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Biomedical subjects

Isa Ozbey

Publications and source records attributed to Isa Ozbey.

9 recordsLinked to original sources
PubMed2005

Urinary tuberculosis: ten years' experience.

In this study of 26 patients, clinical features diagnosed as urinary tuberculosis in our nephrology and urology clinics between 1993 and 2002 were investigated retrospectively. Fifteen patients (52%) were male, and mean age was 43.5 (18-71). Twenty percent of the patients were asymptomatic. Frequency-dysuria (46%), flank pain (33%), and macroscopic hematuria (12%) were presenting symptoms. Physical examination was not diagnostically helpful in most patients. Hematuria and/or pyuria were detected in 80% of the patients. Eleven patients had positive urine cultures of Mycobacterium tuberculosis (42%), and 7 patients had positive smears (25%). Definitive diagnosis of urinary tuberculosis was established microbiologically in 15 patients (58%) and histopathologically in 11 patients (42%). Tuberculin skin test was positive in 60% of the patients. Eight patients had an abnormal chest roentgenogram. Hydronephrosis (majority bilateral) in 11 patients (42%), contracted bladder in 9 patients (34.6%), and renal calcification in 6 patients (23%) were detected. Two patients also had genital tuberculosis (epididymoorchitis). Although only medical treatment was applied in 13 patients for 9 months, in the rest of the patients medical therapy plus surgical intervention was carried out. End-stage renal failure developed in one patient who died on hemodialysis. Renal functions had decreased moderately in two other patients. In conclusion, the diagnosis of urinary tuberculosis was able to be established after the obstructive complications and functional losses were developed in a fair number of cases. Surgical treatment was carried out in half the patients. Urinary tuberculosis should be taken into consideration because early diagnosis and treatment is very important for the presenting of irreversible sequelae.

Adolescent↗
PubMed2004

Extracorporeal shock wave lithotripsy in children: experience using a mpl-9000 lithotriptor.

Our objectives were to assess the value of extracorporeal shock wave lithotripsy (ESWL) in treating pediatric urolithiasis, and to determine the factors that may affect treatment success. Between January 1993 and August 2002, 129 children with upper urinary tract calculi (134 renoureteral units) were treated using a Dornier MPL-9000 lithotriptor. The series consisted of 77 boys and 52 girls with an age range from 20 months to 14 years (average age: 8.7 years). All ESWL procedures took place under general anaesthesia or sedation with ketamin or fentanyl. Under ultrasonic or fluoroscopic guidance, children were treated with a maximum 2,550 shocks at an average of 19.5 kV. Success was defined as the lack of any visible stone fragments on post-treatment radiological evaluation. The patients were assessed 3 months after ESWL treatment and the results were compared using chi(2)-tests to detect factors that might be associated with treatment success. There were 105 renal, 20 ureteral, four bilateral renal and one unilateral renal plus contralateral ureteral calculi. The mean sizes were 15.7 mm for pelvic, 17.8 mm for renal and 10.2 mm for ureteral stones. One or two lithotripsy sessions were sufficient in most cases (71.6%). In 15 (11.6%) patients, double J stents introduced before lithotripsy were left indwelling until all stone fragments were voided. Overall success rates were 89.5% for pelvic, 85.5% for renal and 75% for ureteral stones. Complications such as urinary tract infection, Steinstrasse and small subcapsular hematoma occurred in 19 (14.7%) patients. The only significant factor associated with the stone-free rate was the diameter of the stone ( P=0.022). This study confirmed that the stone-free rate is significantly influenced by stone size. Because children with stone disease are at risk for a longer period than adults, their cumulative likelihood of stone recurrences may be higher. Thus, we agree with other authorities that minimally invasive treatment, such as ESWL, is mandatory in children with urolithiasis.

Adolescent↗
PubMed2003

Outpatient urethrocutaneous fistula repair with local anesthesia in adult patients.

The aim of this prospective study was to demonstrate that urethrocutaneous fistulas could be repaired under local anesthesia in adult patients without catheters. Between 1998 and 2000, 32 patients with urethrocutaneous fistulas were repaired under local anesthesia. The patients were divided into two groups in terms of whether they did or did not have catheters. The catheterized group (group I) included 15 patients and the uncatheterized group (group II) included 17 patients. Although the uncatheterized patients were discharged the same day as their operation, catheterized patients were discharged 4 to 6 days postoperatively. Patients were reevaluated on postoperative day 7 and month 3 in terms of wound infection, urethral stricture, and recurrence of fistula. All patients tolerated the fistula repair under local anesthesia. The success rate of fistula repair was 93.3% and 94.1% in the catheterized and uncatheterized groups, respectively. During postoperative days 1 through 7, wound infection was seen in 2 patients in group I but was not noted in the uncatheterized group. Fistulas recurred in one patient from each group (6.6% and 5.8%, respectively) after 3 months postoperatively. As a result, the authors suggest that catheterless fistula repair with local anesthesia in the adult age group is an effective, safe, and inexpensive procedure.

Adult↗
PubMed2002

Can varicocelectomy significantly change the way couples use assisted reproductive technologies?

PURPOSE: We assessed how varicocelectomy alters semen quality in a large cohort of infertile men and determined whether it can change patient candidacy for assisted reproductive technology procedures. MATERIALS AND METHODS: A cohort of 540 infertile men with clinical palpable varicocele underwent microsurgical varicocelectomy and were followed more than 1 and 2 years postoperatively for alterations in semen quality and conception, respectively. Preoperatively and postoperatively the total motile sperm count was calculated in all semen analyses. Based on total motile sperm count values patients were divided into 4 groups according to the type of assisted reproductive technology for which they qualified, including 0 to 1.5 million or less (intracytoplasmic sperm injection candidates), 1.5 to 5 million or less (in vitro fertilization candidates), 5 to less than 20 million (intrauterine insemination candidates) and 20 million or greater sperm (spontaneous pregnancy candidates). Preoperative and postoperative semen quality was compared among individuals in these cohorts to determine the shifts in assisted reproductive technology care that are possible after varicolectomy. RESULTS: Mean patient age was 29.5 years (range 18 to 58). Microsurgical varicocelectomy was bilateral in 393 patients (73%), on the left side in 146 (27%) and on the right side in 1 (0.2%). A positive response to varicocelectomy, defined as a greater than 50% increase in total motile sperm count, was observed in 271 patients (50%). An overall spontaneous pregnancy rate of 36.6% was achieved after varicocelectomy with a mean time to conception of 7 months (range 1 to 19). Of preoperative in vitro fertilization and intracytoplasmic sperm injection candidates 31% became intrauterine insemination or spontaneous pregnancy candidates after varicolectomy. Of intrauterine insemination candidates 42% gained the potential for spontaneous pregnancy. CONCLUSIONS: Varicocelectomy has significant potential not only to obviate the need for assisted reproductive technology, but also to down stage or shift the level of assisted reproductive technology needed to bypass male factor infertility.

Adolescent↗
PubMed2002

Sexual dysfunction in type II diabetic females: a comparative study.

Diabetes Mellitus (DM) is considered to play a principle role in the etiopathogenesis of sexual dysfunction both in men and women. The aim of this study is to evaluate sexual function in Type II diabetic women. A total of 72 young diabetic women (mean age: 38.8 years) with no other systemic diseases and 60 age-matched healthy women were enrolled in our study. We sought from them a detailed medical and sexual history and used the Index of Female Sexual function (IFSF) questionnaire (Kaplan et al., 1999). The mean IFSF score of diabetic women was 29.3 +/- 6.4 and was 37.7 +/- 3.5 in normal cases (p < 0.05). Lack of libido was the most common symptom in diabetics and was observed in 77% of the women. Diminished clitoral sensation was observed in 62.5% of the women, 37.5% complained of vaginal dryness and 41.6% had vaginal discomfort. Orgasmic dysfunction was found in 49% of the women. The incidence of all these related symptoms were significantly higher when compared to controls. We concluded that significant percentage of diabetic women that we observed experience sexual dysfunction of varying degrees that diminishes their quality of life.

Adult↗
PubMed2002

Adult nonpalpable testis: is laparoscopy always required?

Laparoscopy is widely used in the diagnosis and treatment of nonpalpable testes. Some nonpalpable testes are vanishing testes. In such cases, unnecessary laparoscopic interventions can be avoided by a careful selection of cases. Between 1996 and 2001, laparoscopic intervention was applied to 107 patients with nonpalpable testes. Of the cases, 23 were bilateral and 84 were unilateral. Patients were between 19 and 27 years of age (average age, 23 years). Diagnostic ultrasonography was performed in 44 of the 84 patients with nonpalpable testes. Dimensions of the scrotal testis were determined by the Prader orchiometer method. The dimensions of the opposite scrotal testis (of the scrotal nubbin) and the abdominal testis were compared with the dimensions of 20 normal, healthy individuals' scrotal testis (control group). Results were evaluated by the Mann-Whitney U test. During laparoscopy, 24 (28.5%) of the patients were found to have a vanishing testis. The vas deferens and the testicular blood vessels ended bluntly at the anterior edge of the interior inguinal ring in one patient, inside the inguinal canal in five patients, and in the scrotum in 18 patients. Among the 84 patients with nonpalpable testes, no testis was found in any of the 18 patients with palpable scrotal nubbins. The opposite scrotal testes were hypertrophic in 17 (70.8%) of 24 patients who had vanishing testis (P < .05), and they were hypertrophic in 22 (36%) of the 60 patients (P > .05) who had laparoscopically identified intraabdominal testes. We conclude that clinical and radiologic diagnosis is sufficient for adult patients with nonpalpable testicles and palpable scrotal nubbins and hypertrophic contralateral scrotal testes. Laparoscopic intervention should be applied to patients who do not have palpable scrotal nubbins.

Adult↗
PubMed2002

Spontaneous rupture of a renal angiosarcoma.

Here we describe the clinical, radiologic, histopathological and immunohistochemical features of a rare spontaneous rupture of renal angiosarcoma detected in the left kidney of a 55-year-old male. Due to the rarity of this neoplasm (less than 15 cases have been reported), there is no unanimous consensus for therapy following radical nephrectomy. In our case there was no flank trauma and retroperitoneal haematoma around the left kidney was seen on computed tomography. The patient underwent left radical nephrectomy and died about 3 months after operation due to multiple bone and liver metastases. To our knowledge, this is the first report of spontaneous rupture of renal angiosarcoma and we suggest that it should be borne in mind that renal angiosarcoma may be a cause of retroperitoneal haematomas.

Biopsy, Needle↗
PubMedDate not supplied

The effect of shock wave lithotripsy on nitric oxide and malondialdehyde levels in plasma and urine samples.

Shock wave lithotripsy (SWL) is accepted as the first treatment choice for most urinary stones, but it has adverse effects on the kidneys. The mechanisms underlying shock wave-induced renal injury have been discussed and include shear stress, thermal and cavitation effects and free radical formation. We investigated the effects of SWL on plasma and urinary nitrite, a stable metabolite of nitric oxide (NO), and malondialdehyde (MDA) concentrations. Between February and October 2004, 12 men and 8 women with renal calculi were treated using a Dornier MPL-9000 lithotriptor. The ages ranged from 22 to 45 years (average age: 33.7 years). Plasma and urinary NO and MDA levels were analysed before, immediately after, 30 and 60 min and 24 h after SWL. Plasma NO levels were higher than baseline levels immediately, and at 30, 60 min and 24 h after treatment (p = 0.016, p = 0.031, p = 0.033 and p = 0.045, respectively). Simultaneously, the mean urinary NO levels also showed significant elevation after SWL compared with baseline values, except for 24 h (p = 0.021, p = 0.023 and p = 0.048, respectively). The mean levels of plasma MDA showed statistically significant elevation immediately, and 30 and 60 min after SWL termination compared with pre-SWL values (p = 0.012, p = 0.008 and p = 0.012, respectively). Urinary MDA levels obtained immediately (p = 0.035), and 30 (p = 0.006) and 60 (p = 0.045) min after SWL were increased compared to pre-SWL values. We speculate that SWL treatment causes oxidative stress caused by renal ischemia-reperfusion (I/R) injury. Additionally, the increase of NO production may have prevented renal damage caused by vasoconstriction.

Adult↗