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Biomedical subjects

Ali Ayyildiz

Publications and source records attributed to Ali Ayyildiz.

At least 19 recordsLinked to original sources

Spontaneous rupture and emergency repairment of the renal pelvis.

A case of spontaneous rupture of the renal pelvis is very rare and unusual occurrence. Our case was a young woman who did not present with any disease that was a factor for pelvic rupture. The diagnosis was confirmed by abdominopelvic CT, and emergency repair of the renal pelvis was performed and a ureteral stent was inserted. Appropriate antibiotherapy was ordered, and the recovery was rapid. The differential diagnosis of this ease is discussed and the literature is reviewed:

Adult↗

Unexpected complication after cystometry in the hypocompliant urinary bladder: formation of a knot in the double lumen urethral catheter--a case report.

Urodynamic evaluation is frequently used in the follow-up of the treatment and diagnosis of incontinence, which develops in connection with a neurogenic or non-neurogenic reason. There is no identified serious complication during or after urodynamic evaluation, present in the literature up to date. Hematuria, due to the urethral catheter, the development of oedema in the urinary bladder wall and the development of urinary bladder spasm as a result of catheter irritation, are some of the complications, which may occur. In this paper, twist and knot formation in the double lumen urethral catheter after cystometry of a patient with a hypocompliant urinary bladder, has been presented.

Aged↗

Intraurethral honey application for urethral injury: an experimental study.

OBJECTIVES: To evaluate the effect of honey applied intraurethrally after urethral injury on histopathological healing. MATERIALS AND METHODS: A total of Wistar male rats were used. The rats were divided into four groups: control (Group 1), sham (Group 2), 1 week honey applied group (Group 3) and 3 weeks honey applied group (Group 4). The urethral damage was caused with a 29 G needle. In sham group, only intraurethral saline solution was given, and 10% of honey was applied to rats in Groups 3 and 4 intraurethrally. After killing, penile tissues were investigated under a light microscopy. RESULTS: The irregularities of urethral epithelium and connective tissue were observed in Group 1. Also narrowing of lumen was present in control group rats except one rat in which no inflammation and total healing were observed. Hyperemia-bleeding was found in whole rats. In Group 2, there were irregularities in urethral epithelium and connective tissue. Total healing was observed in one rat. In Group 3, while regularity in urethral epithelium was present in six rats, inflammation and fibrosis was absent in rats. In Group 4, inflammation and fibrous tissue accumulation were not observed in rats. CONCLUSIONS: Intraurethral honey, applied after urethral injury, prevents inflammation, accelerates urethral healing and provides perfect healing.

Animals↗

Surgical treatment options in proximal hypospadias: retrospective analysis of 171 cases at a single institution.

AIM: So far, various techniques have been used in the surgical treatment of proximal hypospadias. The aim of all techniques is to form a near to normal penis functionally and cosmetically. In the present study, proximal hypospadias cases operated in our clinic were evaluated. MATERIAL METHOD: Overall 171 cases with proximal penile, penoscrotal and scrotal meatus, aged between 3 and 28 were included in the study. Early and late postoperative complication rates and factors affecting success were investigated retrospectively. RESULTS: Sixteen cases underwent Duckett, 20 Onlay, 28 free tube, 56 Belt-Fuqua and 51 Thiersch operations. Success rate at early postoperative period was 60.8%, while it became 81.2% following secondary interventions. CONCLUSION: No effect of operation technique and meatus levels were observed on complication rates whilst previous operation increased complication rates significantly.

Adolescent↗

A comparison of free skin graft, fascia lata, alloderm, bovine pericardium and primary repair in urethrocutaneous fistulas without diversion: an experimental study.

The purpose of this study is to compare primary repair procedure with those that use bio-concordant materials in the treatment of urethrocutaneous fistula. Twenty-five New Zealand rabbits were randomly placed into five groups (primary repair, free graft, allograft fascia lata, alloderm and bovine pericardium repair groups). A single dose of 20 mg/kg of ceftriaxon was applied intramuscularly as a prophylactic dose. Urethrocutaneous fistula was formed on midpenile level. Later, while primary repair was applied in one group, repair with free grafts and with other bio-concordant materials were performed in other groups. Urinary diversion was not used in any of the rabbits. The macroscopic observation was evaluated with urethrography obtained 21 days after the operation and then the rabbits were sacrificed. A total point was obtained by awarding a point to each good parameter in the histopathological evaluation and all the groups were compared. The urethrographic findings and macroscopic examinations were normal in all groups. In histopathological examinations, ranging from the best to worst results, bovine pericardium group (8 points) had a better total score than primary repair group (7 points), allograft fascia lata group (7 points) and alloderm group (7 points). The free graft group had the worst total point (6 points). Bio-concordant materials can be used in urethrocutaneous fistula repair as an alternative to primary repair or to the grafts obtained from body tissues.

Animals↗

Investigation of factors affecting result of distal hypospadias repair: comparison of two techniques.

OBJECTIVES: To evaluate the factors affecting the results, as well as the success of two techniques, by retrospectively investigating cases of distal hypospadias in which the patients had undergone Mathieu urethroplasty or tubularized incised plate urethroplasty. METHODS: We retrospectively evaluated 117 patients who underwent distal hypospadias repair. A percutaneous suprapubic catheter (Cistofix) and urethral split catheter were placed as a diversion in the 41 patients undergoing Mathieu urethroplasty. The Cistofix and urethral catheter were placed in 35 patients and a urethral catheter was placed in 41 of the patients who underwent tubularized incised plate urethroplasty. The success rates were compared according to the surgical technique, age, hypospadias status (primary or secondary), type of urinary diversion, and presence of chordee. RESULTS: No statistically significant difference in the success rate was found between the two techniques. Furthermore, the different types of diversion used in tubularized incised plate urethroplasty did not affect the success rate. When the success of primary hypospadias repair (n = 84) was compared with secondary hypospadias repair (n = 33), success in patients with secondary hypospadias was low. No difference was observed when operational success was compared in terms of patient age (older versus younger than 5 years of age) or the presence or absence of chordee. CONCLUSIONS: Our results have shown that tubularized incised plate urethroplasty should be preferred for distal hypospadias because of the better cosmetic results, invasive urinary diversions should be avoided, and the most importance should be given to the initial surgical intervention.

Adolescent↗

The effect of cyanoacrylic glue on rat testis, urethra and spongiosal tissue: an experimental study.

PURPOSE: We examined the effect of Glubran2 on the rat urethra and spongiosal tissue as well as the histopathological effect. We also investigated its clinical use. MATERIALS AND METHODS: Eight control and 12 study group male Wistar rats were used in our study. The corpus spongiosum tissues, including the urethra and the tunica albuginea of the testis, were cut 0.5 and 0.2 cm long, respectively. Incision areas in the control group were sutured. In the study group Glubran2 was dripped on the area. Three weeks later all rats were sacrificed. The penile and testicular tissues were histopathologically investigated. One-way ANOVA and the t test were applied for statistical analysis. RESULTS: When the study group was compared with the control group, the difference in urethral healing (p = 0.001), urethral lumen irregularity (p = 0.036), spongiosal tissue healing (p = 0.001), inflammation (p = 0.000), hyperemia-bleeding (p = 0.036) and total healing (p = 0.001) were statistically significant. When the study and control groups were compared, the difference in inflammation (p = 0.000), necrotic areas (p = 0.002), tunica albuginea irregularity (p = 0.005), Sertoli's and Leydig cell destruction (p = 0.005), and testicular spermatogenesis (p = 0.005) were statistically significant. CONCLUSIONS: While perfect healing in the urethral and spongiosal tissues supports the clinical application, damage to the seminiferous tubules, decreased spermatogenesis at the operated site, tunica albuginea irregularity in a fourth of the testes and calcification in 1 testis were observed.

Animals↗

Plasmakinetic prostate resection in the treatment of benign prostate hyperplasia: results of 1-year follow up.

AIM: In our randomized prospective study, we aimed to evaluate the efficiency of plasmakinetic resection of prostate (PKRP) by comparing the preoperative and postoperative results of the transurethral resection of prostate (TURP) and PKRP techniques which we administered in patients with benign prostate hyperplasia (BPH) in our clinic. METHODS: Of 57 patients for whom we thought an operative intervention was necessary, 30 cases in the first group had a TURP and 24 cases in the second group had a PKRP. International prostate symptom scores (I-PSS), uroflowmetry, measurement of residual urine amount and ultrasonography were performed for each patient both preoperatively and postoperatively (first month and first year). Operation times, urethral catheterization times, preoperative and postoperative Hb, Htc and serum Na values of the patients were compared and the complications of the groups were also compared. RESULTS: On first month and first year follow up between the groups, there was no significant statistical difference in I-PSS, maximum flow rate, average flow, residual urine and size of the prostate. The decrease in serum Na level was found to be significantly higher in the TURP group (P < 0.05). The operation times were not significantly different between the groups. While the postoperative catheterization time was 75.7 h in TURP group, it was found to be 42 h in PKRP group and it was clear that catheterization time was significantly shorter (P < 0001). CONCLUSION: It is obvious that PKRP is as efficient as TURP and it has a similar morbidity. In our opinion, PKRP makes a promising treatment for BPH with its advantages, such as early removal of postoperative urethral catheter, a shorter hospital stay and the absence of TUR syndrome risk.

Aged↗

Do children with primary nocturnal enuresis have a retarded bone age? A cross-sectional study.

OBJECTIVE: Nocturnal enuresis is a common pediatric problem, the etiology of which is unclear. In recent years, various studies have been published stating that children with nocturnal enuresis exhibit growth and skeletal maturation retardation. METHODS: In this cross-sectional study, we included 27 patients (16 boys, 11 girls) between the ages of 6 and 14 years who had presented with primary nocturnal enuresis (PNE) complaints. We included in the evaluation 19 healthy subjects (12 boys, 7 girls), who were the siblings of the children with PNE, as the control group. RESULTS: The patients in both groups were similar in chronological age, bone age, height and weight, with no significant difference between groups (P>0.05). CONCLUSION: The two groups in our study consisted of the same genetic background. Thus, our results were found to be different from the previous studies. We have concluded that there is no direct relationship between enuresis nocturnal and skeletal maturation.

Adolescent↗

Stoller afferent nerve stimulation in woman with therapy resistant over active bladder; a 1-year follow up.

AIM: In this prospective observational study, we investigated the efficacy of Stoller afferent nerve stimulation (SANS) in subjects with overactive bladder who failed anticholinergic treatment. METHODS: Thirty-five subjects with overactive bladder who failed therapy with oxybutynin participated in this study. Treatment (n = 35) was given once a week for 30 minutes for overall 10 weeks. In treatment, SANS device (Urosurge) was used. Subjects were assessed with 3-day voiding diary, SEAPI quality of life questionnaires and cystometry before therapy after completion of therapy and at one-year follow-up. RESULTS: In 54% (n = 19) of subjects complete recovery was obtained after treatment. Urgency and SEAPI were reduced significantly whereas urine volume increased significantly (p < 0.01). Complete recovery was maintained in eight of the 19 subjects at one year. CONCLUSIONS: SANS treatment has a short-term positive effect in patients with resistant overactive bladder. However, it was also established that efficacy was maintained at 1 year in only 23% of subjects.

Adult↗

Effect of sildenafil citrate on viability of flaps: an experimental study in rats.

Various pharmacological agents have been used to try and elucidate the pathophysiology of ischaemia and necrosis of flaps. Their most important disadvantage is the need for relatively high doses given systemically, which increases the risk of potential side effects. Topical or local agents are more useful. Sildenafil citrate, the specific inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE 5) was studied as an antianginal drug during the late 1980s, but is now used for its effect on erectile function in men. Sildenafil citrate causes dilatation of peripheral arteries and veins and the inhibition of the thrombus-forming ability of platelets in vivo. Our study was designed to test the efficacy of sildenafil citrate on the viability of flaps.

Animals↗

Improved flap viability with site-specific delivery of sildenafil citrate using fibrin glue.

Sildenafil is a cyclic guanosine-specific phosphodiesterase type 5 (PD-5) inhibitor that is widely used for erectile dysfunction. Potent and competitive inhibition of PD-5 enhances levels of cyclic guanosine monophosphate (cGMP). Fibrin glue-apart from tissue fixation-has been used for slow release of drugs. In this study, local delivery of Sildenafil citrate with fibrin glue was accomplished to improve random flap survival. Fifty Wistar rats were randomized into 5 groups, and a standardized dorsal random-pattern skin flap was elevated in each rat. In Group I (n = 10), the base of the flap was divided, making it a "graft" control to study the graft effect. In Group II (n = 10), a thin Silastic sheet was used to separate the flap from the underlying vascular bed, and no pharmacologic treatment was given. In Group III (n = 10), only 0.5 mL of fibrin glue was applied to the flap donor site. In Group IV (n = 10), 2.5 mg of sildenafil citrate mixed in 0.5 mL of fibrin glue was applied to donor site of the flap, whereas 10 mg of sildenafil citrate mixed in 0.5 mL of fibrin glue was applied in Group V (n = 10). Area of flap survival was evaluated on postoperative seventh day. Total necrosis of all of the flaps was observed in "graft" control group (Group I). Sildenafil and fibrin glue groups (Group IV and V) resulted in a statistically significant decrease in flap necrosis compared with Groups II and III (P < 0.0001). A statistically significant difference could not be documented between Group II and Group III (P > 0.0001). The decrease in skin necrosis was statistically significant in Group V compared with Group IV (P < 0.0001). Histologic examination revealed significantly increased vascular density in Groups IV and V compared with Groups II and III (P < 0.0001), whereas a significant difference could not be documented between Groups IV and V (P > 0.0001) and between Groups II and III (P > 0.0001). In view of these results, topical sildenafil application seems to improve flap survival in random-pattern skin flaps in dose-dependent manner.

Animals↗

Effect of intraurethral Mitomycin-C on healing and fibrosis in rats with experimentally induced urethral stricture.

BACKGROUND: In the pathogenesis of urethral stricture, fibrosis is associated with an excessive collagen increase. After the recognition that topical application of Mitomycin-C (MMC) inhibits fibroblast proliferation and is effective in preventing scar formation, many studies have been carried out on this subject outside the scope of urology. The aim of the present study is to observe the intraurethral impact of the employment of low doses of MMC on scar formation and fibrosis in experimental rat model. METHODS: Urethral injuries were made by internal urethrotomy knife. The study was carried out with 35 adult male Wistar albino rats. Five rats were allocated to the control group (group 1), 10 to a group that was administered 2 mg/L MMC (group 2) and 20 to a group that was administered 10 mg/L MMC (group 3). Mitomycin-C was administered to the injured urethra in the form of irrigation for 5 min. The rats were sacrificed 14 days later in order to evaluate chronic inflammation and fibrosis and their penises were histopathologically examined under light microscopy with hematoxilen eosin and trichrom stains. RESULTS: When group 2 was compared with control group, the differences in hemosiderin-laden macrophages (HLM), mononuclear cell infiltration (MCI) and fibrosis were found to be statistically significant (P < 0.01, P < 0.05, P < 0.005, respectively). When group 3 was compared with control group, the differences in HLM, MCI and fibrosis were also found to be statistically significant (P < 0.05, P < 0.05, P < 0.005, respectively). In the comparison of group 2 with group 3, no statistically significant differences were found in terms of the these parameters. CONCLUSIONS: Although MMC is toxic at high doses, the antifibrotic effect of the intraurethral low dose MMC may be useful in combination therapy for internal urethrotomy.

Animals↗

A huge bladder cystine stone.

An unusual cystine stone that occur only in patients, who have cystinuria is presented in 24-year-old man. Radiographs showed a giant bladder stone shadow, 8.0 x 10.0 x 5.0 cm in size. The literature was reviewed to identify the giant stones as well as the huge cystine stone which is exceptional yet as.

Adult↗