Yusuf Ziya Atesci

Erratum to “Does Urinary Bladder Shape Affect Urinary Flow Rate in Men with Lower Urinary Tract Symptoms?”

In the paper titled “Does Urinary Bladder Shape Affect Urinary Flow Rate in Men with Lower Urinary Tract Symptoms?” we should add an author who has contributed to our study for the images: Murat Cinar, Department of Biomedical Engineering, Faculty of Engineering and Architecture, Izmir Katip Celebi University, 35620 Izmir, Turkey. In addition we should here correct the affiliation of one of the authors named Omer Karal and the postal code in the affiliation of the author Mahmut Pekedis.

The relationship between bladder wall thickness and lower urinary tract symptoms: Does bladder wall thickness change after alpha-blocker therapy with alfuzosin?

INTRODUCTION We evaluate the association between lower urinary tract symptoms (LUTS) and bladder wall thickness (BWT) and investigate whether alfuzosin might improve BWT. METHODS We retrospectively reviewed the data of 164 patients with LUTS. Patients were divided into 2 groups according to BWT (Group 1: BWT ≤5 mm, n = 69; Group 2: BWT >5 mm, n = 95). Age, international prostate symptom score (IPSS), maximum and average urinary flow rates (Qmax and Qave), quality of life (QoL), postvoid residual (PVR) urine volume, prostate volume and prostate-specific antigen (PSA) were compared between the 2 groups. In total, 102 patients underwent transurethral resection of the prostate (TURP) and 62 patients were treated with alfuzosin. We compared BWT, Qmax, Qave, IPSS, QoL, PVR and PSA before and at the sixth month of alfuzosin therapy. A p value of <0.05 was considered statistically significant. RESULTS The mean BWT of Group 1 was 3.72 ± 0.56 mm and Group 2 was 6.43 ± 1.13 mm. There was a significant difference between the 2 groups in terms of mean Qmax and PVR. There was no statistical difference between the groups in terms of Qave, IPSS, QoL, prostate volume and PSA. There was significant difference between BWT before (6.8 ± 2.1) and after (4.6 ± 1.3) treatment with alfuzosin in 62 patients (p = 0.02). There was a significant difference between pre- and post-treatment values of mean Qmax, Qave, IPSS, QoL score, and PVR with alfuzosin. CONCLUSION BWT is a non-invasive and effective test to evaluate patients with lower urinary tract obstruction and may be used for showing the effectiveness of alpha-blocker therapy in patients with LUTS.

Recent management of urinary stone disease in a pediatric population

The incidence of stone disease has been increasing and the risk of recurrent stone formation is high in a pediatric population. It is crucial to use the most effective method with the primary goal of complete stone removal to prevent recurrence from residual fragments. While extracorporeal shock wave lithotripsy (ESWL) is still considered first line therapy in many clinics for urinary tract stones in children, endoscopic techniques are widely preferred due to miniaturization of instruments and evolution of surgical techniques. The standard procedures to treat urinary stone disease in children are the same as those used in an adult population. These include ESWL, ureterorenoscopy, percutaneous nephrolithotomy (standard PCNL or mini-perc), laparoscopic and open surgery. ESWL is currently the procedure of choice for treating most upper urinary tract calculi in a pediatric population. In recent years, endourological management of pediatric urinary stone disease is preferred in many centers with increasing experience in endourological techniques and decreasing sizes of surgical equipment. The management of pediatric stone disease has evolved with improvements in the technique and a decrease in the size of surgical instruments. Recently, endoscopic methods have been safely and effectively used in children with minor complications. In this review, we aim to summarize the recent management of urolithiasis in children.

Long-term results of permanent memotherm urethral stent in the treatment of recurrent bulbar urethral strictures

PURPOSE To evaluate the long term outcomes of permanent Memotherm urethral stent in the treatment of recurrent bulbar urethral stricture. MATERIALS AND METHODS Twenty patients who underwent permanent Memotherm urethral stent implantation due to recurrent bulbar urethral stricture following previous unsuccessful surgical procedure from 1996 to 2002 were included in the study. Long-term outcomes of the patients were evaluated. RESULTS The overall success rate was 87.5% at the end of the tenth year. There was discomfort in implantation area in eight patients about 1 month following the procedure. These patients were treated with alpha-blocker and anti-inflammatory drugs. Stone formation was observed at the urethral stent implantation area in two patients. Post-void dripping has been observed in 15 patients up to the postoperative 3rd month. Stress urinary incontinence was observed in a patient with a 1-year follow-up. Partial stent migration was observed in two patients. None of the patients experienced pain during erection. CONCLUSION Memotherm urethral stent is a minimal invasive surgical procedure which can be safely and effectively used in patients with recurrent urethral stricture.

Unilateral complete ureteral duplication with distal ureteral stone: A rare entity

Complete duplex ureters opening separately into the urinary bladder is extremely rare; they can be embryologically explained as a development of two ureteral buds separately from a single mesonephric duct. We describe a case of unilateral complete ureteral duplication with distally localized ureteral stone in a 49-year-old male who presented with right flank pain.

The use of the amplatz sheath in percutaneous nephrolithotomy: does amplatz sheath size matter?

Objectives: To evaluate the effect of Amplatz sheath size used in percutaneous nephrolithotomy (PCNL) on postoperative outcome, bleeding, and renal impairment rates. Materials and Methods: One-hundred and ten patients who underwent uneventful percutaneous nephrolithotomy between November 2011 and October 2012 were included in the study. The patients were divided into 5 groups based on Amplatz sheath size (22, 24, 26, 28 and 30 Fr). Groups were comppared in terms of pre- and post-operative mean hemoglobin, creatinine, nephrostomy time, nephrostomy tube diameter, operative time, and fluoroscope time. Results: Mean operative time, preoperative hemoglobin and creatinine values were similar in all groups. Postoperative mean hemoglobin level was significantly lower and postoperative mean creatinine level was significantly higher in patients who were treated with a larger Amplatz sheath when compared to a smaller size (p < 0.05). It was observed that nephrostomy time and nephrostomy tube size significantly increased as the Amplatz sheath size increased. Seven patients presented with postoperative infection (1, 2, 1, 0 and 3 patients in Group I, II, III, IV, and V respectively), 13 patients presented with bleeding requiring blood transfusion (2, 4, and 7 patients in Group III, IV, and V respectively), and residual stone was observed in 9 patients (5, 2, 0, 1, and 1 patients in Group I, II, III, IV, and V respectively). Conclusion: Although the use of a larger Amplatz sheath for larger stones seems to be suitable, this is not the case for smaller stones. For smaller stones, a smaller Amplatz sheath size would be useful to decrease the bleeding and renal impairment rates.

Does Urinary Bladder Shape Affect Urinary Flow Rate in Men with Lower Urinary Tract Symptoms

We aimed to investigate the role of urinary bladder shape which may potentially change with advancing age, increased waist circumference, pelvic ischemia, and loosening of the urachus on bladder emptying and UFR. We retrospectively investigated the medical records of 76 men. The patients were divided into two groups according to bladder shapes in MRI scan (cone and spheric shapes). There was a significant difference between the two groups in terms of IPSS, Qmax, Qave, and waist circumference. A positive correlation has been demonstrated between mean peak urinary flow rate measured with UFM and mean flow rate calculated using the CP. There was a significant difference between mean urinary flow rates calculated with CP of cone and sphere bladder shapes. The change in the bladder shape might be a possible factor for LUTS in men and LUTS may be improved if modifiable factors including increased waist circumference and loosening of the urachus are corrected.

The stone formation in the Memotherm urethral stent implantation area: Is it a rare complication?

Recurrent urethral stricture is one of the biggest problems in urology. Urethral stents as an alternative treatment has been used since 1985. The stone formation in the Memotherm (Angiomed) urethral stent implantation area is a rare complication. We report the case of a 67-year-old man who had a stone in the Memotherm urethral stent implantation area 6 years after his urethral stent surgery.

A clinical study comparing BIVAP saline vaporization of the prostate with bipolar TURP: Early complications, physiological changes and postoperative follow-up outcomes

INTRODUCTION We compare BIVAP saline vaporization of the prostate with bipolar transurethral resection of the prostate (TURP) in the treatment of benign prostatic hyperplasia. METHODS In total, we included 86 patients treated with BIVAP (n = 44) and bipolar TURP (n = 42). The inclusion criteria were maximum urinary flow rate (Qmax) ≤10 mL/s, International Prostate Symptom Score (IPSS) ≥16, and prostate volume measured with transrectal ultrasound scan between 30 and 80 mL. Serum electrolyte, hemoglobin, and hematocrit levels were determined preoperatively and postoperatively. All patients were evaluated at the postoperative first and third months and the IPSS score, post-void residual urinary volume (PVR), Qmax, and average urinary flow rate (Qave) were compared. Statistical analyses were performed using SPSS 16.0 program and statistical significance was set at p < 0.05. RESULTS Preoperative demographic characteristics were similar in the 2 groups. The mean operation time was significantly higher (p = 0.02) and hospitalization time was significantly lower (p = 0.04) in the BIVAP group when compared to the bipolar TURP group. There was no significant difference between 2 groups in terms of preoperative and postoperative serum electrolyte, hemoglobin and hematocrit levels. Postoperative complication rates were similar in the 2 groups. The only exception was the rate of severe dysuria, which was significantly higher in the BIVAP group. No statistical difference was noted between the groups in terms of postoperative follow-up results. CONCLUSION Bipolar TURP is a safe and highly effective technique which can be used in the surgical treatment of benign prostatic obstruction with minimal side effects. BIVAP saline vaporization of the prostate seems to be a potential alternative to bipolar TURP with shorter hospitalization time.

Benign phyllodes tumour of the prostate: An extremely rare entity

Benign phyllodes tumour (BPT) of the prostate is a very rare neoplasm. It is composed of hyperplastic and neoplastic glandular stromal proliferation. Patients with BPT of the prostate generally present with lower urinary tract symptoms and hematuria. BPT of the prostate can potentially cause recurrent obstructive symptoms. Complete transurethral resection (TUR) and close postoperative follow-up is recommended. A 59-year-old man presented with dysuria and obstructive urinary symptoms. Flexible cystoscopy revealed prostatic hyperplasia and a polypoidal lesion originating from the right lateral lobe of the prostate. Magnetic resonance imaging revealed a 3 × 2.5-cm mass lesion in the right lateral lobe of the prostate. TUR of the prostate was performed and the pathological examination revealed benign prostatic hyperplasia and benign phyllodes tumour of the prostate.