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Altıntaş E, Şahin A, Babayev H, Gül M, Batur AF, Kaynar M, Kılıç Ö, Göktaş S. Machine learning algorithm predicts urethral stricture following transurethral prostate resection. World J Urol 2024; 42:324. [PMID: 38748256 PMCID: PMC11096196 DOI: 10.1007/s00345-024-05017-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 04/22/2024] [Indexed: 05/18/2024] Open
Abstract
PURPOSE To predict the post transurethral prostate resection(TURP) urethral stricture probability by applying different machine learning algorithms using the data obtained from preoperative blood parameters. METHODS A retrospective analysis of data from patients who underwent bipolar-TURP encompassing patient characteristics, preoperative routine blood test outcomes, and post-surgery uroflowmetry were used to develop and educate machine learning models. Various metrics, such as F1 score, model accuracy, negative predictive value, positive predictive value, sensitivity, specificity, Youden Index, ROC AUC value, and confidence interval for each model, were used to assess the predictive performance of machine learning models for urethral stricture development. RESULTS A total of 109 patients' data (55 patients without urethral stricture and 54 patients with urethral stricture) were included in the study after implementing strict inclusion and exclusion criteria. The preoperative Platelet Distribution Width, Mean Platelet Volume, Plateletcrit, Activated Partial Thromboplastin Time, and Prothrombin Time values were statistically meaningful between the two cohorts. After applying the data to the machine learning systems, the accuracy prediction scores for the diverse algorithms were as follows: decision trees (0.82), logistic regression (0.82), random forests (0.91), support vector machines (0.86), K-nearest neighbors (0.82), and naïve Bayes (0.77). CONCLUSION Our machine learning models' accuracy in predicting the post-TURP urethral stricture probability has demonstrated significant success. Exploring prospective studies that integrate supplementary variables has the potential to enhance the precision and accuracy of machine learning models, consequently progressing their ability to predict post-TURP urethral stricture risk.
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Affiliation(s)
- Emre Altıntaş
- Faculty of Medicine, Department of Urology, Selcuk University, Tıp Fakültesi Alaeddin Keykubat Yerleşkesi Selçuklu, Konya, 42131, Turkey.
| | - Ali Şahin
- Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Huseyn Babayev
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Murat Gül
- Faculty of Medicine, Department of Urology, Selcuk University, Tıp Fakültesi Alaeddin Keykubat Yerleşkesi Selçuklu, Konya, 42131, Turkey
| | - Ali Furkan Batur
- Faculty of Medicine, Department of Urology, Selcuk University, Tıp Fakültesi Alaeddin Keykubat Yerleşkesi Selçuklu, Konya, 42131, Turkey
| | - Mehmet Kaynar
- Faculty of Medicine, Department of Urology, Selcuk University, Tıp Fakültesi Alaeddin Keykubat Yerleşkesi Selçuklu, Konya, 42131, Turkey
| | - Özcan Kılıç
- Faculty of Medicine, Department of Urology, Selcuk University, Tıp Fakültesi Alaeddin Keykubat Yerleşkesi Selçuklu, Konya, 42131, Turkey
| | - Serdar Göktaş
- Faculty of Medicine, Department of Urology, Selcuk University, Tıp Fakültesi Alaeddin Keykubat Yerleşkesi Selçuklu, Konya, 42131, Turkey
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Özer H, Koplay M, Baytok A, Seher N, Demir LS, Kılınçer A, Kaynar M, Göktaş S. Texture analysis of multiparametric magnetic resonance imaging for differentiating clinically significant prostate cancer in the peripheral zone. Turk J Med Sci 2023; 53:701-711. [PMID: 37476894 PMCID: PMC10387871 DOI: 10.55730/1300-0144.5633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 02/01/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Texture analysis (TA) provides additional tissue heterogeneity data that may assist in differentiating peripheral zone(PZ) lesions in multiparametric magnetic resonance imaging (mpMRI). This study investigates the role of magnetic resonance imaging texture analysis (MRTA) in detecting clinically significant prostate cancer (csPCa) in the PZ. METHODS This retrospective study included 80 consecutive patients who had an mpMRI and a prostate biopsy for suspected prostate cancer. Two radiologists in consensus interpreted mpMRI and performed texture analysis based on their histopathology. The first-, second-, and higher-order texture parameters were extracted from mpMRI and were compared between groups. Univariate and multivariate logistic regression analyses were performed using the texture parameters to determine the independent predictors of csPCa. Receiver operating characteristic (ROC) curve analysis was conducted to assess the diagnostic performance of the texture parameters. RESULTS : In the periferal zone, 39 men had csPCa, while 41 had benign lesions or clinically insignificant prostate cancer (cisPCa). Themajority of texture parameters showed statistically significant differences between the groups. Univariate ROC analysis showed that the ADC mean and ADC median were the best variables in differentiating csPCa (p < 0.001). The first-order logistic regression model (mean + entropy) based on the ADC maps had a higher AUC value (0.996; 95% CI: 0.989-1) than other texture-based logistic regression models (p < 0.001). DISCUSSION MRTA is useful in differentiating csPCa from other lesions in the PZ. Consequently, the first-order multivariate regressionmodel based on ADC maps had the highest diagnostic performance in differentiating csPCa.
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Affiliation(s)
- Halil Özer
- Department of Radiology, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Mustafa Koplay
- Department of Radiology, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Ahmet Baytok
- Department of Radiology, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Nusret Seher
- Department of Radiology, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Lütfi Saltuk Demir
- Department of Public Health, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Abidin Kılınçer
- Department of Radiology, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Mehmet Kaynar
- Department of Urology, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Serdar Göktaş
- Department of Urology, Faculty of Medicine, Selcuk University, Konya, Turkey
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Gül M, Çulha MG, Bocu K, Batur AF, Altıntaş E, Kaynar M, Göktaş S, Kılıç Ö. Turkish Validation of the Hallym Post Micturition Dribble Questionnaire (HPMDQ) and Evaluation of Bulbar Urethral Massage Response. jus 2022. [DOI: 10.4274/jus.galenos.2021.2021.0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Batur AF, Gülmen M, Böcü K, Gül M, Kaynar M, Kılıç Ö, Göktaş S. Changes That Have Occurred in the Surgical Treatment Preference for Non-emergent Kidney Stones During the COVID-19 Pandemic: Six Months of Clinical Experience in A Tertiary Referral Centre. jus 2021. [DOI: 10.4274/jus.galenos.2020.0029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Gul M, Batur AF, Böcü K, Kaynar M, Kilic O, Göktaş S. Seasonal fluctuation of erectile dysfunction: A cross-sectional study from a tertiary university hospital across 10 years. Andrologia 2021; 53:e14019. [PMID: 33599339 DOI: 10.1111/and.14019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 01/29/2021] [Accepted: 02/07/2021] [Indexed: 12/11/2022] Open
Abstract
Erectile dysfunction (ED) shares several risk factors with diabetes mellitus (DM), hypertension (HT) and coronary vascular disease (CVD), which were well-associated with seasonal fluctuation with the highest peak in winter. In this study, we aimed to determine whether ED demonstrates seasonal fluctuations with the above-mentioned systemic diseases. Database from a tertiary university hospital between 2010 and 2020 was deciphered to retrieve patients diagnosed with ED. Patients with primary bladder tumour and post-procedural ED constituted the negative control groups from the same study period. International index of erectile function questionnaire (IIEF-15) was used to segregate included patients into mild/moderate and severe ED groups. The probability of detecting DM, HT and CVD in patients with severe ED was significantly higher than that of with mild/moderate ED (p < 0.05). More ED symptoms emerged and were diagnosed in the winter seasons even though no statistical significance was observed between patients with mild/moderate and severe ED (p = 0.946, Cramer's V coefficient = 0.19). The seasonal variation of patients with bladder tumour and post-procedural ED groups showed no significant difference (p > 0.05, both). ED admissions are associated with higher peaks in the winter seasons. This may help in daily clinical practice to warrant better clinical and epidemiological interpretation of ED.
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Affiliation(s)
- Murat Gul
- School of Medicine, Department of Urology, Selcuk University, Konya, Turkey
| | - Ali Furkan Batur
- School of Medicine, Department of Urology, Selcuk University, Konya, Turkey
| | - Kadir Böcü
- School of Medicine, Department of Urology, Selcuk University, Konya, Turkey
| | - Mehmet Kaynar
- School of Medicine, Department of Urology, Selcuk University, Konya, Turkey
| | - Ozcan Kilic
- School of Medicine, Department of Urology, Selcuk University, Konya, Turkey
| | - Serdar Göktaş
- School of Medicine, Department of Urology, Selcuk University, Konya, Turkey
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Batur AF, Kaynar M, Çelik ZE, Göktaş S. Paratesticular Solitary Fibrous Pseudotumor and a Brief Literature Review. jus 2019. [DOI: 10.4274/jus.galenos.2019.2649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Gül M, Altıntaş E, Kaynar M, Buğday MS, Göktaş S. The predictive value of platelet to lymphocyte and neutrophil to lymphocyte ratio in determining urethral stricture after transurethral resection of prostate. Turk J Urol 2017; 43:325-329. [PMID: 28861306 DOI: 10.5152/tud.2017.14478] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 02/01/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The pathology of urethral stricture disease is still unclear however progressive inflammation may contribute to the development of urethral stricture. The platelet-to- lymphocyte ratio (PLR) is a new and simple marker that indicates inflammation. In this study we aimed to investigate the predictive value of neutrophil to lymphocyte ratio (NLR) and PLR in patients with urethral stricture who underwent transurethral resection of prostate (TURP). MATERIAL AND METHODS A total of 208 patients who underwent bipolar-TURP were included in this study. Patients who had previously undergone surgery due to any urethral pathology, posterior urethral strictures, previous or ongoing treatment for any cancer, hematologic disorders, presence of an active infection at the time of surgical intervention, and prior blood transfusion were excluded. PLR, NLR and red cell distribution width (RDW) levels were measured. In order to investigate the predictive values of NLR and PLR variables, binary logistic regression analysis was performed. RESULTS No statistically significant differences were observed between the groups in terms of age, NLR, RDW, prostate size and operative times. Statistically significant differences were presented only in the median PLR- values. For predicting urethral stricture, the optimal cut-off value was 112.5, (sensitivity: 0.84, specificity: 0.64; AUC=0.762, 95% CI 0.684-0.84). CONCLUSION In this study we showed that PLR can be used to determine urethral stricture as a cost-effective, common, and simple biomarker in patients after TURP.
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Affiliation(s)
- Murat Gül
- Clinic of Urology, Van Training and Research Hospital, Van, Turkey
| | - Emre Altıntaş
- Department of Urology, Selçuk University School of Medicine Konya, Turkey
| | - Mehmet Kaynar
- Department of Urology, Selçuk University School of Medicine Konya, Turkey
| | | | - Serdar Göktaş
- Department of Urology, Selçuk University School of Medicine Konya, Turkey
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Ovet G, Alpfidan I, Sakarya Y, Sakarya R, Ozcimen M, Göktaş S, Erdoğan E. The acute effect of pseudoephedrine on choroidal thickness. Clin Ter 2017; 167:63-6. [PMID: 27424504 DOI: 10.7417/ct.2016.1927] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate the acute effects of pseudoephedrine (PE) on choroidal thickness in healthy young patients. METHODS Fifty patients with nasal and sinus congestion who were prescribed 60 mg oral PE at the otolaryngology department were recruited for this study. The enhanced depth imaging (EDI) optic coherence tomography (OCT) (Spectralis OCT; Heidelberg Engineering, Heidelberg, Germany) choroidal thickness measurements were performed at baseline and 1, 3 and 6 hours at 7 points. RESULTS The right eyes of 50 healthy subjects (22 women and 28 men) were included in this study. The mean choroidal thickness at fovea was 293.12 μm, 279.80 μm, 295.80 μm, and 294.52 μm at baseline, 1, 3 and 6 hours respectively. A significant reduction in choroidal thickness versus baseline was observed at all points at 1 hour. CONCLUSIONS The choroidal thickness decreased 1 hour after oral administration of PE and returned to baseline thickness at 3 hours. We suppose that this transient decrease might be associated with vasoconstriction due to activation of sympathetic alpha adrenoceptors.
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Affiliation(s)
- G Ovet
- Medical Sciences University Training and Research Hospital, Department of Otorhinolaryngolgy, Konya,Turkey
| | - I Alpfidan
- Medical Sciences University Training and Research Hospital, Department of Ophthalmology, Konya,Turkey
| | - Y Sakarya
- Medical Sciences University Training and Research Hospital, Department of Ophthalmology, Konya,Turkey
| | - R Sakarya
- Medical Sciences University Training and Research Hospital, Department of Ophthalmology, Konya,Turkey
| | - M Ozcimen
- Medical Sciences University Training and Research Hospital, Department of Ophthalmology, Konya,Turkey
| | - S Göktaş
- Medical Sciences University Training and Research Hospital, Department of Ophthalmology, Konya,Turkey
| | - E Erdoğan
- Medical Sciences University Training and Research Hospital, Department of Ophthalmology, Konya,Turkey
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Kulaksızoğlu H, Akand M, Kılıç Ö, Gül M, Kucur M, Göktaş S. Prostate myths: What is the prostate awareness in the general male population in Turkey? Turk J Urol 2015; 40:150-5. [PMID: 26328169 DOI: 10.5152/tud.2014.80090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 05/26/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate prostate awareness in the general male population and discover the common misinformation about prostate diseases (PDs). MATERIAL AND METHODS A cross-sectional population sampling was performed in the general population for men between the ages of 18-70 with a survey conducted by medical students. The survey consisted of 15 questions addressing different aspects of PDs and common misinformation in the general population. All participants were stratified according to age, degree of education, occupation and whether the person himself or a close relative had visited a urologist for PDs. All questionnaires were anonymous, and patients were informed about the confidentiality of the results. RESULTS A total of 1004 men between the ages of 18-70 were included in the study (mean age 38.0±12.9 years). Of those included, 20.2% were primary school graduates, 8.6% were secondary school graduates, 25.5% were high school graduates, 39.8% were university graduates, and 5.8% had a doctorate or higher education. Of all 1004 men, 31.5% had seen a urologist or attended an interview with a close relative for a PDs-related visit in a urologist's office; 56.2% reported "prostate" as a disease and only 16.5% as an organ. In terms of beliefs, 50.2% believed that all men had a "prostate," 5.4% said that sexual activity would cause PDs, 13% thought that sexual activity would prevent PD, 24.9% reported that a rectal exam would affect sexual activity, and 63.5% believed that urinating when squatting would prevent prostate hyperplasia. Prostate cancer transmission to sexual partners was marked as true by 5% of the men. As many as 41.3% of the participants believed that early prostate surgery for BPH would prevent prostate cancer, and 13% reported that sexual activity ceases with prostate surgery and that retrograde ejaculation or anejaculation is the end of sexual activity in men. CONCLUSION The survey clearly showed that prostate awareness is still very unsatisfactory in the Turkish male population and that urologists need to better inform the general population. PD knowledge is still lacking throughout all education levels. This is a unique study showing a cross-sectional analysis of the Turkish community; however, the applicability of these results to other communities should be evaluated.
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Affiliation(s)
- Haluk Kulaksızoğlu
- Department of Urology, Bilim University Şişli Florence Nightingale Hospital, İstanbul, Turkey
| | - Murat Akand
- Department of Urology, Selçuk University Faculty of Medicine, Konya, Turkey
| | - Özcan Kılıç
- Department of Urology, Selçuk University Faculty of Medicine, Konya, Turkey
| | - Murat Gül
- Department of Urology, Selçuk University Faculty of Medicine, Konya, Turkey
| | - Mustafa Kucur
- Department of Urology, Selçuk University Faculty of Medicine, Konya, Turkey
| | - Serdar Göktaş
- Department of Urology, Selçuk University Faculty of Medicine, Konya, Turkey
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Başal Ş, Malkoç E, Aydur E, Yıldırım İ, Kibar Y, Kurt B, Göktaş S. Fibrous pseudotumors of the testis: The balance between sparing the testis and preoperative diagnostic difficulty. Turk J Urol 2015; 40:125-9. [PMID: 26328164 DOI: 10.5152/tud.2014.21284] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 05/26/2014] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine a paradigm that will be helpful for urologists to manage fibrous pseudotumors, which are a very rare condition of the testis. MATERIAL AND METHODS We retrospectively evaluated the patients with fibrous pseudotumors in our uropathological database from 1995 to 2013. Patients who had tumor markers and ultrosonography (USG) screening before surgery and a final pathology report of a fibrous pseudotumor were included in the study. RESULTS In total, 838 patients with a testis mass were evaluated. Only 6 of these patients met the inclusion criteria. The mean age was 34 years (min: 20, max: 72). Serum tumor markers were in the normal range for all patients. The scrotal tumors were not clearly related to the testis parenchyma, and the radiologists could not definitively determine the nature of the masses (benign or malignant). A concomitant hydrocele was detected in 2 patients. After inguinal exploration, radical orchiectomy was performed in one patient with an ipsilateral atrophic testis, and biopsies were taken from the lesions for frozen section analysis in the other 5 patients. Pathologists reported benign tumors for all of these patients based on the frozen sections, and testicular sparing surgery was then performed in these 5 patients. CONCLUSION If scrotal tumors are detected by ultrasonography in patients with normal tumor markers, and the tumor cannot be clear distinguished from the testis, these patients might have a fibrous pseudotumor, and organ-sparing surgery can be performed on these patients.
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Affiliation(s)
- Şeref Başal
- Department of Urology, Gülhane Military Medical Academy Haydarpaşa Training Hospital, İstanbul, Turkey
| | - Ercan Malkoç
- Department of Urology, Gülhane Military Medical Academy Haydarpaşa Training Hospital, İstanbul, Turkey
| | - Emin Aydur
- Department of Urology, Gülhane Military Medical Academy, Ankara, Turkey
| | - İbrahim Yıldırım
- Department of Urology, Gülhane Military Medical Academy, Ankara, Turkey
| | - Yusuf Kibar
- Department of Urology, Gülhane Military Medical Academy, Ankara, Turkey
| | - Bülent Kurt
- Department of Pathology, Gülhane Military Medical Academy, Ankara, Turkey
| | - Serdar Göktaş
- Department of Urology, Selçuklu University Faculty of Medicine, Konya, Turkey
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Cetinkaya F, Zübarioğlu AU, Göktaş S. Pediatricians' knowledge about recent advances in anaphylaxis treatment in Istanbul, Turkey. Turk J Pediatr 2009; 51:19-21. [PMID: 19378886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Severe anaphylactic reactions are medical emergencies in children and require immediate recognition and treatment. Many advances have been reported recently in the treatment of anaphylaxis. Despite this, little is known about whether or not these advances are known by all pediatricians. To evaluate the knowledge of pediatricians on the recent advances in the treatment of anaphylaxis, some pediatricians from istanbul were asked to complete an anonymous questionnaire. A total of 124 pediatricians agreed to participate in the study. Most attendants (92%) knew epinephrine as the first drug in the treatment of anaphylaxis, but more pediatricians (65%) also preferred subcutaneous route as the most effective route for injection. In addition, more than 80% did not know the trademarks of epinephrine autoinjectors or the amount of the drug in the autoinjectors. Our data show that the level of pediatricians' knowledge about recent advances in the management of anaphylaxis is unsatisfactory. Pediatricians' failure to know recent advances in the management of anaphylaxis may endanger children when assistance is required. Educational programs aimed at improving the general knowledge of pediatricians on recent advances in anaphylaxis are urgently needed.
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Affiliation(s)
- Feyzullah Cetinkaya
- Department of Pediatrics, Sişli Etfal Research and Training Hospital, Istanbul, Turkey
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Abstract
BACKGROUND Standard post-orchiectomy radiotherapy (RT) is accepted as a standard management option for stage I seminoma. METHODS Retrospective evaluation of 74 patients with stage I seminoma was performed according to the Royal Marsden staging system. All of the patients underwent RT in the Radiation Oncology Department of Gülhane Military Medical Academy between 1974 and 1995. The median age of patients was 27 years (range, 20-56). Radiotherapy was applied to all of the patients after orchiectomy for adjuvant purposes. Sixty-nine patients underwent RT while five patients who had recurrence received chemotherapy following radiotherapy. RESULTS After a mean follow-up period of 54 months, the 5-year overall survival rate was 98.61%, which complied with the literature. The disease-free survival rate was 90.54%. According to the World Health Organization toxicity scale, acute enteritis was 9.4% for grade I and 5.4% for grade II, while nausea/vomiting was 36.4% for grade I and 5.4% for grade II. CONCLUSION To avoid acute toxicity related to RT, prognostic risk factors should be well-known and patients with low risk factors should be monitored carefully after orchiectomy. RT should be directed to the para-aortic +/- ipsilateral pelvic lymph nodes in high risk patients. Although post-orchiectomy RT is a traditional management option for clinical stage I seminoma, the results of RT should be well-known to compare it with other treatment options (e.g. RPLND, adjuvant chemotherapy and surveillance).
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Affiliation(s)
- Metin Güden
- Department of Radiation Oncology, Gülhane Military Medical Academy, Ankara, Turkey
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Abstract
PURPOSE Several studies have shown a positive association of dietary fat with prostate cancer. Leptin, a peptide hormone that has a role in the regulation of body weight, currently serves as a more accurate biomarker for total body fat. We designed a study to determine whether leptin influences cellular differentiation and the progression of prostate cancer. MATERIALS AND METHODS In this study we investigated serum leptin in 21 patients with prostate cancer, 50 with benign prostatic obstruction and 50 healthy individuals matched for sex, body mass index and age. Patients with cancer were stratified into 2 groups by the disease spread, including groups 1--organ confined and 2--advanced disease, and into 3 groups by the differentiation degree, including groups 3--Gleason sum 2 to 4 or well differentiated, 4--Gleason sum 5 to 7 or moderately differentiated and 5--Gleason sum 8 to 10 or poorly differentiated. RESULTS We noted significant differences in serum leptin in the cancer versus control and cancer versus benign prostatic obstruction groups. In addition, in the prostate cancer group serum leptin correlated with prostate specific antigen and biopsy Gleason score. We also observed significant differences in serum leptin in groups 1 versus 2, 3 versus 5 and 4 versus 5. CONCLUSION Leptin may have roles in the development of prostate cancer through testosterone and factors related to obesity. It influences cellular differentiation and the progression of prostate cancer.
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Affiliation(s)
- Kenan Saglam
- Department of Internal Medicine, Gülhane University, Etlik, Ankara, Turkey
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Göktaş S, Peşkircioğlu L, Tahmaz L, Kibar Y, Erduran D, Harmankaya C. Is there significance of the choice of prone versus supine position in the treatment of proximal ureter stones with extracorporeal shock wave lithotripsy? Eur Urol 2000; 38:618-20. [PMID: 11096246 DOI: 10.1159/000020341] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine whether there is a significance of the choice of prone versus supine position in the treatment of proximal ureter stones with extracorporeal shock wave lithothripsy (ESWL). METHODS Ninety-six patients with proximal ureter stones underwent ESWL. The procedure was performed in the supine position in 48 of them (group 1) and in the prone position in the other 48 patients (group 2). Stone-free rates, repeat ESWL rates, shocks per patient and shocks per session were compared in both groups. RESULTS The mean session number per patients was 1.64+/-0.75 in group 1 and 1. 33+/-0.59 in group 2 (p = 0.224). The stone-free rates 3 months after ESWL were 88.3% in group 1 and 90.6% in group 2. The difference between the results was statistically insignificant (p<0.05). Therefore, these two parameters were similar in both groups. On the other hand, the number of shocks per session was 4,863.54+/-2, 114.85 in group 1 and 3,704.16+/-1,726.75 in group 2. This difference was statistically significant (p = 0.011). The patients tolerated the supine position better in general. Patients in the prone position experienced discomfort on inspiration and expiration and pain localized to the lumbar vertebrae. CONCLUSION These results suggest that the supine position decreases the number of shocks per session in the treatment of proximal ureter stones with ESWL and this will be cost-effective.
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Affiliation(s)
- S Göktaş
- Gülhane Military Medical Academy and School of Medicine, Ankara, Turkey
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Abstract
OBJECTIVE To report the use of seromuscular enterocystoplasty (SE) combined with detrusorectomy, in children. PATIENTS AND METHODS Between 1993 and 1998, SE was performed in 10 children (aged 10-17 years) with a spastic neurogenic bladder resulting from spinal trauma. Before surgery all children were incontinent and despite anticholinergic medication and clean intermittent catheterization, their bladder capacity was 60-100 mL and their intravesical pressure 40-60 cmH2O. RESULTS Before surgery, the mean end-filling intravesical pressure was 47.7 cmH2O and the mean bladder capacity 82.9 mL. At 3 months after surgery the mean end-filling intravesical pressure was decreased to 21.1 cmH2O and the mean bladder capacity increased to 319.6 mL. One patient (a 14-year-old girl) had urinary retention soon after surgery and has since used clean intermittent catheterization. The other children were able to void successfully using the Valsalva manoeuvre; none were incontinent. All patients were followed and there were no changes in intravesical pressure and bladder capacity. CONCLUSION In providing most of the desired features of an ideal augmentation segment, SE is a good and effective method of bladder augmentation.
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Affiliation(s)
- M Dayanç
- Department of Urology, Gülhane Military Medical Academy, Ankara, Turkey
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DeAntoni EP, Göktaş S, Stenner J, O'Donnell C, Crawford ED. A cross-sectional study of vasectomy, time since vasectomy and prostate cancer. Prostate Cancer Prostatic Dis 1997; 1:73-78. [PMID: 12496919 DOI: 10.1038/sj.pcan.4500209] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/1997] [Revised: 08/07/1997] [Accepted: 08/08/1997] [Indexed: 11/08/2022]
Abstract
Past studies of the association of vasectomy and prostate cancer have reported inconsistent results. Our objective was to investigate whether vasectomy and time since vasectomy are associated with a higher risk of prostate cancer. We conducted a cross-sectional study on unduplicated records of >95 000 participants in a longitudinal study (1993-1995) of prostate cancer screening conducted during Prostate Cancer Awareness Week. Vasectomy was reported by 28%, and there were 2530 biopsies. (chi)(2) tests and logistic regression analyses were used and found that vasectomy and an increased length of time since vasectomy are not associated with a higher risk of prostate cancer.
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Affiliation(s)
- E P DeAntoni
- Division of Urology, C319, University of Colorado Health Sciences Center, 4200, E. Ninth Avenue, Denver, Colorado, USA
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Abstract
Two subtypes of priapism have been described based on the pathophysiologic mechanism. The more common type, termed stasis priapism, is characterized by a low flow state in which inadequate venous outflow creates an acidotic hypoxic environment leading to a painful prolonged erection. The other less common subtype, high flow priapism, is arteriogenic. We used embolization therapy in one case with long lasting stasis priapism and in the other with high flow priapism due to bilateral arteriosinusoidal fistulae in the penis. In both cases we used polyvinyl alcohol for embolization and sexual potency preservation. Priapism is the persistence of erection that does not result from sexual desire. Hauri et al. described two variants of priapism. In high flow priapism (non-ischaemic) there is unregulated arterial inflow to the lacunar spaces due to a lacerated cavernous artery associated with previous perineal and penile trauma. In stasis priapism, the second type, the basic abnormality could be due to a more pronounced or prolonged blood entrapment inside the vascular spaces of the corpora cavernosa sustained by an unknown cause. There are many treatment methods especially for low flow ischaemic variant. We report two different kinds of priapism and embolization therapy in both of them with polyvinyl alcohol.
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Affiliation(s)
- S Göktaş
- Department of Urology, Gülhane Military Medical Academy, Etlik, Ankara, Turkey
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Affiliation(s)
- S Göktaş
- Faculty Department of Urology, Gülhane Military Medical Academy, Ankara, Türkiye
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