Browsing by Author "Lekili M."
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Item Effects of extracorporeal shockwave lithotripsy at different stages of pregnancy in the rabbit(Mary Ann Liebert Inc., 1997) Gümüş B.; Lekili M.; Kandiloǧlu A.R.; Işisaǧ A.; Temeltaş G.; Nazli O.; Büyüksu C.Although 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, we 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 Re: The safety of overnight hospitalization for transurethral prostatectomy a prospective study of 200 patients(Lippincott Williams and Wilkins, 1998) Lekili M.[No abstract available]Item Effect of long-term alcohol abuse on male sexual function and serum gonadal hormone levels(Akademiai Kiado Rt., 1998) Gümüş B.; Yiǧitoǧlu M.R.; Lekili M.; Uyanik B.S.; Müezzinoǧlu T.; Büyüksu C.Purpose: The relationship between chronic alcohol abuse and male sexual dysfunction and pituitary gonadal function abnormalities remains uncertain. The purpose of this study was to assess the effect of chronic alcoholism on sexual functions and serum hormone levels. Materials and methods: Forty-five chronically alcoholic men and a control group of thirty healthy non-alcoholic volunteers were enrolled in the study. Each of the men in the study and control group were interviewed according to a sexual dysfunction questionnaire by an urologist. Blood samples were collected for evaluation of hormone levels. Sera were stored at -70°C for analysis. Results: The sexual desire and erection scores of alcoholic men were not statistically different from those of the control group. Fourteen out of the 45 alcoholic men complained of loss of erection during sexual activity. No significant difference in hormone levels between groups was found except for FSH. Conclusion: In the absence of hepatic and gonadal failure in chronically alcoholic men, there is no significant difference in serum hormonal levels, sexual dysfunction form, and sexual functions between alcoholics and normal healthy nonalcoholic men.Item Combination of transrectal and transvaginal ultrasound examinations in the diagnosis of female incontinence(1998) Lekili M.; Gümüs B.; Tarhan S.; Yorulmaz I.; Temeltas G.; Büyüksu C.Stress urinary incontinence is a common problem for women. We investigated the use of transvaginal and transrectal endosonography in the evaluation of women with stress urinary incontinence in comparison with lateral chain cystography. Twenty-four patients with clinically determined stress urinary incontinence were evaluated consequently with transvaginal and transrectal ultrasound and conventional lateral chain cystography. Posterior urethrovesical angle and urethral lengths were measured at rest and during Valsalva manoeuver. The results, compared with X-ray cystourethrography, enabled us to show the combination of transvaginal and transrectal ultrasonographic examinations may provide further information than transvaginal and transrectal procedure alone.Item The effects of extensive vas mobilization on testicular histology during orchiopexy(Akademiai Kiado Rt., 1998) Lekili M.; Gümüş B.; Kandiloǧlu A.R.; Işisaǧ A.; Müezzinoǧlu T.; Büyüksu C.We were aware that extensive mobilization of vas deferens during orchiopexy could cause secondary infertility due to testicular damage and/or functional obstruction of the vas deferens. We decided to perform this experimental study in order to document the effects of this procedure on the testis. Thirty adult fertility-proven New Zealand white rabbits were randomly divided into 3 groups. Ten rabbits underwent extensive mobilization of the vas deferens and the other 10 rabbits had vasectomy on the left side. The remaining 10 rabbits were explored on the left side only and were considered sham controls. Four weeks later all rabbits underwent bilateral orchiectomy. Mean seminiferous tubular diameters and Johnsen's testicular biopsy scores were noted. Comparison of the three groups showed that vas mobilization and vasectomies cause no effect on the viability of testis, however, significant testicular histological changes, which were different from the controls and contralateral testis, were observed. We concluded that during any surgical intervention involving the inguinal canal, vascular and neural supports of the vas deferens should be preserved as much as possible in order to avoid iatrogenic damages to the testis.Item Prevalence of nocturnal enuresis and accompanying factors in children aged 7-11 years in Turkey(Scandinavian University Press, 1999) Gümüş B.; Vurgun N.; Lekili M.; Işcan A.; Müezzinoǧlu T.; Büyüksu C.There 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 7-11 y, 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 Granulomatous hepatitis following intravesical bacillus Calmette-Guerin therapy(1999) Özbakkaloǧlu B.; Tünger Ö.; Sürücüoǧlu S.; Lekili M.; Kandiloglu A.R.Although intravesical bacillus Calmette-Guerin (BCG) administration is an effective method in the treatment of superficial urinary bladder carcinoma, some complications may arise such as a granulomatous reaction either in the urinary tract or, in rare cases, outside the urinary tract. We report in this paper a case of granulomatous hepatitis following intravesical BCG administration.Item Serum levels of total acid phosphatase, prostatic acid phosphatase, total and free prostate-specific antigen in patients within chronic hemodialysis program(2001) Gümüş B.; Lekili M.; Uyanik B.S.; Temeltaş G.; Büyüksu T.; Kürşat S.Objective: To investigate the effect of terminal renal failure with chronic hemodialysis on prostatic disease markers [total acid phosphatase (TAP), prostatic acid phosphatase (PAP), prostate-specific antigen (PSA) and free prostate-specific antigen (fPSA)]. Patients and Method: Total acid phosphatase (TAP), prostatic acid phosphatase (PAP), prostate-specific antigen (PSA) and free prostate-specific antigen (fPSA) were measured in 28 patients over 40 years of age on terminal renal failure with chronic hemodialysis. Correlation was calculated between the dialysis duration and prostatic disease marker levels. Results: There was no evidence of artefactual elevation of prostatic disease markers. TAP, PAP, PSA and fPSA levels were in the normal range in all of the patients. However, PSA and fPSA levels decreased as the dialysis duration increased. Conclusion: Prostatic disease markers were useful in the routine screening of men receiving long-term dialysis, but the clinicians should be on alert when the dialysis duration increases.Item A rare complication of radical nephrectomy: A pancreatic pseudocyst(2002) Lekili M.; Coskun T.; Gunduz I.; Temeltas G.; Buyuksu C.[No abstract available]Item A rare complication of radical nephrectomy: A pancreatic pseudocyst(2002) Lekili M.; Coskun T.; Gunduz I.; Temeltas G.; Buyuksu C.[No abstract available]Item Renal cell carcinoma: New prognostic factors?(2003) Kirkali Z.; Lekili M.Purpose of review: There are limited independent predictors of survival in patients with renal cell carcinoma. Factors related to the tumor, host and treatment may help us to predict prognosis to a certain extent. Prognostic indicators would enable selection of patients who can benefit from adjuvant therapy and thus should be enrolled in clinical trials. This review highlights developments in the identification of current prognosticators for patients with renal cell carcinoma. Recent findings: Tumor stage, grade and patient-performance status are the known prognostic indicators in renal cell carcinoma. Besides these parameters, many molecular and cytogenetic markers were evaluated recently. Unfortunately, none of these parameters appear to be a better predictive prognostic factor than the usual staging and grading. Therefore, efforts to identify new markers for tumor proliferation and progression are still ongoing. It was recently reported that low carbonic anhydrase 9 staining may be an independent poor prognostic factor in patients with renal cell carcinoma. Moreover, there is increasing interest in prognostic indices and predictive algorithms for survival. Staging systems that combine the pathological features with additional prognostic variables have been constructed to predict outcome. The UCLA Integrated Staging System seems to be superior to staging alone in differentiating patients' survival. Summary: Although the literature reviewed contains numerous promising clinical, histological, molecular and cytogenetic parameters, none of them has yet been shown to have an independent prognostic value.Item Col IV and Fn Distribution in Prostatic Adenocarcinoma and Correlation of 67LR, MMP-9 and TIMP-1 Expression with Gleason Score(2003) Işisaǧ A.; Neşe N.; Ermete M.; Lekili M.; Ayhan S.; Kandiloǧlu A.R.OBJECTIVE: 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, and fibronectin (Fn), an adhesion protein in extracellular matrix. Others are matrix metalloproteinase-9 (MMP-9), a type IV collagenase, tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), which has a high affinity for MMP-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 Comparison of the nuclear matrix protein 22 with voided urine cytology in the diagnosis of transitional cell carcinoma of the bladder(2004) Lekili M.; Şener E.; Demir M.A.; Temeltaş G.; Müezzinoǧlu T.; Büyüksu C.Several 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 Bullous pemphigoid associated with prostate adenocarcinoma(2004) Öztürkcan S.; Ermertcan A.T.; Şahin M.T.; Türkdoǧan P.; Inanir I.; Lekili M.Bullous pemphigoid is a common autoimmune skin disease characterized by the presence of subepidermal blisters. It has been associated with underlying neoplasia in isolated reports. A 78-year-old man with generalized blisters was diagnosed as bullous pemphigoid on clinical, histopathological and direct immunofluorescence grounds. His free and total prostate specific antigen (PSA) levels were high and histopathological examination of a prostate specimen revealed prostate adenocarcinoma. We present this rare case to discuss the possible association between bullous pemphigoid and prostate adenocarcinoma.Item The preference of urologists about contraception; [Doǧum Kontrol Yönteṁ inde Ürologlarin Terċ iḣi](2004) Asan C.; Ateşçi Y.; Gündüz M.I.; Gümüş B.; Lekili M.Introduction: We evaluated the contraceptive methods which one is use or suggest by the urologists. Materials and Methods: We send e-mails to resident or specialist of urology and questioned their age, marital status, mean coitus count per a week, which method is use or suggest and his opinion for male oral contraception. Results evaluated with SPSS 11.0. Results: 193 persons included the study. Mean age was 32.4. Mean coitus count per a week was 2.5. Female oral contraception (n=45, 23.3%), condom (n=42, 21.8%) and coitus interruptus (n=29, 15%) were methods which most uses by the urologists. There is no choice for the vasectomy noted. Condom (22.8%), vasectomy (16.6%) and female oral contraception (16.1%) were methods which most suggests by the urologists. Conclusion: Urologists don't use vasectomy and rate of suggest of this method is very low. Condom is a common method for the contraception in this group. Coitus interruptus as a contraception method, is a common method in urologists who are married.Item Evaluation of pain caused by urethrocystoscopy in patients with superficial bladder cancer: A perspective of quality of life(2005) Müezzinoǧlu T.; Ceylan Y.; Temeltaş G.; Lekili M.; Büyüksu C.Aim: 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. © 2005 S. Karger GmbH.Item Population standards of prostate specific antigen values in men over 40: Community based study in Turkey(2005) Müezzinoǧlu T.; Lekili M.; Eser E.; Uyanik B.S.; Büyüksu C.Objective: To determine the prostate specific antigen (PSA) population standards of a cluster of Turkish men with no clinical evidence of prostate cancer. Patients and methods: We evaluated PSA values of the men who were living in a well-defined, rural district of Western Anatolia. Two hundred fifty-seven men agreed to participate in this population-based study. They underwent clinical examination, transrectal ultrasonography and serum PSA measurement. The association between serum PSA and age, prostate volume and age, PSA and prostate volume, and PSA density (PSAD) and age were assessed. Distributions of serum PSA levels, prostate volumes (PV), and PSAD values as a function of age were generated. Results: The upper limit of normal PSA concentration were 4.51 ng/ml for men aged 40-49 years, 4.36 ng/ml for 50-59 years, 6.17 ng/ml for 60-69 years, and 10.18 ng/ml for over 70 years. The upper limit of normal (95th percentile) for the serum PSA concentration increased with age. Across the entire age range, no correlation was found between the serum PSA concentrations and age while significant correlation was found between serum PSA concentration and prostate volume. Conclusion: In this present study, the PSA values in different age intervals showed higher than those observed in previous studies. The PSA values are mainly affected by prostate volume rather than age. © Springer 2005.Item Pre/post meal PSA values: Should it be measured in pre-meal blood serum?; [Açlik-tokluk PSA deǧerleri: Ölçümler açlik kaninda mi yapilmali?](2005) Müezzinoǧlu T.; Lekili M.; Ceylan Y.; Var A.; Büyüksu C.Introduction: 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 Serum lipid levels in benign prostatic hyperplasia(2006) Lekili M.; Müezzinoǧlu T.; Uyanik B.S.; Büyüksu C.The 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 (m2) respectively. Men were considered obese if their body mass index was over 25 kg/m2. 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. © Springer-Verlag 2006.Item Which one is responsible for pain during transrectal guided prostate biopsy: Prostate or anal canal [2](2006) Lekili M.; Lu T.M.; Ceylan Y.; Temelta G.; Büyüksu C.[No abstract available]