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Öğe A case report: Ureteral triplication seen along with ipsilateral ureterocele(1999) Yurdakul, Talat; Karalezli, Giray; Karabacak, KadirThe fourth case of ureteral triplication associated with ipsilateral ureterocele is reported. Weigert-Meyer law was not valid for this case.Öğe Combination Antioxidant Effect of Alpha-tocoferol and Erdosteine in Ischemia-Reperfusion Injury in Rat Model(Springer, 2010) Yurdakul, Talat; Kulaksızoğlu, Haluk; Pişkin, Mehmet Mesut; Avunduk, Mustafa Cihat; Ertemli, Esra; Gökçe, Gürhan; Barışkaner, Hulagü; Büyükbaş, Sadık; Kocabaş, Volkan[Abstract not Available]Öğe Combination Antioxidant Effect of Alpha-Tocoferol and Erdosteine in Ischemia-Reperfusion Injury in Rat Model(Springer, 2010) Yurdakul, Talat; Kulaksızoğlu, Haluk; Pişkin, Mehmet Mesut; Avunduk, Mustafa Cihat; Ertemli, Esra; Barışkaner, Hulagü; Büyükbaş, Sadık; Kocabaş, VolkanIntroduction Renal ischemia/reperfusion (I/R) which is an important cause of renal dysfunction is inevitable in renal transplantation, surgical revascularization of the renal artery, partial nephrectomy and treatment of suprarenal aortic aneurysms. Aim The purpose of this study was to investigate the efficacy of alpha-tocopherol and erdosteine combination in the reduction in injury induced by ROS in a rat model of renal ischemia-reperfusion. Materials and methods Thirty-six-male Wistar albino rats weighing 200-250 g were utilized for this study. Rats were divided into six groups, and each group was consistent of six rats: (1) sham-operated (control), (2) ischemia group (3) I/R group, (4) I/R/alpha-tocoferol group (5) I/erdosteine group (6). I/R/alpha-tocoferol and erdosteine group. Biochemically tissue MDA, XO and SOD activities, light and electron microscopic findings were evaluated. Results The erdosteine and alpha-tocoferol significantly reversed the effect of protein oxidation and lipid peroxidation induced by I/R shown by the decreased levels of MDA and XO activities. Both MDA and XO levels were found to be lower in group 6 compared to single agent treatment groups, and this was significantly different. All treatment groups showed increased SOD activity, which accounts for their oxidative properties. The mean Paller score of the combination treatment group (group 6) was lower than all groups except the sham group (3.67 +/- 1.2), and this finding was statistically significant (0.05). Our results showed that the antioxidant pretreatment with alpha-tocopherol and erdosteine combination reduced lipid peroxidation of renal cellular membranes in a model of normothermic renal ischemia-reperfusion in rats. Combination of erdosteine and alpha-tocopherol has a synergistic effect of protection against oxidative processes. Long-term use of alpha-tocopherol seems to have a greater effect on the prevention of IR injury. However, further investigations are needed for the clinical applications of our findings.Öğe Haemostatic Role and Histopathological Effects of a New Haemostatic Agent in A Rat Bladder Haemorrhage Model: An Experimental Trial(WILEY-BLACKWELL, 2010) Kılıç, Özcan; Gönen, Murat; Acar, Kadir; Yurdakul, Talat; Avunduk, Mustafa Cihat; Esen, Hacı Hasan; Öz, MehmetOBJECTIVE To investigate the haemostatic efficacy and histopathological effects of a new haemostatic agent, Ankaferd BloodStopper (R) (ABS; Ankaferd Drug Cosmetic Co., Istanbul, Turkey) in a rat bladder haemorrhage model. ABS is a unique combination of five plant extracts that has been used in Turkish traditional medicine as a haemostatic agent for external traumatic bleeds. MATERIALS AND METHODS In all, 20 male Sprague-Dawley rats were divided into two equal groups. In both groups, the mucosa was damaged on the posterior wall (PW) of the bladder. The liquid form of ABS was applied to the bleeding area of one group (group 1) and 0.9% NaCl to the bleeding area of the other group (group 2, controls). The solutions were applied drop by drop with a 2 mL injector until the bleeding stopped and the bleeding times recorded. For histopathological examination, two tissue samples were taken from all rats in each group; one from the damaged mucosa in the PW and one from undamaged mucosa in the lateral wall (LW). Two sections were prepared from all samples. One section was stained with haematoxylin and eosin (H&E), and the rest was used for immunohistochemical staining for fibronectin. RESULTS The mean bleeding times were 65 s and 147 s for groups 1 and 2, respectively (P < 0.001). In the pathological specimens stained with H&E, fibrosis and other studied pathological features were similar in the LW samples in groups 1 and 2. Similarly, there were no differences between the PW samples of groups 1 and 2. In the pathological specimens stained for fibronectin, the number of attenuated cells was similar in the LWs of group 1 and 2 (P = 0.21) as well as in the PWs of each group (P = 0.066). CONCLUSIONS ABS decreased bleeding time and did not increase fibrotic reactions in rat bladder tissue.Öğe I?nfertil Erkeklerde Yüksek Inguinal ve Mikro Cerrahi ile Subinguinal Varikoselektominin Karşılaştırılması(2003) Yurdakul, Talat; Gökçe, Gürhan; Kısakol, Gürcan; Kılınç, MehmetBu çalışmada; infertilite tedavisinde yüksek inguinal varikoselektomi, yöntemi ile, subinguinal mikrocerrahiyle varikoselektomi, komplikasyonları, semen parametreleri ve hormon profillerine etkileri açısından karşılaştırılmıştır. Yüksek inguinal yöntemle (Grup 1) 50 olguda 70, subinguinal mikrocerrahiyle (Grup 2) 50 olguda 77 varikoselektomi yapıldı. Grup 1'de olguların sekizinde (%16,6) nüks oluştu ve 5 olguda hidrosel gelişimi (%10,4) saptandı; grup 2'de 2 olguda (%4) nüks saptandı. Grup 2'de hiçbir olguda hidrosel gelişimi gözlenmedi (P<0.05). Grup 1 ve grup 2'de; preoperatif ve postoperatif ortalama sperm sayıları, hareketlilik ve serum hormon düzeyleri arasında anlamlı bir fark bulunamadı. Ancak grup 2'de Serbest Testosteron düzeyindeki artış grup 1'e göre istatiksel olarak anlamlı bulundu (P<0,05). Subinguinal mikroskobik cerrahi lokal anesteziyle uygulanabilmesi, nüks oranının ve hidrosel oluşumunun düşük olması nedeniyle varikoselektomide alternatif bir yöntemdir.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 Leiomyosarcoma of Spermatic Cord(2000) Karalezli, Giray; Yurdakul, Talat; Avunduk, Mustafa Cihat; Selçuk, AlaaddinSpermatik kordonun malign tümörleri seyrektir. Bunların pek çoğu sarkomlardır. 38 yaşında erkek hasta nontesti- küler skrotal kitle ile başvurdu. Hastaya sağ inguinal eksplorasyon yapıldı. Frozen section'daki malign kriterler nedeniyle hastaya geniş bir spermatik kordon diseksiyonu ile birlikte radikal orşiektomi uygulandı. Histopatolojik tanı leiomyosarkom idi.Öğe Long-Term Results of Deep Dorsal Vein Resection of the Penis in Corporal Venous Insufficiency(2000) Yurdakul, TalatWe performed deep dorsal vein resection of the penis ( DDVRP ) in 26 impotent men who were determined to have venous leak by pharmacocavernosometry. Postoperatively, by mean follow-up period of 18 months, six patients (23.1 %) had unaided erections, seven became responsive to intracavernous injection (ICI) of papaverine (26.9%). Total success rate was 50%. Three patients underwent placement of penile prosthesis. Ten patients did not accept any further therapy. Smoking and age were found to be significantly different between the success and failure group. Despite modest success rates with long-term follow-up venous surgery can be offered to younger nonsmoker patients.Öğe On-Demand Tramadol Hydrochloride Use in Premature Ejaculation Treatment(ELSEVIER SCIENCE INC, 2012) Kaynar, Mehmet; Kılıç, Özcan; Yurdakul, TalatOBJECTIVES To determine the efficacy of tramadol in premature ejaculation (PE) treatment compared with placebo. METHODS A single-blind, placebo-controlled, crossover study was conducted with 60 lifelong (primary) patients with PE. The patients were randomized into 2 groups, each consisting of 30 patients, who took tramadol or placebo on demand. PE was defined as an intravaginal ejaculation latency time of <= 60 seconds in 90% of intercourse episodes. The efficacy of the drugs was assessed using the intravaginal ejaculation latency time, ability of ejaculation control, and sexual satisfaction scores after an 8-week treatment period. RESULTS All participants completed the study voluntarily. Two groups were similar in terms of the patient demographics. Increases in the intravaginal ejaculation latency time, ability of ejaculation control, and sexual satisfaction score between the placebo and tramadol groups were compared with the baseline values in both groups. At the end of study period, the tramadol group had significantly (P<.001) greater values for all 3 parameters compared with those in the placebo group. CONCLUSIONS On-demand use of low-dose tramadol is effective for lifelong PE. Currently, selective seratonin reuptake inhibitors such as dapoxetine, are a more popular treatment option for PE. However, tramadol might be considered an alternative agent for primary PE treatment.Öğe Pelvic Hydatic Disease Causing Renal Failure(2006) Yurdakul, Talat; Pişkin, Mehmet MesutPelvik hidatik kistin akut böbrek yetmezliği oluşturması son derece nadir bir durumdur. Pelvik yerleşimli hidatik kiste bağlı gelişen obstrüktif üropatinin sebep olduğu akut böbrek yetmezliğine giren 24 yaşındaki bir olguyu sunuyoruz.Öğe Prediction of varicocelectomy outcome from sperm recovery and survival tests(1999) Yurdakul, Talat; Aydos, KaanAmaç: Varikoselektominin seminal parametreler üzerine olan olası etkilerini önceden tahmin etmeye yönelik bir metodun geliştirilmesi. Hastalar ve Yöntem: Klinik varikoseli bulunduğu ortaya konan 27 erkekte, varikoselektomi öncesi ve sonrası, sperm swim-up ve 24 saatlik motilite analizleri yapıldı. Sonuçlar: Operasyon öncesi ve sonrası sperm konsantrasyonu, motilite ve morfoloji parametreleri karşılaştırıldı. Sperm konsantrasyonunda anlamlı düzelme saptanırken, motilite ve morfolojilerinde bir düzelme gözlenmedi. Bunun üzerine, aynı parametreler, sperm swim-up sonrası ve 24. saat sperm motilite değerleri bakımından hastalar yeniden gruplandırılarak tekrar analiz edildiler. Swim-up sonrası elde edilen ortalama motil spermatozoa (median %90.0) ve 24. saat motil spermatozoa yüzdeleri (median %80.0) hesaplandı. Swim-up sonrası sperm motilitesi %90 olan erkeklerde, sperm sayı, motilite ve morfoloji yüzdeleri, operasyon öncesi değerlere göre anlamlı derecede düzelmiş bulundu (sırasıyla; p0.0002, 0.0202 ve 0.0108). %90 motil sperm elde edilmiş olanlarda ise, postoperatif sperm sayısı ile operasyon öncesi swim-up değerleri arasında bir ilişki bulunamadı (p0.7353). 24. saatte motil spermatozoa oranlan %80 olan erkeklerde varikoselektomiyi takiben, yine, sperm sayı, motilite ve morfoloji değerlerinde anlamlı düzelme kaydedildi (sırasıyla; p0.0004, 0.0068 ve 0.0203). 24. saatteki motil spermatozoa oranı %80 olduğunda ise, sperm sayı, motilite ve morfoloji değerlerinde operasyon öncesi ve sonrası arasında anlamlı bir fark bulunamadı (sırasıyla; p0.3066, 0.0609 ve 0.3655). Tartışma: Çalışmanın sonuçları, varikoselli hastalarda, standart semen parametrelerinin varikosel operasyonunun prognozu hakkında kısıtlı bilgi verdiklerini ortaya koymuştur. Bu nedenle, swim-up ve sperm canlılığı testlerinin standart sperm analizini tamamlayan ve bu olgularda seminal parametrelerdeki düzelmeyi önceden tahmin ettirebilecek güvenilir metodlar olduğu kanısına varıldı.Öğe Prevention of Renal Damage by Alpha Tocopherol in Ischemia and Reperfusion Models of Rats(Springer-Verlag, 2003) Avunduk, Mustafa Cihat; Yurdakul, Talat; Erdemli, Esra; Yavuz, AyşeIschemia-reperfusion injury in rat kidneys most probably comes from oxidative stress, but the possible preventive effect of alpha-tocopherol (AT) treatment on this injury has not yet been established. Forty male Wistar rats were randomly divided into four groups. The left renal arteries of all rats except the controls were clamped to induce renal ischemia. The left kidneys of the rats in the ischemia group were removed following 40 min ischemia. The rats in the ischemia-reperfusion and ischemia-reperfusion-AT groups were treated similarly, but in these groups the renal arteries were re-perfused for 1 h following ischemia. The rats in the ischemia-reperfusion-AT group also received 10 mg/kg AT 3 h prior to ischemia. The specimens were examined histopathologically and ultrastructurally, and the tissue calcium levels were measured. Light microscope and ultrastructural examination showed that the greatest damage occurred in the ischemia-reperfusion group. The highest level of tissue calcium was also found in this group. In the ischemia-reperfusion-AT-treated group, less tissue damage and a lower tissue calcium concentration was found compared to both the ischemia and ischemia-reperfusion groups. Our results indicate that AT can reduce tissue damage after ischemia-reperfusion injury.Öğe Sperm retrieval and IVF-ICSI results in the treatment of obstructive and non-obstructive azoospermia(2005) Yurdakul, Talat; Görkemli, Hüseyin; Aktan, Murad; Duman, Selçuk; Güven, SelçukOBJECTIVE: It is usually possible to recover sperm in both obstructive and non-obstructive azoospermic patients by microsurgical epididymal aspiration (MESA) or testicular sperm extraction (TESE) and ICSI could be performed with these spermatozoas. STUDY DESIGN: Ninty-one males were diagnosed as azoospermia in the Urology Department, when sperm was able to recovered, intracytoplasmic sperm injection (ICSI) treatment was applied in our Assisted Reproductive Technology (ART) unit during the period of November 2000 to April 2003. MESA was performed to 13 obstructive azoospermic (OA) males and TESE was performed to 78 non-obstructive azoospsermic (NOA) males. RESULTS: Mature spermatozoa were picked up from all of the obstructive azoospermic patients. Mature spermatozoa were also picked up from 47 (60%) NOA patients. 92 ovulation induction cycles were carried out for ICSI. Of these cycles 29 were carried out with epididymal mature spermatozoa and 63 cycles carried out with testicular mature spermatozoa in non-obstructive azoospermics. In MESA group, fertilization rate was 149/243 (61%). Biochemical pregnancies were achieved in 6 couples (46%), a healthy twin was delivered in one couple (7.6%) and pregnancies of two couples are ongoing. In TESE group, fertilization rate was 181/488 (37.3%). Biochemical pregnancies were achieved in 13 couples (27%) and in 7 (14.8%) couples healthy delivery were done, one of them was twin . CONCLUSION: When sperm can be picked up by MESA or TESE from an azoospermic patient,IVF/ICSI is the only choice of treatment for these infertile couples.Öğe Spinal Kord Yaralanmalı Hastalarımızda Ürodinamik Değerlendirimi(1997) Özerbil, Önder M.; Yurdakul, Talat; Şendur, Ö. Faruk; Özeroğlu, Mehmet; Küçükşen, Sami; Sert, İ. ÜnalSpinal kord yaralı 21 hastanın mesane fonksiyonları ürodinamik olarak incelendi ve nörolojik muayene bulguları ile karşılaştırıldı. Bu bilgiler doğrultusunda üriner sistem tedavileri uygulanarak, takipleri gerçekleştirildi. Ürodina'mi sonuçlarına göre 10 hiperrefleks mesaneli hastanın 9'u dissinerjik sfinkterli, 11 arefleks mesaneli hastanın 5'i nonkoordine sfinkterli iken, 6'sı koordine sfinkterli idi. Arefleks mesaneli iki hastanın mesane kompliansları düşüktü. Suprasakral lezyonlu (T6) bir hasta arefleks mesaneye sahipti. 5 hastaya kontrolleri sonunda cerrahi tedavi önerilirken, diğer hastaların temiz aralıklı kateter, Oksibutinin HCI veya suprapubik taping-Valsalva-Crede ile kombine saatli işeme şeklindeki tedavileri sağlandı. Nörojenik mesane tedavisi, nörolojik muayeneden ziyade ürodinamik pensiplere dayandırılmalıdır. Ürodinamik inceleme hastanın durumuna göre yılda en az bir kez tekrarlanmalı ve tedaviler buna göre yönlendirilmelidir.Öğe 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, AlparslanObjective: 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, BaselÖğe Transurethral resection of ejaculatory ducts in the treatment of complete ejaculatory duct obstruction(SPRINGER, 2008) Yurdakul, Talat; Gokce, Gurhan; Kilic, Ozcan; Piskin, M. M.Objectives To evaluate the value of transurethral resection of the ejaculatory duct (TURED) in the treatment of complete ejaculatory duct obstruction (EDO) as a treatable cause of male factor infertility. Materials and methods We retrospectively evaluated 12 azoospermic infertile men who were diagnosed as having complete EDO. The mean age of the patients was 32 years (range 24-40). Inclusion criteria were EDO in patients with azoospermia, normal serum levels of gonadotropins and testosterone and evidence of obstruction on transrectal ultrasonographic (TRUS) images. The definitive diagnosis was based on the absence of an efflux of methylene blue injected through the seminal vesicles during cystoscopy. All patients were treated by TURED. Results Before TURED, all patients were azoospermic and had been considered as candidates for in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). Following the operation, sperms were seen in the ejaculates of 11/12 patients. After a mean follow-up period of 12 (range 4-36) months, five (41.6%) pregnancies were noted (three spontaneous, one with intrauterine insemination and one with IVF/ICSI). Conclusion Transurethral resection was found to be a safe and somewhat effective approach for the treatment of EDO. After TURED, a significant improvement was achieved in semen parameters, and spontaneous pregnancy resulted in three cases. In addition, TURED can reduce the need for expensive procedures such as IVF/ICSI as this modality allows IVF/ICSI to be performed with ejaculated instead of surgically retrieved sperm.Öğe Tübero sklerozlu hastada bilateral renal anjiomyolipom sebebi ile masif retroperitoneal kanama(2009) Kılıç, Özcan; Yurdakul, Talat; Kaynar, Mehmet; Özbek, Orhan; Baba, FüsunRenal anjiomyolipom (AML), tüberoskleroz kompleksinin (TS) en yaygın ürolojik bulgusudur. Bu kitleler daha çok kanamayla iliskili önemli derecede morbiditeye sebep olabilirler. Burada, bilateral renal cerrahi uygulanan TS ile iliskili, iki tarafı ve çok sayıda renal AML’si bulunan hastayı sunuyoruz. Olgu, klinik bulgular ve tedavi yöntemleri esliğinde tartısılmıstır.Öğe Use of a laser to detect viable but immotile spermatozoa(BLACKWELL VERLAG GMBH, 2004) Aktan, Tahsin Murad; Montag, M; Duman, Selçuk; Görkemli, Hüseyin; Rink, Klaus; Yurdakul, TalatA prerequisite for the success of intracytoplasmic sperm injection (ICSI) is the use of viable sperm that will support oocyte activation and embryo development. Usually, spermatozoa are selected according to motility, which is a clear indication for viability. However, in cases with complete asthenozoospermia, it is impossible to select viable sperm by morphological means. Here we report for the first time on the use of a laser to discriminate between viable and dead immotile spermatozoa. The application of a single laser shot to the far end of the sperm tail causes a curling of the sperm tail only in viable sperm, similar to the reaction observed in the hypo-osmotic swelling test. Using this method for sperm selection prior to ICSI we achieved high fertilization and cleavage rates in cases with immotile sperm in fresh testicular biopsy material as well in cases with ejaculated immotile sperm. It is concluded that laser sperm interaction allows for the identification of viable but immotile spermatozoa.Öğe Varicocele testiculopathy: A novel cause for treatment failure in hypogonadotropic hypogonadism(1999) Yurdakul, Talat; Iıı, Carl O. Brunıng37 year-old-male with acquired hypogonadotropic hypogonadism, primary infertility, and decreased libido after 20 months of continued gonadotmpin therapy presented with bilateral varicoceles. Bilateral subinguinal varicocelectomy with operative microscope was done. Serum testosterone level, total motile sperm count, 24-hour sperm motility, and libido markedly improved. The couple spontaneously conceived four months post-operatively. Varicocelectomy improved both spermatogenesis and testosterone synthesis in a man with acquired hypogonadotropic hypogonadism. Varicocele is a reversible cause for gonadotmpin treatment failure.
