Radiofrequency ablation treatment of kidney tumors

Günümüzde teknolojideki gelişmelere paralel olarak küçük boyutlu böbrek tümörlerinin tedavisinde alternatif tedavi yöntemlerinin sayısı giderek artmaktadır. Böbrek tümörlerinin radyofrekans ablasyon tedavisi, perkütan ve laparosko- pik olarak uygulanabilmektedir. Bu yöntem kısa iyileşme süresi, azalmış morbidite oranı ve uzun süreli takiplerde güvenilir onkolojik sonuçların elde edilmesi gibi önemli avantajlara sahiptir. Bir minimal invaziv tedavi yöntemi olarak böbrek tümörleri tedavisinde kullanımı giderek ya ygınlaşmaktadır.Nowadays, the number of alternative treatment modalities in the treatment of small sized renal tumors increases parallel to the technological developments. Radiofrequency ablation therapy can be performed by both percutaneous and laparoscopic ways. This modality has some significant advantages, such as short recovery time, decreased morbid ity rate and obtaining reliable oncological outcomes in the long -term follow-up. This technique is being increasingly used in the treatment of small renal tumors as a minimally invasive treatment modality

The relationships between waist circumference as an indicator of central obesity and lower urinary tract symptoms, erectile dysfunction and metabolic syndrome components

Objectives: In this study, we aimed to evaluate the relationshipbetween waist circumference, which is as anindicator of central obesity, and lower urinary tract symptoms,erectile dysfunction and metabolic syndrome components.Materials and methods: The data of 52 patients withmoderate-severe lower urinary tract symptoms, who hadno previous diagnosis of benign prostatic hyperplasia andprostate specific antigen 102 cm). Age, weight, urine flow rates, prostate volume,and prostate specific antigen value and lipid profiles wereseparately determined for all patients. Data on chronicsystemic diseases and erectile function was also evaluatedand possible relations between them were investigated.Results: The mean age of patients was 60,6±7,8 years.It was determined that diabetes in 17 (%32,69), hypertensionin 22 (%42,30), coronary artery disease in 13(%25) and erectile dysfunction in 24 (%46.15) patients.Positive correlations were found between waist circumferenceand the parameters of age, International ProstateSymptom Score, body weight, prostate volume, triglycerideand LDL-cholesterol levels. Nevertheless, there wasa negative correlation between waist circumference andurine flow rates. While the data of all subgroups werecompared, it was seen that increased waist circumferencewas with worsened lower urinary tract symptomsand sexual function.Conclusions: Increased waist circumference had negativeimpacts on lower urinary tract symptoms and sexualfunctions, and it was with increasing frequency of diabetes,coronary heart disease, hypertension and metabolicsyndrome.Key words: Central obesity, lower urinary tract symptoms,sexual function, metabolic syndrom

Epididymoorchitis as the First Finding in Patients with Brucellosis

Purpose. Acute scrotal pain as the first symptom of brucellosis is rarely observed. We aimed to evaluate the data of male patients with brucellosis and epididymoorchitis as the initial diagnosis. Material and Methods. The data of seven patients presented with testicular pain, hyperemia, swelling, and increased fever were reviewed. Concomitant focal diseases as well as clinical, laboratory, and radiological findings were retrospectively evaluated. Results. The mean age of the patients was 22.28 ± 7.78 (16–35) years. All patients presented with scrotal pain, swelling, and increased sweating. Additional findings included fever, asthenia, arthralgia, dysuria, shiver and rash, weight loss, and vomiting in 6, 5, 4, 4, 3, 2, and 1 patient, respectively. In all of 7 patients, the agglutination tests of Rose-Bengal and Wright were positive. Coombs test was positive only in 3 patients. The patients underwent antibiotic and conservative treatment. No relapse was observed following the treatment. Conclusion. In endemic regions, epididymoorchitis caused by brucellosis should be considered in the differential diagnosis of patients presenting with acute scrotal pain. Clinical and serological findings are sufficient for the diagnosis. Conservative management combined with antibiotic therapy is adequate for managing brucellar epididymoorchitis

Does Urinary Bladder Shape Affect Urinary Flow Rate in Men with Lower Urinary Tract Symptoms?

We aimed to investigate the role of urinary bladder shape which may potentially change with advancing age, increased waist circumference, pelvic ischemia, and loosening of the urachus on bladder emptying and UFR. We retrospectively investigated the medical records of 76 men. The patients were divided into two groups according to bladder shapes in MRI scan (cone and spheric shapes). There was a significant difference between the two groups in terms of IPSS, Qmax, Qave, and waist circumference. A positive correlation has been demonstrated between mean peak urinary flow rate measured with UFM and mean flow rate calculated using the CP. There was a significant difference between mean urinary flow rates calculated with CP of cone and sphere bladder shapes. The change in the bladder shape might be a possible factor for LUTS in men and LUTS may be improved if modifiable factors including increased waist circumference and loosening of the urachus are corrected

Minimally invasive treatment in kidney tumors: Initial experience in radiofrequency- ablation

Amaç: Bu çalışmada böbrek tümörü tanısıyla yaptığımız radyofrekans tümör ablasyonu (RFTA) uygulamasındaki ilk deneyimlerimizi sunmayı amaçladık. Gereç ve Yöntem: 2011-2012 yıllarında böbrek tümörü tanısıyla RFTA yapılan 5 hastanın verileri değerlendirildi. RFTA işlemi, 4 hastada ultrason klavuzluğunda (USG-RFTA) ve 1 hastada retroperitoneal teknikle laparoskopi eşliğinde (L-RFTA) genel anestezi altında gerçekleştirildi. RFTA öncesi rutin renal kitle biyopsisi yapıldı. Hastalar işlem sonrası 1, 3, 6 ve 12. aylarda ve sonrasında yılda bir kontrastlı radyolojik görüntüleme teknikleri ile kontrol edildi. 1. ay kontrolde canlı tümör dokusu varlığı rezidü ve ilk ay kontrolü normal olup sonraki aylarda saptanan canlı (kontrastlanan) tümör dokusu nüks olarak değerlendirildi. 1. ay kontrolde rezidü varlığı da başarısızlık olarak kabul edildi. Bulgular: Ortalama yaş 65,2 ±10,2 yıl ve ortalama tümör boyutu 27,6±4,34 mm bulundu. İşlemlerin 3’ü sol ve 2’si sağ tarafa uygulanmıştır. Sağ taraf işlemlerinden biri sağ parsiyel nefrektomili soliter böbreğe yapılmıştır. Tüm biyopsi patolojileri renal hücreli kanser olarak bulundu. İki (%40) USG-RFTA olgusunda 1. ay kontrolde rezidü varlığı (başarı- sızlık) gözlendi. İşlem başarısı %60 olarak belirlendi. Başarı- sızlık gözlenen 2 olguya USG-RFTA tekrarı yapıldı. Takiben kontrolü yapılan 1 olgunun ilk ay kontrolünde rezidü saptanmazken, diğer olgunun kontrolü henüz yapılmamıştır. Ortalama takip süresi 11,4±6,65 ay olup, bu süre içinde hiçbir olguda nüks gözlenmemiştir. Hiçbir hastada uygulamaya bağlı komplikasyon gözlenmemiştir. Sonuç: RTFA işlemi seçilmiş böbrek tümörlerinin tedavisinde güvenli, daha az invaziv ve etkili bir tedavi yöntemi olarak görünmektedir.Objective: In this study, we aimed to present our initial results in radiofrequency ablation of kidney tumors (RFTA). Material and Methods: In 2011-2012, the data of 5 patients who underwent RFTA were evaluated. The RFTA applications were performed by ultrasound guided percutaneous technique (USG-RFTA) in 4 patients and by retroperitoneally laparoscopic technique in 1 under general anesthesia. Previously, a routine renal mass biopsy was applied. Patients were radiologically controlled at 1., 3., 6., 12. months and then annually. The presence of viable tumor at 1st month was accepted as the residue and at subsequent controls after 1st was accepted as recurrence. The presence of residual tumor at 1st control was evaluated as the failure. Results: The mean age was 65.2 ±10.2 years and the mean tumor size was 27.6±4.34 mm. 3 apllicaitons were left-sided and 2 were right-sided. One of right-sided aplication was performed in a partially nephrectomized solitary kidney. All biopsies demonstrated renal cell carcinoma. The presence of residue at 1st month control (the failure) was determined in 2(40%) USG-RFTA cases. The success rate was estimated as 60%. USG-RFTA repeated in the failed cases. Subsequently, one was controlled at 1st month and no residual tumor was determined . The other was not evaluated yet. The mean follow-up duration without any recurrence was 11.4±6.65 months. No complication related to the application was occurred