Coşkun Şahin

Comparison of Different Forms of Local Anesthetic in Cystoscopy: A Prospective Randomized Study

1 Mehmet Kalkan1, Sadi Turkan2, Abdullah Keretli3, Coskun Şahin1, Muhammet Fuat Ozcan4, Serkan Altinova4 1Sema Hastanesi, Uroloji Klinigi, Istanbul, 2Ozel Anadolu Hastanesi, Uroloji Klinigi, Kastamonu, 3Sema Hastanesi, Anestestezi ve Reanimasyon Klinigi, Istanbul, 4Ankara Ataturk Egitim ve Arastirma Hastanesi, Uroloji Klinigi, Ankara, Turkiye Lokal Anestezi ile Sistoskopi / Cystoscopy with Local Anaesthesia Comparison of Different Forms of Local Anesthetic in Cystoscopy: A Prospective Randomized Study

Collective Circumcision Performed in Sudan: Evaluation in Terms of Early Complications and Alternative Practice

OBJECTIVE To present the results and complications of a collective circumcision application performed using a thermocautery device with the patient under local anesthesia in Sudan. MATERIALS AND METHODS A total of 5871 children aged 7 days to 17 years (mean 5.7 years) living in different regions of Sudan were circumcised from May 3 to 25, 2012. The circumcision procedures were performed by an experienced urologist and specialized healthcare officers with the patients under local anesthesia using a Thermo-Med TM 806 cautery device. The outcomes were evaluated in terms of early complications. RESULTS None of the patients experienced bleeding that required surgical intervention. Mild hemorrhage developed in 3 cases but resolved with cauterization. One child developed tachycardia and syncope after the injection; however, no treatment was needed, and observation was sufficient. One patient developed a scrotal abscess, which was surgically treated. None of the patients developed complications from the local anesthetic agent. CONCLUSION Although we are not in favor of collective circumcisions, our results have demonstrated that this type of circumcision can be performed safely with appropriate equipment and personnel in those regions in which circumcisions cannot be performed in a hospital setting for socioeconomic reasons.

A Bladder Wall Angiomyolipoma as a Manifestation of Tuberous Sclerosis: First Case Report

A 21-year-old female patient admitted to the emergency department complaining of left side pain. Hypovolemic shock, which was probably caused by retroperitoneal bleeding from left sided renal angiomyolipoma, was developed. Abdominal computed tomography showed multiple fat containing lesions in different, regions including right bladder wall, lower pole of left kidney, and right kidney. Some lesions compatible with tuberous sclerosis such as angiofibromas, Shagreen patches, myocardial, and brain hamartomas were also detected. Bladder wall mass showing intra- and extravesical extensions was seen at exploration. We removed the tumor completely preserving bladder trigone. Angiomyolipoma located at lower pole of left kidney was also removed. Diagnosis of bladder angiomyolipoma was confirmed by the immunohistochemical examination. Recurrent or residual mass was not detected at the three-months-follow-up. We report the first case of bladder angiomyolipoma confirmed by histopathologically as a tuberous sclerosis.

Retrospective Analysis of Patients with Genitourinary Fistula

Objective: To present the outcomes of patients treated at a tertiary center for a diagnosis of genitourinary fistula secondary to gynecological and obstetric etiologies. Study Design: In this retrospective study, analysis was made of 18 patients with a diagnosis of genitourinary fistula in a tertiary center between January 2006 and June 2016. Patient data were taken from the archives and patient histories. A record was made of examinations, diagnostic methods such as cystoscopy and fistulography and appropriate medical treatments, demographic data, intraoperative and post-operative complications, duration of hospital stay, surgical operations and types, diameter and location of fistulas. Results: Of the 18 cases, 14 were secondary to obstetric trauma. In 10 of these 14 cases, fistula had developed after difficult vaginal delivery and in four cases, after caesarean section. Four of the 18 cases were secondary to gynecological surgeries, namely hysterectomy and cystocele repairs. Vesicovaginal fistulas were repaired transvaginally while vesicouterine fistulas and bilateral ureterovaginal fistulas were repaired transabdominally. The mean hospital stay was 3.8±1.5 days (2-7 days). Patients were followed up closely in the first 3 months and recurrence developed in only one case. Conclusion: Fistulas secondary to gynecological procedures are uncommon while fistulas secondary to inadequate perineal care, insufficient labor monitoring and difficulties in vaginal delivery techniques are more prevalent in Turkey. Thorough evaluation, using all diagnostic tools for complete diagnosis, understanding the pathophysiology and choosing the best surgical procedure are mandatory to obtain good outcomes after the surgical

Repair of Adult Hypospadias Under Local Anesthesia: The Technique and Outcomes

DOI: 10.4328/JCAM.2068 Received: 28.09.2013 Accepted: 23.10.2013 Printed: 01.07.2015 J Clin Anal Med 2015;6(4): 410-3 Corresponding Author: Mehmet Kalkan, Fatih Üniversitesi Tıp Fakültesi Hastanesi, Sahil Yolu Sok. No: 16, 34844 Dragos, Maltepe, İstanbul, Turkey. T.: +905322650917 F.: +9

Scrotal Lipomatosis Mimicking Varicocele: A Case Report and Review of the Literature

Scrotal lipomatosis is a rarely seen disease with an etiology that is not fully understood. Some information suggests that this disease may be associated with infertility. It is characterized by pain-free scrotal swelling. In this study, we reported a scrotal lipomatosis case presenting due to infertility and pain-free scrotal swelling. It was operated on with the initial diagnosis of varicocele, but once fatty tissue was observed in the scrotum, the case was diagnosed as scrotal lipomatosis. Here, we present this rare case with a literature review.

Minimal invasive pyeloplasty technique with vertical surgical approach: An alternative to laparoscopic pyeloplasty

This retrospective clinical study presents pyeloplasty results following a muscle‐splitting dissection, with mini‐flank incision, using instruments held in a vertical position. Between 2004 and 2010, dismembered pyeloplasty (Anderson‐Hynes) was performed in 37 cases (32 males and 5 females) with an average age of 26 years (range, 20–56 years). The technique was carried out through a window opened by separating the lateral abdominal muscles. Operation duration, length of incision, postoperative pain, complications, and radiological and clinical results were discussed. The operation duration was between 50 and 90 minutes (average = 65 minutes), the incisional length 5 and 7 cm (average = 5.2 cm), and visual pain scale was 4.1 ± 3.1 and 3.3 ± 3.4 at 4 and 24 hours after the operation, respectively. The duration of hospitalization was between 30 and 120 hours (average = 42 hours). In a retrospective analysis of our study, one case was reoperated on, following recurrence with obstruction, there were 9 cases with prolonged dilation in response to diuretics and 29 cases with complete recovery. Pyeloplasty operations, with a vertical surgical approach through smaller incisions and muscle separation, offered shorter periods of hospitalization, less postoperative pain, acceptable cosmetic results and higher rates of functional recovery.