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    Embarking with laparoscopic radical prostatectomy and dealing with the complications and collateral problems: A single-center experience
    (Aves, 2020) Akdere, Hakan; Aktoz, Tevfik; Arikan, Mehmet Gurkan; Atakan, Irfan Huseyin; Veneziano, Domenico; Gozen, Ali Serdar
    Objective: The aim of the present study was to report our single-center initial experience in laparoscopic radical prostatectomy (LRP) with special emphasis on the complications and collateral problems and their management. Material and methods: A total of 48 patients (mean age 64 years) underwent LRP in our institution between August 2014 and July 2018. Two surgeons completed a fellowship training program for LRP before. Mentored operations started after the first 10 cases. The patients were divided in two groups of 30 (group I) and 18 (group II) patients. Demographic, preoperative, peroperative, and postoperative data were collected prospectively. Anesthesiology and nurses' team performances, as well as problems and their management, were reviewed. Results: The demographic data for both groups (group I vs. group II) were similar. Estimated blood loss (695.5 +/- 139.23 vs. 398 +/- 339.39 mL) and intraoperative complication rates (36.66% vs. 5.55%) were significantly (p<0.05) higher in group I. Conversion to open surgery occurred in 7 (20%) patients in group I and in 1 (5.55%) patient in group II. Continence rates at 12 (83%) months were similar in both groups. Positive surgical margins were 8.33% for pT2 and 27.1% for pT3 stages. Conclusion: A validated fellowship program before starting LRP and performing the first cases under mentorship are helpful. The complication and conversion rates decrease after 30 cases in addition to the improved experience also with improved cooperation with the anesthesiologist and scrub nurse.
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    Malignant Mesothelioma of Tunica Vaginalis Testis: Macroscopic and Microscopic Features of a Very Rare Malignancy
    (Springernature, 2017) Arda, Ersan; Arikan, Mehmet Gurkan; Cetin, Gizem; Kuyumcuoglu, Ugur; Usta, Ufuk
    Malignant mesothelioma of the tunica vaginalis testis (MMTVT) is an extremely rare tumour, usually mimicking benign pathologies of the scrotum. Our case is an 84-year-old male patient who appealed with a painless, left-sided scrotal swelling longer than 2 months. Although the level of tumour markers was normal, ultrasonographic examination results forced us to perform an inguinal scrotal exploration. Multiple small papillary tumours, both on tunica vaginalis and tunica albuginea, were detected intraoperatively. Due to these findings, radical orchiectomy was performed. A pathological evaluation showed malignant mesothelioma (MM) of the tunica vaginalis testis. Exposure to asbestos is a well-known risk factor. Furthermore, a history of trauma, herniorrhaphy and chronic hydroceles is blamed as a possible risk factor. Scrotal ultrasonography is the mainstay of primary diagnosis and, therefore, it should not be overlooked when dealing with benign scrotal cysts or hydroceles, which are very common pathologies at these decades, too. Radical inguinal orchiectomy is the primary treatment choice for localised MMTVT disease, whereas in signs of lymph node metastasis, inguinal lymph node dissection is required. Radical resection should be completed with chemotherapy and/or radiotherapy for an advanced or recurrent disease. This case, which is very rarely reported in the literature and detected during inguinal exploration, along with the pathological works that supported the diagnosis, was presented with this report.
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    The role of primary nocturnal enuresis in the aetiology of overactive bladder syndrome
    (Polish Urological Assoc, 2023) Cakioglu, Basri; Arikan, Mehmet Gurkan; Tas, Tuncay; Bilir, Burak
    Introduction The aim of this study was to investigate the effect of nocturnal enuresis (NE) in childhood on the development and course of overactive bladder (OAB) in adulthood. Material and methods Between January and September 2021, data from patients who visited the Urology Outpatient Clinic with OAB symptoms were collected. Patients with a history of diabetes mellitus, neurological diseases, bladder outlet obstruction, active urinary system infection, or previous medical treatment for OAB and those who did not agree to join the study were excluded. Patients with a diagnosis of NE in childhood were classified as group 1, and patients without a diagnosis of NE were classified as group 2. Demographic data were recorded. Frequency of incontinence, and the number of daytime voids and nocturia were evaluated according to a three-day voiding diary. In addition, the maximum urinary flow ratio (Qmax), bladder wall thickness, and postvoid residual volume were determined using uroflowmetry and pelvic ultrasound. Results After applying the inclusion/exclusion criteria, the mean age of the study group of 103 patients, consisting of 34 women and 69 men, was 32.85 +/- 11.20 years (18-65), and the mean BMI of both groups was 26.62 +/- 3.34 (19.49-39.18). Sixty-five of 103 patients (63.1%) had a history of childhood NE diagnosis. Patients in the group with a history of NE were younger than those without a history of NE. Conclusions The earlier onset and more intense course of OAB symptoms in patients diagnosed with NE in childhood suggests that NE may be a triggering factor in the aetiology of OAB.