Endoscopic Cystolithotripsy for a Giant Stone in The Orthotopic Neobladder: A Case Report

Radical cystectomy and urinary diversion is an excellent treatment option for invasive bladder cancer. Ileal conduit and orthotopic neobladder have been applied as the most frequent urinary diversion methods for many years. Stone formation is a rare complication in the ortotopic neobladder. In the case presented, a 67-year-old-man who had undergone radical cystectomy and orthotopic neobladder reconstruction ten years ago with no complaints in the following five years presented with fever, dysuria, and urinary frequency. We detected a 10.8 cm stone in the neobladder, and the giant stone was fragmented by endoscopic cystolithotripsy via transurethral approach. Complete stone clearance was achieved

Genetic polymorphism in the serotonin transporter gene-linked polymorphic region and response to serotonin reuptake inhibitors in patients with premature ejaculation

OBJECTIVES: Serotonin plays a central role in ejaculation and selective serotonin reuptake inhibitors have been successfully used to treat premature ejaculation. Here, we evaluated the relationship between a polymorphism in the serotonin transporter gene-linked polymorphic region (5-HTTLPR) and the response of patients with premature ejaculation to SSRI medication. METHODS: Sixty-nine premature ejaculation patients were treated with 20 mg/d paroxetine for three months. The Intravaginal Ejaculatory Latency Time and International Index of Erectile Function scores were compared with baseline values. The patients were scored as having responded to therapy when a 2-fold or greater increase was observed in Intravaginal Ejaculatory Latency Time compared with baseline values after three months. Three genotypes of 5-HTTLPR were studied: LL, LS and SS. The appropriateness of the allele frequencies in 5-HTTLPR were analyzed according to Hardy-Weinberg equilibrium using the χ2-test. RESULTS: The short (S) allele of 5-HTTLPR was significantly more frequent in responders than in nonresponders (

Cutaneous Metastasis from Squamous Cell Carcinoma of The Bladder: A Case

Objective: To report a case with cutaneous metastasis of bladder squamous cell carcinoma. Very few cases of skin metastases from the urinary bladder are reported in the literature.Case report: Cutaneous metastasis of bladder squamous cell carcinoma is an extremely rare clinic entity associated with poor prognosis. Cutaneous metastasis is accepted as a late manifestation of systemic spread. A 58-year-old man had undergone radical cystoprostatectomy with pelvic lymph node dissection in November 2013. The pathology report showed a moderately differentiated squamous cell bladder carcinoma with a staging of T3N0M0. Then, a large regional cutaneous lesion measuring 4x3.5 cm with an ulcerated and necrotic appearance located in the suprapubic area was detected in February 2014, and the lesion was removed with a 2 cm safety margin. The pathologic examination revealed squamous cell carcinoma. This report describes an interesting and rare case of cutaneous metastasis of bladder squamous cell carcinoma as the primary presentation of metastatic disease with a generally dismal prognosis.Conclusion: The skin metastasis of bladder squamous cell carcinoma is a rare clinical entity with a poor prognosis. Clinicians should be aware of this rare entity

Kidney Stones and Ceftriaxone

Metabolic causes such as hypercalciuria, urinary tract infection, and obstruction are the most common aetiologies of urolithiasis, and drugs, although important in this regard, are rarely the cause of urolithiasis. Administration of one of these drugs, ceftriaxone (CTX), has been associated with biliary pseudolithiasis in adult and paediatric patients, and rarely may cause urolithiasis. Several factors, including drug concentration and incubation time, are very important for determining the degree of CTX/calcium (Ca) crystallisation in the urine. According to this data, CTX crystallisation was a dose and time-dependent reaction. It is particularly important to monitor patients on high-dose long-term CTX treatment with the urinary Ca to creatinine ratios, ultrasound sonography, and renal function testing, as these individuals may be at greater risk of large stones and renal damage. This type of screening may help prevent permanent complications in the future. This underlying review will help to educate readers on the pathophysiology and interaction between CTX and urolithiasis

The prevalence and severity of varicocele in adult population over the age of forty years old: a cross-sectional study.

Objectives: To investigate the prevalence and severity of varicocele in adult population over the age of 40. We also measured testicular size, consistency, and total testosterone levels with an aim to observe the effect of varicocele on testis as men age.Methods: Two hundred twenty-four patients with varicocele, 241 patients without varicocele who admitted to our clinic were enrolled in the study. We stratified participants by four age groups (40-49, 50-59, 60-69, >70yr). Patients were grouped according to varicocele grade and laterality. The morning testosterone level was drawn. The subgroups were compared with each other.Results: Overall, varicocele prevalence was 48%. Of the patients, 104 had unilateral, 120 had bilateral varicocele. Of the patients with varicocele, 62 (13.30%) were found as grade 3, 99 (21.10%) were grade 2, and 63 (13.60%) were grade 1. The percentages of smaller testes in grade 1, grade 2, and grade 3 varicocele group were 20.60, 79.80, and 88.70 and a significant association was detected. Age stratification of the data revealed the smaller and soft testis prevalence as well as higher grade varicocele prevalance increased in older age groups.Conclusions: Varicocele presence is associated with lower testicular size, softer testicular consistency, and lower testosterone levels, especially in older patients with bilateral and high-grade varicocele

Foreign Body Stone of the Ureter Originated from the Suture Thread: A Case Report

Foreign bodies placed into the ureter are uncommon. Unintentionally placed nonabsorbable sutures may cause obstruction and stone formation. If not recognized, the patient may become symptomatic. We present a diagnosis of a rare case from Turkey, in which a ureter stone was formed by a nonabsorbable suture in a male patient with a previous laparotomy

Is Cardiometabolic Index a Predictive Marker for Renal Cell Cancer Aggressiveness?

Studies show that metabolic syndrome is a factor for developing renal cell cancer (RCC) and tumour aggressiveness. In our study, we evaluated the association between renal cell cancer and cardiometabolic index (CMI) which meets the main components of the metabolic syndrome. We retrospectively reviewed the records of 310 consecutive patients with RCC who underwent radical nephrectomy at our institution. We evaluated the tumour size, histologic subtype, Fuhrman nuclear grade. CMI was calculated as the product of waist circumference (WC) to waist-to-height ratio (WHtR) and triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-c). CMI were statistically higher in patients with tumour size ≥ 7 cm than those < 7 cm (p<0.05). Mean CMI level was 2.34 ± 0.84 in patients with high tumour size; and 1.18 ± 0.74 in the other group. The patients with high tumour size had higher TG levels, higher WC and lower HDL-c levels. Similarly, CMI levels were statistically higher in patients with Fuhrman grade 3 and 4 than patients with Fuhrman grade 1 and 2 (p<0.001). The patients with high Fuhrman grade had higher TG levels, higher WC and lower HDL-c levels. The simplicity of WC and height measurement and TG and HDL assessment make CMI an easily applicable index for the evaluation of cardiovascular dysfunction. The components of CMI may have effect on tumour carcinogenesis in similar pathways. In this context, CMI which meets the main components of the metabolic syndrome, can be a useful index for the evaluation and calculation of renal cell cancer aggressiveness