The impact of Coronavirus disease 2019 (COVID-19) on urinalysis parameters.

BACKGROUND: Creatinine elevation and changes in urinalyse parameters may be seen due to acute kidney injury during COVID-19. In the present study, we aimed to investigate the changes in urinalysis of COVID-19 patients with normal kidney function. METHODS: The data of COVID-19 patients with normal renal functions were retrospectively analyzed. Urinalysis parameters of these patients were recorded. The patients were divided into three groups as mild, moderate and severe with respect to the clinical course of the disease. It was examined whether the urine analysis values in the groups were different from normal reference values and whether these values were different between the groups. In addition, possible relationship between the urinalysis parameters and the clinical severity of the disease was investigated. RESULTS: There are three groups; mild (N.=40), moderate (N.=38) and severe (N.=42). Mean age were significantly higher in the severe group, while gender distribution of the groups was similar (P=0.033, P=0.091) Creatinine values of all patients were normal. There were 6.7% glucose positivity, 13.4% protein positivity, 5.8% urobilinogen positivity and 7.5% ketone positivity in urine dipstick analysis and these changes were all significantly higher than the reference values (P=0.008, P<0.0001, P=0.016, P=0.016). Pyuria and hematuria were detected in 8.3% and 9.2%, respectively. The urinalysis parameters and urine microscopy findings were not affected by the severity of the disease. CONCLUSIONS: Glycosuria, proteinuria, pyuria and hematuria may occur during COVID-19 disease, regardless of comorbidity and renal dysfunction. However, these urine parameters were not correlated with the severity of the disease.

Complementary Ureterorenoscopy after extracorporeal Shock Wave Lithotripsy in proximal ureteral stones: success and complications.

OBJECTIVE: The aim of this study was to demonstrate the effect of extracorporeal shock wave lithotripsy application on the success and complications of ureteroscopic lithotripsy in proximal ureter stones. METHODS: The data of 87 patients who did not respond to shock wave lithotripsy and underwent ureteroscopic lithotripsy were retrospectively analyzed and classified as group I, and 99 patients who received ureteroscopic lithotripsy as primary treatment were classified as group II. Demographic features, response to treatment, and preoperative and postoperative complications were compared between the two groups. RESULTS: There was no difference between the two groups in terms of gender, operation times, stone sizes, and ureteroscope diameters. (p>0.05). Infective complications such as postoperative fever, pyelonephritis, and urosepsis were similar in both groups (p=0.142, p=0.291, and p=0.948). Stone migration was observed in 10 (11.5%) and 6 (6.1%) patients in groups I and II, respectively (p=0.291). Impacted stone was seen in 47 (54%) patients in group I and in 15 (15.2%) patients in group II (p<0.0001). Mucosal laceration occurred in 11 (12.6%) and 3 (3%) patients in groups I and II, respectively (p=0.028). Ureteral perforation was detected in 3 (3.4%) patients in group I and 1 (1%) patient in group II, whereas ureteral avulsion was not observed in either group (p=0.524). CONCLUSIONS: It was concluded that the application of shock wave lithotripsy before ureteroscopic lithotripsy in proximal ureter stones did not affect the success. Although the results are similar in terms of postoperative infection, shock wave lithotripsy application has been found to increase the risk of stone impaction into the mucosa and ureteral laceration.

Measuring urinary 8-hydroxy-2'-deoxyguanosine and malondialdehyde levels in women with overactive bladder.

Purpose: In this study, we aimed to explain the role of oxidative stress in women with overactive bladder (OAB) by investigating the levels of 8-hydroxy-2'-deoxyguanosine (8-OHdG), a marker of oxidative DNA damage, and malondialdehyde (MDA), an indicator of lipid peroxidation. Materials and Methods: A total of 90 women were included in the study: 45 female patients diagnosed with OAB at Hopa State Hospital Urology Polyclinic and 45 healthy women without any metabolic or neurologic disease. Levels of MDA and 8-OHdG were measured in 24-hour urine samples for all subjects. Results: Urinary levels of MDA and 8-OHdG were significantly higher in the OAB group than in the control group (p<0.001). A significant positive correlation (p<0.001) was found between the measurements of 8-OHdG and MDA. Conclusions: Oxidative stress may be important in the pathophysiology of OAB, because levels of 8-OHdG and MDA are increased. Increased levels of 8-OHdG may be due to damaged nuclear and mitochondrial DNA as a result of oxidative attacks caused by free radicals. Nevertheless, further randomized and prospective studies with larger patient populations are needed.

Complementary Ureterorenoscopy after extracorporeal Shock Wave Lithotripsy in proximal ureteral stones: success and complications

SUMMARY OBJECTIVE: The aim of this study was to demonstrate the effect of extracorporeal shock wave lithotripsy application on the success and complications of ureteroscopic lithotripsy in proximal ureter stones. METHODS: The data of 87 patients who did not respond to shock wave lithotripsy and underwent ureteroscopic lithotripsy were retrospectively analyzed and classified as group I, and 99 patients who received ureteroscopic lithotripsy as primary treatment were classified as group II. Demographic features, response to treatment, and preoperative and postoperative complications were compared between the two groups. RESULTS: There was no difference between the two groups in terms of gender, operation times, stone sizes, and ureteroscope diameters. (p>0.05). Infective complications such as postoperative fever, pyelonephritis, and urosepsis were similar in both groups (p=0.142, p=0.291, and p=0.948). Stone migration was observed in 10 (11.5%) and 6 (6.1%) patients in groups I and II, respectively (p=0.291). Impacted stone was seen in 47 (54%) patients in group I and in 15 (15.2%) patients in group II (p<0.0001). Mucosal laceration occurred in 11 (12.6%) and 3 (3%) patients in groups I and II, respectively (p=0.028). Ureteral perforation was detected in 3 (3.4%) patients in group I and 1 (1%) patient in group II, whereas ureteral avulsion was not observed in either group (p=0.524). CONCLUSIONS: It was concluded that the application of shock wave lithotripsy before ureteroscopic lithotripsy in proximal ureter stones did not affect the success. Although the results are similar in terms of postoperative infection, shock wave lithotripsy application has been found to increase the risk of stone impaction into the mucosa and ureteral laceration.

Association Between Complete Blood Count Parameters and Urinary Stone Disease.

BACKGROUND: Complete blood count (CBC) parameters may associated with multiple diseases. Urinary stone disease is common public problem. Predictive value of CBC parameters may be associated with urinary stone disease. OBJECTIVES: To analyze the association between complete blood count (CBC) parameters and urinary stone disease. PATIENTS AND METHODS: This study was a retrospective observational study of 3,099 patients who were admitted to the urology outpatient clinic or diagnosed with urinary stone disease in the emergency services department. There were 353 patients included in the study that had ultrasonography (USG) and/or non-contrast computerized tomography (NCCT) and a CBC. Patients who had non-urinary system inflammatory disease in USG or NCCT, had fever, non-urinary system infection, anemia or diagnosed hematologic malignancy were excluded (n = 27). Patients were divided into two groups: a stone group (n = 74) and a control group (n = 252). Data of patients were retrieved from the hospital database and statistical analysis was performed. RESULTS: An increase in RDW, MPV, PDW, WBC, granulocyte percentage and a decrease in lymphocyte percentage is statistically associated with urinary stone disease (P < 0,001, P < 0.001, P = 0.006, P < 0.001, P = 0.003, P = 0.034, respectively). Microscopic hematuria is associated with urinary stone disease and the odds ratio for urinary stone prediction is 67.7 (P < 0.001). In addition, none of the CBC parameters were associated with stone burden. CONCLUSIONS: When evaluating flank pain in patients, it is important to remember that CBC parameters may support urinary stone disease, and considering CBC results may be useful in the diagnosis of urinary stone disease.

Varicocele: tissue stress in the etiology.

BACKGROUND/AIM: It is accepted that red blood cell distribution width (RDW) is a novel prognostic marker that reflects oxidative stress and chronic inflammation. In this study, we aimed to investigate the correlation between RDW and varicocele, the etiology of which has not fully elucidated yet. This study also aimed to study the mean platelet volume (MPV) values of the patient and control group. MATERIALS AND METHODS: RDW and MPV levels were measured in 50 varicocele subjects (group 1) and 48 healthy controls (group 2) from January 2012 to January 2014, retrospectively. RESULTS: MPV levels were significantly higher in group 1 than in group 2 (P < 0.001). Although the relationship was weak, the patients with varicocele had significantly lower RDW values than did the controls (r: 0.24 P = 0.026). Positive correlations were not found between varicocele grade and MPV and RDW values (P < 0.05). CONCLUSION: Higher MPV values are associated with increased odds of developing varicocele.

Could spot urine analysis of calcium and uric acid help predict density of urinary stone in computerized tomography? A preliminary study.

BACKGROUD: This research studies if Hounsfield density of urinary stone can be predicted without computerized tomography (CT) caused by because increased radiation exposure in follow-up of patients. METHODS: The records of patients with renal or ureteral stone were analyzed retrospectively for the time period between November 2013 and April 2014. The inclusion criteria defined were: no multiple stones; stone size ≥3 mm; presence of renal and ureteral stones; absence of staghorn stone. All CT images were assessed in abdominal windows by a single radiologist. Hounsfield Unit (HU) value of CT was used to interpret the density of the stone. The density of the stone was measured in the longest axis of the stone center (core) and the edges (periphery) of each stone. Biochemical analysis of spot urine calcium (Ca) and uric acid (UA) was done at the time of diagnosis. Correlation and linear regression analysis was performed. RESULTS: Forty patients were included the study and median age of patients is 22 (IQR 21-28). Since the unit was a military hospital, most patients admitted to hospital were young male conscripts with low median age. It has been found that spot urine uric acid and uric acid/Ca ratio is associated with stone density as HU (P=0.004, P<0.001). Although predictive value appeared low, linear regression model statistically predicted stone density as HU (P<0.001 R2=0.32). Stone size has proved to be positively correlated with stone density (P<0.001). CONCLUSIONS: Despite the predictive value of urine analysis model is low, it may be considered to predict HU attenuation of stone. Spot urine analysis of calcium and uric acid may be helpful for both diagnosis and follow-up. We believe that controlled studies with larger patient populations will provide further insights into this issue.