Ali Cift

Urothelial neoplasm of the bladder in childhood and adolescence: a rare disease

ABSTRACT Purpose: Bladder tumors are rare in children and adolescents. For this reason, the diagnosis is sometimes delayed in pediatric patients. We aimed to describe the diagnosis, treatment, and follow-up methods of bladder urothelial neoplasms in children and adolescents. Materials and Methods: We carried out a retrospective multicenter study involving patients who were treated between 2008 and 2014. Eleven patients aged younger than 18 years were enrolled in the study. In all the patients, a bladder tumor was diagnosed using ultrasonography and was treated through transurethral resection of the bladder (TURBT). Results: Nine of the 11 patients (82%) were admitted with gross hematuria. The average delay in diagnosis was 3 months (range, 0–16 months) until the ultrasonographic diagnosis was performed from the first episodes of macroscopic hematuria. A single exophytic tumor (1–4cm) was present in each patient. The pathology of all patients was reported as superficial urothelial neoplasm: two with papilloma, one with papillary urothelial neoplasm of low malignant potential (PUNLMP), four with low grade pTa, and four with low grade pT1. No recurrence was observed during regular cystoscopic and ultrasonographic follow-up. Conclusions: Regardless of the presence of hematuria, bladder tumors in children are usually not considered because urothelial carcinoma in this population is extremely rare, which causes a delay in diagnosis. Fortunately, the disease has a good prognosis and recurrences are infrequent. Cystoscopy may be unnecessary in the follow-up of children with bladder tumors. We believe that ultrasonography is sufficient in follow-up.

Outcomes of microsurgical subinguinal varicocelectomy to treat painful recurrent varicocele

In this study, was evaluated the outcomes of patients undergoing microsurgical varicocelectomy to treat scrotal pain due to recurrent varicocele were evaluated. A total of 27 patients who underwent microsurgical varicocele ligation for recurrent varicocele and scrotal and/or testicular pain were included in this retrospective study. Recurrent varicocele in all patients was diagnosed with by physical examination and coloured Doppler ultrasonography (CDUSG). All patients underwent pre‐operative follow‐up and post‐operative follow‐up at 3 and 6 months by physical examination, assessment of using the Visual Analog Scale (VAS) score, and CDUSG. The rRecurrent varicocele was grade 3 in 24 patients (88.9%) and grade 2 in 3 patients (11.1%). In all cases, the varicocele was on the left side. The mean VAS score was 6.5 (range 5–8) pre‐operatively, 0.7 (range 0–5) at 3 months post‐operatively, and 0.3 (range 0–4) at 6 months post‐operatively (p < 0.001). Post‐operative complete responseresolution, partial resolutionponse, and non‐responsiveness rates were 85.2%, 11.1%, and 3.7% at the 3rd month post‐operatively, respectively, and 88.8%, 7.5%, and 3.7% at the 6th month post‐operatively, respectively. During follow‐up, there was recurrence in 1 patient (3.7%) and hydrocele in 1 patient (3.7%). Microsurgical subinguinal varicocelectomy is an effective treatment for patients with scrotal pain caused by recurrent varicocele.

Management of Forgotten Ureteral Stents: Relationship between Indwelling Time and Required Treatment Approaches

Background: Double-J stents are widely used in urology practice, and removal of these stents can sometimes be forgotten. Aims: To investigate whether indwelling time of double-J stent can predict which treatment modality is required for removal of the stent from the body. Study Design: A multicentre, retrospective observational study. Methods: The data of 57 patients who were treated for forgotten ureteral stents between January 2007 and December 2014 were evaluated retrospectively. Patients were classified into four groups according to indwelling time of the stents: 6-12 months, 13-24 months, 25-36 months, and >36 months. Encrustation and associated stone burden of the stents were evaluated with non-contrast stone protocol computerised tomography. Results: Patients were classified according to their duration of the stent indwelling time. Simple cystoscopic stent retrieval was performed in 71.4% of patients in the 6-12 months group, 44% of patients in the 13-24 months group, 6.2% of patients in the 25-36 months group, and 11.1% of patients in the >36 months group. A percutaneous or open surgery was required in no patients with an indwelling time of double-J stent shorter than 30 months. Conclusion: Transurethral and/or percutaneous combined endo-urological approaches are usually sufficient for the removal of forgotten double-J stents. Transurethral procedures are sufficient for the treatment of patients with double-J stent indwelling times less than 30 months.

Complete penile skin necrosis

Superficial penile skin infections may be presented in different clinical situations that vary from simple infection to organ loss and serious morbidity and mortality. Antibiotic treatment and, if necessary, urgent debridement is required. A 46-year-old male patient with the complaints of urethral discharge and pain admitted to our outpatient clinic. He declared that there were midpenil tenderness and erythema 14 days ago which occurred after sexual intercourse. Complete penile skin necrosis with purulent discharge was detected in physical examination. After wound debridement and 14-days of intravenous antibiotic treatment, wound site culture was negative and then full-thickness skin grafting was performed. Urgent antibiotic treatment should be given, especially for the skin infections of the genital area. Despite the rapid spread of antibiotic treatment, clinical presentation may worsen within hours. It should be noted that especially in diabetics and elderly patients with poor hygiene, the infection may spread to anogenital region and may lead to fulminant necrotizing fasciitis which can present with severe morbidity and mortality. Reconstructive surgery is planned after the control of infection and according to the amount of tissue loss.

The Damage of Penile Doppler Ultrasonoghraphy in Diagnosis of Penile Mondor's Disease: A Report of Two Cases.

Penile Mondors disease is a thrombophlebitis of the superficial dorsal vein of the penis. It is a rare clinical diagnosis and generally resolves spontaneously. A simple physical examination is sufficient for diagnosis but color Doppler ultrasonography is often carried out as a further investigation. We describe two patients who developed priapism due to penile Doppler ultrasonography which was used for diagnosis of these patients. Now, in our opinion this examination was unnecessary.

Can Hounsfield Unit Value Predict Type of Urinary Stones

1 Alper Gök1, Ali Çift1, Bahri Gök2, Kemal Ener3, Mehmet Özgür Yücel1, Hacı Polat1, Can Benlioğlu1, Bedreddin Kalyenci1, Zeki Ender Güneş4 1Adıyaman Üniversitesi Tıp Fakültesi, Üroloji, Adıyaman, 225 Aralık Devlet Hastanesi, Üroloji, Gaziantep, 3Ankara Atatürk Eğitim ve Araştırma Hastanesi, Üroloji, Ankara, 4Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Üroloji, Ankara, Türkiye Böbrek Taş Cinsleri / Type of Urinary Stones Can Hounsfield Unit Value Predict Type of Urinary Stones?

Perkütan Nefrolitotomide Başarıyı Etkileyen Faktörler

Community mental health centers are centers where patients with heavy mental disorders are provided with not only treatments in order to develop individual functioning, but also psychosocial support services and follow-up and treatment services as well in their own residence integrated with their primary healthcare in accordance with community-based mental health model. In order to provide an efficient mental health care service in a country, first the citizens of that country should be protected in terms of mental health, then the risky groups should be determined, and early diagnosis and treatment methods should be provided and in order to increase the quality of healthy life mental health and rehabilitation services which are composed of education and consultancy steps, should be offered. This study has been conducted in order to compile the research results for the development of nursing services in community-based mental health services in our country, which are still in development stage. In the study, in order to assess the development of community-based mental health services, the founding and functioning of community health service centers and the efficiency of community mental health nurses in those centers, PsychINFO, PsychARTICLES, MEDLINE, PubMED, The COCHRANE LIBRARY, CINAHL databases have been scanned for articles published between the years 1999 and 2014.