Giant Ectopic Ureter Mimicking Pelvic Organ Prolapse: A Case Report

Ectopic ureter is one of the most common urinary tract anomalies. We, herein, present a case of a giant ureter with ectopic orifice, mimicking pelvic organ prolapse, which is the first in the literature. A 59-year-old female patient presenting with frequently recurrent urinary tract infection had grade 3 pelvic organ prolapse. On examination, the organ producing the appearance of prolapse was found to be a right ureter of giant size and was obstructed by a large stone at the distal segment. The proximal end of the ureter ended blindly. After exploration, the stone was removed, the ureter was detached from the urethra, and the lumen was tied off and cut 5 cm proximally. At 6 months postoperatively, the patient is being followed up without any clinical problems. In such cases with nonfunctioning renal segment draining proximally, the chance of cure can be obtained without a need for a comprehensive intervention such as total abdominal ureterectomy

Can High Preoperative Neutrophil-lymphocyte Ratio Predict the Recurrence and Progression Risk of Non-muscle-invasive Bladder Tumors?

WOS: 000469807700001Objective: Neutrophil-lymphocyte ratio (NLR) is a well-known, cost-effective biomarker of inflammatory conditions, and its protumor effect has been shown in different types of cancers. In this study, we aimed to evaluate the relationship between blood parameters, especially NLR, with the risk of progression and recurrence in non-muscle-invasive bladder tumors (NMIBT). Materials and Methods: Seventy-six patients were included in the study. Patients were divided into low, moderate and high-risk groups according to the risk of progression and recurrence. The preoperative blood parameters of the patients were recorded from the patient files and the NLR of each patient was calculated. These parameters were compared in terms of progression and recurrence risk groups. P values less than 0.05 were accepted statistically significant. Results: Neutrophil-lymphocyte ratio was significantly higher in the high-risk group in both the progression and recurrence risk groups than in the low and moderate risk groups (p<0.001). In addition, according to the post hoc results, the NLR values in the high-moderate and moderate-low risk groups showed significant differences (high-moderate and moderate-low values in terms of risk of recurrence were 4.66 vs 3.67 and 3.67 vs 2.88, respectively, p<0.001; high-moderate and moderate-low values in terms of risk of progression were 4.72 vs 3.68 and 3.68 vs 2.92, respectively, p<0.001). Conclusion: In our study, we found that groups with high risk of recurrence and progression had higher NLR values in patients with NMIBT. NLR, which is cheap, rapid and routinely applied in preoperative evaluation, is a promising biomarker in the prognostic classification of bladder tumors. Well-designed, large-scale prospective studies with long-term follow-up are needed to determine the role of NLR in this issue

The effect of Hydrodistension in combination with Pentosan Polysulfate on treatment outcomes and compliance in the treatment of bladder pain syndrome

WOS: 000464434700036PubMed ID: 30881421Objective: In the present study, we investigated the efficacy of bladder hydrodistension combined with pentosan polysulfate (PPS) treatment in interstitial cystitis (IC)/bladder pain syndrome (BPS). Methods: In this study, 339 patients diagnosed with IC/BPS were categorized into two groups. The first group only received 300 mg/day PPS, while the second group received 300 mg/day PPS following bladder hydrodistension. The results were evaluated at the 3rd, 6th, and 12th months after the first dose using the interstitial cystitis symptom index (ICS!), international cystitis problem index (ICPI), visual analog scale (VAS), and female sexual function index (FSFI). Results: PPS treatment started just after hydrodistension was significantly more effective than PPS treatment alone and combined treatment significantly reduced the rate of non-compliance such that, at the end of the 3rd month, 12.1% patients in Group-1 did not continue their treatment whereas only 1.9% of patients in Group-2 did not continue. Conclusions: The study results indicate that PPS treatment started just after hydrodistension yields significantly better results in terms of both symptom improvement and treatment compliance in patients with IC/BPS

A new technique in the treatment of ureteroenteric anastomosis stricture: Repair of ureteroenteric anastomosis stricture with low lombotomy incision (retroperitoneal approach)

WOS:000633508400001PubMed: 33743548Introduction and aim Ureteroenteric anastomosis stricture (UEAS) is one of the complications of urinary diversion and may lead to serious consequences. in this study, we evaluated our UEAS revision technique outcomes performed with a low lombotomy incision in the lateral decubitus position. Materials and methods Eleven patients who underwent surgical repair due to isolated right UEAS between January 2010 and June 2019 were included in the study. Anastomosis stricture was confirmed by ultrasonography, computed tomography or magnetic resonance urography techniques. Ultrasonography was used to detect hydronephrosis, which is a finding secondary to stricture. However, opaque urography imaging methods were used to confirm the definitive diagnosis of the stricture. Demographic and clinical data, preoperative and postoperative 3rd month serum creatinine, estimated glomerular filtration rate (eGFR) and dynamic renal scintigraphy data of patients were evaluated. Results The mean operation time was 49.7 +/- 9.3 minutes. No perioperative complications were observed. While the overall stricture rate was 11.4%, the isolated right-sided stricture rate was 5.7%. Preoperative and postoperative serum creatinine values were similar. Preoperative eGFR value was 58.8 +/- 12.9 mL/min/1.73 m(2) and postoperative value was 53.5 +/- 11.5 mL/min/1.73 m(2). T1/2 level decreased in postoperative period (22.3 +/- 8.2 min vs 15.1 +/- 4.3 min). Conclusions Open revision of the UEAS with retroperitoneal approach provides lower morbidity rates and shorter hospitalisation time compared to other methods. The retroperitoneal approach is the main advantage of this technique and prevents morbidity caused by other techniques performed intraperitoneally and owing to it is an open technique, it can be easily applied in isolated right-sided UEAS

Prognostic Significance of Body Mass Index and Other Tumor and Patient Characteristics in Non Metastatic Renal Cell Carcinoma

WOS: 000437812800005PubMed ID: 29464679Purpose: In this retrospective study, we aimed to investigate the prognostic effect of body mass index (BMI) in localized renal cell carcinoma (RCC) cases who underwent surgical treatment. Furthermore, the assessment of various patient and tumor characteristics and surgical methods on survival has been identified as additional targets. Materials and Methods: Three hundred and eighty patients with localised, non-metastatic, unilateral RCC who underwent radical or partial nephrectomy in our clinic between January 2007 and December 2016 were enrolled in this study. Age, gender, height, weight, BMI, operation type and method, pathology results and tumor stage of the patients were recorded. Patients were divided into 3 groups according to body mass index (BMI): Normal weight ( 30 kg/m(2)) as groups 1, 2 and 3, respectively. We analyzed the relation between the BMI, gender, smoking, hypertension, type and method of surgical treatment, histologic subtype, tumor stage, estimated glomerular filtration rate (eGFR) and cancer-specific (CSS) and recurrence free survival (RFS). All data analysis was performed using SPSS Statistical Software for Windows (Version 13.0) and a P value less than 0.05 was considered to be significant. Results: The effect of BMI on both CSS and RFS was statistically significant (P <.001). There was also a significant relation between smoking, operation type (partial/radical), eGFR and tumor stage and CSS and RFS. Conclusion: Our findings show that overweight and obese RCC patients according to the BMI have a more favorable prognosis. Multicenter, prospective studies with more cases and longer oncological follow-up period are needed to support these findings

Comparison of percutaneous nephrostomy and double J stent in symptomatic pregnancy hydronephrosis treatment

WOS: 000431261100030PubMed ID: 29714462Background/aim: We aimed to compare the success rate of percutaneous nephrostomy (PCN) and double J stenting (DJS) in the treatment of symptomatic pregnancy hydronephrosis. Materials and methods: Diagnosis and grading of hydronephrosis were performed by urinary ultrasound (USG) and Doppler mode was used for evaluation of renal arterial resistivity index (RI). Patients were divided into two groups according to the method used for the treatment of hydronephrosis: group A (PCN, n = 38) and group B (DJS, n = 46). A P value < 0.05 was considered significant. Results: The number of patients requiring second intervention was higher in group B (P = 0.0018) and time to secondary intervention was significantly earlier in group B also (P = 0.0025). The number of tertiary intervention was again higher in group B (5/16 vs. 1/6) and the need for tertiary intervention was higher in patients who underwent DJS implantation as a secondary intervention than those who underwent PCN (5/11 vs. 1/11, P = 0.0012). The time to tertiary intervention was longer in patients with PCN than in those with DJS (P = 0.0048). Conclusion: PCN may be preferred to DJS in symptomatic pregnancy hydronephrosis because it requires fewer re-interventions after longer times

Do sperm parameters and infertility affect sexuality of couples?

WOS: 000424997800039PubMed ID: 28766811We aimed to analyse the relationship between sperm parameters and International Index of Erectile Function (IIEF) score, the Female Sexual Function Index (FSFI) score, the testosterone (T) level in infertile men and between FSFI score and partners' fertility. Patients were divided into three groups; (group 1: azoospermia [n=57], group 2: sperm count 15million [n=81]). Patients and their partners filled the IIEF and FSFI forms. The normality of the tests was analysed with Kolmogorov-Smirnov and Shapiro-Wilk tests. Spearman's rho test, a nonparametric test, was used to correlate the data. A value of p<.05 was considered statistically significant. There was a positive correlation between the sperm count, other sperm parameters, morphology and motility and IIEF score, FSFI score and T (p=.037, .028 and .041 respectively). We found a positive correlation between IIEF score and FSFI score (p=.182). Infertile partners' FSFI score was lower than fertile partners' scores (p=.023). Male infertility causes severe sexual dysfunction in couples, and female sexual dysfunction increases in parallel to that of men. Male sexual function also tends to decrease with low sperm count. While the clinician evaluates infertile couples, psychological and sexual functions should also be evaluated and patients should not be deprived of appropriate treatment

Comparison of long-term outcomes of laparoscopic and robot-assisted laparoscopic partial nephrectomy

WOS: 000464659600007PubMed ID: 30887679In this study, we compared the long-term oncological and functional outcomes of laparoscopic partial nephrectomy (LPN) and robot-assisted laparoscopic partial nephrectomy (RAPN) performed in the treatment of renal tumors. The data of 142 patients (RAPN = 71, LPN = 71) were evaluated. Demographic data, perioperative and postoperative outcomes, long-term (5-year) overall survival (OS) and cancer-specific survival (CSS) rates of the patients were compared between the two groups. A P value of less than 0.05 was considered statistically significant The mean follow-up time was 61.38 months. There were more complex tumors in the RAPN group (P = 0.014). The duration of warm ischemia time (WIT) was shorter in the RAPN group (P = 0.019). Perioperative and postoperative outcomes were similar. There were no differences between the groups in terms of 5-year metastasis-free survival, OS, and CSS rates. Hypertension, diabetes, and preoperative estimated glomerular filtration rate (eGFR) were the predictive factors for renal insufficiency; and preoperative eGFR, WIT, and positive surgical margin were the predictive factors for 5-year CSS. We concluded that RAPN is an important minimally invasive treatment method for partial nephrectomy with long-term favorable results, especially in complex tumors. Comparisons of two methods should be made with comparative, prospective, randomized, high case number studies, and the place of RAPN in the treatment of these tumors should be clarified