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Objectives: Hypospadias is the most common anomaly of the male genital system after undescended testis. More than 200 surgical repair techniques have been described for the treatment of hypospadias due to many different meatus localisations and other accompanying anomalies. Kutlay defined a new technique in 2010 with 10 patients with distal hypospadias patients. We compared this new technique with tubularized incised plate urethroplasty (TIP) which is one of the most frequently performed methods. Methods: 148 patients with hypospadias who underwent surgery at the Urology and Pediatric Surgery Clinic during the period of January 2010 to December 2022 in the first and 2nd clinic, were retrospectively analyzed. The study focused on the remaining 83 patients with distal hypospadias for the purpose of comparison. Results: The mean age of group one was 10.0 (± 6.9, range 2–27), while for group two it was 10.8 (± 5.9, range 3–23). There was no statistically significant difference between the two groups in terms of anatomical position of the meatus, stricture and fistula complications (p > 0.5). Conclusion: The Kutlay technique has been described as an easy-to-learn and feasible method with reliable results. No significant difference in complications was observed in this study compared with TIP, which is known as the standard technique worldwide. We would like to suggest that the method be considered for further evaluation with larger patient groups and different techniques. [ABSTRACT FROM AUTHOR]

Production of β-Lactamase enzymes is an important mechanism of resistance in Gram-negative bacteria. The aim of this study was to investigate the relationship between the Extended-Spectrum β-Lactamase (ESBL)-positive Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) strains isolated from the urine cultures and the underlying diseases and also to assess the antibiotic resistance. The bacteria were identified according to conventional methods including colony morphology, gram stains, oxidase test and biochemical tests (indole production, Triple Sugar Iron (TSI) agar, Simmon's Citrate agar, Christensen's Urea agar, and motility test medium). BD Phoenix automated system (Becton Dickinson, USA) was used for further identification of the bacteria that were identified as E. coli and K. pneumoniae and for assessing the resistance rates and ESBL production. A total of 401 E. coli and 58 K. pneumoniae strains were isolated from the urinary specimens. Of these, 159 (39.6%) of E. coli and 26 (44.8%) of K. pneumoniae strains were ESBL-positive. The most active antibiotics against ESBL-positive E. coli and K. pneumoniae strains were carbapenems. Underlying diseases were detected in a total of 148 ESBL-positive strains (80%), including 127 (79.8%) of E. coli and 21 (80.8%) of K. pneumoniae strains. Common underlying diseases were benign prostate hyperplasia (BPH), urolithiasis, neurogenic bladder, urethral stricture, vesicoureteral reflux (VUR), hypospadias, ureteropelvic junction (UPJ) obstruction, vesicointestinal fistula, and cystocele (p<0.05). In the treatment of urinary system infections, ESBL-positive E. coli and K. pneumoniae strains should be kept in mind and the underlying diseases should be studied and treated. [ABSTRACT FROM AUTHOR]

Objectives Prolidase plays a major role in collagen turnover, matrix remodeling, and cell growth. Benign prostatic hyperplasia (BPH) may be associated with an increased extracellular matrix deposition. Therefore, the present study was designed to investigate the plasma prolidase activity, oxidative status, and peripheral mononuclear leukocyte DNA damage in patients with BPH. Patients and methods Twenty-six male patients with BPH and 24 healthy male subjects were included in this study. Blood samples were collected from antecubital vein after an overnight fasting period, and the plasma was separated. Plasma prolidase activity, total antioxidant capacity (TAC), total oxidant status (TOS), and oxidative stress index (OSI) were determined. The peripheral lymphocyte oxidative DNA damage was determined using an alkaline single cell gel electrophoresis assay (comet assay). Results The plasma prolidase activity, TOS levels, OSI values, and peripheral mononuclear leukocyte DNA damage were significantly higher (P < 0.001), while the TAC levels were significantly lower (P < 0.001) in patients with BPH than controls. In BPH patients, the prolidase activity was significantly associated with TAC levels (r = −0.366, P < 0.05), TOS levels (r = 0.573, P < 0.001), and OSI (r = 0.618, P < 0.001) and peripheral mononuclear leukocyte DNA damage (r = 0.461, P < 0.001). Conclusions Our results showed that BPH might be associated with an increased oxidative stress, and also an increased plasma prolidase activity. Increased prolidase activity might play an important role in the etiopathogenesis and/or progression of BPH. [ABSTRACT FROM AUTHOR]

The aim of the study was to compare the percutaneous nephrolithotomy (PCNL) complications according to the modified clavien classification during and after the learning curve. In our study, PCNL procedures were applied to 275 patients between May 2010 and June 2014. The complications were retrospectively compared according to the Modified Clavien Classification during and after the learning curve. The first 50 cases were defined as the learning curve and referred to as Group-1 and the following cases as Group-2. We performed 294 PCNL applications on a total of 275 patients. The average duration of surgery was 120 (65-230 min.-max.) minutes and 80.2 (20-140 min.-max.) minutes in Group-1 and in Group-2, respectively (p<0.05). When complications, following PCNL, were evaluated according to the modified Clavien classification, grade I, II, IIIa, IIIb, IVa, IVb, and V complications were observed in 12 (15%), 54 (67.5%), 10 (12.5%), 4 (5%), 0 (0%), 0 (0%), and 0 (0%) patients of group 1, respectively. When group 2 was evaluated, grade I, II, IIIa, IIIb, IVa, IVb, and V complications were observed in 24 (12.4%), 132 (68.4%), 30 (15.5%), 6 (3.1%), 1 (0.5%), 1 (0.5%), and 0 (0%) patients, respectively. Grade-5 complication was not observed in any of our patients. The Modified Clavien Classification may be useful for the comparison of PCNL complications during and after the learning curve for reporting outcomes. [ABSTRACT FROM AUTHOR]

The aim of the present study was to evaluate the results of the cases that underwent radical nephrectomy due to renal cell carcinoma (RCC) and to discuss the results together with the literature. Eighty-three patients (51 males), who underwent radical or partial nephrectomy because of renal tumor between 2005 and 2011 were retrospectively evaluated 70 patients underwent open radical nephrectomy and 13 patients underwent open partial nephrectomy. With regard of tumor localization, 50 were localized in the left and 33 were localized in the right kidney. Tumor sizes varied between 2 cm to 16 cm. According to the subtypes of RCC, five-year survival rate was 72% for clear cell, 80% for papillary carcinoma, 66.6% for chromophobe, and 71.4% for other malignant lesions. Five-year disease specific survival rates of the patients with T1, T2, T3, and T4 renal carcinoma were 91.3%, 87.5%, 50%, and 0%, respectively. Radical nephrectomy is the standard method for the treatment of RCC. Survival rate in the patients with renal tumor is directly associated with the tumor stage. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the efficacy and reliability of ureteroscopic pneumatic lithoripsy (URSPL) in patients with ureter calculi. Methodology: A total of 612 patients who were treated with URS-PL in Medical school of Yuzuncu Yil University, Van State Hospital and Bingol State Hospital in the period between April 2005-May 2010 were studied. Diagnoses of ureter stones were made with intravenous pyelography (IVP) or computerize tomography (CT). Ureteral balloon dilation was not performed on any patient. On the post-operative 1st, 7th and 21st days, control direct urinary system graphic (DUSG) was taken. The rates of stone free and complication were analyzed with the ki-kare test. P < 0.05 was accepted as significant. Results: The mean age of the patients was 39±10 (18-75). There were 417 males (68.13%) and 195 females (31.86%). The mean volume of calculi in patients was 10.1±2.3 mm. Of these patients, 121 had proximal ureter stone, 169 medial ureter stones and 322 had distal ureter stones. In the first session of URS-PL, the calculi of 96 patients in proximal ureter (80%), those of 143 patients in medial ureter (85%) and those of 305 patients (95%) in distal ureter were cracked successfully. The mean stone free rate was 92.4% (79.4% in upper ureter, 94.1% in middle ureter and 93.7% in distal ureter (P < 0.05). Overall complication rate was 7.6% (7.7% in distal ureter, 3.9% in middle ureter and 11.8% in proximal ureter) (P>0.05). Most common peroperative complications of the procedure were ureteral perforation 4,2% (n=26), infection 2.2% (n=14), and mucosal laceration 1.9% (n=12). The most common late complication was ureteral stricture in 1.3% (n=8) of patients. Conclusion: Although URS-PL is a commonly used application for the treatment of patients with proximal and middle ureter stones, its common usage could also be extended to patients with distal ureter stones in the first stage of treatment, and it could be considered as an efficient and reliable procedure. [ABSTRACT FROM AUTHOR]

Renal cell carcinoma (RCC) is rare neoplasm and rarely extends to IVC. Perinephric and venous system invasion is an important prognostic sign for RCC. The tumor may grow intraluminally into the renal vein and Inferior Vena Cava (IVC) as an extension of primary tumor. In this report, we present two unusual case of venous system involvement, invasion of RCC into SVC. RCC with tumor thrombus extension into the IVC remains a difficult operative challenge. However surgical intervention should be performed. Our cases were successfully operated and their post operative recovery was uneventful. [ABSTRACT FROM AUTHOR]

Introduction: Trace elements are primary components of biological structures; however, they can be toxic when their concentrations are higher than those needed for biological functions., Materials and Methods: In the present study serum levels of trace elements were measured in 30 patients (mean age was 26.9±11.2 years) newly diagnosed with germ cell testicular cancer and 32 healthy volunteers (mean age: 27.4±10.8) by using furnace atomic absorption spectrophotometer. Serum samples were stored at-20ºC until assays., Results: In patients with germ cell testicular cancer, the diagnosis was seminoma in 15, mix germ cell tumor in 7, embryonal carcinoma in 4, yolk sac tumor in 2 and teratoma in 2 patients. There was stage I testicular tumor in 19 patients (63.3%) while stage II in 6 patients (20.0%), stage IIIA in 4 patients (13.3%) and stage IIIC in one patient (3.4%). It was found that serum Co, Cu, Mg and Pb levels were increased (p<0.05), whereas Fe, Mn, and Zn levels were decreased in patients with testicular cancer (p<0.05)., Conclusions: These alterations may be important in the pathogenesis of testicular cancers; however, further prospective studies are needed to identify the relationship between testicular cancer and trace elements.

Trace elements are essential components of biological structures, but they can be toxic at concentrations beyond those necessary for their biological functions. In the present study, groups of 35 patients with bladder cancer and 34 healthy volunteer controls were measured for trace elements using a furnace atomic absorption spectrophotometer. Serum levels of Cd, Ni and Co were increased (p<0.05) and Mn and Zn were decreased (p<0.05) in patients with bladder cancer. In the present study, a relationship was seen between the level of trace elements and the occurrence of bladder cancer, suggesting that an increase in the serum level of Cd, Ni, Co and a decrease in the levels of Zn and Mn might be important causes of bladder cancer occurrence; however, defining such a cause-and-effect relationship needs several prospective studies to be done, which seems necessary with regard to the high prevalence of this cancer.

Purpose: To compare diffusion-weighted magnetic resonance imaging (DW-MRI) with cystoscopy in the diagnosis and follow-up of patients with bladder tumor and to investigate any histopathological correlation., Materials and Methods: Totally 59 patients, between 31-85 years (mean age 60∓13) referred to our clinic due to a hematuria complaint were enrolled and evaluated by upper urinary system pathology and then DW-MRI (average 7 days) and cystoscopy. Apparent diffusion coefficients (ADCs) of images were calculated., Results: While a mass in bladder was determined with cystoscopy in 43 out of 59 patients,the mass was not determined in 16 of the patients (n=34 malign, n=9 benign). While a mass was determined in 40 out of 59 patients with DW-MRI,the mass was not determined in 19 of the patients(n=40 malign, n=19 benign). Regarding ADC values, mean ADC values of 34 patients who were diagnosed with a bladder tumor (1.05∓0.22x10(-3) mm2/s), were significantly lower than the mean ADC values obtained from the normal bladder wall (1.830∓0.18x10(-3) mm2/s) whereas a statistically significant difference was found (p<0.001). ADC values in 9 patients with a benign lesion (1.73∓0.12x10(-3) mm2/s), were not found statistically different from the mean ADC values obtained from the normal bladder wall (1.78∓0.2x10(-3) mm2/s) (p>0.05). A significant difference was determined between ADC values of benign lesions and the ADC values of malign lesions (p<0.001)., Conclusions: According to cystoscopy, values of DW-MRI's related with sensitivity, specificity and accuracy were found, respectively 90%, 93% and 91%. As the DW-MRI is a non-invasive and a rapid technique, and does not contain ionized radiation and because it is accepted as an important marker of tumor cellularity, it may be used as an alternative in future diagnosis and follow-up of bladder tumors.