Correlation of neutrophil-lymphocyte ratio and risk scores in non-muscle invasive bladder cancer. / Correlación entre el índice neutrófilo/linfocito y las puntuaciones de riesgo en el cáncer de vejiga no músculo-invasivo.

OBJECTIVES: Aim of this study is to evaluate the correlation between European Organization for Research and Treatment of Cancer (EORTC) risk score and neutrophil-lymphocyte ratio (NLR) in patients with non-muscle invasive bladder cancer and the relationship between NLR and risk groups. METHODS: We retrospectively reviewed data of 212 patients with non-muscle invasive bladder cancer were included in the study. The tumors were graded according to the 1973 World Health Organization grading system and the tumor node metastasis (TNM) 2012 staging system. Patients were categorized low, intermediate and high risk for recurrence and progression, according to European Association of Urology guidelines. Serum values for the NLR were measured on the day before the operation to ascertain the baseline value for neutrophil and lymphocyte counts and statistically analyzed. RESULTS: Of the 212 patients, 193 were male and 19 were female. Mean age was 66.7. Mean NLR score was 3.04±2.11. T1 tumors, G3 tumors, multiple tumors and>3cm tumors seen mostly in patients with NLR>2.41. Low, intermediate and high risk groups compared and NLR rates were significantly higher in high risk group patients (P<.001). When the correlation between NLR and EORTC recurrence and progression scores was evaluated, it was observed that as NLR value increased, recurrence (r=0.252, P<.001) and progression (r=0.145, P=.034) scores increased significantly. CONCLUSIONS: This study demonstrated the association of high NLR value with T1 tumor, high grade, multiple tumor,>3cm tumor and EORTC high risk group in non-muscle invasive bladder cancer patients. There was also a positive correlation between NLR and EORTC recurrence and progression scores.

Cellular Angiofibroma of the Spermatic Cord.

Cellular angiofibromas are rare, slow-growing mesenchymal tumours, most often localised in the vulva and perineum of women. We present a case of a 60-year-old male with a 7-cm large cellular angiofibroma in the inguinal canal extending toward the testis, detected after inguinal herniorraphy. Inguinal orchiectomy was performed and the pathology report revealed a cellular angiofibroma containing a lot of mast cells in the stroma, which was collagenised with spindle-shaped cells and characterised by hyalinised vascular structures. The localisation and nature of this type of mass makes initial diagnosis difficult. Differential diagnosis is important to rule out histologically malignant aggressive angiomyxomas and other solitary fibrous tumours. As local recurrence may occur after resection, long-term follow-up is necessary.

Relation between blood vitamin B12 levels with premature ejaculation: case-control study.

The aim of this study was to investigate whether vitamin B12 levels are associated with premature ejaculation (PE). A total of 109 subjects (56 PE and 53 controls) were included in this study. PE was defined as self-reported intravaginal ejaculatory latency time (IELT) based on the Diagnostic and Statistical Manual of Mental Disorders IV criteria and those who had had an IELT of <2 min was considered as PE. All participants were evaluated using premature ejaculation diagnostic tool (PEDT), International Index of Erectile Function (IIEF) and Beck Depression Inventory (BDI). The vitamin 12 levels were measured in all subjects. The mean age between the PE and controls was comparable (p = .084). Mean IIEF and BDI scores between the two groups did not statistically differ. The mean IELT values in the PE group were significantly lower than in the control group (p < .0001). PE patients reported significantly lower vitamin B12 levels compared with the controls (213.14 vs. 265.89 ng ml-1 ; p < .001). The ROC analysis showed a significant correlation between the diagnosis of PE and lower vitamin B12 levels. This study has demonstrated that lower vitamin B12 levels are associated with the presence of PE. This work also shows a strong correlation between vitamin B12 levels and the PEDT scores as well as the IELT values.

Nonischaemic priapism associated with selective serotonin-3 receptor antagonist.

Priapism is a rare but severe urological emergency of erection of penis in the absence of physical and psychological sexual stimulation. Priapism is often idiopathic and is commonly associated with medications and underlying medical or traumatic causes. In this report, we present a case of a 70-year-old White Caucasian man who developed priapism after the administration of ondansetron, which is a selective serotonin type-3 (5-HT3) receptor antagonist. This case is unique, because, to date, there are only two presented cases in literature. The objective of this case report is to highlight the importance of recognising the possibility of priapism with ondansetron because this condition is not commonly seen in clinical practice to be associated with ondansetron and may go unrecognised. Also, potential pathophysiological mechanisms involved in the development of ondansetron-induced priapism are presented.

Endoscopic Treatment of Renal Hydatid Cyst with Percutaneous Access through an All Seeing Needle.

A 44-year-old woman, who had had left flank pain for the previous 3 months, was treated successfully for renal hydatid cyst disease by using an endoscopic technique with percutaneous access through an all seeing needle. Abdominal ultrasonography showed a Gharbi type III cyst in the lower pole of the left kidney. Computerised tomography of the abdomen revealed a bulky solid-cystic mass with calcified and well-defined wall and daughter cyst without contrast enhancement. The patient, who refused any renal operation, underwent a percutaneous intervention with access through an all seeing needle access. There were no intraoperative or early postoperative complications. To our knowledge, this is the first published report of this minimally invasive percutaneous access technique through an all seeing needle.