Eray Hasirci

Labial fusion causing urinary incontinence and recurrent urinary tract infection in a postmenopausal female: a case report

A 73-year-old postmenopausal woman was admitted with recurrent urinary tract infection and a history of incontinence. General physical examination was normal. Complete labial fusion was noticed on genital examination. Surgical intervention was performed. This therapy alleviated incontinence and recurrent urinary tract infection.

Single Injection Results of Endoscopic Treatment of Vesicoureteric Reflux with Different Tissue-Bulking Substances in Patients with End Stage Renal Failure

PURPOSE To evaluate the outcome of subureteral injections by using calcium hydroxyapatite (CaHa), dextranomer/hyaluronic acid copolymer (Dx/HA), and polydimethylsiloxane (PDS) in patients with end-stage renal failure (ESRF) who have vesicoureteral reflux (VUR). PATIENTS AND METHODS One hundred-one patients (166 renal units) with ESRF secondary to VUR were included in this retrospective study. The reflux was bilateral in 65 of the cases. CaHa, Dx/HA and PDS were used in 57, 26, and 18 patients, respectively. All patients were reviewed with regard to age, sex, reflux grade, type of injected materials, injectable agent volume, and outcome. RESULTS The reflux resolved completely in 30 patients (50/96 renal units, 52.1%), in 17 patients (27/44 renal units, 61.4%), and in 4 patients (5/26 renal units, 19.2%) with CaHa, Dx/HA, and PDS, respectively. Regression rates of reflux to grade I with these agents in the same order were 3.1% (2 patients, 3/96 renal units), 4.5% (1 patient, 2/44 renal units), and 11.5% (2 patients, 3/26 renal units). Thus, the overall success rate were noted as 55.2%, 65.9%, and 30.7%, respectively. There was no difference among these three injectables with regard to overall success rates (P = 0.062). No significant correlation with age, reflux grade, agent volume, and significant difference with sex were observed (P > 0.05). CONCLUSIONS In this group of patients, the success rate of the subureteral injection treatment does not appear to be affected by the type of the injectable agent. In addition, the cure rates were independent from the individual factors, reflux grades, and injected volumes.

Distribution and number of Cajal-like cells in testis tissue with azoospermia

We investigated the number and distribution of Cajal‐like cells in patients with azoospermia. A total of 99 patients with non‐obstructive azoospermia were divided into subgroups [19 patientsin hypospermatogenesis group (S1), 40 patients in maturation arrest group (S2), 20 patients in a Sertoli cell‐only syndrome (S3), and 20 patients in a testicular atrophy and fibrosis group (S4)], and 20 patients with obstructive azoospermia group (S0). Sections stained with a c‐kit antibody were studied by light microscopy to determine the number and distribution of Cajal‐like cells in peritubular and perivascular areas of testis. The number of Cajal‐like cells were higher in all the non‐obstructive groups than in the obstructive group (S0: 2.43 cells/mm2, S1: 3.14 cells/mm2, S2: 4.00 cells/mm2, S3: 4.57 cells/mm2, S4: 3.86 cells/mm2) but statistically significantly different (p < 0.05) in the S2 and S3 subgroups only. Distribution of Cajal‐like cells were similar in all groups. The number and distribution of Cajal‐like cells in non‐obstructive groups suggest that these cells may affect spermatogenesis. This cellular type can be responsible for the regulation of cellular motility or spermatogenesis. Electrophysiological and electron microscopic studies are needed to better define morphology and function of Cajal‐like cells in the testis, especially totally the normal testis tissue.

Expression of maspin in testis tumors with germ cells andits relation with angiogenesis factors.

BACKGROUND/AIM We aimed to evaluate the importance of maspin expression in testicular tumors with germ cells, its effect on prognosis, and the relation with angiogenesis factors. MATERIALS AND METHODS The paraffin blocks of the orchiectomy materials of 32 patients who had undergone orchiectomy due to testicular tumors were taken within the scope of the study. The specimens of the cases included in the study group were reexamined under light microscope. RESULTS While just one maspin-positive sample was found in the seminoma cases, maspin stained positively in 6 of the nonseminoma germ cell tumors (NSGCTs). No statistical difference was found between maspin and tumor stage, size, alpha fetoprotein values, vascular endothelial growth factor, Ki-67, and CD31. A statistically positive correlation was only determined between maspin and p53 (P < 0.001). CONCLUSION Maspin protein, whose expression in some tumors is accepted as a poor prognostic factor, is also expressed in testicular tumors with germ cells. However, according to our study, it is difficult to say whether this protein is a favorable or poor prognostic factor in testicular tumors and to understand how the effect mechanism works. The positive correlation between maspin and p53 in the NSGCTs makes us think that maspin might have displayed an effect on the p53 pathway.

Medical dissolution therapy for kidney stone with low density on non-contrast computed tomography

Objective: To review the outcome of dissolution therapy in low-density urinary stones defined by nonenhanced computed tomography. Materials and Methods: The outcome of dissolution therapy in patients treated between May 2011 and July 2016 was retrospectively reviewed. Potassium sodium hydrogen citrate was used in cases with syone of <800 Hounsfield units determined by non-enhanced computed tomography. A decrease of 50% in the long axis of the stone was defined as partial dissolution. Cases with complete and partial stone dissolution were taken as the treatment success group whereas those who could not tolerate the treatment and who has less than 50% decrease in stone size were noted as treatment failure. The patients were compared with respect to age, body mass index, stone size, stone density, duration of treatment and follow-up, urine pH and serum uric acid levels. Results: Of 46 patients 31 completed the treatment course. A full response was obtained in 22 (71%) and a partial response in 4 (12.9%) cases. The basic factors found to affect the success of treatment were stone surface area, pre-treatment urine pH and serum uric acid levels. Conclusion: Low-density urinary stones can be successfully treated with dissolution therapy. In patients with radiolucent stones, the stone density should be measured by using non-enhanced computed tomograms. In cases examined with suitable stone density, dissolution treatment can be started without determining the exact type of the stone.

Can We Predict the Outcome of Varicocelectomy Based on the Duration of Venous Reflux

OBJECTIVE To investigate the outcome of varicocelectomy based on the duration of venous reflux (DVR) of the pampiniform plexus veins. MATERIALS AND METHODS In total, 138 patients with clinically palpable varicoceles were evaluated for DVR with color Doppler ultrasonography from May 2009 to August 2014. The DVR was defined as the DVR of a varicocele in the supine position during the Valsalva maneuver. Patients with bilateral, recurrent, or subclinical varicoceles; hormonal imbalances involving follicle-stimulating hormone, luteinizing hormone, or total testosterone; azoospermia; and intraoperative or postoperative complications were excluded. Of the 138 patients, 76 met the inclusion criteria. All patients were treated with subinguinal microscopic varicocelectomy. Restoration of all three semen parameters (concentration, motility, and morphology) to normal values 6 months postoperatively was considered to indicate treatment success. The patients were divided into those with a DVR of <4.5 seconds (Group 1) and ≥4.5 seconds (Group 2). RESULTS The mean age of the patients was 29.39 (±6.03) years. No statistically significant relationship was found between the success rate and varicocele grade. The cutoff DVR value was calculated as 4.5 seconds using a receiver operating characteristics curve according to patients who underwent successful treatment. The success rates of Groups 1 and 2 were 40.0% and 88.2%, respectively (P = .0001). CONCLUSION The results of this analysis indicate that a DVR of ≥4.5 seconds predicts better outcomes of varicocelectomy.