The relationships between preoperative urodynamic parameters and clinical outcomes in urinary stress incontinence

The aim of present study was to evaluate the influence of urodynamic parameters on preoperative and postoperative clinical pictures in stress incontinence.Charts of patients, who were operated for stress incontinence using autologous rectus fascia sling between March 1999 and January 2005 in Tepecik Training and Research Hospital Urology Clinic, were evaluated retrospectively.A total of 41 patients were divided into two subgroups as, pure (10 patients) and mixed stress incontinence (31 patients) groups. Mean age of patients was 50.4 (33-70) years. Fifteen patients had intrinsic sphincter insufficiency (ISI). Mixed incontinence group had lower volume for first sensation and more detrusor overactivity than pure group. ISI did not alter the success of operation. Urodynamically no relationship was found between detrusor pressure and postoperative postvoiding residual urine (P>0.05).In conclusion, urodynamic evaluation before surgery was not related to preoperative and postoperative clinical picture of patients, but first sensation of bladder is only predictive for the success in fascial sling surgery

Does Pons Plaque Affect Urination and Urodynamic Functions in Multiple Sclerosis?

OBJECTIVE: More than %80 of Multiple Sclerosis (MS) patients are observed to have urinary system dysfunctions during the course of their ilnesses. Neuronal control of the bladder is highly complicated. Autonomic and somatic nerve systems have to function in coordination. It is known that bladder functions are controlled by medial frontal lobe in the cerebral hemispheres and by pontine reticular formation in the brainstem. A i m: In MS, the relationship between the localization of the plaque and bladder dysfunction is not clear. The aim of this study was to identify the effects of the plaque in pons on the clinical and urodynamic findings by comparing the patients having periventricular and pontine plaques and the ones having only periventricular plaque METHODS: Between May 2001 to June 2003,25 MS patients of whom 15 were females and 10 males studied. The mean age of the patients was 44, while the mean disease duration was 57.2 month. Mean EDSS was 1.82(0-3). The patients were divied into two groupes. Group I (12 cases) consisted of those having periventricular and pons plaque, whereas Group II (13 cases) consisted of those having only periventricular plaque. All patients who had spinal cord plaque excluded. Urodynamic evaluation were done. RESULTS: Comparing the plaque localization and the urodynamic results did not reveal any statistical difference between the groups (p=0.841). The symptoms observed in the groups were studied with respect to their relation with the urdynamic findings. All the symptomatic cases in Group I and half of the symptomatic cases in Group II had abnormal urodynamic findings. Among the asymptomatic cases, %71.4 of Group I and %40 of Group II had normal urodynamic findings. CONCLUSION: As a result, existance of pontine plaque in those having periventricular plaque does not affect the urologic symptoms and urodynamic function

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

Prostate Cancer Incidence in Turkey: An Epidemiological Study

Background: This study aimed to determine the incidence of prostate cancer in Turkey in a population-based sample, and to determine clinical and pathological characteristics of the cases. Materials and Methods: All newly diagnosed prostate cancer patients were included in this national, multi-centered, prospective and non-interventional epidemiological registry study conducted in 12 cities representing the 12 regions of Turkey from July 2008 to June 2009. The population-based sample comprised 4,150 patients with a recent prostate cancer diagnosis. Results: Age-adjusted prostate cancer incidence rate was 35 cases per 100,000 in Turkey. At the time of diagnosis, median age was 68, median PSA level was 10.0 ng/mL. Digital rectal examination was abnormal in 36.2% of 3,218 tested cases. Most patients had urologic complaints. The main diagnostic method was transrectal ultrasound guided biopsy (87.8%). Gleason score was 7 in 20.6% of the cases. There was a statistically significant positive correlation between serum PSA level and Gleason score (p=0.000). The majority of patients (54.4%) had clinical stage T1c. Conclusions: This is the first population-based national data of incidence with the histopathological characteristics of prostate cancer in Turkey. Prostate cancer remains an important public health concern in Turkey with continual increase in the incidence and significant burden on healthcare resources.WoSScopu

Does a previous prostate biopsy-related acute bacterial prostatitis affect the results of radical prostatectomy?

ABSTRACT Objective To The standard technique for obtaining a histologic diagnosis of prostatic carcinomas is transrectal ultrasound guided prostate biopsy. Acute prostatitis which might develop after prostate biopsy can cause periprostatic inflammation and fibrosis. In this study, we performed a retrospective review of our database to determine whether ABP history might affect the outcome of RP. Materials and Methods 441 RP patients who were operated in our clinic from 2002 to 2014 were included in our study group. All patients’ demographic values, PSA levels, biopsy and radical prostatectomy specimen pathology results and their perioperative/ postoperative complications were evaluated. Results There were 41 patients in patients with acute prostatitis following biopsy and 397 patients that did not develop acute prostatitis. Mean blood loss, transfusion rate and operation period were found to be significantly higher in ABP patients. Hospitalization period and reoperation rates were similar in both groups. However, post-op complications were significantly higher in ABP group. Conclusion Even though it does not affect oncological outcomes, we would like to warn the surgeons for potential complaints during surgery in ABP patients

A Case of Iatrogenic Ureter Injury: Recent Diagnostic and Treatment Methods

The ureters are rarely exposed to trauma. Ureteral injuries are generally in the form of iatrogenic, blunt injuries, and rarely penetrating injuries. Iatrogenic injuries often occur during surgical procedures. They do not present with specific findings and symptoms, therefore, they have late-onset symptoms. Imaging modalities of choice are usually intravenous pyelography and computed tomography. Treatment is tailored to the location of the trauma

Prostate cancer volume estimations based on transrectal ultrasonography-guided biopsy in order to predict clinically significant prostate cancer

ABSTRACTIntroduction:Tumor diameter is a reliable parameter to estimate tumor volume in solid organ cancers; its use in prostate cancer is controversial since it exhibits a more irregular pattern of growth. This study aimed to examine the association between the tumor volume estimations based on transrectal ultrasound (TRUS) guided biopsy results and the tumor volume measured on the pathological specimen.Materials and Methods:A total of 237 patients who underwent radical retropubic prostatectomy (RRP) were included in this retrospective study. The differences and correlations between cancer volume estimations based on TRUS guided biopsy findings and cancer volume estimations based on post-prostatectomy pathology specimens were examined. In addition, diagnostic value of TRUS guided biopsy-based volume estimations in order to predict clinically significant cancer (>0.5 cc) were calculated.Results:The mean cancer volume estimated using TRUS biopsy results was lower (5.5±6.5 cc) than the mean cancer volume calculated using prostatectomy specimens (6.4±7.6 cc) (pConclusions:TRUS guided biopsy-derived estimations seem to have a limited value to predict pathologically established tumor volume. Further studies are warranted to identify additional methods that may more accurately predict actual pathological characteristics and prognosis of prostate cancer.</sec