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Tokuc E, Eksi M, Kayar R, Demir S, Topaktas R, Bastug Y, Akyuz M, Ozturk M. Inflammation indexes and machine-learning algorithm in predicting urethroplasty success. Investig Clin Urol 2024; 65:240-247. [PMID: 38714514 PMCID: PMC11076797 DOI: 10.4111/icu.20230302] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/06/2023] [Accepted: 12/29/2023] [Indexed: 05/10/2024] Open
Abstract
PURPOSE To assess the predictive capability of hematological inflammatory markers for urethral stricture recurrence after primary urethroplasty and to compare traditional statistical methods with a machine-learning-based artificial intelligence algorithm. MATERIALS AND METHODS Two hundred eighty-seven patients who underwent primary urethroplasty were scanned. Ages, smoking status, comorbidities, hematological inflammatory parameters (neutrophil-lymphocyte ratios, platelet-lymphocyte ratios [PLR], systemic immune-inflammation indexes [SII], and pan-immune-inflammation values [PIV]), stricture characteristics, history of previous direct-visual internal urethrotomy, urethroplasty techniques, and grafts/flaps placements were collected. Patients were followed up for one year for recurrence and grouped accordingly. Univariate and multivariate logistic regression analyses were conducted to create a predictive model. Additionally, a machine-learning-based logistic regression analysis was implemented to compare predictive performances. p<0.05 was considered statistically significant. RESULTS Comparative analysis between the groups revealed statistically significant differences in stricture length (p=0.003), localization (p=0.027), lymphocyte counts (p=0.008), PLR (p=0.003), SII (p=0.003), and PIV (p=0.001). In multivariate analysis, stricture length (odds ratio [OR] 1.230, 95% confidence interval [CI] 1.142-1.539, p<0.0001) and PIV (OR 1.002, 95% CI 1.000-1.003, p=0.039) were identified as significant predictors of recurrence. Classical logistic regression model exhibited a sensitivity of 0.76, specificity of 0.43 with an area under curve (AUC) of 0.65. However, the machine-learning algorithm outperformed traditional methods achieving a sensitivity of 0.80, specificity of 0.76 with a higher AUC of 0.82. CONCLUSIONS PIV and machine-learning algorithms shows promise on predicting urethroplasty outcomes, potentially leading to develop possible nomograms. Evolving machine-learning algorithms will contribute to more personalized and accurate approaches in managing urethral stricture.
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Affiliation(s)
- Emre Tokuc
- Urology Clinic, Haydarpasa Numune SUAM, University of Health Sciences, Istanbul, Türkiye.
| | - Mithat Eksi
- Urology Clinic, Bakırkoy Dr. Sadi Konuk SUAM, University of Health Sciences, Istanbul, Türkiye
| | - Ridvan Kayar
- Urology Clinic, Haydarpasa Numune SUAM, University of Health Sciences, Istanbul, Türkiye
| | - Samet Demir
- Urology Clinic, Haydarpasa Numune SUAM, University of Health Sciences, Istanbul, Türkiye
| | - Ramazan Topaktas
- Urology Clinic, Haydarpasa Numune SUAM, University of Health Sciences, Istanbul, Türkiye
| | - Yavuz Bastug
- Urology Clinic, Haydarpasa Numune SUAM, University of Health Sciences, Istanbul, Türkiye
| | - Mehmet Akyuz
- Urology Clinic, Haydarpasa Numune SUAM, University of Health Sciences, Istanbul, Türkiye
| | - Metin Ozturk
- Urology Clinic, Haydarpasa Numune SUAM, University of Health Sciences, Istanbul, Türkiye
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Kayar R, Bastug Y, Tokuc E, Topaktas R, Akyurek EA, Kayar K, Artuk I, Ozturk M. Pan-immune-inflammation value as a prognostic tool for overall survival and disease-free survival in non-metastatic muscle-invasive bladder cancer. Int Urol Nephrol 2024; 56:509-518. [PMID: 37773579 DOI: 10.1007/s11255-023-03812-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/14/2023] [Indexed: 10/01/2023]
Abstract
PURPOSE To evaluate the association between preoperative pan-immune inflammation value (PIV) and overall survival (OS) and disease-free survival (DFS) in patients who underwent radical cystectomy for non-metastatic muscle-invasive bladder cancer. METHODS A total of 119 patients with non-metastatic muscle-invasive bladder cancer who underwent radical cystectomy at our institution between January 2014 and January 2022 were included in this retrospective study. PIV was calculated using the formula (monocyte count × neutrophil count × platelet count)/lymphocyte count. Ideal cut-off values for PIV were determined using ROC curve analysis. Kaplan-Meier analysis was used to evaluate the impact of PIV on survival outcomes. RESULTS The mean age of patients was 65 ± 14 years, and the mean follow-up duration was 36 months. The ideal cutoff value for PIV was determined to be 406.29, and a PIV above this value was associated with poorer OS (p < 0.001) (73 months vs. 21 months) and DFS (p = 0.002) (35 months vs 19 months). Higher neutrophil-to-lymphocyte ratio (NLR) values were also associated with poorer OS (p < 0.001) and DFS (p < 0.001), with similar effectiveness to PIV. PIV was found to be significantly more effective than platelet-to-lymphocyte ratio (PLR) and systemic immune inflammation index (SII) in predicting DFS. CONCLUSION Preoperative PIV may serve as an independent prognostic factor for OS in patients who undergo radical cystectomy with non-metastatic muscle-invasive bladder cancer. A high PIV value was associated with poorer survival outcomes. Prospective multicenter studies are needed to further validate the relationship between PIV and histopathological features of bladder cancer.
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Affiliation(s)
- Ridvan Kayar
- Department of Urology, University of Health Sciences, Haydarpasa Numune SUAM, Tıbbiye Str. No: 40, Uskudar, Istanbul, Turkey
| | - Yavuz Bastug
- Department of Urology, University of Health Sciences, Haydarpasa Numune SUAM, Tıbbiye Str. No: 40, Uskudar, Istanbul, Turkey
| | - Emre Tokuc
- Department of Urology, University of Health Sciences, Haydarpasa Numune SUAM, Tıbbiye Str. No: 40, Uskudar, Istanbul, Turkey.
| | - Ramazan Topaktas
- Department of Urology, University of Health Sciences, Haydarpasa Numune SUAM, Tıbbiye Str. No: 40, Uskudar, Istanbul, Turkey
| | - Elif Atag Akyurek
- Faculty of Medicine, Department of Medical Oncology, Dokuz Eylul University, Izmir, Turkey
| | - Kemal Kayar
- Urology Clinic, Kilis Prof.Dr. Alaeddin Yavasca State Hospital, Kilis, Turkey
| | - Ilker Artuk
- Department of Urology, University of Health Sciences, Haydarpasa Numune SUAM, Tıbbiye Str. No: 40, Uskudar, Istanbul, Turkey
| | - Metin Ozturk
- Department of Urology, University of Health Sciences, Haydarpasa Numune SUAM, Tıbbiye Str. No: 40, Uskudar, Istanbul, Turkey
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Akyuz M, Ozsoy E, Tokuc E, Artuk I, Kayar R, Bastug Y, Öztürk Mİ. Management and outcomes of urethral stricture: single centre experience over 13 years. Aktuelle Urol 2023; 54:482-486. [PMID: 36002031 DOI: 10.1055/a-1904-6943] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
AIM To present a comprehensive summary of the diagnosis, treatment and follow-up process of patients who underwent open urethroplasty in our tertiary referral center for the treatment of urethral stricture in the last 13 years. MATERIALS AND METHODS Two hundred and forty-five (245) patients who underwent open urethroplasty between January 2008 and June 2021 were retrospectively analysed. Detailed history, physical examination, uroflowmetry, retrograde urethrography and/or voiding cystourethrography and/or urethroscopy were used throughout the preoperative diagnosis process. While evaluating the postoperative patency rates, the absence of preoperative voiding symptoms after the operation and Qmax 15 ml/sec and above were taken into account. RESULTS Mean stricture length was 3.8 +/- 1.4 cm. Transurethral endoscopic interventions in 79 patients (32.2%), catheterisation in 55 patients (22.4%), trauma in 54 patients (22%), infection in 15 patients (6.2%), and idiopathology in 42 patients (17.2%) were the causes for the stricture. Buccal mucosal graft was used in 125 patients (51%), penile skin flap in 32 patients (13%), end-to-end anastomosis in 83 patients (33.8%) and Heineke-Mikulicz technique in 5 patients (2%). Mean follow-up period was 67.1 +/- 28.9 months. Success rates of patients were 84% (105) in buccal mucosal graft, 78.1% (25) in penile skin flap, 86.7% (72) with end-to-end anastomosis and 80% (4) with Heineke-Mikulicz technique. CONCLUSION Among treatment options for urethral stricture, urethroplasty techniques is the most successful treatment. Consideration of the factors leading to the formation of the stricture, with the intraoperative findings and surgical experience will maximize the benefit the patient receives.
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Affiliation(s)
- Mehmet Akyuz
- Urology, Istsanbul Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Emrah Ozsoy
- Urology, Ünye Çakırtepe Hospital, Ordu, Turkey
| | - Emre Tokuc
- Urology, Istsanbul Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Ilker Artuk
- Urology, Istsanbul Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Ridvan Kayar
- Urology, Istsanbul Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Yavuz Bastug
- Urology, Istsanbul Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Metin İshak Öztürk
- Urology, Istsanbul Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
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Kalkanli A, Sönmez SZ, Guvel M, Aglamis E, Araz S, Asfuroglu A, Avci HK, Aydin M, Aydos M, Balci U, Baran C, Bastug Y, Baydilli N, Bayrak O, Benlioglu C, Halil Bozkurt I, Bursali K, Can U, Coser S, Caglar Cakici M, Calik G, Cift A, Cilesiz NC, Demir DO, Demir M, Cihan Demirel H, Dursun M, Demirelli E, Ekenci BY, Eksi M, Ergin G, Ergin IE, Erkan A, Fikri O, Tugrul Gezmis C, Gül A, Guzelsoy M, Ibis MA, Inkaya A, Ipekci T, Karakeci A, Karkin K, Kaya C, Kazan O, Koray Kirdag M, Cagri Kizilcay Y, Koseoglu B, Kucuk E, Gonultas S, Ogras MS, Olgun A, Ordek E, Ozbey I, Sarier M, Senel S, Tahra A, Toprak T, Yigit Yalcin M, Hizir Yavuzsan A, Yazar S, Hacıbey İ, Yildirim K, Yilmaz K, Yilmaz S, Yoldas M, Yuce A, Ozgur Yucel M, Nedim Yuceturk C, de la Rosette J, Kadioglu A. Management of Priapism: Results of a Nationwide Survey and Comparison with International Guidelines. Urol Res Pract 2023; 49:225-232. [PMID: 37877823 PMCID: PMC10544432 DOI: 10.5152/tud.2023.22209] [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] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 04/06/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVE The aim of this study is to evaluate current urologic practice regarding the management of priapism in Turkey and compare with international guidelines. METHODS Urologists and urology residents were invited to an online survey consisting of 30 multiple-choice questions on priapism-related clinical practices that were consid- ered most important and relevant to practices by using Google Forms. RESULTS Total number of responses was 340. Respondents reported that they recorded a detailed patient's medical history and physical examination findings (n = 340, 100%) and laboratory testing, which includes corporal blood gas analysis (n=323, 95%). Participants announced that they performed Doppler ultrasound for 1/4 cases (n = 106, 31%), but 22% of the participants (n=75) replied that they performed in >75% of cases. Participants (n=311, 91%) responded that the first-line treatment of ischemic priapism is decompression of the corpus cavernosum. Moreover, most respondents (n = 320, 94%) stated that sympathomimetic injection drugs should be applied as the second step. About three-quarters of respondents (n = 247, 73%) indicated adrenaline as their drug of choice. Phosphodiesterase type 5 inhibitors seems to be the most pre- ferred drug for stuttering priapism (n=141, 41%). Participants (n=284, 84%) replied that corpora-glanular shunts should be preferred as the first. A large number of par- ticipants (n = 239, 70%) declared that magnetic resonance imaging can be performed in cases with delayed (>24 hours) priapism to diagnose corporal necrosis. Most of the participants (84%) responded that penile prosthesis should be preferred to shunts in cases with delayed (>48 hours) priapism. CONCLUSION It would be appropriate to improve the training offered by professional associations and to give more training time to the management of priapism during residency.
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Affiliation(s)
- Arif Kalkanli
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Salih Zeki Sönmez
- Department of Urology, Bağcılar Education and Research Hospital, Istanbul, Turkey
| | - Mine Guvel
- Istanbul Provincial Health Directorate, Istanbul, Turkey
| | | | - Seyhmuz Araz
- Department of Urology, Esenyurt Necmi Kadıoğlu State Hospital, Istanbul, Turkey
| | | | - Huseyin Kursad Avci
- Department of Urology, Ankara Gülhane Training and Research Hospital, Ankara, Turkey
| | - Memduh Aydin
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Murat Aydos
- Department of Urology, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Ugur Balci
- Department of Urology, Katip Çelebi University, School of Medicine, Izmir, Turkey
| | - Caner Baran
- Department of Urology, Okmeydanı Education and Research Hospital, Istanbul, Turkey
| | - Yavuz Bastug
- Department of Urology, Haydarpaşa Education and Research Hospital, Istanbul, Turkey
| | - Numan Baydilli
- Department of Urology, Erciyes University, School of Medicine, Kayseri, Turkey
| | - Omer Bayrak
- Department of Urology, Gaziantep University, School of Medicine, Gaziantep, Turkey
| | - Can Benlioglu
- Department of Urology, Adıyaman University, School of Medicine, Adiyaman, Turkey
| | | | - Kerem Bursali
- Department of Urology, Şişli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Utku Can
- Department of Urology, Kartal Dr Lütfi Kırdar Training and Research Hospital, Istanbul, Turkey
| | - Seref Coser
- Department of Urology, Evliya Çelebi Training and Research Hospital, Kütahya, Turkey
| | - Mehmet Caglar Cakici
- Department of Urology, Göztepe Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Gokhan Calik
- Department of Urology, Medipol University, School of Medicine, Istanbul, Turkey
| | - Ali Cift
- Department of Urology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Nusret Can Cilesiz
- Department of Urology, Biruni University, School of Medicine, Istanbul, Turkey
| | | | - Murat Demir
- Department of Urology, Van YY University, School of Medicine, Van, Turkey
| | | | - Murat Dursun
- Department of Urology, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey
| | - Erhan Demirelli
- Department of Urology, Giresun University, School of Medicine, Giresun, Turkey
| | - Berk Yasin Ekenci
- Department of Urology, Dışkapı Training and Research Hospital, Ankara, Turkey
| | - Mithat Eksi
- Department of Urology, Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Giray Ergin
- Department of Urology, Koru Hospital, Ankara, Turkey
| | - Ismail Emre Ergin
- Department of Urology, Cumhuriyet University, School of Medicine, Sivas, Turkey
| | - Anil Erkan
- Department of Urology, Katip Çelebi University, School of Medicine, Izmir, Turkey
| | - Onur Fikri
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Cem Tugrul Gezmis
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Abdullah Gül
- Department of Urology, Bursa Education and Research hospital, Bursa, Turkey
| | - Muhammet Guzelsoy
- Department of Urology, Katip Çelebi University, School of Medicine, Izmir, Turkey
| | - Muhammed Arif Ibis
- Department of Urology, Keçiören Training and Research Hospital, Ankara, Turkey
| | - Abdurrahman Inkaya
- Department of Urology, Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Tumay Ipekci
- Department of Urology, Bahceşehir University, School of Medicine, Istanbul, Turkey
| | - Ahmet Karakeci
- Department of Urology, Fırat University, School of Medicine, Elazığ, Turkey
| | - Kadir Karkin
- Department of Urology, Adana City Hospital, Adana, Turkey
| | - Coskun Kaya
- Department of Urology, Eskişehir City Hospital, Eskişehir, Turkey
| | - Ozgur Kazan
- Department of Urology, Göztepe Medeniyet University, School of Medicine, Istanbul, Turkey
| | | | - Yigit Cagri Kizilcay
- Department of Urology, Balıkesir University, School of Medicine, Balıkesir, Turkey
| | - Burak Koseoglu
- Department of Urology, Ankara City Hospital, Ankara, Turkey
| | - Emrah Kucuk
- Department of Urology, Akçakale State Hospital, Şanlıurfa, Turkey
| | - Serkan Gonultas
- Department of Urology, aziosmanpaşa Training and Research Hospital, Istanbul, Turkey
| | | | - Ahmet Olgun
- Department of Urology, Elazığ City Hospital, Elazığ, Turkey
| | - Eser Ordek
- Department of Urology, Gazi University, School of Medicine, Ankara, Turkey
| | - Isa Ozbey
- Department of Urology, Kahta State Hospital, Adıyaman, Turkey
| | - Mehmet Sarier
- Department of Urology, Atatürk University, School of Medicine, Erzurum, Turkey
| | - Samet Senel
- Department of Urology, Ankara City Hospital, Ankara, Turkey
| | - Ahmet Tahra
- Department of Urology, Medipol University, School of Medicine, Istanbul, Turkey
| | - Tuncay Toprak
- Department of Urology, Istinye University, School of Medicine, Istanbul, Turkey
| | | | - Abdullah Hizir Yavuzsan
- Department of Urology, Kartal Dr Lütfi Kırdar Training and Research Hospital, Istanbul, Turkey
| | - Selim Yazar
- Department of Urology, Şanlıurfa Training and Research Hospital, Şanlıurfa, Turkey
| | - İbrahim Hacıbey
- Department of Urology, Rize Training and Research Hospital, Rize, Turkey
| | - Kadir Yildirim
- Department of Urology, Medical Park Hospital, Elazığ, Turkey
| | - Kemal Yilmaz
- Department of Urology, Malatya Training and Research Hospital, Malatya, Turkey
| | - Sercan Yilmaz
- Department of Urology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Mehmet Yoldas
- Department of Urology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ahmet Yuce
- Department of Urology, Darende State Hospital, Malatya, Turkey
| | - Mehmet Ozgur Yucel
- Department of Urology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Cem Nedim Yuceturk
- Department of Urology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Jean de la Rosette
- Department of Urology, Medipol University, School of Medicine, Istanbul, Turkey
| | - Ates Kadioglu
- Department of Urology, Section of Andrology, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey On Behalf of Turkish Urology Academy
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Bastug Y, Tokuc E, Bastug N, Artuk I, Tosun C, Cakiroglu HS, Aykan S. Systemic immune-inflammation index, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio are predictors of sperm presence in microdissection testicular sperm extraction. Andrologia 2022; 54:e14419. [PMID: 35266170 DOI: 10.1111/and.14419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/30/2021] [Revised: 02/25/2022] [Accepted: 03/01/2022] [Indexed: 12/18/2022] Open
Abstract
The aim of this study is to evaluate the value of the haematologic inflammatory parameters in predicting sperm retrieval rates during microdissection testicular sperm extraction (micro-TESE).159 patients diagnosed with non-obstructive azoospermia were included in the study. After excluding the patients that do not fit the inclusion criteria, age, smoking status, body-mass index, serum luteinizing hormone, follicle-stimulating hormone, total testosterone levels and neutrophil, lymphocyte and platelet counts were recorded. Neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic immune-inflammation index were calculated. The primary outcome was defined as the presence of spermatozoa during the procedure and the association between the candidate predictors and primary endpoint were evaluated by logistic regression analysis. Then, a baseline model from age, smoking, body-mass index and hormonal levels was built. Ratios and indexes were included, respectively, and were compared by multivariate analyses. Each of all three parameters was an independent predictor of obtaining spermatozoa during micro-TESE procedure (all p < 0.001). Even though all three parameters were significant, neutrophil-lymphocyte ratio and systemic immune-inflammation index stood out as more powerful than platelet-lymphocyte ratio (p < 0.08, p < 0.08 respectively). Additionally, adding these parameters individually to the baseline model significantly empowered the predictive value (all p < 0.001). Using haematologic inflammatory parameters in the prediction of sperm presence during microdissection testicular sperm extraction may be helpful when consulting the patient with having a better foresight of the procedural outcomes.
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Affiliation(s)
- Yavuz Bastug
- Department of Urology, Haydarpasa Numune SUAM, University of Health Sciences, Istanbul, Turkey
| | - Emre Tokuc
- Department of Urology, Haydarpasa Numune SUAM, University of Health Sciences, Istanbul, Turkey
| | - Nesrin Bastug
- Department of Gynecology and Obstetrics and IVF Unit, Emsey Hospital, Istanbul, Turkey
| | - Ilker Artuk
- Department of Urology, Haydarpasa Numune SUAM, University of Health Sciences, Istanbul, Turkey
| | - Cagatay Tosun
- Department of Urology, Haydarpasa Numune SUAM, University of Health Sciences, Istanbul, Turkey
| | - Halime Sena Cakiroglu
- Department of Gynecology and Obstetrics, Zeynep Kamil SUAM, University of Health Sciences, Istanbul, Turkey
| | - Serdar Aykan
- Urology Clinic, Emsey Hospital, Istanbul, Turkey
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Yencilek F, Yilmaz SG, Yildirim A, Gormus U, Altinkilic EM, Dalan AB, Bastug Y, Turkmen S, Turkan S, Isbir T. Apolipoprotein E Genotypes in Patients with Prostate Cancer. Anticancer Res 2016; 36:707-711. [PMID: 26851028] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Apolipoprotein E (ApoE) is a potential inhibitor of cell proliferation, immune regulation and modulation of cell growth and differentiation; it also has a substantial role in antioxidant activity. ApoE has a potential role in prostate cancer progression. MATERIALS AND METHODS ApoE genotyping was performed using real-time polymerase chain reaction (RT-PCR) for blood samples from a group of patients with prostate cancer (n=68) and a control group (n=78). RESULTS The frequency of the E3/E3 genotype was significantly higher in patients compared to controls (p=0.004). E3/E3 genotype carriers were 3.6-fold more likely to be patients than controls (odds ratio=3.67, 95% confidence interval=1.451-9.155; p=0.004). Additionally, the patients with E3/E3 genotype had significantly higher Gleason score (p=0.017), and more patients with this genotype had a Gleason score higher than 7 (p=0.007). Individuals carrying the E4 allele were significantly more common in the control group (p=0.006). The frequency of the E3/E4 genotype was found to be significantly higher in controls compared to patients (p=0.007), and patients were significantly less likely to have this genotype than controls (odds ratio=0.89, 95% confidence interval=0.833-0.967, p=0.007). Individuals carrying the E2/E3 genotype had a significantly lower Gleason score (p=0.049)-all of the patients with this genotype had a Gleason score lower than 7 (p=0.024). CONCLUSION E3/E3 genotype may be a potential risk factor for prostate cancer and high Gleason scoring. The E4 allele maybe a risk-reducing factor for prostate cancer.
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Affiliation(s)
- Faruk Yencilek
- Department of Urology, Faculty of Medicine, Institute of Health Sciences, Yeditepe University, Istanbul, Turkey
| | - Seda Gulec Yilmaz
- Department of Molecular Medicine, Institute of Health Sciences, Yeditepe University, Istanbul, Turkey
| | - Asif Yildirim
- Department of Urology, Göztepe Education and Research Hospital, Istanbul, Turkey
| | - Uzay Gormus
- Department of Biochemistry, Faculty of Medicine, Istanbul Bilim University, Istanbul, Turkey
| | - Emre Murat Altinkilic
- Department of Molecular Medicine, Institute of Health Sciences, Yeditepe University, Istanbul, Turkey
| | | | - Yavuz Bastug
- Department of Urology, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Selda Turkmen
- Department of Molecular Medicine, Institute of Health Sciences, Yeditepe University, Istanbul, Turkey
| | - Sadi Turkan
- Department of Urology, Anatolia Hospital, Kastamonu, Turkey
| | - Turgay Isbir
- Department of Medical Biology, Faculty of Medicine, Institute of Health Sciences, Yeditepe University, Istanbul, Turkey
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Yencilek F, Yildirim A, Yilmaz SG, Altinkilic EM, Dalan AB, Bastug Y, Isbir T. Investigation of Interleukin-1β Polymorphisms in Prostate Cancer. Anticancer Res 2015; 35:6057-6061. [PMID: 26504029] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Cytokine-mediated immune and inflammatory responses are considered to play an important role in the pathogenesis of prostate cancer. The present study investigated certain interleukin-1β (IL1β) polymorphisms and their association with prostate cancer. MATERIALS AND METHODS Genotyping of the IL1B-31(rs 1143627 G>A) and IL1B-511(rs 16944 A<G) polymorphisms were performed using real-time polymerase chain reaction for blood samples from a group of patients with prostate cancer (n=71) and controls (n=76). RESULTS The frequency of the IL1B-31(rs1143627) AG heterozygote genotype was found to be significantly lower in patients compared to controls (odds ratio=0.648, 95% confidence interval=0.463-0.908; p=0.036). The genotypic frequencies of IL1B-511(rs16944) between prostate cancer patients and controls were statistically significantly different (p=0.001). The frequency of AG genotype for IL1B-511(rs16944) was 0.5-fold lower in patients with prostate cancer than in the controls (odds ratio=0.546; 95% confidence interval=0.377-0.791; p=0.001). CONCLUSION Our data show that individuals carrying the IL1B-31(rs1143627) and IL1B-511(rs16944) AG genotypes had a decreased risk for developing prostate cancer. Out of all the possible combinations analyzed, IL1B-31(rs1143627) G with IL1B-511(rs16944) G combination had a protective association with prostate cancer.
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Affiliation(s)
| | - Asif Yildirim
- Department of Urology, Göztepe Education and Research Hospital, Istanbul, Turkey
| | - Seda Gulec Yilmaz
- Department of Molecular Medicine, Institute of Health Sciences, Yeditepe University, Istanbul, Turkey
| | - Emre Murat Altinkilic
- Department of Molecular Medicine, Institute of Health Sciences, Yeditepe University, Istanbul, Turkey
| | | | - Yavuz Bastug
- Department of Urology, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Turgay Isbir
- Department of Medical Biology, Faculty of Medicine
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Koyuncu H, Yencilek F, Kalkan M, Bastug Y, Yencilek E, Ozdemir AT. Intrarenal Surgery vs Percutaneous Nephrolithotomy in the Management of Lower Pole Stones Greater than 2 cm. Int Braz J Urol 2015; 41:245-51. [PMID: 26005965 PMCID: PMC4752086 DOI: 10.1590/s1677-5538.ibju.2015.02.09] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 05/22/2014] [Indexed: 11/30/2022] Open
Abstract
Purpose To compare the efficacy of RIRS and PNL in lower pole stones ≥2 cm. Materials and and Methods: A total of 109 patients who underwent PNL or RIRS for solitary lower pole stone between April 2009 and December 2012, were retrospectively analyzed. Lower pole stone was diagnosed with CT scan. Stone size was assessed as the longest axis of the stone. All patients were informed about the advantages, disadvantages and probable complications of both PNL and RIRS before the selection of the procedure. Patients decided the surgery type by themselves without being under any influences and written informed consent was obtained from all patients prior to the surgery. Patients were divided into two groups according to the patients’ preference of surgery type. Group 1 consisted of 77 patients who underwent PNL and Group 2 consisted of 32 patients treated with RIRS. Stone free statuses, postoperative complications, operative time and hospitalization time were compared in both groups. Results There was no statistical significance between the two groups in mean age, stone size, stone laterality, mean follow-up periods and mean operative times. In PNL group, stone-free rate was 96.1% at first session and 100% after the additional procedure. In Group 2, stone-free rate was 90.6% at the first procedure and 100% after the additional procedure. The final stone-free rates and operative times were similar in both groups. Conclusions RIRS should be an effective treatment alternative to PNL in lower pole stones larger than 2 cm, especially in selected patients.
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Affiliation(s)
- Hakan Koyuncu
- Department of Urology, Yeditepe University Medical Faculty, Istanbul, Turkey
| | - Faruk Yencilek
- Department of Urology, Yeditepe University Medical Faculty, Istanbul, Turkey
| | - Mehmet Kalkan
- Department of Urology, Fatih University Medical Faculty, Istanbul, Turkey
| | - Yavuz Bastug
- Department of Urology, Beykoz State Hospital, Istanbul, Turkey
| | - Esin Yencilek
- Department of Radiology, Haydarpasa Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Tunc Ozdemir
- Department of Urology, Yeditepe University Medical Faculty, Istanbul, Turkey
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Yencilek E, Sarsılmaz A, Kilickesmez O, Koyuncu H, Eryildirim B, Gurses B, Bastug Y, Erihan B. The Daily Resistive Index measurement useful tool in the estimation of the optimal time interval between two Shock Wave Lithotripsy sessions. Med Ultrason 2015; 17:175-179. [PMID: 26052567 DOI: 10.11152/mu.2013.2066.172.dyr] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE : To monitor the impact of Shock Wave Lithotripsy (SWL) on the renal resisive index (RI) and to investigate the potential of the RI measurement for the estimation of the optimal duration between 2 SWL sessions. MATERIAL AND METHODS Thirty patients with single pelvis renalis stone were included. Participitants were grouped according to their age as group 1 (<40 years, mean age 36.2+/-3.9 years) and group 2 (>/=40 years, mean age 55.4+/-6.5 years). RI measurement was performed in of all patients prior to SWL. After SWL, RI was monitored daily until RI returned to their pre-SWL values. RESULTS The mean stone size was 2 8.97+/-3.62 in group 1 and 10.08+/-4.67 mm in group 2 (p=0.077). Following SWL, the RI value of both goups increased and the higher RI value was measured at the 24th hour as compared with their pre-SWL values (p<0.001). In day 2 RI of the groups declined, but the differences were still statistically different from their pre-SWL RI values (p<0.001). However, on the third day, RI of group 1 was close to their pre-SWL level (p=0.143). But, in group 2, RI value returned to their pre-SWL limits on day 4 (p=0.229). CONCLUSIONS RI measurement gives important data regarding SWL related acute renal trauma and should be used as an US marker for recovery after SWL.
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Affiliation(s)
- Esin Yencilek
- Department of Radiology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey.
| | - Aysegul Sarsılmaz
- Department of Radiology, Yeditepe University Medical Faculty, Istanbul, Turkey
| | - Ozgur Kilickesmez
- Department of Radiology Istanbul Education Hospital, Istanbul, Turkey
| | - Hakan Koyuncu
- Department of Urology, Yeditepe University Medical Faculty, Istanbul, Turkey
| | - Bilal Eryildirim
- Department of Urology Kartal Lutfi Kırdar Education and Research Hospital, Istanbul, Turkey
| | - Bengi Gurses
- Department of Radiology, Yeditepe University Medical Faculty, Istanbul, Turkey
| | - Yavuz Bastug
- Department of Urology Beykoz State Hospital, Istanbul, Turkey
| | - Bilger Erihan
- Department of Urology, Yeditepe University Medical Faculty, Istanbul, Turkey
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Yencilek E, Koyuncu H, Arslan D, Bastug Y. The measurement of the prostatic resistive index is a reliable ultrasonographic tool to stratify symptoms of patients with benign prosthatic hyperplasia. Med Ultrason 2014; 16:208-213. [PMID: 25110761] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIMS To evaluate the correlation between lower urinary tract symptoms (LUTS) and the resistive index (RI) of the transitional (TZ) and peripheral zone (PZ) of the prostate and to assess the impact of alpha blocker (AB) treatment on RI changes. MATERIAL AND METHODS TZ-RI and PZ-RI values of 60 patients with LUTS were calculated by using transrectal ultrasound (TRUS). Correlations between the severity of LUTS and RI values were established. Then, AB was given to moderately and severe symptomatic patients with LUTS. One month after AB usage, TRUS was applied to assess the impact of AB on the TZ-RI, PZ-RI and the international prostate symptom score (IPSS). RESULTS Participants were divided into 3 groups as mild (n=14), moderate (n=25) and severe symptomatic (n=21) patients. Mean TZ-RI and PZ-RI were statistically different between the three groups (p<0.01). TZ-RI and PZ-RI were correlated with the severity of LUTS (r=0.757, p<0.01 and r=0.699, p<0.01 respectively). A decrease in symptom severity and RI values in moderate and severe symptomatic groups were significant after AB treatment. CONCLUSIONS TZ-RI and PZ-RI values can reflect the severity of LUTS and the AB treatment decreases the TZ-RI and the PZ-RI. Measuring the RI of the prostate by TRUS can be a useful tool to stratify LUTS's severity.
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Affiliation(s)
- Esin Yencilek
- Department of Radiology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey.
| | - Hakan Koyuncu
- Department of Urology, Yeditepe University Medical Faculty,Istanbul,Turkey
| | - Deniz Arslan
- Haydarpasa Numune Education and Research Hospital,Istanbul,Turkey
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