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1.
Transplant Proc ; 52(10): 3204-3208, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32605774

RESUMEN

OBJECTIVES: To evaluate the outcome of endoscopic treatment of symptomatic vesicoureteral reflux (VUR) in patients with VUR in both transplanted and native renal units. MATERIAL AND METHODS: Between January 2014 and December 2019, 23 transplanted patients with symptomatic VUR with reflux in both transplanted and native kidney were included in the study. All patients were patients with a history of kidney failure due to reflux nephropathy. A voiding cystourethrography was performed after at least 1 episode of acute glomerulo pyelonephritis or deterioration of the graft function. All patients underwent a urine culture and an ultrasonic evaluation preoperatively. A dextranomer/hyaluronic acid bulking agent was injected via endoscope by a rigid metal needle around a double J stent. Clinical success was defined as absent of febrile urinary tract infection during the follow-up period. RESULTS: The procedure was applied in 52 effected renal units; of these, 27 were transplanted kidneys, and 25 were native kidneys. Overall clinical success was achieved in 69.6% (N = 16) of patients. The success rate after the first procedure was 52.2% (N = 12), whereas 17.3% (N = 4) achieved success after the second treatment. No intraoperative complications occurred throughout the endoscopic procedure. Minor postoperative complications included 2 (10%) cases of self-limiting episodes of hematuria that did not require intervention. CONCLUSION: Endoscopic treatment of symptomatic VUR for both transplanted ureter and native ureter is a safe treatment in most of the patients. Therefore, endoscopic ureteral injection is a treatment modality with low morbidity that should be preferred to open surgery as first-line treatment in this subgroup of patients.


Asunto(s)
Trasplante de Riñón/efectos adversos , Complicaciones Posoperatorias/cirugía , Ureteroscopía/métodos , Reflujo Vesicoureteral/cirugía , Niño , Preescolar , Dextranos/administración & dosificación , Femenino , Humanos , Ácido Hialurónico/administración & dosificación , Masculino , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Uréter/cirugía , Reflujo Vesicoureteral/etiología
2.
Andrologia ; 52(7): e13641, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32379354

RESUMEN

The microsurgical varicocelectomy is the gold standard treatment with a low recurrence rate and less postoperative complications. We compared the surgical outcomes and difficulty in intra-operative vascular Doppler ultrasound-assisted microscopic varicocelectomy (IVDU-MV) with MV in primary and recurrent varicocele. A total of 228 infertile patients with clinically palpable varicocele were included in the study. One hundred fifteen patients were operated on with the standard MV approach, whereas the other 113 patients were operated on with IVDU-MV. Perioperative outcomes, sperm parameters and operative difficulty of the procedure were evaluated. The operative times were significantly shorter for the IVDU-MV group for primary and recurrent varicocele (p = .001). Mean number of veins ligated for primary and recurrent varicocele was significantly higher in the IVDU-MV group than in the MV group (6 ± 1.4 vs. 4.8 ± 1.8 and 3.7 ± 0.9 vs. 2.9 ± 1.2; p < .01). The increase in mean sperm motility was significantly higher in the IVDU-MV group for both primary and recurrent varicocelectomy patients (p < .05). A significant number of IVDU-MV procedures were described as easy in both primary and recurrent varicocelectomy procedures (p = .006). The use of Doppler ultrasound(US) revealed advantages in ligating veins, preserving arteries and improving sperm motility and facilitates the operation for the surgeon, especially during recurrent varicocele repair.


Asunto(s)
Infertilidad Masculina , Varicocele , Humanos , Infertilidad Masculina/etiología , Infertilidad Masculina/cirugía , Masculino , Microcirugia , Recuento de Espermatozoides , Motilidad Espermática , Espermatozoides , Resultado del Tratamiento , Ultrasonografía Doppler , Varicocele/diagnóstico por imagen , Varicocele/cirugía
3.
Int. braz. j. urol ; 46(1): 60-66, Jan.-Feb. 2020. tab
Artículo en Inglés | LILACS | ID: biblio-1056357

RESUMEN

ABSTRACT Objectives: To investigate the characteristics of cases of NIH category I acute prostatitis developed after transrectal prostate biopsy and clarifiy the risk factors and preventive factors. Materials and Methods: We retrospectively reviewed the medical records of 3.479 cases of transrectal ultrasound-guided needle biopsies performed with different prophylactic antibiotherapy regimens at two different institutions between January 2011 and February 2016. The patients of Group I have received ciprofl oxacin (n=1.523, 500mg twice daily) and the patients of Group II have received ciprofl oxacin plus ornidazole (n=1.956, 500mg twice daily) and cleansing enema combination as prophylactic antibiotherapy. The incidence, clinical features and other related microbiological and clinical data, were evaluated. Results: Mean age was 62.38±7.30 (47-75), and the mean prostate volume was 43.17±15.20 (21-100) mL. Of the 3.479 patients, 39 (1.1%) developed acute prostatitis after the prostate biopsy procedure. Of the 39 cases of acute prostatitis, 28/3.042 occurred after the first biopsy and 11/437 occurred after repeat biopsy (p=0.038). In Group I, 22 of 1.523 (1.4%) patients developed acute prostatitis. In Group II, 17 of 1.959 (0.8%) patients developed acute prostatitis. There was no statistical difference between the two groups according to acute prostatitis rates (X2=2.56, P=0.11). Further, hypertension or DM were not related to the development of acute prostatitis (P=0.76, X2=0.096 and P=0.83, X2=0.046, respectively). Conclusions: Repeat biopsy seems to increase the risk of acute prostatitis, while the use of antibiotics effective for anaerobic pathogens seems not to be essential yet.


Asunto(s)
Humanos , Masculino , Anciano , Ornidazol/administración & dosificación , Prostatitis/etiología , Biopsia con Aguja/efectos adversos , Ciprofloxacina/administración & dosificación , Profilaxis Antibiótica/métodos , Enema/métodos , Antibacterianos/administración & dosificación , Próstata/patología , Prostatitis/prevención & control , Factores de Tiempo , Biopsia con Aguja/métodos , Reproducibilidad de los Resultados , Estudios Retrospectivos , Factores de Riesgo , Resultado del Tratamiento , Ultrasonografía Intervencional , Combinación de Medicamentos , Persona de Mediana Edad
4.
Transplant Proc ; 52(1): 191-195, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31901322

RESUMEN

PURPOSE: The study aimed to evaluate the feasibility and effectiveness of the endoscopic treatment in transplanted patients with neurogenic bladder who complained of symptomatic vesicoureteral reflux (VUR). MATERIAL AND METHODS: Fifteen patients with VUR who were previously diagnosed with a neurogenic bladder were included in the study. The Lich-Gregoire technique was used for ureterovesical anastomosis during transplantation, and a double J stent was inserted routinely in the ureter to protect the anastomosis. The sting operation was performed under general anesthesia in the lithotomy position. A 4.8 Fr double J stent (Boston Scientific, Boston, MA) was inserted to prevent the risk of ureteral obstruction. Successful treatment was defined as absent acute glomerulopyelonephritis (AGPN) during follow-up and as absent VUR on radiological evaluation. RESULTS: Clinical success was achieved in 6 of 10 patients (60%) who presented with recurrent febrile urinary tract infection (UTI) and in 4 of 6 (66%) patients who presented with gradually graft function deterioration. In 3 patients, the ureteral neo-orifice could not be localized during the operation owing to severe trabeculation of the bladder wall. The other 2 patients with a previous history of augmented bladder procedures had a hypotension attack during bladder filling; hence, the operation was stopped to prevent further complications. Two patients, whose clinical symptoms did not resolve after the sting procedure, accepted open ureteral reimplantation surgery. CONCLUSION: Endoscopic management of the VUR in the transplant patients with neurogenic bladder function is safe and effective in at least half of the patients in a mid-term follow-up period.


Asunto(s)
Trasplante de Riñón/efectos adversos , Vejiga Urinaria Neurogénica/etiología , Vejiga Urinaria Neurogénica/cirugía , Procedimientos Quirúrgicos Urológicos/métodos , Reflujo Vesicoureteral/etiología , Reflujo Vesicoureteral/cirugía , Anastomosis Quirúrgica/métodos , Niño , Preescolar , Endoscopía/métodos , Femenino , Humanos , Masculino , Estudios Retrospectivos , Adulto Joven
5.
Clin Exp Nephrol ; 24(5): 483-488, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-31955313

RESUMEN

BACKGROUND: To evaluate the outcome of endoscopic treatment for symptomatic vesicoureteral reflux (VUR) disease in renal transplantation patients and to determine the factors that were associated with the success rate of the treatment. METHODS: A total of 121 symptomatic VUR diseases diagnosed between 2014 and 2018 in 3560 renal transplant patients. The results of 49 VUR cases that presented with febrile urinary tract infection (UTI) and were hospitalized for antibiotic treatment were included in the study. Reflux was detected by voiding cystourethrogram and treatment was performed by endoscopic Deflux® injection. The result of endoscopic treatment was evaluated clinically by 3 months periods. RESULTS: The mean time between transplantation and endoscopic treatment was 59.6 (5-132) months, and the mean follow-up period after the endoscopic treatment was 14 (6-48) months, respectively. The success rate after the first injection was 59.1% (n = 29) and 67.3% (n = 33) after the second injection. One patient developed anuria, one patient febrile UTI and four patients developed minimal macroscopic hematuria after the procedure. CONCLUSIONS: Endoscopic treatment of symptomatic VUR in transplanted kidney is a safe and feasible procedure. The amount of bulking agent or duration between the transplantation and diagnosis of VUR does not have any impact on the success of the treatment. However, the younger age of the patients and the female gender seem to have a positive effect on the outcome of the procedure.


Asunto(s)
Cistoscopía , Dextranos/administración & dosificación , Ácido Hialurónico/administración & dosificación , Trasplante de Riñón , Agentes Urológicos/administración & dosificación , Reflujo Vesicoureteral/terapia , Adulto , Factores de Edad , Anciano , Anuria/etiología , Cistoscopía/efectos adversos , Dextranos/efectos adversos , Femenino , Hematuria/etiología , Humanos , Ácido Hialurónico/efectos adversos , Masculino , Persona de Mediana Edad , Retratamiento , Factores Sexuales , Resultado del Tratamiento , Infecciones Urinarias/etiología , Agentes Urológicos/efectos adversos
6.
Int Braz J Urol ; 46(1): 60-66, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31851459

RESUMEN

OBJECTIVES: To investigate the characteristics of cases of NIH category I acute prostatitis developed after transrectal prostate biopsy and clarifiy the risk factors and preventive factors. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 3.479 cases of transrectal ultrasound-guided needle biopsies performed with different prophylactic antibiotherapy regimens at two different institutions between January 2011 and February 2016. The patients of Group I have received ciprofloxacin (n=1.523, 500mg twice daily) and the patients of Group II have received ciprofloxacin plus ornidazole (n=1.956, 500mg twice daily) and cleansing enema combination as prophylactic antibiotherapy. The incidence, clinical features and other related microbiological and clinical data, were evaluated. RESULTS: Mean age was 62.38 ± 7.30 (47-75), and the mean prostate volume was 43.17 ± 15.20 (21-100) mL. Of the 3.479 patients, 39 (1.1%) developed acute prostatitis after the prostate biopsy procedure. Of the 39 cases of acute prostatitis, 28/3.042 occurred after the fi rst biopsy and 11/437 occurred after repeat biopsy (p=0.038). In Group I, 22 of 1.523 (1.4%) patients developed acute prostatitis. In Group II, 17 of 1.959 (0.8%) patients developed acute prostatitis. There was no statistical difference between the two groups according to acute prostatitis rates (X2=2.56, P=0.11). Further, hypertension or DM were not related to the development of acute prostatitis (P=0.76, X2=0.096 and P=0.83, X2=0.046, respectively). CONCLUSIONS: Repeat biopsy seems to increase the risk of acute prostatitis, while the use of antibiotics effective for anaerobic pathogens seems not to be essential yet.


Asunto(s)
Antibacterianos/administración & dosificación , Profilaxis Antibiótica/métodos , Biopsia con Aguja/efectos adversos , Ciprofloxacina/administración & dosificación , Enema/métodos , Ornidazol/administración & dosificación , Prostatitis/etiología , Anciano , Biopsia con Aguja/métodos , Combinación de Medicamentos , Humanos , Masculino , Persona de Mediana Edad , Próstata/patología , Prostatitis/prevención & control , Reproducibilidad de los Resultados , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento , Ultrasonografía Intervencional
7.
Minerva Urol Nefrol ; 71(4): 386-394, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31086130

RESUMEN

BACKROUND: To evaluate the factors including pelvic dimensions, which might influence operative difficulty and complications after open radical cystoprostatectomy and orthotopic neobladder reconstruction in men. METHODS: A total of 198 RC patients operated in our institution with preoperative magnetic resonance (MRI) were analyzed were included in the study. Pelvic dimensions, including interspinous distance (ISD), bony femoral - (BFW) and soft tissue width (SW), apical prostate depth (AD), upper conjugate (UC), lower conjugate (LC) were measured by preoperative MRI. BFW, ISD, and SW indexes were defined as BFW/AD, ISD/AD, and SW/AD, respectively. Complicatons were classified according to the Clavien-Dindo classification system. As indicators of surgical difficulty; transfusion rate (TR), estimated blood loss (EBL), operative time (OT) and hospital stay (HS) were assessed. SPSS version 17.0 was used for statistical analyses. RESULTS: A total of 239 complications developed in 143 of the 198 patients (72.2%). Correlation analysis revealed a significant indirect relationship between TR and SW/AD (P=0.023). For EBL, there were significant indirect correlations between the SW/AD, BFW/AD and ISD/AD indexes (P=0.026, P=0.05, P=0.009; respectively). Additionally, OT was directly correlated body mass index (BMI) (P=0.001); and indirectly correlated with UC, SW/AD, and BFW/AD (P=0.047, P=0.038, P=0.016, respectively). On multivariate logistic regression analyses higher American Society of Anesthesiologist (ASA) score was associated with major complications. Multivariate analyses revealed that pathological stage was a significant predictor of EBL. CONCLUSIONS: Patients with smaller pelvises might undergo more difficult surgeries. However, it seems that small sized pelvis does not impact on operative difficulty and complication rate in radical cystoprostatectomy and orthotopic neobladder.


Asunto(s)
Pelvis/anatomía & histología , Pelvis/cirugía , Procedimientos de Cirugía Plástica/métodos , Prostatectomía/métodos , Vejiga Urinaria/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Pérdida de Sangre Quirúrgica/estadística & datos numéricos , Transfusión Sanguínea/estadística & datos numéricos , Humanos , Tiempo de Internación , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Tempo Operativo , Pelvis/diagnóstico por imagen , Complicaciones Posoperatorias/epidemiología , Próstata/diagnóstico por imagen , Próstata/cirugía , Vejiga Urinaria/diagnóstico por imagen
8.
Urol J ; 16(2): 168-173, 2019 05 05.
Artículo en Inglés | MEDLINE | ID: mdl-30882157

RESUMEN

PURPOSE: To report on an ascending radical retropubic prostatectomy (RRP) technique and determine whether this technique has better perioperative, oncological and functional outcomes than the standard RRP technique applied in our clinic Material and Methods:The perioperative and functional outcomes of the 246 patients that underwent standard RRP (N = 150) or modified RRP (N = 96) were evaluated, retrospectively. In the modified RRP technique the dorsal vasculare complex (DVC) was controlled at first. Thereafter, the bladder neck was incised at the prostate-vesical junction. After seminal vesicles and vasa were exposed, posterior dissection was continued until to the apex. Finally, the urethra was divided. To assess the differences between the two groups the independent sample T-test and chi-square test were used. RESULTS: The mean volume of  estimated blood loss (EBL) was significantly longer in the standard RRP group than in the modified RRP group (610 vs. 210 ml, respectively; P= .001). The mean operative time (OT) was significantly less in the modified RRP group (177 vs. 134 min, respectively; P = .003), as were the transfusion rate TR (P = .041). With regard to the rate of postoperative complications, a statistically significant difference was observed between the two groups (P = .014). Continence rates after 3 and 12 months postoperatively were 98.95% and 98.95 % in the modified RRP group, and 97.33% and 98.66% in the standard RRP group, respectively ( P = .83). CONCLUSION: We observed that the EBL, TR and OT were significantly lower when we applied the modified RRP technique to patients. This modified technique might be applicable for institutions as an alternative procedure for the standard RRP technique.


Asunto(s)
Prostatectomía/métodos , Neoplasias de la Próstata/cirugía , Anciano , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Procedimientos Quirúrgicos Robotizados , Resultado del Tratamiento
9.
Turk J Urol ; 44(4): 362-366, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-29932406

RESUMEN

OBJECTIVE: The aim of the study was to compare the different surgical approaches of two centers on outcomes of live donor laparoscopic nephrectomy. MATERIAL AND METHODS: The first 98 patients of each centre who underwent laparoscopic donor nephrectomy (LDN) or hand-assisted laparoscopic donor nephrectomy (HALDN) were included in the study. The following data were used for analyses: donor age, weight, height, body mass index (BMI), transfusion requirement, operative time, ischemia time and postoperative complications. RESULTS: Median age, BMI, operation time and estimated blood loss (EBL) was 47.29 years, 27.91 kg/m2, 110.73 minutes, and 78.95 mL, respectively. Operation time was significantly shorter in the HALDN group (t=-3.554, p<0.01). EBL was not significantly different between the two groups. The difference in hospitalization time and warm ischemia times (WIT) was not significant between the two surgical technique groups (t=-1.554, t=1.258; p>0.05). No statistically significant difference was detected in the intraoperative and postoperative complication rates between two groups (p>0.05). The postoperative complication rate was 7.14% (n=7) and 6.12% (n=6) in the LDN and HALDN groups, respectively. There were two patients with conversion to open surgery in the HALDN group because of lumbar vein injury. CONCLUSION: The operative and postoperative outcomes for the two techniques were found to be similar. The HALDN technique preserves the benefits of minimally invasive surgery. In experienced urologic laparoscopy centres both techniques promise similar success rates.

10.
Minerva Urol Nefrol ; 70(4): 422-428, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-29595043

RESUMEN

BACKGROUND: The aim of the study was to characterise urological complications after renal transplantation and to evaluate the role of minimally invasive management for urological complications. METHODS: A total of 920 kidney transplantations were performed between 2008 and 2015. All patients were followed up for at least 1 year after transplantation. Complications regarded as urological were urinary leakage, ureteral stricture, urinary malignancy, bladder outlet obstruction (BOO) and urinary calculi. We evaluated data from the time of occurrence of urological complications and the type of the management prescribed. RESULTS: Among 920 transplantations performed in our clinic, 41 (4.4%) urological complications arose. Twenty (48.8%) of the complications occurred during the first 3 months and 21 (51.2%) occurred after 3 months, postoperatively. Ureteral strictures were found in 14 (34.1%) patients, urinary tract stones in seven (17%), BOO in 6 (14.6%) and urinary leakage was observed in 5 (12.1%) patients. Ureteral stricture was managed with endoscopic approach in eight (61.3%) patients. Urinary tract stones and urinary leakage were managed in 7 (100%) and 4 (75%) patients with endoscopic approach. Overall 29 (70.7%) of 41 urological complications were managed with endourological approaches. CONCLUSIONS: It is likely that the importance of open surgery could decrease in the future. Endoscopic management of urological complications have come to have an important role in the treatment of urological complications after transplantation.


Asunto(s)
Trasplante de Riñón/métodos , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Complicaciones Posoperatorias/cirugía , Enfermedades Urológicas/etiología , Enfermedades Urológicas/cirugía , Procedimientos Quirúrgicos Urológicos/métodos , Adulto , Anciano , Endoscopía , Femenino , Humanos , Litiasis/etiología , Litiasis/cirugía , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Enfermedades Urológicas/diagnóstico por imagen
11.
Asian J Androl ; 19(4): 477-481, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-27121195

RESUMEN

The aim of our study was to evaluate the outcome of penile prosthesis implantation in patients with various comorbidities as a cause of erectile dysfunction (ED). The data of 181 patients who underwent surgery between 1998 and 2012 in two centers were evaluated. The mean age of the patients was 52.2 years (range: 31-71 years). The study group contained 162 patients (89.5%) with malleable prostheses and 19 (10.5%) with inflatable implants. All patients were re-evaluated 1 month later to assess prosthesis function and complications, and further re-examinations were performed if needed. Satisfaction was defined as having satisfactory intercourse and happiness with the device in general. The follow-up period was at least 12 months for each patient. The postoperative complication rate was 32% (n = 58). The number of complications with inflatable and malleable prostheses was 7 (3.9%) and 51 (28.1%), respectively. Overall, 21 prostheses (11.6%) had to be removed because of various complications and patient dissatisfaction. Patients with prior radical surgery had higher extraction rates (ƛ = 14.606, P < 0.05, Chi-square test). The main reasons for removal were erosion (n = 11; 6.1%) and infection (n = 3; 2.1%). With respect to satisfaction during intercourse, we found that 104 (57.5%) patients described themselves as very satisfied with the prosthesis, while 21 (11.6%) were unsatisfied. The high explantation rate in patients with prior surgery was remarkable in our study. Our results revealed that a malleable prosthesis should not be the preferred type of implant for patients with prior surgery.


Asunto(s)
Disfunción Eréctil/etiología , Disfunción Eréctil/terapia , Implantación de Pene/métodos , Prótesis de Pene , Complicaciones Posoperatorias/terapia , Procedimientos Quirúrgicos Urológicos/efectos adversos , Adulto , Anciano , Coito , Remoción de Dispositivos , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Implantación de Pene/efectos adversos , Prótesis de Pene/efectos adversos , Diseño de Prótesis , Falla de Prótesis , Infecciones Relacionadas con Prótesis , Resultado del Tratamiento
13.
Kaohsiung J Med Sci ; 32(9): 464-8, 2016 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-27638406

RESUMEN

The aim of this study was to describe a technique using full-thickness skin grafts (FTSGs) from different parts of the body for salvage urethroplasties and the present outcomes. A total of 24 men underwent urethroplasties for strictures averaging 7.7 cm (range, 5-17 cm) in length, using FTSGs from the inner arm, inner thigh, or abdominal skin. Each of these cases had at least one failed urethroplasty. Twenty-four patients underwent surgery for 26 urethral strictures, with a mean follow-up period of 23.2 (5-44) months and a mean operation time of 140 (115-180) minutes. Reconstruction of the urethra with skin grafting was successful in 18 out of the 26 procedures during the first attempt (69%). A "redo" skin grafting was performed for the eight failed cases, with four successful procedures (50%). Overall, the success rate was 84% (22 out of 26 urethral strictures); however, the failed cases developed abscesses and later, ureterocutaneous fistulas. No hair formation from the skin grafts was seen. Skin grafts provide useful alternative graft sources for previously failed long-segment urethral strictures in which the buccal mucosae are not available or are insufficient for salvage urethroplasties with an acceptable success rate.


Asunto(s)
Terapia Recuperativa , Trasplante de Piel , Estrechez Uretral/cirugía , Procedimientos Quirúrgicos Urológicos , Adolescente , Humanos , Masculino , Persona de Mediana Edad , Insuficiencia del Tratamiento , Adulto Joven
14.
Arch Ital Urol Androl ; 88(2): 97-100, 2016 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-27377083

RESUMEN

OBJECTIVE: To evaluate the treatment modalities of total ureteral avulsion and to clarify the risk factors of this serious complication. METHODS: This study retrospectively analyzed the data of 3 patients with complete ureteral avulsion during ureteroscopy. Of the three patients, two had distal ureteral complete avulsion, and one total ureteral avulsion on both ends. Ureteroneocystostomy (UNC) was immediately performed after distal ureteral avulsion cases. Ileal ureter substition was performed on the same session after the total ureteral avulsion in both ends. Two of the patients were under chronic use of corticosteroid treatment due to diagnosis of idiopathic trombocytopenic purpura and myastenia gravis and all patients had unsuccesful shockwave litotripsy (SWL) treatment history with at least 1 month period before surgery. RESULTS: The patient who had ileal ureter substitution was followed at 3-month intervals by ultrasonography and renal function tests and she was uneventful after a 2 year follow-up period. The patients treated with UNC were followed up at 3 month interval by ultrasonography and renal function tests. They had normal renal function 1 year after the operation CONCLUSION: Complete ureteral avulsion is a rare but severe complication. Treatment modality can vary and ileal ureter can be applied succesfully in the total ureter avulsion in both ends when bladder capacity is not enough for a Boari flap. Failed SWL and/or corticosteroid treatment history of patients seems to increase the risk of the ureteral avulsion.


Asunto(s)
Uréter/cirugía , Enfermedades Ureterales/cirugía , Ureteroscopía/efectos adversos , Adulto , Anciano , Cistostomía/métodos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Estudios Retrospectivos , Factores de Riesgo , Uréter/diagnóstico por imagen , Uréter/lesiones , Enfermedades Ureterales/diagnóstico por imagen , Procedimientos Quirúrgicos Urológicos/métodos
15.
Arch Ital Urol Androl ; 88(2): 111-4, 2016 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-27377086

RESUMEN

OBJECTIVES: This study was organized to assess the relationship of enuresis nocturna (EN) and upper airway obstruction (UAO) in children. MATERIAL AND METHODS: This study was multi-centrically and prospectively designed including 79 children who presented to a urology clinic with symptoms of EN between January 2013 and February 2014. Sixty-four age-matched children with no history of urological complaints were randomly recruited from children admitted to a pediatric clinic as a control group. All children and parents were asked to fill out a dysfunctional elimination syndrome (DES) questionnaire and children were examined by an ear, nose and throat (ENT) specialist to evaluate the UAO. Descriptive statistics, chisquare and Mann-Whitney-U tests were used to compare variables. RESULTS: The mean ages of the 79 children (48 male, 31 female) in the study group and the 64 children (41 male, 23 female) in the control group were 10.14+/-3.38 and 9.17+/- 2.85, respectively. Family history of the study showed that 19% of the children's mothers, 10% of the children's fathers and 37% of the children's siblings had experienced EN. There was a significant difference between the study and the control groups in terms of urge to urinate, bladder emptying, bowel symptoms and psychological stress. There was also a significant difference between rates of tonsillar hypertrophy and nasopharynx obstruction in the EN group (p = 0.009). CONCLUSION: In this study we found that half of the children with EN had tonsillar hypertrophy, which was significantly higher than in the control group. Further studies are needed to clarify the exact relationship between UAO and EN.


Asunto(s)
Tonsila Faríngea/patología , Obstrucción de las Vías Aéreas/epidemiología , Enuresis Nocturna/epidemiología , Tonsila Palatina/patología , Adolescente , Estudios de Casos y Controles , Niño , Femenino , Humanos , Hipertrofia , Masculino , Enuresis Nocturna/etiología , Estudios Prospectivos , Estrés Psicológico/epidemiología , Encuestas y Cuestionarios
16.
J Sex Med ; 13(8): 1227-32, 2016 08.
Artículo en Inglés | MEDLINE | ID: mdl-27319275

RESUMEN

BACKGROUND: Vasculogenic erectile dysfunction is a harbinger of vascular disease. Comprehensive cardiac workup is accepted to be beneficial in men with this condition, especially those with otherwise unrecognized cardiovascular disease. We aimed to evaluate the role of two-dimensional speckle-tracking echocardiography (2D-STE) for noninvasive evaluation in patients with documented arteriogenic erectile dysfunction. METHODS: 64 consecutive men with Doppler proven erectile dysfunction of more than 3 months of duration were recruited. Patients divided into 2 groups according to mean peak systolic velocity (PSV). Patients with PSV <20 cm/sn constituted Group 1 and patients with PSV ≥20 cm/sn constituted Group 2. All underwent echocardiography and were compared. According to the 2D-STE analysis for the left atrium (LA); strain during ventricular systole (LARes), during late diastole (LA-Pump), strain rate during ventricular contraction (LA-SRs), during passive ventricular filling (LA-SRe), during active atrial contraction (LASRa) values and for LV; global longitudinal strain (GLS), strain rate in systole (GSRs), strain rate in early diastole (GSRe), and strain rate in late diastole (GSRa) values were obtained. RESULTS: Beside diastolic parameters, LA-Res and LA-Pump were found to be significantly different between groups. GLS and GSR values were lower in Group 1. Moreover, correlation analysis revealed a significant correlation of GLS values with PSV (r = -0.4, P = .001). CONCLUSION: Myocardial deformation parameters by 2D-STE are valuable for detection of subclinical cardiovascular dysfunction in men with arteriogenic erectile dysfunction. This noninvasive method may be used as an emerging prognostic marker for risk stratification.


Asunto(s)
Función del Atrio Derecho/fisiología , Disfunción Eréctil/diagnóstico por imagen , Impotencia Vasculogénica/diagnóstico por imagen , Disfunción Ventricular Izquierda/diagnóstico por imagen , Función del Atrio Izquierdo/fisiología , Velocidad del Flujo Sanguíneo/fisiología , Diástole/fisiología , Ecocardiografía Doppler/métodos , Disfunción Eréctil/fisiopatología , Atrios Cardíacos/diagnóstico por imagen , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Impotencia Vasculogénica/fisiopatología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Estrés Fisiológico/fisiología , Sístole/fisiología , Disfunción Ventricular Izquierda/fisiopatología
17.
Korean J Urol ; 54(8): 558-60, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23956834

RESUMEN

Sarcoidosis is a multisystem, inflammatory disorder characterized by the presence of noncaseating epithelioid granulomas. Sarcoidosis can involve the genitourinary system by affecting the kidney and genitals. Most characteristic genital lesions proceed to granuloma and can comprise the epididymis, testis, and vas deferens. Few case reports have been published on this rare entity. We report a case in which a man presented with bilateral epididymal sarcoidosis and severe oligospermia. Corticosteroid treatment, which was applied in gradually decreasing doses for 6 months, dissolved the testicular granuloma. Consequently, semen analysis demonstrated a significant increase in the sperm count to within normal limits.

18.
Korean J Urol ; 54(7): 486-9, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23878694

RESUMEN

Metastatic malignant melanoma of the prostate is extremely rare in clinical practice, and only one case has been reported in the English literature in the past 30 years. We report a case of malignant melanoma that metastasized to the prostate and review the current literature. A 50-year-old man with a history of malignant melanoma metastasis to the left axilla, which was excised 3 years ago, presented with lower urinary tract symptoms and gross hematuria. He underwent cystoscopy and transurethral resection of the prostate. The pathological examination showed metastatic malignant melanoma of the prostate gland. The patient died 6 months after the transurethral resection.

19.
Turk J Urol ; 39(3): 147-52, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26328099

RESUMEN

OBJECTIVE: The aim of this study was to examine the effects of the retropubic and perineal radical prostatectomy techniques on postoperative urinary continence. MATERIAL AND METHODS: This study included patients who had undergone radical retropubic (RRP) (n=54) or radical perineal prostatectomies (RPP) (n=142) in our clinic between December 2006 and December 2010 with the indication of localized prostate cancer. Preoperative, and postoperative continence levels of the patients were evaluated on the day of catheter removal, and at 3., 6. or 12. months using University of California-Los Angeles (UCLA) prostate cancer index query forms completed by the patients themselves in outpatient clinics. RESULTS: Mean ages of the perineal, and retropubic groups were 62.3 (48-77), and 62.5 (50-74) years, respectively. The absolute urinary control rates of the RPP patients on the first days, and the first, third, sixth, and twelfth months were 44.3, 63.6, 76.2, 79.5, and 86.1%, respectively. The same rates were 51.4, 75.7, 78.4, 89.2, and 91.9% for the RRP group, respectively. CONCLUSION: There was no significant difference between RRP groups as for the frequency of urinary incontinence.

20.
Arch Ital Urol Androl ; 84(3): 158-60, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23210410

RESUMEN

Hemangiopericytoma, which is derived from pericytes, is rarely seen in the kidney and adical nephrectomy with or without chemotherapy is the treatment of choice in most of the cases. We report a fifty-year-old male patient presenting with gross hematuria that radiologic evaluation confirmed due to a solid mass in the right kidney. Its clinical manifestations and radiologic tests were similar to renal cell carcinoma. Radical nephrectomy was performed and the pathological examination revealed the specimen as hemangiopericytoma. No additional treatment was added and the patient remained disease free at the end of the first year follow up after radical nephrectomy.


Asunto(s)
Hemangiopericitoma , Neoplasias Renales , Hemangiopericitoma/diagnóstico , Humanos , Neoplasias Renales/diagnóstico , Masculino , Persona de Mediana Edad
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