Finger Asisted Laparoscopic Renal Cyst Excision:A Simple Technique

Purpose: Simple renal cysts are asymptomatic incidental findings; however, for a small subset of benign renal cysts, patients may present with pain, hematuria, recurrent infection, pyelocaliceal obstruction, or hypertension. Laparoscopic cyst ablation is an effective minimally invasive modality for the treatment of symptomatic benign renal cysts. We describe a simple laparoscopic cyst excision technique.Materials and Methods: Between June 2003 and May 2008, 28 patients underwent laparoscopic renal cyst excision via retroperitoneal approach. In our technique, retroperitoneum and Gerota’s fascia were dissected with finger blindly before insertion of the trocars to the retroperitoneal space. Following finger dissection, 3 trocars were placed and the cyst walls were excised at the level of renal cyst and base of the cysts were cauterized with electrocautery scissors.Results: Mean patients’ age was 59.3 years (range, 31 to 72 years). Mean operation duration time was 46 minutes (range, 27 to 102 minutes). Symptomatic and radiological success were achieved in 26 (92.8%) and 27 (96.4%) patients, respectively, with a median follow-up of 28 months (range, 6 to 56 months). No serious complications were encountered. Conclusion: Laparoscopy is a versatile minimally invasive modality ideal for treating benign symptomatic renal cysts. According to our experience, we think that the finger assisted laparoscopic cyst excision is an easy and noninvasive procedure

Comparison of Ultrasonography and Cystoscopy in the Evaluation of Hematuria

Objective:Every day, many patients visit hospital due to hematuria. Ultrasonography and/or cystoscopy are performed in the initial evaluation and management. In this study, we compared ultrasonography and cystoscopy in the evaluation of microscopic or macroscopic hematuria.Materials and Methods:A total of 55 patients, who presented to our clinic with the complaint of hematuria between July 2016 and October 2017, were enrolled in this study. After obtaining informed consent, the patients were directed to urinary ultrasonography and cystoscopy for the evaluation of hematuria.Results:Ultrasonography showed 45 (81.8%) normal bladder and 10 (18.2%) masses, and cystoscopy detected 39 (70.9%) normal bladder and 16 (29.1%) masses in the bladder (p=0.001). Ultrasonography was able to report only 8 (50%) of 16 masses detected via cystoscopy. Two (20%) of 10 masses reported by ultrasonography were not confirmed through cystoscopy. The sensitivity and specificity of ultrasonography in detecting and excluding masses in the bladder were calculated to be 50% and 94.9%, respectively. Ultrasonography failed to detect lesions at the posterior, dome and right side and bladder neck. The cut-off value for blood cell count in urine to refer the patient to a cystoscopy procedure was detected to be 15 with 60% sensitivity and 50% specificity.Conclusion:With low sensitivity, ultrasonography could not offer enough knowledge about the bladder masses as sufficient as cystoscopy

Evaluation of Urinary Inverted Papillomas: A Report of 13 Cases and Literature Review

Inverted papilloma (IP) of the urothelium accounts for 2.2% of urothelial neoplasms. The aim of this study was to report the results of 13 patients with urinary IP, pointing out the clinical features, presentations, treatment options and outcomes. The mean age and mean follow-up periods of the patients were 60.23+3.25 (range, 44-81) years and 30 (range, 6-42) months, respectively. There was no coexistence of urothelial carcinoma with IP at presentation. Cystoscopy showed a solitary papillary tumor in the bladders of 11 patients and solid pedunculated tumors in the remaining two patients. The site of development was the bladder in 12 cases (92%) and ureter in one (8%) case. Transurethral bladder tumor resection was performed in 12 cases. For the case with IP in the ureter, nephroureterectomy was performed. Pathologic examination demonstrated that seven of the 13 cases were of the trabecular type and six were of the glandular type. Of the 13 cases, two (7%) had recurrence, at 1 year and 1 month and 1 year and 5 months from initial resection. The male to female ratio was 5.5:1. Initial symptoms included macroscopic hematuria in five cases, microscopic hematuria in four, and dysuria and microscopic hematuria in three; one case was asymptomatic. IPs of the urinary bladder are benign tumors that can be treated successfully by transurethral resection and fulguration of the tumor bed. In addition, these lesions must be followed up closely for recurrence and malignant transformation

Two-glove-finger-balloon Dissection of Retroperitoneal Space for Laparoscopic Urology

We present our experience in retroperitoneal interventions with 2 catheter mounted glove fingers through 2 access points. Methods: Patients were placed in the lateral decubitus position, and the retroperitoneum was accessed by blunt dissection through a 10-mm transverse skin incision on the posterior axillary line. Another incision was performed through the anterior axillary line, and the surgeon inserted his finger to dissect the muscle layers in the retroperitoneum to develop an initial space to place the glove finger balloon, which was attached to a 14-F Nelaton catheter. Results: This technique was performed on 32 patients. The mean operation time was 57.4 ± 26.7 minutes. A satisfactory retroperitoneal space for the operation was provided and both balloons inflated to 500 mL. No complications were observed. Conclusion: Retroperitoneal laparoscopy using 2 balloons is a safe, cheap, effective minimally invasive procedure, and we believe that the technique described above both decreases both the operation time and cost

Spontaneous Ureteral Stent Fragmentation: A Case Report and Review of the Literature

Ureteral stents have been widely used for more than two decades with different indications. Due to the widespread usage of ureteral stents, the number of possible complications of ureteral stents has increased, including stent migration, encrustation, stone formation, and fragmentation. Among these complications, ureteral stent fragmentation is rare. Herein, we present a case of spontaneous ureteral stent fragmentation and review the relevant literature

Oxidative stress parameters in patients with prostate cancer, benign prostatic hyperplasia and asymptomatic inflammatory prostatitis: A prospective controlled study

Background. The imbalance between oxidant and reductant mechanisms creates a nidus for the etiopathogenesis of several diseases. In this study, we aimed to compare the oxidative stress (OS) parameters in patients who were diagnosed with prostate cancer (pCa), benign prostatic hyperplasia (BPH) or asymptomatic inflammatory prostatitis (AIP), according to the histopathologic examination of transrectal ultrasonographic prostate biopsy and transurethral prostate resection specimens