Gender-related Differences in Surgically Treated Patients with Renal Cell Carcinoma

Objective:The aim of the study was to investigate gender-specific differences in the Turkish patients with renal cell carcinoma (RCC) undergoing radical or nephron-sparing nephrectomy and compare the results with those in other regions.Materials and Methods:Data of 76 patients, who were clinically diagnosed with RCC and underwent radical or nephron-sparing nephrectomy from January 2011 to August 2017, were retrospectively evaluated. Age and gender of the patients and the size, histological type, grade and pathological stage of the tumors were recorded. A chi-square test was used for comparing categorical variables, whereas the Student’s t-test was used for the same purpose in the continuous variables.Results:Of the 67 patients, 39 (58.2%) were male and 28 (41.8%) were female; male-to-female ratio was 3:2. The mean age of the male and female patients was 63.4±11.7 years and 59.3±14.3 years, respectively and the mean tumor size was 5.7 and 5.3 cm, respectively. There were differences in mean age, tumor size and Fuhrman grade, however, none of them reached the level of statistical significance. Twenty four of the male and 25 of the female patients had low-stage, 15 of the male and 3 of the female patients had high-stage disease. Thus, the male patients had higher stage disease than the female patients and the difference was statistically significant (p=0.011).Conclusion:Turkish women with RCC had significantly lower stage disease than Turkish men, although grade and size of the tumor did not present a statistically significant difference. The results were similar with other European studies

A Stranger in the Epididymis: Ectopic Spleen

Splenogonadal fusion, which can be clinically confused with testicular neoplasms as they present with testicular swelling, is a rare abnormality in young adults. Intraoperative frozen section analysis can be helpful in diagnosing such cases and preventing unnecessary orchiectomies. We report a case in which frozen section analysis was done and testis-sparing surgery could be performed

Bladder Carcinoma in a 24-Year-Old Patient: A Case Report and Review of the Literature

Urothelial bladder carcinoma is a rare condition in young patients. Clinicians have less inclination to perform cystoscopy in this age group because benign causes of hematuria are more common. Thus, diagnostic delays of up to one year may occur. We report a 24-year-old male patient with urothelial bladder cancer. Clinical behavior and prognosis in young individuals are controversial. The definitions of “young patient” are highly variable and different World Health Organization pathological classification systems are used for reporting. Generally, it presents as a low-stage and low-grade disease, nevertheless, it may present with high-grade tumors, even with muscle-invasive cancer

Unnecessary Repeated Total PSA Tests; Evaluation with Minimum Retest Interval and Reference Change Value

Objective: The aim of study was to determine unnecessary repeated total prostate specific antigen(tPSA) according to minimum retest interval and to evaluate the change between consecutive measurement results with RCV.Material and Methods: According to report of Association for Clinical Biochemistry and Laboratory Medicine, when first result is raised, it is recommended to repeat tPSA once in 6 weeks to assess the trend. tPSA test results which were requested between March 2015 and 2017 in our hospital were evaluated retrospectively. If tPSA was>2.5 ng/mL and this test was repeated in less than 6 weeks, it was determined as unnecessary repeated test. RCV was calculated.Results: The number of tPSA was 1794 and number of consecutive tPSA requested was 427 (12.5%). The first tPSA result was>2.5 ng/mL in 46.4% (198/427) of consecutive tPSA tests, 49% of these tests(97/198) were unnecessary. RCV was calculated as 51.45%. In 82.5% (80/97) of unnecessaryrepeated tPSA, the change between two results was smaller than RCV. Number of consecutive tests which changed below RCV was significantly lower in appropriately requested tPSA tests than unnecessary repeated tPSA (p=0,002).Conclusion: Absence of significant difference between two consecutive results in unnecessary repeated test according to RCV suggests the importance of test requesting according to guidelines. We believe that our work will raise awareness about reducing unnecessary request

Mikroskobik idrar analizini öngörmede idrar strip testinin performansı

Amaç: Çalışmanın amacı, manuel mikroskopik idrar analizi öngörmek için idrar strip analizinin performansını değerlendirmektir. Yöntem: İdrar yolu enfeksiyonu (İYE) şüphesi olan hastalardan alınan ve hem mikroskopik hem de strip analizi yapılan idrar örnekleri çalışmaya dahil edildi. Eritrosit strip (Erit-S) ve lökosit strip (Lök-S) testlerinin “eser”, “1+”, “2+”, “3+” kestirim değerleri için duyarlılık, özgüllük, pozitif ve negatif olabilirlik oranları (LR+, LR-), test öncesi ve sonrası şans, test sonrası olasılık değerleri hesaplandı. Koşullu olasılığı belirlemek için Bayes teoremi kullanıldı. ROC eğrisinin altındaki alan (AUC) hesaplandı. Bulgular: Lök-S ve Erit-S için AUC sırası ile 0,923 ve 0,975 olarak bulundu. Lök-S testi “1+”, Erit-S testi “eser” kestirim değerinde yeterli duyarlılık ve özgüllükteydi (>%80). LR+ değerine göre Lök-S “3+” kestirim değerinde, Erit-S tüm kestirim değerlerinde; LR- değerine göre Lök-S eser, Erit-S eser ve “1+” kestirim değerlerinde post-test olasılıkta anlamlı farklılık sağladı (0,1). İYE dönemsel prevalans hızı test öncesi olasılığı %5,95 olarak bulundu. İYE tanısı içinidrar örneği alınan hastalarda mikroskobik incelemeye göre İYE post test olasılığı Lök-S “3+” kestirim değerinde %39, Erit-S “3+” kestirim değerinde %74 idi. Sonuç: İdrar strip analizinin manuel mikroskobik analizdeki lökosit ve eritrosit pozitifliğini öngörmede yeterli olduğu bulundu. İdrar strip analizinde tanısal güç öngörme performansı kestirim değerlerine göre farklılık gösterdi. Çalışmamızın bu konuda farkındalık sağlayacağı ve klinisyenlerin İYE ön tanılı hastalarda test istem tercihlerinin belirlemesinde ve gereksiz test istemlerinin önlenmesinde yararlı olacağı görüşündeyi

Penil Entrapment with A Steel Nut and Its Treatment with A Dental Micro Motor

Entrapment or strangulation of the penis is an uncommon condition that requires prompt medical intervention to avoid mechanical and/or vascular injuries. Severe complications such as edema, necrosis, skin infection, penile amputation, and urethral fistula may occur. There is no universally accepted method for treatment, and medical treatment can be delayed due to feelings of humiliation or self-attempt to release the entrapment. Intracavernosal aspiration is a surgical procedure used to evacuate blood from the obstructed corpus cavernosum. This procedure reduces penile size making it easier to remove the ring. However, it does not alleviate the inflammatory idea in the interstitial spaces and penile skin. This paper describes a case study of a 34-year-old male patient who was evaluated in the department of emergency with penile entrapment in a thick steel ring that was placed for prolonged erection. Removing the ring manually was attempted in the emergency department but failed, causing more engorgement in the distal part of the penis. The following admission, the patient was expeditiously transferred to the operating room where the surgical team interposed a wooden tongue depressor between the penile shaft and the ring. Subsequently, a manual hacksaw was used to excise the constriction device. Nevertheless, owing to the substantial diameter of the ring, the hacksaw became fractured and subsequently, a micromotor was employed for the ring removal procedure. Throughout the cutting process involving the micromotor, the ring was continuously cooled with an iced isotonic solution. Within thirty minutes, the ventral and dorsal sides of the steel ring were cut, and it was removed in two pieces

To evaluate the etiology of erectile dysfunction: What should we know currently?

Erectile dysfunction (ED) is the inability to develop normal erection or an hardening problem at various extent that causes inability to maintain the erection for the sufficient time required for a complete sexual activity. It can be the result of neurologic, psychogenic, vascular, urogenital and hormonal abnormalities. It is reported that it affects 52-67% of men between 40 and 70 years old. Numerous theories and opinions are issued in the literature in order to explain the hemodynamic changea that occur during erection and detumescence. Especially the effects of chronic diseases and psychogenic factors on the pathophysiology of erectile dysfunction are common matters of discussion in recent years. In this review, we will evaluate the current developments in the literature about the etiology of erectile dysfunction