RETROGRADE INTRARENAL SURGERY OR PERCUTANEOUS NEPHROLITHOTOMY: WHICH ONE IS MORE EFFECTIVE FOR 1-2 CM RENAL STONES IN PEDIATRIC PATIENTS?

INTRODUCTION: Urinary stone disease is less common in pediatric age group and it has an increasing incidence. In this study, our hypothesis is to evaluate if one of the techniques, PNL or RIRS is superior than the other in terms of stone free status (SFR), fluoroscopy time (FT), operation time (OT), complication rate (CR), JJ stent insertion rate, and hospitalization duration (HD) in children

Raised Adenosine and Adenosine Deaminase in Bladder Cancer Require Less Postoperative Analgesia Compared with Benign Prostatic Hyperplasia After Transurethral Resection

Transurethral resection of the prostate (TUR-P) and transurethral resection of bladder tumor (TUR-BT) are common urological operations. Our aim was to show whether there was an association of the adenosine molecular pathway with postoperative pain level and malignancy status. A total of 93 patients with ages between 55 and 72 years old who underwent TUR-P (n = 47) and TUR-BT (n = 46) under spinal anesthesia between August 2017 and July 2018 were retrospectively analyzed. On the day of surgery, at the postoperative 24th and 48th hours, plasma adenosine levels and serum adenosine deaminase (ADA) levels were measured. The malignant group had significantly higher adenosine (median 171.51 IQR = 147.69-196.32 vs. median 57.82, IQR = 54.06-62.34, p < 0.001) and ADA levels (median 19.10, IQR = 12.85-22.05 vs. median 7.00, IQR = 5.80-10.80, p < 0.001) preoperatively. Although their levels decreased at the postoperative 24th and 48th hours, the levels remained significantly higher in the malignant group until the postoperative 24th hour (p < 0.001). Lower pain level during the first 36 h and less analgesic requirement during the first 24 h were observed in the malignant group (p < 0.001). In addition, patients with higher tumor grades experienced less pain up to the postoperative 6th hour (p < 0.016). A strong positive correlation was observed between adenosine and ADA levels before surgeries for all patients (rho = 0.637, p < 0.001). There were also negative correlations between VAS score and adenosine level (rho = - 0.721, p < 0.001) or VAS and ADA (rho = - 0.658, p < 0.001). In multivariate analysis, preoperative adenosine level (OR = 4.742, p < 0.001) was found to be the most important parameter affecting postoperative non-opioid analgesic requirement. According to our preliminary results, lower postoperative pain scores and less additional analgesic requirement may be associated with an increase in endogenous adenosine levels in malignant cases

DOES THE USE OF FLUOROSCOPY REALLY AFFECT THE SUCCESS RATE OF RETROGRADE INTRARENAL SURGERY?

INTRODUCTION: Fluoroscopy is used for access sheath insertion and postoperative control during retrograde intrarenal surgery(RIRS) operation but with this technique both patient and operation team are exposed to radiation. The use of fluoroscopy is disadvantage for both patient and surgeon. Considering results of recent studies, it is clearly seen that fluoroscopy doesn't affect the success and complication rates of RIRS. In this study, we aimed to compare the results of both fluoroscopy and fluoroscopy-free groups, to show if there is a significant difference

Cavernous Sinus capillary hemangioma: Case report and literature review

Introduction: Capillary hemangioma of the cavernous sinus is considered a benign vascular skull base tumor. In this case report, a patient with capillary hemangioma located in the cavernous sinus who was operated on with endoscopic endonasal approach is presented. Research question: What should be considered when planning the treatment for capillary hemangiomas located in the cavernous sinus? Material and methods: The treatment approaches applied in 12 patients with a diagnosis of capillary hemangioma located in the cavernous sinus, reported in the English literature, are reviewed in this article. We presented the clinical and radiological results of the treatments. Results: Cavernous sinus capillary hemangiomas are considered benign tumors. However, surgical treatment is preferred in the foreground because of the neurological deficits due to the compression effect caused by the mass. In the case reported by Masman et al. for the first time in the literature in 2021, they provided total excision with the endoscopic endonasal approach in the patient they first diagnosed by taking a biopsy with the endoscopic endonasal approach. In our case report, we provided total excision with endoscopic endonasal transsphenoidal approach. Discussion and conclusion: Many factors should be considered when deciding on the treatment method in these patients. Although radiotherapy is quite effective in the treatment of capillary hemangioma, surgery should be preferred, especially in symptomatic patients. In patients who cannot undergo surgery, radiotherapy is very valuable, although the long-term results are not yet known

Evaluation of the pathologic results of prostate biopsies in terms of age, Gleason score and PSA level: Our experience and review of the literature

Objective: To evaluate the pathologic and clinic results of our large series of transrectal prostate biopsies in relation to Gleason score, age and PSA level. Materials and Methods: We reviewed the pathologic results of transrectal prostate biopsies performed because of high PSA levels and abnormal digital rectal examination findings between January 2008 and February 2012. Results: The pathologic result of 835 prostate biopsies was benign in 82.2% and malign in 17.8%. Furthermore in 3.7% high grade PIN (Prostatic Intraepitelial Neoplasia) or ASAP (Atypical Small Acinar Proliferation) was shown. In the interval of total PSA values between 4 and 10 ng/dl, that is thw so-called grey zone, cancer detection rate was 12.4%. There was a significant relationship between cancer detection and cancer stage at all high levels of PSA also in the grey zone. The most common Gleason score observed was 3 + 3 wirh a rate of 7.4% whereas the second most commonly observed scare was 3 + 4 with a rate of 2.5%. In the patients with abnormal digital rectal examination findings but normal PSA levels according to age the cancer detection rate was 8.7%, in patients with only high PSA levels the rate was 41.2% and in the patients with both high PSA levels and abnormal digital rectal examination findings. the rate was 49.3%. Conclusion: Our study underlines the relationship between age, PSA level and pathologic stage of prostate cancer and also the importance of digital rectal examination

A Giant Ureteral Stone without Underlying Anatomic or Metabolic Abnormalities: A Case Report

A 28-year old man presented with left flank pain and dysuria. Plain abdominal film and computed tomography showed a left giant ureteral stone measuring 11.5 cm causing ureteral obstruction and other stones 2.5 cm in size in the lower pole of ipsilateral kidney and 7 mm in size in distal part of right ureter. A left ureterolithotomy was performed and then a double J stent was inserted into the ureter. The patient was discharged from the hospital 4 days postoperatively with no complications. Stone analysis was consistent with magnesium ammonium phosphate and calcium oxalate. Underlying anatomic or metabolic abnormalities were not detected. One month after surgery, right ureteral stone passed spontaneously, left renal stone moved to distal ureter, and it was removed by ureterolithotomy. Control intravenous urography and cystography demonstrated unobstructed bilateral ureter and the absence of vesicoureteral reflux

Comparative Biochemical And Motor Function Analysis Of Alpha Lipoic Acid And N-Acetyl Cysteine Treatment On Rats With Experimental Spinal Cord Injury

AIM: Spinal Cord Injury (SCI) is a devastating health problem both for the patient and the clinician. Numerous treatment modalities have been studied to reverse the effects of spinal cord injury. Herein is reported the effects and the comparison of Alpha Lipoic Acid and N-Acetyl Cysteine on rats with SCI. MATERIAL and METHODS: 38 adult male Sprague-Dawley rats were randomly divided into 5 groups: only laminectomy, laminectomy and trauma, laminectomy trauma and Alpha Lipoic Acid 100 mg/kg IP administration, laminectomy trauma and N-Acetyl Cysteine 300 mg/kg IP administration, and vehicle group (PEG). The trauma model was the Modified Allen Weight drop method. After the procedure, the rats' motor function was evaluated using the modified Tarlov Scale and consequently they were sacrificed and the spinal cord tissue was analyzed biochemically for inflammation markers. RESULTS: Both Alpha Lipoic Acid and N-Acetyl Cysteine administration after the injury significantly improved the results. There was no statistically significant difference in between the agents. CONCLUSION: Although these agents both proven to be effective in ameliorating the effects of SCI, there was not enough evidence in this research to conclude the benefit of one agent over the other.WoSScopu