A Retrospective Analysis of 83 Patients with Testicular Mass Who Underwent Testis-Sparing Surgery: The Eurasian Uro-oncology Association Multicenter Study.

INTRODUCTION: Herein, we analyzed the histopathological, oncological and functional outcomes of testis-sparing surgery (TSS) in patients with distinct risk for testicular cancer. METHODS: This is a multicenter retrospective study on consecutive patients who underwent TSS. Patients were categorized in high- or low-risk testicular germ cell tumor (TGCT) according to the presence/absence of features compatible with testicular dysgenesis syndrome. Histology was categorized per size and risk groups. RESULTS: TSS was performed in 83 patients (86 tumors) of them, 27 in the high-risk group. Fifty-nine patients had a non-tumoral contralateral testis present. Sixty masses and 26 masses were benign and TGCTs, respectively. No statistical differences were observed in mean age (30.9 ± 10.32 years), pathological tumor size (14.67 ± 6.7 mm) between risk groups or between benign and malignant tumors (p = 0.608). When categorized per risk groups, 22 (73.3%) and 4 (7.1%) of the TSS specimens were malignant in the high- and low-risk patient groups, respectively. Univariate analysis showed that the only independent variable significantly related to malignant outcome was previous history of TGCT. During a mean follow-up of 25.5 ± 22.7 months, no patient developed systemic disease. Local recurrence was detected in 5 patients and received radical orchiectomy. Postoperative testosterone levels remained normal in 88% of those patients with normal preoperative level. No erectile dysfunction was reported in patients with benign lesions. CONCLUSION: TSS is a safe and feasible approach with adequate cancer control, and preservation of sexual function is possible in 2/3 of patients harboring malignancy. Incidence of TGCT varies extremely between patients at high and low risk for TGCT requiring a careful consideration and counseling.

The Efficiency and Safety of Mirabegron Monotherapy for the Treatment of Urge Incontinence in Women Aged >80 Years.

Objective We aimed to evaluate the efficacy and safety of mirabegron monotherapy in very older (>80 years) women with overactive bladder (OAB) who were discontinued anticholinergic drugs by the other departments. Material and methods The present retrospective study evaluated very older (>80 years) women with OAB who were discontinued anticholinergic drugs by the other departments between May 2018 and January 2021. Efficacy assessments were performed using Overactive Bladder-Validated Eight-Question (OAB-V8) scores before and after mirabegron monotherapy (12 weeks). Safety was evaluated based on adverse events (hypertension, nasopharyngitis, and urinary tract infection), electrocardiography, hypertension measure, uroflowmetry (UFM), and post-voiding. Patient data including demographic characteristics, diagnoses, values before and after mirabegron monotherapy, and adverse events were evaluated. Results A total of 42 very older (>80 years) women with OAB who used mirabegron monotherapy (50 mg per day) were included in this study. Frequency, nocturia, urgency, and total OAB-V8 scores were significantly lower after mirabegron monotherapy than before mirabegron monotherapy (p < 0.05, p < 0.05, p < 0.05, and p < 0.05, respectively). There was no significant difference between systolic-diastolic blood pressure and heart rate before and after mirabegron monotherapy treatment. Conclusion Mirabegron monotherapy is an effective and safe therapy in very older (>80 years) women with OAB.

The timing of micro-TESE: what is the ideal age for male and female partner to bring a child to home?

OBJECTIVE: The aim of this study was to analyze the results of microsurgical testicular sperm extraction (micro-TESE) and investigate the potential factors that may affect the successful sperm retrieval and timing of micro-TESE. METHODS: A total of 56 patients with nonobstructive azoospermia (NOA) who underwent micro-TESE procedure between January 2017 and December 2019 were retrospectively analyzed. The patient age, marriage duration, infertility duration, smoking, chronic illness, varicocele status, previous scrotal surgeries, and the presence of genetic disease were noted by an urologist for all patients. RESULTS: The mean age of patients was 33.28±4.4 (22-44) years. Our total sperm-retrieval rate was 55.4% (n:31). Sixteen (28.6%) pregnancies were achieved and 15 (26.8%) healthy live births could be managed. Only the marriage duration (p=0.016) and infertility duration (p=0.015) were detected to be the significant factors to manage successful sperm retrieval. Men with NOA younger than 35.2 years and having a female partner younger than 36.9 years seemed to have the best chance to have a living healthy baby. CONCLUSIONS: The fertility decreased by both male and female age and for men with NOA. The early visit to doctor seemed to have positive effect.

Examination of clinical data and semen analysis results of patients undergoing orchiectomy for testicular tumor.

OBJECTIVE: Testicular tumor constitutes 1% of male neoplasms. Infertility can be determined in patients with testicular tumors before orchiectomy due to the deterioration of spermatogenesis. The aim of this study was to show the clinical, radiological, and pathological characteristics and spermiogram results of patients with testicular tumor and their relationship with each other. METHODS: The data of patients who underwent orchiectomy due to testicular tumor between 2016 and 2019 were reviewed retrospectively. These data included sociodemographic data of the patients, pretreatment spermiogram characteristics, level of serum tumor markers, characteristics of the ultrasonography, type of orchiectomy, and histopathological examination. RESULTS: This study included 53 male patients, with a mean age of 33.51±12.86 years. The mean levels of all tumor markers were above the reference levels. The mean tumor size was 34.68±23.32 mm. Multiple localizations and microlithiasis were detected in 11.3 and 13.2% of the tumors, respectively. The most common masses were hypoechoic (n=37; 69.8%) and hypervascular (n=47; 81%). Spermiogram and cryopreservation were performed in 29 (54.7%) of 53 patients preoperatively. The mean sperm concentration before orchiectomy was 24.21×106 /mL and group A sperm motility 0.79%, group B sperm motility 39.10%, group C sperm motility 9.83%, and group D sperm motility 22.69% in testicular tumors. CONCLUSION: Spermatogenesis adversely affected before the treatment due to local and systemic effects of testicular cancer. Fertility expectations can be increased in the subsequent years by semen analysis and referral to cryopreservation.

The timing of micro-TESE: what is the ideal age for male and female partner to bring a child to home?

SUMMARY OBJECTIVE: The aim of this study was to analyze the results of microsurgical testicular sperm extraction (micro-TESE) and investigate the potential factors that may affect the successful sperm retrieval and timing of micro-TESE. METHODS: A total of 56 patients with nonobstructive azoospermia (NOA) who underwent micro-TESE procedure between January 2017 and December 2019 were retrospectively analyzed. The patient age, marriage duration, infertility duration, smoking, chronic illness, varicocele status, previous scrotal surgeries, and the presence of genetic disease were noted by an urologist for all patients. RESULTS: The mean age of patients was 33.28±4.4 (22-44) years. Our total sperm-retrieval rate was 55.4% (n:31). Sixteen (28.6%) pregnancies were achieved and 15 (26.8%) healthy live births could be managed. Only the marriage duration (p=0.016) and infertility duration (p=0.015) were detected to be the significant factors to manage successful sperm retrieval. Men with NOA younger than 35.2 years and having a female partner younger than 36.9 years seemed to have the best chance to have a living healthy baby. CONCLUSIONS: The fertility decreased by both male and female age and for men with NOA. The early visit to doctor seemed to have positive effect.

Examination of clinical data and semen analysis results of patients undergoing orchiectomy for testicular tumor

SUMMARY OBJECTIVE: Testicular tumor constitutes 1% of male neoplasms. Infertility can be determined in patients with testicular tumors before orchiectomy due to the deterioration of spermatogenesis. The aim of this study was to show the clinical, radiological, and pathological characteristics and spermiogram results of patients with testicular tumor and their relationship with each other. METHODS: The data of patients who underwent orchiectomy due to testicular tumor between 2016 and 2019 were reviewed retrospectively. These data included sociodemographic data of the patients, pretreatment spermiogram characteristics, level of serum tumor markers, characteristics of the ultrasonography, type of orchiectomy, and histopathological examination. RESULTS: This study included 53 male patients, with a mean age of 33.51±12.86 years. The mean levels of all tumor markers were above the reference levels. The mean tumor size was 34.68±23.32 mm. Multiple localizations and microlithiasis were detected in 11.3 and 13.2% of the tumors, respectively. The most common masses were hypoechoic (n=37; 69.8%) and hypervascular (n=47; 81%). Spermiogram and cryopreservation were performed in 29 (54.7%) of 53 patients preoperatively. The mean sperm concentration before orchiectomy was 24.21×106 /mL and group A sperm motility 0.79%, group B sperm motility 39.10%, group C sperm motility 9.83%, and group D sperm motility 22.69% in testicular tumors. CONCLUSION: Spermatogenesis adversely affected before the treatment due to local and systemic effects of testicular cancer. Fertility expectations can be increased in the subsequent years by semen analysis and referral to cryopreservation.

Evaluation of depression, anxiety and quality of life in patients with non-obstructive azoospermia.

OBJECTIVE: The aim of this study was to determine the levels of depression, anxiety and quality of life in non-obstructive azoospermia (NOA) patients who attended our clinic. MATERIALS AND METHODS: A total of 40 male patients were included in the study troubled with non-obstructive azoospermia. An etiological classification was made according to the hormone levels of the patients. The semen specimen was obtained by masturbation from the patients. Three questionnaires, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Short Form of the World Health Organization Quality of Life Questionnaire, were utilized in the study. RESULTS: The mean age of the patients in the study was 32.75±5.22 years. The patients were classified as follows: 26 (65%) patients were idiopathic, 11 (27.5%) patients were hyper-hypo and 3 (7.5%) patients could not be reached. In this cohort, 62.5% of patients had minimal depression, 27.5% of patients had mild depression and 10% of patients had moderate depression. In addition, 97.5% of patients had minimal anxiety and 2.5% of the patients had mild anxiety. Quality of life scores of the patients were 58.75% for general health status, 70.98% for physical health status, 72.92% for psychological status, 65% for social relations and 66.25% for environmental status. CONCLUSION: NOA particularly affects men in terms of biological, psychological and social aspects. In order to evaluate the quality of life and psychiatric conditions patients with azoospermia, various questionnaires may be applied before infertility treatment. Thus, patients who need psychiatric support can be identified.

Does Watching a Relaxing Video During Cystoscopy Affect Pain and Anxiety Levels of Female Patients? A Randomized Controlled Trial.

BACKGROUND: Cystoscopy is noted to be more painful in men. Research has been done to support the use of video in men to reduce pain; it would follow that video would be useful in reducing pain in women as well. AIMS: The aim of this study was to evaluate the effect of watching a relaxing video during cystoscopy on the pain and anxiety levels of female patients. DESIGN: The study was a single-center, parallel, randomized, controlled, nonblinded trial. SETTING: This study was carried out in the cystoscopy unit of a training and research hospital in Turkey. PARTICIPANTS: Sixty female patients aged 18 years and older undergoing rigid cystoscopy for the first time and under local anesthesia. METHODS: The participants were randomized into two equal groups: video and control. Data were collected with Visual Analog Scale, State-Trait Anxiety Scale, and hemodynamic parameters. RESULTS: A statistically significant difference was found between the two groups in terms of pain levels during and after cystoscopy (p < .001). Pain levels were significantly lower in the video group during and after the procedure. A statistically significant difference was also found between the groups in terms of anxiety levels before and after cystoscopy (p < .05). Anxiety levels were significantly lower in the video group after the procedure. Satisfaction levels were higher in the video group (p < .001). CONCLUSION: According to this study, watching a relaxing video during cystoscopy had a positive effect on pain, anxiety, satisfaction levels, and hemodynamic parameters of the patients.

The clinical features and treatment options of intratesticular epidermoid cysts. / Las características clínicas y opciones de tratamiento de los quistes epidermoides intratesticulares.

OBJECTIVES: In this study, we aimed to define the clinico-radiological data and treatment options for intratesticular epidermoid cysts (IEC). MATERIALS AND METHODS: We retrospectively reviewed the medical records of the patients that under went surgery for testicular mass between 1995 and 2017. Data of the patients whose histopathological evaluation revealed IEC were recorded.  RESULTS: A total of 20 patients with IEC were identified.While three of 20 patients were excluded due to incomplete data, the remaining 17 patients with pathologically proven IEC were reviewed and analyzed in the study. The mean patient age was 22.2 years (range, 17-29 years). All patients were presented with painless testicular swelling and/or mass. Serum tumor markers of all patients were within the ranges. Four patients treated with radical orchiectomy (23.5%), while 13 patients under went partial orchiectomy (76.5%). The mean size ofthe IEC was 17.7x15.1 mm (range, 26x10 mm). IEC swere mostly located in the middle pole of the testes (10of 17 patients, 58.8%). CONCLUSIONS: This study is designed in retrospective nature, but the patient population is one the largest reported in the literature. According to our study, we can easily state that partial orchiectomy can be performed safely after FSA in patients that have IECs.

OBJETIVOS: En este estudio, nuestro objetivofue definir los datos clínico-radiológicos y las opciones de tratamiento de los quistes epidermoides intratesticulares (CEI). MATERIALES Y MÉTODOS: Revisamos retrospectivamente los registros médicos de los pacientes que se sometieron a cirugía para la masa testicular entre 1995 y 2017. Entre ellos se registraron los datos de los pacientes cuya evaluación histopatológica reveló IEC. RESULTADOS: Se identificaron un total de 20 pacientes con IEC. Mientras que tres de los 20 pacientes fueron excluidos debido a los datos incompletos, los 17pacientes restantes con IEC patológicamente probada se revisaron y analizaron en el estudio. La edad media de los pacientes fue de 22,2 años (rango, 17-29años). A todos los pacientes se les presentó hinchazón y/o masa testicular indolora. Los marcadores tumorales séricos de todos los pacientes estaban dentro de los rangos. Cuatro pacientes tratados con orquiectomía radical (23,5%), mientras que 13 pacientes se sometieron a orquiectomía parcial (76,5%). El tamaño medio de la IEC fue de 17,7x15,1 mm (rango, 26x10 mm). Los IEC se encontraban principalmente en el polo medio de los testículos (10 de 17 pacientes, 58,8%). CONCLUSIONES: Este estudio está diseñado de forma retrospectiva, pero la población de pacientes es una de las más numerosas que se han publicado en la literatura. Según nuestro estudio, podemos afirmar fácilmente que la orquiectomía parcial se puede realizar de manera segura después de la FSA en pacientes que tienen CEI.

Las características clínicas y opciones de tratamiento de los quistes epidermoides intratesticulares / The clinical features and treatment options of intratesticular epidermoid cysts

OBJETIVOS: En este estudio, nuestro objetivofue definir los datos clínico-radiológicos y las opciones de tratamiento de los quistes epidermoides intratesticulares (CEI). MATERIALES Y MÉTODOS: Revisamos retrospectivamente los registros médicos de los pacientes que se sometieron a cirugía para la masa testicular entre 1995 y 2017. Entre ellos se registraron los datos de los pacientes cuya evaluación histopatológica reveló IEC. RESULTADOS: Se identificaron un total de 20 pacientes con IEC. Mientras que tres de los 20 pacientes fueron excluidos debido a los datos incompletos, los 17pacientes restantes con IEC patológicamente probada se revisaron y analizaron en el estudio. La edad media de los pacientes fue de 22,2 años (rango, 17-29años). A todos los pacientes se les presentó hinchazón y/o masa testicular indolora. Los marcadores tumorales séricos de todos los pacientes estaban dentro de los rangos. Cuatro pacientes tratados con orquiectomía radical (23,5%), mientras que 13 pacientes se sometieron a orquiectomía parcial (76,5%). El tamaño medio de la IEC fue de 17,7 x 15,1 mm (rango, 26 x 10 mm). Los IEC se encontraban principalmente en el polo medio de los testículos (10 de 17 pacientes, 58,8%). CONCLUSIONES: Este estudio está diseñado de forma retrospectiva, pero la población de pacientes es una de las más numerosas que se han publicado en la literatura. Según nuestro estudio, podemos afirmar fácilmente que la orquiectomía parcial se puede realizar de manera segura después de la FSA en pacientes que tienen CEI

OBJECTIVES: In this study, we aimed to define the clinico-radiological data and treatment options for intratesticular epidermoid cysts (IEC). MATERIALS AND METHODS: We retrospectively reviewed the medical records of the patients that under went surgery for testicular mass between 1995 and 2017. Data of the patients whose histopathological evaluation revealed IEC were recorded. RESULTS: A total of 20 patients with IEC were identified.While three of 20 patients were excluded due to incomplete data, the remaining 17 patients with pathologically proven IEC were reviewed and analyzed in the study. The mean patient age was 22.2 years (range, 17-29 years). All patients were presented with painless testicular swelling and/or mass. Serum tumor markers of all patients were within the ranges. Four patients treated with radical orchiectomy (23.5%), while 13 patients under went partial orchiectomy (76.5%). The mean size ofthe IEC was 17.7 x 15.1 mm (range, 26 x 10 mm). IEC swere mostly located in the middle pole of the testes (10of 17 patients, 58.8%). CONCLUSIONS: This study is designed in retrospective nature, but the patient population is one the largest reported in the literature. According to our study, we can easily state that partial orchiectomy can be performed safely after FSA in patients that have IECs

Does preoperative use of silodosin affect the stages of f-urs Procedure? / ¿Afecta el uso de silodosin preoperatorio los pasos de la ureteroscopia flexible?

OBJECTIVES: To evaluate the effect of silodosin on stages of the flexible ureterorenoscopy (F-URS) procedures. METHODS: Between November 2015 and August 2017, a total of 76 patients suffering from 10-30 mm kidney stone were enrolled in this randomized prospective study. Patients were randomly divided into 2 groups for treatment: Group 1 had F-URS with preoperative daily uptake of 8 mg silodosin for 10 days, and group 2 had F-URS without silodosin uptake. None of the patients had preoperative JJ stenting. Stages of the F-URS was defined as entrance to bladder time (ETBT) with a semirigid ureterorenoscope (R-URS), entrance to ureteric orifice time (ETUOT) with R-URS using a guide wire and proceeding 2 cm inside the ureter, application of access sheath time (AAST) using the guide wire advanced through R-URS, F-URS time (FURST) + lithotripsy with laser time (LT), and total operation time (OT). We compared the time of each stage between two groups. RESULTS: There were 38 patients group1 and 2, respectively. There was one ureteral access sheath (UAS) application failure in group 1, and 3 failures in group 2 (p = 0.307). The ETBT, ETUOT, and AAST were significantly short in group 1 than group 2 (p = 0.001,0.007,0.002). CONCLUSIONS: Although preoperative use of silodosin facilitated only an insignificant positive effect on UAS placement failure, it eased the F-URS procedure by reducing the ETBT, ETUOT, and AAST in seconds. More studies are needed to make an exact conclusión

OBJETIVOS: Evaluar el efecto de la silodosina en las etapas de los procedimientos de ureterorrenoscopia flexible (F-URS). MÉTODOS: Entre noviembre de 2015 y agosto de 2017, un total de 76 pacientes con cálculos renales de 10-30 mm se inscribieron en este estudio prospectivo aleatorizado. Los pacientes se dividieron aleatoriamente en 2 grupos para el tratamiento: el grupo 1 tenía F-URS con captación diaria preoperatoria de 8 mg de silodosina durante 10 días, y el grupo 2 tenía F-URS sin captación de silodosina. Ninguno de los pacientes tenía stent JJ preoperatorio. Las etapas del F-URS se definieron como entrada al tiempo de la vejiga (ETBT) con un ureterorrenoscopio semirrígido (R-URS), entrada al tiempo del orificio ureteral (ETUOT) con R-URS usando una guía y 2 cm dentro del uréter. Aplicación del tiempo de vaina de acceso (AAST) utilizando el cable de guía avanzado a través de R-URS, tiempo de F-URS (FURST) + litotricia con tiempo de láser (LT) y tiempo total de operación (OT). Comparamos el tiempo de cada etapa entre dos grupos. RESULTADOS: Hubo 38 pacientes grupo 1 y 2, respectivamente. Hubo una falla en la aplicación de la cubierta de acceso ureteral (UAS) en el grupo 1 y 3 fallas en el grupo 2 (p = 0,307). ETBT, ETUOT y AAST fueron significativamente cortos en el grupo 1 que en el grupo 2 (p = 0,001, 0,007, 0,002). CONCLUSIONES: Aunque el uso preoperatorio de silodosina facilitó solo un efecto positivo insignificante en la falla de colocación de UAS, alivió el procedimiento de F-URS al reducir el ETBT, ETUOT y AAST en segundos. Se necesitan más estudios para llegar a una conclusión exacta

Does preoperative use of silodosin affect the stages of F-URS procedure? / ¿Afecta el uso de silodosin preoperatorio los pasos de la ureteroscopia flexible?

OBJECTIVES: To evaluate the effect of silodosin on stages of the flexible ureterorenoscopy (F-URS) procedures. METHODS: Between November 2015 and August 2017, a total of 76 patients suffering from 10-30 mm kidney stone were enrolled in this randomized prospective study. Patients were randomly divided into 2 groups for treatment: Group 1 had F-URS with preoperative daily uptake of 8 mg silodosin for 10 days, and group 2 had F-URS without silodosin uptake. None of the patients had preoperative JJ stenting. Stages of the F-URS was defined as entrance to bladder time (ETBT) with a semirigid ureterorenoscope (R-URS), entrance to ureteric orifice time (ETUOT) with R-URS using a guide wire and proceeding 2 cm inside the ureter, application of access sheath time (AAST) using the guide wire advanced through R-URS, F-URS time (FURST) + lithotripsy with laser time (LT), and total operation time (OT). We compared the time of each stage between two groups. RESULTS: There were 38 patients group1 and 2, respectively. There was one ureteral access sheath (UAS) application failure in group 1, and 3 failures in group 2 (p=0.307). The ETBT, ETUOT, and AAST were significantly short in group 1 than group 2 (p=0.001,0.007,0.002). CONCLUSIONS: Although preoperative use of silodosin facilitated only an insignificant positive effect on UAS placement failure, it eased the F-URS procedure by reducing the ETBT, ETUOT, and AAST in seconds. More studies are needed to make an exact conclusion.

OBJETIVOS: Evaluar el efecto de la silodosina en las etapas de los procedimientos de ureterorrenoscopia flexible (F-URS).MÉTODOS: Entre noviembre de 2015 y agosto de 2017, un total de 76 pacientes con cálculos renales de 10-30 mm se inscribieron en este estudio prospectivo aleatorizado. Los pacientes se dividieron aleatoriamente en 2 grupos para el tratamiento: el grupo 1 tenía F-URS con captación diaria preoperatoria de 8 mg de silodosina durante 10 días, y el grupo 2 tenía F-URS sin captación de silodosina. Ninguno de los pacientes tenía stent JJ preoperatorio. Las etapas del F-URS se definieron como entrada al tiempo de la vejiga (ETBT) con un ureterorrenoscopio semirrígido (R-URS), entrada al tiempo del orificio ureteral (ETUOT) con R-URS usando una guía y 2 cm dentro del uréter. Aplicación del tiempo de vaina de acceso (AAST) utilizando el cable de guía avanzado a través de R-URS, tiempo de F-URS (FURST) + litotricia con tiempo de láser (LT) y tiempo total de operación (OT). Comparamos el tiempo de cada etapa entre dos grupos. RESULTADOS: Hubo 38 pacientes grupo 1 y 2, respectivamente. Hubo una falla en la aplicación de la cubierta de acceso ureteral (UAS) en el grupo 1 y 3 fallas en el grupo 2 (p=0,307). ETBT, ETUOT y AAST fueron significativamente cortos en el grupo 1 que en el grupo 2 (p=0,001, 0,007, 0,002). CONCLUSIONES: Aunque el uso preoperatorio de silodosina facilitó solo un efecto positivo insignificante en la falla de colocación de UAS, alivió el procedimiento de F-URS al reducir el ETBT, ETUOT y AAST en segundos. Se necesitan más estudios para llegar a una conclusión exacta.

The cognitive fusion prostate biopsy using a smart phone in the diagnosis of prostate cancer. / Biopsia de próstata cognitiva utilizando un dispositivo móvil.

OBJECTIVES: In this research, we designed a cognitive fusion(CF) prostate biopsy(PB) (CFPB) technique by examining the multiparametric MRI of prostate (MP_MRI-P) images in a smart-phone near the trans-rectal ultrasound (TRUS) device, and examined the results. METHODS: Between January 2011 and January 2017, a total of 344 men who had PB enrolled in this study. Group 1 had a minimum of a 12-core standard TRUS PB (TRUSPB). Group 2 had CFPB while examining the MP_ MRI-P images in a smartphone near the TRUS device. A minimum 12 cores + cognitive targeted 1-3 biopsy were taken. The detection of Pca and significant Pca in group 1 and 2 were evaluated and compared. Then, the effect of MP_MRI-P findings on the detection of prostate cancer (Pca) and significant Pca were evaluated. RESULTS: Group 1 and 2 included 138 and 206 patients. After the PB, 45(32.8%) and 33(23%) patients ingroup 1, and 74(35.9%) and 60(29%) patients in-group 2 were detected to have Pca and significant Pca, respectively (p=0.001 for both). Higher PIRADS caused significant detection of Pca and significant Pca (p=0.004 and 0.002). Nodule in MP_MRI-P caused significant detection of Pca and significant Pca (p=0.001 and 0.001). Especially, when PSA was <10ng/ml, higher PIRADS and nodule in MP_MRI-P caused significant detection of Pca and significant Pca (p=0.02 and 0.019 for PIRADS, and p=0.01 and 0.042 for nodules). CONCLUSIONS: In the advanced hands with our new technique, the CFPB using prebiopsy MP_MRI-P seems to be an effective method to detect Pca and significant Pca.

OBJETIVOS: En este estudio de investigación diseñamos una técnica de biopsia de próstata (BxP) con fusión cognitiva (FC) (BxPFC) mediante el examen de la RMN multiparamétrica (RMNmp) de la próstata en un dispositivo móvil cerca del aparato de ecografía transrectal (ETR) y examinamos los resultados.MÉTODOS: Entre enero de 2011 y enero del 2017 se incluyeron en el estudio un total de 344 varones sometidos a BxP. El Grupo 1 hizo una BxP guiada por ecografía transrectal estándar que tenía un mínimo de 12 muestras. El Grupo 2 fue sometido a BxPFC utilizando un dispositivo móvil para evaluar las imágenes de la RMNmp de próstata cerca del aparato de ecografía transrectal. Se tomaron un mínimo de 12 muestras + 1-3 dirigidas de forma cognitiva. Se evaluaron y compararon la detección de CaP y de CaP significativo entre los grupos. También se evaluó el efecto de los hallazgos de la RMNmp de próstata sobre la detección de cáncer de próstata y CaP significativo. RESULTADOS: Los grupos 1 y 2 incluyeron 138 y 206 pacientes respectivamente. Después de la BxP, se detectaron 45(32,8%) pacientes con CaP y 33(23%) con CaP significativo en el grupo 1, y 74(35,9%) y 60(29%) pacientes en el Grupo 2, respectivamente (p=0,001 para ambos). Los valores más altos de PIRADS se asociaron con una detección significativa de CaP y CaP significativo (p=0,004 y 0,002). La presencia de un nódulo en la RMNmp se asocia con una detección significativa de CaP y CaP significativo (p=0,001 y 0,001). Especialmente, cuando el valor del PSA era <10 ng/ml, el PIRADS más alto y existía un nódulo en la RMN mp el diagnóstico de CaP y CaP significativo era significativamente mayor (p=0,02 y 0,019 para PIRADS, y p=0,01 y 0,042 para nódulos). CONCLUSIONES: Con nuestra nueva técnica en manos expertas, la BxP con fusión cognitiva utilizando las imágenes de RMNmp previa parece ser un método efectivo para detectar CaP y CaP significativo.

The cognitive fusion prostate biopsy using a smart phone in the diagnosis of prostate cancer / Biopsia de próstata cognitiva utilizando un dispositivo móvil

OBJECTIVES: In this research, we designed a cognitive fusion(CF) prostate biopsy(PB) (CFPB) technique by examining the multiparametric MRI of prostate (MP_MRI-P) images in a smart-phone near the trans-rectal ultrasound (TRUS) device, and examined the results. METHODS: Between January 2011 and January 2017, a total of 344 men who had PB enrolled in this study. Group 1 had a minimum of a 12-core standard TRUS PB(TRUSPB). Group 2 had CFPB while examining the MP:_MRI-P images in a smartphone near the TRUS device. A minimum 12 cores + cognitive targeted 1-3 biopsy were taken. The detection of Pca and significant Pca in group 1 and 2 were evaluated and compared. Then, the effect of MP_MRI-P findings on the detection of prostate cancer (Pca) and significant Pca were evaluated. RESULTS: Group 1 and 2 included 138 and 06 patients. After the PB, 45(32.8%) and 33(23%) patients ingroup 1, and 74(35.9%) and 60(29%) patients in-group 2 were detected to have Pca and significant Pca, respectively (p = 0.001 for both). Higher PIRADS caused significantdetection of Pca and significant Pca (p = 0.004 and 0.002). Nodule in MP_MRI-P caused significant detection of Pca and significant Pca (p = 0.001 and 0.001). Especially, when PSA was <10ng/ml, higher PIRADS and nodule in MP_MRI-P caused significant detection of Pca and significant Pca (p = 0.02 and 0.019 for PIRADS, and p = 0.01 and 0.042 for nodules). CONCLUSIONS: In the advanced hands with our new technique, the CFPB using prebiopsy MP_MRI-P seems to be an effective method to detect Pca and significant Pca

OBJETIVOS: En este estudio de investigación diseñamos una técnica de biopsia de próstata (BxP) con fusión cognitiva (FC) (BxPFC) mediante el examen de la RMN multiparamétrica (RMNmp) de la próstata en un dispositivo móvil cerca del aparato de ecografía transrectal (ETR) y examinamos los resultados. MÉTODOS: Entre enero de 2011 y enero del 2017 se incluyeron en el estudio un total de 344 varones sometidos a BxP. El Grupo 1 hizo una BxP guiada por ecografía transrectal estándar que tenía un mínimo de 12 muestras. El Grupo 2 fue sometido a BxPFC utilizando un dispositivo móvil para evaluar las imágenes de la RMNmp de próstata cerca del aparato de ecografía transrectal. Se tomaron un mínimo de 12 muestras + 1-3 dirigidas de forma cognitiva. Se evaluaron y compararon la detección de CaP y de CaP significativo entre los grupos. También se evaluó el efecto de los hallazgos de la RMNmp de próstata sobre la detección de cáncer de próstata y CaP significativo. RESULTADOS: Los grupos 1 y 2 incluyeron 138 y 206 pacientes respectivamente. Después de la BxP, se detectaron 45(32,8%) pacientes con CaP y 33(23%) con CaP significativo en el grupo 1, y 74(35,9%) y 60(29%) pacientes en el Grupo 2, respectivamente (p = 0,001 para ambos). Los valores más altos de PIRADS se asociaron con una detección significativa de CaP y CaP significativo (p=0,004 y 0,002). La presencia de un nódulo en la RMNmp se asocia con una detección significativa de CaP y CaP significativo (p = 0,001 y 0,001). Especialmente, cuando el valor del PSA era < 10 ng/ml, el PIRADS más alto y existía un nódulo en la RMN mp el diagnóstico de CaP y CaP significativo era significativamente mayor (p = 0,02 y 0,019 para PIRADS, y p = 0,01 y 0,042 para nódulos). CONCLUSIONES: Con nuestra nueva técnica en manos expertas, la BxP con fusión cognitiva utilizando las imágenes de RMNmp previa parece ser un método efectivo para detectar CaP y CaP significativo

The analgesic efficacy of ultrasound guided unilateral transversus abdominis plane block in the pain management of shock wave lithotripsy. / Eficacia analgésica del bloqueo unilateral del plano del musculo transverso abdominal guiado por ecografía en el manejo del dolor de la litotricia por ondas de choque.

OBJECTIVES: We conducted this study to evaluate the analgesic efficacy of ultrasound guided unilateral transversus abdominis plane (TAP) block when used in combination with oral diclofenac administration during extracorporeal shock wave lithotripsy (SWL). DESIGN AND SETTING: The study is a retrospective clinical experimental study conducted in a university hospital between January 2017 and January 2018. METHODS: 42 SWL eligible patients were divided into three groups. Group 1 (n: 15) received no medication due to patient's preference. Group 2 (n: 15) received 50 mg oral diclofenac 30 minutes prior to the procedure, and Group 3 (n: 12) received both oral diclofenac and unilateral ultrasound (US) guided TAP block 30 minutes before the procedure. Patient`s characteristics, SWL data and "visual analogue pain scale" (VAS) scores were collected and compared between groups. RESULTS: A total of 44 eligible patients were included in the study. When compared between groups, patient's characteristics including age, body mass index, and SWL data including stone size, SWL number, total energy transmitted and duration of the procedure, were similar and there was no statistical significance. Between groups statistical significance was achieved in only VAS scores. Mean VAS scores in groups 1,2, and 3 were 6.3 ± 1.8, 4.3 ± 2.3, and 1.3 ± 1.0, respectively. No complication was seen in any of the groups. CONCLUSION: Pain relief during SWL operations is still a challenging issue for many clinicians. Our study demonstrates that, among many other anesthetic/analgesic agents and techniques described, unilateral US guided TAP block and diclofenac combination is a feasible option for pain relief during SWL procedures.

OBJECTIVO: Llevamos a cabo un estudio para evaluar la eficacia analgésica del bloqueo unilateral del plano del musculo transverso abdominal (TAP) guiado por ecografía utilizado en combinación con la administración oral de diclofenaco durante la litotricia extracorporea por ondas de choque (LEOC).MATERIAL Y MÉTODOS: Estudio clínico experimental retrospectivo llevado a cabo en un hospital universitario entre Enero de 2017 y Enero del 2018. 42 pacientes sometidos a LEOC fueron incluidos. Se dividieron en tres grupos. Grupo 1 (n=15): No recibió medicación debido a las preferencias del paciente. Grupo 2 (n=15): Recibieron 50 mg de diclofenaco oral 30 minutos antes del procedimiento; y Grupo 3 (n=12): recibieron ambos diclofenaco oral y bloqueo unilateral del plano del musculo transverso abdominal guiado por ecografía 30 minutos antes del procedimiento. Se recogieron y compararon entre los grupos las características de los pacientes, los datos de la LEOC y las puntuaciones de la escala visual analógica (EVA). RESULTADOS: Se incluyeron 44 pacientes en el estudio. En la comparación entre grupos, las características del paciente, incluyendo edad e índice de masa corporal, y los datos de la LEOC, incluyendo tamaño de la litiasis, número de ondas de choque, energía total transmitida y duración del procedimiento, fueron similares y no hubo diferencias estadísticamente significativas. En la comparación entre grupos, solo la puntuación de la EVA alcanzó significación estadística. Las puntuaciones medias de la EVA fueron 6,3 ± 1,8, 4,3 ± 2,3 y 1,3 ± 1,0, en los grupos 1, 2 y 3 respectivamente. No hubo complicaciones en ninguno de los grupos. CONCLUSIONES: El alivio del dolor durante las intervenciones de LEOC es todavía un desafío para muchos clínicos. Nuestro estudio demuestra que entre otros agentes anestésicos/analgésicos y técnicas descritas, la combinación de bloqueo unilateral del plano del musculo transverso abdominal (TAP) guiado por ecografía y diclofenaco oral es una opción factible para el alivio del dolor durante la LEOC.

Eficacia analgésica del bloqueo unilateral del plano del musculo transverso abdominal guiado por ecografía en el manejo del dolor de la litotricia por ondas de choque / The analgesic efficacy of ultrasound guided unilateral transversus abdominis plane block in the pain management of shock wave lithotripsy

Objectivo: Llevamos a cabo un estudio para evaluar la eficacia analgésica del bloqueo unilateral del plano del musculo transverso abdominal (TAP) guiado por ecografía utilizado en combinación con la administración oral de diclofenaco durante la litotricia extracorporea por ondas de choque (LEOC). Material y métodos: Estudio clínico experimental retrospectivo llevado a cabo en un hospital universitario entre Enero de 2017 y Enero del 2018. 42 pacientes sometidos a LEOC fueron incluidos. Se dividieron en tres grupos. Grupo 1 (n = 15): No recibió medicación debido a las preferencias del paciente. Grupo 2 (n = 15): Recibieron 50 mg de diclofenaco oral 30 minutos antes del procedimiento; y Grupo 3 (n = 12): recibieron ambos diclofenaco oral y bloqueo unilateral del plano del musculo transverso abdominal guiado por ecografía 30 minutos antes del procedimiento. Se recogieron y compararon entre los grupos las características de los pacientes, los datos de la LEOC y las puntuaciones de la escala visual analógica (EVA). Resultados: Se incluyeron 44 pacientes en el estudio. En la comparación entre grupos, las características del paciente, incluyendo edad e índice de masa corporal, y los datos de la LEOC, incluyendo tamaño de la litiasis, número de ondas de choque, energía total transmitida y duración del procedimiento, fueron similares y no hubo diferencias estadísticamente significativas. En la comparación entre grupos, solo la puntuación de la EVA alcanzó significación estadística. Las puntuaciones medias de la EVA fueron 6,3 ± 1,8, 4,3 ± 2,3 y 1,3 ± 1,0, en los grupos 1, 2 y 3 respectivamente. No hubo complicaciones en ninguno de los grupos. Conclusiones: El alivio del dolor durante las intervenciones de LEOC es todavía un desafío para muchos clínicos. Nuestro estudio demuestra que entre otros agentes anestésicos/analgésicos y técnicas descritas, la combinación de bloqueo unilateral del plano del musculo transverso abdominal (TAP) guiado por ecografía y diclofenaco oral es una opción factible para el alivio del dolor durante la LEOC

Objectives: We conducted this study to evaluate the analgesic efficacy of ultrasound guided unilateral transversus abdominis plane (TAP) block when used in combination with oral diclofenac administration during extracorporeal shock wave lithotripsy (SWL). Design and setting: The study is a retrospective clinical experimental study conducted in a university hospital between January 2017 and January 2018. METHODS: 42 SWL eligible patients were divided into three groups. Group 1 (n: 15) received no medication due to patient’s preference. Group 2 (n: 15) received 50 mg oral diclofenac 30 minutes prior to the procedure, and Group 3 (n: 12) received both oral diclofenac and unilateral ultrasound (US) guided TAP block 30 minutes before the procedure. Patient`s characteristics, SWL data and "visual analogue pain scale" (VAS) scores were collected and compared between groups. Results: A total of 44 eligible patients were included in the study. When compared between groups, patient's characteristics including age, body mass index, and SWL data including stone size, SWL number, total energy transmitted and duration of the procedure, were similar and there was no statistical significance. Between groups statistical significance was achieved in only VAS scores. Mean VAS scores in groups 1,2, and 3 were 6,3 ± 1,8, 4,3 ± 2,3 y 1,3 ± 1,0, respectively. No complication was seen in any of the groups. Conclusion: Pain relief during SWL operations is still a challenging issue for many clinicians. Our study demonstrates that, among many other anesthetic/analgesic agents and techniques described, unilateral US guided TAP block and diclofenac combination is a feasible option for pain relief during SWL procedures

Application of ureteral access sheath under direct visualization: Description of a technique for difficult ureters. / Aplicación de la vaina de acceso ureteral bajo visión directa: Descripción de la técnica en uréteres difíciles.

OBJECTIVES: To introduce a new technique for the placement of ureteral access sheaths (UAS) when there is failure in standard UAS placement. MATERIALS AND METHODS: Between March 2014 and June 2016, a total of 25 patients had difficulty while UAS placement during F-URS procedures. The placement of UAS in these patients was accomplished by utilizing the technique outlined in this study. The causes of difficulty in UAS placement, kinds of UAS deformation, ureteric injuries, and operation time were recorded for all procedures conducted in this study. RESULTS: The pre-operative and post-operative mean stone sizes, Hgb, urea, and creatinine levels were 10.64 (5-19)mm and 1.8 (2-4)mm (p<0.000); 13.9 (10.50-16.73)g/dL and 12.81 (9.4-16.6)g/dL (p = 0.0001); 30.73 (15-48)mg/dL and 28.83 (16- 41)mg/dL (p = 0.067); 1.07 (0.74-1.79)mg/dL and 1.10 (0.77-1.75)mg/dL (p = 0.242), respectively. The causes of difficulty in UAS placement were mainly the failure of insertion at ureteric orifice due to orifice shape and angle (not stenosis) in 18 (72%), narrow ureter in 3 (12%), twisted ureter in 3 (12%) and duplex ureter in 1 (4%) of patients. Angulation deformity with kinking was observed in 10 (40%) of operations. No buckling or kinking due to external force was noted. Providing a smooth insertion force of the F-URS accomplished insertion in patients with angulation deformities without difficulties. Mild mucosal heamorragia was observed in 16 (64%) patients. Mean operation time was 57 minutes and each operation ended with success. CONCLUSIONS: Application of UAS under direct visualization provides a safer UAS placement, makes the F-URS more applicable, and we think this technique decreases the operation time when there is difficulty in UAS placement.

OBJETIVOS: Introducir una nueva técnica de inserción de las vainas de acceso ureteral (VAU) cuando fracasa la inserción estándar. MATERIAL Y MÉTODOS: Entre marzo 2014 y junio 2016 hubo dificultades durante la inserción de la VAU para la ureterorrenoscopia flexible (URS-F) en un total de 25 pacientes. La inserción de la VAU se consiguió utilizando la técnica descrita en este estudio. En todos los casos incluidos en el estudio se registraron las causas de dificultad de inserción de la VAU, tipo de deformación de la vaina, lesiones ureterales y tiempo de operación. RESULTADOS: Los valores pre y postoperatorios de tamaño medio de las litiasis, hemoglobina, urea, y creatinina fueron 10,64 mm (5-19 mm) y 1,8 mm (2-4) (p<0,000); 13,9 g/dL(10,50-16,73) y 12,81 g/dL(9,4-16,6) (p = 0,0001); 30,73 mg/dL(15-48) y 28,83 mg/dL(16- 41) (p = 0,067); 1,07(0,74-1,79) mg/dL y 1,10(0,77- 1,75) mg/dL(p = 0,242), respectivamente. Las causas de dificultad de inserción de la VAU fueron principalmente el fallo de inserción en el orificio ureteral debido a la forma y ángulo del orificio (no estenosis) en 18 pacientes (72%), uréter estrecho en 3 (12%) y duplicación ureteral en uno (4%). Se observó deformidad por angulación y el catéter retorcido en 10 operaciones (40%). No se observó deformidad o retorcimiento por fuerzas externas. Se consiguió una inserción sin dificultad en los pacientes con deformidades por angulación siempre que la fuerza de inserción del ureteroscopio flexible fuera suave. Se apreció una hemorragia mucosa leve en 16 pacientes (64%). El tiempo medio de operación fue de 57 minutos y en todos los casos la operación se terminó con éxito. CONCLUSIONES: La inserción de una VAU bajo visión directa ofrece una colocación más segura, hace la URS-F más aplicable, y nosotros pensamos que esta técnica disminuye el tiempo de operación cuando hay dificultades para la colocación de la VAU.

Application of ureteral access sheath under direct visualization: Description of a technique for difficult ureters / Aplicación de la vaina de acceso ureteral bajo visión directa: Descripción de la técnica en uréteres difíciles

Objectives: To introduce a new technique for the placement of ureteral access sheaths (UAS) when there is failure in standard UAS placement. Materials and methods: Between March 2014 and June 2016, a total of 25 patients had difficulty while UAS placement during F-URS procedures. The placement of UAS in these patients was accomplished by utilizing the technique outlined in this study. The causes of difficulty in UAS placement, kinds of UAS deformation, ureteric injuries, and operation time were recorded for all procedures conducted in this study. Results: The pre-operative and post-operative mean stone sizes, Hgb, urea, and creatinine levels were 10.64 (5-19)mm and 1.8 (2-4)mm (p<0.000); 13.9 (10.50-16.73)g/dL and 12.81 (9.4-16.6)g/dL (p=0.0001); 30.73 (15-48)mg/dL and 28.83 (16-41)mg/dL (p=0.067); 1.07 (0.74-1.79)mg/dL and 1.10 (0.77-1.75)mg/dL (p=0.242), respectively. The causes of difficulty in UAS placement were mainly the failure of insertion at ureteric orifice due to orifice shape and angle (not stenosis) in 18 (72%), narrow ureter in 3 (12%), twisted ureter in 3 (12%) and duplex ureter in 1 (4%) of patients. Angulation deformity with kinking was observed in 10 (40%) of operations. No buckling or kinking due to external force was noted. Providing a smooth insertion force of the F-URS accomplished insertion in patients with angulation deformities without difficulties. Mild mucosal heamorragia was observed in 16 (64%) patients. Mean operation time was 57 minutes and each operation ended with success. Conclusions: Application of UAS under direct visualization provides a safer UAS placement, makes the F-URS more applicable, and we think this technique decreases the operation time when there is difficulty in UAS placement

Objetivos: Introducir una nueva técnica de inserción de las vainas de acceso ureteral (VAU) cuando fracasa la inserción estándar. Material y métodos: Entre marzo 2014 y junio 2016 hubo dificultades durante la inserción de la VAU para la ureterorrenoscopia flexible (URS-F) en un total de 25 pacientes. La inserción de la VAU se consiguió utilizando la técnica descrita en este estudio. En todos los casos incluidos en el estudio se registraron las causas de dificultad de inserción de la VAU, tipo de deformación de la vaina, lesiones ureterales y tiempo de operación. Resultados: Los valores pre y postoperatorios de tamaño medio de las litiasis, hemoglobina, urea, y creatinina fueron 10,64 mm (5-19 mm) y 1,8 mm (2-4) (p<0,000); 13,9 g/dL(10,50-16,73) y 12,81 g/dL(9,4-16,6) (p = 0,0001); 30,73 mg/dL(15-48) y 28,83 mg/dL(16- 41) (p = 0,067); 1,07(0,74-1,79) mg/dL y 1,10(0,77- 1,75) mg/dL(p = 0,242), respectivamente. Las causas de dificultad de inserción de la VAU fueron principalmente el fallo de inserción en el orificio ureteral debido a la forma y ángulo del orificio (no estenosis) en 18 pacientes (72%), uréter estrecho en 3 (12%) y duplicación ureteral en uno (4%). Se observó deformidad por angulación y el catéter retorcido en 10 operaciones (40%). No se observó deformidad o retorcimiento por fuerzas externas. Se consiguió una inserción sin dificultad en los pacientes con deformidades por angulación siempre que la fuerza de inserción del ureteroscopio flexible fuera suave. Se apreció una hemorragia mucosa leve en 16 pacientes (64%). El tiempo medio de operación fue de 57 minutos y en todos los casos la operación se terminó con éxito. Conclusiones: La inserción de una VAU bajo visión directa ofrece una colocación más segura, hace la URS-F más aplicable, y nosotros pensamos que esta técnica disminuye el tiempo de operación cuando hay dificultades para la colocación de la VAU

Three Distraction Methods for Pain Reduction During Cystoscopy: A Randomized Controlled Trial Evaluating the Effects on Pain, Anxiety, and Satisfaction.

BACKGROUND: Cystoscopy is a safe diagnostic procedure commonly used to evaluate lower urinary tract symptoms. This can cause pain, anxiety, and dissatisfaction in patients undergoing cystoscopy. OBJECTIVES: The aim of this study was to compare the effects on pain, anxiety, and satisfaction of distraction methods used during cystoscopy. DESIGN: Single-center, open-label, randomized, parallel-group trial. SETTING: Cystoscopy unit of a training and research hospital in Turkey. PARTICIPANTS: Male patients ≥18 years of age who underwent rigid cystoscopy for the first time. METHODS: A total of 120 male patients were recruited and randomized into four groups as music, stress ball, video, and control group. Data were collected using visual analog scale for pain and satisfaction, State-Trait Anxiety Inventory for anxiety, and hemodynamic parameters. The primary outcome was the difference with respect to pain scores among intervention groups. Other outcome measures were anxiety and satisfaction scores. RESULTS: Pain severity during cystoscopy was found to be significantly lower in the intervention groups than the control group. In the video group, the severity of pain during cystoscopy was also found to be significantly lower than music and stress ball groups (p = 0.006, p < 0.001). After cystoscopy, anxiety levels were significantly lower and satisfaction levels were significantly higher in the intervention groups than in the control group. Anxiety levels were significantly lower in the video group than music and stress ball groups (p < 0.001, p < 0.001). Satisfaction levels were also significantly higher after cystoscopy in the video group than in the music and stress ball groups (p = 0.018, p = 0.018). CONCLUSIONS: According to this study, distraction methods used during rigid cystoscopy were found to have a reducing effect on pain, anxiety, and dissatisfaction. As the results of the study are evaluated, video should be recommended to be the first preferred distraction method during rigid cystoscopy.

Quistes gigantes en la poliquistosis renal. Un indicador poco frecuente de nefrectomía / Giant polycystic kidney. A rare indication for nephrectomy

A 49-year-old male patient was diagnosed with ADPKD while the evaluation of urinary tract infection in 2010. He was suffering from nutritional problems due to gastro-intestinal disturbances and vomiting secondary to the pressure of the kidneys. He was also a candidate for kidney transplantation, but there was no adequate and enough space in the abdomen for the transplant kidney. Therefore, we performed open unilateral nephrectomy to the bigger kidney. As we now there is not too many cases regarding giant polycystic kidney nephrectomy, we presented our case to make additional contribution to the current literature

Se diagnosticó poliquistosis renal autosómica dominante a un paciente masculino de 49 años durante la evaluación de un cuadro de infección urinaria en 2010. El paciente padecía problemas nutricionales debido a trastornos gastrointestinales y vómitos causados por la presión de los riñones. Asimismo, era candidato a trasplante renal, pero el espacio del abdomen no era adecuado ni suficiente para realizar este procedimiento. Por lo tanto se realizó una nefrectomía unilateral, en el riñón de mayor tamaño. Debido a que no se conocen muchos casos de nefrectomía en pacientes con poliquistosis renal con quistes gigantes, presentamos este para realizar un aporte a la bibliografía existente