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    Comparative results of transurethral incision with transurethral resection of the prostate in renal transplant recipients with benign prostate hyperplasia
    (Urol & Nephrol Res Ctr-Unrc, 2018) Sarıer, Mehmet; Duman, İbrahim; Kılıç, Süleyman; Yüksel, Yücel; Demir, Meltem; Aslan, Mesut; Emek, Mestan; Yücetin, Levent; Tekin, Sabri; Yavuz, Asuman Havva
    Purpose: The aim of this study is to compare the results of transurethral incision of the prostate (TUIP) and transurethral resection of the prostate (TURP) for the surgical treatment of benign prostate hyperplasia (BPH) in patients with renal transplantation. Materials and Methods: Between April 2009 and May 2016, BPH patients with renal transplants whose prostate volumes were less than 30 cm(3) were treated surgically. Forty-seven patients received TURP and 32 received TUIP. The patients' age, duration of dialysis, duration between transplant and TURP/TUIP, preoperative and postoperative serum creatinine (SCr), International Prostate Symptom Score (IPSS), maximum flow rate (Qmax) and postvoid residual volume (PVR) were recorded. At 1-,6- and 12-month follow-up, early and long-term complications were assessed. Results were evaluated retrospectively. Results: In both groups, SCr, PVR and IPSS decreased significantly after the operation, while Qmax increased significantly (P < .001). There was no difference between the two groups in terms of increase in Qmax and decrease in IPSS, SCr and PVR (P = .89, P = .27, P = .08, and P = .27). Among postoperative complications, urinary tract infection (UTIs) and retrograde ejaculation (RE) rates were higher in the TURP group than the TUIP group (12.7% versus 6.2% and 68.1% versus 25%,respectively), whereas urethral strictures were more prevalent in the TUIP group (12.5% versus 6.3%). Conclusion: For the treatment of BPH in renal transplant patients with a prostate volume less than 30 cm(3) , both TUIP and TURP are safe and effective.
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    Öğe
    Comparative Results of Transurethral Incision with Transurethral Tesection of the Prostate in Renal Transplant Recipients with Benign Prostate Hyperplasia
    (Lippincott Williams & Wilkins, 2018) Sailer, Mehmet; Duman, Ibrahim; Yuksel, Yucel; Demir, Meltem; Yucetin, Levent; Tekin, Sabri; Yavuz, Asuman H.
    [No abstract available]
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    Öğe
    Results of minimally invasive surgical treatment of allograft lithiasis in live-donor renal transplant recipients: a single-center experience of 3758 renal transplantations
    (Springer, 2019) Sarıer, Mehmet; Duman, İbrahim; Yüksel, Yücel; Tekin, Sabri; Demir, Meltem; Arslan, Fatih; Yavuz, Asuman Havva
    Allograft lithiasis is a rare urologic complication of renal transplantation (RT). Our aim is to present our experience with minimally invasive surgical treatment of allograft lithiasis in our series of live-donor renal transplant recipients. In a retrospective analysis of 3758 consecutive live-donor RTs performed in our center between November 2009 and January 2017, the results of minimally invasive surgery for the treatment of renal graft lithiasis diagnosed at follow-up were evaluated. Twenty-two (0.58%) patients underwent minimally invasive surgery for renal graft lithiasis. The mean age was 41.6 years, and duration between RT and surgical intervention was 27.3 months (range 3-67). The mean stone size was 11.6 mm (range 4-29). Stones were located in the urethra in 1, bladder in 2, ureter in 9, renal pelvis in 7 and calices in 3 patients. Surgical treatment included percutaneous nephrolithotomy in 1, cystoscopic lithotripsy in 3, flexible ureteroscopic lithotripsy in 6 and rigid ureteroscopic lithotripsy in 12 patients. No major complications were observed. One patient (4.5%) who underwent flexible ureteroscopy developed postoperative urinary tract infection. All patients were stone-free except two (9%) patients who required a second-look procedure after flexible ureteroscopic lithotripsy for residual stones. Stone recurrence was not observed in any patient during a mean follow-up duration of 30.2 months (range 8-84). Renal transplant lithiasis is uncommon and minimally invasive surgical treatment is rarely performed for its treatment. Endourological surgery may be performed safely, effectively and with a high success rate in these patients.
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    Öğe
    Results of multiplex polymerase chain reaction assay to ıdentify urethritis pathogens
    (2017) Sarıer, Mehmet; Duman, İbrahim; Göktaş, Şafak; Demir, Meltem; Kukul, Erdal
    Objective: The purpose of this study was to evaluate the results of multiplex polymerase chain reaction (PCR) test applied to identify the pathogens in male patients who attended our urology clinic with a pre-diagnosis of urethritis related with sexual intercourse.Materials and Methods: In this study, we included a total of 91 male patients, who sought medical advice in our clinic between August 2015 and October 2016 due to complaints of urethral discharge, dysuria and urethral itching, having a visible urethral discharge during the physical examination or a positive leukocyte esterase test (Combur-Test®-Roche) in the first urine sample. In the urethral swab samples of these patients, urethritis pathogens were searched with a multiplex PCR test. The multiplex PCR kit, which is able to identify nine pathogens and produced by PathoFinder® (Holland), was used in the process. The pathogens that could be detected by the kit were Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, Gardnerella vaginalis, Trichomonas vaginalis, Treponema pallidum, and Candida albicans.Results: The average age of the subjects was 35.1 years. Sixty one out of 91 patients (67%) were found to have a pathogen in the urethral swab sample. In 45 patients (49.4%), only one pathogen, in 12 (13.1%) - two different pathogens and in 4 (4.3%) patients, 3 different pathogens were detected. The pathogens found were as follows: Ureaplasma urealyticum in 22 patients (27.1%), Gardnerella vaginalis in 15 (18.6%), Neisseria gonorrhoeae in 13 (16.1%), Mycoplasma genitalium (10 patients; 12.3%), Mycoplasma hominis (8 patients; 9.9%), Chlamydia trachomatis (8 patients; 9.9%), Trichomonas vaginalis (3 patients; 3.8%), and Candida albicans (2 patients; 2.4%). None of the patients were identified with Treponema pallidum. None of the pathogens were identified in 30 patients (32.9%) whose samples were examined by PCR method.Conclusion: Sexually transmitted pathogens that are quite difficult to identify and that cause urethritis are possibly defined with only one swab sample in a short time using multiplex PCR method providing new possibilities and scopes for the diagnosis.
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    Öğe
    Results of transurethral resection of the prostate in renal transplant recipients: A single center experience
    (Springer, 2018) Sarıer, Mehmet; Tekin, Sabri; Duman, İbrahim; Yüksel, Yücel; Demir, Meltem; Alptekinkaya, Furkan; Koşar, Alim; Yavuz, Asuman Havva; Güler, Mehmet
    The aim of this study was to retrospectively evaluate the early and long-term results of renal transplantation (RT) patients undergoing transurethral resection of the prostate (TURP) due to benign prostate hyperplasia (BPH). Eighty-nine patients with RT performed in our hospital underwent TURP between November 2008 and March 2016. Results were evaluated along with early and long-term complications. Patients were followed up for a minimum of 12 months. The mean age of the patients was 61.4 +/- 7.4 years. The median duration of dialysis was 28 (0-180) months. The median duration between transplantation and TURP was 13 (0-84) months. Before TURP, the mean serum creatinine (sCr) was 1.99 +/- 0.83 mg/dL and the mean prostate volume was 33.3 +/- 14.6 cm(3). The mean Q (max), Q (ave) and PVR values were 9.5 +/- 3.7, 5.2 +/- 2.2 ml/s and 85(5-480) mL, respectively. None of the patients developed perioperative and postoperative major complications. Twelve patients (13.4%) developed urinary tract infections in the postoperative period. The sCr, IPSS and PVR values significantly decreased, while Q (max) and Q (ave) significantly increased at the 1-month follow-up. At the 6-month follow-up, 63 (70.8%) patients had retrograde ejaculation. Patients were followed up for a median of 42 (12-96) months. Three patients (3.3%) were re-operated for bladder neck contracture and eight (8.9%) patients were re-operated for urethral stricture. TURP can be safely and successfully applied for the treatment of BPH after RT. LUTS and renal functions significantly improve after the operation. Patients should be followed up for UTIs in the short term and for urethral stricture in the long term.
  • Küçük Resim
    Öğe
    The outcomes of transurethral incision/resection of the prostate (TUIP/TURP) performed early after renal transplantation
    (2018) Sarıer, Mehmet; Duman, İbrahim; Demir, Meltem; Yüksel, Yücel; Emek, Mestan; Kukul, Erdal
    Objective: In the early period after renal transplantation, urinary retention stemming from bladder outlet obstruction (BOO) may directly affect graft success. The aim of this study was to evaluate the early and long-term outcomes of transurethral resection of the prostate (TURP) and transurethral incision of prostate (TUIP) procedures performed in the first month following RT due to BOO. Material and methods: Between February 2009 and March 2016, 38 male patients underwent TURP/ TUIP due to BOO within the first 30 days of renal transplantation. The urodynamic and renal function assessment results of all patients were collected during the pre-and postoperative periods. All patients were followed up for a minimum of 12 months for short and long-term complications. The results were evaluated retrospectively. Results: The mean age of the patients who underwent operations was 59.2±12 years. The median duration of dialysis was 41 months (range 0-180). Before the operation the mean serum creatinine (sCr) level was 1.8±0.7 mg/dL, the mean total PSA level was 1.6±1.1 ng/mL. Of the voiding parameters, the mean Qmax and Qave were measured as 8.2±4.5 mL/sec and 4.6±2.5 mL/sec, respectively. The median post-micturition residual urine (PMR) was 105 mL (range 10-400). TURP/TUIP operations were performed at a median of 19 days (range 8-30) after renal transplantations. None of the patients experienced major complications. In the early postoperative period, 5 patients (13.1%) developed urinary tract infection. The mean decrease in sCr in the first month following TURP/TUIP was 1.4±0.4 mg/dL (p<0.001). The mean Qmax (22.4±11.1 mL/sec), and Qave (11.7±5.4 mL/sec) increased significantly (p<0.001), while the median PMR (15 mL, range 0-205) decreased significantly (p<0.001). The mean follow-up period after the procedure was 46.8±23.3 months. During the follow-up period, 3 (7.8%) patients suffered from urethral stricture and 2 (5.2%) patients from bladder neck obstruction. Conclusion: In the surgical treatment of urinary retention arising from BOO in the first month following renal transplantation, TURP/TUIP yield safe and successful results. In addition, regarding the short and long term outcomes, these procedures may be safely performed with low morbidity