Cengiz Canakci

Retrograde Intrarenal Surgery for the Treatment of Renal Stones in Patients With a Solitary Kidney

OBJECTIVE To evaluate the efficacy and safety of retrograde intrarenal surgery (RIRS) in the treatment of renal stones in patients with a solitary kidney. MATERIALS AND METHODS From December 2008 to March 2012, 24 patients with a solitary kidney who were treated with RIRS for renal stones were included in the study. All patients were preoperatively evaluated with urine culture, serum biochemistry, urinary ultrasonography, noncontrast computed tomography or intravenous urography, or both. The procedure was considered as successful in patients with complete stone disappearance or fragments <4 mm on computed tomography. Preoperative, operative, and postoperative data of the patients were retrospectively analyzed. The mean serum creatinine levels before and after the procedures were compared using a paired sample t-test. RESULTS The study included 24 patients with a mean age of 44.41 ± 12.15 years (range, 24-70). The mean stone size was 19.83 ± 5.90 mm (range, 10-35). The mean operative time was 55.83 ± 10.90 minutes (range, 40-75). The success rates were 83.3% and 95.8% after the first and second procedures, respectively. A pigtail stent was placed in all patients. The mean serum creatinine levels before the procedures and at 2 weeks after removal of the pigtail stents were 1.54 ± 0.55 mg/dL (range, 0.7-2.8) and 1.56 ± 0.50 mg/dL (range, 0.9-2.6), respectively (P = .92). Minor complications, classified as Clavien I or II, occurred in 4 patients (16.6%). No major complications (Clavien III-V) occurred in the study group. CONCLUSION RIRS is an effective and safe procedure that can be used to manage renal stones in patients with a solitary kidney.

Primary Leiomyosarcoma of the Adrenal Gland: A Case Report with Immunohistochemical Study and Literature Review

Primary adrenal leiomyosarcoma is extremely rare tumor. We report a case with adrenal leiomyosarcoma. Our case was a 48-year-old man who presented with lower urinary tract symptoms. Ultrasonography and magnetic resonance imaging revealed approximately 9 cm solid mass originating from right adrenal gland. He underwent right adrenalectomy. Pathology of the specimen showed histologic and immunohistochemical features of adrenal leiomyosarcoma.

The value of the NMP22 test for superficial bladder cancer diagnosis and follow-up

OBJECTIVE In this study, we investigated the efficacy of nuclear matrix protein 22 (NMP22) in the diagnosis and surveillance of bladder cancer. MATERIAL AND METHODS Patients with hematuria or who applied for cystoscopic control of proven bladder cancer were prospectively enrolled in this study. Routine cytologic examination and NMP22 test were performed on the voided urine sample obtained before the cystoscopy. The patients who had been diagnosed with bladder cancer were categorized according to stage, grade, number, size of the tumor and risk of the disease. Then the diagnostic performance of the NMP22 and the cytology test, alone or in combination, were evaluated separately using ROC curves in the diagnosis and surveillance groups. RESULTS A total of 87 patients (87/136) were investigated because of hematuria. The sensitivity, specificity, positive and, negative predictive values, and positive likelihood ratio (LR+) of the NMP22 test were 70, 80, 68, 81, and 3.42%, respectively. While, the sensitivity, specificity, positive and, negative predictive values, and positive likelihood ratio (LR+) of the cytology examination were 27, 96, 82, 68, and 7.36%, respectively. There were 49 patients in the bladder cancer group. The sensitivity, specificity, positive, and negative predictive values and positive likelihood ratio (LR+) of the NMP22 test in these patients were 33, 76, 31, 78 and 1.37%, respectively. The sensitivity, specificity, positive and, negative predictive values, and positive likelihood ratio (LR+) of the cytology examination were 25%, 97%, 75%, 80% and 9.25, respectively. CONCLUSION NMP22 test can be used as an adjunctive tool for the detection of bladder cancer, but its diagnostic performance is limited in surveillance when used alone or in combination with a cytology examination.

Evaluation of the Lower Urinary Tract Symptoms and Erectile Dysfunction with Uroflowmetry, IPSS and IIEF Questioniares

This study was conducted to investigate the relationship between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) in aging men. The population of elderly men in Turkey has increased through last two decades. Therefore, problems of aging men had found growing scientific attention in our country. In this study, we investigated the association between LUTS and ED, while considering the other concomitant factors for ED, including severity of urinary symptoms according to uroflowmetric measurements.

Bilateral pyelolitotomy for cystine stones encircling the bilateral D-J stents in an infant presenting with anuria

SUMMARY Cystinuria is a hereditary disorder of cystine and dibasic amino acids (lysine, arginine, ornithine) transport across the luminal membrane of renal tubules and intestine, resulting in recurrent nephrolithiasis. Predominant clinical finding of this disease is the occurrence of recurrent cystine stones. Cystine stones frequently occur in the second or third decade of life with an occasional occurrence in infancy. Atypical symptoms of renal stones as anuria can become apparent in infancy. Bilateral cystine stones causing acute anuria in infants are extremely rare. We report the first case of bilateral pyelolitotomy performed for cystine stone and impacted bilateral double-J (DJ) stents in an infant presenting with anuria. In our patients DJ stents were removed, and a stone-free state was successfully achieved.