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WOS: 000410748000009 PubMed ID: 27761633 To establish if a retropulsion prevention device for ureteral stones equalizes surgical success and push-back rates of Ho:YAG laser and pneumatic lithotripters for upper ureteral stones. Patients with upper ureteral stones (n = 267) were treated endoscopically at the Department of Urology between April 2014 and December 2015. Patients were randomly assigned to pneumatic and Ho:YAG laser lithotripters as group-1 and group-2, respectively. Lithotripsy was performed with Stone Cone(TM) in both groups. The surgical success rate on the first postoperative day was 81.5 % (n = 106) and 90.6 % (n = 116) for group-1 and group-2, respectively, and the difference between the groups was statistically significant (p < 0.05). The relation between stone size and surgical success was statistically significant for both groups (p < 0.01). Surgical success for the stones closer than 2 cm to the UPJ was 23.1 % for the pneumatic group versus 64 % for the laser group (p < 0.01). Lithotripsy time was significantly longer in group-2 (16.48 +/- 4.74 min) than group-1 (12.24 +/- 3.95 min) (p < 0.01). Ho:YAG laser lithotripsy is more successful than pneumatic lithotripsy for upper ureteral stones and a retropulsion prevention device does not equalize the surgical success of Ho:YAG laser and pneumatic lithotripters for upper ureteral stones on the first postoperative day and one month after surgery. Although the success rate of the first month after surgery is higher in group-2, the difference is not statistically significant. Academical Study Supporting Unit of Ahi Evran University [PYO-TIP.4005.13.005] This study was supported by the contribution of the Academical Study Supporting Unit of Ahi Evran University by the number of PYO-TIP.4005.13.005.

WOS: 000355215000008 PubMed ID: 25827355 To enhance rat penises experimentally with rectus muscle fascia (RMF) and testicular tunica vaginalis grafts (TVG). Twelve Wistar albino rats were distributed into two equal Groups, A and B. There were six rats in each group. RMF and TVG were used to enhance rat penises in Groups A and B, respectively. Circumferences of the penises were measured preoperatively and at three different times after the operation. Two, two and eight rats were killed 10 days, 1 month and 2 months after the operation, respectively, for histopathological examinations. When we compared the measurements of preoperative and immediately postoperative circumferences, the mean increase was 23.4 +/- A 2.9 % in Group A and 19.9 +/- A 1.7 % in Group B. According to paired t test, the difference was significant (p < 0001), but the comparison between preoperative and postoperative first-month measurements was not found to be significant (p > 0.05). Histological examinations revealed an intensive inflammatory process at 10 days after the operation. Grafts were found to be totally absorbed in the first- and second-month examinations. In our study, implanted TVG and RMF could not survive because of insufficient vascularization and failure to maintain satisfactory surgical success. More studies are needed to increase the effectiveness of surgical techniques.

WOS: 000400894500016 PubMed ID: 28269994 Purpose: To evaluate the durability differences between five different type of guidewires against laser energy in an in vitro experimental ureteral model. Methods: The study was performed at the Department of Urology, Medicine Faculty of Ahi Evran University. An in vitro experimental ureteral model was created for the work; a silicon ureteral model in a saline-filled container. Experiments were performed on five different type of guidewires; ZIPwire, Sensor polytetrafluoroethylene (PTFE) Nitinol guidewire, Roadrunner (R) PC wire guide, Amplatz Super Stiff, and Zebra Urologic Guidewire. These guidewires were grouped from one to five, respectively. Laser fibers were contacted to the guidewire, and laser energy was fired to the premarked tip and body parts in different adjustments. Results: The breakage of the guidewires was detected only on the flexible tip parts in group 1a, group 1b, group 2a, group 2b, group 4a, and group 4b. The body parts of the guidewires were resistant to laser energy in all groups and did not break. The breakage of the guidewires occurred after 3 J x 10 Hz (30W) experiment. Group 1a and 1b were different from group 2a, 2b, 4a, and 4b according to Kruskal-Wallis H test. Conclusions: The body parts of the guidewires in all study groups were resistant to laser energy. The tip parts of Zipwire (TM), Sensor (TM) PTFE Nitinol, and Amplatz Super Stiff (TM) guidewire should be kept away from the surgical field when the high power settings of the laser are being used. The body parts of the guidewires can be utilized in the surgical field safely. Ahi Evran University Scientific Research Projects Coordination Unit [TIP.A3.16.010] This work was supported by Ahi Evran University Scientific Research Projects Coordination Unit. Project Number: TIP.A3.16.010. The author thanks Prof. Dr. Ayhan Karabulut for his scientific support. The author also thanks Dr. Samet Cetinkaya and Fatma Eroglu for their technical support.

WOS: 000418412900003 PubMed ID: 29410884 Introduction It has been shown that CD47 is an important diagnostic and prognostic marker in many cancer types. However, the relationship between CD47 and bladder tumor stage has not been shown in previous studies. To the best of our knowledge, this is the first study investigating the association of CD47 with stages of bladder cancer. Material and methods Surgical specimens of 175 patients were included in the study. The CD47 staining assessment was performed in the following categories; none, focal, moderate and diffuse. The statistics of the study were tested using t-test and analysis of variance. Results We demonstrated much less CD47 staining extent in Ta tumor pathology compared to T1 and T1+T2+T3+T4 tumor pathology (p = 0.034 and p = 0.016, respectively). We also showed that the average value of CD47 staining extent with CIS+ was significantly higher compared to CIS-among NMIBC p = 0.0248). However, no significant differences in CD47 staining pattern were observed in the following study groups: high vs. low-grade tumors in non-muscle invasive bladder cancer (NMIBC); MIBC (T2-T4) vs. NMIBC; lymph node involvement (N1-N3) vs. non- lymph node involvement (N0) in MIBC (T2-T4). Conclusions Our study demonstrated that CD47 might have a critical role in the progression of Ta to T1 stage. Furthermore, we showed that CD47 is highly expressed in CIS+ NMIBC compared to CIS-NMIBC. Thus, differentiating stages with the help of this new potential marker may help clinicians treat bladder tumors better. Future studies to determine the role of CD47 on pathophysiology, diagnosis and prognosis of bladder tumor are warranted.

WOS: 000412261200009 PubMed ID: 28976350 OBJECTIVES: To compare the success of the 'tubularized incised plate urethroplasty' (TIPU)' and 'Onlay island flap urethroplasty' (OIFU) techniques for the repair of primary proximal hypospadias. MATERIAL AND METHODS: A retrospective evaluation was made of the medical records of 68 patients with primary, non-complicated hypospadias, who were operated on in the Department of Urology Ministry of Health Ankara Education and Research Hospital, between January 1997 and December 2012. Patients who underwent hypospadias surgery with TIPU were labelled as Group 1 and the OIFU technique as Group 2. Patient age, native meatus localization, operation time, diversion type, surgical success and complication rates were all assessed. Surgical success was evaluated with direct vision of voiding and uroflowmetry at the time of catheter removal, then at 2 weeks, 6 weeks, 6 months and 1 year. RESULTS: Group 1 consisted of 43 patients and Group 2 of 25 patients. The mean age of patients was 6.4-3.1 years in Group 1 and 8.0 +/- 4.6 years in Group 2 (p=0.09). The mean operating time was significantly lower in Group 1. (Group 1- 1 04.8 +/- 16.8 min, Group 2-1 25.4 +/- 24.7min; p

PubMed ID: 28976350 OBJECTIVES: To compare the success of the 'tubularized incised plate urethroplasty' (TIPU)' and 'Onlay island flap urethroplasty' (OIFU) techniques for the repair of primary proximal hypospadias. MATERIAL AND METHODS: A retrospective evaluation was made of the medical records of 68 patients with primary, non-complicated hypospadias, who were operated on in the Department of Urology, Ministry of Heal- th Ankara Education and Research Hospital, between January 1997 and December 2012. Patients who underwent hypospadias surgery with TIPU were labelled as Group 1 and the OIFU technique as Group 2. Patient age, native meatus localization, operation time, diversion type, surgical success and complication rates were all assessed. Surgical success was evaluated with direct vision of voiding and uroflowmetry at the time of catheter removal, then at 2 weeks, 6 weeks, 6 months and 1 year. RESULTS: Group 1 consisted of 43 patients and Group 2 of 25 patients. The mean age of patients was 6.4±3.1 years in Group 1 and 8.0±4.6 years in Group 2 (p=0.09). The mean operating time was significantly lower in Group 1. (Group 1- 104.8±16.8 min, Group 2-125.4±24.7min; p

WOS: 000410254700007 PubMed ID: 28891801 OBJECTIVE: We aimed to identify the changes in the application rate of two surgical techniques in distal hypospadias repair in years and compare the most popular two surgical repair techniques for distal hypospadias in terms of surgical outcomes, the factors that affect the outcomes, which were performed over a 20 year period. METHODS: In this study, the records of 492 consecutive patients that had undergone an operation for distal hypospadias in the urology clinic of Ankara between May 1990 and December 2010 using either Mathieu or TIPU surgical techniques were reviewed retrospectively. The patients who had glanular, coronal, and subcoronal meatus, were accepted as distal hypospadias cases. Among the 492 examined medical records, it was revealed that 331 and 161 surgical interventions were performed by using the Mathieu urethroplasty technique (Group-1) and TIP urethroplasty technique (Group-2), respectively. Group-1 was divided into two subgroups; namely Group-1a (patients with primary hypospadias) and Group-1b (patients with previous hypospadias operation). Likewise, Group-2 was divided into two subgroups; namely group-2a and group-2b. The patients' ages, number of previously urethroplasty operations, localization of the external urethral meatus prior to the operation, chordee state, length of the newly formed urethra, whether urinary diversion was done or not, post-operative complications and data regarding the follow-up period were evaluated, and the effects of these variables on the surgical outcome were investigated via statistical analyses. The primary objective of this study is to identify the changes in the application rate of two surgical techniques in distal hypospadias repair over the a 20 year period, and the secondary objectives are to compare the most popular two surgical repair techniques for distal hypospadias in terms of surgical outcomes, and the factors affecting the outcomes. Independent samples t test and Pearson's Chi-square test was used for statistical analysis. p0.05). The concurrent utilization of the cystostomy and urethral stent was significantly more frequent in group-1 (p

WOS: 000397175400002 PubMed ID: 28116737 Purpose: We aimed to investigate the efficacy of silodosin 4 mg/day and 8 mg/day for medical expulsive therapy (MET) of lower ureteral stones. Materials and Methods: We retrospectively analyzed the medical records of 161 patients admitted to urology clinics of Ahi Evran University Medical Faculty and Ankara Training and Research Hospital with distal ureteral stones and treated with MET with different doses of silodosin between January 2013 and August 2015. 81 patients were treated with silodosin 4mg/day in group-1 and 80 patients with silodosin 8mg/day in group-2. Age, gender, complaints on admission, stone size, the distance between the stone and ureterovesical junction, stone passage rate, duration of stone passage after starting MET, and adverse effects were noted from the charts of the patients, and the groups were compared. Results: There were 81 patients in group-1, and 80 patients in group-2. Two groups were similar for age (P =.38) and gender (P =.92). Spontaneous stone passage was seen in 41 (50.9%) patients in group-1, and in 59 (73.8%) patients in group 2. The groups were different for spontaneous stone passage rate (P =.002). In group-1, 10 (25%) patients that could not pass their stones spontaneously and were treated with extracorporeal shockwave lithotripsy (SWL), and 30 (75%) of them were treated with ureterolithotripsy. Eight (38%) patients that could not undergo ureterolithotripsy and/or anesthesia and were not able to pass their stones were treated with SWL, and 13 (62%) patients were treated with ureterolithotripsy in group-2. All of the patients were stone free at the end of the treatment. Conclusion: A dose of 8 mg/day should be preferred if silodosin is to be preferred for MET in lower ureteral stones.

PubMed ID: 28891801 OBJECTIVE: We aimed to identify the changes in the application rate of two surgical techniques in distal hypospadias repair in years and compare the most popular two surgical repair techniques for distal hypospadias in terms of surgical outcomes, the factors that affect the outcomes, which were performed over a 20 year period. METHODS: In this study, the records of 492 consecutive patients that had undergone an operation for distal hypospadias in the urology clinic of Ankara between May 1990 and December 2010 using either Mathieu or TIPU surgical techniques were reviewed retrospectively. The patients who had glanular, coronal, and subcoronal meatus, were accepted as distal hypospadias cases. Among the 492 examined medical records, it was revealed that 331 and 161 surgical interventions were performed by using the Mathieu urethroplasty technique (Group-1) and TIP urethroplasty technique (Group-2), respectively. Group-1 was divided into two subgroups; namely Group-1 a (patients with primary hypospadias) and Group-lb (patients with previous hypospadias operation). Likewise, Group-2 was divided into two subgroups; namely group-2a and group-2b. The patients' ages, number of previously urethroplasty operations, localization of the external urethral meatus prior to the operation, chordee state, length of the newly formed urethra, whether urinary diversion was done or not, post-operative complications and data regarding the follow-up period were evaluated, and the effects of these variables on the surgical outcome were investigated via statistical analyses. The primary objective of this study is to identify the changes in the application rate of two surgical techniques in distal hypospadias repair over the a 20 year period, and the secondary objectives are to compare the most popular two surgical repair techniques for distal hypospadias in terms of surgical outcomes, and the factors affecting the outcomes. Independent samples t test and Pearson's Chi-square test was used for statistical analysis. p0.05j. The concurrent utilization of the cystostomy and urethral stent was significantly more frequent in group-1 (p

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Amaç: Bu çalışmada obezitenin vücut dışından şok dalga tedavisi (ESWL) sonuçları üzerindeki etkisini araştırmayı amaçladık. Gereç ve yöntemler: Retrospektif olarak yapılan bu çalışmada Haziran 2011 ve Mayıs 2014 yılları arasında ESWL yapılmış 134 hasta değerlendirildi. ESWL yapılan hastalar iki gruba ayrıldı. İki grupda üreter üst uç taşına sahipdi. Grup 1 94 normal kiloya sahip, grup 2 ise 40 morbid obez hastadan oluşmaktaydı. Bulgular: Grup 1 ve 2 için ortalama yaşları sırasıyla 45,6±12,1 ve 45,3±15,5’di (p=0,98). Gruplar arasında demografik veriler açısından istatistiksel fark saptanmadı. Taş boyutu ve vücut kitle indeksi (VKİ) grup 1 ve grup 2 için sırasıyla 81,7±25,7 mm² ve 86,3±22,4 mm² (p=0,51), 27,4±2,9 ve 42,9±2,1 (p

WOS: 000362577000033 PubMed ID: 26439053 OBJECTIVE: Ureteral obstruction leads to permanent changes in the structure of the kidney by several mechanisms. In this study, it was hypothesized that there would be a protective effect of misoprostol against diclofenac in rats with unilateral ureteral obstruction (UUO). MATERIALS AND METHODS: Twenty-two female rats were randomized into 5 groups of 4 and 2 rats for the control group. The right ureter was sutured. The rats were grouped as control, contrast agent, contrast agent +N-acetylcysteine (NAC), diclofenac and diclofenac + misoprostol groups. Radiographic contrast agent was given iv on the 3rd day and other agents were administered orally for 1 week. The rats were sacrified after 1 week and histopathological and biochemical oxidative stress markers were evaluated. RESULTS: The contrast agent and NAC group had lower rates of hemorrhage, inflammation, obstructive dilatation and fatty degeneration compared to the contrast agent only group (p < 0.05). No differences were seen in the normal kidneys. Between all the groups, there was no difference for tubule epithelium damage (p > 0.05). The contrast agent and NAC group had higher rates of antioxidant SH level compared to the contrast agent only group (p < 0.05) and lower rates of oxidative end product carbonyl groups (p < 0.05). For normal kidneys no difference was seen. No statistical difference was seen in MDA levels (p > 0.05). Statistically no difference was seen between the diclofenac group and the diclofenac and misoprostol group neither pathologically nor chemically (p > 0.05). CONCLUSIONS: These results showed that NAC is protective against radiographic contrast agent toxicity when given before and after administration in obstructed kidneys as in previous data. Misoprostol was not observed to have any protective effect against diclofenac in obstructed kidneys.

Uterovezikal fistüller çoğunlukla yatrojenik nedenlerle meydana gelen ve nadir görülen genitoüriner fistüllerdendir. Bu makalede üçüncü sezaryen operasyonu sonrası uterovezikal fistül gelişen bir olgu literatür bilgileri eşliğinde sunulmuştur. Uterovesical fstulas are rare genitourinary fstulas developing secondary to iatrogenic etiologies. In this article, we report a a post- cesarean vesicouteri fstula with review of the literature.

Objectives: The aim of this study was to document if stones at the lower ureter alter the micturition capability of the patients and to investigate whether endoscopic removal of these stones restores normal urinary flow rates or not in the 3 months of follow-up. Methods: Forty patients with lower ureteral stone (group 1) and 20 control subjects with proximal ureteral stone (group 2) were enrolled into the study. All patients underwent uroflowmetry testing before and 3 months after the treatment for endoscopic stone removal. The mean average and peak flow rates with a sufficient voided volume (≥150 ml) were evaluated before and after surgery and compared between the groups. Results: Mean values of the peak flow rates before and after surgery were 20.3 and 27.5 ml/s in group 1 and 22.5 and 23.6 ml/s in group 2, and the mean average flow rate values before and after surgery were 10.5 and 13.6 ml/s in group 1 and 11.4 and 12.1 ml/s in group 2. Statistically significant differences were determined between before and after ureteroscopy values were determined in terms of average (p < 0.05) and peak flow rates (p < 0.01) in group I; however, there no significant difference was seen in the control group. Conclusion: We document for the first time in the literature that patients with lower ureteric stones have a reduction in their urinary stream which resolves with endoscopic removal of the stones.

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