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Öğe The best management of superficial bladder tumours: Comparing TUR alone versus TUR combined with intravesical chemotherapy modalities?(2000) Altay B.; Girgin C.; Kefi A.; Çikili N.To compare retrospectively the recurrence rates of TUR alone versus different intravesical chemotherapy modalities in superficial bladder cancer cases, 187 patients with stage Ta and T1 bladder tumours were treated with transurethral resection followed by adjuvant intravesical chemotherapy with mitomycin, BCG or epirubicin or by transurethral resection alone. All patients in this study had historically proven transurethrally resectable primary, category Ta and T1 transitional cell carcinoma (TCC) of the bladder. Group I included transurethral resection alone, and the other groups included intravesical mitomycin-C (Group II), BCG (Group III) and epirubicin (Group IV) therapies after transurethral resection. 146 male and 41 female patients (78% male and 22% female patients) in this study were diagnosed as primary TCC bladder tumours. Only 52 of them were stage Ta and 135 of them were stage T1 bladder tumours. Examining the histological grade of the bladder tumours, 88 (47%) of the patients had grade I, 53 (28%) had grade IIa, 30 (16%) had grade IIb and remaining 16 (9%) had grade III bladder cancers. The recurrence rates were 25% for Group I, 23.8% for Group II, 26.2% for Group III and 22.7% for Group IV. These values were given with disregarding the grade and volume of the bladder tumours. For solitary, less than 3 cm low grade tumours (grade I, IIa) recurrence rates were 16% for Group I, 15.4% for Group II, 17.8% for Group III, 17.2% for Group IV (p > 0.05). As a result of this retrospective study, for patients with low grade, stage Ta and T1 tumours TUR alone may be the best treatment modality. Although intravesical chemotherapy is effective in decreasing short-term incidences of tumour recurrence, it has not decreased long-term incidences of tumour recurrence. The high cost and adverse side effects of intravesical chemotherapy should also be taken into consideration in superficial, single, low grade tumours of bladder.Öğe Central and peripheral motor conduction to cremasteric muscle(2005) Ertekin C.; Bademkiran F.; Yildiz N.; Ozdedeli K.; Altay B.; Aydogdu I.; Uludag B.The few electrophysiologic studies of the cremasteric muscle (CM) have mainly been restricted to the cremaster reflex with no reference to central and peripheral nerve conduction to the muscle, probably for technical reasons. Twenty-six normal adult male volunteers were studied by transcranial magnetic cortical stimulation (TMS) and stimulation of thoracolumbar roots. The genitofemoral nerve (GFN) was stimulated electrically at the anterior superior iliac spine and a needle electrode was inserted into the CM for conduction studies. The motor latency to the CM from the cortical TMS ranged from 20 to 33 ms among the subjects (25.8 ± 2.9 ms, mean ± SD). Magnetic stimulation of the lumbar roots produced a motor response of the CM within 9.6 ± 1.9 ms (range, 6-15). The central motor conduction time to the CM was 16.5 ± 2.8 ms (range, 10-21). Stimulation of the GFN produced a compound muscle action potential with a mean value of 6.4 ± 1.8 (range, 4-10) ms in 23 of the 26 cases. Thus, central motor nerve fibers to the CM motor neurons exist, and there may be a representation area for the CM in the cerebral cortex. The GFN motor conduction time to the CM may have clinical utility, such as in the evaluation of the groin pain due to surgical procedures in the lower abdomen.Öğe Clinical experience of penile prosthesis surgery [Peni·l protez yerleşti·ri·lmesi· cerrahi·si·nde kl·i?ik deneyi·mleri·?iz](2007) Turna B.; Umul M.; Altay B.; Apaydin E.; Semerci B.; Çikili N.Introduction: The aim of this study is to analyze the data of men with erectile dysfunction who had been inserted with various types of penile prosthesis; focusing on the examination of the re-operations and patient and partner satisfaction. Materials and Methods: Medical records of 284 men implanted with either malleable or inflatable penile prostheses from January 1989 to December 2006 were reviewed and retrospectively analyzed. During that period, 250 malleable and 34 inflatable penile prostheses were inserted. The AMS 600 Malleable prosthesis was inserted in 97 cases, the AMS 650 Malleable prosthesis in 6 cases, the Mentor Malleable prosthesis in 143 cases, the Mentor Acuform prosthesis in 4 cases, the AMS Dynaflex prosthesis in 21 cases, the AMS Ultrex Plus prosthesis in 9 cases and the Mentor Alpha-1 prosthesis in 4 cases. Most patients (n=234) received spinal anesthesia during their operations. Regarding the surgical approaches penoscrotal, infrapubic or subcoronal approaches were used. One hundred and fifty-six men and 110 partners were interviewed regarding the satisfaction of the operations. Results: All patients had a history consistent with an organic etiology of erectile dysfunction, including vascular disease in 58%, diabetes in 10.9%, radical pelvic surgery in 11.3%, Peyronie's disease in 8.8% and others in 10.9%. The mean patient age was 64.3 years (range 31-74) and follow-up was 24 months (range 3-68). Eighty patients (28.2%) had transient minor complications such as penile edema, penile or scrotal hematoma or infections responsive to treatment. Besides, 19 patients (6.7%) had to be re-operated because of major complications such as: uncontrolled infection-14, mechanical failure-3, inadequate length-1 and spontaneous urethral prosthesis erosion-1. Overall, 92 (70.2%) of 131 men and 66 (73.3%) of 90 partners with malleable penile prosthesis sind 22 (88%) of 25 men, and 18 (90%) of 20 partners with inflatable penile prosthesis were satisfied with the results of the penile prosthesis surgery concerning sexual relationship. Conclusion: Use of penile prostheses is a safe and efficient long term therapeutic option in patients with erectile dysfunction.Öğe Comparing the anti-inflammatory effects of corticotherapy and non- steroid anti-inflammatory drugs in infertile patients with infectious aetiology(1999) Altay B.; Girgin C.; Çikili N.To compare the anti-inflammatory effectiveness of corticotherapy and non-steroid semi-inflammatory drugs (NSAID), we examined (26 infertile men with infectious aetiology. Seventy-seven patients were on corticotherapy and antibiotherapy (thirty-eight patients on high-dose and thirty-nine patients on low-dose corticotherapy). Forty-nine patients had antibiotherapy and NSAID. According to our results in both the high-and low-dose groups sperm motility significantly improved, but in the high dose group more side effects were reported. In order to overcome the effects of infections on male infertility, we prefer corticotherapy instead of NSAID because it is more effective that NSAID.Öğe Comparison of Gleason scores from sextant prostate biopsies and radical prostatectomy specimens(2001) Altay B.; Kefi A.; Nazli O.; Killi R.; Semerci B.; Akar I.Objectives: We compared the Gleason scores obtained from sextant prostate biopsy and radical prostatectomy (RP) specimens in patients with localized prostate cancer. Patients and Methods: Sixty-one patients having a clinical diagnosis of localized prostate cancer underwent needle biopsy under transrectal ultrasonography (TRUS) and RP. Grading and staging were assigned based on Gleason scores and the TNM system, respectively. Results: Mean patient age was 65.5 ± 13.43 years and mean PSA level was 14.69 ± 3.95. Mean Gleason score for prostate biopsy and RP specimen were 5.85 ± 0.7 and 6.34 ± 1.44, respectively. With respect to clinical stage, there were 20 patients in stage 1 and 41 patients in stage 2 prostate cancer. Comparing the Gleason scores, the biopsy score was lower in 26 (42.26%) and higher than RP specimens in 7 (11.84%) cases, and there was agreement between the biopsy and RP specimens in 28 (45.9%) patients. The difference between the two Gleason scores was ± 1 for 18 patients (29.5%) and ± 2 or more for 17 patients (27.86%). Conclusion: In our study, high Gleason score biopsies with elevated PSA level (>10 ng/ml) were risk factors for extraprostatic extension, and we demonstrated that Gleason scores were significantly correlated with seminal vesicle and lymph node invasion (p < 0.05). The Gleason scores of biopsy and RP specimens agreed with 45.9% of TRUS-guided sextant prostate biopsies, and this ratio was 91.1% in moderately differentiated tumors. Copyright © 2001 S. Karger AG, Basel.Öğe The effect of percutaneous nephrostomy implementation on the outcome of ureteroscopic stone treatment(Urology and Nephrology Research Centre, 2019) Kizilay F.; Simsir A.; Altay B.; Nazli O.; Cüreklibatir I.; Semerci B.Purpose: We aimed to investigate the effect of percutaneous nephrostomy (PCN) implementation on the second ureteroscopy (URS) outcomes after a failed URS. Materials and Methods: The data of four hundred forty-eight patients with an unsuccessful URS history were evaluated. Patients were divided into two groups; patients who underwent PCN before second URS (Group A) and patients who did not (Group B). We compared the stone access rate in the second URS between the two groups according to patient and stone characteristics and operative data. Then, group A was subdivided into two groups according to stone access as; access succeeded (Group A1) and access failed (Group A2). We also compared stone access rates between these two groups in terms of gender, age, body mass index, stone size, side, location, grade of hydronephrosis and PCN duration. All data were available immediately after surgery and obtained from patient files and the outcome assessment was performed during the study period. Results: Stone access rate was higher in group A than group B (143/196 vs 41/252, P = .0018). Mean nephrostomy duration and mean hydronephrosis grade were significantly higher and mean stone size was significantly lower in group A1 than group A2 (18.74 vs 9.62 days, P < .001; grade 3.25 vs 1.21, P = .038; and 7.286 vs 12.631 mm P < .001, respectively). Conclusion: PCN is a favourable intervention after a failed URS and increases the success rate of the second operation with ease of implementation and minimal morbidity. © 2019, Urology and Nephrology Research Centre.Öğe The effects of female age on the outcome of testicular sperm extraction and intracytoplasmic sperm injection in infertile patients with azoospermia(Akademiai Kiado Rt., 2002) Altay B.; KefI A.; Tavmergen E.; ÇIkIlI N.; Semerci B.; Goker E.T.Introduction: Testicular sperm extraction (TESE) is well-defined procedure for surgical sperm retrieval in obstructive and non-obstructive azoospermia. This study was focused on the effectiveness of testicular sperm extraction and intracytoplasmic sperm injection (ICSI) for azoospermic men with different female age subgroups. Materials and methods: A total of 107 men with azoospermia underwent TESE and ICSI treatment. The women were examined in three groups 20-29, 30-34 and 35 years or older. The main outcome in this study was fertilization and pregnancy rates with TESE and ICSI. Results: Spermatozoa were successfully retrieved during 97 of 107 (90.7%) TESE attempts, resulting in the fertilization of 286 of 563 (50.4%) injected metaphase II oocytes. Two hundred and fifty-five of them were transferred (89.8%). The clinical pregnancy rate and ongoing pregnancy rate per embryo transfer were 22.5% and 20.6% respectively. When comparing the fertilization and pregnancy rates, it was observed that women between the ages of 20-29 years had significantly higher pregnancy rates than women over 34 years of age (p < 0.05). Conclusion: The female age is a major factor in determining successful implantation in ICSI.Öğe Evaluation of sexual dysfunction in patients with luts, relationship with testosterone, leptin and serum lipid levels: Re-evaluation after alpha blocker treatment [Alt üri·ner si·stem semptomlu hastalarda ci·nsel di·sfonksi·yonun araştirilmasi, testosteron, lepti·n, kan li·pi·dleri·i·le i·li·şki·si·: Alfa bloker (tamsulo?in) tedavi·si·sonrasi yeni·den degerlen?irme](2005) Rodoplu A.; Turna B.; Altay B.; Umul M.; Semerci B.Introduction: Lower urinary tract symptoms (LUTS) associated with BPH and erectile dysfunction (ED) are common problems in aging male. In this study, we aimed to determine the causes of the relationship between LUTS and ED, and the possible effects of body mass index (BMI), serum leptin, free testosterone (IT) and lipid levels on LUTS and ED etiology. Materials and methods: Between June 2003 and February 2004, 46 patients were recruited in this study. All patients underwent physical examination including digital rectal examination, urine analysis, uroflowmetry and residual urine volume assessment. Serum leptin, lipid and free testosterone levels were analyzed. All patients' BMI were determined. Thirty-three patients received alpha blocker treatment and 13 patients were in the watchful waiting group. Erectile capacity and voiding symptoms of the patients were analyzed with International Index of Erectile Function (IIEF-5), International Prostate Symptom Score (IPSS), respectively before and after alpha blocker treatments. Ejaculatory function was assessed with Danish Prostate Symptom Score sexual-function questionnaire (DAN-PSSsex). Data were analyzed using the Pearson correlation test, Mann-Whitney test and Kruskal-Wallis test. Results: There was a negative correlation between IPSS and IIEF (p<0.05). The incidences of ED in patients with LUTS were 50%, 81.8% and 69.2% in patients with mild, moderate and severe symptom, respectively. The frequency of erectile dysfunction was very high in patients especially with moderate symptoms. After alpha blocker treatment the percentage of patients with mild symptoms decreased, but those with moderate and severe symptoms increased. In our study there was no significant correlation between IIEF and fT levels but the mean level of fT in patients with ED was under 15 ng/ml. There was no correlation between serum lipid levels and the other parameters. Conclusion: There is a strong correlation between LUTS and ED. As the severity of LUTS increases the incidence of ED increases. Alpha blocker treatment seems to slightly increase the incidence of ED and ejaculatory problems. Patients with LUTS and ED have lower levels of fT, but this is not statistically significant. There is no correlation between serum lipids and other parameters. Leptin levels might be important in predicting LUTS and ED relationship for future research.Öğe Evaluation of the effects of antioxidant treatment on sperm parameters and pregnancy rates in infertile patients after varicocelectomy: a randomized controlled trial(Nature Publishing Group, 2019) Kızılay F.; Altay B.In this study, we aimed to evaluate the effect of oral antioxidant treatment on semen parameters and pregnancy rates in infertile men who underwent varicocelectomy. The study was conducted between January 2016 and January 2018. Subinguinal microscopic varicocelectomy was performed in 90 patients who were referred for infertility and diagnosed with clinical varicocele. The patients were divided into two groups. The first group received antioxidant treatment for 6 months after the operation (n = 62); the second group did not receive treatment after the operation (n = 28). The semen analysis was performed at the time of diagnosis and at 6 months postoperatively. The postoperative treatment semen parameters and pregnancy rates between the two groups were compared. The improvement in total sperm count (+ 45.9% vs + 26.8%), total motile sperm count (+ 50.6% vs + 29.7%), sperm concentration (+ 71.4% vs + 54.5%), sperm count in normal morphology (+ 75.7% vs + 39.9%), and total (+ 28.6% vs + 18.3%) and progressive motile sperm count (+ 60.4% vs + 38.9%) were significantly higher in the treated group than in the untreated group (p = 0.011, p < 0.001, p = 0.008, p < 0.001, p = 0.024 and p < 0.001, respectively). The clinical pregnancy rate in the first group was significantly higher than that in the second group (29% vs 17.9%) (p = 0.029). We concluded that the antioxidant treatment provides an important contribution to varicocelectomy outcomes and improves pregnancy rates. © 2019, Springer Nature Limited.Öğe EVect of lisinopril on renal tissue damage in unilateral ureteral obstruction in rats(2012) Karabuga Ä.; Akbay K.; Turna B.; Vatansever H.S.; Altay B.; Güzel E.; Uluer E.T.; Ustun G.; Ekren F.; Nazli O.; Muftuoglu S.; Apaydin E.In this study, it was aimed to investigate apoptosis in renal injury and the eVect of lisinopril in rat model, which constitute unilateral ureteral obstruction. The retroperitoneal ureter was ligated with a 4.0 silk for the experimental model of ureteral obstruction in Wistar albino rats. Untreated group (n = 20) received no treatment. For the lisinopril-treated group (n = 20), 20 mg/kg/day of drug was given orally. Ultrastructural diVerences were analyzed using electron microscopic technique; apoptotic distribution was analyzed using the TUNEL method. After electron microscopic evaluation, on the 4th and 14th day in the untreated group, edema in the glomeruli, loss of microvillus and apoptotic cells in proximal tubule cells and sclerosis in the glomeruli were detected. On the 4th day in the lisinopril-treated group, the kidney was ultrastructurally normal and a less number of apoptotic cells were only observed on the 14th day. On light microscopic examination on the 4th and 14th day in the untreated group, while the glomeruli were normal in structure, the boundary of the proximal tubule was disrupted and some picnotic cells in both the proximal and collecting tubules were observed. In both 4th and 14th day of the lisinopril-treated group, kidney showed normal structure, although in some places picnotic cells in the collecting tubules were observed. In conclusion, lisinopril was eVective and it may prevent early renal damage in the direct obstruction model. © Springer-Verlag 2011.Öğe Hand and Genital Sympathetic Skin Potentials in Flaccid and Erectile Penile States in Normal Potent Men and Patients With Premature Ejaculation(1995) Ertekin C.; Colakoglu Z.; Altay B.Sympathetic skin potentials were recorded from the hand and genital region in 14 normal potent men and 18 patients with premature ejaculations. With the penis flaccid the sympathetic skin potentials obtained did not differ significantly in both groups. However, when erection was induced by 50 mg. intracavernous papaverine injection, the genital sympathetic skin potentials were significantly suppressed in all but 3 normal men, while the hand potentials did not change. In subjects with premature ejaculation genital and hand sympathetic skin potentials were suppressed during erection as a generalized bodily reaction except in 1 patient. This phenomenon may indicate that the specific and regional suppression of genital sympathetic activity during erection could not be properly adjusted in patients with premature ejaculation. © 1995 American Urological Association, Inc.Öğe Immunohistochemical expression of connexin 43 and occludin in the rat testis after epididymal and vasal ligation(2008) Altay B.; Turna B.; Öktem G.; Aktug H.; Semerci B.; Bilir A.Objective: To describe the effects of epididymal and vasal ligation, in an experimental rat model, by using connexin 43 and occludin immunohistochemistry as well as transmission electron microscopy. Design: Comparative and controlled experimental research study. Setting: University animal research and histology laboratories in Turkey. Animal(s): Wistar male rats in experimental and control groups. Intervention(s): The control group underwent sham operation (n = 7). The first experimental group (n = 7) underwent unilateral epididymal ligation, whereas the second experimental group (n = 7) underwent unilateral vasal ligation to induce experimental epididymal and vasal obstruction models, respectively. All animals were then killed at 90 days. Main Outcome Measure(s): Immunohistochemical expression of connexin 43 and occludin for testicular tissues was determined after epididymal and vasal obstruction models. Ultrastructural morphological changes were examined by electron microscopy. Result(s): Results of the semiquantitative analysis revealed that expressions of both occludin and connexin 43 in the rat testis were decreased in the experimental groups compared with in the sham-operated group. However, changes after vasal ligation were more prominent. Ultrastructural examination confirmed decreased intercellular communication as well as increased cellular degeneration among the ipsilateral and contralateral testicular tissues. Conclusion(s): Immunohistochemical expression of occludin and connexin 43 were decreased in the testis after vasal and epididymal ligation when compared with the sham-operated group. Ultrastructural changes indicating cell degeneration were more prominent after vasal ligation. © 2008 American Society for Reproductive Medicine.Öğe Influence of high mixed anti-globulin reaction rate on efficiency of assisted reproductive techniques in the management of male infertility [Yüksek mi·kst anti·globuli·n reaksi·yon dege?i?in i·nferti·l erkek hastalarin tedavi·si·nde kullanilan yardimci üreme yöntemleri·ni·n başarisi üzeri·ne etk·i?i](2007) Aliyeva U.; Turna B.; Mukhtarov E.; Altay B.; Semerci B.; Çikili N.Introduction: Retrospective analysis of the results of assisted reproductive techniques (ART) of infertile males with high mixed anti-globulin reactions (MAR). Materials and Methods: Data of 69 infertile male patients with high mixed anti-globulin reactions values (>15%) treated in Ege University IVF Centre between 1997 and 2005 were retrospectively evaluated. Various assisted reproductive techniques (ART): Intrauterine inseminations (IUI), in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) were applied to all patients. The influences of high MAR values on ART were analyzed. Patients were also categorized with regards to smoking and receiving corticotherapy before treatment. SPSS 13.0 for Windows XP were used for statistical analysis. Results: Mean patients age was 35.5±3.9 years old. Mean MAR value was 84±0.2%. A total of 87 ART were applied (65 IUI, 18 ICSI and 4 IVF). Out of 69 patients 21 (30.4%) of them received corticosteroids before any ART for 3 months. ART were successful in 15 infertile couples: 5 IUI (success: 6.1%); 9 ICSI (success: 50%); 1 IVF (success: 25%) and unsuccessful in 54 infertile couples. We had 15 successful ART and only 6 of them (42.86%) were instructed corticotherapy before ART and this constituted 28.5% of patients receiving corticotherapy. We had 15 successful and 54 unsuccessful ART cycles out of 69 couples. Male partner had an anamnesis about smoking at 53% and 80% of couples with successful and unsuccessful ART cycles respectively and the difference was statistically significant (p<0.05). Corticotherapy did not seem to influence the results of ART (p>0.05). Conclusion: It is possible to achieve as high as 22% success rates of pregnancy even in the presence of high MAR values. Corticotherapy did not influence ART results. Smoking has a negative effect ART results.Öğe Morphology and innervation of the human cremaster muscle in relation to its function(2008) Kayalioglu G.; Altay B.; Uyaroglu F.G.; Bademkiran F.; Uludag B.; Ertekin C.The electromyographic properties of the cremaster muscle (CM) are quite different from other skeletal muscles. It shows excessive spontaneous discharges, and the motor unit shape and firing frequency of the CM muscle differ from that of limb muscles. In this study, CM of six adult cadavers and six orchiectomy specimens were used to reveal the detailed histology of the muscle and provide an anatomophysiological explanation for these unusual electromyographic properties. Routine histochemical stains revealed the CM was composed of several distinct bundles of smooth and striated muscle fibers within connective tissue. The smooth muscle fibers that were more profuse than previously known and were not arranged in layers, but widely dispersed between striated muscle fibers. Bielschowsky silver staining technique, anti-neurofilament and anti-synaptophysin immunostaining showed the presence of multiple motor end-plates observed as a series of small dots or lines running along the striated muscle fibers and several nerve endings on a single muscle fiber. Myosin immunostaining confirmed the CM is a slow-twitch muscle, and ?-actin smooth muscle immunostaining confirmed the presence of a large number of smooth muscle fibers. There were also small multipolar neurons forming nerve plexuses between smooth muscle fibers. Anti-GFAP immunostaining confirmed the presence of glial cells similar to astrocytes. In conclusion, the findings of this detailed anatomical study showed the CM, widely known as a striated muscle, contains a large number of smooth muscle fibers, and the spontaneous electromyographic discharges are due to the presence of multiple motor end-plates and dense innervation. © 2008 Wiley-Liss, Inc.Öğe The role of sperm parameters on ICSI success [Sperm parametrelerinin ICSI başarisindaki rolü](2004) Altay B.; Apaydin E.; Erdogan Ö.; Tavmergen Göker E.; Tavmergen E.; Semerci B.Introduction: In this study, we aimed to investigate the relation between the sperm parameters and fertilization and pregnancy rates in intracytoplasmic sperm injection (ICSI) method which is applied to infertile couples. Materials and Methods: Four hundred thirty six couples who applied to Ege University Family Planning and Infertility Research and Treatment Center between January 2000 and January 2002 period were enrolled to the study. Infertile couples of males were evaluated by physical examination, spermiogram and hormone profile. Sperm morphologies were evaluated with Kruger criteria. Results: One hundred twenty two of 493 infertile males (24.74%) had oligozoospermia, 59 of them had asthenozoospermia (11.96%), 67 of them (13.61%) had teratozoospermia and 188 of them oligoasthenozoospermia (38.13%). For the statistical analysis, 57 (11.56%) infertile patients with normal sperm parameters were considered as the control group. The fertilization rates were as follows: 70.9% in oligozoospermic group, 72.8% asthenozoospermic group, 67.4% in teratozoospermic group, 66.7% oligoasthenozoospermic group and 79% for the control group. (p=0.27) Pregnancy rates in oligozoospermic group was 41.3%, in asthenozoospermic group was 43.9%,in teratozoospermic group 35.9%, in oligoasthenozoospermic group was 46.4% and for the control group was 49.1% (p=0.632). Conclusion: We did not see any difference between the disorders of sperm parameters oligozoospermia, asthenozoospermia, teratozoospermia, oligoasthenozoospermia. ICSI seems to be a successful method in the treatment of male infertility.Öğe Sexual dysfunctions and their associations with neurological level in spinal cord injured patients [Spinal kord yaralanmali hastalarda cinsel fonksiyon bozukluklari ve nörolojik düzey ile ilişkileri](2006) Taş I.; On A.Y.; Altay B.; Özdedeli K.Objective: To determine sexual dysfunction and its association with neurological examination findings in spinal cord injured patients. Materials and Methods: Forty-three patients (30 men, 13 women) who were out of the spinal shock period were enrolled to the study. Information about the post-injury sexual functions was obtained via questionnaires. Erectile function was evaluated by International Index of Erectile Function-5 (IIEF-5), women sexual function was evaluated with Female Sexual Function Index (FSFI). Neurological level was determined according to American Spinal Injury Association (ASIA) impairment scale. These levels were classified into 4 groups, namely, T10 and above, T11-L2, conus, and cauda according to the alignment of the spinal cord centers responsible of sexual function. The relations between the data about erection, ejaculation, lubrication and orgasm, and neurological level were investigated. Results: Mean IIEF-5 score in men was 7±6.69. It was found that at levels of T10 and above; reflex erections were preserved with a 100% ratio. At conus-cauda lesions; while psychogenic erections were preserved with a 100% ratio, reflex erections were absent. In all patients with neurologic levels at or below T12, psychogenic erections were present. Ejaculation was present in 43.3% of men. Ejaculation rate was lower in T10 and above levels when compared with that in conus-cauda levels. Orgasm was present in 83.3% of the patients with conus-cauda lesions, and 54.5% of the patients with lesions above this level. Mean FSFI score in women was 2.35±0.94. Despite the lack of sufficient data in women, it was determined that in 83.3% of the patients with conus-cauda lesions, psychogenic lubrication was preserved while reflex lubrication was not. Orgasmic disorder was noteworthy in this limited sample of female patients. Conclusion: This study has demonstrated there is impairment in sexual dysfunction in both sex after spinal cord injury and that the classification of neurological level according to the spinal centers regulating sexual function in spinal cord injured patients has an imperative place in the estimation of the remaining sexual function.Öğe Simultaneous resection of a bladder tumor and prostate is oncologically and functionally safe(Kuwait Medical Association, 2020) Kizilay F.; Sahin M.; Turna B.; Altay B.; Nazli O.; Semerci B.Objective: The aim of this study is to compare the outcomes of patients who underwent simultaneous transurethral resection of the prostate (TURP) and transurethral resection of bladder tumor (TURBT) with those who underwent only TURBT. Design: Historical-cohort Setting: Department of Urology, Ege University School of Medicine, Turkey Subjects: One hundred and eighty-six patients who underwent TUR were included in the study. Intervention: Tumor characteristics, complication, recurrence and progression rates, recurrence localizations, and elapsed time to recurrence were compared between the groups. Main outcome measures: Outcomes of simultaneous resection Results: The bladder tumor recurrence rate was 36.6% for group A and 29.8% for group B (P=.068), and the progression rates were 8.2% and 6.4%, respectively (P=.084). There was no significant difference between the elapsed time to recurrence (8.28±1.17 vs. 6.54±1.28 months) and the rate of prostatic urethral recurrence (1.8% vs. 1.7%, P=.712 and P=.395, respectively). Complication rates and progression distribution of tumors were also similar in both groups. Conclusion: It is safe to resect an incidentally detected bladder tumor along with prostate resection, with similar rates of progression, recurrence, and complications. © 2020, Kuwait Medical Association. All rights reserved.Öğe Sperm function tests in clinical practice [Klinik uygulamadaki sperm fonksiyon testleri](AVES İbrahim KARA, 2017) Kızılay F.; Altay B.Conventional semen analysis solely is not completely adequate to predict pregnancy outcomes. Therefore, advanced sperm function tests have been developed and introduced to clinical practice. These tests use different methods and techniques to evaluate different stages of fertilization steps. In this review, we reported some commonly used sperm function tests: sperm penetration assay, sperm-zona pellucida binding test (hemizona assay), acrosomal reaction test, hyaluronan binding test, hypo-osmotic swelling test, magnetic-activated cell sorting and zeta sperm selection. We discussed the literature concerning these tests, the utilization techniques and also purpose and mechanism of each test. We emphasized the importance of sperm function tests in predicting in vitro fertilization and pregnancy outcomes and in the management of infertile couples and also the limitations of these tests. Along with improvements in molecular biology techniques, we believe that more applicative and beneficial tests will be developed in the near future. © 2017 by Turkish Association of Urology.Öğe Sympathetic skin response recorded from the genital region in normal and diabetic women(Elsevier Masson SAS, 2005) Seçil Y.; Özdedeli K.; Altay B.; Aydogdu I.; Yilmaz C.; Ertekin C.Aim of the study. - An electrophysiological technique assessing the sympathetic skin activity related to sudomotor function from the genital skin has been described previously in normal adult man. The problems of the genitourinary tracts and the sexual disorders are difficult to analyse in women. In this paper, a method for recording the genital sympathetic skin responses (g-SSR) has been described in normal women and the objective changes were demonstrated in female patients with diabetes mellitus. Material and method. - Our study comprised 20 healthy adult women (mean age 42.5:years) and 20 diabetic women (mean age 52.8:years). We examined both left hand sympathetic skin responses (SSR) and genital region SSR by electrophysiological methods. Superficial Ag-AgCl electrodes were placed on perineum in front of the anal sphincter and 1-1.5:cm lateral to right labia majora for recording after the stimulation of the right median nerve. All g-SSRs from both recording sites were analysed, latency and amplitudes were compared in normal subjects and patients. Results. - It has been clearly demonstrated that the g-SSR is easily obtained from all normal female subjects in labia majora-perineum montage. In seven of 20 diabetic patients g-SSR could not be elicited. Mean amplitude was significantly reduced in diabetic group according to normal subjects (P < 0.05). Conclusion. - It was concluded that the method described in this study is easily applied and objectively evaluated for the female patients with genitourinary and sexual problems. © 2005 Elsevier SAS. All rights reserved.Öğe What kind of differences are there between BPH and prostate cancer regarding PSA and its derivates? [BPH ve prostat kanseri·nde PSA ve türevleri·arasinda nasil ?ir fark vardir?](2006) Üstün G.; Altay B.; Ekren F.; Turna B.; Semerci B.; Çikili N.Introduction: Prostate cancer is one of the most important malignancies of male population because of its high morbidity and mortality. Early detection is important to obtain better treatment outcome. Prostate specific antigen (PSA) is a key marker for early detection of prostate cancer. The aim of this retrospective study is to compare prostate specific antigen (PSA) and free/total PSA (f/t PSA) ratios in patients with benign prostatic hyperplasia (BPH) and prostate cancer. In addition, PSA alterations' correlation with Gleason score in prostate cancer patients and age-specific PSA levels in BPH patients were analysed. Materials and methods: A total of 662 patients, who underwent surgical treatment for BPH or patients diagnosed with primary prostate cancer at Urology Department of Ege University between January 2001 and December of 2003, were recruited in the current study. All data were achieved from patient data archives retrospectively. Patients were analysed in 2 groups: BPH (543 patients) and prostate cancer (119 patients) patients. We compared PSA, f/t PSA ratios and PSA density (PSA-D) between 2 groups. We also reviewed the correlation between PSA levels and Gleason score in prostate cancer patients and age-specific PSA levels in BPH patients. Statistical analysis was done with SPSS 10.0. Results: 321 of 543 BPH cases underwent transurethral resection of prostate (TURP) and 222 BPH cases underwent suprapubic transvesical prostatectomy (SPTVP). 9 patients were diagnosed as prostate cancer pathologically who were considered as clinically BPH preoperatively. Median ages of the patients with BPH and prostate cancer are 68.5 and 66.9 years old, respectively. Median PSA in prostate cancer group was 32.3 ng/ml (0.4-165.6. ng/ml) and median PSA in BPH group was 5.3 ng/ml (0.2-19.4 ng/ml). 51 out of 543 BPH patients have PSA values more than 10 ng/ml (rate %9.3). f/t PSA ratios were available in 66 patients with prostate cancer. Median and mean f/t PSA ratios in this group were 0.14 (0.01-0.72) and 0.12, respectively. In BPH group, median and mean f/t PSA ratios were 0.19 (0.01-0.70) and 0.19, respectively. Mean PSA levels of prostate cancer patients with Gleason score of below 7.7 and above 7 were 22.7, 35.9, 32, respectively. Mean PSA levels stratified according to decades in BPH patients were 1.9 in 40-49 years old group, 3.4 in 50-59 years old group, 4.2 in 60-69 years old group, 5.8 in 70 years old and older group. Median and mean PSA density in prostate cancer (58 patients) cases were 1.38 and 0.54, respectively whereas median and mean PSA density in BPH (420) cases were 0.08 and 0.06, respectively. Conclusion: There is significant difference between prostate cancer and BPH patients with regards to f/t PSA and PSA-D values. In addition, PSA levels correlate well with Gleason scores in prostate patients. Age-specific PSA values are valid in BPH patients.
