Abdullah Cirakoglu

Does Leaving the Biopsy Needle in Povidone-Iodine Solution Reduce Infective Complications after Biopsy?

Aim. The aim of this study is to evaluate whether leaving the biopsy needle used during prostate needle biopsy in 10% povidone-iodine (betadine) solution affects the infectious complications forming after biopsy. Material and Method. This study retrospectively evaluated the data of 176 patients with prostate biopsy performed between December 2012 and April 2014. Patients in Group 1 (n = 89) were given ofloxacin as a prophylactic antibiotic before biopsy. Patients in Group 2 (n = 87) had the biopsy needle left in povidone-iodine solution for 1 minute before each use, in addition to antibiotic prophylaxis. The two groups were compared in terms of infective complications developing after biopsy. Results were analyzed using the Mann–Whitney U test and Fishers exact test. Results. The distribution of infective complications after biopsy according to group was as follows. Group 1, not using betadine, had 15.7% fever, 13.5% hospital stay, 12.4% urinary retention, 10.1% prostatitis, and 5.6% sepsis. The distribution of the same complications in Group 2 using betadine was identified as 5.7% fever, 4.6% hospital stay, 3.4% urinary retention, 2.3% prostatitis, and 0% sepsis. The use of betadine was found to significantly reduce the infectious complications after biopsy compared to the control group (p < 0.05). Conclusion. At the end of this study leaving the prostate needle in povidone-iodine solution before each use during prostate biopsy was found to reduce the infective complications and hospital stay after biopsy.

Assessment of Two-Years Bladder Biopsy and Cystectomy Outcomes

Objective: To evaluate the outcome of bladder biopsy and resection evaluated in pathology department in 2014-2015. Material and methods: A total of 78 cases from 2014 to 2015 were included in this study. Reports of the cases were removed from the archive and the age, gender, diagnosis and prognostic parameters of the cases were recorded. The distribution of cases according to age and gender was evaluated. Results: 65 of the cases were male, 13 of the cases were female. The average age of cases is between 39 and 90. Twenty-one cases were cystitis and squamous metaplasia. The mean age of benign lesions is between 41 and 85. Five cases of dysplastic lesions were observed. The average age is 61.6 and all of them are male. 52 of the cases were malignant. 49 of the cases were male, 3 of the cases were female. 19 cases of non-invasive papillary urothelial carcinoma, 1 case of low malignant potential urothelial neoplasm, 2 of the prostate adenocarcinoma metastasis, 30 of invasive carcinoma. 20 of the cases were pT1, 9 of the cases were pT2, 1 of the case was pT4 and 19 of the cases were pTa. The mean age was 64.5. Invasive tumors are all male. The mean age was 74.6. Conclusion: In this study, tumors and non-tumoral lesions were seen spreading to a wide range of age in bladder. Benign and malignant lesions were observed in males. Benign lesions were more common in females than malignant lesions in females.

Comparison of serum acetyl hydrolase (PAF-AH) and paraoxonase 1 (PON1) values between prostate cancer patients and a control group

The aim of the study was to measure platelet‐activating factor acetyl hydrolase (PAF‐AH) and paraoxonase (PON1) enzyme activity levels in patients with high Psa values to compare with healthy peers and also to determine the efficacy of these parameters in predicting pathologic results of patients with high Psa values. This study included 66 patients with Psa value > 4 ng/dl (Group 1) and 44 patients with Psa <4 ng/dl (Group 2) for a total of 110 patients. Parameters measured in serum of PON1, PAF‐AH, and MDA were compared between the groups. Additionally the same parameters were compared between patients with prostate biopsy performed due to high Psa and diagnosed with cancer and the control group with normal Psa values. The PAF‐AH activity in Group 1 was 125.17 ± 8.64 and in Group 2 was 120.08 ± 9.23 U/ml (p = 0.003). The PON1 activity was 63.12 ± 6.74 and 65.91 ± 7.77 U/ml in the groups, respectively (p = 0.04). Additionally, there were significant differences identified between the control group and PCa diagnosis group in terms of PAF‐AH and PON1 activities (p = 0.004 and p = 0.02, respectively). The enzyme activity of PAF‐AH and PON1 measured in serum of patients with high Psa value and patients with diagnosis of prostate cancer (PCa) were identified to have changed by a significant amount compared to healthy peers with normal Psa value. It was concluded that these parameters may be beneficial markers for use in assessment of patients with high Psa value.

PSA request analysis: how should this be interpreted? What may be overlooked / PSA istem analizi: Nasıl yorumlanmalı? Gözden kaçanlar nelerdir?

Abstract Objective: Prostate specific antigen is widely used for the diagnosis, treatment, and follow-up of prostate cancer. However, despite being organ-specific, PSA is not specific to cancer. As some patients with elevated PSA level have normal biopsy results and some others with low PSA levels have cancer diagnosed in biopsy examination, PSA creates diagnostic uncertainty both for clinicians and patients. Moreover, different PSA results received for the same subject at separate time points as well as smalllarge fluctuations in PSA levels perturb both sides. In a setting where there are so many unknowns we have PSA in our hands without any restrictions for ordering it. This study analyzed PSA orders, patient traffic, and economic burden within a 6-year period. Methods: The number of PSA tests and patient outcomes at a training and research hospital between October 2006 and May 2013 were evaluated. Results: Of 12107 tPSA orders, 73.6% were ordered by the urology clinic and 26.4% orders were made from other outpatient clinics. When patients at follow-up for prostate cancer are excluded because their tPSAs have to be more commonly checked, we detected that 28.22% of tests were ordered at intervals of less than 1 year. The average tPSA testing frequency was 91.84±1.21 days (0-330). The number of patients younger than 40 years who were tested for tPSA was 287. Of these, 25.43% were ordered by the urology clinic and the remaining by other medical branches. Conclusion: A state of chaos surrounds PSA order and interpretation. Neither patients nor physicians are aware of PSA-related outcomes. Therefore, each hospital should hold sessions on PSA testing and inform physicians about them. Furthermore, a detailed public education should be provided and seminars should be organized at the national level. Özet Amaç: Gunumuzde prostat kanserinin tanı, tedavi ve takiplerinde yaygın olarak prostatik spesifik antijen (PSA) kullanılmaktadır. Fakat PSA organ spesifik olmasına rağmen kanser spesifik değildir. PSA duzeyi yuksek olanlarda prostat biyopsi sonucunun normal gelmesi, diğer taraftan PSA duzeyi duşuk hastalarda biyopsi sonucu kanser gelmesinden dolayı PSA hem klinisyende hem de hastada sıkıntı yaratmaktadır. Aynı zamanda aynı kişide PSA’da farklı sonucların cıkması ve PSA’da kucuk-buyuk değişimler her iki tarafı da huzursuz etmektedir. Bu calışmada; hicbir istem kısıtlaması olmayan PSA istemleri analiz edilmiştir. Metod: Ekim 2006-Mayıs 2013 tarihleri arasındaki PSA istemleri değerlendirildi. Bulgular: 7100 kişiye 12107 adet tPSA, 5053 kişiye 7852 adet serbest PSA (sPSA) olcumu yapılmıştı. 12107 tPSA isteğinin %73.6’sı uroloji, %26.4’sı diğer kliniklerden yapılmıştı. Prostat kanseri nedeniyle takip edilen hastalarda tPSA’nın daha sık bakılması gerektiğinden bu hastalar değerlendirme dışı bırakıldığında, %28.22 oranında bir yıldan kısa aralıklarla bakıldığını tespit ettik. tPSA bakılma sıklığı ortalama 91.84 ±1.21 gun (0-330) olarak hesaplandı. Urolojide test istenen ve PSA>4.0 ng/ml uzerinde olan hasta sayısı 347 idi. Ancak, 77 hastaya biyopsi yapılmıştı ve 23 hastada prostat kanseri saptanmıştı (%29.8). Diğer hastalar hakkında hicbir bilgi bulunamadı. 40 yaş altında tPSA bakılan hasta sayısı 287 idi. 40 yaş altı tPSA istemlerinin %25.43’u uroloji kliniğinden geri kalanlar ise diğer branşlardan istenmişti. Sonuç: PSA isteminde ve yorumlanmasında bir kaos ortamı soz konusudur. PSA sonuclarından ne hastaların ne de doktorların haberi bulunmaktadır. Bu nedenle her hastanede PSA ile ilgili oturumlar duzenlenmeli, doktorlar bu konuda bilgilendirilmelidir. Ayrıca ulusal duzeyde topluma detaylı eğitimler verilmeli ve seminerler duzenlenmelidir.

Are erectile functions affected by AB0 blood group

AIM The aim of this study was to investigate whether there is a relationship between erectile dysfunction (ED), thought to be a vascular disease, and AB0 blood group. MATERIAL AND METHOD The study included 350 people abiding by the study criteria who applied to our clinic from April 2012-April 2015. The patients were divided into two groups including those with ED (Group 1) and those without (Group 2). Age, blood group, IIEF-5 score and presence of additional diseases were recorded. Erectile functions were analyzed according to blood group. RESULTS There was no difference between the mean age of 111 patients with ED and that of 239 patients without ED included in the study (p = 0.284). There was no difference between patients in the two groups in terms of smoking, alcohol use, hypertension and diabetes (p > 0.05). Among patients in the ED group, the mean IIEF-5 score according to blood group was 19.8 ± 5.04 in the 0 blood group, 16.5 ± 5.2 in the A blood group, 17.2 ± 5.3 in the B blood group and 13.3 ± 3.02 in the AB blood group. The IIEF-5 scores of individuals in the 0 blood group were significantly high compared to individuals in other blood groups (p = 0.004). Logistic regression analysis found that compared to the 0 blood group, the erectile dysfunction risk was 3.9 times greater for the A blood group, 3.5 times greater for the B blood group and 4.7 times greater for the AB blood group (p = 0.001) (Table 3). CONCLUSION The risk of erectile dysfunction was significantly increased for individuals in the A, B and AB blood groups compared to individuals in the 0 blood group.