Browsing by Author "Akdeniz, CB"

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    Treatment of giant prostatic urethral stone with prostatolithotomy case report
    Bozkurt, YE; Akdeniz, CB; Gümüs, BH
    Introduction: The patient with prostatic urethral stones of the size mentioned in the case report is very rare, and there is no standard surgical procedure for patients with giant stones in the prostatic urethra.Presentation of case: A 62-year-old male patient presented to the emergency department with complaints of dysuria and hematuria. Computed tomography showed a prostatic urethral stone measuring 78x48x56 mm. Open prostatolithotomy was performed by extending the bladder incision towards the prostate capsule and the stone was removed.Discussion: Prostate stones can be classified into two types: true prostate stones, which form within the prostate's tissues, and urethral stones, which develop in the prostatic urethra. Urethral stones can be primary (forming in the urethra) or secondary (migrating from the upper urinary tract).Conclusion: Treatment options vary based on stone size and patient history, with endoscopy recommended as the primary approach. However, in cases with large stone burdens, open surgical methods may be preferred.
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    Long-term results of three-part penile prosthesis implantation with Ectopic reservoir placement in the treatment of erectile dysfunction: is supramuscular tubulation a reliable method?
    Bozkurt, YE; Akdeniz, CB; Gümüs, BH
    Background Penile prosthesis implantation is the last resort for refractory erectile dysfunction. Reservoir placement is one of the biggest challenges in inflatable penile prosthesis implant surgery in several cases, especially in patients with abnormal pelvic anatomy. Ectopic reservoir placement with supramuscular approach has many advantages in these cases. Results No complications were encountered except wound site infection in 2 patients which could be controlled with antibiotic treatment. EDITS scores were not statistically different between patients divided into 2-year groups according to follow-up time. Median values of EDITS scores were high in all groups, suggesting that couples had high sexual satisfaction both in the long term and in the short term. Conclusions We recommend placement of the supramuscular tube and reservoir through the incision described, especially in patients whose pelvic anatomy has been modified by lower abdominal surgery.
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    Comparison of Standard Open Wound Care and Vacuum-assisted Closure Therapy in Fournier's Gangrene
    Bali, ZU; Akdeniz, CB; Muezzinoglu, T; Üçer, O; Kara, E
    Objective: Management of Fournier's gangrene (FG) includes large wound debridement, broad-spectrum antibiotic, wound care and re-debridement if necessary. The aim of our study was to compare standard open wound care and vacuum-assisted closure (VAC) therapy in patients with FG. Materials and Methods: Thirty-three patients (29 males and 4 females) who underwent surgery for FG were enrolled in the present study. The data was evaluated retrospectively. The patients were divided into two groups according to wound care after large wound debridement. Standard open wound care with antibiotic pomade was performed twice a day in 14 patients arid VAC therapy was performed every 48-72 hours in 17 patients. The data of the two groups were compared. Results: Twenty-three (69.7%) patients had Diabetes Mellitus and 20 patients (60%) had poor hygiene. The re-debridement rate in patients who received standard open wound care was statistically higher than in those who underwent VAC therapy (p=0.016). There were no statistically significant differences in mortality rate, length of hospital stay and need for reconstruction between the groups. When the data were analyzed, no statistically significant difference was found in FG Severity index score, length of hospital stay and mortality rate. However, the relationship between mortality rate and location of lesion was statistically significant (p=0.03). Four patients died, 3 (75%) due to wide necrotizing fasciitis extending to the abdominal wall. Conclusion: The present study showed that the technique used for wound care did not influence mortality, need for reconstruction and length of hospital stay. The only advantage of VAC therapy was decreased re-debridement rate in patients with FG.
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    Partial Urethrectomy for Female Urethral Transitional Epithelial Cell Carcinoma
    Üçer, O; Akdeniz, CB; Yüksel, MB; Temeltas, G; Müezzinoglu, T
    To present a female case of partial urethrectomy and the following adjuvant chemo-radio-therapy for urethral transitional epithelial cell carcinoma originating from distal urethra in the light of literature. The patient was a 64-year-old female presented with dysuria, intermittent hematuria and a palpable urethral mass that she first experienced a few months ago. On physical examination of the vagina, papillary tumor was observed at the urethral meatus. During cystoscopy procedure, punch biopsy was performed from the tumoral lesion which lines from the middle urethra to distal. After the pathologic examination result of transitional epithelial cell carcinoma of urethra partial urethrectomy with urethroplasty was performed. On pathologic examination, high grade transitional epithelial cell carcinoma of urethra with squamous differentiation was detected. Three cures of gemcitabine and cisplatin were adminisered. After detecting a local recurrent mass four months after the surgery we planed radiotherapy and then surgical resection of the mass if needed. In women with distal urethral tumors, urethra-sparing surgery is alternative to primary urethrectomy if negative surgical margins can be achieved intra-operatively. Patients with tumor progression usually need to receive chemo-radio-therapy after the surgery.