Browsing by Author "Erbatu, O"

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    Obstructive Uropathy in Advanced Prostate Cancer
    Erbatu, O; Müezzinoglu, T
    Objective: The incidence of advanced prostate cancer increases in proportion to new treatment options and prolonged life expectancy. Especially in advanced disease, prostate cancer is a progressive disease that can cause obstructive uropathy. This study investigated the relationship between the characteristics of advanced prostate cancer and obstructive uropathy.Materials and Methods: This study retrospectively evaluated the data of prostate adenocarcinoma patients admitted to the Urology Clinic of Manisa Celal Bayar University Hospital between 2017 and 2021. Of them, 48 were advanced prostate cancer patients, and they were all included. All patients in the study received hormonal therapy along with chemotherapy for prostate cancer treatment. The relationship between hydronephrosis and patient age, creatinine and prostate -specific antigen (PSA) values, urinary tract infections, prostate volume, pathological features of cancer, and castration resistance was evaluated.Results: Parameters that we found to be associated with obstructive uropathy (OU) are as follows: high creatinine level at the time of diagnosis of cancer (p<0.001), increase in creatinine at follow-up (p=0.001), urinary infection at the time of diagnosis of cancer (p=0.002) and at follow-up (p=0.003), development of castration resistance during treatment (p=0.038) and high PSA values at the time of diagnosis of prostate cancer (p=0.011).Conclusion: Renal functions should be observed very carefully in advanced prostate cancer patients who develop or are at risk of developing OU. High PSA values and/or castration resistance should be approached carefully in terms of the patients prognosis. It should not be forgotten that their significant relationship with OU has been demonstrated.
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    Comparison stone-free rate and effects on quality of life of percutaneous nephrolithotomy and retrograde intrarenal surgery for treatment of renal pelvis stone (2-4 cm): A prospective controlled study
    Ucer, O; Erbatu, O; Albaz, AC; Temeltas, G; Gumus, B; Muezzinoglu, T
    Objectives: The aim of our study was to compare the effects on quality of life (QoL) and stone-free rate (SFR) of percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS) in patients with renal stones 2-4cm. Materials and methods: A total of 102 patients with renal pelvis stones were enrolled in this prospective controlled study, of which 52 were performed RIRS and 50 with PNL. The QoL was evaluated by using Short From-36 pre- and post-operatively. Also, the surgical data of all patients during and after the operations were compared between the 2 groups. Results: The mean age, body mass index, stone size and density of the patients in the 2 groups were statistically similar (p > 0.05). The SFR of PNL and RIRS were found 94% (47/50) and 73% (38/52), respectively (p < 0.01). There were no statistically differences between operation times, minor complication rates and Short From-36 scores of the 2 groups. Hospitalization times were 1.13 0.34days for RIRS and 2.9 5.7days for PNL (p < 0.05). While the blood transfusion rate of PNL group was 8% (4/50), none patient was made blood transfusion in RIRS. Conclusions: The results of our study show that the blood transfusion rates and hospitalization times of RIRS group are significantly lower than PNL for management of renal pelvis stone 2-4cm. Despite these advantages of RIRS, the SFR is significantly lower than PNL for these stones. The effects on QoL of the both interventions before and after surgery were similar.
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    Evaluating the effect of histopathological parameters of prostate adenocarcinoma on prognosis in radical prostatectomy specimens
    Tercan, E; Erbatu, O; Üçer, O; Metin, S; Nese, N
    BACKGROUND: Over the past decade, significant updates have been made regarding the classification and grading of prostate adenocarcinoma in radical prostatectomy specimens, following decisions reached in international conferences and through impactful publications. These alterations are closely linked to patient prognosis. OBJECTIVES: Observe the incidence of these changes and their impact on patient prognosis. Additionally, investigate the relationship between histopathological and clinical parameters to assist in multidisciplinary treatment planning. DESIGN: Retrospective cohort study SETTING: Tertiary university hospital METHODS: Hematoxylin and eosin, along with immunohistochemistry stained sections, were reevaluated, and clinical information, including patient demographics, preoperative PSA levels, and patient follow-up were collected from patients who underwent radical prostatectomy at our center. SAMPLE SIZE: 182 patients. MAIN OUTCOME MEASURES: Biochemical recurrence. RESULTS: The study highlighted the negative prognostic effects of factors such as Gleason grade group, lymphovascular invasion, intraductal carcinoma, positive surgical margins, extraprostatic extension, pathological T stage, and seminal vesicle invasion. These factors are important determinants of recurrence-free survival in prostate adenocarcinoma patients. CONCLUSION: This study identified comedonecrosis and intraductal carcinoma as independent negative prognostic factors. A 3-mm cutoff for positive surgical margins was supported, while the current cutoff for extraprostatic extension may require reevaluation. The impact of cribriform pattern and ductal carcinoma appears to be influenced by the grade group. No independent relationship was found between the Gleason score/pattern on positive surgical margins or extraprostatic extension and prognosis. Further, large-scale studies with long-term follow-up are needed.
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    Oncocytic Adrenocortical Carcinoma: A Rare Case Report
    Üçer, O; Erbatu, O; Tan, A; Müezzinoglu, T
    Oncocytic neoplasms of the adrenal cortex are uncommon and generally benign and non-functioning. About 20% of adrenocortical oncocytic neoplasms show malignant components. A 39-year-old woman with an adrenocortical oncocytic carcinoma is reported in this article. The patient presented with mild right-sided pain. Computed tomography (CT) showed a 3 cm x 2 cm tumor in the right adrenal gland. The mass was atypical for adrenal adenoma and follow-up was recommended. Follow-up CT after 1 year showed tumor growth (5 cm) and the patient underwent laparoscopic surgery for pathologic verification. She was diagnosed as oncocytic adrenocortical carcinoma based on the pathologic diagnostic criteria. Due to their rarity, especially in cases of malignancy, there are no clear treatment and follow-up protocols. Curative surgical treatment should aim for complete excision of the tumor. As the literature about these tumors develops, more information about the nature of the disease will come to light.
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    A Giant Paratesticular Liposarcoma
    Erbatu, O; Nese, N; Müezzinoglu, T
    Liposarcoma is a tumour originating from the mesoderm, which captures nearly twenty percent of all sarcomas. It first described by Lesauvage in 1845. Seventy percent of cases are extremity and retroperitoneum masses. Paratesticular liposarcoma is a rare entity. For treatment, a tumour-free margin radical orchiectomy with wide local excision and high ligation of the spermatic cord should be performed. If needed radiotherapy should be applied. An eighty-six-year-old male patient with paratesticular liposarcoma is reported in this article.
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    Radical Prostatectomy Outcomes in Patients with Clinical Lymph Node Involvement from The Turkish Urooncology Database
    Tavukçu, HH; Erbatu, O; Akdogan, B; Izol, V; Yücetas, U; Sözen, S; Aslan, G; Sahin, B; Tinay, I; Müezzinoglu, T; Baltaci, S
    Objective: This study aimed to investigate pathological lymph node involvement in selected patients and the relationship of prostate-specific antigen (PSA) progression-free survival rates between patients with and without lymph node involvement on preoperative conventional radiologic imaging. Limited data is available about local treatment outcomes in patients with prostate cancer (PCa) having clinical lymph node involvement. Materials and Methods: Using the national PCa database, patients who underwent radical prostatectomy (RP) and pelvic lymph node dissection between 2001 and 2019, with pathologic lymph node involvement, were included in the study. Patients were divided into two groups as those with and without clinical lymph node involvement by preoperative imaging. Results: A total of 213 patients were included in the final analysis, wherein 164 are with and 49 are without lymph node involvement. After the mean follow-up periods of 33.9 months, a significant difference was not found between the two groups in terms of recurrence, adjuvant treatment necessity, and final status. The multivariate analysis for 5-year PSA recurrence-free survival revealed that surgical margin positivity was the only significant factor (p=0.016, hazard ratio: 2.67, confidence interval: 1.19-5.98). Conclusion: Our results revealed that preoperative clinical lymph node status did not affect the 5-year PSA recurrence-free survival in pathologic lymph node involvement of patients treated with RP and pelvic lymph node dissection. Therefore, RP stands as an effective treatment option in selected patients with PCa having clinical lymph node involvement.
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    Treatment Options in Low-risk Prostate Cancer Patients: A Retrospective Database Report
    Erbatu, O; Müzzinoglu, T; Akdogan, B; Aslan, G; Sözen, S; Baltaci, S; Süer, E; Izol, V; Üçer, O; Ataus, S; Türkeri, L; Tinay, I
    Objective: This report examined the approaches to low-risk patients using the data from the Urologic Cancer Database -Prostate, Urooncology Association.Materials and Methods: In this study, there were 920 patients with low-risk prostate cancer according to the current guidelines of the European Urology Association. Patient data were obtained from the Urological Cancer Database -Prostate, the Turkish Urooncology Association (UroCaD-P) from records of the years 1995-2021. Ethics committee approval was obtained for this study to publish in the form of a database report.Results: Our study was conducted with 920 patients with low-risk prostate cancer. Therefore, at the time of diagnosis, all patients in the study were ISUP 1, had a prostate specific antigen (PSA) level lower than 10 ng/mL, and clinically T1-T2a. Surgical treatment was used in 750 (81.5%) of the patients. At the time patients were retrieved from the database for the study, 140 patients (15.2%) were in the active surveillance (AS) process. Thirty patients (3.2%) in the study received their local treatment as radiotherapy (RT). The mean age value at cancer detection in the study was 61.9. The mean ages of the patients who were under AS and who underwent radical prostatectomy (RP) were 61.3 and 61.7 years, respectively. In the RT group, the mean age was 66.7 years. The mean PSA value of the whole group was 5.81 ng/mL. While it was 5.94 in AS patients, it was calculated as 5.89 in patients who underwent radical surgery. The mean PSA value of the RT group was 5.40. The pathological upgrade was detected in 225 patients (30%) after surgery. Surgical margin positivity was in 160 of the patients (21.3%) who underwent surgery. In addition, 100 patients (13.3%) had extracapsular disease. The seminal vesicle invasion was detected in 25 patients (3.3%) after surgery.Conclusion: We predict that the incidence of low-risk prostate cancer will increase over time due to the aging of the population, the use of PSA, advances in imaging modalities, and increasing biopsy success rates. Therefore, the importance of the existence of multicentric databases containing this patient group is undeniable. More studies are needed with these databases, including both patient demographics and treatment outcomes. Hopefully, this database report will be an important step in this direction.
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    Impact of previous SWL on ureterorenoscopy outcomes and optimal timing for ureterorenoscopy after SWL failure in proximal ureteral stones
    Irer, B; Sahin, MO; Erbatu, O; Yildiz, A; Ongun, S; Cinar, O; Cihan, A; Sahin, M; Sen, V; Ucer, O; Kizilay, F; Bozkurt, O
    Purpose We aimed to evaluate the impact of previous unsuccessful shock wave lithotripsy (SWL) therapy on ureterorenoscopy (URS) outcomes in proximal ureteral stones and to define whether there is any optimal timing for safe URS after SWL. Methods The patients who underwent URS for proximal ureteral stones between the years 2015 and 2018 in eight centers were included. Patients were divided into two groups according to previous SWL history; group 1 consisted of patients without SWL before URS for the stone [SWL (-)] and group 2 consisted of patients with a previous SWL for the stone [SWL (+)]. Demographics, operation outcomes and stone characteristics were compared between these two groups. Regarding the complication and success rates, optimal timing for URS after SWL for the stone was calculated with receiver operator characteristics curve analysis. Results Totally 638 patients were included (group 1: 466 patients and group 2: 172 patients). The operation and hospitalization times, rate of ureteral stenting and complications were significantly higher in group 2. Stone free status was similar between the groups. Optimal timing for URS after SWL was calculated as 16.5 days (AUC = 0.657, p = 0.012) with a sensitivity of 68% and specificity of 72%, regarding the complication rates. Complication rates were significantly higher in patients who were operated before 16.5 days (27.7% vs 6.5%, p < 0.001). Conclusions The optimal timing; 2-3 weeks delay of the URS procedure after unsuccessful SWL may decrease complication rates according to our results.
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    Predictive Factors of Ureterorenoscopy Outcomes in Proximal Ureteral Stones: A Multicenter Study of Aegean Study Group of the Society of Urological Surgery
    Sen, V; Irer, B; Erbatu, O; Yildiz, A; Ongun, S; Cinar, O; Cihan, A; Sahin, M; Sahin, MO; Ucer, O; Kizilay, F; Bozkurt, O
    Introduction: We aimed to evaluate the predictive factors in a holistic manner for ureterorenoscopy (URS) outcomes in proximal ureteral stones by a multicenter study. Materials and Methods: The data of patients who underwent URS for proximal ureteral stones between the years 2015 and 2018 in eight centers were recorded retrospectively. Patients were divided into two groups according to URS success: Group 1 consisted of patients with successful URS, and Group 2 consisted of patients with unsuccessful URS. The two groups were compared in terms of risk factors, stone, and clinical characteristics of patients. Results: A total of 638 patients were included in the study. Group 1 consisted of 527 (82.6%) patients, and Group 2 consisted of 111 (17.4%) patients. In multivariate logistic analysis, the key risk factors for URS success was found to be age (OR = 0.980, 95% [CI] = 0.963-0.996, p = 0.018), stone area (OR = 0.993, 95% [CI] = 0.989-0.997, p = 0.002), and operation time (OR = 0.981, 95% [CI] = 0.968-0.994, p = 0.005). Conclusions: To make the treatment decision of proximal ureteral stones, it is necessary to examine several parameters including available equipment, stone, and patient characteristics. Physicians should keep these risk factors in mind in the decision of treatment options.
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    Mechanisms and grading of nocturia: Results from a multicentre prospective study
    Bozkurt, O; Irer, B; Kizilay, F; Erbatu, O; Sen, V; Cinar, O; Ongun, S; Cihan, A; Ozdemir, T; Tasdemir, D; Ucer, O
    Objective To identify the pathophysiological mechanisms of nocturia and the correlation of these mechanisms with nocturia severity. Methodology After approval by the local ethics committee, all patients with nocturia (>= 1 nocturnal void/night) were included and filled the Overactive Bladder questionnaire, Nocturia Quality of Life, Incontinence Questionnaire - Male Lower Urinary Tract Symptoms (male), International Consultation on Incontinence Questionnaire - Female Lower Urinary Tract Symptoms (female) and 3-day frequency-volume chart. Patients were divided into three groups according to the severity of nocturia: group 1 consisted of patients with mild (1-2 voids/night), group 2 with moderate (3-4 voids/night) and group 3 with severe nocturia (>4 voids/night). Comparative analysis was performed between groups, andP About 68.1%, 64.1% and 8.7% of the patients had nocturnal polyuria (NP), reduced bladder capacity and global polyuria, respectively. 42.7% of the patients had mixed nocturia. 6.1% of the patients did not comply with the aforementioned subtypes and defined as isolated nocturia. Regarding the severity of nocturia, 155 (41%) patients had mild, 167 (45%) patients had moderate and 57 (15%) patients had severe nocturia. Increased nocturia severity was related with decreased quality of life; higher age, urinary tract symptom scores, nocturnal urine volume, evening fluid consumption and beta-blocker medication rates. Increased nocturia severity was also associated with higher NP, global polyuria and reduced bladder capacity rates. Conclusions Nocturia mechanisms may vary between mild and moderate to severe nocturia groups according to the present study. Nocturia grading with identification of subtypes may help for better standardisation of the diagnostic and treatment approaches as well as for the design of future clinical trials.
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    Comparison of Efficacy and Complications of Holmium Laser and Pneumatic Lithotripters Used in the Ureterorenoscopic Treatment of Proximal Ureter Stones, a Multi-Center Study of Society of Urological Surgery Aegean Study Group
    Irer, B; Sen, V; Erbatu, O; Yildiz, A; Ongün, S; Çinar, Ö; Cihan, A; Sahin, M; Sahin, MO; Üçer, O; Kizilay, F; Bozkurt, O
    Objective:The aim of this study is to compare the efficacy and complications of holmium laser and pneumatic lithotripsy used in the ureterorenoscopic treatment of proximal ureteral stones. Materials and Methods: Data of 638 patients, who underwent ureterorenoscopy (URS) due to proximal ureteral stones in different centers, were obtained from patient files. The patients were divided into two groups according to the type of lithotripter used: group 1; laser lithotripter (n=324; 50.8%) and group 2; pneumatic lithotripter (n=314; 49.2%). URS was considered successful upon determination stone-free status with the imaging methods after treatment. The effectiveness and the complications of holmium:yttrium-aluminum-garnet laser and pneumatic lithotripsy were compared. Results: The total success rate of URS was 82.6% and the complication rate was 8.1%. The mean age of patients was similar between the groups; however, the body mass index values, stone surface area and stone Hounsfield unit were significantly higher in group 1. Although the mean operative time, complication rate and the mean length of hospital stay were similar between the groups; the URS success and postoperative ureteral J stent use rates were significantly higher in group 1 and the push-back rate was significantly higher in group 2. Conclusion: If laser lithotripsy is available in a clinic, we believe that it is better to use it as the first option in the treatment of proximal ureter stones. However, considering that it is not easy to access laser lithotripters due to their high cost in Turkey, pneumatic lithotripters may be an effective and inexpensive alternative that can also be safely used in these cases.
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    Effects of mirabegron on JJ stent-related symptoms: A multicentric study
    Cinar, O; Tanidir, Y; Ozer, S; Cizmeci, S; Erbatu, O; Ozdemir, T; Girgin, R; Ongun, S; Ucer, O; Kizilay, F; Sen, V; Irer, B; Bozkurt, O
    Aims of the study To investigate the effect of mirabegron 50 mg/daily for JJ stent-related symptoms after ureteroscopic stone surgery. Methods Medical records of 145 patients who were given a single daily oral dose of 50 mg of mirabegron for relieving stent-related symptoms were retrospectively analysed. Demographic and clinical data and stone parameters were recorded. All participants completed the Turkish version of the Ureter Symptom Score Questionnaire (USSQ-T) on the postoperative 7th day, and again after at least 3 weeks, before JJ stent removal. The severity of stent-related symptoms was statistically compared before and after the mirabegron treatment. Results The mean urinary symptoms score decreased significantly from 30.87 +/- 9.43 to 22.61 +/- 6.78 (P < .0001), mean body pain score decreased significantly from 21.82 +/- 11.22 to 14.03 +/- 7.52 (P < .0001), mean work performance score decreased from 10.50 +/- 8.61 to 7.02 +/- 6.51 (P < .0001) and mean general health score decreased significantly from 15.43 +/- 6.50 to 11.12 +/- 3.70 (P < .0001). The mean sexual matters score significantly decreased from 3.88 +/- 3.40 to 2.48 +/- 2.03 (P < .0001), the additional problem score decreased from 9.31 +/- 4.61 to 6.51 +/- 2.83 (P < .0001) and the overall quality of life (QoL) score decreased from 5.18 +/- 1.94 to 4.23 +/- 1.71 after mirabegron use (P < .0001). Conclusion Daily use of 50 g of mirabegron significantly improved stent-related symptoms, sexual matters and quality of life.