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Öğe Blind Ending Uriner: A Rarely Diagnosed Ureteral Duplication Anomaly in Childhood(2010) Balasar, Mehmet; Pişkin, Mehmet Mesut; Çiçekçi, Faruk; Gürbüz, RecaiBlind ending ureıer is a rare congenital malformation of the urinary system and is classified as a ureteral duplication anomaly. Mast cases are not diagnosed until they become symptomatic. Although it is a congenital malformation, patients are usually diagnosed in the 3rd and 4th decades and presentation in childhood is very rare. Mostly they manifest with loin pain, urinary tract infection, or stone disease. Intravenous pyetogram, retrograde pyelogram, and computerized tomography can be used for diagnosis. Voiding cystourethrography must be performed to exclude associated vesicoureteral reflux. Herein, we report an 11-year-old child who hud a blind ending duplicated ureter associated with vesicoureteral reflux causing renal atrophy.Öğe Can Eosinophil Count, Platelet Count, and Mean Platelet Volume Be a Positive Predictive Factor in Penile Arteriogenic Erectile Dysfunction Etiopathogenesis?(SAGE PUBLICATIONS INC, 2017) Sonmez, Mehmet Giray; Goger, Yunus Emre; Sonmez, Leyla Ozturk; Aydin, Arif; Balasar, Mehmet; Kara, CengizBlood count parameters of patients referring with erectile dysfunction (ED) were examined in this study and it was investigated whether eosinophil count (EC), platelet count (PC), and mean platelet volume values among the suspected predictive parameters which may play a role in especially penile arteriogenic ED etiopathogenesis had a contribution on pathogenesis. Patients referring with ED complaint were evaluated. Depending on the medical story, ED degree was determined by measuring International Index of Erectile Function. Penile Doppler ultrasonography was taken in patients suspected to have vasculogenic ED. According to penile Doppler ultrasonography result, patients with arterial deficiency were included in the penile arteriogenic ED group and the patients with normal results were included in the nonvasculogenic ED group. A total of 36 patients participated in the study from the penile arteriogenic ED group and 32 patients from the nonvasculogenic ED group. Compared with the nonvasculogenic ED group, the penile arteriogenic ED group's low International Index of Erectile Function score, high EC, mean platelet volume and PC values were detected to be statistically significant (p < .001, p = .021, p = .018, p = .034, respectively). No statistically significant difference was observed among the two groups when age, white blood cells, red blood cells, and hemoglobin values were considered. Pansystolic volume velocities were detected as statistically significantly low compared with the nonvasculogenic ED group in the measurements made in 5th, 10th, 15th, and 20th minutes on the right and left sides in the penile arteriogenic ED group. High MPV value and PC is a significant predictive factor for penile arteriogenic ED and vasculogenic ED and high EC is specifically predictive of arteriogenic ED.Öğe Comparison of 50 ?g and 25 ?g Doses of Intrathecal Morphine on Postoperative Analgesic Requirements in Patients Undergoing Transurethral Resection of the Prostate With Intrathecal Anesthesia(Elsevier Science Inc, 2010) Duman, Ateş; Apilioğulları, Seza; Balasar, Mehmet; Gürbüz, Recai; Karcıoğlu, MuratStudy Objective: To compare the efficacy of 50 mu g and 25 mu g closes of intrathecal morphine on postoperative pain in patients undergoing transurethral resection of the prostate (TURP) with low-close bupivacaine Design: Randomized, double-blinded study Setting: Konya Hospital Patients: 70 ASA physical status I. II, and III patients Interventions: Patients were randomized to two groups Group A patients received 5 mg of 0.5% hyperbaric bupivacaine (one mL) and 50 mu g of morphine (0 5 mL) Group B patients received 5 mg of 0.5% hyperbaric bupivacaine (one mL) and 25 mu g of morphine (0 5 mL) Measurements: Postoperative pain scores, patient and surgeon satisfaction, and side effects such as emesis, pruritus, and respiratory depression, were recorded. Main Results: Postoperative pain characteristics were similar between the two groups Frequency of emesis was similar between the groups, while pruritus was significantly higher in Group A No antipruritic medication was required in any patient Patient and surgeon satisfaction was evaluated as good or excellent in both groups. Conclusions: Intrathecal morphine at a dose of 25 mu g provides similar postoperative analgesia and less pruritus than the 50 mu g dose in patients undergoing TURP.Öğe DOES A SPINAL BLOCK AT SACRAL LEVEL PROVIDE ADEQUATE ANESTHESIA FOR TRANSURETHRAL RESECTION OF THE PROSTATE CONDUCTED WITH CONTINUOUS IRRIGATION RESECTOSCOPE?(GUNES KITABEVI LTD STI, 2011) Apiliogullari, Seza; Sakalli, Melike; Duman, Ates; Balasar, Mehmet; Ogun, Cemile OztinIntroduction: It has been previously reported that a spinal block at L1 level is adequate for transurethral resection of prostate (TURP) if low bladder pressure is provided. This study aims to compare adequacy and the characteristics of spinal anesthesia with low dose bupivacaine and bupivacaine + fentanyl combinations for TURP conducted with continuous irrigation resectoscope. Materials and Method: After Ethical Committee approval and informed consent, 50 patients were included with randomization. Spinal anesthesia was conducted in the sitting position with 5 mg of hyperbaric bupivacaine + 0.4 ml 0.9% NaCl in group B (n=25) and 5 mg of hyperbaric bupivacaine + 0.4 ml (20 mu g) fentanyl in group BF (n=25). Sensory block levels, motor block properties, quality of intraoperative anesthesia, surgical convenience and side effects were recorded. Results: The groups were similar regarding maximum block levels (L2), motor block and hemodynamic, properties. Sufficient analgesia was provided without additional analgesics in 46 of 50 patients with a sensory block higher than S1. Two groups were similar in terms of the quality of anesthesia, convenience for the surgeon and side effects. Conclusion: Bupivacaine (5mg) with or without fentanyl provides safe and adequate anesthesia, with a sensory block higher than S1, when continuous irrigation resectoscope is used for TURP.Öğe Ischemic priapism: Can eosinophil count and platelet functions be positive predictive factors in etiopathogenesis(CANADIAN UROLOGICAL ASSOCIATION, 2017) Sonmez, Mehmet Giray; Kara, Cengiz; Karaibrahimoglu, Adnan; Sonmez, Leyla Ozturk; Goger, Yunus Emre; Balasar, Mehmet; Taskapu, Hakki HakanIntroduction: We evaluated the relation between ischemic priapism (IP) and blood count parameters in IP patients. We especially wanted to examine the contribution of eosinophil count (EC), platelet count (PC), and mean platelet volume (MPV) values, which are suspected predictive parameters for vascular endothelium damage and venoocclusive pathogenesis and etiopathogenesis, particularly in IP. Methods: A total of 40 IP patients fulfilled the study criteria. Forty healthy volunteers in a similar age group were included as the control group. Complete blood count values were compared between the two groups. Intergroup comparisons were performed using the Mann-Whitney U test, and the chi-square test was used to assess the relationship between categorical variables in the patient groups. The area under the curve was calculated by receiver operating characteristic (ROC) regression analyses. Epidemiological diagnosis percentages were calculated by finding cutoff values. Results: The IP group's high MPV, PC, and EC values compared to those of the control group were detected to be statistically significant (p<0.001, p=0,03, p=0.001, respectively). No statistically significant difference was observed between the two groups for other blood count parameters. Statistically significant values for IP were measured as MPV: positive predictive value: 84%; EC: positive predictive value: 71.4%; and PC: positive predictive value: 61.4%. Conclusions: High MPV, PC, and EC values are significant positive predictive factors in IP etiopathogenesis. No proof was detected for other blood count parameters playing an active role in IP etiopathogenesis.Öğe Male infertility associated with de novo pericentric inversion of chromosome 1(AVES, 2017) Balasar, Ozgur; Zamani, Ayse Gul; Balasar, Mehmet; Acar, HasanInversion occurs after two breaks in a chromosome have happened and the segment rotates 180 degrees before reinserting. Inversion carriers have produced abnormal gametes if there is an odd number crossing-over between the inverted and the normal homologous chromosomes causing a duplication or deletion. Reproductive risks such as infertility, abortion, stillbirth and birth of malformed child would be expected in that case. A 54-year-old male patient was consulted to our clinic for primary infertility. The routine chromosome study were applied using peripheral blood lymphocyte cultures and analyzed by giemsa-trypsin-giemsa (GTG) banding, and centromer banding (C-banding) stains. Y chromosome microdeletions in the azoospermia factor (AZF) regions were analyzed with polymerase chain reaction. Additional test such as fluorescence in situ hybridization (FISH) was used to detect the sex-determining region of the Y chromosome (SRY). Semen analysis showed azoospermia. A large pericentric inversion of chromosome 1 46, XY, inv(1) (p22q32) was found in routine chromosome analysis. No microdeletions were seen in AZF regions. In our patient the presence of SRY region was observed by using FISH technique with SRY-specific probe. Men who have pericentric inversion of chromosome 1, appear to be at risk for infertility brought about by spermatogenic breakdown. The etiopathogenic relationship between azoospermia and pericentric inversion of chromosome 1 is discussed.Öğe Sakral düzeyde bir spinal blok seviyesi sürekli irrigasyon rezektoskopuyla yapılan transüretral prostat rezeksiyonları için yeterli anestezi sağlar mı?(2011) Apilioğulları, Seza; Sakallı, Melike; Duman, Ateş; Balasar, Mehmet; Öğün, Cemile ÖztinGiriş: Mesane basıncı düşük tutulduğunda L1 seviyesinde ki spinal bloğun transüretral prostat rezeksiyonu (TURP) için yeterli olduğu bildirilmiştir. Bu çalışmada sürekli irrigasyon rezektoskopu kullanılarak uygulanan TURP operasyonlarında spinal düşük doz (5 mg) bupivakain ile bupivakain fentanil kombinasyonunun spinal anestezi yeterliliği ve özellikleri açısından karşılaştırılması amaçlandı. Gereç ve Yöntem: Etik kurul onayı ve yazılı onamları alınan 50 hasta randomize yöntemle çalışmaya alındı. Oturur pozisyonda Grup B'de (n25) 5 mg hiperbarik bupivakain 0,4 ml %0,9 NaCl, Grup BF' de (n25) 5 mg hiperbarik bupivakain 0,4 ml (20?g) fentanil ile spinal anestezi yapıldı. Duyusal blok seviyeleri, motor blok değerleri, intraoperatif anestezi kalitesi, cerrahi çalışma koşulları ve yan etkiler kayıt edildi. Bulgular: Her iki grupta hemodinamik değişiklikler, maksimum duyusal blok seviyesi (L2) ve motor blok özellikleri açısından farklılık gözlenmedi. Duyusal blok seviyeleri S1'den yüksek olan 50 olgunun 46'sında yeterli cerrahi analjezi koşulları ek analjezi uygulanmaksızın sağlandı. Anestezi kalitesi ve cerrahın çalışma koşulları açısından gruplar benzerdi ve yan etkiler açısından fark yoktu. Sonuç: Fentanilli ya da fentanilsiz 5mg bupivakain ile S1 düzeyinin üzerinde bir duyusal blok, sürekli irrigasyon rezektoskopu kullanılarak yapılan TURP operasyonları için güvenli ve yeterli anestezi sağlamaktadır.
