Caner Ediz

Condyloma Acuminata of the Urinary Bladder; A Rare Case Report

Condyloma Acuminata (CA) is a sexually transmitted disease caused by the Human Papilloma Virus (HPV) of the papovavirus family and it can be seen on the genital or perianal area, sometimes the external urethral orifice or the bladder. Involvement of bladder is very rare and it may be related with immnuosuppression. In our case, the patient came to the hospital with genital lesions and urinary irritation symptoms such as dysuria and pollakiuria. Genital warts were located in the genital area, therefore we took excisional biopsy. And then, the lesions were treated with bipolar cauterization. Cystoscopy was performed to check for involvement of urinary system. There was hyperemia in the base of the bladder and the inter trigonic line and there was an increase in vascularization. We took cold cup punch biopsies from several suspicious areas. The pathological results of external genital warts and bladder biopsies were found consistent with condyloma acuminata. The lesions in the bladder were fulgurated and immunotherapy was performed to prevent recurrence of CA.

Positive Predictive Values in Diagnosis of Incidental Prostate Cancer

Objective: Although the incidence of incidental prostate cancer (IPCa) decreases in recent years; for patients who performed by transurethral resection of the prostate (TURP) due to bladder outlet obstruction with or without prostatism symptoms (BPH), it is still can be seen. This article purposes to answer two questions a) for urologist, which clinical parameters including obesity and smoking have positive predictive value. b) for pathologists; which materials are wholly sampled for reducing the cancer ? Methods: We evaluated 1315 cases who were performed by TURP due to bladder outlet obstruction with or without prostatism symptoms the years 2006-2015. The ages of the patients, smoking, body mass index (BMI), digital rectal examination (DRE) findings, preoperative prostate specific antigen (PSA) levels, uroflow values, total prostate volume determined by suprapubic ultrasound and Gleason score were recorded. We analyzed the relationship between these parameters and IPCa. These situation compared with benign prostate tissue materials. Results: Totally 31 cases (2.35%) were found in the IPCa. While the cases of 24 were pT1a, 7 cases were pT1b. Age, body mass index, PSA, peak current speed and mean flow rate parameters respectively 8.887, 5.668, 9.660, 4.814 and 3.716 times as an incidental effect in detecting prostate cancer has been concluded. Conclusion: Older patient age, over the 25 kg/m2 of BMI, over the 4 ng/dl of PSA levels, the peak flow rate less than 10 ml/sec and the mean flow rate less than 5 ml/sec might be independent risk factors for detecting IPCa. More external validation is needed for confirming our results. Key words: Incidental prostate cancer, clinic parameters, diagnosis

Percutaneous nephrolithotomy in very elderly patients (Age 75 and Over)

Amac: Perkutan nefrolitotomi (PNL),tum dunyada bobrek tasi cerrahi tedavisinde guvenle kullanilan minimal invaziv bir yontemdir. Ilk PNL ameliyati Mart 1998 tarihinde yapilan klinigimizde yetmis bes yas uzeri ilk PNL ameliyati ise Haziran 2000 tarihinde bilateral olarak yapildi. Calismamizda, 75 yas ve ustu hastalara yapilan PNL operasyonlari incelendi. Yontemler: PNL islemleri genel anestezi altinda yapildi. Hastalara, supin pozisyonda sistoskopi yapildiktan sonra ureter orifisinden ureter kateteri C kollu floroskopi esliginde takilarak uretral foley katetere tespit edildi. Sonrasinda hastalar prone pozisyona alinarak floroskopi esliginde Chiba ignesi ile bobrege girildi. Amplatz renal dilatator setiyle 30F’e kadar dilatasyon saglandi. Islem sonrasi renal kilif icerisinden nefrostomi kateteri yerlestirildi. PNL sonrasi 4 mm’den kucuk taslar, klinik onemsiz tas reziduleri kabul edildi. Bulgular: Mart 1998 – Aralik 2014 tarihleri arasinda, 16 yilda toplam 3003 perkutan nefrolitotomi islemi yapildi. Bu hastalardan 27 tanesi 75 yas ve uzeriydi. Bu hastalara, biri bilateral olmak uzere 28 PNL islemi yapildi. Hastalarin yas ortalamasi 79,37 (75-88) yil olarak hesaplandi. 20 (%74) hastada tam tassizlik saglandi. 2 hastada tubeless PNL yapildi. Viseral organ yaralanmasi, sepsis ya da olum gorulmedi. Sonuc: Minimal invaziv bir yontem olan PNL, yuksek guvenlik, dusuk komplikasyon oranlari, daha kisa hastanede kalis suresi, yuksek hasta memnuniyeti saglamasi, daha yuksek tassizlik oranlari ile acik bobrek tasi cerrahisine gore avantajli bir hale gelmistir. Uriner sistem tas hastaliginin cerrahi tedavisinde PNL guvenli ve etkili bir yontemdir

Comparación de los resultados después de flouroquinolonas y terapias de combinación en prostatitis crónica tipo IIIA

PURPOSE We investigated retrospectively the clinical outcomes of the patients with type iii inflammatory chronic prostatitis, who were treated with fluoroquinolones with and without an α-blocker between 2009-2011. MATERIAL AND METHODS Diagnosis was established with medical history (symptoms presented longer than 3 months within previous 6 months), physical examination, Meares-Stamey test and the questionnaire of the NIH-CPSI. The responses to the treatment were assessed with uroflowmetry test and the questionnaire of NIH-CPSI at initial and after 4 weeks of the treatment. The patients with incomplete data and treatment and who treated with α-blockers and/or antibiotics in the period 4 weeks prior to the therapy started in our clinic and had any surgery of lower urinary tract previously were excluded. The patients were classified under 6 groups; group1=ciprofloxacin, group2=ofloxacin, group3=levofloxacin, group4=ciprofloxacin+tamsulosin, group5=ofloxacin+tamsulosin, group 6=levofloxacin+tamsulosin. Wilcoxon Signed Ranks and Kruskal Wallis test were used for comparison of results. Mann Whitney U test with Bonferroni correction made was used as posthoc (P<.05). RESULTS The median scores of NIH-CPSI decreased significantly in all groups (P<.05). Levofloxacin reduced the median total scores of NIH-CPSI more than ciprofloxacin and ofloxacin monotherapies. The combination therapies were better than antibiotic therapies alone and best result was obtained in levofloxacin+tamsulosin combination. CONCLUSION Tamsulosin+fluoroquinolone (especially tamsulosin+levofloxacin) combinations yielded better results in both NIH-CPSI scores and peak flow rates.