Browsing by Author "Gunlusoy, Bulent"

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Differences Between Patients With and Without Persistent PSA After Radical Prostatectomy in Clinically High-Risk And/Or Locally Advanced Prostate Cancer
(Galenos Publ House, 2025) Eker, Anıl; Degirmenci, Tansu; Bozkurt, İbrahim Halil; Celik, Serdar; Gunlusoy, Bulent; Çetin, Taha; Karaca, Berk
Objective: This study aimed to identify preoperative and postoperative factors associated with persistent prostate-specific antigen (PSA) following radical prostatectomy (RP) in patients with clinically high-risk and/or locally advanced prostate cancer. Understanding these factors can guide early postoperative management decisions, including adjuvant treatment strategies. Materials and Methods: A retrospective analysis was conducted on 183 patients who underwent RP for locally advanced prostate cancer between 2009 and 2023. Patients were divided into two groups: those with persistent PSA at 1 month postoperatively (group 2, n=43), and those without (group 1, n=140). Preoperative and postoperative variables, including PSA levels, clinical stage, biopsy grade group, tumor volume, and pathological findings, were compared between groups. Results: Patients in group 2 had significantly higher preoperative PSA levels (24.6±19 ng/mL vs. 15±15.5 ng/mL, p<0.001), advanced clinical stage (≥T2B: 52.6% vs. 32.1%, p=0.032), and higher percentage of positive biopsy cores (p=0.011). Postoperative findings demonstrated a higher tumor volume (20.2±14.1 cc vs. 10.7±10.5 cc, p=0.002), tumor density (p=0.005), and positive surgical margins (86% vs. 70%, p=0.025) in group 2. Patients in group 2 had higher rates of lymph node dissection, adjuvant therapy, and early salvage radiotherapy. Conclusion: Preoperative PSA levels, biopsy grade group, positive surgical margins, and advanced pathological stage are critical predictors of persistent PSA after RP. Early identification of high-risk patients enables personalized management plans, including timely initiation of adjuvant therapies, to improve outcomes. Further prospective studies are needed to refine risk stratification models and personalize treatment strategies.
Citation - WoS: 1
Citation - Scopus: 1
Histologic and Physiologic Analysis of the Relationship Between the Dorsal Nerve of the Penis and the Corpus Cavernosum on a Rat Model. a Complementary Pathway on the Innervation of Penile Erection?
(Wiley, 2022) Kozacıoğlu, Zafer; Vatansever, H. Seda; Onal, Tuna; Kutlu, Necip; Ozel, Fehmi; Gunlusoy, Bulent; Gumus, Bilal H.
Aim The dorsal nerve of the penis (DNP) is the terminal branch of the pudendal nerve which is responsible for the somatic innervation of the penis. This study aims to outline any direct role of the DNP in the hemodynamics of erection histologically and physiologically. Materials and Methods Fifteen Wistar albino rats were sorted into the electrical activity (n = 6), intracavernous pressure (n = 4), and control (n = 5) groups. The dorsal nerve was electrostimulated and the simultaneous changes in intracavernous pressure and smooth muscle activity were recorded. Penile tissues were collected, fixed, and sectioned, the slides were stained with either hematoxylin-eosin for morphological evaluation or using the indirect immunoperoxidase technique to analyze the distributions of eNOS, iNOS, and nNOS. Results During electrostimulation, there was a simultaneous statistically significant decrease in the electrical activity inside the corpora in electromyography and an increase in intracavernous pressure. eNOS and iNOS immunoreactivities were higher in the study group than in the control group. nNOS immunoreactivity was moderate in both study and control groups. Conclusion Some fibers in the dorsal nerve of penis continue into the corpora cavernosa through the tunica albuginea and have an active, direct role in the hemodynamic process of erection, which may be complementary to the main route of innervation.