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    Comparison of Systematic, Targeted and Combined Prostate Biopsy: Our Clinical Outcomes
    (2022) Şenoglu, Yusuf; Taşkıran, Arda Taşkın; Yüksel, Alpaslan; Baba, Dursun
    Objective: 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 ?4 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 ?4 lesions, suggest that the PIRADS scoring is a high-level guide in detecting malignancy.
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    The Current Approach for Small Adrenal Masses
    (2022) Şenoglu, Yusuf; Balık, Ahmet Yıldırım; Ediz, Emre; Yüksel, Alpaslan; Baba, Dursun
    Adrenal 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.
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    Revascularization in Erectile Dysfunction due to Pelvic Trauma
    (2019) Yüksel, Alpaslan; Karaca, Okay Güven; Baba, Dursun; Şenoglu, Yusuf; Tekin, Ali
    Erectile dysfunction is defined as the inability to achieve penile erection necessary for sexualintercourse or to sustain erection sufficiently. Although the treatment options for erectiledysfunction are limited, the most common surgical treatment is penile prosthesis implantation.In addition, penile revascularization of the penis is very effective in the treatment of erectiledysfunction due to different vasculogenic reasons, especially pudendal artery occlusion, afterperineal trauma. Modified Furlow Fisher technique including anastomosis of the inferiorepigastric artery to the penile dorsal vein is a successful treatment option among therevascularization techniques. Despite invasive preliminary evaluations such as duplex Dopplerultrasound, dynamic cavernosometry, selective internal pudendal arteriography, and the longand difficult surgical procedure, it is highly effective in particularly selected young patients.