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Öğe Adrenal Myelolipom: Adrenal Bezin Nadir Bir Tümörü(2022) Karabekiroğlu, Nur Tunç; Düzcü, Selma Erdoğan; Gucuk, AdnanMyelolipomlar hematopoetik hücreler ile iç içe matür adipöz dokudan oluşan adrenal bezin nadir görülen benign ve hormonal olarak inaktif tümörleridir. Adrenal kortikal tümörler içerisinde ikinci sıklıkta görülürler. Bu tümörler genellikle görüntüleme işlemleri sırasında insidental olarak saptanırlar. Otopsi serilerinde insidansı yaklaşık olarak %0.08-0.2 arasında değişmektedir. Patogenezleri belirsiz olmakla birlikte primer olayın enfeksiyon, kronik stres veya adrenal bez dejenerasyonuna bağlı retiküloendotelyal hücrelerde meydana gelen metaplastik değişiklikler olduğu düşünülmektedir. Genellikle tek taraflı adrenal kitle olarak görülürler ve bu tümörlerin büyük kısmı asemptomatiktir. Nadiren 4 cm’den büyük kitle yapısı oluştururlar. Bu tümörlerde malign transformasyon bildirilmemiştir. Ancak benign tümörler olmalarına rağmen diğer adrenal tümörlerden ayırıcı tanısının yapılması önemlidir. Burada karın ağrısı ve kabızlık şikayetleriyle başvuran 40 yaşında erkek hastada yapılan tetkikler sırasında saptanan sağ adrenal bez yerleşimli myelolipom olgusu sunulmuştur ve myelolipomların klinikopatolojik özellikleri gözden geçirilmiştir.Öğe The comparison of laparoscopy, shock wave lithotripsy and retrograde intrarenal surgery for large proximal ureteral stones(Canadian Urological Association, 2013) Ozturk, M. D. Ufuk; Sener, Nevzat Can; Goktug, H. N. Goksel; Gucuk, Adnan; Nalbant, Ismail; Imamoglu, M. AbdurrahimIntroduction: In this study we compare the success rates and complication rates of shock wave lithotripsy (SWL), laparoscopic, and ureteroscopic approaches for large (between 1 and 2 cm) proximal ureteral stones. Methods: In total, 151 patients with ureteral stones between 1 and 2 cm in diameter were randomized into 3 groups (52 SWL, 51 laparoscopy and 48 retrograde intrarenal surgery [RIRS]). The groups were compared for stone size, success rates, and complication rates using the modified Clavien grading system. Results: Stone burden of the groups were similar (p = 0.36). The success rates were 96%, 81% and 79%, respectively in the laparoscopy, SWL, and ureteroscopy groups. The success rate in laparoscopy group was significantly higher (p < 0.05). When these groups were compared for complication rates, RIRS seemed to be the group with the lowest complication rates (4.11%) (p < 0.05). SWL and laparoscopy seem to have similar rates of complication (7.06% and 7.86%, respectively, p = 0.12). Interpretation: To our knowledge, this is the first study to compare the results of laparoscopy, SWL and RIRS in ureteral stones. Our results showed that in management of patients with upper ureteral stones between 1 and 2 cm, laparoscopy is the most successful method based on its stone-free rates and acceptable complication rates. However, the limitations of our study are lack of hospital stay and cost-effectiveness data. Also, studies conducted on larger populations should support our findings. When a less invasive method is the only choice, SWL and flexible ureterorenoscopy methods have similar success rates. RIRS, however, has a lower complication rate than the other approaches.Öğe Comparison of Percutaneous Nephrolithotomy, Shock Wave Lithotripsy, and Retrograde Intrarenal Surgery for Lower Pole Renal Calculi 10-20 mm(Karger, 2013) Ozturk, Ufuk; Sener, Nevzat Can; Goktug, H. N. Goksel; Nalbant, Ismail; Gucuk, Adnan; Imamoglu, M. AbdurrahimObjective: To compare the results of percutaneous nephrolithotomy (PCNL), shock wave lithotripsy (SWL), and retrograde intrarenal surgery (RIRS) for 1- to 2-cm lower pole kidney stones. Patients and Methods: This retrospective study was based on data collected from the files of patients between January 2007 and May 2012. The files of 383 patients (221 SWL, 144 PCNL, 38 RIRS) were evaluated. The groups were compared for stone size, success rate, and complication rate using the modified Clavien grading system. Results: The stone burdens of the groups were similar (p = 0.36). The success rates were 76, 94, and 73%, respectively, in SWL, PCNL, and RIRS. The highest stone-free rate was in the PNL group (p < 0.05). When the complication rates were evaluated using the Clavien grading system, they were determined to be 13% in PCNL, 3% in SWL, and 5% in RIRS. Especially GII and GIII complications were more common in the PCNL group (p < 0.05). Conclusion: PCNL seems to be the most successful but most invasive method. However, with relatively low complication rates, SWL and RIRS are other techniques to keep in mind. To determine the first-line treatment, prospective randomized studies with larger series are needed. Copyright (C) 2013 S. Karger AG, BaselÖğe Efficacy and safety of propiverine and terazosine combination for one year in male patients with luts and detrusor overactivity(Brazilian Soc Urol, 2013) Sener, Nevzat Can; Ozturk, Ufuk; Goktug, H. N. Goksel; Gucuk, Adnan; Nalbant, Ismail; Yesil, Suleyman; Imamoglu, M. AbdurrahimPurpose: To evaluate the long term efficacy and safety of the use of propiverine and terazosine combination in patients with LUTS and DO by a placebo controlled study. Materials and Methods: One hundred patients were enrolled in the study. They were randomized into two groups (each group consisted of 50 patients). Terazosine and placebo were administered to the patients in Group 1 and terazosine plus propiverine HCL was administered to Group 2. The patients were evaluated by international prostate symptom score (IPSS), the first four questions of IPSS (IPSS4), the 8th question of IPSS (quality of life-QoL), overactive bladder symptom score questionnaire (OAB-q V8), PSA test, urodynamic studies, post voiding residue (PVR). All patients were followed for one year and were reassessed for comparison. Results: IPSS, IPSS4, OAB symptoms, QoL score, PVR, and Qmax scores of the groups did not differ. After one year treatment, there was significant improvement in IPSS, IPSS4, OAB symptoms, QoL and Qmax values in Group 2. No significant improvement was noted for the same parameters in Group 1. Conclusion: This is the first study to show long term safety and efficacy of anticholinergic therapy for patients with LUTS. In patients with OAB or DO, long term anticholinergic treatment may be regarded as a treatment option.Öğe Evaluation of electrocardiographic ventricular and atrial repolarization markers in patients with high grade varicocele(2019) Erdal, Emrah; Sincer, İsa; Gucuk, Adnan; Güneş, Yılmaz; Bostancı, Emre; İnanır, MehmetAim: Varicocele is abnormal dilation of testis veins without unclear pathophysiology. Morphological studies showed imbalance between vasoconstrictor and vasodilator mechanisms. We aimed to determine the relationship between varicocele and cardiovascular system disorders with electrocardiography (ECG) parameters. Methods: This is a prospective study which was conducted in a University Hospital between February and June 2018. Thirty patients (18-45 years old) with high grade varicocele from urology outpatient clinic and 32 healthy volunteers for the control group were recruited to the study. Results: P-min. value was significantly higher in control group than patients with high grade varicocele (p= 0.03). PR, QT and QTc intervals, PWD and P-max values were similar. Also, there were no significant differences in terms of the other ECG parameters between the groups. Conclusions: In this small prospective study we have found no association between high grade varicocele and potential electrocardiographic arrhythmia predictors namely OTd, QTc interval, PWD, Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio. Long-term follow-up and large-scale prospective studies are needed to confirm our results.Öğe Factors Influencing the Duration of Urine Leakage following Percutaneous Nephrolithotomy(Hindawi Ltd, 2014) Uyeturk, Ugur; Gucuk, Adnan; Kemahli, Eray; Dagistan, Emine; Yildiz, Mevlut; Yilmaz, Burak; Metin, AhmetPurpose. The duration of urine leakage following the removal of the nephrostomy tube after percutaneous nephrolithotomy (PCNL) shows significant variations depending on the techniques used. We aimed to assess the factors likely to influence the duration of urine leakage. Material and Methods. In total, 103 patients who underwent PCNL were reviewed retrospectively. DUL was evaluated regarding patient characteristics, thickness of the access line, presence of hydronephrosis, and residual stones. Results. DUL was significantly prolonged in accordance with a decrease in the thickness of parenchyma tissue (R = -0.716, P < 0.001). DUL was prolonged as the degree of hydronephrosis (R = 0.526, P < 0.001) and the number of patients with residual stones (R = 0.273, P = 0.005) increased. Median DUL was significantly longer in patients with residual stones than those without residual stones (P = 0.002). In the receiving operating curve analysis, the optimum cut-off value of parenchymal thickness for hospitalization <= 12 h was 17.2mm (sensitivity, 90.2%; specificity, 69.4%; P = 0.001). Conclusions. We found that parenchymal thickness of the access line, hydronephrosis, and residual stones were the most influential factors determining DUL following PCNL, respectively.Öğe The role of phosphodiesterase type-5 inhibitors in Benign Prostatic Hyperplasia, current approaches(Galenos Yayincilik, 2013) Kemahli, Eray; Gucuk, Adnan; Uyeturk, UgurBoth benign prostatic hyperplasia (BPH) that manifested with lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are common health problems reducing quality of life in aging males. It has presumed that phosphodiesterase type 5 (PDE5) inhibitors which are primarily used in the treatment of ED may have therapeutic effects on BPH because of possible common pathophysiology between BPH and ED. There are many recent studies relevant to the this issue. Especially, after the FDA approval of tadalafil in the treatment of BPH, it has been entered to our daily practice as monotherapy or in combination with alpha-blocker drugs. PDE5 inhibitors may be preferred as a first line treatment option in patients who suffer both BPH and ED simultaneously, however, it is possible to use in patients with BPH only. Younger patients with low body mass index and with severe LUTS have more benefit with PDE5 inhibitor therapy. Flushing, gastroesophageal reflux, headache, and dyspepsia are the most frequently reported adverse effects of PDE5 inhibitors. These adverse effects are mild to moderate, and require the therapy to be discontinued in a small portion of patients. In this review, it is aimed to evaluate the use of PDE5 inhibitors in the treatment of BPH with the current literatures.
