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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.
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.
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.
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.

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