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Biomedical subjects

Levent Emir

Publications and source records attributed to Levent Emir.

7 recordsLinked to original sources
PubMed2006

Proteus syndrome with multiple genitourinary abnormalities.

Proteus syndrome is a rare hamartomatous disorder comprising a broad spectrum of congenital malformations and overgrowth of multiple tissues. Some rare urogenital malformations have been reported before. This case is unique for the presence of multiple genitourinary anomalies including retroperitoneal cystic mass, intra-abdominal testicle with hematoma and ureterovesical stricture apart from common clinic findings of proteus syndrome.

Humans↗
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

A new technique combining both polypropylene and vaginal wall sling procedures: can it minimize the risk of urethral and vaginal erosion occurring with synthetic materials?

We describe a new technique combining in situ vaginal wall and polypropylene mesh slings that may decrease potential erosive complications caused by synthetic materials. A folded mucosal patch harboring the polypropylene mesh was placed between mid-urethra and bladder neck. Using this technique, 12 consecutive women (age range 44-66 years) were operated. Preoperative evaluation included a detailed history, pelvic examination, stress test, cystourethroscopy, basic urodynamic evaluation (cystometry, Valsalva leak point pressure measurement), and urine culture. Based on these evaluations, three, seven, and two patients had type I, II, and III stress urinary incontinence, respectively. A paraurethral cyst excision was carried out in one patient and anterior colporrhaphy in four patients during the same operation. No ischemia or sloughing at the operation site occurred in any case. Pelvic examination was repeated in all patients after 3 and 6 months of follow-up and symptoms were determined after 12 months of follow-up in eight patients by telephone interview. Average follow-up was 10 months (range: 6-14 months). None of the patients were incontinent, or complained of sexual dysfunction or erosive complications after 1 year. Since there are two distinct barriers between the sling and both urethra and vagina, our technique covers all advantages of a sling procedure with synthetic materials and avoids the risk of urethral and vaginal erosion. The other advantage of this technique is the concomitant utilization of the vaginal wall as sling material.

Adult↗
PubMed2004

A huge unusual mass on the penile skin: acrochordon.

Acrochordons are flesh-coloured pedunculated lesions which occur in areas of skin folds. Although they are common in other sites of the body, we report the first case of huge penile acrochordon in the literature. Clinical, pathological and surgical findings of this lesion were presented and discussed.

Aged↗
PubMed2003

Onlay island flap urethroplasty: a comparative analysis of primary versus reoperative cases.

OBJECTIVES: To compare the outcome of the onlay technique in cases with an untouched urethral plate (group 1) and patients who had undergone previous hypospadias repairs (group 2). METHODS: The records of the 50 patients undergoing onlay island flap urethroplasty in the past 10 years were reviewed. The frequency of fistula formation in both groups was compared using the appropriate statistical methods. RESULTS: Seventeen and 33 patients were enrolled into groups 1 and 2, respectively. No statistically significant difference in patient age was present between the two groups (P >0.05). Flap necrosis in 2 patients and skin necrosis in 1 patient were encountered in group 2, with the meatus located at the penoscrotal region. Ischemic skin changes occurred in one primary patient with a mid-penile meatus. Urethrocutaneous fistula occurred in 2 (11.7%) of 17 primary cases and in 14 (42.4%) of 33 cases with multiple previous operations (Pearson chi-square test, P <0.05). A fistula rate of 61.5% was recorded in group 2 when the urethral meatus was located at the penoscrotal region. After withdrawal of the cases with penoscrotal meatus, the incidence of urethrocutaneous fistula was 6.7% (1 of 15) and 30% (6 of 20) in groups 1 and 2, respectively. CONCLUSIONS: Multiple previous operations affected the outcome of repair with the transverse onlay preputial flap, particularly in cases with a penoscrotal meatus. Repeat hypospadias repairs are more prone to complications.

Adolescent↗
PubMed2003

Mathieu urethroplasty as a salvage procedure: 20-year experience.

PURPOSE: We assessed the results of the Mathieu procedure in a series of patients who had undergone multiple prior hypospadias repairs. MATERIALS AND METHODS: Medical records of 55 boys who underwent repeat surgery with the Mathieu procedure were retrospectively reviewed. Prior surgeries, level of hypospadias defect, number of prior surgeries and complications were recorded. Statistical analyses were performed on factors that would impact the outcome. RESULTS: Mean patient age at the time of the salvage Mathieu procedure was 10.33 years (range 2 to 30). In 14 of the 55 patients (25.4%) fistula occurred following the salvage repair. Complications were split glans in 1 case, skin dehiscence in 1 and complete breakdown of the repair in 1. Fistula formation did not differ in groups categorized according to the level of the urethral meatus. Fistula occurred in 6 of 37 (16.2%) and 8 of 18 (44.4%) boys who underwent 1 and more than 1 prior surgery, respectively (p = 0.04). CONCLUSIONS: Although the Mathieu operation had a favorable outcome (74.6% cure) as a salvage procedure in 1 stage, fistula occurred more frequently as the number of prior surgeries increased. Therefore, if primary surgery fails, repeat operation should be performed by an experienced "hypospadiologist."

Adolescent↗