Person: ERSÖZ, CEVPER
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Publication Open Access Mesh 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.Publication Open Access Comparison 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 calculiPublication Open Access Association 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.