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Öğe Adolesan Varikosele Güncel Yaklaşımlar(2019) Baba, Dursun; Kayıkçı, Muhammet AliVarikosel, 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.Öğe ANOMALİ BÖBREKLERDE FLEKSİBLE ÜRETEROSKOPİ (f-URS) DENEYİMLERİMİZ(2021) Bozkurt, İbrahim Halil; Şahan, Murat; Polat, Salih; Deyirmenci, Özgür; Koraş, Ömer; Baba, Dursun; Gökalp, FatihGiriş: 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.Öğe 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 TaskinBackgroundAlthough 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.Öğe 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, AliObjective: 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.Öğe Case report: HIV negative isolated scrotal Kaposi's sarcoma(Elsevier Ltd, 2014) Özmen, Hamid; Baba, Dursun; Kaçağan, Coşkun; Kayıkçı, Ali; Çam, KamilDISCUSSION 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.Öğe 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, AlpaslanObjective: 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.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 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, AnilObjective: 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.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 Complete urethral rupture accompanying penile fracture: a case report(Bmc, 2025) Baba, Dursun; Ekici, Necati; Taskiran, Arda Taskin; Senoglu, Yusuf; Basaran, Ekrem; Balik, Ahmet YildirimIntroduction 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.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 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 YildirimBackground 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.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 Investigation of rs11568476 Polymorphism in the SLC13A2 Gene in Turkish Patients with Hypocitraturia and Calcium-Containing Kidney Stones(Mdpi, 2025) Basaran, Ekrem; Baba, Dursun; Senoglu, Yusuf; Yuksel, Alpaslan; Kayikci, Muhammet Ali; Duzenli, Selma; Tekin, AliBackground and Objectives: Hypocitraturia is a major risk factor for calcium-containing kidney stone disease. Citrate inhibits stone formation by binding calcium in the urine. The SLC13A2 gene encodes the sodium-dependent dicarboxylate cotransporter 1 (NaDC1), a membrane transport protein that facilitates citrate reabsorption in the proximal renal tubules. Variants in this gene, such as rs11568476 (V477M), have been shown to significantly impair transporter activity. This study aimed to investigate the presence of the rs11568476 polymorphism in SLC13A2 and its association with hypocitraturia in Turkish patients with calcium-containing kidney stones. To our knowledge, this is the first genetic study evaluating this polymorphism in a Turkish cohort. Materials and Methods: This prospective cross-sectional study included 90 patients diagnosed with calcium-containing kidney stones at D & uuml;zce University Faculty of Medicine, Department of Urology. Based on 24 h urinary citrate levels, patients were divided into two groups: normocitraturic (n = 38) and hypocitraturic (n = 52). Blood and 24 h urine samples were analyzed for biochemical parameters. The rs11568476 polymorphism in SLC13A2 was analyzed using Real-Time PCR. Results: There were no significant differences between the two groups in terms of age, gender, and most biochemical parameters. Serum uric acid levels were significantly higher in the hypocitraturic group (p = 0.002), whereas family history of stone disease was more prevalent in the normocitraturic group (p = 0.024). Genetic analysis revealed no polymorphism in the rs11568476 region; all patients exhibited the homozygous wild-type genotype (GG). Conclusions: No association was observed between the rs11568476 polymorphism and hypocitraturia in this cohort. The absence of the polymorphism suggests that this variant may be rare or absent in the Turkish population. These findings highlight the importance of investigating additional genetic and environmental contributors to hypocitraturia and nephrolithiasis through larger, multicenter studies.Öğe Investigation of the Relationship of Two-Glass Test with Prostate Biopsy and Presence and Grade of Asymptomatic Prostate Inflammation in Men with Serum Prostate-Specific Antigen Level Between 2.5-10 ng/ml(Duzce Univ, Fac Medicine, 2024) Yuksel, Alpaslan; Tekin, Ali; Senoglu, Yusuf; Baba, Dursun; Gamsizkan, MehmetObjective: Prostate-specific antigen (PSA) is utilized as a marker to detect prostate cancer. Elevated PSA levels often lead to prostate biopsy to assess the potential presence of cancer. However, PSA elevation is not specific to cancer and can be caused by various conditions, including benign prostatic hyperplasia (BPH), urinary tract infections, and chronic prostatitis. Notably, approximately 66% of patients undergoing biopsy do not have prostate cancer, leading to unnecessary procedures and associated complications. Chronic prostatitis is detected in around 40% of these biopsies. The two-glass test involves examining urine before and after a rectal examination to diagnose chronic prostatitis. This study aims to investigate the effectiveness of the two-glass test in predicting prostatitis and inflammation in patients with PSA levels between 2.5-10 ng/ml who have undergone prostate needle biopsy. Materials and Methods: The study included fifty-two male patients aged between 50 and 78 years with PSA levels between 2.5 and 10 ng/ml who presented to our clinic. All patients underwent the EPS-two-glass test and prostate biopsy. EPS (expressed prostatic secretion) is obtained by collecting fluid from the urethra after prostate massage, while VB-3 (voided bladder-3) is urine collected after a massage. These samples are used to detect prostate infection. Prostate inflammation was deemed significant if >= 10 leukocytes were observed under the microscope. Patients were categorized into three groups based on pathology results: prostate cancer, BPH, and chronic prostatitis. The chronic prostatitis group was further classified based on histopathological calcification described by Nickel. Results: Chronic prostatitis was detected in 38% of the study participants. VB3 positivity was significantly higher in the chronic prostatitis group compared to the other groups (p = 0.028). Although no significant difference was observed in the prevalence of inflammation and PSA elevation, PSA levels were higher in the multifocal inflammation subgroup compared to the focal inflammation group. Conclusions: The relationship between chronic prostatitis and PSA elevation remains unclear. Although this study did not find a statistical relationship between inflammation and PSA elevation, the significant correlation between chronic prostatitis and VB3 positivity suggests a potential link. These findings can serve as a foundation for further research aimed at reducing unnecessary biopsies.Öğe Mesanenin nadir benign neoplazmı: Mesane leiomyomu(Duzce University Medical School, 2019) Baba, Dursun; Başaran, Ekrem; Kayıkçı, Muhammet AliMesanenin benign mezenşimal lezyonları oldukça nadirdir ve tüm mesane tümörlerinin %1-5’inin oluştururlar. Bunların içinde de en sık leiomyoma saptanmaktadır. Benign lezyonlar radyolojik olarak maling kitleleri taklit etmesi nedeniyle klinik öneme sahiptir. Tanı radyolojik tetkiklerle kitlenin saptanması ve sonrasında yapılan cerrahi eksizyon ya da biyopsi ile histopatolojik olarak konulmaktadır. Ekstravezikal ve intramural form sistoskopik olarak saptanamayabilirken intravezikal leiomyomlar sistoskopi ile saptanabilir. Sistoskopi sırasında mesane içinde protrüde, kısmen düzgün sınırlı ve yüzeyi mesane mukozası ile kaplı lezyonlar görüldüğünde mesane leiomyomu ayırıcı tanıda düşünülmelidir. 44 yaşında kliniğimize irridatif semptomlarla tarafımıza başvuran ve mikroskopik hematüri saptanan erkek hastada mesanede 2x2 cm kitle saptandı. Minimal invaziv tedavi (TUR-mesane) sonrasında leiomyoma tanısı konulan vaka sunulmaktadır. Anahtar kelimeler: Leiomyom; mesane.Öğe Optimizing Prostate Cancer Diagnosis: A Prospective, Randomized Comparison of 12-core vs. 20-core Biopsy for Detection Accuracy and Upgrading Risk(Galenos Publ House, 2025) Baba, Dursun; Coban, Soner; Caliskan, Ahmet; Senoglu, Yusuf; Kayikci, Muhammet Ali; Tekin, AliObjective: This study compares the diagnostic efficacy of 12-core and 20-core transrectal ultrasound (TRUS)-guided prostate biopsy protocols in detecting prostate cancer (PCa) and evaluates the clinical significance of extended biopsy protocols. Materials and Methods: A prospective, randomized, single-center study was conducted with 511 patients who underwent TRUS-guided prostate biopsy for suspected PCa. Patients were randomly assigned to either a 12-core biopsy group (n=248) or a 20-core biopsy group (n=263). The primary endpoint was the cancer detection rate, while secondary endpoints included clinically significant cancer detection [International Association of Urological Pathology (ISUP) grade >= 2], biopsy-pathology correlation, upgrade rates, and complication assessment. Results: The 20-core biopsy group had a significantly higher cancer detection rate (39.2%) compared to the 12-core group (28.6%). However, clinically significant cancer detection rates were similar between the groups. The 20-core protocol reduced the likelihood of ISUP grade 1 cancer being upgraded after radical prostatectomy, improving diagnostic accuracy. A strong correlation was observed between tumor burden in biopsy and radical prostatectomy specimens. Prostate-specific antigen density analysis identified an optimal cutoff value of 0.1058, providing 66.1% diagnostic accuracy. Complication rates were comparable between the protocols [5.65% (n=14), 6.46% (n=17)]. Conclusion: The 20-core biopsy protocol enhances overall cancer detection and reduces unnecessary upgrading in low-risk PCa cases, improving diagnostic precision. While multiparametric magnetic resonance imaging (MRI)-guided fusion biopsy offers high accuracy, its limited availability makes extended biopsy protocols a viable alternative, particularly in centers without MRI-based targeting methods. Further multicenter studies are needed to refine biopsy strategies for clinical practice.Öğe Penil fraktür ve eşlik eden üretral travma: Tam idrar tahlili rutinde yapılmalı mıdır?(2013) Kayıkçı, Ali; Kaçağan, Coşkun; Baba, Dursun; Çam, Haydar KamilPenil fraktür erekte olan peniste, korpus kavernosum ve/veya korpus spongiosumların yırtılmasından kaynakla nmaktadır. Bu duruma üretral rüptür, dorsal sinir ve damar yaralanmaları da eşlik edebilmektedir. Penil fraktürün s ebe pleri arasında, seksüel ilişki, mastürbasyon, zorlayıcı penil manüpulasyon bulunmaktadır. Yaklaşık %40 varan oranlarda üretral yaralanma da görülmektedir. Bu vakada penil fraktüre eşlik eden üretra travması olgusu tartışılmıştır. Tam idrar tahlilinde mikroskopik hematüri saptanması üretra travm asını düşündürmüştür. Dolayısıyla her vakada üretral travma eşlik edebilir. Bu sebeple tüm hastalarda işemeyle ilgili y akınması olmasa da tam idrar tahlili yapılmalıdır Özellikle de mikroskopik hematüri saptananlarda cerrahi ekspolarasyo nda üretral dokunun bütünlüğü kontrol edilmelidir.Öğe Rare Benign Neoplasm of the Bladder: Leiomyoma of the Bladder(Duzce University, 2019) Baba, Dursun; Başaran, Ekrem; Kayıkçı, Muhammet AliBenign mesenchymal lesions of the bladder are very rare and constitute 1-5% of all bladder tumors. Among these, leiomyoma is the most common. Benign lesions are clinically important because they mimic radiologically malign masses. The diagnosis is made histopathologically by detecting the mass by radiological examinations and subsequent surgical excision or biopsy. Extravesical and intramural forms may not be detected cystoscopically, while intravesical leiomyomas can be detected by cystoscopy. Bladder leiomyoma should be considered in the differential diagnosis when protruding, partially smoothly bound and covered bladder mucosa lesions are observed during cystoscopy. A 44-year-old male patient who presented to our clinic with irridative symptoms and was found to have microscopic hematuria and 2x2 cm mass in the bladder. A case of leiomyoma diagnosed after minimally invasive treatment (TUR-bladder) is presented.
