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Association between selective serotonin and serotonin-noradrenaline reuptake inhibitor therapy and hematuria
(2022) Sarıer, Mehmet; Demir, Meltem; Emek, Mestan; Özgen, Ali; Turgut, Hasan; Özdemir, Candan
Background: Selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs) are used as first-line treatment for many psychiatric diseases, especially major depressive disorder. However, an important side effect of these drugs is the risk of bleeding due to platelet dysfunction. The aim of this study was to determine the frequency of hematuria in patients using SSRI/SNRIs and to compare with a control group. Methods: This study included patients who were followed up and treated with SSRI/SNRI in the psychiatric outpatient clinic of the Antalya Medical Park Hospital between 1 January 2021 and 31 March 2021 and a control group comprising patients who presented to the medical check-up outpatient clinic between the same dates. Complete urinalysis was performed for all patients and the results were compared between the groups. Results: Each group included 100 patients with a female/male ratio of 1. The mean age was 41.45 ± 13.47 (16-74) years in the study group and 40.51 ± 13.75 (20-70) years in the control group (p = 0.519). Mean duration of SSRI/SNRI use in the study group was 13.35 ± 1.32 (1-64) months. The prevalence of hematuria was 17% in the SSRI/SNRI group and 6% in the control group (p = 0.015). All cases of hematuria were microscopic hematuria. Conclusion: Hematuria is significantly more common in patients receiving SSRI/SNRI treatment. The use of SSRI/SNRI should also be taken into account when investigating the etiology of hematuria.
Evaluating the utility of the AF Genital System test for pathogen diagnosis in acute male urethritis
(WILEY, 2022) Sarıer, Mehmet; Sepin, Nevgun; Emek, Mestan; Germen, Aysegul Tezcan; Hoscan, Mustafa Burak; Konuk, Elcin; Turgut, Hasan
This study evaluated the effectiveness of the A.F. Genital System (Liofilchem®, Italy) in detecting pathogens compared with multiplex real- time polymerase chain reaction (PCR) in men with acute urethritis. Men diagnosed as having acute urethritis between 1 April 2021 and 31 December 2021 were included. Urethral swab samples were ob-tained for A.F. Genital System and PCR testing in a randomly determined order. The efficacy of the A.F. Genital System was analysed by comparing the results of the two tests. The study included 83 patients (mean age 34.1 ± 11.3 years). A urethritis patho-gen was detected in 69 patients (83.1%) by PCR and only 15 patients (18.1%) with the A.F. Genital System. The sensitivity of the A.F. Genital System in detecting acute urethritis pathogens was 21.7% (95% confidence interval [CI]: 13.6– 32.8), and the specificity was 100% (95% CI: 78.5– 100). Its sensitivity was 20% (95% CI: 7.1– 45.2) in the diagnosis of gonococcal urethritis and 19.1% (95% CI: 11.2– 30.4) in the diagnosis of non- gonococcal urethritis. PCR detected two or more urethritis pathogens in 9 patients (13.0%), while no polymicrobial infection was detected with the A.F. Genital System. Based on the results of multiplex real- time PCR, the A.F. Genital System had very low sensitivity in the detection of pathogens in acute male urethritis. It should be kept in mind that using this test in patients with acute urethritis may result in a high missed diagnosis rate for urethritis pathogens.
Evaluation of sexual function according to the size of the needle used in transrectal-ultrasonography-guided prostate biopsy
(GALENOS YAYINCILIK, 2021) Turgut, Hasan; Sarıer, Mehmet; Öztorun, Kenan; Yalçın, Kenan; Özgür, Güner Kemal
Objective: This study aimed to evaluate the sexual function in patients who underwent a transrectal ultrasonography-guided prostate needle biopsy (TRUS-Bx) using 16G and 18G needles. Materials and Methods: Ninety patients underwent TRUS-Bx. Group 1 included patients who underwent biopsy with an 18G needle (n=45), and group 2 included patients who underwent biopsy with a 16G needle (n=45). Sexual function in both groups was prospectively compared. Additionally, the patients' age, prostate-specific antigen (PSA), prostate volume, cancer detection rate, complication rates, visual analog scale (VAS), and International Index of Erectile Function (IIEF) scores were compared. Results: Age, PSA, prostate volume, cancer detection rate, complication rates and VAS were not found statistically different between the groups. No difference was observed between the two groups in terms of the five main items of IIEF before the procedure. The intercourse satisfaction value was found to be significantly lower after the procedure than before the procedure in group 1 (p<0.05). Orgasmic function, intercourse satisfaction, and overall satisfaction were statistically significantly lower after the procedure than before the procedure in group 2 (p<0.001). Orgasmic function and overall satisfaction were lower in group 2 and significantly different between the two groups four weeks after the procedure (p<0.001). Conclusion: Although erectile function, sexual desire, and intercourse satisfaction were not different on using different needle sizes, in patients where 16G needles were used, orgasmic function and overall satisfaction were lower four weeks after the procedure.
Prognostic value of HPV DNA in urothelial carcinoma of the bladder: a preliminary report of 2-year follow-up results
(2021) Sarıer, Mehmet; Süremen Usta, Sibel; Turgut, Hasan; Öztürk, Sefa Alperen; Soylu, Ahmet; Emek, Mestan; Kukul, Erdal; Bozcuk, Hakan; Sepin, Nevgün
Purpose: The association between the human papillomavirus (HPV) and anogenital carcinomas is well established. However, despite its anatomic adjacency, the relationship between HPV and urothelial carcinoma of the bladder (UCB) is less clear. Recent meta-analysis and case-control studies demonstrated a significant relationship between the presence of HPV DNA and UCB. The aim of this clinical study was to compare the 2-year follow-up results of HPV-positive and HPV-negative UCB patients to evaluate the prognostic value of HPV DNA positivity in UCB. Methods: The study included patients with stage pTa and pT1 UCB who underwent polymerase chain reaction (PCR) analysis of HPV DNA between January 1 and November 30, 2018. Based on their PCR results, 19 HPV-positive and 38 HPV-negative UCB patients who had regular follow-up in our clinic were evaluated in terms of tumor recurrence and disease progression over a 2-year follow-up period. Results: There was no significant difference between the groups in terms of age, follow-up time, smoking, or tumor grade (P= .576, P= .368, P= .080, and P= .454). Tumor recurrence was observed at least once in 47.3% (n=9) of the 19 HPV-positive patients and 36.8% (n=14) of the 38 HPV-negative patients (P= .445). There was no difference in disease progression between the groups during follow-up. Conclusion: In our sample of UCB patients, the presence of HPV DNA was associated with a trend toward higher recurrence rate during the 2-year follow-up, though the difference was not statistically significant. No difference in disease progression was observed based on HPV DNA positivity.
Update on the management of urological problems following kidney transplantation
(Karger, 2021) Sarıer, Mehmet; Yayar, Özlem; Yavuz, Asuman; Turgut, Hasan; Kukul, Erdal
Urological problems in kidney transplant recipients are not limited only to posttransplantation urological complications. These problems are a cause of significant patient mortality and morbidity that have wide-ranging effects on graft survival throughout the entire life of the graft. Ultimately, the transplant comprises a major portion of the urinary system; therefore, the transplant team should be prepared for foreseeable and unforeseeable urological problems in the short and long terms. These mainly include postoperative urological complications (urine leakage, ureteral stenosis, and vesicoureteral reflux), bladder outlet obstruction, and graft urolithiasis. In recent years, significant advances have been made in the management of urological complications, especially due to advances in endourologic interventions. The aim of this review is to summarize the management of urological problems after kidney transplantation in the context of the current literature.
Laparoscopic live donor nephrectomy: experience of high-volume center with 2,477 cases
(2021) Ozturk, Sefa Alperen; Yuksel, Yucel; Erbis, Halil; Aliosmanoglu, İbrahim; Sarıer, Mehmet; Yayar, Ozlem; Yavuz, Havva Asuman; Demirbas, Alper
Objective: Donors' health and safety are mandatory in the living-donor kidney transplantation procedure. Laparoscopic live donor nephrectomy (LLDN) provides an increase in donor numbers with its benefits and becomes a standard of care. We aimed to explain the results, complication rates, tips, and tricks of the largest number of LLDN case series ever performed in the literature. Materials and methods: Between August 2012 and December 2019, 2,477 live donor case files were analyzed retrospectively. Age, gender, hospitalization times, body mass index, warm ischemia times, operation times, numbers of arteries, side of the kidneys, and complications were noted. Results: 1,421 (57.4%) of 2,477 donors were female (p = 0.007). Operation times and warm ischemia times were found longer in right-sided LLDN and donors with multiple renal arteries (p = 0.046, <0.001, and <0.001, respectively). Obesity (BMI >30 kg/m2) did not affect warm ischemia times while prolonging the operation times (p = 0.013). Hospitalization times and numbers of complications were higher in obese donors. Conclusions: LLDN seems to be a reliable solution with fewer complications and higher satisfaction rates. We hope to illuminate the way with tips and trick points for beginner transplant surgeons based on the experience obtained from 2,477 LLDN cases.
Evaluation of the efficacy of masturbation on distal ureteral stones: a prospective, randomized, controlled study
(Springer Science and Business Media B.V., 2020) Turgut, Hasan; Sarıer, Mehmet
Purpose: To evaluate the effect of masturbation on the spontaneous expulsion of distal ureteral stones 5–10 mm in size. Material and methods: A total of 128 men with distal ureteral stones were randomly divided into 3 groups. All patients received standard medical therapy. Patients in group 1 (n = 43) were instructed to masturbate at least 3–4 times a week, patients in group 2 (n = 41) received tamsulosin 0.4 mg/day, and patients in group 3 (controls, n = 44) received standard medical therapy alone. Rates of expulsion, need for analgesic, and ureterorenoscopic lithotripsy were compared between the groups. Results: The mean ages of the patients in groups 1, 2, and 3 were 37 ± 5.0, 37.6 ± 4.6, and 38.4 ± 6.8 years, respectively (p = 0.7). The mean stone size in each group was 6.93 ± 1.1 mm, 7.1 ± 0.9 mm, and 6.87 ± 1.1 mm, respectively (p = 0.4). Spontaneous passage rates in groups 1, 2, and 3 were 81.4%, 80.5%, and 43.2%, respectively, and were significantly higher in group 1 (p = 0.001) and group 2 (p = 0.001) when compared with group 3. Analgesic requirement in groups 1, 2, and 3 was 1.7 ± 0.6, 1.5 ± 0.6, and 1.8 ± 0.6 times per day, respectively, and was significantly lower in the tamsulosin group than in the control group (p = 0.004) Conclusion: Masturbation and tamsulosin increased the spontaneous passage of distal ureteral stones 5–10 mm in size. Masturbating at least 3–4 times a week was as effective as tamsulosin. Masturbation and tamsulosin also reduced the need for ureterorenoscopic lithotripsy.
New approach to microscopy of gram-stained urethral smear: the kissing slide method
(2020) Sarıer, Mehmet; Demir, Meltem; Turgut, Hasan; Hizel, Aydan; Emek, Mestan; Kukul, Erdal; Sepin, Nevgün
Background: The effectiveness of microscopy of Gram-stained smear (GSS) for the detection of male urethral infection is debatable, especially in cases with low inflammation and no visible urethral discharge. This clinical study compared GSS samples collected with the conventional swab method and our new technique, the kissing slide method, together with polymerase chain reaction results to demonstrate the effectiveness of this new method in men with acute urethritis. Methods: The study included 64 men who presented to the urology outpatient clinic with complaints of acute urethritis between October 2019 and January 2020. Two GSS samples were collected from each patient, first using the kissing slide method (applying the slide directly to the urethral mucosa), followed by the conventional method. The results were compared with polymerase chain reaction findings. Results: The patients' mean age was 37.4 ± 7.8 years, and 68.7% had no visible urethral discharge on physical examination. At a GSS threshold of ?5 polymorphonuclear leukocytes/high-power field, sensitivity values were 60% (95% confidence interval [CI], 42.32%-75.41%) for the kissing slide method and 23.33% (95% CI, 11.79%-40.93%) for the conventional method. At a threshold of ?2 polymorphonuclear leukocytes/high-power field, sensitivity values with the kissing slide and conventional methods were 80% (95% CI, 62.69%-90.5%) and 50% (95% CI, 33.15%-66.85%) in all patients, and 66.67% (95% CI, 41.71%-84.82%) and 20% (95% CI, 7.047%-45.19%) in cases without visible urethral discharge, respectively. Conclusion: The new kissing slide method is a noninvasive alternative method that may have better sensitivity than the conventional GSS sampling method in the diagnosis of male acute urethritis. Randomized studies are needed to verify these findings.
Tamsulosin-induced hyperprolactinemia in a patient with multiple sclerosis: a case report
(Galenos Yayincilik, 2019) Gorgel, Ahmet; Soylu, Ahmet; Gorgel, Sacit; Tecellioglu, Mehmet; Sarıer, Mehmet
Drug-induced hyperprolactinemia is one of the most common causes of non-physiologic hyperprolactinemia. In contrary to other anterior pituitary hormones, prolactin is not controlled via hypothalamic-pituitary negative feedback mechanism. Since prolactin secretion is inhibited mainly by dopamine, some drugs such as antipsychotics and prokinetics which block dopamine receptors may lead to hyperprolactinemia. Nevertheless, despite this well-known phenomenon, most of cases of drug-induced hyperprolactinemia are asymptomatic. On the other hand, hyperprolactinemia due to tamsulosin that is an alpha adrenergic receptor antagonist has not been reported yet. Herein, we present a 39-year-old woman with multiple sclerosis who developed hyperprolactinemia after starting treatment with tamsulosin for neurogenic bladder disease.
Classification of non-gonococcal urethritis: a review
(Springer, 2019) Sarıer, Mehmet; Kukul, Erdal
Non-gonococcal urethritis (NGU) is the most common disease of the genital tract in men. Recent studies have recommended avoiding the empiric antibiotic administrations that constitute the classical treatment approach in NGU and to aim toward treatment of causative pathogens. However, the classification of NGU agents remains controversial. In addition, the relevance of the commensalism of Mycoplasma hominis, Ureaplasma urealyticum, Ureaplasma parvum, and Gardnerella vaginalis, which are among the opportunistic pathogens found in the urethral flora, has yet to be determined. Furthermore, there are certain pathogens on which sufficient studies have not been conducted, although they are known to be NGU pathogens, and their statuses should be updated. In this review, the classification of NGU pathogens is summarized in the light of the current literature.
Polymerase chain reaction assay in acute urethritis
(Wiley, 2019) Sarıer, Mehmet
Acute urethritis is the most common sexually transmitted disease in men. The literature shows a significant development in diagnosis and treatment methods for the disease in recent years. The biggest development is undoubtedly the widespread use of nucleic acid amplification tests such as polymerase chain reaction (PCR) assay. The PCR assay has provided detection of urethritis pathogens that are difficult to identify, both immediately and with high sensitivity
Prevalence of polymicrobial infection in urethritis
(Galenos Yayincilik, 2019) Sarıer, Mehmet
Objective: Urethritis is the most common sexually-transmitted disease in men and is classified as gonococcal (GU) and non-gonococcal (NGU) according to the pathogens. Increased urethritis prevalence in recent years has brought the presence of polymicrobial infection into question. The objective of this study was to investigate the prevalence of polymicrobial infections in patients diagnosed with urethritis in a urology outpatient clinic, based on real-time multiplex polymerase chain reaction (Rt-MPCR) assay outcomes. Materials and Methods: Data of 171 patients diagnosed with urethritis and undergone Rt-MPCR analysis in a urology outpatient clinic between February 2017 and June 2018 were retrospectively studied. The pathogens that could be detected by the Rt-MPCR were Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, Ueroplasma parvum, Gardnerella vaginalis, Trichomonas vaginalis, Candida albicans and herpes simplex virus type 1-2. Results: The mean age of 171 patients was 33.8 (19-56) years. According to the Rt-MPCR outcomes, polymicrobial infections were found in 16.9% (29/171) of patients. Two-pathogen polymicrobial urethritis was found in 14% (24/171) of the patients, and three-pathogen polymicrobial urethritis in 2.9% (5/171). Among the cases of polymicrobial urethritis, coexistence of both GU and NGU pathogens was found in 17.3% (5/29) and that of only NGU pathogens in 82.7% (24/29). Overall distribution of urethritis pathogens was found to be as follows: Chlamydia trachomatis 22.9%, Neisseria gonorrhoeae 21.7%, Gardnerella vaginalis 16.8%, Ureaplasma urealyticum 14.2%, Mycoplasma genitalium 10.5%, Ueroplasma parvum 4.7%, Mycoplasma hominis 3.7%, Trichomonas vaginalis 3.1%, Candida albicans 1.8% and herpes simplex virus type -2 1.2%. Conclusion: The presence of polymicrobial urethritis should be taken into consideration when planning treatment for urethritis. Particularly, the association of NGU urethritis pathogens should be considered in the cases of polymicrobial urethritis.
HPV infection in urology practice
(Springer, 2020) Sarıer, Mehmet; Ceyhan, Ali Murat; Sepin, Nevgun; Ozel, Esin; Inal, Mehmet Murat; Kukul, Erdal; Soylu, Ahmet
Human papillomavirus (HPV) is the most common pathogen of sexually transmitted disease worldwide. While HPV is responsible for low-grade benign lesions in the anogenital area such as condyloma acuminatum, it is also strongly associated with cervical, anal, vulvar/vaginal, and penile carcinomas. In addition to being an oncogenic virus, HPV causes a substantial socioeconomic burden due to the recurrence of benign lesions, the lack of a definitive treatment option that provides a complete cure, and the high cost of treatment. The global incidence of HPV infection is rising, especially among young and sexually active individuals; as a result, in recent years these infections have also become increasingly conspicuous in urology practice, both as incidental findings and primary complaints. The aim of this review is to evaluate the pathogenesis, diagnosis, and treatment modalities of HPV infections in light of the current literature from the urologist's perspective.
The necessity of voiding cystourethrogram for the evaluation of recipient candidates in adult renal transplantation
(Federal Research Center Transplantology & Artificial Organs V I Shumakov, 2020) Sarıer, Mehmet; Callioglu, M.; Yuksel, Yu
Objective. While international guidelines necessitate Voiding Cystourethrogram (VCUG) for pediatric patients, it is unnecessary for the evaluation of adult patients without urological disorders as renal transplant candidates. The objective of this study was to evaluate the results of adult candidates who underwent VCUG before transplantation and to demonstrate the necessity for this imaging. Methods. A retrospective study of the data of 1265 adult candidates who underwent VCUG before transplantation at our center, was undertaken. VUR, the presence of Postvoiding residual urine (PVR) (>100 ml), Low bladder capacity (LBC) (<100 ml), and urethral pathologies were evaluated with VCUG. Results. The mean age was 42.3 +/- 1.3. The mean dialysis period was 27.8 +/- 4.2 months. According to the VCUG results, 19.2% of the patients had pathological findings. On the other hand, the rate of urological disorders was only 5.1%, according to end-stage renal disease (ESRD) etiologies. VCUG outcomes indicated bilateral high-grade reflux in native kidneys in 4.4% (n = 56) of the candidates, unilateral high-grade reflux in 4.1% (n = 52), bilateral low grade reflux in 2.1% (n = 26), unilateral low-grade reflux in 2.4% (n = 30), and reflux in rejected transplanted kidney in 2.3% (n = 29). In addition, significant LBC was noted in 4.8% (n = 61), significant PVR in 1.1% (n = 14), and urethral stricture in 0.5% (n = 6) of the candidates. Conclusion. VCUG should be considered as a part of routine evaluation in adult renal transplant recipient candidates as well as in pediatric candidates, even if their ESRD etiologies are not due to urological disorders.
Relationship between masked arterial hypertension and erectile dysfunction
(Codon Publications, 2020) Ates, Ismail; Mutlu, Deniz; Kaya, Zeynettin; Okutucu, Sercan; Sarıer, Mehmet; Cilingiroglu, Mehmet
Background Erectile dysfunction (ED) has a marked negative effect on quality of life. The association between sustained hypertension (HT) and ED has been clearly shown. However, there is no study evaluating masked HT and ED. We aimed to assess the prevalence of masked HT and the related factors in patients with ED. Methods A total of 64 consecutive males with ED (mean age: 50.4 +/- 9.8 years) were enrolled in the study. The Sexual Health Inventory for Men (SHIM) questionnaire was used to evaluate the erectile status of the patients. Office and 24-h ambulatory blood pressure (BP) of all patients were measured. Results We detected masked HT in 24 of 64 patients with ED (37.5%). The SHIM score was slightly lower in masked HT group compared to true normotensives, but the difference was not statistically significant (10.8 +/- 5.2 vs. 11.4 +/- 4.6; p=0.65). There was no significant correlation between all-day systolic and diastolic BP with SHIM scores (R=0.076, p=0.55; R=0.079; p=0.53). When the patients with masked HT were classified according to the nocturnal BP reduction, the SHIM scores of patients with the nondipping pattern were lower than the dippers (9.8 +/- 5.3 vs. 12.0 +/- 5.1; p=0.001). Conclusions The prevalence of masked HT is high in patients with ED. Patients with masked HT and nondipping nocturnal BP pattern have more profound ED. The coexistence of masked HT and ED is thought to be a marker of increased cardiovascular risk.
Is there any association between urothelial carcinoma of the bladder and human papillomavirus? A case-control study
(Karger, 2020) Sarıer, Mehmet; Sepin, Nevgun; Keles, Yildiz; Imir, Levent; Emek, Mestan; Demir, Meltem; Kukul, Erdal; Soylu, Ahmet
Objectives: Human papillomavirus (HPV) is a well-known oncogenic virus associated with anogenital carcinomas. Despite the anatomical proximity of the bladder and the anogenital region, the relationship between HPV and urothelial carcinoma of the bladder (UCB) is still a controversial issue. This study aimed to test the urethral swabs and first-void urine samples of patients with UCB for HPV-Deoxyribonucleic acid (DNA) using polymerase chain reaction (PCR) assay and to compare the results with a control group. Materials and Methods: Sixty-nine patients who were diagnosed with UCB between January and December 2018 were included in this case-control study. Sixty-nine patients who visited the urology outpatient clinic for non-oncological reasons within the study period were designated as the control group. Urethral swab and first-void morning urine samples were collected from each patient. HPV-DNA presence was investigated using a PCR kit that can detect a total of 22 HPV genotypes, of which 18 are high-risk and 3 are low-risk genotypes. Results: The mean age of the patients included in the study was 63.2 +/- 12.6 years and the male to female ratio was 5.3. HPV-DNA was detected in 28.9% (20/69) of the patients in the case group and in 8.7% (6/69) of the patients in the control group. HPV-DNA positivity was significantly higher in the case group (OR 4.24; 95% CI 1.63-12.34). No statistically significant relationship was found between HPV-DNA positivity and tumor grade (p = 0.36). Conclusion: A statistically significant relationship exists between HPV infection and UCB, regardless of the tumor grade.
Evaluation of histopathologic results of testicular tumors in Antalya: multi center study
(Galenos Yayincilik, 2020) Sarıer, Mehmet; Tunc, Mustafa; Ozel, Esin; Duman, Ibrahim; Kaya, Sagfettin; Hoscan, Mustafa Burak; Unsal, Cagatay
Objective: Testicular tumors constitute 1% of all malignancies in men. Being a relatively uncommon tumor, there are few descriptive studies in the literature. The aim of this study is to retrospectively investigate the histopathological results of testicular tumors in our region. Materials and Methods: In this descriptive multicenter study, we evaluated the histopathologic results of 124 patients who underwent radical or partial orchiectomy with a diagnosis of testicular tumor between 2011 and 2019 in the region of Antalya, Turkey. All specimens were examined by the pathologists in a single center. Data pertaining to patient age, type of operation, histopathological tumor type, tumor size, and pathological stage of the primary tumor (pT) were analyzed. Results: The mean age of the 124 patients included in the study was 35.14 +/- 15.3 (2-80) years. Most (98.4%) of the analyzed specimens were radical orchiectomy materials, while only 1.6% were partial orchiectomy materials. Mean tumor size was 4.01 +/- 2.29 (0.5-11) cm. Tumor size was <= 2 cm in 29 (23.4%) specimens and >= 2 cm in 95 (76.6%) specimens. In terms of histopathology, 76.8% were germ cell tumors, 6.4% were gender cord-stromal tumors, 4.8% were ductal canal and rete testis tumors, and 12% were secondary tumors of the testis. Pathological stage of the pT was pT1 in 46%, pT2 in 39%, and pT3 in 15% of the patients. Conclusion: Although patient age and histopathological distribution of testicular tumors were generally consistent with the literature, the average tumor size in the orchiectomy materials was notably large. Initiatives are required to increase public awareness of the importance of early detection. In addition, our findings suggest that urologists feel hesitant to practice testis-sparing surgery despite recommendations in international guidelines.
Evaluation of the renal arteries of 2,144 living kidney donors using computed tomography angiography and comparison with intraoperative findings
(Karger, 2020) Sarıer, Mehmet; Callioglu, Mehmet; Yuksel, Yucel; Duman, Enes; Emek, Mestan; Usta, Sibel Surmen
Objectives:A carefully chosen and suitably prepared kidney donor is essential in living-donor kidney transplantation. Computed tomography angiography (CTA) is an effective imaging method for evaluating the renovascular morphology of donor candidates. The aim of this study was to evaluate renal artery variations in kidney donors using CTA and compare the findings with the number of arteries detected during laparoscopic donor nephrectomy.Materials and Methods:The study included 2,144 living donors who underwent pretransplant renovascular assessment using CTA and laparoscopic donor nephrectomy in our center between August 2012 and October 2018. The number of renal arteries to the donor kidney detected on CTA was compared with the number of arteries discovered intraoperatively.Results:The mean age of the 2,144 living kidney donors included in the study was 47.19 +/- 13.3 (18-87) years. According to CTA findings, 81.1% (n= 1,738) had a single renal artery, 17.2% (n= 369) had double renal arteries, 1.6% (n= 35) had triple renal arteries, and 0.1% (n= 2) had quadruple renal arteries. The same number of renal arteries were detected by CTA and in laparoscopic donor nephrectomy in 97.9% (n= 2,099) of the donors. In the other 2.1% (n= 45), fewer renal arteries were detected intraoperatively compared to their CTA findings. None of the donors included in the study had a greater number of renal arteries discovered during nephrectomy than by CTA.Conclusion:CTA is a highly accurate method for the evaluation of renovascular variations in donor candidates for living-donor kidney transplantation. However, it must be kept in mind that double or multiple renal artery variations may be detected on CTA in 18.9% of donor candidates.

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