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Biomedical subjects

D Erol

Publications and source records attributed to D Erol.

At least 37 records · Page 2Linked to original sources
PubMed1999

Quantitative evaluation of biopty gun testis needle biopsy. Correlation between biopsy score of varicocele-bearing testis and sperm count.

OBJECTIVE: To investigate the applicability of quantitative evaluation of needle biopsy of the testis and any correlation between biopsy score and sperm parameters in infertile or subfertile men with varicocele. STUDY DESIGN: A total of 45 infertile men with clinical left varicocele were included in the study. All patients underwent left varicocelectomy and bilateral biopty gun needle biopsy of both testes. Spermiograms were obtained before and three months after the operation. The biopsy specimens were evaluated for Johnsen and Agger score, Leydig cell score, germ cell/Sertoli cell ratio, mean tubular diameter, peritubular fibrosis, and tubular and basement membrane hyalinization. RESULTS: Mean sperm count, motility and normally configured motile sperm counts increased 20%, 25% and 60% by month 3, respectively (P < .05). We did not observe any significant change in normally configured sperm counts. A mean of 14 tubuli per testis were obtained with single-pass needle biopsy. Johnsen and Agger scores, Leydig cell scores, mean tubular diameter and germ cell/Sertoli cell ratios of both testes were comparable. However, there was significantly less peritubular fibrosis, tubular hyalinization and basal membrane hyalinization in the right testis when compared to the varicocele-bearing left testis (P < .05). We found positive correlations between Johnsen and Agger score of varicocele-bearing left testis and preoperative normally configured motile sperm counts (Pearson's r = .34 and P < .05 and Pearson's r = .41 and P < .05, respectively). The Leydig cell score of varicocele-bearing testis correlated inversely with sperm counts (Pearson's r = -0.37, P < .05). CONCLUSION: These observations may prove of prognostic value in infertile or subfertile men with varicocele.

Adult↗
PubMed1999

The relation between p53 overexpression and lymph node metastases in clinical stage t2 and t3a transitional cell bladder carcinoma.

Mutant p53 protein overexpression is generally associated with poorly differentiated invasive bladder tumors. The survival in such cases is also expected to be poor. The objective of the present study was to determine whether immunohistochemical staining for p53 was predictive of lymph node metastases in early muscle invasive transitional cell bladder cancer. Immunohistochemical staining for mutant p53 was performed on formalin fixed transurethral resection specimens of 31 patients who underwent radical cystectomy. Eleven tumors were grade II and 20 tumors were grade III. There were 16 stage T2 and 15 stage T3a tumors. Staining with p53 was categorised as positive if distinct nuclear staining was observed in > or = 20% of the cells. Results were compared according to grade, stage (T2 versus T3a) and lymph node metastases. Seventeen tumors (55%) were positive for mutant p53. Eleven cases had lymph node metastases which could not be assessed preoperatively. The distribution of p53 positive rate between grade II and grade III cases, and T2 and T3a tumors was not different. All the 11 patients with lymph node metastases had positive tumors for p53. We assume that p53 positive rate can be used to distinguish high risk patients for lymph node metastasis. Patients with stage T2 or T3a and p53 positive bladder cancer should be considered for early aggressive treatment options.

Biomarkers, Tumor↗
PubMed1998

Lessons from 197 Mathieu hypospadias repairs performed at a single institution.

Over a 15-year period, 197 Mathieu hypospadias repairs were performed at our institution. The present study reports our experience with this operation with an analysis of factors associated with unfavorable results. Cosmetic results were either excellent or satisfactory in all but 4 cases (2%). Overall, 42 patients (21%) voided with a fistula. A history of a previous operation, flap length, type and structure of the suture, suturing technique, existence of chordee and torsion, and circumcision status were analyzed as prognostic factors. Fifteen years were divided into three equal time intervals, and the success rates of these intervals were also compared. The length of the flap, (< vs >/=20 mm), suture structure (monofilament versus multifilament), and suture type (6-0 vs 5-0) were found to be factors with a significant influence on success rates (P < 0.05). The fistula rates of the three 5-year intervals were 52%, 28%, and 11%, respectively. The difference between time periods was also significant (P < 0.01). On multivariate analysis, only the difference between time intervals remained significant. The present analysis suggests that experience could be considered the most important factor affecting the success rate of hypospadias surgery. We recommend not changing the type of operation so often that not enough experience can be gained. The best results can be achieved in the most experienced hands.

Adolescent↗
PubMed1998

Effects of the 5 alpha-reductase inhibitor finasteride on serum levels of gonadal, adrenal, and hypophyseal hormones and its clinical significance: a prospective clinical study.

In the present study, we investigated the effects of a steroid 5 alpha-reductase inhibitor, finasteride, when given orally (5 mg/day), on the serum levels of gonadal, hypophyseal, and adrenal hormones and the clinical significance of these effects. Forty-eight patients with a mean age of 63 (range 49-81) were included in the study. All patients had symptoms of benign prostatic hyperplasia. Serum levels of testosterone, dihydrotestosterone, follicle-stimulating hormone (FSH) luteinizing hormone (LH), prolactin, aldosterone, cortisol, and dehydroepiandrosterone were determined before the study. The degree of symptoms in each patient and serum prostate specific antigen levels were determined together with uroflowmetric studies. Sexual status of the patients was also assessed with a self-administered questionnaire. All patients received finasteride, 5 mg/day, for 6 weeks. All of the above mentioned studies were repeated at month 3 and month 6. All of the patients had baseline hormonal values within the normal range. At month 3, the dihydrotestosterone level decreased by 60%, while the testosterone level increased by 15%. FSH and LH levels decreased by 24% and 16%, respectively. The changes in the serum levels of these hormones were further evident at month 6. No significant changes were noted in the serum levels of prolactin, aldosterone, cortisol, and dehydroepiandrosterone. Thirty-six patients (75%) were judged to be potent before the treatment. Finasteride caused erectile dysfunction in 8 patients (22%) by month 3 and in 12 (33%) by month 6. A substantial improvement was noted in symptoms of benign prostatic hyperplasia in all patients. The serum prostate specific antigen level decreased by 42% and 50% at month 3 and at month 6, respectively. Continued administration of finasteride, 5 mg/day alters the serum levels of testosterone, dihydrotestosterone, FSH, and LH significantly. Finasteride also causes sexual dysfunction in a substantial number of patients and should be offered with caution to patients who have an active sexual life.

5-alpha Reductase Inhibitors↗
PubMed1997

Effect of transurethral indwelling catheter on serum prostate-specific antigen level in benign prostatic hyperplasia.

OBJECTIVES: The purpose of this prospective study was to determine the influence of indwelling transurethral catheters on the serum prostate-specific antigen (PSA) levels in patients with benign prostatic hyperplasia (BPH). We compared the PSA values of preoperatively catheterized and noncatheterized patients. METHODS: Ninety patients undergoing a prostatectomy for benign disease were included. The indwelling catheter (IC) group and noncatheterized (NC) group each consisted of 45 patients. A total of 83 patients who did not have prostate carcinoma were analyzed by means of PSA, PSA density (PSAD), and pathologic presentations. Prostate pathologies that might elevate PSA values were excluded to demonstrate the correlation of PSA levels and standard urethral catheterization. RESULTS: A statistically significant relationship was determined between an indwelling urethral catheter and an elevated serum PSA value. The average PSA level of the IC group was 2.6 times that of the NC group. CONCLUSIONS: PSA, PSAD, and age-adjusted PSA levels were elevated above normal ranges in patients with BPH who had an indwelling urethral catheter.

Catheters, Indwelling↗
PubMed1997

A new application of laparoscopic instruments in percutaneous bladder stone removal.

The aim of this study is to describe a new technique using laparoscopic instruments for percutaneous bladder stone management and determine the efficacy of this procedure. The technique is based on percutaneous removal of the bladder stone(s) by using laparoscopic instruments under video-cystoscopic visualization. Laparoscopic large grasper or butterfly net like sac were used to extract bladder stones in six patients who were candidates of open cystolithotomy. Satisfactory results have been obtained in patients with solitary bladder stones that have diameters up to 3 cm or multiple stones. In selected cases, operation time, urethral and mucosal damage, hospital stay, and cost can be decreased to a minimum with this simple technique. It may be an alternative method to previously reported percutaneous bladder calculi management modality, in which percutaneous nephrolithotomy devices have been utilized.

Adult↗
PubMed1997

Role of Tile classification in predicting urethral injuries in pediatric pelvic fractures.

Urologic lesions accompanying pelvic fractures is a well-known entity, and reports on the correlation of pediatric pelvic fracture type with lower urinary tract injury are few in the literature. We have reviewed 27 records and x-ray films of male pediatric patients who required urologic intervention after trauma to see which type of fracture, classified according to Tile, has a higher predilection of urologic injury. Most of the fractures that were considered to be mechanically stable and mainly localized to the anterior pelvic arch had urologic lesions that were generally confined to the bulbomembranous urethra (48%).

Adolescent↗
PubMed1997

Malignant gonadal stromal tumor with bulky metastasis at diagnosis.

A 63-year-old man underwent inguinal orchiectomy for painless enlargement of the left testis. The diagnosis of malignant gonadal stromal tumor was made on the basis of morphology and immunohistochemical studies. At computed tomography there was bulky retroperitoneal metastasis. The patient then underwent retroperitoneal lymphadenectomy and received 6 courses of platinum-based chemotherapy at the end of which complete response was documented. However, at 18 months' follow-up, computed tomography revealed recurrent retroperitoneal metastasis. The patient was put on chemotherapy regimen again. But he developed pulmonary metastasis and died 28 months after the initial diagnosis. The clinical course of this patient suggests that malignant gonadal stromal tumor, if metastatic at diagnosis, may have a poor prognosis against most aggressive treatment approaches.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1997

13 years' experience of penile fracture.

Thirty-two cases of penile fracture in 1983-1996 were retrospectively reviewed and the patients were recalled for assessment of current status. The time from injury to repair ranged from 8 to 31 hours. The tear in the tunica albuginea was repaired with absorbable interrupted sutures. All patients were discharged on the day after operation. Skin loss required dermal grafting one month postoperatively in one patient. Erectile function returned within 2 days and coitus was achieved on average 13 days after the repair. Two patients had slight penile curvature which did not impede coitus. At long-term follow-up all patients reported satisfactory function.

Adolescent↗
PubMed1997

The correlation between prostate-specific antigen and age. Analysis of prostate-specific antigen values from 4,846 Turkish men with symptomatic benign prostatic hyperplasia.

OBJECTIVE: To analyze serum prostate-specific antigen (PSA) levels of men proven to have benign prostatic hyperplasia (BPH) and to document any correlation between PSA, age and resected or enucleated prostate tissue. PATIENTS AND METHODS: Serum PSA values, age and weight of specimens of 4,846 men who underwent prostatectomy in the Ankara region between January 1, 1991, and December 24, 1995, were reviewed retrospectively. RESULTS: Serum PSA values correlated directly with age (Pearson's r = 0.45, p < 0.00001). The mean PSA values of men in each decade of age differed significantly (p < 0.0001) from all other decades. However, the correlation between the weight of the prostatectomy specimen and age or PSA did not reach statistical significance. CONCLUSION: The effect of age on PSA is evident in men with symptoms of BPH. The existence of symptomatic BPH should also be considered together with age when interpreting PSA levels.

Aged↗
PubMed1997

A novel continent cutaneous reservoir: application of appendiceal Mitrofanoff principle to Stanford pouch.

We describe our modification of Stanford pouch orthotopic bladder replacement both by formation of the pouch with absorbable staples (poly-GIA) and diverting it with the appendiceal Mitrofanoff conduit. This operation was performed on two patients with focal invasive bladder cancer--a male patient with bladder extrofia and a patient with a severely contracted bladder due to interstitial cystitis. No operative or postoperative complications were encountered. Follow-up after operation ranged between 6 and 16 months. The functional and cosmetic results of the operation were satisfactory. This operative modification may be considered for the patient requiring cystectomy who is not a candidate for orthotopic bladder replacement.

Adult↗
PubMed1996

A malignant mixed gonadal stromal tumour of the testis with heterologous components.

We report a case of malignant mixed gonadal stromal tumour in the testis, which consisted of epithelial heterologous components and metastasized to the retroperitoneal lymph nodes. The primary lesion and biopsy of the retroperitoneal metastases showed predominance of the Sertoli cell component. The patient was put on chemotherapy.

Humans↗
PubMed1996

Techniques of corporoplasty for penile curvature: review of 18 patients.

Penile curvature which can be acquired or combined with some congenital anomalies may cause trouble in sexual function or can affect the psychological status of the individual. Whatever the causes or the results are, this condition has been tried to be corrected for many years by many different techniques. Eighteen patients with penile curvature have been reviewed. Thirteen patients underwent Nesbit procedure, in 3 patients plication of the tunica albuginea was done and in 2 patients longitudinal incision and horizontal closure of the tunica albuginea were performed. In all cases the results were both functionally and cosmetically satisfying. The advantages and disadvantages of these techniques are discussed, with a review of the relevant literature.

Adolescent↗
PubMed1996

Conservative management of stage T2 or T3a bladder cancer with deep transurethral resection followed by four cycles of chemotherapy.

OBJECTIVE: To evaluate the efficacy of the conservative management of stage T2 and T3a bladder cancer with deep (radical) transurethral resection (TUR) followed by four cycles of chemotherapy with methotrexate, vinblastine, epirubicin and cisplatin (MVEC) and its impact on bladder preservation and tumour recurrences. PATIENTS AND METHODS: Between May 1990 and June 1995, 19 patients with stage T2 or T3a transitional cell carcinoma of the bladder who refused radical cystectomy entered the study. The patients were re-evaluated 4 weeks after completion of the treatment by cystoscopy, TUR of the tumour site and multiple deep bladder biopsies. The patients were maintained on periodic local and systemic surveillance with cystoscopy and deep biopsy every 3 months, and annual intravenous urography and computed tomography. RESULTS: Seventeen patients completed the treatment protocol; 13 patients were tumour-free at the first evaluation after treatment and six of these had tumour recurrences in the bladder during surveillance. Eleven patients retained their bladder in a functional state for a mean duration of 36 months (range 12-62+) and seven of them remain free of recurrence after a mean duration of 41 months (range 8-58+). CONCLUSION: Deep TUR of the bladder tumour followed by four cycles of MVEC chemotherapy is an effective alternative in the conservative management of patients with stage T2 and T3a bladder cancer. We suggest this protocol for patients who refuse or are unsuitable for surgery.

Aged↗
PubMed1996

The role of pentoxifylline in the treatment of erectile dysfunction due to borderline arterial insufficiency.

OBJECTIVE: To investigate the effects of pentoxifylline on penile blood flow and potency in patients with erectile dysfunction due to borderline arterial insufficiency. PATIENTS AND METHODS: Following a routine diagnostic evaluation, 36 patients with borderline arterial disease diagnosed using penile duplex ultrasonography were included in the study. Of these patients, 20 (mean age 54 years, range 40-66) received 1.2 g of pentoxifylline daily, divided into three doses orally, for 2 months and 16 (mean age 54 years, range 34-65) received a placebo. Peak systolic velocities (PSVs) before and after the treatment were compared with those in patients receiving a placebo. The clinical improvement in erectile function was also evaluated. RESULTS: Twelve of 20 patients receiving pentoxifylline had an increase in PSV at the end of the treatment period. The mean change in PSV achieved by pentoxifylline treatment (6.25 cm/s) was significantly higher than that achieved by the placebo (0.38 cm/s). Seven patients had a positive response (successful coitus achieved after treatment with pentoxifylline). No serious side-effects occurred. CONCLUSION: Pentoxifylline was well tolerated and could increase penile arterial inflow, shown objectively as an increase in PSV on penile duplex ultrasonography. These findings should encourage further studies of the efficacy of pentoxifylline in the treatment of impotence.

Adult↗
PubMed1995

A prostaglandin synthesis inhibitor, diclofenac sodium in the treatment of primary nocturnal enuresis.

Various treatment modalities have been used in Primary Nocturnal Enuresis (PNE) and pharmacotherapy is widely accepted. Prostaglandins increase detrusor pressure, decrease urethral pressure and lead to sodium excretion. They also antagonize hydro-osmotic effect of vasopressin by competing with this hormone. According to these functions of prostaglandins it is suggested that inhibition of prostaglandin synthesis may have value in the management of PNE. We evaluated the efficacy or oral diclofenac sodium treatment in 78 patients. We conclude that diclofenac sodium, an inhibitor of prostaglandin synthesis, is a good alternative agent for nocturnal enuresis particularly as a supplementary treatment combined to Imipramine, with 60% complete response and 13.3% recurrence rate.

Adolescent↗
PubMed1994

Scrotal calcinosis.

Calcinosis is a rare benign lesion of the scrotum. A new case with scrotal calcinosis is presented and the relevant literature is reviewed.

Calcinosis↗