BÖBREK HÜCRELİ KANSERİ TAKLİT EDEN ABDOMİNAL KAYNAKLI DESMOPLASTİK KÜÇÜK YUVARLAK HÜCRELİ TÜMÖR: BİR OLGU SUNUMU VE YAYINLARIN GÖZDEN GEÇİRİLMESİ

Introduction: A 25 year-old woman admitted to our clinic due to left lomber pain, weakness and abdominal mass. On computerized tomography, 140×110×50 mm in diameter solid mass was detected in upper pole of the left kidney on computerized tomography (CT). The patient underwent left radical nephrectomy and histopathological examination of the specimen was reported as pyelonephritis. Six months after the operation, the patient admitted to our clinic with huge intraabdominal mass. It was defined as hematoma or abcess on CT. One thousand cc necrotic clot like material was evacuated in exploration. Histopathological examination of this material indicated desmoplastic small round cell tumor

Seperation of dorsal vein complex from the urethra by blunt finger dissection during radical retropubic prostatectomy.

We present our initial experience on the isolation of dorsal vein complex by blunt finger dissection in 26 patients with localised prostate cancer who underwent open retropubic radical prostatectomy. Loss of blood was between 300 and 500 mL (mean 350 mL). Two of 26 patients (7.6%) required blood transfusion. There was no positive surgical margin at prostatic apex in the patients. Twenty four of our patients (92.4%) were continent on the 3(rd) month. Control of dorsal vein complex is very important to decrease blood loss and to improve intraoperative exposure of retropubic area in order to get negative margin of prostatic apex and to provide the urethra long enough for a nice urethrovesical anastomosis. According to our initial experience, this technique seems to provide these aims

Occurence and treatment of stone street after extracorporeal shock wave lithotripsy

Bobrek tasi nedeniyle ekstrakorporeal sok dalga litotripsi (ESL) uygulanan 4,200 olgu tas yolu olu§ma sikligi, sonuglan ve tedavi yakla§imlan agisindan retrospektif olarak degerlendirildi. Olgulann 256'sinda (% 6) tas yolu gelistigi saptandi. Bunlardan duzenli izlemi olan 217 hasta galismaya dahil edildi. Tas yolu olusma sikligi 1 cm'den kuciik taslarda % 1.3, 3 cm'den buyuk taslarda ise % 20 olarak bulundu. Olgulann 103'unde (% 47.6) spontan, 91'inde (% 41.9) yine ESL ile duzelme saglandiT ESL'nin ba§ansiz oldugu 16 olguya (% 7.3) ureterorenoskopi, 7 olguya (% 3.2) ise ureterolitotomi yapildi. '"|as yolu geli§en olgular dikkatli izlenmeli ve dilatasyon gelisen olgularda ilk tedavi segenegi tekrar ESL olrrfalidir. ESL'nin basansiz oldugu olgularda ise tercih edilen tedavi yontemi ureterorenoskopi olmakla birlikte, acik cerrahi girisim ender de olsa gerekebilmektedir.Occurence And Treatment Of Stone Street After Extracorporeal Shock Wave Lithotripsy- A total of 4,200 patients xvith kidney stones were evaluated for the occurence, treatment and outcome of stone streets after extracorporeal shock wave lithotripsy (ESL) treatment, retrospectively. Of these patients 256 (6 %) had stone street formation and 217 patients with regular folloiv-ups were included into the study. The incidence of stone street formation ivas 1.3 %for stones smaller than 1 cm, and 20 % for stones larger than 3 cm. Spontaneous relief was attained in 103 patients (47.6 %), ivhile additional ESL was necessary in 91 patients (41.9 %). Sixteen patients (7.3 %) underwent ureterorenoscopy and 7 (3.2 %) cases were treated with ureter oliihotomy after repeat ESL failure. In conclusion, patients with stone street formation should be observed carefully and ESL should be considered again in patients with dilated upper tracts. Ureterorenoscopy is the method of choice if ESL remains unsuccessful, and open surgery may be necessary in rare cases

A multicenter-based critical analysis of laser settings during intrarenal laser lithotripsy by the Turkish academy of urology prospective study group (ACUP study)

Objective: In this multicenter prospective study, we aimed to evaluate the use of holmium:yttrium aluminum garnet laser during retrograde intrarenal surgery for kidney stones and the relationship between laser-related parameters and procedure-related perioperative parameters. Material and methods: The 769 patients whose laser setting parameters (fiber thickness, number of shots, frequency (max.), laser power (max.), and total energy) were completely registered were included in this study program. The intraoperative ureteral lesions were evaluated using postureteroscopic lesion scale (PULS) scores and the postoperative complications with the modified Clavien-Dindo classification system. Results: The maximum levels of laser power and the frequency were used in the middle calyceal stones; the value of total energy consumed was found to be higher gain in cases with multiple stones (all parameters P < .05). There was a significant positive correlation among (mean number of shots [P < .001, r = 0.46], frequency [P = .009, r = 0.1], maximum power [P < .001, r = 0.11], total energy [P < .001, r = 0.25]), anesthesia time (P < .001, r - 0.42), surgery time (P < .001, r - 0.47), and stone size. The mean number of shots increased (P < .001, r = 0.25), and the frequency level decreased (P < .001, r = -0.17) significantly with increasing Hounsfield unit (HU) values. Again, the mean number of shots and maximum laser power increased in correlation with the increasing hospitalization time (P = .004, r = 0.09 and P = .02, r = 0.07, respectively). In addition, it was observed that higher laser subparameter values and thicker fibers were used in PULS grade 2. Conclusion: As the stone size and HU values increased, laser-setting parameters were found to show significant variability. The increase in different parameters of the laser setting was found to be associated with longer anesthesia time, surgery time, and hospitalization period and increased risk of local trauma with PULS grade

Retrograde intrarenal surgery of renal stones: A critical multi-aspect evaluation of the outcomes by the Turkish Academy of Urology Prospective Study Group (ACUP Study)

Aims To outline and evaluate the incidence, management and follow-up of the residual fragments (RFs) following retrograde intrarenal surgery (RIRS) of renal stones by the Turkish Academy of Urology Prospective Study Group (ACUP Study). Methods Following the ethical committee approval, 15 centers providing data regarding the incidence, management, and follow-up of RFs after RIRS were included and all relevant information was recorded into the same electronic database program () created by Turkish Urology Academy for Residual Stone Study. Results A total of 1112 cases underwent RIRS for renal calculi and RFs were observed in 276 cases (24.8%). Of all the parameters evaluated, our results demonstrated no statistically significant relation between preoperative DJ stenting and the presence of RFs (chi 2 (1) = 158.418; p = 0.099). RFs were significantly higher in patients treated with UAS (82 patients, 29.3%) during the procedure compared to the cases who did not receive UAS (194 patients, 23.3%) (chi 2 (1) = 3.999; p = 0.046). The mean period for a secondary intervention after RIRS was 28.39 (+/- 12.52) days. Regarding the procedures applied for RF removal, re-RIRS was the most commonly performed approach (56%). Conclusions Despite the reported safe and successful outcomes, the incidence of RFs is higher, after the RIRS procedure particularly in cases with relatively larger calculi. Such cases need to be followed in a close manner and although a second flexible ureteroscopy is the treatment of choice for fragment removal in the majority of these patients, shock wave lithotripsy and percutaneous nephrolithotomy may also be preferred in selected cases.Turkish Association of Urolog