A Retroperitoneal Calcified Mass: Synovial Sarcoma.

Retroperitoneal synovial sarcoma is an extremely rare and aggressive tumor. Although it does not have a typical radiological appearance, it can sometimes appear as a calcified mass. The most important step in the treatment of synovial sarcoma is complete resection. However, despite complete resection, local recurrence and systemic spread rates remain high, and chemo/radiotherapy may be considered in high-risk patients.

Is RIRS Safe and Efficient In Patients With Kidney Stones Who Had Previous Open, Endoscopic, or Percutaneous Kidney Stone Surgery? One Center Retrospective Study.

PURPOSE: In our study, we assessed the efficiency and reliability of retrograde intrarenal surgery secondary to open surgery for kidney stone treatment. Moreover, we compared the efficiency and safety of retrograde intrarenal surgery for the patients with previous history of open surgery, percutaneous nephrolithotomy, secondary retrograde intrarenal surgery (RIRS) and primary RIRS. MATERIALS AND METHODS: Data was retrospectively reviewed. Patients who had kidney anomalies, who had been stented due to ureteral stricture in the operation and who were < 18 years old, were excluded. There were 30 patients who underwent RIRS secondary to open surgery. The demographic and stone characteristic as well as intraoperative and postoperative data of the patients were recorded. 30 patients with similar demographic and stone characteristics to those patients were selected by match pairing method from patients who had previous PNL, RIRS history and had undergone primary RIRS. A total of 120 patients, in total 4 groups, were included in the study. RESULTS: Statistically significant difference was detected among the groups with regards to shock wave lithotripsy history and preoperative JJ stent rate. There was no statistically significant difference in terms of stone characteristics, intraoperative and postoperative data. CONCLUSION: RIRS is an efficient and safe method for kidney stone treatment of the patients with previous history of open surgery, percutaneous nephrolithotomy and retrograde intrarenal surgery. It has a similar efficiency and safety for the patients who have undergone retrograde intrarenal surgery. This is the first study that compares the patients especially  with different previous surgery methods.

Comparison of Retrograde Intrarenal Surgery and Percutaneous Nephrolithotomy Methods For Management of Big- Sized Kidney Stones(? 4 cm): Single Center Retrospective Study.

Purpose: Management of ? 4 cm sized kidney stone is a rarely seen problem in urology. Few studies are present about this issue. Percutaneous nephrolithotomy(PNL), Retrograde Intrarenal Surgery(RIRS) and open surgery are the methods used in stone management. In our study we aimed to compare RIRS and PNL in the management of ? 4 cm sized kidney stones. MATERIALS AND METHODS: Among patients who had undergone RIRS and PNL in D?skap? Y?ld?r?m Beyaz?t Train-ing and Research Hospital, 94 patients who had ? 4 cm sized kidney stones were included our study. The demo-graphic, intraoperative and postoperative data of these patients and complications were evaluated retrospectively. RESULTS: 94 patients (67 PNL, 27 RIRS) were in the study. Stone laterality, urinary anomaly and gender were sim-ilar in two groups.(Group PNL(P) and Group RIRS(R)) Stone number were 2.55 ± 1.44 and 2.78 ± 1.42 in Group P and R, respectively. Stone size were 47.06 ± 7.02 and 46.41 ± 6.00 mm. in Group P and R, respectively. The differences between two groups were not statistically significant.(P > .05) In Group P scopy time, hospital stay and stone free rate were higher and operation time was lower than Group R. And the difference was statistically significant(P < .05). CONCLUSIONS: As a result, PNL is an effective method and operation time is lower than RIRS. Also a second oper-ation for JJ stent taking is lower in PNL . RIRS is a safe method. RIRS has less complications and hospitalization time. They are feasible in treatment of ? 4 cm sized kidney stones.

Primary Signet Ring Cell Carcinoma of the Prostate: A Rare Case Report.

Primary prostatic signet ring cell carcinoma is a rare form of cancer with a poor prognosis, which is generally treated with a traditional prostate adenocarcinoma therapy. This case report presents a 70-year-old diagnosed with primary prostatic signet ring cell carcinoma, treated with a combination of radiotherapy and hormone therapy and a 16 month survival without an evidence of the disease at follow up.

The Association of Encrustation and Ureteral Stent Indwelling Time in Urolithiasis and KUB Grading System.

PURPOSE: To evaluate the management of prolonged indwelling ureteral stents and the newly developed KUB (kidney, ureter, and bladder) grading system for the classification of encrusted stents in urolithiasis. METHOD: This study involved 69 patients that had indwelling and forgotten ureteral stents for more than 6 months after urolithiasis treatment. They were categorized into 4 groups based on indwelling time and were reviewed retrospectively. Patients whose ureteral stent could not be removed with simple cystoscopy were graded according to stone surface area and the KUB system. RESULTS: The mean stent indwelling time was 23.1 months. Stone burden in KUB and, in proportion to that, total KUB (T) score showed increased association that was directly proportional to indwelling time (p < 0.001, p = 0.008). Surgical intervention was required in 73.9% of patients. Among patients requiring surgery, 78.4% were treated in a single session and multi-modal interventions were performed in 70.5%. K score ? 3 was found to be associated with multiple surgery requirements (odds ratio [OR];11.25, %95 confidence interval [CI]:2.132-59.375),multi-modal procedure requirements (OR;16.50, %95 CI:3.434-79.826 ), and lower stone-free rates (p = 0.04). Bscore ? 3 was associated with multi-modal procedure requirements (OR;8.90, %95 CI:1.052-75.462). U score ? 3and T score ? 9 were associated with an operating time >180 minutes (p < 0.001, p = 0.008). CONCLUSION: Prolonged indwelling time of the ureteral stent in urolithiasis is associated with increased encrustation and stone burden. Since the KUB system specifies stone burden and its particular localization, it can be used as a simple, convenient method for the planning treatment of encrusted ureteral stents.

Does Tadalafil Increase The Uptake of Finasteride into Prostate Tissue? A Biochemical and Histological Evaluation in Rats.

PURPOSE: To histopathologically and biochemically evaluate the hypothesis that tadalafil increases the uptake of a second medication into the prostate tissue by increasing the blood supply in the prostate. METHODS: Forty 12-week-old Sprague Dawley male rats were equally divided into 5 groups and were administered drugs orally as follows: Group 1 - no drugs, Group 2 - 10 days of finasteride, Group 3 - 10 days of finasteride + tadalafil, Group 4 - 30 days of finasteride, and Group 5 - 30 days of finasteride + tadalafil. At the end of 10 days of drug administration in Group1, 2, and 3, and at the end of 30 days of drug administration in Group 4 and 5,blood samples were collected from rats and analyzed for serum androgen levels. In addition, prostate tissues were removed for histological examination. RESULTS: The mean DHT level as well as the minimum and maximum epithelial thicknesses in Group 3 were lower than those in Group 2. However, there was no statistical significant difference (P = 0.989, P = 0.176, and P = 0.070, respectively). The mean DHT level as well as the minimum and maximum epithelial thicknesses in Group 5 were lower than those in Group 4. However, there was no statistical significant difference (P = 0.984, P = 0.147, and P= 0.478, respectively). The mean minimum and maximum epithelial thicknesses in Group 3 and Group 4 were not statistically different (P = 0.488 and P = 0.996, respectively). CONCLUSION: The similarity of the mean minimum and maximum epithelial thickness in Group 3 and Group 4 may be indicate that the combination therapy provides an early histological effect. However, the fact that there was no statistical significant difference between Group 2 and Group 3, and between Group 4 and Group 5, in terms of the mean DHT level and minimum-maximum epithelial thicknesses suggests that longer term studies with more rats are necessary to test the validity of our hypothesis.