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Biomedical subjects

Eriz Ozden

Publications and source records attributed to Eriz Ozden.

14 recordsLinked to original sources
PubMed2007

Chronic constipation as a causative factor for development of varicocele in men: a prospective ultrasonographic study.

OBJECTIVE: The purpose of this study was to determine the role of chronic constipation in the etiopathogenesis of varicocele in men. METHODS: In this prospective study, group 1 included 25 male patients who had symptoms of chronic constipation for a mean duration +/- SD of 17.0 +/- 20.3 months (range, 3-96 months), and group 2 included 26 male subjects without any symptoms associated with constipation. All subjects were evaluated by both physical examination and scrotal ultrasonography. For the plexus pampiniformis (PP) veins, a mean diameter exceeding 2 mm and reflux for more than 1 second were accepted as suggestive findings for varicocele, as described previously. RESULTS: Left varicocele was detected in 13 (52%) of the 25 patients in group 1 and in 5 (19%) of the 26 subjects in group 2 (P = .02). The mean diameters of the left PP veins were 2.58 +/- 0.97 mm (range, 1.2-4.3 mm) in group 1 and 1.71 +/- 0.53 mm (range, 1.0-3.0 mm) in group 2 (P < .001). A significant difference was detected between the two groups for varicocele prevalence and the mean diameter of the left PP veins. CONCLUSIONS: Chronic constipation is a significant causative factor for the development of left varicocele, which may be attributable to the accompanying distention of the sigmoid colon and distal part of the descending colon, with resultant compression of the left testicular vein in the retroperitoneum. Therefore, we propose routine ultrasonographic examinations for the possible development of varicocele in men with chronic constipation.

Adult↗
PubMed2006

Effect of premicturitional bladder volume on the accuracy of postvoid residual urine volume measurement by transabdominal ultrasonography: rate of bladder fullness is of great importance for preventing false-positive residue diagnosis.

OBJECTIVE: The purpose of this study was to evaluate the effect of premicturitional bladder volume (V1) on postvoid residual urine volume (V2) measurements and to assess the ideal V1 for an accurate V2 determination. METHODS: Twenty-five healthy men without any urinary symptoms constituted the study group. Measurements by transabdominal ultrasonography for V1 and V2 were performed for each subject at 3 different phases, each of which was preceded by oral intake of 1000 mL of water and accompanied by "mild," "moderate," and "severe" sensations of micturition, respectively. RESULTS: Mean +/- SD V1 and V2 during the first, second, and third phases were 117.7 +/- 70.3 and 1 +/- 1, 356.2 +/- 112.3 and 11.5 +/- 12 and 639.6 +/- 171.8 and 58.8 +/- 35.2 mL, respectively. With 50 mL as the cutoff value for a pathologic V2, 15 (60%) men had V2 in the third phase exceeding this value, whereas the same rate was calculated as 0% for either of the first 2 phases. No patient with V1 of less than 540 mL had V2 of greater than 50 mL. CONCLUSIONS: Postvoid residual urine volume measurements with an uncomfortably full bladder result in high false-positive postmicturitional residue values even in healthy young men. We strongly advise that V1 measurements of the bladder be performed before V2 measurements and that V2 not be measured if V1 is greater than 540 mL.

Abdomen↗
PubMed2006

Unilateral idiopathic hydrocele has a substantial effect on the ipsilateral testicular geometry and resistivity indices.

OBJECTIVE: The purpose of this study was to determine whether hydrocele has any effect on the volume and shape of the ipsilateral testis and can be implicated as a cause of testicular ischemia. METHODS: Group 1 consisted of 23 patients with unilateral idiopathic hydrocele, whereas 30 healthy men constituted group 2. All patients underwent scrotal ultrasonography by which testicular dimensions in craniocaudal (D(cc)), anteroposterior (D(ap)), and mediolateral axes were measured, followed by calculation of the D(cc)/D(ap) ratio and testicular volume. By color Doppler analysis, the resistivity index of the subcapsular artery (RI(sc)) and the resistivity index of the intratesticular artery were determined. RESULTS: The mean D(cc)/D(ap) ratio +/- SD for group 1 was 1.7 +/- 0.3 (range, 1.1-2.3), significantly lower than that of group 2, which was 1.9 +/- 0.3 (range, 1.3-2.2) (P = .028). Mean testicular volume values of subjects having hydrocele for more than and less than 6 months were 13.4 +/- 7.3 and 22.5 +/- 5.1 cm3, respectively; the difference between the subgroups was significant (P = .003). For the ipsilateral testis, mean RI(sc) values were 0.70 +/- 0.06 (range, 0.60-0.80) in group 1 and 0.65 +/- 0.06 (range, 0.59-0.83) in group 2. The mean RI(sc) was significantly higher in group 1 (P = .006). CONCLUSIONS: Unilateral idiopathic hydrocele has a tendency for rounding rather than flattening the ipsilateral testis as well as elevating the RI(sc) on the affected side. To the best of our knowledge, no strict spectral Doppler analysis criteria have been proposed for testicular ischemia yet. Therefore, the impact of the difference of the RI(sc) should raise the suspicion for ischemia, and further research is needed to elucidate any effect on spermatogenesis.

Adolescent↗
PubMed2005

Transrectal sonographic features of prostatic intraepithelial neoplasia: correlation with pathologic findings.

PURPOSE: This study was conducted to evaluate the transrectal sonographic (TRUS) features of prostatic intraepithelial neoplasia (PIN) by comparing the histopathologic results with TRUS findings in patients who had undergone TRUS-guided prostate biopsy. METHODS: From an initial set of 307 patients who underwent TRUS-guided prostate biopsy, TRUS findings for 44 patients whose pathologic results were consistent with PIN were reviewed retrospectively. Among these 44 patients, 12 had only PIN, 20 PIN associated with prostatitis, and 12 PIN associated with prostate cancer foci. After exclusion of the foci that included PIN associated with prostatitis and PIN associated with prostate cancer at the same site, the pathologic results for the core specimens from the 100 PIN foci were correlated with TRUS findings according to their location. The sonographic features sought were hypoechoic areas and regions of heterogeneous echogenicity. RESULTS: Positive TRUS findings were detected in 43% of PIN and 36% of high-grade PIN (HGPIN) focise. For the HGPIN foci with positive TRUS findings, the detected sonographic features were clusters of millimetric hypoechoic foci (CMHF) (53%), hypoechoic areas with well-defined borders (27%), and heterogeneous echogenicity (20%) (not significant). The sensitivity of the presence of CMHF for the diagnosis of HGPIN was only 19%. CONCLUSIONS: TRUS-detected CMHF may indicate HGPIN. Because of the limited sensitivity of this finding, TRUS detection of CMHF does not warrant biopsy, although these lesions warrant close monitoring.

Aged↗
PubMed2005

3-Dimensional computerized tomography in follow-up of patients with urinary diversion.

INTRODUCTION: The aim of our study was to evaluate the usefulness of 3-dimensional computerized tomography (3D-CT) in routine follow-up of patients who had undergone radical cystectomy and different kinds of urinary diversions and compare it with conventional CT. PATIENTS AND METHODS: Nineteen patients (18 men, 1 woman) who had undergone radical cystectomy and different kinds of urinary diversions with diagnosis of invasive bladder cancer were enrolled into the study. The mean age of the patients was 55.5 (46-69) years. For all patients, conventional CT was performed, followed by 3D reconstruction of these images. RESULTS: Orthotopic ileal neobladder (Abol-Enein and Ghoneim procedure) was performed in 12, rectosigmoid pouch (Mainz pouch II) in 2 and ileal conduit in 5 patients. There were no pathological findings visible either on conventional CT or on 3D-CT, but the shape, configuration, and the relationships of the pouch with ureters, urethra and other adjacent organs were much better visualized on 3D-CT. CONCLUSION: 3D-CT did not have any advantages over conventional CT for showing pathological findings that were oncological origin, but as the anatomy of the lower urinary tract can be perfectly demonstrated, we think that it may be used for planning of a re-operation after urinary diversion and may help the urologist who has less experience with radiological studies to evaluate pouch configuration and indentations to the adjacent organs better.

Aged↗
PubMed2005

Is fluid ingestion really necessary during ultrasonography for detecting ureteral stones? A prospective randomized study.

OBJECTIVE: Ultrasonographic evaluation of ureteral stones is usually performed after fluid ingestion for filling the bladder to visualize the ureterovesical junction better. We hypothesized that water ingestion may decrease the imaging quality of ultrasonography for detecting ureter stones. In our prospective randomized study, the accuracy of ultrasonography for detecting ureteral stones performed with or without fluid intake were evaluated. METHODS: The study population comprised 150 consecutive patients thought to have ureteral stones who underwent ultrasonography. Patients were divided into 2 groups. Group A patients ingested 500 mL of water to distend the bladder before ultrasonographic examination. Group B patients were restricted from drinking any water at least 4 hours before the procedure. RESULTS: Ultrasonography showed 35 (67.30%) of 52 stones in group A and 68 (93.15%) of 73 stones in group B. The difference of detection rates between the 2 groups was statistically significant (P < .001). The greatest improvement in detection rates was noted in the middle ureter stones. The evaluated sensitivity and specificity rates for group A were 67% and 82%, respectively, and those for group B were 93% and 94%. When the 2 methods were compared, total accuracy of ultrasonography increased from 71% in group A to 93% in group B. CONCLUSIONS: This prospective randomized study showed that the diagnostic accuracy of ultrasonography for detection of middle ureteral stones increased significantly when performed without any water ingestion before the procedure. We recommend that patients thought to have ureteral stones should be first examined without any fluid ingestion.

Adolescent↗
PubMed2005

Follow-up of the transrectal ultrasonographic features of the prostate after biopsy: does any ultrasonographically detectable lesion form secondary to the first biopsy?

OBJECTIVE: The purpose of this study was to evaluate the transrectal ultrasonographic features of the prostate after biopsy and to find out whether any ultrasonographically detectable lesion forms secondary to biopsy. METHODS: Prebiopsy transrectal ultrasonographic findings in 60 consecutive patients who underwent repeated biopsies were evaluated. Detected lesions that were not defined before the first biopsy were considered postbiopsy-formed lesions and were sampled during the second biopsy. All transrectal ultrasonographically detected lesions were correlated with histopathologic results in the same locations. RESULTS: There were 7 (11.6%) patients with new hypoechoic lesions formed after the first biopsy. Histopathologic analysis of postbiopsy-detected lesions showed that 38.5% were cancer; 62.5% of the detected benign lesions were prostatitis foci. CONCLUSIONS: Prostate biopsy does not give rise to formation of fibrotic scar tissue in the peripheral zone. Most postbiopsy-detected lesions are prostatitis foci, but all hypoechoic lesions must be sampled during repeated prostate biopsies because of the 38.5% cancer detection rate.

Aged↗
PubMed2004

Clitoral metastasis from transitional cell carcinoma of the renal pelvis: CT and MRI findings.

Metastatic tumors of the clitoris are extremely rare. We report a case of clitoral metastasis in a 75-year-old woman who was treated for transitional cell carcinoma of renal pelvis 2 years ago. The computed tomography and magnetic resonance imaging findings are presented with a short review of the literature. To the best of our knowledge, clitoral metastasis originating from transitional cell carcinoma of the renal pelvis has not been reported in the English language literature.

Aged↗
PubMed2004

The long core needle with an end-cut technique for prostate biopsy: does it really have advantages when compared with standard needles?

OBJECTIVE: To evaluate the failure rate, core length and fragmentation rate for each different stroke length of the end-cut (BioPince) needle in order to show the performance of the needle for different stroke lengths and compare these with the standard side-notch needle. METHODS: TRUS guided biopsy of the prostate was performed on 86 consecutive men between June 2002 and May 2003. The patients were randomized into two groups with 43 men in each group. Patients in group A underwent 8 core biopsy with the end-cut needle in different stroke lengths; 13, 23 and 33mm respectively. Patients in group B underwent 8 core biopsy with the side-notch needle. The cores have been evaluated and compared for failure rates, core lengths, number of core lengths under 5mm and fragmentation rates. RESULTS: When the end-cut needle was used, a significant number of failure rates was noted; with an overall failure rate of 16%. The failure rates were 26% for 13mm stroke length, 18% for 23mm stroke length and 10% for 33mm stroke length respectively. These failure rates showed statistically significant difference from standard needle for overall and for every separate stroke length ( p<0.001 for all). Standard needle and the cores taken with 33mm stroke length of the end-cut needle had similar low fragmentation rates while 13 and 23mm stroke lengths had higher rates. Of the overall cores taken by BioPince needle, 46/344 (13%) of the cores were shorter than 5mm and this was significantly higher than the standard needle with 3/344 cores less than 5mm ( p<0.001). The end-cut needle when used with the 33mm stroke length has improved the core length by 68% according to the standard side-notch needle. CONCLUSIONS: Our results showed that the performance of the end-cut needle worsens with decreased stroke lengths. The end-cut needle showed high failure rates which necessitates new punctures for taking a core. Additionally, the fragmentation rates are not lower than the standard needle and it has higher rates of taking small core samples. The only significant advantage of this needle over the standard needle is taking longer cores when it has been used at 33mm stroke lengths.

Adult↗
PubMed2004

The value of transrectal ultrasound guided needle aspiration in treatment of prostatic abscess.

INTRODUCTION: Prostatic abscess (PA) is a very uncommon disorder. The value of transrectal ultrasound (TRUS) guided aspiration in the treatment of PA has not been clearly defined. We present our experience with six such patients. MATERIALS AND METHODS: Between July 1997 and December 2002, six patients with PA were diagnosed by TRUS and treated by TRUS guided needle aspiration in our department. PA was defined as hypoechoic, inhomogeneous, thick walled fluid collection. TRUS guided needle aspiration of the abscess was performed transrectally in all patients with a 20-cm long 18 gauge Chiba needle. Successful treatment criteria were defined as clinical improvement in symptoms and decrease of more than half of the estimated abscess volume on follow up TRUS control. Patients with continuing clinical symptoms were defined as treatment failures. RESULTS: The most common TRUS finding was detection of a hypoechoic area with inhomogeneous structures, which was determined in all patients (100%). In some patients irregular contour and heterogeneous areas were additionally described. TRUS guided needle aspiration treatment of PA was successful in five of six patients (83.3%). In one patient treatment failed and the abscess recurred 3 weeks after the procedure. As this patient had additionally a bladder outflow obstruction, transurethral resection of the prostate was performed instead of a repeat procedure. There were no complications associated with the procedure. CONCLUSIONS: In conclusion, TRUS has an important value in diagnosis and treatment of PA. TRUS guided aspiration is an effective and minimally invasive treatment modality for PA which causes no serious complications.

Abscess↗
PubMed2003

The optimum doses of and injection locations for periprostatic nerve blockade for transrectal ultrasound guided biopsy of the prostate: a prospective, randomized, placebo controlled study.

PURPOSE: We evaluated the efficiency of various amounts of local anesthesia and various numbers of injection sites to determine the most effective pain control with the least number of injections and the amount of injected medium in patients who underwent transrectal ultrasound guided prostate biopsy. MATERIALS AND METHODS: Transrectal ultrasound guided 8 core biopsy of the prostate was performed in 175 consecutive men. Patients were randomized into 7 groups with 25 per group. Group 1 received 5 cc saline and groups 2 to 7 received 2.5, 5 or 10 cc 1% lidocaine injected as local anesthesia at basal or basal plus apical locations. The patients were then evaluated for pain and other complications to determine whether there was a difference regarding groups. RESULTS: Mean pain scores were significantly lower than in saline group for all anesthesia injected groups except group 2 with a 2.5 cc bilateral basal injection. The most effective pain control was achieved by 10 cc anesthetic injections. Basal plus apical injections were not superior than only basal injections for pain control. There was no significant difference in the hematuria, hematospermia, rectal bleeding or infection rate among the groups. Increasing the number of injections and amount of lidocaine had no effect on complication rates. CONCLUSION: Our placebo controlled, prospective, randomized study indicated that 10 cc local anesthetic injections supply significantly better pain control than lower doses for periprostatic nerve blockade during prostate biopsy. Although bilateral basal plus apical 10 cc lidocaine injections resulted in the lowest mean pain score, there was no statistically significant difference from 10 cc bilateral basal injections.

Aged↗
PubMed2003

Use of percent free prostate-specific antigen density to improve the specificity for detecting prostate cancer in patients with normal rectal examinations and intermediate prostate-specific antigen levels.

INTRODUCTION: As prostatic volume influences percent free prostate-specific antigen (PSA) in patients with prostate cancer, we evaluated whether percent free PSA density, which relates the serum percent free PSA to the volume of the prostate determined by transrectal ultrasound, could increase the specificity of cancer detection in men with normal digital rectal examinations and intermediate PSA levels. MATERIALS AND METHODS: We prospectively evaluated 105 consecutive men with normal digital rectal examinations and serum PSA levels of 4.1-10.0 ng/ml. All patients underwent at least sextant prostate biopsies to establish the diagnosis. For detection of total and free PSA we used an Immulite free and total PSA assay. We compared PSA density, percent free PSA and percent free PSA density for their utility in cancer detection. RESULTS: Overall, 20 of 105 patients (19%) had prostate cancer. The area under the curve (AUC) for percent free PSA density was 0.771, not significantly higher than the AUC of 0.75 for PSA density (p = 0.778), but significantly higher than the AUC of 0.604 for percent free PSA (p = 0.021). Of these three parameters, percent free PSA density yielded the highest specificity percentage (54.1%) at 95% sensitivity. CONCLUSIONS: Percent free PSA density is more specific than percent free PSA in distinguishing benign from malignant disease in men with a normal digital rectal examination and an intermediate PSA level. Further study is necessary to discover whether percent free PSA density is superior to percent free PSA or PSA density.

Aged↗
PubMed2003

Increased prostate-specific antigen in subclinical prostatitis: the role of aggressiveness and extension of inflammation.

OBJECTIVES: Subclinical prostatitis is a very frequent histologic finding in pathological examinations of prostate biopsy and prostate surgery material. In this study, we tried to investigate the correlation between the morphological parameters of histological prostatitis and total serum prostate-specific antigen (PSA)-PSA density (PSAD) to determine if either the extent or aggressiveness of inflammation might affect serum PSA. METHODS: 269 patients who had undergone TURP or transvesical prostatectomy with pathological diagnosis of BPH and prostatitis were included in the study. We retrospectively reviewed and scored the extent and aggressiveness of inflammation in prostate specimens of BPH, according to the scale that has been reported by Irani et al. and then correlated those scores with PSA and PSAD. RESULTS: When the inflammation grades correlated with PSA and PSAD, the extent of the inflammation did not show a significant correlation with total PSA and PSAD (p > 0.05). However, there was a statistically significant correlation between aggressiveness grades and total PSA and PSAD (p < 0.001). Median PSA levels in grades 0, 1 and 2 of aggressiveness of inflammation were 3.2, 4.2 and 5.8 respectively. CONCLUSION: Aggressiveness grade of the inflammation in subclinical prostatitis is the most important morphological factor that is responsible for PSA elevation. We believe that it should be a more accurate guide for the clinician if pathologists report on the aggressiveness grades of the inflammation, especially on initial prostate biopsies, in order to help for timing of the further biopsy.

Aged↗