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Objective: In this study, the aim was to compare the results of mini and standard percutaneous nephrolithotomy (PCNL) for the treatment of pediatric kidney stones. Materials and Methods: Data for 128 patients < 18 years of age who underwent mini and standard PCNL due to pediatric kidney stones were retrospectively examined. Patients were divided into two groups: mini-PCNL (16-20 Fr) and standard PCNL (26 Fr). Surgery time, number of punctures to the pelvicalyceal system, hospital stay, postoperative hemoglobin drop, complications and stone-free status (SFR) were compared between the groups. Additional surgical intervention (double-J stent, ureterorenoscopy, secondary PCNL) performed after the surgery was recorded. The absence of residual stones or < 3 mm residual stones on kidney, ureter and bladder radiography (KUB) and ultrasonography (USG) performed in the third postoperative month were accepted as success criteria. Results: There were 32 (43.8%) patients in the mini-PCNL group and 41 (56.2%) patients in the standard PCNL group. The mean age was 9.3 ± 4.1 years in the mini-PCNL group and 10.1 ± 5.4 years in the standard PCNL group. Mean stone size in the mini-PCNL group was 2.1 ± 1.2; while for standard PCNL it was 2.3 ± 1.4. The mean surgery time was statistically significantly higher in the mini-PCNL group (p = 0.005). There was no difference between the groups in terms of intraoperative double J stent use, postoperative complications and SFR. A double J stent was inserted in two patients in the mini-PCNL group and in one patient in the standard PCNL group due to urine leakage from the nephrostomy tract in the postoperative period. Although the postoperative hemoglobin drop was found to be significantly higher in standard PCNL (p = 0.001), hematuria and blood transfusion rates were low in both groups. Mean hospital stay was shorter in the mini-PCNL group compared to standard PCNL (3.6 ± 1.2 days vs. 2.5 ± 1.1; p = 0.018). Conclusions: Although mini-PCNL has longer surgery time compared to standard PCNL, it should be preferred for the treatment of pediatric kidney stones due to advantages such as similar success and complication rates to standard PCNL, short hospital stay and less postoperative hemoglobin drop.

Abstract. Objectives:. This study aimed to investigate the effect of the coronavirus disease 2019 (COVID-19) pandemic on the treatment of children with primary monosymptomatic nocturnal enuresis (MNE) with desmopressin melt versus an enuresis alarm. Materials and methods:. This study included 56 children with primary MNE who were taking desmopressin melt or using an alarm. Their anxiety levels were evaluated using the Social Anxiety Scale for Children-Revised. For both treatment methods, data from a 3-month bedwetting diary between the third and sixth months of the pre-pandemic treatment were compared with those assessed during the same period during the pandemic. Results:. Prior to the COVID-19 pandemic, the median 3-month mean frequency of MNE was 1 (0–7.67) in children using desmopressin melt versus 1.33 (0–6) in those using alarm treatment (p = 0.095). During the COVID-19 pandemic period, the median monthly mean frequency of MNE was 1.33 (0–7.33) in children using desmopressin melt versus 6 (1.33–13) in those using alarm treatment (p

Purpose: To evaluate stone free rate (SFR) predictivity of three different scoring systems in patients with kidney stones larger than 20 millimeters undergoing retrograde intrarenal surgery(RİRS). Methods: Digital records of a total of 166 patients were reviewed retrospectively. Epidemiological characteristics (age, gender, medical history) of the patients, stone and affected kidney characteristics (size, volume, location, density, opaque, presence of urinary system anomaly, presence of stones in different calyx, number of stones, lower pole stone, renal infundibulopelvic angle (IPA), renal infundibulopelvic length (RIL), hydronephrosis), and operative characteristics (preoperative ureteral stent, operation duration, postoperative residual fragments, hospitalization time and complications were recorded. Each patient was scored separately according to the Resorlu-Unsal Scoring System (RUSS), the modified Seoul National University Renal Stone Complexity (S-ReSC) and R.I.R.S scoring systems based on the stone characteristics seen on CT. Results: All three methods had statistically acceptable sensitivity and specificity values. Sensitivity for R.I.R.S nomogram is 62.3%, specificity is 77.1% (cut-off: 7.5 points, area under the curve (AUC):0.735, p < 0.001), sensitivity for RUSS nomogram is 60.7%, specificity is 77.9% (cut off: 2.5, AUC = 0.749, p < 0.001), sensitivity for the Modified S-ReSC nomogram was determined as 65.6% and specificity as 71.2% (cut off: 2.5, AUC = 0.743, p < 0.001). The residual stone ratio was found to be higher in the presence of lower pole stone. While the cut-off value for IPA was 44.5°, this value was calculated as 24.5 mm for RIL. Conclusion: Three scoring systems demonstrate accceptable sensitivity and specificity in predicting stone free rate(SFR) with stones ≥ 20 mm. Multivariate analysis highlighted the superiority of the R.I.R.S. scoring system for SFR predictivity. In the presence of lower pole stones, IPA and RIL are important factors in predicting surgical success. [ABSTRACT FROM AUTHOR]

Abstract. Background:. We aimed to determine if the ratio of the upper to the lower diameter of the ureter could have any predictive value for ureteral stone impaction. Materials and methods:. Patients who had a solitary unilateral ureteric stone, determined by noncontrast computerized tomography, were assessed if they had undergone ureteroscopic lithotripsy. A total of 111 patients, 84 males (76%), and 27 females (24%), were recruited to the study. Demographic data of the patients and preoperative radiological parameters based on noncontrast computerized tomography were recorded. The impaction status was also assessed during the operation. Results:. Of the 111 patients, ureteral stones in 63 (57%) patients were determined to be impacted, and ureteral stones in 48 (43%) were nonimpacted. Impacted stones were more common in older patients, female patients, and patients with an American Society of Anesthesiologists score of 2. Conclusions:. Significant relationships were found between the impaction status and transverse stone length, longest stone length, upper diameter of the ureter, ratio (upper diameter of the ureter/lower diameter of the ureter), and anteroposterior diameter of the pelvis. These parameters were higher in patients with impacted stones.

ABSTRACT Purpose: We aimed to determine pre-operative and post-operative sexual function scores of patients who underwent four-arm polypropylene mesh implantation surgery to treat urinary incontinence and pelvic organ prolapse. Materials and Methods: A prospective study from January 2011 to November 2015 including patients (n: 72) submitted to surgical mesh implantation (four-arm anterior mesh implant (Betamix POP4®, Betatech Medical, Turkey) questioned the patients with Female Sexual Function Index evaluation form. The questionnaire was applied to all patients at pre-operative, post-operative 3rd month and post-operative 1st year periods. Results: The mean age of the patients was 47.2±7.1 years. The mean Body Mass Index (kg/m2) was 28.7±3.7. The average of incontinence duration (year) was 4.6±2.6 and the average for operation time (min) was 35.7±2.1. After the urinary incontinence and pelvic organ prolapse surgery, it was observed that incontinence complaints of patients reduced. Furthermore, there was a positive change in quality of life and sexual function of patients at the post-operative period. There was a statistically significant increase according to Female Sexual Function Index score among all three periods (16%, 86% and 100% respectively, p=0.001) and improvement of sexual functions was observed. Conclusions: Transvaginal mesh use in the surgical treatment of pelvic organ prolapse improves quality of life. However, risk factors such as transvaginal mesh usage indication, surgical technique and experience of the surgeon, suitability of the material, the current health status of the patient and postoperative personal care of the patient may affect the success of operations.

Objective: The aim was to evaluate the effect of yellow and red centaury St. John's Wort (St. JW) oil on inflammation and urethral fibrosis development in a rat urethral trauma model. Materials and Methods: A total of 24 male rats were divided into 5 groups. No urethral damage was induced in the sham group. The urethras of all rats in the other groups was traumatized at 6 o'clock with a specially designed urethrotome blade. Group 1 was administered 0.5 cc of St. JW oil once daily for 15 days. Group 2 was administered 0.5 cc of red centaury oil intraurethrally once daily for 15 days. The traumatized rats in Group 3 were not treated (St. JW and red centaury oil were not administered). St. JW oil was administered to 3 rats in the Sham 1 group (Group 4), and red centaury oil was administered to 3 rats in the Sham 2 group (Group 5). A 20-G/32-mm intravenous cannula sheath was used for intraurethral administration. On the 15th day, rats were sacrificed and penectomy was performed for histologic evaluation. Results: Spongiofibrosis, mucosal inflammation, and congestion were significantly decreased in the yellow St. JW oil group when compared with the red centaury oil group and the untreated group (group to which neither St. JW nor red centaury oil was administered). Conclusion: In this study, intraurethral administration of yellow St. JW oil was found to significantly reduce mucosal inflammation, spongiofibrosis, and obstruction after urethral trauma. According to the results of this study, we think that St. JW oil may be a promising option in the treatment of urethral stricture. [ABSTRACT FROM AUTHOR]

Over leimyosarkomu çok kötü prognozlu agresif nadir bir tümördür. Uterin tümörlerin aksine ovaryan düz kas tümörleri, yumurtalık tümörlerinin sadece% 1'ini içeren çok nadir tümörlerdir. Ovaryan leimyosarkom genellikle postmenapozal periyotta görülür. Ancak bu vakada olduğu gibi premenapozal periyottada tanı konabilir. Primer pür ovaryan leimyosarkomlar ovaryan düz kas hücreli tümörlerin malign alt grubunu oluşturur. Bu nedenle kökenleri, etiyolojisi, histolojik özellikleri, klinik davranışları ve optimal tedavileri hala belirsizdir. 59 yaşında bir hasta, karnında kitle ve ağrı şikayeti ile hastanemize başvurdu. Ameliyat öncesi çeklen abdominal ultrasonografi ve bilgisayarlı tomografide tüm abdomeni dolduran kitle tespit edildi.Total histerektomi, bilateral salpingo-ooferektomi, omentektomi, appendektomi, bilateral pelvik ve paraaortik lenf nodu diseksiyonu ve peritoneal yıkama yapıldı. Histopatolojik incelemede primer ovaryan leimyosarkom tespit edildi. Bildiğimiz kadarıyla mevcut vakamızla birlikte literatürde 73 vaka bildirilmiştir.

Amaç: Stres üriner inkontinans tedavisinde gerilimsiz vajinal tape ve transobturator tape uygulamasının etkinliği, güvenliği ve her iki yöntemin hayat kalitesini karşılaştırmayı amaçladık.Gereç ve Yöntem: Nisan 2006 ile Nisan 2008 tarihleri arasında stres üriner inkontinans nedeniyle transobturator tape uygulanan 45 hasta ile gerilimsiz vaginal tape uygulanmış 33 hastanın verileri karşılaştırıldı. Demografik özellikleri, başarı oranı, kısa dönemdeki komplikasyonlar ve operasyonun semptomlar ve yaşam kalitesi üzerine etkileri değerlendirildi.Bulgular: Total 78 hastanın ortalama yaşı 48.77±4.78 (34-79) olarak hesaplandı. Transobturator tape yapılan hastaların ortalama operasyon süresi sırasıyla 12.89±4.09 dakika idi. Gerilimsiz vaginal tape yapılan hastaların ortalama operasyon süresi 30.21±2.89 dakika idi. Ortalama operasyon süresi gerilimsiz vaginal tape yapılan gurpta istatistiksel olarak daha yüksekti. Urogenital distress inventory-6 anketinin analizinde her iki grubun kendi içinde postoperatif dönemde anlamlı derecede düzelme olduğu tespit edildi.Sonuç: Her iki prosedür güvenli ve etkili metodlardır. Aynı zamanda hayat kaliteleri üzerine istatistiksel olarak anlamlı derecede düzelmeler yaptığını tespit ettik. Yine de stres üriner inkontinansın tedavi modalitelerinin etkinliğini değerlendirmek için randomize kontrollü ve daha uzun takip süreleri olan çalışmalara ihtiyaç vardır.

Amaç: Kurtarma sistektomisi; mesane tümörü için başarısız küratif tedavi sonrası tümörün nüks etmesi sonucunda yapılan sistektomi tipidir. Biz bu endikasyonla kliniğimizde yapmış olduğumuz kurtarma sistektomilerinin sonuçlarını literatür eşliğinde retrospektif olarak değerlendirmeyi amaçladık. Materyal ve Metod: Ağustos 2011 ile Mayıs 2013 tarihleri arasında mesane tümörü tanısı ile kurtarma sistektomisi yapılan 11 hasta demografik özellikleri, preoperatif ve postoperatif patolojileri, perioperatif ve postoperatif komplikasyonları ve üriner diversiyon yöntemleri açısından retrospektif olarak değerlendirildi. Bulgular: Operasyon sonrası hastaların ortalama takip süresi 10,3 (3-20,8) ay idi. Sistektomi öncesi Transüretral rezeksiyon (TUR) materyallerine göre yapılan patolojik evrelemede 2 hastada T1 (%18,1), 8 hastada T2 (%72,7) 1 hastada T4 (%9) iken; sistektomi sonrası patolojik incelemede bu dağılım , 4 hastada T2 (%36,3), 3 hastada T3 (%27,2) ve 4 hastada T4 (%36,3) olarak bulundu. Hastaların 1'inde skuamöz hücreli karsinom bildirilirken, 2 hastada lenf nodu tutulumu bildirildi. Postoperatif erken (

Agresif anjiyomiksoma; sıklıkla pelvik yumuşak dokular ve perinede ortaya çıkan, nadir görülen benign bir tümördür. Agresif anjiyomiksoma ilk kez 1983 yılında Steeper ve Rosai tarafından tanımlanmıştır. Ana tedavi metodu geniş lokal eksizyodur. Yüksek rekürrens oranı vardır. Bu vakada 32 yaşında skrotal anjiomiksoma olgusunu literatür eşliğinde sunmayı amaçladık.

Purpose: Salvage cystectomy is performed when recurrences or treatment failures occur or curative treatment for bladder cancer is not possible . In this article, we aimed to present our experience of salvage cystectomies in light of current literature. Material and Methods: Folders of patients underwent salvage cystectomy between August 2011 and May 2013 were compared according to demographics, pre and post operative pathology reports, complicatons and types of urinary divertion. Results: Mean follow-up was 10,3 (3-20,8) months. When pathologies were compared by peroperative transurethral resection (TUR), 2 (18.1%) patients were T1, 8 (%72.7) patients were T2, 1 (9%) patient was T4; pathology specimens following cystectomy was T2 in 4 (36.3%), T3 in 3 (27.2%) and T4 in 4 (36.3%) patients. 1 patient had squamous cell carcinoma, 2 patients had lymph node metastasis. 1 patient suffered from bleeding, one patient sufferd from ileal extravasation, 1 suffered from urine extravasation and one patient suffered from infection in early postoperative period (

Tuberculosis is a disease that affects almost every organ. The diagnosis and treatment of primary genitourinary tuberculosis is cumbersome and often requires invasive procedures for diagnosis. It is mandatory to differentiate tuberculous epididymitis from other causes of intrascrotal diseases such as bacterial epididiymitis and tumors. We discussed a case of tuberculous epididymitis presenting with a scrotal mass, to emphasize that tuberculous should also be considered in the differential diagnosis, besides malignancy

Amaç: Bu çalışmamızda Plasma Kinetik Doku Tedavi Sistemi ile transüretral rezeksiyon (TURP) yapılan, semptomatik benign prostat hiperplazili (BPH) hastaların kısa dönem sonuçlarını inceleyerek, Plasma Kinetik Doku Tedavi Sisteminin etkinlik ve yan etki profilini ortaya koymaya çalıştık. Materyal ve Metod: Mart 2011 ile şubat 2012 tarihleri arasında kliniğimize başvuran benin prostat hiperplazi (BPH) tanısı ile ameliyat kararı alınan 86 hasta çalışma kapsamına alındı. Hastaların; IPPS semptom skorlaması, üroflowmetri, artık idrar miktarı tayini, prostat hacimleri, belirlendi. Tüm hastaların ameliyat sonrası üretra darlığı, mesane boyun darlığı, inkontinans gibi erken ve geç istenmeyen yan etkileri kaydedildi. Hastalar ameliyat süreleri, ameliyat sırasında kullanılan irrigasyon sıvısı miktarı ve transfüzyon gerekliliği, ameliyat sonrası hastanede kalış ve katerizasyon süreleri, irrigasyon sıvısı miktarları kaydedildi. 6.ayda hastalardan elde edilen veriler ameliyat öncesi verilerle kıyaslandı. Ameliyatı gerçekleştiren doktorlara görüntü kalitesinin 0"dan 10"a doğru artış gösterdiği söylendikten sonra, skala üzerinde kişisel derecelendirme yapmaları istendi. Bulgular: Çalışmaya dahil edilen 86 hastadan 24"ünün başvuru nedeni akut üriner retansiyona bağlı olarak gelişen glob vezikale idi. Bir hastada yatış endikasyonu hematüri nedeniyle olmuştu. Çalışmaya alınan hastaların operasyon öncesi IPSS değerlerinin genel ortalaması 22,2 idi. Postoperatif 6.aydaki sorgulamalarında ortalama IPSS değeri 6,8 olarak tespit edilmiştir. Operasyondan hemen sonra, rezektoskopun çıkarılmasını takiben, cerrahın cerrahi alan görüntü kalitesini ölçmeyi hedefleyen VAS skoru ortalaması 7,41, cihazın kanama kontrolü yeteneğini ölçmeyi hedefleyen VAS skoru ortalaması 7,62 bulunmuştur. Sonuç: Çalışmamızda ortaya çıkan sonuçlar ve literatür verileri kılavuzluğunda; bipolar TURP teknolojisinin, mesane çıkım obstrüksiyonuna yol açmış benign prostat hiperplazisinin endoskopik cerrahi tedavisinde daha iyi hemodinamik stabilite ve cerrahi işlem sırasında daha yüksek konfor sağlaması nedeniyle monopolar TURP uygulamalarına iyi bir alternatif olduğu kanısına vardık.

Purpose The aim of this study, to investigate whether there is any association between enuresis in childhood and nocturnal polyuria syndrome (NPS) in adult life. Methods The study consisted of thirty five patients with nocturnal polyuria, and thirty five healthy people without nocturnal polyuria in adult life, were asked to assess their enuresis in childhood. Results There was a history of enuresis in childhood in 18 (51.42%) of 35 of men with nocturnal polyuria and in 4 (11.42%) of 35 without nocturnal polyuria. Enuresis in childhood was significantly more common in men with nocturnal polyuria than without nocturnal polyuria. The difference was significant (P

OBJECTIVES: To investigate the acute effect of phosphodiesterase type 5 (PDE5) inhibitor on erectile dysfunction by evaluating serum oxidative status and prolidase activity. METHODS: Serum samples of 36 patients with erectile dysfunction and 30 control cases were analyzed for total antioxidant status, total oxidant status, and prolidase activity, before and after the administration of tadalafil citrate. RESULTS: Before and after tadalafil citrate administration, serum total antioxidant status, total oxidant status, and prolidase were 1.1+0.0 vs. 1.6 + 0.0 umol H2O2 Eq/L, 10.3+1.1 vs. 6.9 + 1.2 umol H2O2 Eq/L, and 236.4+19.5 vs. 228.2 + 19.2 U/L, respectively (p