Acute kidney injury following supine mini-PNL versus retrograde intrarenal surgery in patients with renal stones < 3 cm: a prospective comparative study

Background: The purpose of the current study was to prospectively compare mini-PNL and RIRS for development of acute kidney injury (AKI), success, and complication rates in a cohort of patients with kidney stones less than 3 cm. Methods: In this prospective study, data of 60 consecutive patients underwent mini-PNL (n=31) or RIRS (n=29) was investigated. Urinary NGAL levels were measured preoperatively and at postoperative 6th hour to evaluate AKI. Success and complication rates were also compared. Results: The mean stone size was signifcantly higher in the mini-PNL group (24.6 mm vs. 18.2 mm, p=0.02). The mean postoperative NGAL levels were 45.6±12.4 and 48.1±13.6 for the mini-PNL and RIRS groups, respectively. The increase was statistically signifcant for both groups (p: 0.01). The diference between the two groups for mean postoperative NGAL measurements was not statistically signifcant (p=0.47). The SFR was signifcantly higher in the miniPNL group (96.7% vs. 79.3%, p=0.04). The complication rates were similar for the two groups (p=0.99). The mean duration of operation was 48.2±22.5 min in the mini-PNL group and 62.6±18.1 min in the RIRS group (p=0.03). The median duration of hospitalization was 1 day for both groups. Conclusions: In patients with renal stones<3 cm in diameter, mini-PNL in supine position provides higher SFR and shorter operative times with similar rates of complications and AKI when compared with RIRS. Mini-PNL should be considered as the primary treatment option together with RIRS for renal stones and should not be ruled out for being a more invasive option

Frequency of Testicular Tumor in Patients with a Diagnosis of Infertility and Asymptomatic Male Applied to a University Hospital

Amaç: Testis tümörü genç erişkin erkeklerde en sık görülen kanserdir. İnmemiş testis, testis tümörü riskini artıran en önemli sebep olmakla birlikte birinci derece akrabalarda testis kanseri öyküsü, karşı testiste insitu germ hücre neoplazisi ve testiküler disgenezis sendromu etyolojide yer almaktadır. Bu çalışmadaki amaç erkek infertilitesi tanısı ile incelenen hastalarda testis tümörü sıklığını araştırmaktır. Hastalar ve Yöntem: Ağustos 2015 - Ağustos 2018 tarihleri arasında üroloji polikliniğine infertilite şikayeti ile başvuran veya kadın hastalıkları ve doğum kliniklerinden konsülte edilen erkek faktörü tanılı 954 erkek hastanın retrospektif değerlendirilmesi yapıldı. Hastaların anamnez, fizik muayene ve spermiogram bulguları kayıt edildi. Yapılan rutin fizik muayenelerinde testiküler kitle saptanan ve bu nedenle radikal orşiektomi yapılan hastaların verileri analiz edildi. Bulgular: İncelenen 954 erkek hastanın dördünde sağ, birinde ise sol testiküler kitle saptandı. Hastaların yaş ortalaması 31,6 (30-35) idi. Bu hastaların hiçbirinde inmemiş testis öyküsü mevcut değildi. Tüm hastaların tümör belirteçleri normal, yapılan bilgisayarlı tomografilerinde lenf nodu veya organ metastazı izlenmedi. Beş hastanın üçünde oligospermi , ikisinde azospermi mevcuttu. Yapılan inguinal orşiektomi operasyon patolojileri ise tüm hastalarda saf seminom olarak raporlandı. Sonuç: Özelllikle infertil erkek hastalarda testis muayenesi yapılırken artmış risk nedeniyle dikkatli olunmasının ve bu popülasyondaki bireylere kendi kendine yapılacakları testis muayenesinin erken tanıda önemli olduğu düşünülmektedir. Anahtar sözcükler: Testis tümörü, infertilite, seminomObjective: Testicular tumor is the most common cancer among the young adult men. Although the undescended testicle is the most common cause which increases the risk of testicular tumor, the testicular cancer diagnosis of any of the first degree relatives, in situ germ cell neoplasia of the other testicle and the testicular dysgenesis syndrome are also included in the etiology. The aim of this study is to investigate the frequency of testicular tumor in patients with infertility. Patient and Methods: 954 male patients, who presented to the urology polyclinic with a complaint of infertility or who were consulted from gynecology and obstetrics clinics with male infertility factor, between August 2015 and August 2018, were evaluated retrospectively. Medical records, physical examination and spermiogram findings were considered. The data of the patients who were diagnosed with testicular mass through physical examinations and underwent radical orchiectomy, were analyzed. Results: Of 954 evaluated male patients with a mean age of 31,6 (30-35) years, four had right testicular mass and one had left testicular mass. None of these patients had a medical record of undescended testicle. Tumor markers of all patients were normal and neither lymph node nor organ metastasis were observed through computerized tomography analysis. 3 of 5 patients had oligospermia and 2 had azoospermia. Pathologic diagnosis of inguinal orchiectomy materials were reported as pure seminoma in all patients. Conclusions: Especially in infertile male patients, when performing testicular examination it should be taken into consideration that there is an increased risk of testicular tumor. It is considered that informing individuals of this population about doing an examination of testicle is important in early diagnosis. Keywords: Testicular tumor, infertility, seminom

Relationship digit ratio with penil length and testis volume in children

Giriş: Androjenlerin uyarımı ile fonksiyonelreseptörlerin aktive olması erkek iç ve dışgenitallerin farklılaşmasında rol oynamaktadır.Homeobox (Hox) genleri embriyogenez sırasındael ve ayak parmakları gibi ekstremite gelişimi,genital tomurcuk farklılaşması, testis ve penisgelişimini düzenlemektedir. Bu gen mutasyonlarındahem parmakların hem de genital sisteminetkilendiği sendromlar bildirilmiştir. Yapılan çalışmalardaikinci ve dördüncü parmak uzunlukoranları ile prenatal testosteron seviyesinin ilişkili,yetişkin testosteron seviyeleri ile de ilişkisizolduğu gösterilmiştir.Bizim çalışmamızda amacımız 2 yaşınınüzerinde hastanemize sünnet için başvuran erkekçocuklarda 2-4 parmak oranı ile penil uzunlukve testiküler volüm arasında ilişkiyi değerlendirmektir.Materyal ve Metod: 2016-2017 yılları arasındasünnet için başvuran 125 erkek çocukçalışmaya alındı. Hipospadias, inmemiş testis,hidrosel, genital veya skrotal cerrahi öyküsü,endokrin hastalıkları bulunan çocuklar çalışmayadahil edilmedi. Tüm çocukların boy ve kilolarıölçülüp vücut kitle indeksleri, boy ve kilogelişim persentil yüzedeleri hesaplandı. Penisve parmak uzunlukları ile testiküler hacim değerlendirmeleriise preoperatif ameliyathanedegenel anestezi sonrası yapıldı. Penil ve parmakuzunluk ölçümleri sürmeli kumpas (verniercaliper)ile testis hacim değerlendirmesi ise praderorşidometrisi ile yapıldı.Bulgular: Çalışmaya alınan çocukların yaşortalaması 7,33±1,22 idi. Gevşek penil uzunlukile sağ 4. parmak uzunluğu, sağ 2/4 parmakoranı ve sol 2/4 parmak oranı ile anlamlı sonuçsaptandı (p=0,001). Gergin penil uzunluk ile sağ4. parmak uzunluğu, sağ 2/4 parmak oranı vesol 2/4 parmak oranı ile korele olduğu görüldü(p<0,05, p<0,05, p=0,001). Total testis hacmiile hem gevşek hem gergin penil uzunluk arasındada anlamlı bir korelasyon izlendi (p<0,05,p=0,001). Sonuç: Literatürde parmak uzunluğu ve oranları ile ilgili değişikhipotezlerle oluşturulmuş birçok çalışma mevcuttur. Ancak bizim çalışmamızdaliterature ile uyumlu sonuçların yanında kısmen de olsa farklısonuçlara ulaşılmıştır. 2/4 parmak oranının hem gevşek hem gergin peniluzunluk için bir gösterge olabilieceği düşünülmektedir.Objective: The activation of functional receptors via the stimulation of androgens has a role in the differentiation of male internal and external reproductive organs. Homeobox (Hox) genes regulate the development of limbs including fingers, genital bud differentiation and the development of testis and penis during embryogenesis. Syndromes in which both the fingers and the genital system are affected due to Hox gene smutations have been reported. Studies have shown that the second and fourth digit length ratios are related the level of prenatal testosterone but not adult testosterone levels. In the present study we eveluated the releation between the 2.-4. Digit length ratio and the penile length and the testicular volume among the patients over two years of age who visited our hospital for circumcision. Materials and Methods: 125 children who applied for circumcision between the years 2016 and 2017 was included in this study. Children with hypospadias, undescended testis, hydrocele, genital or scrotal surgery record and with endocrine disorders was excluded. Weights and lengths of all children were measured, body mass indexes and weight and length development percentiles were calculated. Penile and digit lengths were measured and testicular volumes were assessed preoperatively after general anesthesia in the operating room. Prader orchidometer was used for the assessment of testicular volumes whereas penile and digit lengths were measured by using vernier caliper. Results: The meanage of children included in this study is 7,33±1,22. Significant results were found between flask penile length and right 4th digit length, right 2/4 digit ratio and left 2/4 digit ratio (p=0,001). It was seen that the stretched penile length was correlated with right 4th digit length, right 2/4 digit ratio and left 2/4 digit ratio (p<0,05, p<0,05, p=0,001 respectively). There was also a significant correlation between total testicle volume and both flaccid and streched penile length (p<0,05, p=0,001 respectively). Conclusions: There are many studies in literature with various hypotheses about digit lengths and ratios. In our work, however, results that are in line with literature have been achieved, as well as partly different results. We believe that 2.-4. finger ratio can be an indicator for both flaccid and stretched penile length

Relation of neutrophil lymphocyte ratio with tumor characteristics in localized kidney tumors

Amaç: Nötrofil/Lenfosit oranının birçok ürolojik tümörde prognostik faktör olduğu gösterilmesine karşın lokalize böbrek tümörlerinde tümörün özellikleri ile ilişkisini araştırmayı amaçladık. Gereç ve Yöntemler: Kliniğimizde renal kitle tanısı ile opere edilen 125 hastanın laboratuvar ve patoloji sonuçları geriye dönük olarak incelendi. Tüm hastaların operasyon öncesi yapılan tam kan sayımlarından nötrofil/lenfosit oranı(NLR) tespit edildi. NLR'nin tümörün boyutu, tarafı, lokalizasyonu, histolojik tipi ve Fuhrman derecesi arasındaki ilişki istatistiksel olarak değerlendirildi. Bulgular: Preoperatif hesaplanan NLR ile hastaların cinsiyet ve yaş faktörleri, tümörün tarafı, lokalizasyonu, boyutu ile istatistiksel olarak anlamlı bir ilişki saptanmadı (p>0,05). Ayrıca tümör histopatolojilerine göre benign ve malign olarak, malign tümörlerde ise berrak hücreli olan ve olmayan olarak ikili gruplandırıldıklarında da NLR ile gruplar arasında istatistiksel olarak anlamlı bir ilişki izlenmedi (p>0,05). Berrak hücreli tümör patoloji raporlarından elde edilen Fuhrman dereceleri ile NLR arasında da istatistiksel olarak anlamlı bir sonuç saptanmadı (p>0,05). Sonuç: NLR'nin böbrek tümörlerinde diğer prognostik faktörlerden bağımsız bir değişken olduğu düşünülmesine rağmen literatürdeki farklı sonuçlardan dolayı daha kapsamlı geniş çalışmalara ihtiyaç vardır.Aim: Considering that neutrophil/lymphocyte ratio is indicated as prognostic factor in many urologic neoplasms, the purpose of this paper is to examine the relation between this ratio and characteristics of tumors in localized kidney tumors. Material and Methods: Laboratory and pathology results of 125 patients operated in our clinic with the diagnosis of renal lump were examined retrospectively. Neutrophil/lymphocyte ratios (NLR) of all patients were detected by an examination of pre-operation complete blood cell counts. The relations between NLR and size, side, location, histological type and Fuhrman degree of tumor were assessed statistically. Findings: Statistically significant relations could not be detected among preoperative NLR and sex and age of patients and size, side and location of tumor (p&lt;0.05). Also, when tumors were divided into two as benign and malign and malign ones were grouped into two as tumors with and without clear cells, statistically significant relations could not be reported between NLR and these groups (p&gt;0.05). A statistically significant relation could not be found between NLR and Fuhrman degrees obtained from clear cell tumor pathology reports (p&gt;0.05). Conclusion: Although it is thought that NLR is a variable independent from the other prognostic factors in the kidney tumors, more comprehensive studies are needed due to different results available in the literature

The Correlation Between Semen Parameters and Galectin-3 Levels of Infertile Men

Objective: Galectin-3 (Gal-3) is a ~30kDa protein which plays role in cell to cell interaction, cancer progression, pathogenesis of infections, and immunmodulation. In male reproductive tract, Gal-3 is present in testes, epididymis, vas deferens, prostate, seminal vesicles and in semen. Ma- terial and Methods: This is a prospective cohort study performed in a university hospital setting. Inclusion criteria were males suffering from infertility who admitted for semen analysis. Gal-3 analysis in semen was performed by chemiluminescent microparticle immunoassay. The semen parameters were evaluated according to World Health Organization criteria (WHO) (2010). Normozoospermia were defined as sperm count ?15x10 6/ml and oligozoospermia were defined as sperm count 0.05). The Gal-3 levels were found to be negatively correlated with total progressive sperm count in oligozoospermia group (r=-0.479; p=0.024). Con- clusion: The findings from this study supports the data that Gal-3 levels are increased in cases with faulty spermatogenesis. Moreover, the pos- sible role of Gal-3 in sperm motility is also supported by the negative correlation between Gal-3 levels and total progressive motile sperm fraction. Further studies about this protein to clarify its potential role in spermatogenesis and sperm functions is still needed

Prolonged urinary leakage in the postoperative period of renal hydatic cyst treatment with oral desmopressin: a case report

<p>Abstract</p> <p>Introduction</p> <p>Prolonged extravasation after renal and ureter surgeries is a bothersome situation for both the patient and the doctor. It is usually related to the suture line not being watertight. The contact between urine and the edges of the wound also delay healing of the wound. In this situation, the first thing to do is to break the contact between the wound and the urine by inserting an adequate stent. Sometimes, this process is not enough. We approached this problem with a different treatment method for a case involving prolonged drainage.</p> <p>Case presentation</p> <p>A 52-year-old Caucasian woman who presented at our clinic with right flank pain was operated on due to a renal hydatic cyst, and cyst removal was performed. On follow-up, prolonged urinary leakage was observed and a desmopressin treatment was started on the patient. Drainage was greatly reduced after desmopressin was started and there was no drainage on the fifth day.</p> <p>Conclusion</p> <p>Prolonged extravasation is a bothersome situation and there can be many reasons for this. Whenever traditional approaches are not enough, oral desmopressin therapy can be started reliably if there are no contraindications for the patient. Eventually, contact between urine and the suture site will cease and therefore the fever and healing time will be shortened.</p