Browsing by Author "Müezzinoǧlu T."
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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 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 Aetiological factors of bladder cancer in the Aegean Region of Turkey between the years 1985-1996(1999) Gümüş B.; Aras O.; Ateşci Y.Z.; Müezzinoǧlu T.A great majority of urological cases are bladder tumours. The purpose of this study is to bring out the aetiological factors related to bladder tumours. The parameters such as age, sex, profession, age at tumour occurrence, smoking, drinking habits, such as the level of consumption of tea and coffee, and accompanying urological diseases were evaluated. Three hundred and forty-seven patients with bladder tumours were included in this study. Of them 332 (95.6%) were males and 15 (4.4%) females. The average age was 62.1 (22-87) years. Of the patients 326 (93.9%) smoked, 175 (50.4%) lived in cities and the other 49.6% lived in the countryside. Of the tumours 89.9% were transitional cell carcinomas. In conclusion, bladder tumours are closely related to consumption of tobacco factors and profession. The risk of tumour development increases progressively in people who are exposed to industrial agents and agricultural chemicals.Item The diagnostic value of the phosphate levels in serum and 24-hour urine samples in patients with recurrent renal stone disease(2002) Müezzinoǧlu T.; Gümüş B.; Şener E.; Ari A.; Büyüksu C.Objective: The aim of this study is to investigate the value of phosphate levels in serum and urine in patients with recurrent renal stone disease. Materials and methods: The patients (n:60) were divided into two groups as first-time stone disease (group 1) and recurrent renal stone disease (group 2). The demographical datas and their historical information were recorded and physical examination was done. The sera and urine for 24 hr were obtained from patients to measure electrolyte levels especially phosphorus. In addition, based on presenting serum phosphate levels, patients were divided into the hypophosphatemia group, less than 2.5 mg/dl; normophosphatemia group, between 2.5-5.2 mg/dl; and hyperphosphatemia group greater than 5.2 mg/dl. Results: The mean age of study group was 45 (21-70) years. Thirty-six patients (60%) were in group 1 and 24 patients (40%) were in group 2. No statistically correlation was found between stone recurrence and phosphate levels both in serum and urine. There was only a statistical association of K levels in 24-hour urine samples between group 1 and 2. Conclusion: There was no significant association between stone recurrence and initial phosphate levels in the serum or in urine. We do not propose to determine phosphate levels routinely in management of patients with stone disease.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 Histopathological effects of sildenafil citrate on rat corpus cavernosum(Elsevier GmbH, 2004) Gümüs B.; Vatansever H.S.; Müezzinoǧlu T.; Müftüoǧluc S.; Kaymaz F.; Büyüksu C.Sildenafil citrate (Viagra) is widely used for the treatment of erectile dysfunction with various etiologies. The aim of the present study was the investigation of histopathological effects of sildenafil citrate on rat corpus cavernosum using light and electron microscopical techniques. Twenty male rats were divided into two groups. The first group (n = 10) was used as a control and the second group (n = 10) was treated with sildenafil citrate. Penile tissue was collected, fixed with formalin and embedded in paraffin for light microscopy, or fixed with gluteraldehyde and osmium tetroxide and embedded in Epon for electron microscopy. Light microscopical analysis showed that the corpus cavernosum was elongated and the number of blood vessels was increased. The amount of connective tissue in the penis was increased and dense collagen and smooth muscle fibers were observed in treated rats. Electron microscopical analysis showed that stromal structures of the corpus cavernosum (collagen fibers and number of cellular elements) were increased in treated rats. Fibroblasts showed signs of activation and the number of other stromaL cells was increased. Immature newly synthesized collagen fibers were observed and penetrated endothelial basement membranes. In addition, endothelial cells also showed signs of activation such as cytoplasmic granules in treated rats, whereas the surface area of blood vessels was increased and basement membranes were thickened. These histopathological changes due to treatment with sildenafil citrate indicate that prolonged use of sildenafil citrate may increase the risk of fibrosis in the penis. © 2003 Elsevier GmbH. All rights reserved.Item Sexual function in ankylosing spondylitis: A study of 65 men(Lippincott Williams and Wilkins, 2004) Pirildar T.; Müezzinoǧlu T.; Pirildar Ş.Purpose: We evaluated sexual function in male patients with ankylosing spondylitis (AS) using the validated International Index of Erectile Function (IIEF). We also assessed the frequency and association of erectile dysfunction with patient age, disease duration, morning stiffness, laboratory activity, disease severity, depression status and medication use in this patient group. Materials and Methods: We evaluated sexual function, in particular erectile dysfunction (ED), using the IIEF in male patients with AS followed regularly at the outpatient clinic of rheumatology and compared results with those in healthy controls. Patient age, disease duration, morning stiffness, laboratory activity, disease severity and medication use were obtained by reviewing the medical record. Affective patient and control states were measured by the Beck Depression Inventory. The Bath AS Functional Index was used to measure functional status in AS cases. Results: To our knowledge this is the first study of the frequency of ED in men with AS (8 of 65 or 12%). Compared to healthy controls patients with AS had significantly lower erectile function, orgasmic function, intercourse satisfaction and overall satisfaction scores according to the IIEF, whereas sexual desire scores were also lower, although not significantly. According to self-reported patient data ED was a prominent characteristic of our population. We were not able to relate any clinical features or laboratory findings to ED except the duration of morning stiffness. The 22 men with a high degree of morning stiffness (greater than 4 hours) had lower erectile function scores compared to the 12 with AS and a low degree of morning stiffness (less than 2 hours) (18.3 ± 1.6 vs 26.5 ± 2.4, p < 0.05). Of 65 patients with AS 25 (38%) were depressed in our study group according to the Beck Depression Inventory, while no healthy controls were depressed when a score of greater than 13 was used as the cutoff. Conclusions: ED can be seen in the course of AS. The pathogenesis of ED in patients with AS is thought to be multifactorial with disease and treatment related factors. Thus, male patients with AS, in particular those with a high degree of morning stiffness, should be encouraged to talk about their sexuality.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 Quality of life in benign prostatic hyperplasia; [Seli̇m prostat büyümesi̇nde yaşam kali̇teṡi](2006) Müezzinoǧlu T.; Çam K.Introduction: In view of the growing tremendous interest in quality of life (QoL) in almost every field of medicine, the scope of this review was to address the place of QoL in benign prostatic hyperplasia (BPH) in terms of selecting appropriate treatment policy. Actually, the target of any proposed treatment for BPH is usually the symptoms of the patient. Therefore, it is more logical to know the status of QoL related to these symptoms for each particular patient in order to provide the most appropriate treatment. Since contemporary measures like symptom scores do not measure BPH specific QoL, they should not solely guide the physician in suggesting a treatment alternative for a BPH patient. In this review, QoL in BPH was discussed inclluding present data and future perspective.Item Item The relationship between serum steroid hormon levels and I-PSS, prostatic volume, residual urine: A community based study; [Serum steroid hormon düzeyleri ile I-PSS, prostat aǧirliǧi ve artik i̇drar baǧintisi: Topluma dayali bir çalişma](2007) Temeltaş G.; Müezzinoǧlu T.; Akar Z.; Lekili M.; Büyüksu C.Introduction: 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, DREAS, 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 (20-46.1), 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 A relationship of sex hormone levels and erectile dysfunction: Which tests should be done routinely?(2007) Müezzinoǧlu T.; Gümüş B.; Temeltaş G.; An Z.; Büyüksu C.Purpse: In this study, the relationship between sex hormone levels and erectile dysfunction (ED), as well as the necessity of routinely measuring sex hormone levels were evaluated. Materials and Methods: This study included one hundred patients admitted to a urology clinic for sexual dysfunction. To determine the hormone levels, following the history (included IIEF-5 score) and physical examination, triple blood samples were collected at intervals of 15 minutes between 08:00 and 10:00 am. Total and free testosterone, prolactin, follicle stimulating hormone and leteinizing hormone levels were studied. Results: Mean ago was 43 (23 - 80) years. IIEF-5 score was less than 21 [9.8 - 4.3 (3 - 19)] in all study groups. There was a statistically significant correlation between tT and FSH, as well as between LH and FSH in Pearson (r = - 0.513, p < 0.001, respectively) and also in Spearman tests (r = - 0.224, p = 0.042 and r = - 0.459, p < 0.001, respectively). However, there was no correlation between age and serum hormone levels (p > 0.05). Of the 100 patients, 18 (18%) had low tT, 77 (77%) had normal and 5 (5%) had high tT levels. No statistically significant correlation was found between decreased libido and tT levels (p > 0.05). Twelve (66.6%) of the 18 patients with low tT had normal libido. Conclusion: Analyzing the medical history in detail and performing a thorough physical examination can reduce the need for excessive studies and consultations, and enables patients to save time and costs.Item The relationship between smoking and lower urinary tract symptoms: Community based study; [Si̇gara alişkanliǧi i̇le alt üri̇ner si̇stem yakinmalari arasindaki̇i̇li̇şki̇: Topluma dayali çalişma](2007) Temeltaş G.; Müezzinoǧlu T.; Üçer O.; Lekili M.; Büyüksu C.Introduction: 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 A survey of patient preparation and technique of ultrasound-guided prostate biopsy: A multicenter study og urooncological association; [Ultrasonografi kιlavuzluǧunda yapιlan prostat biyopsisinde hasta hazιrlιǧι ve teknik anketi: Üroonkoloji derneǧi çcok merkezli çalιşmasι](Turk Uroloji Dernegi, 2007) Bozlu M.; Akduman B.; Mungan U.; Özen H.; Baltaci S.; Türkeri L.; Kirkali Z.; Akdaş A.; Adsan Ö.; Akdoǧan B.; Altinel M.; Ataus S.; Ayan S.; Bilen C.Y.; Çal Ç.; Çek M.; Dündar M.; Işeri C.; Koşan M.; Lekili M.; Müezzinoǧlu T.; Özer G.; Özgök Y.; Perk H.; Soyupak B.; Soyupek S.; Soylu A.; Sözen S.; Şengör F.; Tansuǧ Z.; Tekin A.; Yildirim A.Introduction: Ultrasound-guided prostate biopsy is the standard method for the diagnosis of prostate cancer. The aim of the present survey is to assess the variability in patient preparation and technique of ultrasound-guided prostate biopsy among Turkish Urologists. Materials and Methods: In July 2004, a questionnaire was sent out to e-mail addresses of the members of Urooncological Association, asking about the details of prostate biopsy protocol of the members. The survey consisted of multiple choice questions about the patient preparation and prostate biopsy technique. Responses were acquired via e-mail and analyzed in detail. Results: Thirty two urologists from 24 centers responded. The biopsy procedure was performed by the urologist only in 54.16% of the centers, both urologist and radiologist in 37.5%, and radiologist only in 8.33%. Transrectal route was the most common method for ultrasound-guided prostate biopsy. A half of the responders performed biopsy when PSA was greater than 4 ng/ml. All of the centers administered antibiotic and a half of them used enema before the procedure. Approximately 37% of responders did not administer any type of analgesia, but 29.1% of all responders administered a periprostatic nerve block for reducing pain during the procedure. Most urologists obtained 10 or 12 biopsy cores and only 20.8% of them obtained routine transitional zone biopsy during the initial biopsy session. Conclusion: This survey demonstrated that patient preparation and technique of ultrasound-guided prostate biopsy is not standardized among Turkish Urologists, and a guideline on prostate biopsy is needed.Item Beliefs and attitudes of physicians dealing with cancer patients about quality of life: A comparative study; [Kanser hastalanyla çalişan hekimlerin yaşam kalitesine yönelik inang ve tutumlari: Karsy̧ilaştirmali bir çalişma](2009) Aydemir O.; Çelik P.; Müezzinoǧlu T.Objective: This study was designed to determine the beliefs and attitudes of physicians dealing with cancer patients about quality of life. Materials and methods: For determining the beliefs and attitudes of physicians about quality of life, a 32-item questionnaire was developed, inspired by the questionnaire developed by Bezjak et al. Two diverse specialties of physicians were enrolled, including 44 urologists, and 73 chest physicians. Results: It was found that all physicians had positive beliefs about quality of life, but they mainly relied on their own clinical experience instead of scales. When the two groups were compared, chest physicians seemed to accord more importance to prolong the patients' survival and to biological parameters in choosing the treatment than did urologists. Conclusion: All physicians dealing with cancer care have positive attitudes towards quality of life assessments. Chest physicians weight quality of life as a lowrank issue compared to urologists in the care of cancer patients. This seems to be due to high mortality rates of lung cancer.Item Sorafenib-induced erythema multiforme in metastatic renal cell carcinoma(2009) Bilaç C.; Müezzinoǧlu T.; Ermertcan A.T.; Kayhan T.C.; Temeltaş G.; Özütrkcan S.; Temiz P.Sorafenib is a new therapeutic agent being used in metastatic renal cell carcinoma, hepatocellular carcinoma, and malignant melanoma. The most frequently seen cutaneous side effects due to sorafenib are erythema, exfoliative dermatitis, acne vulgaris, and flushing. Folliculitis, eczema, and erythema multiforme are other, rare side effects of sorafenib. A 59-year-old man underwent left radical nephrectomy due to renal cell carcinoma 8 months ago, and after the operation he received immunochemotherapy and then sorafenib. On the third day of sorafenib therapy his lesions occurred. His dermatologic examination revealed multiple erythematous papules on his neck, arms, and legs and bullae and iris lesions on his palms and soles. He was diagnosed as having erythema multiforme. In the literature we found only 1 other erythema multiforme case due to sorafenib. We present this interesting case to show and discuss cutaneous side effects of sorafenib, especially erythema multiforme as a very rare cutaneous side effect. © 2009 Informa UK Ltd.