Ali Saribacak

Varicocele Repair Improves Testicular Histology in Men with Nonobstructive Azoospermia.

Objective. To determine the histopathological differences after varicocele repair in testicular tissue in males with nonobstructive azoospermia. Methods. Between 2009 and 2014, 45 men with complete azoospermia and palpable varicocele, presenting with primary infertility of at least 1 year, undergoing varicocele repair at our institution were selected for the study. A standard systematic testicular 6-core Tru-Cut biopsy was performed during varicocele repair. Other biopsies were obtained from each testicle of all patients at the time of microscopic sperm extraction procedure. Results. Nineteen patients were selected for the study. Testicular biopsy specimens were classified as Sertoli cell only on preoperative histopathological analysis in 14 patients. After varicocele repair, focal spermatogenesis (n = 3) and late maturation arrest (n = 2) were found in these patients. Average Johnsen score was significantly increased after varicocelectomy (P = 0.003). Motile sperm was found in one patient on postoperative semen analyses and in 10 more patients in the microscopic sperm extraction procedure. Preoperative high serum follicle stimulating hormone level and venous reflux were significantly and negatively correlated with the increase in average Johnsen score (P < 0.05). Conclusions. Our findings suggest significant improvement in testicular histology after varicocele repair.

Percentage of free prostate-specific antigen (PSA) is a useful method in deciding to perform prostate biopsy with higher core numbers in patients with low PSA cut-off values

The aim of this study was to evaluate the predictive role of percentage of free prostate‐specific antigen (%fPSA) cut‐points in prostate cancer (PCa) detection in patients with total PSA (tPSA) levels between 2.5 ng/mL and 10.0 ng/mL. In total, 1321 consecutive initial transrectal ultrasound (TRUS)‐guided 12‐core biopsies performed between 2005 and 2011 were evaluated retrospectively. Benign pathologies, high‐grade prostatic intraepithelial neoplasia, and atypical small acinary proliferations were categorized as noncancerous (benign), and prostate adenocarcinomas were categorized as cancerous (malignant). The patients were categorized according to: Catalonas published %fPSA categories (<10%, 10–15%, 15–20%, 20–25%, or > 25%); digital rectal examination (DRE) results [benign (negative) or suspicious of malignancy (positive)]. There was a significant relationship between the %fPSA cut‐points and detection of PCa in DRE‐negative patients. The presence of a 10% cut‐point increased the probability of PCa threefold. The %fPSA was significantly more related to PCa than the tPSA value in receiver operating characteristic (ROC) curve analyses (p = 0.001). Based on our findings, a lower %fPSA, especially <10%, is an important parameter when deciding whether to perform a biopsy on patients with a tPSA between 2.5 ng/mL and 10 ng/mL.

Aşırı Aktif Mesane Hastalarının Afektif Mizaç Özellikleri

INTRODUCTION Overactive bladder (OAB) is generally characterized by urinary urgency with or without incontinence and increased frequency of voiding and nocturia. Although animal studies have demonstrated the relationship between defective serotonergic neurotransmission and OAB, its etiology is still unclarified. Temperament profiles are hypothesized to be related with serotonergic activity and are studied in many psychosomatic disorders. Thus, we assume that OAB is related with a certain type of temperament. METHOD 29 patients, who were admitted to the urology outpatient clinic at Kocaeli University and clinically diagnosed with OAB syndrome, were recruited for the study. Temperament profiles were evaluated with the Temperament Evaluation of Memphis Pisa Paris and San Diego Autoquestionnaire (TEMPS-A). Depressive, hyperthymic, cyclothymic, anxious and irritable temperament scores in patients were compared with those in 25 healthy controls. RESULTS Patient and control groups were similar in terms of age (p=.65), sex (p=.64) and educational level (p=.90). Anxious temperament scores were higher (p=.02) and hyperthymic temperament scores were lower (p=.02) in patients with OAB compared to controls. Depressive, cyclothymic and irritable temperament scores were similar in both groups. There was no significant differences between men and women in both groups in terms of different temperament profile scores. CONCLUSION Hypothetically, there might be an association between anxious temperament and OAB syndrome reflecting serotonergic dysfunction. However, OAB syndrome must be considered from the aspect of the interdependence of psychosomatic implications in a narrow sense and psychosomatic dimensions due to the psychological predisposition in the individual case.

Inflammatory Myofibroblastic Tumor of the Bladder

DOI: 10.4328/JCAM.656 Received: 24.03.2011 Accepted: 01.04.2011 Printed: 01.05.2013 J Clin Anal Med 2013;4(3): 239-40 Corresponding Author: Ali Saribacak, Yerkoy Devlet Hastanesi Uroloji Klinigi Yerkoy, Yozgat, Turkiye. T.: +90 3545162470 (4031) GSM: +905327086077 F.:+90 3545166147 E-Mail:saribacak@gmail.com Ozet Mesanenin inflamatuar miyofibroblastik tumoru (IMT) nadir gorulmekle birlikte embriyonel rabdomyosarkom ve leiomyosarkomdan ayrimi radikal girisimlerden kacinilmasi acisindan onemlidir. Bu yazida, 32 yasinda makroskopik hematuri ile basvuran ve IMT tanisi konulan bir hastanin ilginc sistoskopik gorunumu ve tedavisi sunulmustur.

Natural Course of Tunica Albuginea Fibrosis and Antifibrotic Effect of Intralesional Verapamil Injec

1 Levend Özkan1, Ali Sarıbacak2, Tayyar Alp Özkan1, Hasan Yılmaz1, Kürşat Yıldız3, Melih Çulha1 1Üroloji Anabilim Dalı, Kocaeli Üniversitesi Tıp Fakültesi, Kocaeli, 2Üroloji Kliniği, Yerköy Devlet Hastanesi, Yozgat, 3Patoloji Anabilim Dalı, Kocaeli Üniversitesi Tıp Fakültesi, Kocaeli, Türkiye Penil Fraktürün Konservatif Tedavisi / Conservative Treatment of Penile Fracture Natural Course of Tunica Albuginea Fibrosis and Antifibrotic Effect of Intralesional Verapamil Injection in Rabbits with Penile Fracture Model