Development of a new scoring system predicting medical expulsive therapy success on 4-10 mm distal ureteral stones: medical expulsive therapy stone score (METSS).

Ureteral stone passage by using medical expulsive therapy (MET) are affected by numerous radiological and clinical parameters. We aimed to construct a scoring system, which would be based on clinical and computed tomography (CT)-derived data, to predict the success of the MET approach. 186 patients presenting to urology clinic or emergency department with unilateral single 4-10 mm distal ureteral stone and who had MET were included. All patients were divided into two groups as the MET-successful group and the MET-unsuccessful group. The success rate of MET was 67.2%. Stone size ≥ 6.5 mm, stone density > 1078 HU, ureteral wall thickness (UWT) > 2.31 mm, ureteral diameter (UD) > 9.24 mm, presence of periureteral stranding (PUS) and presence of diabetes mellitus (DM) were stated as the independent risk factors. Based on the regression coefficients on multivariate logistic regression analysis, 1 point for stone size > 6.5 mm, 2 points for stone density > 1078 HU, 2 points for UWT > 2.31 mm, 3 points for UD > 9.24 mm, 1 point for presence of PUS and 1 point for presence of DM were assigned to patients for each risk factor. Higher medical expulsive therapy stone score (METSS) indicated lower MET success. All patients were classified into three risk groups according to METSS: low risk (0-3 points; success percentage: 92.8%); intermediate risk (4-5 points; success percentage: 60.4%) and high risk (6-10 points; success percentage: 8.3%). The METSS seems to separate successfully the patients with a favorable or adverse constellation of factors.

Primary testicular osteosarcoma.

Primary testicular osteosarcoma is an extremely rare type of malignant tumor, and to our knowledge, only two other cases have previously been reported in the medical literature. A 63-year-old man, who presented with a large painless left inguinal and scrotal mass, underwent radical orchiectomy. Pathological examination was suggestive of testiscular osteosarcoma. The patient received no adjuvant therapy and after 12 months of follow-up, the patient remains free of disease.

The effect of trimetazidine on renal oxidative stress in partial and complete ureteral obstructions in a rat model.

BACKGROUND/AIM: Renal oxidative stress occurs in ureteral obstructions. The purpose of this study was to investigate the effect of the antioxidant and antiischemic agent trimetazidine (TMZ) on oxidative stress following ureteral obstruction. MATERIALS AND METHODS: Ten groups were established. Sham groups were checked as controls after 1 and 3 weeks. The other 8 groups had partial or complete ureteral obstruction while receiving or not receiving trimetazidine (TMZ) at 5 mg/kg daily and were evaluated after either 1 week or 3 weeks. Creatinine and cystatin C measurements were performed in the serum. Malondialdehyde, myeloperoxidase, catalase, and glutathione peroxidase activity were measured in renal tissue and serum. RESULTS: In the 1-week groups, tissue malondialdehyde, serum myeloperoxidase, and glutathione peroxidase activity increased significantly with obstruction and TMZ use compared to the control group (P < 0.005). In the 3-week TMZ group, cystatin C, tissue malondialdehyde, serum and tissue myeloperoxidase, and tissue glutathione peroxidase differed significantly (P < 0.05). There was no significant difference in all parameters after 3 weeks of partial obstruction (P > 0.05), with only serum malondialdehyde being significantly elevated (P < 0.05). CONCLUSION: TMZ did not exhibit a renal oxidative stress-lowering effect in obstruction. It causes mild impairment of renal functions in obstruction. Patients using TMZ must be closely monitored in terms of kidney function in the event of any ureteral obstruction.