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PubMedID: 27888151 Objective To evaluate the characteristics and outcomes of ureteroscopy (URS) in children treated in several hospitals participating in the Clinical Research Office of the Endourological Society (CROES) Study, and to present the overall results of pediatric URS compared with adults. Patients and Methods The CROES Study collected data on consecutive patients treated with URS for urolithiasis at each participating center over a 1-year period. The collected prospective global database includes data for 11,885 patients who received URS at 114 centers in 32 countries. Of these URS-treated patients, 192 were ?18 years old. Results Of the 114 centers participating in the study, 42% had conducted pediatric URS. Among the pediatric cases, 7 were infants, 53 were small children, 59 were school-aged children, and 73 were adolescents. A considerable number (37%) of the pediatric cases had previously undergone URS treatment. No differences in the surgical outcomes of the adults and children were reported. The URS-treated children had a greater number of positive preoperative urine cultures when compared with adult cases treated. A semirigid scope was used in the vast majority of pediatric cases (85%). According to the present data, within the group of URS-treated children, the younger the child, the more readmissions occurred. Conclusion URS is as efficient and safe in children as it is in adults. The data suggest that readmissions among URS-treated children are associated with age, with the likelihood of readmissions greater among younger age groups. © 2016 Elsevier Inc. Boston Scientific Corporation Funding Support: The CROES URS Global Study was supported by an unrestricted educational grant from Boston Scientific, which had no involvement in the design, collection, analysis, interpretation, or reporting of the data. Dr Nienke Wijnstok provided statistical support for the analyses reported.

Children with bilateral kidney stones are generally treated using staged percutaneous nephrolithotomy (PCNL). Reports related to simultaneous bilateral PCNL (SBPCNL) in children are scarce. We aimed to evaluate the efficacy and safety of SBPCNL in children.The children who underwent SBPCNL applications between January 2007 and February 2010 in our clinic were evaluated. Patient data were collected from the retrospective reviews of hospital records.SBPCNL was conducted in five patients for bilateral renal stones. The mean age of the patients was 6.28 years (range 0.75-15 y), and the mean follow-up was 10.6 months (range 1-36 mos). The mean renal stone burden was 19 mm (range 11-22 mm). Four children underwent bilateral standard PCNL, and one child underwent bilateral tubeless PCNL. The mean duration of SBPCNL was 75 minutes (range 55-120 min), and the hospitalization time was 4 days (range 2-5 d). No blood transfusion was necessary in any patient. Except for the patient with complex renal stones, all patients were stone free after the intervention, and none needed a conversion to open surgery.SBPCNL is a safe and effective procedure in children if they are selected properly and if the surgeon has sufficient experience with the procedure. More studies with a higher number of participants are needed, however, for further evaluation of the procedure.

The goal in the treatment of stone disease causing infantile obstructive uropathy is to obtain a quick resolution of the obstruction using the least invasive treatment modality available and rendering the patient stone-free, if possible. Two infants with bilateral kidney stones, the first of whom also had ureteral stone, were referred to our clinic with acute renal failure and were treated successfully in a single session using minimally invasive methods. In this report, we discuss the management of these two cases, aged 9 and 26 months, which resulted in favorable outcomes.

Summary Semen profile and meiotic segregation products are important for assessing aneuploidy risk and risk of resulting infertility. To determine the effect of varicocelectomy on semen profile and aneuploidy frequency, we investigated semen profile and aneuploidy frequency of selected chromosomes in patients with varicocele before and after varicocelectomy. Chromosomal aneuploidy for selected chromosomes was evaluated using chromosome-specific DNA fluorescence in situ hybridisation (FISH) probes. There was a significant difference in the level of normal sperm morphology before and after varicocelectomy (P > 0.007). There were no significant differences in aneuploidy frequency of chromosomes 1, 16, 17 and 18 in sperm nuclei obtained from patients before varicocelectomy compared with 6–7 months after varicocelectomy (P > 0.05), although FISH analysis with chromosomes 17 and 18 combination showed a higher aneuploidy frequency before varicocelectomy than after varicocelectomy (7.81 ± 9.67 versus 4.03 ± 1.46 respectively). In conclusion, varicocele seems to affect the semen profile but minimally affects aneuploidy frequency. Varicocelectomy demonstrates a repairing effect on the semen profile and contributes to a slight decrease in aneuploidy frequency in some but not all chromosomes.

Aim To investigate the value of virtual cystoscopy using contrast material to fill the bladder during routine abdominopelvic computed tomography (CT) examinations for the detection of bladder tumours. Materials and methods Thirty-three consecutive patients (25 men and eight women; are range 51–82 years; mean age ± SD, 65 ± 7 years) who had painless macroscopic haematuria and were suspected to have bladder neoplasms were prospectively evaluated with virtual cystoscopy. After intravenous injection of contrast medium, the contrast material-filled bladders were examined with single-detector helical CT with 2-mm section thicknesses. Source CT data were transferred to a workstation for interactive navigation using surface rendering. All the patients also underwent conventional cystoscopy. Results The results of virtual cystoscopy were compared with the findings from the conventional cystoscopy. Seventy-one of 78 bladder tumours detected with conventional cystoscopy in 28 patients were also shown on virtual images. The bladders of five patients appeared normal on both conventional cystoscopy and virtual cystoscopy. On virtual cystoscopy, seven of the 12 lesions that were ≤5 mm in diameter could be identified. The following statistical values for the identification of bladder lesions using virtual cystoscopy were calculated: sensitivity 94%, specificity 90%, positive predictive value 87%, negative predictive value 93%, and accuracy 93%. Conclusion CT virtual cystoscopy is a noninvasive technique that can be used successfully for detection of bladder tumours >5 mm in selected cases during daily routine abdominopelvic work.

Symptomatic simple renal cysts can be treated by combination of percutaneous aspiration and sclerotherapy. A number of sclerosing agents including glucose, phenol, iophendylate, polidocanol, minocycline and pantopaque have been used in the past to prevent reformation of cyst. In this study, tetracycline HCL solution is evaluated as a sclerosant for treatment of simple renal cysts.Our study treated 76 cysts in 70 patients with symptomatic renal cysts. Aspiration and sclerotherapy was performed on 56 cysts, and 20 cysts aspirated without sclerotherapy as a control group. Treatment was performed under local anesthesia and punctured under ultrasound guidances with an 18-gauge needle. Tetracycline HCL (20%) was injected into the cystic cavity according to cyst diameter. All patients were followed up with an ultrasound examination at 3 months, 6 months, and then at yearly intervals. The reduction rate was estimated by a comparison of the volume of the cyst before and after treatment. A cyst reduction of 50% or greater in diamater was considered as a successful treatment.The average follow-up period was 9.8 months in the sclerotherapy group and 9.9 months in the control group. The success rate was 85.7% in the sclerotherapy group. There was a significant difference in the reduction rate of tetracycline HCL sclerotherapy group and control group. No major complications were encountered.

Purpose We studied the use of magnetic resonance imaging in the diagnosis of penile fracture. Materials and Methods Between 1997 and 2012, fifteen patients (age range 17-48 years, mean age 37 years) with suspected penile fracture underwent MRI examinations. Ten patients were injured during sexual intercourse, whereas four patients were traumatized by non-physiological bending of the penis during self manupilation, one patient was traumatized falling from the bed. Investigations were performed with 1.5T MR unit. With the patient in the supine position, the penis was taped against the abdominal wall and surface coil was placed on the penis. All patients were studied with axial, coronal, sagittal precontrast and postcontrast T1-weighted TSE(TR/TE:538/13 msn) and T2-weighted TSE(5290/110 msn) sequences. All patient underwent surgical exploration. The follow-up ranged from 3 months to 72 months. Clinically all patients showed normal healing process without complications. In 11 patients a shortening and thickening of tunica albuginea was observed. Three patients have post traumatic erectil disfunction. Results In all patient corpus cavernosum fractures were clearly depicted on a discontinuity of the low signal intensity of tunica albuginea. These findings were most evident on T1WI and also depicted on T2W sequences. Images obtained shortly after contrast medium administration showed considerable enhancement only in rupture site. Subcutaneous extratunical haematoma in all patients were also recognizable on T2 WI. MRI findings were confirmed at surgery. Conclusions Magnetic resonance imaging is of great value for the diagnosis of penile fracture. Furthermore this method is well suited for visualising the post-operative healing process

To retrospectively evaluate our institutional experience with non-hilar-clamping simple enucleation (SE) and enucleoresection (ER) for the treatment of exophytic renal tumors regarding their oncological outcomes.We retrospectively evaluated patients treated between 2006 and 2013 for clinical exophytic T1-T2a renal tumors using open nephron-sparing surgery.A total of 33 patients underwent SE and 39 underwent ER. The mean tumor size was 38.7 mm. None of the patients had positive surgical margins. No local recurrences were observed during the postoperative follow-up period (mean 40.7 ± 23.4 months); however, ipsilateral adrenal and contralateral kidney metastasis was detected in one of the patients. There was no statistically significant difference in the R.E.N.A.L Nephrometry Score, operative time, or intraoperative blood loss in the non-hilar-clamping SE and ER groups (P.05). During the third postoperative month, the estimated glomerular filtration rate (eGFR) levels in the SE group were significantly reduced compared with the preoperative eGFR levels (P = .046).SE and ER with non-hilar clamping are safe, acceptable approaches for treating exophytic renal tumors.

Introduction To describe a new alternative technique to overcome several disadvantages of previous techniques to repair idiopathic hydrocele. Idiopathic hydrocele, which causes scrotal enlargement and discomfort for patients, is an abnormal fluid collection between the parietal and visceral layers of tunica vaginalis of the testis. Surgical and sclerotherapy treatments have previously been used to treat this problem. Technical considerations Forty-five patients with hydrocele (aged 19 to 67 years) underwent an alternative procedure using a silicone catheter 15 to 20 cm in length in which holes had been made to enable flow of the hydrocele fluid from the parietal layer of the tunica vaginalis to the surrounding scrotal tissue. After an incision of approximately 5 mm on the scrotal wall with a scalpel knife, a cannula was pushed through the hydrocele sac with a gentle rotation until reaching the upper scrotal wall. A silicone catheter with holes was passed through the cannula to the point of the incision by way of the cannula. At the end, both tips of the catheter were sutured. During the procedure, the hydrocele fluid was emptied using an angiocatheter before the cannula was removed. Conclusions The results of this study indicate that this procedure does not require dissection, incision, or manipulation of the scrotal contents during treatment. It also resulted in a low rate of recurrence during the 1 to 3 years of follow-up. Additionally, the procedure has minimal complications and requires a short time, only about 15 minutes.

Minimally invasive methods, especially the novel techniques, gain more and more popularity in benign prostate hyperplasia (BPH) treatment. Transurethral ethanol injection is one of these novel methods as it is easy to apply for BPH treatment and quite successful. The present study evaluates the results of a single-year transurethral ethanol injection prostate (TUEP) follow-up employed for the first time in our country.Fifty-two patients with lower urinary tract symptoms underwent TUEP. It was performed in ten patients under local anesthesia and in 42 patients under sedation. Dehydrated ethanol with a concentration of 95-98 % was injected using transurethral approach with a rigid cystoscope. Forty-two patients were followed for 1 year.At the end of the first year, the average patients' IPSS scores decreased from 22.6 to 12.8 and prostate volume from 49.5 to 38.8 cc. Q-average increased from 3.3 to 7.1 ml/s and Qmax from 6.4 to 9.7 ml/s. Residual urine decreased from 160.1 ml to 68 cc. There were not any dire postoperative complications. In 77.8 % of the patients, TUEP succeeded. In 13.8 % of the patients, alternative treatment methods were to be employed.TUEP, an effective minimally invasive treatment option, can be performed with medically high-risk BPH patients under regional anesthesia. The procedure is easy, inexpensive, safe, and rapid to us. Yet, long-term and multi-centered studies with larger patient series are needed to define further benefits.

The use of laparoscopic scissors or blades in laparoscopic nondismembered pyeloplasty is quite common; however, the incision made using these tools may cause difficulties for the surgeon. We developed an efficient, safe, reusable, and inexpensive instrument to incise the pelvis and ureter during laparoscopic pyeloplasty. The aim of the present study was to evaluate the new laparoscopic instrument designed for pelvic and ureteric incisions.The cold knife consists of an internal urethrotome that is transformed into an endoscopic instrument that can be inserted easily through a 5-mm-diameter trocar. It has a manual retraction system that enables a stand-by position for added protection when no incisions are being made. The new tool was trialed in laparoscopic Y-V pyeloplasty. Data regarding perioperative parameters and outcomes were collected and analyzed.Eight patients participated in the present study. All patients underwent Y-V pyeloplasty using a three-port retroperitoneal access. Mean operative time was 166.2 minutes (range: 100-300). There were no complications during the procedures.Laparoscopic cold knife for laparoscopic pyeloplasty is a simple, safe, reusable, and inexpensive instrument with a low maintenance cost.

The giant hyperplasia of the prostate is extremely rare pathology of prostate gland. Here, we report the successful removal of the 9th heaviest prostate ever reported in the literature.

Introduction: This study aimed to determine the seroprevalence of hepatitis B virus (HBV) infection in children and females in the middle Black Sea Region of Turkey and to assess the impact of the universal infant hepatitis B vaccination program started in 1998. Methodology: The laboratory records of 12,057 patients who attended the Samsun Maternity and Children’s Hospital between January 2007 and November 2009 were evaluated retrospectively. In this period, hepatitis B surface antigen (HBsAg), the antibody to hepatitis B surface antigen (anti-HBs), was studied from serum samples using the enzyme linked immunosorbent assay method. Results: In the total population, HBsAg seropositivity was found to be 3.8% (456/12010); anti-HBs was 32.6% (3526/10800). HBsAg was 3.5%, in the 0-14 year age group, 8.2% in the 15-18 group, 3.3% in the 19-49 group, and 8.0% in the over 49 group. The seropositivity of HBsAg decreased by half in patients between zero and 14 years of age (4.2%) who were included in the universal vaccination program when compared with those in the 15-18 year group (8.2%) who were not included in the program. There was a significant difference in HBsAg seropositivity between boys (5.8%) and girls (3.9%) (p < 0.05). Conclusions: According to the hepatitis B seroprevalence records of our region, HBsAg was 3.5% in the 0-14 year age group, 8.2% in the 15-18 year group. It may therefore be suggested that, since 1998, the vaccination program in our region has been successful.

The aim of this study was to investigate the vascular branching morphology of the aortic arch in the long-legged buzzard. For this purpose, two long-legged buzzards were evaluated in this study. The latex injection method was used to investigate the branching of the aortic arch. Two innominate brachiocephalic trunks branched continually from aortic arch caudoventral to the primary bronchi and ventral to the syrinx. The left subclavian artery gave rise to sternoclavicular, thoracic, axillary and intercostal arteries in this region. On the right side, it was observed that the right subclavian artery gave off thoracic, sternoclavicular and intercostal arteries, and the axillary artery was the branch of thoracic artery differently from the left one. Each carotid artery was continued to the middle of the neck and soon disappeared, becoming covered by the muscles of the anterior part of the neck, and entering the canal formed by the inferior spinous processes of the cervical vertebrae, within which it ran hidden, and in close contact with its fellow of the other lateral side, to near the head. This morphological study in the long-legged buzzard will elucidate the vascular organization for regional blood supply, and provide specific anatomical data.

soygur, tarkan/0000-0001-7014-1798; Onal, Bulent/0000-0003-0540-2693; Onal, Bulent/0000-0003-0540-2693; Burgu, Berk/0000-0003-1546-1179; Ozden, Ender/0000-0003-3196-4024 WOS: 000293688300097 PubMed: 21784482 Purpose: We evaluated factors affecting complication rates of ureteroscopy for pediatric ureteral calculi. Materials and Methods: We retrospectively evaluated 642 children who underwent ureteroscopy at 16 Turkish centers between 2000 and 2010. Semirigid ureteroscopy was used with various calibers to treat 670 ureteral units in 660 sessions. Complications were evaluated according to the Satava and Clavien classification systems. Univariate and multivariate analyses were done to determine predictive factors affecting complication rates. Results: A total of 367 females and 265 males were studied. Mean +/- SD patient age was 90.2 +/- 51.4 months (range 4 to 204). Mean +/- SD stone size, operative time and postoperative hospital stay were 8.9 +/- 4.7 mm, 45.8 +/- 23.8 minutes and 1.8 +/- 2.8 days, respectively. At a mean +/- SD followup of 13.3 +/- 17.6 months 92.8% of patients were stone-free and efficacy quotient was 90.3%. Complications, which occurred in 8.4% of patients (54 of 642), were intraoperative in 25 (Satava grade I to II in 22), early postoperative in 25 (Clavien grade I to II in 23) and late postoperative in 4 (all grade III). While operative time, age, institutional experience, orifice dilation, stenting and stone burden were statistically significant on univariate analysis, multivariate analysis revealed that operative time was the only statistically significant parameter affecting the complication rate. Conclusions: Semirigid ureteroscopy is effective, with a 90% stone-free rate and efficacy quotient. Most complications are low grade and self-limiting. Our results confirm that prolonged operative time is an independent predictor of complications, and should be considered when choosing and performing the treatment modality.

In this multicenter study we aimed to evaluate the efficacy and safety of percutaneous nephrolithotomy in children with respect to different features and using the Clavien classification system.Percutaneous nephrolithotomies performed in children at 3 urology departments between March 2006 and May 2010 were included in the study. Results are presented for complex/simple renal stones, tubeless/totally tubeless percutaneous nephrolithotomy, simultaneous bilateral percutaneous nephrolithotomy, instrument size and age groups. Patients were divided into 3 distinct groups, infants and toddlers (3 years or younger, group 1), preschool children (4 to 7 years, group 2) and school children (8 to 16 years, group 3). Perioperative complications are presented according to the modified Clavien classification system.A total of 140 percutaneous nephrolithotomies were performed in 130 patients (41.5% female, mean age 10.17 years). There were 23, 25 and 92 renal units in groups 1, 2 and 3, respectively. Pediatric instruments were used in 60 renal units and adult-sized instruments in 80. General assessment of complications showed Clavien grade I complications in 17 patients, II in 4, IIIa in 11 and IIIb in 7. There were no grade IV or V complications.Percutaneous nephrolithotomy can be applied safely in children of varying ages, even infants. Complications, as assessed with Clavien classification, are comparable to those seen in adults provided there is enough experience with the technique.

WOS: 000283683900041, PubMed: 20466680, Background. Erectile dysfunction (ED) is prevalent in end-stage renal disease (ESRD) and has been associated with impaired health-related quality of life (HRQoL). HRQoL, in turn, is related to morbidity and mortality in ESRD patients. Previous studies have shown improved HRQoL with ED treatment using sildenafil and vardenafil. However, no study has examined the effects of sildenafil or vardenafil on HRQoL in impotent ESRD patients. Furthermore, vardenafil has never been tested and its safety profile has not been determined in ESRD patients. The aim of this randomized crossover study was to compare the effects of sildenafil and vardenafil on measures of HRQoL and on ED scores as well as to determine the safety profile of vardenafil in ESRD patients. Methods. In 32 haemodialysis patients with impotence, ED and HRQoL were evaluated by the International Index of Erectile Function (IIEF-5) and the 36-item Short-Form Health (SF-36) surveys, respectively. Patients were randomized into sildenafil and vardenafil groups. After a 4-week treatment and 2-week washout periods, crossover was performed and an additional 4-week treatment was administered. IIEF-5 and SF-36 surveys were given before and after each treatment period. Adverse effects were evaluated by interview. Friedman tests and Bonferroni-adjusted Wilcoxon signed-rank tests were used to compare groups and for post hoc analysis, respectively. Results. IIEF-5 and SF-36 scores were significantly improved by both sildenafil and vardenafil compared to pretreatment values. There were no differences between sildenafil and vardenafil with respect to the studied parameters. Adverse effect profiles were also similar. No patient dropped out because of side effects. Conclusions. Sildenafil and vardenafil caused similar improvements in ED and HRQoL in haemodialysis patients. Vardenafil was well tolerated in our patient population.

Objective: We aimed to evaluate the efficacy and safety of percutaneous nephrolithotomy (PNL) in infants and small children (12–36 months). Methods: The PNL applications conducted in children Results: The mean age of the patients was 22.76 months (5–36 months) and the mean body weight was 11.51 kg (6–15 kg). In twelve renal units, pediatric instrumentation was used and among these, two had miniperc. In the other eight renal units, adult-size instrumentation was employed. Except for the patient with complex renal stones, all patients were stone free after the intervention and none required a conversion to open surgery. There were grade 1–2 complications in 3 patients. The postoperative hemoglobin drop was greater in the children who underwent PNL with adult-size instrumentation. Conclusion: In this young age group, in addition to standard PNL, simultaneous bilateral PNL, tubeless PNL and in urgent cases of renal failure, urgent PNL, are safe and effective treatment modalities provided patients are selected properly and the surgeon performing the procedure has the necessary experience.

Background Surgical shunting might be considered as the only option in the treatment of extended ischemic priapism that does not respond to aspiration and medication. Objective A modified, simple, minimally invasive, and easily applicable artificial cavernosal–venous shunt technique for treating priapism is described in this report. Design, setting, and participants A total of 15 patients with extended and nonresponsive low-flow priapism were treated with this technique between January 1998 and February 2007. Intervention When the conservative treatment of low-flow priapism does not yield the expected results, then the temporary cavernosal–cephalic vein shunt should be applied. The standard equipment required for this modified technique includes three angiocaths, two shorn blood serum sets, and saline solution with heparin. The blood in the cavernosa and the saline solution infusion are incorporated into the systemic circulation with the aid of serum sets and angiocaths. Measurements Priapism duration, history, causes, its relation with sexual stimulation, pain, and any prior management of priapism were assessed in all patients. A complete blood count and blood gases assessment were conducted in corporal aspirates, and duplex penile ultrasonography was performed, which showed attenuated blood flow in the cavernosal artery. Results and limitations This technique was applied in 15 patients. Complete detumescence was achieved in 13. In the two cases in whom the technique did not yield the expected results, there was a need for a sapheno–cavernosal shunt. These patients later complained of erectile dysfunction and penile pain that continued for 6 mo. Of the 13 patients in whom detumescence was achieved, 3 reported erectile dysfunction according to International Index of Erectile Function (IIEF) scores at the 12-mo follow-up. Conclusions Artificial cavernosal–cephalic vein shunt in the treatment of priapism is simple, safe, effective, easily applicable, and warrants primary consideration when the second-line treatment of priapism is initiated.

Objective: To determine the efficacy of intrarectal lidocaine gel alone and a combination of lidocaine gel with 2 different longer-acting local anesthetic (LA) agents that were injected into the periprostatic area before transrectal ultrasound-guided prostate biopsy. Patients and Methods: One hundred patients undergoing transrectal prostate biopsy were randomized into 4 groups of 25 patients each. Before the biopsy, group 1 received no local anesthesia, group 2 received 2% lidocaine gel intrarectally, group 3 received intrarectal lidocaine gel and 5 ml bupivacaine (0.25%) injected into periprostatic area, and group 4 received lidocaine gel intrarectally and a 5-ml ropivacaine injection (0.25%) in the same location as group 3. Pain levels during and after the biopsy were assessed by using a 10-point linear visual analog scale (VAS). Results: Patients in groups 3 and 4 had significantly lower VAS scores than those in groups 1 and 2, both during and 1 h after biopsy. There were no differences in the pain scores between groups 1 and 2. Conclusion: The combination of intrarectal lidocaine gel and periprostatic longer-acting LA agents significantly reduces the pain related to prostate biopsy, whereas intrarectal lidocaine gel administration alone does not reduce pain. Thus, administration of the periprostatic longer-acting LA agents alone is adequate.

In this case report, the procedure of penis replanting and its complications after genital self-mutilation in a male adult are explained.

We compared chromosome 8 and 11 aneuploidies on bladder biopsy tumor tissues and bladder washing samples of transitional cell carcinoma (TCC) and their relationship to tumor malignancy. Interphase fluorescence in situ hybridization (FISH) was applied to nuclei of washing material and biopsy samples of 17 patients with TCC. Incidence of cells having aneuploidy was clearly nonrandom from patient to patient. There was no significant difference in the incidence of aneuploid frequency for chromosomes 8 and 11 between biopsies of bladder tumors and bladder washing samples ( P > 0.05). For chromosome 8, incidence of disomic cells (having two signals) in grade III tumors was significantly lower than in grade II tumors of both washing samples ( P = 0.004) and biopsy materials ( P = 0.005), indicating a high frequency of aneuploidy. The incidence of nuclei with four or more than four signals of chromosome 8 was significantly higher in grade III tumors than in grade II tumors in washing samples ( P = 0.031 and 0.003, respectively). Similarly, in biopsy material, the incidence of nuclei with more than four signals of chromosome 8 was significantly higher in grade III tumors than in grade II tumors ( P = 0.004). For chromosome 11, in both washing samples and biopsy materials, the incidence of disomic cells (having two signals) in grade III tumors was significantly lower than that detected in grade II tumors ( P = 0.031 and 0.014, respectively), indicating a high frequency of aneuploidy. In biopsy materials, the incidence of nuclei with three or four signals was significantly higher than that in grade II tumors ( P = 0.014 and 0.012, respectively). These findings suggest that FISH analysis of bladder washing samples can be efffectively detected as genetic changes of bladder tumors. It might predict genetic progression of these tumors, which might be related to tumor stage, because higher stages of tumors showed a higher incidence of aneuploidies of chromosomes 8 and 11.

We studied the frequency of aneuploidy in sperm nuclei of six infertile men with abnormal semen profile and normal karyotype, using fluorescence in situ hybridization (FISH) with DNA probes for chromosomes 8, 10, X and Y. The control group consisted of four healthy fertile men with normal karyotype and semen profiles. The purpose of this study was to determine whether there are differences between infertile male donors and control donors for: (1) the incidence of sex chromosome aneuploidy, and (2) the number of disomies for chromosomes 8, and 10 cosegregating with chromosomes X and Y. FISH analysis showed no significant differences of sex ratios of the sperm nuclei in and between infertile and control groups. The most significant abnormalities in the infertile group were clusters of sperm nuclei bearing XY and XYY. In addition, the incidence of disomic sperm nuclei for chromosomes 8 and 10 consegregating with sex chromosomes was not significantly different beween the patient and control groups, nor within them. However, the total frequency of aneuploid sperm nuclei was significantly different beween the infertile group and the control group. We observed a significant excess of sperm nuclei bearing chromosome 10 along with disomy for chromosome Y (10YY). In conclusion, our results from FISH analysis demonstrate a significantly increased frequency of aneuploidy for the sex chromosomes in sperm nuclei from infertile men. Therefore it may be concluded that infertility is a risk factor for sex chromosome aneuploidy in sperm nuclei.

OBJECTIVE We present our experience with the various sonographic and CT findings observed in patients with hydatid disease involving the kidney. The imaging characteristics of various echinococcal cysts were evaluated comparatively to offer a diagnostically better explanation for the radiologic images and to assist the urologist in defining the nature of the cyst and its content preoperatively. Renal involvement is extremely rare in patients with hydatid disease. METHODS The clinical and radiological features in 17 patients with renal hydatid disease are described. Two patients (4 and 28 years old) had renal colic with passage of debris in urine (hydatiduria). Five males and twelve females were 4-61 years old (mean 37 years). Their histories, physical findings and imaging procedures were evaluated. Plain abdominal radiographs were taken in 17 patients. RESULTS Plain film showed calcified mass compressing the pelvicalyceal system and/or ureter in 10 cases. Sonography showed typical features of echinococcal cysts in 14 cases, especially in the liver and spleen. CONCLUSIONS Sonography demonstrates the internal cystic content better. When daughter cysts are present, CT establishes the diagnosis. CT scan provides further information on the affected organ and involvement of other organs, calcification of the cyst wall and density. The diagnosis was suggested preoperatively in all patients, and confirmed surgically in 12 patients. Eight total nephrectomies and four partial nephrectomies were performed. The others are being followed up.

Urethral duplication is a rare anomaly that manifests itself in various ways. We present a case with a prostatic urethral duplication without incontinence. To our knowledge this is the first case to be reported and has been discussed within Effmann's classification.