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    The effectiveness of local steroid injection after internal urethrotomy to avoid recurrence
    (Pagepress Publ, 2015) Yildirim, Mehmet Erol; Kaynar, Mehmet; Ozyuvali, Ekrem; Badem, Huseyin; Cakmak, Muzaffer; Kosem, Bahadir; Cimentepe, Ersin
    Objective: Local steroid injection to the stricture region after internal urethrotomy (IU) is a promising technique to avoid the recurrence, although the effectiveness and safety of this technique is still controversial. We aimed to determine the efficacy and safety of local steroids as applied with the IU procedure. Material-Method: A total of 83 patients data with urethral stricture in men were examined retrospectively. Patients classified in two groups who had steroid injection with internal urethrotomy or not. Metil prednisolone 40 mg was injected with transurethral injection needle in the stricture region at the 5, 7 and 12 o'clock sites at the same session with internal urethrotomy. Procedure was considered successful if patient did not report any voiding difficulty and maximum flow rate > 15 mL/second for a voided volume of at least 150 mL after removal of the catheter. Patient's age, time to recurrence, previous recurrences were evaluated. Results: The mean age was 56.4 (18-83) years. Of those patients 33/83 had recurrent stenosis. Nineteen out of these 33 recurrent stenosis patients were treated with local steroid injection and 14/33 had no injection. Only two patients of the steroid treated group had recurrence. Despite that 12 patients had recurrence in the steroid non-treated group. Also the primary stenosis patients showed no recurrence at the steroid+ IU group. Conclusions: The use of local steroids with IU seems to decrease the high stricture recurrence rate following IU. When local steroids were administered with complementary intention, the disease control outcomes are encouraging. Further robust comparative effectiveness studies are now required.
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    Urethral Caruncle Causing Bilateral Bladder Diverticula: A Case Report
    (Aves, 2016) Ozyuvali, Ekrem; Yildirim, Mehmet Erol; Kosem, Bahadir; Cimentepe, Ersin
    An urethral caruncle is a benign vascular tumor usually originating from the rear lip of the external urethral meatus and is usually observed in postmenopausal women. It is not included within the list of causes of bladder overdistension in women. We present a case of a urethral caruncle as a rare cause of acute urinary obstruction in a 71-year-old woman. The 71-year-old woman had occasional bleeding from a mass in the urethral meatus for 3 years. A reddish mass, measuring 3 cm in diameter, was noted at the posterior lip of the urethral meatus. The mass was diagnosed to be a urethral caruncle and was removed. Microscopically, the squamous epithelium, which covered the urethral caruncle, was found to be keratinized, with the proliferation of atypical cells with swollen nuclei in the entire mucosal layer. The patient could urinate better after the indwelling urethral catheter was taken out.
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    Urological recommedations of Hadji Pasha's, a Turkish aged doctor in Anatolia
    (Mashhad Univ Med Sciences, 2016) Yildirim, Mehmet Erol; Canbal, Metin; Ozyuvali, Ekrem; Karatas, Omer Faruk
    Objective: Urinary tract conditions have been an important part of diseases from antiquity until today. Historically, many plants and herbs have been used for the treatment of urinary disorders. Methods: Celaluddin Hizir bin Ali el-Konevi (Hadji Pasha) is one of the most famous physician who lived in Anatolia between 13th and 14th centuries. He has written one of the most important medical books of that era, Muntehab-iSifa (solution of wellness) in Turkish. General medical information about the diseases in this book, focus on diagnosis and treatment. Results: The herbal solutions for urological disorders such as, urinary incontinence, urinary stones or erection problems are told in this section. Conclusion: Many of the herbal medicines addressed in this book are being widely used in current medicine, but the usage of these herbals in daily urology practice is limited. In this study, we aimed to share the advices for the urological diseases and the related herbal medicines that are named in Hadji Pasha's book, Muntehab-iSifa, with today's physicians.