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    Modified Penile Inversion Vaginoplasty: First Case Series of a Turkish Single Center
    (Mary Ann Liebert, Inc, 2023) Arda, Ersan; Arikan, Mehmet Guerkan; Top, Husamettin
    Purpose: The aim of this study is to share our outcomes, including complications and their managements, of a modified penile inversion vaginoplasty (PIV) technique applied to transgender individuals, which we presume to be the first reported case series of a single center from Turkey.Methods: A cross-sectional study, including adult transgender cases who underwent male to female gender-affirming surgery in our institution, between January 2015 and December 2019, was planned. The same modified PIV technique, in which the spatulated urethra was incorporated to the penile skin flap, was applied to all cases. Demographic data including case characteristics, medical history with prior operative details, and complications detected during follow-up examination were collected prospectively.Results: The mean age of 30 cases included in the study was 31.03 +/- 7.05 years. The mean length of hospitalization after the surgical procedures was 10.13 +/- 2.24 days. The mean vaginal depth measured at postoperative 1st year follow-up examination was 14.2 +/- 2.95 cm. Satisfactory neovaginal moistening was reported by 24 (80%) cases. In 8 (26.6%) of 30 cases, no complication was reported at all. Intraoperative (rectal injury) and postoperative (meatal stenosis, vaginal narrowing, scars, infections, etc.) complications occurred in 22 (63.4%) cases. Postoperative satisfaction rates including mental, physical, and social health in general were found to be 81.84% (66-98%).Conclusion: The modified PIV can be used as a preferred technique showing high satisfactory outcomes, especially in cases with short penile skin or circumcision, due to the achievable lubricity and vaginal width/depth.
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    Prognostic Role of Tumor Percentage in Multiparametric MRI for Upgrade Prediction Before Radical Prostatectomy
    (Galenos Publ House, 2024) Arikan, Mehmet Guerkan; Ecer, Goekhan; Sahin, Mehmet Fatih; Hereklioglu, Savas; Goekalp, Fatih; Arda, Ersan; Akguel, Burak
    Objective: To determine the parameters that can predict upgrade with multiparametric magnetic resonance imaging (mpMRI) findings before radical prostatectomy Materials and Methods: The study included 69 patients who were diagnosed with prostate cancer (PCa) between January 2017-December 2020 and subsequently underwent RP. Patients were divided into two groups by comparing prostate biopsies and RP specimens as patients with upgrade (group 1) and patients without upgrade (group 2). Of the 69 patients, 26 were in group 1 and 43 in group 2. The images were evaluated by a single radiologist experienced in mpMRI using the Prostate Imaging Reporting and Data System v2.1 scoring system. Biopsy and RP pathology specimens were evaluated by an experienced neuropathologist. Results: The median prostate-specific antigen (PSA) levels were higher in patients with upgraded pathology [8.60 (5.90-14.00) ng/dL vs. 7.70 (5.20-10.00) ng/dL, respectively; p=0.040]. The prostate volume [31.88 (23.40-51.48) vs. 48.06 (23.40-87.35); p=0.009] and PSA density [3.72 (2.17-5.62) vs. 5.75 (3.35-9.6), respectively; p=0.007] were lower in patients with upgraded pathology. The tumor percentage on mpMRI was not different between the groups [3.70 (1.80-16.20 Conclusions: Although the percentage of tumors on multiparametric mpMRI is an inadequate pattern to predict upgrade in PCa patients, prospective studies