Amaç: Penil fraktür ürolojik aciller içinde pek sýk rastlanmayan bir durumdur. Tanýnýn erken konulmasýnda ve tedaviye biran önce baþlanýlmasýnda yarar vardýr. Bu çalýþmada penil fraktür ile baþvuran olgulardaki klinik özelliklerin, bu hastalara uygulanan taný metodlarýnýn, cerrahi yöntemin ve sonuçlarýnýn incelenmesi amaçlanmýþtýr.
Gereç ve Yöntem: Penil fraktür tanýsý almýþ ve opere edilmiþ olan 26 hastanýn retrospektif incelemesi yapýldý. Çalýþmadaki bütün hastalar 1996-2007 yýllarý arasýnda kliniðimizde tedavi edilmiþti. Hastalarýn anamnez, fizik muayene, görüntüleme yöntemleri operasyon bulgularý ve kontrol muayenelerine ait bilgilerine hasta kayýtlarýndan ulaþýldý.
Bulgular: Penil fraktürün 16 olguda cinsel iliþki esnasýnda, 5 olguda masturbasyon sýrasýnda, 5 olguda ise uyku esnasýnda düþme sonucunda olduðu anamnez ile saptandý. Tüm hastalara taný, anamnez ve fizik muayene ile konuldu. Bütün hastalara subkoronal sirkumferansiyel insizyon uygulandý. Onbeþ olguda sað, on olguda sol, bir olguda her iki korpus kavernozum yaralanmasý ile birlikte üretra yaralanmasý saptandý.Hastalarýn hiçbirinde, bir yýllýk kontrollerinde erektil disfonksiyon veya penil deviyasyon gerçekleþmedi.
Sonuçlar: Penil fraktür tanýsý koymak için anamnez ve fizik muayene yeterli olmakta ve diðer taný metodlarýna genellikle ihtiyaç duyulmamaktadýr. Subkoronal sirkumferansiyal insizyonun seçildiði erken cerrahi yaklaþýmla iyi sonuçlar elde edilmektedir.

Purpose: Penile fracture is a rare condition among urological emergencies. There are benefits of early diagnosis and immediate treatment. In this study we aimed to asses clinical presentation of the patients with penile fracture and diagnostic methods, surgical procedure and outcomes of theraphy in these patients.
Material an Methods: Twenty six patients with penile fracture who had surgical intervention are retrospectively analysed. All patients were treated at our clinic between 1997 and 2007. The data about the history, physical examination, imaging modalities, the findings at operation and follow up of the patients were collected from medical records.
Results: Penile fracture developed during sexual intercourse in 16 patients, while 5 patients had penile fracture during masturbation and 5 had penil fracture because of rolling from bed. All patients diagonised with history and physical examination. Circumferantial subcoronal insicion applied to all patients. Right corpus cavernosal injury was detected in 15 patients, left sided injury was detected in 10 patients, one patient had injury in both corpus cavernosum with urethral injury. None of the patients developed erectile dysfunction or penile deviation at one year follow up period.
Conclusions: For diagnosis of penile fracture, history and physical examination is usually adequate and there is no need for further diagnostic procedures. Satisfactory results are achived with immediate surgery in which circumferential subcoronal incision is chosen.

Amaç: Biz retrospektif olarak yaptýðýmýz bu çalýþmada; bir yýllýk dönemde acil servise baþvuran zehirlenme olgularý ile ilgili verileri toplamayý, demografik ve etyolojik özellikleri ile prognozlarýný araþtýrarak, literatür ile karþýlaþtýrmayý amaçladýk.
Gereç ve Yöntemler: Ankara Numune Eðitim ve Araþtýrma Hastanesi (ANEAH) Acil Servisi’ne 01.09.2006 ile 31.08.2007 tarihleri arasýndaki bir yýllýk süreçte akut zehirlenme nedeniyle baþvuran 14 yaþ üstü tüm olgular; yaþ ve cinsiyet daðýlýmlarý, zehirlenme nedenleri, prognoz ve mortalite oranlarý açýsýndan araþtýrýldý.
Bulgular: Akut zehirlenme nedeniyle acil servise gelen 1288 olgunun 790’ý (%61.3) kadýndý. Yaþ ortalamasý kadýnlarda 28.5±15.1 yýl, erkeklerde 31.3±16.3 yýl idi. En sýk karþýlaþýlan zehirlenme nedenleri; ilaçlar (%58.69), karbon monoksit (%19.25), alkol (%8.15) ve mantar (%6.99) idi. Tüm olgularýn %53.1’i intihar amaçlý zehirlenmelerdi ve kadýnlarda bu oran daha yüksekti (%70). Olgularýn %85.7’si acil serviste, %8’i dahiliye kliniklerinde, %6.3’ü ise yoðun bakým ünitelerinde izlendi. Yoðun bakýmda kalýþ süreleri ortalama 3.77±2.05 gündü. Mortalite oraný %0.31 olarak bulundu.
Sonuç: Sonuç olarak; zehirlenme olgularý sýklýkla, genç kadýnlarda ve ilaç alýmý þeklinde görülmektedir. Olgulara acil müdahalenin olabildiðince erken yapýlmasý ve gerektiðinde yoðun bakýmlarda izlenmesi, mortalitenin azaltýlmasý yönünde büyük öneme sahiptir. Ama daha da önemlisi yaygýn olarak kullanýlan ve ulaþýlmasý kolay olan analjezik ve antidepresan gibi ilaçlarýn kontrollü kullandýrýlmasý gerektiði kanýsýndayýz.

Objective: In this retrospective study we aimed to gather one year data about intoxication cases admitted to emergency service, examine their
demographic and etiologic characteristics and compare these with literature.
Material and Methods: Cases older than 14 years admitted to Ankara Numune Reseach and Training Hospital Emergency Service between 1st
September 2006 and 31th August 2007 because of acute poisoning examined for age and gender distribution, poisoning etiology, prognosis and mortality rates.
Results: 790 (61.3%) of 1288 people who came to the emergency service because of acute poisoning were female. Mean age was 28.5±15.1 years and 31.3±16.3 years in female and in male patients respectively. Most common cause of the poisonings were drugs (58.69%), carbonmonoxide (19.25%), alcohol (8.15%) and mushroom (6.99%). Of all the events 53.1% were attempts to suicide and this rate was 70% in females. While 85.7% of the cases were followed in emergency service, 8% in internal medicine clinic and 6.3% in ICU. For all the patients, mean duration in ICU was 3.77±2.05 days. Mortality rate was found to be 0.31%.
Conclusions: It can be concluded that intoxication is encountered in females more commonly and most common with a drug. The carrying out of urge interventions as possible as early and observation in ICU is of great importance. That is why we are in opinion that the usage of the medicines such as analgesics and antidepressant drugs which are easy to reach should be taken under control.

Amaç: Cerrahi menopoz hastalarýnda, östrojen formlarýndan transdermal östradiol hemihidrat jel ve intranasal östradiol hemihidrat sprey uygulamalarýnýn serum hormon, lipid deðerleri ve mamografik dansite üzerine etkilerinin karþýlaþtýrýlmasý.
Gereç ve Yöntem: Çalýþmaya Þiþli Etfal Eðitim ve Araþtýrma Hastanesi Kadýn Hastalýklarý ve Doðum Kliniði menopoz polikliniðine baþvuran, cerrahi menopozlu toplam 58 hasta alýndý.
Hastalar 3 gruba ayrýlarak birinci gruba (n=20) Estrava transdermal jel (Östradiol hemihydrate 3x0,5 mg/gün), ikinci gruba (n=20) ise intranazal sprey (Östradiol hemihydrate 2x150 mcg/gün) nasal sprey verildi. Üçüncü grup (n=18) ise kontrol grubu olarak belirlendi.
Hastalarýn tedavi öncesi ve sonrasý mamografik dansitelerindeki deðiþiklikler Wolfe skorlamasýna göre deðerlendirildi. Total kolesterol, HDL, LDL-kolesterol, trigliserid, FSH, LH, E2, TSH, testosteron, kortizol ve DHEAS düzeyleri de ayný dönemlerde bakýldý.
Bulgular: Transdermal jel, intranazal sprey gruplarýnýn, tedavi sonrasý E2 deðerleri tedavi öncesinden anlamlý olarak yüksek bulundu (p= 0,003, p=0,0001). Transdermal jel, intranazal sprey, kontrol gruplarýnýn tedavi öncesi ve sonrasý mamografik dansiteleri arasýnda, istatistiksel farklýlýk gözlenmedi (p>0,05).
Sonuç: Çalýþmamýzda transdermal jel ve intranazal spreyin her ikisinin de serum E2 düzeylerini arttýrdýðý saptanmýþ, mamografik deðerlendirmede her iki grupta da kontrol grubuna göre dansitede anlamlý fark saptanmamýþtýr.

Objective: To compare the effects of transdermal estradiol hemihydrate gel and intranasal estradiol hemihyrate spray applications on serum hormone and lipid values and mammographic density in surgical menopause patients.
Material and Method: A total of 58 surgical menopause patients who admitted to Menopause Policlinic in Sisli Etfal Training and Research Hospital Obstetrics and Gyneacology Clinic was included in our study. Patients were divided into three groups: Group 1 (n=20) received Estrava transdermal gel (estradiol hemihydrate 3x0.5 mg/day), group 2 (n= 20) received intranasal spray (estradiol hemihydrate 2x150μg/ day), group 3 (n=18) was accepted as the control group. The differences in mammographic densities before and after the treatment of the patients were evaluated according to the Wolfe Scoring System. The serum levels of total cholesterol, HDL, LDL, trigliceride, FSH, LH, E2, TSH,
testosterone, cortisole and DHEAS were evaluated at the same time periods.
Results: The level of serum estradiol after the treatment in transdermal gel and intranasal spray groups was significantly higher than before the
treatment (p= 0.003, p= 0.0001). There was no statistically significant difference in the mammographic densities before and after the treatment in the transdermal gel, intranasal spray and control groups (p>0.05).
Conclusion: In our study, both transdermal gel and intranasal spray groups proved to increase serum estradiol levels whereas there was no difference in terms of mammographic densities of the groups according to control group.

Tedavi deðerlendirmesine yönelik hasta anketleri, kiþinin bedensel ve psikolojik açýdan bireysellik içerdiðinden öznel bir karaktere sahiptir. Bu anketler öznel yapýsýna raðmen hasta memnuniyetini ve tedavi edilen elin iþlevselliðini ölçmede oldukça etkindir.
Amaç: Bir seri karpal tünel sendromu olgusunda PEM (hasta memnuniyet ölçeði) ve Boston anketi kullanarak hasta memnuniyetini ölçmek ve kullanýlan iki ölçek arasýndaki korelasyonu ortaya koymaktý.
Hastalar ve Yöntem: Kliniðimizde 2006-2007 tarihleri arasýnda karpal tünel sendromu tanýsý ile cerrahi tedavi uygulanan 3’ü erkek, 21’i kadýn toplam 24 hastanýn (ortalama yaþ 50. 4) 32 el bileði (8 olguda çift taraflý tutulum)bu çalýþmaya alýndý. On üç (%40,6) el bileðinde sol, on dokuz (%59,4) el bileðinde ise sað taraf tutulumu vardý. 5 (%20,8) hastada Diabetus Mellitus Tip II, 3 (%12,5) hastada ise kronik sigara tüketimi öyküsü vardý. Yakýnmalarýn ortaya çýkmasý ile cerrahi giriþim arasýnda geçen süre 26 aydý. “Mini-open” karpal tünel gevþetmesi uygulanan hastalara ameliyat öncesi ve sonrasý (6.ay) Boston (Levine) anketi ve PEM (Hasta Memnuniyet Ölçeði) anketi uygulandý. Her iki anketin verileri, SPSS 11. 5 programýnda istatistiksel olarak incelendi.
Bulgular: Her iki anketin sonuçlarýna göre cerrahi tedavi ile etkin bir iyileþme saðlandýðý saptandý. Boston iþlevsel deðerlendirme alt-ölçeði ile PEM sonuçlarý arasýnda orta düzeyde, Boston hasta yakýnmalarýna dayalý deðerlendirme alt-ölçeði ile PEM arasýnda ise düþük seviyede korelasyon bulundu.
Tartýþma ve Sonuç: Bu çalýþmada, uzun yýllardan bu yana kullanýmda olan Boston anketine kýyasla PEM anketinin; düþük maliyetli, kolay uygulanabilen ve hasta memnuniyetini deðerlendirebilen bir yöntem olduðu saptandý.

Patient rated scales for the evaluation of treatment are generally subjective as they consist of functional and psychological individualities. Despite those scales are subjective by nature, they are effective in assessing the patient satisfaction and functionality of treated hand.
Aim: Our aim was to assess the patient satisfaction in a series of carpal tunnel syndrome, by using PEM (Patient Evaluation Measurement) and Boston Questionnaire, then to evaluate the correlation between two scales.
Patients and Methods: 32 wrists (8 subjects double sided) of 24 patients (mean age 50.4) whereas 3 are male and 21 are female, who applied to our clinics in 2006 and 2007 were included into our study. Twelve wrists were right hand side and twenty were left hand side. 5 patients were suffering type II diabetes mellitus and 3 were having smoking history. The average “symptom to surgery” time was 26 months. Boston questionnaire and PEM scale were applied preoperatively and postoperatively (6 months) to the subjects who went under “mini-open” carpal tunnel release. Data from both scales were analysed by using SPSS (version 11.5) statistics software.
Results: Results from both scales demonstrate effective recovery after surgical treatment. PEM was found to be correlated with Boston Functional Rating Sub-scale and Complaint-based Rating Sub-scale, moderately and poorly, respectively.
Discussion and Conclusion: In reference to Boston questionnaire as a scale in use for a long time, PEM was considered to be a low cost, easy-to-use scale that rates the patient satisfaction in carpal tunnel syndrome.

Amaç: PTEN (phosphatase and tensin); 10.kromozomda (10q23.3) lokalize tümör supresör gen olarak belirlenmiþ önemli bir moleküler marker’dýr. Bu retrospektif çalýþmada mide adenokarsinomlarýnda PTEN ekspresyonu, PTEN ekspresyonunun prognostik parametre olarak anlamlýlýðý ve diðer prognostik parametrelerle iliþkisi araþtýrýlmýþtýr.
Gereç ve Yöntem: Mide adenokarsinomu tanýsý almýþ 60 olguya ait tümör içeren parafin bloklardan elde edilen kesitlere PTEN (Clone 28H6, Novocastra, UK) ile immunohistokimyasal boyama prosedürü uygulandý.
Bulgular: PTEN ekspresyonu ile Lauren sýnýflamasý ve histolojik grade arasýnda istatistiksel olarak anlamlý bir iliþki saptandý. Ancak PTEN ekspresyonu ile vasküler invazyon, perinöral invazyon, lenf nodu metastazý, TNM (primer tümör, lenf nodu, uzak metastaz) evresi arasýnda istatistiksel olarak anlamlý bir iliþki bulunmamýþtýr.
Sonuç: Çalýþmamýzda Lauren sýnýflamasýna göre diffuz tip karsinomlarda, intestinal tip karsinomlara göre PTEN ekspresyon kaybýnýn daha belirgin olduðu ve differansiasyon azaldýkça PTEN ekspresyon kaybýnýn arttðý saptanmýþtýr. Sonuçta PTEN ekspresyonunun malign transformasyonla, progresyonla ve diðer prognostik parametrelerden histolojik grade ile iliþkili olduðu görülmüþtür.

Objective: PTEN (phosphatase and tensin) is an important molecular marker that works as a tumor supressor gene located on the 10th chromosome (10q23.3). In this retrospective study, PTEN expression and its relationship with prognostic parameters have been investigated.
Study design: Slides obtained from paraffine blocks of 60 gastric adenocarcinoma immunohistochemically stained with PTEN (Clone 28H6,
Novocastra, UK).
Results: Statistically significant relationship was found between Lauren‘s classification, histologic grade and PTEN expression. But we were unable to show significant relationship with PTEN and vascular invasion, perineural invasion, lymph node metastasis, TNM (primary tumor, lymph node, distant metastasis) stage.
Conclusions: We found that PTEN expression loss is more prominent in the diffuse type carcinomas than the intestinal types and also there is a reverse correlation between histologic differentiation and PTEN loss. As a result PTEN expression was found to be related to malignant transformation, tumor progression and histologic grade.

Amaç: Tibia diafiz kýrýðý nedeniyle kilitli intramedüller çivi uygulanan hastalarýn klinik ve radyografik orta dönem sonuçlarýnýn deðerlendirilmesi.
Çalýþma planý: Tibia diafiz kýrýðý nedeniyle kilitli intramedüller çivi ile internal tespit uygulanan 67 hasta (45 erkek, 22 kadýn; ort. yaþ 36,9; daðýlým 16-69) çalýþmaya dahil edildi. Kýrýklar 42 hastada sað, 25 hastada ise sol tarafta idi. Hasta grubumuzda, kýrýðýn oluþ anýndan ameliyata kadar geçen süre ortalama 12 gün (daðýlým 1–35 gün), ortalama takip süresi ise 46,5 ay (daðýlým 6–123 ay) idi. Takip sonuçlarý Johner ve Wruhs kriterlerine göre deðerlendirildi.
Sonuçlar: Çalýþma grubumuzda ortalama kaynama süresi 21,1 hafta olarak bulundu (medyan 18 hafta, daðýlým 6–36 hafta). Johner ve Wruhs kriterlerine göre 67 olgunun 36’sýnda (%53,7) mükemmel, 17’sinde (%25,3) iyi, 7’sinde (%10,5) orta ve 7’sinde (%10,5) kötü sonuç elde edildi. 67 olgunun 14’ünde (%20,9) açýsal dizilim kusuru, 12’sinde (%17,9) komþu eklem hareket kýsýtlýlýðý görüldü.
Çýkarýmlar: Bu çalýþma grubunda klinik baþarý oranýný düþüren en önemli iki faktörün açýlý kaynama ve komþu eklem hareket kýsýtlýlýðý olduðu görüldü. Bu iki problemin de, primer cerrahi esnasýnda kýrýk redüksiyonuna dikkat edilmesi, sistemin statik kilitlenmesini gerektiren olgularýn iyi belirlenmesi, dinamizasyon ve yük verme zamanýna daha dikkatli karar verilmesi, ayný zamanda bu hastalarýn düzgün bir rehabilitasyon programýna alýnmasý gerekliliði ortaya çýkmýþtýr.

Objectives: The evaluation of the clinical and radiological midterm results of the patients with tibia diaphysis fractures treated by locked intramedullary nails.
Methods: 67 patients with tibia diaphysis fracture who were treated with locked intramedullary nail (45 male, 22 female; mean age 36,9; range 16 to 69) were included in the study. The fractures were on the right side in 42 patients and on the left side in 25 patients. The mean period between the operation and the onset of the fracture was 12 days (range 1-35 days) and the mean follow-up period was 46,5 months (range 6 to 123 months). The results were evaluated according to Johner-Wruhs criteria.
Results: In our study group, the average time to union was 21,1 weeks (median 18 weeks, range 6 to 36 weeks). According to the Johner-Wruhs criteria; of 67 patients, the results were excellent in 36 patients (53,7%), good in 17 patients (25,3%), fair in 7 patients (%10,5) and poor in 7 patients (10,5%). 14 patients (20,9%) with malalignment and 12 patients (17,9%) with restriction of adjacent joint motion were also reported.
Conclusion: Malalignment and the restriction of adjacent joint motion were found to be the two important factors responsible of the decrease in the clinical satisfaction rates. We believe that in order to fix those two factors; proper reduction of the fracture during the primery surgery, welldetermination of the cases necessiating statical locking, much care taken about dinamisation and weight bearing times and an appropriate rehabilitation program are mandatory.

Amaç: Doðal ve cerrahi yolla menapoza girmiþ hormon alan ve almayan kadýnlarýn anksiyete ve depresyon açýsýndan deðerlendirilmesi amaçlanmýþtýr.
Materyal ve Metod: Abant Ýzzet Baysal Týp Fakültesi Kadýn Hastalýklarý ve Doðum AD‘ýnda Menopoz polikliniðine baþvuran postmenopozal dönemdeki hormon kullanan 50 olgu ile benzer yaþ grubunda ve postmenopozal dönemde hormon kullanmayan 50 kontrol olgu ile çalýþýldý. Her iki gruba sosyodemografik bilgi formu, Hamilton Anksiyete Derecelendirme Ölçeði, Hastane anksiyete ve depresyon skalasý uygulandý. Veriler SPSS for Windows 10.0 programýnda istatistiksel olarak deðerlendirildi.
Bulgular: Menopoza doðal ve cerrahi olarak giren ve hormon kullanan ve kullanmayan kadýnlar arasýnda Hamilton anksiyete deðerlendirme ölçeði ve hastane anksiyete ve depresyon skalasý test sonuçlarýnda hormon alanlarla almayanlar arasýnda fark bulunmadý.
Sonuç: menopozun doðal ya da cerrahi yolla ortaya çýkmasý ruhsal belirtiler üzerinde anlamlý fark yaratmamaktadýr. Hormon kullanýmýnýn menopozlu kadýnlarda duygulaným deðiþiklikleri üzerinde olumlu etkisi bulunmamýþtýr.

Aim: In this study our aim is to understand the effect of HRT on symptoms of anxiety and depression in natural or surgical menopause period.
Material and Method: Fifty women with natural or surgical menopause who applied to the outpatient clinics of obstetrics and gynecology
department of Abant Izzet Baysal University, Izzet Baysal Medical faculty were included in this study. Subjects (n=50) were evaluated into two groups with one group to receive HRT and the other (control group) did not. Both groups underwent sociodemographic information form; Hamilton Anxiety and Depression Scale and Hospital Anxiety and Depression Scale. SPSS for windows 10.0 programme was used for statistical analysis.
Results: Hamilton Anxiety Rating Scale and Hospital Anxiety and Depression Scale test results showed no difference between surgical and natural menopausal women receiving HRT and not receiving HRT.
Conclusions: As far as psychological findings concerned; surgical or natural menopause does not cause statistically significant difference. HRT has no positive effects on mood changes of menopausal women.

Bilateral eþzamanlý paramedian talamik enfaraktlar (BPTE) nadir görülen tablolardýr. Hastalar ani bilinç bulanýklýðý, bakýþ paralizileri ve kognitif bozukluklarla tanýnabilirler. Biz bu sunumda acile bilinç bulanýklýðý ile baþvuran ve mantetik resonans görüntülemelerinde (MRG), diffuzyon kesitlerde parlayan ve ADC haritalamada sönen bilateral paramedian talamik enfarkt saptanan 6 vakanýn klinik ve radyolojik özellikleri ile ve prognozunu sunmayý amaçladýk.

Bilateral simultaneous thalamic infarction (BPTI) is a rare syndrome. Patients attend to the hospital with acute unconsciousness, gaze palsies and cognitive deficits. Here we presented clinical and radiological features and prognosis of 6 cases. They were admitted to the hospital with sudden onset of unconsciousness. Diffusion weighted MRI showed hyperintensity on bilateral paramedian thalamic region and hypointensity on ADC mapping consistent with acute infarction.

Son yýllarda, tüm cerrahi branþlarda minimal invazif cerrahiye yönelim baþlamýþtýr. Üreterorenoskopi, düþük morbidite ve mükemmel tedavi sonuçlarýný saðlayan birçok geliþmenin içinde en baþlarda yeralmýþtýr. Düþük çaplý üreteroskoplarýn ve geliþmiþ kamera sistemlerinin üretilmesi gibi teknolojik ilerlemeler, endoürologlarýn üreteroskopi endikasyonlarýný geniþletmesine izin vermiþtir. Üreterorenoskop sayesinde tüm üst üriner sistem birçok ürolojik hastalýðýn teþhis ve tedavisi amacýyla görüntülenebilmektedir. Bu makalede, üreterorenoskopi tüm yönleriyle tartýþýlmýþtýr.

In recent decades, there has been a shift toward minimally invasive surgery in all surgical subspecialties. Ureterorenoscopy represents an area on the top in which there have been numerous advances that have resulted in excellent patient outcomes with low morbidity. Technologic improvements like production of low diameter ureteroscopes and improved camera systems have led the endourologists to increase the indications of ureterorenoscopy. By means of ureterorenoscopy, the entire upper urinary tract can now be accessed for diagnosis and treatment of many urologic conditions. Herein, we discussed ureterorenoscopy in all aspects.

Prostat kanseri erkeklerde en sýk taný konulan kanserdir. Özellikle orta-ileri yaþ erkeklerde, PSA taramalarý ya da parmakla rektal muayene sonrasýnda prostat kanseri þüphesi mevcut ise, taný için yapýlmasý gereken transrektal ultrasonografi eþliðinde prostat biyopsileri alýnmasýdýr. Baþlangýçta prostat biyopsileri, doðrudan rektal muayenede palpe edilen lezyona yönelik uygulanmýþtýr. Zamanla, biyopsilerin tanýsal deðerini arttýrmak için teknik iyileþtirmeler gündeme gelmiþ, bu amaçla 6 odaklý sekstant biyopsiler, lateral zon örneklemeleri, 10-12 odaklý (double-sekstant) biyopsiler klinik uygulamaya girmiþtir. Son yýllarda prostat kanseri tanýsýnda satürasyon biyopsisi olarak tanýmlanan, 20 veya daha çok odaktan alýnan biyopsiler üzerine çalýþmalar yoðunlaþmýþtýr. Satürasyon biyopsilerinin tanýsal deðeri ve gerekliliðine dair yayýnlar incelendiðinde, ürologlar arasýnda önemli fikir ayrýlýklarý oluþtuðu izlenmektedir. Bu derlemede özellikle tekrarlanan prostat biyopsileri negatif sonuçlanan fakat klinik veya biyokimyasal olarak prostat kanseri þüphesi devam eden olgular ya da aktif izleme alýnan olgular gibi seçilmiþ hasta gruplarýnda satürasyon biyopsilerinin yararlýlýðý ele alýnmýþtýr.

Prostate cancer is the most diagnosed cancer in men. If there is any suspicion of prostate cancer after PSA screening or digital rectal examination (DRE), transrectal ultrasonography guided prostate biopsies should be performed particularly for the middle aged or elderly population. Previously, prostate biopsies used to directly focus on the lesion palpated in DRE. In time, technical advances such as 6 core sextant biopsies, lateral zone sampling or 10 – 12 core (double sextant) biopsies came up and were introduced into clinical practice in order to improve the diagnostic value of prostate biopsies. Recently, investigations are focused on a new biopsy technique called saturation biopsy which includes 20 prostatic cores or more. There is a big controversy among urologists about the diagnostic value and necessity of this new technique. In this review current studies concerning the use of saturation biopsy and its potential benefits particularly for selected patients with repeated negative prostate biopsies whose suspicion for prostate cancer is still clinically or biochemically relevant or for those undergoing active surveillance protocols are being assesed and discussed.