Laparoscopic adrenalectomy: Our clinical experiences with the first 10 patients

Objectives: The aim of this study is to present the resultsof our first ten laparoscopic adrenalectomy cases whichwere performed in our clinic.Materials and methods: Between December 2010 andSeptember 2012 the standard transperitoneal laparoscopicadrenalectomy was performed on 10 patients.Data of patients such as age, weight, height, operationtime, hospitalization time, complications, size of adrenalmass and pathological diagnosis were retrospectively reviewedand recorded from the hospital records.Results: Three of ten patients were male and seven ofthem were female. The mean age of the patients was42.12±11.4 (21-55) years. Mean operation time was recordedas 136±23.6 (100-190) min. Mean tumor size was7.1±2.7 (5-12) cm. None of the patients required bloodtransfusion. Mean hospital stay was 2.3±1.2 (2-6) days.Pathological diagnoses of masses were pheocromacytomain two patients, adrenal adenoma in six, myelolipomain one and pseudocist in one.Conclusions: According to our experience with the limitednumber of the first ten cases, transperitoneal laparoscopicadrenalectomy is a safe and effective treatmentmodality, associated with minimal morbidity. To obtainmore reliable information larger series with long-term resultsof laparoscopic adrenalectomy is needed.Key words: Laparoscopy, adrenalectomy, experience,transperitonea

Our laparoscopic radical nephrectomy experiences

Objective: In this study our aim is to present outcomes of laparoscopic radical nephrectomy (LRN) we have been applying for the management of renal masses. Methods: We retrospectively examined medical files of 54 cases who underwent LRN in the Urology Clinics of Dicle University between October 2010, and April 2014. Archival files of the patients were retrospectively analyzed as for age, gender, obesity, dimensions, and laterality of renal mass, smoking status, history of hypertension, histopathology results, blood transfusion (if any), hospital stays, peri- and post-operative complications, drain removal times, and method of removal of the nephrectomy material. Results: Our study population (n=54) consisted of 21 male, and 33 female patients with a mean age of 58,8 (29-82) years. Some of them were smoker (n=23), hypertensive (n=15), and obese (n=32) patients. Renal masses with a median diameter of 6.2 cm (4,5-16,5) were localized in the right (n=23) or left (n=31) kidneys. In all cases, transperitoneal approach was preferred. In 3 cases we have to switch to an open surgery. In 8 patients, blood transfusions were required. In 18 patients 4th port was used for the retraction of the liver, while in other cases only 3 ports were used. Median operative time was 115.6 min (75-192). Median hospital stay was 3,9 days (3-16). In one case abundant bleeding occurred because of splenic artery injury. Conclusion: Transperitoneal LRN is a minimally invasive surgical method which can be performed rapidly, and effectively. We think that in procedures performed in compliance with surgical principles, LRN can be realized safely with lower complication rates even by urologists in their initial experiences

A questionnaire study about gonadal shield use of urologists

Objectives: Our aim is to reflect routines, awareness,and consciousness level of urologists about usage of gonadalshield (GS) in Turkey.Materials and methods: Because of this objective aquestionnaire which includes 15 questions was prepared.The questionnaire was delivered to urologists in a TurkishUrology congress. Data derived from 271 urologists byface to face interview were evaluated.Results: Participant were urologists (n=271), consistedof professors (n=33), associate professors (n= 36), assistantprofessors (n= 36), specialists (n=94), and residents(n=81). According to the data obtained from the questionnaires,22% of the participants acquired their first informationabout GS as a medical student, 44% during theirresidency training, and 14% of them had no informationabout GS at all. Besides 64% of them did not read anymedical article about this subject until that time, and 54%them practically hadn’t seen any GS during their urologypractice. In 82% of the hospitals where participants wereworking hadn’t had any GS, and 18% of the urologistshad indicated that GS was available in their hospitals, andthey used them once in a while. Urologists responded favorably(20%) or unfavorably (80 %) to the question of ‘Doyou find yourself or your colleagues adequately sensitive,and mindful about GS use?Conclusions: Sensitivity and awareness about use ofgonadal shields among Turkish urologists are not at adesired level and for this reason, it is not used widely.The urologists should be informed in urological academicplatforms about gonad protecting devices.Key words: Gonad shield, questionnaire survey, radiation,urologis

The results of transrectal prostate biopsy in patients with low levels of prostate specific antigen

Objectives: The aim of this study is to evaluate the resultsof prostate biopsy of patients who had the prostatespecificantigen (PSA) levels below 4 ng/ml.Material and methods: The medical records of 63 patientswho underwent transrectal prostate biopsy, betweenJanuary 2005 and December 2011, due to suspicionof prostate cancer with the PSA levels under 4 ng/mlwere retrospectively reviewed.Results: Transrectal Prostate biopsy was performed to63 patients. Prostate cancer was detected in 12 (19%)patients. The mean value of PSA was 2.5 ng/ml. TheGleason score of Prostate cancer patients was 6,8 (5-7)and the number of positive cores were 3.Conclusions: The rate of prostate cancer was found as19% in patients with levels of PSA under 4 ng/ml and thisratio is compatible with the results of previous reports

Association of microRNA-related gene polymorphisms and idiopathic azoospermia in a south-east Turkey population

MicroRNAs (miRNAs) are small conserved non-coding RNA molecules that post-transcriptionally regulate gene expression. Although it is reported in many studies that there are associations between alterations of miRNA homeostasis and pathological conditions such as cancer, psychiatric and neurological diseases, cardiovascular disease and autoimmune disease, the effects of common genetic variants of these genes on male infertility are unclear. To better understand this effect, we performed a case-control study including a total of 108 infertile men with idiopathic azoospermia and 125 fertile control subjects. Real-time polymerase chain reaction was used to genotype six single-nucleotide polymorphisms (SNPs) of microRNA biogenesis pathway genes and the associations between individual and combined genotypes and idiopathic azoospermia were analysed. The results showed significant difference between the individual AA genotype frequency of the GEMIN3 (rs197388) gene in the patient and control groups, indicating that the AA genotype may be considered as indicative of a higher predisposition to idiopathic azoospermia. The combined genotype analysis, including six SNPs, revealed statistically significant differences between the patients and control subjects for some combinations. For example, the frequency of genotype distributions of the AA\CA-CC-TT-AT genotype combination for the XPO5-RAN-DICER1-GEMIN3 combined loci was significantly different, and it may be considered a predisposition to idiopathic azoospermia. According to the obtained results, both individual and combined genotypes of SNPs from miRNA genes may be used to predict the risk of male infertility with idiopathic azoospermia