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Biomedical subjects

M Cetinkaya

Publications and source records attributed to M Cetinkaya.

At least 19 recordsLinked to original sources
PubMed2001

Evaluation of urethrovesical angle by ultrasound in women with and without urinary stress incontinence.

Our aim was to investigate the role of ultrasonographic imaging in the evaluation of genuine stress incontinence (GSI). The posterior urethrovesical angles (PUVA) of each of 50 incontinent (group I) and 50 control cases (group C) were measured by both transperineal and transvaginal ultrasonography (TP-USG, TV-USG). In group I the angles were 94.9 +/- 10.9 at rest and 102.7 +/- 16.1 by TP-USG (P<0.001), and 100.6 +/- 11.1 at rest and 103.3 +/- 9.6 during Valsalva by TV-USG (not significant). In the control group these measurements were 93 +/- 5.3, 96.2 +/- 7.9 (P<0.001) and 98 + 8.8, 101.1 +/- 10.3 (P=0.001) by TV-USG, respectively. The degree of alteration of the angle, originating with Valsalva maneuver (delta-PUVA) was 7.7 +/- 11.8 in group I and 3.2 +/- 4.95 in group C (P=0.014) by TP-USG, and 2.7 +/- 11.8 and 3.2 +/- 6.16 by TV-USG (NS). Our data reveal that PUVA and delta-PUVA have important roles in GSI pathophysiology; however, ultrasonography, especially by the transvaginal route, cannot be a reliable useful method as a diagnostic tool in the evaluation of GSI.

Female↗
PubMed2001

Polymorphisms of glutathione S-transferase genes (GSTM1, GSTP1 and GSTT1) and bladder cancer susceptibility in the Turkish population.

We investigated the effect of the GSTM1 and GSTT1 null genotypes, and GSTP1 313 A/G polymorphism on bladder cancer susceptibility in a case control study of 121 bladder cancer patients, and 121 age- and sex-matched controls of the Turkish population. The adjusted odds ratio for age, sex, and smoking status is 1.94 [95% confidence intervals (CI) 1.15-3.26] for the GSTM1 null genotype, and 1.75 (95% CT 1.03-2.99) for the GSTP1 313 A/G or G/G genotypes. GSTT1 was shown not to be associated with bladder cancer. Combination of the two high-risk genotypes. GSTM1 null and GSTP1 313 A/G or G/G, revealed that the risk increases to 3.91-fold (95% CI 1.88-8.13) compared with the combination of the low-risk genotypes of these loci. In individuals with the combined risk factors of cigarette smoking and the GSTM1 null genotype, the risk of bladder cancer is 2.81 times (95% CI 1.23-6.35) that of persons who both carry the GSTM1-present genotype and do not smoke. Similarly, the risk is 2.38-fold (95% CI 1.12-4.95) for the combined GSTP1 313 A/G and G/ G genotypes and smoking. These findings support the role for the GSTM1 null and the GSTP1 313 AG or GG genotypes in the development of bladder cancer. Furthermore, gene-gene (GSTM1-GSTP1) and gene-environment (GSTM1-smoking, GSTP1-smoking) interactions increase this risk substantially.

Female↗
PubMed2001

P53 codon 72 polymorphism in bladder cancer--no evidence of association with increased risk or invasiveness.

We studied the effect of the p53 gene Arg72Pro polymorphism on bladder cancer susceptibility in a case control study of 121 bladder cancer patients and 114 age-sex matched controls to determine whether this polymorphism is a biomarker for the risk and how aggressive the disease is. Genomic DNA was obtained from venous blood samples for genotype determination by PCR and restriction digestion. The genotype frequencies in the patient group were Arg/Arg: 0.3553, Arg/Pro: 0.4711, Pro/Pro: 0.1736, and in the control group Arg/Arg: 0.3684, Arg/Pro: 0.4825, Pro/Pro: 0.1491. The distribution of genotypes between the two groups was not statistically different (chi2 = 0.260, df: 2, P=0.878). The patient group was subdivided into two groups as superficial bladder cancer (n = 88) and invasive bladder cancer (n = 33), according to the presence of muscle invasion. The distribution of genotypes in the superficial group was Arg/Arg: 0.3409, Arg/Pro: 0.5114, Pro/Pro: 0.1477 and in the invasive group Arg/Arg: 0.3940, Arg/Pro: 0.3636, Pro/Pro: 0.2424. No association was observed with the invasiveness of the tumor (chi2 = 2.542, df 2, P = 0.281). Stratification of the data by tobacco exposure did not result in a significant difference in genotype frequencies. These data do not support an association between the p53 Arg72Pro polymorphism and bladder cancer.

Adult↗
PubMed2000

A comparison of fluid absorption during transurethral resection and transurethral vaporization for benign prostatic hyperplasia.

OBJECTIVES: To compare the absorption of irrigant fluid during transurethral vaporization of the prostate (TUVP) and transurethral resection of the prostate (TURP). PATIENTS AND METHODS: Thirty patients with clinical benign prostatic hyperplasia were randomly assigned to undergo TURP or TUVP; 1.5% glycine +1% ethanol solution was used as the irrigating solution. The volume of irrigant absorbed during surgery was estimated from the ethanol concentration in the patient's expired breath, sampled every 10 min. RESULTS: In both groups, the estimated absorbed fluid volume increased with the duration of surgery (P < 0.05). At the end of surgery, the mean (median, range) fluid absorption during TUVP was 672 (606, 0-1400) mL and during TURP was 1347 (975, 453-2965) mL; the difference was statistically significant (P < 0.05). CONCLUSION: Although TURP has a greater associated risk of fluid absorption than TUVP there may still be severe fluid absorption with the latter. Even though TUVP is potentially less harmful than TURP in poor-risk patients, ethanol monitoring is beneficial for increasing patient safety.

Absorption↗
PubMed1999

Effect of transurethral resection on serum free/total prostate-specific antigen levels in patients with benign prostatic hyperplasia.

OBJECTIVES: Transurethral resection of the prostate (TURP) can cause elevation of total serum prostate-specific antigen (PSA). However, the effect of these procedures on free PSA and percent free PSA is still unknown. The aim of this study was to investigate the effect of TURP on serum total PSA, free PSA, and free/total (f/t) PSA ratio in patients with benign prostatic hyperplasia (BPH) and to determine the reliability of f/t PSA ratio after such interventions. METHODS: Fifty-three patients with BPH who underwent TURP because of severe bladder outlet obstruction symptoms were included in this study. All patients underwent digital rectal examination and transrectal ultrasound (TRUS), and routine hematologic (complete blood count) and serum biochemical tests, urine analysis, and a peak urinary flow test were performed. Serum total PSA and free PSA levels were determined 1 hour before and 24 hours after TURP by using enzyme immunometric assay. Preoperative and postoperative free and total PSA and f/t PSA ratio were statistically compared. RESULTS: Although postoperative total PSA and free PSA increased significantly compared with preoperative values (P <0.001 and P = 0.024, respectively), the difference between preoperative and postoperative f/t PSA ratios was not statistically significant (P = 0.103). CONCLUSIONS: Finding no significant change in f/t PSA ratio, although there is a significant increase in the serum levels of total and free PSA, suggests to us that f/t PSA ratio may be a more reliable parameter in the early period after such interventions as TURP.

Aged↗
PubMed1998

Effect of postnecrotic and alcoholic hepatic cirrhosis on development of benign prostatic hyperplasia.

BACKGROUND: The object of this study was to investigate the effects of hepatic cirrhosis on the development of benign prostatic hyperplasia and consequent effects on prostatic volume, serum prostate-specific antigen (PSA), and prostatism symptoms. METHODS: Sixty patients with postnecrotic cirrhosis and alcoholic cirrhosis at age 40 and over, and 20 voluntary subjects in the same age group with normal hepatic functions, were evaluated with prostatic volume calculation by transrectal ultrasound, symptom scoring according to American Urology Association (AUA) criteria, measurement of serum prostate-specific antigen (PSA), serum total testosterone (TT), free testosterone (FT), estradiol (E2), and calculation of E2/FT ratios, and the results were analyzed statistically by the Mann-Whitney U-test. RESULTS: Serum FT and TT levels were significantly lower in the hepatic cirrhosis group compared to the control group (P = 0.0000 and P = 0000, respectively). Though mean serum E2 level was a little higher in cirrhotic patients compared to controls, the difference was not significant; however, the higher E2/FT ratio in the cirrhotic group was statistically significant (P = 0.27 and P = 0.0002, respectively). In the cirrhotic group, the decrease in FT and TT levels was greater, as the disease advanced. While E2 and E2/FT ratio increase, correlate with poor prognosis, no statistically significant differences were found. Mean prostatic volume, serum PSA level, and total symptom score were significantly higher in the control group, compared to the cirrhotic group (P = 0.0001, P = 0.0006, and P = 0.002, respectively). Prostatic volume decreased parallel to severity of disease in cirrhotic patients. CONCLUSIONS: The main reason for the decrease in mean prostatic volume in cirrhotic patients compared to subjects in the same age group with normal hepatic functions was the decrease in serum FT and TT levels, and the secondary cause was the increase in E2/FT ratio, indicating estrogenic predominance.

Adult↗
PubMed1998

Relationship between prostate specific antigen density, microvessel density and prostatic volume in benign prostatic hyperplasia and advanced prostatic carcinoma.

The aim of this study was to investigate the relationship between prostate specific antigen density and prostate volume with microvessel density in patients with benign prostatic hyperplasia and advanced prostatic carcinoma. Sixty-eight patients with benign prostatic hyperplasia and 11 patients with advanced prostatic carcinoma participated in the study. The paraffin blocks of all patients were stained with CD34 by the standard immunohistochemical technique and microvessel density, prostate specific antigen density and prostatic volume were determined. In patients with benign prostatic hyperplasia the mean microvessel density, mean prostate specific antigen density and mean prostatic volume were 74+/-89+/-22.73, 0.12+/-0.10 and 59.97+/-27.0 ml, respectively. There was no correlation between prostate specific antigen density and mean prostatic volume or microvessel density (r = 0.079 and -0.095, respectively). In patients with advanced prostatic carcinoma the mean microvessel density, mean prostate specific antigen density and mean prostatic volume were 147.90+/-47.55, 0.63+/-0.41 and 54.00+/-22.42 ml, respectively. In this group, while there was a good correlation between prostate specific antigen density and microvessel density (r = 0.785), no significant correlation was found between prostatic volume and microvessel density (r = -0.07). There was significant statistical difference in patients with advanced prostatic carcinoma compared to patients with benign prostatic hyperplasia in terms of mean microvessel density (p<0.0001). The findings that there was no correlation between prostatic volume and MVD either in benign prostatic hyperplasia or in prostatic carcinoma suggest that microvessel development is not correlated with prostatic volume but may be correlated with morphology.

Aged↗
PubMed1997

Spontaneous fragmentation of a double J stent.

A variety of indications have made the use of double J stents routine in urology. Minimal and moderate side effects of ureteral stent are common, when the indwelling time exceeds 6 weeks the incidence of severe complications, like fragmentation increase. We report a case of stent fragmentation after an indwelling period of 12 months. Despite the variety of complications the severity requires close monitoring of the patient.

Adult↗
PubMed1997

A case of growing teratoma syndrome.

Residual masses are a common finding after chemotherapy for metastases from nonseminomatous germ cell tumours of the testes. The prognosis of these patients with resected teratoma following successful cisplatin-based combination chemotherapy generally has been assumed to be good. Herein we reported an unusual teratoma case named "growing teratoma syndrome' by Logothetis et al. This patient was treated with multiple operations.

Adult↗
PubMed1997

Erectile dysfunction in premature ejaculation.

Between October 1993 and December 1995, 45 patients with premature ejaculation were included in this study. The patients were divided into two groups etiologically, as having primary or secondary ejaculation. After a complete laboratory evaluation all patients underwent papaverine tests color Doppler ultrasonography pharmacocavernosometry-cavernosography and consequently organic etiology were investigated. Venous leakage was found in 5 (22,7%), arterial or mix insufficiency in 2 (9%) of the patients with primary premature ejaculation. In secondary premature ejaculation group, venous leakage was encountered in 9 patients (39,1%), arterial insufficiency in 2 patients (8,6%). In conclusion, investigation of organic etiology for the patients with premature ejaculation, particularly with secondary premature ejaculation, seems to be beneficial for correct diagnosis.

Adult↗
PubMed1997

The value of cavernous body biopsy in evaluating of impotent men.

Rapid advances in the basic understanding of the anatomy, physiology and pharmacology of penile erection have drastically changed the clinical approach to patients with erectile dysfunction. To evaluate the value of microscopic architecture of the corpora cavernosa, we examined cavernous body biopsies taken during penile prosthesis implants. We studied on 12 impotent patients 25 to 67 years old who underwent implantation of a penile prosthesis. The biopsy was stained with H&E (Hematoxylin and Eosin) for general architecture, Masson Trichrome for collagen distribution and EVG for elastic fibers. Except 3 cases no pathological changes were determined at H&E staining. At collagen staining, roughly increased collagen distribution was determined in all cases. There were no appreciable differences in distribution of elastic fibers. In conclusion our data demonstrate that cavernous body biopsy is of limited value to determine etiologic factors in patients with erectile dysfunction.

Adult↗
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↗
PubMed1996

Urodynamic parameters in preoperative evaluation of patients with bladder tumours.

Urodynamic evaluation was done in 28 patients with various staged bladder tumours. In 12 patients with superficial bladder tumours all urodynamic parameters were in normal range. Thirteen patients of 16 with invasive bladder tumours had low capacity of bladder and 5 of them also had involuntary contractions. In this study we suggest that urodynamic parameters in patients with bladder tumour became significantly abnormal when the first tumour invasion is seen at the muscular layer of the bladder (p < 0.05); so compliance significantly decreased and the other pathological conditions were followed (p < 0.05).

Adult↗
PubMed1996

A urodynamic evaluation of patients with renal, upper and lower ureteric stones.

OBJECTIVE: To investigate the urodynamic variables of the patients with renal, upper and lower ureteric stones and compare the results according to the location of the stone. PATIENTS AND METHODS: Pre-operatively, 49 patients with kidney, upper and lower ureteric stones were evaluated to determine bladder capacity, compliance and urine volume at first sensation. Patients with urinary tract infection, neurogenic pathology and bladder outlet obstruction were excluded. The patients were divided into two groups; 20 patients with kidney and upper ureteric stones and 29 patients with lower ureteric stones. RESULTS: The mean bladder compliance, bladder capacity and volume at first sensation were all significantly lower in patients with lower ureteric stones (P = 0.026, P = 0.005 and P = 0.042, respectively). These patients also had more prominent irritative symptoms, urgency and frequency. However, the mean values of bladder capacity, compliance and volume at first sensation were within normal limits in both groups. CONCLUSION: Lower ureteric stones cause more irritative bladder symptoms than do renal and upper ureteric stones and lower ureteric stones should be considered as a possible cause of sensory urgency.

Adult↗
PubMed1996

Comparative early results of transurethral electroresection and transurethral electrovaporization in benign prostatic hyperplasia.

OBJECTIVE: To compare the results of conventional transurethral electroresection of the prostate (TURP) and transurethral electrovaporization (TUEP) in patients with symptomatic benign prostatic hyperplasia. PATIENTS AND METHODS: The study comprised 46 patients with moderate or severe symptoms of prostatism and a maximal flow rate of < 15 mL/s. Pre-operatively, all patients underwent a digital rectal examination and the determination of prostatic volume by ultrasonography, and a symptom score, the maximal flow rate, post-void residual urine, routine biochemical variables and serum prostate specific antigen were measured. The haematocrit and blood Na+ levels were also determined pre-operatively and again 24 h after the operation. Patients were divided randomly into two groups: the first underwent a conventional TURP and the second TUEP using 240-300 W of cutting current. Three months after operation, all the variables were remeasured and the values compared with those before treatment and between the groups. RESULTS: The improvements in symptom score, maximum flow rate and residual urine were slightly better after TURP than after TUEP but the differences between treatments were not statistically significantly different. However, TUEP used slightly less irrigant solution, allowed earlier removal of the urethral catheter, required no blood transfusions and was easier to perform. CONCLUSION: Although the improvements in the objective variables 3 months after TUEP were almost the same as after TURP, there were advantages in using less resources: further studies with more patients and a longer follow-up are required to determine the efficacy and safety of this procedure.

Electrocoagulation↗
PubMed1995

Evaluation of impotent men with intracorporeal injection of papaverine and colour Doppler ultrasound.

Fifty impotent patients have been evaluated with intracorporeal injection of papaverine and colour Doppler ultrasound. The papaverine tests were negative in 34 of 50 patients. Nineteen of 34 patients with negative papaverine results showed normal colour Doppler findings. In 14 of 16 patients with positive papaverine results the colour Doppler analysis revealed normal structure and functions. Correlation between intracorporeal papaverine injection and colour Doppler ultrasound results was found in 59% (p < 0.01). We concluded that intracorporeal papaverine injection is an effective, simple diagnostic test for beginning evaluation of impotent men. However, this screening test should be supported by colour Doppler ultrasound.

Adult↗