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Öğe Could Retrograde Intrarenal Surgery be Used as an Efficient Technique in the Treatment of Calyceal Diverticula Stones(Coll Physicians & Surgeons Pakistan, 2022) Cakiroglu, Basri; Tas, Tuncay; Aksoy, Suleyman Hilmi; Arda, ErsanObjective: To evaluate the efficacy of retrograde intrarenal surgery (RIRS) and holmium laser lithotripsy in the treatment of symptomatic renal calyceal diverticular (CD) stones. Study Design: A case series. Place and Duration of Study: Department of Urology, Hisar Intercontinental Hospital, from 2008 and 2019. Methodology: Patients who underwent holmium laser lithotripsy with RIRS to manage symptomatic CD stones were evaluated retrospectively. Demographics, stone size, operation and hospital stay duration, the success of treatment and complications were noted. Result: Among the 30 treated patients, 13 patients were female and 17 were male. The mean age was 45.4 +/- 11.9 (26-64), the stone diameter was 14.4 +/- 4.1 mm, operation time was 70.47 +/- 35.7 (35-155) minutes, and mean length of hospital stay was 1.27 +/- 0.5 (1-3) days. In those patients who underwent RIRS, 26 (86.7%) were successfully treated while in 4 of 30 patients (13.3%) the procedure was not successful. Complications were observed in 10 (33.3%) patients. Clavien-I complications were demonstrated in 6 patients, Clavien III complications were demonstrated in 3 patients. One patient had urosepsis, 2 patients had ureteral laceration, and one patient with Clavien IV complication had perirenal hematoma. Conclusion: Laser lithotripsy therapy with RIRS is a safe and effective treatment for symptomatic calyceal diverticular stones and can be offered as the first-line treatment for calyceal diverticular stones.Öğe Early Clinical Results of the Tolerability, Safety, and Efficacy of Autologous Platelet-Rich Plasma Administration in Erectile Dysfunction(Elsevier Sci Ltd, 2021) Tas, Tuncay; Cakiroglu, Basri; Arda, Ersan; Onuk, Ozkan; Nuhoglu, BarisIntroduction: Platelet-rich plasma (PRP) is useful in the treatment of different conditions and diseases as it contains concentrated levels of many growth factors. Aim: The aim of this study was to investigate the effectiveness of autologous PRP application in the treatment of erectile dysfunction (ED) in patients with metabolic syndrome. Methods: In this prospective study conducted in June 2019, 31 patients with ED were included. The International Index of Erectile Function-Erectile Function domain (IIEF-EF) questionnaires were used to evaluate erectile function (EF). After administering the intracavernous autologous PRP 3 times with an interval of 15 days, IIEF-EFs were evaluated 1, 3, and 6 months later. Main Outcome Measure: IIEF in the 1st, 3rd, and 6th months and adverse events. Results: While the mean IIEF-EF was 18 before the application, the mean IIEF-EF was 20 in the first, third, and sixth months after the procedure (P < .001). However, even though IIEF-EF values increased numerically, median value remained within the mild-moderate classification (scores between 17 and 21). Postprocedure sexual satisfaction scores were significantly higher than preprocedure values (8 vs 6, respectively; P 1/4 .002). In the first follow-up of a patient after the 3rd injection, a 4-mm diameter fibrotic plaque was observed on the ventral side in the middle of the penis shaft. Conclusion: In conclusion, our findings suggest that larger studies as well as placebo-controlled studies are needed to add PRP to the treatment protocol in ED. Copyright (C) 2021, The Authors. Published by Elsevier Inc. on behalf of the International Society for Sexual Medicine.Öğe Predicting Lamina Propria Invasion in Patients with Non-muscle-invasive Bladder Cancer: Do RDW and NLR Really Work?(Galenos Publ House, 2019) Senturk, Aykut Bugra; Ekici, Musa; Aydin, Cemil; Baykam, Mehmet Murat; Tas, Tuncay; Arda, Ersan; Cakiroglu, BasriObjective: To determine the role of preoperative neutrophil-to-lymphocyte ratio (NLR) and red cell distribution width (RDW) in predicting lamina propria invasion in bladder cancer. Materials and Methods: Eighty-eight patients with non-muscle-invasive bladder cancer were evaluated retrospectively. The patients were divided into those with Ta tumors (group 1: n=36) and those with T1 tumors (group 2: n=52). For each patient, white blood cell, neutrophil, and leukocyte counts and RDW values were evaluated. Results: NLR was significantly lower in patients with Ta tumors. In addition, NLR below 3.22 was associated with 80.6% probability of Ta disease. RDW sensitivity in Ta non-muscle-invasive bladder tumors was much higher compared to T1 tumors. RDW below 15.35 was associated with 94.4% probability of Ta disease. Conclusion: NLR and RDW are basic blood parameters that physicians can assess easily. Our results indicate that a combination of NLR and RDW can help clinicians predict lamina propria invasion in non-muscle-invasive bladder tumors.Öğe Reliability of thermocautery-assisted circumcision: retrospective analysis of circumcision performed voluntarily in countries of low socioeconomic status(Sage Publications Ltd, 2019) Cakiroglu, Basri; Gozukucuk, Ali; Arda, Ersan; Tas, TuncayObjective: The objective of this study was to evaluate the reliability of thermocautery-assisted circumcision performed voluntarily in patients of poor countries. Material and methods: Between 2016 and 2019, 32,000 children aged 7 days to 17 years were circumcised in multiple countries. The patients' urological examinations were done before the administration of local anaesthesia. Patients revealed to have undescended testicle, inguinal hernia, hypospadias, varicocele, penile rotation anomaly, epispadias and infection were not circumcised. All procedures were performed under local anaesthesia by using thermocautery. Afterwards, mucosa and skin were sutured using absorbable suture and the circumcised penis was dressed. Patients were instructed to remove the dressing after 3 days. Results: Bleeding, requiring surgical intervention and drug reactions were not observed. The most observed complication was mucosal oedema, which occurred in approximately one-quarter of patients (26%, 8320/32,000) and continued for 3-5 days after the surgery. The most serious complication was a trapped penis, which occurred in 25 patients (0.078%). In six (0.018%) cases, meatal stenosis developed. Wound infection developed in only 10 (0.03%) cases, through the formation of an aseptic environment. Penile adhesion was seen in 35 cases (0.1%) and improved with anti-inflammatory treatment without any surgical intervention. Conclusion: Thermocautery-assisted circumcision can be used as an effective, safe and useful technique with few complications and rapid healing rates.Öğe 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, BurakIntroduction 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.
