents significantly reduces the pain related to prostate biopsy, whereas intrarectal lidocaine gel administration alone does not reduce pain. Thus, administration of the periprostatic longer-acting LA agents alone is adequate. Copyright (C) 2009 S. Karger AG, Basel
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    Totally Tubeless Percutaneous Nephrolithotomy: Is It Safe and Effective in Preschool Children?
    (MARY ANN LIEBERT, INC, 2010) Ozturk, Ahmet; Guven, Selcuk; Kilinc, Mehmet; Topbas, Emrah; Piskin, Mesut; Arslan, Mehmet
    Background and Purpose: After the introduction of tubeless percutaneous nephrolithotomy (PNL), many studies conducted in adult patients have confirmed its efficacy and safety. There are limited studies reporting that tubeless PNL can be safely applied in children, however. Furthermore, there are no reports that evaluate the use of totally tubeless PNL in children. The present study evaluates the results of totally tubeless PNL in preschool children. Patients and Methods: The data of children seen in our clinic who were considered suitable for totally tubeless PNL were analyzed. Of 16 children, 8 patients underwent totally tubeless PNL (group 1) and 8 standard PNL (group 2). The two groups of patients were compared with regard to length of hospitalization, analgesic requirements, transfusion rates, hemoglobin (Hb) decrease, and immediate, early, and late complications. Results: The mean ages of the patients were 56.6 months (9-84 mos) and 56.0 months (5-84 mos), and the mean follow-up was 21.5 months (3-44 mos) and 43.4 months (36-54 mos) in groups 1 and 2, respectively. Both groups were similar with regard to age, stone size, Hb change, and complications. Although operation duration, hospitalization period, and analgesic requirement were less in the totally tubeless PNL group, these differences were not statistically significant. Conclusions: The latest application of PNL, totally tubeless PNL, is also a safe and effective procedure in very small children if they are selected properly and if the surgeon has sufficient experience with the procedure. More studies with a higher number of participants are needed, however, to confirm that totally tubeless PNL increases the comfort of pediatric patients, decreases their hospitalization period, and is more economical.