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    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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    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