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Öğe Association between serum inhibin-B levels and coronary artery disease in aging males(Termedia Publishing House Ltd, 2013) Kocoglu, Hasan; Alan, Cabir; Cakir, Dilek Ulker; Malkoc, Ercan; Cosansu, Kahraman; Kinlmaz, Bahadir; Ertung, YunusIntroduction: Atherosclerosis is a systemic disorder. It is a frequent leading cause of coronary artery disease (CAD). Similarly, atherosclerotic vascular alterations could lead to testicular arterial blood flow reduction and impairment of testicular function with age. Inhibin-B has been validated as a valuable serum marker of testicular functions and its correlation with testicular volume was shown in some studies done before. The purpose of this study is to investigate the association between serum inhibin-B levels and CAD in elderly men. Material and methods: Between March 2009 and March 2010, fifty-two 50-80-year-old consecutive patients with Gensini score over 20 and ejection fraction (EF) > 50% were included in the study as the CAD group. Fifty healthy men without any cardiac disease history were recruited as the control group. All patients in the CAD group who had indications for coronary artery angiography underwent selective coronary artery angiography. Results: Inhibin-B, total testosterone and testicular volume levels were found to be significantly lower in the CAD group in comparison with the control group (p = 0.004, p < 0.0001, and p = 0.001 respectively). Conclusions: In this study, although no correlation was found in CAD patients between Gensini score and inhibin-B or testicular volume, inhibin-B levels and testicular volume were significantly lower in patients with CAD than in healthy men. In order to fully assess the relationship between serum inhibin-B levels and CAD, multi-centered prospective and longitudinal studies must be done in elderly male patients.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 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 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 Efficacy of duloxetine in the early management of urinary continence after radical prostatectomy(S. Karger AG, 2014) Alan, Cabir; Eren, Ali E.; Ersay, Ahmet R.; Kocoglu, Hasan; Basturk, Gokhan; Demirci, EmrahAim: To evaluate the efficacy of early duloxetine therapy in stress urinary incontinence occurring after radical prostatectomy (RP). Material and Method: Patients that had RP were randomly divided into 2 groups following the removal of the urinary catheter. Group A patients (n = 28) had pelvic floor exercise and duloxetine therapy. Group B patients (n = 30) had only pelvic floor exercise. The incontinence status of the patients and number of pads were recorded and 1-hour pad test and Turkish validation of International Consultation on Incontinence Questionnaire-Short Form test were applied to the patients at the follow-up. Results: When the dry state of the patients was evaluated, 5, 17, 3, and 2 of 28 Group A patients stated that they were completely dry in the 3rd, 6th, 9th and 12th month respectively and pad use was stopped. There was no continence in 30 Group B in the first 3 months. Twelve, 6, and 8 patients stated that they were completely dry in the 6th, 9th and 12th month, respectively. But 3 of 4 patients in whom dryness could not be provided were using a mean of 7.6 pads in the first day and a mean of 1.3 pads after 1 year. When pad use of the patients was evaluated, the mean monthly number of pad use was determined to be 6.2 (4-8) in the initial evaluation, 2.7 (0-5) in the in 3rd month, 2 (0-3) in the 6th month and 1.6 (0-2) pad/d in the 9th month in the group taking medicine. The mean monthly number of pads used was determined to be 5.8 (4-8) in the initial evaluation, 4.3 (3-8) in the 3rd month, 3 (0-6) in the 6th month and 1.6 (0-6) pad/d in the 9th month in the group not taking medicine. Conclusion: According to the results, early duloxetine therapy in stress urinary incontinence that occurred after RP provided early continence. © 2014 S. Karger AG, Basel.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 Is cognitive processing affected in adults with hypospadias?: P300 study(De Gruyter Poland Sp Z O O, 2015) Tekeli, Hakan; Kocoglu, Hasan; Alan, Cabir; Tavsanli, Mustafa Emir; Yasar, Halit; Malkoc, Ercan; Kendirli, Mustafa TanselBackground: Hypospadias is a common urogenital system disorder. The frenulum, which is the most sensitive area of the glans penis, is not present in patients with hypospadias. This may lead to a failure in sexual and ejaculatory function, and cause emotional problems affecting cognitive processes. Aim: We aimed to study auditory Event Related Potentials (ERP) in patients with hypospadias to understand the status of cognitive function. Materials and Methods: Seventeen patients with hypospadias who presented to the Urology Outpatient Clinic of anakkale Military Hospital, and 11 healthy individuals of similar age were chosen. The auditory oddball paradigm with ERP from the Cz and Fz head regions were studied. The latency and amplitude of the P300 wave were measured. Results: Both, the study and control groups consisted of young males. Although the study group had a longer P300 latency and lower P300 amplitude when compared to control group, the results were not statistically significant (p: 0.059 and 0.346 respectively). Conclusion: Although the results are not statistically significant, our findings indicate that there may be cognitive changes in patients with hypospadias. Further studies of larger sample size and older patient cohorts are needed.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 Squamous cell carcinoma caused by neglected giant bladder diverticulum stone(Polish Urological Assoc, 2010) Kocoglu, Hasan; Alan, CabirThe incidence of bladder diverticulum is approximately 1.7% in children and 6% in adults. Dysplasia, leukoplakia, and squamous metaplasia may develop in approximately 80% of diverticulum. Chronic infection and inflammation, secondary to urinary stasis have been suggested as the cause of this situation. Bladder tumors arising inside of a diverticulum are uncommon, with a reported incidence ranging from 0.8% to 10% so discussions related to the diagnosis and the treatment of these cases are pending. The most common histological subtype of diverticulum tumors are transitional cell carcinoma (TCC) and squamous cell carcinoma (SCC), constitute 70-80% and 20-25% of all tumors respectively. TCC together with SCC is reported as 2% of all tumors, adenocarcinoma constitutes only a 2% portion. Stasis in the diverticulum may give rise to stone formation. Literature holds a large number of cases dealing with squamous cell carcinoma caused by bladder diverticulum. Until now, a case report depicting the coexistence of these pathologies (SCC, diverticulum and diverticulum stone) simultaneously in one case has not been reported. In our case, neglected bladder diverticulum stones may have caused SCC. Our case was treated with radical cystectomy. Urologists should be vigilant in this regard and diverticulum should be managed before complications happen.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.
