Effect of Mirabegron on Intraocular Pressure in Patients with Glaucoma

Objective: Assessment of the effects of mirabegron treatment used for overactive bladder (OAB) symptoms in glaucoma patients on intraocular structures.Materials and Methods: One hundred-twenty six female glaucoma patients, who received mirabegron treatment for OAB symptoms between January 2017 and January 2018, were included in the study. One hundred-twenty female glaucoma patients were chosen as controls. The mean age of the patients in the study and control groups was 46.74 and 44.42, respectively. A daily single dose of 50 mg mirabegron was prescribed for OAB treatment. Intraocular pressure (IOP) was assessed in 4th and 12th weeks in both groups. In the beginning of the treatment period, the mean IOP was 15.20 (+/- 3.20) mmHg in the study group and 15.70 (+/- 4.20) mmHg in controls.Results: The mean IOP in the study group was 15.80 (+/- 3.80) mmHg and 16 (+/- 4.20) mmHg on the 4th and 12th weeks, respectively. The mean IOP controls was 15.60 (+/- 4.80) and 15.80 (+/- 3.20) mmHg on the 4th and 12th weeks, respectively. No significant difference was found on the 4th and 12th weeks of treatment between the groups in terms of intraocular pressure.Conclusion: Mirabegron treatment used for OAB does not affect IOP in patients treated for primary open-angle glaucoma

Influence of the Presence of Muscularis Propria on Recurrence and the Quality of Transurethral Resection in Low-Grade, Stage pTa Bladder Tumors

Objective Transurethral resection (TUR) of the bladder and intravesical chemotherapy is the standard treatment option for non-muscle-invasive bladder tumors. Inadequate tumor resection results in early recurrence and staging inaccuracies, which all will change the course of the disease. High-quality TUR treatment is therefore an important factor in the treatment of non-muscle-invasive bladder tumors. In this study, we investigated the significance of detecting the presence of muscularis propria (MP) in pathology specimens of low-grade, stage pTa tumors in patients who were treated with TUR due to primary bladder tumors, with regard to recurrence, time to recurrence and progression. Materials and Methods Initially, 841 patients who were treated with TUR due to primary bladder tumors were enrolled in the study. A total of 597 patients were excluded from the study because they failed to meet the study criteria. Group 1 consisted of patients with MP detected in the pathology specimens; whereas group 2 consisted of patients whose TUR specimens did not include MP. The patients were evaluated with regard to gender, tumor number, presence or absence of MP, and recurrence status. Results MP was observed in only 14 (15.2%) of 92 patients with recurrence, but not in the remaining 78 (84.8%) (p=0.004). Progression occurred in 4 (14.2%) patients of group 1 and 28 (29%) patients of group 2 (p=0.159). In univariate analysis, tumor multiplicity (p=0.003) and the absence of MP (p=0.004) were found to have effects on recurrence. In multivariate analysis, these two parameters were also found to be have effects on recurrence (p=0.004). Conclusion In this study, it was pointed out that MP presence in the pathology specimens of low-grade stage pTa tumors is an indicator of a high quality TUR and, a well-done TUR is important for the prevention of recurrence

The factors predicting biochemical recurrence in patients with radical prostatectomy

Objective: The main objective of this study was to evaluate the factors predicting recurrence in patients who underwent radical prostatectomy (RP) for localized prostate cancer. Materials and Methods: A total of 275 patients who underwent RP between 2000 and 2012 years in our clinic were evaluated retrospectively and 238 patients who met our criteria were included in the study. The effect of PSA values at diagnosis in addition the histopathological variables on the risk of recurrence was evaluated. Biochemical recurrence (BCR) is defined as “an increase of > 0.2 ng/ml or more in the serum total PSA count”. The statistical analysis of this study was done using SPSS for Windows Version 15.0 package program. Values below p < 0.05 are accepted as statistically significant. Results: The mean follow up, age and PSA of patients were 37,2 months, 66,01 ± 6,85 years and 11,12 ng/ml, respectively. BCR rate was 28% (68/238). Univariate analysis revealed that PSA levels during initial diagnosis (p < 0.0001), Gleason score (GS) (p < 0.0001), prostatic capsule involvement (p < 0.005), extracapsular extension (p = 0.0001), seminal vesicle involvement (p < 0.003) and surgical margin positivity (p < 0.014) were significant factors in predicting recurrence, while multivariate analysis showed that PSA at initial diagnosis (p = 0.002) and GS (p = 0.003) were independent prognostic factors. PSA > 10 ng/ml and Gleason score > 7 are considered as the risk factors for BCR. Conclusion: Our study results showed that PSA value during initial diagnosis as well as Gleason score were independent factors in predicting BCR following radical prostatectomy

Colon perforation during percutaneous nephrolithotomy and fistula closure with Spongostan following conservative therapy

Percutaneous nephrolithotomy (PCNL) is the first-line treatment for kidney stones. Colon perforation is a rare, but dangerous, complication. Colonic perforation might be very serious if it is not found early. After an unsuccessful extracorporeal shockwave lithotripsy, a 45-year-old female underwent a left-sided PCNL for two 1-cm kidney stones in the left kidney upper pole calyx. During dilatation, a colon perforation was suspected. The procedure was finished by inserting a 14Fr re-entry catheter into the colon. On postoperative day 5, a fluoroscopy was performed by injecting contrast dye through the re-entry catheter, which showed a fistula formation between skin and colon. The catheter was removed completely. A 16Fr external drainage catheter was inserted over the guide-wire through the fistula tract. The fistula was closed by introducing prepared absorbable hemostatic gelatin powder (Spongostan) particles into the fistula tract through the catheter. Fistula tracks can be closed early by injecting absorbable Spongostan particles into the colonic fistula tract, thereby reducing inpatient time and increasing patient comfort

Our Results in Penile Fractures

Introduction Penile fracture is a urological emergency caused by direct trauma to an erected penis, tearing the tunica albuginea in the corpus cavernosum. The preferred treatment method is draining the hematoma and surgical repair of tunica albuginea tear as soon as possible following diagnosis. Materials and Methods Forty-nine patients who were diagnosed with penile fracture between January 2009 and December 2014 were reviewed. Physical examination was performed to see the extent of penile hematoma, the side of the penile curvature and the presence of blood in the external meatus. Two patients who were diagnosed with urethrorrhagia underwent retrograde urethrogram for urethral injury. In all patients, penile skin was peeled using a circular subcoronal degloving incision and tunica tear was repaired using absorbable suture materials. The patients were then followed for painful erections, penile deformities and erection angles. Results The average age of the 49 patients, who were included in the study, was 36.5 years (21-65). In their etiological questioning, most patients reported the fracture occurring during sexual intercourse. Retrograde urethrography was indicated in 2 patients with blood in the external meatus and were diagnosed with urethral injury. The patients were taken to emergency surgery. Tunica defects varied between 1 and 2 cm. Incomplete urethral injuries were primarily repaired around 18 French Foley catheter. None of the patients reported penile deformity or painful erections. Their erection angles were found to be within the normal range. Conclusion Even though it is a relatively rare condition, penile fractures are so important that might cause serious complications when not treated surgically. A thorough anamnesis and physical examination suffice for diagnosis

Toilet training age and influencing factors: a multicenter study

Tarhan H, çakmak ö, Akarken İ, Ekin RG, ün S, Uzelli D, Helvacı M, Aksu N, Yavaşçan ö, Mutlubaş-özsan F, Cun S, Koç F, özkarakaş ö, İlbey Yö, Zorlu F. Toilet training age and influencing factors: a multicenter study. Turk J Pediatr 2015; 57: 172-176.To determine toilet training age and the factors influencing this in our country, 1500 children who had completed toilet training were evaluated in a multicenter study. the mean age of toilet training was 22.32±6.57 months. the duration it took to complete toilet training was 6.60±2.20 months on the average. in univariant analysis, toilet training age increased as the parental education level, specifically that of the mother, increased. the training age of children whose mothers had over 12 years of education differed significantly from that of children of mothers with less education. There was no significant difference in toilet training age with regard to the education level of the father, or the employment status of the mother. We also found significant differences with respect to family income level, toilet type and training method. in multivariant analysis, family income >5000 TL and use of a potty chair were determined to be factors affecting toilet training age. in conclusion, toilet training age in Turkey, a developing country, was found to be lower than that in developed countries

Bilateral Primary Renal Lymphoma Presenting with Acute Renal Failure

Non-Hodgkin’s lymphoma is a multisystem disease presenting with painless lymph node involvement in patients between 40 and 70 years of age. Kidney failure can be seen in about 10% of lymphoma patients due to different reasons. However, renal failure caused by lymphomatous parenchymal infiltration of the kidneys is very rare. In this study, we present a case of bilateral primary renal lymphoma presenting with acute renal failure