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Öğe Advantages of routine flexible nephroscope usage in percutaneous nephrolithotomy operations : Early results of prospective randomized study(Mary Ann Liebert Inc, 2012) Gücük, Adnan; Kemahlı, Eray; Üyetürk, Uğur; Tuygun, Can; Yıldız, Mevlüt; Metin, AhmetÖğe Alleviation of kidney damage induced by unilateral ureter obstruction in rats by rhodiola rosea(Mary Ann Liebert, Inc, 2013) Üyetürk, Uğur; Terzi, E. Hakan; Kemahlı, Eray; Gücük, Adnan; Tosun, Mehmet; Çetinkaya, AyhanPurpose: To evaluate the efficacy of Rhodiola rosea extract in terms of alleviating the renal damage induced by unilateral ureter obstruction (UUO) in rats. Material and Methods: Thirty Wistar albino male rats were divided into five groups: (I) Control, (II) UUO 7 days, (III) UUO 7 days+extract,(IV) UUO 14 days, and (V) UUO 14 days+extract. Seven or 14 days after the initiation of the experimental procedure, the left kidneys of rats in all five groups were removed for histological examination, and their blood was drawn for biochemical measurements. Result: Median malondialdehyde (MDA) and glutathione peroxidase (GPx) levels were, respectively, 39.4 (5.04) nmol/mL and 25.8 (8.01) nmol/minute/mL in group I, 77.9 (12.38) nmol/mL and 5.8 (1.95) nmol/minute/mL in group II, 48.7 (12.1) nmol/mL and 9.1 (2.3) nmol/minute/mL in group III, 58.5 (23.83) nmol/mL and 8.4 (2.1) nmol/minute/mL in group IV, and 44.8 (4.97) nmol/mL and 13.8 (3.73) nmol/minute/mL in group V. There was a statistically significant difference among the groups in terms of MDA and GPx levels (p<0.05 for both). The median numbers of apoptotic cells were 1 (1), 8 (2.25), 3 (1.25), 23.5 (9), and 7 (I) in groups I, II, III, IV, and V, respectively. There was a statistically siginificant difference among the groups in terms of apoptotic cell number (p<0.05). Conclusion:R. rosea extract was shown to alleviate the renal damage induced by UUO through its antioxidant effects. The mechanism by which R. rosea extract causes these effects merits further investigation.Öğe Alpha blocker treatment and intra-operative floppy iris syndrome(Galenos Yayıncılık, 2015) Özyalvaçlı, Mehmet Emin; Doğan, Ümit; Gücük, AdnanBenign prostate hyperplasia (BPH) in the leading cause of lower urinary tract symptoms (LUTS) in elderly ages. Alpha blocker treatment which is advised by urology guidelines is the main treatment of LUTS related to BPH. Alpha-1 receptor has three different subtypes including alpha-1A, alpha-1B and alpha-1D. About 98% of alpha blockers are related with prostate stromal elements and 70% of the alpha receptors are alpha-1A receptors. These receptors are responsible for contraction of prostate, bladder and urethral smooth muscles. Dizziness, fatigue, orthostatic hypotension, syncope, nasal congestion, and retrograde ejaculation are the common adverse effects of alpha blockers. Intra-operative floppy iris syndrome (IFIS), which may cause irreversible blindness, was firstly defined in patients treated with tamsulosin (an alpha-1A receptor blocker) during cataract surgery. Afterwards, it has also been shown that other alpha blockers may also cause IFIS. Pathophysiology of IFIS has not been clearly defined. This clinical picture may occur within hours after alpha blocker treatment or it may develop many years after cessation of the treatment. This paper reviews the literature and presents alpha blocker related IFIS and preventive measurements to minimalise the development of IFIS.Öğe Are stone density and location useful parameters that can determine the endourological surgical technique for kidney stones that are smaller than 2 cm? A prospective randomized controlled trial(Urol & Nephrol Res Ctr-Unrc, 2019) Gücük, Adnan; Yılmaz, Burak; Gücük, Sebahat; Üyetürk, UğurPurpose: We aimed to evaluate whether these parameters could be guiding for us in selection between retrograde intrarenal surgery (RIRS) and mini-percutaneous nephrolithotomy (PNL) procedures in kidney stones that are smaller than 2 cm. Materials and Methods: The patients who had kidney stones smaller than two cm and were planned to undergo surgery were randomly distributed into 2 groups prospectively. RIRS was performed in the RIRS group using a 7.5-F fiberoptic flexible ureterorenoscope while mini-PNL group was dilated up to 16.5F and mini-PNL was performed with 12F nephroscopy. Preoperative characteristics, operative and postoperative results were compared in two groups. Thereafter, intra and intergroup comparisons were made to determine the effects of Hounsfield unit (HU) value indicating the stone density being higher or lower than 677 and stone location on stone-free rates. Results: The study involved 60 patients including 30 in each group. The groups' preoperative values were similar. The hospitalization time and the total duration of scopy were longer in mini-PNL when the postoperative values were compared (P <.0001). In terms of stone densities, HU values that were lower than 677 in the mini-PNL group affected the stone-free rate and reduced it from 100% (> 677HU) to 55.6% (< 677HU), whereas the change was significant (P =.005). Lower calyx stones affected the RIRS results negatively, whereas multiple calyceal stones affected the mini-PNL group negatively. Conclusion: Both methods had a similar success rate, but lower pole stones, multiple calyceal stones and stone density parameters affected the stone-free rates significantly, and these may be effective in treatment selection.Öğe Do antibiotic prophylaxis and/or circumcision change periurethral uropathogen colonization and urinary tract infection rates in boys with VUR?(Elsevier Sci Ltd, 2013) Gücük, Adnan; Burgu, Berk; Gökçe, İlker; Mermerkaya, Murat; Soygur, TarkanBackground: To evaluate the effect of circumcision and/or antibiotic prophylaxis on periurethral flora and associated bacteriuria in male children with and without vesicoureteral reflux (VUR). Patients and methods: The study included 91 boys with low-grade VUR and 106 healthy boys (control) without VUR. The boys with VUR were randomized as antibiotic prophylaxis only and antibiotic prophylaxis plus circumcision. The boys without VUR were randomized as circumcision group and followed-up group without circumcision. Periurethral swab and urine cultures were obtained from the participants at the beginning of the study, and at 1st, 3rd, 6th, 9th, and 12th month. The groups were compared in terms of positive periurethral and urine cultures. Results: The positive periurethral culture rate was significantly lower in the circumcised boys at all measurement times. The positive urine culture rate in the circumcised boys was lower than in the uncircumcised boys. Subgroup analysis based on age groups showed that age did not affect these statistical differences. Conclusion: Circumcision decreases colonization of periurethral bacterial pathogenic flora. In boys with low-grade VUR, circumcision plus antibiotic prophylaxis prevented recurrent and febrile urinary tract infections. (C) 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.Öğe Do renal cysts affect the success of extracorporeal shockwave lithotripsy? A retrospective comparative study(2013) Gücük, Adnan; Öztürk, Ufuk; Üyetürk, Uğur; Kemahlı, Eray; Akın, Güven; İmamoğlu, M.Abdurrahim; Metin, AhmetThe aim of this study was to assess the effect of simple renal cysts on extracorporeal shockwave lithotripsy (SWL) in patients with calyceal renal calculi. Patients with simple renal cysts >35 mm and ipsilateral renal calculi <20 mm that were treated with SWL constituted group 1 (cyst + calculi). The control group included patients aged >40 years that had renal calculi <20 mm and no cysts that were treated with SWL. The 2 groups were compared according to age, gender, body mass index, calculi size, localization, and density, the calculi fragmentation rate, and the percentage of stone-free patients. Mean cyst size in group 1 was 44.04 ± 9.08 mm. Mean age in group 1 was 61.4 ± 10.2 years versus 56.9 ± 8.2 years in the control group; the difference was significant (P = 0.045). There were not any other significant differences between the 2 groups, except for the stone-free rate (P > 0.05), which was 33.3% in group 1 and 68.2% in the control group (P = 0.017). The presence of renal cysts in a patient with calculi requires that an individualized treatment plan be devised, so as to provide the patient with the most effective treatment. © 2013 Adnan Gücük et al.Öğe Does the hounsfield ünit value determined by computed tomography predict the outcome of percutaneous nephrolithotomy?(Mary Ann Liebert Inc, 2012) Gücük, Adnan; Üyetürk, Uğur; Öztürk, Ufuk; Kemahlı, Eray; Yıldız, Mevlüt; Metin, AhmetPurpose: We aimed to evaluate whether the Hounsfield unit (HU) value predicts outcome in percutaneous nephrolithotomy (PCNL). Patients and Methods: One hundred and seventy-nine patients who had undergone PCNL in our clinics in the last 4 years were included. Demographic and clinical data of the patients and complications, if any, were recorded. The mean age of the patients was 45.3 +/- 14.3 years (range 5-82 y), and 111 of them were males (62%). The mean stone size and HU values were found to be 693.1 +/- 628.0 (95-4200) mm 2 and 706.3 +/- 245.0 (214-1325), respectively. Results: In logistic regression analysis, the size of the stone, the opacity of the stone, and the HU values were found to be independent predictors of the failure of the procedure (P < 0.05). A cutoff value of 677.5 was used for the HU in the receiver operating characteristics analysis. Having a HU value under the cutoff value increased the likelihood of procedure failure by 2.65 times, whereas stones residing in the staghorn localization increased failure by 5.68. It was also observed that if the stone's size was 485 mm(2) or more, the chance of failure increased by 1.9, whereas when the stone was nonopaque, failure increased by 6.04 times (P < 0.05). There was a positive correlation between hematocrit decrease and a decrease in HU values (P < 0.05), but no correlation was observed between the HU values and duration of surgery or fluoroscopy (P > 0.05). Conclusion: In addition to the size and location of the stones, the HU value determined in the unenhanced CT scan may be one of the parameters affecting PCNL outcomes. PCNL is a more efficient method in stones with higher HU values. Therefore, the HU values may be a useful tool for the selection of the treatment modality in patients with renal stones.Öğe Does ureteral access sheat usage lead to permanent damage in the ureter? a placebo controlled trial in a rabbit model(Acta Cirurgica Brasileira, 2018) Gücük, Adnan; Söyler, Gizem; Üyetürk, Uğur; Yılmaz, Burak; Nalbant, İsmailPurpose: To evaluate the clinical stenosis or precursor histological changes that ureteral access sheaths commonly used in ureteroscopic surgeries may cause in the long term in ureter. Methods: In this study, the animals were divided into 9 groups and according to their groups, ureters of the rabbits were endoscopically fitted with 2F and 3F ureter catheters. The catheters were left in place and withdrawn after a specified period of time. All the ureters were excised and evaluated macroscopically, microscopically and histologically. Ureter diameters were measured and FGF-2 (+) labeled fibroblasts were counted in connective tissue as stenosis precursors. Results: Macroscopically or microscopically, no stenosis was found in any group. The ureter diameter of the group that were catheterized for the longest time with the catheter that had the widest diameter was significantly lower than the group with the shorter duration and the catheter with the narrower diameter and the control group. When the groups were compared in terms of their FGF values, there was a significant difference in FGF-2 counts at all three ureter levels (p < 0.05). Conclusion: The use of ureteral access sheath may lead to histological changes, as its diameter and duration increase.Öğe Effect of mitomycin, bevacizumab, and 5-Fluorouracil to inhibit urethral fibrosis in a rabbit model(Mary Ann Liebert, Inc, 2014) Üyetürk, Uğur; Gücük, Adnan; Fırat, Tülin; Kemahlı, Eray; Kükner, Aysel; Özyalvaçlı, Mehmet EminBackground and Purpose: Mitomycin C (MMC), bevacizumab, and 5-fluorouracil (5-FU) are frequently used in cancer treatment. Each of these agents also exhibits antiproliferative properties in different tissues. We compared the efficacy of MMC, bevacizumab, and 5-FU may inhibit urethral fibrosis (UF) without statistically significant differences among them. Materials and Methods: Forty male rabbits with traumatized urethras were divided into four groups: Group 1 (control), no medical treatment; group 2, MMC applied to the traumatized area; group 3, bevacizumab applied to the traumatized area; and group 4, 5-FU applied to the traumatized area. All animals were euthanized after 28 days to evaluate the presence of chronic inflammation and fibrosis. Tissue samples were subjected to hematoxylin and eosin and Masson trichrome staining to assess the presence of fibrosis, the state of the epithelium, and collagen density. Results: The MMC and control groups showed the most significant difference in outcomes (P<0.001), followed by the bevacizumab (P=0.002) and 5-FU groups (P=0.005). No statistically significant difference was noted when all three treatment groups were compared with one another. Histopathologic examination revealed inflammatory cell infiltration in the connective tissue, irregular collagen bundles, increased fibroblasts, and a moderate degree of fibrosis in the control group. Compared with controls, all treatment groups exhibited mild fibrosis, less collagen bundle irregularity, and lower numbers of fibroblasts. Conclusion: MMC, bevacizumab, and 5-FU may inhibit UF. There were no statistically significant differences in the effectiveness among the three agents.Öğe Effects of sildenafil treatment on patients with Peyronie's disease and erectile dysfunction(Springer London Ltd, 2014) Öztürk, Ufuk; Yeşil, Süleyman; Göktuğ, Hasan Nedim Göksel; Gücük, Adnan; Tuygun, CanIt has been shown on experimental rat models that type 5-phosphodiesterase isoenzyme (PDE5) inhibitors have anti-fibrotic effects for Peyronie's disease (PD); however, this issue has not been addressed clinically. The aim of this study was to document the effects of PDE5 inhibitors used for erectile dysfunction (ED) seen in PD patients on the main course of the PD clinically. A total of 39 PD patients with ED were divided into two groups. Patients in Group 1 (n = 18) served as controls and received 400 IU vitamin E per day. Those in Group 2 (n = 21) received 50 mg sildenafil per day for 12 weeks. Penile plaque volume was assessed by palpation and by duplex ultrasound. Erectile capacity, penile deformity and plaque characteristics were assessed by the International Index of Erectile Function questionnaire form (IIEF-5) and penile duplex ultrasound. Statistically significant improvement in all parameters was observed within both groups except for IIEF score in Group 1 when compared with the initial values. Significant reduction in plaques and pain were observed in 7 (33.3 %) and 14 (66.6 %) patients in Group 2 and 6 (33.3 %) and 9 patients (42.8 %) in Group 1, respectively. At the end of the therapy, improvement in IIEF score and reduction in pain were statistically significant in Group 2 compared with Group 1 (p = 0.028 and p = 0.045, respectively). We conclude that continuous administration of oral PDE5 inhibitors may be a candidate for medical treatment of PD; however, more controlled studies are needed.Öğe An experimental study on effects of pyrrolidine dithiocarbamate on ischemia-reperfusion injury in testis(Canadian Urological Association, 2016) Kemahlı, Eray; Yıldız, Mevlüt; Fırat, Tülin; Özyalvaçlı, Mehmet Emin; Üyetürk, Uğur; Yılmaz, Burak; Gücük, AdnanIntroduction: The aim of this experimental study was to investigate the histopathological and biochemical effects of pyrrolidine dithiocarbamate, an antioxidant and inhibitor of NF-k beta, on ischemia-reperfusion injury in rats. Methods: A total of 21 male Wistar-Albino rats were randomly distributed into three groups as sham group (Group 1), ischemia-reperfusion (I/R) group (Group 2) and I/R with pyrrolidine dithiocarbamate (PDTC) group (Group 3). Left testicles of rats in Groups 2 and 3 underwent testicular torsion of 720 degrees for four hours and 100 mg/kg of PDTC was administered intraperitoneally prior to detorsion in Group 3. An hour after detorsion process, left orchiectomies were performed and 5 ml of intracardiac blood samples were drawn from rats in all three groups. Histopathological examination of testis tissues performed and measurement of superoxide dismutase (SOD) and malondialdehyde (MDA) levels in blood samples were taken. Results: Elevated levels of MDA and decreased SOD activity, together with decreased Johnson tubular biopsy scores consistent with I/R injury were observed in Group 2 (p<0.05). Group 1 and Group 3 were similar in terms of MDA levels, SOD activity, and Johnson scores (p>0.05). Conclusions: Our results indicated that PDTC may have beneficial effects for alleviation of I/R injury in testicular tissue in rats. Understanding the underlying mechanisms and exploration of its diagnostic and therapeutic potential requires further randomized, controlled trials on a larger scale.Öğe İmpakte proksimal üreter taşlarında antegrad perkütan, laparoskopik ve retrograde üreteroskopik tedavilerin karşılaştırılması(2012) Gücük, Adnan; Burgu, Berk; Tuygun, Can; Demirel, Fuat; İmamoğlu, AbdurrahimAmaç: Büyük impakte proksimal üreter taşlarının tedavisinde laparoskopik üreterolitotomi, antegrad perkütan ve retrograd üreteroskopik litotripsi tedavilerinin karşılaştırılması. Yöntemler: Kliniğimizde büyük impakte proksimal üreter taşı tanısı ile antegrad perkütan litotripsi (PNL), laparoskopik üreterolitotomi, ve retrograde üreteroskopik (URS) litotripsi tedavisi uygulanan hastalar çalışmaya alındı. Bu tedavilerin uygulandığı ve retrospektif olarak verilerine ulaşılabilen hastalardan her gruptan randomize olarak seçilen 25 hasta çalışmaya dahil edildi. Daimi antikoagülan kullanan, üreteral darlık, multipl taş, anatomik anomali, kronik böbrek yetmezliği olan hastalar çalışma dışında bırakıldılar. Hasta özellikleri, preoperatif ve postoperatif sonuçlar karşılaştırıldı. Bulgular: Toplam 75 hasta çalışmaya alındı. Gruplar hasta yaşı, cinsiyet ve taş boyutları açısından benzer bulunmuştur (p>0.05). Ameliyat sonrası taşsızlık oranları değerlendirildiğinde URS grubunda diğer iki grupdan anlamlı sayılacak oranda daha düşüktü (p=0.011). Hematokrit düşüşü, analjezik gereksinimi farkı yine anlamlıydı ve en düşük URS grubunda en yüksek PNL grubunda saptandı. Hospitalizasyon süresi en yüksek laparoskopi grubunda olup 3 grup arasında anlamlı farklılık vardı. Operasyon süresi en kısa URS grubunda olup fark anlamlıydı (p=0.021). Sekonder prosedür gereksinimi yine URS grubunda diğerlerinden anlamlı olarak yüksekti (p=0.37). Sonuç: Bu taş grubunda laparoskopik üreterolitotomi ve PNL ile yüksek başarı oranları vardır. Pnömotik litotriptör ile uygulanan URS tedavisinin başarı oranı düşük, ek prosedür gereksinimi yüksek olması gibi önemli dezavantajları vardır. Bu nedenle cerrahi deneyim ve ekipman varlığında PNL ve laparoskopik üreterolitotomi daha öncelikli düşünülmesi gereken tedavi alternatifleridir.Öğe Is cystoscopy needed in spontaneous ürethral prolapses(Mary Ann Liebert Inc, 2012) Kemahlı, Eray; Üyetürk, Uğur; Gücük, Adnan; Yılmaz, Burak; Yağlı, Ömer Faruk; Metin, AhmetÖğe Kas İnvaziv Olmayan Mesane Karsinomlu Hastalarda Klinikopatolojik Parametrelerin Rekürrens ve Progresyonla İlişkisi(2015) Özyalvaçlı, Gülzade; Özyalvaçlı, Mehmet Emin; Gücük, Adnan; Astarcı, Hesna Müzeyyen; Üyetürk, Uğur; Kemahlı, ErayAmaç: Bu çalışmada Abant İzzet Baysal Üniversitesi (AİBÜ) Tıp Fakültesi'nde ilk tanısı pTa ve pT1 transisyonel hücreli mesane karsinomlu hastalarda evre ve grade gibi histopatolojik parametrelerin yanısıra yaş, tümör boyutu, tümör sayısı ve reTUR gibi klinik verilerin rekürrens ve progresyonla ilişkisinin ortaya konması amaçlanmıştır. Yöntem: 2008-2013 yılları arasındaki Abant İzzet Baysal Üniversitesi'nde ilk transüretral rezeksiyon (TUR) sonrası patolojik tanısı transizyonel hücreli mesane kanseri olarak rapor edilen (pTa, pT1) ardışık 119 hasta retrospektif olarak değerlendirildi. Bu hastalara ait klinik veriler ve histopatolojik preparatlar AİBÜ Üroloji ve Patoloji A.D. arşivinden elde edildi. Bulgular: Çalışmamıza dahil edilen hastaların 109'u erkek, 10'u bayandı. Ortalama takip süresi 30.14ay (2.86-80.74) idi. Univariate analizinde rekürrens ile tümör boyutu, grade'i, evresi, sayısı, Re-TUR ve sigara kullanımı arasında istatistiki fark varken progresyon ile tümör grade'i, boyutu, sayısı ve sigara kullanımı arasında istatistiki fark vardı. Multivariate analizde rekürrensi belirlemede bağımsız prediktif faktörler tümör boyutu (OR: 5.26,%95CI: 1.42-19.55) ve sigara kullanımı(OR: 4.65,%95CI: 1.2317.53) iken progresyonu belirlemede sadece tümör grade'i saptandı(OR: 5.32,%95CI 1.37-20.59). Kaplan Meier analizinde tümör boyutu <3 olan hastalar ile >=3 cm'nin üzerindeki hastalarda tahmini rekürrens zamanı sırasıyla 14.8ay (11.41-18.31) ve 7.6 ay (5.76-9.49) iken tümör sayısı tekli grup ile çoklu grupta sırasıyla 14.43ay (6.51-22.35) ve 7.17ay (5.63-8.70) idi. Gruplar arasında istatistiki anlamlı fark vardı (p=0.009). Sonuç: pTa ve pT1 mesane tümörlü hastaların progresyonunu öngörmede grade'in tek başına çok önemli olduğu ve WHO 2004'te güncellenen ikili derecelendirme sisteminin bu tümörleri derecelendirmede daha kolay ve uygun olabileceği düşünülmüştür. Evrelendirmede bu tümörlerin rekürrens açısından farklılık gösterdiği ve aslında klinik olarak yüzeyel başlığı altında aynı kategoride yer almasının çok da doğru bir yaklaşım olmadığı sonucuna varılmıştır.Öğe Lower urinary tract symptoms and related factors in female university students(Wiley, 2020) Gücük, Sebahat; Ural, Ülkü Mete; Kayhan, Mehmet; Gücük, AdnanObjectives Our study aims to determine the symptoms and frequency of lower urinary tract in female university students and its related factors. Methods This cross-sectional study was conducted between January and June 2017. To determine their sociodemographic characteristics and toilet habits, the Bristol Female Lower Urinary Tract Symptoms questionnaire, a 21-item questionnaire, was applied to female university students accepting to participate in the study using the face-to-face interview method. Results The study was completed with 1091 individuals. The mean age of the participants was 20.27 +/- 1.69 years. The question "Do you feel a sudden urination sensation and run to the toilet?" was answered by 1.1% (n: 12) of the participants with "Always," while 34.8% (n: 380) replied "Never." In terms of feeling a sudden urination sensation, 0.5% (n: 6) of the participants stated that they "always" experience micturition, while 15.0% (n: 164) answered with "Seldom." The complaint of being unable to empty their bladder completely while urinating was higher in students with constipation problems (P.04) and a body mass index (BMI) > 24.9 (P.02). Conclusions Lower urinary tract complaints are a common problem. We believe that routine medical screening should be performed for female university students whose living conditions change when they start university; besides, we suggest that well-attended and repeatable training programs for healthy living behaviors, urinary habits, and hygiene should be organized for university students.Öğe LRIG2 mutations cause urofacial syndrome(Cell Press, 2013) Stuart, Helen M.; Roberts, Neil A.; Burgu, Berk; Daly, Sarah B.; Urquhart, Jill E.; Gücük, AdnanUrofacial syndrome (UFS) (or Ochoa syndrome) is an autosomal-recessive disease characterized by congenital urinary bladder dysfunction, associated with a significant risk of kidney failure, and an abnormal facial expression upon smiling, laughing, and crying. We report that a subset of UFS-affected individuals have biallelic mutations in LRIG2, encoding leucine-rich repeats and immunoglobulin-like domains 2, a protein implicated in neural cell signaling and tumorigenesis. Importantly, we have demonstrated that rare variants in LRIG2 might be relevant to nonsyndromic bladder disease. We have previously shown that UFS is also caused by mutations in HPSE2, encoding heparanase-2. LRIG2 and heparanase-2 were immunodetected in nerve fascicles growing between muscle bundles within the human fetal bladder, directly implicating both molecules in neural development in the lower urinary tract.Öğe Nation-wide analysis of the impact of covid-19 pandemic on daily urology practice in Turkey(Wiley, 2020) Bozkurt, Ozan; Şen, Volkan; İrer, Bora; Sağnak, Levent; Gücük, AdnanObjective To present a nation-wide analysis of the workload of urology departments in Turkey week-by-week during Covid-19 pandemic. Methodology The centres participating in the study were divided into three groups as tertiary referral centres, state hospitals and private practice hospitals. The number of outpatients, inpatients, daily interventions and urological surgeries were recorded prospectively between 9-March-2020 and 31-May-2020. All these variables were recorded for the same time interval of 2019 as well. The weekly change of the workload of urology during pandemic period was evaluated, also the workload of urology and the distributions of certain urological surgeries were compared between the pandemic period and the same time interval of the year 2019. Results A total of 51 centres participated in the study. The number of outpatients, inpatients, urological surgeries and daily interventions were found to be dramatically decreased by the 3rd week of pandemics in state hospitals and tertiary referral centres; however, the daily urological practice were similar in private practice hospitals throughout the pandemic period. When the workload of urology in pandemic period and the same time interval of the year 2019 were compared, a huge decrease was observed in all variables during pandemic period. However, temporary measures like ureteral stenting, nephrostomy placement and percutaneous cystostomy have been found to increase during Covid-19 pandemic compared with normal life. Conclusions Covid-19 pandemic significantly affected the routine daily urological practice likewise other subspecialties and priority was given to emergent and non-deferrable surgeries by urologists in concordance with published clinical guidelines.Öğe Neutrophil-lymphocyte ratio as a predictor of recurrence and progression in patients with high-grade pT1 bladder cancer(Canadian Urological Association, 2015) Özyalvaçlı, Mehmet Emin; Özyalvaçlı, Gülzade; Kocaaslan, Ramazan; Çeçen, Kürşat; Üyetürk, Uğur; Kemahlı, Eray; Gücük, AdnanIntroduction: We investigated the value of the preoperative neutrophil-lymphocyte ratio (NLR) in predicting recurrence and progression of high-grade pT1 non-muscle-invasive tumour in patients with bladder cancer during a 5-year follow-up period. Methods: We retrospectively reviewed data of 1100 patients with bladder cancer; these patients underwent transurethral resection and were monitored at multiple centres from 2008 to 2013. In total, 166 consecutive and newly diagnosed patients with high-grade pT1 tumours were included in this study. The NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count. Results: Of the 166 patients, 152 were male. The patients were evaluated as two separate groups in terms of recurrence and progression. The mean follow-up period was 24.2 months (interquartile range 13.8-36.6 months). A statistically significant difference was found between recurrence and tumour size (p = 0.001), number of tumours (p < 0.001), NLR (p < 0.001), and smoking (p = 0.007). No statistically significant correlation was found between NLR and progression. According to receiver operating characteristic (ROC) analysis, the optimum cut-off value for the NLR was >= 2.43 (74% sensitivity, 60% specificity, p < 0.001; area under the curve [AUC] 0.687, 95% confidence interval [CI] 0.607-0.767). Multivariate logistic regression analysis determined that the following factors were independent predictors of recurrence in patients with high-grade pT1 non-muscle-invasive bladder cancer: tumour number (OR 5.32, 95% CI 2.10-12.90), NLR of >= 2.43 (OR 2.587; 95% CI 1.156-5.789), and smoking (OR 4.17, 95% CI 1.31-13.21). Conclusion: A high preoperative NLR may play an important role in predicting recurrence of superficial transitional cell type high-grade pT1 bladder tumours. Prospective studies are required to validate the role of NLR as a prognostic marker in high-grade pT1 bladder tumours.Öğe Portal hypertension secondary to benign prostatic hyperplasia(Galenos Yayıncılık, 2022) Küçükyangöz, Mustafa; Söğütdelen, Emrullah; Gücük, Sebahat; Gücük, AdnanBenign prostatic hyperplasia (BPH) obstructs the bladder outlet. Patients with BPH frequently present with lower urinary tract symptoms. However, patients with BPH can present with serious fatal complications unless diagnosed and treated sufficiently. In this case report, we present the case of a 63-year-old male patient with renal insufficiency, generalized edema, and portal hypertension due to chronic obstructive uropathy secondary to BPH. To the best of our knowledge, this is the first report to present portal hypertension secondary to BPH as a rare complication.Öğe Posttraumatic high-flow nonischemic priapism(Lippincott Williams & Wilkins, 2018) Nalbant, İsmail; Tuygun, Can; Gücük, Adnan; Conkbayır, Işık; Öztürk, Ufuk; Yılmaz, Muhammed Şahin; İmamoglu, Muhammed AbdurrahimPriapism is an uncommon disorder, and nonischemic priapism is seen less frequently in children, generally after trauma. Although it seems to be an advantage that urgent intervention is not required because of no cavernous ischemia, it is likely to be misdiagnosed because of the asymptomatic potential. We aimed to present a case of posttraumatic nonischemic priapism.
