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Öğe Ateşli silah ile penis ve skrotum yaralanması ve başarılı tamiri(Dicle Üniversitesi Tıp Fakültesi, 2009) Gedik, Abdullah; Tutuş, Ali; Kayan, Devrim; Bircan, Mehmet KamuranKırk yedi yaşında erkek hasta silah ile yaralanmadan 3 saat sonra acil servisimize başvurdu. Hastada geniş skrotal defekt vardı. Her iki testis ve korpus kavernozum yaralanmıştı. Üretra ve korpus spongiosum tamamen kopmuştu. Opere edilerek penisteki yaralanması onarılan hastanın postoperatif 6. haftada yapılan kontrolünde hasta sonuçtan memnun olduğunu ve ereksiyonların devam ettiğini belirtti. Tek yakınması glans penisteki hafif his kaybı idi. Genital yaralanmaların tedavisinde testis ve penisin korunması için tüm olasılıklar değerlendirilmelidir.Öğe Blunt and penetrating bladder injuries(Aves, 2010) Gedik, Abdullah; Gedik, Ercan; Tutus, Ali; Kayan, Devrim; Bircan, KamuranObjectives: We aimed to review our diagnostic and treatment protocols for patients with injured bladders by blunt and penetrating traumas. Materials and methods: Fifty-two patients with injured bladders hospitalized in the Urology and General Surgery clinics between January 1996 and January 2009 were retrospectively evaluated. Results: Of the patients 43 (81%) were males and 9 (19%) were females, and their ages were between 17 and 70 (mean 31.9 +/- 12.11). Twenty eight (54%) of the patients were injured by penetrating and 24 (46%) by blunt traumas. The mean transportation time to hospital was 155 +/- 34.12 (range 30-1440) min. Retrograde cystographies could only be done in 28 patients. In the remaining hemodynamically unstable 24 patients, bladder injuries were diagnosed during laparatomy. Totally 41 (79%) patients including all 28 penetrating injuries and 13 of 24 blunt injuries had intraperitoneal bladder rupture. The rupture was retroperitoneal in the remaining 11 (21%) patients injured by blunt traumas. Intraabdominal adjacent organ injuries were more frequent in intraperitoneally ruptured cases. In extraperitoneally ruptured patients bone fractures were the main adjacent pathologies. Intraperitoneal rupture of all 41 patients was sutured primarily and we replaced a cystostomy tube in 14 of these patients. In 7 of 11 cystographically diagnosed retroperitoneal ruptures we only replaced a urethral Foley catheter for treatment. In the remainining 4 patients the bladder was sutured primarily because wide rupture and diffuse extravasation. One patient was lost because of acute respiratory distress syndrome developed following surgery. Wound infections, pneumonia, intraabdominal abcess, enterocutaneous fistula, and evisceration were seen as postoperative complications in 4, 2, 1, 1, and 1 patients, respectively. Conclusions: When diagnosed early the success rate of treatment in bladder injuries was quiet high. The adjacent organ injuries were the main pathologies increasing the postoperative morbidity and mortality.Öğe Blunt and penetrating renal injuries: 18-year experience(Aves, 2009) Gedik, Abdullah; Gedik, Ercan; Deliktas, Hasan; Sahin, Hayrettin; Bircan, KamuranObjective: We evaluated patients who were treated for renal injuries. Materials and methods: A total of 203 patients (168 males, 35 females; mean age 31 +/- 9 years) who underwent treatment for renal injuries between January 1990 and August 2008 were evaluated with respect to etiology, diagnostic methods, the severity of injury, accompanying organ injuries, treatment, and complications. Renal injuries were graded according to the severity scale of the American Association for the Surgery of Trauma. Results: Penetrating injuries accounted for 60.1% (n= 122), and blunt trauma accounted for 39.4% (n= 80), while one patient had both. The majority of penetrating injuries were gunshot wounds (69.7%). Six patients (3%) had bilateral renal injury. Time to presentation ranged from 20 minutes to 10 days (mean 113 min). Emergency laparotomy was performed in 117 patients ((57.6%). Radiological investigation was made in 86 patients (42.4%), of whom 22 patients underwent laparotomy due to hemodynamic deterioration, and 64 patients (31.5%) were treated conservatively for grade I to III injuries (46, 15, and 3 patients, respectively). Isolated renal injury was seen in 74 patients (55 blunt, 19 penetrating), while 129 patients (63.6%) had accompanying intra-abdominal and 72 patients had extra-abdominal injuries. A total of 140 renal procedures were performed in 139 patients, including nephrorrhaphy (n= 54), partial nephrectomy (n= 5), nephrectomy (n= 74), and renal artery repair (n= 1). No renal pathology was detected in four patients (2.9%) and only a double J stent was placed in two patients. Perioperative mortality occurred in five patients (2.5%). The overall mortality rate was 16.8% (n= 34). The mean transfusion requirements were 3.4 +/- 0.8 units and 2.3 +/- 0.6 units, and the mean hospitalization times were 9.2 +/- 3.5 days and 13 +/- 2 days in patients treated surgically and conservatively, respectively. Conclusion: Nonoperative management of renal trauma in hemodynamically stable patients preserves renal function and reduces nephrectomy rates.Öğe Böbrek leiomyomu: Olgu sunumu(2009) Uzunlar, Ali Kemal; Akgün, Işık İkbal; Gedik, Abdullah; Özekinci, SelverBöbrek leiomyomu, nadir görülen böbrekdeki düz kas hücrelerinden köken alan benign mezenkimal tümördür. Sıklıkla böbrek kapsülü ve pelvise yakın alanlarda yerleşir. Klinik semptomlar nonspesifiktir. Bu çalışmada, sol total nefrektomi yapılan bir hastadaki böbrek leiomyom olgusu rapor edilmektedir.Öğe Body mass index, body fat percentage, and the effect of body fat mass on SWL success(Springer, 2007) Akay, Ali Ferruh; Gedik, Abdullah; Tutus, Ali; Sahin, Hayrettin; Bircan, Mehmet KamuranObjectives In the present study, we investigated the effects of the Body Mass Index (BMI), the Body Fat Percentage (BFP), and the Body Fat Mass (BFM) on success of SWL, prospectively. Patients and methods The BMI, BFP, BFM values of patients, who were treated by SWL due to upper urinary system stone disease (pelvis renalis, upper ureter, kidney lower and upper calices) between January and December 2005 in our hospital's urolithiasis center, were measured. Patients with stones smaller than 5 mm or larger than 20 mm and patients who had a stone localized somewhere other than in the upper urinary system, were not included in the study. Patients evaluated to be clinically successful according to the SWL were put in group 1, and the other patients who were not successful were included in group 2. Results About 158 (97 male, 61 female) patients aged between 16 and 92 (mean 36.69 (+/- 13.22) years), put on SWL therapy due to presence of upper urinary system stone disease, were included in the study. While the mean BMI was 23.97 +/- 0.4 in group 1 and 25.98 +/- 0.5 (P = 0.02) in group 2, BFP was 23.85 +/- 0.8 in group 1 and 29.19 +/- 1.1 (P = 0.001) in group 2, and BFM was determined to be 16.74 +/- 0.7 and 21.19 +/- 1.01 (P = 0.001) in group 2. Regarding all the parameters (BMI, BFP, BFM), the statistical analyses carried out between the groups showed significant differences. Conclusion BFP and BFM parameters are also important factors along with the BMI in providing a successful SWL treatment. All the parameters should be considered regarding the success of the treatment and the patients should be informed.Öğe Cerrahi öncesi cilt temizliğinde iki ayrı yöntemin karşılaştırılması(1998) Şahin, Hayrettin; Boylu, Şükrü; Bircan, M. Kamuran; Akay, A. Ferruh; Gedik, AbdullahBu çalışmada, cerrahi girişim öncesinde cilt temizliği için kullanılan, povidon-iyötun iki ayrı uygulama şekli karşılaştırılmıştır. Ürolojik nedenle ameliyat edilen 43 hastanın 22'sine püskürtme, 21 'ine klasik yöntemle cilt temizliği uygulandı. Hastalar postoperatif, ateş, yara infeksiyonu ve yara açılması yönünden karşılaştırıldı. İki yöntem arasında post-operatif komplikasyonlar açısından anlamlı fark saptanmadı.Öğe Changes in Collagen Type 3, Elastin, Fibrosis and Cajal Cell in Congenital Ureteropelvic Junction Obstruction(Galenos Yayincilik, 2014) Deliktas, Hasan; Issi, Oktay; Gedik, Abdullah; Sahin, HayrettinObjective To compare changes in collagen type 3, elastin, fibrosis and cajal cells through histopathological examination of the ureteropelvic junction (UPJ) segments of pediatric and adult patients who had undergone AndersonHynes pyeloplasty for ureteropelvic junction obstruction (UPJO). Materials and Methods Histopathological evaluation was made of the UPJ segments of 52 patients who underwent Anderson-Hynes pyeloplasty for UPJO between January 2005 and January 2008. Patients were separated into 2 groups as pediatric, aged <= 15 years (group 1, n=10) and adult, aged > 15 years (group 2, n=42). UPJ segments of both groups were compared histopathologically (collagen type 3, elastin, fibrosis and cajal cells). Radiographic evaluations were made with diuretic renogram and/or intravenous pyelography. Results Mean age of group 1 patients was 8.12 +/- 2.6 years (1-12 years) and of group 2 patients, 38.16 +/- 5.91 years (16-62 years). Mean follow-up period was 18 months (9-24 months). No statistically significant difference was determined between the groups in respect of collagen type 3, elastin, fibrosis or cajal cells (p>0.05). Conclusion As the pathology in the UPJ obstruction is a congenital defect, the histopathology does not change with age.Öğe Dev üreter taşı: olgu sunumu(Dicle Üniversitesi Tıp Fakültesi, 2009) Kılınç, İlhan; Gedik, Abdullah; Akın, DavutÜriner sistemde taşlar renal, üreterik, mesane ve üretra gibi değişik lokalizasyonlarda görülebilir. Üreter taşları genellikle tek ve 2 cm den küçük taşlardır. Nadir olarak dev üreter taşlarına rastlanılmaktadır. Biz de sol üreterde 10 cm uzunluğunda dev üreter taşı olan olguyu görüntüleme bulguları ile sunduk. Sol yan ağrısı nedeni ile hastanemize başvuran 28 yaşındaki erkek hastanın, çekilen direkt üriner sistem grafisi ve intravenöz ürografi ile sol üreterde yaklaşık 10 cm uzunluğunda taş olduğu görüldü. Hastaya açık üreterolitotomi gerçekleştirilip taş çıkarıldı. Cerrahi ile alınan taşın uzun çapı 10 cm ölçüldü. Dev üreter taşı tespit edilen olgularda taşın lokalizasyonu, böbrek fonksiyonlarını, obstrüksiyonun derecesini, olayın akut mu yoksa kronik mi olduğunu ve altta yatan başka bir patolojinin olup olmadığını belirlemek için görüntüleme yöntemleri önem taşımaktadır.Öğe The diagnosis and treatment of penile fracture: our 19-year experience(Turkish Assoc Trauma Emergency Surgery, 2011) Gedik, Abdullah; Kayan, Devrim; Yamis, Sait; Yilmaz, Yakup; Bircan, KamuranBACKGROUND The aim of this study was to retrospectively evaluate our approach to the diagnosis and treatment of penile fracture. METHODS We retrospectively evaluated the results of 107 patients with penile fracture treated in our clinic between January 1990 and January 2009. Patient age, etiology of each fracture, history, physical examination results, radiologic findings, type of treatment, and postoperative complications were recorded. In 5 cases cavernosography was performed and in 8 cases retrograde urethrography. RESULTS The most common etiologies of penile fracture were coitus and manually bending the penis for detumescence. Diagnoses were made based on history and physical examination in 102 patients and cavernosography in 5 patients. In order to evaluate urethral injury in 8 cases, retrograde urethrography was performed. Rupture was repaired surgically in 101 patients, but 6 patients were treated conservatively. Among the 6 conservatively treated patients, 3 developed penile curvature 6 months post-treatment; no complications occurred in the surgically treated patients. CONCLUSION Cavernosography should be performed only when history and physical examination are insufficient for diagnosis, and retrograde urethrography should be performed when urethral injury is suspected. In order to prevent the development of penile curvature and to ensure rapid recovery, early surgical repair is advised.Öğe Does the Histopathologic Pattern of the Ureteropelvic Junction Affect the Outcome of Pyeloplasty?(Urol & Nephrol Res Ctr-Unrc, 2015) Issi, Oktay; Deliktas, Hasan; Gedik, Abdullah; Ozekinci, Selver; Bircan, Mehmet Kamuran; Sahin, HayrettinPurpose: To investigate the effects of the histopathologic pattern of obstructed ureteropelvic junction (UPJ) specimens, including collagen type 3, elastin, fibrosis and Cajal cells, on the outcome of pyeloplasty. Materials and Methods: Histopathological specimens obtained following Anderson-Hynes pycloplasty from 52 patients with intrinsic ureteropelvic junction obstruction (UPJO) between January 2005 and January 2008 were evaluated histopathologically. Patients with extrinsic or secondary UPJO were excluded. Preoperative and postoperative radiographic evaluations were performed either via diuretic renography or intravenous pyelography, or both. Six months post-surgery the patients were divided into 2 groups, as successful surgery (group 1) and unsuccessful surgery (group 2). Histopathological findings (collagen type 3, elastin, fibrosis and Cajal cells) in each group were statistically compared. Results: The study included 52 patients (21 female and 31 male). Mean age of the entire study population was 39.42 +/- 14.5 years, versus 39.63 +/- 14.9 years in group 1 (n = 47) and 37.4 +/- 10.0 years in group 2 (n = 5). Median follow-up was 18 months. There weren't any significant differences in collagen type 3, elastin, fibrosis, or Cajal cells between the 2 groups (P > .05). Conclusion: The histopathologic pattern of UPJ was not a factor associated with the success of pyeloplasty. Based on the present findings, we conclude that surgical technique is more important than the histopathologic pattern of UPJ for the successful treatment of UPJO.Öğe The effect of l-carnitine on testicular ischemia- reperfusion ınjury due to testicular torsion in rats(2012) Deliktaş, Hasan; Gedik, Abdullah; Bircan, Mehmet Kamuran; Nergiz, YusufYapılan bu deneysel çalışmada testis torsiyonu sonucu gelişen iskemi ve detorsiyon sonrasında gelişecek olan reperfüzyonun tes- tiste neden olacağı hasarı önlemede L-Karnitinin etkinliği araştırılmıştır. Bu çalışmanın amacı, ratlarda oluşturulan tek taraflı torsiyon ve detorsiyonu takiben, torsiyone testiste ve karşı testiste gelişebilecek olan reperfüzyon hasarı üzerine L-Karnitinin etkilerini araştırmaktır. Toplam 20 yetişkin erkek rat kontrol grubu, (Grup 1) iskemi / reperfüzyon grubu (Grup 2) ve iskemi / re- perfüzyon + L-Karnitin grubu ( Grup 3) olmak üzere 3 gruba ayrıldı. Dört saatlik torsiyon periyodundan sonra yapılan detorsiyondan hemen sonra ikinci gruba 1 ml serum fizyolojik, 3. gruba ise 500 mg/kg L-Karnitin intraperitoneal olarak verildi. Ve bu dozlar 8 saat sonra tekrarlandı. Histolojik olarak L-Karnitinin torsiyone testiste ve karşı testiste gelişen iskemi / reperfüzyon hasarını düzelttiği görülmüştür.Öğe The Effect of L-Carnitine on Testicular Ischemia-Reperfusion Injury due to Testicular Torsion in Rats(Modestum Ltd, 2012) Deliktas, Hasan; Gedik, Abdullah; Nergiz, Yusuf; Bircan, Mehmet KamuranThis experimental was study designed to examine the efficacy of L-carnitine in preventing reperfusion injury following testicular torsion. We aimed to evaluate the effects of L-carnitine, administered during the reperfusion period, on the torsed and contralateral non- torsed testes in cases of unilateral testicular torsion in rats. This experimental study was performed in the research laboratory Dicle University, School of Medicine, between March 1, 2007 and May 31 2007. The study included 20 adult male rats those 6 months old that were divided into 3 groups: a sham group (group 1), ischemia/reperfusion group (group 2), and ischemia/reperfusion + L-carnitine group (group 3). In group 2 one ml of serum physiologic was injected intraperitoneally versus 500 mg/kg of L-carnitine in group 3 immediately after detorsion following a 4-h torsion period; the doses were repeated after 8 h later. Histologically, Sections of the left testes in group 2 showed irregularities in germinal epithelial cell configuration and degeneration in several cells, and all the samples of the right testes in group 2 had arrested sperm maturation and primary spermatocytes had a dusky appearance in some tubules, while all remaining groups were normal. L-carnitine had a positive effect on ipsilateral and contralateral testes. The positive effect of L-carnitine in reducing reperfusion damage in ipsilateral and also in contralateral testis was histopathologically observed. We think L-carnitine should always be apllied immediately after repurfusion period and should be repeated after 8 hours in testicular torsion cases.Öğe THE EFFECT OF THE SELECTIVE CYCLOOXYGENASE II INHIBITOR PARECOXIB ON RENAL MORPHOLOGY AND FUNCTION IN ACUTE UNILATERAL URETERAL OBSTRUCTION(Carbone Editore, 2014) Tutus, Ali; Deliktas, Hasan; Gedik, Abdullah; Gezici, Ayten; Ozekinci, Selver; Sahin, HayrettinObjectives: This experimental study aimed to examine the efficacy of parecoxib in the treatment of kidney obstruction. The histopathological and seintigraphic effects of the selective cyclooxygenase 11 (cox-in inhibitor parecoxib on renal morphology and function were determined following surgically induced unilateral ureteral obstruction. Materials and methods: The study included 20 male Spragne-Dawley rats that were assigned to 2 groups of 10 each The rats underwent diethylenetriamine pentaacetic acid (DTPA) renal scintigraphy to calculate basal glomerular filtration rate (GFR) values at the beginning of the study. The left ureters in groups 1 and 2 were ligated distally. The rats in group 2 received parecoxib 5 mg-kg(-1)d(-1), for 21 d post surgery, whereas those in group.] received nothing. At the end of postoperative d 21 DTPA renal scintigraphy was repeated in all the rats before undergoing bilateral nephrectomy. All kidneys were evaluated histologically. Results: Histologically, there were no differences between the right kidneys in groups 1 and 2, whereas the occurrence of cortical congestion, glomerular congestion, interstitial inflamation + congestion, and interstitial fibrosis was significantly lower in the left kidneys in group 2 than in those in group I (cortical congestion: P = 0.005; glomerular congestion: P = 0.03; interstitial infomation + congestion: P = 0.01; interstitial fibrosis:,P = 0.005). Scintigraphically; left kidney and right kidney CFR values in group 2 were higher than those in group I; the difference was significant (left kidneys: P = 0.001; right kidneys: P = 0.009). Conclusion: Histopathologically and scintigraphically, kidney function was preserved at the highest level in group 2. Parecoxib treatment was effective in preserving renal function in the obstructed and non obstructed (contralateral) kidneys, and can be administered during the obstruction period until the time radical treatment of obstruction can be performed.Öğe Efficacy of peripheral lidocaine application (neural therapy) in the treatment of neurogenic detrusor overactivity in multiple sclerosis patients(Wiley, 2017) Tamam, Yusuf; Özdemir, Hasan Hüseyin; Gedik, Abdullah; Tamam, Cüneyt; Nazlıkul, HüseyinAimsMany agents and treatments are used in the treatment of neurogenic detrusor overactivity (NDO) in MS patients, but no study has been conducted on the use of peripheric lidocaine (neural therapyNT) on MS patients. We evaluated the effects of local administration of lidocaine on NDO in Multiple Sclerosis (MS) patients. MethodsFor each patient local anesthetic lidocaine was injected at each session. Sessions were held once a week for 5 weeks. At each session, Th 10-L1, urogenital segment intradermal injections, Frankenhauser, and sacral epidural injections were given. The patients had clinical and urodynamic assessment 1 month before and 3, 9, and 12 months after NT. In addition, multiple sclerosis quality of life inventory (MSQL-54) and bladder control scale (BLCS) was performed for patients. ResultsTwenty-eight patients were included in the study (8 males, 20 females). The patients' average age was 31.78.1 years. The injection therapy significantly improved volume at first involuntary bladder contraction (FCV), maximal detrusor pression during filling (P det. max.), maximal cystometric bladder capacity (MCC) after 3 months. Also, the MSQL-54 and BLCS scores were improved with treatment. However, these improvements reached a maximum 3 months after treatment, but from the 9 month a regression was seen in the parameters, and after 12 months the findings were seen to be slightly above their basal levels. ConclusionsThese results suggest that NDO treatment in MS patients could be an effective treatment which is easy and has very few side effects, and is cost effective.Öğe Elektif ürolojik cerrahide preoperatif kan donasyonu(1997) Şahin, Hayrettin; Gedik, Abdullah; Akay, A. Faruk; Bircan, M. Kamuran; Göçmen, MustafaBu prospektif çalışmada, elektif ürolojik cerrahide preoperatif kan donasyonun etkinliği ve güvenilirliği araştırılmıştır. Çalışma grubunu benign prostat hiperplazisi nedeniyle operasyon planlanan hastalar oluşturmuş¬tur. Aktif bakteriyemisi olmayan hemoglobin konsantrasyonu 11 g/dl'nin üzerinde olan tüm hastalar çalışmaya dahil edilmiştir. Otuz üç hastanın preoperatif donasyon için uygun bulunmasına karşın, bunlardan ancak 23'ü işlemi kabul etmiştir. Yirmi üç hastadan toplam 44 ünite kan alınmıştır. Bu kanların 15 ünitesi ototransfüzyon, 29 ünitesi isi homolog transfüzyon için kullanılmıştır. Elektif ürolojik cerrahi uygulanacak hastalara ototransfüzyon için preoperatif kan donasyonunun etkin ve güvenli bir yöntem olduğu gösterilmiştir. Bu yöntemin tüm cerrahlar tarafından daha yaygın kullanılması gerektiği düşünülmüştür.Öğe EXPRESSION OF E-CADHERIN, COX-2, P53 AND BCL-2 IN PROSTATE CARCINOMAS: CORRELATION WITH TUMOR DIFFERENTIATION AND METASTATIC POTENTIAL(Taylor & Francis Ltd, 2010) Ozekinci, S.; Uzunlar, A. K.; Senturk, S.; Gedik, Abdullah; Buyukbayram, H.; Mizrak, B.Prognostic factors of prostate cancer such as PSA stage Gleason grade and surgical margins have limitations they are inable to indicate metastatic potential The aim of this study was to investigate expression of e-cadherin cox-2 p53 and bcl-2 in prostate carcinomas and to search association with tumor differentiation and metastatic potential Eighty-seven prostate cancer specimens were retreived from tissue blocks embedded in parafin and expression patterns of e-cadherin cox-2 p53 and bcl-2 were investigated by immunoperoxidase method Gleason scoring system was used for tumor grading and expression patterns of these antibodies were compared among different tumor grades Seven cases (8%) had well-differentiated 39(45%) had moderately differentiated and 41 (47%) had poorly differentiated tumors Metastases were present in 31 patients (35%) There was a statistically significant association between tumor differentiation and expression of e-cadherin or bcl-2 (p < 0 01) however no association was found between tumor differentiation and expression of cox-2 or p53 (p > 0 01) There was no association between expressions of e-cadherin cox-2 p53 or bcl-2 and metastasis E-cadherin expression is less frequent in poorly differentiated tumors whereas bcl-2 expression is more frequent However there is no relation with metastatic potential and expression of these markers Expression of cox-2 and p53 is neither related to the degree of differentiation nor to the metastatic potentialÖğe FSHR Single Nucleotide Polymorphism Frequencies in Proven Fathers and Infertile Men in Southeast Turkey(Hindawi Publishing Corporation, 2010) Balkan, Mahmut; Gedik, Abdullah; Akkoc, Hasan; Ay, Ozlem Izci; Erdal, M. Emin; Isi, Hilmi; Budak, TurgayThe influence of FSH receptor (FSHR) variants on male infertility is not completely understood. The present investigation is the first screening study for SNP at nucleotide position -29 in the core promoter region and codon 680 in exon 10 of the FSHR and the effect of the serum levels of FSH on male infertility in Southeast Turkey. The SNPs in codon 680 and at position -29 of the FSHR gene were analyzed by PCR-RFLP technique in 240 men with proven fathers, and 270 infertile men (150 nonobstructive azoospermic and 120 severe oligozoospermic). The separate analysis for SNP at nucleotide position -29 did not show any difference in genotypic frequencies and serum FSH levels. The genotype distribution of SNP at position 680 was different but does not influence serum FSH levels. Together the two SNPs form four discrete haplotypes (A-Thr-Asn, G-Thr-Asn, A-Ala-Ser, and G-Ala-Ser) occurring in 10 combinations. A statistically significant difference in the allelic distribution of G-Asn/G-Ser and G-Ser/G-Ser genotype between proven fathers and infertile men but there were not any statistically significant difference in the overall frequency of the four FSHR haplotypes. We conclude that the FSHR haplotype does not associate with different serum FSH levels but it is differently distributed in proven fathers and infertile men.Öğe Glomerüler filtrasyon hızı hesaplanmasında kullanılan üç ayrı yöntemin karşılaştırılması(1997) Şahin, Hayrettin; Kaplan, Abdurrahman; Muhtar, A. Cengiz; Bircan, Kamuran; Gedik, AbdullahBu çalışmada, glomerüler filtrasyon hızının (GFR) hesaplanmasında kullanılan üç değişik yöntem yatmakta olan 16 hastada karşılaştırıldı. Üç yöntem arasında anlamlı fark saptanmadı (p>0.05). İki böbreğin karşılaştırmalı GFR değerinin bilinmesi gerekmiyorsa ya da böbrekler üzerine toksik ilaçları başlamadan önce Crockcroft ve Gault'un tanımladığı yöntemle GFR ölçülebilir. İki böbrek için ayrı ayrı GFR bilinmesi gerekiyorsa renal sintigrafi ya da ayrı toplanan idrarlarda hesaplanan kreatinin klirensi kullanılabilir.Öğe Histopathologic and Urodynamic Effects of the Anticholinergic Drugs Oxybutynin, Tolterodine, and Trospium on the Bladder(Wiley, 2017) Orgen, Seyfettin; Deliktas, Hasan; Sahin, Hayrettin; Gedik, Abdullah; Nergis, YusufObjectives: This study aimed to evaluate the effects of intravesical instillation of the anticholinergic drugs oxybutynin, tolterodine, and trospium on bladder capacity and histopathological changes in the bladder mucosa. Methods: The study included 20 male New Zealand white rabbits that were randomly allocated to four groups of five. In the oxybutynin, tolterodine, and trospium groups, the drugs used were 1 mg/kg of crushed tablet mixed with 5 mL of saline, instilled intravesically once per day for 4 weeks. The control group was administered only 5 mL of saline once per day for 4 weeks. Urodynamic measurement of the bladder was made before and after treatment. At the end of the treatment the animals were killed and the bladders were evaluated histopathologically. Results: There were no significant differences between pre- and post-treatment bladder capacity in any of the groups (P>0.05). Histopathological evaluation showed that the mucosal epithelium was intact and there was minor inflammation in the control group and oxybutynin group (P>0.05), whereas there was destruction of the mucosal epithelium and findings of diffuse inflammation in the tolterodine (P=0.014) and trospium (P=0.014) groups. Conclusion: Intravesical oxybutynin treatment was observed to be safe; however, a single daily dose of oxybutynin may not be sufficient to increase bladder capacity. Intravesical use of trospium and tolterodine at high doses caused epithelial destruction and diffuse inflammation in the bladder mucosa. The irritation associated with epithelial destruction and inflammation prevented an increase in bladder capacity.Öğe Is percutaneous cystostomy always necessary in transvaginal repair of benign vesicovaginal fistulae?(E-Century Publishing Corp, 2016) Gedik, Abdullah; Deliktas, Hasan; Celik, Nurettin; Kayan, Devrim; Bircan, Mehmet KamuranPurpose: To retrospectively evaluate benign, primary vesicovaginal fistulas (VVF), to determine the outcomes of using only a urethral catheter without cystostomy as a urinary diversion. Methods: Twenty-five women with VVF were treated between April 2008 and October 2014 and evaluated retrospectively. Only primary, benign fistulas were included in this study. Patients with a malignant etiology and/or prior irradiation were excluded, as they required a more complex repair. All included VVFs were treated without replacing a percutaneous cystostomy. All patients were called back on postoperative day 10 for urethral catheter removal. Cystography was not performed before catheter removal. Patients were followed in our clinic postoperatively for one year. Results: Twenty-five patients with VVF were treated using a transvaginal technique without percutaneous cystostomy. All patients, except for two, were discharged the day after surgery. There were no major complications, Clavien Class 2 or greater and no recurrent fistulas were detected. Conclusion: We used only a urethral catheter for 10 days postoperatively in transvaginal VVF repairs. The results show that transvaginal repair of benign VVFs only with urethral catheter is successful and cost effective. Cystography was not necessary before catheter removal.
