Does Platelet Mass Index Play a Role in Predicting Biochemical Recurrence in Localized Prostate Cancer?

Objective:The aim of this study is to investigate the association of preoperative platelet mass index (PMI) with tumor pathologic features and postoperative biochemical recurrence in patients undergoing radical prostatectomy due to localized prostate cancer.Materials and Methods:Data of 141 patients, who underwent radical prostatectomy for localized prostate cancer between April 2004 and April 2017, were retrospectively screened. Patient age, preoperative prostate-specific antigen (PSA) level, platelet count, mean platelet volume and PMI value, neutrophil-lymphocyte ratio (NLR), tumor grade, Gleason score, tumor volume, lymph node involvement, surgical margin positivity and biochemical recurrence at 3 months were all noted. The relationship of preoperative PMI value with age, PSA, pathologic parameters, surgical margin positivity and biochemical recurrence was evaluated.Results:The mean age of the patients was 61.79±5.98 years, the mean PSA value was 9.50±6.69 ng/mL, mean PMI was 2003.91±486.69, and the mean NLR was 2.79±2.06. There was no correlation of PMI value with PSA, pathological stage, Gleason score, lymph node involvement, tumor volume, surgical margin positivity, and biochemical recurrence. There was statistically significant negative correlation between PMI and Gleason score.Conclusion:In our study, we could not demonstrate preoperative PMI as a prognostic factor for early biochemical recurrence in patients undergoing radical prostatectomy for prostate cancer. To achieve a better conclusion that we can generalize, there is a need for prospective studies with larger patient series

Evaluation of Social Reflex Resulting from Observation of Blood in the Urine

WOS: 000429815500002Objective: In this study, we aimed to evaluate the level of public awareness of hematuria. Materials and Methods: In September 2017, a survey of randomly selected 400 patients who presented to our outpatient clinic in a period of 1 month was conducted. The survey focused on patients' background and knowledge of urology and hematuria. Results: A hundred and sixteen (29%) females and 284 (71%) male patients participated in our survey. Two hundred and seven (51.7%) patients were under age 50 and 193 (48.3%) were over 50 years of age. 155 (38.8%) patients were primary school graduates, 59 (14.8%) - secondary school, 98 (24.5%) - high school, and 88 (22%) were university graduates. Three hundred and thirty-two (83%) patients described that they have previously seen blood in their urine and, 68 (17%) patients did not. There was no statistically significant difference in patients who went immediately to the urology outpatient clinic in the case of hematuria, but those who thought that they may have tumor were older in age. No significant difference was observed in the answers to the questionnaires between gender and between hematuria experience. Those who immediately went to the urology clinic in the presence of hematuria were in the smoking group. Conclusion: Public awareness of health is of utmost importance. However, it was seen that even patients who may be at risk for malignant diseases were not able to lead the way in public awareness

Which Factors Affect the Hospital Re-admission After Treatment Approaches to Urethral Strictures?

WOS: 000419241900003Objective: To investigate patient-and procedure-related factors associated with hospital re-admission following urethral manipulations for the treatment of urethral strictures. Materials and Methods: Data of patients who underwent dilation or internal urethrotomy for urethral strictures between 2011 and 2016 were retrospectively analyzed. Patients who were admitted to our institute for any reason within one month after hospital discharge were evaluated. The patient-and procedure-related factors affecting the readmission rates were revealed by multiple binary logistic regression using stepwise backward elinimination. Results: The average age of 76 male patients was 61.7 +/- 14.4 years. The mean maximal flow rate at preoperative uroflowmetry was 6.01 +/- 4.3 and the median American Society of Anesthesiologists score was 2.38. The process was the first for 45 (59.2%) patients, the second for 16 (21.1%) patients, the third for 9 (11.8%) patients, and the fourth for 6 (7.9%) patients. Amplatz dilators, cold knife and Ho: YAG laser were used in 50%, 27.6% and 22.4% of patients, respectively. The mean length of hospital stay was 0.89 +/- 0.31 days, and the complication rate was 19.7% (15/76). The mean urethral catheter dwell time was 8.9 +/- 14.2 day. Overall, the procedure was successful in 61 (80.3%) patients and failed (Q(max) < 15 mL/sec) in 19.7% of the cases. Fifteen (19.7%) patients were re-admitted, while 2 (2.6%) patients among them were re-hospitalized for further treatment. Comorbidity and age were independent predictors of re-admission. Conclusion: We found that younger age and lower comorbidities predicted hospital re-admission following procedures for urethral strictures

Üretra Darlıklarında Tedavi Yaklaşımlarına Göre Hastaneye Tekrar Başvuruyu Etkileyen Faktörler

Amaç: Üretral darlıklara müdahale edildikten sonra hastaneye tekrar başvuru nedenleri ile ilişkili hasta ve prosedüre bağlı faktörleri araştırmaktır.Gereç ve Yöntem: 2011 ile 2016 yılları arasında üretra darlığı nedeni ile dilatasyon veya internal üretrotomi uygulanan hastaların tıbbi kayıtları retrospektif olarak incelendi. Hastaneden taburcu olduktan sonraki 30 gün içinde hastaneye herhangi bir sebeple yeniden başvuran hastalar değerlendirildi. Tekrar başvuru oranlarını etkileyen hasta ve prosedüre bağlı faktörler, geriye doğru kademeli çoklu ikili lojistik regresyon analizi kullanılarak ortaya çıkarıldı.Bulgular: Yetmiş altı erkek hastanın yaş ortalaması 61,7±14,4 yıldı. Preoperatif üroflowmetride ortalama maksimal akım hızı 6,01±4,3, ortalama Amerikan Anesteziyologları Derneği skoru 2,38 idi. Kırk beş (%59,2) hastada birinci, 16 (%21,1) hastada ikinci, 9 (%11,8) hastada üçüncü, 6 (%7,9) hastada dördüncü kez işlem yapıldı. Amplatz dilatörleri, soğuk bıçak ve Ho:YAG lazeri sırasıyla %50, %27,6 ve %22,4 hastalarda kullanıldı. Ortalama yatış süresi 0,89±0,31 gün, komplikasyon oranı %19,7 (15/76) idi. Ortalama uretral kateterin kalma süresi 8,9±14,2 gündü. Toplam 61 (%80,3) hastada başarı elde edildi. Olguların %19,7'sinde işlem başarısız oldu (Qmaks <15 mL/sn). On beş (%19,7) hasta hastaneye tekrar başvurdu; 2 (%2,6) hasta daha ileri tedavi için hastaneye yatırıldı. Komorbidite ve yaş, hastaneye tekrar başvurunun bağımsız öngörü faktörüdür.Sonuç: Genç yaş ve düşük komorbiditenin üretra darlıkları için yapılan müdahaleler sonrasında hastaneye tekrar başvuruyu öngörebileceğini tespit ettikObjective: To investigate patient- and procedure-related factors associated with hospital re-admission following urethral manipulations for the treatment of urethral strictures. Materials and Methods: Data of patients who underwent dilation or internal urethrotomy for urethral strictures between 2011 and 2016 were retrospectively analyzed. Patients who were admitted to our institute for any reason within one month after hospital discharge were evaluated. The patient- and procedure-related factors affecting the readmission rates were revealed by multiple binary logistic regression using stepwise backward elinimination. Results: The average age of 76 male patients was 61.7±14.4 years. The mean maximal flow rate at preoperative uroflowmetry was 6.01±4.3 and the median American Society of Anesthesiologists score was 2.38. The process was the first for 45 (59.2%) patients, the second for 16 (21.1%) patients, the third for 9 (11.8%) patients, and the fourth for 6 (7.9%) patients. Amplatz dilators, cold knife and Ho:YAG laser were used in 50%, 27.6% and 22.4% of patients, respectively. The mean length of hospital stay was 0.89±0.31 days, and the complication rate was 19.7% (15/76). The mean urethral catheter dwell time was 8.9±14.2 day. Overall, the procedure was successful in 61 (80.3%) patients and failed (Qmax <15 mL/sec) in 19.7% of the cases. Fifteen (19.7%) patients were re-admitted, while 2 (2.6%) patients among them were re-hospitalized for further treatment. Comorbidity and age were independent predictors of re-admission.Conclusion: We found that younger age and lower comorbidities predicted hospital re-admission following procedures for urethral stricture

Complete Urethral Rupture Related with Penile Fracture Occurring during Sexual Intercourse: A Case Report and Review of the Literature

WOS: 000435448100011Complete disruption of the urethra due to penile fracture is a very rare occurrence. Herein, we report a case of a 39-year-old man who presented with penile fracture and complete disruption of the urethra as a result of sexual intercourse and present a review of the literature on penile fracture. Surgical exploration at presentation was performed and primary repair was done. In follow-up, the patient reported moderate erectile dysfunction which over time responded to phosphodiesterase-5 inhibitor drugs. Early surgical repair and evaluation for concomitant urethral injury in case of penile fracture is highlighted in this report

Mesane Kanserinde Organ Koruyucu Yaklaşım: Güncel Durum Değerlendirmesi

Intravesical bacillus Calmette-Guerin (BCG) therapy is the gold standard treatment option in high-risk non-invasive bladder cancer. However, BCG is a very toxic agent. A significant proportion of patients have BCG intolerance after beginning intravesical treatment. Radical cystectomy is the recommended approach for patients with either BCG failure or BCG intolerance. Alternative intravesical salvage treatments are needed for patients who cannot tolerate radical cystectomy due to comorbidities or who refuse surgery. In this review, current intravesical treatment alternatives to radical cystectomy in intravesical BCG failure are discussed with oncologic outcomes.İntravezikal bacillus Calmette-Guérin (BCG) tedavisi yüksek riskli kasa invaze olmayan mesane kanserinde altın standart tedavi seçeneğidir. Bununla beraber BCG oldukça toksik bir ajandır. Tedaviye başladıktan sonra hastaların önemli bir kısmında BCG intoleransı izlenir. İster BCG başarısızlığı olsun, ister BCG intoleransı olsun radikal sistektomi bu aşamada önerilen tedavi yaklaşımı olmaktadır. Komorbiditeleri nedeniyle radikal sistektomiyi tolere edemeyecek ya da böylesi bir cerrahiyi kabul etmeyen hastalarda alternatif intravezikal kurtarma tedavilerine ihtiyaç vardır. Bu derlemede intravezikal BCG başarısızlığında radikal sistektomiye alternatif intravezikal güncel tedavi seçenekleri onkolojik sonuçlarıyla birlikte tartışılmıştır

Are Haematological Parameters Reliable for Differential Diagnosis o Testicular Torsion and Epididymitis?

Objective: Acute scrotum is a urological emergency that can result in loss of the testis if the differential diagnosis is not made immediately. Testicular torsion (TT) and epididymo-orchitis (EO) are the two most common causes of acute scrotum. Our aim was to evaluate the utility of haematological parameters for the diagnosis of both TT and EO and for differential diagnosis of these two conditions

Does Platelet Mass Index Play a Role in Predicting Biochemical Recurrence in Localized Prostate Cancer?

WOS: 000444033700005Objective: The aim of this study is to investigate the association of preoperative platelet mass index (PMI) with tumor pathologic features and postoperative biochemical recurrence in patients undergoing radical prostatectomy due to localized prostate cancer. Materials and Methods: Data of 141 patients, who underwent radical prostatectomy for localized prostate cancer between April 2004 and April 2017, were retrospectively screened. Patient age, preoperative prostate-specific antigen (PSA) level, platelet count, mean platelet volume and PMI value, neutrophil-lymphocyte ratio (NLR), tumor grade, Gleason score, tumor volume, lymph node involvement, surgical margin positivity and biochemical recurrence at 3 months were all noted. The relationship of preoperative PMI value with age, PSA, pathologic parameters, surgical margin positivity and biochemical recurrence was evaluated. Results: The mean age of the patients was 61.79 +/- 5.98 years, the mean PSA value was 9.50 +/- 6.69 ng/mL, mean PMI was 2003.91 +/- 486.69, and the mean NLR was 2.79 +/- 2.06. There was no correlation of PMI value with PSA, pathological stage, Gleason score, lymph node involvement, tumor volume, surgical margin positivity, and biochemical recurrence. There was statistically significant negative correlation between PMI and Gleason score. Conclusion: In our study, we could not demonstrate preoperative PMI as a prognostic factor for early biochemical recurrence in patients undergoing radical prostatectomy for prostate cancer. To achieve a better conclusion that we can generalize, there is a need for prospective studies with larger patient series

Perkütan Nefrolitotomide Charlson Komorbidite İndeksi'nin Postoperatif Clavien Komplikasyon Skalası Üzerine Etkisi

Amaç Perkütan nefrolitotomi (PNL), komorbiditesi olan hastalarda komplikasyonlara daha duyarlı olmaları nedeniyle zorludur. Bu çalışmada, kliniğimizde PNL operasyonları sonrası belirlenen komplikasyonlar üzerinde eşlik eden durumların etkisini hastaların yaşlarını da dikkate alarak dikkate alarak incelemeye çalıştık. Gereç ve Yöntem Haziran 2002 ve Haziran 2012 tarihleri arasında kliniğimizde, PNL uygulanan 360 hasta retrospektif olarak incelendi. Bu çalışmada hastalar, demografik özellikleri, akses giriş yerleri, yaşa göre düzeltilmiş Charlson Komorbidite İndeksi'ne (ACCI) göre preoperatif komorbiditeleri ve Clavien-Dindo Sınıflandırma Sistemi kullanılarak gelişen postoperatif komplikasyonları açısından değerlendirildi. Bulgular Çalışmaya alınan 360 hastanın yaş ortalaması 46 idi (10-83 yıl). Hastaların 220'si (%61,1) erkek ve 140'ı (%38,9) kadındı. ACCI sınıflamasına göre hastaların 169'u (%46,9) grup 1 ve 191'i (%53,1) grup 2 olarak tanımlandı. Olguların 212'sine (%58,8) alt kaliks, 136'sına (37,7%) orta kaliks ve 12'sine (3,3%) de üst kaliks girişi uygulandı. Komplikasyonlara bakıldığında ACCI grup 1 hastalarda %12,4 sınıf 1, %18,9 sınıf 2, %8,28 sınıf 3a ve ACCI grup 2 hastalarda %6,8 sınıf 1, %26,7 sınıf 2, % 6,28 sınıf 3a komplikasyon görüldü (p=0,098; 0,16; 0,49). Sınıf 3b ve sınıf 4a komplikasyonlar sadece ACCI grup 2 hastalarda görüldü. Sınıf 4b ve 5 komplikasyon her iki grup hastalarda da görülmedi. Sonuç Biz hastaların yaşlarını da dikkate aldığımızda, ameliyat sonrası komplikasyon oranları arasında anlamlı bir fark gözlemlemedik. Bu nedenle, tanımlanmış preoperatif komorbiditelerin PNL işlemleri ve operasyonları için risk faktörleri olmadığını düşünmekteyiz.Objective Percutaneous nephrolithotomy (PCNL) in comorbid patients is challenging due to the high susceptibility to complications. In our study, by taking the age of patents into account, we have tried to figure out the impact of comorbid conditions on complications identified after PCNL operations in our clinic. Materials and Methods Three hundred-sixty patients, who underwent PCNL in our clinic between June 2002 and June 2012, were retrospectively analyzed. The patients were assessed in terms of demographic characteristics, access locations, preoperative comorbidity using the age-adjusted Charlson's Comorbidity Index (ACCI) and postoperative complications using the Clavien-Dindo classification of surgical complications. Results The mean age of the patients was 46 (10-83) years. Two hundred-twenty (61.1%) patients were male and 140 (38.9%) were female. According to preoperative ACCI, 169 (46.9%) of the cases were classified as group 1 and 191 (53.1%) of the cases as group 2. In 212 (58.8%) patients, entry into the lower calyx, in 136 (37.7%) - into the middle calyx and in 12 (3.3%) patients, entry into the upper calyx was done. The rate of complications in ACCI group 1, grade 1, grade 2 and grade 3a was 12.4%, 18.9%, 8.28% and in group 2, it was 6.8%, 26.7%, 6.28%, respectively. There was no significant difference between the groups (p=0.098, p=0.16 and p=0.49, respectively). Grade 3b and grade 4a complications were seen only in group 2 (1.04%, 0.52%, resceptively). Grade 4b and 5 complications were not observed in both groups. Conclusion Considering the age of patients, we have not observed a significant difference in the rate of postoperative complications between the groups. Therefore, we assume that the recognized preoperative comorbidities are not risk factors for PCNL procedures and operations