Publications by authors named "Abdullah Hizir Yavuzsan"

14 Publications

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The fate of paratesticular masses: 13 years' experience in a tertiary referral centre.

Aktuelle Urol 2021 Apr 14. Epub 2021 Apr 14.

Şişli Hamidiye Etfal Training and Research Hospital, Urology, Şişli, Turkey.

Objective: Paratesticular neoplasms exhibit different behaviours, depending on the embryological tissue of origin. Treatment modalities can depend on the differential diagnosis. The aim of this study is to present the clinical, morphological and histopathological features of patients with paratesticular masses and their follow-ups and is intended to increase awareness of the issues.

Methodology: We included 31 excisions of paratesticular masses, after radiological diagnosis as paratesticular mass in our hospital between 2007-2020. Information on treatment modalities, tumour recurrence, metastasis, and survival rates were obtained from hospital archives. All patients were evaluated by taking patients' history, physical examination, scrotal ultrasound, chest radiography, and serum tumour markers. Treatment modality was selected according to intraoperative findings. Haematoxylin-eosin sections were examined, and immunohistochemical analyses were performed for smooth muscle actin, desmin, Ki67, CD34, S100, and myogenin. Ten high-power fields were counted to document Ki67 and p53 nuclear positivity rates.

Results: A total of 31 operations were performed with recurrence in three patients. Histomorphological and immunohistochemical examination revealed eleven malignant masses; eight rhabdomyosarcomas, a leiomyosarcoma, a liposarcoma and a large B cell lymphoma. Other excised masses were benign and infective lesions.

Conclusion: Paratesticular masses are heterogeneous tumours that follow different clinical courses. Clinicians must be aware of this histological diversity in order to plan a treatment pathway. This study is one of the largest published series, with a long follow-up period. It shows that the most critical features in determining prognosis are histopathological subtype and tumour grade.
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http://dx.doi.org/10.1055/a-1345-6808DOI Listing
April 2021

Factors predicting duration and success of semirigid ureteroscopy for ureteral stones in different localizations.

Arch Esp Urol 2021 Apr;74(3):335-342

Department of Urology. Dr. Sadi Konuk Training and Research Hospital. Istanbul. Turkey.

Objective: In this study, we aimed to determine the factors predicting the duration and successof semirigid ureteroscopy performed for the treatment of ureteral stones in different localizations. MATERIALS AND METHODS: Medical records of the patients whom under went semirigid ureteroscopy for urolithiasis in our centre between January 2015 and December 2019 were retrospectively reviewed. The study group composed of 170 patients and divided into three subgroups; of which 54 in proximal ureter (31.8%), 51 in the mid (30 %) and 65 (38.2%) in the distal ureter. Predictive factors of semirigid ureteroscopy duration and success were determined by performance of correlation analysis and multivariate analysis.

Results: Overall stone-free rate was calculated as 78.8%. Success rates for proximal, mid and distal ureteral stones were 72.2% (39/54 patients), 74.5% (38/51 patients) and 87.7% (57/65 patients), respectively. Complications were present in 19 patients (11.2%). Multivariate analysis indicated that stone diameter and stone burden independently affected the stone-free rate. Statistically significant negative correlation was determined between success of the procedure and stone diameter, stone burden, impaction and more proximal stone localization. While there was a statistically significant positive correlation between duration of procedure and stone burden, diameter, impaction, historyof ipsilateral ureteroscopy and more proximal stone localization, there was negative correlation between duration of procedure and stone-free status. CONCLUSION: We conclude that stone diameter, stone burden, impaction and more proximal stone localization are common factors affecting both duration and success of semirigid ureteroscopy. In addition, stone size and stone burden were determined as independent markers of stone-free status.
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April 2021

Sexual intercourse before exercise has a detrimental effect on lower extremity muscle strength in men.

Postgrad Med J 2021 Apr 1. Epub 2021 Apr 1.

Urology, University of Health Sciences Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.

Introduction: The question of whether sexual intercourse can harm athletic performance is a long-debated topic since first sport competitions were invented. Therefore, due to the lack of solid evidence, we aimed to evaluate the effects of sexual intercourse on muscle training performance.

Materials And Methods: Physically and sexually active, 50 men (age=29.3±1.14 years) were enrolled in the study. Participants completed three weight training sessions and all sessions were at the same time of the day. The maximum weight was adjusted in the first session. In the second and third sessions, they performed five repetitions of the squat with their maximum weight for each set with a total of five sets after participating in and abstaining from sexual intercourse the night before, respectively. The duration of sexual intercourse was measured with a stopwatch.

Results: The mean duration of sex was measured to be 13.8±3.61 min. Furthermore, the mean lifted weight before sex was calculated to be 109.4±11.41 kg and the mean lifted weight after sex was calculated to be 107±11.05 kg. According to obtained data, sexual intercourse has a significant detrimental effect on maximum weight in squat training (p=0001).

Conclusion: Results demonstrate that sexual intercourse within 24 hours before exercise have detrimental effect on lower extremity muscle force, which suggests that restricting sexual activity before a short-term activity may be necessary.
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http://dx.doi.org/10.1136/postgradmedj-2020-139033DOI Listing
April 2021

Regression of the Sweet's syndrome after Bacillus Calmette-Guérin therapy: A bladder cancer case report.

Urol Case Rep 2020 Jul 9;31:101202. Epub 2020 Apr 9.

University of Health Sciences Sisli Hamidiye Etfal Training and Research Hospital Urology Department Istanbul Turkey, Turkey.

The Sweet's syndrome is a rare dermatosis which can be related to underlying malignancies. In this case we presented a case, who applied to our clinic with severe dermatosis and hematuria. We diagnosed high grade non-muscle invasive bladder tumor, which was treated with transurethral resection of bladder-tumor and six cycle of Bacillus Calmette-Guérin therapy. After the treatment the dermatosis was regressed almost completely. However, recurrent bladder tumor was detected at the first control cystoscopy.
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http://dx.doi.org/10.1016/j.eucr.2020.101202DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7163327PMC
July 2020

The rupture of an abdominal aortic aneurysm at the level of horseshoe kidney: A case report.

Urol Case Rep 2020 May 23;30:101110. Epub 2019 Dec 23.

University of Health and Sciences Sisli Etfal Traning and Research Hospital Urology Department Istanbul, Turkey.

Kidney anomalies are always a challenge even for the most experienced vascular and urologic surgeons in the reconstruction of the abdominal aortic segment. In the literature, the most common anomalies of the kidney are the horseshoe kidney.

The Case: A 77-year-old male headed to the emergency department with complaints of acute abdominal pain and sudden onset of fatigue. The enhanced CT-scan performed and the horseshoe kidney with the ruptured aortic aneurysm seen. The cardiovascular and transplantation surgery team decided to perform explorative surgery.
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http://dx.doi.org/10.1016/j.eucr.2019.101110DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7066202PMC
May 2020

First live donor nephrectomy with abdominal tortuous aorta and two renal arteries: A renal transplantation case report.

Urol Case Rep 2020 Mar 11;29:101097. Epub 2019 Dec 11.

Health Sciences University, Sisli Hamidiye Etfal Training and Research Hospital, Department of Pediatric Surgery, Istanbul, Turkey.

46-year-old wife (donor) and 52-year-old husband (recipient) admitted to our clinic for kidney transplantation. CT angiography of the donor showed us there were bilateral renal double artery and a tortuous aorta that is deviated to the left side. The main artery cannot be reached by laparoscopy because of the upper level of renal artery and deviation of the aorta and an open conversion was performed. Presence of tortuous aorta with multiple renal arteries makes laparoscopic donor nephrectomy a challenging procedure even preformed by an experienced surgeon. The possibility of open conversion should always be kept in mind in these cases.
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http://dx.doi.org/10.1016/j.eucr.2019.101097DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6931104PMC
March 2020

A purely penoscrotal approach: Reservoir placement of an inflatable penile prosthesis (IPP) in an orthotopic neobladder patient. Case report.

Arch Ital Urol Androl 2019 Oct 2;91(3). Epub 2019 Oct 2.

Department of Urology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Science, Istanbul.

Introduction: The inflatable penile prosthesis (IPP) is the last step in drug-resistant erectile dysfunction treatment. IPP implantation can be challenging, especially following a cystoprostatectomy with an orthotopic neobladder. There is no consensus about surgical techniques for placement of an IPP reservoir in such patients. In this paper, we present a case of an IPP and reservoir placement with a single penoscrotal incision.

Case: A 55-year-old patient, who underwent radical cysto-prostatectomy with an orthotopic neobladder seven years ago, presented with severe erectile dysfunction. His oncologic status was stable, and he was in remission. He also had high blood pressure and took medication for it. He previously used different medical treatments, such as oral phosphodiesterase-5 inhibitors (PDE5i), intraurethral prostaglandin E2 (PGE2) installations, and Trimix injections. As far as we know, he had no benefit from these treatments. A three-piece IPP was recom- mended. After a discussion of surgical techniques, we chose the penoscrotal approach, and the ectopic reservoir was placed through the inguinal canal, guided by a forefinger.

Results: The total operative time was 60 minutes, and the estimated blood loss was minimal. There were no perioperative complications. The patient was discharged on postoperative day one. He could start to use the IPP in the first month. His sexual and urinary functions were normal, and there was no abdominal bulging from the ectopic reservoir at the three-month follow-up.

Conclusions: In conclusion, ectopic placement of the reservoir through a single penoscrotal incision appears to be a safe and acceptable surgical technique for postoperative ED following a radical cystoprostatectomy with an orthotopic neobladder.
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http://dx.doi.org/10.4081/aiua.2019.3.191DOI Listing
October 2019

Aggressive co-existence: Collecting duct and clear cell carcinoma in the same kidney.

Turk J Urol 2019 11 19;45(Supp. 1):S131-S134. Epub 2018 Dec 19.

Department of Urology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey.

As in every organ, synchronous multiple cancers are rarely encountered in kidneys. In the literature, mostly co-existence of renal cell carcinoma and transitional cell carcinoma was reported. In the literature, the co-existence of collecting duct carcinoma and clear cell carcinoma was described only for a few cases with different patterns. With these two cases, we aimed to present a very rare entity with synchronous existence of clear cell renal cell carcinoma and collecting duct carcinoma in the same kidneys.
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http://dx.doi.org/10.5152/tud.2018.44342DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6922041PMC
November 2019

The impact of single positive surgical margin features on biochemical recurrence after robotic radical prostatectomy.

Int Braz J Urol 2019 Jan-Feb;45(1):45-53

Department of Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.

Objective: Parameters predictive of biochemical or clinical recurrence after Radical Prostatectomy (RP) were determined as pre-treatment PSA value, pathologic tumor stage, tumor grade and presence of Positive Surgical Margin (PSM), extracapsular extension and seminal vesicle invasion and the status of pelvic lymph nodes. The aim of our study is to evaluate the effect of additional features in patients undergoing RP in our clinic.

Materials And Methods: We studied 556 RP operations performed between 2009 and 2016 for prostate cancer at this clinic. Preoperative and postoperative data of the patients were retrospectively reviewed. RP specimens were examined by two pathologists specialized in this subject. Of these patients, 78 (14.02%) patients with PSM were included in the study. The pathology slides of these patients were reassessed. The length of PSM (mm), localization (apex, basis and posterolateral) and Gleason pattern at this margin was determined and statistical correlations with BCR were calculated.

Results: The mean follow-up after the RP of 41 patients included in the study was 37.4 ± 13.2 months. During the follow-up period of the patients, BCR was observed in 16 patients (39.02%). No statistically significant difference was observed in age and prostate volume between the groups with and without BCR development (p > 0.05). Preoperative PSA level was found to be statistically significantly higher in the group with BCR development compared to the group without recurrence (p = 0.004). In-group comparisons in each aforementioned Gleason score groups were performed in terms of BCR development and the preoperative Gleason score in the group with development of recurrence was found to be statistically significantly higher compared to the group without recurrence (p = 0.007). The length of the surgical margin was measured as 7.4 ± 4.4 mm in the BCR-developing group and 4.7 ± 3.8 mm in the no-BCR- developing group; it was statistically significantly higher in the group with development of recurrence (p = 0.03).

Conclusion: Length and location of the PSM and the Gleason score detected in the PSM region could not predict biochemical recurrence according to the results of this present study. However high preoperative PSA value is an independent prognostic factor for biochemical recurrence.
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http://dx.doi.org/10.1590/S1677-5538.IBJU.2017.0702DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442133PMC
June 2019

Comparison of robotic and laparoscopic partial nephrectomy for small renal tumours.

Arch Ital Urol Androl 2017 Jun 30;89(2):93-96. Epub 2017 Jun 30.

Bakirkoy Sadi Konuk Research and Training Hospital, Department of Urology, Istanbul.

Objective: To evaluate a single surgeon oncological and functional outcomes of laparoscopic partial nephrectomy (LPN) compared to robotic partial nephrectomy (RPN) for pT1a renal tumours.

Materials And Methods: Between 2006 and 2016, a retrospective review of 42 patients who underwent LPN (n = 20) or RPN (n = 22) by same surgeon was performed. Patients were matched for gender, age, body mass index (BMI), American Society of Anaesthesiologists (ASA) score, tumour side, RENAL and PADUA scores, peri-operative and post-operative outcomes.

Results: There was no significant differences between the two groups with respect to patient gender, age, BMI, ASA score, tumours side, RENAL and PADUA scores. Mean operative time for RPN was 176 vs. 227 minutes for LPN (p = 0.001). Warm ischemia time was similar in both groups (p = 0.58). Estimated blood loss (EBL) was higher in the LPN. There was no significant difference with preoperative and postoperative creatinine and percent change in eGFR levels. Only one case in LPN had positive surgical margin.

Conclusions: RPN is a developing procedure, and technically feasible and safe for small-size renal tumours. Moreover RPN is a comparable and alternative operation to LPN, providing equivalent oncological and functional outcomes, as well as saving more healthy marginal tissue and easier and faster suturing.
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http://dx.doi.org/10.4081/aiua.2017.2.93DOI Listing
June 2017

Robotic kidney transplantation: The Bakırköy experience.

Turk J Urol 2016 Dec;42(4):295-298

Clinic of Nephrology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey.

Objective: Robotic kidney transplantation, first described by Hoznek and colleagues, and has been improved by investigators like Oberholzer and Menon. We realized the first robotic kidney transplant (RKT) in our clinic in December 2015. In this study, we aimed to present the first 15 cases we performed within 3 months.

Materİal And Methods: Starting from January 2016, we performed 15 RKTs in our hospital. Before surgery, the whole robotic procedure was thoroughly explained to the patients and their informed consents were taken.

Results: We performed RKT in 7 male and 8 female patients. Mean patient age was 37.4±10.8 years. Mean body mass index of the patients was 22.6±3.35 kg/m. Mean preoperative creatinine and hemoglobin levels were 6.14±2.12 mg/dL and 10.04±1.64 g/dL, respectively. Mean operative time was 300.3±104.2 minutes. Mean warm ischemia and re-warming times were 1.9±0.54 minutes and 73.3±30.7 minutes, respectively. We did not need any necessity to switch to open surgery, and any intraoperative complication did not develop in any patient. Lymphocele which is one of the most frequently encountered complications was not observed in our series.

Conclusion: We think that using a minimally invasive approach greater number of patients will be able to benefit from this treatment modality, and this important health issue may decrease significantly.
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http://dx.doi.org/10.5152/tud.2016.12369DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5125746PMC
December 2016

Immediate Continence Rates in RALRP: A Comparison of Three Techniques.

JSLS 2016 Oct-Dec;20(4)

Department of Urology, Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital, Istanbul, Turkey.

Background And Objectives: Robot-assisted laparoscopic radical prostatectomy (RALRP) is said to provide excellent long-term continence. In this study, we compared the early incontinence outcomes of our patients, who had undergone no reconstruction, posterior reconstruction only, or total anatomic restoration and posterior reconstruction.

Methods: We retrospectively analyzed the patients who underwent RALRP for localized prostate cancer by a single surgeon in our clinic from January 1, 2009-February 1, 2016. Continence was defined as no leakage or use of a safety pad for minimal leakage. The main outcome measure was continence at postoperative week 1 and months 1, 6, and 12.

Results: Between 2009 and 2016, 239 patients underwent RALRP for localized prostate disease. Seventy-four patients underwent a standard approach (group 1), 88 had posterior reconstruction (group 2), and 77 had posterior reconstruction with total anatomic restoration (group 3). After 1 week, 24.3% of the patients in group 1 (18/74), 31.8% in group 2 (28/88), and 45.8% in group 3 (33/72) were continent ( = .02). One month after the surgery, continence rates for groups 1, 2, and 3 were 56.7, 67, and 75%, respectively (0.065). After 6 and 12 months, continence rates for groups 1, 2, and 3 were 72.9 and 87.8%, 81.8 and 89.7%, and 84.7 and 91.6%, respectively ( = .178 and .7484).

Conclusion: Anatomic restoration improves continence rates in the early period after RALRP. Even though other parameters were higher in the total restoration group, immediate continence (at 1 week) was significantly better.
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http://dx.doi.org/10.4293/JSLS.2016.00058DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5067246PMC
March 2017

A Prospective Randomized Controlled Study to Compare Acupuncture and Dapoxetine for the Treatment of Premature Ejaculation.

Urol Int 2016 7;97(1):104-11. Epub 2016 Apr 7.

Department of Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.

Purpose: To compare the safety and efficacy of dapoxetine and acupuncture for the treatment of premature ejaculation (PE) with other treatment methods.

Methods: One hundred twenty patients with PE in an outpatient urology clinic were randomized to receive dapoxetine 30 mg and 60 mg, acupuncture or sham acupuncture. The intravaginal ejaculatory latency time (IELT), the PE diagnostic tool (PEDT) score, and adverse events were compared.

Results: There were no differences between the groups in terms of age, body mass index, baseline IELT and PEDT scores (p > 0.05). After 4 weeks, IELT was significantly longer compared to baseline values in all groups (p < 0.001 for all comparisons). Comparisons between the groups showed that changes in IELT and PEDT observed after 4 weeks with dapoxetine 60 mg was significantly higher than those achieved in all other groups (p < 0.001 for all comparisons), changes observed with dapoxetine 30 mg was significantly higher than those achieved with acupuncture and sham acupuncture groups (p < 0.001 for both comparisons) and changes observed with acupuncture was significantly higher than those observed with sham acupuncture (p < 0.001).

Conclusion: Our results confirm previous reports on the efficacy and safety of dapoxetine. Although less effective than dapoxetine, acupuncture had a significant ejaculation-delaying effect.
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http://dx.doi.org/10.1159/000445253DOI Listing
April 2017

A Prospective Randomized Controlled Study to Compare Acupuncture and Dapoxetine for the Treatment of Premature Ejaculation.

Urol Int 2016 7;97(1):104-11. Epub 2016 Apr 7.

Department of Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.

Purpose: To compare the safety and efficacy of dapoxetine and acupuncture for the treatment of premature ejaculation (PE) with other treatment methods.

Methods: One hundred twenty patients with PE in an outpatient urology clinic were randomized to receive dapoxetine 30 mg and 60 mg, acupuncture or sham acupuncture. The intravaginal ejaculatory latency time (IELT), the PE diagnostic tool (PEDT) score, and adverse events were compared.

Results: There were no differences between the groups in terms of age, body mass index, baseline IELT and PEDT scores (p > 0.05). After 4 weeks, IELT was significantly longer compared to baseline values in all groups (p < 0.001 for all comparisons). Comparisons between the groups showed that changes in IELT and PEDT observed after 4 weeks with dapoxetine 60 mg was significantly higher than those achieved in all other groups (p < 0.001 for all comparisons), changes observed with dapoxetine 30 mg was significantly higher than those achieved with acupuncture and sham acupuncture groups (p < 0.001 for both comparisons) and changes observed with acupuncture was significantly higher than those observed with sham acupuncture (p < 0.001).

Conclusion: Our results confirm previous reports on the efficacy and safety of dapoxetine. Although less effective than dapoxetine, acupuncture had a significant ejaculation-delaying effect.
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http://dx.doi.org/10.1159/000445253DOI Listing
April 2017