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Adolesan Varikosele Güncel Yaklaşımlar
(2019) Baba, Dursun; Kayıkçı, Muhammet Ali
Varikosel, adolesan yaş grubunda da erişkin yaş grubuna benzer sıklıkta görülmektedir. İnfertiliteye neden olabileceği için tanı ve tedavisinde dikkatli ve titiz olunmalıdır. Genel olarak adolesan varikosellerinde fertiliteyi korumak ve testis fonksiyonlarının korunması için yüksek derecede varikosel ya da testis volümünde % 20 azalma cerrahi endikasyon olarak kabul görmektedir. Bu nedenle adolesan varikoseli olan hastaların testis volümleri seri ultrason ölçümleri ve muayene ile yakından takip edilmelidir. Ergenlik döneminden sonra spermiyogram takibi de seri ultrason ölçümleri takipte önemli katkılar sağlar. Cerrahi tedaviden elde edilen başarı nedeniyle bu yaş grubunda tanısı oldukça önemlidir. Bu çalışma da adolesan varikosel tanı ve tedavisi incelenmiştir.
ANOMALİ BÖBREKLERDE FLEKSİBLE ÜRETEROSKOPİ (f-URS) DENEYİMLERİMİZ
(2021) Bozkurt, İbrahim Halil; Şahan, Murat; Polat, Salih; Deyirmenci, Özgür; Koraş, Ömer; Baba, Dursun; Gökalp, Fatih
Giriş: Anomalili böbreklerde böbrek ve proksimal üreter taşı hastaları için uyguladığımız fleksibl-URS ( f-URS) başarısını, komplikasyonlarını ve postopertif sonuçları sunmayı amaçladık. Gereç ve Yöntem: Nisan 2010 ile Haziran 2020 y ılları arasında anomali böbreği olan f-URS uygulanan 69 hastanın dosyaları retrospektif olarak tarandı. Hastalar ın dermografik özellikleri, operasyon süresi,skopi süresi, taşsızlık oranları, komplikasyon oranları kaydedildi. Final taşsızlık (FSFR); postoperastif birinci ayda yapılan ultrasonografi ve radiografik de ğerlendirilerek ta şın yoklu ğu veya bilgisayarlı tomografide 2mm den büyük ta ş fragmanı görülmemesi olarak tanımlandı. Bulgular: Toplam 69 hastanın; parsiyel nefrektomili üç, bifid pelvisli dört, atnalı böbrekli 14, ektopik böbrekli 15, rotasyon anomalilisekiz, duplike üreterli 12 ve kaliksiyel divertikül 13 hastaya f-URS yapıldı. Ortalama taş boyutu 15.1±7.7 mm 2 ve ortalama taş dansitesi (HU) 983±242 olarak saptandı. Tek seansta hastaların %78.2’sinde taşsızlık sağlanmışken ek gişim ile final taşszılık%85,5 olarak saptandı. Sonuç: Anormal böbrekli hastalarda f-URS teknik olarak zorlayıcı olabilse de endoürolojik tekniklerdeki ilerlemeler onu güvenli ve etkili bir prosedür haline getirmiştir. f-URS; daha az invaziv yap ısıve kabul edilebilir komplikasyon oranları nedeniyle anormal böbreklerdeki çoğu taş için çok etkili bir tedavi yöntemidir.
Before the Needle: The Impact of Ejaculation on Prostate Biopsy Outcomes in a Prospective Comparative Study
(Springernature, 2025) Baba, Dursun; Dilek, Ismail Eyup; Ekici, Necati; Ozel, Mehmet Ali; Balik, Ahmet Yildirim; Basaran, Ekrem; Taskiran, Arda Taskin
BackgroundAlthough transrectal ultrasound (TRUS)-guided prostate biopsy is widely used for prostate cancer diagnosis, the role of pre-biopsy ejaculation in influencing procedural outcomes and complication risk remains largely unexplored. This study aimed to evaluate whether recent ejaculation affects seminal vesicle volume, biopsy-related complications, and patient-reported outcomes.MethodsIn this prospective comparative study, 32 patients undergoing TRUS-guided 12-core prostate biopsy were divided into two groups based on their sexual activity: the ejaculation group (n = 14), who ejaculated within 24 h prior to the procedure, and the abstinence group (n = 18), who reported abstinence for at least 3 days. Data collected included seminal vesicle volume, pain scores, urinary symptoms, erectile function, quality of life, and post-procedural complications. Histopathological results were also recorded and summarized. ROC analyses were used to determine cutoff values for key complications. Although transperineal biopsy is now recommended by current EAU guidelines, our study was conducted using the transrectal approach, which remains widely practiced and relevant in clinical settings.ResultsWhile seminal vesicle volume tended to be higher in the abstinence group, the difference was not statistically significant (p = 0.184). No meaningful differences were found in pain perception, urinary symptoms, erectile function, or quality of life. However, hematospermia (p = 0.017) and hematochezia (p = 0.011) were significantly more frequent in the ejaculation group. ROC analysis showed that abstinence <= 7.5 days predicted hematospermia (AUC = 0.731), and abstinence <= 2 days predicted hematochezia (AUC = 0.760). A pain score >= 1.5 was predictive of hematuria (AUC = 0.810). Histological analysis revealed benign findings in the majority of patients, with no significant difference in cancer grade between groups.ConclusionEjaculation prior to TRUS-guided prostate biopsy may increase the risk of certain complications without negatively affecting patient comfort. Abstinence duration could serve as a simple and modifiable factor in optimizing biopsy preparation. Despite the limited sample size, this prospective study provides preliminary evidence supporting patient counseling on sexual activity prior to biopsy.
BORAKS PROSTAT KANSERİ HÜCRELERİNDE OTOFAJİ YOLAĞINI REGÜLE EDEREK PROLİFERASYONU ENGELLER
(Afyonkarahisar Sağlık Bilimleri Üniversitesi, 2026) Başaran, Ekrem; Hacıoğlu, Ceyhan; Uyurca, Sare; Baba, Dursun; Taşkıran, Arda Taşkın; Balık, Ahmet Yıldırım
AMAÇ: Otofaji, kanser hücrelerinin hayatta kalmasında ve te-daviye karşı direnç geliştirmesinde kritik bir rol oynamaktadır. Esansiyel bir iz element olan bor, çeşitli biyolojik süreçlerde yer almaktadır; ancak, prostat kanserinde boraksın antitümör etki-leri üzerine yapılan araştırmalar sınırlı olup, bu bağlamda otofa-jinin rolü hâlen yeterince anlaşılmamıştır. Bu çalışma, boraksın DU-145 insan prostat kanseri hücrelerinde otofaji üzerindeki etkilerini ve bu etkilerin moleküler düzeydeki mekanizmaları araştırılmıştır.GEREÇ VE YÖNTEM: : DU-145 hücreleri in vitro koşullarda kültürlenmiş ve boraks ile muamele edilmiştir. Hücre canlılığı ve proliferasyonu, MTT (3-(4,5-dimetiltiazol-2-il)-2,5-difenil-tetrazolyum bromür) testi ve BrdU (5-bromo-2'-deoksiüridin) inkorporasyon yöntemi ile değerlendirilmiştir. Sitotoksik bo-raks konsantrasyonları belirlendikten sonra, otofaji ile ilişkili belirteçler olan Beclin1, mikrotübül ilişkili protein 1 hafif zincir 3 (LC3-II) ve sequestosome-1 (SQSTM1) ekspresyon düzeyleri ölçülmüştür.BULGULAR: Elde edilen sonuçlar, boraksın DU-145 hücre canlı-lığını doz bağımlı olarak anlamlı biçimde azalttığını göstermiş-tir. Ayrıca, boraks hücre proliferasyonunu baskılamış ve hücre döngüsünün S fazındaki hücre oranını önemli ölçüde azaltmış-tır. Moleküler düzeyde ise boraks uygulaması, SQSTM1’in azal-masına, Beclin1 ve LC3-II’nin ise artmasına yol açarak otofajinin indüklendiğine işaret etmiştir.SONUÇ: Bu bulgular, boraksın DU-145 prostat kanseri hücre-lerinin proliferasyonunu otofajik yolakları aktive ederek inhibe ettiğini göstermektedir. Gözlemlenen etkilerin, büyük ölçüde Beclin1/LC3-II/SQSTM1 sinyal yolunun modülasyonu ile ilişkili olduğu düşünülmektedir. Ayrıca, boraksın bir otofaji aktivatö-rü ile kombinasyonu, antitümör etkinliğini artırabilir ve prostat kanseri tedavisinde umut verici bir strateji sunabilir.
Borax Triggers Ferroptosis by Modulating the TfR1/GPX4/ACSL4 Pathway in Prostate Cancer Cells with Differential Androgen Sensitivity
(Springernature, 2025) Basaran, Ekrem; Hacioglu, Ceyhan; Baba, Dursun; Taskiran, Arda Taskin; Balik, Ahmet Yildirim
Prostate carcinoma remains a predominant contributor to cancer-associated morbidity in males, with rising prevalence and therapeutic resistance highlighting unmet clinical needs. Ferroptosis-a non-apoptotic cell death mechanism mediated through iron-catalyzed phospholipid peroxidation-has emerged as a promising strategy to circumvent drug-resistant malignancies. We investigated the mechanistic interplay between transferrin receptor 1 (TfR1) and borax-mediated ferroptotic activation in androgen-responsive and androgen-independent prostate adenocarcinoma models. Cytotoxic effects of borax on LNCaP and DU-145 cells were assessed using CCK-8 and BrdU assays across 2.5 mu M to 320 mu M concentrations over 24-72 h. Expression and levels of TfR1, GPX4, ACSL4, GSH, MDA, total ROS, and intracellular Fe2(+) were evaluated through ELISA, Western blotting, and RT-PCR. Ferroptosis specificity was confirmed using ferrostatin-1 inhibition studies and exclusion of apoptosis/necroptosis/autophagy by pharmacological inhibitors. Nuclear alterations and superoxide anion production were examined using DAPI staining. IC50 values were 138 mu M (95% CI: 115-153 mu M) for LNCaP cells and 92.1 mu M (95% CI: 83.4-102 mu M) for DU-145 cells, with DU-145 demonstrating higher sensitivity. Borax exposure in DU-145 cells decreased GSH and GPX4 levels while increasing MDA, ROS, Fe2(+), ACSL4, and TfR1 expression. Ferrostatin-1 pretreatment effectively attenuated these effects, confirming ferroptosis-dependent mechanisms. Nuclear abnormalities and elevated superoxide production were observed. These findings demonstrate that borax induces cytotoxicity in prostate cancer cells through ferroptosis via TfR1/GPX4/ACSL4 cascade modulation, suggesting a potential role for TfR1 in governing ferroptotic vulnerability. While high concentrations limit immediate clinical application, these results establish mechanistic foundations for ferroptosis-targeted therapy development in prostate cancer.
Can Laparoscopic Adrenalectomy Be A Reliable Method for Adrenal Masses Larger than 4 Cm?: Our Clinical Outcomes
(Galenos Publ House, 2025) Senoglu, Yusuf; Balik, Ahmet Yildirim; Baba, Dursun; Taskiran, Arda Taskin; Basaran, Ekrem; Tekin, Ali
Objective: The laparoscopic approach to large adrenal masses is becoming increasingly common. Our study aims to investigate the reliability and effectiveness of adrenalectomy performed with laparoscopic surgery in adrenal masses larger than 4 cm. Materials and Methods: Fifty-two patients who underwent transperitoneal laparoscopic adrenalectomy in our clinic between January 2014 and July 2022 were evaluated retrospectively. Each patient's age, gender, hormonal activity status, tumor size and side, hospital stay, amount of bleeding, operation time, complication rates (Clavian classification), pathology results, and surgical margin positivity were evaluated. Thirty patients with tumor size over 4 cm and 22 patients under 4 cm were compared separately. Results: There was no statistically significant difference between the two groups regarding hospital stay (p=0.11). When the operation time and bleeding amount were compared, no statistically significant difference was found between these two groups (p=0.392, p=0.761; respectively). Although slightly more complications were seen in patients with tumors smaller than 4 cm, no statistical difference was observed (p>0.05). Surgical margin positivity was detected only in one of the patients with a tumor size of less than 4 cm, and this patient was reported to have adenoma. All operations were completed laparoscopically. No complications occurred in Clavien class 3 or above in any of the patients. Conclusion: Our study and experience unequivocally demonstrate that transperitoneal laparoscopic adrenalectomy is not only effective but also remarkably safe for large (>4 cm) adrenal masses.
Case report: HIV negative isolated scrotal Kaposi's sarcoma
(Elsevier Ltd, 2014) Özmen, Hamid; Baba, Dursun; Kaçağan, Coşkun; Kayıkçı, Ali; Çam, Kamil
DISCUSSION The pathogenesis of KS has still not been clearly elucidated. However, it is known that all forms of KS are associated with HHV-8 infections. A defect in immune system was almost always necessary. Therefore, KS is usually associated with HIV infection. KS of the penis has been reported in HIV negative patients. Very few cases of scrotal KS have been presented. In a recent review, only 1 patient had scrotal KS out of 32 cases with HIV negative KS. In our case, the patient received a cycle of chemotherapy that might affect his immune system. The lymphangioma-like type is a common morphological sub-type. While lymph edemas are commonly observed in this sub-type, no edema in the lymphs was present in our case.CONCLUSION Classical KS is generally observed in the lower extremities, it can rarely affect scrotal skin as isolated lesions. Therefore, a careful physical examination should also include scrotum for these patients.INTRODUCTION Kaposi's sarcoma (KS) is a rare angioproliferative disorder of the vascular endothelium. The development of KS requires Human Herpes Virus 8 (HHV-8) infection. An associated HIV infection is usually seen. Isolated scrotal KS has rarely been reported. In this article, we present a case of KS that primarily involved the scrotum in a HIV negative patient.PRESENTATION OF CASE A 71-year old male patient admitted to the outpatient department due to nodular lesions on the scrotum. The patient declared that these lesions were present for nearly 5 years. Past medical history revealed that he underwent left thoracotomy and upper lobectomy in 2006 for adenosquamous lung carcinoma. Then, he received a single cycle of adjuvant chemotherapy consisted of docetaxel and cisplatin. Physical examination revealed 3 black small nodules on the scrotum. The anti-HIV test was negative. All scrotal lesions were surgically excised. The pathological investigation revealed KS of the lymphangioma-like type. © 2014 Elsevier B.V. All rights reserved.
Clinical reasoning with machines: evaluating the interpretive depth of AI in urological case assessments
(Bmc, 2026) Taskiran, Arda Taskin; Balik, Ahmet Yildirim; Basaran, Ekrem; Baba, Dursun; Kayikci, Muhammet Ali
Background Large language models (LLMs) are increasingly utilized as decision-support tools in medicine. However, their clinical reliability and applicability remain uncertain. This study compared ChatGPT-3.5, ChatGPT-4o, and Gemini 1.0 Pro in responding to standardized urological clinical scenarios evaluated by blinded experts. Methods This observational cross-sectional study included 75 urology specialists categorized by experience (< 10 years vs. >= 10 years). Participants independently and blindly rated anonymized AI-generated responses for 10 common urological cases using a 5-point Likert scale across four predefined domains: accuracy, reliability, clinical applicability, and interpretive depth. Normality was assessed with the Shapiro-Wilk test, and ANOVA or Kruskal-Wallis tests were used as appropriate, followed by post-hoc pairwise analyses. Inter-rater reliability was calculated using Cronbach's alpha and Fleiss' kappa. Spearman correlation coefficients were computed to examine associations among rating domains. Results ChatGPT-4o achieved the highest mean scores across all domains, followed by Gemini 1.0 Pro and ChatGPT-3.5. Performance differences were statistically significant for all parameters (p < 0.05), with the largest gaps observed in accuracy (4.4 +/- 0.48 vs. 4.0 +/- 0.52 vs. 3.7 +/- 0.56) and clinical applicability (4.2 +/- 0.49 vs. 3.8 +/- 0.51 vs. 3.5 +/- 0.55). A moderate positive correlation was observed between accuracy and reliability (r = 0.50), while the previously reported negative correlation between reliability and interpretive depth was corrected to r = - 0.18, indicating only a weak inverse relationship. Inter-rater agreement was high (Cronbach's alpha = 0.84; Fleiss' kappa = 0.72). Conclusion Newer-generation large language models, particularly ChatGPT-4o, showed higher performance scores in terms of accuracy and clinical applicability in standardized urological decision-support scenarios. However, these findings should be interpreted with caution and require confirmation through repeated-measures or mixed-model analyses as well as validation in real-world clinical settings. Ongoing benchmarking of evolving AI systems remains important to monitor longitudinal improvements while ensuring safety, reliability, and appropriate clinical use.
Comparison of Early Versus Late Urethral Catheter Removal After Transurethral Resection of the Prostate in Patients with Benign Prostate Hyperplasia
(Duzce Univ, Fac Medicine, 2023) Senoglu, Yusuf; Tekin, Ali; Yildirim, Olcay; Baba, Dursun; Yuksel, Alpaslan
Objective: Transurethral resection of the prostate (TURP) is considered the standard in the surgical therapy of lower urinary tract symptoms related to benign prostate hyperplasia (BPH). However, there is no consensus on the timing of catheter removal. In this study, we aimed to compare the long-term effects of early and delayed removal of urethral catheters who underwent TURP.Methods: We prospectively analyzed a total of 91 patients who underwent TURP. Patients were randomized into two groups; the early (postop 1st-2nd days) and delayed (7th day) removal of the urethral catheter. After the surgery in 1, 3, and 6th months, we evaluated all patients regarding treatment success. In addition, international prostate symptom score (IPSS), quality of life (QoL), maximum flow rate, postvoid residual urine volume, and morbidities (hematuria, infection, urethral stricture, irritative symptoms, need for re-operation) were assessed at all visits.Results: After TURP, there was no statistical difference in urodynamic parameters, complications, IPSS, and QoL in both groups. Only in the 3rd-month, the maximum flow rate was higher in favor of the early group. Despite similar results in both groups, strictures occurred earlier in the early group than delayed group (respectively 1 and 3 months).Conclusions: These results suggest that there are no differences in efficacy and complications in groups of early or delayed urethral catheter removal after TURP. The results of long-term studies with large series should be awaited to reach a more definite conclusion. We have tried to shed light on a topic without consensus on the time of urethral catheterization after TURP.
Comparison of Infectious Complications After Transrectal Prostate Biopsy Under Two Antibiotic Prophylaxis Regimens: Ceftriaxone Plus Cefixime Versus Ciprofloxacin Plus Gentamicin
(Wiley, 2026) Balik, Ahmet Yildirim; Ediz, Emre; Ayvacik, Burak; Taskiran, Arda Taskin; Basaran, Ekrem; Baba, Dursun
Objectives To compare the effectiveness and safety of two antibiotic prophylaxis regimens, ciprofloxacin plus gentamicin and ceftriaxone plus cefixime, in preventing infectious complications after transrectal ultrasound-guided prostate biopsy.Methods The study retrospectively reviewed 705 consecutive patients who underwent transrectal ultrasound-guided prostate biopsy between January 2020 and January 2024. Group 1 (n = 374) received ciprofloxacin plus gentamicin, and Group 2 (n = 331) received ceftriaxone plus cefixime. All patients underwent standard rectal preparation with povidone-iodine, and needle-tip disinfection with formalin. The primary outcome was the development of post-biopsy infectious complications, while secondary outcomes included sepsis and infection-related hospitalization.Results The two groups were comparable in terms of age, body mass index, prostate-specific antigen levels, and comorbidities. The overall rate of post-biopsy infection was 1.4%, occurring in 1.1% patients in Group 1 and 1.8% patients in Group 2 (p = 0.61). The incidence of complicated urinary tract infection was 0.3% versus 0.9%, and infection-related hospitalization occurred in 0.5% versus 0.3% of patients in Group 1 and Group 2, respectively, with no cases of sepsis observed. In univariable analyses, diabetes mellitus, histopathological chronic prostatitis, and pre-biopsy antibiotic use were not significantly associated with post-biopsy infection.Conclusion The combination of ceftriaxone and cefixime showed a safety profile broadly consistent with the combination of ciprofloxacin and gentamicin for biopsy prophylaxis. Considering increasing fluoroquinolone resistance and growing restrictions, this cephalosporin-based regimen may be considered a feasible option for transrectal ultrasound-guided prostate biopsy when implemented together with strict antiseptic measures.
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, Yusuf
Objective: 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.
Comparison of Preoperative Urine Culture and Intraoperative Renal Pelvis Culture in Patients Who Underwent Flexible Ureterorenoscopy
(Galenos Publ House, 2022) Gökalp, Fatih; Koras, Ömer; Polat, Salih; Sahan, Murat; Baba, Dursun; Bozkurt, İbrahim Halil; Eker, Anil
Objective: There is no correlation between the preoperative bladder urine culture (PBUC) sensitivity test and the results of the renal pelvic urine culture (RPUC) test. Materials and Methods: A total of 129 patients who underwent f-URS included the study. Preoperatively, PBUC was collected in all cases, and RPUC was taken when starting the surgery. Results: In PBUC, there was growth in 25 (19.4%) patients and in RPUC, there were only in 35 (27.1%) cases. Preoperative tomographic urine density at the renal pelvis [odds ratio (OR): 0.848, p<0.001], grade >= 2 hydronephrosis (OR: 18.970, p=0.001), and lower calyceal stone location (OR: 0.033, p=0.017) were determined as independent predictive factors for RPUC growth. The ability of tomographic urine density to foresee positive RPUC positivity was determined to be 0.858 (0.780-0.936). The tomographic urine density threshold for RPUC positivity prediction was 4.5, with 80% sensitivity and 77.7% specificity. Conclusion: PBUCs do not necessarily mean accurate colonization. Obtaining renal pelvis urine samples is important for managing postoperative infectious complications. Patients that have preoperative hydronephrosis and nominal tomographic urine density could develop RPUC even if the preoperative bladder urine samples are negative.
Comparison of Systematic, Targeted and Combined Prostate Biopsy: Our Clinical Outcomes
(Galenos Yayincilik, 2022) Şenoğlu, 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 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.
Complete urethral rupture accompanying penile fracture: a case report
(Bmc, 2025) Baba, Dursun; Ekici, Necati; Taskiran, Arda Taskin; Senoglu, Yusuf; Basaran, Ekrem; Balik, Ahmet Yildirim
Introduction and importancePenile fracture is a rare urological emergency. It occurs due to the penis being subjected to force during intercourse or other causes. Treatment is usually surgical. Urethral injury accompanies 10-20% of cases. In this case, a complete urethral rupture accompanying a penile fracture is aimed to be presented.Presentation of caseA 45-year-old male patient presented to the emergency department with complaints of a snapping sound, pain, and sudden loss of erection during sexual intercourse. After a while, bleeding from the external meatus and inability to urinate were added to his complaints. Physical examination showed typical signs of penile fracture along with urethrorrhagia. The penile doppler ultrasound result was reported to be consistent with a penile fracture and uretral injury. Approximately one hour after presenting to the emergency department, the patient underwent surgery. Considering the possibility of urethral rupture, a urethroscopy was performed before fracture repair, revealing a urethral defect approximately 8 cm proximal to the external meatus. Surgical repair found a near-complete bilateral rupture of the corpus cavernosum and a complete urethral rupture. The urethral rupture and fracture area were repaired according to surgical procedure standards. No additional complaints or new pathologies were observed in the early postoperative follow-up. The patient was discharged with a catheter on postoperative day 3. On the 14th postoperative day, the patient's catheter was removed. At the 3-month follow-up, the patient had no urinary complaints, and the uroflowmetry test showed a Qmax of 35. No pathology was detected in the urethrography performed. At the one-year follow-up, the patient's International Index of Erectile Function (IIEF) score was 26, indicating no additional complaints.Clinical discussionComplete urethral rupture and bilateral corpus cavernosum rupture are rare urological emergencies, typically resulting from trauma applied to an erect penis. A physical examination, ultrasonography, and, when necessary, imaging techniques such as cystoscopy are the diagnostic modalities employed in such cases. Early surgical treatment has been shown to improve functional outcomes and reduce long-term complications.ConclusionEarly surgical intervention in the treatment of penile fractures not only preserves sexual function but also significantly reduces long-term complications. Urethral rupture should always be considered in fractures accompanied by urethrorrhagia and hematuria.
The Current Approach for Small Adrenal Masses
(Galenos Publ House, 2022) Şenoğlu, 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.
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, Ekrem
Objective: 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.
Gestational Hydronephrosis: A Retrospective Analysis of the Clinical Outcomes of Ureteral Stent Placement Versus Conservative Treatment
(Mdpi, 2025) Baba, Dursun; Yurtcu, Engin; Ayvacik, Burak; Kucuk, Yusuf Salih; Taskiran, Arda Taskin; Ozel, Mehmet Ali; Balik, Ahmet Yildirim
Background and Objectives: Gestational hydronephrosis (GH) is a physiological condition commonly observed during pregnancy, resulting from hormonal effects and mechanical compression of the ureters by the enlarging uterus. Although often asymptomatic, GH can cause urinary stasis, recurrent infections, and renal function impairment in symptomatic cases. The optimal management of such cases remains controversial, especially regarding the role of ureteral stent placement. This study aimed to compare clinical outcomes-including renal function, inflammatory markers, and obstetric parameters-in pregnant women with symptomatic GH who underwent ureteral stent placement versus those managed conservatively. Materials and Methods: We conducted a retrospective cohort study at D & uuml;zce University Hospital between 2020 and 2024, including 40 pregnant women diagnosed with symptomatic GH. The patients were divided into the following two groups: those who received a ureteral stent (n = 20) and those who were managed with conservative treatment (n = 20). Conservative management included hydration therapy, acetaminophen-based analgesia, and close clinical monitoring. The parameters assessed included serum creatinine, estimated glomerular filtration rate (GFR), inflammatory markers (C-reactive protein, erythrocyte sedimentation rate, and white blood cell count), urinary findings, obstetric outcomes, and postpartum complications. Statistical significance was set at p < 0.05. Results: Gestational age at diagnosis was significantly higher in the stent group (29.1 +/- 3.2 weeks) than in the non-stent group (27.1 +/- 3.5 weeks; p = 0.045), possibly reflecting increased mechanical compression in later pregnancy. Renal function parameters (serum creatinine and GFR), inflammatory markers (CRP, ESR, and WBC count), and obstetric outcomes (birth weight, Apgar scores) showed no significant differences between groups (p > 0.05). Interestingly, gestational diabetes mellitus (GDM) was more prevalent in the non-stent group (20% vs. 5%; p = 0.042), although no significant differences were found in fasting glucose levels. Conclusions: Ureteral stent placement in symptomatic GH does not appear to significantly improve renal function or obstetric outcomes. However, it may provide symptom relief in select patients with persistent or severe discomfort. Given the limitations of retrospective data and a small sample size, further prospective studies with larger cohorts and quality-of-life assessments are warranted to optimize management strategies and enhance patient-centered care.
Hyperbaric oxygen therapy attenuates urethral stricture formation after urethral injury: an experimental rabbit study
(Springer, 2026) Danis, Hasan; Yuksel, Alpaslan; Baba, Dursun; Senoglu, Yusuf; Taskiran, Arda Taskin; Basaran, Ekrem; Tekin, Ali
Purpose Urethral stricture (US) is a frequent and challenging urological entity characterized by spongiofibrosis and luminal narrowing, often leading to recurrent infections, urinary retention, and upper tract deterioration. Despite various endoscopic and open surgical options, high recurrence rates remain a major problem, and there is no established medical therapy to prevent stricture formation. To investigate the protective effect of hyperbaric oxygen (HBO) therapy on fibrosis and stricture formation in an experimental urethral injury model in rabbits using objective endoscopic, radiologic, and histopathologic parameters. Methods Twenty-eight male New Zealand rabbits were randomized into three groups: sham (n = 8), urethral injury without treatment (control, n = 10), and urethral injury plus HBO (HBO, n = 10). Among the 20 rabbits with urethral injury, allocation to the untreated control group (Group 2) and the HBO treatment group (Group 3) was performed in a 1:1 ratio using a computer-generated randomization list. Standardized circumferential electrocoagulation was applied to the bulbar urethra in the control and HBO groups. HBO was administered at 2 ATA, 90 min/day for 21 consecutive days starting on the day of injury. On day 28, all animals underwent urethroscopy and retrograde urethrography; urethral specimens were then harvested for histopathological evaluation. Fibrosis was graded (0-3) using Masson trichrome staining. Results Normal urethral diameters were similar among the groups (p = 0.604). Median stricture diameter was significantly lower in the untreated control group compared with the HBO and sham groups (2.15 mm vs. 8.05 mm and normal segment, respectively; p < 0.001). Median percentage urethral narrowing was 78.52% in the control group and 23.51% in the HBO group (p < 0.001). Fibrosis scores were significantly higher in the control group than in the HBO and sham groups (p < 0.001). Conclusion HBO therapy significantly attenuated fibrosis and urethral narrowing in this experimental urethral injury model. These findings suggest that HBO may represent a promising adjuvant strategy to prevent US formation after urethral trauma, warranting further clinical investigation.
Hyperbaric oxygen therapy attenuates urethral stricture formation after urethral injury: an experimental rabbit study (vol 44, 220, 2026)
(Springer, 2026) Danis, Hasan; Yuksel, Alpaslan; Baba, Dursun; Senoglu, Yusuf; Taskiran, Arda Taskin; Basaran, Ekrem; Kantarcloelu, Sinem
[Abstract Not Available]
İnfertil Erkeklerde TyG İndeksi ve TG/HDL Oranının Semen Parametreleri ile Olası İlişkileri
(2026) Baba, Dursun; Taşkıran, Arda Taşkın; Başaran, Ekrem; Kayıkçı, Muhammet Ali; Balık, Ahmet Yıldırım
Amaç: Bu çalışmada infertil erkeklerde metabolik risk belirteçleri olan trigliserid-glukoz (TyG) indeksi ve trigliserid/HDL kolesterol (TG/HDL) oranı ile semen parametreleri arasındaki ilişki araştırıldı. Gereç ve Yöntemler: 2018–2024 yılları arasında semen analizi yapılan 18–60 yaş arası 275 erkek retrospektif olarak incelendi. Demografik, biyokimyasal ve semen verileri değerlendirildi. Korelasyon analizleri ve çok değişkenli lojistik regresyon yapıldı. Bulgular: Ortalama yaş 34,9 ± 6,9 yıl, VKİ 25,9 ± 3,4 kg/m² idi. Daha yüksek TyG indeksi ve TG/HDL oranı, düşük total motilite (TyG r=-0,18, p=0,004; TG/HDL r=-0,16, p=0,009), progresif motilite (TyG r=-0,22, p<0,001; TG/HDL r=-0,21, p=0,001) ve normal morfoloji (TyG r=-0,15, p=0,012; TG/HDL r=-0,13, p=0,025) ile ilişkili bulundu. Lojistik regresyon analizinde yaş (OR 1,04, p=0,016), VKİ (OR 1,07, p=0,007), TyG indeksi (OR 1,38, p=0,003) ve TG/HDL oranı (OR 1,22, p=0,021) düşük semen kalitesinin bağımsız belirleyicileri olarak saptandı. Sonuç: Bu çalışma, daha yüksek TyG indeksi ve TG/HDL oranının semen parametrelerinde, özellikle motilite ve morfoloji açısından bozulma ile ilişkili olabileceğini göstermektedir. Bu indeksler erkek infertilitesinin değerlendirilmesinde destekleyici belirteçler olarak kullanılabilir, ancak öngörücü değerleri sınırlıdır. Bu nedenle bağımsız tanısal araçlardan ziyade tamamlayıcı göstergeler olarak yorumlanmalıdır. Bulguların doğrulanması ve klinik öneminin netleştirilmesi için daha geniş ve farklı popülasyonlarda yürütülecek prospektif çalışmalara ihtiyaç vardır.

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