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Öğe THE AFFECTS OF INCREASING EXPERIENCE ON THE PERCUTANEOUS NEPHROLITHOTOMY OPERATIONS(Aves, 2007) Ugras, Yahya Murat; Gunes, Ali; Soylu, Ahmet; Baydinc, Yasar CanIntroduction: Importance and priority of minimally invasive methods in treatment of kidney stones are known and accepted by concerned medical doctors. Percutaneous nephrolithotomy is a minimally invasive surgical technique that is being applied for 30 years, and is also continuing its evolution meanwhile. From the first years of establishment to date, indications and surgical technique of this operation is developed as well as surgical results. Application in our country for this operation began at 1990's. Knowing how surgical results are affected by passing time and increasing experience is important for both getting information on how budding young surgeons should be trained on this issue and for developing anticipation on the future of percutaneous nephrolithotomy. In this review, in the light of national and international publications, we tried to summarize the evolution process, investigate the affects of increasing clinical and academical experience on results and give an idea on the surgical training methods of percutaneous nephrolithotomy.Öğe Alt üriner yol semptomu nedeniyle cerrahi tedavi uygulanan hastalarda bozulmuş böbrek fonksiyonları(2011) Altunoluk, Bülent; Soylu, Ahmet; Beytur, Ali; Söylemez, Haluk; Baydinç, CanÖz: Amaç: Alt üriner yol semptomu nedeniyle cerrahi tedavi uygulanan hastalarda böbrek fonksiyonlarındaki bozulma oranını ve bunun hasta yaşı, semptom ciddiyeti ve eşlik eden hastalıklarla ilişkisini belirlemeyi amaçladık. Gereç ve yöntem: Polikliniğimize 01/06/2001-31/03/2005 tarihleri arasında alt üriner sistem semptomları ile başvuran ve ameliyat edilen 369 hastanın kayıtları retrospektif olarak incelendi ve muayene bulguları ile laboratuvar sonuçları kaydedildi. Bulgular: Operasyon öncesi serum kreatinin değeri ?1.4 mg/dL olan hasta sayısı 315 (%85.4), >1.4 mg/dL olanların sayısı ise 54 (%14.6) idi. Kreatinin değeri ?1.4 mg/ dL olanların yaş ortalamaları 68.64±8.24 iken, kreatinin değeri >1.4 mg/dL olanların yaş ortalamaları 72.56±7.96 olarak bulundu (p<0.05). İlerleyen yaş ile serum kreatinin değerinin arttığı, böbrek fonksiyon bozukluğunun semptom skorundaki artış ile arttığı, hipertansiyon ve diyabet gibi kronik hastalıkların varlığında böbrek yetmezliği oranlarının 2.5 kat arttığı (%25.5’e karşılık %10.9) saptandı. İşeme sonrası rezidü idrar ile böbrek fonksiyon bozukluğu arasında ilişki saptanmadı. Ayrıca renal dilatasyonun serum kreatinin seviyesi yüksekliğine eşlik ettiği kaydedildi. Sonuç: Alt üriner yol semptomu olan hastalarda böbrek yetmezliğinin erken tanısı ve tedavisi için ilk başvuru anında böbrek fonksiyonlarını gösteren serum kreatinin seviyesine mutlaka bakılmalıdır.Öğe Artan deneyimin perkütan nefrolitotomi ameliyatına katkıları(Türk Üroloji Dergisi/Turkish Journal of Urology, 2007) Uğraş, Yahya Murat; Güneş, Ali; Soylu, Ahmet; Baydinç, Yaşar CanÖz: Böbrek taşlarının tedavisinde minimal invaziv işlemlerin önemi ve önceliği, bu konuyla ilgili tüm hekimler tarafından bilinmekte ve kabul edilmektedir. Perkütan nefrolitotomi, 30 yıldır uygulanan ve bu süre içinde evrimleşmeye devam eden minimal invaziv bir cerrahi tekniktir. İlk ortaya konduğu yıllardan bugüne kadar bu ameliyatın endikasyonları ve tekniği olduğu kadar sonuçları da değişmiştir. Ülkemizdeki uygulamaları 1990’lı yıllarda gelişmeye başlayan perkütan nefrolitotomi ile ilgili olarak, geçen zaman ve artan deneyimin cerrahi sonuçları nasıl değiştirdiğini bilmek; hem yeni yetişen cerrahların bu konuda nasıl eğitilmesi gerektiği konusunda bilgi vermesi ve hem de bu ameliyat tekniğinin geleceği konusunda öngörüde bulunmayı sağlaması açısından önemlidir. Bu derlemede, ülkemizden ve dünyadan yapılan yayınların ışığında perkütan nefrolitotominin ülkemizde ve dünyada geçirdiği gelişim süreci özetlenmekte, artan klinik ve akademik deneyimin sonuçlar üzerine etkisi incelenmekte ve bu ameliyatla ilgili cerrahi eğitim sürecinin nasıl olması gerektiği konusunda fikir verilmeye çalışılmaktadır. Başlık (İngilizce): The affects of increasing experience on the percutaneous nephrolithotomy operations Öz (İngilizce): Introduction: Importance and priority of minimally invasive methods in treatment of kidney stones are known and accepted by concerned medical doctors. Percutaneous nephrolithotomy is a minimally invasive surgical technique that is being applied for 30 years, and is also continuing its evolution meanwhile. From the first years of establishment to date, indications and surgical technique of this operation is developed as well as surgical results. Application in our country for this operation began at 1990’s. Knowing how surgical results are affected by passing time and increasing experience is important for both getting information on how budding young surgeons should be trained on this issue and for developing anticipation on the future of percutaneous nephrolithotomy. In this review, in the light of national and international publications, we tried to summarize the evolution process, investigate the affects of increasing clinical and academical experience on results and give an idea on the surgical training methods of percutaneous nephrolithotomy.Öğe Auditory event related potentials in patients with premature ejaculation(Urology, 2001) Özcan, Abdulcemal; Özbek, Emin; Soylu, Ahmet; Yılmaz, Uğur; Güzelipek, Mehmet; Balbay, DeryaObjectives. To investigate in a descriptive manner the P300 component of the event-related potential (ERP), which is related to aspects of cognitive processing, in patients with premature ejaculation (PE) to determine whether there is a cognitive alteration in this condition. Recent studies with short latency evoked potentials such as cortical somatosensory evoked potentials have indicated that afferent sensory inputs from the genital area to the nervous system are increased in PE. However, the cortical neural process of ejaculation has remained poorly understood. Methods. We performed ERPs in 20 patients with PE and in 20 age-matched healthy subjects. ERPs were evoked by an auditory oddball paradigm consisting of 150 tone bursts (80% 1 kHz; 20% 2 kHz). The latencies of the N200 and the P300 waves and the amplitude of the P300 wave were measured. Results. The mean latencies of the N200 and P300 waves were significantly longer in the patients with PE than in the controls (P 0.04 and 0.03, respectively). No significant difference was found in the P300 amplitude between the controls and patients (P 0.05). Conclusions. These data indicate that the greater cortical representation of sensory stimuli from the genital areas that has been shown with somatosensory evoked potential studies might be related to a cognitive/ neurobehavioral dysfunction. The dysfunction involves an increased time to evaluate and categorize the stimuli in the central nervous system, with no change in the quality of cognition and neural disinhibition by the prefrontal cortex to early sensory processing in subcortical or primary cortical regions, which are cognitive neural processes underlying ERP generation.Öğe Clitoral electromyography(The Journal of Urology, 2002) Yılmaz, Uğur; Soylu, Ahmet; Özcan, Abdul Cemal; Kamışlı, ÖzdenPurpose The clitoris has several histomorphological and functional similarities to the penis. In this study we evaluated spontaneous and evoked electromyography activity in the clitoris. Materials and Methods We evaluated 11 healthy female volunteers with clitoral electromyography using a concentric needle electrode placed intracorporeally. The hand, foot and genital sympathetic skin responses, and spontaneous electrodermal activity were simultaneously recorded with silver surface electrodes. Another concentric needle electrode was placed subdermally on the mons pubis to differentiate clitoral activity from possible artifact. After recording spontaneous electromyography and electrodermal activity the left median nerve was stimulated to record evoked clitoral activity, and the sympathetic skin response in the hand, foot and genital regions. Results There was spontaneous electromyography activity in the corpus clitoris. All dermal sites, including the hand, foot and genital regions, showed spontaneous electrodermal activity. No spontaneous activity was recorded from the subdermal needle electrode. Distraction of attention and coughing increased the amplitude and frequency of spontaneous clitoral electromyography and electrodermal activity at all sites. After stimulating the left median nerve all sites except that of the subdermal needle electrode showed evoked activity. Conclusions The demonstrated evoked and spontaneous clitoral electromyography activity seems to indicate a sympathetic tonus of the corpus clitoris, as recorded from the corpus cavernosum of the penis in human males. Clitoral electromyography may be a useful objective assessment tool for evaluating female sexual dysfunction as well as genital autonomic innervation.Öğe Comparison of antioxidant enzyme activity in the internal spermatic vein and brachial veins of patients with infertile varicocele(Springer, 2008) Ozbek, Emin; Cekmen, Mustafa; Simsek, Abdulmuttalip; Turkoz, Yusuf; Soylu, Ahmet; Ilbey, Y. Ozlem; Balbay, M. DeryaAim Recent studies have shown that both oxidative and reductive stresses are present within the internal spermatic vein of patients with varicocele. The aim of this study was to compare the activities of antioxidant enzymes in the internal spermatic vein and brachial vein of patients with varicocele. Methods Fifteen primary infertile varicocele patients and ten normal-nonvaricocele-fertile control subjects participated in this study. The patients and subjects were first given a physical and color doppler examination, and then whole blood samples were drawn from the brachial vein and a dilated internal spermatic vein during surgery. Superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) enzyme activities were assessed by enzymatic methods, and the results were compared using the Mann-Whitney U test. Results The activity of SOD in the internal spermatic veins and brachial veins of patients with varicocele was 60.17 +/- 2.15 and 42.10 +/- 1.60 U/g protein, respectively; that of GSH-Px was 5.44 +/- 0.14 and 3.92 +/- 0.14 U/g protein, respectively. The results were statistically significant (P < 0.05). In the control group, the activity of SOD in the internal spermatic veins and brachial veins was 43.12 +/- 1.80 and 40.01 +/- 2.10 U/g protein, respectively; that of GSH-Px was 3.35 +/- 0.20 and 3.7 +/- 0.10 U/g protein, respectively (P > 0.05). Conclusions Increased antioxidant enzyme activity in the internal spermatic vein may be due to increased oxidative stress in the internal spermatic vein: the increase in antioxidant enzyme activity may be a response to offset the toxic actions of reactive oxygen species. Further studies are needed to confirm this suggestion.Öğe Comparison of Venous Blood Gas Levels Between Pampiniform Plexus and Brachial Vein in Patients With Varicocele(Aves Yayincilik, Ibrahim Kara, 2010) Beytur, Ali; Soylu, Ahmet; Ugras, Yahya Murat; Gunes, Ali; Baydinc, Yasar CanObjectives: In this study, we aimed to determine whether there were some changes in the oxygenation and metabolism of testis tissue in patients with varicocele by comparing blood gas levels in dilated pampiniform plexus and brachial vein. Patients and Methods: Venous blood samples of 52 patients (mean age 24.4 +/- 7 years; range 17 to 49 years) who underwent varicocelectomy were taken from most dilated vein of the pampiniform plexus and simultaneously from brachial vein during varicocelectomy. In these samples, pH, lactate, SO(2), pO(2), pCO(2), HCO(3) values were measured and their means were compared. Results: While there were no significant differences between the pH, pO(2) and SO(2) levels of venous samples from brachial vein and pampiniform plexus, lactate level was significantly higher, pCO(2) and HCO(3) levels were significantly lower. Despite these significant differences, mean values measured were within normal laboratory ranges. Conclusion: Although the results of this study showed that varicocele caused statistically significant decreases in the rate of oxygen consumption and metabolism level in the testis tissue compared with the peripheral tissues, values obtained from the venous sample of pampiniform plexus were normal. Therefore, diminished oxygen consumption and decreased metabolism can not explain the negative effects of varicocele on testis tissue. This topic remains to be elucidated in later studies.Öğe Deep dorsal vein embolization with N-butyl-2-cyanoacrylate and lipiodol mixture in venogenic erectile dysfunction: early and late results(Assoc Radiology & Oncology, 2009) Kutlu, Ramazan; Soylu, AhmetBackground. The aim of the study was to perform and evaluate pelvic venoablation with N-butyl-2-cyanoacrilate (NBCA) and lipiodol injection into the deep dorsal vein for the treatment of 32 patients with venogenic erectile dysfunction. Methods. A total of 32 patients with the confirmed diagnosis of venogenic erectile dysfunction, with (n = 15) or without (n = 17) associated comorbidities were included. Deep dorsal veins were embolized with NBCA and lipiodol mixture. All patients were evaluated using the erectile function domain of the International Index of Erectile Function questionnaire (IIEF) before, at 3 months and 1 year after embolization. Results. While the post-operative 3(rd) month scores were increased significantly in all groups (p < 0.001), there was a significant decrease at 12(th) month when compared to that of 3rd month (p < 0.001). But this decrease was significantly higher than those of preoperative values (p < 0.001). In patients without comorbidities post-operative 3rd and 12(th) month scores were significantly higher than that of patients with comorbidities (p < 0.04 and p < 0.02, respectively). Although scores at 12(th) month were significantly higher compared to preoperative values, patients with comorbidities were dissatisfied with the quality of erection. Conclusions. Our pelvic venoablation technique was effective short-term. A limitation of this technique is that some patients are not candidates for this procedure due to comorbidites.Öğe Deterioration of renal function in patients operated for lower urinary tract symptoms(Aves, 2011) Altunoluk, Bulent; Soylu, Ahmet; Beytur, Ali; Soylemez, Haluk; Baydinc, CanObjective: We aimed to investigate the rate of deterioration of the renal function in patients operated for lower urinary tract symptoms, the relation between this rate and patient age, symptom severity, and accompanying diseases. Materials and methods: The data of 369 patients who admitted to our clinic with lower urinary tract symptoms and operated between 01/06/2001 and 31/03/2005 were retrospectively evaluated, and the examination findings and laboratory results have recorded. Results: The preoperative serum creatinin level was <= 1.4 mg/dL in 315 (85.4%) patients and >1.4 mg/dL in 54 (14.6%) patients. The mean age of the patients with serum creatinin level <= 1.4 mg/dL was 68.64 +/- 8.24 years, and that of patients with serum creatinin level >1.4 mg/dL was 72.56 +/- 7.96 years (p<0.05). The level of serum creatinin increased with increasing age, and the renal function was worsened with the increase of symptom score. Also, in the presence of the chronic diseases such as hypertension and diabetes, the rate of renal dysfunction increased by 2.5 times (25.5% vs. 10.9%). There was no correlation between postvoiding residue urine and renal dysfunction. Additionally, the renal dilatation accompanied the increase in the serum creatinin level. Conclusion: In the patients with with lower urinary tract symptoms, the serum creatinin level must be evaluated at the first admission for early diagnosis and treatment of renal dysfunction.Öğe EVALUATION OF SYMPTOMS DUE TO URETERAL STENTS(Aves, 2007) Soylu, Ahmet; Altunoluk, Bulent; Soylemez, Haluk; Yologlu, Saim; Baydinc, Yasar CanIntroduction: Double J ureteral stents are being used in urological practice for more than 25 years and in the recent years indications have continued to expand. Thus the complications and side effects of ureteral stents are also more frequent than previously reported. In addition to the severe complications resulting from forgotten or intentionally left stents for longer durations in ureters, they might also cause physical and emotional side effects due to bothering symptoms. The majority of the uncomfortable symptoms are related to urinary tract and these symptoms have severe negative impact on patients' general health status and quality of life. In this study, we evaluated the symptoms bothering the patient and impairing the quality of life due to stents. Materials and Methods: One hundred and twenty eight men and 79 women who were treated with ureteral double J stents were recruited. The patients were followed with a questionnaire consisting of 14 questions concerning urgency, incontinence, painful voiding, incomplete emptying, urethral pain, hematuria, sleep disturbance, need for analgesics, overall weakness, social life enjoyment, sexual dysfunction, getting permission from work/school, urinary tract infection and the need for extra antibiotics at 1 and 4 weeks after stent insertion and 1 week after stent removal. In addition to the presence or absence of a symptom, the frequency of the symptom, when it is present, was also asked based on a subjective classification [occasionally (25%), sometimes (50%), most of the time (75%), all of the time (100%)]. The symptoms of each period are compared by statistical analysis. Results: The mean age was 40.1 (range: 8-80) years. The indications for double J insertion were nephro-ureterolithiasis (n: 184), pregnancy related hydronephrosis (n: 8), malignancy (n: 7), ureteropelvic junction obstruction (n: 5), ureterovesical junction obstruction (n: 2), perforation (n: 1). There was no history of previous double J stent insertion in any patient. Double J stents were inserted to the right, left and both ureters in 92, 100 and 15 patients respectively. All double J stents used in the study were made up of polyethylene and except for 4 patients' stents with 6F diameter and 26 cm length were inserted. In the 4 pediatric patients 4.8 F diameter and 16 cm length double J stents were used. There was no change in the social life enjoyment with stent placement or removal. All other symptoms increased with the increased duration of the stent and decreased with the removal. The most significant two symptoms at the post insertion one week were painful voiding (43%) and urgency (41%) resulting from irritation of the stent. Also these two symptoms were significantly high (73%) at the fourth week. Conclusion: The results of our study indicates that ureteral stents have negative impact on general health status, sexual functions, school/work performance and quality of life in addition to the increased urinary tract related symptoms, and these negative effects increase with the duration of the stent. Therefore, the indications and durations of the ureteral stents must be revisited in the light of the quality of life, and unnecessary insertions and longer durations should be avoided.Öğe Finasterid improves the sensitivity of digital rectal examination for prostate cancer detection(Galenos Yayincilik, 2007) Soylu, AhmetPurpose: Men undergoing screening for prostate cancer are recommended to undergo digital rectal examination and prostate specific antigen measurement. We previously presented data from the Prostate Cancer Prevention Trial indicating that finasteride improves the performance characteristics of prostate specific antigen for cancer detection. In the current study we report the impact of finasteride on digital rectal examination sensitivity and specificity. Materials and methods: We examined the sensitivity and specificity of digital rectal examination in Prostate Cancer Prevention Trial subjects receiving finasteride or placebo who underwent prostate biopsy, had prostate specific antigen measurement and digital rectal examination within 1 year before biopsy and were on treatment at biopsy. Results: Of 9,423 men in the finasteride group 4,579 and 5,112 of 9,459 in the placebo group met study evaluation requirements. Of 4,579 men in the finasteride group 695, including 264 with Gleason 7 or greater and 81 with Gleason 8 or greater, and 1,111 of 5,112 in the placebo group, including 240 with Gleason 7 or greater and 55 with Gleason 8 or greater, were diagnosed with prostate cancer. In men in the placebo and finasteride groups digital rectal examination sensitivity was greater for detecting higher grade tumors. The sensitivity of digital rectal examination was significantly greater for cancer detection in men receiving finasteride than placebo (21.3% vs 16.7%, p=0.015). Digital rectal examination sensitivity was also greater for detecting high grade (Gleason 7 or greater and 8 or greater) cancers in men receiving finasteride but this did not attain statistical significance. Digital rectal examination specificity was similar in men receiving finasteride or placebo. Conclusions: Finasteride significantly improves prostate cancer detection with digital rectal examination.Öğe An impulse control disorder case with penile fracture and trichotillomania(Tubitak Scientific & Technological Research Council Turkey, 2007) Cumurcu, Birguel Elbozan; Kaya, Burhanettin; Celikel, Feryal Cam; Soylu, Ahmet; Erdemir, FikretPenile fractures are classically described as presenting with rapid detumescence of an erection associated with blunt trauma. This clinical finding is due to a tear in the tunica albuginea surrounding the corpora cavernosum. In this study, we report and discuss a case of trichotillomania and penile bending impulse resulting in penile fracture, which was operated in the urology clinic. The possible psychological and psychiatric problems underlying the impulsive behavior are discussed, and the value of a psychiatric evaluation is emphasized.Öğe İntralüminal papaverin uygulaması ile üreter dilatasyonu(2003) Güneş, Ali; Zengin, Tahir; Yılmaz, Uğur; Soylu, Ahmet; Uğraş, Y. Murat; Balbay, M. DeryaÖZET: Üreterorenoskopi işlemi öncesi üreter orifisi ve intramural üreterin dilatasyonu önerilmekte ve dilatasyon için en sık koni uçlu metal bujiler ve balon dilatatörler kullanılmaktadır. Bu çalışmada üreter orifisine yerleştirilen Swan-Ganz kateteri ile intralüminal papaverin uygulamasının üreter dilatasyonu üzerine etkileri incelendi. Kliniğimizde elektif endoürolojik cerrahi uygulanan ve toplayıcı sistemlerinde patoloji olmayan 20 hastanın girişim öncesi sistoskopi sırasında, sağ üretere 240 mg (8cc) papaverin HCl + iopamidol (2cc), aynı anda sol üretere de serum fizyolojik (8cc) + iopamidol (2cc) karışımı 5 saniyede yavaşca verildi. Her iki üreterde madde verildikten hemen sonra, 5., ve 10. dakikalarda floroskopik olarak iki taraf üreterin çapları ve intralüminal basınç değerleri ölçüldü. Papaverin verilmeyen taraf ve verilen tarafın basınç ve çap değişimleri karşılaştırıldı. Papaverin verilen üreterde 5. ve 10. dakikalarda istatistiksel olarak anlamlı basınç düşüklüğü ve çap genişlemesi saptandı (p<0.01). İki grup kıyaslandığında basınç yönünden anlamlı bir fark bulunmazken (p>0.05), çap yönünden papaverinin daha etkili şekilde dilatasyon yaptığı gözlendi (p<0.01). İşlem esnasında ve işlemden sonra vital bulgularda anlamlı değişiklik saptanmadı ve komplikasyon gelişmedi. Üreterorenoskopik girişimler öncesinde intralüminal papaverin uygulamasının üreteri dilate ederek girişimi kolaylaştıracağı ve komplikasyon oranını düşürebileceği düşünüldü.Öğe İntralüminal Papaverin Uygulaması İle Üreter Dilatasyonu(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2003) Güneş, Ali; Zengin, Tahir; Yılmaz, Uğur; Soylu, Ahmet; Uğraş, Y.Murat; Balbay, M. DeryaÜreterorenoskopi işlemi öncesi üreter orifisi ve intramural üreterin dilatasyonu önerilmekte ve dilatasyon için en sık koni uçlu metal bujiler ve balon dilatatörler kullanılmaktadır. Bu çalışmada üreter orifisine yerleştirilen Swan- Ganz kateteri ile intralüminal papaverin uygulamasının üreter dilatasyonu üzerine etkileri incelendi. Kliniğimizde elektif endoürolojik cerrahi uygulanan ve toplayıcı sistemlerinde patoloji olmayan 20 hastanın girişim öncesi sistoskopi sırasında, sağ üretere 240 mg (8cc) papaverin HCl + iopamidol (2cc), aynı anda sol üretere de serum fizyolojik (8cc) + iopamidol (2cc) karışımı 5 saniyede yavaşca verildi. Her iki üreterde madde verildikten hemen sonra, 5., ve 10. dakikalarda floroskopik olarak iki taraf üreterin çapları ve intralüminal basınç değerleri ölçüldü. Papaverin verilmeyen taraf ve verilen tarafın basınç ve çap değişimleri karşılaştırıldı. Papaverin verilen üreterde 5. ve 10. dakikalarda istatistiksel olarak anlamlı basınç düşüklüğü ve çap genişlemesi saptandı (p<0.01). İki grup kıyaslandığında basınç yönünden anlamlı bir fark bulunmazken (p>0.05), çap yönünden papaverinin daha etkili şekilde dilatasyon yaptığı gözlendi (p<0.01). İşlem esnasında ve işlemden sonra vital bulgularda anlamlı değişiklik saptanmadı ve komplikasyon gelişmedi. Üreterorenoskopik girişimler öncesinde intralüminal papaverin uygulamasının üreteri dilate ederek girişimi kolaylaştıracağı ve komplikasyon oranını düşürebileceği düşünüldü.Öğe Intratesticular arteriovenous malformation color doppler sonographic findings(J Ultrasound Med, 2003) Kutlu, Ramazan; Alkan, Alpay; Soylu, Ahmet; Sığırcı, Ahmet; Dusak, AbdurrahimArteriovenous malformations (AVMs) of male genitalia are rare. In the literature there are reports of AVMs involving the scrotum,1,2 penis,3 spermatic cord,4 testis, and epididymis5 and interventional treatment of scrotal AVMs.6 In our literature search, we found no report about intratesticular AVMs. In this report we present the sonographic features of a small intratesticular AVM, which was incidentally found in a patient during scrotal examination for infertility evaluation. This rare entity should be considered in the differential diagnosis of intratesticular masses.Öğe Isolated inguinal bladder hernia(Trakya Üniversitesi Tıp Fakültesi Derg.(YA. Balkan Medical Journal, 2010) Baysal, Tamer; Soylu, Ahmet; Erdoğan, ÖzgülÖz: İzole inguinal kanal içerisine mesane herniasyonu nadir görülür. Tanı genellikle cerrahi sırasında intraoperatif olarak ya da intraoperatif gelişen yaralanma sonucu konur. Radyolojik görüntüleme ile erken tanı cerrahi onarım sırasında komplikasyonlardan kaçınmak için önemlidir. Bilgisayarlı tomografi herniasyonun detaylarını ortaya koymada en önemli görüntüleme seçeneğidir. Biz rastlantısal olarak tespit ettiğimiz inguinal yerleşimli herniasyon olgusunun intravenöz pyelografi ve bilgisayarlı tomografi bulgularını sunuyoruz.Öğe Isolated Inguinal Bladder Hernia(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2010) Baysal, Tamer; Soylu, Ahmet; Erdogan, OezguelIsolated urinary bladder herniation into the inguinal canal is rare. It is often diagnosed intraoperatively during surgery or is identified after intraoperative injury. Early diagnosis with radiologic imaging is important to avoid complications during repair surgery. Computed tomography seems the best imaging choice to outline the details of herniation. We report an incidentally discovered case of inguinal bladder herniation with intravenous pyelography and computed tomography findings.Öğe İzotretinoin Tedavisi Sırasında Gelişen Herpes Genitalis: Olgu Sunumu(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2009) Öztürk, Savaş; Çetin, Cumali; Soylu, Ahmetİzotretinoin, A vitamini türevi olan ve akne tedavisindesık kullanılan sentetik bir retinoiddir. Sistemik retinoidlerin HSV-1 replikasyonunu azaltarak virusidal aktivite gösterdiği in vivo ve invitro çalışmalarla gösterilmiş ve rekürren herpes enfeksiyonlarında tedavi amacıyla kullanılmıştır. Bununla birlikte bazı yayınlarda izotretinoin tedavisi sırasında herpetik enfeksiyonların tetiklenebileceği de rapor edilmiştir. Seksüel çeşitliliğin artması ve otoinokülasyon nedeniyle genital herpes enfeksiyonları içinde HSV-1 prevalansı giderek artmaktadır. Literatürde izotretinon tedavisi sırasında gelişen genital herpes enfeksiyonunu bildirilmemiştir. Bu yazıda, nodüler akne vulgaris tedavisi için 40 mg/gün izotretinoin tedavisi başlanan 17 yaşında bir erkek hastada, 15 gün sonra gelişen bir herpes genitalis olgusu sunulmuştur.Öğe Labial füzyonun neden olduğu işeme zorluğu(İnönü Üniversitesi, Turgut Özal Tıp Merkezi, Nükleer Tıp Anabilim Dalı, Malatya., 2004) Soylu, Ahmet; Sarıer, Mehmet; Davarcı, Mürsel; Baydinç, Yaşar CanÖz: Labial füzyon, labium minör veya labium majörün orta hatta kısmi veya tam yapışıklığıdır. Sıklıkla 6 ay-6 yaş arası kız çocuklarda görülür. Nedeni tam olarak bilinmemekle beraber dolaşımdaki estrojen seviyesindeki azalma veya irritasyona bağlı vulvar epitelyumun aşınması ile ilişkili olabilir. Nadir olarak üriner sistem yakınmalarına neden olmaktadır. Bu makalede kliniğimize zor idrar yapma yakınması ile başvuran ve cerrahi olarak yapışıklığın açıldığı labial flizyonlu bir olgu sunulmaktadırÖğe Percutaneous nephrolithotomy for pediatric stone disease(Scandinavian Journal of Urology and Nephrology, 2003) Güneş, Ali; Uğraş, Murat Yahya; Yılmaz, Uğur; Baydinç, Can; Soylu, AhmetObjective: We evaluated the outcomes and complications of percutaneous nephrolithotomy (PNL) operations performed in pediatric patients using adult-sized surgical equipment at our center. Material and Methods: The medical and surgical records of 23 children who underwent a total of 25 PNL operations using 24 or 26 F rigid nephroscopes were evaluated retrospectively. The following aspects were considered: stone burden; duration of surgery and complications; details concerning recovery, success, residual fragments and auxiliary procedures; and follow-up details. Results: The success rate of a single PNL session was 70.8%; with the use of auxiliary procedures this was increased to 91.6%. Perioperative and early postoperative complications were excessive bleeding and transfusion in two patients, hydropneumothorax in one, perforation of the collecting system in three and urinoma in one. Complications were more common in children aged <7 years or with staghorn stones. The mean time to catheter removal was 3.4 days and the mean hospitalization time was 4.8 days. Idiopathic hypercalciuria, hypocitraturia, cystinuria and hyperoxaluria were diagnosed in two, two, one and three patients, respectively. Conclusion: Performing PNL with adult-sized equipment is associated with significant complications in children aged <7 years or with staghorn stones. This treatment should not be considered in routine clinical practice. As all stone-removal methods are associated with complications, PNL should be used only if other methods fail or are unavailable.
