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ŞİMŞEK, FERRUH

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ŞİMŞEK

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FERRUH

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2017 - 20193
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    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, Ferruh
    OBJECTIVE: 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.
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    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, Ferruh
    To 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.
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    Value of Urinary Brain-Derived Neurotrophic Factor Levels on the Assessment of Botulinum Toxin Type A Treatment for Neurogenic Detrusor Overactivity in Children with Myelodysplasia
    (ELSEVIER SCIENCE INC, 2019) ŞEKERCİ, ÇAĞRI AKIN; Sekerci, Cagri Akin; Tanidir, Yiloren; Toprak, Tuncay; Basok, Banu Isbilen; Isman, Ferruh; Simsek, Ferruh; Akbal, Cem; Tarcan, Tufan
    Purpose: Urinary cytokines are proposed to predict urodynamic findings and outcome of intradetrusor botulinum neurotoxin type A injection in children with myelodysplasia. The relationship between urinary brain-derived neurotrophic factor and neurogenic and nonneurogenic detrusor overactivity has been shown as well. We prospectively investigated the effect of intradetrusor botulinum neurotoxin type A injection on urine brain-derived neurotrophic factor levels in children with nonneurogenic detrusor overactivity due to myelodysplasia. Materials and Methods: Urine samples of 23 children with nonneurogenic detrusor overactivity due to myelodysplasia were collected and analyzed before and 1 and 3 months after intradetrusor botulinum neurotoxin type A injection, and urodynamics were performed before and 6 weeks after injection. Brain-derived neurotrophic factor levels and urodynamic findings were analyzed and statistical comparisons were done. Results: Mean +/- SD age was 100.0 +/- 34.5 months. Ratio of girls to boys was 2.8. Brain-derived neurotrophic factor levels significantly decreased (p < 0.006), and maximum cystometric capacity and maximum detrusor pressure improved significantly following intradetrusor botulinum neurotoxin type A injection compared to preoperatively (p < 0.001). No statistical correlations were determined between brain-derived neurotrophic factor levels and urodynamics. Of all analyses only bladder compliance 5 ml/cm H2O or less vs greater than 5 ml/cm H2O at postoperative urodynamics was associated with statistically increased urine brain-derived neurotrophic factor levels, suggesting that increased urine brain-derived neurotrophic factor predicts treatment failure. Conclusions: The present study does not suggest that urine brain-derived neurotrophic factor is a reliable followup marker in children with nonneurogenic detrusor overactivity due to myelodysplasia. However, this factor may have a role in treatment planning, which needs to be established in future large prospective studies.