Mehmet Mesut Piskin

Primary hydatid cyst in adrenal gland: a case report.

The hydatid cyst of the adrenal gland is extremely rare pathology of the adrenal gland; here we report an adrenal hydatid cyst that presented as a solitary renal tumor.

Hemostatic Efficacy and Histopathological Effects of Ankaferd Blood Stopper in an Experimental Rat Model of Cyclophosphamide-induced Hemorrhagic Cystitis

OBJECTIVE To evaluate the hemostatic efficacy and histopathological effects of Ankaferd Blood Stopper (ABS) in an experimental rat model of cyclophosphamide-induced (CYP) hemorrhagic cystitis (HC). MATERIALS AND METHODS Forty male Sprague-Dawley rats were included in the study. Firstly, 10 rats were divided equally into 2 groups where the first group was administered only an intraperitoneal (i.p.) injection of normal saline to constitute the negative control group (CON). The remaining 5 rats were administered only a single i.p. injection of CYP (without any further treatment) for induction of HC to constitute the positive control group (HC). Subsequently, the remaining 30 rats, which also received i.p. CYP for induction of HC, were divided into 3 groups to which intravesical saline (SAL group), epinephrine (EPN group), and ABS (ANK group) were administered for 3 consecutive days. Ten days after the third instillation, cystectomy was performed for histopathological examination. Specimens were evaluated for presence of congestion, edema, necrosis, ulceration, and regenerated epithelium, and scores were given for each parameter according to the severity. RESULTS No statistically significant difference was observed for congestion, edema, necrosis, and ulceration between HC-SAL, and also between CON-ANK groups (all P values >.05). There was a significant difference for total scores between EPN and ANK groups (P = .009). There was statistically significant difference for regenerating epithelium between CON-EPN, CON-ANK, HC-ANK, and SAL-ANK groups. CONCLUSION Intravesical administration of ABS is at least as efficacious as EPN in terms of congestion, edema, necrosis, and ulceration. Moreover, ABS can be considered as a better option in inducing regenerating epithelium than EPN.

Unusual Presentation of Renal Cell Carcinoma: Gluteal Metastasis

Renal cell carcinoma (RCC) has widespread and unpredictable metastatic potential. The most common sites of metastatic RCC are the lungs, lymph nodes, bones, liver, and brain; however the soft tissue metastasis is rare (2,3). Here we report a 76-year-old male patient who had renal cell carcinoma presented with gluteal metastasis. To our knowledge this is the first renal cell cancer case with gluteal metastasis at the initial diagnosis.

Pure Squamous Cell Carcinoma after Intravesical BCG Treatment

Besides the commonly seen side effects of intravesical BCG instillations, very rare complications have been reported including new tumor formation other than transitional cell carcinoma of the bladder. Here we report the first case of pure squamous cell carcinoma formation in a BCG-treated patient with pure transitional cell carcinoma.

Aromatase deficiency in an adolescent girl misdiagnosed as congenital adrenal hyperplasia in infancy and childhood

A 15-year-old girl was admitted to the pediatric endocrinology department due to an absence of menarche. She has healthy parents and seven sisters. She was the offspring of a second-degree consanguineous marriage by normal vaginal delivery after full-term gestation. Her past history revealed corrective surgery of ambigious genitalia at postnatal 3 months and use of prednisolone until 6 years of age with the diagnosis of congenital adrenal hyperplasia. She had no salt wasting crisis. There was no history of drug ingestion in pregnancy. The voice of the mother had thickened during pregnancy. On physical examination, the patient’s height was 156 cm (–0.91 SDS), weight was 54 kg (0.19 SDS), body mass index was 22.19 (0.64 SDS), and blood pressure was 126/79 mmHg. On pubertal examination, the following were observed: breast development was Tanner stage 3; there was no increased pigmentation of the genital area; pubic hair was Tanner stage 3; there was no palpable gonads; phallus length was 1.5 cm; vaginal orifice was current; and the external genitalia was consistent with the Prader stage 3. On laboratory assessments complete blood count, urinalysis, renal and liver tests, serum and urine electrolytes, and thyroid function tests were normal. Basal hormone levels were: adrenocorticotropic hormone (ACTH) 33 pg/mL (7–63 pg/mL); cortisol 20.65 μg/dL (6.7–22.6 μg/dL); 17-hydroxyprogesterone (OHP) 0.82 ng/dL (0.07–1.7 ng/dL); dehydroepiandrosterone sulfate (DHEAS) 80 μg/dL; (51–321 μg/dL); follicle stimulating hormone (FSH) 96 mU/mL (1.5–12.8 mU/mL); luteinizing hormone (LH) 21.5 mU/mL (0.1–12 mU/mL); Estradiol (E2) 1 pg/mL

Renal stone composition does not affect the outcome of percutaneous nephrolithotomy in children

PurposeWe sought to investigate the association between renal stone composition and percutaneous nephrolithotomy outcomes in pediatric patients and define the characterization of the stone composition.MethodsThe data of 1157 children who underwent percutaneous nephrolithotomy between 1991 and 2012 were retrieved from the multicenter database of the Turkish Pediatric Urology Society. The study population comprised 359 children (160 girls, 199 boys) with stone analyses. Patients were divided into five groups according to the stone composition [group 1: calcium oxalate; group 2: calcium phosphate; group 3: infection stones (magnesium ammonium phosphate, ammonium urate); group 4: cystine; group 5: uric acid, xanthine stones].ResultsPatient characteristics, perioperative, postoperative, and stone characteristics were compared considering the stone composition. There were no significant differences between the groups concerning age, sex, side involved, preoperative hematocrit levels, and solitary renal unit. Patients with cystine stones were more likely to have a history of stone treatment. Groups 2 and 5 had mostly solitary stones. However, group 3 had staghorn stone more often, and group 4 frequently had multiple stones. Overall stone-free rate (79.4%) was similar among the groups. Although stone composition was related to blood transfusion and prolonged operative and fluoroscopy screening times on univariate analysis, it was not a significant predictor of them on multivariate analysis.ConclusionsStone composition was not a predictor of outcomes of pediatric percutaneous nephrolithotomy. However, cystine and infection stones, which are larger and filled multiple calyxes due to the nature of stone forming, were more challenging cases that need multiple tracts.

Polyorchidism; unilateral, one atrophic undescended double testicles

Polyorchidism is a very rare genitourinary anomaly defined with the presence of more than two testicles. Polyorchidism is associated up to 40% with undescended testicles. The present report is about an incidentally detected triorchidism case with unilateral, one atrophic undescended double testicles. A 4-year-old child, diagnosed with undescended left testicle revealed during orchiopexy polyorchidism with distinct epididymis and vas deferens. Whereas one of the testicles was in regular size; the other two were atrophic. Orchiectomy was conducted on the atrophic testicle and orchiopexy to the regular size testicle. The atrophic testicle excised was referred histopathological analysis and was diagnosed as atrophic testis. The patient discharged on the first postoperative day, was considered as normal during postoperative evaluation made on the third postoperative day. Polyorchidism is a rare genitourinary abnormality, and its management is still controversial. Yet, we believe that orchiectomy is to be conducted in atrophic testicle cases.

Fracture With Urethral Injury: Evaluation by Retrograde Urethrogram

Penile fracture is a rare condition. It primarily involves the rupture of the corpus cavernosum during erection, which may also affect the corpus spongiosum and urethra. We describe the case of a 35-year-old man who presented with acute penile pain, penile swelling, and a hematuria after a blunt trauma during sexual intercourse. The emergency retrograde urethrogram revealed a rare condition, extravasation of the opaque material from the penile urethra into the cavernous structure. The partial rupture of the corpus cavernosum with urethral disruption was repaired surgically. At the 3-month postoperative follow-up control, no complications were reported by the patient who has had both normal erectile and voiding functions. In cases of penile fracture with suspected urethral injury, retrograde urethrogram can be used for definitive diagnosis.

Ischemic priapism: Can eosinophil count and platelet functions be positive predictive factors in etiopathogenesis

INTRODUCTION We evaluated the relation between ischemic priapism (IP) and blood count parameters in IP patients. We especially wanted to examine the contribution of eosinophil count (EC), platelet count (PC), and mean platelet volume (MPV) values, which are suspected predictive parameters for vascular endothelium damage and venoocclusive pathogenesis and etiopathogenesis, particularly in IP. METHODS A total of 40 IP patients fulfilled the study criteria. Forty healthy volunteers in a similar age group were included as the control group. Complete blood count values were compared between the two groups. Intergroup comparisons were performed using the Mann-Whitney U test, and the chi-square test was used to assess the relationship between categorical variables in the patient groups. The area under the curve was calculated by receiver operating characteristic (ROC) regression analyses. Epidemiological diagnosis percentages were calculated by finding cutoff values. RESULTS The IP groups high MPV, PC, and EC values compared to those of the control group were detected to be statistically significant (p<0.001, p=0,03, p=0.001, respectively). No statistically significant difference was observed between the two groups for other blood count parameters. Statistically significant values for IP were measured as MPV: positive predictive value: 84%; EC: positive predictive value: 71.4%; and PC: positive predictive value: 61.4%. CONCLUSIONS High MPV, PC, and EC values are significant positive predictive factors in IP etiopathogenesis. No proof was detected for other blood count parameters playing an active role in IP etiopathogenesis.

Intravenous paracetamol for relief of pain during transrectal-ultrasound-guided biopsy of the prostate: A prospective, randomized, double-blind, placebo-controlled study

Transrectal‐ultrasound‐guided prostate biopsy (TRUS‐PBx) is the standard procedure for diagnosing prostate cancer. The procedure does cause some pain and discomfort; therefore, an adequate analgesia is necessary to ensure patient comfort, which can also facilitate good‐quality results. This prospective, randomized, double‐blinded, placebo‐controlled study aimed to determine if intravenous (IV) paracetamol can reduce the severity of pain associated with TRUS‐PBx. The study included 104 patients, scheduled to undergo TRUS‐PBx with a suspicion of prostate cancer, that were prospectively randomized to receive either IV paracetamol (paracetamol group) or placebo (placebo group) 30 minutes prior to TRUS‐PBx. All patients had 12 standardized biopsy samples taken. Pain was measured using a 10‐point visual analog pain scale during probe insertion, during the biopsy procedure, and 1 hour postbiopsy. All biopsies were performed by the same urologist, whereas a different urologist administered the visual analog pain scale. There were not any significant differences in age, prostate‐specific antigen level, or prostate volume between the two groups. The pain scores were significantly lower during probe insertion, biopsy procedure, and 1 hour postbiopsy in the paracetamol group than in the placebo group. In conclusion, the IV administration of paracetamol significantly reduced the severity of pain associated with TRUS‐PBx.