Person: ERSÖZ, CEVPER
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- PublicationOpen AccessMesh related vesico-peritoneal fistula presenting with urinary ascites: A case report(2019-03-01T00:00:00Z) İLKTAÇ, ABDULLAH; ERSÖZ, CEVPER; DOĞAN, BAYRAM; KALKAN, Senad; İLKTAÇ, ABDULLAH; ERSÖZ, CEVPER; DOĞAN, BAYRAM; KALKAN, SENADVesicoperitoneal fistula is a very rare entity of epithelialized communication between peritoneal cavity and bladder.1 It results in accumulation of urine in peritoneal cavity and causes elevated urea and creatinine levels mimicking acute renal failure. Incisional hernia is common complication of abdominal surgery and often repaired with non-absorbable mesh.2 Using dual mesh can reduce mesh related complications but migration to adjacent organs can still happen and cause severe complications. Here we present a case of mesh related vesico-peritoneal fistula presenting with urinary ascites 2 years after incisional hernia repair.
- PublicationOpen AccessThe relationship of neutrophil to lymphocyte ratio with testicular cancer(2020-01-01) İlktaç, Abdullah; Akbulut, Habib; Akçay, Muzaffer; Ersöz, Cevper; Doğan, Bayram; İLKTAÇ, ABDULLAH; DOĞAN, BAYRAM; ERSÖZ, CEVPER; AKÇAY, MUZAFFER; AKBULUT, HABİBPurpose: To assess the relationship between testicular germ cell tumors (TGCT) and neutrophil to lymphocyte ratio (NLR) and to determine whether this ratio can be used as a serum tumor marker. Material and Methods: Sixty-one patients with testicular germ cell tumors were included into the study. Patients were grouped as localized and non-localized. Histologically patients were categorized as seminoma and nonseminomatous germ cell tumors. Complete blood cell count was measured the day before surgery and at the postoperative 1st month. Preoperative and postoperative mean NLR values were compared. Results: Thirty-six patients (59%) had seminomas and 25 patients (41%) had nonseminomatous testicular cancer. Forty-fi ve patients (73.8%) had localized and 16 patients (26.2%) had non-localized testicular cancer. There was a statistically signifi cant difference between preoperative and postoperative mean NLR of the localized patients (p=0.001) but no such difference was detected for non-localized patients (p=0.576). Nineteen patients with localized seminomas had normal preoperative serum tumor markers. There was a signifi cant difference between preoperative and postoperative mean NLR in this group of patients (p=0.010). Twenty-six patients with localized tumors had preoperative increased serum tumor markers which normalized after orchiectomy. Mean NLR of these patients signifi cantly decreased from 3.10±2.13 to 1.62±0.59 postoperatively (p=0.010). Conclusions: NLR appears to be a useful marker for TGCT. It is successful in predicting localized and non-localized disease in early postoperative period.
- PublicationOpen AccessComparison of Scoring Systems in Predicting Success of Percutaneous Nephrolithotomy(2019-01-01T00:00:00Z) AKÇAY, MUZAFFER; Tosun, Muhammed; GEVHER, FATİH; KALKAN, Senad; ERSÖZ, CEVPER; Kayali, Yunus; Tepeler, Abdulkadir; AKÇAY, MUZAFFER; TOSUN, MUHAMMED; GEVHER, FATİH; KALKAN, SENAD; ERSÖZ, CEVPER; KAYALI, YUNUSBackground: Scoring systems are useful to inform the patients about the success and complication rates of the operation prior the surgery. Aims: To determine the applicability of the popular scoring systems (Guy’s, stone size, tract length, obstruction, number of involved calices, and essence/stone density and Clinical Research Office of the Endourological Society) by means of examining preoperative data of patients treated with percutaneous nephrolithotomy. Study Design: Cross sectional study. Methods: We retrospectively reviewed files of the patients who had undergone percutaneous nephrolithotomy in our center between 2011 and 2015. Excluded from the study were patients aged <18 years, and those who were not assessed preoperatively with computed tomography. Preoperative computed tomography images of all patients were assessed by a single observer, and patients were graded based on three scoring system. Demographic data were analyzed along with perioperative data (operation, fluoroscopy, length of hospital stay, changes in hematocrit values, location, and number of access sites, stone-free and complication rates). Results: A total of 298 patients who had been treated with 300 procedures were enrolled into the study. Mean age, stone burden, number of stones, and density were 48.1±12.9 years, 663.5±442.8 mm2, 1.8±1.1 and 888.3±273 HU respectively. Scores of the cases based on Guy’s, stone size, tract length, obstruction, number of involved calices, and essence/stone density, and Clinical Research Office of the Endourological Society scoring system were calculated as 2, 7.6, and 222.1 points respectively. 81.6% of the patients were stonefree. Complications were detected in 30 (9.9%) patients. Based on receiver operating characteristic curve analysis a positive correlation was detected between success rate and scoring systems, i.e., Guy’s (p=<0.001, r=-0.309), stone size, tract length, obstruction, number of involved calices, and essence/stone density (p=<0.001, r=-0.295), and Clinical Research Office of the Endourological Society (p=<0.001, r=0.426). The Clinical Research Office of the Endourological Society scoring system had the highest predictive value. The sensitivity rates rates for Guy’s, Clinical Research Office of the Endourological Society and Stone scoring system were as 78.78%, 80% and 82.34% respectively. Conclusion: All of scoring systems predicted correctly the success of the percutaneous nephrolithotomy procedures. The Clinical Research Office of the Endourological Society scoring system had the highest predictive value. Keywords: Percutaneous nephrolitotomy, scoring methods, specificity and sensitivity, urinary calculi
- PublicationOpen AccessActinomyces neuii subsp. neuii Isolated from Perineal Abscess; Case Report(2019-04-01T00:00:00Z) AKBAŞ, EMEL; Sumbul Gultepe, Bilge; ERSÖZ, CEVPER; CEYLAN, AYŞE NUR; DOYMAZ, Mehmet Ziya; AKBAŞ, EMEL; SÜMBÜL, BİLGE; ERSÖZ, CEVPER; CEYLAN, AYŞE NUR; DOYMAZ, MEHMET ZIYAActinomyces are gram positive bacilli which generally colonize in mouth, colon and vagina. The members of genus Actinomyces are facultative anaerobic or microaerophilic organisms and have a branching flamentous structure. They cause classical actinomycosis. Among the Actinomyces species; A. israelii, A. viscosus, A. naeslundii, A. odontolyticus, A. bovis and A. neuii are the mostly isolated organisms from clinical cases. A rarely encountered member of this group, Actinomyces neuii does not show branching and is catalase and CAMP positive and is a coryneform shaped bacillus. Although Actinomyces is mostly found as contaminating organism, in some cases it is reported as a pathogen. Actinomyces neuii has been reported in chorioamnionitis, neonatal sepsis, vertebral osteomyelitis, cervical lymphadenitis, breast abscess, fatal bacteremia and postoperative endophthalmitis. In our case, A. neuii was isolated from a perineal abcess and it was not previously reported. In our case, Actinomyces neuii was identified by commercial identification systems. For this purpose; VITEK MS and VITEK (R) 2 Compact (both by bioMerieux, France) were used in the clinical microbiology laboratory and then this identification was confirmed as the Actinomyces neuii subsp. neuii by the 16S rRNA sequencing. Also, the positivity of CAMP was demonstrated in the laboratory. As in the cases of other actinomycosis, the treatment of the abcess caused by the Actinomyces neuii is through the surgical debridement. The antimicrobial susceptibility testing is not performed since the organism is reported to be susceptibile to common antibiotics. Beta lactam antibiotics are acknowledged as the proper selection for antibiotic treatment.
- PublicationOpen AccessPrimitive Neuroectodermal Tumor of the Testis(2021-11-01T00:00:00Z) DEMİR, Tarık; ALİYEV, Altay; ŞEKER, Mesut; ERSÖZ, CEVPER; ÇOBAN, GANİME; TÜRK, HACI MEHMET; DEMİR, TARıK; ALİYEV, ALTAY; ŞEKER, MESUT; ERSÖZ, CEVPER; ÇOBAN, GANİME; TÜRK, HACI MEHMETA 21-year male presenting with left testicular mass and retroperitoneal lymphadenopathy underwent radical orchiectomy; and his pathological examination showed a mixed germ cell tumor composed of primitive neuroectodermal tumor mixed with mature teratoma. Six cycles of IE (ifosfamide, etoposide) and VAC (vincristine, doxorubicin, cyclophosphamide) chemotherapy were given after sperm preservation. He then underwent retroperitoneal lymph node dissection (RPLND). No tumor was detected in the removed lymph nodes, and all lymph nodes were reported as showing reactive changes.
- PublicationOpen AccessFournier Gangrene Caused by Migration of Foreign Body from Rectum to Bladder(2020-01-01T00:00:00Z) DOĞAN, BAYRAM; İLKTAÇ, ABDULLAH; Sahin, Mehmet Oguz; Sen, Volkan; ERSÖZ, CEVPER; İLKTAÇ, ABDULLAH; ERSÖZ, CEVPERFournier gangrene is a serious infectious disease with high mortality and morbidity rates characterized by rapidly progressive skin necrosis. Immediate debridement of infected necrotic tissue and broad spectrum antibiotic therapy are the main principles of the treatment. Size of the debrided area, advanced age, colorectal predisposition and renal insufficiency are the factors affecting the mortality. In this case report, we present a rare case of Fournier gangrene caused by migration of foreign body from rectum to bladder.
- PublicationOpen AccessImpact of Percutaneous Renal Access Technique on Outcomes of Percutaneous Nephrolithotomy(2012-07-01T00:00:00Z) TEPELER, Abdulkadir; ARMAGAN, Abdullah; AKMAN, Tolga; POLAT, Emre Can; Ersoz, CEVPER; TOPAKTAS, Ramazan; ERDEM, Mehmet Remzi; ONOL, Sinasi Yavuz; ERSÖZ, CEVPERBackground and Purpose: Percutaneous nephrolithotomy (PCNL) is regarded as the gold standard for the treatment of patients with renal stones larger than 2 cm in diameter. Creating a percutaneous renal access is the initial and probably the most important step in performing a PCNL. Two primary methods of obtaining proper percutaneous renal access under fluoroscopic guidance are described: The -triangulation- and the -eye of the needle- techniques. In this article, we compare these two techniques in terms of success and complication rates.
- PublicationOpen AccessAssociation of intrinsic sphincter deficiency with urine flow acceleration measurement(2020-09-01T00:00:00Z) GÖKMEN KARASU, AYŞE FİLİZ; Aydin, Serdar; KALKAN, Senad; ERSÖZ, CEVPER; GÖKMEN KARASU, AYŞE FİLİZ; KALKAN, SENAD; ERSÖZ, CEVPERBackground Intrinsic sphincter deficiency (ISD) is associated with an inability to maintain mucosal coaptation either at rest or in the presence of stress resulting from damage to muscles or nerves that maintain tonus. The purpose of our trial was to determine the role of urodynamic measurements of flow such as maximum flow rate, flow time, and acceleration speed of flow to assess the urethral resistance on prediction of stress incontinence and ISD. Materials and Methods Our study was based on a retrospective analysis of urodynamic records of female patients performed for urinary incontinence. Mean flow rate, maximum flow rate, detrusor pressure at maximum flow, vesical pressure at maximum flow, maximum detrusor pressure, and flow rate at maximum detrusor pressure measurements were extracted from the voiding phase of urodynamic charts. The slope of the maximum flow was used to calculate acceleration of flow (Qacc). The urodynamic records of 142 women were reviewed and Qacc was measured. Results The mean age of the ISD group was 53.3 +/- 12.5 (24-78) and of the non-ISD group 53.7 +/- 12.5 (35-74). The mean Qacc (30.3 +/- 16.1 degrees [mL/s(2)]) in the ISD group was significantly higher than in the non-ISD group (21.6 +/- 9.6 degrees [mL/s(2)]). Urodynamic bladder capacity of the non-ISD group (432.3 +/- 90.4 mL) was higher than the ISD group (389.2 +/- 109) (P = .01). Conclusion The Valsalva leak point pressure and maximum urethral closure pressure measurements in assessing urethral function are not useful for predicting incontinence surgery failure. We demonstrated that Qacc is higher in ISD stress incontinent women than stress incontinent women. Qacc may demonstrate urethral resistance and tonus in a more reliable manner.