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    Can the Urologists Perform Stone Analysis, Metabolic Evaluation and Metaphylaxis at Urinary Tract Stone Disease in Tekirdağ?
    (2019) Yazıcı, Cenk Murat; Akgül, Hacı Murat; Arda, Ersan; Akpınar, Haluk
    Objective: As the urolithiasis is an endemic situation in our country, the urologists are well-experienced about thissituation. The prevention of urolithiasis recurrence is as important as the surgical treatment. For this reasonmetabolic evaluation and medical treatment of stone disease is extremely important. This study aimed to evaluateurological specialists' views of metabolic evaluation and medical treatment of urolithiasis. Thus, the main problemsand the probable solutions about medical treatment and metabolic evaluation of urinary system stone disease can beevaluated.Methods: The urologists working at Tekirdag were invited to the study. A face-to-face questionnaire, which wascomposed of three parts, was performed to the participants. In the first section, the demographic characteristics of theparticipants were evaluated. In the second and third sections, the approach of participants to metabolic evaluationand medical treatment in urolithiasis were investigated, respectively.Results: A total of 29 urologist who routinely performed endourological surgery were included to the study. When weevaluated their endourological practice, 65.5% of the participants were performing 10-25 endourological surgery permonth. When we asked the approach of participants about the metabolic evaluation, 34.5% reported that they did notperform metabolic evaluation to their adult patients and 65.5% did not perform to the children with urolithiasis. Allparticipants believed the efficacy of medical treatment however, 66% of the participants were performing at less thanhalf of their patients in clinical practice.Conclusions: The clinical practice about metabolic evaluation, stone analysis and metaphylaxis were lower thanexpected. Most of the participants were not able to make metabolic evaluation and stone analysis. Further studies areneeded to resolve the problems associated with metabolic evaluation and metaphylaxis administration.
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    Predictive and prognostic impact of preoperative complete blood count based systemic inflammatory markers in testicular cancer
    (Brazilian Soc Urol, 2020) Arda, Ersan; Arikan, Gurkan; Akdere, Hakan; Akgül, Murat; Yüksel, Ilkan
    Purpose: To determine the utility of preoperative complete blood count (CBC) based systemic inflammatory markers in the prediction of testicular cancer and its prognosis. Material and Methods: Between 2008-2017 the data of all testicular tumor patients undergoing radical orchiectomy were retrospectively analyzed. Patient baseseline characteristics (age, tumor stage, tumor markers, etc.) and results of routine preoperative blood tests including mean platelet volume (MPV), red cell distribution width (RDW), lymphocyte ratio (LR) and neutrophil ratio (NR) were retrieved. In addition, neutrophil to lymphocyte ratio (NLR) was calculated. Results: Mean age of the tumor and control group was 36.0 +/- 15 and 30.50 +/- 11 years, respectively. Mean RDW, NR and NLR were significantly higher in the tumor group with p values<0.001; whereas LR and MPV were significantly higher in the control group (p<0.001). Receiver Operating Characteristic (ROC) analyses of LR, NR, RDW, MPV, and NLR are shown in Table-3. The cut off values for RDW and NR were found as 13,7 (Area under the curve (AUC): 0.687, sensitivity = 42.2%, specificity = 84.8%) and 55.3 (AUC:0.693, sensitivity 72.2%, specificity 62%), respectively. Area under the curve for NLR in tumor group was 0.711, with a threshold value of 1.78 and sensitivity=81.8% and specificity= 55.4% (AUC:0.711/sig<0.001) that together with RDW exhibited the best differential diagnosis potential which could be used as an adjuvant tool in the prediction of testicular tumor and its prognosis. Conclusion: Several systemic inflammatory markers, which are obtained by routinely performed cost-effective blood tests, could demonstrate incremental predictive and prognostic information adjuvant to preoperativly achieved testiscular tumor markers.
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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
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    The clinical significance of abnormal ejaculation by silodosin. Is it important?
    (Blackwell Publishing Ltd, 2021) Akgül, Murat; Yazıcı, Cenk Murat; Şipal, Timuçin; Arda, Ersan
    We aimed to evaluate the effect of the abnormal ejaculation (AEj) on patients using silodosin in terms of drug cessation. We also analysed the possible factors that may affect the decisions of patients with AEj to proceed or change their medication. The patients (n = 118) treated with silodosin 8 mg daily were prospectively analysed. In order to evaluate the erectile function, ejaculatory function, depression and sexual satisfaction; IIEF, MSHQ-EjD, Beck's depression and Golombok-Rust questionnaires were given to patients respectively. Patients were re-evaluated at the 3rd month of their treatment. The rate of AEj was 52.5%. Nearly 42% of the patients with AEj desired to stop their medication whereas it was 7.1% at patients without AEj (p <.001). The pre-treatment International Prostate Symptom Score (IPSS) and the decrease in IPSS score were significantly lower in patients who demand to stop their treatment (p <.05). AEj was significantly higher in patients who wanted to stop their medication (p <.001). Even if they had an AEj, patients who were happy with the clinical efficacy of silodosin did not want to change their drug. In addition to this, pre-treatment ejaculatory status was an important indicator for patients to decide drug cessation due to AEj side effect of silodosin. © 2021 Wiley-VCH GmbH.
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    The value of hematological inflammatory parameters in the differential diagnosis of testicular torsion and epididymorchitis
    (E-Century Publishing Corp, 2021) Arikan, Mehmet G.; Akgül, Murat; Akdeniz, Esra; Iskan, Gülce; Arda, Ersan
    Objective: Aim of this study is to investigate the effectiveness of mean platelet volume (MPV), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) values, that can easily be obtained with complete blood count (CBC), in the diagnostic differentiation of testicular torsion and epididymorchitis. Method: Data of patients, who admitted to the urology or emergency departments, diagnosed with acute scrotum, between 20082017, were reviewed and retrospectively extracted. Basic characteristics (age,etc.) of patients and blood test results were retrieved. Inflammatory markers such as MPV, NLR and PLR were compared between groups. Result: After determining inclusion/exclusion criteria, a total of 111 patients were divided as testicular torsion, epididymorchitis and control group, including 37 patients each. Mean age of groups were 19.27 +/- 6.93, 26.27 +/- 6.23 and 23.24 +/- 8.49 years, respectively. Statistical significance was found in epididymorchitis and testicular torsion groups compared to the control group according to NLR (P<0.01). PLR showed a statistically significant relationship only with the epididymorchitis group and control group (P=0.46). However, according to MPV values, no statistically significance was found between the groups. Additionally, ROC analyse was performed to evaluate predictive cut-off values of NLR and PLR for the diagnostic differentiation of both groups. Conclusion: Inflammatory markers, obtained from routinely performed low-cost CBC, might be used as adjuvant parameters to differentiate acute scrotal pathologies like testicular torsion and epididymorchitis.
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    Urodynamic findings of multiple sclerosis patients at a single institution
    (Bayrakol Medical Publisher, 2020) Akgül, Murat; Yazıcı, Cenk Murat; Malak, Arzu; Altunan, Bengü; Arda, Ersan; Turgut, Nilda
    Aim: Multiple sclerosis (MS) is a chronic and progressive disease of the central nervous system (CNS). The destructive effect of MS on the urogenital system has been demonstrated in many studies especially in young adults. Urodynamic evaluation is recommended in the diagnosis of urogenital system pathologies for MS patients. Unfortunately, there are not enough studies evaluating the urodynamic examinations of MS patients in our country. In this study, urodynamic findings of patients with MS were evaluated. Material and Method: A total of 58 patients (39 female and 19 male) were included in the study. The urodynamic findings of the patients in the same center between January 2011 and October 2017 were evaluated retrospectively. Urodynamic evaluation was performed with 20 ml of infusion per minute according to the International Continence Society standards. Results: The mean age of the patients was 47.4 +/- 8.8 years. The mean duration of multiple sclerosis was 11.8 +/- 7.4 years. When the features of multiple sclerosis were evaluated, 13 (22.4%) patients had a progressive type, 20 (34.5%) had a secondary progressive type, and 25 (43.1%) had relapsing-remitting (with relapses and remissions). The urodynamic findings of the patients are shown in Table 1. Urodynamic evaluations of patients with urinary incontinence are reported as 'Urge type urinary incontinence' was observed in 30 (83.3%), 'stress type urinary incontinence' in 5 (13.9%) and 'mixed type urinary incontinence' in 1 (2.8%) patient. Discussion: Multiple sclerosis is a common neurological pathology which has different urinary system findings. Detrusor overactivity is the most common urinary manifestation, and patients may also have impaired contractility, detrusor sphincter dyssynergia, urodynamic stress incontinence, and bladder outlet obstruction.