Browsing by Author "Yilmaz, Fatih"

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Histopathological Findings of Testis Torsion According to Parenchymal Regions: New Recommendations for Damage Detection and Future Directions
(SAGE Publications Inc, 2026) Sagir, Suleyman; Yilmaz, Fatih
Testis torsion is a scrotal emergency in which parenchymal damage cannot be accurately predicted. This situation leads to atrophy in the follow-up of patients who underwent orchidopexy, and potentially reversible injury can be detected in the orchiectomy series. This study aimed to find answers to questions about the accurate detection of testes with potentially reversible injury. The testes of patients who underwent orchiectomy due to testis torsion under the age of 35 (n = 54) were re-examined. Considering the vascular anatomy of the testis, necrotic changes in the epididymal, anti-epididymal, and central regions were scored from grade 1 to 3. The necrosis score was obtained by multiplying the degree and percentage of necrotic areas. Potentially reversible injury (Grade 1) was detected in 10 (18%) testes, and 3 of them had partial necrotic changes. Grade 1 injury could be detected after a symptom duration of up to 168 h, while grade 3 could be observed after as short as 6 h. The median symptom duration of Grade 3 necrosis was higher than that of Grade 1 and Grade 2, but this difference was not statistically significant (P = .066). Testis pain, swelling, and abdominal pain were most commonly seen in high-grade injuries (P = .047). The highest necrosis scores were observed in the central region of the testes, followed by the epididymal and anti-epididymal side (P = .035). Clarification of the injury pattern of the twisted testes will allow a more accurate estimation of parenchymal damage and salvage ability.
Citation - WoS: 2
Citation - Scopus: 2
Prognostic and Predictive Value of Tertiary Lymphoid Structures in Turbt Materials: Should It Be Seated in the Routine Pathological Examination, and Can It Be Used in Deciding on the Treatment Method?
(Elsevier Science inc, 2024) Yilmaz, Fatih; Sagir, Suleyman
Objective: This study aims to reveal the importance of tertiary lymphoid structures (TLS) in transurethral resection of bladder tumor (TURBT) materials with a practical and applicable method in which the effect of a certain threshold value on survival and treatment response can be implicated. Methods: TURBT materials that had not previously received any treatment (chemotherapy, radiotherapy, or immunotherapy) and were diagnosed for the first time at Mardin Training and Research Hospital between 2014 and 2022 were included in the study. The maximum TLS per 4x magnification field (field diameter: 4.5 mm) was recorded. Grouping and statistical analysis of the TLS number were performed using threshold values of ">= 1", ">= 2", and ">= 3". Results: TLSs were more frequently found in high-grade tumors (P = 0.008) and showed a strong association with stage progression (P < 0.001). It was also significantly associated with many adverse histopathological parameters. Conversely, high TLS (>= 1, >= 2, and >= 3) appeared to be associated with fewer recurrences (P = 0.032, P = 0.001, and P = 0.018, respectively), and cases with higher TLS showed longer recurrence-free survival (P = 0.089, P = 0.023, P = 0.037, respectively). TLS >= 3 was found to be an independent parameter that was associated with favorable RFS (P = 0.019, HR = 0.401), and multifocality was found to be an independent risk factor for RFS (P = 0.023, HR = 2.302). Conclusion: This study is the first to demonstrate the relationship between the presence and specific thresholds of TLS in TURBT materials with prognostic parameters. Including this information in the routine pathological examination of TURBT materials will allow a more accurate approach to treatment and follow-up, especially in patients with non-muscle invasive bladder cancer (NMIBC).