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ObjectiveIn urology guidelines, endourological treatmentssuch as percutaneous nephrolithotomy (PCNL)and retrograde intrarenal surgery (RIRS) arerecommended for lower pole stones with a diameter of10-20 mm, especially in cases where extracorporealshock wave lithotripsy (SWL) fails or SWL is notappropriate. In this study, we compared the results ofpatients who underwent RIRS and mini percutaneousnephrolithotomy (m-PCNL) for lower pole stones witha diameter of 10-20 mm.Material and MethodThe data of 187 patients (116 RIRS, 71 m-PCNL)who underwent endourological treatment (RIRS orm-PCNL) for 10-20 mm lower pole kidney stonesbetween 2020 and 2022 were retrospectivelyanalyzed. To avoid preoperative biases, propensityscore-matching was applied based on a 1:1 ratio.According to the results of the analysis, 65 patientswho underwent RIRS and 65 patients who underwentm-PCNL were included in the study. Intraoperative(operation time, fluoroscopy time) and postoperativefindings (hospitalization time, drop in hematocrit,stone-free rates, and complications) were comparedbetween the two groups. Postoperative stonedetection of 4 mm or larger was defined as clinicallysignificant residue. Complications were classifiedaccording to the Clavien scoring system and asintraoperative-postoperative.ResultsWhen the two groups were compared in terms ofdemographic characteristics (age, gender, bodymass index) and radiographic stone characteristics(stone size, stone laterality, stone opacity, and stonedensity), no statistically significant difference wasobserved. When the groups were compared in termsof operation time, fluoroscopy time and hospitalizationtime, these periods were statistically significantlyshorter in the RIRS group (p, AmaçÜroloji kılavuzlarında 10-20 mm arası alt pol taşlarındaözellikle ekstrakorporal şok dalga litotripsi(SWL)'nin başarısız olduğu veya SWL'nin uygun olmadığıdurumlarda endoürolojik tedaviler olan perkütannefrolitotomi (PCNL) ve retrograd intrarenal cerrahi(RİRC) önerilmektedir. Bu çalışmada 10-20 mmarası alt pol taşlarında RİRC ile mini perkütan nefrolitotomi(m-PCNL) uygulanan hastaların sonuçlarınıkarşılaştırdık.Gereç ve Yöntem2020 ile 2022 yılları arasında 10-20 mm arası alt polböbrek taşı nedeniyle endoürolojik tedavi (RİRC veyam-PCNL) uygulanan 116’sı RİRC, 71’i m-PCNL olantoplam 187 hastanın dosyaları retrospektif olarak incelendi.Preoperatif yanlılıkları önlemek için 1:1 oranıtemel alınarak eğilim skoru eşleştirmesi (propensityscore-match) uygulandı. Analiz sonucuna göre RİRCuygulanan 65 hasta ve m-PCNL uygulanan 65 hastaçalışmaya dahil edildi. İki grup arasında intraoperatif(operasyon süresi, floroskopi süresi) ve postoperatifbulgular (hastane yatış süresi, hematokrit düşüşü,taşsızlık oranları ve komplikasyonlar) karşılaştırıldı.Operasyon sonrası 4 mm veya daha büyük taşsaptanması klinik anlamlı rezidü olarak tanımlandı.Komplikasyonlar Clavien skorlama sistemine göre veintraoperatif-postoperatif olarak sınıflandırıldı.BulgularHer iki grup, demografik özellikler (yaş, cinsiyet, vücutkitle indeksi), radyografik taş karakteristikleri (taşboyutu, taş lateralitesi, taş opasitesi, ve taş dansitesi)açısından karşılaştırıldığında istatistiksel olarak anlamlıfark gözlenmedi. Operasyon süresi, floroskopisüresi, hastane yatış süresi açısından gruplar karşı-laştırıldığında, RİRC grubunda bu süreler istatistikselolarak anlamlı derecede daha kısaydı (p

Aim: To investigate the hormonal properties and results of 71 patients, who were diagnosed with nonobstructive azoospermia (NOA) and performed micro-TESE (microsurgical testicular sperm extraction) at our clinic, and the relationship of these results and Johnsen scores. Patients and Method: We retrospectively reviewed the data of 71 patients who came to our clinic and were diagnosed with NOA and got performed micro-TESE between the years of 2010 and 2014. Variables such as age, the duration of infertility, operations underwent, mean testis volumes, blood FSH (follicle stimulated hormone), LH (luteinizing hormone), total testosterone and prolactin levels, results and their relations with sperm retrieval rates were examined. Results: Sperm were found in 25 (35.21%) of 71 patients, who were performed micro-TESE, and 6 (8.45%) of them have developed pregnancy. Mean testis volumes were found 14.3 ± 3.80 (4-22) cc on the right and 13.7 ± 3,41 (4-20) cc on the left. As FSH and LH values increased, the probability of sperm retrieval rate was decreased (p 0,05). Conclusion: In micro-TESE, the success of sperm retrieval can be affected by patient age, having testis operation history, testis volume, patient's hormonal profile. Sperm retrieval success correlates with histology, blood FSH and LH values, if there is a relation sperm retrieval success and patient age, duration of infertility, blood total testosterone, prolactin levels and testis volume is unclear. Amaç: Kliniğimizde nonobstruktif azospermi (NOA) tanısıyla mikro-TESE (mikrocerrahi testiküler sperm ekstraksiyonu) uygulanan 71 hastanın sonuçlarını, hormonal özelliklerini ve bu sonuçların Johnsen skorlarıyla ilişkisini incelemek. Hastalar ve Yöntem: Kliniğimize 2010-2014 yılları arasında başvuran ve NOA tanısıyla mikro-TESE uygulanan 71 hastanın verilerini retrospektif olarak inceledik. Hastaların yaşı, infertilite süreleri, geçirdiği operasyonlar, ortalama testis volümleri, kan FSH (folikül stimülan hormon), LH (luteinizan hormon), total testosteron ve prolaktin düzeyleri, biyopsi alınan hastaların biyopsi sonuçları ve bunların mikro-TESE başarısı ile ilişkisi değerlendirildi. Bulgular: Mikro-TESE uygulanan 71 hastanın 25’inde (%35,21) sperm bulunmuş, bunların 6 (%8,45) tanesinde gebelik gelişmiştir. Ortalama testis hacimleri sağ 14,3±3,80 (4-22) cc, sol 13,7±3,41 (4-20) cc olarak bulunmuştur. FSH ve LH değeri arttıkça sperm bulma olasılığı azalmıştır (p0,05). Sonuç: Mikro-TESE’de sperm elde etme başarısı hasta yaşı, geçirilmiş testis operasyonu, testis volümü, hastanın hormonal profili ile değişebilmektedir. Sperm elde etme başarısı histoloji, kan FSH ve LH değerleri ile korele olup, hasta yaşı, infertilite süresi, kan total testosteron, prolaktin değerleri ve testis volümü ile ilişkisi net değildir

Aim: To present our clinical experience about infective complications due to ultrasound guided transrectal prostate biopsy under ciprofloxacin plus third-generation cephalosporin (Ceftriaxone) combination prophylaxis. Material and Method: The 1193 patients that used combination of ceftriaxone 1 g intramuscular 1 hour before biopsy and ciprofloxacin 500 mg twice a day for 5 days after biopsy were included to study. Before biopsy, urine analysis and urinary cultures were not performed routinely. Serious infective complications such as acute prostatitis and urosepsis, causing microorganisms were evaluated. Results: Serious infective complications occurred in (1.3%) 16 patients. Fifteen of them had acute prostatitis and urine culture results were positive in 10/15 patients for Escherichia coli. The strains were uniformly resistant to ciprofloxacin. Only 1 patient had urosepsis and his blood and urine cultures demonstrated extended- spectrum %u03B2-lactamase-producing (ESBL) Escherichia coli also resistant to ciprofloxacin. Antibiotic treatment-related side effects were not observed in any patient. Discussion: Although there is not a certain procedure, ciprofloxacin is the most common used antibiotic for transrectal prostate biopsy prophylaxis. On the other hand, the incidence of ciprofloxacin resistant Escherichia coli strain is increasing. Thus, new prophylaxis strategies have to be discussed. Ceftriaxone plus ciprofloxacin prophylaxis is safe and can be useable option for prophylaxis of prostate biopsy.

Introduction and Aim: Treatment of high-flow priapism varies from watchful waiting to mechanical compression with ice packs, aspiration, intracavernous admission of alpha- adrenergic agonists or even open surgery with ligation of the artery concerned. Embolisation is also a choise for treatment for high-flow priapism. Autologous clot, gelfoam, N-butyl-cyanoacrylate, and metallic micro-coils have been used as embolic agents. Case: In our case, we first used thrombin for autologous cloth formation but recanalisation occured. After two weeks we had to make superselective coil embolisation to bubocavernosal segment of pudental artery.Conclusion:Micro-coil embolisation was the permanent choise of treatment for post traumatic priapism., Yüksek akımlı priapizm tedavisi buz uygulaması, aspirasyon, intrakavernöz alfa adrenerjik agonist ilaç enjeksiyonu ve kavernozal arterin açık cerrahi ile bağlanması ile de yapılabilmektedir. Embolizasyon da yüksek akımlı priapizm tedavisi için bir seçenek olabilir. Otolog pıhtı, gelfoam, N-bütil-siyanoakrilat ve metal mikro koiller embolizan materyal olarak kullanılmaktadır.Bizim vakamızda, ilk seçenek olarak otolog pıhtı oluşumu için trombin kullanılmıştı. Ancak rekanalizasyon oluşumu nedeniyle iki hafta sonra pudental arterin dalı olan bubocavernosal artere süperselektif coil embolizasyonu yapmak zorunda kaldık.Travmatik priapizm tedavisinde, mikro-coil embolizasyonu kalıcı tedavi seçeneği olmuştur

Introduction and Aim: Treatment of high-flow priapism varies from watchful waiting to mechanical compression with ice packs, aspiration, intracavernous admission of alpha- adrenergic agonists or even open surgery with ligation of the artery concerned. Embolisation is also a choise for treatment for high-flow priapism. Autologous clot, gelfoam, N-butyl-cyanoacrylate, and metallic micro-coils have been used as embolic agents. Case: In our case, we first used thrombin for autologous cloth formation but recanalisation occured. After two weeks we had to make superselective coil embolisation to bubocavernosal segment of pudental artery.Conclusion:Micro-coil embolisation was the permanent choise of treatment for post traumatic priapism., Yüksek akımlı priapizm tedavisi buz uygulaması, aspirasyon, intrakavernöz alfa adrenerjik agonist ilaç enjeksiyonu ve kavernozal arterin açık cerrahi ile bağlanması ile de yapılabilmektedir. Embolizasyon da yüksek akımlı priapizm tedavisi için bir seçenek olabilir. Otolog pıhtı, gelfoam, N-bütil-siyanoakrilat ve metal mikro koiller embolizan materyal olarak kullanılmaktadır.Bizim vakamızda, ilk seçenek olarak otolog pıhtı oluşumu için trombin kullanılmıştı. Ancak rekanalizasyon oluşumu nedeniyle iki hafta sonra pudental arterin dalı olan bubocavernosal artere süperselektif coil embolizasyonu yapmak zorunda kaldık.Travmatik priapizm tedavisinde, mikro-coil embolizasyonu kalıcı tedavi seçeneği olmuştur

Aim: Displaced and intraarticular humerus distal fractures require surgical treatment. In this study we evaluated to functional results of the surgical treatment of distal humerus intraarticular fractures in adults. Additionally, we evaluated the factors affecting surgical outcomes. Material and Method: Between 2005 to 2010, 22 elbows of 21 patients who were operated for distal humerus intraarticular fractures were evaluated retrospectively. 11(52.4%) patient were male and 10(47.6%) were female, mean age 46.2 (range 17 to 71). Fractures were classified as type B3 for 10, type Cl for 6 and type C2 for 6 subjects according to AO classifications. We performed paralel double locking plate for 9(41%), perpendicular double plate for 2(9%), K wires and screw combination for 7(32%), and single plate for 4(18%) patients. Functional assesment were performed with the MEPS and q-DASH scoring systems. Results: Mean follow-up was 30.4(5-68) months. Fracture healing was observed in all of the patients. Mean elbow flexion of 117 (90145) degrees and extension loss of 24.3 (0-60) were noted. 10 (47.6%) patients were excellent, 6 (28.6%) were goad, 3 (14.3%) were fair and 2(9.5%) were poor according to MEPS. Mean q-DASH scores were 15 (0-69.8) in 21 patients. Good results were obtained in fractures treated with stable fixation, in early performed surgeries, and in early started rehabilitation. Discussion: Treatment of distal humerus intraarticular fractures with anatomical reduction, stable osteosynthesis, and early rehabilitation are very important in obtaining successful outcomes. Additionally, age and fracture type are important factors to conclude good results..

Objective: To evaluate the spectrum of urinary tract stone compositions in patients managed at one center.Methods: A total of 710 urinary calculi, passed spontaneously or after extracorporeal shock-wave lithotripsy as well as collected by endoscopic or open surgical procedures were analyzed by applying chemical and physicochemical methods primarily used for detecting minerals in our laboratory. Results: The distribution of stone compositions were noted as 454 (64.9%) calcium oxalate; 104 (14.6%) calcium phosphate; 99 (13.9%) struvite; 24 (3.3%) uric acid; 21 (2.9%) mixed; 5 (0.7%) cystine; and 3 (0.4%) xantine stones. Conclusion: Calcium stones, calcium oxalate in particular predominate among other types of urinary calculi in our center. Infection stones still have a considerable incidence that stays near to calcium phosphate calculi. This data can be helpful for dietary recommendations and treatment plans in cases without stone type assessment., Amaç: Bölgemizde tedavi edilen üriner sistem taþ hastalarýnýn taþ kompozisyonunun spektrumunu deðerlendirmek. Metod: Ekstrakorporeal þok dalga litotripsi, endoskopik veya çeþitli açýk cerrahi yöntemleriyle elde edilenler ile hastalarýn kendi düþürdükleri toplam 710 üriner taþ, laboratuarda esas olarak mineralleri saptamak için kullanýlan kimyasal ve fizikokimyasal yöntemler kullanýlarak incelendi.Bulgular: Taþlarýn 454ü (%64.9) kalsiyum okzalat, 104ü kalsiyum fosfat (%14.6), 99u struvite (%13.9), 24ü ürik asit (%3.3), 21i karýþýk (%2.9), 5i (%0.7) sistin, 3ü ksantin (%0.4) idi. Sonuç: Bizim bölgemizde kalsiyum taþlarý, özellikle kalsiyum okzalat diðer taþ tipleri arasýnda daha fazla görülmektedir. Enfeksiyon taþlarý da kalsiyum fosfat taþlarýna yakýn seviyede belirgin bir insidansa sahiptir. Bu veriler taþ analizi deðerlendirmesi yapýlmamýþ hastalarda beslenme önerileri ve tedavi planlarý için yararlý olabilir.