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In this study, we aimed to determine whether there is a significant difference in endocan expression levels between prostate adenocarcinoma and prostate hyperplasia tissues by using an immunohistochemical method. Materials and Methods: All of 51 patients, who were getting treatment for the last 5 years, participated in the study. 31 of 51 patients underwent transrectal sonography (TRUSG) -assisted prostate biopsy because of prostate adenocarcinoma as diagnosed with elevated PSA levels and histopathological examination. The remaining 20 patients comprised the control group. The control group included patients with benign prostate hyperplasia based on pathological examination. Results: It was found that there was strong positive epithelial staining in 74.2% of patients with prostate cancer while in 5% of controls, indicating a statistically significant difference (P.001). It was also found that the rate of strong positive endothelial staining was 77.4% in the patient group whereas 5% in the control group (P.001). Also, the rate of strong positive stromal staining was 64.5% in the patient group while 5% in the control group (P.001). Conclusion: We found that tissue endocan expression level was statistically significantly higher in patients with prostate cancer compared to those with benign prostate hyperplasia by using an immunohistochemical method.

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.

Obturator nerve block (ONB) has been performed in surgeries of transurethral resection of bladder tumors (TUR-BT) for the prevention of the development of obturator muscle contraction. Currently, classic and inguinal approaches are frequently being used. In the present study, we aimed to compare the success rate, performance speed, and complication risks of both approaches.Sixty-six patients who underwent TUR-BT under spinal anesthesia were randomly selected, and ONB was performed on the tumor location side using classic (n = 33) or inguinal (n = 33) approaches. Ten milliliters of 0.25% bupivacaine were administered using a peripheral nerve stimulator in both approaches.Two endpoints were defined in the study: Primary endpoint; the duration of the determination of the obturator nerve and number of interventions when each participant is assessed in at the end of the ONB procedure. Secondary endpoint; development of contractions, and complications each participant is assessed during the TUR-BT and 24 hours after ONB. (Clinical Trial Registration Number: ACTRN12617001050347)Result: General anesthesia was applied to the five patients in the classic ONB group who detected diffuse or bilateral tumors. These patients were excluded from the study. Contractions developed in 4 patients in each group, no statistically significant difference was detected between the groups (14.3%, n = 4 versus 12.1%, n = 4) (P = 1.00). No complications were detected in both groups during the TUR-BT and 24 hours after ONB. We found that the inguinal approach provided a statistically significant advantage regarding the number of punctures (1.9 ± 0.9 versus1.5 ± 0.7) (P = .036), and duration of the procedure (99.1 ± 48.4 seconds versus 76.0 ± 31.9 seconds) (P=.029) compared with the classic approach.Although complications and success rates were similar in both groups, the inguinal method may be abetter approach because it is faster and requires fewer punctures.

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.

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.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.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; p0.001) The distribution of meatus localization was similar in both groups. At 1 year postoperatively, urethrocutaneous fistula was the only complication and the definitive success rates were 81.6% in Group 1 and 72% in Group 2.Despite less frequent usage since the description and popularization of TIPU for proximal hypospadias repair, OIFU remains a valuable technique as a single-stage procedure in cases where the urethral plate is insufficient. Currently, both TIPU and OIFU are used successfully in the treatment of patients with proximal hypospadias.

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.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 Chisquare test was used for statistical analysis. p0.05 was considered as statistically significant.There were no statistically significant differences between the subgroups in terms of age, length of the neo-urethra, number of previously performed urethroplasty operations, surgical success rates, or complications (p0.05). The concurrent utilization of the cystostomy and urethral stent was significantly more frequent in group-1 (p0.05; Pearson's Chi-square test). It was determined that over time, TIP urethroplasty has become a more preferred technique for the repair of distal hypospadias.Both surgical techniques have similar success rates in distal hypospadias cases. TIP urethroplasty has become the method of choice over time.

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.

We aimed to investigate the efficacy of silodosin 4 mg/day and 8 mg/day for medical expulsive therapy(MET) of lower ureteral stones.We retrospectively analyzed the medical records of 161 patients admitted to urologyclinics of Ahi Evran University Medical Faculty and Ankara Training and Research Hospital with distal ureteralstones and treated with MET with different doses of silodosin between January 2013 and August 2015. 81 patientswere 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, andthe groups were compared.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 undergoureterolithotripsy 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.A dose of 8 mg/day should be preferred if silodosin is to be preferred for MET in lower ureteral stones.

Objective : To evaluate the results of the patients with primary proximal hypospadias repaired by “tubularized incised plate” urethroplasty (TIPU). Methods: Thirty-three patients who were operated with TIPU technique in our clinic between 2003-2011 for primary hypospadias with proximal penile and penoscrotal meatus were retrospectively evaluated. Evaluation of the success in this study was, “voiding without fistula”. Results: Mean age was 6.82±3.07 (1-13). Fifteen patients (45.4%) had penoscrotal and 18 patients (54.6%) had proximal penil meatus. Postoperative success was evaluated with direct vision of voiding at the time of un-catheterization, 2 weeks and 6 months after un-catheterization. Success rates were 5/15 and 10/18 after the first repair in the level penoscrotal and proximal penil, respectively. Overall success rate was 45.5% after the first repair. Patients with urethral fistula after first repair were undergone second repair, success rates were increased to 9/15 and 16/18 in the levels of penoscrotal and proximal penil, respectively. Overall success rate after second repair was 75.8%. Conclusion: TIPU may be confidently applied for the patients with proximal hypopadias in experienced clinics, if there is not an uretral cordi or/and abnormality in the development of urethral plate. Key words: Proximal, hypospadias, tubularize incised plate urethroplasty

Background Acupuncture therapy has been used by many researchers in both male and female sexual dysfunction studies. Objective To determine whether acupuncture is effective as a premature ejaculation (PE) treatment compared with paroxetine and placebo. Design, setting, and participants The study was conducted with methodologic rigor based on Consolidated Standards of Reporting Trials (CONSORT) criteria. Ninety patients referred to the urology clinic at a tertiary training and research hospital with PE were included in this randomized controlled trial and randomly assigned into paroxetine, acupuncture, and placebo groups. Heterosexual, sexually active men aged between 28 and 50 yr were included. Men with other sexual disorders, including erectile dysfunction; with chronic psychiatric or systemic diseases; with alcohol or substance abuse; or who used any medications were excluded. Intervention The medicated group received paroxetine 20mg/d; the acupuncture or sham-acupuncture (placebo) groups were treated twice a week for 4 wk. Measurements Intravaginal ejaculation latency times (IELTs) and the Premature Ejaculation Diagnostic Tool (PEDT) were used to assess PE. IELTs were calculated by using a partner-held stopwatch. Data were analyzed statistically. Results and limitations Median PEDT scores of paroxetine, acupuncture, and placebo groups were 17.0, 16.0, and 15.5 before treatment, and 10.5, 11.0, and 16.0 after treatment, respectively ( p =0.001, p =0.001, and p =0.314, respectively). Subscores after treatment were significantly lower than subscores before treatment in the paroxetine and acupuncture groups but remained the same in the placebo group. Significant differences were found between mean-rank IELTs of the paroxetine and placebo groups ( p =0.001) and the acupuncture and placebo groups ( p =0.001) after treatment. Increases of IELTs with paroxetine, acupuncture, and placebo acupuncture were 82.7, 65.7, and 33.1s, respectively. Extent of ejaculation delay induced by paroxetine was significantly higher than that of acupuncture ( p =0.001). The most important limitation of the study was the lack of follow-up. Conclusions Although less effective than daily paroxetine, acupuncture had a significant stronger ejaculation-delaying effect than placebo.

Objectives To assess the long-term results and efficiency of open reconstruction techniques for pediatric and adolescent post-traumatic urethral strictures. Methods A total of 75 patients who had undergone open reconstructive urethroplasty for post-traumatic bulbous or posterior urethral obliterative strictures resulting from pelvic fracture urethral injuries were retrospectively analyzed. The mean patient age was 12.3 years (range 6-17). Of the 75 patients, 38 had a bulbar stricture and 37 had posterior urethral obliteration. Perineal end-to-end anastomotic repair, urethral pull-through, and ureteral tube graft urethroplasty were performed in 54, 20, and 1 patient, respectively. All patients were followed up by medical history and a urinary flow rate evaluation at 6 and 12 months postoperatively. Results The patients were followed up for 12-94 months (mean 43.2). The urethral strictures were successfully treated with end-to-end anastomotic urethroplasty in 37 (68.5%) of 54 patients, urethral pull-through urethroplasty in 14 (70%) of 20 patients, and ureteral tube graft in 1 patient. The total primary success rate was 69.3% (52 of 75 patients). Recurrent stricture developed in 23 patients. Of these 23 patients, 7 and 11 were successfully treated with secondary end-to-end anastomosis and direct vision internal urethrotomy, respectively. The overall success rate was 93.3% (70 of 75 patients). Five patients with treatment failure were still in follow-up, with direct vision urethrotomy performed, as needed. No penile curvature, penile shortening, or urethral diverticula developed. Conclusions The results of our study have shown that open urethral reconstruction techniques are effective for primary and secondary surgical interventions in pediatric and adolescent patients with post-traumatic urethral strictures in experienced centers. These techniques provide excellent long-term results with minimal morbidity.

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.