Intravenous paracetamol for relief of pain during transrectal-ultrasound-guided biopsy of the prostate: a prospective, randomized, double-blind, placebo-controlled study

Transrectal-ultrasound-guided prostate biopsy (TRUS-PBx) is the standard procedure for diagnosing prostate cancer. The procedure does cause some pain and discomfort; therefore, an adequate analgesia is necessary to ensure patient comfort, which can also facilitate good-quality results. This prospective, randomized, double-blinded, placebo-controlled study aimed to determine if intravenous (IV) paracetamol can reduce the severity of pain associated with TRUS-PBx. The study included 104 patients, scheduled to undergo TRUS-PBx with a suspicion of prostate cancer, that were prospectively randomized to receive either IV paracetamol (paracetamol group) or placebo (placebo group) 30 minutes prior to TRUS-PBx. All patients had 12 standardized biopsy samples taken. Pain was measured using a 10-point visual analog pain scale during probe insertion, during the biopsy procedure, and 1 hour postbiopsy. All biopsies were performed by the same urologist, whereas a different urologist administered the visual analog pain scale. There were not any significant differences in age, prostatespecific antigen level, or prostate volume between the two groups. The pain scores were significantly lower during probe insertion, biopsy procedure, and 1 hour postbiopsy in the paracetamol group than in the placebo group. In conclusion, the IV administration of paracetamol significantly reduced the severity of pain associated with TRUS- PBx. Copyright (C) 2015, Kaohsiung Medical University. Published by Elsevier Taiwan LLC. All rights reserved

Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging of a Patient with Squamous Cell Carcinoma of Prostate

Primary squamous cell carcinoma is an uncommon tumor of the prostate gland. We report a 77-year-old male patient with urinary frequency and constipation. Fine needle biopsy from prostate was suspicious of squamous cell carcinoma of the prostate. Whole body positron emission tomography/computed tomography scan revealed high fluorodeoxyglucose uptake in prostate gland. Transurethral resection confirmed the diagnosis. In contrast to prostatic adenocarcinoma, high fluorodeoxyglucose accumulation was observed in the primary tumor of the prostate gland

Characteristics of sildenafil erections in healthy young men

Abstract Aim: To determine the effect of sildenafil citrate on the nocturnal penile erections (i.e. time to onset, the duration of erection, and the interval between first and second erections) of healthy young men. Methods: Twenty-two potent men, 23-29 years old, were recruited for the study. All subjects completed three sessions over consecutive nights using the RigiScan monitoring device (Dacomed, Minneapolis, USA). After a first night of adaptation, night 2 records were their baseline values, and on night 3 they received 100 mg of sildenafil citrate. Statistical comparisons were done between the second and third night data. Results: The mean time to onset of the first erection with sildenafil citrate was (34 ± 18) min, whereas it was (74 ± 24) min (P < 0.001) without sildenafil citrate. The number of erections observed during the first 5 h after sildenafil citrate medication was 3.6 ± 0.5 in contrast to 2.4 ± 0.5 with no medication (P = 0.001). The interval between first and second erections was shorter with sildenafil citrate: (52 ± 26) min vs. (85 ± 34) min (P = 0.01). The duration of the last erection was statistically significantly longer with the sildenafil citrate: (64 ± 33) min vs. (42 ± 28) min (P < 0.01). Conclusion: Healthy young men achieved erection within 34 min after sildenafil citrate administration, which is shorter than the 1 h interval proposed by the manufacturer. The interval between the first and second erections was shorter and the duration of the last nocturnal erection was longer. (Asian J Androl 2005 Dec; 7: 395-398

Adrenal Lymphangioma Mimicking Renal Cyst: A Case Report and Review of the Literature

We present a case of a 44-year-old female who was evaluated for left recurrent flank and abdominal pain. Abdominal ultrasonography demonstrated a large cystic mass on the upper pole of the left kidney. Magnetic resonance imaging showed a large, homogenous cystic mass measuring 8.5 × 9.5 cm with well-defined contours, being hypointense on T1-weighted images and hyperintense on T2-weighted images on the upper pole of the left kidney without a distinct plan between adrenal gland. According to clinical and radiological findings, surgical excision was carried out with a subcostal flank incision. Histologic and immunohistochemical examination demonstrates that the definite diagnosis is cystic lymphangioma of the left adrenal gland. Adrenal lymphangioma is a very rare lesion. This is the unique case of an adrenal lymphangioma considered as a renal cyst because of its radiological appearance

Development of a prospective data registry system for retrograde intrarenal surgery in renal stones: Turkish academy of urology prospective study group (ACUP study)

OBJECTIVE:We aimed to report the development of a prospective data registry by generating a retrograde intrarenal surgery (RIRS)-specific electronic case report form (eCRF), which can be used by multiple centers in Turkey.MATERIAL AND METHODS:The Stone Disease Study Group of Turkish Urology Academy developed a template for the necessary data to be collected, which was then implemented within a dedicated server. Urologists from different universities, research and training centers, and private hospitals were invited to participate in this data registry. Each urologist was provided with a unique username and password after they agreed to participate in the study.RESULTS:In March 2015, the development of the eCRF was completed, and the server was opened for data input in April 2015. We started a prospective clinical data registry for all patients undergoing RIRS for renal stone(s) in 15 participating hospitals. Until the end of June 2016, 1112 RIRSs on 1264 patients have been included in the dataset.CONCLUSION:The easy-to-use eCRF specifically developed for RIRS was first of its kind in Turkey. This prospective data registry harvests important data that will be used to identify real-world demographic, clinical and operative data of patients with renal stone who undergo RIRS in various urology departments throughout Turkey. The results of this dataset will be presented in various papers.Turkish Association of Urolog

Testiküler kitlenin nadir sebebi: Fıtık eşliğinde paratestiküler liposarkom

Yumuşak dokunun sık gözlenen tümörü olan liposarkomun paratestiküler yerleşimi oldukça nadir görülmektedir. Sıklıkla ekstrape- ritoneal yağ dokusundan köken alan bu tümörler distale doğru korda ait yağ dokusuyla devam etmektedir. Tanı; genellikle operasyon sırasında şüphe üzerine histopatolojik değerlendirme ile konur. Bu yazıda testiküler kitle nedeni ile opere edilen paratestiküler lipo- sarkom ve beraberinde inguinal hernisi olan olgu sunulmuştu

A novel cannulation technique for difficult urethral catheterization

Introduction: To propose a novel cannulation technique for difficult urethral catheterization procedures. Technique: The sheath tip of an intravenous catheter is cut off, replaced to the needle tip and pushed through the distal drainage side hole to Foley catheter tip, and finally withdrawn for cannulation. In situations making urethral catheterization difficult, a guide wire is placed under direct vision. The modified Foley catheter is slid successfully over the guide wire from its distal end throughout the urethral passage into the bladder. Results: The modified Foley catheter was used successfully in our clinic in cases requiring difficult urethral catheterization. Conclusions: This easy and rapid modification of a Foley catheter may minimize the potential complications of blind catheter placement in standard catheterization

Effectiveness of pelvic floor muscle training on symptoms and uroflowmetry parameters in female patients with overactive bladder.

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Background/aim: To evaluate the effects of pelvic floor muscle training (PFMT) on symptoms of overactive bladder (OAB) as well as uroflowmetry parameters and functional bladder capacity. Materials and methods: Fifty-nine female patients with OAB symptoms were included. Patients were assessed by SEAPI-QMM, uroflowmetry, and abdominal ultrasound. A specially designed PFMT program using a Pilates ball was generated for patients. The training period was 1-h sessions twice a week for 6 weeks and aerobic home exercises to be performed at home 4 or 5 times every other day. Following training, subjects were reevaluated for body mass index, SEAPI questionnaire, and uroflowmetry. Results: Initial mean SEAPI score, mean maximum and average flow rates, and mean voided volume were 9.8 ± 7.2, 29.8 ± 16.4 mL/s, 16.3 ± 8.7 mL/s, and 211.6 ± 173.5 mL, respectively. After completion of the training program, SEAPI scores improved significantly to 3.4 ± 6.4 (P < 0.05). Maximum and average flow rate results did not show significant changes, whereas voided volume seemed to have improved in conjunction with patients’ symptom scores (Pearson correlation coefficient: 0.86). Conclusion: According to our results, we think that proper PFMT results in increase of functional bladder capacity as well as improvement in OAB symptoms and can be recommended as first-line therapy or in conjunction with medical therapy in severe cases

Time to change the management of upper urinary tract urothelial carcinoma

status: publishe