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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 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 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 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.Öğe Renal apoptosis after shockwave application in rabbit model(Mary Ann Liebert Inc, 2006) Çimentepe, Ersin; Eroğlu, Muzaffer; Öztürk, Ufuk; Bayrak, Ömer; Tuygun, Can; Acar, Abuzer; Üzüm, NüketPurpose: To identify any apoptotic effect of shockwave lithotripsy (SWL) on renal tubular and glomerular cells. Materials and Methods: Thirty-five male New Zealand White rabbits were divided into five groups of seven rabbits each: I (control), II (sham), and III, IV, and GV (treated and sacrificed 1, 7, and 28 days after SWL, respectively). Intramuscular anesthetic agent (ketamine HCl; 20 mg/kg) and intravenous contrast medium (iohexol 300 mg of I/mL) were administered to animals in group II. The left kidneys of animals in groups III, IV, and V were exposed to 2000 shockwaves at 18 kV after administration of anesthesia and contrast medium. The animals were sacrificed on day 1, 7, or 28 after SWL, and the kidneys were removed. Apoptotic and proliferative indices of renal tubular and glomerular cells were determined by terminal deoxynucleotidyl transferase dUTP nick and label (TUNEL) and Ki-67 labeling methods, respectively, counting 1000 cells in each preparation. Results: No apoptosis was detected in glomerular cells in any group. The mean apoptotic indices of the tubular cells in animals in groups I and II were 483.0 +/- 85 and 484.4 +/- 105, respectively with no significant difference between the groups. In groups III and IV, the mean apoptotic indices were 343.4 +/- 89 and 358.4 +/- 61, respectively. There were no statistically significant differences between groups III and IV and the control group. Similarly, there were no significant differences in the apoptotic indices in groups III and IV. However, the apoptotic index in group V was 821.4 +/- 57, significantly higher than in the control group. The proliferative indices of all SWL groups were lower than that of the control group. Conclusion: Shockwave lithotripsy has an apoptotic effect on renal tubular cells that can be detected 4 weeks after the procedures, but no apoptotic effect on glomerular cells. Treatment with SWL also attenuates the proliferation of both tubular and glomerular cells.Öğe Routine flexible nephroscopy for percutaneous nephrolithotomy for renal stones with low density : a prospective, randomized study(Elsevier Science Inc, 2013) Gücük, Adnan; Kemahlı, Eray; Üyetürk, Uğur; Tuygun, Can; Yıldız, Mevlüt; Metin, AhmetPurpose: We evaluated the usefulness of routine flexible nephroscopy during percutaneous nephrolithotomy. Materials and Methods: Patients diagnosed with kidney stones who were scheduled to undergo percutaneous nephrolithotomy between March 2011 and July 2012 were randomized into 2 groups. Group 1 underwent standard percutaneous nephrolithotomy using rigid nephroscopy. Group 2 underwent flexible nephroscopy, in addition to standard percutaneous nephrolithotomy and laser lithotripsy or basket catheter stone extraction, as needed. Surgery was performed subcostally and with minimal percutaneous access in group 2 to use the advantages of flexible nephroscopy. We compared the 2 groups in terms of preoperative stone characteristics and postoperative success criteria, including the stone-free rate, bleeding, number of access sites, etc. Results: The study included 61 males (76.3%) and 19 females (23.8%) with a mean +/- SD age of 43.75 +/- 12.4 years (range 19 to 74). There was no significant difference in stone size, HU density or stone location between the 2 groups. Comparison of perioperative and postoperative parameters revealed a higher stone-free rate (92.5% vs 70%), fewer access sites and a lower hematocrit decrease in group 2. The stone-free rate was higher in patients with stones with a density of less than 677.5 HU (100% in group 2 vs 64.7% in group 1). Conclusions: Routine flexible nephroscopy during percutaneous nephrolithotomy was associated with a higher stone-free rate, fewer interventions and less bleeding, especially in patients with low HU density stones.
