Türk popülasyonunda oligozoospermi ve azospermi hastalarında infertilitenin genetik nedenleri

Objective: Advances in the science of genet- ics and the development of assisted reproductive techniques focus on the genetic causes of infer- tility. The aim of this research is to reveal genetic abnormalities in terms of sex chromosome aneu- ploidy and Y chromosome microdeletions. Material and Methods: A total of 350 patients with azoospermia or severe oligozoospermia were selected. After general examination of the patients and laboratory investigations were performed, cartoypes and Y chromosome microdeletions were examined. Results: A total of 225 infertile men with non-obstructive azoospermia (NOA) and 125 in- fertile men with oligozoospermia were enrolled into the study. The overall cytogenetic anomaly rate was 16%. Chromosomal changes were detected in 32 of 350 (9.1%) cases. The most common genetic anomaly was 47, XXY (Klinefelter syndrome) and the incidence was 11.5% in NOA group. This rate was 3.2% in oligozoospermia group. Y chromosome microdeletions were detected in 24 (6.8%) patients and similarly, it was observed more frequently in the NOA group than in the oligozoospermia group. Conclusion: The incidence of genetic causes have been increasing with the severity of infertil- ity. As a result, genetic screening and appropriate genetic counseling are needed before the use of assisted reproductive techniques.Amaç: Genetik bilimindeki ilerlemeler ve yardımcı üreme tekniklerindeki gelişmeler, infer- tilitenin genetik nedenlerine odaklanmamızı sağ- lamaktadır. Bu çalışmada, sex kromozomu anöplo- idisi ve Y kromozom mikrodelesyonları açısından genetik anormallikleriaraştırmayı amaçladık. Gereç ve Yöntemler: Azospermi veya şiddet- li oligozoospermi (≤ 5 milyon spermatozoa/ml) olan toplam 350 hasta analiz edildi. Hastalar genel muayene ve laboratuvar değerlendirmesi sonrası, karyotip ve Y kromozom mikrodelesyonu açısın- dan değerlendirildi. Bulgular: Non-obstrüktif azospermi (NOA) olan toplam 225 infertil erkek ve oligozoospermi olan 125 infertil erkek çalışmaya dahil edildi. Ge- nel sitogenetik anomali oranı% 16 idi. Üç yüz elli vakanın 32’sinde (% 9,1) kromozom değişiklikleri tespit edildi. En sık görülen genetik anomali 47, XXY (Klinefelter sendromu KS) idi ve insidansı NOA grubunda % 11.5 ve oligozoospermi gru- bunda % 3,2 idi. Y kromozom mikrodelesyonu 24 (% 6.8) hastada tespit edildi ve benzer şekilde NOA grubunda oligozoospermi grubuna göre daha sık görüldü (% 9.3 vs % 2.4, sırasıyla). Sonuç: İnfertilitenin şiddeti ile birlikte gene- tik nedenlerin görülme sıklığı artmaktadır. Sonuç olarak, yardımcı üreme tekniklerinin kullanılma- sından önce genetik tarama ve uygun genetik da- nışmanlığa ihtiyaç duyulmaktadır

A nationwide survey on the impact of COVID-19 pandemic on minimal invasive surgery in urology practice

Objective: The beta-coronavirus (COVID-19) pandemic has changed the clinical approach of 93% of urologists worldwide, and this situation has affected the use of laparoscopic and robot-assisted laparoscopic methods, which are known as minimally invasive surgery (MIS). This study aimed to determine the effects of the COVID-19 pandemic on MIS in urology practice at national level. Design, setting and participants: A total of 234 urologists in Turkey participated in an online survey between August 22 and September 23, 2020. Outcome measurements and statistical analysis: Descriptive statistical analyses were conducted to determine the participants’ demographic characteristics and responses to multiple-choice questions. Results: While 54% of urologists stated that they were concerned about the possibility that the patients planned to undergo MIS were carrying COVID-19 or false-negative for the virus, 51% considered that open surgery was safer than MIS in this regard. The pandemic led to a difference in the preferences of 40% of the urologists in relation to open or MIS methods, and during the pandemic, 39% of the urologists always directed their patients to open surgery. It was determined that during the pandemic, there was a statistical decrease in the intensity and weekly application of MIS methods among all surgical procedures compared to the pre-pandemic (P <.001 and P <.001, respectively). MIS was preferred for oncological operations by 97.3% of the urologists during the pandemic, with the most performed operation being radical nephrectomy (90.7%). Among oncological operations, radical prostatectomy was most frequently postponed. To prevent virus transmission during MIS, 44% of the urologists reported that they always used an additional evacuation system and 52% took additional precautions. There were a total of 27 healthcare workers who took part in MIS and tested positive for COVID-19 after the operation. Conclusions: Although the number of operations has decreased during the ongoing pandemic, MIS is a method that can be preferred due to its limited contamination and mortality in urology practice provided that safety measures are taken and guideline recommendations are followed

A rare cause of acute post renal failure: Retroperitoneal fibrosis

Retroperitoneal fibrosis is an inflammatory process which may cause acute renal failure. In patients who admitted to emergency services with obstructive uropathy, retroperitoneal fibrosis should be considered in the differential diagnosis. We present our ten cases who admitted to emergency department with obstructive acute renal failure related to retroperitoneal fibrosis

Partial nephrectomy in horseshoe kidney: Primary carcinoid tumor

Primary neuroendocrine carcinoma of the kidney is a rarely observed clinical condition because neuroendocrine cells are not found in kidney parenchyma. It’s not clinically and radiologically possible to distinguish from other kidney tumors. Incidence with horseshoe kidney anomaly, it should be considered as a definitive diagnosis for the patients with this condition. In this case report, we reported about a carcinoid tumor in horseshoe kidney in a 37-year-old woman