Effect of the Anesthetic Method on the Outcomes of Ureteroscopy for Proximal Ureteral Stones: A Multi-center Study of the Society of Urological Surgery Aegean Study Group

Objective:To analyze the effect of the anesthesia method (spinal and general) on the outcome of ureteroscopy (URS) in patients treated for proximal ureteral stones.Materials and Methods:Patients, who underwent URS for proximal ureteral stones at various urology clinics in Turkiye, were included in the study. The patients were divided into two groups according to the anesthesia method performed; the procedure was performed under spinal anesthesia (SA) in group 1 and general anesthesia (GA) in group 2. Patients’ demographic, perioperative data and complication rates were compared between the two groups in a retrospective manner.Results:There were 309 and 329 patients in groups 1 and 2, respectively. The mean stone area and Hounsfield unit in GA group were higher (p0.05). The rate of success of URS, which is accepted as complete stone-free status, was higher in the SA group (p=0.041).Conclusion:URS, which is used in the treatment of proximal ureteral stones, has a high success rate, independent of the anesthesia method used. It is important to keep in mind the patient’s comorbidities prior to selecting the anesthesia method and that the stone area and the Hounsfield unit are the important factors affecting the outcomes

Comparison of Efficacy and Complications of Holmium Laser and Pneumatic Lithotripters Used in the Ureterorenoscopic Treatment of Proximal Ureter Stones, a Multi-Center Study of Society of Urological Surgery Aegean Study Group

Objective:The aim of this study is to compare the efficacy and complications of holmium laser and pneumatic lithotripsy used in the ureterorenoscopic treatment of proximal ureteral stones.Materials and Methods:Data of 638 patients, who underwent ureterorenoscopy (URS) due to proximal ureteral stones in different centers, were obtained from patient files. The patients were divided into two groups according to the type of lithotripter used: group 1; laser lithotripter (n=324; 50.8%) and group 2; pneumatic lithotripter (n=314; 49.2%). URS was considered successful upon determination stone-free status with the imaging methods after treatment. The effectiveness and the complications of holmium:yttrium-aluminum-garnet laser and pneumatic lithotripsy were compared.Results:The total success rate of URS was 82.6% and the complication rate was 8.1%. The mean age of patients was similar between the groups; however, the body mass index values, stone surface area and stone Hounsfield unit were significantly higher in group 1. Although the mean operative time, complication rate and the mean length of hospital stay were similar between the groups; the URS success and postoperative ureteral J stent use rates were significantly higher in group 1 and the push-back rate was significantly higher in group 2.Conclusion:If laser lithotripsy is available in a clinic, we believe that it is better to use it as the first option in the treatment of proximal ureter stones. However, considering that it is not easy to access laser lithotripters due to their high cost in Turkey, pneumatic lithotripters may be an effective and inexpensive alternative that can also be safely used in these cases

Evaluation of the Relationship Between Duration of Smoking and Clinical and Pathologic Characteristics of Bladder Cancer at Diagnosis

Objective: In this study, we aimed to evaluate the relationship between the duration of smoking and clinical and pathological characteristics of malignant bladder cancer at diagnosis. Materials and Methods: In this study, a total of 41 patients who were diagnosed with primary bladder cancer and underwent transurethral resection of bladder tumor in our clinic were included in this study. Clinical and pathological features of bladder tumor such as demographic data, smoking status and tumor size, cystoscopic appearance, tumor grade and grade, presence of lamina propria invasion in histopathological examination, presence of necrosis and inflammation were obtained from medical records. The association of these properties with smoking was evaluated retrospectively. Results: In this study, mean age of patients was determined to be 69.07 years and mean duration of smoking was 49.8 pack-years. We demonstrated that there was a statically significant relationship between duration of smoking and size of tumors, histological grade and grade of the tumor, solid appearance of the tumor, lamina propria invasion of the tumor, squamous differentiation of the tumor, and presence of histopathological inflammation and necrosis in the tumor. Conclusion: The duration of smoking in patients with bladder cancer, may be an important factor that gives information about aggressivity of tumors at the diagnosis to urologist and pathologist

Evaluation of the Relationship Between Duration of Smoking and Clinical and Pathologic Characteristics of Bladder Cancer at Diagnosis

Objective: In this study, we aimed to evaluate the relationship between the duration of smoking and clinical and pathological characteristics of malignant bladder cancer at diagnosis. Materials and Methods: In this study, a total of 41 patients who were diagnosed with primary bladder cancer and underwent transurethral resection of bladder tumor in our clinic were included in this study. Clinical and pathological features of bladder tumor such as demographic data, smoking status and tumor size, cystoscopic appearance, tumor grade and grade, presence of lamina propria invasion in histopathological examination, presence of necrosis and inflammation were obtained from medical records. The association of these properties with smoking was evaluated retrospectively. Results: In this study, mean age of patients was determined to be 69.07 years and mean duration of smoking was 49.8 pack-years. We demonstrated that there was a statically significant relationship between duration of smoking and size of tumors, histological grade and grade of the tumor, solid appearance of the tumor, lamina propria invasion of the tumor, squamous differentiation of the tumor, and presence of histopathological inflammation and necrosis in the tumor. Conclusion: The duration of smoking in patients with bladder cancer, may be an important factor that gives information about aggressivity of tumors at the diagnosis to urologist and pathologist

Determination of Six Transmembrane Protein of Prostate 2 Gene Expression and Intracellular Localization in Prostate Cancer

Objective: In this study, we aimed to determine the relationship between the RNA and protein expression profile of six transmembrane protein of prostate 2 (STAMP2) gene and androgen and the intracellular localization of STAMP2. Materials and Methods: RNA and protein were obtained from androgen treated lymph node carcinoma of the prostate (LNCaP) cells, untreated LNCaP cells, DU145 cells with no androgen receptor, and STAMP2 transfected COS-7 cells. The expression profile of STAMP2 gene and the effect of androgenes on the expression was shown in RNA and protein levels by using Northern and Western blotting methods. In addition, intracellular localization of the naturally synthesized STAMP2 protein and the transfected STAMP2 protein in COS-7 cells after androgen administration in both LNCaP cells was determined by immunofluorescence microscopy. Results: We found that the RNA and protein expression of STAMP2 gene in LNCaP cells are regulated by androgenes, the power of expression is increased with the duration of androgen treatment and there is no STAMP2 expression in DU145 cells which has no androgen receptor. As a result of the immunofluorescence microscopy study we observed that STAMP2 protein was localized at golgi complex and cell membrane. Conclusion: In conclusion, we have demonstrated that STAMP2 may play an important role in the pathogenesis of the prostate cancer and in the androgen-dependent androgen-independent staging of prostate cancer. In addition, STAMP2 protein, which is localized in the intracellular golgi complex and cell membrane, may be a new target molecule for prostate cancer diagnosis and treatment