Purpose: The study was aimed to investigate the safety of the transrectal ultrasound-guided prostate needlebiopsy in the elderly.Material and methods: Five hundered fifteen patients, who underwent prostate biopsy between 2017-2020,were included in the study. All patients' demographic data, comorbidities, laboratory findings, prostate volumes,prostate biopsy pathology results, and post-biopsy complications were retrospectively analyzed. The patientswere divided into 2 groups: group-1 consisting of patients under the age of 65 and group-2 with above the ageof 65.Results: There were 244 in group-1 and 271 patients in group-2. The mean age of group-1 was 59.50±3.98,group-2 was 71.45±4.57 years. In group-1, post-biopsy fever was observed in 5 (2%), hematuria in 44 (18%),hemospermia in 79 (32.4%), and rectal bleeding in 7 (2.9%) patients. In group-2, post-biopsy fever was observedin 15 (5.5%), hematuria in 69 (25.5%), hemospermia in 21 (7.7%), and rectal bleeding in 11 (4.1%) patients. Thesevere sepsis findings were observed in 2 patients (0.2%) in group-1 and 6 (2.2%) in group-2. In the logisticregression-analysis, it was determined that the risk of complication increased significantly as the age, PSA, andhigher PSA density.Conclusion: In our study, it was revealed that the risk of complications was higher in the elderly and that thecomplications observed may be more seriously. Therefore, we consider that a more careful approach should betaken in elderly patients to prevent the complications related with prostate biopsy.
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Objective: Factors that may influence the efficiency and reliability of shock wave lithotripsy have been examined in the treatment of stone diseasein patients aged 0-2.Materials and Methods: The data of 149 patients treated with shock wave lithotripsy in our clinic between the ages of 0 and 2 years wereevaluated retrospectively. Factors for predicting success in terms of overall stone-free rate were analyzed using univariate and multivariate analyses.Results: The mean age of the group was 14.39±4.56 months. The stone-free status was achieved in 102 (70.5%) patients in the first session, 15(65.2%) of 23 patients in the second session, and 2 (50%) of 4 patients in the third session. Thus, 122 (81.9%) of the children were stone-free aftershock wave lithotripsy at an average of 10.01±11.34 months of follow-up. The mean stone size was 8.66±3.47 mm. Moreover, smaller stone size andsingle stones were found to be significant predictors of treatment success (p=0.007 and p≤0.001, respectively). Additionally, it was determined thatthe single number of stones had a positive effect on treatment success in multivariable analysis (area under the curve=0.683, p=0.002). There wereno major complications observed.Conclusion: Our study has shown that shock wave lithotripsy can be used with high success and low morbidity in the treatment of urinary systemstone disease in children aged 0-2, especially in the presence of a single stone.
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Objective: There is a lack of information about the relationship between germ cell testicular tumors and hematological parameters commonly used in other tumors.In this study, it was aimed to determine the value of hematological parameters used in other malignancies in the diagnosis of localized germ cell testicular cancer.Materials and Methods: Hematological parameters between patients who underwent radical orchiectomy with a pre-diagnosis of localized germ cell testiculartumor and those who underwent varicocelectomy in the same period as the control group between January 2015 and March 2019 in our clinic were compared todetermine the diagnostic value of hematological parameters in testicular tumor.Results: The mean age of 39 patients diagnosed as having localized testicular tumor was 33 years. While seminoma was detected in 17 patients, non-seminomatousgerm cell tumors were detected in 22 patients. In the assessment of preoperative blood samples; neutrophil count (5.6 vs 4.1, p≤0.001), neutrophil percentage(65.8 vs 57.4, p≤0.001) and neutrophil/lymphocyte ratio (2.6 vs 1.8, p≤0.001) were significantly higher, while lymphocyte ratio was significantly lower (25.3 vs31.4, p≤0.001) in patients with testicular tumor than in the control group (n=121). In the receiver operating characteristic analysis performed for the neutrophil/lymphocyte ratio, the cut-off point was found to be 2.25 (area under the curve =0.71, 95% confidence interval: 0.622-0.816, sensitivity: 66.7%, selectivity: 73.6%).Conclusion: Neutrophil/lymphocyte ratio, which is one of the hematological parameters, can be used as an auxiliary tool for examination and imaging methods inthe diagnosis of stage I germ cell testicular tumor, which is considered to be an early stage.
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Objective: To show our retrograde intrarenal surgery (RIRS) experience in anomalous kidney stones and compare its safety and efficiency withnormal kidney stones.Materials and Methods: Between 2012 and 2018, patient data was reviewed retrospectively and 1700 procedures were taken into consideration.Forty-seven anomalous kidney stones were included in the study (group A). In these patients, 18 had calyx diverticulum, 12 had horseshoe kidney,8 had ureteral duplication, 2 had ectopic kidneys, 1 had malrotation, and 1 had bifid pelvis. After making a matched pair analysis, 47 normalkidney stones with similar demographic and stone characteristics were included in our study (group N). Demographic, stone, intraoperative andpostoperative data were recorded. We compared these groups regarding efficiency and safety.Results: Average scope time, hospitalization time, and postoperative double J-stent rate were higher in group A. The difference was statisticallyinsignificant (p>0.05). Ureteral access sheath usage was higher in group N, though the difference was statistically insignificant (p=0.63). Stonefreerates and success rates were higher in group N though the difference was not statistically significant (p>0.05). The rate of complications wasstatistically significantly higher in group A (p=0.02).Conclusion: RIRS can be used in the management of anomalous kidney stones. It is an efficient and safe method. Prospective and larger patientnumbered studies are needed.
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Aim: We aimed to reveal the clinical, laboratory, radiological findings of infarction in the renal artery and itsbranches due to thrombosis, its effects on renal functions and the measures to be taken.Methods: The study sample included 8 patients who were admitted to the emergency department of KutahyaUniversity of Health Sciences Evliya Celebi Training and Research Hospital between 2018-2020, and who werehospitalized with the diagnosis of acute renal infarction. Patients were retrospectively analyzed with clinicalfindings, CT angiography-abdomen, clinical observations, prognosis and complications.Results: Of the patients, 5 were male and 3 were female. The mean age was 55.13 (29-69) years. One patientpresented with bilateral renal infarction, while 7 had unilateral renal infarction. The etiology of the patients wasidiopathic in 2, atrial fibrilation (AF) in 3 patients, and atherosclerosis in 3 patient. The mean serum creatinineof 1.24 (0.7-3.2) mg/dl and the mean blood leukocyte level of 16925 (11000-26000) mcL were determined. Themean length of hospital stay was 4.6 (3-7) days. Anticoagulant therapy was initiated in all patients for risk ofrecurrent renal infarction and thromboembolism.Conclusion: We revealed that renal infarction, rarely seen in urology practice, has nonspecific clinical findings;therefore, it should be kept in mind in differential diagnosis for patients presenting with sudden-onset oblique orabdominal pain, and that diagnosis can be made using contrast-enhanced CT. We determined that AF andvalvular heart diseases which cause atherosclerosis and cardiac thrombosis play an important role in theetiology.
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