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TARCAN, TUFAN

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TARCAN

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TUFAN

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  • Publication
    The effect of intradetrusor botulinum neurotoxin type A on urinary NGF, TGF BETA-1, TIMP-2 levels in children with neurogenic detrusor overactivity due to myelodysplasia
    (WILEY, 2017) ŞEKERCİ, ÇAĞRI AKIN; Top, Tuncay; Sekerci, Cagri Akin; Isbilen-Basok, Banu; Tanidir, Yiloren; Tinay, Ilker; Isman, Ferruh Kemal; Akbal, Cem; Simsek, Ferruh; Tarcan, Tufan
    AimsThe aim of this study was to determine the value of urine nerve growth factor (NGF), transforming growth factor beta 1 (TGF-Beta-1), tissue inhibitor of matrix metalloproteinase 2 (TIMP-2) levels to predict the urodynamic profile before and after botulinum neurotoxin type A (BoNT-A) treatment in children with myelodysplasia. MethodsThis prospective study included 15 children with myelodysplasia who underwent intradetrusor BoNT-A injections due to neurogenic detrusor overactivity (NDOA). Urine samples of each child were collected before and after BoNT-A injections, specifically at the first and third postoperative months. Urine samples were analyzed with ELISA method and NGF, TGF-Beta-1, and TIMP-2 levels were measured. Urine marker levels and clinical findings were assessed for statistical significance with Wilcoxon Signed Ranks Test and Friedman Test. ResultsA total of 15 children (5 boys and 10 girls) were assigned as the study group. Mean age of the patients was 7.12.5 years (range 2.5-11). A statistically significantly decline was observed in urinary TGF-Beta-1 and NGF levels following BoNT-A injections, compared to the preoperative levels (P<0.05). TIMP-2 levels also tend to decrease following BoNT-A injections but this was not statistically significant compared to the preoperative levels. ConclusionThis preliminary study, suggests urinary TGF-Beta-1 and NGF as a potent marker in children with NDOA, as they decline following BoNT-A injection. Further studies are needed in identifying their special role in assessing treatment success after invasive interventions.
  • Publication
    Intradetrusor botulinum neurotoxin A (BoNT-A) injections decrease bladder fibrosis secondary to partial urethral obstruction in the male rat model
    (WILEY, 2012) TİNAY, İLKER; Tinay, Ilker; Tanidir, Yiloren; Cikler, Esra; Cetinel, Sule; Tarcan, Tufan
    Aims We evaluated effects of BoNT-A injections on bladder function and histomorphology in a male-rat-overactive-bladder model, created by partial urethral obstruction.
  • Publication
    Safety and Efficacy of Retropubic or Transobturator Midurethral Slings in a Randomized Cohort of Turkish Women
    (KARGER, 2014) TARCAN, TUFAN; Tarcan, Tufan; Mangir, Naside; Sahan, Ahmet; Tanidir, Yiloren; Sulukaya, Muhammed; Ilker, Yalcin
    Objective: The aim of this study was to evaluate the safety and efficacy of retropubic (RP) or transobturator (TO) midurethral slings (MUS) in a prospective randomized cohort of Turkish women. Patients and Methods: A total of 54 women with urodynamic stress urinary incontinence (SUI) were randomized to undergo either RP or TO MUS between August 2006 and February 2013 in a tertiary referral center by a single surgeon. All patients had history, physical examination, urodynamic evaluation and quality of life assessments. The validated Turkish versions of the SEAPI, ICIQ-SF and OAB-V8 questionnaires were used. The Advantage (R) RP and the Obtryx (R) TO MUS Systems were used for all RP and TO procedures. Results: Twenty-seven patients were randomized to each group. The median follow-up was 48.5 +/- 21.8 months. The median hospital stay was 24.0 +/- 4.8 h and median operative time was 35.0 +/- 19.9 min. The overall objective and subjective cure rates were 92.6 and 79.6%, respectively. The quality of life of all patients significantly increased after the operation compared to their preoperative status. Patients with a poorer subjective cure rate were those with mixed urinary incontinence, whose preoperative SEAPI and OAB-V8 scores were significantly higher. Conclusion: MUS surgery is highly effective and could safely be performed in a cohort of Turkish women with SUI in subspecialty centers by experienced surgeons. There is no significant difference between RP or TO applications in terms of safety and efficacy. Further studies with long-term follow-up data are required. (C) 2014 S. Karger AG, Basel
  • PublicationOpen Access
    Consistency of uroflowmetry analysis in children among observers
    (2023-01-01) ŞEKERCİ, ÇAĞRI AKIN; TANIDIR, YILÖREN; TARCAN, TUFAN; YÜCEL, SELÇUK; ŞEKERCİ Ç. A., TANIDIR Y., TARCAN T., YÜCEL S.
    © 2023 Wiley Periodicals LLC.Aim: The aim of the study is to compare the intra- and inter-observer interpretations of the same uroflowmetry study at two different times. Materials and Methods: Two-hundred children with a voided volume of 50% above the expected bladder capacity were included. All traces were asked to be evaluated by 11 observers two times in a time span of 1 month. These observers consist of pediatric urologists (n = 2), pediatric urology fellows (n = 2), urology residents (n = 5), and certified urodynamics nurses (n = 2). Each uroflowmetry was asked to be assessed for three domains: voided volume (VV), detrusor sphincter dyssynergia (DSD), and flow curve pattern (FCP). Results: Of the 200 patients with a median age of 10 (4–18) years, 128 (64%) were girls and 72 (36%) boys. The maximum flow rate and the median voided volume were found to be 20 (4–61) mL/s and 232 (116–781) mL. The Fleiss\" kappa coefficient of VV, DSD, and FCP in the first assessment was 0.510, 0.501, and 0.346. In the second assessment, κ values were 0.530, 0.422, and 0.373. The best-agreed findings were similar at both times. These were found to be low VV (0.602 and 0.626) and intermittent pattern (0.500 and 0.553). Interpreters were found to have a statistically significant difference in agreement with their own interpretation at different times. Conclusion: Both inter- and intra-observer reliability of the agreement point out the problem in the standardization of uroflowmetry. Inter- and intra-observer reliability of uroflowmetry interpretation can be increased by defining precise numbers and numerical algorithms.
  • Publication
    The comparison of anxiety levels in children who underwent invasive or non-invasive urodynamic studies
    (2022-05-13) ŞEKERCİ, ÇAĞRI AKIN; TARCAN, TUFAN; YÜCEL, SELÇUK; TANIDIR, YILÖREN; Sekerci C. A., Can Ozkan O., Tanidir Y., Tarcan T., Yucel S.
    INTRODUCTION AND OBJECTIVE: Urodynamic studies play an important role in the evaluation of children with lower urinary tract dysfunction. In this study, we aimed to examine the effects of invasive and non-invasive urodynamic studies on the anxiety levels of children with the help of an anxiety scale. METHODS: Children aged 8-17 years who were scheduled for uroflowmetry (UF) or filling cystometry (FC) and who agreed to fill out an anxiety scale were included in the study. It was the first UF or FC of all children. “The Screen for Child Anxiety Related Disorders (SCARED)” form consisting of 41 questions was used in the evaluation. All children included in the study filled the form themselves. The SCARED results of children who underwent UF and FC were compared. RESULTS: A total of 56 children with a mean age of 10.85þ/- 2.98 years were included in the study. 31 (55.4%) of the children were females and 25 (44.6%) were males. The number of children who had UF was 26 (46.4%; 8.5 (8-14) years), and 30 (53.6%; 11.5 (8-17) years) had FC. The total SCARED scores of the children who underwent UF and FC were 26.5 (5-75) and 27 (2-57), respectively, and there was no statistical difference (p[0.980) (Table 1). A significant difference was found only in "Separation Anxiety Disorder" among sub-score evaluations (p[0.049) (Table 1). In children who underwent filling cystometry, there was no statistical difference in the total SCARED score between those who did and did not do clean intermittent catheterization (28 (3-41); 27 (2-57), respectively) (p[0.860). CONCLUSIONS: The SCARED scores above 25 indicate an anxiety disorder, and interestingly, in this study, both the invasive and noninvasive urodynamic study groups scored over 25. We consider that non-invasive urodynamic tests may cause stress on children as much as invasive ones.
  • Publication
    Predictive factors of full response to desmopressin treatment in children with primary monosymptomatic enuresis nocturna
    (2023-02-01) ÖZGÜR, GÜNAL; TANIDIR, YILÖREN; TARCAN, TUFAN; YÜCEL, SELÇUK; Ozgur G., Sekerci C. A., TANIDIR Y., Tarcan T., YÜCEL S.
  • Publication
    The effect of doxazosin and sildenafil citrate combination on bladder tissue contractility, alpha adrenergic receptor, and iNOS subtype expression in a male rat model of partially bladder outlet obstruction
    (WILEY, 2017) TİNAY, İLKER; Gumrah, Abdulkadir; Tanidir, Yiloren; Tinay, Ilker; Ozyurek, Mustafa; Tarcan, Tufan
    AimsOur aim was to investigate the effects of doxazosin, sildenafil, and their combination on bladder tissue contractility and adrenergic receptor (AR) and inducible nitric oxide synthase (iNOS) expression utilizing a male rat model of partial urethral obstruction (PUO). MethodsThirty male Sprague Dawley rats were divided into five groups. Except the SHAM group, all animals in remaining four groups underwent surgery for PUO. No further treatment was given to the first group (NT group). Remaining three groups received 6 weeks of treatment with 20mg/kg doxazosin (D group), 20mg/kg sildenafil (S group), 20mg/kg doxazosin, and 20mg/kg sildenafil combination (DS group), respectively via oral gavage. Then, bladder strips were harvested from each animal for isometric tension studies and for real time polymerase chain reaction studies of both AR subtypes and iNOS mRNA. ResultsContractile responses to carbachol and electrical field stimulation at various concentrations/frequencies showed a significant increase after PUO. Any treatment helped to normalize these increased responses. Alpha 1a and 1d AR subtype expressions were found to be down- and up-regulated, respectively, in every group with PUO, compared to SHAM group. iNOS expression was similar in D and NT groups and significantly increased in S and DS groups. ConclusionsContractile changes of rat bladder tissue due to PUO were prevented by sildenafil or doxazosin alone or in combination where combination treatment did not provide any additional advantage. Further studies are needed to clarify the role of phosphodiesterase inhibitors and combination treatment in the treatment of LUTS.
  • PublicationOpen Access
    Normal glanular and meatal measurements in boys and men
    (2023-01-01) ŞEKERCİ, ÇAĞRI AKIN; ÖZKAN, ONUR CAN; GENÇ, YUNUS EMRE; TANIDIR, YILÖREN; TARCAN, TUFAN; YÜCEL, SELÇUK; ŞEKERCİ Ç. A., ÖZKAN O. C., Sahak M. Y., GENÇ Y. E., TANIDIR Y., TARCAN T., YÜCEL S.
    Objective: To determine the normal vertical urethral meatus length (ML), maximum glanular width (MGW), the glanular seam length (between the lowest edge of urethral meatus and the glans closure line corona) (GSL) and GSL/ML ratio in all age groups. Materials and Methods: Consecutive patients presented to urology and pediatric urology outpatient clinics were included in the study. Penile abnormalities, known endocrinological disorders, history of penile/urethral surgery were excluded. MGW, ML, and GSL were measured with a caliper. Glanular and meatal measurements were compared according to ages. Results: A total of 1398 boys and men (380 (27.18%) prepubertal (1-12), 203 (14.52%) adolescent (13-19), and 815 (58.30%) postpubertal (19-93)) with a median age of 31 years (range: 1-93) were included in the study. In consecutive age groups, ML and GSL gradually increased and became steady between 16-19 & 20-30 age groups and 10-12 & 13-15 age groups, respectively. On the other hand, MGW gradually increased until 20 years of age and became steady at median of 35 mm over 20 years of age. Another interesting finding was a rather stable GSL/ML ratio in all age groups. Pairwise comparison of different age groups seemed to be similar and suggests a fixed ratio of 1.33 (IQR: 0.6). Conclusion: The normal glanular and meatal measurements may guide the surgeons for better cosmetic results during hypospadias repair. The GSL/ML ratio appears to be a stable measure for all ages to achieve better cosmetic results.
  • PublicationOpen Access
    Can Surgical Technique Affect the Success of Endoscopic Treatment in Children with Vesicoureteral Reflux and Overactive Bladder Syndrome?
    (GALENOS YAYINCILIK, 2015-09-05) ŞEKERCİ, ÇAĞRI AKIN; Sahan, Ahmet; Akbal, Cem; Garayev, Asgar; Sekerci, Cagri Akin; Sulukaya, Muhammed; Tanidir, Yiloren; Tinay, Ilker; Tarcan, Tufan; Simsek, Ferruh
    Objective Traditional subureteral transurethral injection (STING) and Double hydrodistention-implantation (Double-HIT) injection techniques for vesicoureteral reflux (VUR) treatment are a less invasive, yet very effective options. The influence of injection techniques in treatment success is not adequately searched in children with overactive bladder syndrome (OAB). The objective of this study to compare the short-term success rates of STING and Double-HIT techniques in children with OAB-VUR complex. Materials and Methods Children who underwent endoscopic injection for VUR between 2010 and 2013 were retrospectively evaluated. Patients were grouped into two groups according to the surgical techniques (STING or Double-HIT). Success of the treatment was defined with a negative voiding cystourethrogram at the 6th postoperative week. Patients were evaluated according to sex, age, pre- and postoperative reflux grades, laterality, type and volume of bulking agent and presence of OAB. Results Both groups were similar in terms of sex, age, lower urinary tract dysfunction, reflux grade and success rates. Surgical technique, score of pediatric lower urinary tract symptom questionnaire, age, sex, laterality of reflux and type of the bulking agent found to have no effect on the overall success rates (p>0.05). Presence of OAB and/or a high grade reflux were identified as statistically significant predictive factors that could affect the treatment results. Conclusion The short-term surgical success of the double-HIT and STING techniques showed no difference in children with OAB. The presence of a high grade reflux and/or OAB seemed to be the main factors for overall success in endoscopic VUR surgery.
  • Publication
    Clinical and Urodynamic Results of Repeated Intradetrusor Onabotulinum Toxin A Injections in Refractory Neurogenic Detrusor Overactivity: Up to 5 Injections in a Cohort of Children With Myelodysplasia
    (ELSEVIER SCIENCE INC, 2018) ŞEKERCİ, ÇAĞRI AKIN; Sekerci, Cagri Akin; Tanidir, Yiloren; Garayev, Asgar; Akbal, Cem; Tarcan, Tufan; Simsek, Ferruh
    OBJECTIVE To determine the efficacy and safety of repeated intradetrusor onabotulinum toxin A (onaBoNT-A) injections in children with neurogenic detrusor overactivity due to myelodysplasia. MATERIALS AND METHODS The study group consisted of 19 children (4 boys and 15 girls) with a mean age of 10.3 +/- 3.1 years old, who had received at least 2 injections of 10 U/kg onaBoNT-A for the treatment of urinary incontinence resistant to anticholinergic treatment and clean intermittent catheterization in our clinic, between 2010 and 2015. Controlled urodynamic studies were performed at the baseline and 3 months after each injection. RESULTS Eight of the children received 3 injections, 5 children had 4 injections, and 2 children had 5 injections. From the baseline to the fifth injection, the detrusor compliance (1.3, 4.5, 10, 20.7, 18.8, and 16.6 mL/cm H2O), the maximum bladder capacity (82.0, 157.0, 191.0, 272.0, 299.0, and 210.5 mL), and the maximum detrusor pressure (55.0, 33.0, 22.0, 12.5, 16.0, and 12.5 cm H2O) were assessed. The findings significantly improved following the first, second, and third injections, when compared with the previous bladder dynamics (P <. 05), but the differences with the fourth were not statistically significant (P >. 05). The continence periods were similar under clean intermittent catheterization after all of the injections (P <. 05), and no severe side effects were observed. CONCLUSION Repeated onaBoNT-A injections are a safe treatment modality and can be offered as an effective alternative choice, instead of more invasive surgery, in children with neurogenic detrusor overactivity due to myelodysplasia. (C) 2017 Elsevier Inc.