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    The combination of furosemide and intravenous hydration does not affect the success of shock wave lithotripsy in renal stone treatment: A prospective randomised single blinded trial
    (Bmj Publishing Group, 2015) Kocaaslan, Ramazan; Küçükpolat, Salim; Karadağ, Mert Ali; Erkan, Erkan; Kadihasanoğlu, Mustafa; Özyalvaçlı, Mehmet Emin; Toktaş, Mahmut Gökhan
    Objectives To investigate the effect of furosemide given before shock wave lithotripsy (SWL) in patients with renal stones. Methods Two-hundred patients with renal stones measuring 6-20mm in diameter were prospectively included in this study. The treatment group (n=100 patients) received 40mg furosemide 30min before SWL plus 1000mL 0.9% sodium chloride, infused during the procedure. Standard SWL alone was used for the control group (n=100 patients). The effectiveness of SWL was compared between the two groups. Results No statistically significant difference was found between the groups in age, stone size, Hounsfield units, urinary pH, stone density, average number of sessions, average number of pulses or mean energy used. The stone-free rate was 69% in the control group and 71% in the treatment group (p=0.758). Conclusions Although it is an easy and safe application, no positive effects of furosemide and hydration were found.
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    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, Adnan
    Introduction: 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.
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    A penile torsion with a fistula due to previous hyp ospadias surgery: A case report
    (2015) Toksoz, Mustafa Rasid; Karabekmez, Furkan Erol; Kocaaslan, Ramazan
    We presented a case of penile torsion due to previous hypospadias surgery. A patient applied to our clinic for treatment of hypospadias fistula and accompanying penile torsion. Patient's urethral fistula was repaired first and penile torsion was corrected in the second stage due to multiple fistula tracts. Proximal based flip flap technique was used for closure of the fistula and simple degloving with release of fibrous tissue and pedicle of the previous preputial island flap was used for correction of the penile torsion. Post hypospadias surgery torsion deformity as in our case may corrected with simple degloving and dissection at the level of the buck fascia
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    A penile torsion with a fistula due to previous hypospadias surgery: A case report
    (2015) Toksoz, Mustafa Rasid; Karabekmez, Furkan Erol; Kocaaslan, Ramazan
    We presented a case of penile torsion due to previous hypospadias surgery. A patient applied to our clinic for treatment of hypospadias fistula and accompanying penile torsion. Patient's urethral fistula was repaired first and penile torsion was corrected in the second stage due to multiple fistula tracts. Proximal based flip flap technique was used for closure of the fistula and simple degloving with release of fibrous tissue and pedicle of the previous preputial island flap was used for correction of the penile torsion. Post hypospadias surgery torsion deformity as in our case may corrected with simple degloving and dissection at the level of the buck fascia.
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    Relationship between Prostate Size and Positive Surgical Margin in the Open Radical Prostatectomy Surgery
    (2016) Özyalvaçlı, Mehmet Emin; Kocaaslan, Ramazan; Yücetaş, Uğur; Erkan, Erkan; Şahin, Ali Feyzullah; Kadıhasanoğlu, Mustafa; Şahin, Yusuf
    Introduction: Our study aims to reveal the correlation between positive surgical margins and prostate volume, thus determining a cutoff value for the prostate volume to predict PCM in patients with open radical prostatectomy.Methodology: In our study, a number of 450 patients who had undergone radical prostatectomy surgery at 2 centers within the last 5 years was evaluated. Age, total PSA, number of positive cores for prostate cancer, Gleason score, transfusion amount and prostate volume were all evaluated in the study. Evaluated all these parameters, 170 consecutive patients of whom data were available were included in the studyResults: Stage T3 and PSA>10 ng/dL were statistically significant for positive surgical margins (p=0,002 and p<0,001, respectively). The number of positive cores and Gleason score from these biopsies was also statistically higher in those with positive surgical margins (p=0,002 and p<0,001, respectively). In the multivariate logistic regression analysis, the risk for PCM was found to be 2.67 times higher in patients with PSA>10 ng/dL (95% CI: 1.18 to 6.04; p = 0.018) and stage T3 increased the risk for PCM by 8.51 times (95% CI: 3.54 to 20.51, p = <0.001). When we performed AUROC analysis to determine the positivity of surgical margin in terms of prostate volume, we achieved a cutoff value of 34.5 with 55% sensitivity and 71% specificity (AUC: 0.646, 95% CI: 0.555 to 0.737, p = 0.002). Again, any value above 34.5 cc was found to statistically significantly increase the risk for PCM by 2.86 times (95% CI: 1.31 to 6.28; p = 0.009).Conclusion: We found that the prostate volume had an important role in positivity of surgical margins. It is likely that addition of prostate volume as well to nomograms used before surgery may be useful in improving of risk assessment in prostate cancer. Furthermore, evaluation of the prostate volume can be used as a prognostic factor for prostate cancer.