Effect of variant histology presence and squamous differentiation on oncological results and patient’s survival after radical cystectomy

Objective: To evaluate the effect of variant histology on pathological and survival findings in patients undergoing radical cystectomy due to muscle invasive bladder cancer. Materials and methods: Data from 146 patients with radical cystectomy performed due to muscle-invasive urothelial carcinoma between January 2006 to November 2016 at our clinic were investigated. The preoperative and postoperative data of patients with variant histology were compared with nonvariant urothelial carcinoma patients. Then of patients with variant histology only those with squamous differentiation (SqD) were compared with nonvariant urothelial carcinoma patients in terms of preoperative, postoperative and survival data. Results: Of the 146 patients, 23 had carcinoma with variant histology. Of these, 17 had SqD, 4 had glandular differentiation, 1 patient had plasmocytoid variant and 1 patient had sarcomatoid variant. In patients with variant histology, postoperative T stage and upstaging was higher, with no difference observed in terms of overall and cancer-specific survival compared with nonvariant urothelial cancer patients. SqD patients were observed to have higher postoperative T stage compared to nonvariant urothelial cancer patients, with no significant difference observed in terms of survival. Conclusions: In cystectomy pathologies, patients with variant histology (especially SqD patients) were observed to have proportionally higher T stage compared to nonvariant urothelial carcinoma; however there were no significant differences for overall survival and cancer-specific survival

Sexual Function in Male Patients with Metabolic Syndrome and Effective Parameters on Erectile Dysfunction

Purpose: We aimed to investigate the relationship between metabolic syndrome and sexual function and effective parameters on erectile dysfunction (ED). Materials and Methods: A total of 1300 individuals were included in this study between January 2009 and July 2012. All of individuals were asked to fill in an International Index for Erectile Function (IIEF) questionnaire. The presence of metabolic syndrome was determined when any three or more of the five risk factors were present according to the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP)-III. Obese individuals were divided into six groups according to modified World Health Organization (WHO) definition. Effective parameters on erectile dysfunction were investigated in individuals with metabolic syndrome. Results: Metabolic syndrome was detected in 455 individuals (35%). Mean domain scores of IIEF for all parameters were higher in individuals without metabolic syndrome than individuals with metabolic syndrome (p < 0.05). Mean domain scores of IIEF were lower in individuals with class 3 obesity than individuals with other obese groups (p < 0.05) for erectile dysfunction. There was statistical difference in terms of mean score of IIEF-Erectile function between smoking and nonsmoking groups (p < 0.05). Seventy percent of individuals with metabolic syndrome and 45% of individuals without metabolic syndrome had ED (p < 0.001). Logistic regression analysis revealed that waist circumference (WC) was the most important criteria for ED (p < 0.05). Conclusions: Metabolic syndrome, smoking and obesity seem to be potential risk factors for ED. We recommend individuals with metabolic syndrome, smoking and obesity should be questioned about ED

The Effect of Combined Therapy with Tamsulosin Hydrochloride and Meloxicam in Patients with Benign Prostatic Hyperplasia Symptoms and Impact on Nocturia and Sleep Quality

Purpose We aimed to compare the effect and feasibility of a combined therapy with tamsulosin hydrochloride plus meloxicam, and tamsulosin hydrochloride alone in patients with benign prostate hyperplasia symptoms and impact on nocturia and sleep quality. Materials and Methods Four hundred male patients were included in this study between 2008 and 2011. Patients were randomly divided into two groups: one received tamsulosin hydrochloride 0.4 mg (Group 1, 200 patients) and the other tamsulosin hydrochloride 0.4 mg plus meloxicam 15 mg (Group 2, 200 patients) prospectively. Patients were evaluated for benign prostate hyperplasia (BPH) symptoms according to the American Urological Association clinical guidelines and sleep quality according to Pittsburgh Sleep Quality Index (PSQI). Patients were reevaluated after three months of treatment. The International Prostatic Symptom Score (IPSS), IPSS-Quality of Life (IPSS-QoL), maximal urinary flow rates (Qmax), average urinary flow rates (AFR), post void residual urine volumes (PVR), nocturia and Pittsburgh Sleep Quality Score (PSQS) were recorded at baseline and after three months. Results Mean age was 63.3 ± 6.6 and 61.4 ± 7.5 years in groups 1 and 2, respectively (p = 0.245). There were no statistically significant differences between both groups. Also, baseline prostate specific antigen (PSA), prostate volume, creatinine, International Prostatic Symptom Score (IPSS), IPSS-Quality of Life (IPSS-QoL), maximal urinary flow rates (Qmax), average urinary flow rates (AFR), post void residual urine volumes (PVR), nocturia and Pittsburgh Sleep Quality Score (PSQS) were similar in both groups. In addition, the total IPSS, IPSS-QoL, PVR, nocturia, and PSQS were significantly lower in Group 2 compared with Group 1 after treatment (p < 0.05). Qmax and AFR were higher significantly in Group 2 compared with Group 1 after treatment (p < 0.05). Conclusions Cyclooxygenase (COX)-2 inhibitors in combination with an alpha blocker may decrease benign prostatic hyperplasia symptoms and increase sleep quality without serious side effects

Influence of Primary or Secondary Muscle Invasive Bladder Cancer on Oncologic Outcomes After Radical Cystectomy

Objective: In this study, we aimed to investigate the oncologic outcomes of patients who were diagnosed with primary (muscle invasive cancer at the time of diagnosis) and secondary (cancer that showed progression from non-muscle invasive bladder cancer) muscle invasive bladder carcinoma (MIBC) before radical cystectomy (RC)

Evaluation of the Prognostic Value of Preoperative Neutrophil-tolymphocyte Ratio in Renal Cell Carcinoma

Objective: To investigate the prognostic value of neutrophil-to-lymphocyte ratio (NLR) in renal cell carcinoma (RCC)

External validation and comparison of the scoring systems (S.T.O.N.E, GUY, CROES, S-ReSC) for predicting percutaneous nephrolithotomy outcomes for staghorn stones: A single center experience with 160 cases

The aim of this study was validation and comparison of stone scoring systems (S.T.O.N.E, GUY, CROES, S-ReSC) used to predict postoperative stone-free status and complications after percutaneous nephrolithotomy (PCNL) for staghorn stones. A total of 160 patients who had staghorn renal stones and underwent PCNL between January 2012 and August 2015 were included in the current retrospective study. Guy, S.T.O.N.E., S-ReSC (Seoul National University Renal Stone Complexity) and CROES (Clinical Research Office of the Endourological Society) nephrolithometry scores were calculated for each patient, and their potential association with stone-free status, operative and fluoroscopy time, and length of hospital stay (LOS) were evaluated. Postoperative complications were graded according to the modified Clavien classification, and the correlation of scoring systems with postoperative complications was also investigated. The mean CROES, S.T.O.N.E, Guy and S-ReSC scores were 143.5 ± 33.6, 9.7 ± 1.6, 3.5 ± 0.5 and 6.2 ± 2.0 respectively. The overall stone-free rate was 59%. All scoring systems were significantly correlated with stone-free status in univariate analysis. However, Guy and S-ReSC scores were the only significant independent predictor in multivariate analysis. And all four nomograms failed to predict complication rates. Current study demonstrated that Guy and S-ReSC scoring systems could effectively predict postoperative stone-free status for staghorn stones. However all four scoring systems failed to predict complication rates