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Transobturator bant (TOB) tekniği, Stres Üriner İnkontinans (SÜİ) tedavisinde en sık uygulanan tekniklerden birisidir. Bu tekniğin uzun dönemde en sık görülen komplikasyonları ağrı ve disparonidir. Mesane perforasyonu, TOB yönteminde sık karşılaşılan bir komplikasyon değildir, ancak olduğu zaman katastrofik bir komplikasyondur. Bu nedenle bu teknikte rutin sistoskopi yapılmalıdır. Bu yazıda, şiddetli kasık ağrısı olan ve mesanesinde taşlaşmış askı materyali saptanan bir kadın hasta sunuldu. Hasta, açık sistolitotomi ve meş eksizyonu ile tedavi edildi., Transobturator tape (TOT) technique is one of the most commonly used techniques in Stress Urinary Incontinence (SUI) treatment. The most common complications of this technique in the long term are pain and dyspareunia. Bladder perforation is not a common complication of the TOT technique but, regardless, it is a catastrophic complication, therefore, routine cystoscopy should be done in this technique. In this report, we present a woman who presented with severe groin pain and was diagnosed with lithified sling material in her bladder. The patient was managed with open cystolithotomy and mesh excision.

WOS: 000419241300002, Objective: Predictive factors that could affect the cure and complication rates of midurethral slings (MUS) in the treatment of stress urinary incontinence (SUI) were investigated. Materials and Methods: A total of 594 women (outside-in transobturator in 285, inside-out transobturator in 91, and retropubic in 218) with SUI and who had undergone MUS were evaluated. The median age was 53.9 (27-82) years. Univariate analyses were done using chi-square test, Student's t-test and the Mann-Whitney U test. Multivariate analyses were done using logistic regression analysis to determine predictive factors affecting cure and complication rates. Results: The mean follow-up time was 48 months. The subjective cure rate was 84% and complication rate was 11.2%. On univariate and multivariate analyses, the cure rate was found to be increased in younger patients [odds ratio (OR): 0.97, 95% confidence interval (CI): 0.95-0.99, p=0.038] and in patients with pure SUI (OR: 2.17, 95% CI: 1.31-3.60, p=0.002). The type of surgery was the only statistically significant parameter affecting the complication rate, which was significantly higher in retropubic MUS procedure (OR: 6.28, 95% CI: 3.51-11.22, p

Objective: To compare the abdominal and transvaginal techniques in the surgical treatment of vesicovaginal fistula (VVF) and analyze the factors affecting its recurrence rate. Materials and Methods: Patients were divided into two groups according to the operation technique used (abdominal-transvaginal) and the recurrence status (recurrent and non-recurrent). The primary endpoint of the study was the comparison of the factors related to fistula and surgical techniques. Results: The number of cases with radiotherapy history was found to be higher in the recurrent group (68.2% vs 11.5%, p, Amaç: Vezikovajinal fistül (VVF) onarımında abdominal ve transvajinal tekniklerin karşılaştırılması ve nükse etki eden faktörlerin analizini yapmaktır. Gereç ve Yöntem: Hastalar operasyon tekniğine göre (abdominal-transvajinal) ve nüks durumuna göre (nüks edenler-nüks etmeyenler) gruplara ayrıldı. Fistül ve cerrahi yöntemlerle ilişkili faktörlerin karşılaştırılması, çalışmanın birincil sonlanım noktasıydı. Bulgular: Radyoterapi öyküsü olan olgu sayısı rekürren grupta daha fazlaydı (%68,2 vs %11,5, p

Objective: In the present study, we investigated the efficacy of bladder hydrodistension combined with pentosan polysulfate (PPS) treatment in interstitial cystitis (IC)/bladder pain syndrome (BPS). Methods: In this study, 339 patients diagnosed with IC/BPS were categorized into two groups. The first group only received 300 mg/day PPS, while the second group received 300 mg/day PPS following bladder hydrodistension. The results were evaluated at the 3rd, 6th, and 12th months after the first dose using the interstitial cystitis symptom index (ICSI), international cystitis problem index (ICPI), visual analog scale (VAS), and female sexual function index (FSFI). Results: PPS treatment started just after hydrodistension was significantly more effective than PPS treatment alone and combined treatment significantly reduced the rate of non-compliance such that, at the end of the 3rd month, 12.1% patients in Group-1 did not continue their treatment whereas only 1.9% of patients in Group-2 did not continue. Conclusions: The study results indicate that PPS treatment started just after hydrodistension yields significantly better results in terms of both symptom improvement and treatment compliance in patients with IC/BPS.

WOS: 000414976900032, PubMed ID: 29151330, Background/aim: We aimed to analyze the effects of stricture location, etiology, age, and catheterization time on recurrence rate and recurrence time in patients who underwent direct vision internal urethrotomy (DVIU) for urethral strictures. Materials and methods: Patients were divided into three groups according to the location of the stricture: penile urethra, membranous urethra, and prostatic urethra strictures. Patients were also divided into three groups according to etiologic factors: strictures secondary to endoscopic procedures, urethral catheterization, and open or radical prostatectomy (anastomotic strictures were included in this group). Patients were also divided into three groups according to catheterization time: < 2, 2-5, and > 5-7 days. Recurrence rate and time data were analyzed according to stricture location, etiology, age, and catheterization time. Results: The recurrence rate was significantly higher in endoscopic procedures. Recurrence rate was significantly lower and recurrence time was significantly earlier in penile urethral strictures. Recurrence rate was significantly lower and recurrence time was significantly longer in short catheterized group than in the other two groups. However, first recurrence time was not different between the groups, while second and multiple recurrence times were significantly earlier in patients < 60 years old. Conclusion: Patients are exposed to multiple operations as a result of frequently recurring urethral strictures. Although DVIU is an important first-line treatment method for strictures, alternative methods should be considered for frequently recurring cases.

Objective: in this study, we aimed to investigate the effect of diabetes-related metabolic changes and chronic complications on lower urinary tract (LUT) functions. Materials and Methods: the study included 286 adult patients with type 1 and type 2 diabetes mellitus (DM). All patients’ demographic data, diabetes-specific history, laboratory and physical examination findings were recorded. All the data were compared with uroflowmetric parameters and the scores of questionnaires used for evaluation of LUT symptoms and functions. Results: in the presence of diabetic peripheral neuropathy (DPN), average urinary flow rate (Qave), International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) score and the Overactive Bladder-questionnaire Short Form (OAB-q SF) score were significantly affected. in the presence of stage 3 or over diabetic nephropathy (DN), ICIQ-SF score was significantly higher. Also, in elderly group, Qave and OAB-q SF score were significantly affected. the Qave was lower both in patients who underwent any surgery due to diabetic complications and in patients with DM-related diseases. Qave and OAB-q SF score were significantly lower in males. Type 2 DM was associated with postvoid residual (PVR) increase and Qave decrease. Poor glycemic control was associated with lower OAB-q SF score. Finally, vitamin D deficiency was found to be associated with an increase in PVR volume. Conclusion: the present study showed that DPN, stage 3 or over DN, aging, DM-related diseases and surgeries, male gender, type 2 DM, poor glycemic control and vitamin D deficiency cause a tendency to develop any kind of LUT dysfunction., Amaç: Bu çalışmanın amacı diyabete bağlı metabolik değişikliklerin ve kronik komplikasyonların alt üriner sistem (AÜS) fonksiyonları üzerine olan etkisini araştırmaktır. Gereç ve Yöntem: Çalışmaya tip 1 ve tip 2 diabetes mellitus (DM) tanılı 286 erişkin hasta alındı. Tüm hastalara ait veriler retrospektif olarak tarandı. Tüm hastaların demografik bilgileri, diyabete özgü hastalık öyküleri, laboratuvar ve fizik muayene bulguları kaydedildi. Hastalara ait tüm veriler üroflovmetrik ölçüm sonuçları ve AÜS semptomu sorgu formlarından elde edilen skorlarla karşılaştırıldı. Bulgular: Diyabetik periferal nöropati (DPN) varlığında ortalama idrar akım hızının (Qave), International Consultation on Incontinence Questionnaire- Short Form (ICIQ-SF) skoru ve Overactive Bladder-questionnaire Short Form (OAB-q SF) skorunun anlamlı olarak etkilendiği saptandı. Evre 3 ve üzeri diyabetik nefropati (DN) varlığında ICIQ-SF skoru anlamlı olarak yüksek saptandı. Ayrıca yaşlı hasta grubunda Qave ve OAB-q SF skorunun anlamlı olarak azaldığı saptandı. Diyabetik komplikasyonlar nedeniyle cerrahi geçirenlerde ve DM ile ilişkili komorbid hastalığı olanlarda Qave anlamlı olarak düşük saptandı. Erkek hastalarda Qave ve OAB-q SF skoru anlamlı olarak düşük saptandı. Tip 2 DM’nin postvoid residual (PVR) volümde artış ve Qave’da azalma ile ilişkili olduğu saptandı. Kötü glisemik kontrolün OAB-q SF skorunda düşüş ile ilişkili olduğu gösterildi. Son olarak D vitamini eksikliğinin PVR volümde artış ile ilişkili olduğu saptandı. Sonuç: Çalışmamızda DPN, evre 3 ve üzeri DN, ileri yaş, diyabetik komplikasyonlar nedeniyle geçirilmiş cerrahiler, DM ile ilişkili komorbid hastalıklar, erkek cinsiyet, tip 2 DM, kötü glisemik kontrol ve D vitamini eksikliği faktörlerinin diyabetik hastalarda AÜS disfonksiyonu gelişimine yatkınlık oluşturduğu saptanmıştır.

WOS: 000419992100006, Introduction: Transrectal prostate biopsy (TPB) is currently a commonly used invasive procedure for the diagnosis of prostatic diseases. Due to increasing infectious complications after TPBs in our institute, it was decided to change antimicrobial prophylaxis regimens and pre-intervention measures. The aim of this study was to evaluate the effects of shorter antimicrobial prophylaxis, intestinal cleansing and single use sterile gels on infections developing after TPBs in our tertiary-care educational hospital. Materials and Methods: Infections developing in the last six months after TPB were evaluated retrospectively by using records of microbiology, radiology and urology departments. Sterilization and disinfection, antimicrobial prophylaxis regimens, intestinal decontamination procedures and routine biopsy procedures were reevaluated in cooperation with the corresponding clinics. Afterwards, it was decided to implement three changes in the TPB practice: 1) Shortening the antimicrobial prophylaxis, 2) Intestinal cleansing one day before the intervention by using enema, and 3) Using sterile gel (single patient use only) during biopsy. Patients were diagnosed as clinical or microbiologically confirmed healthcare-associated infection according to the 'Centers for Disease Control and Prevention' criteria. The preintervention period was 2007 July-December and the intervention period was 2008 January-July. Results: Overall infection/infectious complication rate (10.5% vs. 3.8%; p=0.007), overall clinically defined infection rate (4.8% vs. 1.1%; p=0.028) and overall microbiologically defined infection rate (5.8% vs. 2.7%; p=0.002) decreased significantly in the post intervention period. Conclusions: Our findings suggest that shorter antimicrobial prophylaxis regimens, using sterile gels and intestinal cleansing may be useful in the control of infections developing after TPB.

Aims Since lower urinary tract dysfunction (LUTD) related to multiple sclerosis (MS) has a different behavior pattern than other types of neurogenic voiding dysfunction, we aimed to prepare a national consensus report for the management of LUTD due to multiple sclerosis in light of available literature. Methods A search of available databases yielded an evidence base of 125 articles after the application of inclusion/exclusion criteria. When sufficient evidence existed, recommendations A (high), B (moderate), or C (low) were made according to the strength of evidence; recommendation D was provided when insufficient evidence existed. Results Available data did not support the use of invasive urodynamics in the initial evaluation of patients with MS and LUTD. Clinical studies on the safety and efficacy of antimuscarinics and alpha-blockers in these patients were scarce and low quality. Desmopressin could be used in MS-related overactive bladder symptoms owing to its short-term effects as an adjunctive treatment. Intravesical botulinum toxin type A treatment in patients with MS and detrusor overactivity was recommended in cases of medical treatment failure or severe side effects due to antimuscarinics. Pelvic floor rehabilitation together with neuromuscular electrical stimulation was also recommended as it increased symptomatic treatment success. This systematic review was not able to find any evidence-based cut off post-void residual value for the recommendation to start clean intermittent catheterization in MS-related LUTD. Conclusions Patients with MS and LUTD could be best managed through the use of this consensus report. Neurourol. Urodynam. 32:1047–1057, 2013. © 2013 Wiley Periodicals, Inc.

Purpose: The evaluation of lower urinary tract (LUT) before transplantation is not required, except in patients with a history of LUT disfunction (LUTD). In this study, we adressed the necessity for lower urinary system evaluation in transplantation candidates classified according to their etiology. Materials and Methods: Sixty-two patients were prospectively evaluated. The patients were evaluated at 2 months preoperatively and at 6 months post transplantation using questionnaires, bladder diary and urodynamic studies. The end stage renal disease (ESRD) etiologies of the patients were divided into three groups as follows: patients with a parenchymal disease, patients with LUTD and those with unknown etiology and the obtained results were evaluated accordingly. Results: The evaluation of 50 patients revealed significant differences in ICIQ-SF (p < 0.001), IPSS (p < 0.001), daily urine volumes (p = 0.05), maximum urinary flow rate (p = 0.03), PVR, the number of patients with VUR and all cystometric parameters between the patient groups divided according to the etiology. The comparison of the groups to each other revealed no statistically significant differences in all parameters between the LUTD group and the patient groups with unknown etiology. Considering that the results from questionnaires of patients with a single voided volume of 100 cc or greater on the bladder diary would be scientifically more significant, they were evaluated separately. Thus, even though the results from questionnaires did not differ between the group with unknown etiology and the LUTD group, there were significant differences when compared to patients who developed ESRD due to a parenchymal disease. Similar findings were found between the results of urodynamic study. Conclusions: The evaluation of lower urinary tract in patients with a history of LUTD and in those with unknown etiology should be initially evaluated by noninvasive methods such as questionnaires and uroflowmetry.

In recent studies, it has been observed that androgen receptors are densely located in pelvic floor muscles. We aimed to investigate the effect of testosterone on urodynamic findings and histopathomorphology of pelvic floor muscles in rats with experimentally induced stress urinary incontinence.Twenty-eight adult female rats were randomized into four groups. Group I: rats in which SUI was induced and single-dose testosterone was administered 30 days later, group II: rats in which SUI was induced and single-dose testosterone was administered within the same session, group III: rats in which SUI was induced and saline was injected intramuscularly 30 days later, and group IV: the sham group. In order to demonstrate objectively the curative and preventive role of testosterone in experimental model of SUI, urodynamic examination and histopathomorphological evaluation of levator ani muscle were performed.Myofiber areas in groups I and II were detected to be significantly larger than those of the control group (P0.001). Another parameter was leak point pressure value by urodynamy. Regarding this parameter, LPP values in groups 1, 2 and 4 were observed to be significantly higher than those of group 3 (P0.001). The results of the comparison among groups 1, 2 and 4 revealed no significance (P0.05), which indicates that testosterone provides continence in a similar way to the group in which sciatic nerve section was not performed.In the present study, it has been demonstrated that testosterone has both preventive and curative effects on rat models of experimental SUI.

Acute renal failure (ARF) is a clinical situation that renal functions deteriorate suddenly within hours to days. Postrenal causes are responsible for a small part of ARF. In this article, we presented a case gone to left nephrectomy priorly, with a right ureter stone led to complete obstruction, ARF, and treated by ureterorenoscopy (URS). A seventy year old male patient was sent to Emergency Department because of anuria for 48 hours. In ultrasonographic exam; there wasn’t hydronephrosis of right kidney. A right lower ureter stone was seen in the non-contrast spiral abdominal computed tomography. The lower ureter stone was removed by URS and JJ catheter was replaced. He was discharged with normal renal function tests. In conclusion, postrenal ARF must be ruled out in patients with acute anuria, especially zero urine, even if hydronephrosis delinea. If postrenal ARF is diagnosed and treated quickly, the outcomes will be excellent.

To assess the results of shockwave lithotripsy (SWL) for renal calculi in upper, middle, and lower calices according to the stone burden.A series of 52 female and 66 male patients with a mean age of 47.8 years and isolated single caliceal stones who underwent SWL monotherapy were enrolled. Stone burden, stone location, number of sessions/shockwaves, and auxiliary procedures were noted for each patient. Stones were located in the upper, middle, and lower calices of 35, 43, and 40, patients respectively, with mean stone burdens of 81.4 mm2, 75.2 mm2, and 96.3 mm2, respectively. Patients were evaluated with intravenous urography, plain film, or ultrasonography. Success was determined 3 months after the last session. Re-treatment rates were calculated. The effect of anatomic factors on the success of treatment for lower-caliceal stones also was determined.The mean stone burden, median number of treatment sessions, and mean number of shockwaves were 84.2 mm2, 2, and 4344, respectively. The auxiliary procedure rate was 16.1%, and the re-treatment rate was 71.2%. Failure was noted in 26 patients (22%). The stone-free rates for stones in the upper, middle, and lower calices were 82.8%, 83.4%, and 67.5%, respectively (P = 0.14). The stone-free rates for stones100 mm2 and 100 to 200 mm2 were 91.2% and 65.5%, respectively (P = 0.001). The efficiency quotient was 49.8, 44.8, and 32.5 for upper-, middle-, and lower-caliceal stones, respectively. Infundibular length (P = 0.006) and infundibular width (P + 0.036) were significant in determining the stone-free rate after treatment of lower-caliceal stones.We recommend SWL as the first choice for treatment of stones200 mm2 in the upper and middle calices. Extracorporeal lithotripsy is one of the options for lower-caliceal stones200 mm2 but has high re-treatment and auxiliary-procedure rates in these cases.

To estimate the prevalence of urinary incontinence (UI), overactive bladder (OAB), and other lower urinary tract symptoms (LUTS) in the Czech Republic, Russia, and Turkey.Stage one of this population-based survey consisted of computer-assisted telephone interviews to obtain prevalence estimates of storage, voiding, and post-micturition LUTS. Stage two face-to-face interviews evaluated subjects with mixed urinary incontinence (MUI), stress urinary incontinence (SUI) or OAB (case group) and a control group (subjects with other incontinence or LUTS complaints, or no symptoms).Prevalence of LUTS categories were determined for each country based on International Continence Society (ICS) criteria.A total of 3130 individuals agreed to participate in the survey, which found high rates of LUTS (men 80%; women 84%) and OAB (men 18%; women 28%). Duration of urinary symptoms was relatively brief (approximately 60% ≤ 3 years) and was associated with relatively modest effects on quality of life and work performance in the majority of individuals. Forty percent had consulted with a healthcare provider about their urinary symptoms, of whom 37% had consulted with a physician and 34% with an urologist, and 12% had been treated with a prescription medication. Drug therapy, while uncommon, was associated with a high degree of self-reported improvement (96%). Because of between-country population differences, aggregate results may not always be representative of results for each of the three countries individually. Study limitations include reliance on patient self-report, and potential bias introduced by patients who declined to participate in the survey.The results of this epidemiologic survey found high rates of LUTS and OAB, but low levels of medical consultation and very low use of medication treatment, despite high levels of improvement when medications were used.

Objective To determine the sensitivity of drug-resistant prostate cancer cell lines to doxazosin-mediated cell death, and the effects of combining doxazosin and chemotherapeutic agents on these cell lines. Materials and methods The cytotoxic effect of doxazosin was initially evaluated in the prostate carcinoma cell lines DU145 and PC-3. Doxazosin was combined either with adriamycin, etoposide or paclitaxel after its cytotoxic effects were detected in these cell lines. The tetrazolium dye (MTT) assay and trypan blue dye-exclusion tests were used to determine drug-mediated cytotoxicity. Experiments were performed at least three times and representative data are presented. Results Both cell lines were sensitive to doxazosin-mediated cytotoxicity and the maximum cytotoxicity was achieved after 72 h. While cell death increased with increasing concentrations of doxazosin, 60 µmol/L doxazosin killed more than half of the cells in these cell lines. The combination of doxazosin with both adriamycin and etoposide resulted in significant synergistic cytotoxic activity at subtoxic concentrations of the drugs. Interestingly, the combination of doxazosin and paclitaxel resulted in antagonistic activity. Conclusion Doxazosin-mediated cytotoxicity in the drug-resistant human prostate carcinoma cell lines was confirmed. Combinations of doxazosin with either adriamycin and etoposide, but not paclitaxel, had synergistic cytotoxic activity in these tumour cell lines. These results suggest that doxazosin could be a new cytotoxic agent, either used alone or combined, in the treatment of prostate cancer.

Leydig cell tumors of the testis are rare, mostly presenting as a testicular mass or as endocrinological symptoms. Here, three patients who were admitted for investigation of primary infertility and one patient presenting with a testicular mass are reported. The histological features were reviewed and an immunohistochemical study was done using a panel of antibodies against cytokeratin, vimentin, inhibin A, S-100, Ki-67, follicle-stimulating hormone, luteinizing hormone, prolactin, p53, bcl-2, and c-erbB2. The latter case (lost during follow up of metastatic disease) demonstrated massive tumor necrosis, extension through the tunica albuginea, and a high mitotic activity and MIB-1 score. Only this malignant case was bcl-2 positive. Of the two oncogenic markers studied, none of the cases were positive for c-erb2, while p53 was positive in more than 50% of cells in the malignant case and in one case of infertility with a large tumor, hemorrhage, focal necrosis and atypical cytological features. We recommend the evaluation of infertile men for Leydig cell tumors, and we believe that a panel of antibodies, including Ki-67, p53 and bcl-2, used for immunohistochemical analysis could be of diagnostic value in the identification of malignant and borderline cases of Leydig cell tumor.

In this study we aimed to show the efficacy of extracorporeal shock wave lithotripsy (ESWL) for urinary stone disease in the pediatric age group and to evaluate the complications encountered after the treatment.67 children with 109 stones underwent ESWL, using a Dornier MPL 9000 lithotriptor. Styrofoam boards were used to protect the lungs. KUB and chest radiographs were taken on the day after treatment. If stone-free status was achieved, the patient was followed with ultrasonography and urine analysis every 6 months for 2 years. If fragments4 mm were present, follow-up was repeated every 3 months.Stone size ranged from 0.5 to 3.5 cm. 71 renoureteral units underwent a total of 129 ESWL sessions. Retreatment was required in 28 patients. The mean number of sessions per unit was 1.8. A stone-free status was achieved in 60 renoureteral units. The overall success rate was 88.6%. The composition of the stone was mixed calcium oxalate and phosphate in the majority of the patients. Auxiliary procedures used were push-back, ureteroscopic stone removal, and open surgery. Hematuria, colics and fever over 38 degrees C were the complications encountered after the treatment.ESWL is the first-line treatment for renal and upper ureteral calculi. However, larger stones which will require several ESWL sessions and consecutively increased number of shock waves are best treated with percutaneous nephrolithotomy plus ESWL. Patients with congenital anomalies necessitating surgical reconstruction are the best candidates for operation.

Prolonged erection is a rare problem in urology but it must be treated effectively. The most common etiological factor is intracavernosal vasoactive agent injection for diagnosis or treatment of erectile dysfunction. The aim of this study was to evaluate the efficacy of intracavernosal adrenalin injection alone in the treatment of priapism. Nineteen patients with prolonged erection were evaluated. Seventeen out of the 19 prolonged erections were due to intracavernosal vasoactive agent injection and the remaining two were idiopathic. In all cases 2 ml adrenalin (1/100 000) was injected in each cavernosal body. In the patients who did not respond to the first injection, repeated adrenalin injections were performed at 20 min intervals. Blood pressure and heart rate were monitored during the injections. Detumescence was achieved in ten (53%) patients after the first injection. Repeated adrenalin injections (2-5 injections) were required in nine patients and eight (42%) of them achieved detumescence. Only one (5%) patient who had 26-h prolonged erection could not achieve detumescence. There was no significant difference in blood pressure and heart rate during the monitoring of the patients when compared to the initial values. No standard treatment method has yet been described for prolonged erection. Repeated aspirations and irrigations for treatment of prolonged erection are problematical applications both for patients and urologist. Intracavernosal adrenalin injection alone can be used with high efficacy and safety for the treatment of prolonged erection especially in patients with a short duration of erection.

Objective: To evaluate the efficacy of Extracorporeal shock wave lithotripsy (ESWL) in renal anomalies. Material and Methods: From 1991 to May 1995, 53 patients with calculi in anomalous kidneys presented to our clinic for treatment with ESWL. Average patient age was 39 years, a range of 6-66 years. These patients (32 male and 21 female) underwent ESWL treatments. ESWL was performed in 27 patients with urolithiasis in duplex system, 18 with horse-shoe kidneys, 4 with unilateral renal agenesis, 2 with pelvic ectopic kidneys, 1 with sigmoid kidney and 1 with L-shaped kidney. Results: Among patients who completed ESWL the rate free of stones was 60.4% and the rate of clinically insignificant residual fragments was 30.2 %. No sign of stone disintegration was observed in 2 patients. They underwent open surgery. The shock waves per therapy varied between 811 and 18,101. Double-J stents were placed in 13 patients. Conclusion: Most patients with calculi in anomalous kidneys can be managed primarily with ESWL.

Objective To show that the fluids obtained from spermatoceles and epididymal cysts are not infected, even though they may be present for long periods, and that these fluids have bactericidal activity. Materials and methods Sixteen patients, 13 with a spermatocele and three with an epididymal cyst, were included in the study. Protein, glucose, chloride, inorganic phosphorus, calcium and magnesium contents were measured and cultures of the fluids were carried out. Bactericidal activity against the Escherichia coli NTCC 10418 clone was tested in different dilutions. Results Biochemical analysis showed that the protein, glucose and ionic content of the fluids was lower than that of serum, except for chloride. Microbiological cultures were negative for all samples. A significant bactericidal effect was obtained with 1/1 dilution and no reproduction was seen with this dilution. Conclusion These findings indicate that the fluids within spermatoceles and epididymal cysts do not become infected under normal circumstances.

Eosinophilic cystitis is an unusual form of cystitis which is characterized by irritative voiding symptoms and haematuria. In the report herein two adult cases of eosinophilic cystitis treated with intravesical Mitomycin-C instillations for prophylaxis of bladder carcinoma are presented and the literature is reviewed.

A case of renal carcinoma in a giant solitary renal cyst is reported. Ultrasonography and CT showed an apparently benign left renal cyst except for wall irregularity. Cytological examination and fat analysis of the cyst content were negative but the fluid was haemorrhagic in nature. Frozen section of the cyst wall revealed malignancy and further histopathologic examination indicated renal cell carcinoma.

Objective: To investigate the effectiveness of ciprofloxacin in the treatment of chronic bacterial prostatitis due to various microorganisms. Methods: Patients with chronic prostatitis symptoms were evaluated by culture of their expressed prostatic secretion and fractionated urine samples according to the four-glass localization test of Meares and Stamey. Patients with an isolated microbial agent were treated with ciprofloxacin 500 mg twice a day for 4 weeks and re-evaluated 1 week and 6 months after the treatment. Results: Sixteen of the 68 (23.5%) evaluated patients were diagnosed as having chronic prostatitis with an isolated microbial agent. Ureaplasma urealyticum was the most common microorganism related to chronic prostatitis. Eradication of the previously isolated microbial agent was found in 11 of the 16 patients at the first-week evaluation. At the 6-month control evaluation no growth was observed on the cultures of seven of the 16 (43.8%) patients, which was accepted as successful treatment. Conclusions: U. urealyticum can be the responsible agent in some chronic prostatitis patients. Ciprofloxacin may be a treatment option in chronic prostatitis.