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1.
Aging Male ; : 1-7, 2020 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-32401117

RESUMO

Introduction: The aim of this study was to evaluate consistency between clinical lymph node positivity and pathological lymph node positivity in patients undergoing open radical cystectomy and pelvic lymph node dissection due to bladder cancer.Material and method: A total of 135 patients who had open radical cystectomy, extended lymph node dissection, and clear preoperative contrast-enhanced abdominopelvic computed tomography (CT) or magnetic resonance imaging (MRI) images were included in the study. Positive clinical lymph nodes and positive pathological lymph nodeswere recorded. The largest positive clinical and pathological lymph nodeswere recorded. In terms of clinical lymph node involvement, compatibility between radiological findings and pathological results was evaluated.Results: In the CT group, the sensitivity was 25.81%, specificity was 95.45%, positive predictive value (PPV) was 66.67%, negative predictive value (NPV) was 78.50%, and accuracy was 77.31%. In the MRI group, the sensitivity was 50.00%, specificity was 100%, PPV was 100%, NPV was 76.92%, and accuracy was 81.25%. For consistency between pathological lymph nodes and clinical lymph nodes according to the imaging type, there was no statistically significant difference in the sensitivity, specificity, NPV, and accuracy rates between the imaging techniques (p > 0.05). However, the PPV was significantly higher in the MRI group than the CT group (100% vs.66.67%, respectively; p = 0.014).Conclusion: Positive lymph nodes play a critical role in the prognosis of patients with bladder cancer and the sensitivity of contrast-enhanced abdominopelvic CT and MRI used routinely in clinical practice is low in lymph node detection. MRI seems more reliable than CT in lymph node detection.

2.
Andrologia ; : e13589, 2020 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-32271471

RESUMO

Anogenital distance (AGD) is the length between the genitals and anus which shows an androgenic activity in the evolution of the reproductive system in the uterine life. For prostatic evolution and development during the embryological stage, androgen exposure is required. In this study, we aimed to investigate the relationship between AGD and benign prostate hyperplasia (BPH)-related lower urinary tract symptoms (LUTS). A total of 70 patients who were admitted to our urology clinics with LUTS due to BPH (LUTS group) and 70 patients without LUTS (control group) were included. All patients were administered an International Prostate Symptom Score form. Data including height, weight, body mass index, total prostate-specific antigen, prostate volume and uroflowmetry Qmax values of all patients were evaluated. The AGD of the LUTS and control groups was measured. The mean AGDAS values of the LUTS group were significantly lower than the control group (p = .013). There was no statistically significant difference between the two groups in terms of the mean adjusted AGDAP values (p = .241). However, the mean adjusted AGDAS values were significantly lower in the LUTS group than the control group (p = .002). Our study results suggest that AGD may be a useful marker in BPH-related LUTS.

3.
Arch. esp. urol. (Ed. impr.) ; 73(1): 54-59, ene.-feb. 2020. ^f54^l59, tab
Artigo em Inglês | IBECS-Express | ID: ibc-ET2-5693

RESUMO

OBJECTIVES: The double-J (DJ) stents are commonly used to relieve the ureteral obstruction. Besides several known benefits, some of the patients encounter stent-related morbidities with considerable effects on the quality of life, general health situation, sexual matters, and daily work performance. In this study, we evaluated the effectiveness of tamsulosin/solifenacin combination and mirabegron in reducing DJ stent-related symptoms. MATERIALS AND METHODS: A total of 120 patients with 28cm 4.7fr DJ catheter inserted due to ureteral obstruction were included in this study. Patients were randomly divided into three groups of 40 each; group one received only oral hydration for six weeks; group two received 0.4 mg tamsulosin/10 mg solifenacin, and group three received 50 mg mirabegron. Preoperative and after 6 weeks, the VAPS, OAB-q index, and IPSSs forms were filled. RESULTS: The mean age of the patients was 41.60 ± 12.34 years. There was no significant difference between the groups in terms of preoperative and postoperative VAPS values (p>0.05). There was a significant difference in postop IPSSs values (p:0.001). It was higher in the hydration group than tamsulosin/solifenacin and mirabegron groups. Postoperative IPSS value of the hydration group was 21.78 ± 2.54 while the tamsulosin/ solifenacin and mirabegron groups were 15.6 ± 4.37 and 13.65 ± 4.97, respectively. The use of mirabegron and tamsulosin/solifenacin combination alleviates the LUTSs related with DJ stent. There was also a significant difference between groups in terms of postoperative OAB-q values (p:0.001). Postoperative OAB-q values in the tamsulosin/solifenacin group were significantly higher than the mirabegron group. Postoperative OAB-q value of the hydration group was 29.95 ± 5.21, while the tamsulosin/solifenacin and mirabegron groups were 23.68 ± 4.07 and 18.15 ± 4.1, respectively. Our results also showed that, as a beta-3 adrenergic receptor agonist, mirabegron can improve the OAB-q scores. CONCLUSION: Tamsulosin and solifenacin combination is a significantly good treatment option for reducing LUTS associated with DJ stents. Mirabegron single therapy showed good results in treating LUTS and better results in treating OAB symptoms related with DJ stents than other therapies


OBJETIVO: El catéter doble J se utiliza para desobstruir el uréter. A parte de los ya conocidos beneficios, algunos pacientes tienen efectos adversos derivados de llevar el catéter que empeoran su calidad de vida, su vida sexual, sus actividades laborales. En este estudio, evaluamos la efectividad de la tamsulosina/solifenacina en combinación y mirabegron en reducir estos síntomas. MATERIAL Y MÉTODOS: Un total de 120 pacientes con cateteres de 28 cm/4.7 Ch fueron incluidos en el estudio. Los pacientes se randomizaron en 3 grupos, 40 en cada grupo (un grupo recibio hidratación oral durante 6 semanas, otro grupo tamsulosina 0,4 mg/10 mg solifenacina y el tercero 50 mg mirabegron). VAPS, OAB q index y IPSS cuestionarios se rellenaron en el preoperatorio y a las 6 semanas de tratamiento. RESULTADOS: La mediana de edad fue de 41ª. No había diferencias significativas en los grupos en términos de valores VAPS preoperatorios y postoperatorios. Se evidenció una diferencia significativa en los valores IPSS (p = 0,001), ya que fue más elevado en el grupo de hidratación oral que el grupo de tamsulosina/solifenacina y mirabegron. El valor postoperatorio de IPSS en el grupo de hidratación fue de 22, mientras que en la tamsulosina y mirabegron fue de 15 y 13, respectivamente. El uso de mirabegron y tamsulosina mejora los síntomas tracto urinario inferior por el catéter. También se evidencio una diferencia significativa entre los grupos en términos de OAB-q (p = 0,001). Los valores postoperatorios OAB-q en el grupo tamsulosina fueron más altos que en el grupo mirabegron. El valor OAB-q postoperatorio en el grupo de hidratación oral fue de 29, tamsulosina 23 y mirabegron 18, respectivamente. Nuestros resultados también demuestran que mirabegron puede mejorar los resultados de OAB-q. CONCLUSIONES: Tamsulosina/solifenacina es un buen tratamiento para mejorar los STUI asociados a catéteres. Mirabegon demuestra también buenos resultados en el tratamiento de los síntomas de vejiga hiperactiva relacionados en el catéter mejor que otras terapias

4.
Int Urol Nephrol ; 52(5): 821-828, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31955364

RESUMO

PURPOSE: To evaluate the ability of thiol-disulphide homeostasis to predict renal injury in ureteral obstruction by matching renal scintigraphy and pathological findings in an experimental rat model. METHODS: 24 rats were randomized and divided into 3 groups as sham, partial and complete. Blood samples for biochemical evaluations and dimercaptosuccinic acid (DMSA) renal scintigraphy were performed at the beginning and on the 7th day postoperatively. Only a midline abdominal incision was done in sham group. Left ureter of partial group was dissected and gently buried into the psoas muscle. In complete group, left ureter was dissected and ligated. RESULTS: Statistically significant association was found between left kidney function loss percentage, native thiol, total thiol and creatinine alterations and pathological EGTI (Endothelial, Glomerular, Tubular, Interstitial) scores (r = - 0.867, r = - 0.815, r = 0.745, r = - 0.911; p = 0.000). Statistically significant difference was detected between groups in terms of postoperative native thiol and total thiol values (p = 0.000, p = 0.001). There was also a significant difference in preoperative and postoperative comparisons of these parameters in partial and complete obstruction groups (p = 0.012, p = 0.018). There was a significant difference in terms of postoperative disulphide/native thiol and native thiol/total thiol ratios in complete obstruction group compared to other groups (p1 = 0.011, p2 = 0.040; p1 = 0.015, p2 = 0.028). CONCLUSIONS: Association with scintigraphic and pathological results empowers the value of this parameter. Disulphide/native thiol and native thiol/total thiol ratios indicate complete obstruction. These findings may shed light to more comprehensive studies.

5.
J Coll Physicians Surg Pak ; 30(1): 94-95, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31931942

RESUMO

Lymphedema is defined as an abnormal accumulation of extracellular fluid in the subcutaneous compartment caused by impaired lymphatic drainage. Scrotal lymphedema is a rare condition characterised by swelling of the scrotal skin due to deterioration in lymphatic drainage. Over time, fibrosis may develop in the scrotum and genital malformations that impair the patient's quality of life. Here, we present the first case in our experience of scrotal lymphedema, which occurred in a 3-year child following circumcision, and subsequently was treated successfully with complex decongestive physiotherapy.

6.
Arch Esp Urol ; 73(1): 54-59, 2020 Jan.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31950924

RESUMO

 OBJECTIVES: The double-J (DJ) stents are commonly used to relieve the ureteral obstruction. Besides several known benefits, some of the patients encounter stent-related morbidities with considerable effects on the quality of life, general health situation, sexual matters, and daily work performance. In this study, we evaluated the effectiveness of tamsulosin/solifenacin combination and mirabegron in reducing DJ stent-related symptoms. MATERIALS AND METHODS: A total of 120 patients with 28cm 4.7fr DJ catheter inserted due to ureteral obstruction were included in this study. Patients were randomly divided into three groups of 40 each; group one received only oral hydration for six weeks; group two received 0.4 mg tamsulosin/10 mg solifenacin, and group three received 50 mg mirabegron. Preoperative and after 6 weeks, the VAPS, OAB-q index, and IPSSs forms were filled. RESULTS: The mean age of the patients was 41.60 ± 12.34 years. There was no significant difference between the groups in terms of preoperative and postoperative VAPS values (p>0.05). There was a significant difference in postop IPSSs values (p:0.001). It was higher in the hydration group than tamsulosin/solifenacin and mirabegron groups. Postoperative IPSS value of the hydration group was 21.78 ± 2.54 while the tamsulosin/ solifenacin and mirabegron groups were 15.6 ± 4.37 and 13.65 ± 4.97, respectively. The use of mirabegron and tamsulosin/solifenacin combination alleviates the LUTSs related with DJ stent. There was also a significant difference between groups in terms of postoperative OAB-q values (p:0.001). Postoperative OAB-q values in the tamsulosin/solifenacin group were significantly higher than the mirabegron group. Postoperative OAB-q value of the hydration group was 29.95 ± 5.21, while the tamsulosin/solifenacin and mirabegron groups were 23.68 ± 4.07 and 18.15 ± 4.1, respectively. Our results also showed that, as a beta-3 adrenergic receptor agonist, mirabegron can improve the OAB-q scores. CONCLUSION: Tamsulosin and solifenacin combination is a significantly good treatment option for reducing LUTS associated with DJ stents. Mirabegron single therapy showed good results in treating LUTS and better results in treating OAB symptoms related with DJ stents than other therapies.


Assuntos
Acetanilidas , Succinato de Solifenacina , Tansulosina , Tiazóis , Bexiga Urinária Hiperativa , Cateteres Urinários , Agentes Urológicos , Acetanilidas/uso terapêutico , Adulto , Quimioterapia Combinada , Humanos , Pessoa de Meia-Idade , Qualidade de Vida , Succinato de Solifenacina/uso terapêutico , Tansulosina/uso terapêutico , Tiazóis/uso terapêutico , Resultado do Tratamento , Bexiga Urinária Hiperativa/tratamento farmacológico , Agentes Urológicos/uso terapêutico
7.
Andrologia ; 52(2): e13471, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31691325

RESUMO

Our aim was to measure the ability of ischaemia-modified albumin (IMA) to predict testicular histopathological damage in the testes of rats with short- and long-term ischaemia using experimental testicular torsion and subsequent reperfusion via detorsion.21 Wistar Albino rats were randomized into three groups. The sham group was subjected to a mid-scrotal incision only. The 4- and 8-hr T/D (Torsion/Detorsion) groups were subjected to left testicular torsion by twisting the testes by 720 degrees counterclockwise. 2 cc venous blood samples were taken from the sham group after the mid-scrotal incision, and from the 4- and 8-hr T/D groups after 4 and 8 hr respectively. After that, the 4- and 8-hr T/D groups were subjected to detorsion. Two days later, orchiectomy was performed. Ischaemia-modified albumin levels were significantly different among the groups at 48 hr prior to orchiectomy (reperfusion; p = .003). Based on the results of the paired comparisons, it was found that IMA levels of the sham group were significantly higher than those of the 4- and 8-hr T/D groups (p = .002 and .009 respectively). Our study has showed that IMA may be used to predict ischaemia/reperfusion injury, which is another complication that may occur following detorsion in testicular torsion.

8.
Rev. Assoc. Med. Bras. (1992) ; 65(12): 1448-1453, Dec. 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1057092

RESUMO

SUMMARY INTRODUCTION Due to spongiofibrosis and inflammatory processes underlying the pathogenesis of urethral stricture, it is possible that the neutrophil-lymphocyte ratio (NLR) may give essential information about the course of the disease and recurrence possibilities. Our study aims to evaluate the correlation between NLR and recurrence rates. METHODS A total of 512 patients who underwent direct visual internal urethrotomy (DVIU) due to urethral stricture in our clinic between February 2010 and January 2018 were evaluated retrospectively. RESULTS The median follow up for non-recurrent and recurrent groups after DVIU was 30 and 36 months, respectively. During the follow-up, 280 (54.7%) of the patients had recurrences, and 232 (45,3%) had no recurrences. The mean time for recurrence after DVIU was 6,5±1,4 months, with a range of 1-36 months. The mean NLR in the non-recurrence group was 2,02±0,87, with a median of 1.9, and 3,66±2,30, with a median of 3 in the recurrence group. A highly significant statistical difference was observed between two groups in terms of neutrophil count and NLR (p: 0.000 - both). The area under curve value for NLR was 0.767, with a standard error of 0.021 (95% CI 0.727-0.808). The cut-off value of NLR was determined as 2.25, with a 70% sensitivity and 67,7% specificity. CONCLUSION By using NLR, the inflammatory features of the urethral tissue can be predicted, and possible recurrences after surgery can be estimated. Consequently, open urethroplasty techniques can be used in cases with a significant NLR value instead of the recurrent endoscopic procedure.


RESUMO INTRODUÇÃO Devido à espongiofibrose e processos inflamatórios subjacentes à patogênese da estenose uretral, pode-se pensar que a relação de linfócitos neutrofílicos (NLR) pode fornecer informações essenciais sobre o curso da doença e as possibilidades de recorrência. O objetivo do nosso estudo é avaliar a correlação entre NLR e taxas de recorrência. MÉTODOS Quinhentos e doze pacientes submetidos à uretrotomia interna visual direta (DVIU) devido à estenose uretral em nossa clínica entre as datas de fevereiro de 2010 e janeiro de 2018 foram avaliados retrospectivamente. RESULTADOS A mediana de acompanhamento para os grupos não recorrentes e recorrentes após a DVIU foi de 30 e 36 meses, respectivamente. Durante o seguimento, 280 (54,7%) dos pacientes tiveram recidivas e 232 (45,3%) não tiveram recidivas. O tempo médio de recorrência após a DVIU foi de 6,5±1,4 mês, com variação de 1-36 meses. A média da RNL no grupo sem recorrência foi de 2,02±0,87 com mediana de 1,9 e 3,66±2,30 com mediana de 3 no grupo com recidiva. Uma diferença estatística altamente significativa foi observada entre dois grupos em termos de contagem de neutrófilos e NLR (p: 0,000 - ambos). A área sob o valor da curva para NLR foi de 0,767 com um erro padrão de 0,021 (IC 95% 0,727-0,808). Valor de corte de NLR determinado como 2,25 com uma sensibilidade de 70%, especificidade de 67,7%. CONCLUSÃO Ao utilizar a RNL, as características inflamatórias do tecido uretral podem ser previstas e possíveis recidivas após a cirurgia podem ser estimadas. Dessa forma, técnicas de uretroplastia aberta podem ser usadas em casos com valor significativo de NLR em vez de procedimento endoscópico recorrente.

9.
Cureus ; 11(8): e5496, 2019 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-31667032

RESUMO

Introduction The aim of this study was to present our results regarding the feasibility and possible complications of 4.5 Fr semi-rigid ureterorenoscopy (URS) treatments in pediatric patients. Methods The files and computer records of a total of 33 pediatric patients (20 males and 13 females), who underwent URS procedures for ureteral stones > 5 mm between January 2013 and June 2017, were retrospectively reviewed. A 4.5 Fr semi-rigid ureteroscope (Ultrathin 4.5/6.5 Fr Ureterorenoscope; Richard Wolf GmbH, Knittlingen, Germany) was used for the URS procedures. For the stone-free rate evaluations, abdominopelvic ultrasound or direct radiography scans were performed one week after the surgery, and low-dose non-contrast computed tomography (CT) was performed during the first month. Results The mean age of the patients was 9.8 ± 2.8 (range 4-16) years old, and the mean ureteral stone size was 8.9 ± 1.4 (range 6-13) mm. The mean surgical duration was 45 ± 21.2 (range 30-75) minutes, and the mean hospital stay length was 1.2 (range 1-4) days. Minor complications occurred in five (15.1%) of the patients. The success rates for the first week and first month were 90.9% and 96.9%, respectively. Conclusion The endoscopic management of pediatric ureteral stones using a 4.5 Fr ureteroscope seems to be a safe and feasible treatment option with high success and low complication rates.

10.
Aging Male ; : 1-6, 2019 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-31615318

RESUMO

Objectives: The management of chronic pelvic pain syndrome (CPPS) is controversial because of the unclear pathogenesis of this disease. In one theory, prostatitis has been proposed to be associated with pelvic venous diseases such as varicocele and hemorrhoids, dilatation of the Santorini plexus. In this study, we investigated the effect of micronized flavonoid fraction (an agent used in venous insufficiency) in the treatment of type III CPPS. Methods: Patients diagnosed with type III chronic prostatitis were randomized and divided into 3 groups. Group 1 consisted of patients using antibiotics + anti-inflammatory + alpha-blocker (n = 47), Group 2 consisted of patients using antibiotics + anti-inflammatory + purified micronized flavonoid fraction (n = 45), and Group 3 consisted of patients using only purified micronized flavonoid fraction (n = 35). Results: The mean age of the patients was 32.93 ± 4.70 (range; 23-44) years. There was a statistically significant difference between the groups in terms of the 6th month NIH-CPSI (National Institute of Health Chronic Prostatitis Symptom Index) total scores (p = .000). Also, it was found that NIH-CPSI total scores at month 12 in Group 3 were significantly higher than those in Group 1 and 2 (p1 = .000, p2 = .002). NIH-CPSI total scores at month 12 in Group 2 were significantly higher than those in Group 1 (p = .000). Conclusion: The use of purified micronized flavonoid will decrease prostatic inflammation occurring due to increased perineal venous return.it can also be preferred as part of multimodal therapy because of its profile with relatively less side effects and being more affordable compared with alpha-blockers.

11.
Arch Ital Urol Androl ; 91(3)2019 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-31577097

RESUMO

OBJECTIVES: Anogenital distance (AGD), the distance from the sexual organs to the anus, is a sexually dimorphic feature in mammals. In this study, we investigated the relationship between anogenital distance and prostate cancer (PCa). METHODS: 52 patients diagnosed with PCa and 60 patients with benign prostate hyperplasia as a control group were included in the study. AGDAP (cephalad insertion of the penis to the center of the anus) and AGDAS (posterior base (first fold) of the scrotum to the center of the anus) measurements of patients were done and noted before biopsy. RESULTS: The mean ages of 52 patients diagnosed with PCa and 60 patients with benign prostatic hyperplasia (BPH) were 67.70 ± 7.74 and 67.03 ± 7.89, respectively. There was no statistically significant difference in terms of age and serum testosterone levels of the patients diagnosed with prostate cancer or BPH (p > 0.05). Mean PSA values of patients diagnosed with prostate cancer wto be statistically higher than patients with BPH (p = 0.000). The mean AGDAP measurements of patients diagnosed with prostate cancer were statistically higher than those diagnosed with BPH (p = 0.000) and there was no significant difference in AGDAS measurements.(p = 0.823; p > 0.05). CONCLUSIONS: Androgen exposure is thought to play a role in the development PCa. Also AGD may be an indicator of prenatal androgen activity. In our study, we found a direct correlation between AGDAP and PCa. In order to reach a definitive conclusion, randomized controlled trials with larger sample number are needed.


Assuntos
Canal Anal/anatomia & histologia , Genitália Masculina/anatomia & histologia , Neoplasias da Próstata/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Pesos e Medidas Corporais , Humanos , Masculino , Pessoa de Meia-Idade
12.
North Clin Istanb ; 6(3): 317-319, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31650124

RESUMO

The first urological international organization occurred in Paris in 1908, and three Ottoman urologists were present among a total of 29. In that year, the Ottoman Urological society had only nine urologists, and almost all were from the Ottoman minorities with the exception of two under the main branch of General Surgery. Among them, Cemil Pasha who was the first dean and department chief of Surgery and Urology of the Medical School in a modern manner (1909) was the most dominant pioneer of the Turkish Surgery-Urology. Four beds out of 20 were separated for the urology clinic.

13.
Arch Ital Urol Androl ; 91(2)2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31266274

RESUMO

OBJECTIVE: Testicular cancers, which are less common than other cancers, are important in terms of being seen in young people. Physical examination, imaging, laboratory and tumor markers are used for diagnosis. There are some studies of some blood parameters that can be involved in inflammation and tumorogenesis. We retrospectively compared hematological values measured in our patients who were diagnosed with testicular tumor in comparison with patients with similar age group who underwent varicocelectomy repair. MATERIALS AND METHODS: This cross-sectional retrospective study included 120 patients who underwent radical inguinal orchiectomy for testicular tumor between January 2010 and December 2018, and 171 patients who underwent varicocelectomy as a control group. Patients with an active infection and hematological disorders were excluded from the study. We evaulated hematological parameters including neutrophil (NEU), lymphocyte (LYM), platelet (PLT) count, and mean platelet volume. The study was conducted on 291 patients. divided in two groups: tumor (n = 120) and varicocele (n = 171). RESULTS: There was no statistically significant difference between the groups in terms of PLT / lymphocyte ratio and mean platelet volume (MPV) levels (p > 0.05). The neutrophil /lymphocyte ratio (NLR) of the tumor group was significantly higher than the varicocele group (p = 0.001; p < 0.05). There was a statistically significant difference between the tumor stages in terms of PLT / Lymphocyte ratios (p = 0.006; p < 0.05). CONCLUSIONS: There was only a statistically significant increase in NLR values in the testicular tumor group compared to the varicocele group. Larger, randomized controlled studies are needed at this field.


Assuntos
Linfócitos/metabolismo , Neutrófilos/metabolismo , Neoplasias Testiculares/diagnóstico , Varicocele/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/metabolismo , Criança , Pré-Escolar , Estudos Transversais , Humanos , Lactente , Masculino , Volume Plaquetário Médio , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Neoplasias Testiculares/sangue , Varicocele/sangue , Adulto Jovem
14.
Aging Male ; : 1-3, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31156005

RESUMO

Urogenital cancers are frequently encountered in daily practice. Prostate cancer is the second most common type in adult males, and 2-3% of all adult cancers are renal cell carcinoma. Kaposi's sarcoma originates from vascular endothelial cells and is the most common type of sarcoma observed in HIV-positive patients. However, the development of all these types of cancer in a patient without immunodeficiency is very rare. Incidence of urological malignancies increase with aging. In contrast to normal population, patient who have one urological malignancy have increased risk of getting another urological malignancy in a follow-up. So follow-up of this kind of patients is crucial and needs to be done carefully. In this case report, we aimed to discuss a 68-year-old patient who was diagnosed with concurrent prostate and kidney cancer and developed penile Kaposi's sarcoma in follow-up.

15.
Aging Male ; : 1-5, 2019 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-31072170

RESUMO

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.

16.
Andrologia ; 51(7): e13295, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30995702

RESUMO

Artificial urinary sphincter (AUS) implantation is the gold standard treatment in total stress urinary incontinence (SIU). Our aim is to evaluate the effect of AUS implantation on erectile function and sexual satisfaction (SS). Fourteen patients aged 58-73 years (mean: 66.92 ± 4.51 years) who underwent AUS implantation by a perineal approach between May 2015 and April 2018 were included in our study. Patients with neurogenic disease or very low or no erectile function and those who underwent non-nerve-sparing radical prostatectomy were excluded. Erectile function and intercourse satisfaction were evaluated pre-operatively and post-operatively at 6-month follow-up using international index of erectile function (IIEF) questionnaires. After AUS implantation; eight patients were totally dry, four achieved social continence (less than one pad/day), and two still had SUI (two or more pads/day). Mean pre- and post-operative IIEF values of the patients were 16.14 ± 3.18 and 17.42 ± 4.43 respectively. Mean pre- and post-operative SS values were 8.57 ± 1.78 and 8.71 ± 2.19 respectively. There was no statistically significant difference between pre- and post-operative IIEF-5 and intercourse satisfaction scores (p > 0.05). Although we did not see a significant effect of AUS implantation in our study, in SIU patients, coital incontinence or unpleasant odour during intercourse can lead to sexual avoidance and reduced SS, and AUS implantation may improve SS.


Assuntos
Orgasmo/fisiologia , Ereção Peniana/fisiologia , Implantação de Prótese , Incontinência Urinária por Estresse/cirurgia , Esfíncter Urinário Artificial , Idoso , Disfunção Erétil/etiologia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Prostatectomia/efeitos adversos , Resultado do Tratamento , Incontinência Urinária por Estresse/etiologia
17.
Aging Male ; : 1-5, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31033371

RESUMO

AIM: To investigate the accuracy of Briganti nomogram in patients who underwent Pelvic lymph node dissection (PLND). METHODS: Hundred and sixty-five patients who underwent radical prostatectomy and PLND between 2012 and 2018 in our clinics were included, and their data were retrospectively screened. RESULTS: The mean age of patients was 63.6 ± 5.8 (range: 49-76) years. Hundred and thirty-five (81.8%) patients had a Briganti score of <5, whereas 30 (18.2%) had a Briganti score of ≥5. The preoperative T-PSA levels, biopsy grades and the incidence of T2b and T2c stages in patients with a Briganti score of ≥5 was significantly higher than that in patients with a Briganti score of <5 (p: .026; p: .000; p: .001, respectively). The incidence of lymph node positivity in patients with a Briganti score of ≥5 (76.7%) was significantly higher than that in patients with a Briganti score of <5 (25.2%) (p: .000). The sensitivity of the Briganti score to detect lymph node positivity was 40.35%, specificity was 93.52%, positive predictive value was 76.67% and the negative predictive value was 74.81%. The accuracy of the test was 75.15%. CONCLUSION: Nomograms provide useful information regarding prostate cancer. Risk estimates should be carefully considered, and treatment decisions should be given with a patient-specific approach.

19.
Int. braz. j. urol ; 45(2): 369-375, Mar.-Apr. 2019. tab
Artigo em Inglês | LILACS-Express | ID: biblio-1002201

RESUMO

ABSTRACT Objective: The pathophysiology of urethral stricture and its recurrence remains vague and one of the important causes is progressive inflammation. It has been shown in recent years that the neutrophil / lymphocyte ratio is a marker of systemic inflammation and is associated with prognosis in many cardiovascular diseases, malignancies and chronic inflammatory diseases. We assessed simple systemic inflammation markers preoperatively and surgical techniques for urethral stricture recurrence after urethroplasty. Patients and Methods: After exclusion criteria applied, a total of 117 male cases operated with urethroplasty in our clinic between January 2012 and June 2017 were included in the study and analyzed retrospectively. Localization and length of the strictures of the patients, neutrophil counts and percentages, lymphocyte counts and percentages, and neutrophil / lymphocyte ratios in preoperative peripheral blood samples were statistically analyzed. Recurrent stricture during first 12 months follow-up after the surgery has been assessed as recurrence. Results: The mean age of the patients was 54.12 ± 16.35 and the mean urethral stricture length was 3.44 ± 1.83 cm. Recurrence was observed in 30.1% of cases who received buccal graft, 30% in penile skin applied cases and 26.1% of cases treated with end-to-end anastomosis and there was no statistically significant difference between neutrophil, lymphocyte, neutrophil / lymphocyte ratio and average stricture segment length between recurrent and non-recurrent cases (p > 0.005). Conclusions: We consider that neutrophil, lymphocyte counts and their ratio prior to urethroplasty and the technique performed are not parameters that can be used to predict stricture recurrence. Prospective and randomized new trials with larger patient populations are needed to make more accurate judgments about the role of these inflammatory parameters.

20.
Turk J Urol ; 45(5): 345-350, 2019 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-30817278

RESUMO

OBJECTIVE: Renal cell carcinoma (RCC) is a tumor that has a tendency of vascular invasion by extending to the inferior vena cava (IVC) after the renal vein. The total resection of the renal tumor and tumor thrombus is considered the optimal treatment. In our study, we aimed to present the results related to 34 consecutive cases of RCC with tumor thrombus. MATERIAL AND METHODS: Of the 442 patients diagnosed with renal tumors between January 2008 and January 2018, 34 (7.6%) had tumor thrombus over the renal vein extending to the IVC. The data of the 34 patients with tumor thrombus were retrospectively reviewed and included in the study. All the 34 patients underwent radical nephrectomy with tumor thrombectomy. The presence of thrombus was evaluated using contrast-enhanced abdominal tomography, magnetic resonance imaging, or color Doppler ultrasonography. The level of thrombus was classified using the Mayo Clinic tumor thrombus classification. Surgery was performed transperitoneally through a modified Chevron incision and mostly in collaboration with other clinics. Complications were classified according to the Clavien system. RESULTS: Of the 34 patients, 22 were males and 12 were females. The mean follow-up period was 36±27.2 months in patients who had a mean age of 61±10.9 years. The mean tumor size was 10.5±3.3 cm. The number of patients according to the thrombus levels I, II, and III were 20, 9, and 5, respectively. The average blood loss was 744±285.4 mL. Radical surgery for all patients who had direct invasion to the vena cava wall and/or level II and III was performed by gastrointestinal and cardiothoracic surgeons. Cardiopulmonary bypass was not performed in any patient. Minor complications (Clavien grades 1-2) were seen in 8 (23.5%) patients, while 2 (5.8%) patients had major complications (Clavien grades 3-5). The mean follow-up period was 36 months (range, 6-72 months). The overall 5-year survival rate was 85.2%. CONCLUSION: We think that radical nephrectomy and caval thrombectomy is a safe and effective method in patients with RCC without tumor exceeding the diaphragmatic level. We believe that the surgical success rate can be increased using a multidisciplinary approach in selected cases.

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