Serhan Çimen

Minimally invasive approaches and their efficacy in pediatric urolithiasis

OBJECTIVE We compared the frequency of usage and success of minimally invasive approaches in the management of pediatric urolithiasis in our clinic. MATERIAL AND METHODS Data from pediatric patients (≤16 years of age) who had undergone percutaneous nephrolithotomy (PNL), ureterorenoscopy (URS), and extracorporeal shock wave lithotripsy (ESWL) between January 2001 and December 2011 were retrospectively investigated. RESULTS In this study, 415 pediatric patients, who were treated for 291 renal, and 124 ureteral stones, were evaluated. The patients were treated with PNL (n=148; 82 boys, 66 girls), URS (n=99; 58 boys, and 41 girls) or ESWL (n=168; 91 boys, and 77 girls). The mean patient ages were 7.3 (1-16), 9.1 (1-16), and 8.8 (1-16) years in the PNL, URS, and ESWL groups, respectively. The stone-free rates after treatment with PNL, URS, and ESWL were 77, 83.8 and 88.7%, respectively. CONCLUSION It is important that selected therapies are properly planned, and the use of minimally invasive approaches is important in pediatric patients due to potentially high recurrence rates. Currently, ESWL, PNL and URS are performed with high success rates for the treatment of stones, and open surgery is rarely used due to the success obtained with minimally invasive approaches.

A rare reason of psa elevation seen during intravesical bcg therapy: Granulomatous prostatitis

Prostatitis accounts for approximately 10-14% of cases of urinary system infections admitted to urologists (1). Acute bacterial prostatitis (98-99%) is the most common type of prostatitis. Granulomatous prostatitis, which differs from chronic bacterial prostatitis, constitutes less than 1% of all prostatitis cases. Etiology is not exactly known (2). When the literature is examined, it is seen that the diagnosis of granulomatous prostatitis is often made after surgical interventions of the prostate, intravesical administration of Bacillus Calmette-Guérin (BCG) in the treatment of bladder cancer, iatrogenic interventions or prostate biopsy performed under transrectal ultrasound (TRUS) guidance in patients having prostate-specific antigen (PSA) elevation. BCG treatment may increase dysuria and irritative symptoms, especially in patients with voiding dysfunction (3). In this article, we aimed to present a case of granulomatous prostatitis who was diagnosed with bladder cancer, had PSA elevation during intravesical BCG therapy, and underwent prostate biopsy under TRUS guidance.