Browsing by Author "Lekili, M"
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Item Which one is responsible for pain during transrectal guided prostate biopsyLekili, M; Lu, TM; Ceylan, Y; Temelta, G; Büyüksu, CItem Assessment of Quality of Life of Partners of Patients with Benign Prostate Hyperplasia: Does Benign Prostate Hyperplasia Disturb Female Partners?Müezzinoglu, T; Çam, K; Kayikçi, A; Lekili, MObjective: Benign prostate hyperplasia (BPH) is a common health problem throughout the world. The aim of the study was to evaluate the consequence of BPH on partners by using Turkish version of a specific quality of life (QoL) scale for partners of BPH patients. Material and Methods: The study group consisted of partners of 300 BPH patients who were admitted to urology outpatient departments of two university hospitals (Duzce University and Celal Bayar University) with lower urinary tract symptoms. BPH patients were asked to fill out International Prostate Symptom Score (IPSS) form, while female partners were separately requested to complete the specific QoL questionnaire. Results: The mean age of patients with BPH was 63.8 +/- 7.2 years and it was 56.3 +/- 6.5 years for female partners. The results of the specific questionnaire showed that QoL of partners were significantly affected. Particularly, most of the the partners had the fear of cancer development and possibility of surgery for their husbands, 77% (231/300 partners) and 79% (237/300 partners), respectively. At night majority of partners woke up frequently because of their husbands, however mostly of them declared no or little disturbance in terms of being tired during the day. On the other hand, it was revealed that there was a significant correlation between QoL degrees of partners and IPSS values of BPH patients (p< 0.001; correlation coefficient 0.664). Conclusion: BPH significantly impairs the QoL of female partners. This negative impact correlates with the IPSS values of BPH patients. Therefore, the physicians should also consider burden of the female partners in the management of BPH patients.Item Col IV and Fn distribution in prostatic adenocarcinoma and correlation of 67LR, MMP-9 and TIMP-1 expression with Gleason scoreIsisag, A; Nese, N; Ermete, M; Lekili, M; Ayhan, S; Kandiloglu, AROBJECTIVE: To assess the immunoreactivity of 5 proteins related to basement membrane (BM) and extracellular matrix in order to investigate whether any of them correlates with differentiation of prostatic adenocarcinoma (PAc). Two of these markers are collagen type IV (Col IV), the collagenous component of basement membrane, andfibronectin (Fn), an adhesion protein in extracellular matrix. Others are matrix metalloproteinase-9 (MMP9), a type IV collagenase, tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), which has a high affinity for A4MP-9, and 67-kd laminin receptor (67LR), which belongs to the non-integrin laminin binding receptor family. STUDY DESIGN: Forty-three PAc cases with Gleason scores ranging between 5 and 10 and 10 benign prostatic hyperplasia (BPH) cases, the control group, were included in the study. Formalin-fixed and paraffin-embedded tissue slides from each case were immunostained with the avidin-biotin-peroxidase method. Immunoreactivity was determined by means of a scoring system similar to the Gleason scoring system. RESULTS: Overexpression of Col IV, Fn, 67LR and MMP-9 was detected in PAc as compared with BPH, whereas no difference was determined in TIMP-1 expression. Among these, only 67LR correlated statistically with Gleason score. CONCLUSION: Expression of 67LR in tumor cells was significantly increased in parallel to tumor grade. This may be useful in microscopic evaluation of PAc.Item Effects of extracorporeal shockwave lithotripsy at different stages of pregnancy in the rabbitGumus, B; Lekili, M; Kandiloglu, AR; Isisag, A; Temeltas, G; Nazli, O; Buyuksu, CAlthough SWL is now the most common treatment modality for urinary tract stone disease, it is not regarded as a safe method for pregnant patients because of its potential harmful effects on fetus, Using a rabbit model, Re investigated whether SWL might cause fetal injury when administered at various developmental stages. Two groups of pregnant rabbits were given 1000 shockwaves either early or late in the gestational period, Time-matched controls did not receive shockwaves, After spontaneous labor, all newborn rabbits were counted, weighted, and measured, and specimens were taken from organs and examined histopathologically. The numbers, weights, and diameters of the newborns in each group were similar, There was no notable histopathologic finding in the heart and brain specimens of any of the newborns, whereas noticeable congestion and multiple focal intraparanchymal microhemorrhages were found in lungs, livers, and kidneys of the animals that had been exposed to shockwaves early in gestation, In conclusion, this study shows that SWL is not a safe treatment in early pregnancy.Item Effects of Neuronal and Glial Restricted Precursor Cells Transplantation on Erectile Function after Experimentally Induced Spinal Cord InjuryTemeltas, G; Dagci, T; Evren, V; Lekili, MIntroduction. Erectile dysfunction is common among patients with spinal cord injury (SCI). Aim. This study aims to investigate the recovery of penile erectile functions of the rats with spinal cord injury (SCI) following transplantation of endogenous neuronal precursors cell (neuronal restricted precursors [NRP]/glial restricted precursors [GRP]) into the injured area of spinal cord. Methods. Twenty-two rats were experimented in three groups. Group 1 (N = 6): Sham; Group 2 (N = 10): SCI + NRP/GRP transplanted in day 9 after operation; Group 3 (N = 6): SCI + culture medium transplanted in day 9 after operation. Analysis of penile reflexes and cavernosal nerve stimulation studies were performed in day 28 after transplantation for each group. All rats in three groups were then sacrificed and the injured regions of spinal cords underwent histological investigation. Main Outcome Measures. These results show improvements to some extent in locomotor and erectile functions although these improvements are far from full functional recovery. Results. Cavernosal nerve stimulation resulted in significantly higher intracavernosal pressure in Group 3 (SCI) although there was no difference between Group 1 (sham) and Group 2 (SCI + NRP/GRP). Number of clusters was similar between groups. Number of erections was higher in Group 3 (SCI) than Groups 1 and 2, and number of cups was higher in Group 2 (SCI + NRP/GRP) than the other two groups. Number of flips was similar in Groups 1 and 2 but lower in Group 3. Number of long flips was highest in Group 1 and lowest in Group 3. The differences between groups were significant. Conclusion. This study emphasized the healing potential of NRP/GRP transplantation following experimental SCI. However, further experimental and clinical studies are required to advance this treatment modality. Temeltas G, Dagci T, Evren V, and Lekili M. Effects of neuronal and glial restricted precursor cells transplantation on erectile function after experimentally induced spinal cord injury. J Sex Med 2009;6:3265-3273.Item Comparison of the Desmoplastic Reaction and Invading Ability in Invasive Ductal Carcinoma of the Breast and Prostatic Adenocarcinoma Based on the Expression of Heat Shock Protein 47 and FascinNese, N; Kandiloglu, AR; Simsek, G; Lekili, M; Ozdamar, A; Catalkaya, A; Coskun, TOBJECTIVE: To investigate the diversity within invasive ductal carcinoma (IDC) and prostatic adenocarcinoma (PCa) by evaluating immunohistochemical expression of heat shock protein 47 (HSP47) and fascin, the molecules that are related to desmoplasia and invasion, and analyze its correlation with clinicopathologic parameters. STUDY DESIGN: HSP47 and fascin immunoreactivity (IR) was evaluated in 49 mastectomies diagnosed as IDC and 57 radical prostatectomies diagnosed as PCa. IR was evaluated as: 0: <5%, 1+: 5-25%, 2+: 25-50%, 3+: >50%. RESULTS: HSP47 and fascin were localized to cytoplasm, and HSP47 and fascin IR were higher in IDC and PCa than benign groups (p<0.05). HSP47 IR in neoplastic cells was 42.1% and 28,6%, in stroma was 81.6% and 15.8% in IDC and PCa, respectively; fascin IR in neoplastic cells was 65.3% in IDC and 15.8% in PCa. Fascin expression correlated with estrogen receptor and progesterone receptor negativity, tumor size and stage in IDC and surgical margin status in PCa. HSP47 expression correlated bilaterality in PCa. HSP47 positively correlated with survival in IDC. CONCLUSION: HSP47 and fascin expression may play role in the pathogenesis of IDC and PCa because their expression is significantly higher in IDC and PCa than their normal counterpart. Although there is no relationship with recurrence or metastatic status, fascin overexpression correlated with tumor size, which may prompt its use as a prognostic factor in IDC. (Anal Quant Cytol Histol 2010;32:90-101)Item Comparison of the nuclear matrix protein 22 with voided urine cytology in the diagnosis of transitional cell carcinoma of the bladderLekili, M; Sener, E; Demir, MA; Temeltas, G; Müezzinoglu, T; Büyüksu, CSeveral urinary markers for transitional cell carcinoma have been investigated, including urine cytology, bladder tumor antigen, autocrine motility factor receptor and fibrin degradation products. Unfortunately, they have poor overall sensitivity. The United States Food and Drug Administration have recently approved nuclear matrix protein (NMP 22) for the detection of occult or rapidly recurring disease after transurethral resection of bladder tumor. The objective of the current study was to assess the sensitivity of NMP 22 for the detection of bladder carcinoma, as well as to correlate the NMP 22 values with multiplicity of tumor, tumor size, configuration, stage and grade respectively. A total of 78 patients (38 with bladder cancer) provided a urine sample which was divided into appropriate aliquots for each of urine cytology and NMP 22. Comparative results demonstrate a clear superiority of NMP 22 in bladder cancer detection (52.6% vs 31.6% sensitivity), while specificity was in favor of urine cytology (100% vs 82.5%). For superficial tumors, sensitivity was 78.5% for NMP 22 and 41.6% for cytology and for invasive cancers, sensitivity was 90% for NMP 22 and 60% for cytology. Urinary NMP 22 levels were significantly correlated with tumor grade and were significantly higher in large tumors than small tumors. NMP 22 test results showed sufficient sensitivity in comparison with urine cytology for the detection of transitional cell carcinoma. However, we do not think that it is a useful tool as a substitute for endoscopic examination for the detection and surveillance in bladder cancer.Item Possible relations between oxidative damage and apoptosis in benign prostate hyperplasia and prostate cancer patientsKosova, F; Temeltas, G; Ari, Z; Lekili, MCancer has been described as the twentieth century plague, and is a very common health problem. It has been reported that ROS and ROS products play a key role in cancer and that oxidative damage is effective in apoptosis initiation. In this study we aimed to evaluate the relationship between MDA (malondialdehyde), DNA damage (8-hydroxyguanine, 8-OH-dG), and caspase-3 in BHP and prostate cancer patients. Twenty male patients with prostate cancer and 20 male patients with benign prostate hyperplasia were included into this study. The MDA (nanomole), DNA damage (nanograms per millilitre), and caspase-3 (nanograms per millilitre) levels were measured in prostate cancer and benign prostate hyperplasia using Elisa kits (Millipore Corporation, Billerica, MA, USA). In the prostate cancer group, serum MDA (30.96 +/- 9.25) and DNA damage (4.42 +/- 0.36) levels were significantly raised (p < 0.05) when compared to the benign prostate hyperplasia group (24.05 +/- 8.06, 3.99 +/- 0.54). However, in the prostate cancer group, serum caspase-3 (2.36 +/- 0.82) levels were statistically significantly lowered (p < 0.05) compared with the benign prostate hyperplasia group (3.15 +/- 1.04). We observed that altered prooxidant, DNA damage levels may lead to an increase in oxidative damage and may consequently play an important role in prostate carcinogenesis. These findings indicate that, although the triggering of these changes is unknown, changes in the levels of MDA, DNA damage, and caspase-3 in the blood are related to prostatic carcinoma development. In addition, it would be appropriate to conduct new studies with a large number of patients at different stages.Item Urachal Urothelial Carcinoma Diagnosed at a Radical Prostatectomy Operation A Case ReportNese, N; Kesici, G; Lekili, M; Isisag, ABACKGROUND: Urachal carcinomas are rare tumors, and the majority of them are adenocarcinomas. Up to now, only 21. urachal urothelial carcinomas (UCas) have been reported. Here, we describe a case of high grade UCa arising from the urachal remnants. CASE: A 66-year-old man presented with voiding difficulties. Prostate specific antigen (PSA) was 5.46 ng/mL. Prostatic adenocarcinoma (PCa) (Gleason score 6) was diagnosed by needle biopsies. After the diagnosis of high grade, muscle invasive UCa with intact mucosa on frozen examination of the dome of bladder wall during the radical prostatectomy operation (RPO), partial cystectomy was performed. Microscopically, among the tumoral islands, cystic structures lined by cells with a benign appearance, which are considered urachal remnants, were noted. Cytokeratin 7 and high-molecular-weight cytokeratin were strongly positive, PSA and carcinoembryonic antigen were negative. Radiotherapy was given for both UCa and PCa. Six months after the diagnosis, an undifferentiated tumor was detected in a bladder transurethral resection specimen; thus, chemotherapy was given.. After 1 course of chemotherapy, the patient was doing well. CONCLUSION: The origin of urachal carcinomas is usually obscured as it is a highly invasive carcinoma. The patient presented here was diagnosed incidentally during RPO. Although the stage was advanced, the tumor was detected before urachal remnants were destroyed. The treatment choice for urachal carcinomas is cystectomy. Adjuvant chemotherapy and radiotherapy are controversial. (Anal Quant Cytol Histol 2010;32:174-177)Item Serum lipid levels in benign prostatic hyperplasiaLekili, M; Müezzinoglu, T; Uyanik, BS; Büyüksu, CThe relationship between serum lipid levels and measures of benign prostatic hyperplasia was investigated. The study was community based. All the participants had undergone a urological investigation which included International Prostate Symptom Score (I-PSS) and Quality of Life Score (QoL), serum lipid concentrations and determination of prostate volume with transrectal ultrasonography. Body mass index was calculated with the formula of weight (kg)/surface area (m(2)) respectively. Men were considered obese if their body mass index was over 25 kg/m(2). BPH was defined by prostate volume greater than 20 ml and I-PSS greater than seven. Comparisons of serum lipid levels between men with BPH and without BPH were done. There was no correlation for serum lipid levels with either mean I-PSS and QoL scores. However, triglyceride and cholesterol levels were the lowest in severe symptomatic men than men with low symptoms. Using clinical definition of BPH that prostate volume was greater than 20 ml and I-PSS was greater than seven, men with BPH had not significantly different serum lipid levels from men without BPH. Our population-based data reflect that there was no relationship between serum lipid levels and certain physiological measures of lower urinary tract symptoms and clinical benign prostatic hyperplasia.Item Sorafenib in Metastatic Renal Cell Carcinoma With Sarcomatoid DifferentiationLekili, M; Muezzinoglu, T; Nese, N; Temeltas, GTargeted therapy in the management of metastatic renal cell cancer has been recently introduced to urology practice. The drugs used for management are used in a very limited number of patients and only for clear cell histology. We present a case where we administered sorafenib, a multikinase inhibitor of tumor-cell proliferation and angiogenesis, to a patient with metastatic renal cell carcinoma of clear cell histology. We found that our results were different from those of previously reported studies, because sarcomatoid differentiation was evident in a histological examination of this case. There was an excellent response to sorafenib. This case report might provide evidence that antiangiogenic agents may be active in any histological type of renal cell carcinoma. However, there are no available data to demonstrate the duration of response and survival benefit. [J Chin Med Assoc 2010;73(5):262-264]Item Comparison of Desmoplastic Reaction and Invading Ability in Invasive Ductal Carcinoma (IDC) of Breast and Prostatic Adenocarcinoma Based on Expressions of Hsp47 and FascinKandiloglu, AR; Nese, N; Simsek, G; Lekili, M; Ozdamar, A; Catalkaya, A; Coskun, TItem THE RELATIONSHIP BETWEEN SMOKING AND LOWER URINARY TRACT SYMPTOMS: COMMUNITY BASED STUDYTemeltas, G; Müezzinoglu, T; Üçer, O; Lekili, M; Büyüksu, CIntroduction: The studies, investigated the relationship between smoking and benign prostatic hyperplasia (BPH), are commonly clinically based. We aimed that whether smoking has any effect on BPH and/or lower urinary tract symptoms in a community based fashion. Materials and Methods: The forms of international prostate symptom score (I-PSS), quality of life (QoL) and asking smoking addiction were fulfilled by 255 men over 40 years old living in a small town of Manisa. Meanwhile prostatic volume and post-voiding residual urine volume calculations with ultrasound were evaluated. Results: While the degree of smoking (package/year) increased, I-PSS, QoL and residual urine volume slightly increased, but no correlation found with Pearson co-efficient. Although no statistically significant relation was observed, prevalence of BPH in this population was higher in smoking men than non smoking men. Conclusion: In this study, although no statistically correlation was found between smoking and BPH, it is observed that smoking is slightly effect the prevalence of BPH. It may be speculated that smoking has variable effects on sex steroids.Item PRE/POST MEAL PSA VALUES: SHOULD IT BE MEASURED IN PRE-MEAL BLOOD SERUM?Müezzinoglu, T; Lekili, M; Ceylan, Y; Var, A; Büyüksu, CIntroduction: Prostate specific antigen (PSA) is the commonly used tumor marker in the early diagnosis of prostate cancer. Although it is highly specific for prostate, its specifity is low for prostate cancer. Since it is affected by many factors other than cancer such as diurnal variations of the secretion, existing of infections or inflammations in the prostatic tissue, volume of prostate, digital rectal examination, ejaculation or rectal manipulations and surgery of the prostate, the value of serum PSA level is limited. Serum insulin level increases and reaches maximum level at first hour due to increased glucose level after meal. Thereafter the level of serum insulin values return to its normal level at approximately two hours after meal. On the other hand, insulin suppresses the production of sex hormone binding protein in liver cells. Therefore, it is logic to investigate PSA levels due to metabolic and hormonal changes after meal. We investigated changes of PSA level after meal in this prospective study. Materials and Methods: Thirty-three healthy cases were included in this study to determine changes of serum PSA levels pre and post-meal manner. All patients were given same regular diet comprised of 700 calories (50-55% carbohydrates, 25-30% lipids and 20% proteins). Blood samples were taken an hour before meal (PSA-0), and one (PSA-1) and two (PSA-2) hours after meal. Serum PSA levels were determined by chemiluminescence method. Paired sample t test and Pearson correlation coefficient were used for statistical analysis. Results: The mean age of the patients was 42 +/- 17.5 (Range 20-80) years. The mean PSA level at one hour before meal, one and two hours after meal were 0.70 +/- 0.69 ngr/ml (PSA-0), 0.74 +/- 0.75 ngr/ml (PSA-1) and 0.65 +/- 0.57 ngr/ml, (PSA-2) respectively. There was no statistically significant difference between serum PSA-0 levels with PSA-1 (p=0.106) and PSA-2 (p=0.109) levels. However, there was a statistically significant difference between first hour and second hour after meal mean PSA levels (p=0.029). Conclusion: Serum PSA values may be affected not only from prostatic disturbances, but also the changes of its metabolism and levels of PSA binding proteins. Insulin, proinsulin, C-peptid and Zn secretion increase after meal. In contrast, glukagon, cortisol, epinephrin, norepinephrin secretion decrease. These differences could also change the levels of detectable fractions of PSA temprorarily and may affect serum total PSA levels. The differences of serum PSA levels represent paralelism with the changes in serum insulin levels after meal. In this study, mean PSA levels increased at first hour after meal and decreased at second hour after meal. These differences in PSA levels could affect the decision making for indication of prostate biopsy in patients with borderline PSA levels and it should be considered when the serum samples are taken whether patients are hungry or not. The determination of ideal serum PSA sampling time would be important in order to prevent false negative or positive serum PSA results. In this way, clinicians would decide not to do invasive procedures especially in patients with borderline serum PSA levels.Item Comparison of Desmoplastic Reaction and Invading Ability in Invasive Ductal Carcinoma (IDC) of Breast and Prostatic Adenocarcinoma Based on Expressions of Hsp47 and FascinKandiloglu, AR; Nese, N; Simsek, G; Lekili, M; Ozdamar, A; Catalkaya, A; Coskun, TItem Evaluation of pain caused by urethrocystoscopy in patients with superficial bladder cancerMüezzinoglu, T; Ceylan, Y; Temeltas, G; Lekili, M; Büyüksu, CAim: The aim of this study is to evaluate patients' tolerance to pain caused by urethrocystoscopy ( UCS) in both diagnosis and the period of follow- up in patients with superficial bladder cancer, and to evaluate these results with respect to quality of life. Patients and Methods: Between March 2003 and October 2004, 66 patients with bladder cancer or hematuria underwent UCS and recorded their overall pain level. Results: The mean age was 60.4 ( range 26 - 83) years. UCS was done only one time in 22 patients for the diagnosis of etiology of hematuria and was done 4 times in 44 patients every 3 months for bladder cancer follow- up. The mean pain scores on first, second, third, and fourth UCS were 4.3 +/- 2.2, 4.7 +/- 2.5, 4.68 +/- 2.45, and 5.1 +/- 2.5, respectively. Statistically significant differences were found among mean pain scores of patients on first, third, and forth cystoscopic examinations ( p < 0.05). No correlation was found between age and pain scores in this study group ( p > 0.05). Conclusion: UCS is a painful surgical procedure and pain tolerance was not observed on repeated UCS. Therefore urologists need to use more effective anesthetic methods to provide better patients' tolerance to pain and quality of life during the endoscopic procedure.Item Prevalence of nocturnal enuresis and accompanying factors in children aged 7-11 years in TurkeyGümüs, B; Vurgun, N; Lekili, M; Iscan, A; Müezzinoglu, T; Büyüksu, CThere has been limited epidemiological research about nocturnal enuresis in Turkey. The objectives of this study were to ascertain the prevalence of nocturnal enuresis and the epidemiological factors associated with this in Turkish children aged 7-11y, living in Manisa. Included in the study were 2000 children from various primary schools in Manisa. Parents were asked to fill out our specially designed questionnaire. In all, questionnaires for 1703 children were completed and returned to the department (871F, 51.1%; 832M, 48.9%). The prevalence of nocturnal enuresis for females was 10.6%, for males it was 16.9% and the overall prevalence was 13.7%. The prevalence of nocturnal enuresis decreased with age. Enuresis nocturna was found to be more common in children with a family history of bedwetting (76.5%). Deep sleeping, poor toilet habits and low educational level of the family were associated with enuresis. Consanguineous marriage did not influence the incidence of enuresis nocturna. There was no difference between enuretics and non-enuretics with reference to breastfeeding, being firstborn or being right- or left-handed. In our opinion, enuresis is an important problem for both families and children in Turkey for which specific guidelines should be developed. Various methods have been tried in the treatment of enuresis because of its multi-factorial aetiology. Child, family and physician co-operating together achieve the best help to both child and family.Item THE RELATIONSHIP BETWEEN SERUM STEROID HORMON LEVELS AND I-PSS, PROSTATIC VOLUME, RESIDUAL URINE: A COMMUNITY BASED STUDYTemeltas, G; Muezzinoglu, T; Akar, Z; Lekili, M; Büyüksu, CIntroduction: It is evaluated that endocrinolgical effect is the most reliable factor for development of histological and clinical BPH which is the common disease in older males. Materials and Methods: In our study, we investigated the relationship between BPH incidence and steroid hormone levels by using the criteria of I-PSS, residual urine and prostatic volume in the men over 40 in a rural town. Total and free testosterone, estradiol, dihidroepiandosteron sulfate, sex hormone binding globulin, FSH and LH levels were analyzed. I-PSS and quality of life scores were evaluated. Results: Mean FSH, LH, DHEAS, SHBG, E2, tT and fT levels were 11.03 +/- 11.06 mIU/ml (0.9-83.7), 9.26 +/- 18.7 mIU/ml (0.7-200), 114, 86 +/- 68.3 pg/dl (30-417), 55.28 +/- 31.4 nmol/L (2-180), 23.03 +/- 9.05 pg/mL (2046.1), 3.9 +/- 1.82 ng/dl (0.2-16) and 13.7 +/- 4.7 pg/mL (0.6-31.6). Mean I-PSS, QoL, residual urine and prostatic volume were 4.7 +/- 5.9 (0-30), 0.7 +/- 1.3 (0-6), 21.5 +/- 30.7 (0-295) ml and 24.4 +/- 11.4 (9-82) gr. respectively. With Pearson correlation system; age, I-PSS, QoL, residual urine and prostatic volume were well correlated with each other (p<0.05). While age increased, FSH and SHBG increased significantly (r=0.2979 and r=0.3642). On the other hand, DHEAS ( r=-0.4792) and fT (r=-0.3306) decreased, while age increased. There was no correlation between E2, LH, tT, SHBG and age. When it is accepted as all the men with their I-PSS over 7 has BPH; fT levels were statistically lower (14/12.3, p=0.009) and their SHBG levels were higher than those without BPH (52.5/64.8, p=0.029). Conclusion: If the diagnosis of BPH is determined with the different combination of I-PSS, residual urine and prostatic volume, no significant data was revealed between serum steroid hormone levels and BPH. fT levels were significantly lower in men with high I-PSS than those with low I-PSS.Item Recurrent Renal Cell Carcinoma in a Pregnant Hemodialysis PatientÇolak, HB; Inci, A; Kutsal, DA; Gök, F; Baytur, YB; Lekili, M; Kürsat, SRenal cell carcinoma is the most common renal neoplasm reported in pregnancy. A successful pregnancy outcome is very important in women with serious chronic renal failure. Our case was a pregnant women diagnosed with renal failure due to a renal mass in the second trimester of her pregnancy. A healthy baby was delivered following intensified hemodialysis sessions.