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1.
Int J Impot Res ; 31(2): 139-144, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30696978

RESUMO

This study investigated the role of carotid artery intima-media thickness (IMT) as a morphological marker of the response of vasculogenic erectile dysfunction (ED) patients to tadalafil, one of the phosphodiesterase 5 inhibitor (PDE5-I). Through March-December 2016, 51 men with vasculogenic ED aged over 30 years were enrolled in this prospective study. Vasculogenic ED was accepted as a normal testosterone level, with penile colour Doppler ultrasonography showing arteriogenic ED, venogenic ED or mixed arteriogenic and venogenic ED. All patients underwent biochemical and hormonal blood tests, ultrasonographic evaluation of the common carotid artery (CCA) IMT and penile colour Doppler ultrasonography. On-demand tadalafil (10 mg or 20 mg in cases of a non-response to 10 mg) was administered to each patient for 2 months. ED was assessed using the short form of International Index of Erectile Function (IIEF-5) before and after the drug therapy. According to the patients' responses to the medication, they were grouped as non-responders or responders. Thirty-one of the 51 patients responded to tadalafil. The mean CCA IMT of the non-responders and responders was 0.9 ± 0.2 mm and 0.6 ± 0.2 mm, respectively (P = 0.000). The IMT of 90% of the non-responders was >0.67 mm, whereas it was >0.67 mm in 40% of the responders. The data were analysed using the Kolmogorov-Smirnov test, Chi-square test, t-test, Mann-Whitney U test and receiver operator characteristic (ROC) curves. Measurement of CCA IMT may offer an alternative and simple method to predict the response of vasculogenic ED patients to PDE5-Is.


Assuntos
Espessura Intima-Media Carotídea , Impotência Vasculogênica/tratamento farmacológico , Pênis/irrigação sanguínea , Inibidores da Fosfodiesterase 5/uso terapêutico , Tadalafila/uso terapêutico , Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Pênis/diagnóstico por imagem , Prognóstico , Estudos Prospectivos , Curva ROC , Turquia , Ultrassonografia Doppler em Cores
2.
Turk J Pediatr ; 61(3): 436-439, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31916725

RESUMO

Tekin A, Yagmur I, Ergün O, Ayik MF, Atay Y, Ulman I, Avanoglu A. Excision of the atrial Wilms` tumor thrombus without sternotomy, atriotomy and cardiovascular By-pass. Turk J Pediatr 2019; 61: 436-439. The treatment of atrial-extention Wilms` tumor thrombus is surgical excision after chemotherapy. Atriotomy with cardiovascular by-pass is the one of the most common method for this procedure. Herein, we aimed to present a case of Wilms` tumor with a tumor thrombus extending into the right atrium totally excised with retrohepatic cavatomy. A 3.5 year-old girl was admitted with the symptom of dysuria. The examinations revealed a mass consistent with Wilms` tumor in the middle and lower poles of the left kidney. Doppler ultrasound and Echocardiographic examinations showed a tumor thrombus extending into the right atrium and some pulmonary nodules which were interpreted to be metastasis. Wilms` tumor was histopathologically diagnosed by an open biopsy. After three courses of chemotherapy imaging studies revealed that the atrial axtention of the tumor thrombus persisted. The tumor thrombus was found to be fibrotic on the magnetic resonance imaging scan of the patient. Therefore, nephroureterectomy along with the excision of the tumor thrombus from the inferior vena cava was done with intraoperative continuous trans-esophageal echocardiography (TEE). The suprarenal and retrohepatic vena cava were exposed by dissecting and ligating all short hepatic veins and completely mobilizing the right lobe of the liver. The thrombus was dissected out via Vertical cavatomy at the retrohepatic level. TEE confirmed complete removal of the thrombus from the atrium; Vena cava was then repaired. There was no need for a blood transfusion, or cardiovascular by-pass (CPB) during the operation. Total exposure of the retrohepatic and subdiaphragmatic vena cava using transplantation techniques is an effective method for the excision of a tumor thrombus without sternotomy, atriotomy and CPB, avoiding possible intra- and postoperative complications in selected cases of Wilms` tumor with intraatrial thrombus extension. The case emphasises the importance of multidisciplinary communication and collaboration.

3.
Int. braz. j. urol ; 44(6): 1194-1199, Nov.-Dec. 2018. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-975658

RESUMO

ABSTRACT Introduction: Various bulking agents were utilized for endoscopic correction of VUR. A study reviewing multi-institutional data showed that the amount of injection material has increased over time with the purpose of improving success rates, which also resulted in costs. We noticed an opposite trend in our center since we started using a new bulking agent. The aim of this study was to evaluate evolution of our practice with different bulking agents. Patients and Methods: Records of VUR patients who underwent subureteric injection with polyacrylate polyalcohol copolymer (PPC) and dextronomere hyaluronic acide (DxHA) between 2005 and 2014 were reviewed. Variation of different parameters throughout the study period was evaluated along with the success rate. Success was defined as complete resolution of reflux. Results: A total of 260 patients with 384 refluxing units were included. The success rate was higher in PPC group compared to DxHA group. There was no statistically significant difference between years regarding distribution of VUR grade, body weight, patient height, and age in PPC group. Despite significant reduction in injection volume, success rate did not decrease through the years with PPC. Conclusion: Different bulking agents may require different injection volumes to achieve the same success rate in endoscopic treatment of vesicoureteral reflux. Habits gained with previous experience using other materials should be revised while using a new agent.

4.
Int Braz J Urol ; 44(6): 1194-1199, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30325612

RESUMO

INTRODUCTION: Various bulking agents were utilized for endoscopic correction of VUR. A study reviewing multi-institutional data showed that the amount of injection material has increased over time with the purpose of improving success rates, which also resulted in costs. We noticed an opposite trend in our center since we started using a new bulking agent. The aim of this study was to evaluate evolution of our practice with different bulking agents. PATIENTS AND METHODS: Records of VUR patients who underwent subureteric injection with polyacrylate polyalcohol copolymer (PPC) and dextronomere hyaluronic acide (DxHA) between 2005 and 2014 were reviewed. Variation of different parameters throughout the study period was evaluated along with the success rate. Success was defined as complete resolution of reflux. RESULTS: A total of 260 patients with 384 refluxing units were included. The success rate was higher in PPC group compared to DxHA group. There was no statistically significant difference between years regarding distribution of VUR grade, body weight, patient height, and age in PPC group. Despite significant reduction in injection volume, success rate did not decrease through the years with PPC. CONCLUSION: Different bulking agents may require different injection volumes to achieve the same success rate in endoscopic treatment of vesicoureteral reflux. Habits gained with previous experience using other materials should be revised while using a new agent.


Assuntos
Resinas Acrílicas/administração & dosagem , Materiais Biocompatíveis/administração & dosagem , Dextranos/administração & dosagem , Ácido Hialurônico/administração & dosagem , Polímeros/administração & dosagem , Refluxo Vesicoureteral/terapia , Criança , Pré-Escolar , Seguimentos , Humanos , Resultado do Tratamento , Ureteroscopia
5.
Arch Ital Urol Androl ; 90(3): 159-162, 2018 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-30362677

RESUMO

OBJECTIVE: Pathological calcifications that occur in various parts of the body may cause stone formation over time. The structure of these stones is similar in many regions of the body. We have studied the relationship between dental calculi and kidney stones. MATERIAL AND METHODS: A total of 183 patients with dental stone complaints or dental calculi were included between April and August 2016 in the Cagri Dental Hospital, Elazig, Turkey. Patients were evaluated with regard to a urinary tract ultrasonography, urinalysis, oral hygiene, and stone and surgical disease history. All information was statistically investigated. RESULTS: The age of the patients in the kidney stones group was significantly higher than the non-kidney stone patients (p < 0.05). In the group with kidney stones, the percentage of dental calculus formation was significantly higher than the group without stones (p < 0.05). In the groups with and without kidney stones, dental stone recurrence rates did not differ significantly (p < 0.05). Urinary pH was significantly lower in the group with stones than the group without stones (p < 0.05). CONCLUSIONS: During a physical examination, the formation of a visible stone, such as a dental calculus, may be an indicator of other types of stones, such as kidney stones, and this should be further investigated.


Assuntos
Cálculos Dentários/diagnóstico , Cálculos Renais/diagnóstico , Adulto , Fatores Etários , Idoso , Cálculos Dentários/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Turquia , Adulto Jovem
6.
J Endourol ; 32(11): 1050-1053, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30280908

RESUMO

OBJECTIVE: Percutaneous nephrolithotomy (PCNL) is a widely accepted and frequently performed operation for large kidney stones. However, there is not much information about the effects of irrigation fluid temperature as well as many other factors that affect success and complications during the operation. In this study, we aimed to investigate the surgical and anesthesiological effects of irrigation fluid used in body temperature and room temperature during and after PCNL. MATERIAL AND METHODS: A total of 108 PCNL patients were performed between June 2016 and April 2018. The half of these patients (54) were performed with body temperature (37°C) irrigation fluid, hence known as body temperature group (BTG), and the other half with room temperature (22°C) irrigation fluid, called as room temperature group (RTG). For the study, we recorded the body temperature of the patients during and after the operation, the amount of irrigation fluid used, the size and location of the kidney stones, the duration of the operation, postoperative shivering time during the patient's wake-up period, pre- and postoperative hemoglobin value, additional blood requirements, postoperative analgesic requirements, and postoperative urinary tract infections. RESULTS: The age of patients, gender distribution, height, weight, body mass index, stone size, and postoperative analgesic requirement showed no significant differences in two groups. The postoperative body heat was significantly higher in the BTG than the RTG. The duration of waking was significantly higher in the RTG than the BTG. The amount of hemorrhage was significantly less in the patients who were irrigated in the RTG. CONCLUSION: The temperature of the irrigation fluid can affect many parameters in the PCNL. We recommend using irrigation in room temperature especially with patients having bleeding risks and irrigation fluid in body temperature especially with patients having anesthetic risks for easier waking process.


Assuntos
Cálculos Renais/cirurgia , Nefrolitotomia Percutânea/métodos , Irrigação Terapêutica/métodos , Adolescente , Adulto , Idoso , Analgésicos/uso terapêutico , Anestesiologia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/etiologia , Período Perioperatório , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Estudos Retrospectivos , Temperatura Ambiente , Resultado do Tratamento , Turquia , Adulto Jovem
7.
Urol J ; 15(6): 339-343, 2018 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-30251752

RESUMO

PURPOSE: The study objective was to evaluate the safety and efficacy of mini-laparoscopic pyeloplasty (mLP) in an adult population and to demonstrate the functional and cosmetic results. METHODS: Data for 29 patients (19 men and 10 women) undergoing mLP for ureteropelvic junction obstruction (UPJO) from May 2014 to December 2016 in Turkey were collected in this prospective study. Inclusion criteria were age ? 18 years, body mass index (BMI) ? 30 kg/m2 and primary UPJO, and no previous surgery on the affected kidney or previous abdominal surgery. Postoperative Visual Analogue Scale scores and the Patient Scar Assessment Questionnaire (PSAQ) were used. Demographic data, perioperative parameters, complications, and postoperative functional and cosmetic results were recorded. All statistical analyses were done by SPSS software. P value of <05 was considered statistically significant. RESULTS: Twenty-nine adults with a mean age of 29.4 ± 10.2 years (19-38 years) were included. The patients' mean BMI was 22.4 ± 4.3 kg/m2 (a range of 16-29 kg/m2). The procedures were performed using three ports (one 5 mm port for the camera and two 3 mm ports). Mean operative time was 119 ± 28.5 minutes (85-144 minutes). Major complications were not observed, as per the Clavien-Dindo classification of surgical complications (grades IV-V). The mean VAS score was 1.2 ± 0.2 points. Functional obstruction was reported in one patient on renal scintigraphy at 12 months postoperatively. The success rate of mLP was 97%. The minimum and maximum PSAQ scores at month 3 postoperatively were 24 and 86, respectively. All the patients were satisfied with the intervention and with their cosmetic results. CONCLUSION: mLP is a safe, effective and feasible treatment method for UPJO in adult patients. This treatment modality offers excellent cosmetic and functional results following treatment for UPJO.


Assuntos
Cicatriz/prevenção & controle , Pelve Renal/cirurgia , Laparoscopia/métodos , Obstrução Ureteral/cirurgia , Procedimentos Cirúrgicos Urológicos/métodos , Adulto , Cicatriz/etiologia , Feminino , Humanos , Laparoscopia/efeitos adversos , Masculino , Satisfação do Paciente , Estudos Prospectivos , Inquéritos e Questionários , Resultado do Tratamento , Procedimentos Cirúrgicos Urológicos/efeitos adversos , Adulto Jovem
8.
J Clin Res Pediatr Endocrinol ; 10(3): 216-222, 2018 07 31.
Artigo em Inglês | MEDLINE | ID: mdl-29595517

RESUMO

Objective: Disorders of sex development (DSD) is a nomenclature intended to defeat the discomfort of families and patients and has found worldwide usage. The aim of this study was to address the perception and usage of terminology among the parents of DSD patients in a tertiary center in western Turkey. Methods: The records of the DSD council (multidisciplinary team where each patient with DSD is discussed) between years 2008-2015 were reviewed retrospectively. Data including details of the management process, patient characteristics and follow-up details were noted. Then inquiries reflecting parental perception about terminology were implemented during clinical visits. Results: In total, 121 patients were evaluated in monthly meetings of the DSD council and 79 inquiries were completed. Fifty-one percent of the families admitted knowing the terms DSD, ambiguous genitalia, "dubious genitals" and intersex. However, only 2% preferred using DSD, 6% intersex and 14% ambiguous genitalia. Fifty-two percent of the parents used a disease name in Latin (mostly hypospadias) addressing the disorder. The offspring of 69% of the parents who were familiar with the name "dubious genitals" were diagnosed in the neonatal period. The preferred terminology used by parents was strongly associated with the terminology used most commonly in the medical speciality their child most often attended. Conclusion: Each country has its own social norms. We suggest therefore that local committees including medical professionals, patients and families should be employed to develop proper terminology.


Assuntos
Transtornos do Desenvolvimento Sexual , Conhecimentos, Atitudes e Prática em Saúde , Pais , Terminologia como Assunto , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Inquéritos e Questionários , Turquia
9.
Urolithiasis ; 46(3): 297-302, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28585181

RESUMO

Percutaneous nephrolithotomy (PCNL) is a commonly used type of minimally invasive treatment in kidney stone surgeries. Surgical success is assessed according to residual stone amount after surgery. The purpose of this study is to compare the two methods' success and practicality that are applied after the fracture of the stone in the patients who applied PCNL and which enable the removal of the residual stones. Among 102 patients who underwent a single-session of PCNL at our department between June 2015 and November 2016 were evaluated. Previously identified irrigation method and our aspiration method which described used in post-operative patients divided into two groups of residual fragments was assessed by computed tomography. The results were evaluated in statistical analyses. Significant p was accepted as p < 0.05. The age and gender distribution of patients in the irrigation and aspiration groups did not differ significantly (p > 0.05). In irrigation and aspiration groups, stone size did not differ significantly (p > 0.05). The amount of residue stones and dust remaining in the irrigation group was significantly higher (p < 0.05) than the aspiration group. Although many methods have been tried before, we think that the aspiration method we have described is a cheaper, more effective and feasible option.


Assuntos
Cálculos Renais/cirurgia , Nefrolitotomia Percutânea/métodos , Adolescente , Adulto , Idoso , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nefrolitotomia Percutânea/efeitos adversos , Nefrolitotomia Percutânea/instrumentação , Estudos Prospectivos , Estudos Retrospectivos , Sucção/efeitos adversos , Sucção/economia , Sucção/métodos , Irrigação Terapêutica/efeitos adversos , Irrigação Terapêutica/economia , Irrigação Terapêutica/métodos , Resultado do Tratamento , Adulto Jovem
10.
Ann Ital Chir ; 89: 534-539, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30665215

RESUMO

AIM: In developing countries, surgery, birth traumas, and especially gynecological procedures are the most common cause of vesicovaginal fistulas (VVFs). We retrospectively evaluated our treatment modalities for VVF repair caused by obstetric causes and compared with the current literature. MATERIALS AND METHODS: We compared the surgical approach preferences and their results with patient characteristics as well as fistula size and location for the management of VVFs. We retrospectively reviewed and prospectively collected data on 63 women who had uterovesical fistulae or VVF surgical repair between October 2004 and November 2017 at our university hospital in southeastern Turkey. RESULTS: A total of 63 patients with a diagnosis of obstetric fistula were primaries. Most of the patients had a total abdominal hysterectomy in 37 cases. After the cause of VVF, the mean time to the operation was 28±11 (range: 15-96) days. The average fistula tract size was 15.2±7.7 (range: 3-33) mm. Patients were followed up for a mean of 12 (range: 6-20) months. The patient who received antibiotic treatment due to urinary tract infection before surgery was 16 (25.3%). In seven (12.9%) patients whose fistula diameter was greater than 2 cm, a recurrence was observed. The overall success rate was 87.1%. The average operative time was 94,5±24,3 (range: 50-150) minutes for a layered closure, 75 (range: 50-80) minutes for an omental flap and 120 minutes (range: 100-150) for a martius flap. There were no intraoperative complications. CONCLUSION: Obstetric VVFs are highly successful with surgical repair. Surgical success rates are especially high in fistula tract sizes of less than 20 mm and in patients with no history of urinary infection. KEY WORDS: Abdominal fistula repair, Transvaginal fistula repair, Vesicovaginal fistula.


Assuntos
Fístula Vesicovaginal/cirurgia , Feminino , Procedimentos Cirúrgicos em Ginecologia/métodos , Humanos , Doença Iatrogênica , Estudos Retrospectivos
11.
J Pediatr Urol ; 12(4): 267.e1-4, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27593922

RESUMO

INTRODUCTION: Benign prostatic hyperplasia (BPH) is generally common in men older than 50 years of age but is extremely rare in childhood. In the literature to date, fewer than five cases have been reported under 18 years of age. Owing to the limited number of cases, the etiology and management of BPH in the first two decades is not clear. OBJECTIVE: We herein report a 17-year-old boy who presented with acute urinary retention due to BPH and was treated with endoscopic transurethral resection of the prostate (TUR-P). CASE REPORT: A 17-year-old male patient with a history of intermittent hematuria was admitted elsewhere with acute urinary retention. An increase in prostate size was detected on digital rectal examination. Pelvic ultrasound revealed a large mass arising from the prostate and filling the bladder lumen. Transrectal ultrasound-guided prostate biopsy (TRUS-Bx) was performed to exclude malignancy. After the documentation of benign prostate tissue in the histopathological analysis, the patient was referred to our clinic for further evaluation and management. Magnetic resonance (MR) imaging revealed a 48 × 55 × 68 mm mass arising from the middle lobe of prostate and filling the bladder lumen (Figure) with an initial diagnosis of a non-ductal malignant tumor because of his age. Enlarged lymph nodes or any sign of metastasis were not detected. Re-examination of the previous biopsy specimens confirmed the absence of malignancy; therefore he underwent endoscopic treatment with TUR-P. Histopathological examination reported BPH. The postoperative 1-year follow-up was uneventful. DISCUSSION: The patient was extensively evaluated with a suspicion of malignancy, especially rhabdomyosarcoma, which is more expected for this age group. Reviewing juvenile cases with BPH in the literature, two authors explained the possible etiologic factors of their cases as gonadotropin supplement therapy for undescended testes and the mother's utilization of a human chorionic gonadotropin-containing agent during pregnancy to prevent spontaneous abortion. Our case had no history of drug intake, endocrinologic abnormality, or any other possible relevant factor. Owing to the limited number of cases, there is not enough data to understand the etiology and also no consensus on the treatment of BPH in the adolescents. Therefore, experiences gained from adult cases guide the pediatric treatment modalities. CONCLUSION: Despite the fact that BPH is very rare in childhood, one should keep it in mind in the differential diagnosis of acute urinary retention and malignant prostate diseases. The endoscopic method is the treatment of choice in BPH.


Assuntos
Hiperplasia Prostática , Adolescente , Humanos , Masculino , Hiperplasia Prostática/complicações , Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/cirurgia , Retenção Urinária/etiologia
12.
J Pediatr Urol ; 12(6): 395.e1-395.e6, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27480468

RESUMO

INTRODUCTION: Various graft and flap techniques have been proposed for urethral reconstruction in proximal hypospadias repair. The Bracka repair involving the transfer of inner prepuce like a Wolfe graft mostly results in satisfactory results besides a high fistula rate. AIM: The aim was to decrease the high fistula rate with Bracka repair; we wanted to use the advantages of vascularized skin in the Bracka method. The aim of this study was to evaluate our results with this modification. STUDY DESIGN: Our modification involves using a flap instead of a graft. In the first stage, chordee was corrected by transection of the urethral plate and dorsal midline plication when necessary. Instead of a graft as suggested by Bracka, inner preputial skin with ample blood supply was transferred and stitched to the denuded ventral penile surface. In the second stage after 6 months, this flap was tubularized in the Thiersch-Duplay fashion. Hospital records of patients who had undergone two stage modified Bracka repair between June 2007 and July 2012 were reviewed, including complaints, complications, and need for interventions. RESULTS: Thirty-eight patients had undergone this operation. Four patients were lost to follow-up. The main complaint was obstructed urinary flow. Voiding symptoms were first attributed to urethral stenosis, but were, however, found to be due to diverticulum and vortex of the urine in the dilated urethra. Twenty-one patients (61%) had voiding problems and 10 patients (29%) had urinary tract infections. Fistula was observed in 23 and diverticula were observed in 24 patients. Of these, 16 patients had both fistula and diverticula. Only two patients (5%) were free of complications and totally satisfied with the operation, and 23 of the 34 patients had complications requiring intervention (Figure). DISCUSSION: Inner preputial flaps used in proximal hypospadias repairs are prone to diverticula formation. They become redundant in time requiring reoperation, thus decreasing the success rate. Careful fixation of the flap to the corpora and allowing time for additional attachment of the urethral plate substitution through fibrotic activity could not overcome this complication. CONCLUSION: Our modification of the Bracka technique using a flap for the plate resulted in a high rate of complications (in particular diverticulum formation) and was therefore abandoned. We recommend careful use of flaps in hypospadias surgery and long-term follow-up studies to evaluate actual functional and cosmetic results.


Assuntos
Divertículo/epidemiologia , Hipospadia/cirurgia , Complicações Pós-Operatórias/epidemiologia , Retalhos Cirúrgicos , Doenças Uretrais/epidemiologia , Adolescente , Criança , Pré-Escolar , Humanos , Hipospadia/patologia , Incidência , Lactente , Masculino , Estudos Retrospectivos , Resultado do Tratamento , Procedimentos Cirúrgicos Urológicos Masculinos/métodos
13.
Urolithiasis ; 44(5): 435-40, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26719036

RESUMO

There is a lack of literature on children compared to adults regarding the long-term effects of extracorporeal shock wave lithotripsy (SWL), specifically in infants. The aim of the present study was to analyze the efficacy and safety of SWL in infants and also evaluate its potential adverse effects in the mid-term. Between May 1999 and December 2013, 36 infants with 39 renal units underwent SWL treatment for kidney stones with an electrohydraulic lithotripter (Dornier MPL 9000/ELMED Multimed Classic). All children were less than 12-month old. The mid-term effects of SWL were examined at the last follow-up by measuring arterial blood pressure, random blood glucose level and ipsilateral kidney size. Evaluation of treatment and its consequences was based on clinical examination, blood tests and conventional imaging (plain abdominal radiography and ultrasound). Overall stone-free rate was 84.6 % after 3-month follow-up without any major complications. Mid-term follow-up was available in 20 of 36 children with a mean follow-up of 3.2 ± 2.8 years (range 0.5-15.3). None of the infants were found to develop new onset of hypertension or diabetes. All treated infant kidneys' sizes were in the normal percentile range. SWL for management of infant kidney stones is effective and safe in the mid-term.


Assuntos
Cálculos Renais/terapia , Litotripsia/efeitos adversos , Feminino , Humanos , Lactente , Masculino , Estudos Prospectivos , Resultado do Tratamento
14.
J Pak Med Assoc ; 65(7): 701-4, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26160076

RESUMO

OBJECTIVE: To investigate the relationship between the HSP 70 genepolymorphism and primary infertility in males with normal sperm-parameters. METHODS: The case-control study was conducted in Sanliurfa, Turkey, from September 2010 to August 2011and comprised infertile males as cases and healthy fertile controls. Deoxyribonucleicacid was isolated from the blood of both groups, and polymorphisms of the HSPA1B gene (NM_005346.4, GI: 3304):c.1059G>A, (PstI G>A; dbSNP: rs1061581G>A) and HSPA1L gene (NM_005527.3, GI: 3305) c.1478C>T (NcoIC>T, dbSNP: rs2227956) were analysed with polymerase chain reaction-restriction fragment length polymorphism technique. SPSS version 11.5 was used for statistical analysis. RESULTS: Of the 140males in the study, 68(28.5%) were infertile cases and 72(51.4%) fertile controls. There was no statistically significant difference between GA (heterozygous) and AA (homozygous, polymorphic) genotypes of the c.1059G>A polymorphic point of the HSPA1B gene or between the A allele of the cases and controls (p>0.05). There was no statistically significant difference between the CT (heterozygote) and TT (homozygous, polymorphic) genotypes of the c.1478C>T polymorphic area of the HSPA1Lgene or between the T alleles of the cases and the controls (p>0.05). CONCLUSIONS: Infertility in males with normal sperm parameters was not significantly associated with HSPA1B:c.1059G>A and HSPA1L:c.1478C>T gene polymorphisms. Further prospective studies with larger sample sizes and different gene groups are required to clarify the issue.


Assuntos
Proteínas de Choque Térmico HSP70/genética , Infertilidade Masculina/genética , Adulto , Alelos , Estudos de Casos e Controles , Predisposição Genética para Doença , Genótipo , Humanos , Masculino , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Polimorfismo de Nucleotídeo Único , Análise do Sêmen , Turquia , Adulto Jovem
15.
Can Urol Assoc J ; 8(3-4): E193-5, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24678364

RESUMO

Malignant fibrous histiocytomas (MFH) are the most commonly seen soft tissue sarcomas in adults. It is rarely seen in some visceral organs. Kidneys are the parenchymal organs in which MFHs are most frequently seen. More than 50 cases of primary renal MFH have been reported. Among these cases, only 1 was reported as primary giant cell subtype in association with urolithiasis. This case report is the second such case with the these characteristics.

16.
World J Mens Health ; 31(3): 215-9, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24459654

RESUMO

PURPOSE: The mean platelet volume (MPV) is a marker of the platelet activity and is reported to increase in vascular diseases. We aimed to investigate the association between MPV and vasculogenic erectile dysfunction (ED). MATERIALS AND METHODS: MPV and platelet (PLT) levels were measured in 50 cases of ED and 40 healthy controls. The diagnosis of vasculogenic ED was based on a detailed sexual history, physical examination, laboratory assessment, and color Doppler ultrasonography. The results are given as mean±standard deviation of the mean. RESULTS: The mean ages of the patient and the control groups were 53.70±12.39 years (range 24~77 years) and 53.85±9.5 years (range 30~73 years), respectively (p=0.947). The MPV and PLT values were significantly higher in the patients with ED than those of the controls (7.49±1.4), (6.85±1.2), (262.97±68), (252.89±82) respectively, p<0.001). However, the MPV values were not statistically significantly different in the patients with severe ED according to the International Index of Erectile Function than in those with mild ED, p>0.05), and there was no correlation between MPV and either age of patients (p=0.905) or duration of ED (p=0.583). CONCLUSIONS: The platelet count and MPV was detected to be increased in patients with vasculogenic ED. This finding suggests a role for platelets in the pathogenesis of vascular complications and that the MPV would be useful in monitoring disease progression.

17.
Urol Int ; 89(2): 191-5, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22776767

RESUMO

OBJECTIVE: To investigate the effects of increased pressure due to the accumulated fluid around testis in hydrocele on testis diffusion and whether this effect (if any) is correlated with the amount of fluid and duration of hydrocele. PATIENTS AND METHOD: 49 patients with unilateral hydrocele were evaluated by magnetic resonance diffusion-weighted imaging. RESULTS: In the study group, while the apparent diffusion coefficient (ADC) values of the testicles with hydrocele differed significantly before and 3 months after the hydrocelectomy (p = 0.001), the ADC values of the testicles without hydrocele were not statistically different (p = 0.101). There was a significant negative correlation between the ADC values of the testicles with hydrocele and the amount of the liquid aspirated during the hydrocelectomy (r = -0.615, p = 0.001). There was no correlation between the ADC values of testis and the duration of hydrocele (r = -287, p = 0.156). This is supported by the findings of the present study of reduced ADC values of testis, meaning reduced diffusion of the testis, with an increasing amount of fluid. CONCLUSION: The pressure of the fluid was suggested to show a mechanical effect that plays an important role in the dysfunction of the testis. The possible dysfunctions of the testicular tissue suggest that they may have a negative effect on fertility.


Assuntos
Imagem de Difusão por Ressonância Magnética/métodos , Hidrocele Testicular/patologia , Testículo/patologia , Adulto , Estudos de Casos e Controles , Fertilidade , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Hidrocele Testicular/diagnóstico , Urologia/métodos
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