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Mesut Gürdal

Publications and source records attributed to Mesut Gürdal.

14 recordsLinked to original sources
PubMed2006

Surgical treatment options in proximal hypospadias: retrospective analysis of 171 cases at a single institution.

AIM: So far, various techniques have been used in the surgical treatment of proximal hypospadias. The aim of all techniques is to form a near to normal penis functionally and cosmetically. In the present study, proximal hypospadias cases operated in our clinic were evaluated. MATERIAL METHOD: Overall 171 cases with proximal penile, penoscrotal and scrotal meatus, aged between 3 and 28 were included in the study. Early and late postoperative complication rates and factors affecting success were investigated retrospectively. RESULTS: Sixteen cases underwent Duckett, 20 Onlay, 28 free tube, 56 Belt-Fuqua and 51 Thiersch operations. Success rate at early postoperative period was 60.8%, while it became 81.2% following secondary interventions. CONCLUSION: No effect of operation technique and meatus levels were observed on complication rates whilst previous operation increased complication rates significantly.

Adolescent↗
PubMed2004

Intermediate-term functional and cosmetic results of the Snodgrass procedure in distal and midpenile hypospadias.

We have evaluated the long-term functional and cosmetic results of the Snodgrass technique in the treatment of anterior and midpenile hypospadias. A total of 70 patients who presented in the period between 1997 and 2002 underwent the Snodgrass procedure for the treatment of hypospadias. Patients who had been operated on 2 or more years previously were recalled for evaluation. Of the 31 cases identified, 19 (61%) were contacted and came for reevaluation. Genital examination and urinary flow measurements were made. Maximum urinary flow rates and voided urine volumes were assessed using the nomograms described by Toguri et al. The mean age of the patients was 6 years (range 2-12) at the time of surgery and 8 years (range 4-17) at the time of evaluation, and the mean follow-up period was 3.1 years (range 2-5). Two patients had had at least one previous surgery, and 17 were primary patients. The hypospadiac meatus was anterior in 16 patients and midpenile in three. Although some patients had urinary spraying due to skin irregularity in the meatus during voiding, 18 patients had normal peak urinary flow rate (Qmax) corresponding to their age group. Only one patient in the equivocally obstructed group had meatal stenosis, which was corrected with meatotomy. All patients had a cosmetic view of a vertical slit tip of the glans. Tubularized incised plate urethroplasty (TIPU) is a successful technique with good functional and cosmetic long-term results in distal hypospadias.

Child↗
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

Nd:YAG laser ablation plus transurethral resection for large prostates in high-risk patients.

OBJECTIVES: To evaluate the outcome and morbidity rate of combined visual laser ablation of the prostate and transurethral resection of the prostate (TURP) in high-risk symptomatic patients with large prostates. METHODS: A total of 28 patients evaluated according to the American Society of Anesthesiologists (ASA) classification to have ASA grade 3 or greater and who had a prostate volume of 50 cm3 or greater, and peak urinary flow rate of less than 15 mL/s underwent visual laser ablation of the prostate plus TURP for severe lower urinary tract symptoms due to benign prostatic hyperplasia. The postoperative evaluation included the American Urological Association symptom score index, maximal urinary flow rate measurement, postvoid residual urine volume, and morbidity. RESULTS: The mean baseline prostate volume and duration of surgery was 85 cm3 (range 50 to 120) and 70 minutes (range 55 to 105), respectively. Surgery was performed under local and spinal anesthesia in 18 and 10 patients, respectively. No perioperative bleeding requiring transfusion or TURP syndrome developed. Urethral catheter drainage was continued for an average of 1.7 days. Only 1 patient developed irritative voiding symptoms. The postoperative follow-up period ranged from 6 to 21 months (median 11). Improvement in the evaluation parameters was noted in all cases. CONCLUSIONS: The results of our study show that visual laser ablation of the prostate plus TURP has the advantage of excellent homeostasis and lower morbidity in men with large prostates. When the patient's medical condition precludes TURP, this combination of techniques may be considered an option in such cases for symptomatic relief of obstructive urinary symptoms due to benign prostatic hyperplasia.

Adenoma↗
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↗
PubMed2003

Contact neodymium: YAG laser ablation of recurrent urethral strictures using a side-firing fiber.

PURPOSE: We evaluated the 2-year follow-up results of contact vaporization of recurrent urethral strictures using a side-firing Nd:YAG laser fiber. PATIENTS AND METHODS: A total of 21 male patients with recurrent benign urethral strictures 5 to 20 mm in length were treated with Nd:YAG laser in the contact mode using a side-firing probe. An initial urethrotomy was made at the 12 o'clock position by retrograde vaporization of the scarred tissue through the total length of the stricture with the aid of a metal guidewire. Then all the scarred tissue was gradually vaporized circumferentially until an adequate channel had been created and healthy normal tissue was visible. RESULTS: The mean operation time was 35 minutes (range 20-55 minutes). No significant bleeding or serious complication was seen in the perioperative or postoperative period. Hospital stay and catheterization time were 48 hours or less in all cases. The success rates at 6, 12, and 24 months were 76%, 67%, and 52%, respectively. The morbidity of the laser treatment was minimal. CONCLUSIONS: The contact Nd:YAG laser is a safe treatment modality for recurrent urethral strictures. In view of the moderately durable successful results, it may be considered a last attempt at a minimally invasive treatment before making the decision for open urethroplasty.

Adult↗
PubMed2003

Predisposing factors and treatment outcome in Fournier's gangrene. Analysis of 28 cases.

OBJECTIVES: To evaluate the etiologic factors and the effects of surgical debridement and adjunctive therapies on morbidity and mortality of Fournier's gangrene. METHODS: 27 males, 1 female, a total of 28 patients with a mean age of 58 years treated for Fournier's gangrene were evaluated retrospectively. RESULTS: Predisposing factors including diabetes, alcohol abuse, paraplegia and renal insufficiency were identifiable in 54% of the patients. Etiologic origin of the gangrene was urogenital, cutaneous and anorectal in 43, 25 and 11% of the patients, respectively. The pathology was limited to genitalia in 10, extending to perineum in 8, the umbilicus in 7 and even up to the axilla in 3 patients. Suprapubic cystostomy and colostomy were necessary in 18 and 2 cases, respectively. We used hyperbaric oxygen therapy in 2 and honey in 6 patients to accelerate wound healing. A repeat debridement was necessary in 39% of the cases. Plastic surgery and grafting were done in 14 patients. Our mortality rate was 7%. CONCLUSION: Early recognition of the pathology and aggressive surgical debridement are the mainstay of the management of Fournier's gangrene. Additional strategies to improve wound healing and increase patient survival are also needed.

Adolescent↗
PubMed2002

Neodymium:YAG visual laser ablation of the prostate: 7 years of experience with 230 patients.

PURPOSE: We evaluated the short and long-term outcome of neodymium:YAG visual laser ablation prostatectomy for treatment of benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: A total of 230 patients with symptomatic BPH underwent visual laser ablation prostatectomy. Evaluation measures included the American Urological Association symptom score, maximum urinary flow rate, post-void residual urine volume and morbidity. RESULTS: Median followup was 36 months (range 6 to 79). Of the patients 220, 196, 180, and 167 were available at 6 months, 1, 2 and 3 years, respectively. Moreover, 98 patients were followed for a minimum 5 years. At 6 months maximum urinary flow rate increased from 6.7 to 17.9 ml. per second, post-void residual urine volume decreased from 159 to 52 ml. and the American Urological Association symptom score was reduced from 22 to 7.2. Improvement in the evaluation parameters also continued at 5 years. Early complications consisted of prostatitis, urinary retention, and bleeding in 6 (2.6%), 3 (1.4%) and 1 (0.4%) patient, respectively. Irritative symptoms persisting greater than 4 weeks were seen in 28 (12.2%) patients. Late complications were bladder neck contracture, urethral stricture, and urinary retention in 3 (1.4%), 2 (0.9%) and 2 (0.9%) patients, respectively. Of the 153 sexually active men 5 noticed erectile impotence at 6 months. There were 20 (12.0%) patients who reported retrograde ejaculation. The reoperation rate was 5.5%. CONCLUSIONS: Our results further confirmed that visual laser ablation prostatectomy is a safe and effective treatment for BPH. It has minimal morbidity and durable therapeutic effects. However, the major disadvantage is postoperative irritative voiding symptoms.

Erectile Dysfunction↗
PubMed2002

Evaluation and treatment of penile fractures: accuracy of clinical diagnosis and the value of corpus cavernosography.

OBJECTIVES: To assess the accuracy of clinical diagnosis and feasibility of treatment on the basis of cavernosographic findings in men with clinical features consistent with penile fracture. METHODS: Forty consecutive patients (mean age 32 years, range 18 to 65) who presented with a history of blunt penile trauma and clinical signs and symptoms indicating penile fracture during the past 11 years were included. The charts of the first 13 patients, who were seen between 1990 and 1994 and were treated surgically on the basis of the clinical findings, were reviewed retrospectively. In the next 27 patients, a prospective study was designed and treatment was determined according to their cavernosogram findings: 21 with evidence of corporal injury treated surgically and 6 with normal imaging treated conservatively. The follow-up ranged from 3 to 32 months (mean 14). RESULTS: The clinical diagnosis of penile fracture was accurate in 11 of 13 patients and was false in 2 (15%). In the prospective study, corporal injury as determined by cavernosography was confirmed surgically in all cases. The cosmetic and functional results were satisfactory in all, including the patients treated conservatively. No serious complication was reported. CONCLUSIONS: In men with blunt penile trauma, the clinical presentation can be misleading and may result in unnecessary surgery. The results also demonstrated that cavernosography is a useful investigation method and may be helpful in selecting the treatment approach in these cases.

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↗