Person: ŞİMŞEK, FERRUH
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ŞİMŞEK
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FERRUH
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Publication Metadata only Evaluation of urinary neutrophil gelatinase-associated lipocalin as a biomarker in pediatric and adult patients with ureteropelvic junction obstruction(2017-03-01) KAYA, CEVDET; ŞAHİN, BAHADIR; TANIDIR, YILÖREN; ŞEKERCİ, ÇAĞRI AKIN; ŞİMŞEK, FERRUH; Talibzade F., KAYA C., ŞAHİN B., TANIDIR Y., ŞEKERCİ Ç. A., AKBAL C., ŞİMŞEK F.Publication Metadata only 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, TufanAimsThe 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 Metadata only Experience with Treatment of Retroperitoneal Fibrosis: Collaboration of Urology and Nephrology Departments for 26 years in Marmara University(TURK NEFROLOJI DIYALIZ TRANSPLANTASYON DERGISI, 2017) ŞEKERCİ, ÇAĞRI AKIN; Sekerci, Cagri Akin; Tanidir, Yiloren; Ozgen, Mahir Bulent; Koc, Mehmet; Akbal, Cem; Simsek, FerruhOBJECTIVE: Retroperitoneal fibrosis (RPF) is a rare condition characterized by the presence of inflammation and fibrosis in the retroperitoneum. This study describes our multidisciplinary approach and our results. MATERIAL and METHODS: Patients diagnosed with RPF at Marmara University between January 1990 and May 2007 were evaluated. Etiologies, demographic characteristics, renal functions, treatments and prognoses of each patient were recorded and data were analyzed. RESULTS: Of all patients, five were female, 15 were male and the mean follow-up was 11.3 years (1-18 years). Six patients were operated unilaterally and five were operated bilaterally with ureterolysis. Median creatinine values at diagnosis were 2.75 mg/dl (0.7-6.9 mg/dl) in females, 3.2 mg/dl (0.84-7.2 mg/dl) in males and 3.11 mg/dl (0.7-7.2 mg/dl) in the whole group. Median baseline creatinine level after surgery (n=11) was found to decrease from 3.63 mg/dl (1.4-7.2 mg/dl to 1.46 mg/dl (0.8-2.6 mg/dl). Baseline and drop in creatinine were compared among patients treated with either surgical or pharmacological methods, and no statistical significance was found. CONCLUSION: Retroperitoneal fibrosis can be treated surgically and pharmacologically. Our study has shown similar success for both methods. Treatment should be specific for each patient in a multidisciplinary fashion.Publication Metadata only Differentiation of ureteral stones and phleboliths using Hounsfield units on computerized tomography: a new method without observer bias(SPRINGER, 2017) ŞEKERCİ, ÇAĞRI AKIN; Tanidir, Yiloren; Sahan, Ahmet; Asutay, Mehmet Kazim; Sener, Tarik Emre; Talibzade, Farhad; Garayev, Asgar; Tinay, Ilker; Sekerci, Cagri Akin; Simsek, FerruhTo differentiate ureteral stones and phleboliths by measuring density [as Hounsfield unit (HU)] and volume (as mm(3)) of the opacities in the bony pelvis on unenhanced computerized tomography (U-CT). A total of 52 patients, who underwent semirigid ureteroscopy and laser lithotripsy for distal ureteral stone and had isochoronous phleboliths in U-CT, were included. Images were reviewed for density and volume of the opacities. Data were compared, and a cut-off value was defined with receiver operating characteristics curve analysis to differentiate the nature of the opacity. Using the cut-off values of 171 mmA(3) for volume (sensitivity 75 %, specificity 100 %) and 643 HU for density (sensitivity 75 %, specificity 93 %), differentiation between stone and phlebolith was achieved. Differentiation of pelvic opacities needs meticulous observation with certain signs on U-CT. On the other hand, our study offers a new method, with certain cut-off values, such as 643 HU and 171 mm(3), which can be used to precisely predict the actual nature of opacities of interest.Publication Open Access Are There Any Differences in the Neural and Extracellular Matrix Proteins Density Between Children and Adults with Intrinsic Ureteropelvic Junction Obstruction?(GALENOS YAYINCILIK, 2017-12-27) KAYA, CEVDET; Sahin, Bahadir; Kaya, Cevdet; Talibzade, Farhad; Tanidir, Yiloren; Ercan, Feriha; Demirci, Elif Kervancioglu; Sekerci, Cagri Akin; Akbal, Cem; Simsek, FerruhObjective: To compare changes in connective, neural and muscle tissues, and extracellular matrix in child and adult patients so that we can create a more objective view on the timing of surgery. Materials and Methods: Twenty-six patients, who were operated for ureteropelvic junction (UPJ) obstruction in our clinic between September 2014 and May 2016, were included in the study. For the evaluation of connective tissue, Masson's trichrome staining was used. Muscle, extracellular matrix elements and neural tissue were evaluated with immunohistochemistry using alpha-smooth muscle actin (a-SMA), Tenascin C and S100, respectively. Microscopically, the tissues were scored according to their staining density (0: No staining; 1: Minor; 2: Moderate, 3: Dense). Results: There were 12 children and 14 adults in the study groups. The initial evaluation showed no statistically significant difference between studied tissue types with respect to staining density for all parameters (Masson: p=0.414, a-SMA: p=0.204, Tenascin-C: p=0.264, S100: p=0.534). There was no statistically significant correlation between staining density and renal function percentage of the affected kidney (Masson: r=0.454, p=0.051, alpha-SMA: r=-0.323, p=0.177 -Tenascin-C: r=0.290, p=0.229 -S100: r=-0.080, p=0.744). Conclusion: Our preliminary study showed some structural changes between adult and child patients but there is no statistically significant difference between the groups with respect to staining density scores. These results state that although UPJ obstruction is an ongoing process, there is no correlation between the histological deterioration degree of the UPJ segment and the loss on renal function for both children and adults.Publication Open 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, FerruhObjective 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 Metadata only 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, FerruhOBJECTIVE 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.Publication Open Access Utility of Voiding Dysfunction Symptom Score in Diagnosis and Treatment of Enuresis Nocturna(GALENOS YAYINCILIK, 2017-03-13) ŞEKERCİ, ÇAĞRI AKIN; Tanidir, Yiloren; Sekerci, Cagri Akin; Top, Tuncay; Talibzade, Farhad; Sahan, Ahmet; Sener, Tarik Emre; Tarcan, Tufan; Simsek, Ferruh; Akbal, CemObjective: The aim of this study was to determine the effectiveness of the voiding dysfunction symptom score (VDSS) in evaluation of children with nocturnal enuresis. Materials and Methods: Four hundred children with nocturnal enuresis were included in the study. They were evaluated with VDSS, physical examination, urinalysis and 2-day voiding diary. All children with nocturnal enuresis symptoms were treated with desmopressin and/or urotherapy. However, children with overactive bladder symptoms were also treated with anticholinergics. Treatment success and change in VDSS were compared and assessed between different treatment methods. Results: Two hundred forty-five children (61.25%) were male and 155 (38.75%) were female. The mean age was 7.6 +/- 3.0 years (range: 5-18). The mean VDSS was 9.2 +/- 6.3. 35% of children with nocturnal enuresis had concomitant daytime symptoms. 126 children (31.5%) had a VDSS of nine or above and majority of these children were treated with anticholinergic therapy. VDSS questionnaire could not help determine treatment success in children with non-monosymptomatic nocturnal enuresis. However, children treated with urotherapy and desmopressine showed significant difference in VDSSs according to their treatment response. Conclusion: VDSS has shown to decrease after treatment in children with mono-symptomatic nocturnal enuresis. The treatment strategies should be checked and modified if VDSS does not decrease after proper therapy as this would increase the success of treatment.Publication Metadata only Güvenli̇k kılavuz teli̇ üreteroskopi̇k taş cerrahi̇si̇nde ruti̇n kullanilmali mi?: Prospekti̇f randomi̇ze çalışma ön sonuçları(2016-11-06) TANIDIR, YILÖREN; ŞAHİN, BAHADIR; ŞENER, TARIK EMRE; TİNAY, İLKER; ŞİMŞEK, FERRUH; TANIDIR Y., ŞAHİN B., ŞENER T. E., Sulukaya M., Sekerci C. A., TİNAY İ., ŞİMŞEK F.Publication Metadata only Is 40cmH(2)O detrusor leak point pressure cut-off reliable for upper urinary tract protection in children with myelodysplasia?(WILEY, 2017) ŞEKERCİ, ÇAĞRI AKIN; Tarcan, Tufan; Sekerci, Cagri Akin; Akbal, Cem; Tinay, Ilker; Tanidir, Yiloren; Sahan, Ahmet; Sahin, Bahadir; Top, Tuncay; Simsek, FerruhPurposeThe purpose of this study, is to find out the most accurate cut-off level for the detrusor leak point pressure (DLPP) in terms of upper urinary tract (UUT) protection in a cohort of children with myelodysplasia. Materials and MethodsOne hundred and ninety-three children with myelodysplasia were included in the study based on the availability of urological evaluation at age of 3 years. Children were assigned to one of two groupsthose who had UUT damage at age 3 (group 1, n: 70) and those without UUT changes (group 2, n: 123), and compared. ResultsUrological follow-up data revealed higher incidences of febrile urinary tract infections and secondary tethering of the spinal cord in group 1. No statistically significant difference was determined between group 1 and group 2 in terms of DLPP values (median 42.5 vs. 39.5cmH(2)O, respectively, P=0.087). Analysis of different cut-off values showed that DLPP above 20cmH(2)O had a higher sensitivity for UUT damage (91.4%). A normal UUT was found in 56.5% and 62.2% of children with DLPP between 20 and 40cmH(2)O, and with DLPP over 40cmH(2)O, respectively. ConclusionsPresent study showed that more than half of the children with myelodysplasia had normal UUT function even with a DLPP of 40cmH(2)O and over. Thus, DLPP, is not the sole decision making parameter to rely for more invasive therapies in children with myelodysplasia. On the other hand, a DLPP cut-off value of 20cmH(2)O showed a higher sensitivity to predict UUT damage instead of 40cmH(2)O. Neurourol. Urodynam. 36:759-763, 2017. (c) 2016 Wiley Periodicals, Inc.