Factors associated with urinoma accompanied by ureteral calculi

Objective: Urinoma is a rare entity and mainly occurs due to acute obstruction such as ureteral stone. We aimed to demonstrate factors associated with urinoma accompanied by ureteral calculi. Material and methods: Data of 550 patients who were diagnosed with ureteral stone by computed tomography (CT) were analyzed retrospectively. In 20 patients perirenal urinoma was associated with ureteral calculi (group I), whereas in other 530 patients no urinoma was detected (group II). Gender, age, size, side and localization of the stone, hydronephrosis, fever, sepsis, urinary tract infections (UTIs), hematuria, serum creatinine, blood urea nitrogen (BUN), white blood cell (WBC), C-reactive protein (CRP), presence of diabetes mellitus (DM), hypertension (HT) and cronic kidney disease (CKD) of the two groups were compared. Results: The average age of the patients were 46.2 (20-71) and 44.9 (10-82) years in group I and group II, respectively (p > 0.05). According to our results leukocytosis, microscopic and macroscopic hematuria, UTIs, increase of serum creatinine, BUN and CRP, diagnosis of DM and HT were significantly associated with urinoma (p < 0.05). In addition, patients with distal ureteral stones are more prone to urinoma (p = 0.001). An interesting finding of the study was that the stone size in group I (median 5 mm [range 3-8]) was significantly smaller than in group II (9.3 mm [4-25]; p = 0.001). Conclusions: Small stone size, distal localisation of the stone in ureter, leukocytosis, hematuria, UTIs, increase of serum creatinine, BUN and CRP, presence of DM and HT are associated with perirenal urinoma

Prospective assessment of VI-RADS score in multiparametric MRI in bladder cancer: accuracy and the factors affecting the results

PURPOSEWe aimed to investigate the accuracy of Vesical Imaging - Reporting and Data System (VI-RADS) in the detection of muscle-invasive bladder cancer (MIBC) and to determine which factors affect the results of this scoring system.METHODSA prospective data analysis of 80 patients who were detected to have bladder tumor was performed between March 2019 and October 2020. VI-RADS scoring was used to determine the probability of muscle invasion. The scores were compared with pathological results to evaluate the accuracy of the VI-RADS scoring system. Interobserver agreement was assessed by VI-RADS scoring of 20 randomly chosen patients by a different experienced radiologist.RESULTSUsing the VI-RADS scoring system, the sensitivity, specificity, positive predictive value, and negative predictive value of multiparametric magnetic resonance imaging (mpMRI) were 87.5%, 87.5%, 63.6%, and 96.6%, respectively. The interobserver agreement expressed as the interclass correlation coefficient (ICC) was 0.72 (95% CI: 0.44-0.84, P < .001). In addition, the flat appearance of the tumor was an important factor affecting the accuracy of the VI-RADS score (odds ratio: 5.3 [95% CI: 1.1-27.0] and relative risk: 1.87 [95% CI: 1.24-2.82]).CONCLUSIONThe mpMRI, used in conjunction with VI-RADS, has proven to be an effective imaging method for detecting muscle invasion in cases of bladder cancer. VI-RADS scoring system can distinguish whether there is a muscle-invasive and non-muscle invasive bladder cancer with acceptable accuracy. In addition, the flat appearance of the tumor is an important entity that can affect the accuracy of the VI-RADS scoring system

Our results of pnomotic lithotripcy and rijit ureteroscopy in ureteral stones

Amaç: Üreter taş tanısı alan olgularda rijit üreteroskopi ve pnomotik litotripsinin etkinli- ğini incelemek. Gereç ve Yöntemler: Üreter taşı nedeniyle rijit üreteroskopi ve pnomotik litotripsi uygulanan 246 olgunun dosyaları geriye dönük incelendi. Sonuçlar tedaviden 3 ay sonra yapılan üriner ultrasonografi ve/veya intravenöz piyelografi ile değerlendirildi. Taş yerleşimine göre tedavi başarısı ve komplikasyon oranları karşı- laştırıldı. Bulgular: Olguların ortalama yaşı 45,0 yıl(dağılım 15-81), 131(%53,2)i erkek, 105(%42,8)i kadın idi. Taşların 114(%46,3)ü sağ, 131(%53,2)i sol, 1(%4,0)i ise bilateral üreter yerleşimliydi. Ortalama taş boyutu 8,75(dağılım 5-35) mm olarak bulundu. Toplam taşsızlık oranı totalde %88,1(distal üreterde %96.7, orta üreterde %87.4 ve proksimal üreterde %80.2) idi. Toplam komplikasyon ise %6.5(alt, orta ve üst üreterde sırasıyla %3.2, %6.4 ve %10.1) olarak gelişti. En sık peroperatif komplikasyon; %2.6 enfeksiyon, %1.1 mukozal hasar ve %4 üreter perforasyonu iken, en sık geç komplikasyon olguların %1.1inde üreter darlığı idi. Üreter taşı olan olgular taş büyüklüğüne göre Grup 1 10 mm (n114) ve Grup 2 10 mm (n132) olarak belirlendi. Grup 1de üreter yerleşimine göre taşsızlık oranları yüksek (proksimal %88, orta %92, distal %100 ve totalde %93.3) ve komplikasyon oranı düşük (%3.4) olarak gözlendi. Sonuç: Üreter taşlarının rijit üreteroskopi ve pnomotik litotripsi ile tedavisi tüm yerleşimlerdeki üreter taşlarında yüksek başarı, hızlı taşsızlık ve düşük komplikasyon oranlarıyla başarılı bir şekilde uygulanabilmektedir. Rijit üreteroskopi ve pnomotik litotripsi ile tedavi edilen alt üreter taşlarında taş büyüklüğü toplam taşsızlık ve komplikasyon oranlarını etkilememektedir.Objective: In patients with a diagnosis of ureteral calculi with rigid ureteroscopy and pneumatic lithotripsy evaluate the effectiveness of. Materials and Methods: Due to ureteral stone rigid ureteroscopy and pneumatic lithotripsy applied retrospectively reviewed the files of 246 cases. Results after 3 months of treatment with ultrasound urinary and /or evaluated with intravenous pyelography. According to Stone residential treatment success and complication rates were compared. Results: Mean age was 45.0 years (range 15-81), 131(53.2 %) were male, 105(42.8 %) were female. Stone of the 114(46.3%) to the right and 131(53.2 %) left , one(4.0 %)s bilateral ureter. Average stone size was 8.75(range 5-35) mm respectively. In total 88.1 % of the total stone-free rate (96.7 % in the distal ureter, middle ureter and proximal ureter was 87.4% and 80.2 %) respectively. Total complication was 6.5% (lower, middle and upper ureter, respectively, 3.2%, 6.4% and 10.1%) has evolved as. The most common intraoperative complication of infection of 2.6%, 1.1% and 4%, ureteral perforation, while mucosal damage, the most common late complication of patients 1.1% were in the ureteral stricture. Patients with ureteral stone by stone size group 1 10 mm (n 132), respectively. According to the placement in group 1 generates higher stone-free rates (88% proximal, middle 92%, and 93.3 % in the distal and total 100%) and low complication rate (3.4%) was observed. Conclusion: Rigid ureteroscopy and pneumatic lithotripsy of ureteral stones treated with ureteral stones in all residential high success and low complication rates and quick stone clearance can be applied successfully. Rigid treated with ureteroscopy and pneumatic lithotripsy lower ureteral stone size does not affect the overall stone free and complication rates

A rare complication of a malleable penile prosthesis: migration to the thigh region

Guner, Bayram/0000-0001-7602-2255WOS: 000326878200038PubMed: 24013620Dear editor, Here, we discuss an unusual prosthesis migration to the thigh region. Because the incidence of erectile dysfunction increases in parallel with the prevalence of neurological, degenerative and vascular diseases among elderly men, the use of penile prostheses is common in this age group. Still, cylinder migration following the implantation of a malleable penile prosthesis is a very rare entity

The impact of ureteral Double-J stent insertion following ureterorenoscopy in patients with ureteral stones accompanied by perirenal fat stranding

WOS: 000440545900004PubMed: 29633793Objective: To evaluate the impact of ureteral stent insertion following semirigid ureterorenoscopy (URS) in patients with perirenal fat stranding (PFS) due to ureteral stones. Material and methods: Data of 600 patients who underwent URS were analyzed retrospectively. Seventy-two patients detected to have PFS accompanying ureteral stone were included. Patients who did not undergo double J (DJ) stent insertion following semirigid URS were classified as Group I (n: 52), while those who underwent stent insertion were classified as Group II (n: 20). Side distribution; localization of the stones, stone size, presence of fever, urinary tract infection (UTIs) and urosepsis rates were compared in the two groups. Results: The average age of the patients was 44.4 (20-71) years. Male/female ratio and side of the stone location showed similar distribution in both groups (p > 0.05). Fever occurred in 23 cases (44.2%) in Group I and in 15 cases (75%) in Group II (p = 0.038). UTIs occurred in 15 cases (28.9%) in Group I and in 12 cases (60%) in Group II (p = 0.03). Urosepsis presented in 3 (5.8%) and 5 (25%) of the patients in Group I and II, respectively (p = 0.033). Conclusions: According to our results, ureteral DJ stent insertion following URS in patients with PFS due to ureteral stone caused an increase on postoperative infection related complications

Right hydronephrosis secondary to swallowing veil needle

Üreter de oluşan obstrüksiyon hidronefroza neden olabilir. Hidronefroza bağlı hastalarda en sık yakınmalar ağrı, batında kitle, idrar yolu enfeksiyonlarıdır. En sık nedenleri arasında uretero-pelvik bileşke darlığı, vezikoureteral reflu, üreter taşları bulunur. Nadir nedenlerinden biri de yutulan yabancı cisimlerdir. Çoğu asemptomatikdir ve fekal yolla atılmaktadır. Bazen yutulan yabancı cisimler gastrointestinal traktan komşu organlara migrate olarak komplikasyonlara neden olmaktadırlar. Yan ağrısı ile gelen kadın hastalarda başörtüsü iğnesi akılda olmalıdır.Obstruction formed in ureter may cause hydronephrosis. Patient having hydronephrosis complains about side pain, mass in the abdomen and urinary tract infections. The most common causes are uretero-pelvic junction obstruction, vesico-ureteral reflux and ureter stones. Hydronephrosis rarely originates from swallowed foreing bodies. And most of these cases are asymptomatic and are thrown through feacal. Sometimes, these bodies cause complications by migrating to adjacent organs from gastrointestinal system. In female patients having abdominal/side pain, scarfpin should be recalled

Early ureteroscopic lithotripsy in acute renal colic caused by ureteral calculi

WOS: 000519233300001PubMed: 31586281Purpose We aimed at comparing the success and complications of early semirigid ureteroscopy (URS) and elective URS in ureteral calculi with renal colic that do not respond to analgesics. Methods We retrospectively analyzed the data of 690 patients with obstructive ureteral stones who underwent URS with stone retrieval. 247 patients who underwent early URS within the first 12 h were classified as group I and 443 patients who underwent elective URS as group II. Both groups were compared in terms of age, sex, creatinine, eGFR, stone size, laterality, location and number of stones, type of lithotriptor, presence of hydronephrosis and success and complication rates. Results The mean age of the patients was 50.4 (18-89 years) (p > 0.05). There was no statistically significant difference between the groups in terms of age, eGFR, side, presence of hydronephrosis, fever, mucosal damage, stone migration, perforated ureter, ureteral avulsion, ureteral stent insertion at the end of the surgery and sepsis (p > 0.05). Both groups had male dominance (p > 0.05). Creatinine was significantly lower in Group I (p < 0.05). The mean stone size was also significantly lower in Group I ( p < 0.05). Middle and proximal ureteral calculi were more common in Group II (p < 0.05). Multiple stones were higher in Group II (p < 0.05). The dominant type of lithotriptor used was pneumatic in Group I and laser in Group II (p < 0.05). Stone-free rates (SFRs) were higher in Group I (98% vs 90% in the first month) (p < 0.05). Postoperative hematuria and infection were more common in Group II (p < 0.05). Conclusions In selected cases, early ureteroscopy is an effective and safe method for distal ureteral calculi smaller than 10 mm that are painful and resistant to analgesic treatment

Comparison of response to treatment of unilateral and bilateral varicocelectomy

WOS: 000395632600024PubMed: 28263485Background/aim: We aimed to compare the results of unilateral and bilateral varicocele surgery. Materials and methods: In two referral hospitals, the data of 180 patients who were treated with unilateral and bilateral microscopic varicocelectomy were retrospectively analyzed. Sperm parameters and spontaneous pregnancy rates were compared in patients who underwent bilateral and unilateral microscopic varicocelectomy. Results: The mean age was 29.6 (17- 46) years. While 82 patients underwent unilateral varicocelectomy (Group I), 98 patients underwent bilaterally varicocelectomy (Group II). Forty (48.8%) spontaneous pregnancies occurred in Group I and 59 (60.2%) in Group II. When we analyzed sperm parameters, the rate of increase in the number of sperm in spermiograms was 17% in Group I and 27.5% in Group II. The rate of increase in sperm mobility was 58.5% and 50% in Group I and II, respectively. The improvement rate in sperm morphology was 46.3% in Group I and 56.1% in Group II. There were no significant differences between all these parameters. Conclusion: In light of our results, although pregnancy rates seemed to be higher in patients who underwent bilateral varicocelectomy, these results were not statistically significant. Improvement rates in sperm parameters were similar between the patients who underwent unilateral and bilateral varicocelectomy

Diagnostic performance of prostate imaging reporting and data system v2.1: Single center experience

Aim: To assess the diagnostic accuracy of PI-RADS v2.1 using multi-parametric magnetic resonance imaging (mpMRI) to detectprostate cancer (pCa) and comparison with transrectal biopsy/radical prostatectomy results.Material and Methods: Between June 2017 and April 2019, 124 patients who underwent mpMRI prior to transrectal biopsy/ radicalprostatectomy were evaluated by a pathology results-blinded uroradiologist using PI-RADS v2.1 categories, retrospectively. PIRADSv2.1 category results were compared with transrectal biopsy/radical prostatectomy results. All clinical data were used in statisticalanalysis.Results: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy values of mpMRI using PI-RADSv2.1 categorization were 96%, 44%, 73%, 88% and 75%, respectively. A significant correlation was observed between a high PI-RADSscore and high pathological grade (p0.001). The inter observer agreement expressed as the ICC was 0.65 (95% CI: 0.33–0.84, p 0.001).Conclusions: The mpMRI, used in conjunction with PI-RADS v2.1, is a useful and promising imaging method in detection of pCa

Do AB0 blood groups affect lower urinary tract symptoms?

WOS: 000502637300015PubMed: 30461381Objective: The aim of this study is to investigate whether there is a correlation between AB0 blood group antigens and Rhesus factor and lower urinary tract symptoms (LUTS). Material and methods: A total of 556 male patients applying to our clinic with LUTS complaints from April 2012-2015 and complying with the study criteria were included in the study. The patients were divided into two groups as those with (Group 1; n=283) and without LUTS (Group 2; n=273) complaints. The effect of blood groups on LUTS complaints was compared using univariate logistic regression analyzes. Results:According to AB0 blood groups, blood groups A (56.7%) and AB (56.9%) were most common in the LUTS group. But 0 blood group (44.1%) was the least common. According to rhesus factor, the incidence of LUTS in Rh (+), and Rh (-) groups were 48.9%, and 66.7%, respectively. Compared to 0 blood group, the LUTS incidence was 1.65, and 1.66 times higher for individuals with blood groups A, and AB, respectively. The same risk increased 2.09 times for individuals with Rhesus factor negative. Conclusion: This study identified a correlation between AB0 blood group and Rhesus factor and LUTS. The risk of LUTS risk increased in individuals with blood group A Rh (). Additionally there was a clear risk increase observed for AB blood group, though this did not reach statistical significance