The Benign Renal Masses that Were Exposed after Nephron-Sparing Surgery: “Postsurgical Fatty Tumor.” Is It Related to the Surgical Technique?

After nephron-sparing surgery (NSS), postsurgical fatty tumor could be mistakenly reported as angiomyolipoma during radiologic imaging of some patients. In the present paper, we studied the postsurgical fatty tumor detected after NSS but not covered before in the literature. In addition, we also evaluated whether the postsurgical fatty tumor was related to the surgical technique employed. Patients admitted to the urology department of our university hospital from 2014 to 2019 and operated with open NSS were evaluated retrospectively. We detected those 156 patients were operated with NSS. Nine patients with angiomyolipoma as primary pathology and four patients with surgical border positivity were excluded from the study. The patients were divided into two groups based on the repair of tumor extraction region. In Group 1, fatty tissue was used for repair, and Group 2 is the primary repair group. In all, 143 patients (Group 1 = 79, and Group 2 = 64) were included in the study. No demographic and radiologic differences, such as number of patients, age, gender, positioning of tumor, mass localization, tumor diameter, and RENAL nephrometry scoring system, were detected between the two groups. Postsurgical fatty tumors were detected in 28 patients in Group 1 and in two patients in Group 2 (P < 0.001). In patients with negative surgical margins after partial nephrectomy, lesions that were radiologically detected mimicking as angiomyolipoma were defined as “postsurgical fatty tumor.” This mass containing adipose tissue only neither depicted vascularization and enhancement nor increase in size for at least 1 year. We assumed that these lesions must be followed as benign lesions not requiring additional treatment

Unusual Presentation of Renal Cell Carcinoma: Gluteal Metastasis

Renal cell carcinoma (RCC) has widespread and unpredictable metastatic potential. The most common sites of metastatic RCC are the lungs, lymph nodes, bones, liver, and brain; however the soft tissue metastasis is rare (2,3). Here we report a 76-year-old male patient who had renal cell carcinoma presented with gluteal metastasis. To our knowledge this is the first renal cell cancer case with gluteal metastasis at the initial diagnosis

Böbrek alt kaliks taşlarının tedavisinde ve tekrar taş oluşumunda kısmi nefrektominin rolü

Böbrek taş hastalığı, tedavi edildikten sonra sık nükseden bir hastalıktır. Böbreklere lokalize taşların % 25-3 5 'ni alt kaliks taşları oluşturmaktadır. Alt kaliks taşlarının tedavisinde pek çok seçenek olmasına rağmen kısmi nefrektominin nüks oranlarını azalttığı belirtilmiştir. Selçuk Üniversitesi Meram Tıp Fakültesi Üroloji kliniğinde Ocak 1992 ile Haziran 2000 tarihleri arasında böbrek alt kaliks taşı teşhisi konan ve cerrahi tedavisi yapılan 57 hasta değerlendirildi. Böbrek anatomisi Sampaio ve arkadaşlarının tarif ettikleri şekilde standart İVP'lerle değerlendirilerek, infundibulapelvik açı, infundibulumun uzunluğu, infundibulumun derinliği ölçüldü. Alt pol nefrektomisi yapılan 29 hasta ile, pyelolitotomi, nefrolitotomi ve pyelonefrolitotomi yapılan 28 hasta ortalama 79 ay takip edildi. Kısmi nefrektomi yapılan hastaların ameliyat öncesi ölçülen infundibulapelvik açı ortalamaları 57 dereceden ameliyat sonrası 108 dereceye yükselirken pyelolitotomi, nefrolitotomi ve pyelonefrolitotomi yapılan hastalarda ortalama açı değerlerinde farklılık gözlenmedi. Alt pol nefrektomisi yapılan hastalarda 78 aylık takip sonucu taş nüksü oranı % 10, pyelolitotomi, nefrolitotomi ve pyelonefrolitotomi yapılan hastalarda ise 80 aylık takip sonucu % 21 idi. Kısmi nefrektomi ile alt kaliks taşı oluşumuna neden olan anatomik faktörün ortadan kaldırılması ile takiplerdeki taş nüks oranlarının azalması sağlanmaktadır.Renal stone disease is a recurrent disease. 25-35% of localized renal stone disease is localized to lower caliyx. In spite of different treatment methods of lower caliceal stones, it's thought that partial nephrectomy decrease recurrence rate. Between January 1992 and July 2000, 57 patients who were diagnosed and surgically treated for their lower caliceal stones, were evaluated in Selçuk University Meram Medical Faculty, Urology department. According to Sampaio et al description for renal anotomy, infundibulopelvic angle, infundibulum length and infundibulum diameter were measured by standard IVP. The mean follow-up period in 29 patients with lower pole nephrectomy and 28 patients with pyelolithotomy, nephrolithotomy and pyelonephrolithotomy was 79 months. The mean infundibulopelvic angle of the patients who were treated with partial nephrectomy increased from 57 degrees preoperatively to 108 degrees postoperatively. This angle of the patients treated with pyelolithotomy, nephrolithotomy and pyelonephrolithotomy remained the same. The recurrence rate of the patients treated with partial nephrectomy was 10 % in 78 month follow-up, but in patients treated with pyelolithotomy, nephrolithotomy and pyelonephrolithotomy this rate was 21 % in 80 month follow-up period. The partial nephrectomy decreases the recurrence rate by eliminating the anatomical factors that cause stone formation

Genetic approach in the male infertility

Önceden idiyopatik erkek infertilitesi olarak tanımlanan önemli sayıdaki androlojik fertilite bozukluğu, gerçekte genetik kökenlidir. Bu genetik sebepleri anlamak, hem tedavi yaklaşımları hem de onların doğacak bebeklerinin taşıyabileceği riskler hakkında hastaların bilgilendirilmesi açısından önem taşımaktadır. Bu derlemede, erkek infertilitesine neden olan genetik faktörler değerlendirilmiştirA substantial number of andrological fertility disorders, formerly defined as idiopathic male infertility is essentially genetic origin. Understanding this genetic causes matter for treatment approaches as well as patients about the risks to the baby to be born. In this review, genetic factors that cause male infertility is evaluate

Oxybutynin addiction amongst prisoners: two case reports

Bu çalışma Konya E tipi cezaevinde kalan ve oxibutinin kullanan veya kullandığı oxibutininin dozunu artırmak isteyen iki mahkumu sunmak için planlandı. Çalışma, oksibütinin, mahkumlar arasında madde ve alkol kullanımı ile elde edilen duygulara benzer etkiler elde etmek için kullanıldığını gösterdi. (Anadolu Psikiyatri Derg 2016; 17(Ek.3):77-79).This study was designed to present two inmates staying Konya E type prison and wanting to increase the prescripttion and/or current dosages of oxybutynin. The study showed that oxybutynin is used to achieve similar feelings to the effects obtained by the use of substance and alcohol among inmates. (Anatolian Journal of Psychiatry 2016; 17(Suppl.3):77-79)

Kromozom 1'in de novo perisentrik inversiyonu ile ilişkili erkek infertilitesi

WOS:000416270600030PubMed ID: 29201526Inversion occurs after two breaks in a chromosome have happened and the segment rotates 180 before reinserting.Inversion carriers have produced abnormal gametes if there is an odd number crossing- over betweenthe inverted and the normal homologous chromosomes causing a duplication or deletion. Reproductive riskssuch as infertility, abortion, stillbirth and birth of malformed child would be expected in that case. A 54-year- old male patient was consulted to our clinic for primary infertility. The routine chromosome study wereapplied using peripheral blood lymphocyte cultures and analyzed by giemsa-trypsin-giemsa (GTG) banding,and centromer banding (C-banding) stains. Y chromosome microdeletions in the azoospermia factor (AZF) regionswere analyzed with polymerase chain reaction. Additional test such as fluorescence in situ hybridization(FISH) was used to detect the sex-determining region of the Y chromosome (SRY). Semen analysis showedazoospermia. A large pericentric inversion of chromosome 1 46,XY, inv(1) (p22q32) was found in routinechromosome analysis. No microdeletions were seen in AZF regions. In our patient the presence of SRY regionwas observed by using FISH technique with SRY-specific probe. Men who have pericentric inversion of chromosome1, appear to be at risk for infertility brought about by spermatogenic breakdown. The etiopathogenicrelationship between azoospermia and pericentric inversion of chromosome 1 is discussed.Kromozom üzerinde iki kırık meydana gelmesi ve aradaki parçanın tekrar yapışmadan önce 180 dönmesiile inversiyonlar oluşur. Eğer normal ve inversiyonlu homolog kromozomlar arasında tek sayıda krosingover olursa, inversiyon taşıyıcılarında duplikasyon ve delesyona neden olarak anormal gamet üretimine nedenolurlar. Bu durumda malformasyonlu çocuk, ölü doğum, düşük ve kısırlık gibi üreme sorunları beklenir.Kliniğimize primer infertilite şikayetiyle 54 yaşındaki erkek hasta refere edildi. Periferik kandan lenfositkültürü yapılarak rutin kromozom çalışması yapıldı ve giemsa-tripsin-giemsa (GTG) bantlama ve sentromerbantlama (C bantlama) ile analiz edildi. Azoospermi faktör (AZF) bölgelerindeki Y kromozom mikrodelesyonlarıpolimeraz zincir reaksiyonu ile incelendi. Ek test olarak Y kromozomundaki cinsiyet belirleyicibölgenin (SRY) tespiti için floresan in situ hibridizasyon (FISH) uygulandı. Semen analizinde azoospermigörüldü. Kromozom 1'in geniş perisentrik inversiyonu, 46,XY, inv(1) (p22q32) karyotipi rutin kromozomanalizinde bulundu. AZF bölgelerinde mikrodelesyon görülmedi. Hastamızdaki SRY bölgesinin varlığıSRY-spesifik problar ile FISH tekniği kullanılarak gösterildi. Kromozom 1'in perisentrik inversiyonunasahip erkekler spermatogenik bozulmanın getirdiği infertilite açısından riskli görünmektedir. Kromozom1'in perisentrik inversiyonu ve azospermi arasındaki etyopatojenik ilişki tartışılmıştı

A prospective randomized comparison of micropercutaneous nephrolithotomy (Microperc) and retrograde intrarenal surgery (RIRS) for the management of lower pole kidney stones

WOS: 000413463500015PubMed ID: 28589217To make a comparison between the safety and efficacy of micropercutaneous nephrolithotomy (microperc) and retrograde intrarenal surgery (RIRS) for the management of lower pole kidney stones up to 15 mm. 60 patients presenting with solitary lower pole kidney stones up to 15 mm were included in the study between March 2013 and December 2015. Patients were randomized into Microperc or RIRS groups with computer-generated numbers. The mean stone size was 10.6 (5-15) and 11.5 (7-15) mm for Microperc and RIRS groups, respectively (P = 0.213). In the Microperc group, the scopy time was 158.5 s, while in the RIRS group, the scopy time was 26.6 s (P = 0.001). The hospitalization period in the Microperc group was 542 h, while it was 19 h in the RIRS group (P = 0.001). No statistical differences were observed during the operating time, pre-operative-post-operative hemoglobin (Hb), serum creatinine, and estimated glomerular filtration speed (e-GFR) values and stone-free rates. No intraoperative complications were observed in either of the groups, while post-operative complications were observed in six patients in Microperc Group and five patients belonging to the RIRS Group (P = 0.922). Both Microperc and RIRS are safe and effective alternatives, and have similar stone clearance and complication rates for the management of lower pole kidney stones up to 15 mm in diameter. However, prolonged hospital stay and scopy times are the main disadvantages of Microperc and further research is needed to evaluate the renal tubular damages caused by both of these methods

Fracture With Urethral Injury: Evaluation by Retrograde Urethrogram

Penil fraktür nadir görülen bir durumdur. Penis ereksiyonu esnasında oluşan travma sonucu öncelikle korpus kavernozum rüptürü oluşur ve bu esnada korpus spongiozum ve üretra da etkilenebilir. 35 yaşında erkek hasta cinsel ilişki sırasında oluşan künt travma sonrasında akut penil ağrı, penil şişlik ve hematüri ile acil servise başvurdu. Acil retrograd üretrogram çekiminde verilen opak maddenin penil üretradan kavernoz yapılara ekstravaze olduğu (nadir görülen) izlendi. Penil üretradaki ve kavernöz yapılardaki parsiyel rüptür cerrahi olarak onarıldı. Hastanın post-operatif 3. aydaki takibinde, komplikasyonun olmadığı ve hastanın ereksiyonunun ve işeme fonksiyonunun normal olduğu gözlendi. Üretral yaralanma şüphesi olan penil fraktur olgularında retrograd üretrogram tanı koyduru cudurPenile fracture is a rare condition. It primarily involves the rupture of the corpus cavernosum during erection, which may also affect the corpus spongiosum and urethra. We describe the case of a 35-year-old man who presented with acute penile pain, penile swelling, and a hematuria after a blunt trauma during sexual intercourse. The emergency retrograde urethrogram revealed a rare condition, extravasation of the opaque material from the penile urethra into the cavernous structure. The partial rupture of the corpus cavernosum with urethral disruption was repaired surgically. At the 3-month postoperative follow-up control, no complications were reported by the patient who has had both normal erectile and voiding functions. In cases of penile fracture with suspected urethral injury, retrograde urethrogram can be used for definitive diagnosi

Böbrek Nakli Sonrası Gelişen Vezikoüreteral Reflü Olgusunda Tedavi Seçimi

Böbrek nakli yapılmış hastaların önemli bir kısmında ürolojik komplikasyonlar gelişmektedir. Gelişen bu ürolojik komplikasyonlar nakil sonrası greft fonksiyonunda gecikme, greft kaybı gibi morbiditelerin ve mortalitenin en önemli sebeplerindendir. Elli yedi yaşında erkek hastada kadaverik böbrek nakli sonrasında vezikoüreteral reflü gelişti. Tekrarlayan idrar yolu enfeksiyonu ve greft fonksiyonlarında bozulmaya yol açması nedeni ile öncelikle subüreterik enjeksiyon denedi; fakat başarılı olmaması üzerine açık prosedürle üreteroneosistostomi işlemi tekrarlandı. Hasta ameliyat sonrası 10. ayında ve takipleri problemsiz olarak devam ediyor. Sonuçta idrar yolu enfeksiyonu ve greft fonksiyonlarında bozulmaya yol açan VUR sonrasında öncelikle daha az invazif bir yöntem olan endoskopik yöntemler tercih edilebilirken, başarısız enjeksiyon; ya da ileri evre vakalarda açık cerrahi prosedürün tercih edilmesi uygun bir yaklaşım olarak görülmektedir.The vast majority of renal transplant patients suffer from urological complications. These urological complications account for the most important causes of morbidity and mortality cases such as delay in graft functions and graft loss following transplantation.57-year-old male patient contracted vesicoureteral reflux (VUR) following cadaveric renal transplantation. Initially subureteric injection was tried because of recurrent urinary tract infection and impairment of graft functions but open procedure ureteroneocystostomy was repeated since the injection failed to produce results. The patient is currently in his post-op month 10 and his follow-ups revealed no problems thus far.While less invasive methods such as endoscopic procedures can primarily be selected for the treatment of VUR, which leads to urinary tract infections and impairment in graft functions subsequently, open surgical procedures are considered to be an appropriate approach for failed injection or advanced stage cases

Midline Prostatic Cyst Marsupialization Using Holmium Laser

Many of the prostatic cysts are asymptomatic and only 5% are symptomatic (Hamper et al., 1990; Higashi et al., 1990). These symptoms include pelvic pain, hematospermia, infertility, voiding dysfunction, prostatitis-like syndrome, and painful ejaculation. Treatment of prostatic cysts includes TRUSG guided drainage, endoscopic transurethral resection, and in some cases even open surgery. In the literature, endoscopic interventions use marsupialization of the midline prostatic cyst with transurethral resection (TUR) or transurethral incision with endoscopic urethrotomy (Dik et al., 1996; Terris, 1995). Holmium: YAG laser was employed for the marsupialization of the cyst wall in midline prostatic cyst treatment for the first time in the present study. Symptoms, treatment, and follow-up are presented in this paper