Myxolipoma of the renal capsule: A case report

AbstractINTRODUCTIONAlthough lipomas are the most common mesenchymal tumors of the human body, primary intrarenal lipomas are quite rare. In this report we present a case of benign mesenchymal tumor with lipomatous and myxoid components.PRESENTATION OF CASEA sixty one years old male patient was admitted to our outpatient clinic for a general control since he had a right radical nephrectomy operation due to renal cell carcinoma (RCC) eight years ago and he did not have any urological control for last 3 years. However the urinary ultrasound revealed a mass lesion on left kidney and then on axial contrast-enhanced computed tomography (CT) scan, there were two masses on the left kidney. In the magnetic resonance imaging (MRI), the tumor on cortex was depicted as a homogeneous low-signal intensity on the T1-weighted pulse sequence and as a heterogeneous high-signal intensity on the T2-weighted pulse sequence. In pathological evaluation, the biopsy material of the cortical mass was a tumoral lesion containing lipomatous and mixoid areas without atypia, mitosis or necrosis which was diagnosed as myxolipoma.DISCUSSIONMyxolipoma, an uncommon type of lipoma, is a benign tumor composed mainly of fat cells with myxoid (mucus-like) components. In our case, the tumor was composed of mature adipocytes together with areas rich in mucoid substances and there were no malignant features including lipoblasts, mitosis or abundant capillary network.CONCLUSIONHerein we present a case of a fatty tumor originating from the renal capsule with the histologic diagnosis of myxolipoma. To the best of our knowledge, myxolipoma, a very rare form of lipoma, is not reported in kidney, in the literature before

Antibiotic susceptibility of escherichia coli strains isolates determined as a cause of urinary tract infection in pediatric patients

Urinary tract infections (UTIs) are bacterial infections that are most commonly encountered by physicians in all age groups both in the Nasocomial hospital and community acquired hospital. International guidelines are used for the selection of antibiotics. However, it is recommended to adopt the international guidelines into local epidemiological data before using it to select the routine treatment. In this study, it was aimed to determine the antimicrobial susceptibility of Escherichia coli (E.Coli) strains isolated from urinary tract infections in children applied due to urinary system infections and treated accordingly. It was designed to be examined to be raised from 249 children, with sales route design and sale to the pediatric and urinary outpatient clinic between July 1, 2019 and July 1, 2020. 210 patients with n≥105 cfu/ml bacteria. Patients with vesicourethral reflux and neurogenic patients were excluded from the study. At the same time, people who can be displayed in the products that have been in use in the last six months and people who have grown Klebsiella, Proteus mirabilis, Candida and ESBL positive bacteria. 98 cultures included in the study were evaluated The mean age of totally 98 patients including 84 females and 14 males diagnosed with urinary tract infection was 37 (1-192) months. There was a statistically significant difference between each group with respect to age and they were as F:49 month and M: 9 respectively (p [Med-Science 2022; 11(2.000): 780-3

Bilateral same-session flexible ureterorenoscopy for renal and/or ureteric stone disease treatment

Arda, Ersan (Trakya author)Objective: To evaluate the effectiveness and safety of bilateral same-session flexible ureterorenoscopy (f-URS) in the treatment of bilateral renal and/ or ureteric stone disease. Patients and methods: From October 2007 to December 2015, 62 patients who had undergone bilateral, same-session f-URS were included in the study. The procedures were performed under general anaesthesia, in lithotomy, and initiated on the side in which the patient was clinically symptomatic or on the side in which the stone was smaller. Plain abdominal radiography, intravenous urography, renal ultrasonography and/or non-contrast computed tomography scans were conducted in all patients. The success rate was defined as, patients who were stone-free or only had residual fragments of < 3 mm. Results: A total of 62 patients (43 male, 19 female), with a mean (SD) age of 39 (15.1) years, were included. The mean (SD) stone size was 23.2 (6.11) mm with a mean (SD) operative time of 58.8 (16.24) min. The stone-free rates were 90.3% and 100% after the first and second procedures, respectively. The mean (SD) hospital stay was 1.58 (0.72) days. There were minor complications (Clavien-Dindo grade I-II) in 10 (16%) patients and major complications (Clavien-Dindo III-IV), e.g. distal ureter laceration and laser injury of the ureter, in two patients. Conclusion: Same session bilateral f-URS is a successful and safe method for bilateral renal and/or ureteric stones. (C) 2018 Production and hosting by Elsevier B.V. on behalf of Arab Association of Urology

The comparison of surgical and thermocautery-assisted techniques used in neonatal circumcision

Neonatal circumcision is a frequent procedure performed all around the globe, and it has a low complication rate when performed by trained experts. Our aim is to evaluate the outcomes and potential complications of two neonatal circumcision techniques. Fifteen hundred twenty-one infants who underwent neonatal circumcision at Hisar Intercontinental Hospital between 2010 and 2020, were evaluated retrospectively. Patients who had surgical procedures were classified as Group 1, whereas those who underwent thermocautery-assisted technique were classified as Groups 2. The outcomes and complications of both groups were compared. Group 1 had 758 patients, whereas Group 2 had 763. Both groups were aged 13.69±7.45 days and 13,44±7.70 days (p=0.1). Although there was no significant difference between the two groups when the complications were examined individually, there was a significant difference when all complications were considered, and the complication rate was greater in group 2 (p=0.01). While the hemorrhage rate was higher in Group 1 (p [Med-Science 2022; 11(2.000): 593-7

Desmopressin versus desmopressin plus oxybutynin in the treatment of children with nocturnal enuresis

Introduction Enuresis is identified as voluntary or involuntary leakage of urine for at least three consecutive months in the daytime and/or nighttime on clothes for children older than five. Monosymptomatic nocturnal enuresis (MNE) describes nighttime wetting without daytime leakage of urine in children with no pathology in the urinary system and it is 80% more common than enuresis. Desmopressin is the most common medical treatment for MNE. The aim of this study is to retrospectively compare the effectiveness of desmopressin as monotherapy and desmopressin + oxybutynin as a combination therapy in the treatment of nocturnal enuresis. Material and method This study retrospectively evaluated 183 patients who applied to pediatrics, pediatrics surgery and urology clinics with the complaint of nocturnal enuresis and diagnosed with primary monosymptomatic nocturnal enuresis between January 2014 and December 2019. The patients were divided into two groups (91 patients) who only received desmopressin therapy (Group 1), and those (92 patients) who received desmopressin and oxybutynin combination therapy (Group 2). Response to treatment, compliance and recurrence ratios were determined in the evaluation. Complete response was accepted as 90-100% decrease in the number of nighttime wetting, partial response was accepted as 50-90% decrease in the number of nighttime wetting and those below 50% were regarded as non-response. The 1st, 3rd, and 6th months of control data of treatment effectiveness of both groups were evaluated and their responses to treatment and the side effects of drugs were examined. Results The mean age 183 patients of whom 103 were male and 80 were female was 10 (6-16) year. In the first month of control of Group 1, 71.4% had a complete cure, 8.8% had a partial cure and 19.8% had no response to treatment. In the third month of control of Group 1, 74.73% gave a complete response and were cured, 5.5% gave a partial response and 19.78% had no response. In the sixth month of Group 1, 70 patients were evaluated as complete response (79.5%), and 5 patients were evaluated as partial response (5.6%). In the first month of control of Group 2, 75% gave a complete response, 10.9% gave a partial response, 14.1% had no response to treatment. In the third month of control of Group 2, 86.9% gave a complete response, 6.52% gave a partial response, and 6.52% had no response. In the sixth month of the control of Group 2, the number of patients who did not come for control and could not be reached was 2, 83 patients out of 90 patients were evaluated as complete response (92.2%), 6 patients were evaluated as partial response (6.6%). Conclusion Desmopressin is the only FDA approved pharmacologic treatment for nocturnal enuresis. Desmopressin reduces urine production and the anticholinergic agent allows the bladder to store more urine. Therefore, combined therapy can be recommended in the MNE treatment for specially selected cases

Safety of greenlight photoselective vaporisation of prostate in lower urinary tract symptoms due to benign prostatic hyperplasia in patients using anticoagulants due to cardiovascular comorbidities

Lasers have been used in the management of benign prostatic hyperplasia for the last two decades. To be comparable, they should reduce or avoid the immediate and long-term complications of transurethral resection of the prostate (TURP) or open prostatectomy (OP), especially bleeding and need for blood transfusion. Although Holmium laser treatment of the prostate was compared frequently in terms of cardiovascular safety with TURP or OP, photoselective vaporisation of the prostate (PVP) was not largely evaluated. In this article we analyzed the current literature to see if there is convincing data to support the observation of some authors that use of PVP is associated with increased safety in patients on anticoagulants with cardiovascular comorbidities. With this purpose a Medline search between January 2004 to March 2013 was performed using evidence obtained from randomised trials, well-designed controlled studies without randomisation, individual cohort studies, individual case control studies and case reports Results: In the last 10 years, several case-control and cohort studies have demonstrated the efficacy of PVP as well as its safety in patients with cardiovascular comorbidities using anticoagulants. The results confirmed the overall lower perioperative and postoperative morbidity of PVP, whereas the efficacy was comparable to TURP in the short term, despite a higher reoperation rate. Conclusion: Although it is still developing, PVP with KTP or LBO seems to be a promising alternative to both TURP and OP in terms of cardiovascular safety and in patients using anticoagulants

Chronic Bacterial Prostatitis in a Turkish Population: The Microbiological Etiology and Distribution

Objective: To investigate the category 2 frequency and microorganism distribution of patients diagnosed with chronic prostatitis in a Turkish population. Methods: Data of 3200 patients diagnosed with chronic prostatitis in the urology outpatient clinic between 2009 and 2014 were retrospectively reviewed. The symptom scores were calculated considering the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) according to pain (0-21 points), quality of life (0-12 points), and urinary (0-10 points) subdomains to a total score of 0-43 points. All patients were checked for symptoms, urinalysis, expressed prostatic secretion (EPS), or urine after prostatic massage (VB3) culture and PCR (Polymerase Chain Reaction) of EPS or VB3 for Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, Mycoplasma genitalium, and Trichomonas vaginalis. Results: The mean age of the patients was calculated as 37.7 +/- 7.4 (range 22-65) years. The average of total NIH-CPSI score was determined as 9.08 (range 1-40). In 223 of 3200 patients, positive culture and/or PCR results were observed. The results were as follows: E. coli 27 (12.1%), E. faecalis 18 (8.1%), S. epidermidis 15 (6.7%), S. haemolyticus 10 (4.5%), S. aureus 5 (2.2%), S. agalactiae 4 (1.8%), Pseudomonas 3 (1.3%), C. trachomatis 24 (10.8%), U. urealyticum 95 (42.6%), M. genitalium 6 (2.7%), M. hominis 14 (6.3%), and T. vaginalis 2 (0.9%). Conclusion: In a Turkish population, category 2 patients constitute 7% of all chronic prostatitis patients. This ratio is consistent with the NIH classification of prostatitis data, but it differs etiologically with U. urealyticum, E. coli, and C. trachomatis being the most proliferated pathogens in our study

Comparison of transurethral incision of the prostate and silodosin in patients having benign prostatic obstruction in terms of retrograde ejaculation

Background: To compare the functional outcomes and retrograde ejaculation (RE) after transurethral incision of the prostate (TUIP) or silodosin in bladder outlet obstruction (BOO) secondary to a small prostate. Methods: Prospectively collected data from December 2011 through December 2014 of 192 LUTS patients having fertility concerns with prostate volume smaller than 40 ml receiving either TUIP or silodosin treatment were prospectively reviewed. The treatment outcomes were evaluated and compared. Results: TUIP was performed in 96 cases and silodosin 8 mg was prescribed in 96 cases. At 12th months after TUIP or continuous silodosin treatment, the decrease in mean International Prostate Symptom Score (IPSS) and postvoiding residual urine (PVR) and the improvement of mean maximal flow rate (Qmax) were significant (p = 0.000). The improvement in IPPS and Qmax was significantly higher in TUIP group compared to silodosin group (p = 0.005, p = 0.000) with a lower rate of retrograde ejaculation (RE) in TUIP group. (11/96 vs 33/96) (p = 0.000) Conclusions: Both TUIP and silodosin ensures comparable improvement in PVR, IPSS and Qmax with a lower rate of RE on the TUIP group in prostates weighing less than 40 grams suggesting that TUIP is a better choice in younger patiens seeking preservation of ejaculation with fertility concerns

COMPARISON OF HOUNSFIELD UNITS OF THE RENAL PAPILLAE IN KIDNEY STONE FORMERS AND NON STONE FORMERS

Objective: To investigate whether renal papillae of patients with nephrolithiasis are more radiodense than that of control patients and to evaluate the predictibility of urolithiasis events using papillary density differences between stone and non stone formers

Relationship between lower urinary tract symptoms and inguinal hernia

Aim: To determine the relationship between inguinal hernia (and inguinal hernia subtypes) and low urinary tract symptoms (LUTS) due to benign prostate hyperplasia (BPH), that could be more common than we think. Method: The study was designed retrospectively and was done in accordance with the principles of the Declaration of Helsinki, including 100 patients aged &gt; 50 years that were divided into 2 groups: patients with BPH (BPH group) and patients with BPH and inguinal hernia (BPH-IH group 2). In addition, the BPH-IH group was subdivided according to 2 inguinal hernia subtypes; patients of BPH-IH subgroup A had direct inguinal hernia (n = 25) and those of BPH-IH subgroup B had indirect inguinal hernia (n = 25). Results: There was no statistical relationship and difference in rates between IPSS scores in both groups (p = 0.659) and there wasn’t a significant correlation between IPSS symptom severity and type of hernia, based on chi square analysis (p = 0.104) Conclusion: We were not able to prove our hypothesis that patients with inguinal hernia and BPH would have higher IPSS scores because of voiding dysfunction