Our Multiple Single-step Access Results in Percutaneous Nephrolithotomy

Objective:The aim of this study is to evaluate the success and complication rates of percutaneous nephrolithotomy (PNL) with multiple single step access in patients with staghorn kidney stones.Materials and Methods:A total of 118 patients with staghorn kidney stones, who underwent PNL in our clinic between 2008 and 2015, were included in the study. All patients were examined with non-contrast abdominal computed tomography before the operation. Demographic data of patients, operation details, intra- and postoperative complications and additional interventions were evaluated.Results:The mean age of the patients included in the study was 49.6 years. The mean operative time was 139.4 minutes and the mean fluoroscopy time was 126.9 seconds. Postoperative residual stone was detected in 28% of the patients. Postoperative fever was observed in 19 patients (16.2%), and sepsis developed in 3 (2.5%) of them. Additional postoperative procedures were required in 11 patients (9.3%). No patient was lost due to complications. Operation success and complication rates were compatible with the literature.Conclusion:For staghorn stones, PNL with multiple single step dilatation technique can be used as an effective and safe method in adult patients

Case Report Transitional Cell Carcinoma in Orthotopic Ileal Neobladder

Urothelial carcinoma developing in orthotopic ileal neobladder is an extremely rare entity. Fewer than 10 cases have been reported in the literature describing urothelial carcinoma recurrence in orthotopic ileal neobladder. We report a case of transitional cell carcinoma recurrence in orthotopic ileal neobladder after 11 years of surgery

Nephrocutaneous Fistula: An Unusual Nephrectomy Indication in Percutaneous Nephrolithotomy

Percutaneous nephrolithotomy (PNL) is recognized as the gold standard treatment method for stones larger than 2 cm due to its high success and acceptably low complication rates. The complications of PNL are well defined. Prolonged urinary leakage is one of them. In this study, a case of post-PNL urine leakage that was eventually treated with nephrectomy is discussed

Does Ozone Administration Have a Protective Effect Against Cisplatininduced Histological Changes in Rat Testis?

Objective:We investigated the protective and therapeutic effects of ozone therapy (OT) on cisplatin (CP)-induced testicular damage.Materials and Methods:Thirty healthy adult male Wistar rats were divided into five groups consisting of 6 animals each: 1) control, 2) CP, 3) OT, 4) OT + CP and 5) CP + OT groups. Histopathological findings, Johnsen scores, thiobarbituric acid-reactive substances (TBARS), glutathione (GSH), superoxide dismutase (SOD), catalase, and GSH peroxidase (GPx) levels were evaluated.Results:CP caused a significant decrease in testicular weight and Johnsen score compared to the control group. In addition, TBARS level was significantly higher, whereas GSH, SOD, catalase and GPx levels were significantly lower in the CP group when compared to the control group. Pre- and post-CP OT significantly increased GSH, SOD, catalase and GPx levels and decreased TBARS level. Also, testicular weight and Johnsen score were increased with OT.Conclusion:The present study showed that OT is protective against CP-induced testicular damage. OT may be beneficial to patients who underwent CP chemotherapy

Vaginocutaneous fistula and inguinal abcess presented 6 years after tension-free vaginal tape sling

Surgical treatment of female stress urinary incontinence (SUI) has become very pop- ular after respectable success with minimal invasive surgeries. This is the first report of long term vaginocutaneous fistula (VCF) plus inguinal abcess after tension-free vaginal tape (TVT). A 67 year-old woman with vaginal discharge lasting more than 3 years complained with a painful swelling in the left inguinal area for the last three months. She had a medical history of TVT sling procedure for SUI six years ago. She had no history of pelvic surgery, cancer treatment or pelvic irradiation before or after TVT sling. No urethrovaginal or vesicovaginal fistula was found in physical examination and cystocopy. MRI showed a vaginocutenaous fistula and inguinal abcess. This case highlights the need for a high index of suspicion for VCF after TVT

Post-renal acute renal failure due to a huge bladder stone

A 63-year old male was referred to our emergency unit due to acute renal failure. The level of serum renal function tests levels, blood urea nitrogen (BUN)/creatinine, were 63 mmol/L/848 μmol/L. CT (Computarised Tomography) scan showed a huge bladder stone (5 cm x 6 cm x 5 cm) with increased bladder wall thickness. Post-renal acute renal failure due to bilateral ureterohydronephrosis was diagnosed. The huge bladder stone was considered to be the cause of ureterohydronephrosis and renal failure. The patient was catheterised and received haemodialysis immediately. He received haemodialysis four times during ten days of hospitalization and the level of serum renal function tests levels (BUN/ creatinine) decreased 18 mmol/L/123 μmol/L. After improvement of renal function, we performed cystoscopy that demonstrated normal prostatic urethra and bladder neck and bilaterally normal ureteral orifices. Bladder wall was roughly trabeculated and Bladder outlet was completely obstructed by a huge bladder stone. After cystoscopy open, cystolithotomy was performed to remove calcium phosphate and magnesium ammonium phosphate stone weighing 200 g removed. Four days after operation the patient was discharged uneventfully and urethral catheter was removed on the seventh day. Post-renal acute renal failure due to large bladder stones is rare in literature. According to the our knowledge; early diagnosis of the stone avoid growth to large size and prevent renal failure

Rare type of bladder cancer: Malign fibrous histiocytoma

Malignant fibrous histocytoma (MFH) is the most common soft tissue sarcoma in adults. Urinary tract is a very rare location for MFH. Involvement of the bladder is more common in males and at the 6th decade of life. A case of MFH of the bladder with poor prognosis is presented. Prognostic factors for MFH are tumor grade, amount of invasion, age, tumor size, and histological type. Survival rate is very low and 3-year disease specific survival is approximately 40%

Metastatic primary urothelial carcinoma of the prostatic urethra: A case report

Introduction: Primary carcinomas of the urethra differ by location and histologic subtype. Primary urethral cancer of the proximal urethra is rare and aggressive tumor with a high propensity for regional and distant metastases. Case description: In this case report, we present primary urothelial carcinoma of the prostatic urethra, diagnosed by transrectal ultrasound-guided biopsy of the prostate and having multiple metastases at the time of diagnosis. Metastatic patients were initiated chemotherapy according to the histological type of urethral cancer. Conclusion: Urothelial carcinomas of the urethra are rarely seen, and therefore there is no standard treatment regimen for early-stage or metastatic disease. Gemcitabine-, platinum-, and taxane-based treatments are used in the metastatic stage

Percutaneous Nephrolithotomy in Patients with Positive Urine Cultures: Do Complications Increase?

WOS: 000435448100004Objective: Our aim in this study to determine whether positive urine culture is a risk factor for infectious complications in patients undergoing percutaneous nephrolithotomy (PNL). Materials and Methods: A total of 958 patients, who underwent PNL in our clinic between 2008 and 2015, were included in the study. The patients were divided into two groups with respect to preoperative urine culture results. Group 1 included 126 patients with nonsterile urine culture. As the control group, 130 patients were randomly selected among patients with preoperative negative urine culture and named as group 2. The groups were compared in terms of demographic data, postoperative complications and additional interventions. Results: The mean age was 51.4 +/- 1.05 years in group 1 was and 48.7 +/- 1.08 years in group 2. On postoperative 1st month computed tomography, postoperative residual stone fragments were observed in 27 patients (21%) in group 1 and 26 patients (20%) in group 2. The groups were similar in terms of treatment success (p=0.878). No significant difference was found between the groups in terms of postoperative fever (p=0.46), sepsis development and intensive care need (p=0.733). Conclusion: PNL would not increase infectious complications in patients with positive urine culture