Browsing by Author "Eren, Murat Tugrul"

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Atypical presentation of SARS-CoV-2 infection in male genitalia
(ELSEVIER SCIENCE INC, 2020-01-01) Ozveri, Hakan; Eren, Murat Tugrul; Kirisoglu, Ceyda Erel; Sariguzel, Nevin
During novel coronavirus 2019 (COVID-19) pandemic, patients usually present with several reports showing symptoms of severe systemic or respiratory illness and, although rare, some genital complaints such as scrotal discomfort can be seen. In the majority of patients, however, genital complaints seem not to be the initial or sole symptoms. In this article, we report an unusual presentation of a male case with severe external genital pain which was suspected to be the first clinical sign of COVID-19.
Bilateral same-session ureterorenoscopy: A feasible approach to treat pan-urinary stone disease
(ARAB ASSOC UROLOGY, 2017-01-01) Ozveren, Bora; Eren, Murat Tugrul; Ozveri, Hakan; Altug, Ugur; Sahin, Ahmet
Objectives: To assess treatment effectiveness and safety of bilateral same-session ureterorenoscopy (BSSU) for the management of stone disease involving the entire urinary system. Patients and methods: We reviewed the records of 64 patients who underwent BSSU for the treatment of bilateral ureteric and/or kidney stones. Size, number, location per side, and the total burden of stones were recorded. Data on stenting, lithotripsy, and stone retrieval, and details of hospital stay and operation times were investigated. Treatment results were assessed using intraoperative findings and postoperative imaging. The outcome was considered successful in patients who were completely stone-free or who had only residual fragments of <= 2 mm. Results: The outcome was successful in 82.8\% of the patients who received BSSU (54.7\% stone-free and 28.1\% insignificant residual fragments). The success rate per renal unit was 89.8\%. There were no adverse events in 73.4\% of the patients. The most common intraoperative complication was mucosal injury (36\%). The complications were Clavien-Dindo Grade I in 9.4\% and Grade II in 7.8\%. Grade IIIa and IIIb (9.4\%) complications required re-treatments. Statistical evaluation showed no association between complication grades and stone, patient, or operation features. Stone burden had no negative impact on BSSU results. The presence of impacted proximal ureteric stones was significantly related to unsuccessful outcomes. Conclusion: BSSU is safe and effective for the management of bilateral urolithiasis. BSSU can prevent recurrent surgeries, reduce overall hospital stay, and achieve a stone-free status and complication rates that are comparable to those of unilateral or staged bilateral procedures. (C) 2017 Production and hosting by Elsevier B.V. on behalf of Arab Association of Urology.
Calyceal diverticular stones: Does the insistence on less invasive technique keep the patient away from a major complication?
(MARMARA UNIV, FAC MEDICINE, 2021-01-01) Eren, Murat Tugrul; Ozveri, Hakan
Calyceal diverticular stones are rare clinical entities without a clearly defined consensus on the treatment. Treatment indications include recurrent urinary tract infections, chronic pain and renal impairment. Treatment modality of surgical approach is usually based on the location of calyceal diverticulum. A 23-year-old woman was presented with a calyceal diverticular stone of 16.5 mm. Her medical history revealed multiple urinary tract infections caused by extended spectrum beta-lactamase (ESBL)-producing Escherichia coli of which the stone was predicted to be the reason. The patient was treated ureterorenoscopically, a decision of which was taken intra-operatively. In conclusion, insisting on performing nephroscopy following an intra-operative retrograde pyelography revealed no apparent ostium which could be interpreted as ureterorenoscopic retriaval would fail and development of postoperative bacteremia despite all precautions taken pre- and intra-operatively were two lessons indicating that all efforts must be exercised to reach the most minimal invasive method for the treatment of calyceal diverticular stones.
Comparative Usefulness of High-frequency Doppler Ultrasonography, Serum PSA Density, and Free to Total Serum PSA Ratio in the Prediction of Prostate Cancer
(GALENOS YAYINCILIK, 2020-01-01) Eren, Murat Tugrul; Guner, Numan Dogu
Objective: In this study, we tried to assess whether power Doppler ultrasonography (PDU) evaluation along with transrectal ultrasound (TRUS) has an additional benefit in the diagnosis of prostate cancer in patients with prostate-specific antigen (PSA) levels of 4-10 ng/mL, when combined with the other methods proposed for this range of PSA. Materials and Methods: Fifty-six patients with PSA values of 4-10 ng/mL were included in the study. Digital rectal examinations, evaluation of total and free PSA, and PDU assessments were done simultaneously with TRUS and eight-core systematic prostate biopsies. Along with the latter, additional biopsies were taken from the suspicious areas detected on PDU. The free/total PSA ratios, PSA density values, TRUS, PDU findings, and biopsy results of 56 patients were recorded and evaluated. Results: Specificity and positive predictive values in detecting prostate cancer in patients with PSA range of 4-10 ng/mL, calculated using the criteria of free/total PSA values <15\%, PSA density values >15\%, and PDU findings, were 94.87\% and 75\%, respectively. These values were significantly higher than those of 89.75\% and 69.73\%, respectively, defined for the criteria of free/total PSA values <15\% and PSA density values >15\%. Conclusion: The results of this study highlighted that PDU may be useful to detect prostate cancer, and decrease the number of unnecessary biopsy recommendations in patients with PSA values of 4-10 ng/mL, when used in combination with free/total PSA ratio and PSA density.
Effect of Temperature and Humidity on Serum Prostate Specific Antigen Levels in Asymptomatic Male Population
(GALENOS YAYINCILIK, 2016-01-01) Eren, Murat Tugrul; Ozveri, Hakan; Cosgun, Erdal
Objective To determine the possible effect of climate parameters on prostate specific anigen (PSA) levels. Materials and Methods Among 2.150 males, 757 individuals participating in a general checkup service at our hospital group in the past one year were enrolled in this study. The mean age was 48.52 and all the individuals underwent PSA screening tests, abdominal ultrasonography examinations including prostatic evaluation, and urine examinations including microscopic evaluation. The data on climate parameters including daily minimum and maximum temperatures and their average values as well as daily moisture levels were obtained from the records of the Turkish State Meteorological Service, including 2 meteorological stations existed in the Anatolian part of Istanbul. First of all, the differences in climatic parameters between the two stations were analyzed. Then, the relationship of PSA levels with daily minimum, maximum and average temperatures along with moisture levels recorded by the two stations was statistically evaluated. Results The mean age of the subjects was 48.52 (15-90) years and the percentage of individuals in age groups below 30, 31-40, 41-50 and over 50 were 5.2\%, 23.2\%, 31.8\%, and 39.8\%, respectively. The mean prostate volume measured by ultrasonography was 30.52 ml which increased with age in compatible with the literature. The mean PSA value was 1.19 ng/ml in all age groups. PSA values were higher in older participants and in those with larger prostate volume. Only PSA and mean humidity levels were statistically different between the two stations (p<0.05). When all parameters of temperature and humidity were grouped according to the months and seasons, it was found that there was no statistically significant difference in PSA levels between the groups (p>0.05 for all parameters). As for months and seasons, a statistically significant difference was observed between four seasons in all parameters of temperatures and humidity levels (p<0.001), but this finding was not valid for alterations in PSA levels in these seasonal intervals. No significant relationship was found between the presence of white blood cells in urine and PSA levels and seasons seemed to have no statistically significant effect on the presence of leukocytes in urine (p>0.18 and p>0.5, respectively). Conclusion Since any proven effect of climate on PSA will increase the sensitivity of PSA in diagnosing prostate cancer and may prevent the decision of an unnecessary biopsy, humidity with a possible influential effect on serum PSA level according to our study definitely needs clarification and confirmation. Therefore, future studies including large number of subjects with detailed data facilitating calculation of thermal sensation are needed to give clearer answers to this topic.
Penile Mondor's in a Covid-19 patient on prophylactic anti-thrombosis with rivaroxaban: a case report
(SPRINGER, 2021-01-01) Eren, Murat Tugrul; Ozveri, Hakan; Kurtoglu, Hilal
Background Penile Mondor's disease (PMD) is thrombophlebitis of the superficial dorsal vein of the penis. Following the occurrence of thrombotic events in the affected veins, the lumen often becomes occluded with fibrin and inflammatory cells. A hyper-coagulative state is one of the underlying causes although most cases of PMD are idiopathic. Coronavirus disease-2019 infection (COVID-19) is associated with frequent thrombotic events. Inflammation and thrombosis play a central role in the course and outcome of COVID-19, which can predispose to both venous and arterial thromboembolism. In this report, we present a 33-year-old male patient diagnosed with PMD during the subacute phase of COVID-19 infection while on prophylactic antithrombotic treatment. Case Presentation A 33-year-old male patient was diagnosed as PMD which occurred during the subacute phase of COVID-19 infection, while he was on active treatment of COVID-19 by prophylactic antithrombotic Rivaroxaban 15 mg therapy and curative antiviral medication. There was no recent sexual intercourse or trauma to the genitals. His PCR test for COVID-19 had become negative, and antibody test was positive at the time of his PMD's onset. Rivaroxaban was replaced by Enoxaparin (8000 IU/0.8 ml.), a low molecular weight heparin administered subcutaneously and twice daily. On the third day of this medication, all coagulative measurements returned to normal. PMD disappeared in the second week. Conclusion Low-dose Rivaroxaban 15 mg is not safe for some COVID-19-associated thromboembolism prophylaxis, and careful follow-up is critical due to the possibility of a wide range of pathologic thrombotic manifestations in COVID-19 infection.