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Öğe Comparison of Laparoscopic and Microscopic Subinguinal Varicocelectomy in terms of Postoperative Scrotal Pain(Soc Laparoendoscopic Surgeons, 2012) Soylemez, Haluk; Penbegül, Necmettin; Atar, Murat; Bozkurt, Yasar; Sancaktutar, Ahmet Ali; Altunoluk, BulentBackground and Objectives: In this study, 2 different varicocelectomy methods were compared with regard to postoperative scrotal pain, length of operation, and complications. Methods: Forty varicocele patients, who visited our clinic because of infertility or scrotal pain between 2008 and 2009, were enrolled in this clinical study. Microscopic subinguinal varicocelectomy was performed on 20 patients in Group I, and laparoscopic varicocelectomy was performed on 20 patients in Group II. Following surgery, the patients were assessed for postoperative requirements for analgesia; return to normal activity; varicocele recurrence; hydrocele formation; scrotal pain at postoperative days 1, 3, and 7; and other complications. Results: Mean age was 24.2 +/- 3.4 years in Group I and 25.1 +/- 12.1 years in Group II. Mean pain scores at postoperative 1, 3, and 7 days in Group I were (5.20 +/- 11.14, 4.60 +/- 10.97, and 3.50 +/- 0.97, respectively) significantly higher than those of Group 11 (0.70 +/- 0.82, 0.60 +/- 10.84, and 0.10 +/- 10.32, respectively). Time to return to normal activity was significantly shorter in Group 11 (3.7 +/- 2.1 days) compared with Group I (6.8 +/- 13.4 days) (p = 0.028). However, the number of recurrences and hydroceles, as a complication of varicocelectomy, was 2 times higher in Group II (10%) than in Group I (5%). Conclusions: We believe that laparoscopic varicocelectomy is a safe, effective, and minimally invasive procedure. Furthermore, reduced postoperative discomfort and earlier return to normal activity are additional advantages of this method.Öğe Current laparoscopic practice patterns among urologists in Turkey(Aves, 2012) Altunoluk, Bulent; Soylemez, Haluk; Ozer, Ali; Efe, Erkan; Sancaktutar, Ahmet Ali; Resim, SefaObjective: Laparoscopic surgery has become increasingly popular in urology over the last decade. This survey was performed to evaluate the current practice patterns in laparoscopy among urologists in Turkey. Material and methods: A detailed questionnaire about urologic laparoscopic practice patterns was distributed to 1242 urologists who were working in Turkey. The questions pertained to age, practice demographics, and the amount and variety of laparoscopy performed. Results: Nearly half of the respondents (48.3%) already performed laparoscopy. Of the urologists in academic settings, including university hospitals and education and research hospitals, 69.6% and 59.4% performed laparoscopy, respectively. In state hospitals, the percentage of those who performed laparoscopy was lower (26.9%). The most important reasons mentioned for performing laparoscopy were shorter hospital stay, patient requests and greater flexibility of possible surgical techniques. The main laparoscopic procedures performed were nephrectomy (benign indication), 91%; renal cyst decortications, 90%; nephrectomy (malign indication), 65%; laparoscopic stone surgery, 47% and pyeloplasty, 38%. A large percentage (77.2%) of respondents intended to attend continuing education and to perform laparoscopy in the future. Conclusions: Our results show that laparoscopic practice steadily increases in frequency and that urologists are willing to substitute open surgery for laparoscopic surgery. The performance of laparoscopic surgery has become a goal for most urologists in Turkey to achieve in the near future.Öğe Deterioration of renal function in patients operated for lower urinary tract symptoms(Aves, 2011) Altunoluk, Bulent; Soylu, Ahmet; Beytur, Ali; Soylemez, Haluk; Baydinc, CanObjective: We aimed to investigate the rate of deterioration of the renal function in patients operated for lower urinary tract symptoms, the relation between this rate and patient age, symptom severity, and accompanying diseases. Materials and methods: The data of 369 patients who admitted to our clinic with lower urinary tract symptoms and operated between 01/06/2001 and 31/03/2005 were retrospectively evaluated, and the examination findings and laboratory results have recorded. Results: The preoperative serum creatinin level was <= 1.4 mg/dL in 315 (85.4%) patients and >1.4 mg/dL in 54 (14.6%) patients. The mean age of the patients with serum creatinin level <= 1.4 mg/dL was 68.64 +/- 8.24 years, and that of patients with serum creatinin level >1.4 mg/dL was 72.56 +/- 7.96 years (p<0.05). The level of serum creatinin increased with increasing age, and the renal function was worsened with the increase of symptom score. Also, in the presence of the chronic diseases such as hypertension and diabetes, the rate of renal dysfunction increased by 2.5 times (25.5% vs. 10.9%). There was no correlation between postvoiding residue urine and renal dysfunction. Additionally, the renal dilatation accompanied the increase in the serum creatinin level. Conclusion: In the patients with with lower urinary tract symptoms, the serum creatinin level must be evaluated at the first admission for early diagnosis and treatment of renal dysfunction.Öğe Effects of acute exercise on the diameter of the spermatic vein, and duration of reflux in patients with varicocele(Informa Healthcare, 2013) Atar, Murat; Soylemez, Haluk; Oguz, Fatih; Beytur, Alt; Altunoluk, Bulent; Kahraman, Bayram; Islamoglu, YahyaObjective. The aim of this study was to investigate the effects of acute exercise on the diameter of the spermatic vein, and on the duration of reflux in patients with varicocele. Material and methods. The study included 38 patients with complaints of infertility and scrotal pain between 2009 and 2010. The diagnoses were made by physical examination and colour Doppler ultrasound, with both performed before and after exercise tests. Results. The mean age of the participants was 25.7 +/- 4.9 years. During the first examination, the grades of the varicoceles detected were as follows: grade I, n = 7; II, n = 10; and III, n = 21. The diameters of veins in patients with grades I, II and III varicocele were 2.1 mm, 2.9 mm and 4.2 mm, respectively, before exercise, whereas they were 2.6 mm, 3.2 mm and 4.3 nun, respectively, after exercise. In patients with grade I varicoceles, compared with pre-exercise values, the diameter of the left spermatic vein and duration of reflux measured during Valsalva manoeuvres were increased significantly after exercise (p = 0.042 and p = 0.034, respectively); similar results were obtained for the patients with grade II varicoceles (p = 0.007 and p = 0.008, respectively). However, the minimal relative increase in cases with grade III varicoceles was not statistically significant (p > 0.05). Conclusions. This study demonstrates that acute exercise increases the spermatic vein diameter and reflux time in patients with varicoceles. These outcomes demonstrate that acute exercise may be an aggravating factor for varicocele, as seen in chronic exercise.Öğe KNOWLEDGE AND ATTITUDE OF EUROPEAN UROLOGY RESIDENTS ABOUT IONIZING RADIATION(Mary Ann Liebert, Inc, 2012) Soylemez, Haluk; Sancaktutar, Ahmet Ali; Silay, Mesrur Selcuk; Penbegül, Necmettin; Bozkurt, Yasar; Atar, Murat; Altunoluk, Bulent[Abstract Not Available]Öğe Knowledge and Attitude of European Urology Residents About Ionizing Radiation(Elsevier Science Inc, 2013) Soylemez, Haluk; Sancaktutar, Ahmet Ali; Silay, Mesrur Selcuk; Penbegül, Necmettin; Bozkurt, Yasar; Atar, Murat; Altunoluk, BulentOBJECTIVE To evaluate the attitude and knowledge of urology residents concerning ionizing radiation, we undertook a survey of European urology residents. METHODS The questionnaire was sent to 1184 urology residents within the database of the European Society of Residents in Urology (ESRU) by e-mail between November 2011 and January 2012. The questionnaire was composed of demographic questions and questions about the frequency of radiation exposure and use of radiation safety measures during fluoroscopy-guided endourologic procedures. In addition, there were questions about education programs and respondents' knowledge about diagnostic imaging modalities. RESULTS A total of 124 questionnaires were returned from urology residents in 20 different European countries. All of the respondents reported that they were routinely exposed to ionizing radiation, and 69 (72.5%) were exposed more than 3 times per week. Despite the common but not sufficient use of lead aprons (75%), use of other radiation protection measures was very low. Although 55% of the respondents had attended an education program in Europe about radiation safety, attendance was highest in Poland (82.6%). The level of knowledge about ionizing radiation was low among urology residents, and approximately half of responders had no idea that commonly used imaging modalities have a fatal cancer risk. CONCLUSION The results of this study showed the lack of knowledge and awareness about the importance of ionizing radiation protection among urology residents in Europe. We therefore suggest radiation safety courses in every step of medical life for doctors, especially for endourologists. UROLOGY 81: 30-36, 2013. (c) 2013 Elsevier Inc.Öğe Knowledge and Attitude of European Urology Residents About Ionizing Radiation REPLY(Elsevier Science Inc, 2013) Soylemez, Haluk; Sancaktutar, Ahmet Ali; Silay, Mesrur Selcuk; Penbegül, Necmettin; Bozkurt, Yasar; Atar, Murat; Altunoluk, Bulent[Abstract Not Available]Öğe A PRACTICAL WAY TO PROTECT PEDIATRIC PATIENTS' GONADS FROM IONIZING RADIATION EXPOSURE DURING PERCUTANEOUS NEPHROLITHOTOMY(Mary Ann Liebert, Inc, 2012) Soylemez, Haluk; Sancaktutar, Ahmet Ali; Altunoluk, Bulent; Atar, Murat; Hatipoglu, Namik Kemal; Bodakci, Mehmet Nuri; Penbegül, Necmettin[Abstract Not Available]Öğe Protective Effects of Zofenopril on Testicular Torsion and Detorsion Injury in Rats(Urol & Nephrol Res Ctr-Unrc, 2011) Altunoluk, Bulent; Soylemez, Haluk; Bakan, Vedat; Ciralik, Harun; Tolun, Fatma InancPurpose: To investigate the protective effect of zofenopril on torsion/detorsion-induced biochemical and histopathological changes in experimental testicular ischemia or reperfusion injury in rats. Materials and Methods: A total of 35 prepubertal male Wistar-Albino rats were divided into five groups, including 7 rats in each group: Group I (sham, S), sham operation; group II (torsion/detorsion-early orchiectomy, T/D-E), 2 hours ischemia and 4 hours reperfusion; group III (torsion/detorsion-late orchiectomy), T/D-L), 2 hours ischemia and 5 days reperfusion; group IV (zofenopril-early orchiectomy, Z-E), 2 hours ischemia, 4 hours reperfusion, and a single dose of zofenopril; and group V (zofenopril-late orchiectomy, Z-L), 2 hours ischemia, 5 days reperfusion, and 5 doses of zofenopril. We determined the tissue levels of malondialdehyde, nitric oxide, glutathione peroxidase, and superoxide dismutase enzyme activities. Histopathologically, mean seminiferous tubule diameter measurements were used. Results: Malondialdehyde (3.490 +/- 0.89 versus 1.729 +/- 0.25 in early period; 3.837 +/- 1.694 versus 1.694 +/- 0.47 in late period) and nitric oxide levels (3.507 +/- 0.44 versus 2.853 +/- 0.54 in early period; 4.010 +/- 0.72 versus 2.446 +/- 0.29 in late period) significantly reduced and glutathione peroxidase (0.012 +/- 0.001 versus 0.017 +/- 0.001 in early period; 0.013 +/- 0.002 versus 0.018 +/- 0.001 in late period) and superoxide dismutase enzyme activities (58.030 +/- 5.97 versus 70.773 +/- 3.85 in early period; 57.421 +/- 7.81 versus 76.329 +/- 4.09 in late period) significantly increased in the testis tissue in zofenopril pretreated groups compared to group T/D both in early and late period (P < .05). The mean seminiferous tubule diameter was significantly better in pretreated group (210.33 +/- 17.32) than group T/D (185.02 +/- 22.45) only in late period (P < .05), but not in early period (209.38 +/- 30.40 versus 208.21 +/- 13.57; P > .05). Conclusion: Treatment with zofenopril decreased damage in ipsilateral testis caused by ischemia/reperfusion, and clinical application of zofenopril might be a new approach for the treatment of testicular torsion in addition to conventional detorsion.Öğe Radiation Exposure-Do Urologists Take it Seriously in Turkey?(Elsevier Science Inc, 2012) Soylemez, Haluk; Altunoluk, Bulent; Bozkurt, Yasar; Sancaktutar, Ahmet Ali; Penbegül, Necmettin; Atar, MuratPurpose: A questionnaire was administered to urologists to evaluate attitudes and behaviors about protection from radiation exposure during fluoroscopy guided endourological procedures. Materials and Methods: The questionnaire was e-mailed to 1,482 urologists, including urology residents, specialists and urologists holding all levels of academic degrees, between May and June 2011. The questionnaire administered to study participants was composed of demographic questions, and questions on radiation exposure frequency, and the use of dosimeters and flexible protective clothes. If a respondent reported not using dosimeters or protective clothes, additional questions asked for the reason. Results: Of the 1,482 questionnaires 394 (26.58%) were returned, of which 363 had completed answers. A total of 307 physicians (84.58%) were exposed to ionizing radiation, of whom 79.61% stated that they perform percutaneous nephrolithotomy at the clinic. Fluoroscopy guidance was the initial choice of 96.19% of urologists during percutaneous nephrolithotomy. Despite the common use of lead aprons (75.24%) most urologists did not use dosimeters (73.94%), eyeglasses (76.95%) or gloves (66.67%) while 46.44% always used thyroid shields during fluoroscopy. When asked why they did not use protective clothing, the most common answers were that protective clothes are not ergonomic and not practical. Conclusions: Results clearly highlight the lack of use of ionizing radiation protection devices and dosimeters during commonly performed fluoroscopy guided endourological procedures among urologists in Turkey.Öğe RADIATION EXPOSURE: DO UROLOGISTS TAKE IT SERIOUSLY IN TURKEY?(Mary Ann Liebert, Inc, 2012) Soylemez, Haluk; Altunoluk, Bulent; Bozkurt, Yasxar; Sancaktutar, Ahmet Ali; Penbegül, Necmettin; Atar, Murat; Hatipoglu, Namik Kemal[Abstract Not Available]Öğe Re: Radiation protection in pediatric radiology(Springer, 2012) Soylemez, Haluk; Sancaktutar, Ahmet Ali; Altunoluk, Bulent; Atar, Murat[Abstract Not Available]Öğe Temperament and Character Differences in Patients with Premature Ejaculation(Aves, 2013) Altunoluk, Bulent; Bagcioglu, Erman; Efe, Erkan; Bahceci, Bulent; Soylemez, HalukIntroduction: The debate on the etiology of premature ejaculation is still ongoing although there was huge amount of biological and psychological theories. We aimed to investigate the personality structure of patients with premature ejaculation via temperament and character inventory. Methods: Forty patients with premature ejaculation and a matched number of healthy people were included. Participants were asked to fill out a questionnaire booklet with separate sections for general demographic information and the temperament and character inventory. Results: Total novelty seeking scores and subscale 1 (exploration-excitability) scores in premature ejaculation patients were significantly higher than in control groups (p<0.05). Total harm avoidance scores and harm avoidance subscale 2 (fear of uncertainty) scores in premature ejaculation patients was found significantly lower than in control group (p<0.05). Beck depression score was significantly higher in patients with premature ejaculation than in control groups. Discussion: Men with premature ejaculation are more impulsive (excitant), more tempered, more excitable and less prone to harmful behavior. Current findings tend to reinforce premature ejaculation based upon combination of neurobiological and psychological reasons.Öğe TIME DEPENDENT OXIDATIVE STRESS EFFECTS OF PERCUTANEOUS NEPHROLITHOTOMY(Mary Ann Liebert, Inc, 2012) Soylemez, Haluk; Bozkurt, Yasar; Penbegül, Necmettin; Sancaktutar, Ahmet Ali; Altunoluk, Bulent; Atar, Murat; Evliyaoglu, Osman[Abstract Not Available]Öğe Time-dependent oxidative stress effects of percutaneous nephrolithotomy(Springer, 2013) Soylemez, Haluk; Bozkurt, Yasar; Penbegül, Necmettin; Sancaktutar, Ahmet Ali; Altunoluk, Bulent; Atar, Murat; Evliyaoglu, OsmanAim of this study was to investigate the effects of operation time of percutaneous nephrolithotomy (PCNL) on renal function and hemodynamic response. Thirty-four patients (14 male, 20 female) with normal renal function who underwent unilateral single-tract PCNL between December 2010 and June 2011 were included in the study. The age, sex, stone size, grade of hydronephrosis, operative time, access pole, shock number of lithotripter, complications, stone-free rate, and hemodynamic parameters during operation were recorded. Total blood count and oxidative stress parameters such as paraoxonase 1 (PON1), total antioxidant status (TAS), total oxidant status (TOS), and malonyldialdehyde (MDA) levels were examined before the operation as baseline levels and then at 30, 60, 90, and 120 min during the operation. The mean age of the patients was 31.4 +/- 18.8 (9-66 years) years. Mean stone size was 35.5 +/- 15.6 mm. Mean serum BUN and creatinine did not change postoperatively (p > 0.05), whereas mean WBC and 24-h urine cortisol were positively and hematocrite were negatively changed significantly (p < 0.05). Oxidative stress parameters such as PON1 and TAS showed statistically significant decreases, while TOS and MDA showed statistically significant increases with increased operation time, especially after 1 h (p < 0.005). A bivariate correlation test showed correlation between oxidative stress parameters and operation time (p = 0.002), but no correlation was found between oxidative stress parameters and other parameters (p > 0.05). Oxidative stress and response to it increased with increasing operative time during a PCNL procedure, especially after 1 h. Further studies with a larger and longer series should be performed to clarify this issue further.
