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Öğe Association between the androgen levels and erectile function, cognitive functions and hypogonadism symptoms in aging males(Taylor & Francis Ltd, 2011) Kocoglu, Hasan; Alan, Cabir; Soydan, Hasan; Ates, Ferhat; Adayener, Cuneyt; Eren, Ali Erhan; Ersay, Ahmet ResitPurpose: Aging in men is characterized by a moderate decrease in plasma testosterone (T) levels. However, the association between partial androgen deficiency of the aging male and clinical symptoms and the ideal screening test are controversial. In this study, we investigated the association between the androgen levels and erectile function, cognitive functions and hypogonadism symptoms in aging males. Materials and methods: We investigated the association between total (TT), calculated free (FT) and bioavailable (BT) testosterone, and various clinical and laboratory parameters in 103 healthy males, 50-80 years old. Biochemical assessment was done after overnight fasting. Questionnaires were used to test for hypogonadism symptoms, erectile and cognitive functions. Results: TT levels were not correlated with aging in this study. However, FT and BT were found to decrease with age due to rising sex hormone binding globulin. TT levels were strongly correlated with FT and BT levels (respectively p = 0.0001, p = 0.0001). TT, FT and BT were only correlated with cognitive functions (p = 0.012, p = 0.004, p = 0.02 respectively). There was no correlation between TT, FT and BT levels and erectile function and hypogonadism symptoms. Conclusion: T values in our study sample did not correlate with clinical signs and symptoms of hypogonadism. Thus, according to our data, symptoms in the aging male should not be indiscriminately assigned to a decrease in TT, FT or BT levels.Öğe Asymmetric dimethyl arginine levels in testicular tissue and blood of rats with induced experimental varicocele(Elsevier Espana Slu, 2014) Alan, Cabir; Ertung, Yunus; Cakir, Dilek Ulker; Topaloglu, Naci; Ersay, Ahmet Resit; Basturk, GokhanIntroduction: Varicocele is one of the reasons for testicular dysfunction and is frequently known to accompany infertility. The basic pathology of varicocele is the development of endothelial dysfunction. The most important factors in development of endothelial dysfunction are impaired endothelial-linked vasodilatation, increase in free oxygen radicals, reduced synthesis and release of nitric oxide (NO), abnormal vasoconstriction and increased levels of dimethyl arginine. Our aim was to identify and illustrate the relationship between asymmetric dimethyl arginine (ADMA) and NO levels in testicular tissue and plasma of rats with induced experimental varicocele. Materials and methods: Twenty-one adolescent (average 6 weeks) male rats were included in the study and randomly divided into 3 groups. Group 1 (control, n=6) did not undergo any procedure. Group 2 (sham, n=6) had the left renal vein circled proximally but ligation was not performed. Group 3 (varicocele-induced, n=9) had partial ligation of the proximal left renal vein to induce left varicocele. Superoxide dismutase (SOD) enzyme activity and levels of end-products of NO, nitrite and nitrate salts were investigated in testis tissue. Nitrite/nitrate and ADMA levels were investigated in plasma. Histopathological examination was completed with routine hematoxylin-eosine and TUNEL dyes. Results: Tissue SOD and plasma ADMA values were clearly increased in the varicocele group compared to the other groups; tissue and plasma nitrite/nitrate levels were clearly reduced in the varicocele group and this was observed to be statistically significant between the groups. Conclusion: We believe our study has opened an important window on the relationship between infertility observed in varicocele patients and ADMA. We believe that broad-series prospective studies to support this are required. (C) 2014 Asociacion Espanola de Andrologia, Medicina Sexual y Reproductiva. Published by Elsevier Espana, S.L.U. All rights reserved.Öğe Biofeedback in the Treatment of Nocturnal Enuresis: May Be an Alternative Method of Treatment?(Derman Medical Publ, 2015) Topaloglu, Naci; Alan, Cabir; Ersay, Ahmet Resit; Eren, Ali Erhan; Basturk, Gokhan; Alan, HandanAim: Biofeedback is re-education of correct voiding to children with visual, tactile and sensorial stimuli. Biofeedback in the treatment of dysfunctional voiding and urinary incontinence can be used. However, in the treatment of nocturnal enuresis is not included in the routine treatment options. We aimed to investigate the feasibility and effectiveness of biofeedback in the treatment of nocturnal enuresis. Material and Method: 50 children aged 5 years or older, who suffered a case of not wetting more than six-month period and admitted complaints of nocturnal urinary incontinence were included in the study. The mean age of patients was 9,4 +/- 2,52 (6-15). 27 patients (54%) were female and 23 patients (46%) were males. Biofeedback treatment performed to patients as 4 sessions. Each sessions were 30 minutes long every week. All patients were informed and advised to do the same exercise for 30 minutes every day at home. Results: Following the biofeedback treatment, incidence of wetting was found to have decreased significantly. 13% (3) of male patients and 11,1% (3) of female patients have not benefits from treatment. 87% (20) of male and 88,9% (24) of female patients have benefits from the treatment, frequency of urinary incontinence was reduced. Following the treatment, clinical improvement was 88%, while the rate of completely dryness was 54%. Statistical difference was found significantly at the incidence of wetting between before and after the treatment (p<0,05). Discussion: The positive results achieved in a short time indicates that the biofeedback method including the active participation of the child and the family in an environment of play, without medication, is candidate for the alternative treatment to nocturnal enuresis treatment.Öğe Comparison of Effects of Alpha Receptor Blockers on Endothelial Functions and Coagulation Parameters in Patients with Benign Prostatic Hyperplasia(Elsevier Science Inc, 2011) Alan, Cabir; Kirilmaz, Bahadir; Kocoglu, Hasan; Ersay, Ahmet Resit; Ertung, Yunus; Eren, Ali ErhanOBJECTIVE To investigate the effects of alpha receptor blockers used in the treatment of benign prostatic hyperplasia (BPH) on endothelial functions, coagulation parameters, and arterial blood pressure. MATERIALS AND METHODS One-hundred fifteen patients admitted to the treatment protocol because of symptomatic BPH were included in this prospective study. Patients were given the following treatments: doxazosin 4 mg/d (n = 25), terazosin 5 mg/d (n = 26), alfuzosin 10 mg/d (n = 26), tamsulosin 0.4 mg/d (n = 21), and observation (n = 17). All cases were evaluated before treatment and in the 12th week of treatment, according to biochemical parameters, endothelial functions, and arterial blood pressure. Biochemical parameters were bleeding time, coagulation time, prothrombin time, activated partial thromboplastin time, total prostate-specific antigen (PSA), and free PSA. Endothelial functions were evaluated with ultrasonography of the brachial artery. RESULTS When coagulation tests were evaluated, there were significant increases in bleeding and coagulation times in the groups using doxazosin and terazosin. Doxazosin and terazosin lowered arterial blood pressure significantly compared with other treatments. With regard to effects on endothelial function, there were significant differences in flow-mediated dilation rates of the brachial artery at 60 and 90 seconds before and during treatment in the alfuzosin and terazosin groups. CONCLUSIONS Alpha receptor blockers can decrease the risk of cardiovascular complications by both reducing platelet aggregation and protecting endothelial functions in patients with prostatic hyperplasia. The only drug with a favorable effect in all 4 areas of interest, including BPH symptoms, blood pressure, platelet aggregation, and endothelial functions, was terazosin. UROLOGY 77: 1439-1443, 2011. (C) 2011 Elsevier Inc.Öğe Diagnostic Value of Plasma Pentraxin3-Level For Diagnosis of Erectile Dysfunction(Urol & Nephrol Res Ctr-Unrc, 2018) Eren, Ali Erhan; Ersay, Ahmet Resit; Demirci, Emrah; Alan, Cabir; Basturk, GokhanPurpose: Erectile dysfunction (ED) is a sexual dysfunction described as the inability to develop or maintain an erection of the penis adequate for sexual intercourse, and its prevalence increases with age. Seen as a common sexual disorder worldwide, organic causes are the underlying reason for 80 percent of ED cases, with the most characteristic pathology responsible for organic ED being atherosclerosis. This study investigates the diagnostic value of plasma PTX-3 levels in arterial ED. Materials and Methods: This study included a total of 45 patients who were admitted to the urology and cardiology outpatient clinics of the Medical Faculty of Canakkale Onsekiz Mart University (COMU) and consented to participate in this study. Patients were categorized into three equal groups in number: (1) patients with ED diagnosed with coronary artery disease (CAD) (15 patients in total); (2) patients with ED not having coronary artery disease or any other equivalent diseases (diabetes mellitus, hypertension and hyperlipidemia) (15 patients in total); and (3) ordinary patients with no ED (15 patients in total). An interview was conducted at the andrology polyclinic with each patient in order to ascertain detailed information on their medical and sexual history and on demographic characteristics. All patients were also administered the International Index of Erectile Function (IIEF) questionnaire. Result: The findings from this study investigating the diagnostic value of plasma PTX-3 levels in ED were statistically significant for two comparisons: the differences between the peripheral blood and cavernous blood values of the patient groups (group 1 and 2) and the control group (group 3), and the differences between the peripheral blood and cavernous blood values of group 2 (patients with ED who do not have CAD) and the control group (group 3). Conclusion: As PTX-3 is more specific than the formerly recognized biochemical markers in endothelial dysfunction, it can be used in the diagnosis of vascular originated ED.Öğe Disorders of sex development(Elsevier Doyma Sl, 2013) Alan, Cabir; Altundas, Ramazan; Topaloglu, Naci; Haciveliogiu, Servet Ozden; Kocoglu, Hasan; Ersay, Ahmet ResitBackground: Disorders of sex development (DSD), which has the possibility of the risk of life-threatening endocrinologic emergencies of the newborn, require a careful multidisciplinary approach. Objectives: The aim of our study is to consolidate the proposed classification, evaluation and management of DSD. Materials and methods: The literatures related with DSD were reviewed to find the best approach for this disease. Results: The detailed history, systemic physical examination of the patient, particular laboratory and imagine evaluations are needed for the urgent treatment of life-threatening abnormalities and the gender assignment. Conclusion: The gender should be assigned depending on the definitive diagnosis, fertility potential, genital appearance, surgical options, and the parents' opinion. (C) 2013 Asociacion Espanola de Andrologia, Medicina Sexual y Reproductiva. Published by Elsevier Esparta, S.L. All rights reserved.Öğe Human os penis(Polish Urological Assoc, 2010) Ersay, Ahmet Resit; Alan, Cabir; Kocoglu, HasanThis report presents a case of a 45-year-old male suffering from a rod-like mass at the base of his penis. He has been aware of its existence since puberty. Physical examination revealed a bone-hard, mobile, stick-like structure behind the corpus spongiosum in the median plane. A calcified periurethral rod-like 5 cm mass at the ventral aspect of intercorporeal septum of the penis was noted on computed tomography (CT) scan. The patient, who had no symptoms associated with erectile dysfunction, refused further diagnostic tests and intervention.Öğe Nitric oxide and asymmetric dimethyl arginine (ADMA) levels in an experimental hydronephrotic kidney caused by unilateral partial ureteral obstruction(Brazilian Soc Urol, 2016) Alan, Cabir; Kurt, Hasan Anil; Topaloglu, Naci; Ersay, Ahmet Resit; Cakir, Dilek Ulker; Basturk, GokhanAim: Our aim is to measure asymmetric dimethyl arginine and nitric oxide levels in rats with induced unilateral acute ureteral obstruction to research the effects on the kidney. Material and Methods: The study included 21 adolescent (average age 6 weeks) Sprague-Dawley male rats weighing between 240-290g divided at random into 3 groups. Group-1: Control group (n= 6): underwent no procedures. Group-2: Sham group ( n= 6): underwent the same procedures as the experimental group without ureter and psoas muscle dissection. Group-3: Group with induced partial unilateral ureteral obstruction (n= 9). All rats were sacrificed after 12 weeks. Superoxide dismutase enzyme activity and nitrite and nitrate salt levels were measured in renal tissue. Plasma nitrite-nitrate and ADMA levels were examined. Results: In the experimental group histopathological changes observed included renal pelvis dilatation, flattened papillae, sclerotic glomerulus and fibrosis. In the experimental group tissue SOD and blood ADMA levels were higher than the control and sham groups (p< 0.05) while tissue NO and plasma NO values were lower than in the sham and control groups (p< 0.05). Conclusion: Oxidative stress and disruption of NO synthesis play an important role in renal function and histopathological changes after obstructive renal disease. To prevent renal complications developing after obstructive nephropathy we believe that a new strategy may be research on reducing ADMA.Öğe Prognostic value of free/total PSA ratio in prediction of bone metastases in patient with prostate cancer(Elsevier Science Bv, 2018) Ozdemir, Semra; Tan, Yusuf Ziya; Ersay, Ahmet Resit; Ozturk, Fulya Koc; Ozdemir, Beril Su[Anstract Not Available]Öğe Protective effect of decorin on acute ischaemia-reperfusion injury in the rat kidney(Termedia Publishing House Ltd, 2011) Alan, Cabir; Kocoglu, Hasan; Altintas, Ramazan; Alici, Bulent; Ersay, Ahmet ResitIntroduction: Transforming growth factor-beta 1 (TGF-beta 1) has a crucial role in collagen synthesis and fibrosis. TGF-beta 1 can be antagonized and/or reduced by the action of certain agents. We propose to identify the role of decorin in treatment of tubular and interstitial fibrosis and in the inhibition of TGF-beta 1 in an acute ischaemic kidney. Material and methods: We grouped 34 female Sprague Dawley type rats into 3 groups as 9 sham, 9 ischaemia-reperfusion (I/R) and 16 I/R + decorin respectively. The rats in the I/R + decorin group had decorin administered intraperitoneally at the dose of 0.1 mg/kg for 9 days after reperfusion. After 9 days, all the rats in the 3 groups were unilaterally nephrectomized. The TGF-beta 1 level was measured immunohistochemically in the nephrectomized material. Results: The TGF-beta 1 level was lower in the I/R + decorin group. Evaluation of apoptotic activity level by caspase staining showed a statistically significant difference between the 3 groups. The number of caspase stained cells was lower in the I/R + decorin group. The amount of collagen in interstitial tissue was higher in the I/R group than in the I/R + decorin group, but this difference was not statistically significant. Conclusions: We found that the TOE-Ill level the so-called initiator of fibrotic activity and apoptotic activity were low in the I/R + decorin group. Additional studies must be performed to understand the role of decorin in inhibition of TGF-beta 1 and to assess decorin's routine use in acute renal ischaemia.Öğe The effectiveness of biofeedback therapy in children with monosymptomatic enuresis resistant to desmopressin treatment(Aves, 2016) Sancak, Eyup Burak; Akbas, Alpaslan; Kurt, Omer; Alan, Cabir; Ersay, Ahmet ResitObjective: To investigate the effect of biofeedback therapy on children with desmopressin-resistant primary monosymptomatic enuresis (MsE). Material and methods: The study comprised both retrospective and prospective sections. A total of 262 medical files of patients who were diagnosed as enuresis between November 2012 and January 2015 were retrospectively screened. Patients with neuropathic bladder, daytime voiding problems, anatomical pathology and enuresis-related diseases were excluded from the study. The demographic data and family characteristics of 29 children with desmopressin-resistant primary MsE were recorded. After biofeedback treatment patients whose frequency of enuretic episodes decrease by more than 50% were included in the successful biofeedback treatment group (SBTG), while other patients were categorized in the unsuccessful biofeedback treatment group (USGBT). The outcomes of uroflowmetry, voided volume, postvoiding residue (PVR) and total bladder volume/age-adjusted normal bladder capacity (TBV/NBC) were recorded before and at the sixth month of the treatment. Results: The mean age of 29 patients included in the study was 9.14 +/- 3.07 (6-15) years. Of patients, 16 were male (55.2%) and 13 were female (44.8%). Before biofeedback treatment the frequency of enuresis was 25.1 +/- 5.76 days/month, while after treatment this was calculated as 8.52 +/- 10.07 days/month. After treatment 8 patients (28.6%) achieved complete dryness. Twenty patients (69%), benefited from biofeedback (SBTG), while there were 9 patients (31%) in the USBTG group. There was no significant difference between the SBTG and USBTG groups in terms of age, body mass index and sex. The average bladder capacity of the patients increased from 215 mL to 257 mL after biofeedback treatment (p<0.001). The TBV/NBC value before treatment was 0.66, while after treatment it was 0.77 (p<0.001). There was a statistically significant difference between the SBTG and USBTG groups in terms of presence of MsE in mother, and both parents (p=0.001, p=0.016, respectively). Conclusion: Biofeedback therapy is a safe, simple, and minimally invasive treatment modality in children with MsE resistant to desmopressin treatment. This treatment, which was found to increase total bladder capacity, may be recommended for children with MsE when conventional desmopressin treatment fails.Öğe Ultrasound-guided X-ray free percutaneous nephrolithotomy for treatment of simple stones in the flank position(Springer, 2011) Alan, Cabir; Kocoglu, Hasan; Ates, Ferhat; Ersay, Ahmet ResitThe purpose of this study was to examine the effectiveness and safety of percutaneous nephrolithotomy with ultrasonography-guided renal access in the flank position without the use of fluoroscopy in any stage of the procedure. Percutaneous nephrolithotomy was performed in flank position under the guidance of ultrasound (USG) without the use of fluoroscopy between December 2008 and January 2010 on 43 patients who had kidney stones bigger than 20 mm. Access to the kidney's proper calyx was achieved by dilatation through the guide wire placed after insertion of the needle through the needle director under the guidance of transrectal ultrasound probe placed on the patient's flank area. A convex USG probe was used for imaging during dilatation and lithotripsy instead of fluoroscopy. Access to the targeted calyx was achieved successfully in all patients (100%). The percentage stone free rate was 86.1% (37 patients). Residual stones were detected in six patients. Their dimensions ranged from 5 to 12 mm. The mean stone diameter was 29 (20-41) mm, duration of surgery was 87.1 +/- A 43.2 (55-210) min and duration of hospital stay was 3.1 (2-8) days. Blood transfusions were given to two patients; none of the patients had major intraoperative or postoperative complications. In comparison with standard percutaneous nephrolithotomy, percutaneous nephrolithotomy in flank position under ultrasonographic imaging instead of using fluoroscopy seems to be safe and effective. This procedure has to be limited to selected cases with one or maximum two big stones in the pelvis or in a single calyx in absence of complex intrarenal anatomy. Both surgical team and the patients were protected from the harmful effects of radiation. Regarding anesthesia, flank position is more comfortable for the patient than prone position.Öğe Unexpected severe hepatotoxicity of ciprofloxacine: two case reports(Taylor & Francis Ltd, 2011) Alan, Cabir; Kocoglu, Hasan; Ersay, Ahmet Resit; Ertung, Yunus; Kurt, Hasan AnilCiprofloxacin is a fluoroquinolone antibiotic that has a relatively low rate of occurence of adverse side effects. However, increasing evidences suggest that ciprofloxacin may cause unexpected severe liver damage. Especially, the risk of hepatotoxicity is significantly higher in elderly men receiving drug for a long time. In this article, 2 cases of unexpected severe hepatoxicity of ciprofloxacin are presented.
