Orhan Yalçin

Adenosine deaminase and xanthine oxidase activities in bladder washing fluid from patients with bladder cancer: a preliminary study

Activities of adenosine deaminase (AD), and xanthine oxidase (XO) enzymes were measured in bladder washing fluid (BWF) from 37 patients with bladder cancer. The patients were divided into several groups according to their sex; pattern, number, and depth of the tumors; and tumor grade. There was a statistically significant difference in XO activities between the patients having no tumor and papillary tumor (p < 0.002). The differences in XO values between the patients having no tumor and single tumor; and with no tumor and multiple tumors were statistically significant (p < 0.012, p < 0.016 respectively). XO activities were increased in patients with both papillary and multiple tumors compared to tumor-free group. Regarding to the depth of tumors, only the differences in XO values between the patients having no tumor and superficial tumor was statistically significant (p < 0.037). XO values of patients in grade1 were higher than the patients having no tumor (p < 0.010). AD activities in patients with multiple and invasive tumor were increased compared to patients with single and superficial tumor. AD values in grade 3 were lower than grade 2. However, we did not find any statistically significant differences in AD activities in all groups. As a conclusion, increased XO activity in BWF might be a potentially important finding as an additional diagnostic biochemical tool for bladder cancer. But we could not say this for AD activity. Further investigations in a larger cohort of patients with bladder cancer are needed to enlighten the possible diagnostic role of XO and AD in BWF.

Prune-belly syndrome associated with omphalocele in a female newborn.

The authors report on a female newborn with prune-belly syndrome (PBS) in association with omphalocele. This case raises the total of omphalocele associated with PBS to seven. The authors suggest that this case lends support to the concept of PBS being caused by an early disturbance of mesodermal development in both the abdominal wall and the urinary tract.

Smoking’s Negative Effect on Pathological Grade and Stage in Patients with Primary, Single, < 3cm Bladder Cancer

Article 1 Smoking’s Negative Effect on Pathological Grade and Stage in Patients with Primary, 2 Single, < 3cm Bladder Cancer 3 4 Ercan Öğreden*, Ural Oğuz, Erhan Demirelli, Orhan Yalçın 5 Giresun University, Faculty of Medicine, Department of Urology, Giresun, Turkey 6 *Correspondence: ercanogreden@gmail.com; Tel.: +9 0 505 896 3960 7 Abstract: Introduction: We investigated the potential effect of smoking on pathological 8 staging in clinically low-risk patients. Material-Methods: Data of 59 patients who were 9 diagnosed with a bladder tumor for the first time and had a single lesion radiologically and 10 endoscopically smaller than 3 cm were investigated, retrospectively. A total of 33 patients 11 who currently smoke or smoked were classified as ever smokers group and 26 patients who 12 did not ever smoke were classified as never smokers group. Pathological diagnoses of the 13 patients in both groups were compared. Results: A total of 9 patients (27.3%) in ever smokers 14 group and 18 patients (69.2%) in never smokers group had Ta disease (p<0.05). Morover, 19 15 patients (57.6%) in ever smokers group and 5 patients (19.2%) in never smokers group had T1 16 disease (p<0.05). The number of patients with low grade (LG) tumor were 8 (24.2%) and 19 17 (73.1%) in ever smoking and never smoking groups, respectively (p<0.05). The number of 18 patients with high grade (HG) tumor were 25 (75.8%) and 7 (26.9%) in ever smoking and 19 never smoking groups, respectively (p<0.05). Ta HG was detected in 9 (27.3%) patients in 20 ever smoking group. In contrast, no patients in never smoking group had Ta HG disease 21 (p<0.05). The number of patients with T1 HG was 17 (51.5%) in ever smoking group and 2 22 (7.69%) in never smoking group (p<0.05). Conclusion:Smoking seems to associate with 23 pathologically worse stage and grade in patients with primary, single, < 3cm bladder cancer. 24

Relationship between Response to PDE5 Inhibitors and Penile Duplex Doppler Ultrasound in Erectile Dysfunction

The relationship between the results of penile duplex Doppler ultrasound (PDDU) and response to vardenafil was investigated in patients diagnosed with erectile dysfunction (ED). Data from 148 patients with ED were analyzed retrospectively. Patients who did not respond to therapy were classified in to Group I (n = 32), those who responded partially were classified into Group II (n = 40), and complete responders were classified into Group III (n = 76). Age, comorbidities, and vascular and penile pathologies were compared among the three groups. While diabetes mellitus (DM) and dyslipidemia positivity adversely affected the response to treatment, the presence of hypertension (HT), Peyronie’s disease and priapism increased the therapeutic response to the treatment (p < 0.05). Arterial insufficiency was present in 20 (30.3%), 25 (37.9%) and 21 (31.8%) of the patients in Group I, Group II and Group III, respectively (p = 0.001). Venous insufficiency was observed in three (14.3%) patients in Group I and in eight (85.7%) patients in Group III (p = 0.001). Arterial/venous insufficiency was seen in 9 (30%), 14 (46.7%) and 7 (23.3%) of the patients in Group I, Group II and Group III, respectively (p = 0.001). The response rate to treatment was highest in normal patients according to PDDU, followed by patients with venous insufficiency. In addition, it was found that DM decreased the response to treatment, whereas the response increased in cases with HT, priapism and Peyronie’s disease.

Comparison of response to treatment of unilateral and bilateral varicocelectomy

BACKGROUND/AIM We aimed to compare the results of unilateral and bilateral varicocele surgery. MATERIALS AND METHODS In two referral hospitals, the data of 180 patients who were treated with unilateral and bilateral microscopic varicocelectomy were retrospectively analyzed. Sperm parameters and spontaneous pregnancy rates were compared in patients who underwent bilateral and unilateral microscopic varicocelectomy. RESULTS The mean age was 29.6 (17-46) years. While 82 patients underwent unilateral varicocelectomy (Group I), 98 patients underwent bilaterally varicocelectomy (Group II). Forty (48.8%) spontaneous pregnancies occurred in Group I and 59 (60.2%) in Group II. When we analyzed sperm parameters, the rate of increase in the number of sperm in spermiograms was 17% in Group I and 27.5% in Group II. The rate of increase in sperm mobility was 58.5% and 50% in Group I and II, respectively. The improvement rate in sperm morphology was 46.3% in Group I and 56.1% in Group II. There were no significant differences between all these parameters. CONCLUSION In light of our results, although pregnancy rates seemed to be higher in patients who underwent bilateral varicocelectomy, these results were not statistically significant. Improvement rates in sperm parameters were similar between the patients who underwent unilateral and bilateral varicocelectomy.

Categorization of ureteroscopy complications and investigation of associated factors by using the modified Clavien classification system.

BACKGROUND/AIM The purpose of the present study was to review the complications of ureteroscopy (URS) by using the modified Clavien classification system (MCCS) and to investigate the factors associated with complications. MATERIALS AND METHODS Data regarding 811 patients who underwent URS for ureteral calculus were analyzed. Peroperative and postoperative complications were recorded. The patients were divided into seven groups depending on the severity of the complications. The association of sex, stone size, number, and localization with each MCCS grade was also evaluated. RESULTS The average age was 45 years. The success of the procedure after one session was 93.5%. Complications were recorded in 57.9% of the patients. According to the MCCS, grade I, II, IIIa, IIIb, IVa, IVb, and V complications were documented in 29.8%, 7.1%, 8.6%, 11%, 0%, 1.2%, and 0% of the patients, respectively. The factors associated with the complications graded by MCCS were sex, stone size, number of stones, and localization. In addition, in multivariate analysis, history of previous surgeries for urolithiasis, orifice dilatation, and instrument size were associated with complications. CONCLUSION According to MCCS, sex, history of previous surgeries for urolithiasis, orifice dilatation, size of the instrument, stone size, number of stones, and localization are associated with different grades of complications in URS.