Browsing by Author "Temeltas G."
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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 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 The effects of botulinum-A toxin on bladder function and histology in spinal cord injured rats: Is there any difference between early and late application?(Lippincott Williams and Wilkins, 2005) Temeltas G.; Tikiz C.; Dagci T.; Tuglu I.; Yavasoglu A.Purpose: We explored the effects of early and late application of botulinum-A toxin (BTX-A) on reservoir function and histological bladder changes in spinal cord injured rats. Materials and Methods: The study was done in 30 Sprague-Dawley rats randomly allocated into 5 groups. Group 1 of 6 rats underwent sham operation only. Group 2 of 6 rats underwent spinal cord transection. Group 3 of 6 rats underwent spinal cord transection followed by BTX-A application into the detrusor muscle 7 days later. Group 4 of 6 rats underwent spinal cord transection, followed by BTX-A application into the detrusor muscle 28 days later. Group 5 of 6 rats underwent spinal cord transection followed by saline injection into the detrusor muscle after 28 days. Spinal cord injury was created by transecting the cord at the T9 to T10 level. All rats underwent cystometric examination initially and on day 42 before sacrifice. The bladders were removed and examined histologically for fibrosis and hyperplasia. Results: On cystometric examination BTX-A caused an improvement in baseline pressure, and the frequency and amplitude of uninhibited detrusor contractions (p <0.001). No significant differences were observed in maximal bladder capacity or urethral opening pressure (p >0.05). Histologically BTX-A led to decreased fibrosis and hyperplasia (p <0.001). No significant differences were found between histological or cystometric among the groups with respect to receiving BTX-A in the early and late periods (p >0.05). Conclusions: BTX-A has a functional and histological healing effect on detrusor hyperreflexia subsequent to spinal cord injury in rats. Although administering BTX-A in the early period had better quantifiable functional and histological outcomes compared to the late period, the difference was not statistically significant. Copyright © 2005 by American Urological Association.Item Evaluation of risk factors and severity of a life threatening surgical emergency: Founder's gangrene (a report of 15 cases)(ARSMB-KVBMG, 2009) Kara E.; Müezzinoglu T.; Temeltas G.; Dinçer L.; Kaya Y.; Sakarya A.; Coskun T.Background: Fournier's gangrene is a rare, rapidly progressive, necrotising fasciitis of the external genitalia and perineum with high morbidity and mortality. Patients and Methods: 15 patients with Fournier's gangrene were enrolled. Gender, age, aetiology, predisposing factors, symptomatology, associated diseases, hospital stay, FGSI, and body surface area were analysed. Results: Ten males and five females were enrolled in the study. The mean age was 54 years (range 23-81). E.coli and acinetobacter were the common organisms cultured. All patients were treated with a common approach of resuscitation, broad-spectrum antibiotics, and wide surgical excision. Common predisposing factors included diabetes mellitus (73.3%), poor personal hygiene (60%), obesity (33.3%), psychosis (20%) and decubitus ulcers (13.2%). Whereas five (33.3%) patients developed synergistic gangrene of the scrotum secondary to anorectal disease, five (33.3%) had a urological source of infection. Mean BSA and FSGI scores were 15.93 ±3.13 and 6.02 ±0.95, respectively. Serum glucose > 140 mg/dl, the existence of septic shock on admission, the spread of gangrene to the perineum and abdominal wall (Groups C and D), BSA ≥: 24 cm2, a cutaneous source of infection and FGSI scores ≥ 7 were factors affecting mortality rates with statistical significance (p < 0.05). There was a direct correlation between the culture of mixed type micro-organisms and the cutaneous source of infection (p > 0.05). The extent of gangrene correlated with higher FGSI scores (≥ 7) (p < 0.05). Mortality and morbidity rates were as 20% (n = 3) and 60% (n = 9). Conclusion: Aggressive surgical debridement and combined antibiotherapy are essential in the management of Fournier's gangrene. FGSI and BSA are useful to assess the severity and prognosis of the disease.Item Effects of neuronal and glial restricted precursor cells transplantation on erectile function after experimentally induced spinal cord injury(Blackwell Publishing Ltd, 2009) Temeltas G.; Dagci T.; Evren V.; Lekili M.Introduction.: 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. © 2009 International Society for Sexual Medicine.Item Bladder Function Recovery in Rats With Traumatic Spinal Cord Injury After Transplantation of Neuronal-Glial Restricted Precursors or Bone Marrow Stromal Cells(2009) Temeltas G.; Dagci T.; Kurt F.; Evren V.; Tuglu I.Purpose: We investigated functional recovery of the lower urinary system in rats with spinal cord injury after transplanting neuronal restricted precursors/glial restricted precursors or neural cells derived from bone marrow stromal cells into the injured area of the spinal cord. Materials and Methods: A total of 30 rats underwent experimentation in 4 groups, including group 1-sham operation, group 2-spinal cord injury plus neuronal restricted precursor/glial restricted precursor transplantation, group 3-spinal cord injury plus bone marrow stromal cell transplantation and group 4-spinal cord injury control. All rats in the 4 groups were investigated urodynamically and sacrificed on day 28 after transplantation. The cells transplanted into the injured spinal cord underwent histological investigation. Results: Transplanted cells (neuronal and glial restricted precursors, and bone marrow stromal cells) were found to maintain a presence in the injured spinal cord area. Baseline pressure, maximum capacity, mean uninhibited contraction amplitude, mean voiding pressure, voided volume and post-void residual volume were significantly better in groups 2 and 3 than in group 4, while baseline pressure in group 2 was better than that in group 3. We found no significant difference among the groups according to mean uninhibited contraction frequency. Conclusions: Although neuronal/glial restricted precursor transplanted rats seemed to have more improvement, all rats in groups 2 and 3 showed some significant improvement in lower urinary system function. On the other hand, the level of this improvement was far from complete functional recovery. © 2009 American Urological Association.Item Sorafenib in Metastatic Renal Cell Carcinoma With Sarcomatoid Differentiation(2010) Lekili M.; Muezzinoglu T.; Nese N.; Temeltas G.Targeted 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. © 2010 Elsevier.Item Sexual dysfunction in female patients with neurodermatitis(2011) Ermertcan A.T.; Gencoglan G.; Temeltas G.; Horasan G.D.; Deveci A.; Ozturk F.Neurodermatitis is a chronic disease affecting the patient's psychosocial status and quality of life. It is associated with a variety of psychologic problems, including demoralization, depression, anxiety, obsessive-compulsive disorder, and sleep disturbances. Coexistence of sexual dysfunction, especially in women, with several systemic diseases has gained interest in recent years. In this study, we evaluated sexual function in female patients with neurodermatitis. We enrolled 89 women (43 patients, 46 controls) in the study. Quality of life was assessed with the Dermatology Life Quality Index (DLQI), and the Female Sexual Function Index (FSFI) was used to determine sexual function. Individuals with psychiatric disorders and/or those using antidepressants were excluded. The total DLQI score was 11.95 6 5.65 in patients with neurodermatitis. The total FSFI score was significantly lower in patients compared with healthy controls (22.76 6 5.31 and 28.83 6 3.50, respectively; P 5 .001). Domain scores of FSFI (desire, arousal, lubrication, orgasm, and satisfaction) except pain were significantly lower in patients with neurodermatitis (P 5 .001). The pain score was also lower in patients than controls, but the difference was not statistically significant (P 5 .073). Neurodermatitis may be associated with sexual dysfunction, and patients with neurodermatitis should be evaluated with regard to sexual function to provide a better quality of life.Item The analysis of the efficacy and safety of transobturator sling operation by using an adjustable sling device in the treatment of stress urinary incontinence(Aras Part Medical International Press, 2014) Temeltas G.; Yuksel M.B.; Tatlı V.; Gumus B.Objectives: We aimed to evaluate the safety and efficacy of a transobturator sling (TOT) procedure by using an adjustable TOT device in the treatment of stress urinary incontinence (SUI).; Materials and Methods: The data of 89 patients who had the diagnosis of SUI and underwent TOT operation by using an adjustable MUS device of SAFYRE t plus (Promedon®) between June 2005-November 2012, were retrospectively evaluated. The pateints were evaluted by the parametres of physical examination, stress test, ultrasonography, uroflowmetry, residual urine measurement, cystometry, subjective incontinence scoring (VASi), patients' satisfaction scoring (VASs), and ICQ-SF questionare. The preoperative, perioperative, and postoperative collected data were statistically analysed to determine the efficacy and safety of TOT application by using SAFYRE t plus.; Results: The mean age, account of parity, and body mass index was 55.3±10.1, 2.34 ± 1.43, and 24.97 ± 3.7, respectively. While the pre- and postoperative results of stress test, VASi, and ICIQ-SF scores were significantly different (P=0.00 in all), the pre- and postoperative results of Qmax and PVR account were similar (P= 0.84, P= 0.79, respectively). The severity of subjective incontinence (VASi score) significantly improved after the operation. The mean VASs score at postoperative 12th month was 7.75±1.11. The subjective and objective cure rates were %89.9 (80/89) and %78.6 (70/89), respectively.; Conclusion: The TOT operation by using SAFYRE t plus, which was an adjustable sling device, seemed to be an efficient, reasonably safe, minimally invasive treatment alternative for the surgical management SUI in women. © 2014 / PMCARAS . All rights reserved.Item The comparison of urodynamic findings in women with various types of urinary incontinence(Brazilian Society of Urology, 2014) Zeren M.F.; Yüksel M.B.; Temeltas G.Purpose: We aimed to determine the differences of the urodynamic findings of mix urinary incontinence (MUI), urge urinary incontinence (UUI), and stress urinary incontinence (SUI), and to evaluate the urodynamic findings in different groups by using bladder sensitivity index (BSI). Materials and Methods: The data of 99 patients who underwent urodynamic testing related to the suspicion of SUI, UUI or MUI were analysed. This analysis included a retrospective evaluation of patients' cards, voiding diaries, and urodynamic reports. At filling cystometry, the parameters of first sensation of bladder filling (FSBF), first desire to void (FDV), strong desire to void (SDV), and bladder capacity (Vmax), which were related to the bladder sensation, were determined. Subsequently, uroflowmetric findings were recorded during bladder emptying. BSI was defined as the ratio of Vmax/ FDV. These results were statistically compared among the goups. Results: The sample included 35(35.5%) MUI, 33(33.3%) UUI and 31 (31.1%) SUI. The mean ages were similar in all groups (P = 0.868). The mean FSBF, FDV, SDV and Vmax values were significantly different among groups (p = 0.004, p < 0.001, p < 0.001, p < 0.001 respectively). Nevertheless, there was no statistically significant difference among the mean daily voiding accounts (P = 0.005). Although the mean maximum flow rate (Qmax) values were similar (P = 0.428), the mean maximum detrusor pressure (Pdetmax) values were significantly different (P = 0.021). The mean BSI values showed no significant differences (P = 0.097). Conclusions: It was concluded that while the use of urodynamic testing could contribute to the management of urinary incontinence, the indexes including BSI requere more detailed and comprehensive studies.Item The long-term results of temporary urethral stent placement for the treatment of recurrent bulbar urethral stricture disease(Brazilian Society of Urology, 2016) Temeltas G.; Ucer O.; Yuksel M.B.; Gumus B.; Tatli V.; Muezzinoglu T.Aim: To evaluate the long term outcomes of temporary urethral stent placement for the treatment of recurrent bulbar urethral stricture. Materials and Methods: Twenty-eight patients who underwent temporary polymer coated urethral stent placement due to recurrent bulbar urethral stricture between 2010 and 2014 were enrolled in the study. The long term outcomes of the patients were analyzed. Results: The mean age of the patients was 62.3±6.4 (44-81). The overall clinical success was achieved in 18 (64.2%) of the 28 patients at a median (range) follow-up of 29 (7-46) months. No patient reported discomfort at the stent site. Stone formation was observed at the urethral stent implantation area only in one patient. Stenosis occurred in the distal end of the stents in two patients and took place in bulbar urethra in seven patients after removed the stents. The mean maximum urine flow rates were 6.24±2.81mL/sec and 19.12±4.31mL/sec before and at 3 months after the procedure, respectively. Conclusion: In this study, the success rate of temporary urethral stent placement has remained at 64.2% at a median follow-up of 29 months. Therefore, our outcomes have not achieved desired success rate for the standard treatment of recurrent bulbar urethral stricture.Item Comparison of pain, quality of life, lower urinary tract symptoms and sexual function between flexible and rigid cystoscopy in follow-up male patients with non muscle invasive bladder cancer: A randomized controlled cross section single blind study(John Wiley and Sons Inc, 2021) Ucer O.; Temeltas G.; Gumus B.; Muezzinoglu T.Objectives: To compare pain, quality of life (QoL), sexual function and lower urinary tract symptoms (LUTS) between rigid (RC) and flexible cystoscopy (FC). Methods: Forty-one patients who were planned control cystoscopies were enrolled the study. At the first cystoscopy, 20 patients (Group 1) and other 21 patients (Group 2) were performed by flexible (15.5 Fr) and rigid cystoscope (15.5 Fr), respectively. At the second cystoscopies, the patients in group 1 and group 2 were performed by rigid and flexible cystosacope, respectively. In all the patients, pain was measured with visual pain scale (VPS) shortly after cystoscopy. Also, SF, QoL and LUTS were assessed by IIEF, SF-36 and MLUTS forms, respectively. Results: While 22 of the patients preferred FC, the other 19 preferred RC (P > 0.05). There were no statistical differences between VPS, IIEF, SF-36 and MLUTS scores of the two groups. In multivariate analysis regarding the quality of life, although sexual function, pain and cystoscopy type did not affect QoL, voiding symptoms affected independently QoL. After both cystoscopy type, IIEF, SF-36 and MLUTS scores did not change statistically. Conclusion: The results showed that the effects on pain, sexual function, QoL and LUTS of RC and FC were similar. In general, cystoscopy did not affect negatively on QoL, sexual function and LUTS of the patients. © 2020 John Wiley & Sons LtdItem Comparison stone-free rate and effects on quality of life of percutaneous nephrolithotomy and retrograde intrarenal surgery for treatment of renal pelvis stone (2-4cm): A prospective controlled study(Lippincott Williams and Wilkins, 2022) Ucer O.; Erbatu O.; Albaz A.C.; Temeltas G.; Gumus B.; Muezzinoglu T.Objectives: The aim of our study was to compare the effects on quality of life (QoL) and stone-free rate (SFR) of percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS) in patients with renal stones 2-4cm. Materials and methods: A total of 102 patients with renal pelvis stones were enrolled in this prospective controlled study, of which 52 were performed RIRS and 50 with PNL. The QoL was evaluated by using Short From-36 pre- and post-operatively. Also, the surgical data of all patients during and after the operations were compared between the 2 groups. Results: The mean age, body mass index, stone size and density of the patients in the 2 groups were statistically similar (p>0.05). The SFR of PNL and RIRS were found 94% (47/50) and 73% (38/52), respectively (p<0.01). There were no statistically differences between operation times, minor complication rates and Short From-36 scores of the 2 groups. Hospitalization times were 1.13± 0.34days for RIRS and 2.9±5.7days for PNL (p<0.05). While the blood transfusion rate of PNL group was 8% (4/50), none patient was made blood transfusion in RIRS. Conclusions: The results of our study show that the blood transfusion rates and hospitalization times of RIRS group are significantly lower than PNL for management of renal pelvis stone 2-4cm. Despite these advantages of RIRS, the SFR is significantly lower than PNL for these stones. The effects on QoL of the both interventions before and after surgery were similar. © 2022 S. Karger AG. All rights reserved.