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M Ihsan Karaman

Publications and source records attributed to M Ihsan Karaman.

14 recordsLinked to original sources
PubMed2006

Human chorionic gonadotropin deteriorates the histology of rat testes.

OBJECTIVES: It is not yet certain whether early hormonal treatment in cryptorchidism is safe for germ cells. We investigated the histologic effects of human chorionic gonadotropin (hCG) therapy on descended testes of rats. DESIGN AND SETTING: Thirty male Wistar albino rats were randomized into two groups. The rats of the hCG group (n=15) were administered 50 IU/kg/day hCG once daily via the subcutaneous route for 15 days. Fifteen rats received subcutaneous isotonic saline and acted as controls. At the first month, testicular tissue was obtained after scarification in both groups. The histological examination was performed to evaluate the seminiferous tubular diameter, germinal membrane thickness, and the percentage of the open seminiferous tubule lumen in each testis to compare the two groups. RESULTS: The percentage of the open seminiferous tubular lumen in testicular tissues of hCG-treated rats was higher than that of controls (p<0.05). The mean germinal membrane thickness in testicular tissues of the hCG group was statistically lower than that of the control group (p<0.05). There was no statistical difference between mean seminiferous tubular diameter in testicular tissues of hCG-treated rats and controls, as expected (p>0.05). Additionally, there were two interesting cases of Sertoli cell only appearance in the hCG group. CONCLUSIONS: We may assume that hCG impairs the seminiferous tubule histology in normal testes of rats. Thus, further experimental studies on dose dependency and the reversibility of these effects are warranted.

Animals↗
PubMed2005

Measurement of pediatric testicular volume with Prader orchidometer: comparison of different hands.

Measurement of testicular volume is a more readily available method of estimating spermatogenesis in adolescence. Traditionally, testicular volumes have been measured with different type of orchidometers or calipers. The most widely used orchidometer is the Prader orchidometer introduced in 1966. This type of orchidometer, a graded series of ellipsoid beads on a string, is used for testicular volume measurement, which is a useful index of puberty in male in order to evaluate male growth and development. Although it is more practical and inexpensive compared with ultrasonography, this instrument has been questioned in regard to its objectiveness in different hands. We designed a prospective clinical study to investigate the correlation between testicular size measurements of three different clinical investigators by using Prader orchidometer. A total of 100 testes in 50 boys with a mean age of 6.4 years (range 1-15 years) who presented to Urology and Pediatrics outpatient clinics of our hospital without urogenital complaints were enrolled to this study. The volumes of each testis were measured independently using Prader orchidometer by three different clinical investigators (A, B and C). Each investigator repeated testicular volume measurements blinded to measurements obtained by others. The measured volumes were recorded separately. Statistical analysis of the results was performed using Pearson's correlation (r) to determine the correlation of orchidometer measurements between the examiners. All statistical analyses and power calculations were performed using computer software. Mean testicular volumes measured by three examiners A, B and C were 4.01+/-3.79 ml (SD) (2-18 ml), 3.66+/-3.46 ml (SD) (1-18 ml) and 3.86+/-3.54 ml (SD) (1-18 ml), respectively. The statistical correlation between the measurements of investigator A and B, A and C, and B and C showed a high correlation {r = 0.954 (P < 0.01), r = 0.964 (P < 0.01), and r = 0.979 (P < 0.01)}, respectively. In the present study, it was shown that testicular size measurement by using Prader orchidometer gives good correlation in different examiners' hands and it is an objective and reliable method in pediatric urological practice.

Adolescent↗
PubMed2005

Case report: a case of bladder dysfunction due to myasthenia gravis.

Detrusor underactivity, due to myasthenia gravis (MG) is extremely rare. Only 4 cases of de novo dysfunction have been reported. We report a case of detrusor underactivity and increased post-void residual urine in a woman with MG. The patient has been managed by clean intermittent catheterization 6 times a day.

Female↗
PubMed2005

A rare case of an adult giant hydroureteronephrosis due to ureterovesical stricture presenting as a palpable abdominal mass.

The giant hydroureteronephrosis is a rare condition. We report a case of a unilateral giant hydroureteronephrosis in an adult patient presenting as palpable abdominal mass secondary to ureterovesical junction (UPJ) stricture. A 51-year-old man presented with a 2-year history of a palpable abdominal mass. Physical examination revealed a grossly distended abdomen that the upper margin of distension was at the level of the epigastrium and the lower one at the suprapubic region. Abdominal ultrasound and computerized tomography demonstrated a very large cystic mass in the right side of retroperitoneum involving all the space from superiorly right sub-diaphragmatic area to the bladder inferiorly. The patient underwent exploration and a right giant hydroureteronephrosis as involving all the retroperitoneal space crossing midline to the left with a liquid content of approximately 7 l caused by stricture at the ureterovesical junction was seen. The hydronephrotic sac was thin and right nephroureterectomy was performed by opening the sac and draining-off the liquid. The literature was reviewed and the management of giant hydronephrosis was discussed.

Constriction, Pathologic↗
PubMed2005

Sparing surgery for an epiderom cyst of the testis: a case report and literature review.

Epidermoid cyst of the testis is relatively rare and accounts for less than 1% of all testicular neoplasms. This condition usually occurs in young men and it is mostly detected by self-examination or routine physical examination. The case of a 27-year-old male with an epidermoid cyst of the testis is discussed. The diagnosis was based on ultrasonography and management was with testicular-sparing surgery. At 2-year follow-up, the patient had had no relapse or metastasis. In epidermoid cysts of the testis, high-frequency ultrasonography is a reliable diagnostic imaging method. Organ-preserving surgery is recommended in the management of these lesions.

Adult↗
PubMed2005

Urodynamic findings in children with cerebral palsy.

AIM: More than one-third of children with cerebral palsy are expected to present with dysfunctional voiding symptoms. The voiding dysfunction symptoms of the cerebral palsy patients in the present study were documented. METHODS: Of the study group, 16 were girls and 20 were boys (mean age: 8.2 years). Children with cerebral palsy were evaluated with urodynamics consisting of flow rate, filling and voiding cystometry, and electromyography findings of the external urethral sphincter to determine lower urinary tract functions. Treatment protocols were based on the urodynamic findings. Anticholinergic agents to reduce uninhibited contractions and to increase bladder capacity were used as a treatment. Clean intermittent catheterization and behavioral modification were used for incomplete emptying. RESULTS: Of the children, 24 (66.6%) were found to have dysfunctional voiding symptoms. Daytime urinary incontinence (47.2%) and difficulty urinating (44.4%) were the most common symptoms. Urodynamic findings showed that neurogenic detrusor overactivity (involuntary contractions during bladder filling) with a low bladder capacity was present in 17 (47.2%) children, whereas detrusor-sphincter dyssynergia was present in four patients (11%). The mean bladder capacity of patients with a neurogenic bladder was 52.2% of the expected capacity. CONCLUSIONS: The present study concluded that voiding dysfunction was seen in more than half of the children with cerebral palsy, which is a similar result to other published studies. We propose that a rational plan of management of these patients depends on the evaluation of the lower urinary tract dysfunction with urodynamic studies. These children benefit from earlier referral for assessment and treatment.

Adolescent↗
PubMed2004

Circumcision in hemophilia: a cost-effective method using a novel device.

BACKGROUND/PURPOSE: The authors conducted a prospective clinical study to see whether the need for and the cost of factor substitution after circumcision can be reduced using a novel device for bloodless circumcision in boys with hemophilia. METHODS: Forty-five boys with hemophilia (age range, 1.5 to 25 years; median age, 11; 40 with hemophilia A, 5 with hemophilia B; weight range, 9 to 75 kg; median weight, 30 kg) were circumcised in our department between 1996 and 2001. Severity of the disease was mild in 9 cases, moderate in 11, and severe in 25. After starting systemic prophylaxis including factor substitution and DDAVP (desmopressin acetate) in reduced doses, all patients underwent circumcision under local anesthesia using a modified straight clamp and a battery-operated diathermic knife specially designed for bloodless circumcision. Duration of factor replacement ranged between 7 and 18 days, and the hospitalization period was 2 to 5 days according to severity of the disease. The last 19 patients were given tranexamic acid orally for 7 days after surgery. RESULTS: Transient minimal bleeding was observed in 5 patients and easily responded to factor administration. Moderate edema and hyperemia along the excision line owing to the diathermic effect of the device lasted for 3 to 4 days. Normal cosmetic appearance was regained within 7 to 21 days. Excellent patient and family satisfaction was reported. The average cost of the operation was calculated as 81 dollars, 144 dollars, and 243 dollars per kilogram in mild, moderate, and severe cases, respectively. CONCLUSIONS: Bloodless circumcision with "diathermic knife" is a practical and reliable alternative for boys with hemophilia. Enhancement of local hemostasis using such an alternative device may reduce the need for factor substitution and, accordingly, the cost of circumcision in hemophiliacs, down to 50%.

Adolescent↗
PubMed2004

Primary retroperitoneal hydatid cyst with unusual clinical manifestation.

Although hydatid disease may affect any organ of the body, there are only a limited number of cases where the primary lesion is in the retroperitoneal region. Since the clinical and laboratory findings are nonspecific, the correct preoperative diagnosis may be difficult. A primary retroperitoneal hydatid cyst that was given a preoperative diagnosis of adrenal mass and treated by adrenalectomy and partial nephrectomy is presented and discussed with the relevant literature.

Echinococcosis↗
PubMed2003

Tunica vaginalis reinforcement flap in reoperative Snodgrass procedure.

Interposing vascularized flaps between urethra and skin sutures is recommended in hypospadias surgery to decrease the rate of urethrocutaneous fistula. For this purpose nine patients with failed results after at least one hypospadias surgery and with insufficient foreskin were included in the study. Tubularized incised plate uretroplasty and tunica vaginalis reinforcement flap were performed to all patients with normal urethral plate. After a mean follow-up of 8.9 months (range 3-20) only one patient had developed a fistula. We believe that tunica vaginalis reinforcement flap decreases fistulas in reoperative hypospadias surgery in patients with insufficient foreskin or with a circumcised penis.

Adolescent↗
PubMed2003

A huge bladder cystine stone.

An unusual cystine stone that occur only in patients, who have cystinuria is presented in 24-year-old man. Radiographs showed a giant bladder stone shadow, 8.0 x 10.0 x 5.0 cm in size. The literature was reviewed to identify the giant stones as well as the huge cystine stone which is exceptional yet as.

Adult↗
PubMed2002

Maternal exposure to diethylene glycol monomethyl ether: a possible role in the etiology of retrocaval ureter.

Retrocaval ureter is a very rare condition. In light of the experimental studies, one of the etiologic factors seems to be maternal contact with diethylene glycol monomethyl ether or ethylene glycol monomethyl ether. A case of cardiovascular, skeletal, and retrocaval ureter anomalies caused by possible maternal contact while pregnant with these materials at her work in a textile factory is presented.

Abnormalities, Multiple↗
PubMedDate not supplied

Comparison of transurethral vaporization using PlasmaKinetic energy and transurethral resection of prostate: 1-year follow-up.

PURPOSE: A prospective study was conducted to evaluate the efficacy and safety of PlasmaKinetic vaporization of prostate (PKVP) relative to standard transurethral resection of prostate (TURP) in the surgical management of benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: Between March of 2001 and February of 2003, 75 patients aged 49 to 80 years (median 66 years) with a complaint of lower urinary-tract symptoms and a mean prostate volume of 50 +/- 6 cc were enrolled in this study. We evaluated the operating time, blood transfusion, postoperative irrigation period, and catheter-removal time. Patients were assessed at baseline and during the follow-up using the International Prostate Symptom Score (IPSS) and maximum urinary flow rate (Q(max)). RESULTS: The mean operation time for PKVP (40.3 +/- 15 minutes) was significantly shorter than that of TURP (55 +/- 11.1 minutes) (P < 0.001). The postoperative irrigation period was significantly shorter in the PKVP group (mean 6 +/- 3 hours) than in the TURP group (mean 20 +/- 8 hours) (P < 0.001). The mean catheter-removal time was significantly later after TURP (68 +/- 21 hours) than after PKVP (35 +/- 9 hours) (P < 0.001). The groups had comparable mean IPSS and Q(max) values at baseline, and both had significant improvement in these parameters after operation. For IPSS, especially at the third month after the operation, PKVP patients showed significantly greater improvement (P < 0.001). There was no difference in Q(max) values between the groups (P > 0.05). Whereas blood transfusion was necessary for two patients in the TURP group, there were no transfusions in the PKVP group. CONCLUSIONS: Because of the short operating time, smaller blood loss, shorter period of irrigation and catheterization, use of isotonic fluid, and absence of electrical current, PKVP is safe and advantageous. Although these early results have shown that this technique may be a good alternative among the minimally invasive methods for the surgical management of BPH, further studies with longer-term results are essential.

Aged↗