Gender-related Differences in Surgically Treated Patients with Renal Cell Carcinoma

Objective:The aim of the study was to investigate gender-specific differences in the Turkish patients with renal cell carcinoma (RCC) undergoing radical or nephron-sparing nephrectomy and compare the results with those in other regions.Materials and Methods:Data of 76 patients, who were clinically diagnosed with RCC and underwent radical or nephron-sparing nephrectomy from January 2011 to August 2017, were retrospectively evaluated. Age and gender of the patients and the size, histological type, grade and pathological stage of the tumors were recorded. A chi-square test was used for comparing categorical variables, whereas the Student’s t-test was used for the same purpose in the continuous variables.Results:Of the 67 patients, 39 (58.2%) were male and 28 (41.8%) were female; male-to-female ratio was 3:2. The mean age of the male and female patients was 63.4±11.7 years and 59.3±14.3 years, respectively and the mean tumor size was 5.7 and 5.3 cm, respectively. There were differences in mean age, tumor size and Fuhrman grade, however, none of them reached the level of statistical significance. Twenty four of the male and 25 of the female patients had low-stage, 15 of the male and 3 of the female patients had high-stage disease. Thus, the male patients had higher stage disease than the female patients and the difference was statistically significant (p=0.011).Conclusion:Turkish women with RCC had significantly lower stage disease than Turkish men, although grade and size of the tumor did not present a statistically significant difference. The results were similar with other European studies

A Stranger in the Epididymis: Ectopic Spleen

Splenogonadal fusion, which can be clinically confused with testicular neoplasms as they present with testicular swelling, is a rare abnormality in young adults. Intraoperative frozen section analysis can be helpful in diagnosing such cases and preventing unnecessary orchiectomies. We report a case in which frozen section analysis was done and testis-sparing surgery could be performed

Bladder Carcinoma in a 24-Year-Old Patient: A Case Report and Review of the Literature

Urothelial bladder carcinoma is a rare condition in young patients. Clinicians have less inclination to perform cystoscopy in this age group because benign causes of hematuria are more common. Thus, diagnostic delays of up to one year may occur. We report a 24-year-old male patient with urothelial bladder cancer. Clinical behavior and prognosis in young individuals are controversial. The definitions of “young patient” are highly variable and different World Health Organization pathological classification systems are used for reporting. Generally, it presents as a low-stage and low-grade disease, nevertheless, it may present with high-grade tumors, even with muscle-invasive cancer

Mikroskobik idrar analizini öngörmede idrar strip testinin performansı

Amaç: Çalışmanın amacı, manuel mikroskopik idrar analizi öngörmek için idrar strip analizinin performansını değerlendirmektir. Yöntem: İdrar yolu enfeksiyonu (İYE) şüphesi olan hastalardan alınan ve hem mikroskopik hem de strip analizi yapılan idrar örnekleri çalışmaya dahil edildi. Eritrosit strip (Erit-S) ve lökosit strip (Lök-S) testlerinin “eser”, “1+”, “2+”, “3+” kestirim değerleri için duyarlılık, özgüllük, pozitif ve negatif olabilirlik oranları (LR+, LR-), test öncesi ve sonrası şans, test sonrası olasılık değerleri hesaplandı. Koşullu olasılığı belirlemek için Bayes teoremi kullanıldı. ROC eğrisinin altındaki alan (AUC) hesaplandı. Bulgular: Lök-S ve Erit-S için AUC sırası ile 0,923 ve 0,975 olarak bulundu. Lök-S testi “1+”, Erit-S testi “eser” kestirim değerinde yeterli duyarlılık ve özgüllükteydi (>%80). LR+ değerine göre Lök-S “3+” kestirim değerinde, Erit-S tüm kestirim değerlerinde; LR- değerine göre Lök-S eser, Erit-S eser ve “1+” kestirim değerlerinde post-test olasılıkta anlamlı farklılık sağladı (0,1). İYE dönemsel prevalans hızı test öncesi olasılığı %5,95 olarak bulundu. İYE tanısı içinidrar örneği alınan hastalarda mikroskobik incelemeye göre İYE post test olasılığı Lök-S “3+” kestirim değerinde %39, Erit-S “3+” kestirim değerinde %74 idi. Sonuç: İdrar strip analizinin manuel mikroskobik analizdeki lökosit ve eritrosit pozitifliğini öngörmede yeterli olduğu bulundu. İdrar strip analizinde tanısal güç öngörme performansı kestirim değerlerine göre farklılık gösterdi. Çalışmamızın bu konuda farkındalık sağlayacağı ve klinisyenlerin İYE ön tanılı hastalarda test istem tercihlerinin belirlemesinde ve gereksiz test istemlerinin önlenmesinde yararlı olacağı görüşündeyi

To evaluate the etiology of erectile dysfunction: What should we know currently?

Erectile dysfunction (ED) is the inability to develop normal erection or an hardening problem at various extent that causes inability to maintain the erection for the sufficient time required for a complete sexual activity. It can be the result of neurologic, psychogenic, vascular, urogenital and hormonal abnormalities. It is reported that it affects 52-67% of men between 40 and 70 years old. Numerous theories and opinions are issued in the literature in order to explain the hemodynamic changea that occur during erection and detumescence. Especially the effects of chronic diseases and psychogenic factors on the pathophysiology of erectile dysfunction are common matters of discussion in recent years. In this review, we will evaluate the current developments in the literature about the etiology of erectile dysfunction

A case with primary signet ring cell adenocarcinoma of the prostate and review of the literature

Primary signet cell carcinoma of the prostate is a rare histological variant of prostate malignancies. It is commonly originated from the stomach, colon, pancreas, and less commonly in the bladder. Prognosis of the classical type is worse than the adenocarcinoma of the prostate. Primary signet cell adenocarcinoma is diagnosed by eliminating the adenocarcinomas of other organs such as gastrointestinal tract organs. In this case report, we present a case with primary signet cell adenocarcinoma of the prostate who received docetaxel chemotherapy because of short prostate specific antigen doubling time

Is endothelial glycocalyx damage a cause of renal scarring in vesicoureteral reflux with febrile urinary tract infection?

Introduction. - Endothelial glycocalyx is a luminal layer which can be damaged by inflammatory agents or pathogens. The endothelial glycocalyx damage is thought to have a role in the formation of renal scars in children who have febrile urinary tract infection and vesicoureteral reflux. This study aimed to compare the blood levels of endothelial glycocalyx components heparan sulfate and Syndecan-1 in children with and without renal scarring due to vesicoureteral reflux-associated febrile urinary tract infection. Materials and methods. - Data of the patients diagnosed with vesicoureteral reflux without renal scarring (Group 1), patients with vesicoureteral reflux and renal scarring (Group 2), and completely healthy children (Group 3) were retrospectively reviewed. Blood levels of heparan sulfate and Syndecan-1 were measured and the results were compared. Results. - The entire cohort consisted of 90 patients; there were 30 patients in each group. Mean patient age was 49.7 +/- 18.0 months. Mean serum heparan sulfate (42.90 +/- 18.90 ng/mL) and Syndecan-1 (37.59 +/- 13.77 ng/mL) levels of Group 2 were significantly higher than those of other groups. The cut-off value for heparan sulfate was 35.17 ng/mL, with a 63% sensitivity and 86% specificity. The cut-off value for Syndecan-1 was 29.99 ng/mL with a 70% sensitivity and 80% specificity. Conclusion. - Our findings indicate that blood levels of heparan sulfate and Syndecan-1 could be related with renal scarring in patients with vesicoureteral reflux, especially in the setting of febrile urinary tract infection. However, due to their low sensitivity, these biomarkers should be used along with clinical data