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Öğe Adenomatous hyperplasia of the rete testis: Not a true hyperplasia, just proliferation!(Termedia Publishing House Ltd, 2013) Ozgur, Tumay; Akin, Mehmet Mustafa; Gokce, Hasan; Davarci, MurselThere are several tumor-like lesions and miscellaneous neoplasms of the rete testis. We present a case with adenomatous hyperplasia of the rete testis (AHRT). The patient was 24 years old with undescended testis and was referred to our hospital. There were no clinical or endocrine abnormalities. Cryptorchidism was unilateral and the other testis was normal. Right orchiectomy was performed and sent to the pathology laboratory for examination. Morphologic and immunohistochemistry findings confirmed the diagnosis of AHRT in the case. The patient's post-operative course continues uneventfully. AHRT is a rare lesion and can be confused with malignancy. It is incidentally detected in microscopic investigation. It may present as a very small lesion detected in microscopic examination or a solid cystic mass lesion which is macroscopically evident. Clinical history, localization, histology features and immunohistochemistry are criteria for differentiating these lesions. We present this rare case for both surgeons and pathologists due to its importance as it can be confused with malignancy.Öğe Caffeic acid phenethyl ester (CAPE) protects against acute urogenital injury following pneumoperitoneum in the rat(Taylor & Francis Ltd, 2014) Rifaioglu, Murat Mehmet; Davarci, Mursel; Nacar, Ahmet; Alp, Harun; Celik, Murat; Sefil, Nebihat Kaplan; Inci, MehmetPurpose: Our aim is to determine the biochemical and histologic changes induced in the kidneys, testis and prostate on possible ischemia and reperfusion (I/R) injury caused by pneumoperitoneum (PNP) in a rat model and to evaluate the ability of protective effects of caffeic acid phenethyl ester (CAPE). Methods: Twenty-eight adult male Wistar albino rats were randomly divided to one of three treatment groups, with seven animals in each group. Sham, laparoscopy (L), and laparoscopy plus CAPE (L + C) group were subjected to 60 min of PNP with 15 mmHg one hour before the desufflation period. Total oxidant status (TOS) and total antioxidant status (TAS) levels were determined in kidney, testis, and prostate. Kidney and testis tissues were removed to obtain a histologic score. Also, Johnsen scoring system was used for testicular tissue analysis. Results: L group had significantly higher TOS and lower TAS levels on kidney and testis compared to the other groups. In prostate biochemical analysis, there was not any difference between groups. No difference was found between groups according to kidney and testis tissues' histologic evaluation. In evaluation of Johnsen scoring, L group showed significant lower score compared to the other two groups. Conclusions: Increased intraabdominal pressure (IAP) had an oxidative effect on kidney and testis but not on prostate in rats. Moreover, it could affect the testicular Johnsen score. All these adverse effects of IAP on both kidney and testis could be prevented by CAPE administration.Öğe Does renal parenchymal thickness affect bleeding in percutaneous nephrolithotomy?(Tubitak Scientific & Technological Research Council Turkey, 2013) Rifaioglu, Mehmet Murat; Onem, Kadir; Celik, Huseyin; Davarci, Mursel; Cetinkaya, Mehmet; Inci, Mehmet; Gunesli Yetisken, AylinAim: Blood loss is a major concern during percutaneous nephrolithotomy. The aim of this study was to evaluate the effect of access point parenchymal thickness on bleeding in percutaneous nephrolithotomy procedures. Materials and methods: In this study 85 patients who had undergone a percutaneous nephrolithotomy operation between February 2009 and July 2011 were reviewed retrospectively. All characteristics of the patients were investigated. The details of the operative procedure and the renal parenchymal thickness at the puncture site were also recorded. Blood loss was calculated during the peroperative and postoperative periods. Correlation and multivariate regression analysis were done to detect predictive factors on bleeding. Results: Of the 85 percutaneous nephrolithotomy procedures done, 12 (14.1%) patients had no diminution of hemoglobin value postoperatively and were excluded. This left 73 percutaneous nephrolithotomy procedures that were evaluated. The mean peroperative hemoglobin drop was 1.79 +/- 1.17 mg/dL. Stone size, operation time, and grade of hydronephrosis were correlated with hemoglobin drop significantly (P = 0.047, P = 0.016, and P = 0.034, respectively). There was no correlation between parenchymal thickness and bleeding (P = 0.545). In multivariate regression analysis, only the operation time was found to be a statistically significant independent predictive factor for peroperative bleeding in percutaneous nephrolithotomy (P = 0.005). Conclusion: Renal parenchymal thickness and the grade of hydronephrosis do not predict peroperative hemorrhage in percutaneous nephrolithotomy procedures.Öğe Histopathologic Evaluation of Neurovascular Bundles and Periprostatic Tissue in Interfascial and Intrafascial Nerve-sparing Radical Prostatectomy Technique: A Cadaveric Anatomic Study(Elsevier Science Inc, 2013) Rifaioglu, Murat M.; Davarci, Mursel; Ozgur, Tumay; Ozkanli, Seyma; Ozdes, Taskin; Inci, Mehmet; Onem, KadirOBJECTIVE To compare interfascial (IEF) or intrafascial (IAF) periprostatic nerve dissection technique in prostate tissue using immunohistochemical methods in fresh cadavers. MATERIALS AND METHODS Prostate tissues of 25 fresh cadavers were removed from rectum and other surrounding structures. IEF nerve dissection (n - 25) was performed on the right and IAF nerve (n - 25) dissection on the left side of each prostate under direct visualization. The base, center, and apex of each prostate lobes and fascia dissected were sampled for blind histopathologic evaluation. Total counts of nerve, artery, and vein were performed on hematoxylin and eosin stained sections, whereas sympathetic and parasympathetic nerve counts were performed on immunohistochemical stained sections. Iatrogenic surgical margin injury at base, center, and apex detected were compared between groups. RESULTS Thickness of neurovascular bundle dissected in IAF was found significantly higher than IEF technique. The number of residual sympathetic fibers after dissection of neurovascular bundle was found significantly higher in IAF group. There were significant decreases in total nerve, parasympathetic, and sympathetic nerve counts only at the central region of prostate in IAF group. A significant decrease was found in the number of residual vein left in the fascia only at the apex by IAF dissection. Of surgical margin injury results, no significant difference was detected between IAF and IEF groups at any location. CONCLUSION IAF provides better preservation of sympathetic but not parasympathetic fibers without increasing surgical injury of prostate capsule. (C) 2013 Elsevier Inc.Öğe Intraurethral Utterbasti Application for Urethral Injury in Rats(Medwell Online, 2012) Yalcinkaya, Fatih Rustu; Davarci, Mursel; Gokce, Ahmet; Guven, Esref Oguz; Inci, Mehmet; Kerem, Mustafa; Ayyildiz, AliUrethral stricture is an illness that can be repeated and that has a troublous treatment process. Uttarbasti which is used in traditional Indian wound healing is a mixture consisting of rock salt, honey and sesame oil. In traditional treatment, there are studies about the effects of honey, wax and sesame oil on wound healing. Researchers aimed at searching the efficiency of the treatment by using uttarbasti in urethral stenosis. In the experiment 18 Wistar Albino type rats which are around 200-250 g were used. These rats were divided into 3 groups and each has 6 rats. Urethra was marked till external meatus with 18G sting. To the 1st group, not any drug was given. To the 2nd group, for 3 weeks saline (1 cc) was given into urethra. To the 3rd group for 3 weeks uttarbasti (1 cc) was applied into urethra. At the end of the 3rd week, all the groups were decapitated. They were taken into histopathological search with their penis tissue and urethra.Öğe Intraurethral utterbasti application for urethral injury in rats(2012) Yalcinkaya, Fatih Rustu; Davarci, Mursel; Gokce, Ahmet; Guven, Esref Oguz; Inci, Mehmet; Kerem, Mustafa; Ayyildiz, AliUrethral stricture is an illness that can be repeated and that has a troublous treatment process. Uttarbasti which is used in traditional Indian wound healing is a mixture consisting of rock salt, honey and sesame oil. In traditional treatment, there are studies about the effects of honey, wax and sesame oil on wound healing. Researchers aimed at searching the efficiency of the treatment by using uttarbasti in urethral stenosis. In the experiment 18 Wistar Albino type rats which are around 200-250 g were used. These rats were divided into 3 groups and each has 6 rats. Urethra was marked till external meatus with 18G sting. To the 1 st group, not any drug was given. To the 2nd group, for 3 weeks saline (1 cc) was given into urethra. To the 3rd group for 3 weeks uttarbasti (1 cc) was applied into urethra. At the end of the 3rd week, all the groups were decapitated. They were taken into histopathological search with their penis tissue and urethra. © Medwell Journals, 2012.Öğe The Investigation of Total PSA, Free PSA, and Free/Total PSA Ratio in Patients With Liver Cirrhosis Patients According to Child-Pugh Score(Elsevier Science Inc, 2013) Inci, Mehmet; Rifaioglu, Murat Mehmet; Inci, Melek; Celik, Murat; Demir, Mehmet; Ulutas, Turker; Davarci, MurselOBJECTIVE To investigate the total prostate-specific antigen (tPSA), free PSA (fPSA), and free/total PSA (fPSA/tPSA) ratio in patients with liver cirrhosis (LC) according to the severity of hepatic insufficiency. METHODS Eighty-two male patients with LC were studied. The severity of liver disease was categorized by Child-Pugh score (Child-Pugh A, B, and C). Forty-two age-matched healthy subjects were used as a control group. The tPSA, fPSA, fPSA/tPSA ratio, total prostate volume (TPV), total testosterone (TT), and total protein (TP) were measured. The LC group was compared with the control group in terms of these parameters. In addition, intra-comparison and inter-comparison was made between all the Child-Pugh groups and normal subjects, in terms of these parameters. RESULTS The tPSA and fPSA levels in LC cases, Child-Pugh A, Child-Pugh B, and Child-Pugh C groups were significantly decreased compared with the control group. The ratio of fPSA/tPSA in the LC subjects and Child-Pugh A groups significantly increased compared with the control group. TT, TP levels, and TPV in patients with LC were significantly lower compared with the control group and the results were significantly correlated with the Child-Pugh score. CONCLUSION The present study reveals that tPSA and fPSA were decreased in patients with LC in comparison to healthy subjects in terms of 3 mechanisms. First, it might be due to shrunken prostatic volume. Second, it also resulted in decreased levels of testosterone because of the abnormality of hypothalamic-pituitary-testicular axis. Third, it might be the diminished serum protein level in the composition of the PSA. UROLOGY 81: 617-622, 2013. (c) 2013 Elsevier Inc.Öğe Left renal atrophy(E-Century Publishing Corp, 2014) Davran, Ramazan; Helvaci, Mehmet Rami; Davarci, MurselBackground: We tried to understand whether or not there is a higher risk of left renal atrophy in human being. Methods: All patients applying to the Hematology Service with any underlying complaint were studied. Results: The study included 2,417 cases (1,248 females). The mean ages were 47.3 versus 50.7 years in females and males, respectively (p<0.000). There were 33 cases (1.3%) with the left renal atrophy against five cases (0.2%) with the right (p<0.001). The left renal atrophy cases have splenomegaly (SM) in 51.5%, thalassemia minors (TMs) in 30.3%, sickle cell diseases (SCDs) in 27.2%, myeloproliferative disorders in 18.1%, chronic lymphocytic leukemia in 6.0%, cirrhosis in 6.0%, solid organ malignancies in 6.0%, chronic obstructive pulmonary disease in 3.0%, multiple myeloma in 3.0%, and Waldenstrom's macroglobulinemia in 3.0%. Similarly, the right renal atrophy cases have SM in 20.0%, TMs in 40.0%, and SCDs in 20.0%. Conclusion: Left renal atrophy may be significantly higher than the right side in human being. Aortic pressure induced flow disorders in the left renal vein, structural anomalies of the left renal vein, and possibly the higher arterial pressure of the left kidney due to the shorter distance to the heart as an underlying cause of atherosclerosis may be some of the possible causes. Due to the stronger arterial wall protecting itself from compression and high prevalences of SM and left varicocele in population, SM induced flow disorders of the left renal vein may be the most common cause.Öğe Left renal atrophy in sickle cell diseases(Medi+World Int, 2016) Helvaci, Mehmet Rami; Davran, Ramazan; Davarci, Mursel; Muftuoglu, Orhan Ekrem; Pocock, LesleyBackground: We tried to understand whether or not there is a difference in occurrence of renal atrophy between the left and right sides in sickle cell diseases (SCDs). Methods: All patients with SCDs were enrolled into the study. Results: The study included 311 patients (153 females). There were seven cases (2.2%) with left renal atrophy against one case (0.3%) with right renal atrophy (p<0.001). Associated thalassemias were detected in 44.0% and splenomegaly in 12.5% of the patients. There was digital clubbing in 6.4%, chronic obstructive pulmonary disease in 4.8%, leg ulcers in 12.8%, stroke in 7.0%, chronic renal disease in 8.6%, pulmonary hypertension in 11.8%, cirrhosis in 3.5%, coronary heart disease in 8.0%, and exitus in 5.7% of the patients. Conclusion: Renal atrophy is significantly higher on the left side in SCDs. Splenomegaly induced flow disorders in left renal vessels, structural anomalies of the left renal vein including nutcracker syndrome and passage behind the aorta, and possibly the higher arterial pressure of left kidney due to the shorter distance to heart as an underlying cause of endothelial damage induced atherosclerosis, may be some of the possible causes. Because of the higher prevalences of left varicocele probably due to drainage of left testicular vein into the left renal vein, high prevalences of associated thalassemias with SCDs as a cause of splenomegaly, and tissue ischemia and infarctions induced edematous splenomegaly in early lives of the SCDs cases, splenomegaly induced flow disorders of left renal vein may be the most significant cause among them.Öğe Mean Platelet Volume-A Predictive Factor for the Diagnosis of Nonsymptomatic Prostatitis: Results of Univariate and Multivariate Models(Sage Publications Inc, 2017) Rifaioglu, Murat Mehmet; Demirbas, Onur; Gokce, Hasan; Davarci, MurselMean platelet volume (MPV) has been reported to be related to inflammation. Prostate-specific antigen (PSA) is a protein produced by the prostate, and this protein may be elevated for several reasons, including prostatitis, benign prostatic hyperplasia, and/or cancer. The aim of the current study was to investigate the predictive effect of MPV values on nonsymptomatic prostatitis diagnosis and the relation between MPV and PSA. A total of 275 patients, 89 affected by benign prostate hyperplasia, 94 by prostate adenocancer, and 92 by prostatitis were included in the current study. PSA, total blood count parameters, and urine analysis were investigated. Findings were compared with the groups. The correlation between MPV and the other parameters were analyzed. Univariate and multivariate logistic regression analysis was performed to determine independent predictors of nonsymptomatic prostatitis diagnosis. MPV was significantly higher in patients with nonsymptomatic prostatitis than the other groups. There were negative correlations between MPV and age, total PSA or free PSA (r = -.123; p = .042, r = -.235; p < .001, r = -.184; p = .006, respectively). According to multivariate regression model, only MPV was identified as the predictive factor for nonsymptomatic prostatitis (odds ratio: 1.451, 95% confidence interval [1.116, 1.887], p = .005). MPV, in the absence of other reasons that increased the MPV level, was significantly increased in cases with nonsymptomatic prostatitis; this increase is significantly higher than elevated PSA level in nonsymptomatic prostatitis patients. MPV could have a predictive value for the diagnosis of nonsymptomatic prostatitis.Öğe Metastatic prostate adenocarcinoma presenting as supraclavicular lymphadenopathy: a report of two cases(Termedia Publishing House Ltd, 2012) Davarci, Mursel; Gokce, Ahmet; Guven, E. Oguz; Yalcinkaya, Fatih R.; Esen, Hasan; Sevinc, AlperClinical examination is very important in the practice of medicine. In patients presenting with a supraclavicular mass, a number of diseases including cancer should be ruled out. Two patients who presented with a bulky left supraclavicular mass were evaluated. Their medical history revealed complaints attributed to lower urinary tract infection. We performed histopathological examination of the lymph nodes with radiological evaluation of the thorax and abdomen. The final diagnoses were prostate cancer in both patients. It should always be kept in mind that prostate cancer is the most frequent cancer in elderly men, and although very unusual, the presenting finding can be cervical or supraclavicular lymphadenopathy; thus clinicians should be aware of urological examinations in such cases.Öğe OPTIMAL CUT-OFF POINT OF STONE SIZE FOR PREDICTING RESIDUAL STONE IN PERCUTANEOUS NEPHROLITOTOMY(Mary Ann Liebert, Inc, 2012) Rifaioglu, Murat Mehmet; Davarci, Mursel; Inci, Mehmet; Demirbas, Onur; Kaya, Yusuf Selim; Baydinc, Can Yasar[Abstract Not Available]Öğe Protective Effects of Caffeic Acid Phenethyl Ester on the Dose-Dependent Acute Nephrotoxicity with Paraquat in a Rat Model(Wiley-Blackwell, 2015) Rifaioglu, Murat Mehmet; Sefil, Fatih; Gokce, Hasan; Nacar, Ahmet; Dorum, Bayram Ali; Davarci, MurselParaquat (PQ), which is used extensively as a potent herbicide throughout the world, is highly toxic in humans. We aimed to determine PQ-induced biochemical and histologic changes in the kidneys, and to evaluate the ability of the protective effects of caffeic acid phenethyl ester (CAPE) against PQ-induced injury in rats. Forty-eight rats were divided into eight groups of six: Group 1: Control; Group 2: 10 mol/kg CAPE; Group 3: 15 mg/kg PQ; Group 4: 30 mg/kg PQ; Group 5: 45 mg/kg PQ; Group 6: 15 mg/kg PQ+CAPE; Group 7: 30 mg/kg PQ+CAPE; Group 8: 45 mg/kg PQ+CAPE. PQ and CAPE were injected intraperitoneally. The levels of the total oxidant status (TOS) and total antioxidant status (TAS) were determined in the supernatants of the excised left kidney. Right kidney tissue of each rat was removed to obtain a histologic score. When PQ-administrated (15, 30, 45) groups compared with other groups, TOS values were found to be significantly higher (p<0.01). PQ (15, 30, 45) groups had significantly diminished values of TAS than the other groups (p<0.001). Of histologic score evaluation, only the PQ45 group had a significantly higher value than the sham, and CAPE groups (p<0.05). Moreover, in CAPE+PQ45 group, the level of histologic score was decreased compared to PQ45 group (p<0.001). In conclusion, the evaluation of the data suggests that CAPE can be used to prevent the acute effects of PQ nephrotoxicity. (c) 2013 Wiley Periodicals, Inc. Environ Toxicol 30: 375-381, 2015.Öğe Recurrent hyponatremia due to tolterodine(Canadian Urological Association, 2012) Ustun, Ihsan; Davarci, Mursel; Demirbas, Onur; Ustun, Nilgul; Gokce, Cumali[Abstract Not Available]Öğe Relationship between endothelial dysfunction and nocturia with benign prostatic hyperplasia(Taylor & Francis Ltd, 2013) Inci, Mehmet; Sarli, Bahadir; Davarci, Mursel; Yalcinkaya, Fatih Rustu; Rifaioglu, Murat Mehmet; Davran, Ramazan; Arica, SecilObjective. There are limited data on whether there is an association between nocturia, benign prostatic hyperplasia (BPH) and endothelial dysfunction. The aim of the present study was to evaluate whether there is an association between nocturia and endothelial dysfunction in patients with BPH. Material and methods. Forty-two men with a diagnosis of BPH and 42 age-matched controls were enrolled. All patients were assessed for frequency and duration of nocturia, and prostate volume, completed the International Prostate Symptom Score (IPSS) questionnaire, and underwent brachial flow-mediated dilatation (FMD) evaluation. Results. There was a negative correlation between FMD and frequency of nocturia (r = -0.879, p < 0.0001). Moreover, there was a negative correlation between duration of nocturia and FMD (r = -0.890, p < 0.0001). In addition, FMD was significantly decreased in the BPH group compared with the control group (6.0 +/- 0.09 to 7.8 +/- 0.10%) (p = 0.0001). Conclusion. In patients with BPH, nocturia is associated with endothelial dysfunction and may be an insidious risk factor for cardiovascular disease.Öğe Urodynamic evaluation of acute effects of sildenafil on voiding among males with erectile dysfunction and symptomatic benign prostate(Tubitak Scientific & Technological Research Council Turkey, 2012) Yalcinkaya, Fatih Rustu; Davarci, Mursel; Akcin, Soner; Gokce, Ahmet; Guven, Esref Oguz; Inci, Mehmet; Balbay, Mevlana DeryaAim: To evaluate the acute effects of sildenafil citrate on micturition of men with erectile dysfunction and symptomatic benign prostatic hyperplasia using urodynamic parameters. Materials and methods: Between June and December 2009, a total of 50 patients over the age of 40 participated in the study. The patients were admitted to our hospital with erectile dysfunction and moderate to severe lower urinary symptoms with benign prostatic hyperplasia. To examine the sexual function of the participants, we used the IIEF-5 Sexual Health Inventory for Men questionnaire. Patients were randomly divided into 2 groups: a treatment group and a control group. A basal urodynamic evaluation was performed in both groups. After the urodynamic evaluation, 50 mg of sildenafil was given to the patients in the control group and 1 h later a second evaluation was performed. Following the urodynamic evaluation, a placebo was given to the patients in the control group and then a second evaluation was performed after 1 h. Results: A statistically significant increase was seen in maximal flow and average flow (Qmax and Qave) after 1 h in the treatment group. The increase in the control group was not significant. Conclusion: Based on the study findings, we suggest that sildenafil has an effect on micturition in the short term. However, to determine the role of sildenafil in the treatment of BPH/LUTS, further studies with larger patient groups are needed.Öğe Villous adenoma of the urinary bladder: rare location(Termedia Publishing House Ltd, 2012) Atik, Esin; Akansu, Bulent; Davarci, Mursel; Inci, Mehmet; Yalcinkaya, Fatih; Rifaioglu, MuratVillous adenomas are common lesions of the gastrointestinal tract but they are rarely located in the urinary tract including the urinary bladder. There are a few case reports and series in the literature. Here we report a 43-year-old male patient who had a polypoid lesion located on the left lateral wall of the urinary bladder. Transurethral resection was performed. The diagnosis was 'villous adenoma of urinary bladder' with clinical and histopathological findings. Villous adenomas are mostly seen in elderly males. The coexistence of villous adenoma with adenocarcinoma, squamous cell carcinoma, and urothelial carcinoma was observed but there is not clear evidence about progression to carcinoma, in spite of its colonic counterpart. Generally complete surgical resection is accepted as curative but there are no exact data about follow-up and recurrence. By presenting this case, we aim to emphasize that it is a rare but important lesion because of coexistence with malignancies and uncertain malignant potential.Öğe WHAT IS THE CLINICAL IMPORTANCE OF STONE SIZE IN PERCUTANEOUS NEPHROLITOTOMY?(Mary Ann Liebert, Inc, 2012) Rifaioglu, Murat Mehmet; Davarci, Mursel; Inci, Mehmet; Kaya, Yusuf Selim; Demirbas, Onur; Baydinc, Yasar Can[Abstract Not Available]Öğe WHAT IS THE IMPORTANCE OF PARENCHYMAL THICKNESS IN PERCUTANEOUS NEPHROLITHOTOMY PROCEDURE?(Mary Ann Liebert, Inc, 2012) Rifaioglu, Murat Mehmet; Davarci, Mursel; Kaya, Yusuf Selim; Demirbas, Onur; Yalcinkaya, Fatih Rustu; Baydinc, Can Yasar[Abstract Not Available]
