Does preoperative hydronephrosis affect the stone-free rate of micro-percutaneous nephrolithotomy?

OBJECTIVES: Micropercutaneous nephrolithotomy (microperc) is a new minimal-invasive technique.We aimed to investigate whether preoperative hydronephrosis has an impact on the stone-free rate of microperc. METHODS: In this study, 66 consecutive patients were included and divided into 2 groups:patients without preoperative hydronephrosis (group-1) and patients with preoperative hydronephrosis (group-2).Both groups were compared for age, gender, body mass index (BMI), stone burden, stone location, fluoroscopy and operative time, blood loss, stone-free rate and perioperative and postoperative complication rates. Parameters were analyzed using univariate and multivariate analyses for the stone-free rate. RESULTS: The mean age, gender, BMI, stone location, and blood loss were similar in both groups (p > 0.05). Stone burden in group-2 was greater than group-1 (p=0.011). In addition, mean fluoroscopy time in group-1 was found to be significantly lower (p < 0.05). However, operative time was comparable among the groups (p=0.169). Lastly, group-2 had a higher rate of perioperative and postoperative complication rates and lower success rate (p=0.023, p=0.027 and p=0.001, respectively). The success was significantly affected by hydronephrosis, stone burden and location (p < 0.05). Logistic regression analysis revealed that unsuccessful outcome was significantly associated only with the presence of hydronephrosis (OR 0.225,p=0.033). CONCLUSION: This study seems to suggest that presence of hydronephrosis is a major factor on the stone free rate of microperc procedures.

OBJETIVOS: La nefrolitotomíamicropercutanea (microperc) es una nueva técnica mínimamente invasiva. Investigamos si la hidronefrosis preoperatoria tiene un impacto sobre la tasa de pacientes libres delitiasis de la microperc.MÉTODOS: En este estudio, 66 pacientes consecutivos fueron incluidos y divididos en 2 grupos: pacientes sin hidronefrosis preoperatoria (grupo 1) y pacientes con hidronefrosis preoperatoria (grupo 2). Se compararon ambos grupos por edad, género, índice de masa corporal (IMC), carga litiásica, localización de la litiasis, fluoroscopia y tiempo operatorio, sangrado, tasa de pacientes libres de litiasis, y tasas de complicaciones peri y postoperatorias. Las variables fueron analizadas utilizando análisis uni y multivariado para la tasa de pacientes libres de litiasis. RESULTADOS: Edad media, género, localización de la litiasis y sangrado fueron similares en ambos grupos (p>0,05). La carga litiásica en el grupo 2 era mayor que en grupo 1 (p=0,011). Además, el tiempo medio de fluoroscopia en el grupo 1 era significativamente menor (pera comparable en los dos grupos (p=0,169). Finalmente, el grupo 2 tenía una tasa de complicaciones peri y postoperatorias mayor y una tasa de éxitos menor (p=0,023, éxito estaba significativamente influido por la hidronefrosis, la carga litiásica y la localización de la litiasis (p>0,05). El análisis de regresión logística reveló que los resultados sin éxito se asociaban significativamente sólo con la presencia de hidronefrosis (OR 0,225,>p=0,033).CONCLUSIÓN: Este estudio parece sugerir que la presencia de hidronefrosis es un factor principal en la tasa de pacientes libres de litiasis de los procedimientos de microperc.

Paratesticular rhabdomyosarcoma mimicking complicated epididymal cyst.

Paratesticular rhabdomyosarcoma (RMS) is a rare nongerm cell intrascrotal malignant tumor in children and young adult/teens resulting from the mesenchymal tissues of the tunica vaginalis, epididymis, spermatic cord, and testis. RMS accounts for approximately 7% of all genitourinary tract RMSs and 12% of all pediatric scrotal neoplasms. Patients usually present with a painless unilateral scrotal mass. We report a 16-year-old boy with a paratesticular RMS mimicking epididymal cyst. To our knowledge, this is the first case reported in the literature presenting as an epididymal cyst.

Luminal Obstruction of Double J Stents Due to Encrustation Depends on Indwelling Time: A Pilot Study.

Double J (DJ) stents serve as a therapeutic option to relieve obstruction. However, incrustation can be an important cause of dysfunction of these stents. We investigated the relationship between incrustation of DJ stents and indwelling time using a grading system for luminal occlusion. The medical records of 42 patients with urolithiasis related to DJ stent incrustation were retrospectively reviewed. All polyurethane DJ stents were examined for severity of incrustation with a grading system based on the occlusion of stent lumen. For the level of grades 3 groups of patients were compared: group 1 included 14 patients whose stents were removed a month after insertion; group 2 included 16 patients whose stents were removed 45 days after insertion; group 3 included 12 patients whose stents were removed 3 months after insertion. The incrustation of 42 DJ stents was graded from 1 to 3 depending on the occlusion of the DJ stent. Mean age of patients was 39.6±6.71 years and median indwelling time was 50 days. The groups were similar regarding age, sex, and side of DJ stent. In comparison, the grade of incrustation in group 3 was higher than the grades in group 1 and group 2 (p=0.001). Incrustation is one of the most important complications of DJ stents, and was related to indwelling time. Therefore, close follow-up and frequent DJ stent changes are very important in patients with urolithiasis.

18F-flouro-2-deoxyglucose positron emission tomography/computed tomography imaging of solitary prostatic and pulmonary tuberculosis mimicking metastatic prostate cancer.

Genitourinary tuberculosis (TB) is a common type of extrathoracic TB and can be found in isolation or associated with pulmonary TB. It contributes to 10-14% of extrapulmonary TB. Prostate TB is rare and usually found incidentally following transurethral resection of the prostate for treatment of benign prostatic obstruction as an isolated lesion in immunocompetant patient. The authors report a case of prostatic and pulmonary TB in animmunocompetant patient investigating for the positive positron emission tomography in lung and prostate. To our knowledge, this is the first case reported in the literature presenting with simultaneous hypermetabolic lesions in the prostate and lung.

Randomized crossover comparison of tamsulosin and alfuzosin in patients with urinary disturbances caused by benign prostatic hyperplasia.

PURPOSE: The aim of this study was to compare the efficacy and safety of alfuzosin (Alf) and tamsulosin (Tam) in patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: One hundred men with benign prostatic hyperplasia (BPH) who were admitted to our urology department with lower urinary tract symptoms (LUTS) were enrolled in this randomized cross-over study. At enrollment, detailed medical history was recorded, and International Prostate Symptom Score (IPSS), digital rectal examination, urinary ultrasound, prostate specific antigen (PSA) level, and uroflowmetry were determined. BPH patients with IPSS greater than 8 and maximum urinary flow rate (Q(max)) lower than 15 ml/s were randomly divided into a Alf-Tam group (Alf for 8 weeks, followed by Tam for 8 weeks) or a Tam-Alf group (Tam for 8 weeks, followed by Alf for 8 weeks). There was no withdrawal period (washout) when switching drugs. RESULTS: In the first treatment period, each drug significantly improved IPSS and Q(max). In both the Alf-Tam and Tam-Alf groups, cross-over was effective in improving IPSS and Q(max). Alf and Tam significantly lowered IPSS and significantly increased Q(max) from baseline (P < 0.001). Neither drug affected serum PSA levels. CONCLUSIONS: Tam and Alf, which were used during different time frames in the same individuals, are associated with similarly favorable outcomes. When one alpha-blocker does not provide a desired effect in the treatment of BPH, switching to another alpha-blocker seems to be beneficial.

Does preoperative hydronephrosis affect the stone-free rate of micro-percutaneous nephrolithotomy? / ¿Afecta la hidronefrosis preoperatoria al procentaje de pacientes libre de litiasis después de nefrolitotomia micropercutanea?

Objectives: Micropercutaneous nephrolithotomy (microperc) is a new minimal-invasive technique. We aimed to investigate whether preoperative hydronephrosis has an impact on the stone-free rate of microperc. Methods: In this study, 66 consecutive patients were included and divided into 2 groups: patients without preoperative hydronephrosis (group-1) and patients with preoperative hydronephrosis (group-2).Both groups were compared for age, gender, body mass index (BMI), stone burden, stone location, fluoroscopy and operative time, blood loss, stone-free rate and perioperative and postoperative complication rates. Parameters were analyzed using univariate and multivariate analyses for the stone-free rate. Results: The mean age, gender, BMI, stone location, and blood loss were similar in both groups (p>0.05). Stone burden in group-2 was greater than group-1 (p=0.011). In addition, mean fluoroscopy time in group-1 was found to be significantly lower (p<0.05). However, operative time was comparable among the groups (p=0.169). Lastly, group-2 had a higher rate of perioperative and postoperative complication rates and lower success rate (p=0.023, p=0.027 and p=0.001, respectively). The success was significantly affected by hydronephrosis, stone burden and location (p<0.05). Logistic regression analysis revealed that unsuccessful outcome was significantly associated only with the presence of hydronephrosis (OR 0.225, p=0.033). Conclusion: This study seems to suggest that presence of hydronephrosis is a major factor on the stone free rate of microperc procedures

Objetivos: La nefrolitotomía micropercutanea (microperc) es una nueva técnica mínimamente invasiva. Investigamos si la hidronefrosis preoperatoria tiene un impacto sobre la tasa de pacientes libres de litiasis de la microperc. Métodos: En este estudio, 66 pacientes consecutivos fueron incluidos y divididos en 2 grupos: pacientes sin hidronefrosis preoperatoria (grupo 1) y pacientes con hidronefrosis preoperatoria (grupo 2). Se compararon ambos grupos por edad, género, índice de masa corporal (IMC), carga litiásica, localización de la litiasis, fluoroscopia y tiempo operatorio, sangrado, tasa de pacientes libres de litiasis, y tasas de complicaciones peri y postoperatorias. Las variables fueron analizadas utilizando análisis uni y multivariado para la tasa de pacientes libres de litiasis. Resultados: Edad media, género, localización de la litiasis y sangrado fueron similares en ambos grupos (p > 0,05). La carga litiásica en el grupo 2 era mayor que en grupo 1 (p = 0,011). Además, el tiempo medio de fluoroscopia en el grupo 1 era significativamente menor (p < 0,05). Sin embargo, el tiempo operatorio era comparable en los dos grupos (p = 0,169). Finalmente, el grupo 2 tenía una tasa de complicaciones peri y postoperatorias mayor y una tasa de éxitos menor (p = 0,023, p = 0,027 y p = 0,001, respectivamente). El éxito estaba significativamente influido por la hidronefrosis, la carga litiásica y la localización de la litiasis (p > 0,05). El análisis de regresión logística reveló que los resultados sin éxito se asociaban significativamente sólo con la presencia de hidronefrosis (OR 0,225, p = 0,033). Conclusión: Este estudio parece sugerir que la presencia de hidronefrosis es un factor principal en la tasa de pacientes libres de litiasis de los procedimientos de microperc