HALP score and albumin levels in men with prostate cancer and benign prostate hyperplasia.

AIMS: To evaluate the diagnostic significance of the novel index combining preoperative haemoglobin, albumin levels, lymphocyte and platelet counts (HALP) in prostate cancer (PCa) patients. METHODS: Between 1 January 2015 to 31 December 2018 at the Hitit University Erol Olçok Education and Research Hospital 225 patients who had undergone transrectal ultrasound guided prostate biopsy or prostate surgery were analysed retrospectively. A total of patients, 155 had benign prostate hyperplasia (group 1) and 70 had PCa (group 2). The preoperative serum levels of haemoglobin, albumin, lymphocyte counts and platelet counts were recorded. The HALP scores and the sub-parameters of this index for each of the two groups were compared. RESULTS: The total Prostate-Specific Antigen (PSA), albumin and lymphocyte differences between the groups were statistically significant (P = 0.0002, P = 0.0001, P = 0.005). The median value of HALP scores in Group 1 and 2 were 49.43 and 51.2, respectively, and this was not statistically significant between groups (P =0 .737). The HALP score had the least Area Under Curve (AUC) value compared with the others (0.514). The AUC of Albumin was larger than PSA for diagnostic efficacy in PCa patients (0.696-0.656). However, albumin levels were statistically significant compared with platelet count and the HALP score (P = 0.0033, P = 0.0068), except PSA and lymphocyte (P = 0.4580, P =0 .1717). CONCLUSION: Further prospective clinical studies that include more patients from multiple centres are needed to show the diagnostic role of the HALP score and its compounds on the patients with PCa.

C-reactive protein and procalcitonin levels in prostate cancer.

AIM: Prostate cancer (PCa) is one of the most common cancers among men in the world. Prostate-specific antigen is the most used biomarker for PCa diagnosis. In this study, we aimed to measure the procalcitonin (PCT) and C-reactive protein (CRP) levels in patients with PCa. METHODS: The patients who underwent transrectal prostate biopsy and transurethral prostate surgery in the last 4 years were included in the study. The patients were divided into two groups according to the pathology reports, group1; benign prostate hyperplasia and group2; prostate cancer. MedCalc Statistical Software version 17.6 was used for statistical analyses. RESULTS: The current study includes 149 patients. There were 118 patients in group 1 and 31 patients in group 2. The mean age of the patients was 66.85 and 69.41 years in groups respectively. Serum CRP and PCT levels were 3.33 and 0.01 in group 4.07 and 0.04 in group 2. Serum PCT levels were significantly higher in patients with PCa. CONCLUSION: We found that the elevated procalcitonin level was associated with prostate cancer. Further studies are needed to define the relationship between procalcitonin and prostate cancer.

Clinical features and outcomes of COVID-19 patients with benign prostatic hyperplasia in ageing male: A retrospective study of 18 cases.

AIM: A worldwide pandemic of coronavirus disease 2019 (COVID-19) which emerged in China in December 2019 affects the world very seriously. We aimed to evaluate the benign prostatic hyperplasia (BPH) patients who were admitted and treated to our hospital due to COVID-19. METHODS: Between March 18, 2020 and April 5, 2020, 18 patients admitted with COVID-19 who has BPH and are using medication for this were included in the study and analysed retrospectively. Diagnosis was confirmed by COVID-19 nucleic acid test by sampling sputum or nasopharyngeal swab. Standard COVID-19 treatment protocol determined by our Ministry of Health was applied to all patients according to their risk groups. Epidemiological, clinical, radiological features, additional diseases, laboratory tests, complications and outcome data of all patients were recorded. RESULTS: Mean age of patients was 59.6 (range: 56-73). As the mode of transmission, 10 (55.5%) of patients were infected in hospital, 5 (27.7%) patients had a relative with COVID-19 and three (16.6%) was unknown. During follow-up, 2 (11.1%) patients were transferred to intensive care unit (ICU). One of these patients dramatically progressed and died. Patients who survived and were not transferred to ICU had lesser comorbidities and were relatively young. Mean duration of hospitalisation was 14.2 days (range 12-19). CONCLUSION: We think that COVID-19 patients with BPH had a low mortality rate and did not have a poor prognosis in this patient group. It is crucial to take comprehensive preventive measures to control COVID-19 transmission via hospital route.

Bibliometric and Comparative Analysis of Castration Resistant and Refractory, Hormone Resistant and Refractory Prostate Cancer Publications.

INTRODUCTION: Prostate cancer is one of the most common cancer among men in the world. Radical prostatectomy is the gold standard treatment for localized prostate cancer but advanced diseases are treated with hormonal therapy. Unfortunately, this treatment is not curative and approximately after 2 years, castration resistant prostate cancer occurs. In this study we aimed to investigate the terminology of castration resistant and refractory, hormone resistant and refractory articles on Web of Science database. MATERIALS AND METHODS: We searched the articles in the title section such as castration resistant prostate cancer, castration refractory prostate cancer, hormone resistant prostate cancer and hormone refractory prostate cancer between 1975 and 2018. Categories, publication years, document types, authors, countries, funding agencies and citation reports were recorded in 4 groups. RESULTS: There were 6733 articles in the system. Most of the articles (72.16%) were published as using castration resistant title. The United States of America and Italy were in the top 5 countries in 4 titles. Oncology and urology nephrology categories consisted more than 80% of the articles. Of these articles, only 1745 (26%) articles had funding agency. DISCUSSION: Different terminology can be used in some diseases. One of these diseases is castration resistant prostate cancer which is referred to different terms such as castration refractory, hormone resistant and refractory. In this study we searched the literature and discussed the results. CONCLUSION: Castration resistant prostate cancer is a serious health problem for clinicians and patients. If international associations, journals and authors use the same terminology, the articles can be published without different titles in the literature.

In vitro bactericidal effect of Ho:YAG laser and pneumatic lithotripsy on ureteral stones colonized with Escherichia coli and Enterococcus faecalis.

The endoscopic treatment of urolithiasis has a high success rate and the complications decreased after the development of lithotripsy techniques. The aim of this study is to investigate the in vitro bactericidal effect of laser and pneumatic lithotripsy on urinary stones colonized with Escherichia coli and Enterococcus faecalis. A total of 40 natural calcium oxalate stones, which were obtained from the patients' urinary systems with rigid ureteroscopy were used in the study. Surfaces of the stones were colonized with E. coli and E. faecalis strains. The fragmentation of the stones was performed using holmium:yttrium-aluminum-garnet laser (Ho:YAG laser) and pneumatic lithotripters in vitro in Eppendorf tubes filled with liquid. After fragmentation, samples taken from Eppendorf tubes were inoculated on blood and EMB agar. The number of colonies was evaluated after 18-24-hour incubation period. The laser lithotripsy technique reduced the number of colonies by 100% and had bactericidal effect on E. coli and E. faecalis. Pneumatic lithotripsy technique had no bactericidal effect on these strains (0%). In the fifth minute of laser irradiation, the average temperature in the Eppendorf tube was 51-55 °C, and the average temperature in the tenth minute was 54-60 °C. The temperatures did not change in the fifth and tenth minutes with the pneumatic lithotripsy procedure. The present study revealed the bactericidal effect of Ho:YAG laser on E. coli and E. faecalis in vitro. Increased ambient temperature during Ho:YAG laser lithotripsy is thought to play a role in the bactericidal effect. But the question of whether an ideal lithotripter efficiently inactivates or destroys bacteria has still not been answered in urology practice. This preliminary study showed the bactericidal effect of Ho:YAG laser lithotripsy, but further studies are needed to investigate the bactericidal effect of Ho:YAG laser in vivo.

Awareness of prostate cancer diagnosis and management among Turkish males: a cross sectional study from Çorum.

Introduction: Prostate cancer is the most common malignancy among men in the United States and the second most common cancer in Turkey. The incidence of prostate cancer is increasing in industrialized countries.Aim: The aim of the study was to assess the knowledge about prostate cancer, its diagnosis, and treatment among patients with lower urinary tract symptoms.Methods: This study was performed from January to April 2015 with the patients applied to our clinic. A questionnaire that includes 10 questions was administered to the participants.Results: One hundred fifty-nine participants were included in this study. The participants' ages were between 40 and 82 with a mean age of 61.5 ± 7.9 years. Patient awareness of prostate biopsy and prostate cancer were 21.37 and 71.06%. The main origin awareness of PSA testing is family and friends. On the other hand, if the doctor advises acout prostate biopsy, 47.16% of the patients would accept and 11.31% of them would refuse this invasive procedure.Conclusion: Prostate cancer is one of the important health-related problem among men in the world. Additional researches are needed to investigate the knowledge of prostate cancer among men and the Ministry of Health may take preventive methods to increase the cancer knowledge level of people.

Does plasma thiol and disulphide be a new marker for prostate cancer in prostate-specific antigen level between 10 and 20 ng/ml?

INTRODUCTION: We aimed to evaluate plasma thiol and disulphide levels as an additional marker to prostate specific antigen (PSA) in the diagnosis of prostate cancer (PCa). METHODS: Between March 2017 and January 2018 prospective study was conducted among patients with PSA levels of 2.5-20 ng/mL without suspicion of malignancy in rectal examination and who underwent prostate needle biopsy. Patients were divided into two groups according to PSA level as 2.5-10 ng/mL (Group 1) and 10.01-20 ng/mL (Group 2). Diagnostic efficacy of thiol, disulphide and PSA levels were measured by ROC analysis. RESULTS: A total of 76 patients were included in the study. There were 49 patients in group 1 and 27 patients in group 2. There was no significant difference between two groups in terms of PSA density and prostate size. In Group 1, area under curve (AUC) was higher in PSA than other parameters with statistically significant difference (p<.05). In group 2, AUC of native and total thiol was higher than PSA but there was no statistically significant difference for AUC in parameters. CONCLUSIONS: We think that plasma thiol test may be used in diagnosis of prostate cancer while PSA levels between 10 to 20 ng/mL. However, further studies are required.

High D-dimer levels are associated with prostate cancer

RESUMO OBJETIVO O câncer de próstata é uma das neoplasias mais comuns em homens. Os principais fatores de risco para a ativação da coagulação e trombose são malignidade e idade mais avançada. O risco de trombose pode estar associado ao aumento do nível dos marcadores de coagulação, tais como o fibrinogênio e D-dímero. O objetivo deste estudo é avaliar a relação entre os marcadores de coagulação e o câncer de próstata. METODOLOGIA Este estudo prospectivo incluiu os pacientes que foram submetidos à biópsia de próstata transretal guiada por ultrassonografia e que passaram por cirurgia da próstata entre janeiro de 2015 e janeiro de 2016. Os níveis no plasma de antígeno prostático específico (PSA), PSA livre (fPSA), porcentagem de fPSA, D-dímero e fibrinogênio foram medidos antes dos procedimentos. Os pacientes foram divididos em dois grupos de acordo com os resultados de patologia. Os pacientes com hiperplasia benigna da próstata foram colocados no grupo 1 e os pacientes com câncer de próstata no grupo 2. RESULTADOS No total, 76 pacientes foram incluídos neste estudo. Houve um total de 53 pacientes no grupo 1 e 23 pacientes no grupo 2. A idade média dos pacientes e os níveis de PSA, fPSA, fibrinogênio e D-dímero foram, respectivamente, 65.33 ± 7.47 anos, 8.21 ± 4.59, 1.41 ± 0.74 ng/ml, 309.75 ± 80.46 mg/dl e 0.42 ± 0.39 µg/ml no grupo 1. No grupo 2, a idade média dos pacientes e os níveis de PSA, fPSA, fibrinogênio e D-dímero foram, respectivamente, 66.08 ± 6.7 anos, 145.69 ± 509.35, 7.32 ± 15 ng/ml, 312.16 ± 69.48 mg/dl, 1.09 ± 2.11 µg/ml. Biópsia da próstata e cirurgia transuretal foram realizadas em 64 (%84,21) e 12 (%15,79) pacientes, respectivamente. CONCLUSÃO O presente estudo demonstrou que os níveis de D-dímero no plasma foram maiores em pacientes com câncer de próstata. Novos estudos com um maior número de pacientes são necessários para definir a relação entre câncer de próstata e distúrbios de coagulação.

Fournier's gangrene: Review of 36 cases.

BACKGROUND: Fournier's gangrene (FG) is a very rare disease in daily urological practice. Despite medical improvements, mortality in FG is still high. Early diagnosis is very important to reduce additional instrumentations and mortality. In this study, we aimed to present the characteristics of the patients with Fournier's gangrene followed in two centers during ten years period. METHODS: The medical records of patients with FG were reviewed retrospectively. The patient characteristics, causative pathogens, laboratory findings and treatment modalities were evaluated. RESULTS: A total of 36 FG cases admitted between January 2008 and February 2018 were included in this study, consisting of 35 male patients, and one female patient with a mean age of 59.27±12.91 years. The mean duration of hospital stay was 19±10.44 days. The most common predisposing factor was diabetes mellitus, which was found in 28 patients. Malignancy was detected in three patients; prostate cancer in two patients and chronic lymphoblastic leukemia in one patient. Two patients had liver cirrhosis, and one patient had Behcet's disease and psoriasis. The microbiological agent was isolated from a wound culture in nine patients. After urgent surgical debridement, daily dressing with nitrofurazone (Furacin) was done. Additional debridement was conducted when necessary. Orchiectomy was performed in 10 patients; two of them underwent bilateral orchiectomy. One patient died because of sepsis on the seventh day of hospital admission. CONCLUSION: FG is a life-threatening urological emergency with a high mortality rate. Treatment with broad-spectrum antibiotics and urgent surgery is pivotal for the prevention of mortality.

Renal angiomyolipoma.

INTRODUCTION: Angiomyolipoma is one of the most common benign solid renal tumors. We investigated the characteristics of renal angiomyolipomas and the clinical outcomes of patients in the last thirteen years. METHODS: The medical records of the patients who underwent nephrectomy were reviewed retrospectively from July 2005 to May 2018. The laboratory data, radiology, and pathology reports were recorded. Patients diagnosed with angiomyolipoma were included in the study. RESULTS: A total of 28 patients were included in the study, eight of them male. The mean age of the patients was 55.89+14.49 years. The patients were treated with open and laparoscopic techniques. Partial nephrectomy was performed in 12 patients(42.85%). After pathological examination, 23 patients were diagnosed as fat rich, four patients as fat poor, and one as epithelioid angiomyolipoma. There were no recurrences in the follow-up 91.21+48.31 months. CONCLUSION: Angiomyolipoma is a rare renal tumor in daily urology practice. Clinicians must be aware of its complications and manage patients well.

Renal angiomyolipoma

SUMMARY INTRODUCTION Angiomyolipoma is one of the most common benign solid renal tumors. We investigated the characteristics of renal angiomyolipomas and the clinical outcomes of patients in the last thirteen years. METHODS The medical records of the patients who underwent nephrectomy were reviewed retrospectively from July 2005 to May 2018. The laboratory data, radiology, and pathology reports were recorded. Patients diagnosed with angiomyolipoma were included in the study. RESULTS A total of 28 patients were included in the study, eight of them male. The mean age of the patients was 55.89+14.49 years. The patients were treated with open and laparoscopic techniques. Partial nephrectomy was performed in 12 patients(42.85%). After pathological examination, 23 patients were diagnosed as fat rich, four patients as fat poor, and one as epithelioid angiomyolipoma. There were no recurrences in the follow-up 91.21+48.31 months. CONCLUSION Angiomyolipoma is a rare renal tumor in daily urology practice. Clinicians must be aware of its complications and manage patients well.

RESUMO OBJETIVO O angiomiolipoma é um dos tumores renais benignos sólidos mais comuns. Investigamos as características dos angiomiolipomas renais e os desfechos clínicos dos pacientes nos últimos treze anos. MÉTODOS Os prontuários dos pacientes, para os quais a nefrectomia foi realizada, foram revisados retrospectivamente de 2008 a 2018. Os dados laboratoriais, relatórios de radiologia e patologia foram registrados. Os pacientes diagnosticados como angiomiolipoma foram incluídos no estudo. RESULTADOS Vinte e oito pacientes foram incluídos no estudo, oito deles do sexo masculino. A média de idade dos pacientes foi de 55,89 + 14,49 anos. Os pacientes foram tratados com técnicas abertas e laparoscópicas. Nefrectomia parcial foi realizada em 12 pacientes (42,85%). Depois de exame patológico, 23 pacientes foram diagnosticados como ricos em gordura, quatro pacientes como gordurosos e um paciente como angiomiolipoma epitelioide. Nenhum paciente teve recorrências no seguimento. CONCLUSÕES O angiomiolipoma é um tumor renal raro na prática urológica diária. Os médicos devem estar cientes das complicações e gerenciar bem os pacientes.

Impact of Prostate Specific Antigen Level on Oncological Outcomes after Open Radical Prostatectomy.

OBJECTIVE: To compare the impact of prostate specific antigen (PSA) on oncological outcomes in the patients with 4-10 and 10.01-20 ng/ml PSA level. STUDY DESIGN: Retrospective comparative study. PLACE AND DURATION OF STUDY: Hitit University, Çorum Erol Olçok Training and Research Hospital, Çorum, Turkey, between February 2010 and January 2018. METHODOLOGY: Patients who underwent open radical prostatectomy in our department were reviewed retrospectively. The patients were divided into two groups according to the PSA level at diagnosis between 4 and 20 ng/ml. The patients with PSA level of 4-10 ng/ml was in group 1 and 10.01-20 ng/ml was in group 2. Preoperative data including age, biopsy Gleason score (GS), PSA level, postoperative pathological reports, T stage, GS, positive surgical margin, upgrading and downgrading, were compared between groups. RESULTS: There were 109 (71.24%) and 44 patients (28.75%) in group 1 and group 2, respectively. The median age and PSA level of the patients was 67 and 64.5 years; 6.12 and 12.45 ng/ml in both groups, respectively. There was no significant difference for age, GS, number of positive biopsy cores except the PSA level (p<0.001). The difference did not reach statistical significance for stage, upgrading, downgrading, positive surgical margin, and prostatectomy GS between groups. CONCLUSION: Serum high PSA level at the time of the diagnosis was unrelated to final pathology. The proportion of local advanced disease and positive surgical margin was higher in patients with low PSA values than high levels without statistically significance.

The effect of metabolic syndrome on prostate cancer final pathology.

AIM OF STUDY: Metabolic syndrome (MetS) is an abnormality that increases the risk of cardiovascular disease and diabetes. In the recent years, studies showed that MetS is associated with increased risk of incidence, aggressiveness, and mortality of prostate cancer (PCa). We examined the influence of MetS at final pathology in Turkish patients with PCa. MATERIALS AND METHODS: MetS was defined according to the American Heart Association, National Heart, Lung, Blood Institute, and International Diabetes Federation and requires any three of five components. The patients without and with MetS were in Group 1 and 2, respectively. Data were compared with independent sample t-test and Chi-squared test. RESULTS: There were 117 patients in the study. The patients' age was between 51 and 77 years with a median of 64.87 ± 5.65 and 62.29 ± 5.57, and prostate-specific antigen (PSA) level of the patients was 8.19 ± 5.35 and 8.68 ± 2.22 ng/ml in Group 1 and 2. Of these patients; Group 1 and 2 had 86 and 31 patients. High-grade PCa (Gleason >7) and advanced PCa (T3, T4) at final pathology were reported in 44.18-18.60% and 38.70-32.25% in Group 1 and 2. CONCLUSION: The patients with MetS are diagnosed significantly younger and had higher PSA levels than the other patients. Advanced disease of PCa is seen much more in patients with MetS.

Elevated neutrophil to lymphocyte and platelet to lymphocyte ratios predict high grade and advanced stage renal cell carcinoma.

INTRODUCTION: Renal cell carcinoma is the most common malignancy of the kidney, which accounts 85% of all renal tumors. In recent years, the incidence of renal cell carcinoma was increased due to the widespread use of imaging techniques. The aim of this study is to investigate the clinical significance of pretreatment neutrophil to lymphocyte and platelet to lymphocyte ratios in patients with renal cell carcinomas. METHODS: The patients who underwent nephrectomy for renal tumor between 2010 and 2018 in two centers were reviewed retrospectively. The age, sex, complete blood test, and pathological results were recorded. The patients who were diagnosed with other carcinomas, benign renal tumors, and missing data of age, complete blood test, and pathological results, were excluded. The patients were divided into two groups according to the T stage and Fuhrman grade, T1-2 and T3-4, G1-2 and G3-4. RESULTS: There were 271 patients in the current study. The male to female ratio was 1.97 and the mean age of the patients was 59.37±11.62 years. Clear cell renal cell carcinoma was the most common subtype in 72.7% of the patients. Both the neutrophil to lymphocyte ratio and the platelet to lymphocyte ratio were significantly higher in patients with high-grade and advanced-stage disease than in the others. The receiver operating characteristic curve showed no significant difference between platelet to lymphocyte ratio and neutrophil to lymphocyte ratio to diagnose the high grade and stage of renal cell carcinoma. CONCLUSION: The neutrophil to lymphocyte and platelet to lymphocyte ratios are easily accessible biomarkers which are used for the prognosis of malignancy. The current study found that these biomarkers may predict the pathological results during the preoperative period.

Nephrocutaneous Fistula After Percutaneous Nephrolithotomy.

Background: Nephrocutaneous fistula (NF) is a rare pathologic condition in urology practice. Xanthogranulomatous pyelonephritis and renal tuberculosis are the two common causes of this pathologic condition. Another rare cause of NF is surgery. Percutaneous nephrolithotomy is standard treatment for >2 cm renal stones. However, this surgery can be associated with surgical complications in long-term follow-up. NF is a rare complication of percutaneous renal surgery. Case Presentation: In this study, we present a 31-year-old man with continuous urine leakage at the nephrolithotomy scar during 11 months, starting from 1 month after surgery. Final confirmation is NF and could be treated with nephrectomy. Conclusion: Surgical treatment such as nephrectomy is essential for non- or low functioning kidney with fistula formation. Patients must be informed about this complication.

[Silk suture granuloma after high orchiectomy].

Suture granuloma is very rare complication of surgical procedures developing from the non-absorbable sutures. The development of suture granuloma is a chronic process and includes multinucleated giant cell formation. It has two step process including the initial reaction of tissue inflicted the passage of the needle and specific inflammatory reaction of the suture material. There is no pathognomonic imaging modality fort he diagnosis of suture granuloma. Surgery is used to for the diagnosis and eradication of the inflammation. A 59 year old man presented with 3*2 cm sized palpable, firm painless nodular mass in the right scrotum. The patient was treated with high orchiectomy before 3 weeks. The mass was excised and reported as silk suture granuloma.

Endothelin-1 Level in Patients with Simple Renal Cyst.

INTRODUCTION: Endothelin-1 (ET-1) is potent vasoconstrictive peptide and elevated ET-1 levels are associated with hypertension, endothelial dysfunction and atherosclerosis. Research on (ET-1) has demonstrated that elevated ET-1 levels in autosomal dominant polycystic kidney disease leads to systemic hypertension. The prevalence of simple renal cysts increases with age and the association with simple renal cyst and hypertension is not clear. The aim of this study was to investigate the ET-1 levels in patients with simple renal cyst and compare them with those in healthy adults. MATERIALS AND METHODS: The study included patients that underwent laparoscopic renal cyst decortication in the Department of Urology and healthy controls. Serum and urinary ET-1 levels were measured before surgery and one month after it in the patients with simple renal cyst. Serum ET-1 levels were measured in healthy adult patients. Ambulatory blood pressure was measured in all patients. Glomerular filtration rate was measured according to the chronic kidney disease epidemiology collaboration formula. RESULTS: Thirty-two patients were included in the present study. Of these, 16 patients with simple renal cyst were allocated into group 1 and 16 healthy patients - in group 2. There was no significant difference between systolic and diastolic blood pressure between the groups (. CONCLUSIONS: The present study demonstrated that serum EL-1 level in patients with simple renal cyst was lower than that in healthy people. Further studies are needed to investigate the EL-1 levels in simple renal cyst patients.