Time between first and second transurethral resection of bladder tumors in patients with high-grade t1 tumors: is it a risk factor for residual tumor detection?

Purpose: We evaluated the risk factors for residual tumor detection after transurethral resection of bladder tumors (TURBT) in patients with newly diagnosed high-grade T1 transitional cell carcinoma of the bladder. Patients and Methods: Overall 132 patients underwent TURBT for primary bladder tumors and were diagnosed as high-grade T1 bladder cancer. Patients with incomplete resections were excluded from the study. Clinical and pathologic characteristics of the patients were compared and multivariate analysis was performed to determine independent prognostic factors. Results: Residual tumor was demonstrated in 57 (43.1%) of the patients. The residual tumor rate was significantly lower in patients with solitary tumors, tumors 3 cm in size, absence of detrusor muscle in the initial TURBT specimen, TURBT performed by trainees and finally, as a new finding, prolonged interval between first and second TURBT are independent predictors for residual tumor detection in patients with high-grade T1 tumors. (c) 2013 S. Karger AG, Base

The Effect of Preoperative Neutrophil-Lymphocyte Ratio on Disease Specific Survival in Testicular Tumor Patients

INTRODUCTION: The effect of hemogram parameters on survival has been evaluated in many studies for patients who have urogenital tumor. In this study, we aimed to evaluate the neutrophil-lymphocyte ratio (NLR) on disease specific survival (DSS) in patients who have testicular tumor. METHODS: The data of 67 patients who treated for primary testicular tumor at our clinic between January 2000 and December 2010 was evaluated retrospectively. Patients' age, histological type of tumor, pathologic stage, serum neutrophil and serum lymphocyte counts and NLR values were recorded. RESULTS: For all patients, mean age, mean serum neutrophil, lymphocyte counts and mean NLR were 33+-8, 4800+-2100, 1100+-520 and 3,69+-1.1, respectively. In histopathological examination, pure seminoma, pure non-seminom and mix histologic type were detected in 21(31.4%), 23(34.3%) and 23(34.3%) patients, respectively. Stage 1 disease and stage ≥2 disease were revealed in 42(62%) and 25(38%)of the patients. During median 67 months follow-up period, DSS rate was 91%. According to previous studies, we determined NLR cut-off value as 4. Patients were divided into two groups as NLR≤4 and NLR>4. There was no statistically significant difference on DSS between two groups. DISCUSSION AND CONCLUSION: According to our outcomes, we observed that NLR was not a prognostic factor to predict of DSS. However, high patient volume and prospective trials are needed to support our results

Prostatic diseases and male voiding dysfunction

OBJECTIVES To evaluate, in a retrospective, single-center trial, our open prostatectomy outcomes andcomplications in the past 12 years to emphasize the feasibility of open prostatectomy for largeprostates.METHODS A total of 1193 patients underwent open prostatectomy from 1995 to 2007. We retrospectivelyanalyzed the data from 664 patients who had preoperative, operative, and postoperative dataavailable.RESULTS The mean patient age was 67.5 years (range 52–86). The mean preoperative prostate-specificantigen value was 9.6 ng/mL (range 1.65– 45.6). The mean prostatic weight was 88.7 g (range45–324) and was significantly different for the 1995–2001 and 2002–2007 groups (73.6 vs 98.2 g,respectively). Of the 664 patients, 208 (31%) had had an indwelling catheter before surgery. Theaverage International Prostate Symptom Score was 21.7 (range 13–32) preoperatively and 10.6(range 8–18) postoperatively (P .005). The average hospitalization was 6.74 days (range4–14). Blood transfusion was required in 12.7% of the patients either intraoperatively orpostoperatively. Postoperatively, 82 patients (12.3%) had urinary tract infections, 22 (3.2%) hadbladder neck obstruction, 5 (0.7%) had urinary incontinence, and 15 (2.3%) had a ureteralmeatus stricture.CONCLUSIONS Open prostatectomy is a feasible treatment option for patients with a large prostate and also forpatients with additional bladder pathologic findings such as bladder calculi or diverticula forwhom endoscopic treatment modalities are not appropriate. Consequently, open prostatectomyis still the primary option for patients with a prostate greater than 100 cm3 and preserves itsimportance in urology practice, even in the presence of endoscopic innovations

Comparison of Efficacy of Shock Wave Lithotripsy in Different Age Groups

Objective: Shock wave lithotripsy (SWL) is a safe and effective treatment for renal stones. The success rate of SWL has been shown to be lower in the elderly populations. However, in these previous studies, the SWL devices and techniques were not compatible with the current devices and techniques. In this study, it was aimed to compare the success rates of SWL in different age groups and evaluate the effect of age on SWL outcomes. Materials and Methods: Data of 472 patients who have undergone SWL was evaluated. The patients were grouped into 3 age categories: 18-40 (n=159), 41-64 (n=180), and ≥65 (n=133) years. Data regarding stone location, stone size, number of SWL sessions, and success rates were recorded. The groups were compared for success rates. Additionally, logistic regression analysis was performed to evaluate the effect of age on success rates of SWL treatment. Results: The success rates in patients in age categories 18-40 years, 41-64 years and ≥65 years were 75.4%, 75.6% and 69.1%, respectively (p=0.37). In the logistic regression analysis, age was not found to be associated with success rates. In the multivariate analysis, greater stone size [odds ratio (OR): 1.59, 95% confidence interval (CI): 1.10-4.24, p=0.04] and lower pole location (OR: 1.65, 95% CI: 1.110-5.327, p=0.04) were found to be associated with lower success rates. Conclusion: There were no significant differences in the rate of success of SWL treatment in different age groups. In patients over 65 years of age, SWL treatment should not be avoided with the assumption of lower success rates

Predicting factors of acute kidney injury after partial nephrectomy and its impact on long-term renal function: A multicentre study of the Turkish Urooncology Association

Objectives To investigate the predictors of acute kidney injury (AKI) after partial nephrectomy and the impact of AKI stage on long-term kidney function. Methods Data of 1055 patients who underwent partial nephrectomy between January 2008 and January 2018 at seven separate tertiary centres were analysed. AKI was defined according to AKI Network criteria. The association between pre-operative and perioperative factors and AKI was evaluated using logistic regression analysis. Recovery of at least 90% of baseline glomerular filtration rate 1 year after partial nephrectomy, change of 1 year glomerular filtration rate compared with baseline glomerular filtration rate and stage >= 3 chronic kidney disease (CKD) progression were assessed according to the stage of AKI. Results AKI was recorded in 281 (26.7%) of 1055 patients after partial nephrectomy, and of these patients, 197 (70.1%) had stage 1, 77 (27.4%) had stage 2 and 7 (2.5%) had stage 3. Higher tumour complexity and baseline glomerular filtration rate were independent predictors for AKI. The proportion of recovering 90% of baseline glomerular filtration rate at 1 year for any patient who had stage = 3 CKD progression for any patient who had stage <= 1 vs stage 2-3 of AKI was 6.2% (95% CI: 4.1%-9.2%) and 63.1% (95% CI: 52.5%-75.6%), respectively (P < .001). Conclusions AKI adversely affects renal function in the long-term after partial nephrectomy and stage 2-3 significantly increases the risk of CKD in the long term