Nephrocutaneous Fistula: An Unusual Nephrectomy Indication in Percutaneous Nephrolithotomy

Percutaneous nephrolithotomy (PNL) is recognized as the gold standard treatment method for stones larger than 2 cm due to its high success and acceptably low complication rates. The complications of PNL are well defined. Prolonged urinary leakage is one of them. In this study, a case of post-PNL urine leakage that was eventually treated with nephrectomy is discussed

Sphingomonas paucimobilis infection with underlying submandibular sialolithiasis

Sphingomonas paucimobilis (S. paucimobilis) gram negatif, aerobik, non-fermentatif, oksidaz () ve katalaz () bir bakteridir. S. paucimobilis, nadir şekilde izole edilmesine rağmen, nozokomiyal ve toplumdan kazanılmış enfeksiyonlara neden olabilir. Kliniğimizdeki bir hastanın bir haftadır sağ submandibüler bölgede şişlik ve yemek yerken artan ağrı yakınması vardı. İki elle yapılan muayenesinde sağ Wharton kanalında 1x1x1 cm boyutunda ağrılı şişlik belirlendi. Sağ submandibüler beze yapılan masaj ile Wharton kanal ağzından gelen pürülan akıntıdan kültür alındı ve S. paucimobilis üretildi. Ultrasonografide kanalda ya da bezde taş saptanmadı, fakat tedavi sırasında submandibüler beze masaj yapılarak sağ Wharton kanalından iki adet taş geldiği gözlendi. On dört günlük intravenöz ampisilin-sulbaktam tedavisi ile enfeksiyonun eradike olduğu gözlendi. Hastanın altı ay sonraki kontrol muayenesinde herhangi bir patolojik bulgu ya da belirti saptanmadı ve ultrasonografisi normal idi. Bilgilerimize göre bu hasta sialolitiazis zemininde S. paucimobilis üretilen ilk siyaladenit olgusudur.Sphingomonas paucimobilis (S. paucimobilis), is a gram-negative, aerobic, non-fermentative, oxidase () and catalase () bacterium. Although S. paucimobilis is isolated very rarely, it can cause both nosocomial and community-acquired infections. A patient admitted to our clinic had a complaint of swelling in the right mandibular region and pain increasing while eating for the previous week. Bimanual palpation revealed a painful swelling of 1x1x1 cm in size inside the right Wharton‘s duct. Via massage over the right submandibular gland, a purulent drainage came up from the opening of the Wharton‘s duct and it was cultivated and S. paucimobilis was isolated. There was no ultrasonographic evidence of calculi in the duct or in the gland, but during the right submandibular gland massage, two stones came out through the Wharton‘s duct. The infection was observed to be eradicated with a 14-day ampicillin-sulbactam treatment. In the control examination after six months, there were no pathological signs or symptoms and the ultrasonogram was normal. As far as we know, this is the first sialadenitis case with underlying sialolithiasis where S. paucimobilis was isolated

Non-venereal sclerosing lymphangitis of the penis: A report of two cases

Non-veneryal sklerozan lenfanjit (NVSL) sert cinsel ilişki sonrası ortaya çıkan, nadir görülen bir hastalıktır. Hastalık ilk olarak 1923 yılında Hoffman tarafından tanımlanmıştır. Genellikle 2. ve 3. dekatta görülür. Penisin koronal sulkusu etrafında ip benzeri sert şişlik ile karakterizedir. Selim seyirli olup genellikle kendiliğinden geriler. Ağrı genellikle olmaz. Ayrıcı tanıda Penil Mondor hastalığı (PMH) mutlaka akla gelmelidir. PMH'de lezyon NVSL'ye göre daha serttir ve üstteki dokuya yapışıktır. Hastalarda ağrı sıklıkla olur. NVSL'de venöz Doppler ultrason normaldir ancak PMH'de artmış ekojeniteli ve sıkıştırılamayan venler izlenir. Burada NVSL tanısı konulan iki olgu sunulmaktadır. Bu hastalığın dermatoloji ve üroloji hekimleri tarafından tanınması ve seyrinin bilinmesi yanlış tanı, gereksiz tetkik ve tedaviden kaçınmak için çok önemlidir.Non-venereal sclerosing lymphangitis (NVSL) is a rare disease that develops after vigorous sexual intercourse. The disease was first described in 1923 by Hoffman. The condition is observed usually in the second or third decade of life. NVSL is characterized by a rope-like hard swelling around the coronal sulcus of the penis. It is generally painless and benign and usually resolves spontaneously. Penile Mondor's disease (PMD) must be considered in differential diagnosis. The lesion is harder and adherent to the underlying skin in PMD. Patients often have pain. Venous Doppler ultrasound is normal in NVSL but increased echogenicity and incompressible veins are observed in PMD. Here, we report two cases of NVSL. Establishing the diagnosis and knowing the course of the disease by dermatologists and urologists is very important to avoid misdiagnosis, unnecessary laboratory examinations and treatment

Cases of a Borderline Pathology That Can Mimic Bladder Cancer: Primary Amyloidosis of Urinary Bladder

Amyloidosis is a disease characterised by accumulation of a fibrillar protein called amyloid in the extracellular space. The kidneys, ureters and the bladder can be affected in the urinary tract. However, primary amyloidosis of bladder is a rare entity. Macroscopic hematuria could be the first and only symptom of primary amyloidosis of the bladder; therefore, it has similar findings with urinary tract malignancies. Histopathological evaluation is mandatory for the diagnosis. Follow-up should always include cystoscopic evaluation as recurrence is expected in the natural course

A Case of Iatrogenic Ureter Injury: Recent Diagnostic and Treatment Methods

The ureters are rarely exposed to trauma. Ureteral injuries are generally in the form of iatrogenic, blunt injuries, and rarely penetrating injuries. Iatrogenic injuries often occur during surgical procedures. They do not present with specific findings and symptoms, therefore, they have late-onset symptoms. Imaging modalities of choice are usually intravenous pyelography and computed tomography. Treatment is tailored to the location of the trauma

Knowledge Attitude and Behavior in the Domain of Organ Transplantation Among Healthcare Professionals Working in a Tertiary Care Hospital and Patients Admitted to the Urology Clinic

Objective: To measure the knowledge level about organ and tissue donation and to determine the attitudes and behaviors of patients admitted to our hospital as well as healthcare professionals working in our hospital. Materials and Methods: A questionnaire designed to document knowledge attitude and behavior in the domain of organ transplantation and donation was prepared by the researchers. This survey was conducted among 298 participants including patients who were admitted to the urology clinic in our hospital between March 2015 and June their relatives as well as healthcare professionals working in our hospital. Results: 90.3% of the participants did not donate any organ previously. Only 50% of respondents knew that brain death and vegetative state were different concepts. 69.1% the participants had knowledge about organ donation. Conclusion: Public education about organ donation and transplantation and a positive attitude on this issue are very important to increase the number of organ donations

Coexistence Between Hodgkin’s Lymphoma and Renal Cell Cancer: Case Report

Renal cell cancer (RCC) is the most common kidney tumor and accounts for 3% of all adult cancers. Hodgkin’s lymphoma (HL) is also constitutes less than 1% of all malignancies with the male predominance. The risk of secondary cancer increases during the treatment period of HL in 15 years of followup. We presented a case indicating co-occurence between HL and RCC and literature review about this rare coincidence

Knowledge Attitude and Behavior in the Domain of Organ Transplantation Among Healthcare Professionals Working in a Tertiary Care Hospital and Patients Admitted to the Urology Clinic

Objective: To measure the knowledge level about organ and tissue donation and to determine the attitudes and behaviors of patients admitted to our hospital as well as healthcare professionals working in our hospital. Materials and Methods: A questionnaire designed to document knowledge attitude and behavior in the domain of organ transplantation and donation was prepared by the researchers. This survey was conducted among 298 participants including patients who were admitted to the urology clinic in our hospital between March 2015 and June their relatives as well as healthcare professionals working in our hospital. Results: 90.3% of the participants did not donate any organ previously. Only 50% of respondents knew that brain death and vegetative state were different concepts. 69.1% the participants had knowledge about organ donation. Conclusion: Public education about organ donation and transplantation and a positive attitude on this issue are very important to increase the number of organ donations

Anomalili Böbreği Olan Hastalarda Perkütan Netrolitotomi Sonuçlanmız

Objective: To evaluate the success and complication rate of percutaneous nephrolithotomy (PNL) performed in patients with congenital anomalies such as horseshoe kidneys, crossed renal ectopia and renal malrotation.Materials and Methods: Data of 1472 patients who underwent PNL operation in our clinic between January 2007 and January 2015 were analyzed retrospectively. PNL was performed in 28 renal units of 26 patients with congenital renal anomalies. Demographic data of the patients, type of congenital renal anomalies, success rate of PNL and complications were evaluated.Results: Out of 28 PNL-performed renal units, 14 were found out to be with fusion and 14 with rotation anomalies. The average age of the patients was 53 (±1.97) years, 19 were male and 7 were female with an average stone size of 515 (±87.4) mm2. The average operating time was 109 (±11.0) minutes and fluoroscopy time was 191 (±48.4) seconds. The stone-free rate detected postoperatively by computed tomography was 55%. Complications included postoperative fever in 3 patients, postoperative arteriovenous fistula in 1 patient, and intraoperative colon injury in 1 patient.Conclusion: PNL is a safe and effective method in the treatment of stones in kidneys with congenital anomaliesAmaç: Atnalı böbrek, crossed renal ektopi ve böbrek malrotasyonu gibi anomalili böbreği olan hastalarda yapılan perkütan nefrolitotomi (PNL) sonuçlarını ve komplikasyonlarını değerlendirmek amaçlandı. Gereç ve Yöntem: Ocak 2007 ve Şubat 2015 yılları arasında kliniğimizde PNL yapılan 1472 hastanın verileri retrospektif olarak incelendi. Böbrek anomalisi olan 26 hasta ve toplamda 28 renal üniteye PNL yapıldı. Hastaların demografik verileri, konjenital anomalinin tipi, PNL başarısı ve komplikasyonlar değerlendirildi. Bulgular: Opere edilen 28 renal ünitenin 14 tanesinde füzyon, 14 tanesinde ise rotasyon anomalisi vardı. Hastaların ortalama yaşı 53 (±1,97) yıldı. Hastaların 19 tanesi erkek, 7 tanesi kadındı ve ortalama taş boyutu 515 (±87,4) mm2 olarak hesaplandı. Ortalama operasyon zamanı 109 (±11,0) dakika ve floroskopi süresi ise 191 (±48,4) saniyeydi. Postoperatif istenen bilgisayarlı tomografide %55 taşsızlık saptandı. Komplikasyon olarak ise 1 hastada intraoperatif kolon yaralanması, 3 hastada ateş yüksekliği ve 1 hastada arteriyovenöz fistül gözlendi. Sonuç: Konjenital anomalili böbrek taşı tedavisinde PNL güvenli ve başarılı bir yöntemdi