Search

Objective: The aim of this study is to report our experience on the management of seminal vesicle cyst which is an exceedingly rare acquired or congenital pathology. Materials and Methods: A retrospective chart review was conducted on seven patients diagnosed with seminal vesicle cyst between March 2011 to March 2020. Patients’ complaints, fertility, physical signs, diagnostic tests or intervention and the obtained findings, surgical intervention, duration of follow-up period, complications, recurrence and histologic examination of the cysts wall were evaluated in patients included. Results: Seven male patients, mean aged 36.29±13.45, IPSS 13.57±4.89, Qmax:21.77±3.42ml/s with seminal vesicle cysts were identified. The patients’ complaints included lower abdominal pain in one patient with giant seminal vesicle cyst and perineal pain, storage lower urinary tract symptoms in six patient. Five patients were fertile and spermiogram was within normal ranges, two patients were infertile. Six patients have ipsilateral renal agenesia. One asymptomatic patient and three patients with storage lower urinary tract sympmtoms followed without intervention. Two infertile patients were operated with transurethral resection. Seminal vesicle cyst >12 cm are evaluated as giant cysts and operated with open excision. Neither complications nor recurrences were observed. Histopathologic examination of the samples were reported to be compatible with seminal vesicle cyst. The median follow–up period was 96 months. Conclusion: The open surgical approach might be considered the definitive form of treatment for giant cysts. Although small asymptomatic seminal vesical cyst can be followed without intervention, the symptomatic cyst protruding to bladder can be managed by transurethral route.

Objective: This study aims to point out reliable diagnosis and correct treatment for rare benign perivaginal masses. Material and Methods: The diagnosis, treatment, histology, and postoperative management were summarized and analyzed by an operation due to benign AVM from the medical records of Sakarya University Training and Research Hospital Urology and Urogynecology clinics between the years 2020-2021. Results: The mean age of the patients was 46.2 years. Among the patients included in the study, 80% had dyspareunia, 50% had dysuria and urgency, and 40% had sensation of mass symptoms. When the cases were examined according to their histopathological diagnoses, 3 cases were leiomyoma, 5 cases were cysts, 2 cases were transitional epithelial-lined cysts, and 1 case was a fibroepithelial polyp. Conclusion: Although benign perivaginal masses are rare, symptoms improve when the correct diagnosis is made, and appropriate surgery is performed. Differential diagnosis is necessary for an appropriate treatment approach.

Background: How COVID-19 affects lower urinary tract symptoms (LUTS) in men has not been demonstrated by published research. This study examined the de novo development of LUTS and the change in the severity of pre-existing LUTS in men hospitalized with COVID-19. A follow-up period of 12 months after COVID-19 infection provided data on the long-term effect of COVID-19 vs. LUTS. Methods: Data were collected from 70 male patients diagnosed with COVID-19 via nasopharyngeal swab RT-PCR technology between June 2020 and April 2021. The patient’s age, comorbidities, date of COVID-19 diagnosis, date of LUTS, International Prostate Symptom Score (IPSS), prostate-specific antigen (PSA), creatinine, and D-dimer levels, urinalysis, urine culture and duration of hospital stay were recorded. Statistical analyses were conducted to compare between pre-COVID and post-COVID IPSS and other data. Results: 42 patients were included in this study with a, mean age of patients were 54.76 ± 11.95 years. In 8 patients there was no change in IPSS pre- vs. post-COVID. In the remaining 34 patients (80.9%), the median IPSS increased from a pre-COVID value of 2 to 10 during COVID (p < 0.001). In the subgroup analysis based on age

Amaç: Laparoskopik ürolojik cerrahideki başlangıç deneyimlerimizi değerlendirmek. Gereç ve Yöntemler: Ocak 2015 ile Ocak 2018 tarihleri arasında laparoskopik ürolojik cerrahi uygulanan hastaların sonuçları retrospektif olarak değerlendirilmiştir. Bulgular: Kliniğimizde laparoskopik cerrahi yapılan 88 hastanın 50’ si (%56.8) erkek, 38’ i (%43.2) kadındı. Hastaların ortalama yaşı 56 ± 14 (17-86) yıl idi. Otuz altı hastaya radikal nefrektomi, 26 hastaya basit nefrektomi, 3 hastaya parsiyel nefrektomi, 9 hastaya nefroüreterektomi, 2 hastaya dismembered pyeloplasti, 4 hastaya adrenalektomi, 7 hastaya üreterolitotomi, 1 hastaya ise orşiektomi uygulandı. Ortalama operasyon süresi sırasıyla 130±20, 119±21, 140±5, 150±21, 117±3, 71±8, 80±11 ve 45 dk, ortalama hastanede kalış süreleri sırasıyla 4.2±1.3, 3.1±1.4, 4.3±1.5, 4.7±1.3, 4±1.4, 3±0.8, 2.8±1 ve 1 gündü. Radikal nefrektomi yapılan hastaların 4’ ünde, basit nefrektomi yapılan hastaların 6’ sında ve nefroüreterektomi yapılan hastaların 3’ ünde olmak üzere toplam 13 (%14,7) hastada açık cerrahiye geçildi. Postoperatif komplikasyon 11 (%12,5) hastada görüldü. Sonuç: Laparoskopik cerrahi; öğrenme eğrisi uzun olan, cerrahın yeteneğine ve tecrübesine bağlı olarak çok iyi fonksiyonel sonuçlar veren minimal invaziv cerrahi yöntemlerden birisi olarak başlangıç döneminde uygun hasta seçimi ve doğru planlama ile başarılı bir şekilde uygulanabilmektedir.

Amaç: Multipl Sklerozda (MS), alt üriner sistem fonksiyon bozuklukları oldukça sık görülmektedir. Çalışmamızda, MS hastalarında alt üriner sistem disfonksiyon semptomları ile hastalığın şiddeti, süresi, alt tipi ve lezyon lokalizasyonu arasındaki ilişkiyi göstermeyi amaçladık. Materyal ve Metod: Son 3 ay içinde nöroloji polikliniğimize başvuran, MS tanılı 42 hastanın demografik özellikleri, MS alt tipi, hastalık süresi, hastalık şiddeti, nörolojik muayeneleri, genişletilmiş özürlülük durum ölçeği (EDSS) puanları, üriner sisteme ait yakınmaları, semptomların süreleri, üriner sistem muayeneleri, fonksiyon testleri (aşırı aktif mesane semptom skoru (OABSS), uluslararası prostat semptom skoru (IPSS)), ürodinamik değerlendirme sonuçları prospektif olarak kaydedildi. İstatistiksel analiz ANOVA, Mann-Whitney U ve non-parametrik Pearson testleri kullanılarak yapıldı. P lt;0.05 anlamlı olarak kabul edildi. Bulgular: Çalışmaya 2010 revize Mc Donald kriterlerine göre MS tanısı almış 42 hasta (13 erkek, 29 kadın) dahil edildi. Diyabet, üriner sistem enfeksiyonu ve ürolojik girişim öyküsü olan hastalar çalışmadan dışlandı. Alt üriner sistem semptomlarının varlığı ile yaş, cins, EDSS, MS alt tipi, hastalık süresi arasında anlamlı bir ilişki bulunmadı (p gt;0,05). İrritatif semptomlar ile cins ve EDSS arasında istatistiksel olarak anlamlı bir farklılık bulunurken (p lt;0,05), obstrüktif semptomlar konusunda benzer ilişki saptanmadı (p gt;0,05). İrritatif ve obstrüktif semptomların varlığı ile lezyon lokalizasyonu arasında da istatistiksel olarak anlamlı bir farklılık saptanmadı (p gt;0,05). Sonuç: Çalışmamız MS’ te hastalık şiddetinin irritatif üriner semptomlar üzerinde önemli bir belirleyici faktör olduğunu göstermektedir.

Abstract This study aimed to evaluate the effect of robotic surgery experience on open radical prostatectomy (ORP) outcomes. We retrospectively reviewed 100 patients who underwent an ORP for clinically localised prostate cancer (PCa) performed by the same experienced surgeon. The groups included the last 50 patients before (Group 1) and the first 50 patients after (Group 2) robotic surgery experience. A detailed history, peroperative, and oncological data were recorded. Continence status and erectile functions were evaluated before surgery and at 1, 3, 6, and 12 months postoperatively by daily pad count and an International Index of Erectile Function (IIEF) short form and were compared between groups. The demographics and preoperative data were similar. The preoperative and postoperative Gleason score was higher in Group 2 (p = 0.001, 0.033; respectively). The operation time (200 vs. 115 min), estimated blood loss (400 vs. 200 ml), peroperative transfusion rate (46% vs. 8%), drain removal time (4 vs. 3 days), hospital stay (5 vs. 4 days), and urethral catheter removal time (21 vs. 14 days) were significantly lower in Group 2 (p

Abstract Background To predict testicular involvement in patients diagnosed with Fournier’s gangrene (FG) using the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score and the site other than lower limb (SIARI) score. Methods The medical records of 51 patients operated for FG in our clinic between December 2012 and April 2022 were evaluated retrospectively in this study. Patients’ demographics, and laboratory test results were compared with the testisticular involvement status. Patients with testisticular involvement (n = 10) were compared with patients without testicular involvement (n = 41). The SIARI score at initial admission was analysed using logistic regression analyses for its performance in predicting testicular involvement with FG. Receiver operating characteristics (ROC) curves and the area under the receiver operating characteristic curve (AUROC) were used to evaluate its discriminating ability. Results The SIARI score had modest performance for diagnosing testicular involvement in FG patients, with ROC analysis showing an AUROC value of 0.83 (p

Abstract Background Many risk factors for pelvic organ prolapse (POP) have been proposed, and the cause is most likely multifactorial. This study aimed to investigate the effect of toileting behaviors on the natural course of anterior vaginal wall prolapse (AVWP). Methods Data on 75 women who underwent surgery for symptomatic AVWP were collected. Patients with grade ≥ II AVWP were included in this study and were divided into two groups according to their voiding and defecation position. The volunteers who voided and defecated in a sitting position comprised Group 1, and those who voided and defecated in a squatting position comprised Group 2. The Colorectal-Anal Impact Questionnaire (CRAIQ), Pelvic Floor Impact Questionnaire (PFIQ), Pelvic Organ Prolapse Impact Questionnaire (POPIQ), Urinary Impact Questionnaire (UIQ) and visual analog scale (VAS) pain scores were used to evaluate the patients’ symptoms. Results Forty-four patients were included in Group 1 (sitting position), and 31 patients were included in Group 2 (squatting position). The groups were similar in terms of BMI, parity, menopause duration, topical estrogen use, comorbidities, the presence of constipation and urinary incontinence, and the pad count for incontinence. The time from initial symptoms to surgery was shorter in Group 2 than in Group 1 12 (3–73) and 24 (2–182) months (p = 0.001), respectively. The PFIQ, POPIQ and POP-related VAS scores were significantly higher in patients who voided and defecated in a squatting position. Conclusion In patients with symptomatic POP, increased IAP while performing the squat position during defecation and voiding may increase the severity of patients' symptoms related to prolapse more than that of sitting position. Therefore, questioning the toileting position of patients with AVWP may help inform management decisions, with changing to a sitting position encouraged.

ABSTRACT Introduction: To evaluate the influence of previous experience as bedside assistants on patient selection, perioperative and pathological results in robot assisted laparoscopic radical prostatectomy. Materials and Methods: The first 50 cases of two robotic surgeons were reviewed retrospectively. Group 1 consisted of the first 50 cases of the surgeon with previous experience as a robotic bedside assistant between September 2016-July 2018, while Group 2 included the first 50 cases of the surgeon with no bedside assistant experience between February 2009-December 2009. Groups were examined in terms of demographics, prostate volume, presence of median lobe, prostate specific antigen (PSA), preoperative Gleason score, positive core number, clinical stage, console surgery time, estimated blood loss, postoperative Gleason score, pathological stage, positive surgical margin rate, postoperative complications, length of hospital stay and biochemical recurrence rate. Results: Previous abdominal surgery and the presence of median lobe hypertrophy rates were higher in Group 1 than in Group 2 (20% vs. 4%, p=0.014; 24% vs. 6%, p=0.012; respectively). In addition, patients in Group 1 were in a higher clinical stage than those in Group 2 (cT2: 70% vs. 28%, p=0.001). Median console surgery time and median length of hospital stay was significantly shorter in Group 1 than in Group 2 (170 min vs. 240 min, p=0.001; 3 vs. 4, p=0.022; respectively). Clavien grade 3 complication rate was higher in Group 2 but was statistically insignificant. Conclusion: Our findings might reflect that previous bedside assistant experience led to an increase in self-confidence and the ability to manage troubleshooting and made it more likely for surgeons to start with more difficult cases with more challenging patients. It is recommended that novice surgeons serve as bedside assistants before moving on to consoles.

With the advancement of technology, flexible ureterorenoscopy (fURS) has gained popularity among urologists, and fURS is widely accepted as an alternative to extracorporeal shockwave lithotripsy and percutaneous nephrolithotomy. Recent technological and surgical innovations have promoted less invasive treatment options, such as fURS. The use of fibre optics in imaging, an increased deflection capability, and more appropriate dimensions of the device have increased the efficiency of fURS in stone disease treatment. However, there are limited data evaluating the efficacy of fURS in kidney stones >2 cm. Thus, in this review article, the authors assess the efficacy and complications of fURS for the treatment of kidney stones >2 cm

ABSTRACT Introduction: The success of the robot assisted radical prostatectomy (RARP) procedures depend on a successful team, however the literature focuses on the performance of a console surgeon. The aim of this study was to evaluate surgical outcomes of the surgeons during the learning curve in relation to the bedside assistant's experience level during RARP. Materials and Methods: We retrospectively reviewed two non - laparoscopic, beginner robotic surgeon's cases, and we divided the patients into two groups. The first surgeon completed the operations on 20 patients with a beginner bedside assistant in February - May 2009 (Group-1). The second surgeon completed operations on 16 patients with an experienced (at least 150 cases) bedside assistant in February 2015 - December 2015 (Group-2). The collected data included age, prostate volume, prostate specific antigen (PSA), estimated blood loss, complications and percent of positive surgical margins. In addition, the elapsed time for trocar insertion, robot docking, console surgery, specimen extraction and total anesthesia time were measured separately. Results: There were no significant differences between the groups in terms of age, comorbidity, prostate volume, PSA value, preoperative Gleason score, number of positive cores, postoperative Gleason score, pathological grade, protection rate of neurovascular bundles, surgical margin positivity, postoperative complications, length of hospital stay, or estimated blood loss. The robot docking, trocar placement, console surgery, anesthesia and specimen extraction times were significantly shorter in group 2 than they were in group 1 (17.75 ± 3.53 min vs. 30.20 ± 7.54 min, p ≤ 0.001; 9.63 ± 2.71 min vs. 14.40 ± 4.52 min, p = 0.001; 189.06 ± 27.70 min vs. 244.95 ± 80.58 min, p = 0.01; 230.94 ± 30.83 min vs. 306.75 ± 87.96 min, p = 0.002; 10.19 ± 2.54 min vs. 17.55 ± 8.79 min, p = 0.002; respectively). Conclusion: Although the bedside assistant's experience in RARP does not appear to influence the robotic surgeon's oncological outcomes during the learning curve, it may reduce the potential complications by shortening the total operation time.