Browsing by Author "Gümüs, BH"

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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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    Comparison of preoperative penile elastographic ultrasound findings and pathological tissue results of patients implemented with penile prosthesis
    Bozkurt, YE; Gümüs, BH; Düzgün, F; Nese, N
    Objective Histopathological analysis of the relationship between penile elastography and erectile dysfunction. Material and method 12 patients who applied to our clinic for erectile dysfunction in the last 1 year and accepted this study were included. Preoperative two-dimensional shear wave elastography imaging was performed in 12 patients and recorded in the Pascal (kPa) unit. Approximately 0.5 x 0.5 x 0.5 cm tissue samples were taken from the right and left cavernous tissue during penile prosthesis implantation operation. Tissue samples were sent to the pathology department. The percentage of the area covered by muscle fibers and elastic fibers in the corpus cavernosum was noted semi-quantitatively (ratio of muscle fibers and cavernous body elastic fiber score). All data obtained were compared with each other. Results Cavernous body elastic fiber score data(Grouped Score 1, 2 and 3) and percentage of cavernous body muscle fibers data (Grouped %10, %20, %30 horizontal ellipsis %100) were compared with Shear wave elastography data (kPa). The results were not statistically significant according to the Kruskal Wallis Test. Cavernous body elastic fiber score and the percentage of cavernous body muscle fibers were also compared, it was not statistically significant according to the Kruskal Wallis test and Spearman's correlation test. Conclusions Penile shear wave elastography can be used clinically to quantitatively assess the amount of smooth muscle cells and elastic fibers in the penis, but it deserves to be studied with a larger number of patients and a more specific interpretation of the pathology preparation.
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    The Relationship of Testicular Sonoelastography with Gonadotropin Hormone Levels and Sperm Parameters
    Bozkurt, YE; Gümüs, BH; Özbay, M; Düzgün, F; Taneli, F; Kurutep, S
    Background: Elastography is a non-invasive medical imaging technique that helps determine the stiffness of organs and other structures in our body. In this study, we investigated the effectiveness of elastography in the diagnosis of infertility. Aim: In this study, we aimed to examine the relationship between testicular elastography and hormonal parameters and sperm parameters. Patients and Methods: The study included 136 patients, 272 testicles were examined, and the mean age of the study participants was 30.1 years. Testicular tissue stiffness was measured by scrotal ultrasonographic shear wave elastography. Gonadotropin and testosterone hormones were measured from blood samples. Spermiogram parameters were studied manually. Results: The control group included 66 patients, and the varicocele group consisted of 70 patients. Testicular stiffness degrees of the control group were measured as 4.29 kPa for the right testis and 4.23 kPa for the left testis. The varicocele group was divided into grades 1, 2, and 3 according to physical examination. In group 1 (grade 1), the right testis was 4.07 +/- 1.24 kPa and the left testis was 3.77 +/- 0.98 kPa. In group 2 (grade 2), the right testis was 4.31 +/- 1.40 kPa and the left testis was 3.98 +/- 0.93 kPa. In group 3 (grade 3), the right testis was 4.73 +/- 1.50 kPa and the left testis was 3.99 +/- 1.68 kPa. Hormone and sperm parameters were not statistically significant when comparing the control and varicocele groups. There was no statistical significance between the testicular tissue stiffness degrees of the control and varicocele groups. Hormone and spermiogram findings were also similar in groups. Conclusion: It is known that varicocele leads to histological tissue changes in the testes. These changes result in tissue softness and loss while affecting sperm parameters and testosterone levels in a negative way. Before varicocele surgery, there is a need for new imaging methods with more sensitivity that can detect tissue changes in the testes.
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    Ultrastructural effect of sildenafil citrate on corpus cavernosum and other genital organs in female rats
    Kilinç, K; Gündüz, MI; Gümüs, BH; Vatansever, S; Kaymaz, F
    Aim: To determine the ultrastructural effects of sildenafil on the female genital organs. Methods: Twenty female cycling Wistar albino rats weighing 250 +/- 20 g were randomly divided into two groups of 10 each. Rats of one group were gavaged with 0.5 mg.kg(-1).d(-1) of sildenafil 3 days in a week for 4 weeks and the other served as the controls. After cessation of treatment animals were sacrificed by cervical dislocation under methoxyflurane anaesthesia. The clitoris, vagina, uterus and bartholin glands were taken at the estrous and were fixed with 10 % formalin solution for light microscopy and 2.5 % glutaraldehyde and osmic acid for electron microscopy. Results: Under the light microscope, the fibrocollageous tissue was found increased, the capillaries enlarged and the connecting tissue elements increased in the corpus cavernosum in the treated group. On electron microscopy, increased connective tissue, fibroblasts with notched nucleus, shorten immature collagen fibers without striation were seen. Abundant foldings and penetration with collagen bundles were observed in the basal membrane. Large connection complexes, especially gap junctions among the wide capillary endothelial cells were observed. Conclusion: There are evident histological changes due to sildenafil citrate in female rat corpus cavernosum. The clitoris and bartholin glands were the most effected organs. While the histopathological changes of clitoral tissue could be expected, an increase in the mass of bartholin gland was surprised.
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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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    Is it necessary to use Sexual Health Inventory for Men (SHIM) routinely?
    Temeltas, G; Gündüz, MI; Ceylan, Y; Gümüs, BH; Büyüksu, C
    This study was conducted to evaluate the prevalence of erectile dysfunction (ED) according to the Sexual Health Inventory for Men (SHIM) and its relationship with age and education. Six hundred and thirty-nine male patients aged >= 20 years attending a urology clinic were studied. After a detailed history and physical examination, all Patients were evaluated with SHIM. Scores were categorized into 5 groups: severe (1-7), moderate (8-11), mild-moderate (12-16), mild (17-21) and normal (22-25). The patients were classified into three groups according to their application to the urology clinic: A - patients attending specifically for ED; B - patients not ED based on SHIM and attending not for ED; C - patients ED based on SHIM, but attending not for ED. In addition, patients were partitioned into 3 age groups according to their age: 20-35, 35-55 and >55 years. Educational levels were of 2 groups: lower education and higher education. Erectile dysfunction was determined in 3.7% in the 20-35 years group, 55% in 3555 years and 41% in >55 years (P < 0.01). In men having ED through SHIM and attending not for ED, the ratio of ED was higher in the lower education than in the higher education groups (P = 0.01). SHIM is a diagnostic tool used for ED, and routine application of SHIM for patients attending the urology clinic is advisable.
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    Long term follow-up results of ablation treatment for patients with small renal mass
    Gümüs, BH; Albaz, AC; Düzgün, F; Üçer, O; Temeltas, G; Müezzinoglu, T; Tarhan, S
    Objective The aim of this study is to evaluate the outcome of ablation therapy in our clinic for the treatment of patients with a small renal mass Materials and Methods: We retrospectively evaluated the technic and follow-up data of 30 patients with 36 tumours who underwent Radiofrequency Ablation (RFA) and Microwave Ablation (MWA) in our clinic. Demographic data, ablation type, tumour characteristics, peroperative and postoperative complications and treatment success of the patients were evaluated. Results A total of 36 tumours who underwent ablation treatments, 23 were treated with RFA, 13 with MWA. The mean tumour size was 28.9 +/- 6.92 mm in RFA and 29.3 +/- 7.70 mm in MWA. The mean follow-up period was 49.6 +/- 24.7 months in patients with RFA and mean follow-up was 16 +/- 8.05 months in MWA treatments. The overall success in MWA administration was calculated as 76.9%, while the overall success in RFA was 80%. Conclusion Long-term oncologic efficacy of RFA appears to be successful in the treatment of T1a renal carcinomas. Further studies can be conducted to elucidate the influence of MWA on long-term oncological outcomes.
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    Relationship between metabolic syndrome and erectile dysfunction
    Gündüz, MI; Gümüs, BH; Sekuri, C
    To determine the relationship between metabolic syndrome (MS) and erectile dysfunction (ED) and to see which risk factors correlated the best with ED. Methods: Seventy-nine cardiology clinic outpatients with coronary artery disease (CAD) and lipid metabolism disorder were recruited. They were categorized as having MS, hypertension (blood pressure greater than 130/85 mmHg) and dyslipidemia. ED was classified based on International Index of Erectile Function scores. Patients were grouped into quartiles based on body mass index (BMI). Chi-square, Pearson's correlation and regression tests were used for statistical analysis. Results: The mean age of the patients was 56.6 years. ED was diagnosed in 59 (74.7 %) of the 79 patients. In the 38 patients with MS, all had ED. ED was not significantly correlated with cholesterol levels (P > 0.05), but was found often in patients who had both hypercholesterolemia and HT (P < 0.01). Nineteen(76 %) of the 25 patients who had dyslipidemia had ED. However, ED was not significantly correlated with dyslipidemia (P > 0.05). Tweenty-two of the 23 patients who had BMI greater than 30 had ED, which was significantly more prevalent than that in those who had normal BMI (P < 0.01). ED was seen in 38 of 53 smoker patients. Although ED was more prevalent in cigarette smokers, it was not significantly different from non-smokers (P > 0.5). Conclusion: ED is present in a high percentage of patients with MS. Among multiple risk factors for ED, MS correlates the most highly. The next most important risk group is the patients with hypertension +hypercholestrolemia and obesity (BMI > 30).
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    Testicular sperm retrieval method
    Gümüs, BH; Atesci, YZ; Ucer, O; Karatas, TC; Buyuksu, C; Nese, N; Kandiloglu, AR
    This research was conducted to evaluate the effects of a transverse vs. longitudinal incision for testicular sperm retrieval. Rats were divided into 4 groups: I: control, II: sham operation, III: longitudinal incision TSRM, IV: transverse incision TSRM. Group II (sham operation) had a dissection of left testis/spermatic cord, then closure of wound. Group III underwent dissection of left testis, then a longitudinal incision (15 mm long) of testis, which was fully opened then closed again and sutured with 5-0 Vicryl (R) sutures. Group IV underwent dissection of the left testis, opening of the testis with a transverse incision, then closure with 5-0 Vicryl (R). The seminiferous tubule diameter was 0.118-0.224 mm in all groups. inflammation and abscess formation occurred in one testis each in the sham and longitudinal incision groups, and in two testes in the transverse incision group. There were no differences in histopathology or scoring between the longitudinal and the transverse incision.
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    Prevalence of metabolic syndrome and its association with erectile dysfunction among urologic patients
    Bal, K; Öder, M; Sahim, AS; Karatas, CT; Demir, Ö; Can, E; Gümüs, BH; Özer, K; Sahin, O; Esen, AA
    OBJECTIVES To identify the prevalence of metabolic syndrome (MS) and its association with erectile dysfunction (ED) among urologic patients. METHODS The study population consisted of 393 male patients aged 40 to 70 years, who were admitted to the urology clinics of four different institutions from February to March 2005. The waist circumference (WC) and triglyceride (TG) and high-density lipoprotein (HDL) cholesterol levels were measured. Patients were divided into two groups: group I consisted of patients with a WC greater than 102 cm, and group 2 consisted of patients with a WC of less than 102 cm. The erectile status of the two groups was compared. RESULTS Of the 393 patients, 157 (39.9%) had MS. Of the 393 patients, 124 with MS (79%) and 146 without MS (61.9%) had ED. The presence of MS was significantly associated with ED (P < 0.001). In the presence of an increased WC with normal serum HDL and TO levels, the relative risk of ED was 1.94. If the patient with an increased WC had a pathologic level of HDL or TG, the relative risk of ED increased up to 2.97-fold. The relative risk of ED in the presence of an increased WC, together with pathologic levels of HDI, and TO, was 3.38. CONCLUSIONS In our study, MS was strongly associated with ED. Fasting blood glucose levels, hypertension, and WC are the most significant risk factors predicting the risk of ED. A more pronounced increase in ED risk in the presence of abdominal obesity, together with altered TG and HDL cholesterol levels, may indicate a special metabolic background of ED regarding tipid metabolism.
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    Erectile function and late-onset hypogonadism symptoms related to lower urinary tract symptom severity in elderly men
    Bozkurt, O; Bolat, D; Demir, O; Ucer, O; Sahin, A; Ozcift, B; Pektas, A; Turan, T; Gümüs, BH; Can, E; Bolukbasi, A; Erol, H; Esen, A
    The aim of this study was to evaluate the relationship between lower urinary tract symptoms (LUTSs), erectile dysfunction (ED) and symptomatic late-onset hypogonadism (SLOH) in ageing men in the Aegean region of Turkey. Five hundred consecutive patients >40 years old who had been in a steady sexual relationship for the past 6 months and were admitted to one of six urology clinics were included in the study. Serum prostate-specific antigen and testosterone levels and urinary flow rates were measured. All patients filled out the International Prostate Symptom Score and Quality of Life (IPSS-QoL), International Index of Erectile Function (IIEF) and Aging Males' Symptoms (AMS) scale forms. Of the patients, 23.9% had mild LUTSs, 53.3% had moderate LUTSs and 22.8% had severe LUTSs. The total testosterone level did not differ between groups. Additionally, 69.6% had ED. The presence of impotence increased with increasing LUTS severity. Symptomatic late-onset hypogonadism (AMS>27) was observed in 71.2% of the patients. The prevalence of severe hypogonadism symptoms increased with the IPSS scores. A correlation analysis revealed that all three questionnaire scores were significantly correlated. In conclusion, LUTS severity is an age-independent risk factor for ED and SLOH. LUTS severity and SLOH symptoms appear to have a strong link that requires etiological and biological clarification in future studies.
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    Association of Angiotensin-Converting Enzyme I/D and eNOS G894T Gene Polymorphisms with Erectile Dysfunction
    Çam, FS; Gümüs, BH; Var, A; Berdeli, A
    Objective: Recent studies suggest that angiotensin II and nitric oxide (NO) may modulate penile smooth muscle tone and contractility. Because genotypes of the angiotensin converting enzyme (ACE) and endothelial nitric oxide synthase (eNOS) polymorphisms have been associated with disorders in the vascular system, in this study, we investigated an association between the ACE I/D and eNOS G894T gene polymorphisms and erectile dysfunction (ED). Material and Methods: A total of 44 patients and 45 control subjects were included in the study. Diagnosis of erectile dysfunction (< 26) was provided by International Index of Erectile Function (IIEF). The ACE I/D ye eNOS G894T gene polymorphisms were genotyped using PCR and RFLP. Results: No significant case-control difference was observed for the ACE I/D and eNOS G894T gene polymorphisms either by genotype or allele frequencies [(ACE I/D-X-2=0.930 p=0.628) and eNOS 894 G/T-X-2=2.114 p=0.348)]. In addition, there was no significant difference between ACE I/D (X-2=3.174 p=0.787) and eNOS G894T (X-2=4.320 p=0.633) and IIEF scores among the patient group. Conclusion: In this study, no association was found between ACE LID and eNOS G894T gene polymorphisms and erectile dysfunction in the Turkish population studied.