Prof. Dr. Abdullah Erdem Canda

Testis sparing surgery (2017)

Can Urol Assoc J. 2017 Mar-Apr;11(3-4):E100-E104. doi: 10.5489/cuaj.4016. Epub 2017 Mar 16.

Is testis-sparing surgery safe in small testicular masses? Results of a multicentre study.

Keske M1, Canda AE2, Yalcin S3, Kilicarslan A1, Kibar Y3, Tuygun C4, Onder E4, Atmaca AF2, Yildirim A5, Ozkanli SS5, Kandemir O6, Kargi T7, Sar M7, Tugcu V7, Resorlu B1, Aslan Y8, Sarikaya S9, Boylu U10, Cicek AF3, Basar H6, Tuncel A8, Balbay MD11.

Author information

Abstract

INTRODUCTION:

Our goal was to evaluate benign and malignant lesions and testicular intraepithelial neoplasia (TIN) in the neighbouring normal-appearing testis tissue in men who underwent radical orchiectomy for testicular mass with a pathologic tumour size of ≤3cm.

METHODS:

In this retrospective, multicentre study, data of 252 patients from 11 different institutions were included. Patients were divided into three groups based on tumour size: Group 1 (0-1 cm; n=35), Group 2 (1.1-2cm; n=99), and Group 3 (2.1-3 cm; n=118). Benign lesions and TIN were sought in the neighbouring testicular tissue and compared between groups.

RESULTS:

Mean patient age was 32.3 years. Benign lesions were reported in 54.3%, 33.3%, and 14.4% of Groups 1, 2, and 3, respectively (p<0.05 between groups). TIN was detected in 20%, 42.4%, and 41.5% of Groups 1, 2, and 3, respectively (p<0.05 for Group 1 vs. Groups 2 and 3; p>0.05 for Groups 2 vs. 3). Multifocality was detected in 8.6%, 4%, and 0% of Groups 1, 2, and 3, respectively (p<0.05 for both Group 1 vs. Group 3 and for Group 2 vs. Group 3; p>0.05 for Group 1 vs. Group 2). A tumour cutoff size of 1.5 cm was found to be significant for detecting benign tumour. TIN and multifocality rates were similar in patients with a tumour size of ≤1.5 vs. >1.5 cm (p>0.05).

CONCLUSIONS:

Benign lesions and TIN in the neighbouring testis were significantly decreased and multifocality was increased in patients with a tumour mass size of ≤1 cm. Testis-sparing surgery should be performed with caution and a safety rim of normal tissue should also be excised.

Open stone surgery (2017)

Cent European J Urol. 2017 Jun 30;70(2):179-184. doi: 10.5173/ceju.2017.1205. Epub 2017 Mar 20.

Open stone surgery: a still-in-use approach for complex stone burden.

Çakici ÖU1, Ener K2, Keske M2, Altinova S2, Canda AE3, Aldemir M2, Ardicoglu A3.

Author information

Abstract

INTRODUCTION:

Urinary stone disease is a major urological condition. Endourologic techniques have influenced the clinical approach and outcomes. Open surgery holds a historic importance in the management of most conditions. However, complex kidney stone burden may be amenable to successful results with open stone surgery. In this article, we report our eighteen cases of complex urinary stone disease who underwent open stone removal.

MATERIAL AND METHODS:

A total of 1701 patients have undergone surgical treatment for urinary stone disease in our clinic between July 2012 and July 2016, comprising eighteen patients who underwent open stone surgery. Patients' demographic data, stone analysis results, postoperative clinical data, and stone status were evaluated retrospectively. The choice of surgical approach is mostly dependent on the surgeon's preference. In two patients, open surgery was undertaken because of perioperative complications.

RESULTS:

We did not observe any Clavien-Dindo grade 4 or 5 complications. Three patients were managed with a course of antibiotics due to postoperative fever. One patient had postoperative pleurisy, one patient had urinoma, and two patients had postoperative ileus. Mean operation time was 84 (57-124) minutes and mean hospitalization time was 5.5 (3-8) days. Stone-free status was achieved in 15 patients (83.3%).

CONCLUSIONS:

Endourologic approaches are the first options for treatment of urinary stone disease. However, open stone surgery holds its indispensable position in complicated cases and in complex stone burden. Open stone surgery is also a valid alternative to endourologic techniques in all situations.

KEYWORDS:

Diabetes and urinary tract and interstitial cells (2014)

Cent European J Urol. 2014;67(4):366-74. doi: 10.5173/ceju.2014.04.art10. Epub 2014 Dec 5.

Does diabetes affect the distribution and number of interstitial cells and neuronal tissue in the ureter, bladder, prostate, and urethra of humans?

Canda AE1, Dogan H2, Kandemir O3, Atmaca AF1, Akbulut Z1, Balbay MD4.

Author information

Abstract

INTRODUCTION:

The aim of this study was to investigate and compare the distribution and number of interstitial cells (ICs) and neuronal tissue in the ureter, bladder, prostate, and urethra of human patients with and without diabetes.

MATERIAL AND METHODS:

Human tissue was obtained from patients who had undergone radical cystectomy for bladder cancer (10 diabetic and 11 non-diabetic males). Interstitial cells were stained immunohistochemically with anti-human CD117 (c-kit) rabbit polyclonal antibody, Vimentin, and Connexin-43. Neural tissue was stained with synaptophysin. The number of ICs and neurons was evaluated and compared between the groups (diabetic versus non-diabetic).

RESULTS:

The mean number of c-kit (+) ICs in bladder lamina propria was significantly decreased in diabetics (32.40 ±12.96 versus 57.18 ±25.37, p = 0.036). The mean number of ICs in the detrusor muscle was significantly decreased in diabetics (40.50 ±16.79 versus 64.55 ±22.08, p = 0.013). Between the groups, no significant differences were detected regarding the number of ICs at the level of the ureter, urethra, and prostate. No significant differences were detected regarding the number of nerves in the ureter, bladder, prostate, and urethra of both groups.

CONCLUSIONS:

The number of ICs may be decreased in the lamina propria and detrusor muscle of the human bladder in diabetes. This can be an underlying cause of lower urinary tract (LUT) dysfunction in diabetics. Research into the development of drugs targeting or stimulating IC function in order to prevent diabetic LUT dysfunction is warranted.