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Öğe A case of primary infertility resulting from circumcaval (retrocaval) ureter(2005) Topsakal, Kahraman; Kaya, Kemal; Kayacan, Ertan; Gültekin, E. YenerIntroduction: We report a rare congenital anomaly, varicocele due to circumcaval ureter (CCU) with infertility. The patient had abnormal semen parameters (decreased sperm motility). Abdominal ultrasound revealed marked right hydronephrosis and testicular ultrasound revealed right varicoid veins. Urography showed typical reverse J deformity on the right side. Helical C.T. confirmed the CCU. We performed classical CCU surgery and in addition Palomo varicocelectomy. The patient became the fertile on the postoperative 8th month. This is the first case of infertility resulting from CCU in the literature.Öğe A CASE OF PRIMARY INFERTILITY RESULTING FROM CIRCUMCAVAL (RETROCAVAL) URETER(Aves, 2005) Topsakal, Kahraman; Kaya, Kemal; Kayacan, Ertan; Gultekin, E. YenerIntroduction: We report a rare congenital anomaly, varicocele due to circumcaval ureter (CCU) with infertility. The patient had abnormal semen parameters (decreased sperm motility). Abdominal ultrasound revealed marked right hydronephrosis and testicular ultrasound revealed right varicoid veins. Urography showed typical reverse J deformity on the right side. Helical C. T. confirmed the CCU. We performed classical CCU surgery and in addition Palomo varicocelectomy. The patient became the fertile on the postoperative 8th month. This is the first case of infertility resulting from CCU in the literature.Öğe Renal hücreli kanserli hastaların tanı ve değerlendirilmesinde üriner NMP22 testinin önemi(Cumhuriyet Üniversitesi, 2003) Kaya, Kemal; Ayan, SemihÖzet Bu çalışmanın amacı mesane tümörünün tam ve takibinde kullanılan üriner matriks protein 22 (]SfMP22)'nin renal hücreli karsinomda (RHK) pozitif olma sıklığım değerlendir mekti. Bilgisayarlı batın tomografisi ile solid renal kitle tespit edilmiş ve RHK ön tanısı ile radikal nefrektomiye hazırlanan 41 hastanın operasyon öncesi üriner NMP22 seviyeleri ölçüldü. Operasyon sonrası 38 renal kitlenin histopatolojik değerlendirmesi RHK olarak bildirildi. İki olguda ksantogranülomatöz pyelonefrit, bir olguda ise küçük hücreli adenokarsinom rapor edildi. Kontrol grubu olarak patoloji sonucu renal taş ya da basit renal kisti olan toplam 30 olgunun idrar örnekleri kullanıldı. Ksantogranülomatöz pyelonefrit olarak bildirilen 2 olgunun yanısıra küçük hücreli adenokarsinom olgusunun test sonucu çalışmaya dahil edilmedi. RHK bulunan hastaların üriner NMP22 değerleri kontrol grubuna göre anlamlı olarak daha yüksekdi. RHK grubundaki 38 hastadan 23'ünün(%60.5) NMP22 değerinin 10 U/mL'nin üzerinde idi. Kontrol grubunda 4 olguda test sonucu 10 U/mL'nin üzerindeydi. RHK olan olgularda patolojik Tümör evresi ile üriner NMP22 değerleri arasındaki korelasyona bakıldığında, evre ilerledikçe NMP22 değeri artmakla birlikte ilişkinin istatistiksel olarak anlamsız olduğu görüldü. NMP22 değerleri ile derece ve tümör büyüklüğü arasındaki ilişkiler de anlamsızdı. Üriner NMP22 testi RHK olan olguların tanınmasına ve rastlantısal RHK tanılarının artmasına yardımcı olabilir. Bunun yanında RHK olgularında da pozitif test değerlerinin alınabiliyor olması, üriner NMP22 değeri yüksek olan mesane tümörü şüpheli hastalarda daha kapsamlı değerlendirmeyi gerekli hale getirmektedir. Renal tümör hücrelerine özgü NMP ölçümlerinin yapılabilmesi bu testin RHK' da kullanılabilirliğini arttıracaktır. Anahtar kelimeler: Renal hücreli karsinom, NMP22Öğe Surgical treatment of penil fractures(2003) Kiliçarslan, Hakan; Gökçe, Gökhan; Kaya, Kemal; Ayan, Semih; Gültekin, Yener EBACKGROUND: Patients diagnosis as penil fracture and treated with surgical methods were evaluated retrospectively between January 1990-February 2002. METHODS: Patients were evaluated by age, trauma type, time passed after the trauma, physical examination and radiologic data. RESULTS: The cause of trauma was blunt trauma in all patients. 14 trauma (60.8%) were during sexual activity, 6 trauma (26%) were during handling the erective penis in morning erection, 3 of trauma (13%) were due to the rolling on to the penis. Urethral bleeding was seen in 1 patient and microscopic hematuria was detected in 5 patients. Subcoronal circular incision was carried out in 16 patients (69.5%), semicircular incision was done directly on the injury in 6 patients (26%) and from penis radix to scrotum was done in 1 patient (4.3%). There was unilateral corpus cavernosum injury in 21 patients. Bilateral corpus cavernosum injury in 1 patient, corpuscavernosum, corpus spongiosum and incomplent urethral injury in 1 patient. Wound infection was detected only in 2 patients at postoperatively early period. After evaluating 20 patients with medical history and physical examination in postoperative control penil curvature permitting sexual activity was detected in 3 patients. CONCLUSION: We concluded that patients with penil fracture may be treated with low complication rate by early surgical procedure.Öğe The relationship between symptoms and urodynamic evaluation in women with urinary incontinence(2003) Kiliçarslan, Hakan; Kaya, Kemal; Güvenal, Tevfik; Gökçe, Gökhan; Ayan, Semih; Gültekin, E. YenerOBJECTIVE: In this study we investigated the relationship between urodynamic findings and medical history, the type of urinary incontinence in women with urinary incontinence. STUDY DESIGN: The retrospective analysis which includes 161 incontinent women wham evaluated with urodynamic investigation between 1990-2001 in Urology department of Cumhuriyet University, Faculty of Medicine was performed. RESULTS: A total of 161 incontinent women were investigated and 67 of 90 women with complaints of pure stress incontinence (74.5%) had genuine stress incontinence, 23 of 40 women with complaints of pure urge incontinence (57.5%) had detrusor instability, 13 of 31 women with complaints of mixed incontinence (41.9%) had mixed incontinence in urodynamic evaluation. CONCLUSION: Pure stress incontinence and pure urge incontinence complaints in medical history had high sensitivity and specifity for diagnosis as well as as uradynamic investigations. But without urodynamic evaluation, medical history is not sufficient alone in objective diagnosis.
