Yencilek, F. | Kalkan, M. | Uzun, H. | Akkuş, E. | Öner, A. | Solok, V.
Article | 2003 | Turk Uroloji Dergisi29 ( 2 ) , pp.126 - 132
Introduction: Glycosaminogylicans (GAG) play as a promotor and inhibitor in some phases of stone formation. Sialic acid (SA) is a low-molecular weight aminosaccaride and found in the molecular structure of GAG and on the surface of many cells. Plasma SA level increases in inflamatory diseases, glomerulonephritis and metabolic abnormalities. Unfortunately, there are only a few studies investigating the relationship between SA level in urine and urological diseases. In this study, the relationship between calcium oxalate crystalization and free, total and complex sialic acid levels in urine and plasma has been investigated. Additional . . .ly, possible effect of potassium citrate on this relationship was also studied. Material and Methods: Thirty wistar female rats were included in this study. They were randomly divided in three groups. 0.12 ml of %5 ethylene glycole was dissolved in water and given to the rats in group 1 by feeding tube two times a day and every other day 0.5 microgram vitamin D3 was added to their drinking water to expose them hyperoxlacuric and hypercalciuric, respectively. Rats in group 2 were exposed to the same procedure as group1. Additionally, 5 mg/day K-Citrat was added to their diet. No special diet program was applied in group 3 (control group). At the end of 30 days, 24 hours urine samples were collected by using metabolic cages and blood samples were taken from each rat. Free and total SA levels were calculated by the technique of measuring thiobarbituric acid as mmol/liter (Warren's method). One way ANOVA test was applied for statistical analysis. Result: Calcium levels measured in plasma and urine were higher in group 1 and 2 than the control group. Similarly, oxalate levels in urine were also higher in group 1 and group 2., The differences were statistically significant when compared with the control group ( Daha fazlası Daha az
Tanriverdi, O. | Yencilek, F. | Koyuncu, H. | Yencilek, E. | Sarica, K.
Article | 2011 | Urology77 ( 2 ) , pp.305 - 308
Objectives To evaluate the causes of emergent stent placement during the postoperative early period after uncomplicated ureteroscopy in 23 patients. Methods Of 276 uncomplicated ureteroscopy procedures performed for the management of ureteral calculi, double-J stent placement was necessary on an emergent basis in 23 patients because of intolerable colic pain and extreme patient discomfort. All stents were inserted within 24 hours after the procedure. Results Of the 23 patients requiring emergent stent placement, 14 were men and 9 were women. The stones had been located in the lower ureter in 11, mid-ureter in 6, and upper ureter in . . .6 patients. All patients had undergone an uncomplicated procedure with no complication evident either during or immediately after ureteroscopic stone management. The intraoperative findings for the 23 patients revealed extensive edema formation, unrecognized small stones embedded in the edematous ureteral wall, unpassed small fragments gathered at the orifice, obstructing blood clots, and kinking of the ureter. A retrospective evaluation of the operative CD recordings and radiographic findings clearly showed that a longer operative time, repeated access, management of a large stone, impacted calculi with ureteral wall edema, a mildly narrowed ureteral segment, ignored caliceal small calculi, and a recent history of urinary tract infection contributed to the need for postoperative intervention. Conclusions Ureteral catheterization, at least in the form of overnight stent placement, might prevent the formation of transient ureteral obstruction, with resultant postoperative patient discomfort and colic pain evident in selected cases. © 2011 Elsevier Inc Daha fazlası Daha az
Kalkan, M. | Uzun, H. | Turkan, S. | Sahin, C. | Fatma, F. | Yencilek, F. | Koyuncu, H.
Article | 2015 | European Journal of General Medicine12 ( 2 ) , pp.101 - 103
To assess the impact of a diagnosis of bladder cancer on smoking behavior and to analyze the role of the physician in smoking cessation. Nonmuscle-invasive bladder cancer patients completed a phone survey of their smoking habits. They were asked about smoking behavior before and after the diagnosis of cancer and whether they had been informed by their physician about the relation between smoking and bladder cancer. Two hundred-twelve patients responded to the survey. The mean age was 60.03±6.36 years. Ninety-three of the 135 current smokers (68.9%) were advised to quit smoking, whereas nine of 20 nonsmokers (45%) were not commented . . .about the future risks of smoking. The results showed that 13% of the current smokers and 35% of the current nonsmokers were not warned about the relation of bladder cancer with smoking. Statistical significance was not seen in terms of sex, disease stage, and tumor grade at diagnosis. The relation between smoking and bladder cancer has been well established. However, some patients are not informed to quit smoking by their physicians. © 2015, TIP ARASTIRMALARI DERNEGI. All rights reserved Daha fazlası Daha az
Sarica, K. | Eryildirim, B. | Yencilek, F. | Kuyumcuoglu, U.
Article | 2009 | Urology73 ( 5 ) , pp.1003 - 1007
Objectives: To evaluate the possible role of being overweight on stone-forming risk factors in children. Methods: A total of 94 children (43 boys and 51 girls, male/female ratio 1:1.8) who were taking no medication or dietary modifications before treatment were included in the study. After a detailed stone disease history, the systolic and diastolic blood pressures were precisely measured and recorded for all patients. The body mass index, 24-hour urine values, and serum stone-forming risk parameters were evaluated in 44 overweight (17 boys and 27 girls; group 1) and 50 normal (26 boys and 24 girls; group 2) children. The results of . . . each group were compared using the Wilcoxon rank sum test. Results: The evaluation of the stone-forming risk factors in both groups revealed that the overweight status might be responsible for the increased excretion of these substances in such children. Most of the children in group 1 demonstrated hypocitraturia and hyperoxaluria (9/44, 20.5%) compared with the patients in group 2. Although the mean urinary oxalate level was 0.74 ± 0.81 mg/kg/24 h for boys and 0.69 ± 0.72 mg/kg/24 h for girls in group 1, relatively lower values were noted in group 2 (0.42 ± 0.52 and 0.45 ± 0.57 mg/kg/24 h for the boys and girls, respectively). Similarly, the children in group 1 had elevated mean urinary calcium and lower citrate excretion compared with the group 2 patients. Conclusions: Overweight status in children might be associated with an elevated risk of stone formation in both sexes owing to the alterations in urine composition. Obese children could be more prone to stone formation, and they should be evaluated and followed up for this aspect. Crown Copyright © 2009 Daha fazlası Daha az
Yencilek, F. | Erturhan, S. | Cangüven, Ö. | Erol, B. | Koyuncu, H. | Göktaş, C. | Sarica, K.
Article | 2009 | Turk Uroloji Dergisi35 ( 4 ) , pp.298 - 303
Objective: The aim of this study was to determine the effect of indomethacin, an anti-inflammatory agent, on apoptosis and crystal deposition developing as a consequence of tubular cell injury induced by hyperoxaluria in an animal model. Materials and methods: Fifty New Zealand rabbits were divided into 3 groups. The first 2 groups were fed with hyperoxaluric diet and Group 3 was the control group with no supplementary procedure or treatment. While the animals in Group 1 were given only hyperoxaluric diet, Group 2 animals was applied indomethacin in addition to the hyperoxaluric diet. Animals were sacrificed at the early (7th day) a . . .nd late (28th day) periods and renal tis-sue specimens were sent for the pathological analysis of crystal deposition and apoptosis. Results: The presence and degree of crystal deposition were significantly less in the specimens obtained from indomethacin-treated group during both the early and late periods ( Daha fazlası Daha az
Yencilek, F. | Kalkan, M. | Uzun, H. | Akkuş, E. | Öner, A. | Solok, V.
Article | 2003 | Türk Üroloji Dergisi/Turkish Journal of Urology29 ( 2 ) , pp.126 - 132
Glikozaminoglikanlar taş oluşumunun bazı aşamalarında promoter, bazı aşamalarında ise inhibitor gibi davranmaktadır. Düşük molekül ağırlıklı bir aminosakkarid olan sialik asit (SA) glikozaminoglikanlanın yapısında bulunur. Kontrollü deney grupları oluşturarak kalsiyum-okzalat kristalizasyonu ile idrarda serbest ve bağlı SA ilişkisini ve potasyum sitratm bu ilişki üzerine etkisini araştırdık. Çalışmamızda Wistar cinsi dişi sıçanlardan 10'arlı 3 ayrı grup oluşturuldu. Grup l 'e 0.12 mi %5 etilen glikol l mi normal çeşme suyunda çözündürülerek 2x1 feeding tüple verilip hiperoksalürik ve günaşırı 0.5 mikrogram vitamin ds sularına karışt . . .ırılıp hiperkalsiürik hale getirildi. Grup 2, Grup l'den farklı olarak sularına 5mg/gün K-Sitrat eklendi. Grup 3'e normal beslemne yapıldı. Bütün sıçanlardan 30. günde metabolik kafesler kullanılarak 24 saatlik idrar ve kan örnekleri alındı. İdrarda serbest ve total SA düzeyleri Warren'in tarif ettiği tiobarbüritik asit tekniği ile standart eğrilere göre mmol/litre cinsinden hesaplandı. İstatistiksel analizde One way ANOVA test'i kullanıldı.Seram ve idrar kalsiyum, idrar okzalat düzeyleri grup l ve 2'de grup 3'e göre artmış olup istatistiksel anlamlı bulundu. Serum total ve bağlı SA düzeyi üç grupta normal sınırlar içerisinde fakat serbest SA grup l ve 2'de kontrol grubuna göre düşük bulundu ve bu istatistiksel anlamlı idi. İdrar total ve bağlı SA düzeyleri grup l ve 2'de grup 3'e göre azalmış bulundu ve bu istatistiksel anlamlı iken kendi aralarında istatistiksel anlamlılık yoktu. Her üç grup idrar serbest SA düzeyi arasında istatistiksel anlamlılık bulunmadı. Kristalüri ile idrar ve serum SA düzeyleri arasında anlamlı ilişki vardır. Potasyum sitrat'ın seram ve idrar SA üzerine anlamlı bir etkisi yoktur. Introduction: Glycosaminogylicans (GAG) play as a promoter and inhibitor in some phases of stone formation. Sialic acid (SA) is a low-molecular weight aminosaccaride and found in the molecular, structure of GAG and on the surface of many cells. Plasma SA level increases in inflammatory diseases, glomerulonephritis and metabolic abnormalities. Unfortunately, there are only a few studies investigating the relationship between SA level in urine and urological diseases. In this study, the relationship between calcium oxalate crystalization and free, total and complex sialic acid levels in urine and plasma has been investigated. Additionally, possible effect of potassium citrate on this relationship was also studied. Material and Methods: Thirty Wistar female rats were included in this study. They were randomly divided in three groups. 0.12 ml of %5 ethylene glycole was dissolved in water and given to the rats in group 1 by feeding tube two times a day and every other day 0.5 microgram vitamin D3 was added to their drinking water to expose them hypcroxlacuric and hypercalciuric, respectively. Rats in group 2 were exposed to the same procedure as group l Additionally, 5 mg/day K-Citrat was added to their diet. No special diet program was applied in group 3 (control group). At the end of 30 days, 24 hours urine samples were collected by using metabolic cages and blood samples were taken from each rat. Free and total SA levels were calculated by the technique of measuring thiobarbituric acid as mmol/liter (Warren's method). One way ANOVA test was applied for statistical analysis. Result: Calcium levels measured in plasma and urine were higher in group 1 and 2 than the control group. Similarly, oxalate levels in urine were also higher in group 1 and group 2., The differences were statistically significant when compared with the control group (p<0.05). Phisma complex and total SA levels were almost the same in all groups but free SA was significantly lower in group 1 and 2 than the controls (p<0.05). Low levels of total and complex SA in the urine were statistically significant in group 1 and 2 compared to the controls (p<0.05). In contrary, there was no significant difference between group 1 and 2. There was no statistical significance in urine free SA levels among 3 groups. Conclusion: In this experimental study, significant correlation is found between crystaluria and urine and plasma SA levels. In our opinion, SA can make a complex with crystals in urine and acts as a promoter in stone formation. Consequently, urine levels of SA can change in crystalluric cases. However, potassium citrate has not any significant effect on urine and plasma SA levels Daha fazlası Daha az
Canguven, O. | Goktas, C. | Yencilek, F. | Cetinel, C. | Albayrak, S.
Article | 2009 | Advances in Urology , pp.126 - 132
Purpose. To evaluate the results of patient symptoms and radiologic outcomes of cystoretroperitoneal shunt (CRS) technique in the treatment of symptomatic simple renal cysts. Patients and Methods. In a prospective study, 37 patients with a simple renal cyst were treated with ultrasound-guided percutaneous CRS-catheter. Radiological success was indicated as no recurrence of the cyst or a reduction in cyst volume by at least half. Results. CRS technique was performed successfully in 36 patients with a simple renal cyst. The mean size of all cysts decreased from 8.8cm (range 7 to 14) to 1.7cm (range 0 to 9; P
Sarica, K. | Yencilek, F.
Review | 2008 | Archivio Italiano di Urologia e Andrologia80 ( 1 ) , pp.27 - 33
Experimental as well as clinical findings reported in the literature suggest that treatment with shock wave lithotripsy (SWL) causes renal parenchymal damage mainly by generating free radicals through ischaemia /reperfusion injury mechanism. Although SWL-induced renal damage is well tolerated in the majority of healthy cases with no permanent functional and/or morphologic side effects, a subset of patients with certain risk factors requires close attention on this aspect among which the ones with pre-existing renal disorders, urinary tract infection, previous lithotripsy history and solitary kidneys could be mentioned. It is clear t . . .hat in such patients lowering the number of shock waves (per session) could be beneficial and has been applied by the physicians as the first practical step of diminishing SWL induced parenchymal damage. On the other hand, taking the injurious effects of high energy shock wave (HESW) induced free radical formation on renal parenchyma and subsequent histopathologic alterations into account, physicians searched for some protective agents in an attempt to prevent or at least to limit the extent of the functional as well as the morphologic alterations. Among these agents calcium channel blocking agents (verapamil and nifedipine), antioxidant agents (allopurinol, vitamin E and selenium) and potassium citrate have been used to minimize these unestimated adverse effects. Additionally, therapeutic application of these agents on reducing stone recurrence particularly after SWL will gain more importance in the future in order to limit new stone formation in these cases. Lastly, as experimental and clinical studies have demonstrated, combination of anti-oxidants with free radical scavengers may provide superior renal protection against shock wave induced trauma. However, we believe that further investigations are certainly needed to determine the dose-response relationship between the damaging effects of SWL application and the protective role of these agents Daha fazlası Daha az
Yencilek, F. | Aktas, C. | Goktas, C. | Yilmaz, C. | Yilmaz, U. | Sarica, K.
Article | 2008 | Urology72 ( 5 ) , pp.987 - 990
Objectives: To evaluate the therapeutic effect of papaverine hydrochloride in the treatment of patients with renal colic pain unresponsive to conventional treatment. Methods: From March 2007 to January 2008, a total of 561 patients with severe renal colic pain due to a ureteral stone were treated with conventional agents (hyoscine-N-butylbromide and diclofenac sodium) in the emergency and urology departments. Of these 561 patients, 110, with no response to the treatment and persistent severe pain, were randomized into 3 groups for additional treatment. The patients in group 1 (n = 37) received intravenous hyoscine-N-butylbromide, th . . .ose in group 2 (n = 37) received papaverine hydrochloride, and those in group 3 (n = 36) received pethidine. Before and after treatment, all patients completed a visual analog scale (VAS) questionnaire, with a scale of 0 (no pain) to 10 (maximal complaint), to measure their subjective pain. The mean VAS score of each group was compared with that of the other groups. Results: The pretreatment mean VAS scores of all 3 groups were not significantly different statistically from each other (4.02 ± 1.20, 4.36 ± 1.97, and 4.27 ± 1.50; P > .05). However, after treatment, the mean VAS scores of the patients treated with papaverine (0.93 ± 0.29) and pethidine (0.81 ± 0.38) were significantly different from those of the hycosine group (3.67 ± 2.21; P < .001). However, the mean VAS scores of groups 2 and 3 were comparable (P = .67). Unlike opioids, no papaverine-related severe side effects were observed. Conclusions: Our results indicate that papaverine hydrochloride can used in an effective manner in the management of renal colic pain in patients unresponsive to commonly used conventional agents. © 2008 Elsevier Inc. All rights reserved Daha fazlası Daha az
Teber, D. | Gözen, A.S. | Cresswell, J. | Canda, A.E. | Yencilek, F. | Rassweiler, J.
Review | 2009 | World Journal of Urology27 ( 5 ) , pp.613 - 618
Objectives: There is a small risk of ureteral injury during laparoscopic radical prostatectomy (LRP). It is important to recognise and repair such ureteral injuries immediately. Laparoscopic reconstructive surgery has proven to be feasible for the treatment of ureteral injury. We report our experience of ureteral injuries during LRP including the incidence, mechanism of injury, management, prevention and outcome. Materials and methods: During a 9-year period, 2,164 LRP's were performed at our clinic. Three cases were complicated by lower ureteral injuries including two complete and one partial transection. The complete transections . . .occurred during posterior dissection of the bladder neck and seminal vesicles, and the partial transection during an extended lymph node dissection. All were recognised and managed intraoperatively. We performed Lich-Gregoir (LG) extravesical ureteral reimplantation for complete transections, and primary repair for the partial ureteral transection. Results: Overall, the incidence of ureteral injuries was 0.13%. Laparoscopic reconstructive surgery was performed successfully in all cases without complication. This added 71, 46 and 59 min, respectively, to LRP operative time. The postoperative course was uneventful in all patients. Hospital stay was 8 days. After 30, 17 and 14 months of follow-up, intravenous urography (IVU) demonstrated good drainage. Conclusion: Recognition and repair of ureteral injuries during LRP requires a high index of suspicion, and expertise in laparoscopic technique. Laparoscopic reimplantation or primary repair of these injuries during LRP is, in experienced hands, a safe, feasible and minimally invasive procedure with the benefits of laparoscopic surgery maintained for the patient. © Springer-Verlag 2009 Daha fazlası Daha az
Yencilek, E. | Sarı, H. | Yencilek, F. | Yeşil, E. | Aydın, H.
Article | 2017 | Urolithiasis45 ( 6 ) , pp.545 - 552
Some in vitro and animal studies have shown endothelial dysfunction in hyperoxaluria models indicating its role in pathogenesis of urolithiasis and relation to CVD. The aim of this study was to investigate endothelial function in patients with urolithiasis in relation to urinary stone risk factors and metabolic parameters. A total of 120 subjects without any known CVD (60 with urolithiasis and 60 healthy subjects) were included into study. Fasting blood and 24-h urine samples were collected to study metabolic parameters (glucose and lipids) and urine stone risk factors (oxalate, citrate, uric acid, and calcium, pH). Endothelial func . . .tion was assessed as flow-mediated dilation (FMD) at the brachial artery. Age, sex, and body mass index were similar in patients and controls. Of urine stone risk factors, oxalate and citrate were higher in patients than controls. Fasting blood glucose, total LDL cholesterol, and triglyceride were higher, and HDL cholesterol was lower in patients than controls. Although within normal limits systolic blood pressure was higher in patient group, patients with urolithiasis had a lower %FMD than controls. Percent FMD was negatively correlated with urinary oxalate/creatinine ratio (p = 0.019, r = -0.315), calcium/creatinine ratio (p = 0.0001, r = -0.505) age (p Daha fazlası Daha az
Menda, F. | Temur, S. | Bilgen, S. | Yencilek, F. | Koyuncu, H. | Sancar, N. | Koner, O.
Article | 2013 | Journal of Anesthesia27 ( 5 ) , pp.720 - 724
Background: Lower urinary tract (LUT) discomfort is a common complaint after transurethral resection of the prostate (TURP), and it may lead to agitation and restlessnes. We have evaluated the efficacy of morphine for preventing TURP-related LUT discomfort symptoms. Methods: This was a prospective randomised study including 60 patients (American Society of Anesthesiologists class I and II) who were scheduled to undergo TURP. The patients were divided into two equally sized groups (group M: morphine, group C: control). A standartized anesthesia method was used. Group M patients received morphine 0.04 mg/kg intravenous (iv) in 100 ml . . .of normal saline followed by an infusion of morphine for 24 h (0.01 mg/kg/h); group C patients received 100 ml normal saline 20 min before the expected extubation time, followed by a normal saline infusion which looked identical to that of the morphine infusion. The incidences and severity of LUT discomfort, postoperative pain, sedation level, postoperative nausea and vomiting (PONV) and respiratory depression were recorded at 0, 1, 2, 6, 12 and 24 h postoperatively. Results: The incidence of LUT discomfort was lower in group M patients at all time points during the study (p < 0.05) except for 2 h postoperatively, and the severity of LUT discomfort was also lower this group at 0, 12 and 24 h postoperatively (p = 0.001, p = 0.04 and p = 0.02, respectively). Pain (numeric rating scale) scores were lower in group M patients at 0 (p = 0.003) and 6 h (p < 0.001). The need for rescue analgesic was lower in group M patients (19 patients in group C, 10 patients in group M; p = 0.04). The incidence of PONV was higher in group M patients (p = 0.03). The incidence of pruritus, respiratory depression and over-sedation were similar among the groups. Conclusion: Based on these results, we conclude that morphine effectively reduces LUT discomfort after TURP at a cost of postoperative nausea and vomiting. © 2013 Japanese Society of Anesthesiologists Daha fazlası Daha az