Comparison of long-term kidney functions after radical nephrectomy and simple nephrectomy

Objective To determine if there is a difference in proceeding to CKD between patients who had undergone radical nephrectomy (RN) and simple nephrectomy (SN) for different indications by comparing the short- and long-term renal function. Materials and Methods We retrospectively analyzed the records of all patients who underwent nephrectomy (either for malign or benign indications) in our clinic between January 2007 and September 2017. The patients were divided into 2 groups according the type of surgery: 1) Radical nephrectomy Group, 2) Simple Nephrectomy Group. Renal function was evaluated with Glomerular Filtration Rate (GFR) calculated using the MDRD formula. Results A total of 276 patients were included in the study. There were 202 patients in RN Group and 74 patients in SN Group. The mean age of the patients in RN Group and SN Group were age 59,2 ± 11,5 and 49,9 ± 15,1 years, respectively (p = 0.001). GFR levels of patients in RN Group versus SN Group were as follows: Preoperative period: 84.9 vs. 81 mL/min/1.73 m2; postoperative 1st day: 60.5 vs. 84.4 mL/min/1.73 m2, postoperative 1st month 58.9 vs. 76 mL/min/1.73 m2, postoperative 1st year: 59.5 vs. 74.1 mL/min/1.73 m2; at last control 60.3 and 76.1 mL/min/1.73 m2. While preoperative GFR was found to be similar in two groups (p = 0.26), postoperative GFR values were found to be significantly lower in Group RN (p < 0.001). In comparison of the decrease in GFR in two groups at last follow-up, significantly higher decrease was observed in RN Group, 29% vs. 6%, (p < 0.05). Conclusion The decrease in GFR exists more common and intensive after RN compared to SN. In long-term, compensation mechanisms that develop after sudden nephron loss like radical nephrectomy deteriorates kidney function more than gradual nephron loss as in benign etiologies which indicates simple nephrectomy

Inflammatory bowel disease is an independent risk factor for male erectile dysfunction

Background and objective: Inflammatory bowel diseases (IBD) are chronic diseases involving the gastrointestinal system, including ulcerative colitis (UC) and Crohn’s disease (CD). Studies have shown a relationship between inflammatory bowel diseases and sexual dysfunction in men but it has been reported that this is due to surgery or the patient’s psychological state. In our study, we aimed to assess the impact of IBD on the sexual functioning of male patients who has no previous pelvic surgery by evaluating the depression status of the patients. Materials and methods: The 334 patients who were followed up in our gastroenterology outpatient clinic between January 2021 and March 2021 were included in the study and they were divided into 2 groups as with (n = 146) and without IBD (n = 188). None of the patients had a history of pelvic surgery or pelvic radiotherapy due to IBD or any other disease. The two groups were compared in terms of demographic data, comorbidities, sexual function, depression status and blood tests. International Index of Erectile Function (IIEF) was used in the evaluation of sexual functions, and the Beck Depression Inventory (BDI) was used in the evaluation of depression. Risk factors for erectile dysfunction (ED) were determined. Results: The mean Beck depression test scores of the two groups were found to be similar (p = 0.361). ED was detected in 52.7% of patients with IBD and 32.4% of patients without IBD (p < 0.0001). In multivariate regression analysis, age (p = 0.008), smoking (p < 0.001), presence of diabetes mellitus (p = 0.02) and presence of IBD (p < 0.001) were determined as independent risk factors for ED. Conclusion: Inflammatory bowel diseases can cause ED regardless of the pelvic surgery performed and the psychological status that occur in these patients

Ureteral access sheath use in retrograde intrarenal surgery

Objective: To determine if there is a difference between postoperative urinary infection rates after retrograde intra-renal surgery (RIRS) when ureteral access sheath (UAS) was used or not used

The safety of deferring operation for prostate carcinoma during the COVID-19 period

The COVID-19 pandemic has led to the restructuring of healthcare delivery. There have been delays in fighting against leading problems such as cancer in this process. Prostate cancer (PCa) is the most common cancer among urological malignancies. We aim to evaluate the differences between patient populations diagnosed with PCa before and during the pandemic and underwent radical prostatectomy (RP) as a treatment. The study was designed retrospectively in a single center. The pathologic, clinic and demographic of patients who underwent RP between 11.03.2020, which is the first date of the pandemic in Turkey, and 31.12.2020 and between 11.03.2019 and 31.12.2019 were compared. 327 patients were appropriate for inclusion criteria. 125 of them were operated during the pandemic and 202 of them before the pandemic. The median between prostate biopsy and RP was 82 days before the pandemic and 97 days during the pandemic (p=0.04). Although there was a significantly longer time between biopsy and RP during the pandemic, gleason score upgrading, upstaging, biochemical recurrence and lymph node involvement were not found significantly different. Additionally, in groups made by the D&apos;amico risk classification, no significant difference was found between the two periods in Gleason Score Upgrading and Upstaging. The deferrability of malignancy treatment is an important problem for the health system due to the high number of oncology patients. The current pandemic has increased the importance of patient selection to minimize the harmful effects of deferred operations. This study showed that the delay of surgery does not affect the oncologic results for PCa. [Med-Science 2022; 11(4.000): 1720-4

Relationship between immunohistochemical staining extent of CD47 and histopathologic features of bladder tumor

WOS: 000418412900003PubMed ID: 29410884Introduction It has been shown that CD47 is an important diagnostic and prognostic marker in many cancer types. However, the relationship between CD47 and bladder tumor stage has not been shown in previous studies. To the best of our knowledge, this is the first study investigating the association of CD47 with stages of bladder cancer. Material and methods Surgical specimens of 175 patients were included in the study. The CD47 staining assessment was performed in the following categories; none, focal, moderate and diffuse. The statistics of the study were tested using t-test and analysis of variance. Results We demonstrated much less CD47 staining extent in Ta tumor pathology compared to T1 and T1+T2+T3+T4 tumor pathology (p = 0.034 and p = 0.016, respectively). We also showed that the average value of CD47 staining extent with CIS+ was significantly higher compared to CIS-among NMIBC p = 0.0248). However, no significant differences in CD47 staining pattern were observed in the following study groups: high vs. low-grade tumors in non-muscle invasive bladder cancer (NMIBC); MIBC (T2-T4) vs. NMIBC; lymph node involvement (N1-N3) vs. non- lymph node involvement (N0) in MIBC (T2-T4). Conclusions Our study demonstrated that CD47 might have a critical role in the progression of Ta to T1 stage. Furthermore, we showed that CD47 is highly expressed in CIS+ NMIBC compared to CIS-NMIBC. Thus, differentiating stages with the help of this new potential marker may help clinicians treat bladder tumors better. Future studies to determine the role of CD47 on pathophysiology, diagnosis and prognosis of bladder tumor are warranted

Is there a PSA cut-off value indicating incidental prostate cancer in patients undergoing surgery for benign prostatic hyperplasia?

Aim: To investigate incidental prostate cancer (IPCa) rate and to determine prostate specific antigen (PSA) cut-off value indicating PCa in patients who underwent surgery by being diagnosed with benign prostatic hyperplasia (BPH) clinically or by standard prostate biopsy

Comparison of long-term kidney functions after radical nephrectomy and simple nephrectomy

Objective. To determine if there is a difference in proceeding to CKD between patients who had undergone radical nephrectomy (RN) and simple nephrectomy (SN) for different indications by comparing the short- and long-term renal function