Person: ŞİMŞEK, FERRUH
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ŞİMŞEK
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FERRUH
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Publication Metadata only Durability of a single successful endoscopic polytetrafluoroethylene injection for primary vesicoureteral reflux: 14-year followup results(ELSEVIER SCIENCE INC, 2007) ŞİMŞEK, FERRUH; Yucel, Selcuk; Tarcan, Tufan; Simsek, FerruhPurpose: We reviewed our 14-year experience with successful single endoscopic subureteral polytetrafluoroethylene injection for the treatment of primary vesicoureteral reflux in children. Materials and Methods: We retrospectively reviewed the charts of 42 patients with primary vesicoureteral reflux who were treated with a single successful subureteral polytetrafluoroethylene injection between 1989 and 1993 and followed with routine 1, 3 and 10-year voiding cystourethrography. Results: The study included 30 girls and 12 boys 2 to 14 years old (median age 6 years). Four patients were lost to followup. Of the 38 remaining patients 28 had unilateral and 10 had bilateral primary vesicoureteral reflux. Endoscopic treatment with subureteral. polytetrafluoroethylene injection was performed in 48 ureters. Followup ranged from 10 to 14 years (mean 12.5 +/- 2.1). Voiding cystourethrography in 38 patients and 48 ureters revealed that 35 ureters (73%) remained free of reflux, whereas reflux recurred in 13 (27%) at a median of 2 years. Of these 13 ureters recurring reflux was grade I to II in 5 and grade III to V in 8. Reflux recurred in 11 of 24 ureters with grade IV to V reflux. Of the 13 recurrences 10 presented as febrile urinary tract infections and only 3 grade I recurrences were detected on voiding cystourethrography alone. No untoward effects were seen in any of these patients with injection of polytetrafluoroethylene. Conclusions: Long-term followup may be warranted after a single successful endoscopic injection for vesicoureteral reflux, particularly high grade reflux. However, followup voiding cystourethrography is unnecessary in patients presenting with febrile urinary tract infection.Publication Metadata only The unconsummated marriage: Its frequency and clinical characteristics in a sexual dysfunction clinic(BRUNNER-ROUTLEDGE, 2008) ŞİMŞEK, FERRUH; Ozdemir, Ozay; Simsek, Ferruh; Ozkardes, Selma; Incesu, Cem; Karakoc, BirguelThe object of this study was to investigate frequency of the unconsummated marriages and its clinical characteristics among the subjects who referred to a sexual dysfunction clinic in Turkey. Four hundred and forty-nine unconsummated marriage cases were evaluated among 1880 subjects referred to Acibadem Sexual Health Clinic, Istanbul, between December 2000 and December 2004. Unconsummated marriage rose from the female partner in 67% of the cases, 7% males, and 26% both. Vaginismus was the most prominent cause in 81% of the cases, erectile dysfunction in 10.5%, premature ejaculation in 5%. Previous reports from Eastern societies including Turkey indicate higher incidences of premature ejaculation and vaginismus than the Western world which underline a strong cultural influence in the backgroundPublication Metadata only A New Cause of Male Infertility After Cisplatin Exposure: The Effect of Cisplatin on Y Chromosomes(ELSEVIER SCIENCE INC, 2009) ŞİMŞEK, FERRUH; Akbal, Cem; Turker, Polat; Ozyurek, Mustafa; Erkanli, Goezde; Simsek, Ferruh; Turker, LeventOBJECTIVES To investigate the impact of cisplatin (CP) on the testes-specific protein, Y-linked (TSPY) gene situated on the Y chromosome. METHODS The control group consisted of 10 rats. Group IIA consisted of 15 rats that underwent orchiectomy and received three cycles of 1 mg/kg, 2.5 mg/kg, or 5 mg/kg CP. Group IIB was,exposed to the same doses of three cycles of chemotherapy but was examined after 3 months of chemotherapy. Group III was exposed to the same doses of chemotherapy without initial orchiectomy. Reverse transcriptase polymerase chain reaction for TSPY messenger ribonucleic acid (mRNA) and immunohistochemical staining for histone 213 were per-formed on the testes. Results were evaluated by one-way analysis of variance. RESULTS Compared with the controls, the expression of TSPY mRNA in Group IIA after exposure to 1 mg/kg CP did not change; however, MRNA levels after exposure to 2.5 mg/kg and 5 mg/kg CP were decreased by 40% and 78%, respectively. In Group III after exposure to the same doses of CP, mRNA levels decreased by 30%, 87.5%, and 88%, respectively. The expression of TSPY was at normal levels except in rats that received 5 mg/kg CP in Group IIB. Immunohistochemical study revealed that histone 213 expression was decreased in a dose-dependent manner. None of the rats from any of the groups died during the study period. CONCLUSIONS Decreased TSPY expression after CP exposure might be another mechanism for male infertility. UROLOGY 73: 1145-1149, 2009. (C) 2009 Elsevier Inc.Publication Metadata only Erectile dysfunction following radiotherapy and brachytherapy for prostate cancer: pathophysiology, prevention and treatment(SPRINGER, 2008) ŞİMŞEK, FERRUH; Akbal, Cem; Tinay, Ilker; Simsek, Ferruh; Turkeri, Levent N.Objectives Although detrimental impact on sexual function following radiotherapy (RT) and brachytherapy decreases the quality of life of prostate cancer survivors, the etiology, pathophysiology, prophylaxis and treatment of this condition has not yet been fully clarified. We reviewed the published literature in terms of etiology, treatment and possible prevention of erectile dysfunction (ED) following RT and/or brachytherapy. Method We have reviewed the literature through a MEDLINE search. Prostate cancer, erectile dysfunction, radiotherapy, brachytherapy, treatment and quality of life were used as keywords. Conclusion Both RT and brachytherapy result in high rates of ED. Although arterial damage seems to be the main cause of ED after RT, exposure of neurovascular bundle to high levels of radiation dose has been also implicated in some studies with brachytherapy. The radiation dose received by the corpora cavernosa at the crurae of the penis may also be important in the etiology of ED. The most important predictive factor of ED following RT is the treatment modality. Intensity-modulated radiotherapy and vessel-sparing prostate radiotherapy are new techniques but those treatments may not guarantee complete preservation of the erectile function. Patients need to be correctly informed on the possible sequela of radiation-based treatments on their sexual well-being while planning their treatment. Patients should also be informed about the possible treatment modalities for ED, which may develop in due course.Publication Metadata only The timing of primary neurosurgical repair significantly affects neurogenic bladder prognosis in children with myelomeningocele(ELSEVIER SCIENCE INC, 2006) ŞİMŞEK, FERRUH; Tarcan, Tufan; Onol, Fikret Fatih; Ilker, Yalcin; Alpay, Harika; Simsek, Ferruh; Ozek, MemetPurpose: The correlation between timing of the primary neurosurgical repair and urological prognosis in infants with open spinal dysraphism remains unknown. We investigated the impact of primary repair timing on neurogenic bladder prognosis in children with myelomeningocele. Materials and Methods: We retrospectively reviewed the records of 401 children with myelomeningocele followed at our multidisciplinary clinic between 1996 and 2005. Among these patients 129 were included in the study based on the availability of urological followup data at age 3 years, which was chosen as an ideal point for the standardization of urological findings. Children were assigned to 1 of 2 groups-those who underwent primary neurosurgical repair within 72 hours of delivery (group 1) and those undergoing repair after 72 hours (group 2). We compared the incidence of febrile urinary tract infections, hydronephrosis, vesicoureteral reflux and secondary tethering of the spinal cord at age 3 years, as well as cystometric bladder capacity and detrusor leak point pressure between the 2 groups. Results: Urological followup data at age 3 years revealed significantly increased incidence of febrile urinary tract infections, vesicoureteral reflux, hydronephrosis and secondary tethering of the spinal cord in children in group 2 compared to group 1 (chi-square, p <= 0.05 for all comparisons). Urodynamic assessment also showed a significantly lower bladder capacity and a substantially higher detrusor leak point pressure in children who received primary repair at later than 72 hours (t test, p < 0.05). A subgroup analysis of group 1 comparing children who underwent repair before and after 24 hours following delivery failed to demonstrate any significant difference in terms of febrile urinary tract infections, vesicoureteral reflux, hydronephrosis and secondary tethering (chi-square, p > 0.05 for all comparisons), whereas mean bladder capacity was significantly higher (t test, P < 0.05) and mean detrusor leak point pressure was lower (t test, p = 0.08) in children undergoing repair within 24 hours of delivery. Conclusions: The timing of primary neurosurgical repair has a significant impact on neurogenic bladder prognosis in children with myelomeningocele. Closure of the spinal lesion on the first day of life seems to provide the best chance for favorable lower urinary tract function.Publication Metadata only Erectile function in prostate cancer-free patients who underwent prostate saturation biopsy(ELSEVIER SCIENCE BV, 2008) ŞİMŞEK, FERRUH; Akbal, Cem; Turker, Polat; Tavukcu, Hasan H.; Simsek, Ferruh; Turkeri, LeventObjective: To evaluate the erectile function following transrectal ultrasound-guided saturation biopsies of the Prostate. Materials and methods: Of the 150 patients included in the study, those with persistently elevated prostate-specific antigen (PSA) level underwent saturation biopsy. A median of 22-core (minimum: 20; maximum: 30) prostate saturation biopsies was taken. Patients were evaluated for erectile function prebiopsy with the 5-item version of the International Index of Erectile Function (IIEF-5) and the IIEF-Erectile Function (IIEF-EF) domain scoring. Concomitant systemic diseases and medications that would interfere with erectile function were recorded. Eighty-eight patients reported to be prostate cancer-free underwent further evaluation with the IIEF-5 questionnaire at 1 and 6 mo postbiopsy. Severity of erectile dysfunction (ED) was classified into four categories. Results: The patients' ages, serum PSA levels, prostate volumes, and number of cores showed no significant correlation with changes in ED scores after the prostate saturation biopsies. According to the IIEF-5, for patients who were previously potent and found to be free of prostate cancer, the ED rates were 11.6% at the first month, and no ED was reported at the sixth month of evaluation. IIEF-5 and IIEF-EF domain scores displayed a statistically significant difference between baseline and first-month scores, but not between baseline and sixth-month scores, which returned to baseline values. Conclusions: Although saturation biopsy of the prostate is a safe procedure on the basis of erectile function, the minimal risk of temporary postbiopsy ED should be discussed with previously potent patients. (C) 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved.Publication Metadata only Long-term results of endoscopic treatment of vesicoureteral reflux with the sub-ureteric injection of calcium hydroxyapatite(SPRINGER, 2007) ŞİMŞEK, FERRUH; Tarcan, Tufan; Tinay, Ilker; Temiz, Yusuf; Simsek, FerruhAim To review our long-term results of the sub-ureteric injection of calcium hydroxyapatite in the endoscopic management of vesicoureteral reflux (VUR) in children. Materials and methods A sub-ureteric injection of calcium hydroxyapatite was given to 14 children (23 ureteral units) affected by VUR grades I-V. All children were followed-up with monthly urine cultures, and a renal ultrasound was done on the postoperative 4th week, while the first voiding cysto-urethrogram (VCUG) control was performed on postoperative week 12. The children were followed-up with yearly renal ultrasound and monthly urine cultures, thereafter. Data from the patients' charts were retrospectively analyzed regarding the outcome of the procedures. Results Mean follow-up time was 52 months (47-60 months). VUR was cured in 47.4% of cases after a single injection. After the second injection the global success rate was 52.1%. Ureteroneocystostomy was performed on seven refluxing ureters of five children unresponsive to sub-ureteric injection therapy. One patient underwent nephroureterectomy because of a non-functioning kidney secondary to ureteral obstruction due to migration of material at the 23rd month postoperatively. Conclusion Although favorable short-term success rates have been reported with the sub-ureteric injection of calcium hydroxyapatite without any side effects, our long-term results showed a low success rate, with the only reported serious morbidity.Publication Metadata only Erectile dysfunction and Peyronie's disease in patient with retroperitoenal fibrosis(SPRINGER, 2008) ŞİMŞEK, FERRUH; Akbal, Cem; Tanidir, Yiloeren; Ozgen, Mahir Bulent; Simsek, FerruhThe aim of this study is to determine the sexual dysfunction in patient with retroperitoneal fibrosis (RPF) and also we explored probability of Peyronie's disease (PD) in this patient group and to compare this with the controls. Ten of 17 male RPF patients formed the basis of this study. Patient's age, concomitant diseases were recorded. The diagnosis of PD was based on a palpable penile plaque or acquired penile curvature. Age-matched 88 patients who were admitted to our outpatient clinic with elevated PSA level served as the control group. All patients were asked to complete the IIEF-5 questionnaire. The severity of the erectile dysfunction (ED) was classified into four categories: severe (5-7), moderate (8-16), mild (17-21), and no ED (22-25). Concomitant systemic diseases were recorded. Statistical analyses were done by the Fisher's exact test and an unpaired-sample t-test. Patients with severe ED or no sexual intercourse in the study group and the control group during the study period were found to be 7 and 14, respectively. The median IIEF-5 score in RPF patients and the control group was 9.8 (min: 5 to max: 23) and 19 (min: 5 to max: 25), respectively. The differences between groups were statistically significant (P = 0.002). In particular, ED was reported in eight RPF patients (80%) which was severe in six (60%) and moderate in two (20%). ED was reported in 45 patients in the control group (51%) which was severe in 14 (15.9%), mild in 25 (28.4%), and moderate in six (6.8%). Patients with RPF had a significant tendency for severe ED compared with the control group (P = 0.0042). Two patients in the RPF group (20%) and one patient in the control group (1.1%) were found to have a penile plaque (P = 0.0279). Relative risk for developing a penile plague was found to be 0.8 in RPF. RPF patients are found to be more prone to developing ED. Penile plaque formation was identified in RPF patients, which may be presumed to relate to the pathological changes of the RPF process, but it remains unclear that these patients demonstrate a higher incidence of plaque formation than the normal population.