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Öğe Açık ve robot yardımlı laparoskopik radikal prostatektominin erken dönem onkolojik ve fonksiyonel sonuçları açısından karşılaştırılması(2022) Kalemci, Serdar; Ergün, Kasım Emre; Bahçeci, Tuncer; Kızılay, Fuat; Turna, BurakAmaç: Radikal prostatektomi (RP), son yirmi yılda açık cerrahiden minimal invaziv cerrahiye kayda değer bir dönüşüm geçirdi. Çalışmamızda lokalize prostat kanseri nedeniyle açık ve robot yardımlı RP yapılan hastaları erken dönem onkolojik ve fonksiyonel sonuçları açısından karşılaştırılmayı amaçladık. Gereç ve Yöntem: Çalışmamıza Ocak 2009 ile Ocak 2014 tarihleri arasında prostat kanseri tanısı alıp RP yapılan 537 hasta dâhil edildi. (Açık retropubik radikal prostatektomi (ARRP)=387, robot yardımlı laparoskopik radikal prostatektomi (RYRP)=150). Hastaların demografik verileri, perioperatif ve postoperatif sonuçları iki grup arasında karşılaştırıldı. Bulgular: Hastaların ortalama yaşı ARRP grubunda 62,9 (46-76), RYRP grubunda ise 61,1 (42-76) yıl idi. Ortalama hastanede kalış süresi, üretral kateterizasyon süresi ve kan transfüzyonu ihtiyacının RYRP grubunda anlamlı olarak daha kısa olduğu görüldü. Cerrahi sınır pozitifliği oranlarının pT2 evreye sahip olanlarda ARRP ve RYRP grubu için sırasıyla %16,3 ve %20 (p=0,412), pT3 evreye sahip olanlarda ise ARRP ve RYRP grubunda sırasıyla %40,9 ve %68,8 (p=0,05) olduğu görüldü. Ortalama takip süresi, ARRP grubunda 30,6 (3-64) ay, RYRP grubunda ise 11,3 (1-24) ay olarak hesaplandı. Takipte RYRP grubunda anastomoz darlığı ve biyokimyasal rekürrens gelişiminin daha az olduğu görüldü (%3,9 vs %29,9 p<0,05, %6,3 vs %20,1 p=0,01). RP sonrası bir yıllık süre içerisinde takipte kontinans oranları açısından her iki grup arasında anlamlı fark saptanmazken (p=0,184), takip süresi 12 ay ve üzerinde olan hastalarda; RYRP grubunda kontinan hasta oranın daha fazla olduğu görüldü (p<0.05). Sonuç: Her iki yaklaşım benzer onkolojik sonuçlar göstermekle birlikte daha iyi fonksiyonel sonuçları ile RYRP lokalize prostat kanseri cerrahisi için standart tedavi olma yolunda hızla ilerlemektedir.Öğe Analysis of factors affecting blood loss during percutaneous nephrolithotomy(Mary Ann Liebert Inc, 2006) Turna, Burak; Nazli, Oktay; Demiryoguran, Serkan; Mammadov, RashadÖğe 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 Factors Affecting Functional Outcomes in Robotic-assisted Laparoscopic Radical ProstatectomyAnalysis of Factors Affecting Functional Outcomes in Robotic-assisted Laparoscopic Radical Prostatectomy(Galenos Yayincilik, 2018) Kizilay, Fuat; Ismaylov, Fuad; Simsir, Adnan; Turna, Burak; Semerci, Bulent; Apaydin, ErdalObjective: 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 Robotic-assisted Laparoscopic Pyleloplasty for Primary Versus Secondary Repair in 119 Consecutive Cases EDITORIAL COMMENT(Elsevier Science Inc, 2012) Turna, Burak; Stein, Robert J.Öğe BENIGN PROSTATIC HYPERPLASIA A 17 YEAR OLD CASE REPORT(2015) Yagmur, İsmail; Turna, Burak; Tekın, Ali; Akıncıoğlu, Emir; Kumbaracı, Banu Sarsık; Ulman, İbrahim…Öğe Benign prostatic hyperplasia: Case report of a 17-year-old(Elsevier Sci Ltd, 2016) Yagmur, Ismail; Turna, Burak; Tekin, Ali; Akincioglu, Emir; Sarsik, Bnu; Ulman, IbrahimIntroduction Benign prostatic hyperplasia (BPH) is generally common in men older than 50 years of age but is extremely rare in childhood. In the literature to date, fewer than five cases have been reported under 18 years of age. Owing to the limited number of cases, the etiology and management of BPH in the first two decades is not clear. Objective We herein report a 17-year-old boy who presented with acute urinary retention due to BPH and was treated with endoscopic transurethral resection of the prostate (TUR-P). Case report A 17-year-old male patient with a history of intermittent hematuria was admitted elsewhere with acute urinary retention. An increase in prostate size was detected on digital rectal examination. Pelvic ultrasound revealed a large mass arising from the prostate and filling the bladder lumen. Transrectal ultrasound-guided prostate biopsy (TRUS-Bx) was performed to exclude malignancy. After the documentation of benign prostate tissue in the histopathological analysis, the patient was referred to our clinic for further evaluation and management. Magnetic resonance (MR) imaging revealed a 48 x 55 x 68 mm mass arising from the middle lobe of prostate and filling the bladder lumen (Figure) with an initial diagnosis of a non-ductal malignant tumor because of his age. Enlarged lymph nodes or any sign of metastasis were not detected. Re-examination of the previous biopsy specimens confirmed the absence of malignancy; therefore he underwent endoscopic treatment with TUR-P. Histopathological examination reported BPH. The postoperative 1-year follow-up was uneventful. Discussion The patient was extensively evaluated with a suspicion of malignancy, especially rhabdomyosarcoma, which is more expected for this age group. Reviewing juvenile cases with BPH in the literature, two authors explained the possible etiologic factors of their cases as gonadotropin supplement therapy for undescended testes and the mother's utilization of a human chorionic gonadotropin-containing agent during pregnancy to prevent spontaneous abortion. Our case had no history of drug intake, endocrino-logic abnormality, or any other possible relevant factor. Owing to the limited number of cases, there is not enough data to understand the etiology and also no consensus on the treatment of BPH in the adolescents. Therefore, experiences gained from adult cases guide the pediatric treatment modalities. Conclusion Despite the fact that BPH is very rare in childhood, one should keep it in mind in the differential diagnosis of acute urinary retention and malignant prostate diseases. The endoscopic method is the treatment of choice in BPH.Öğe Bilateral seminal vezikül agenezisi ve soliter pelvik böbreğin eşlik ettiği bilateral konjenital vaz deferens agenezisi(2013) Umul, Mehmet; Altay, Barış; Turna, Burak; Nazlı, OktayVaz deferens anomalileri yaygın değildir ve infertil erkeklerin % 1-2'sinde görülmektedir (1).Bu durumun olası nedenleri hala belirsiz olup Wolf kanallarının defektif gelişimi sonucu ortaya çıkmaktadır. Seminal vezikül ve böbrek anomalileri sıklıkla vaz deferens anomalilerine eşlik etmektedir. Bu vaka takdimi ile bilateral vaz deferens agenezisine eşlik eden bilateral seminal vezikül agenezisi ve soliter pelvik böbreği olan bir olgu sunulmuştur.Öğe Bir Üroloji Kliniğindeki Adli Vakaların epidemiyolojisi(2011) Şimşir, Adnan; Şenol, Ender; Kalemci, Serdar; Turna, Burak; Çıkılı, Necmettin…Öğe Böbrek alt kaliks taşlarının tedavisinde vücut dışı şok dalga litotripsi ile fleksibl üreterorenoskopinin karşılaştırılması(Ege Üniversitesi, 2014) Turna, Burak; Nazlı, OktayAlt kaliks taşı, böbrek taşı, ESWL, fleksibl üreterorenoskopi;Günümüzde üriner sistem taş hastalığının tedavisinde minimal invaziv yöntemler standart tedavi yöntemleri olarak kabul edilmektedir. Böbrek alt kaliks taşlarının tedavisi bulunduğu yerin anatomik yapısı nedeniyle özellik göstermektedir ve tedavi alternatifleri açısından henüz yerleşmiş bir öncelik sırası bulunmamaktadır.Bu çalışma böbrek alt kaliks taşlarının tedavisinde vücut dışı şok dalgası ile taş kırma (ESWL) ve fleksibl üreterorenoskopi (fURS) yöntemlerinin etkinliğini ve güvenirliğini karşılaştırmak amacıyla düzenlenmiştir. 01 Nisan 2011-01 Nisan 2014 tarihleri arasında kliniğimize başvurmuş olan, izole böbrek alt kaliks taşı bulunan 60 erişkin hasta çalışmamıza dahil edilmiştir. 30 hasta ESWL grubu (Grup 1) ve 30 hasta fURS grubu (Grup 2) olarak randomize edildi.Çalışmamızda Elmed Multimed Classic ESWL cihazı ve fURS için Storz 7.5 F Flex x-2 cihazı kullanılmıştır. Her iki tedavi grubunun yaş,cinsiyet,vücut kitle indeksi ve taş boyutları açısından benzer özelliklere sahip olduğu saptandı. Operasyon süresinin ESWL grubunda fURS grubuna göre istatistiksel anlamlı olarak daha kısa olduğu saptandı (55/97 dk , p=0.01). Perioperatif komplikasyonlar açısından iki grup arasında istatiksel olarak anlamlı fark saptanmadı. Postoperatif 1.ayda radyolojik görüntüleme (BT) ile hastalar değerlendirildi.ESWL grubunda taşsızlık oranı %66.6 (20/30) saptanırken fURS grubunda %80 (24/30) saptandı ve sonuçlar istatistiksel olarak anlamlı bulunmadı (p=0.28). Sonuç olarak böbrek alt kaliks taşlarının tedavisinde kabul görmüş olan yöntemlerden ikisi olan ESWL ve fleksibl üreterorenoskopiyi karşılaştırdığımız bu çalışmada literatür ile uyumlu ve kabul edilebilir etkinlik ve güvenirlik sonuçları elde edilmiş gözükmektedir.Fleksibl üreterorenoskopi deneyimi arttıkça büyük olasılıkla başarı oranlarımız deneyimli merkezlerle karşılaştırılacak seviyelere gelecektir.Öğe The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study: Staghorn Versus Nonstaghorn Stones(Mary Ann Liebert Inc, 2011) Desai, Mahesh; De Lisa, Antonello; Turna, Burak; Rioja, Jorge; Walfridsson, Helena; D'Addessi, Alessandro; Wong, Carson; de la Rosette, JeanPurpose: The study compared characteristics and outcomes in patients with staghorn or nonstaghorn stones who were treated with percutaneous nephrolithotomy (PCNL) within the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study. Patients and Methods: Data over a 1-year period from consecutively treated patients from 96 centers worldwide were collated. The following variables in patients with staghorn or nonstaghorn stones were compared: National prevalence, patient characteristics, access method, puncture frequency and outcomes, including bleeding rates, operative time, and duration of hospital stay. Results: Data from 5335 eligible patients were collated; 1466 (27.5%) with staghorn and 3869 (72.5%) with nonstaghorn stones. Staghorn stone presentation varied between centers from 67% in Thailand to 13% in Argentina. The frequencies of previous procedures were similar between groups, but shockwave lithotripsy was less frequent in patients with staghorn stones compared with nonstaghorn (16.8% vs 22.6%) and positive preoperative urine cultures were more frequent in patients with staghorn than nonstaghorn stones (23.4% vs 13.1%). Patients with staghorn stones underwent multiple punctures more frequently than those with nonstaghorn stones (16.9% vs 5.0%). Postoperative fever, bleeding, and the need for blood transfusion were more frequent, the median operative time and duration of hospital stay were longer, while the proportion of patients remaining stone free was lower (56.9% vs 82.5%) in patients with staghorn than nonstaghorn stones. Conclusions: The proportion of patients with staghorn stones varies widely between centers. Stone-free rates were lower, complications more frequent, and operative time and hospital stay were longer in patients with staghorn stones.Öğe Comments to: Anterior segment morphologic changes related to alpha-1 adrenergic receptor antagonists use(Wichtig Publishing, 2016) Palamar, Melis; Emre, Sinan; Turna, Burak; Yagci, AyseÖğe Comparative results of shockwave lithotripsy for renal calculi in upper, middle, and lower calices(Mary Ann Liebert Inc, 2007) Turna, Burak; Ekren, Fatih; Nazli, Oktay; Akbay, Kaan; Altay, Baris; Ozyurt, Ceyhun; Cikili, NecmettinBackground and Purpose: To assess the results of shockwave lithotripsy (SWL) for renal calculi in upper, middle, and lower calices according to the stone burden. Patient and Methods: A series of 52 female and 66 male patients with a mean age of 47.8 years and isolated single caliceal stones who underwent SWL monotherapy were enrolled. Stone burden, stone location, number of sessions/shockwaves, and auxiliary procedures were noted for each patient. Stones were located in the upper, middle, and lower calices of 35, 43, and 40, patients respectively, with mean stone burdens of 81.4 mm(2), 75.2 mm(2), and 96.3 mm(2), respectively. Patients were evaluated with intravenous urography, plain film, or ultrasonography. Success was determined 3 months after the last session. Re-treatment rates were calculated. The effect of anatomic factors on the success of treatment for lower-caliceal stones also was determined. Results: The mean stone burden, median number of treatment sessions, and mean number of shockwaves were 84.2 mm(2), 2, and 4344, respectively. The auxiliary procedure rate was 16.1%, and the re-treatment rate was 71.2%. Failure was noted in 26 patients (22%). The stone-free rates for stones in the upper, middle, and lower calices were 82.8%, 83.4%, and 67.5%, respectively (P = 0.14). The stone-free rates for stones <100 mm(2) and 100 to 200 mm(2) were 91.2% and 65.5%, respectively (P = 0.001). The efficiency quotient was 49.8, 44.8, and 32.5 for upper-, middle-, and lower-caliceal stones, respectively. Infundibular length (P = 0.006) and infundibular width (P = 0.036) were significant in determining the stone-free rate after treatment of lower-caliceal stones. Conclusions: We recommend SWL as the first choice for treatment of stones <200 mm(2) in the upper and middle calices. Extracorporeal lithotripsy is one of the options for lower-caliceal stones <200 mm(2) but has high re-treatment and auxiliary-procedure rates in these cases.Öğe Comparative study of extracorporeal shock wave lithotripsy outcomes for proximal and distal ureteric stones(Springer, 2008) Turna, Burak; Akbay, Kaan; Ekren, Fatih; Nazli, Oktay; Apaydin, Erdal; Semerci, Buelent; Guenaydin, Guerhan; Cuereklibatir, IbrahimObjective To assess the efficacy of extracorporeal shock wave lithotripsy (ESWL) monotherapy for isolated proximal ureteral calculi and compare it to that for isolated distal calculi. Patient and methods We treated 68 patients with isolated ureteral stones using MPL 9000. Stones were located in the proximal and distal ureters in 44 and 24 patients, respectively. Patients were stratified according to stone burden and degree of obstruction. Data of all patients were prospectively collected for stone burden, stone localization, number of sessions, number of shock waves, stone-free rates (SFRs), complications, re-treatment rates and auxiliary procedures. Outcomes regarding ureteral localization were compared. Results The overall SFR was 85.3% with a 41.2% re-treatment and 17.6% auxiliary procedure rate. The mean number of shock waves applied for each stone was not different among the two ureteral locations. The SFRs were 86.3% and 79.1% for proximal and distal ureteral stones, respectively (P = 0.17). For the group with stones < 100 mm(2), the SFR was 85.4% and 89.5% for the proximal and distal ureter, respectively. Although the degree of obstruction did not affect SFR of the entire group (P = 0.12) and the proximal ureter group (P = 0.96), it adversely affected SFR in the distal ureter (P = 0.017). Conclusions ESWL outcomes for the ureteral calculi support the use of lithotripsy particularly for stones < 100 mm(2). Treatment efficacy was not significantly different among stones localized in proximal and distal ureters. Degree of obstruction did not affect the ESWL outcomes in the proximal ureter, but it adversely affected SFR in the distal ureter.Öğe Comparison of long-term outcomes of laparoscopic and robot-assisted laparoscopic partial nephrectomy(Wiley, 2019) Kizilay, Fuat; Turna, Burak; Apaydin, Erdal; Semerci, BulentIn this study, we compared the long-term oncological and functional outcomes of laparoscopic partial nephrectomy (LPN) and robot-assisted laparoscopic partial nephrectomy (RAPN) performed in the treatment of renal tumors. The data of 142 patients (RAPN = 71, LPN = 71) were evaluated. Demographic data, perioperative and postoperative outcomes, long-term (5-year) overall survival (OS) and cancer-specific survival (CSS) rates of the patients were compared between the two groups. A P value of less than 0.05 was considered statistically significant The mean follow-up time was 61.38 months. There were more complex tumors in the RAPN group (P = 0.014). The duration of warm ischemia time (WIT) was shorter in the RAPN group (P = 0.019). Perioperative and postoperative outcomes were similar. There were no differences between the groups in terms of 5-year metastasis-free survival, OS, and CSS rates. Hypertension, diabetes, and preoperative estimated glomerular filtration rate (eGFR) were the predictive factors for renal insufficiency; and preoperative eGFR, WIT, and positive surgical margin were the predictive factors for 5-year CSS. We concluded that RAPN is an important minimally invasive treatment method for partial nephrectomy with long-term favorable results, especially in complex tumors. Comparisons of two methods should be made with comparative, prospective, randomized, high case number studies, and the place of RAPN in the treatment of these tumors should be clarified.Öğe Complications and management of complications during laparoscopic urologic procedures(Mary Ann Liebert Inc, 2006) Apaydin, Erdal; Turna, Burak; Demiryoguran, Serkan; Nazli, OktayÖğe Complications and management of laparoscopic urologic cases: Ege University experience(Mary Ann Liebert Inc, 2006) Apaydin, Erdal; Cal, Cag; Turna, Burak; Demiryoguran, Serkan; Simsir, Adnan; Umul, MehmetÖğe Consequences of epididymal ligation on prepubertal rats(Sci Printers & Publ Inc, 2007) Aktug, Huseyin; Ozdedeli, Kaan; Altay, Baris; Cureklibatur, Ibrahim; Turna, Burak; Yilmaz, OzlemOBJECTIVE: To study prospectively experimental effects of unilateral epididymal obstruction on testis and epididymis histopathologically in prepubertal rats. STUDY DESIGN: Organ weights, mean seminiferous tubule diameter (MSTD), mean ductus epididymis diameter (MDED), mean tubular biopsy scores (MTBS) and histopathology of 21 male albino Wistar rats were compared with the immunostaining affinity of antidesmin, anti-vimentin, anti-laminin and anti-collagen antibodies. RESULTS: Statistical analysis of mean weight of testes, MTBS, mean epididymal weight, MDED and MSTD was significant. Evaluation of testis and epididymis revealed cellular damage, basal membrane impairment and granulomatous infiltration. CONCLUSION: Histopathologic alterations with MSTD are early indicators for ipsilateral and contralateral injury. Even the presence of criteria such as intactness and cellular integrity does not guarantee there is no sperm leakage or immunologic damage. Therefore the impairment of basal integrity is a switch code in determining spermatogenic failure.Öğe COVID-19 Lung Findings Detected by Ga-68-PSMA PET/CT for Staging Purposes in Patients With Prostate Cancer(Lippincott Williams & Wilkins, 2022) Erkek, Burcin Karasah; Omur, Ozgur; Ozkok, Serdar; Turna, Burak[No Abstract Available]Öğe CpG island hypermethylation of RAR-beta and RASSF1 genes in cell-free DNA of cases with prostate cancer(Ios Press, 2008) Ozlem-Dogan, Zeynep; Yilmaz, Sunde; Avci, Cigir B.; Numanoglu, Sinem; Dodurga, Yavuz; Onay, Huseyin; Demiryoguran, Serkan; Turna, Burak; Nazli, Oktay; Gunduz, Cumhur
