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Öğe A Stacking Ensemble Learning Approach for Intrusion Detection System(2021) Uçar, Murat; Uçar, Emine; İncetaş, Mürsel OzanIntrusion detection systems (IDSs) have received great interest in computer science, along with increased network productivity and security threats. The purpose of this study is to determine whether the incoming network traffic is normal or an attack based on 41 features in the NSL-KDD dataset. In this paper, the performance of a stacking technique for network intrusion detection was analysed. Stacking technique is an ensemble approach which is used for combining various classification methods to produce a preferable classifier. Stacking models were trained on the NSLKDD training dataset and evaluated on the NSLKDDTest+ and NSLKDDTest21 test datasets. In the stacking technique, four different algorithms were used as base learners and an algorithm was used as a stacking meta learner. Logistic Regression (LR), Decision Trees (DT), Artificial Neural Networks (ANN), and K Nearest Neighbor (KNN) are the base learner models and Support Vector Machine (SVM) model is the meta learner. The proposed models were evaluated using accuracy rate and other performance metrics of classification. Experimental results showed that stacking significantly improved the performance of intrusion detection systems. The ensemble classifier (DT-LR-ANN + SVM) model achieved the best accuracy results with 90.57% in the NSLKDDTest + dataset and 84.32% in the NSLKDDTest21 dataset.Öğe Can antibiotic preference affect bleeding in percutaneous nephrolithotomy? Retrospective comparative study of two commonly used antibiotics(Professional Medical Publications, 2020) Akkoç, Ali; Aydın, Cemil; Uçar, Murat; Topçuoğlu, MuratObjective: Bleeding is one of the most common and alarming complication of percutaneous nephrolithotomy (PCNL). In this study, we aimed to compare the effects of ciprofloxacin and cefuroxime on the bleeding in PCNL procedures. Methods: The study was a retrospective analysis of 97 patients who underwent PCNL between February 2011 and June 2017. We just included the patients who had single tract lower pole PCNL for more objective evaluation of bleeding in the study. The patients were divided into two groups as ciprofloxacin group (Group-I, n:40) and cefuroxime group (Group-II, n:56) according to the type of antibiotic used in the operation. Patient age, gender, body mass index, stone size, preoperative INR, preoperative and postoperative platelet counts and difference, operative time, need for blood transfusion, postoperative fever, hospital stay, postoperative hemoglobin and hematocrit drop were analyzed. Results: There was no statistically significant difference in patients' gender distribution, body mass index, preoperative INR, preoperative and postoperative platelet counts, preoperative and postoperative platelet difference, duration of operation, hospital stay, postoperative fever and need for postoperative blood transfusion between two antibiotic groups (p > 0.05). Mean patient age was 42,75 +/- 16,97 in Group-I and 35,54 +/- 14,71 in Group-II (p < 0.05). The mean stone size of Group-I and Group-II were 27,23 +/- 7,05 mm and 30,59 +/- 8,20, respectively (p < 0.05). The mean postoperative hemoglobin and hematocrit drop were significantly higher in Group-I than in Group-II. The mean hemoglobin drop was 1,73 +/- 0,95 for Group-I and 1,28 +/- 0,67 for Group-II (p < 0.05). The mean hematocrit drop was 5,17 +/- 2,76 for Group-I and 3,80 +/- 1,99 for Group-II (p < 0.05). Conclusion: On the basis of the results of the initial study, the antibiotic preference in patients undergoing surgery may be one of the bleeding factors during and after PCNL.Öğe Can subfoveal choroidal thickness replace subjective tests in patients using tadalafil to treat erectile dysfunction?(Blackwell Publishing Ltd, 2020) Aslan, Fatih; Topçuoğlu, Murat; Öktem, Çağlar; Akkoç, Ali; Uçar, MuratWe aimed to determine the effect on choroidal thickness of daily 5 mg tadalafil use in patients with erectile dysfunction (ED) and to evaluate agreement between short form of International Index of Erectile Function (IIEF 1–5, 15) scores and choroidal thickness during follow-up. Enhanced depth imaging spectral domain–optical coherence tomography (EDI-OCT) was used to measure full choroidal thickness in the subfoveal area, choroidal thickness (CT) and small-choroidal-vessel-layer (SCVL) thickness. Thirty of the 45 patients included complete their follow-ups and exhibited medication continuity. Patients were divided into two groups, five (16.7%) with ED at any level at third-month follow-up, and 25 (83.3%) with no ED, and subgroup analysis was then performed. Median changes in SCVL thickness at first- and sixth-month follow-ups were 20.5 µm versus 9.0 ?m (p =.001) and 23.5 µm versus 12.5 µm (p =.005) in patients without and with ED respectively. The SCVL thickness increased by 20 ?m compared with the baseline level, indicating an improvement in the patient's complaints of erectile dysfunction. The level of increase in SCVL thickness can be a useful and objective guide to clinicians if they cannot be present when the IIEF questionnaire is administered. © 2020 Blackwell Verlag GmbHÖğe Can we predict preoperative tumor aggressivity with hemogram parameters in renal cell carcinoma? a novel calculation method(Springer, 2019) Uçar, Murat; Soyupek, Sedat; Oksay, Taylan; Özorak, Alper; Akkoç, Ali; Topçuoğlu, Murat; Koşar, AlimWe aim to investigate the prognostic significance of the hemoglobin X lymphocyte / neutrophil ratio (HLNR) and hemoglobin x lymphocyte / platelet ratio (HLPR) with tumor aggressivity in patients with renal cell carcinoma. We retrospectively analyzed 127 patients' data who had diagnosed as renal cell carcinoma between 2008 and 2019 in Suleyman Demirel University Hospital. Tumor and patient characteristics, hemoglobin, neutrophil, lymphocyte, platelet values HLNR and HLPR were calculated in preoperative hemogram parameters. The relationship between tumor pathological stage, Fuhrman nuclear grade and tumor necrosis with HLPR and HLNR analyzed with statistically. There was a negative correlation between pathologic stage, Fuhrman nuclear grade and tumor necrosis with HLNR. P values are 0.003, 0.012 and 0.015 respectively. HLNR was lower in patients with high pathologic stage, high Fuhrman nuclear grade and accompanying tumor necrosis positiveness. There was a negative correlation between pathologic stage, Fuhrman nuclear grade and tumor necrosis with HLPR. P values are 0.001, 0.014 and 0.047 respectively. HLPR was lower in patients with high pathologic stage, high Fuhrman nuclear grade and accompanying tumor necrosis positiveness. High pathological stage, high Fuhrman nuclear grade and existence of tumor necrosis are associates with preoperative low HLNR and low HLPR in renal cell carcinoma patients. They can be used as prognostic markers in patients with renal mass preoperatively.Öğe ChatGPT-3.5 and ChatGPT-4 Performance in Testicular Cancer: A Comparative Study(2025) Uysal, Ümit; Uçar, Murat; Sağır, SüleymanObjective: The aim of our study is to assess the reliability of Chat Generative Pre-trained Transformer (ChatGPT), compare the performance of ChatGPT-4 to ChatGPT-3.5, and explore its potential roles in healthcare decision-making. Materials and Methods: Thirty questions related to testicular cancer were prepared, based on the 2023 European Association of Urology guidelines and clinical experience. These questions were systematically posed to ChatGPT-3.5 and ChatGPT-4, and responses were rated by three independent urologists using a six-point Likert scale. The median score from the three specialists was used as the final score. Results: Both ChatGPT versions provided an incorrect answer to one question, scoring a one. For GPT-3.5 and GPT-4, the percentage of responses considered incorrect by the urologists was 20% and 13.3%, respectively, while correct responses (scoring 3 or higher) accounted for 80% and 86.7%. For general information-diagnosis questions, GPT-3.5 and GPT-4, had average scores of 4.29 and 4.80, with median values of 4.27 and 4.67. For treatment follow-up questions, average scores were 3.60 and 4.16, with median values of 3.60 and 4.20. GPT 4 generally outperformed GPT-3.5, but the difference was not statistically significant (p>0.05). Conclusion: Our study shows that ChatGPT-4 is more reliable and accurate than ChatGPT-3.5 in testicular cancer-related queries. Continued development of its database and clinical capabilities could optimize ChatGPT’s utility in healthcare.Öğe Duloxetine in the Treatment of Women with Urinary Incontinence: A Systematic Review and Meta-analysis of Efficacy Data from Randomized Controlled Clinical Trials(2023) Mangir, Naside; Uçar, Murat; Gülpınar, Ömer; Özkürkçügil, Cüneyd; Demirkesen, Oktay; Tarcan, TufanDuloxetine is the only available agent for the medical treatment of stress urinary incontinence (SUI). In this systematic review, we analyzed the efficacy and safety of duloxetine treatment in women with SUI and stress-predominant mixed urinary incontinence (SPMUI). We searched the literature using OVID MEDLINE, Embase and ULAKBIM (Turkish database) databases for placebo-controlled studies on the use of duloxetine in women with SUI or SPMUI. Data on change in incontinence episode frequency (IEF), decrease in the number of continence pads used, increase in voiding interval (minute) and discontinuation rates due to adverse effects and lack of efficacy (%) were extracted. A total of 12 randomized controlled trials were included. Duloxetine treatment results in an 18% decrease in IEF and 16% decrease in the number of incontinence pads used compared to pre-treatment status. It also increases the time interval between the voids by 18 min. Duloxetine treatment was associated with higher treatment discontinuation rates compared with placebo. The reason for discontinuation was related to the side effects of the treatment rather than lack of efficacy. Duloxetine can be an effective treatment option in women with UI based on high-level evidence supporting its efficacy. Further studies with larger patient populations and longer durations of follow-up are required to assess its safety profile.Öğe Duloxetine in the Treatment of Women with Urinary Incontinence: A Systematic Review and Meta-analysis of Efficacy Data from Randomized Controlled Clinical Trials(Galenos Publishing House, 2023) Mangir, Naside; Uçar, Murat; Gülpınar, Ömer; Ozkurkcugil, Cüneyd; Demirkesen, Oktay; Tarcan, TufanDuloxetine is the only available agent for the medical treatment of stress urinary incontinence (SUI). In this systematic review, we analyzed the efficacy and safety of duloxetine treatment in women with SUI and stress-predominant mixed urinary incontinence (SPMUI). We searched the literature using OVID MEDLINE, Embase and ULAKBIM (Turkish database) databases for placebo-controlled studies on the use of duloxetine in women with SUI or SPMUI. Data on change in incontinence episode frequency (IEF), decrease in the number of continence pads used, increase in voiding interval (minute) and discontinuation rates due to adverse effects and lack of efficacy (%) were extracted. A total of 12 randomized controlled trials were included. Duloxetine treatment results in an 18% decrease in IEF and 16% decrease in the number of incontinence pads used compared to pre-treatment status. It also increases the time interval between the voids by 18 min. Duloxetine treatment was associated with higher treatment discontinuation rates compared with placebo. The reason for discontinuation was related to the side effects of the treatment rather than lack of efficacy. Duloxetine can be an effective treatment option in women with UI based on high-level evidence supporting its efficacy. Further studies with larger patient populations and longer durations of follow-up are required to assess its safety profile. © Copyright 2023 by the Association of Urological Surgery / Journal of Urological Surgery published by Galenos Publishing House.Öğe Evaluation of exposure and awareness of radiation in healthcare professionals exposed to ionizing radiation(2020) Uçar, Murat; Akkoç, Ali; Topçuoğlu, Murat; Öztürk, Sefa Alperen; Demir, MuratAim: To evaluate radiation exposure and awareness of radiation in healthcare professionals exposed to ionizing radiation. Material and Methods: The study was carried out at the Alanya Alaaddin Keykubat University Training and Research Hospital and the Süleyman Demirel University Hospital. Physicians, nurses, paramedics, anesthesia technicians, caregivers and cleaning staff exposed to radiation, participated in the study. An inquiry form was prepared to carry out the study, in which the demographic characteristics of the healthcare professionals, the characteristics related to the radiation they were exposed to, the effects that may occur due to this exposure were asked; the relationship between these was statistically analyzed according to the answers. Results: One hundred twenty-nine healthcare professionals, 81 men and 48 women, participated in the study. Most of the healthcare professionals exposed to radiation have been working for more than 10 years and at a distance of less than 3 meters to the radiation source. Thirty-two of the participants (24.8%) did not use any personal protective equipment. On the day of exposure to radiation, 91 persons (70.54%) were experiencing symptoms such as weakness, fatigue, and headache, unlike other days. It was determined that personal protective equipment use did not correlate to education levels and radiation training background. Conclusion: Most of the healthcare professionals exposed to radiation have not previously received any training on radiation and do not use personal protective equipment regularly. This situation causes these persons to complain of weakness, tiredness or headaches at the end of the day.Öğe Expression and diagnostic potential of circulating miR-107, miR-134-5p, miR-149-5p, miR-370-3p, and miR-221 in prostate cancer and benign prostatic hyperplasia: A preliminary study(Page Press Publications, 2025) Akkoç, Ali; Sarban, Hamiyet Eciroglu; Yildiz, Fatma; Günizi, Ozlem Ceren; Uçar, MuratBackground: MicroRNAs (miRNAs) have shown promise as diagnostic biomarkers for prostate cancer (PCa). This study aimed to evaluate the expression of miR-107, miR-134-5p, miR-149-5p, miR-370-3p, and miR-221 in whole blood to distinguish PCa from benign prostatic hyperplasia (BPH) and potentially reduce unnecessary biopsies. Methods: Whole blood samples were collected from 20 PCa patients, 17 histologically-confirmed BPH patients (all with PSA > 4 ng/mL), and 20 healthy controls over 60 years without symptoms suggesting prostatic disease and PSA < 4 ng/mL. miRNA levels were quantified using qRT-PCR. Diagnostic potential was assessed via correlation analyses with clinical parameters and ROC curve evaluation. Statistical significance was set at p < 0.05. Results: miR-107, miR-134-5p, miR-149-5p, and miR-370-3p were significantly overexpressed in PCa patients compared to BPH (p < 0.0001). ROC analysis identified miR-134-5p (AUC: 0.94) and miR-149-5p (AUC: 0.93) as strong predictors of PCa. Additionally, miR-149-5p showed a positive correlation with PSA levels (r = 0.2627, p < 0.05). Conclusions: This preliminary study demonstrated that miR-107, miR-134-5p, miR-149-5p, and miR-370-3p were significantly overexpressed in PCa patients compared to the BPH group. ROC analysis highlighted their diagnostic potential in distinguishing BPH from PCa. Despite the limited sample size, these findings provide early evidence to guide future research on the diagnostic value of miRNAs in prostate cancer. © 2025, Page Press Publications. All rights reserved.Öğe How did the COVID-19 pandemic affect audience’s attitudes in webinars?(2021) Tanıdır, Yılören; Gökalp, Fatih; Akdoğan, Nebil; Batur, Ali Furkan; Şekerci, Çağrı Akın; Eğriboyun, Sedat; Değer, Mutlu; Şahin, Bahadır; Akarken, İlker; Aydın, Cemil; Altan, Mesut; Oktay, Ozman; Uçar, Murat; Güdeloğlu, Ahmet; Ongun, Şakir; Akbal, Cem; Esen, AdilIntroduction: Following the COVID-19 pandemic, the face-to-face meetings are delayed to a future date, which is still not clear. However, seminars, meetings and conferences are necessary for updating our knowledge and skills. Web-based seminars (webinars) are the solutions to this issue. This study aimed to show the participant behaviour when webinars present at the COVID-19 pandemic era. Methods: From December 2017 to July 2020, 58 webinars were broadcasted via the Uropedia, electronic library of SUST. Data of all webinars were collected with the YouTube analytics and application of the Uropedia. Data of streaming webinars included participant behaviours such as content views, engagement time, total unique attendees, average engagement time and the number of audience to leads. Data were split into two groups; group-1 is webinars before COVID-19 (before March 2020) and group-2 is the webinars during COVID-19. Results: Total broadcast time and total page view number were found to be 112.6 hours (6761 minutes) and 15 919, respectively. The median participant age was 40.1 y. Median content view and median engagement time were found to be 261.0 and 12.2 minutes, respectively. Comparison of two groups revealed a significant increment in the content views (group-1; 134.0 range = 86.0-87.0 and group-2; 414.0 range = 296.0-602.0, P < .001) and the number of the unique attendees (group 1; 18.0 range = 10.0-26.0 and group-2; 57.0 range = 27.0-100.0, P < .001) following COVID-19. However, the median engagement time of the audience did not seem to change with the COVID-19 pandemic (group-1; 11.5 range = 10.0-13.3 minutes and group-2; 13.2 range = 9.4-18.1 minutes, P = .12). Conclusion: The webinars are effective ways to share information and have many advantages, including low cost, reaching a high number of audiences. Audience number and page visits seemed to increase following the COVID-19 pandemic. However, this era did not seem to affect the critical attitude of the audience, which is engagement time.Öğe İyonlaştırıcı radyasyona maruz kalan sağlık çalışanlarında radyasyon maruziyeti ve farkındalığının değerlendirilmesi(Alanya Alaaddin Keykubat Üniversitesi, 2020) Uçar, Murat; Akkoç, Ali; Topçuoğlu, Murat; Öztürk, Sefa Alperen; Demir, MuratAmaç: İyonize radyasyona maruz kalan sağlık çalışanlarında radyasyon maruziyeti ve farkındalığını değerlendirmek.Gereç ve Yöntem: Çalışma Alanya Alaaddin Keykubat Üniversitesi Eğitim ve Araştırma Hastanesi ve Süleyman Demirel Üniversitesi Hastanesi’nde gerçekleştirildi. Çalışmaya radyasyona maruz kalan hekimler, hemşireler, sağlık memurları, anestezi teknisyenleri, hasta bakıcıları ve temizlik personelleri katıldı. Çalışmayı gerçekleştirmek için bir sorgulama formu hazırlandı. Bu formda çalışanların demografik özellikleri, maruz kaldığı radyasyon ile ilgili özellikler, bu maruziyete bağlı oluşabilecek etkiler soruldu ve cevaplara göre aralarında ilişki olup olmadığı istatistiksel olarak incelendi. Bulgular: Çalışmaya 81 erkek, 48 kadın olmak üzere 129 sağlık çalışanı katıldı. Radyasyona maruz kalan sağlık çalışanlarının çoğu 10 yıldan daha uzun süredir ve radyasyon kaynağına 3 metreden daha yakın mesafede çalışmaktaymış. Çalışmaya katılanlardan 32 (%24,8) si hiçbir kişisel koruyucu donanım (KKD) kullanmıyordu. Radyasyona maruz kalındığı gün 91 kişi diğer günlerden farklı olarak halsizlik, yorgunluk, baş ağrısı gibi bir şikayet hissediyormuş. KKD kullanımının öğrenim düzeyi ve radyasyon eğitimi almakla ilişkisi olmadığı saptandı.Sonuç: Radyasyona maruz kalan sağlık çalışanlarının çoğu radyasyon ile ilgili daha önce bir eğitim almamış ve KKD’leri düzenli kullanmamaktadır. Bu durum kişinin gün sonunda halsizlik, yorgunluk ya da baş ağrısı gibi şikayetleri olmasına neden olmaktadır.Öğe Laparoskopik radikal prostatektomi deneyimlerimiz: Tek merkez sonuçları(Alanya Alaaddin Keykubat Üniversitesi, 2017) Uçar, Murat; Akkoç, Ali; Oksay, Taylan; Çapkın, Tahsin; Soyupek, Sedat; Koşar, AlimAmaç: Kiliniğimizdelaparoskopik radikal prostatektomi operasyonu yapılan hastaların özellikleriile onkolojik ve fonksiyonel sonuçlarının değerlendirilmesi.Hastalarve Yöntem:Kliniğimizde 2008-2011 yılları arasında baştan sona laparoskopik olarak yapılan23 radikal prostatektomi vakası retrospektif olaraktarandı. Hastaların preoperatif özellikleri, perioperatif vepostoperatif komplikasyonları ve bunların tedavileri, biyokimyasal nüksoranları incelendi.Bulgular: Hastaların operasyonsonrası prostatektomi patolojileri 19 hastada Gleason skoru 3+3 (%82,6), 3hastada 3+4 (%13), 1 hastada 4+3 (%4,3) olarak geldi. Cerrahi sınır 5(%21,7) hastada pozitif (+) olaraktespit edildi. TNM 2009 evrelemesine göre 4 (%17,3) hastanın patolojisi T2a, 13(%56,5) hastanın T2c, 5 (%21,7) hastanın T3a, 1 (%4,3) hastanın T3b olarakgeldi. İki (%8,6) hastada postoperatifanastomoz kaçağı meydana gelmiş, 1 (%4,3) hastada ise vezikorektal fistülmeydana gelmiştir. On beş (%65,2) hastada postoperatif dönemde erektildisfonksiyon (ED) gelişmiştir. Beş (%21,7) hasta anastomoz darlığı nedeniyletekrar opere edilmiştir. Postoperatif 1. yılda 3 (%13) hastada biyokimyasalnüks saptanmıştır (prostat spesifik antijen (PSA) değeri >0,2 ng/ml). Sonuç: Onkolojik ve fonksiyonel sonuçlaraçısından bakıldığında açık retropubik radikal prostatektomi (RRP) velaparoskopik radikal prostatektomi (LRP) sonuçları benzerdir. Ancak LRP’deöğrenme eğrisi uzun olduğu için operasyon süresi ilk serilerde RRP’den dahauzundur. Öğrenme eğrisi tamamlandıktan sonra LRP postoperatif ağrı, kantransfüzyonu ihtiyacı, hastanede kalış süresi açısından RRP’ye göre dahaavantajlı bir cerrahi tekniktir.Öğe Microsurgical testicular sperm extraction results in nonobstructive azospermic disease and evaluation of the factorsa affecting these results(Alanya Alaaddin Keykubat Üniversitesi, 2017) Uçar, Murat; Oksay, Taylan; Özorak, Alper; Soyupek, Sedat; Armağan, Abdullah; Koşar, AlimAim: To investigate the hormonal properties and results of 71 patients, who were diagnosed with nonobstructive azoospermia (NOA) and performed micro-TESE (microsurgical testicular sperm extraction) at our clinic, and the relationship of these results and Johnsen scores. Patients and Method: We retrospectively reviewed the data of 71 patients who came to our clinic and were diagnosed with NOA and got performed micro-TESE between the years of 2010 and 2014. Variables such as age, the duration of infertility, operations underwent, mean testis volumes, blood FSH (follicle stimulated hormone), LH (luteinizing hormone), total testosterone and prolactin levels, results and their relations with sperm retrieval rates were examined. Results: Sperm were found in 25 (35.21%) of 71 patients, who were performed micro-TESE, and 6 (8.45%) of them have developed pregnancy. Mean testis volumes were found 14.3 ± 3.80 (4-22) cc on the right and 13.7 ± 3,41 (4-20) cc on the left. As FSH and LH values increased, the probability of sperm retrieval rate was decreased (p <0.05). There was no correlation between total testosterone and prolactin levels with sperm retrieval in TESE (p> 0,05). Conclusion: In micro-TESE, the success of sperm retrieval can be affected by patient age, having testis operation history, testis volume, patient's hormonal profile. Sperm retrieval success correlates with histology, blood FSH and LH values, if there is a relation sperm retrieval success and patient age, duration of infertility, blood total testosterone, prolactin levels and testis volume is unclear.Öğe Nadir bir olgu; Testiküler rüptür(Alanya Alaaddin Keykubat Üniversitesi, 2017) Uçar, Murat; Akkoç, AliAkut skrotumçocukluk ve adölesan dönemde sık görülen ürolojik acillerden birisidir. Testisyaralanmalarında testiküler rüptür oldukça nadir görülen bir durumdur.Testiküler rüptürde erken eksplorasyon ve onarım gerekmektedir. Erkeneksplorasyon testis orşiyektomi oranlarını azaltmaktadır. Bu çalışmada biznadir görülen bir durum olan künt travma sonrası testiküler rüptür olan birhastayı ve tedavisini sunduk.Öğe Perinephric abscess as a rare cause of acute abdomen: A case report(Selçuk BAŞAK, 2020) Güler, Yilmaz; Şengül, Serkan; Çalış, Hasan; Uçar, Murat; Özen, ÖzkanRenal and perinephric abscesses are usually confined within the Gerota's fascia and treated with conservatively. We herein present a case with peritonitis caused by the spillage of perinephritic abscess into the abdomen through the Gerota’s fascia, which is clinical outcome. A 41-year-old female patient was admitted to emergency room with complaints of abdominal pain, bloating, fever, and fatigue. During the operation, an abscess of approximately 20x15cm in size was observed to extend into the abdominal cavity through the Gerota's fascia, causing secondary peritonitis. On the 20th postoperative day, the patient was uneventfully discharged. Delay in diagnosis of renal and perinephric abscesses can lead to fatal complications. Laparotomy is a life-saving approach in cases that cannot be treated with percutaneous drainage, when the abscess is large and causes complications such as strictures, fistulas, or secondary peritonitis, by extension through the Gerota's fascia, as in our case.Öğe Renal kitle nedeniyle radikal nefrektomi yapılan hastaların tümör karakteristiklerinin değerlendirilmesi: 18 yıllık sonuçlarımız(2019) Uçar, Murat; Soyupek, Sedat; Oksay, Taylan; Özorak, Alper; Güzel, Ahmet; Öztürk, Sefa AlperenAmaç Süleyman Demirel Üniversitesi Tıp Fakültesi’nde 18 yıllık süreçte böbrekte kitle nedeniyle radikal nefrektomi veya parsiyel nefrektomi yapılan hastaların demografik özelliklerinin, tümör histopatolojilerinin ve bunların birbirleriyle ilişkisinin incelenmesi. Gereç ve Yöntem Şubat 2000 - Kasım 2017 arasında Süleyman Demirel Üniversitesi Üroloji poliklinigine başvuran ve böbrekte kitle tanısıyla radikal nefrektomi veya parsiyel nefrektomi yapılan 245 hastanın verileri incelendi. Hastaların yaşı, cinsiyeti, preoperatif görüntülemedeki lezyon boyutu, patolojik lezyon boyutu, patolojik tanısı, varsa histolojik subtipi ve fuhrman derecesi, mikrovasküler invazyon, sinir invazyonu, sürrenal invazyonu, lenf nodu invazyonu, tümör nekrozu, eşlik eden piyelonefrit verileri değerlendirildi. Hastaların demografik özelliklerinin yanısıra, yaş ile klinik tümör evresi arasındaki ilişki, histolojik subtip ile patolojik evre arasındaki ilişki, metastaz ile tümör boyutu arasındaki ilişki, tümör nekrozu ile patolojik evre arasındaki ilişki, tümöre eşlik eden piyelonefrit ile patolojik evre arasındaki ilişki, mikrovasküler invazyon ile patolojik evre arasındaki ilişki ve sinir invazyonu ile patolojik evre arasındaki ilişkiler iki değişkenli korelasyon analizi ile incelendi. Anlamlılık değeri olarak p<0,05 kabul edildi. Anlamlı saptanan ilişkilerin basit doğrusal regresyon analizi ile anlamlılık dereceleri (r değeri) saptandı. Bulgular İncelenen 245 hastanın ortalama yaşı 61,26 olarak bulundu. Renal kitle nedeniyle opere edilen hastalardan; 202 hastada (%82,44) renal hücreli karsinom (RHK), 13 hastada (%5,30) RHK olmayan kanser (skuamöz hücreli ya da transizyonel hücreli), 11 (%4,48) hastada onkositom, 1 (%0,40) hastada anjiyomiyolipom, 3 (%1,22) hastada adenom, 6 (%2,44) hastada piyelonefrit, 9 (%3,67) hastada komplike kist saptandı. En büyük tümör boyutları alındığında ortalama tümör boyutu 7,21 cm olarak bulunmuştur. 38 hastada renal kitle ?4 cm (T1a), 90 hastada >4- ?7 cm arasında (T1b), 77 hastada >7- ? 10 cm (T2a), 40 hastada 10 cm den büyük (T2b) saptandı. Metastaz olan 26 hastada fuhrman derecesi 3 ya da 4, 8 hastada fuhrman derecesi 1 ya da 2 olarak bulundu. Klinik tümör evresi ile yaş arasında bir ilişki saptanmadı. Histolojik subtip ile patolojik evre arasında bir ilişki saptanmadı. Metastaz ile tümör boyutu arasında herhangi bir ilişki saptanmadı. Fuhrman derecesi ile patolojik evre arasında anlamlı derecede korelasyon saptandı. Tümör nekrozu, mikrovasküler invazyon ve sinir invazyonu ile patolojik evre arasında korelasyon saptandı. Eşlik eden piyelonefrit ile patolojik evre arasında herhangi bir ilişki saptanmadı. Sonuç Renal kitlelerin patolojik tanı ve tedavisinde cerrahi önemli bir yer tutmaktadır. Tümörün klinik evresine ve histopatolojik özelliklerine bakarak agresifliği hakkında kolayca bilgi edinilebilir.Öğe Retroperitoneal high ligation versus subinguinal varicocelectomy: Effectiveness of two different varicocelectomy techniques on the treatment of painful varicocele(Wiley, 2019) Akkoç, Ali; Aydın, Cemil; Topaktaş, Ramazan; Altın, Selçuk; Uçar, Murat; Topçuoglu, Murat; Şenturk, Aykut BuğraIn the present study, we compared the retroperitoneal high ligation with subinguinal varicocelectomy on the treatment of painful varicocele. A total of 90 patients who underwent retroperitoneal high ligation (n = 45) and subinguinal varicocelectomy (n = 45) for painful varicocele were included in this prospective study. Varicocele in all patients was diagnosed with by physical examination and coloured Doppler ultrasonography. All the patients underwent a conservative treatment for pain for 4 weeks. Patient ages, varicocele grades, preoperative pain scores, postoperative pain scores at 6 months, duration of surgeries, complications and recurrences were recorded. Complete success rate for chronic scrotal pain was found to be 80% in retroperitoneal varicocelectomy group and 71% in subinguinal varicocelectomy group. Partial success rate was 11% for retroperitoneal varicocelectomy group and 18% for subinguinal ligation group. There was no significant difference between two groups in terms of pain and complications. However, the operation time was significantly lower in the Palomo group. Although microsurgical subinguinal varicocelectomy is the current approach for the treatment of varicocele, retroperitoneal high ligation can achieve the same pain resolution with shorter operative duration compared to loupe-assisted subinguinal varicocelectomy.Öğe Solitary fibrous tumor of urinary bladder in a female patient and transurethral enucleation of tumor(Alanya Alaaddin Keykubat Üniversitesi, 2018) Akkoç, Ali; Söğütçü, Nilgün; Uçar, MuratSolitary fibrous tumors are rare neoplasms, initially defined in visceral pleura. Recently, they have been noticed to have ubiquitous distribution of human body. Solitary fibrous tumor of bladder is extremely rare especially in the females. We are presenting a bladder solitary fibrous tumor case of 62-years-old female patient who underwent transurethral enucleation instead of conventional transurethral resection of bladder tumor. According to our research, this is the fourth case of solitary fibrous tumor in a female urinary bladder in the literature.Öğe The effect of potassium citrate on overactive bladder disease: A cross-sectional study(Coll Physicians & Surgeons Pakistan, 2020) Uçar, Murat; Akkoç, Ali; Topçuoğlu, Murat; Özturk, Sefa Alperen; Demir, MuratObjective: To show the effect of potassium citrate treatment on overactive bladder disease in patients with kidney stone and overactive bladder symptoms. Study Design: Experimental study. Place and Duration of Study: Department of Urology, Alanya Alaaddin Keykubat University and Department of Urology, Suleyman Demirel University, Turkey, from October 2019 to July 2020. Methodology: Patients with an indication for starting potassium citrate therapy because of kidney stone, and patients with symptoms of overactive bladder disease were included in the study. At the beginning of the treatment, the overactive bladder-version 8 form was filled and potassium citrate 10 meq 2x2 dose was started to the patients. The effect of potassium citrate on the symptoms of overactive bladder disease was demonstrated by filling the overactive bladder-version 8 form after one month of treatment. Results: A total of 82 people, 36 men and 46 women, participated in the study. Potassium citrate treatment caused a significant increase in urine pH levels (p<0.001). After potassium citrate treatment, there was a significant decrease in the score of the overactive bladder-version 8 form. (p<0.001). A positive correlation was found between age and overactive bladder-version 8 score change (p = 0.004). Conclusion: Potassium citrate can be used in the treatment of overactive bladder disease. The effect of potassium citrate treatment on ameliorating overactive bladder symptoms is more distinct in elderly patients.Öğe The impact of COVID-19 pandemic on urological emergencies, 8 months results of a multicenter retrospective study from Turkey(2022) Alkış, Okan; Başer, Aykut; Çağlayan, Mustafa Serdar; Teke, Kerem; Avcı, İbrahim Erkut; Yaşar, Adem; Keskin, Ercüment; Yüksekkaya, Mustafa; Celen, Sinan; Özlülerden, Yusuf; Ölçücü, Mahmut Taha; Uçar, Murat; Güzel, Ahmet; Asutay, Mehmet Kazım; Bahçeci, Tuncer; Öncel, Halil FeratAbstract Objectives: We aimed to reveal the change of urological emergencies during the COVID-19 pandemic compared to the same period of the previous year. Methods: The number of admissions to the emergency department (ED), admissions to the urology outpatient clinic, emergency urological consultations, and urological and emergency urological surgeries during the periods April-November-2019 and AprilNovember-2020 were recorded. The data of the COVID-19 period were compared with the previous year. Results: While the number of admissions to the urological outpatient clinic was 160,447 during the COVID period, it was 351,809 during the non-COVID period. The number of admissions to the ED decreased from 3.2 million to 2.4. The number of admissions to the urology outpatient clinic significantly decreased by 54% during the pandemic (p=0.001). Percutaneous cystostomy performed due to acute urinary obstruction decreased by 27.96%, double J stent, nephrostomy decreased by 16.61%, and ureterorenoscopy decreased by 12.26%. Urogenital trauma also decreased. On the contrary, surgical procedures performed due to penile fracture, gross hematuria, Fournier gangrene, and testicular torsion increased. Conclusion: During the COVID-19 pandemic, a significant decrease was observed in non-COVID patients' admissions to the emergency and urology department, and in urologic surgeries.
