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Öğe Benign prostat hiperplazili hastalarda transüretral prostat rezeksiyonu sonrası erken ve geç üretral kateter çekilmesinin sonuçlarının karşılaştırılması(Düzce Üniversitesi, 2014) Şenoğlu, Yusuf; Tekin, AliAmaç: Benign prostat hiperplazisi (BPH) ile ilişkili alt üriner sistem semptomlarının altın standart tedavi yöntemi olan transüretral prostat rezeksiyonu (TURP) sonrası irrigasyon amaçlı üretral kateter uygulanması rutin bir uygulama olmakla birlikte, bu kateterizasyon süresi konusunda henüz bir fikir birliği yoktur. Bu çalışmada, TURP yapılan hastalarda üretral kateterin postoperatif erken ve geç çekilmesinin etkilerini karşılaştırmak amaçlanmıştır. Gereç ve Yöntem: TURP yapılan 91 hasta, kanama kontrolü sonrası üretral kateter çekilme zamanına göre erken (postop 1-2. gün) ve geç (postop 7. gün) olmak üzere iki gruba 1: 1 oranında randomize edildi. Olgular operasyon sonrası 1, 3 ve 6. aylarda tedavi başarısı (uluslararası prostat semptom skoru (IPSS), üriner semptomlara bağlı yaşam kalitesi (YK) değerlendirmesi, üroflovmetri (maksimum ve ortalama akış hızı, işenen hacim) ve rezidüel idrar volümü ölçümü) ve morbidite (hematüri, enfeksiyon, üretral darlık, irritatif semptomlar, re-operasyon gerekliliği) açısından değerlendirildi. Bulgular: İki grup arasında postoperatif izlemde ürodinamik incelemeler, IPSS, YK ve morbidite açısından istatistiksel anlamlı bir farklılık saptanmadı. Sadece 3. ayda maksimum ve ortalama idrar akış hızları erken grupta daha yüksek bulundu. İzlem sonunda benzer oranlar içermekle birlikte, üretral darlık gelişiminin erken grupta geç kateter çekilen gruba göre daha erken (sırasıyla 1 ve 3 ay) ortaya çıktığı gözlenmiştir. Sonuç: Bu sonuçlar, TURP sonrası erken ve geç üretral kateter çekilmesinin etkinlik ve cerrahi morbidite bakımından önemli bir farklılık olmayabileceğini düşündürmektedir. TURP ardından üretral kateterin ne kadar tutulması gerektiği gibi görüş birliği bulunmayan bir konuya ışık tutmaya çalıştık.Öğe The Comparison of Magnetic Resonance Imaging/Transrectal Ultrasound Fusion Biopsies with Conventional Transrectal Biopsies in Prostate Cancer Detection(Galenos Yayincilik, 2021) Baba, Dursun; Balık, Ahmet Yıldırım; Yüksel, Alpaslan; Şenoğlu, YusufObjective: The conventional technique for histological prostate cancer diagnosis is transrectal ultrasound (TRUS)-guided random sampling of the peripheral prostate zone. However, due to method insufficiency and recent developments in prostate imaging, new biopsy methods were introduced. This study aimed to evaluate prostate cancer detection rates by the standard and magnetic resonance (MR) fusion biopsy methods. The main purpose of our study is to mutually evaluate prostate cancer detection rates and results of standard and cognitive MR fusion biopsy methods and share our experiences in this process. Materials and Methods: Patients, who underwent prostate biopsy due to elevated serum prostate-specific antigen levels (>4ng/mL) and/or suspicious rectal examination, were retrospectively evaluated. A total of 160 patients were included in the study between January 2018 and January 2021. Patients were divided into two groups according to the applied method, as standard biopsy (SB) and MR fusion biopsy. Results: Prostate cancer was reported in 25 (31.3%) of 80 patients who underwent SB, wherein 20 (25%) were determined with clinically significant cancer. Prostate cancer was reported in 30 (37.5%) of 80 patients who underwent MR fusion biopsy, wherein 25 (31%) were reported as clinically significant cancer. A statistically significant difference was found in detecting prostate cancer and clinically significant prostate cancer when the prostate imaging-Reporting and Data System (3,4,5) scores were compared with each other (p<0.05, p=0.00). The additional SB to MR-targeted fusion biopsy was statistically significant in prostate cancer diagnosis (p=0.01, p<0.05). Conclusion: The additional SB to targeted biopsy increased the detection rate of clinically significant prostate cancer. Larger randomized studies are needed to reach a consensus on the ideal biopsy technique.Öğe Comparison of Systematic, Targeted and Combined Prostate Biopsy: Our Clinical Outcomes(Galenos Yayincilik, 2022) Şenoğlu, Yusuf; Taşkıran, Arda Taşkın; Yüksel, Alpaslan; Baba, DursunObjective: Our aim was to compare the diagnostic efficacy of the standard systematic, targeted and combined prostate biopsy methods in prostate cancer. Materials and Methods: Total of 161 patients who underwent prostate biopsy combined with magnetic resonance imaging-ultrasonography fusion method between August 2018 and March 2021 was evaluated retrospectively. Clinically important and insignificant cancer detection rates of biopsy results between standard, targeted and combined biopsy (CB) methods were compared. Changes in the results were also evaluated in terms of Prostate Imaging-Reporting and Data System (PIRADS) scores. Results: Prostate cancer was diagnosed in 46 (28.6%) patients by CB. Fourteen (8.7%) patients were interpreted as a clinically insignificant disease. Prostate cancer and clinically significant disease detection rates were statistically significant in favor of CB compared to targeted biopsy (TB). There was no statistically significant difference between systematic biopsy and TB results. Additionally, it was observed that cancer detection rates were higher in PIRADS o4 lesions compared to PIRADS 3 lesions in all biopsy methods. Conclusions: Our results have shown that combined prostate biopsy led to higher detection of prostate cancer and provides increased detection of clinically significant disease. High rates of clinically significant cancer, especially in patients with PIRADS o4 lesions, suggest that the PIRADS scoring is a high-level guide in detecting malignancy.Öğe The Current Approach for Small Adrenal Masses(Galenos Publ House, 2022) Şenoğlu, Yusuf; Balık, Ahmet Yıldırım; Ediz, Emre; Yüksel, Alpaslan; Baba, DursunAdrenal tumors originate from the medulla or cortex of the adrenal gland and may be benign or malignant, functional or non-functional. Adrenal tumors discovered during imaging for non-adrenal indications are called incidentalomas and are more common than non-incidental masses. Most incidentalomas are hormonally inactive and benign. Adrenal masses are approximately 30-35 mm in diameter at the time of diagnosis. While masses less than 4 cm are generally considered to be small masses, they are at lower risk for malignancy than adrenal masses larger than 4 cm. An incidentally detected adrenal mass should be investigated for malignancy and functional activity. Hormonal activity or malignancy of the adrenal mass are indications for surgery. Laparoscopic surgery for adrenal adenomas is the gold standard. Evaluation is important to determine the treatment and follow-up process. Although the frequency of benign small adrenal masses increase with age, even if the mass size is <4 cm in young patients, because of their rarity at this age, a closer follow-up is required. The ideal follow-up schedule for these small masses <4 cm in diameter has not been precisely defined. However, clinical guidelines recommend clinical and hormonal follow-up for at least 4 years, and follow-up imaging [computed tomography (CT), magnetic resonance imaging] 6-12-24 months after the first CT. If the size increase in a followed mass is >0.8 cm/ year, surgery is recommended, but the malignancy rate is low in these masses.Öğe The Efficacy of N-acetylcysteine Against Renal Oxidative Stress After Extracorporeal Shock Wave Treatment: An Experimental Rat Model(2020) Baba, Dursun; Çam, H. Kamil; Şenoğlu, Yusuf; Yüksel, Alpaslan; Erdem, Havva; Başaran, EkremObjective: To evaluate effects of renal extracorporeal shock wave lithotripsy (SWL) on plasma Oxidative Stress index (OSI) and to observehistopathological alterations in an experimental model. Secondly, protective role of N-acetylcysteine (NAC) was investigated.Materials and Methods: A total of 24 rats were randomly divided into 3 groups as control (group 1), SWL + saline (group 2), and SWL + NAC(group 3). Study groups were further divided into two subgroups as short-term and long-term. In groups 2 and 3, 2000 shock waves were applied.Intraperitoneal saline was administered in group 2, and intraperitoneal NAC was given to group 3. No treatment was administered to group 1.Blood samples and nephrectomy specimens were obtained for biochemical and histopathological examinations, respectively. OSI was calculatedby measuring plasma total antioxidant status (TAS) and total oxidant status (TOS). Acute and chronic histopathological damage were evaluated bylight microscopy.Results: SWL caused a remarkable increase in oxidative stress. Strikingly, TOS levels were significantly lower (p=0.027) and TAS levels weresignificantly higher (p=0.006) in rats with SWL + NAC (group 3). As a result, OSI was lower (p=0.013). This effect was particularly significant in theshort-term subgroup. It was also concluded that tubular damage and interstitial inflammation were higher in the SWL group (p=0.022). These acutehistological alterations were slighter in rats with NAC.Conclusion: The current study demonstrated that SWL can cause severe oxidative stress and acute renal damage by increasing free oxygen radicalproduction. NAC was effective in decreasing SWL-induced oxidative stress and preventing certain histological alterations to some extent.Öğe Investigation of Factors Affecting the Stone-Free Rate in Elderly Patients with Urinary Stones After Shock Wave Lithotripsy(Duzce University Medical School, 2021) Yüksel, Alpaslan; Baba, Dursun; Şenoğlu, Yusuf; Taşkıran, A.T.Aim: Urinary stone disease is an important disease seen in all age groups, including elderly patients. It can cause kidney failure and urinary infection problems. Shock wave therapy, which is the minimal invasive among the different treatment alternatives, is preferred for kidney and proximal ureteral stones smaller than 2 cm. Studies on the efficacy and safety of this treatment in elderly patients are limited. This study aimed to investigate the factors affecting the stone-free rate (SFR) in elderly patients with urinary stones after shock wave lithotripsy. Material and Methods: The data of 120 patients in the Urology department of Duzce University Faculty of Medicine between 2010 and 2018 over 65 years old who underwent extracorporeal shock wave lithotripsy (ESWL) for urinary system stone disease were evaluated retrospectively. The data obtained from these patients included sex, age, location of the stone (upper, middle, or lower calyx, renal pelvis, ureter), number of shock waves, stone size, and the need for the auxiliary procedure were analyzed. Results: Of the 120 patients, 82 (68.3%) were male and 38 (31.7%) were female. Comorbidity was present in 49 patients. An overall SFR of 65.8% (n=79) was found. The highest SFR was found in middle calyx stones with 79.3% (23 of the 29 patients). Post-ESWL auxiliary procedures were needed in 36 (30%) patients. Two patients developed subcapsular renal hematoma and pyelonephritis. Conclusion: ESWL is an appropriate even the first option for elder male with favorable stone size. Furthermore, ESWL caused acceptable morbidity in older patients. © 2021, Duzce University Medical School. All rights reserved.Öğe Prostatic Carcinosarcoma(2017) Şenoğlu, Yusuf; Çam, Kamil; Erdem, Havva; Kayıkçı, Muhammet Ali; Tekin, AliProstat karsinosarkomu, sarkomatöz ve karsinomatöz unsurlardan oluşan nadir bir malignitedir. Sıklıkla kötü prognozu olan çok agresif tümörlerdir. Bu olgu sunumunda, 3 yıl maksimum androjen blokajı alan prostat adenokarsinomu olgusunda prostat karsinosarkomu gelişen 78 yaşındaki bir erkek hasta sunuldu. Bu nadir görülen malignitenin klinik ve patolojik özelliklerini güncel bilgilerle tanımlamaya çalıştıkÖğe Prostatic Carcinosarcoma: A Case Report(Galenos Yayincilik, 2017) Şenoğlu, Yusuf; Çam, Kamil; Erdem, Havva; Kayıkçı, Muhammet Ali; Tekin, AliProstatic carcinosarcoma is a rare malignancy composed of sarcomatous and carcinomatous elements. Predominantly, they are very aggressive tumors with a poor prognosis. In this case report, a 78 year-old male patient with prostate adenocarcinoma developing prostatic carcinosarcoma after using androgen blockade for 3 years was presented. We tried to define the clinical and pathological features of this rare malignancy with current information.Öğe Prostatik Üretrada Dev Taş(2017) Şenoğlu, Yusuf; Tekin, Ali; Şenoğlu, Gizem DemirGiriş: Prostatik üretrada, dev taşlar oldukça nadir görülmektedir. Obstrüktif yakınmaları ve kabızlık şikayeti olandev prostatik üretra taşı olgusunu literatür bilgileriyle değerlendirdik.Olgu: 57 yaşında hasta yaklaşık 2 yıldır olan dizüri, şiddetli obstrüktif semptomlar ve kabızlık nedeniyle başvurdu.Bilgisayarlı tomografide prostatik üretrayı tamamen dolduran 46mm çapında taş saptandı. Transvezikalprostatolitotomilitotripsi eşliğinde uygulandı. Bir ay sonra tüm yakınmaların sonlandığı görüldü. Yapılanincelemede taş, kalsiyum oksalat taşı olarak raporlandı.Sonuç: Büyük boyutta üretral taşların tedavisi ile ilgili literatür bilgisi oldukça azdır. Bu vaka sunumunda büyükprostatik üretral taşların tanı ve tedavisi açısından üroloji camiasına ışık tutmaya çalıştık.
