Koyuncu, H. | Yencilek, F. | Erturhan, S. | Eryildirım, B. | Sarica, K.

Article | 2011 | International Urology and Nephrology43 ( 1 ) , pp.7 - 13

Objective: To evaluate the natural course of the stone disease in pediatric patients from different perspectives among which the spontaneous passage and stone recurrence rates evaluated during the follow-up. Materials and methods: A total of 142 children referring with primary urinary stone disease were evaluated and followed. All children in the study were divided into two groups with respect to the age (Group 1: 0-5 years and Group 2: 6-15 years). Children were followed with respect to spontaneous passage rates, recurrence-regrowth rates, physical as well as the renal growth rates. Results: Stone recurrence has been noted in 44% o . . .f patients in group 1, this value was 31% in group 2. Children with at least one identifiable metabolic abnormality tended to have higher recurrence rates than the others despite conservative measures. The average stone recurrence rate in children without any metabolic abnormality was 14% and nearly 50% in children with an identifiable metabolic abnormality. Conclusions: We may emphasize that due to the high recurrence and re-growth rates, all children with urinary stone disease should be followed closely with regular visits. The evaluation of metabolic risk factors in children with renal stone disease is the basis of medical treatment aimed at preventing recurrent stone events and the growth of pre-existing calculi. © 2010 Springer Science+Business Media, B.V Daha fazlası Daha az

Teber, D. | Guven, S. | Simpfendörfer, T. | Baumhauer, M. | Güven, E.O. | Yencilek, F. | Rassweiler, J.

Article | 2009 | European Urology56 ( 2 ) , pp.332 - 338

Background: Use of an augmented reality (AR)-based soft tissue navigation system in urologic laparoscopic surgery is an evolving technique. Objective: To evaluate a novel soft tissue navigation system developed to enhance the surgeon's perception and to provide decision-making guidance directly before initiation of kidney resection for laparoscopic partial nephrectomy (LPN). Design, setting, and participants: Custom-designed navigation aids, a mobile C-arm capable of cone-beam imaging, and a standard personal computer were used. The feasibility and reproducibility of inside-out tracking principles were evaluated in a porcine model w . . .ith an artificially created intraparenchymal tumor in vitro. The same algorithm was then incorporated into clinical practice during LPN. Interventions: Evaluation of a fully automated inside-out tracking system was repeated in exactly the same way for 10 different porcine renal units. Additionally, 10 patients underwent retroperitoneal LPNs under manual AR guidance by one surgeon. Measurements: The navigation errors and image-acquisition times were determined in vitro. The mean operative time, time to locate the tumor, and positive surgical margin were assessed in vivo. Results and limitations: The system was able to navigate and superpose the virtually created images and real-time images with an error margin of only 0.5 mm, and fully automated initial image acquisition took 40 ms. The mean operative time was 165 min (range: 135-195 min), and mean time to locate the tumor was 20 min (range: 13-27 min). None of the cases required conversion to open surgery. Definitive histology revealed tumor-free margins in all 10 cases. Conclusions: This novel AR tracking system proved to be functional with a reasonable margin of error and image-to-image registration time. Mounting the pre- or intraoperative imaging properties on real-time videoendoscopic images in a real-time manner will simplify and increase the precision of laparoscopic procedures. © 2009 European Association of Urology Daha fazlası Daha az

Aydin, H. | Yencilek, F. | Erihan, I.B. | Okan, B. | Sarica, K.

Article | 2011 | Urological Research39 ( 6 ) , pp.451 - 458

Both the prevalence of cardiovascular risk factors and event rate are increased in patients with urolithiasis. Screening is recommended to all patients who have high cardiovascular risk. The aim of this study was to document 10-year risk of cardiovascular disease and mortality in asymptomatic patients with urolithiasis. Consecutive 200 patients with calcium oxalate urolithiasis were compared with 200 age- and sex-matched healthy controls. Ten-year cardiovascular disease risk was calculated with the Framingham Risk Score and mortality risk with SCORE risk score. Calcium, oxalate, and citrate excretion were studied as urinary stone ri . . .sk factors. The results indicate that patients with urolithiasis had higher total cholesterol (p < 0.0001), lower HDL-cholesterol (p < 0.0001), and higher systolic blood pressure (p < 0.0001) and hsCRP (p < 0.0001) compared with controls. Patients with urolithiasis had a higher Framingham Risk Scores [OR 8.36 (95% CI 3.81-18.65), p = 0.0001] and SCORE risk score [OR 3.02 (95% CI 1.30-7.02), p = 0.0006] compared with controls. The Framingham and SCORE risk score were significantly correlated with urinary calcium (p = 0.0001, r = 0.460, and p = 0.005, r = 0.223, respectively) and oxalate excretion (p = 0.0001, r = 0.516, p = 0.001, r = 0.290, respectively). In multiple linear regression analysis, urinary calcium and oxalate excretion, age, sex, total cholesterol, HDL-cholesterol, hsCRP and smoking were the independent predictors of 10-year cardiovascular disease risk and urinary calcium and oxalate excretion, age, sex, total cholesterol, fasting blood glucose for 10-year cardiovascular mortality. In conclusion, patients with calcium oxalate urolithiasis carry high risk of cardiovascular disease and mortality. All patients should be screened at the initial diagnosis of urolithiasis for the risk factors. © 2011 Springer-Verlag Daha fazlası Daha az

Gürses, B. | Kabakçi, N. | Akşit, H.Z. | Yencilek, F. | Kovanlikaya, A. | Kovanlikaya, I.

Article | 2007 | Australasian Radiology51 ( SUPPL. 1 ) , pp.451 - 458

Splenosis is a well-known entity, caused by autotransplantation of splenic tissue as a result of trauma or splenectomy. Patients are generally asymptomatic, and this entity is diagnosed during routine diagnostic imaging. Cystic changes in splenic implants have been defined before but, as to our knowledge, radiological demonstration of cystic components has not been published in the literature. It is well-known that unusual locations of the splenic implants create diagnostic problems, sometimes leading to unnecessary surgical interventions. In this report splenosis, mimicking a renal tumour, with cystic changes in the biggest splenul . . .e, and diagnosis with ferrumoxide-enhanced MRI is presented. © 2007 The Authors Daha fazlası Daha az

Yencilek, F. | Onal, B. | Erozenci, A. | Talat, Z. | Ataus, S.

Article | 2009 | Urologia Internationalis83 ( 3 ) , pp.295 - 299

Objective: To determine whether recurrence at first follow-up cystoscopy predicts future recurrence in patients with an intermediate risk of superficial bladder cancer. Methods: In total, 304 patients were classified as low (n = 60), intermediate (n = 177) or high risk (n = 67) based on the primary pathological/clinical findings, as previously described in literature. The intermediate-risk group was further divided into 2 subgroups based on recurrence at the first follow-up cystoscopy: A (recurrence negative) and B (recurrence positive). Results: The mean recurrence rates of low-, intermediate- and high-risk patients were 1.76, 6.41 . . . and 9.49, respectively (p < 0.05). Similarly, the difference in the recurrence rates between subgroups A (4.37) and B (9.12) was found to be statistically significant (p = 0.00). Additionally, while the difference between the low-risk group and subgroup A was statistically significant (p = 0.008), there was no significance between subgroup B and the high-risk group (p = 0.892). In the multivariate analysis, the most significant prognostic parameter for recurrence was the outcome of the first follow-up cystoscopy, followed by tumor multiplicity and grade. Conclusions: Patients showing recurrence at first follow-up cystoscopy in the intermediate-risk group should be classified as high-risk patients and treated accordingly. © 2009 S. Karger AG, Basel Daha fazlası Daha az

Kilickesmez, O. | Inci, E. | Atilla, S. | Tasdelen, N. | Yetimoglu, B. | Yencilek, F. | Gurmen, N.

Article | 2009 | Journal of Computer Assisted Tomography33 ( 6 ) , pp.828 - 833

Objectives: The purpose of this study was to calculate the apparent diffusion coefficient (ADC) values of different renal and adrenal lesions to evaluate the ability of diffusion-weighted imaging in characterizing masses and determining malignancy. Methods: A total of 52 patients consisting of 67 renal lesions and 28 patients with 33 adrenal lesions in addition to 50 healthy controls with normal kidneys were enrolled in the study. Diffusion-weighted imaging was performed with b factors of 0, 500, and 1000 s/mm, and the ADCs of the normal kidney and renal and adrenal lesions were calculated. Results: The mean (SD) ADCs of the renal c . . .ortex and medulla of the control group were 2.08 (0.22) × 10 and 1.94 (0.18) × 10 mm/s, respectively. Focal renal lesions were as follows: simple cysts (2.94 [0.20] × 10 mm/s), hemorrhagic cysts (1.71 [0.38] × 10 mm/s), angiomyolipomas (1.40 [0.21] × 10 mm/s), renal cell carcinomas (1.06 [0.39] × 10 mm/s), metastases (1.50 [0.13] × 10 mm/s), and hydronephrosis (1.54 [0.25] × 10 mm/s). The mean ADCs of all these pathologies were significantly different when compared with normal parenchyma. Diffusion-weighted imaging was also able to differentiate angiomyolipomas and hemorrhagic cysts from renal cell carcinomas. Adrenal lesions were subgrouped as adenomas (1.41 [0.27] × M10 mm/s), nonadenomatous solid masses (1.08 [0.28] × 10 mm/s), and cysts (2.82 [0.24] × 10 mm/s). The mean ADCs of adenomas were significantly different when compared with nonadenomatous solid masses and cysts. Conclusions: Our findings show that ADC measurement has a potential ability to differentiate benign and malignant focal renal and adrenal lesions with the guidance of conventional sequences. When used alone, diffusion-weighted imaging may lead to misdiagnoses due to overlapping ADCs of the lesions. Copyright © 2009 by Lippincott Williams & Wilkins Daha fazlası Daha az

Yencilek, F. | Erturhan, S. | Canguven, O. | Koyuncu, H. | Erol, B. | Sarica, K.

Article | 2010 | Urological Research38 ( 3 ) , pp.195 - 199

The objective of this study is to assess the efficacy of an alpha-1 adrenergic receptor blocking agent on the spontaneous passage of proximal ureteral calculi ?10 mm. 92 patients having single radio-opaque proximal ureteral stone ?10 mm were randomized into two groups. Group 1 patients (n = 50) were followed with classical conservative approach and patients in Group 2 (n = 42) additionally received tamsulosin, 0.4 mg/day during 4 weeks follow-up. The stone passage rates, stone expulsion time, VAS score, change in colic episodes, and hospital re-admission rates for colicky pain were compared. The patients were furthermore stratified . . .according to stone diameters Daha fazlası Daha az

Koyuncu, H. | Ergenoglu, M. | Yencilek, F. | Gulcan, N. | Tasdelen, N. | Yencilek, E. | Sarica, K.

Article | 2011 | Journal of Andrology32 ( 2 ) , pp.151 - 154

The aim of this study was to evaluate the possible relationship between varicocele and saphenofemoral insufficiency in patients diagnosed with primary varicocele. A total of 70 patients with the primary diagnosis of varicocele were included into the study. A total of 30 age-matched healthy adults were also included in the study as a control group. Varicocele was diagnosed by palpation and observation of each spermatic cord in standing position before and during a valsalva maneuver. Additionally, scrotal Doppler and lower extremity venous Doppler ultrasonography were performed. Patients who were with spermatic varicose vein larger th . . .an 3.0 mm were included in the study group as a varicocele patient. At the lower extremity venous Doppler ultrasonography, a retrograde flow lasting longer than 0.5 seconds during normal breathing or at the valsalva maneuver was considered to be meaningful for saphenofemoral junction insufficiency. Thirty-six (51.35%) patients had insufficiency in saphenofemoral junction in the study group (6 [8.5%] bilateral, 30 [42.85%] unilateral) whereas 8 (26.6%) had insufficiency in the control group (2 [6.6%] bilateral, 6 [20%] unilateral insufficiency). The patients with primary varicocele had a statistically significant (P 5 .02) higher rate of venous insufficiency in their saphenofemoral junctions when compared with the control group. In the present study, the rate of saphenofemoral insufficiency has been found to be statistically higher in patients with primary varicocele compared with healthy men. Depending on the common presence of valvular insufficiency, we believe that the presence of varicocele should be investigated in the young population suffering from saphenofemoral junction insufficiency Daha fazlası Daha az

Mutlu, N. | Türkeri, L.N. | Yencilek, F. | Demir, A. | Emerk, K.

Article | 2009 | The Canadian journal of urology16 ( 2 ) , pp.4558 - 4567

BACKGROUND: Data on utilizing complexed prostate specific antigen (cPSA) offering increased diagnostic performance over other available clinical parameters in diagnosis of prostate cancer is still controversial. Our objective was to determine diagnostic performance of cPSA compared to total prostate specific antigen (tPSA) and corresponding ratios for possible routine application. METHODS: In a prospective study including overall 315 consecutive men, 177 patients with suspicious digital rectal examination, and/or tPSA value > 2.5 ng/ml underwent prostate biopsy. Serum samples for tPSA, cPSA and free PSA were analyzed using automated . . . chemiluminometric technology. RESULTS: Area under the curve (AUC) for cPSA, although greater, was not statistically different compared to that of tPSA (p = 0.253). AUCs of f/c, f/t and c/t ratios were all found significantly inferior. At clinically relevant 2.37 ng/ml threshold, cPSA performed with 85% sensitivity and significantly higher specificity of 63.1%, compared to same sensitivity and specificity of 57.2% at a 3.00 ng/ml cut off for tPSA. CONCLUSIONS: Utilizing automated assay systems at predetermined cut off value for cPSA we would be able to save 27.1% of the biopsies while missing 13.4% of the cancers. Therefore, results of this study indicate higher discriminatory power of cPSA in diagnosis of prostate cancer for clinically relevant 2.5-4 ng/ml tPSA range Daha fazlası Daha az

Yencilek, F. | Sarica, K. | Eryildirim, B. | Erturhan, S. | Karakok, M. | Kuyumcuoglu, U.

Article | 2010 | International Urology and Nephrology42 ( 2 ) , pp.361 - 367

Objectives The effect of verapamil on tubular ischemia that is demonstrated by HIF-1a positivity in tubular cells following hyperoxaluria was evaluated in a rabbit model. Methods Thirty-six healthy male rabbits were randomly divided into three groups. Animals in the hyperoxaluric group were fed with 0.75% ethylene glycol. The verapamil group was fed identically to the hyperoxaluric group. Additionally, the verapamil group received verapamil orally (0.1 mg/kg). The control group received no special diet. Six animals in each group were killed on the 7th day of the experiment and the remaining six at the 28th day. Kidneys of the rabbit . . .s were examined by histopathologic and immunohistochemical analysis to detect the presence and degree of HIF-1a positivity. Results On the 7th day analysis, severe and moderate degree staining for HIF-1a in hyperoxaluric group were shown in four and two, respectively. In the verapamil group, however, three of six specimens showed nuclear staining (moderate in two and severe in one). Two of six specimens in the control group had minimal staining. The 28th day evaluation showed that two of the hyperoxaluric group had minimal degree nuclear staining but not in the remaining four. No staining was shown in the verapamil and control group animals. Conclusions Hyperoxaluria-related ischemia formation may be responsible for subsequent alterations in renal tubules. As a protective agent, verapamil was found to limit the presence of hypoxic changes as documented by HIF-1 alpha positivity in this study. These data also support the presence ischemic insult after hyperoxaluria induction in animal model. © Springer Science+Business Media, B.V. 2009 Daha fazlası Daha az

Gürses, B. | Tasdelen, N. | Yencilek, F. | Kilickesmez, N.O. | Alp, T. | Firat, Z. | Gürmen, A.N.

Article | 2011 | European Journal of Radiology79 ( 2 ) , pp.172 - 176

Purpose: The aim of this study was to compare the diffusion tensor parameters of prostate cancer, prostatitis and normal prostate tissue. Materials and Methods: A total of 25 patients with the suspicion of prostate cancer were included in the study. MRI was performed with 3 T system (Intera Achieva, Philips Medical Systems, The Netherlands). T2 TSE and DTI with ss-EPI were obtained in each subject. TRUS-guided prostate biopsy was performed after the MRI examination. Images were analyzed by two radiologists using a special software system. ROI's were drawn according to biopsy zones which are apex, midgland, base and central zone on e . . .ach sides of the gland. FA and ADC values in areas of cancer, chronic prostatitis and normal prostate tissue were compared using Student's t-test. Results: Histopathological analysis revealed carcinoma in 68, chronic prostatitis in 67 and was reported as normal in 65 zones. The mean FA of cancerous tissue was significantly higher (p < 0.01) than the FA of chronic prostatitis and normal gland. The mean ADC of cancerous tissue was found to be significantly lower (p < 0.01), compared with non-cancerous tissue. Conclusion: Decreased ADC and increased FA are compatible with the hypercellular nature of prostate tumors. These differences may increase the accuracy of MRI in the detection of carcinoma and to differentiate between cancer and prostatitis. © 2010 Elsevier Ireland Ltd Daha fazlası Daha az

Yencilek, F. | Sarica, K. | Erturhan, S. | Yagci, F. | Erbagci, A.

Article | 2010 | Urologia Internationalis84 ( 3 ) , pp.260 - 264

Objectives: To evaluate the efficacy of semirigid ureteroscopy in the management of ureteral stones located in different parts of the ureter. Methods: 1,503 patients were treated with semirigid ureteroscopy. All ureteral stones were either removed only by a basket catheter or disintegrated by pneumatic lithotripsy. Success rates, auxiliary procedures, complication rates and operation time were comparatively evaluated according to stone location. Results: Overall, mean stone size and age were 12.1 ± 3.7 mm and 43.2 ± 9.72 years, respectively. While 1,416 patients (94.2%) were completely stone-free, the procedure was unsuccessful in 8 . . .7 cases (5.8%). The success rate was relatively low in the proximal ureter (71.7%) when compared with the mid (94.8%) and distal ureter (98.9%) (p = 0.021). Mean operation time was 25.4 ± 11.7 min. Longer duration of operation and higher complication rate were found in proximal ureteral calculi. Stone migration to the kidney and hematuria were the main reasons of failure in the proximal ureter and ureteral stenting was needed for 56.4% of patients with upper ureteral stone. Conclusions: Semirigid ureteroscopy can be the treatment of choice in lower and midureteral stones. However, it is an invasive and less successful treatment modality for proximal ureteral stones with relatively high complication rates. © 2010 S. Karger AG, Basel Daha fazlası Daha az