A Pancreatic Fistula as a Rare Complication of Laparascopic Radical Nephrectomy: A Case Report

We report an unusual case of pancreatic fistula after transperitoneal laparoscopic left radical nephrectomy. A 43 years old male patient presented with severe abdominal pain and abdominal distension 71 day after the surgery. Computerized tomography (CT) demonstrated a large fluid collection in the operated renal fossa. The treatment, which comprised percutaneous drainage led to a closure of the fistula 20 days after therapy

IMPACT OF EXPERIENCE ON WARM ISCHEMIA TIME AND ITS COMPONENTS DURING ROBOT ASSISTED PARTIAL NEPHRECTOMY

WOS: 000308488203161

Flexible Ureterorenoscopy versus Semirigid Ureteroscopy for the Treatment of Proximal Ureteral Stones: A Retrospective Comparative Analysis of 124 Patients (vol 11, pg 1867, 2014)

WOS: 000363226100021PubMed ID: 26341779

Are There Relationships between Seminal Parameters and the Neutrophil-to-Lymphocyte Ratio or the Platelet-to-Lymphocyte Ratio?

Purpose: The aim of this study was to evaluate the relationship of seminal parameters with the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR), which are inflammatory markers, in men with an abnormal semen analysis and men with normozoospermia. Materials and Methods: Fifty-seven men with abnormal semen analyses and 59 men with normozoospermia were included in this cross-sectional study. A complete blood count was recorded, and the NLR and PLR were calculated from the hematologic parameters. Results: The NLR was 1.84±0.78 in the normozoospermic group and 1.80±0.75 in the abnormal semen analysis group. The PLR was 95.32±35.47 in the normozoospermic group and 93.57±28.09 in the abnormal semen analysis group. No significant differences were found between the normozoospermic and the abnormal semen analysis group in the NLR (p=0.828) or the PLR (p=0.768). In addition, no seminal parameters were correlated with the NLR or the PLR (p＞0.05). Conclusions: We do not recommend using the NLR or the PLR as markers to screen for abnormal semen parameters or male infertility

Plasmakinetic vaporization versus plasmakinetic resection to treat benign prostatic hyperplasia: A prospective randomized trial with 1 year follow-up

WOS: 000342455500003PubMed ID: 25295128Introduction: We evaluate the efficacy and outcomes of plasma-kinetic vaporization (PKVP) and plasmakinetic resection (PKR) to treat benign prostatic hyperplasia (BPH). Methods: A total of 183 patients with BPH underwent plasmakinetic prostatic surgery between 2008 and 2012 at Kars State Hospital and Kafkas University Faculty of Medicine, Turkey. After clinical and preoperative evaluation, the patients were randomized to PKRP or PKVP groups sequentially by using computer-generated numbers. Group 1 included 96 patients treated with PKR. Group 2 included 87 patients treated with PKVP. Patients in both groups were compared in terms of hemoglobin drop, operation time, catheter duration, reobstruction, incontinence and recatheterization. Results: When we compared the maximum flow rates (Qmax values) at the 12th month, there was no statistical difference between 2 groups. Group 1 had a mean Qmax value of 17.92 +/- 3.819 and Group 2 had a 18.15 +/- 3.832 value (p > 0.05). There was a statistical difference between the groups in terms of hemoglobin drop, catheter duration and operation time. The mean catheter duration in Group 1 was 3.74 +/- 1.049 days, and in Group 2 it was 2.64 +/- 0.849 days (p < 0.05). Operation time was statistically longer in Group 2 (PKVP) and hemoglobin drop was statistically higher in Group 1 (PKR). Conclusion: PKVP for BPH is safe and effective. When compared with PKRP, it provides a significantly shorter catheter duration and less bleeding due to hemostasis control with similar IPSS and Qmax improvements after 1 year

Prostate-specific antigen reduction after empiric antibiotic treatment does not rule out biopsy in patients with lower urinary tract symptoms: prospective, controlled, single-center study

Background: To evaluate men, with lower urinary tract symptoms and newly elevated serum prostate specific antigen (PSA) to determine whether a three-week course of ciprofloxacin antibiotics lowers serum PSA levels and affects recommendations for prostate biopsy. Methods: A prospective, controlled, single-center prospective trial of 177 men with a newly elevated PSA and lower urinary tract symptoms was conducted. Patients were randomized to three weeks of ciprofloxacin or observation. After three weeks, patients PSA levels and derivatives were repeated. At the end of 3 weeks, all patients underwent TRUS guided systematic 12-core prostate biopsies regardless of the final PSA value. Results: Of 177 men who completed the study, 88 were in the treatment and 89 in the observation group. 46.5% of treatment and %18 of control groups patients PSA levels had decreased after 3 weeks and a significant PSA reduction was observed in the treatment group compare to control group (p: 0.035) but no significant prostate cancer detection rates were observed between the groups (p: 0.418). Also, in the treatment group prostate cancer detection rate was significantly higher in patients whom PSA levels were decreased (p: 0.011). Conclusion: This study has shown that, use empirical antibiotic treatment decreased the PSA levels but did not have any effect on prostate cancer detection. In addition, prostate cancer detection rates were found to be higher in patients with reduced PSA levels after treatment. Therefore, it may not be safe to rule out biopsies in patients who achieve a satisfactory PSA response to antibiotics

Holding Strength of Suture: An Experimental Study Using Porcine Kidney

WOS: 000417379500003Background and Objectives: The search for the perfect suture is going on and has resulted in the introduction of many different suture types into the market. The purpose of this study is to investigate the holding strength (HS) of different sutures in the renal parenchyma in an experimental study on pig kidneys. Methods: The HS that caused sliding of the suture was investigated in 5 adult porcine kidneys with 7 suture variants. HS-caused tearing of the kidney was investigated with 3 suture types on 5 kidneys. The third investigation, performed on 5 porcine kidneys, was a comparison between 2-0 Vicryl sutures with a Hem-o-lok clip and 2-0 V-Loc sutures with 1 knot. The Friedman test was used to compare the groups. Post hoc analysis was performed with the Wilcoxon signed ranks test (Bonferroni corrected). Results: For HS causing sliding of the suture, the mean HSs of the tested sutures were as follows: 2-0 Vicryl with 1 Hem-o-lok clip, 3.26 +/- 0.55 N; 2-0 Vicryl with 2 Hemo-lok clips, 4.1 +/- 0.46 N; 2-0 V-Loc, 2.52 +/- 0.63 N; 4-0 V-Loc, 1.62 +/- 0.17 N; 0 Quill, 0.48 +/- 0.16 N; 2-0 Vicryl with 1 Hem-o-lok clip (halfway), 3.62 +/- 0.66 N; and 2-0 V-Loc (halfway), 1.02 +/- 0.40 N. For HS causing tearing of the kidney, the mean value of 2-way 2-0 Vicryl ( Hem-olok in the middle) was 13.28 +/- 1.38 N, 2-0 2-way Vicryl (Hem-o-lok at the end) was 5.86 +/- 0.75 N, and 2-way 2-0 V-Loc was 3.98 +/- 1.60 N. For the third group, the difference between the 2 suture variants was not statistically significant. Conclusion: Our study revealed that 2-0 Vicryl (polyglactin 910) sutures with 2 Hem-o-lok clips had the maximum HS in renal parenchyma when compared with other sutures

Retroperitoneal laparoscopic decortication of simple renal cysts using the bipolar PlasmaKinetic scissors

Objectives: To analyse the efficacy, safety and feasibility of retroperitoneal laparoscopic decortication of simple renal cysts using bipolar PlasmaKinetic scissors

Impact of Three-Dimensional Printed Pelvicaliceal System Models on Residents' Understanding of Pelvicaliceal System Anatomy Before Percutaneous Nephrolithotripsy Surgery: A Pilot Study

Objective: To investigate the impact of three-dimensional (3D) printed pelvicaliceal system models on residents' understanding of pelvicaliceal system anatomy before percutaneous nephrolithotripsy (PCNL). Materials and Methods: Patients with unilateral complex renal stones indicating PCNL were selected. Usable data of patients were obtained from CT-scans in Digital Imaging and Communications in Medicine (DICOM) format. Mimics software version 16.0 (Materialise, Belgium) was used for segmentation and extraction of pelvicaliceal systems (PCSs). All DICOM-formatted files were converted to the stereolithography file format. Finally, fused deposition modeling was used to create plasticine 3D models of PCSs. A questionnaire was designed so that residents could assess the 3D models' effects on their understanding of the anatomy of the pelvicaliceal system before PCNL (Fig. 3). Results: Five patients' anatomically accurate models of the human renal collecting system were effectively generated (Figs. 1 and 2). After presentation of the 3D models, residents were 86% and 88% better at determining the number of anterior and posterior calices, respectively, 60% better at understanding stone location, and 64% better at determining optimal entry calix into the collecting system (Fig. 5). Conclusion: Generating kidney models of PCSs using 3D printing technology is feasible, and the models were accepted by residents as aids in surgical planning and understanding of pelvicaliceal system anatomy before PCNL