The Risk Factor and The Severity of Symptoms Relation in Women with Overactive Bladder

Aim: To investigate whether risk factors for overactive bladder (OAB) in women are associated with symptom severity and to assess the impact of symptom severity on the quality of life. Material and Method: Symptoms of 100 female patients (aged, 47.70 +/- 12.34 years) who were diagnosed with OAB were assessed using the Boyarsky symptom score (BSS). Data for age, educational status, body mass index (BMI), chronic disease, vaginal deliveries, constipation, smoking, consumption of alcohol, tea, coffee, or carbonated drinks and diets involving spicy food were recorded. Subcategories for each factor regarding quantity were established. The findings were statistically correlated with the BSS and with each urinary symptom individually. Each patient's quality-of-life (QoL) scores were correlated with the severity of each symptom and the total, obstructive and irritative BSS. Results: Urgency was related with BMI, spicy food, vaginal deliveries, menopause, and advanced age. Nocturia had a relation with menopause and advanced age. Total BSS was significantly correlated with coffee consumption. Irritative BSS was correlated with menopause and advanced age and obstructive BSS was correlated with constipation. Total and irritative BSS were both positively correlated with the QoL score. Discusion: Risk factors can affect the severity of symptoms and these factors should be considered when planning therapy

Bariatric Surgery and Urinary Stone Disease

Obesity is a major public health problem and has been suggested to play a role in the etiology of urinary tract stone disease. Furthermore, the increasingly widespread use of surgery in the treatment of obesity also is related with urinary stone disease. In daily practice, patients to whom obesity surgery has been planned or who have undergone obesity surgery are seen more frequently. This review aims to highlight the urological evaluation and management of this patient group

Fever and Systemic Inflammatory Response Syndrome Seen After Percutaneous Nephrolithotomy: Review of 1290 Adult Patients

Aim: Although accepted as minimally invasive, percutaneous nephrolithotomy (PCNL) still poses a significant risk of complications. Recent studies suggest that the incidence of sepsis may be higher than previously reported. The systemic inflammatory response syndrome (SIRS) seen in the subset of patients with or without bacteremia, is a life threatening complication and the purpose of this study is to give an insight to the relation between a post-operative fever episode and the risk of developing SIRS. Material and Method: Medical files of 1646 adult patients to whom a PCNL operation was performed were reviewed. A total of 1290 patients fulfilled the needed criteria and were included in the study. Study variables were recorded from the medical files for statistical analysis. Results: Stone burden had a statistically significant correlation with SIRS (p= 2 complications were seen to increase the hospitalization period (p= 120 min. was the only operative variable that had correlation with both fever and SIRS (p2 g/dl (Delta haemoglobin-Hb) and Clavian 5 complications had statistically significant correlations with fever. ASA score >= 3, operation time >120 min. Delta Hb > 2 gr/dl, stone size and Clavian 5 complications had statistically significant correlations with the development of SIRS. The incidence of a fever episode, which was seen in 181 patients (14%), to progress to SIRS, which leaded to death, was found to be 1.6%. Discussion: Postoperative fever has a low risk of progressing to a life threatening condition. But special attention should be given to patients that also have the other SIRS criteria; blood loss more than 2 g/dl and/or operation time more than 120 minutes. Although only encountered in a small subset of patients, multiple organ dysfunctions can develop leading to death

Predicting Surgical Outcome of Percutaneous Nephrolithotomy: Validation of the Guy's Stone Score and Nephrolithometric Nomogram in Terms of Success and Complications

This single institution retrospective study aims to validate the ability of Guy's stone score and the nephrolithometric nomogram to predict the success of PCNL and to assess the correlation of the scoring systems with the complications encountered. Material and Method: Medical files of 1646 adult patients to whom a PCNL operation was performed were reviewed. A total of 1325 patients fulfilled the needed criteria and were included in the study. Study variables were recorded from the medical files for statistical analysis. Results: Stone burden was the only pre-operative, operative and post-operative variable that had a statistically significant correlation both with success and also with the complications encountered (p 120 minutes, presence of a staghorn stone, intra-and post-operative blood transfusion, duration of the nephrostomy catheter, Delta Hg more than 2 gr/dl and and positive post-operative urine/blood culture were the other associated variables related to the complications encountered (p< 0.05). ROC curve analysis performed to the nephrolithometric nomogram data showed that with a cut of value of 80.5% for success, the nomogram has a sensitivity of 71% and specificity of 74% (ROC AUC= 80%). The nomogram was further analyzed for an association between the complications encountered and showed that the association is not strong enough to predict a possible complication (ROC AUC= 67%). Discussion: This study shows that the nephrolithometric nomogram has a good predictive accuracy for success (AUC= 0.80) and the Guys's stone score has a good correlation both with success and with complications (p< 0.05) and can be used for pre-operative counseling and decision making

Papillary renal cell carcinoma within a renal oncocytoma: Case report of very rare coexistence

Renal oncocytomas accounts for 3% to 9% of primary renal neoplasms. The coexistence of renal cell carcinoma (RCC) within the oncocytoma is extremely rare. We report the case of an asyptomatic 74-year-old man with papillary RCC within oncocytoma managed with left radical nephrectomy