Cem Yücel

Clinical Value of Core Lenght in Saturation Prostate Biopsy

Öz What’s known on the subject? and What does the study add? To our best knowledge, our study is the first to evaluate the clinical value of total core length in saturation prostate biyopsy. Mean and total core length may not have significant impact on prostate cancer detection in patients receiving saturation prostate biopsy. ORIGINAL RESEARCH Urooncology Correspondence: Cem Yücel MD, University of Health Sciences, İzmir Tepecik Training and Research Hospital, Clinic of Urology, İzmir, Turkiye E-mail: meclecuy@hotmail.com ORCID-ID: orcid.org/0000-0003-0838-9199 Received: 19.11.2017 Accepted: 26.02.2018 Cite this article as: Yücel C, Budak S. Clinical Value of Core Lenght in Saturation Prostate Biopsy. J Urol Surg 2018;5(2):93-97. ©Copyright 2018 by the Association of Urological Surgery / Journal of Urological Surgery published by Galenos Publishing House. Cem Yücel1, Salih Budak2

Can we expand the borders in active surveillance for low-risk prostate cancer?:

Purpose: We assessed the outcomes of men with low-risk prostate cancer enrolled in active surveillance. Methods: From January 2008, patients in our clinic who were classified as having low-risk prostate cancer according to the D’Amico classification were included in the protocol. Follow-up consisted of regular prostate-specific antigen tests, digital rectal examinations and biopsies. Outcomes were compared between men who progressed and those who did not, and survival analysis was obtained. Results: The mean follow-up period was 46 months. A total of six patients received curative treatment during follow-up as a result of meeting progression criteria. The mean follow-up time from the beginning of active surveillance until curative therapy was 27.1 months. Four of our 64 patients lost their lives due to diseases other than prostate cancer, none of the patients were lost due to prostate cancer. When patients who showed progression and those who did not were compared in terms of positive core numbers and the core tumour percentage we found no significant difference between the two groups (P>0.05) Conclusion: Active surveillance seems to be a safe and feasible practice in men with low-risk prostate cancer. Gleason score, clinical stage and initial prostate-specific antigen seem to be the most definite criteria for the selection of patients, while it is thought that the number of positive cores is a matter that can be dealt with more flexibility. Level of evidence: Not applicable for this multicentre audit.

The Rare Togetherness of Bladder Leiomyoma and Neurofibromatosis

Neurofibromatosis Type 1 (Von Recklinghausen disease) is a common, autosomal dominant hereditary disorder characterized by involvement of multiple tissues derived from the neural crest. Urinary system involvement in neurofibromatosis is a rare condition. Leiomyoma of the bladder is a rare benign mesenchymal tumor. In this case, our experience and approach regarding the bladder leiomyoma development in a patient diagnosed with neurofibromatosis are presented and the literature data has been reviewed.

Comparison of two different renal access techniques in one-stage percutaneous nephrolithotomy: triangulation versus “eye of the needle”

BACKGROUND Two primary methods used to create appropriate percutaneous renal access under fluoroscopic guidance are the triangulation technique (TT) and the “eye of the needle” (EN) technique. To the best of our knowledge, no study has yet compared the EN versus TT renal access methods that precede one-stage dilatation during percutaneous nephrolithotomy (PCNL). OBJECTIVES Compare effects of renal access techniques on the stone-free rate of one-stage PCNL, and the influence on outcomes. DESIGN Retrospective cross-sectional study. SETTINGS Tepecik Training and Research Hospital, Turkey. PATIENTS AND METHODS The records of patients with renal stones larger than 2 cm in diameter who underwent PCNL in our hospital between January 2008 and September 2017 were retrieved. Patients who had undergone one-stage PCNL with the EN renal access technique (EN group) were compared with patients who had undergone one-stage PCNL with the TT renal access technique (TT group). MAIN OUTCOME MEASURES Operative time, stone size, access location, stone side, length of hospital stay, Hounsfield unit (HU), fluoroscopy time, change in hemoglobin level, complications (modified Clavien classification) and stone-free rate. SAMPLE SIZE 195. RESULTS Of 272 records, 195 met inclusion criteria. The one-stage PCNL stone-free rate and other outcomes did not differ significantly between the EN (n=91, 46.7%) and TT groups (n=104, 53.3%). CONCLUSION According to our study, renal access for one-stage PCNL can be achieved using either the EN or TT technique. The renal access technique used does not independently affect the complication rate. LIMITATIONS Retrospective, small sample size, and no comparison of body mass index.

Effect of seasonal variation on the success of micro-dissection testicular sperm extraction: A pilot study

The aim of this study is to investigate the relationship between seasonal variation and the success of micro‐dissection testicular sperm extraction (mTESE). A total of 395 patients who were diagnosed with non‐obstructive azoospermia, who had undergone mTESE operation for the first time, and who did not have an obstructive pathology, were included in the study. The patients were divided into 12 groups according to the month of the operation and four groups according to the season. The groups were compared with regard to age, duration of infertility, BMI, hormone profile and sperm retrieval rate of mTESE. The maximum sperm retrieval rate was obtained in January (69.7%) and the minimum sperm retrieval rate was obtained in November (50.0%). No statistically significant difference was detected when the mTESE results were compared with regard to months (p = 0.638). The maximum sperm retrieval rate was obtained in the summer (62.8%) and the minimum was obtained in spring (57.0%). No statistically significant difference was determined between groups created according to seasons (p = 0.865). We did not observe a statistically significant relationship between the sperm retrieval rate and the seasons. Studies conducted in regions with different climate features could better reveal the relationship between seasonal variation and the success of mTESE.

Investigation of the effect of body mass index (BMI) on semen parameters and male reproductive system hormones

AIM To evaluate the effects of body mass index (BMI) ratio on semen parameters and serum reproductive hormones. MATERIALS AND METHODS The data of 454 patients who prsented to male infertility clinics in our hospital between 2014 and 2015 were analyzed retrospectively. Weight, height, serum hormone levels and semen analysis results of the patients were obtained. BMI values were calculated by using the weight and height values of the patients and they were classified as group 1 for BMI values ≤ 25 kg/m2, as group 2 for BMI values 25-30 kg/m2 and as group 3 for BMI values ≥ 30 kg/m2. RESULTS The mean values of BMI, semen volume, concentration, total motility, progressive motility, total progressive motile sperm count (TPMSC), normal morphology according to Kruger, head abnormality, neck abnormality, tail abnormality, FSH, LH, prolactin, T/E2, total testosterone and estradiol parameters of the patients were considered. Patients were divided according to BMI values in Group 1 (n = 165), Group 2 (n = 222) and Group 3 (n = 56). There was no statistically significant difference in terms of all variables between the groups. CONCLUSIONS We analyzed the relationship between BMI level and semen parameters and reproductive hormones, demonstrating no relationship between BMI and semen parameters. In our study, BMI does not affect semen parameters although it shows negative correlation with prolactin and testosterone levels.