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    Antegrade stent placement in laparoscopic upper urinary tract surgery. Is there an easy way?
    (TERMEDIA PUBLISHING HOUSE LTD, 2019) Gokcen, Kaan; Gokce, Gokhan; Kordan, Yakup; Kirac, Emre; Dundar, Gokce; Gultekin, Emin Yener
    Introduction: Antegrade placement of double J stents in laparoscopy is considered a challenging and time-consuming process due to limitations regarding stent flexibility. Aim: To describe the method we used to facilitate the antegrade placement of intracorporeal stents in laparoscopic upper urinary tract (LUUT) surgery and report its results. Material and methods: Data obtained from 42 consecutive patients who had stents placed antegradely in laparoscopic pyeloplasty or in laparoscopic ureterolithotomy for middle-upper ureteral stones were retrospectively evaluated. The mean age of the patients was 30.1 +/- 18.6 (10 months-68 years) and 13 patients were in the paediatric age group. All patients in the paediatric age group underwent laparoscopic pyeloplasty. Results: The mean operative time for the 42 total cases, of which 32 underwent laparoscopic dismembered pyeloplasty and 10 laparoscopic ureterolithotomy, was 126.9 +/- 33.5 (70-200) min and the intraoperative stent placement time was calculated as 2.61 +/- 0.8 (1.5-5) min. The patients, who had a mean hospitalization time of 2.8 +/- 0.9 (2-5) months, required no additional interventions and no complications were encountered intraoperatively. In the patient series that had a mean follow-up time of 17.4 +/- 11.3 (1-35), it was determined only in 1 patient that the distal tip of the stent had not been in the bladder. Conclusions: The described modified antegrade stent placement technique is a practical method that is safe for all LUUT cases in both paediatric and adult age groups and it has been shown to produce successful outcomes and to be time-saving.
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    Comparison of Prostate Specific Antigen and Neuropeptide Y Parameters in Patients with Prostate Cancer
    (Galenos Publ House, 2024) Ozturk, Abuzer; Saygin, Huseyin; Asdemir, Aydemir; Bolat, Serkan; Ergin, Ismail Emre; Kirac, Emre; Korgali, Esat
    Objective: Prostate cancer is a solid tumor that can be fatal in men. Early detection and proper management are essential for improving outcomes and reducing mortality rates associated with this disease. This study aimed to evaluate the potential of neuropeptide Y (NPY) as a biomarker to enhance the effectiveness of prostate specific antigen (PSA) testing in diagnosing and predicting prostate cancer prognosis. NPY, a well-known sympathetic neurotransmitter, possesses growth-promoting and angiogenic properties in various cell types, including those relevant to prostate cancer. Additionally, NPY has been linked to neuroendocrine differentiation of prostate cancer cells. By comparing the efficacy of PSA testing alone with the addition of NPY, this study aimed to determine whether NPY could offer additional predictive value for prostate cancer progression and prognosis. Materials and Methods: This study involved 90 patients each diagnosed with localized prostate cancer (LPC), metastatic prostate cancer (mPC) at diagnosis, and metastatic castration-resistant prostate cancer (mCRPC) who visited our urology clinic between 2022 and 2023. Blood samples were collected from all participants between 08:00 and 09:00 after a 12 hour fast. In the LPC and mPC groups, samples were collected upon diagnosis, whereas in the mCRPC group, samples were collected upon development of treatment resistance. NPY levels in blood samples were analyzed using enzyme-linked immunosorbent assay method. Serum NPY levels were compared between the LPC, mPC, and mCRPC groups. Results: PSA values were calculated as 12.6 (7.08-32.47) ng/L in the LPC group, 159 (73.1-405.2) ng/L in the mPC group, and 38.33 (18.4-132) ng/L in the mCRPC group, with a statistically significant difference between the groups (p<0.001). The average NPY values were 351.3 +/- 162.7 ng/L in the LPC group, 276.5 +/- 85 ng/L in the mPC group, and 272.13 +/- 94.7 ng/L in the mCRPC group. NPY values were found to be statistically significantly higher in the LPC group (p=0.018). Conclusion: The serum NPY levels were notably elevated in the LPC group compared with the mPC and mCRPC groups. This finding implies a potential association between low NPY levels and mPC as well as mCRPC.
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    Determination of kidney stone prevalence in Sivas city center: A retrospective research
    (Bayrakol Medical Publisher, 2021) Saygin, Huseyin; Cinar, Ziynet; Ozturk, Abuzer; Kirac, Emre; Ergin, Ismail Emre; Velibeyoglu, Arslan Fatih; Korgali, Esat
    Aim: In this study, it was aimed to determine the prevalence of urinary stone disease (USD) in the center of Sivas based on data from patients who were diagnosed with USD at the urology clinic of the hospitals in Sivas center. Material and Methods: This is a retrospective study. The records of the patients who applied to the Urology Department of the Faculty of Medicine of Sivas Cumhuriyet University and Sivas Numune Hospital i between 2014 and 2019 were examined in this research. Evaluations of statistics were made on the basis of data to determine the prevalence of USD in Sivas center. Results: The data of 30218 people (20114 mates and 10104 females) who applied to the Urology Policlinic of Sivas Central Hospitals in 2014 and 2019 were evaluated for USD. Also, 4739 patients who were operated in both hospitals were evaluated according to gender and age. Results significantly increased with age for both genders (p<0.05). On the other hand, the number of people treated with Extracorporeal Shock Wave Lithotripsy (ESWL) in both hospitals was 1543. They were evaluated by age and gender, and results were not statistically significant (p>0.05). The prevalence of USD in the Sivas Center was determined as 8%. Agglomeration was observed in 31-70 age groups in both sexes. The results showed that the risk of USD was twice as high among men in both Numune Hospital and C.U Hospital. Discussion: Our country is one of the regions where USD is common, but there are not enough prevalence studies on this subject. It is a known fact that processes of diseases and treatment put a great burden on the economy of the country. Knowing the frequency of the disease makes it easier to take precautions. More epidemiological studies in larger populations are needed to direct health policies.
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    Effects of psoriasis and metabolic syndrome on male sexual functions
    (Imr Press, 2021) Saygin, Huseyin; Tosun, Mustafa; Ozturk, Abuzer; Ergin, Ismail Emre; Kirac, Emre; Asdemir, Aydemir; Velibeyoglu, Arslan Fatih
    Background and Objective: Psoriasis is a chronic inflammatory systemic skin disease triggered by psychological, genetic and environmental factors. The effect of psoriasis on sexual health has not been fully elucidated. Coexistence of psychiatric disorders also affects negatively the life quality of psoriasis patients. This study investigates the relationship between the severity of the current illness, psychosocial health problems and coexisting metabolic syndrome on sexual health in male patients with psoriasis. Materials and methods: 52 male patients diagnosed with psoriasis and 50 healthy men included for the study. Patient groups Psoriasis Area Severity Index (PASI) and The Dermatology Life Quality Index (DLQI) were tested, subsequently International Index of Erectile Function (IIEF), Hamilton Rating Scale for Depression (HAM-D) tests and Metabolic syndrome (MetS) were reported for both groups. Eventually, the patient groups treaments were recorded. Results: IIEF, HAM-D scores and MetS were significantly different between the two groups (P = 0.017, P = 0.005, P = 0.009). IIEF score had a significant negative correlation with age, HAM-D and PASI scores (r = -0.405, -0.217 and -0.394, P = 0.028, 0.043 and 0.014). It is seen that the frequency and severity of ED increased with methotrexate treatment. Conclusion: It is showed that psoriasis has negative effects on male sexual health in this study. Our opinion of the reason is the natural course of the disease, its coexistence with diseases such as metabolic syndrome and depression, and the agents used in its treatment.
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    Fluoroquinolone Resistance Level in Rectal Swab Taken Before Transrectal Ultrasound Prostate Biopsy
    (Galenos Publ House, 2022) Saygin, Huseyin; Ozturk, Abuzer; Asdemir, Aydemir; Ergin, Ismail Emre; Velibeyoglu, Arslan Fatih; Kirac, Emre; Hasbek, Mursit
    Objective: It has been shown that antibiotic prophylaxis before transrectal ultrasound prostate biopsy (TRUS-Bx) reduces the incidence of post-biopsy infectious complications. Without the superiority of a particular antibiotic regimen, there are differences in the antibiotic regimens used by clinics. However, recently, there have been serious concerns about TRUS-Bx-related infectious complications due to the increase in fluoroquinolone (FQ)-resistant bacterial strains. To overcome this global problem, alternative antibiotic prophylaxis should be investigated and appropriate antibiotic management should be applied in patients who will undergo TRUS-Bx. This study aimed to determine the antibiotic susceptibility of the rectal flora based on rectal cultures before TRUS-Bx, to systematically determine the basic prevalence of FQ resistance, to investigate the relationship between FQ resistance and the risk of infection after TRUS-Bx, and to determine the susceptibility of Fosfomycin and trimethoprim-sulfamethoxazole (TMP-SMX) as an alternative to the FQ group.Materials and Methods: Rectal swab cultures were taken from each patient to undergo TRUS-Bx two days before the procedure. Two daily doses of 500 mg ciprofloxacin were given orally for one week, starting one hour before the procedure. All patients underwent 12 core biopsies.Results: Antibiograms obtained from rectal swabs showed sensitivity to FQ in 78 patients (89.7%), to Fosfomycin in 85 patients (97.7%), to TMP-SMX in 78 patients (89.7%).Conclusion: Although different antibiotic prophylaxis methods are discussed due to FQ resistance in today's medical practices, FQ sensitivity continues at a high rate of 89.7% in our region and still seems to be a viable prophylaxis method.