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Permanent URI for this collectionhttps://hdl.handle.net/11443/932
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Item Prostate volume effect on Gleason score upgrading in active surveillance appropriate patients(PAGEPRESS PUBL, 2019-01-01) Camur, Emre; Coskun, Alper; Kavukoglu, Ovunc; Can, Utku; Kara, Onder; Camur, Arzu Develi; Sarica, Kemal; Narter, Kamil FehmiIntroduction: Gleason Score (GS) upgrading rates in the literature are reported to be around 33-45\%. The relationship between prostate volume and GS upgrading should be defined, aiming to reduce upgrading rates in patients with low risk groups who are eligible for active surveillance (AS) or minimally invasive treatment, by varying biopsy cores, or lengths of cores according to prostate volumes. In this regard, the aim of our study was to establish the relationship between prostate volume and GS upgrading. Materials and methods: We retrospectively analyzed the medical records of 78 patients, who were appropriate for AS between 2011-2016 at our hospital. Inclusion criteria were patient age under 65 years, PSA level under 10 ng/ml, GS (3 + 3) or (3 + 4), and 3 or less positive cores, clinical stages <= T2. GS increase in radical prostatectomy specimen was considered as `upgrading' and in addition, score reported by biopsy as 3 + 4 but in surgical specimen as 4 + 3 were also considered as `upgrading'. The effect of prostate volume on Gleason grade upgrading was examined by calculating upgrading rates separately for patients with prostate volume 30 ml or less, those with 30 to 60 ml, and those over 60 ml. Results: As a result of the analysis of the data, upgrading was seen in 35 (44.8\%) of 78 patients included in the study. In the cohort mean prostate volume was 49.8 (+/- 26.3) ml. Twenty-two patients (28.2\%) had prostate volume 30 ml or less, 34 (43.6\%) 30 to 60 ml, and 22 (28.2\%) 60 ml or more. The patients were divided into two groups as those with and without GS upgrading. Between the groups prostate volume and prostate volume range (0-30/31-60/> 60) were not significantly different (p value > 0.05). Conclusions: Gleason grade upgrading causes patients to be classified in a lower risk group than they actually are, and may lead to inappropriate treatment. This condition has a direct effect on the decision of active surveillance. Therefore, it is important to define the factors that can predict GS upgrading in active surveillance appropriate patients. In this study, we found that prostate volume has no significant effect on upgrading in active surveillance appropriate patients.Item Dose routine intraoperative Double J stent insertion avoid urine leakage after open partial nephrectomy?(PAGEPRESS PUBL, 2022-01-01) Bosnali, Efe; Dillioglugil, Ozdal; Teke, Kerem; Yilmaz, Hasan; Bayrak, Busra Yaprak; Uslubas, Ali Kemal; Avci, Ibrahim Erkut; Argun, Omer Burak; Kara, OnderObjective: To evaluate the impact of Double stent (DJS) insertion during open partial nephrectomy (OPN) on postoperative prolonged urinary leakage. Materials and methods: A retrospective study was made in consecutive cases of OPN performed between 2002 and 2020 for localized kidney tumors at our tertiary center. Urinary leakage was defined as drainage > 72 hours after surgery by biochemical analysis consistent with urine or radiographic evidence of urine leakage. The patients were divided into two groups according to intraoperative DJS placement, and compared regarding clinicopathologic characteristics, perioperative and postoperative outcomes. Univariate and multivariate logistic regression analyses were performed to determine the factors associated with urinary leakage after the operation. Results: Review of records identified 182 patients who were included in the study. In 73 (40\%) patients PN was performed without insertion of a DJS. Thus, 109 (60\%) of patients had a DJS inserted. Apart from higher preoperative eGFR values among patients with DJS (96.6 vs. 94.3 mL/min/1.73 m(2)