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Permanent URI for this collectionhttps://hdl.handle.net/11443/932
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Item Bilateral recurrent external obturator muscle hematoma: An unusual cause of pelvic pain in hemophilia(SPANDIDOS PUBL LTD, 2016-01-01) Arpaci, Taner; Sasmaz, Ilgen; Akbas, Tugana; Eken, Alper; Ozgur, Anil; Antmen, BulentFollowing joint hemorrhages, intramuscular hemorrhages are the second most prevalent bleeding pattern in hemophiliac patients. Hematomas of the iliopsoas muscle are a well-known complication of hemophiliaItem The role of RENAL, PADUA and C-index scoring systems in predicting the results of partial nephrectomy without ischemia(ELSEVIER SINGAPORE PTE LTD, 2019-01-01) Alma, Ergun; Ercil, Hakan; Eken, Alper; Deniz, Mehmet Eflatun; Tumer, Erbay; Oksuzler, Fatma Yasemin; Gurbuz, Zafer GokhanObjective: To evaluate the feasibility and renoprotective effect of off-clamp partial nephrectomy (PN) by renal scoring systems. Methods: After approval of the local ethics committee, the radiological and clinical data of patients with renal masses who underwent PN between January 2012 and January 2017 were evaluated in two university hospitals. Total 132 patients who underwent open surgery and off-clamp technique were included. All patients underwent contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) preoperatively. Preoperative demographic data, estimated glomerular filtration rate (e-GFR) and hematocrit changes, operation time, tumor volume and hospitalization time from patients were evaluated separately and statistically for each of the three scoring systems. Results: Our study consisted of 132 patients with a mean age of 53.9 +/- 113.9 with 69 male and 63 female. Statistically significant difference between the risk groups in RENAL and PADUA scoring were found according to tumor T stage and tumor volume (p < 0.005). Statistically significant difference was only found between risk groups of RENAL scoring system in e-GFR reduction (p<0.05). There was no statistically significant difference between the groups in the complications of all three classification systems (p > 0.005). Conclusions: In our study, all three scoring sytem successfully predicted the surgical complexity ve surgical outcomes and our results indicate that off-clamp PN has similar success and complications rates when compared to the literature. The off-clamp PN must be kept in mind to maintain postoperative renal functions eligible patients. (C) 2018 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V.Item Safety, efficacy and outcomes of the new GreenLight XPS 180W laser system compared to the GreenLight HPS 120W system for the treatment of benign prostatic hyperplasia in a prospective nonrandomized single-centre study(CANADIAN UROLOGICAL ASSOCIATION, 2015-01-01) Eken, Alper; Soyupak, Bulent; Acil, Meltem; Arpaci, Taner; Akbas, TuganaIntroduction: We compare and evaluate the safety, efficacy, and short-term outcomes of the new GreenLight XPS 180W (GL-XPS) laser system with the former generation GreenLight HPS 120W (GL-HPS) system for the treatment of benign prostatic hyperplasia (BPH) in a prospective nonrandomized single-centre study. Methods: From May 2012 to June 2013, 161 consecutive patients with lower urinary tract symptoms secondary to BPH were included: 88 patients were treated with the GL-HPS system and 73 were treated with the GL-XPS system. The perioperative variables International Prostate Symptom Score (IPSS), quality of life (QOL), and maximum flow rate (Qmax) were recorded at baseline, at one month and 6 months. Serum prostate-specific antigen (PSA) was assessed at baseline. Results: The mean age was 70.2 years in the GL-HPS group and 68.6 years in the GL-XPS group. Prostate volumes were 62.3 mL and 61.3 mL, respectively. Both groups showed significant postoperative improvement in the IPSS, QOL, Qmax variables compared to baseline levels. There were no significant differences in improvement in IPSS and QOL between groups. However, both operating and catheterization times were shorter in patients in the GL-XPS group. The overall postoperative complication rate was similar in both groups. Conclusion: Both GreenLight systems provide safe, effective tissue vaporization with significant clinical relief of BPH obstruction. The GL-XPS system appears more favourable with regard to reduced operating and hospitalization time, suggesting more cost-effective and efficient tissue removal.Item Computed tomography based evaluation of prostatic fiducial marker migration between the periods of insertion and simulation(AVES, 2017-01-01) Arpaci, Taner; Ugurluer, Gamze; Ispir, Emine Burcin; Eken, Alper; Akbas, Tugana; Serin, MeltemObjective: The aim of this study was to determine whether significant fiducial marker migration occurs between the periods of prostatic marker insertion and computed tomography (CT) performed for radiotherapy planning and if a waiting period is necessary. Material and methods: Thirty-nine patients with prostate adenocarcinoma underwent fiducial marker insertion before radiotherapy between June 2013 and December 2015. Three markers were inserted by one radiologist under the guidance of transrectal ultrasonography. All patients underwent CT three hours after insertion to confirm the number and position of fiducial markers. Radiotherapy planning CT was performed on an average of 11 days (range 7-20) after insertion. CT images were imported into treatment planning system to analyze the position of fiducial markers. Point-based marker match algorithm was used to find the distance of marker migration. The mean and maximum distances between each fiducial markers were calculated. Results: The mean distance of migration was 1.029+/-0.42 mm (range 0.23-1.93 mm) and the maximum distance was 1.361+/-0.59 mm (range 0.25-2.74 mm). The distance of marker migration was not statistically significant for the groups organized according to the timing of marker insertion, prostate volume, patient age, prostate specific antigen level and Gleason score. Conclusion: According to our results significant fiducial marker migration did not occur during the interval between insertion and treatment planning CT. It should be taken into consideration that performing simulation on the same day as marker insertion might prevent increased cost and delayed radiation therapy by saving the patients from extra visits to the clinic.Item Safety and efficacy of photoselective vaporization of the prostate using the 180-W GreenLight XPS laser system in patients taking oral anticoagulants(SAGE PUBLICATIONS LTD, 2018-01-01) Eken, Alper; Soyupak, BulentObjective To evaluate the safety and efficacy of the 180-W GreenLight XPS laser system for the treatment of benign prostatic hyperplasia in patients taking oral anticoagulants. Methods All consecutive patients admitted for lower urinary tract symptoms associated with benign prostatic hyperplasia from November 2012 to October 2016 and who underwent photoselective vaporization of the prostate with the 180-W GreenLight XPS laser were included in the study. The perioperative outcomes examined were the operating time, laser time, energy usage, and duration of postoperative catheterization. Functional parameters (International Prostate Symptom Score, maximum urinary flow rate, and post-void residual urine volume), prostate volume, and serum prostate-specific antigen concentration were examined at baseline and 3 months. Perioperative complications, if any, were noted. Results All functional parameters (International Prostate Symptom Score, maximum urinary flow rate, and post-void residual urine volume) significantly improved from baseline to 3 months. A small number of patients experienced at least one minor adverse event. There was no difference in the rate of adverse events between patients who were and were not taking anticoagulants. Conclusions Photoselective vaporization with a 180-W laser is an efficacious and safe treatment for benign prostatic hyperplasia, even in patients taking anticoagulant medications.Item Microdissection testicular sperm extraction (micro-TESE): Predictive value of preoperative hormonal levels and pathology in non-obstructive azoospermia(ELSEVIER TAIWAN, 2018-01-01) Eken, Alper; Gulec, FerayThe aim of this study was to evaluate the predictive value of preoperative hormonal levels and pathology, as well as the outcome of microsurgical testicular sperm extraction in patients with non-obstructive azoospermia (NOA), presenting to our clinic for treatment of infertility. The records of 145 men with NOA who underwent microdissection testicular sperm extraction (micro-TESE) between March 2013 and November 2016 were studied. The patient's age, testicular volume, hormonal profile for follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone (TT), and testicular pathology were recorded. The sperm retrieval, the clinical pregnancy and live birth delivery rates were noted. Our testicular sperm retrieval rate was 65.5\%. There was no statistical difference in age, testicular volume, or hormonal levels in the TESE-positive and negative groups. Hypospermatogenesis was found in testicular histopathology in 57 of 117 patients (48.7\%) who underwent testicular biopsy. Sertoli Cell-Only (SCO) syndrome was seen in 20.5\%, Germ Cell Maturation Arrest (MA) in 16.3\%, and Atrophy-hyalinization in 14.5\%. Seven men had Klinefelter's syndrome (KS), four of whom were TESE-positive. There were no adverse effects of the procedure except for infection at the incision site in one patient. Single intracytoplasmic sperm injection (ICSI) cycles were performed in 92 couples leading to 41 clinical pregnancies and 26 live birth deliveries. Micro-TESE is a safe procedure in experienced hands and provides infertile men with NOA an opportunity to father children. However unselected candidates with NOA should be counselled at the outset that only 17.9\% will eventually become biological fathers. Copyright (C) 2017, Kaohsiung Medical University. Published by Elsevier Taiwan LLC.