The sufficiency of 6 core sextant prostate biopsy in patients with prostate specific antigen (PSA) values over 20 ng/mL

Objective: In this study, we aimed to investigate sufficiency of 6 core prostate biopsy in patients with PSA levels elevated above 20 ng/mL. Materials and methods: The medical record of the patients who received prostate biopsy at our institution between August 2011 to August 2016 who had serum total PSA values above 20 ng/mL, were reviewed retrospectively. In this study, we included 40 patients who received 6 core prostate biopsy and 40 patients who received 12 core prostate biopsy. A total number of 80 patients were enrolled in this study. Patients were divided into two groups, a 6 core biopsy group and a 12 core biopsy group. These groups are compared according to age, total PSA, prostate volume and final pathological diagnosis. Results: Based on final pathological diagnosis, 2 patients (5%) had benign pathology and 38 patients (95%) had PCa in both group 1 and 2. The cancer detection rate in both groups was 95%. Although there were higher values of mean age, mean total PSA, and mean prostate volume in group 1, there was no statistically significantly difference at this variables in both groups. Conclusion: Although taking 6 core biopsies is not recently recommended, we proved that 6 core biopsy is adequate for patients with PSA values above 20 ng/mL

Case Report Transitional Cell Carcinoma in Orthotopic Ileal Neobladder

Urothelial carcinoma developing in orthotopic ileal neobladder is an extremely rare entity. Fewer than 10 cases have been reported in the literature describing urothelial carcinoma recurrence in orthotopic ileal neobladder. We report a case of transitional cell carcinoma recurrence in orthotopic ileal neobladder after 11 years of surgery

Self-sufficient settlement - a new form of housing for Izmir

Ungültige Zeichen vorhanden!Diese Diplomarbeit befasst sich mit der Idee eine autarke Siedlung bzw. ein energieeffizientes Stadtplan für Izmir/Yagcilar zu entwerfen. Dabei werden Aspekte wie Energie, Wasser, Lebensmittel und Abfall miteinbezogen. Das Konzept des Siedlungs-Ökosystems verwendet eine Kombination von bereits vorhandenen, innovativen Technologien um ein integriertes Community-Design zu entwerfen wo saubere Energie, Wasser und Lebensmittel direkt innerhalb einer Siedlung produziert bzw. generiert werden können. Dazu gehörenden Technologien sind Energie-Positive-Homes, erneuerbare Energien, Energiespeicherung, ertragreiche ökologische Lebensmittelproduktion, vertikale Landwirtschaft, Aquaponik, Wassermanagement und Abfall-zu-Ressource-Systeme. Die kompakte Mehrzwecknutzung ermöglicht autarke Gemeinschaften wo die kommunale Nutzung der Systemen wie z.B. Landwirtschaft, Kultur und Null-Abfall-Systeme der wertvollste Mittelpunkt dieses Siedlungssystems ist. Dies garantiert eine positive Energiebilanz und lädt jeden Menschen dazu ein, Teil des lokalen Ökosystems zu werden. So entstehen Verbindungen zwischen Mensch und Natur und Konsum und Produktion. Dieses Siedlungssystem wurde entwickelt, damit es im Laufe der Zeit organisch wachsen, sich anpassen und verwandeln kann.This diploma thesis deals with the idea of designing a self-sufficient housing estate or an energy-efficient city plan for Izmir / Yagcilar. It includes aspects such as energy, water, food and waste. The settlement ecosystem concept uses a combination of existing, innovative technologies to design an integrated community design where clean energy, water and food can be produced or generated directly within the boundaries of a settlement. Those technologies include energy-positive homes, renewable energy, energy storage, high-yield organic food production, vertical agriculture, aquaponics, aeroponics, water management, and waste-to-resource systems. The compact, multi-purpose usage design enables self-sufficient communities where the municipal use of agricultural and zero-waste systems is the most valuable characteristic of this settlement design. This kind of design also guarantees a positive energy balance and invites everyone to become part of the local ecosystem. This creates connections between man and nature, consumption and production. This settlement system has been designed to grow organically, adapt and transform over time.12

Endoscopic, Single-Session Management of Encrusted, Forgotten Ureteral Stents

Background and Objectives: Remained or forgotten ureteral double-J stents may cause serious complications. Removing of an encrusted, forgotten stent can be challenging. We present our experience with heavily encrusted ureteral stents and discuss the endourologic treatment options as well as their effectivity. Materials and Methods: Eleven men and six women (mean 48.58 ± 14.48 years of age) with 18 encrusted forgotten stents (mean 16.4 ± 13.25 months of indwelling) were treated at our clinic. All patients underwent the operation after negative urine cultures were obtained. Their medical records were retrospectively reviewed and analyzed in terms of number of interventions required to remove the stent, operation time, complications, hospital stay and stone-free rate. Results: According to the Forgotten-Encrusted-Calcified (FECal) classification, the most common form of stent encrustation was grade III (64.7%) and 17.6% of the stents were fragmented. Four of 17 patients were initially treated with extracorporeal shock-wave lithotripsy. The patients required a mean of two endoscopic interventions for removing the encrusted stent and all stents were removed endoscopically in a single session. The mean operating time was 63.3 ± 41.8 minutes. Cystolithotripsy followed by ureteroscopy was the most common intervention (41.1%). Of the 17 patients, peroperative and postoperative complications were Clavien grade I in two, grade II in two and grade IIIb in one. The mean hospital stay was 1.3 ± 0.99 days. All patients were stone-free after a month of stent removal. Conclusions: The endourological removal of the encrusted forgotten stents in a single session is feasible and effective with a minimal morbidity. The treatment strategy should be to minimize the number of interventions

Post-renal acute renal failure due to a huge bladder stone

A 63-year old male was referred to our emergency unit due to acute renal failure. The level of serum renal function tests levels, blood urea nitrogen (BUN)/creatinine, were 63 mmol/L/848 μmol/L. CT (Computarised Tomography) scan showed a huge bladder stone (5 cm x 6 cm x 5 cm) with increased bladder wall thickness. Post-renal acute renal failure due to bilateral ureterohydronephrosis was diagnosed. The huge bladder stone was considered to be the cause of ureterohydronephrosis and renal failure. The patient was catheterised and received haemodialysis immediately. He received haemodialysis four times during ten days of hospitalization and the level of serum renal function tests levels (BUN/ creatinine) decreased 18 mmol/L/123 μmol/L. After improvement of renal function, we performed cystoscopy that demonstrated normal prostatic urethra and bladder neck and bilaterally normal ureteral orifices. Bladder wall was roughly trabeculated and Bladder outlet was completely obstructed by a huge bladder stone. After cystoscopy open, cystolithotomy was performed to remove calcium phosphate and magnesium ammonium phosphate stone weighing 200 g removed. Four days after operation the patient was discharged uneventfully and urethral catheter was removed on the seventh day. Post-renal acute renal failure due to large bladder stones is rare in literature. According to the our knowledge; early diagnosis of the stone avoid growth to large size and prevent renal failure

Rare type of bladder cancer: Malign fibrous histiocytoma

Malignant fibrous histocytoma (MFH) is the most common soft tissue sarcoma in adults. Urinary tract is a very rare location for MFH. Involvement of the bladder is more common in males and at the 6th decade of life. A case of MFH of the bladder with poor prognosis is presented. Prognostic factors for MFH are tumor grade, amount of invasion, age, tumor size, and histological type. Survival rate is very low and 3-year disease specific survival is approximately 40%

The Rare Togetherness of Bladder Leiomyoma and Neurofibromatosis

Neurofibromatosis Type 1 (Von Recklinghausen disease) is a common, autosomal dominant hereditary disorder characterized by involvement of multiple tissues derived from the neural crest. Urinary system involvement in neurofibromatosis is a rare condition. Leiomyoma of the bladder is a rare benign mesenchymal tumor. In this case, our experience and approach regarding the bladder leiomyoma development in a patient diagnosed with neurofibromatosis are presented and the literature data has been reviewed

To evaluate the etiology of erectile dysfunction: What should we know currently?

Erectile dysfunction (ED) is the inability to develop normal erection or an hardening problem at various extent that causes inability to maintain the erection for the sufficient time required for a complete sexual activity. It can be the result of neurologic, psychogenic, vascular, urogenital and hormonal abnormalities. It is reported that it affects 52-67% of men between 40 and 70 years old. Numerous theories and opinions are issued in the literature in order to explain the hemodynamic changea that occur during erection and detumescence. Especially the effects of chronic diseases and psychogenic factors on the pathophysiology of erectile dysfunction are common matters of discussion in recent years. In this review, we will evaluate the current developments in the literature about the etiology of erectile dysfunction