Stone formation on surgical staple in the bladder: A long-term complication of laparoscopic colposuspension

We present a case of a bladder stone that developed around a surgical staple after laparoscopic colposuspension. The patient had undergone laparoscopic colposuspension for stress urinary incontinence at another institution 6 years ago. The hernia mesh and a tacker had been used as a surgical stapler. The stone and staple were retrieved endoscopically. To our knowledge, this is the first case of such a complication after laparoscopic colposuspension with a stapling device. © 2007 Lippincott Williams & Wilkins, Inc

Nocturnal enuresis and allergy

Objective. To investigate whether an interaction exists between nocturnal enuresis and allergy. Material and methods. Thirty-seven (20 boys, 17 girls) children with monosymptomatic nocturnal enuresis were recruited. We studied an allergy panel that included total IgE, 10 examples of inhalant-specific IgE, 10 examples of food-specific IgE, eosinophilic cationic protein (ECP) and Phadiotop. The same panel was studied in a control group of 18 children without monosymptomatic nocturnal enuresis. Results. We did not determine statistically significant differences between the enuretic group and the control group in terms of levels of total IgE, the 10 examples of inhalant-specific IgE and Phadiotop. However, two (soybean and hazelnut) of the 10 food-specific IgE and ECP levels did differ significantly between the two groups. Conclusions. This first specific IgE study showed that there may be a relationship between nocturnal enuresis and soybean and hazelnut food allergens. Our findings may explain some cases of nocturnal enuresis. However, further studies are necessary to explain the underlying mechanisms and management of this disorder. © 2005 Taylor & Francis

Correlations between the ICIQ-SF score and urodynamic findings

Aims: The primary aim of this prospective study was to examine the correlations between "The International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF)" score and urodynamic findings in patients with urge incontinence. In addition, we aimed to observe the alterations of these parameters with antimuscarinic therapy. Methods: Between January and December 2005, patients referred to our department with urge incontinence were examined. After taking a detailed clinical history, physical examination, and urinalysis, each patient was asked to complete an ICIQ-SF questionnaire. We carried out subtracted cystometry according to a fixed protocol on all patients. Patients who were defined as detrusor overactivity incontinent were given antimuscarinic therapy for 3 months. Following treatment, filling cystometry and ICIQ-SF scoring were repeated in all patients. All pre- and post-treatment data of 18 male and 42 female patients were transferred to the SPSS 11.0 for Windows program, and statistical analyses were performed. Results: The patients' ages ranged from 28 to 70 (mean 49.8) years. We found statistically significant differences between the pre- and post-treatment parameters (mean ICIQ-SF score, first sensation, cystometric capacity, maximum detrusor pressure, compliance; P < 0.01). We found negative correlation between pre-treatment mean ICIQ-SF score and first sensation (correlation coefficient -0.266, P < 0.05) and positive correlation between pre-treatment mean ICIQ-SF score and maximum detrusor pressure (correlation coefficient 0.4, P < 0.01). Conclusions: ICIQ-SF scoring is a practical and reliable method for baseline and post-treatment evaluation of patients with urge incontinence. Significant correlation exists between ICIQ-SF score and urodynamic parameters. © 2007 Wiley-Liss, Inc

Successful repair of a bladder herniation after old traumatic pubic symphysis diastasis using bone graft and hernia mesh

Bladder herniation associated with pubic symphysis diastasis is a very rare condition. We report a case with bladder herniation after traumatic pubic symphysis disruption. The patient was treated with open reduction of the bladder and definitive internal fixation of the pubis. We used a bone allograft for closure of the diastasis and a prolene mesh graft for supporting the abdominal wall. We obtained a successful outcome during a 12-month follow-up period. © Springer-Verlag 2007

A prospective randomized study for comparing bipolar plasmakinetic resection of the prostate with standard TURP

Objectives: To compare clinical results of plasmakinetic (PK) resection vs. standard monopolar resection of the prostate, i.e. transurethral resection of the prostate (TURP). Materials and Methods: 48 patients were included in this study between January 2003 and October 2003. They were randomized into two groups (TURP:PK) with a ratio of 1:1. PK resections (n = 24) were carried out by using PlasmaKinetic Tissue Management System (Gyrus Medical Ltd, Cardiff, UK) and PlasmaSect electrodes. TURPs (n = 24) were done by using a 26-Fr continuous-flow resectoscope and Karl Storz 27040 electrodes. Patients were assessed for safety and efficacy by measuring the IPSS and maximum flow rates at 1, 3, 6 and 12 months and residual urine measurement at 3, 6 and 12 months and transrectal ultrasonography at 6 months. Results: The patients' ages ranged from 50 to 82 (mean 64 ± 10) years. Groups were similar for operation time, bleeding score, resected tissue, catheterization time and irrigated volume. Mean serum Na levels at the end of the operation were 141.7 ± 5.1 in the TURP group and 145.2 ± 4.4 in the PK group (p = 0.013). The IPSS, QOL score and Qmax had improved significantly in the postoperative period without any differences in either group. Conclusions: The main advantage of PK resection seems to be decreasing the risk of TUR syndrome, thus, larger prostates could be treated without a time limitation, theoretically. However, this technique brings no advantages in terms of intra- and postoperative bleeding, hospital stay, operation time and late complications. Copyright © 2006 S. Karger AG

Partial nephrectomy using a monopolar radiofrequency device: An animal model

Objectives: To compare the use of radiofrequency (RF) and electrocautery in partial nephrectomy without renal artery clamping for bleeding and tissue destruction. Methods: Sixteen adult rabbits were randomized into two groups. Partial nephrectomy using a monopolar RF device without renal artery clamping was performed in 8 rabbits (RF group) and partial nephrectomy using electrocautery was performed in the rest (cautery group). Four rabbits in each group (rabbits 1, 3, 5, and 7) were kept for follow-up, and the operated kidneys of the rest were removed for histopathologic evaluation. The tissue samples were placed in 10% formalin solution and sent to the pathology laboratory. The groups were compared in terms of bleeding and tissue destruction. Results: The mean blood loss was 3.6 ± 1.2 mL in the RF group and 8.3 ± 2.7 mL in the control group (P = 0.003). A rabbit in the control group died on postoperative day 3 because of bleeding. Others were followed up for 3 months postoperatively. The amount of thermal destruction was comparable between the two groups. Varying degrees of thermal destruction were observed at the cutting margins in both groups. No difference was found between the two groups in terms of the deepness of thermal injury (1 to 2 mm). Conclusions: The findings of our experimental study showed that the use of the RF electrode in partial nephrectomy without renal artery clamping resulted in less intraoperative bleeding without differences in terms of tissue destruction. © 2006 Elsevier Inc. All rights reserved

Garlic supplemented diet attenuates gentamicin nephrotoxicity in rats

Purpose: To demonstrate the effect of a 4% pulverized garlic supplemented diet on the nephrotoxicity induced by gentamicin in rats. Materials and Methods: Twenty four healthy male Wistar rats, weighing between 220 - 260grams, were divided into three groups. The rats were randomly assigned to either the gentamicin injection without garlic supplementation group (Group I, n = 8), gentamicin injection with garlic supplementation group (Group II, n = 8), and control group (Group III, n = 8). Urine from the rats was collected and the volume (mL), microalbumin (mg/L), creatinine (mg/dL), Na (mmol/L), K (mmol/L), Cl (mmol/L), P (mg/dL), N-acetyl glucosamine (NAG) (U/L) and pH values were measured. Then urea (mg/dL), creatinine (mg/dL), total protein (g/dL) and cystatin (mg/L) values were measured for the blood samples obtained from tail veins. Results: The median NAG value for the control group (52.050 U/L) was similar to value for Group II (56.400 U/L), which received gentamicin and the garlic diet. However, the median NAG value for Group I (77.030 U/L), which received gentamicin without garlic supplementation, was determined to be statistically significantly higher (p = 0.010) than the value for the control group. In addition, the mean cystatin value for Group II (1.360 U/L) was found to be statistically significantly lower than the value for the Group I (2.240 U/L) (p = 0.015). Conclusions: In this study we showed the effect of 4% pulverized garlic supplemented diet for preventing nephrotoxicity induced by gentamicin in rats by using as parameters NAG in urine samples and cystatin C in serum samples