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Öğe 2. Radikal prostatektomi materyallerinde histolojik prognostik faktörler ve parsiyel örnekleme yöntemleri üzerine bir çalışma(2002) Doganavsargil, Basak; Hekimgil, Mine; Şimşir, Adnan; Cal, Cag; Soydan, Saliha…Öğe Amyloidosis of seminal vesicles; incidence and pathologic characteristics.(2012) Argon, Asuman; Şimşir, Adnan; Sarsik, Banu; Tuna, B; Yorukoglu, K; Niflioğlu, Gg; Sen, Sait…Öğe Analysis of Factors Affecting Functional Outcomes in Robotic-assisted Laparoscopic Radical Prostatectomy(2018) Kızılay, Fuat; İsmaylov, Fuad; Şimşir, Adnan; Turna, Burak; Semerci, Bülent; Apaydın, Erdalbjective: in addition to ensuring cancer control, prevention of incontinence and erectile dysfunction, which significantly impact patients’ quality of life, is also an important issue in robot-assisted laparoscopic radical prostatectomy (RALRP) operations. in this study, we aimed to evaluate the factors affecting postoperative urinary continence and erectile function in patients who underwent RALRP due to localized prostate cancer in our clinic. Materials and Methods: Our study included 439 patients who were diagnosed with stage 1 prostate cancer and underwent RALRP. Patients’ age, preoperative prostate-specific antigen (PSA) value, prostate volume, radical prostatectomy material Gleason score, operative time, transperitoneal surgical approach (posterior or anterior), and surgical margin and extraprostatic extension statuses were recorded. Postoperative continence and erectile function status of the patients were questioned and recorded via telephone interviews and in outpatient clinic follow-up. Patients were divided into groups according to postoperative incontinence and erectile dysfunction status and the variables were compared between the groups. Results: There was no statistically significant difference between the continent and incontinent groups in terms of age, preoperative PSA, prostate volume, operative time, postoperative Gleason score, surgical margin status, extraprostatic extension status, or anterior or posterior approach (p>0.05). There was no statistically significant difference between the groups with and without erectile dysfunction in terms of prostate volume, operative time, postoperative Gleason score, surgical margin status, or extraprostatic extension status (p>0.05), while there were statistically significant differences between the 2 groups in terms of age (p<0.001), preoperative PSA value (p=0.042), and surgical technique (p<0.001). Conclusion: We concluded that patient- and disease-related factors did not significantly affect postoperative urinary continence in patients undergoing RALRP due to prostate cancer, while patient age, preoperative PSA value, and operative technique had a significant effect on erectile function.Öğe Analysis of Prognostic Factors Affecting Cancer-specific Survival in Renal Tumors Larger than Ten Centimeters(2019) Kızılay, Fuat; Şimşir, Adnan; Akıncıoğlu, Emir; Kalemci, Serdar; Çal, Çağla; Cüreklibatır, İbrahim; Kumbaracı, Banu SarsıkObjective: the aim of this study was to evaluate the relationship between prognostic factors and cancer-specific survival (CSS) in renal tumors larger than ten centimeters. Materials and Methods: We evaluated the data of 126 patients who underwent open radical nephrectomy due to a renal mass larger than 10 cm between January 2010 and June 2016. Kaplan-Meier analysis or Cox regression was used to analyze the relationship between CSS and variables. Pairwise group comparisons were also evaluated with the Log-Rank test. A p-value <0.05 was considered statistically significant. Results: Mean follow-up was 68.5 months and mean survival was 39.2 months. the relationships between tumor histopathology, stage and CSS were significant. Tumor size negatively affected CSS, but the relationship was not significant. Tumor stage (T2b, T3b), tumor thrombus, lymph node metastasis and adjuvant therapy were the most effective independent factors affecting CSS according to Cox regression analysis results. Conclusion: Although tumor size is an important prognostic factor for T2b and lower stage kidney tumors, this effect is less in larger tumors and other clinicopathological features should be considered further to predict prognosis.Öğe Analysis of Prognostic Factors Affecting Cancer-specific Survival in Renal Tumors Larger than Ten Centimeters(2019) Kızılay, Fuat; Şimşir, Adnan; Akıncıoğlu, Emir; Kalemci, Serdar; Çal, Çağla; Cüreklibatır, İbrahim; Kumbaracı, Banu SarsıkObjective: The aim of this study was to evaluate the relationship between prognostic factors and cancer-specific survival (CSS) in renal tumors larger than ten centimeters. Materials and Methods: We evaluated the data of 126 patients who underwent open radical nephrectomy due to a renal mass larger than 10 cm between January 2010 and June 2016. Kaplan-Meier analysis or Cox regression was used to analyze the relationship between CSS and variables. Pairwise group comparisons were also evaluated with the Log-Rank test. A p-value <0.05 was considered statistically significant. Results: Mean follow-up was 68.5 months and mean survival was 39.2 months. The relationships between tumor histopathology, stage and CSS were significant. Tumor size negatively affected CSS, but the relationship was not significant. Tumor stage (T2b, T3b), tumor thrombus, lymph node metastasis and adjuvant therapy were the most effective independent factors affecting CSS according to Cox regression analysis results. Conclusion: Although tumor size is an important prognostic factor for T2b and lower stage kidney tumors, this effect is less in larger tumors and other clinicopathological features should be considered further to predict prognosis.Öğe Analysis of recurrent urethral strictures due to iatrogenic urethral trauma(2017) Kızılay, Fuat; Şimşir, Adnan; Özyurt, CeyhunBackground/aim: We aimed to analyze the effects of stricture location, etiology, age, and catheterization time on recurrence rate and recurrence time in patients who underwent direct vision internal urethrotomy (DVIU) for urethral strictures. Materials and methods: Patients were divided into three groups according to the location of the stricture: penile urethra, membranous urethra, and prostatic urethra strictures. Patients were also divided into three groups according to etiologic factors: strictures secondary to endoscopic procedures, urethral catheterization, and open or radical prostatectomy (anastomotic strictures were included in this group). Patients were also divided into three groups according to catheterization time: <2, 2–5, and >5–7 days. Recurrence rate and time data were analyzed according to stricture location, etiology, age, and catheterization time. Results: the recurrence rate was significantly higher in endoscopic procedures. Recurrence rate was significantly lower and recurrence time was significantly earlier in penile urethral strictures. Recurrence rate was significantly lower and recurrence time was significantly longer in short catheterized group than in the other two groups. However, first recurrence time was not different between the groups, while second and multiple recurrence times were significantly earlier in patients <60 years old. Conclusion: Patients are exposed to multiple operations as a result of frequently recurring urethral strictures. Although DVIU is an important first-line treatment method for strictures, alternative methods should be considered for frequently recurring cases.Öğe Androjen baskılama tedavisinin prostat kanserli hastalardaki yan etkileri(2006) Şimşir, Adnan; Cal, Cag…Öğe Basınç-akım çalışması için dolum sistometrisi gerekli mi?(2011) Şimşir, Adnan; Mammadov, R; Ozyurt, Ceyhun; Kızılay, Fuat…Öğe Bir Üroloji Kliniğindeki Adli Vakaların epidemiyolojisi(2011) Şimşir, Adnan; Şenol, Ender; Kalemci, Serdar; Turna, Burak; Çıkılı, Necmettin…Öğe Böbreğin müsinöz tübüler iğsi hücreli karsinomu ve tanı sorunları(2011) Sarsik, Banu; Şimşir, Adnan; Sen, Sait…Öğe Böbrekte kitle nedeniyle yapılan iğne kor biyopsileri ve tanı zorlukları(2009) Sen, Sait; Sarsık, B; Şimşir, Adnan; Kısmalı, Erkan; Gokmen, E…Öğe BPH de akut uriner retansiyon ve cerrahi risk(2011) Kızılay, Fuat; Şimşir, Adnan; Cureklibatır, İbrahim…Öğe BPH Tedavisinde 5-Alfa Redüktaz İnhibitörlerine ne kadar devam edilmelidir?(2010) Şimşir, Adnan; Cureklibatır, İ…Öğe Carbapenem-resistant Klebsiella pneumonia infection outbreak in a tertiary urology clinic: analysis of influencing factors with a controlled trial(2020) Kızılay, Fuat; Aliyev, Bayram; Şimşir, Adnan; Kalemci, Serdar; Köse, Timur; Taşbakan, Meltem; Pullukçu, HüsnüBackground/aim: Carbapenem-resistant Klebsiella pneumoniae (CR-KP) infections encountered in urology patients differentiate from infections caused by other factors, both in respect to prophylaxis and treatment stage, and require a special approach. We aimed to analyse the predisposing factors and the antibiotherapies for CR-KP infection outbreak in a tertiary urology clinic. Materials and methods: There were 75 patients in the CR-KP positive group (Group I) and 146 patients in the CR-KP negative group (Group II). Analysis of the predisposing factors for CR-KP infection and comparison of the reinfection rate and the antibiotherapies in the 2 groups were the endpoints. Results: in the first group, age, comorbidity, previous antibiotic use, and nephrostomy tube rates were higher (P = 0.015, P = 0.001, P = 0.004, and P < 0.001, respectively). in the second group, open urological surgery rate, and the proportion of patients presenting with flank pain, lower urinary tract symptoms, and haematuria were higher (P = 0.029, P < 0.001, P < 0.001, and P = 0.007). in the first group, the proportion of patients treated with transurethral bladder tumour resection was higher, whereas, percutaneous nephrolithotomy was higher in the second group (P = 0.045 for both). While hospitalization and Foley catheterization duration were longer in the first group (P < 0.001 for both), double J stent and nephrostomy duration were longer in the second group (P < 0.001 and P = 0.005). Mean leukocyte count at admission was higher in the first group (P < 0.001). Conclusion: Advanced age, comorbidities, previous antibiotic use, and prolonged Foley catheterization duration are predisposing factors for this infection in the urology department. Two-week administration of combination antibiotic regimens containing carbapenem were effective for the treatment of this infection.Öğe Carbapenem-resistant Klebsiella pneumonia infection outbreak in a tertiary urology clinic: analysis of influencing factors with a controlled trial(2020) Kalemci, Serdar; Köse, Timur; Taşbakan, Meltem; Pullukçu, Hüsnü; Aliyev, Bayram; Kızılay, Fuat; Şimşir, AdnanBackground/aim: Carbapenem-resistant Klebsiella pneumoniae (CR-KP) infections encountered in urology patients differentiate frominfections caused by other factors, both in respect to prophylaxis and treatment stage, and require a special approach. We aimed toanalyse the predisposing factors and the antibiotherapies for CR-KP infection outbreak in a tertiary urology clinic.Materials and methods: There were 75 patients in the CR-KP positive group (Group I) and 146 patients in the CR-KP negative group(Group II). Analysis of the predisposing factors for CR-KP infection and comparison of the reinfection rate and the antibiotherapies inthe 2 groups were the endpoints.Results: In the first group, age, comorbidity, previous antibiotic use, and nephrostomy tube rates were higher (P = 0.015, P = 0.001, P= 0.004, and P < 0.001, respectively). In the second group, open urological surgery rate, and the proportion of patients presenting withflank pain, lower urinary tract symptoms, and haematuria were higher (P = 0.029, P < 0.001, P < 0.001, and P = 0.007). In the first group,the proportion of patients treated with transurethral bladder tumour resection was higher, whereas, percutaneous nephrolithotomywas higher in the second group (P = 0.045 for both). While hospitalization and Foley catheterization duration were longer in the firstgroup (P < 0.001 for both), double J stent and nephrostomy duration were longer in the second group (P < 0.001 and P = 0.005). Meanleukocyte count at admission was higher in the first group (P < 0.001).Conclusion: Advanced age, comorbidities, previous antibiotic use, and prolonged Foley catheterization duration are predisposing factorsfor this infection in the urology department. Two-week administration of combination antibiotic regimens containing carbapenem wereeffective for the treatment of this infection.Öğe Comparison of the Abdominal and Transvaginal Techniques in the Surgical Treatment of Vesicovaginal Fistula and Analyzing the Factors Affecting Its Recurrence(2020) Kızılay, Fuat; Özdemir, Turan Senem; Aliyev, Bayram; Şimşir, Adnan; Kalemci, Serdar; Özyurt, CeyhunObjective: To compare the abdominal and transvaginal techniques in the surgical treatment of vesicovaginal fistula (VVF) and analyze the factors affecting its recurrence rate. Materials and Methods: Patients were divided into two groups according to the operation technique used (abdominal-transvaginal) and the recurrence status (recurrent and non-recurrent). The primary endpoint of the study was the comparison of the factors related to fistula and surgical techniques. Results: The number of cases with radiotherapy history was found to be higher in the recurrent group (68.2% vs 11.5%, p<0.001). Although fistulas were more subtrigonally located in the transvaginal repair group, the supratrigonal localization was more frequent in those operated with abdominal technique (p=0.019). While the rates of first and second recurrences were more in the cases managed by the transvaginal technique (p=0.041), the length of hospitalization and the mean operation time were longer in women managed by abdominal technique (p=0.025 and p=0.019, respectively). Conclusion: The abdominal technique provides more favorable outcomes by allowing extensive tissue exposure and omental tissue flep in the surgical treatment of VVF. Patients with a history of radiotherapy are more likely to have a recurrence after the surgery and repetitive treatment may be needed.Öğe Could serum testosteron level and BMI predict PSA relaps in prostate cancer patients undergoing radical surgery.(2011) Şimşir, Adnan; Mammadov, R; Cureklibatır, İ; Gunaydın, G…Öğe Do tumor size and location affect survival in upper urinary tract urothelial carcinoma?(2023) Kalemci, Serdar; Ergün, Kasım Emre; Kızılay, Fuat; Şimşir, Adnan; Köse, TimurAim: This study aimed to evaluate the effect of tumor location based on clinicopathologic features on cancer-specific survival (CSS) of patients who were treated surgically for locally/locally advanced upper tract urothelial carcinoma (UTUC). Materials and Methods: A single-center series of 145 patients with UTUC who underwent radical nephroureterectomy between May 2010 and August 2019 were included in the study. Patients were stratified based on the location of the tumor as renal pelvis and ureter located tumor. Clinicopathologic characteristics and oncological outcomes were compared according to tumor location and CSS rates after surgery were graphically explored using Kaplan–Meier curves. Results: At a mean follow-up time of 41.8 (4-124) months after surgery, 65 patients (44.8%) died from UTUC. Kaplan-Meier curves showed that tumor location was not associated with CSS in the analysis performed according to tumor stage, grade, and size. In the analysis that was conducted without regard to tumor location, worse CSS was found for patients with pT3 disease versus those with ?pT2 and with high-grade tumors versus those with low-grade (p=0.025 and p=0.011, respectively). Conclusion: Tumor location was not associated with CSS in any of the analyses. Regardless of tumor location, patients with pT3 disease and high-grade tumors, have a worse prognosis. Further studies on prognostic factors are needed to evaluate the advantages of these factors in the management of patients with UTUC.Öğe Evaluation of Lower Urinary Tract Functions in Diabetic Patients(2019) Eskidemir, Ümit; Şimşir, Adnan; Şimşir, Ilgın Yıldırım; Kızılay, Fuat; Özyurt, CeyhunObjective: in this study, we aimed to investigate the effect of diabetes-related metabolic changes and chronic complications on lower urinary tract (LUT) functions. Materials and Methods: the study included 286 adult patients with type 1 and type 2 diabetes mellitus (DM). All patients’ demographic data, diabetes-specific history, laboratory and physical examination findings were recorded. All the data were compared with uroflowmetric parameters and the scores of questionnaires used for evaluation of LUT symptoms and functions. Results: in the presence of diabetic peripheral neuropathy (DPN), average urinary flow rate (Qave), International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) score and the Overactive Bladder-questionnaire Short Form (OAB-q SF) score were significantly affected. in the presence of stage 3 or over diabetic nephropathy (DN), ICIQ-SF score was significantly higher. Also, in elderly group, Qave and OAB-q SF score were significantly affected. the Qave was lower both in patients who underwent any surgery due to diabetic complications and in patients with DM-related diseases. Qave and OAB-q SF score were significantly lower in males. Type 2 DM was associated with postvoid residual (PVR) increase and Qave decrease. Poor glycemic control was associated with lower OAB-q SF score. Finally, vitamin D deficiency was found to be associated with an increase in PVR volume. Conclusion: the present study showed that DPN, stage 3 or over DN, aging, DM-related diseases and surgeries, male gender, type 2 DM, poor glycemic control and vitamin D deficiency cause a tendency to develop any kind of LUT dysfunction.Öğe Evaluation of the lower urinary tract before renal transplantation : To which?how?(2012) Şimşir, Adnan; Dheir, H; Mammadov, R; Hoscoskun, C; Toz, H; Ok, E; Ozyurt, Ceyhun…
