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    Is doppler ultrasonography reliable in the evaluation of solid testicular lesions?
    (2020) Cimen, Serhan; Ozaydogdu Cimen, Ayla
    Aim: Evaluation of using color Doppler ultrasonography in the diagnosis of testicular solid lesions. The aim of our study was to determine the rate of benign lesions in patients with hypervascularized solid intratesticular lesions. Material and Methods: The data of 88 patients who underwent inguinal orchiectomy and who were diagnosed to have a scrotal mass in color Doppler ultrasound examination between March 2013 and March 2018 were retrospectively evaluated. All patients’ age, complaints during their admission to hospital, size of solid lesions, preoperative tumor markers (AFP, bHCG and LDH) and post operative pathology results were evaluated. Two-tailed tests were used to determine the value of preoperative numerical parameters and Fisher’s exact test to compare preoperative non-numerical parameters of both malignant and benign solid lesions, and p0.05 was considered significant.Results: The mean age of the patients was 38.54±19.09 years. The mean lesion size was 4.21±2.65 cm. The high levels of tumor markers (AFP, bHCG, LDH) were detected in 24 (27.2%) patients before the operation. In 72 patients, the size of the lesion was greater than 1 cm and in 16 patients it was less than 1 cm. As a result of the pathological evaluation of the testicular masses, it was found that 29 (32.9%) were malignant and 59 (67.1%) were benign. High levels of tumor markers, palpability and large solid lesion size were found as parameters predicting malignancy.Conclusion: In the evaluation of testicular masses with scrotal USG and Doppler USG, the rate of benign mass detection is relatively higher. In small masses, non-palpable masses and in patients with no tumor marker elevation, testicular biopsy or testicular preventive surgery should be considered.
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    Protective effects of ghrelin on kidney tissue in rats with partial ureteral obstruction
    (Tubitak Scientific & Technological Research Council Turkey, 2019) Cimen, Serhan; Tasdemir, Cemal; Vardi, Nigar; Ates, Burhan; Tasdemir, Seda; Ozaydogdu Cimen, Ayla
    Background/aim: The aim was to investigate the protective and therapeutic effects of ghrelin, which has antioxidant and antiinflammatory activity, on preventing kidney damage that occurs by induced partial ureteral obstruction in rats. Materials and methods: Twenty-eight adult male rats were included in the study, and the rats were divided into 4 groups. After the laparotomy operation on the sham group, the ureter was identified in the retroperitoneal area and was duly sutured (n = 7). Ghrelin was administered for seven days intraperitoneally, and after the nephrectomy performed on the 15th day, the rats were sacrificed (n = 7). A partial ureteral obstruction was performed after the laparotomy on the PUO group. The rats were sacrificed after the nephrectomy operation performed on the 15th day (n = 7). A partial ureteral obstruction was formed after the laparotomy followed by seven days of waiting in the PUO i ghrelin group. Ghrelin was given in the dose of 10 ng/kg per day intraperitoneally for the next 7 days, and the rats were sacrificed after the nephrectomy operation performed on the 15th day (n = 7). All groups were evaluated for histological damage and catalase, superoxide dismutase, total glutathione, malondialdehyde, and myeloperoxidase levels were measured in the same tissues. Results: When the 2nd group and the sham group were compared histologically, it was observed that the damage had increased by a statistically significant level in the partial ureteral obstruction group (P 0.001). When the group which was ghrelin-treated after the partial ureteral obstruction was compared to the group with just partial ureteral obstruction, the histopathological changes were found to decrease significantly in that group (P = 0.001). While the statistical significance of the levels of CAT, GSH, and MP() enzymes was detected among biochemical changes in the 2nd group when compared to the sham group (P < 0.01), the 3rd group showed a statistically significant difference in the levels of SOD and GSH enzymes compared to the 4th group (P < 0.05). Conclusion: Ghrelin administration to rats after the formation of an experimental partial unilateral ureteral obstruction reduces tissue damage due to ghrelin's antiinflammatory and antioxidant effects. Ghrelin administration may prevent tissue damage biochemically and histopathologically in obstructive uropathy cases.
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    Radiological evaluation and our surgical experience in patients with penile fracture
    (2019) Cimen, Serhan; Ozaydogdu Cimen, Ayla
    Aim: We aimed to investigate the clinical features, diagnostic methods and surgical methods and results of patients who presented with penile fractures. Material and Methods: The data of 18 patients who underwent surgical treatment between December 2008 and 2018 in our clinic were evaluated retrospectively. Age and etiologic factors were evaluated. Following physical examination, all patients underwent superficial penile ultrasonography in the radiology clinic. Ultrasonically, length, location and side of the rupture were determined. The patients were questioned by the postoperative IIEF-5 questionnaire. Pre and post-operative complications were evaluated in patients. Postoperative erectile functions were evaluated. Results: The mean age was 39.22 ± 14.47 (19-67). The time to contact the emergency department was 4.33 ± 1.97 hours (2-8 hours). In the history of the patients, the causes of the penile fracture included the forceful manipulation of the penis in 5 patients (27.8%), rolling over in the bed while sleeping in 5 patients (27.8%), sexual intercourse in 6 patients (33.3%) and masturbation in 2 patients (11.1%). Mean rupture in tunica albuginea was 12.66 ± 3.06 mm (8-20mm). While 11 (61.1%) of the defects were detected in the right corpus spongiosum, 7 (38.9%) were detected in the left corpus spongiosum. The tunica albuginea defect was located in the distal penile in 14 patients (77.8%), in the midpenil in 3 patients (16.7%) and in the proximal penile in 1 patient (5.5%). The mean hospital stay was 3 ± 0.90 days (2-5 days). Postoperative the IIEF-5 score was 26.05 ± 1.55 (23-29). Conclusion: Penile fracture is a rare urologic emergency that can be diagnosed clinically. Radiological imaging may be required in suspected cases. Early surgical treatment provides successful results in terms of functional, cosmetic and erectile functions