Urology

Epidemiological investigations of burn patients help health services to identify the need for burn care and to plan burn care facilities. Various epidemiological studies on burn injury have been conducted, but they have usually covered major burn victims who required hospitalization or minor burn victims who were treated at health care centers. Few studies have included burn victims who were not admitted to any health care center. Through a population-based questionnaire, we studied the epidemiology of the entire population of burn victims, including those who did not seek medical attention. Thus, we identified the actual frequency of hospital admission and the frequency of se-quelae. In total, 1068 persons from the city of Denizli, Turkey were questioned about burns in the last 10 years and the burn prevalence was found to be 12.6%. Only 33.3% of the burn victims were treated at a health care center; thus, 66.7% of the victims were treated at home with traditional burn wound care methods. Etiologic factors such as the age and sex of each victim, the cause and anatomic location of the burn, and location of the victim when burned were all investigated. The overall percentage of sequelae was 31.3%; of these, 89.5% were cosmetic problems, 7.9% were functional impairments, and 2.9% were physiological problems. The low percentage of health care center admissions and high incidence of sequelae suggest the need for professional burn care centers that can be easily reached by burn victims. (J Burn Care Res 2008;29:446 – 450)

Background: We investigated the correlation between standardized uptake value (SUVmax), tumor size and
Fuhrman grade in patients with renal cell carcinoma (RC).  Materials and Methods: We retrospectively analyzed
the data of 54 patients with clear cell renal cell carcinoma histopathologically diagnosed who underwent fuorine-18
fuoro-2 deoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) between
January 2005 and March 2014.  Results: Avarage tumor sizes were 5.64±1.85, 6.85±2.24 and 7.98±2.45 in low,
medium and high SUVmax groups, respectively. The Spearman’s correlation coeffcient between the tumor size
and SUVmax was 0.385 (p=0.004) and between the Fuhrman grade and SUVmax was 0.578 (p<0.001). Conclusions:
SUVmax appears highly correlated with tumor size and Fuhrman grade in patients with histopathologically
confrmed clear cell RC. Multicenter studies are needed to provide larger series for more accurate results

significance. Results: There was statistical significance between NLR and patients with severe IPSS score (>20) and over age 60 years (p = 0.02). Patients younger than 60 years had statistical significance between NLR and PSA <2.5 ng/dl (p = 0.004). When body mass index was selected, there was statistical significance between prostate volume <35 ml (p = 0.009) and age >60 years (p = 0.028). If 60 years of age was selected as cutoff value, there is statistical significance between age and severe IPSS, and in terms of mild erectile dys-function, PSA >2.5 ng/dl, and prostate volume >35 ml. Conclusion: We found positive correlation between NLR and severe symptoms and progression of BPH. In this manner, anti-inflammatory therapy could contribute to the medical treatment of BPH. Higher NLR may be a candidate marker for severity of symptoms in BPH patients.

This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the author's institution and sharing with colleagues. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier's archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/authorsrights

Introduction: We investigated the prognostic significance of the neutrophil-to-lym-phocyte ratio on tumor stage and Fuhrman nuclear grade in renal cell carcinoma. Methods: The records of 432 patients with RCC who underwent radical or partial ne-phrectomy between 2005 and 2014 were retrospectively reviewed. Patients were classified as group lower tumor stage(T1 + T2) and higher(T3 + T4). As like tumor stage, Fuhrman nuclear grade were classified lower (G1+G2) and higher(G3+G4) too. The best NLR cut off value was 3.01.Two sample t-test or Mann–Whitney U-test used for the continuous variables and a chi-square test or Fisher's exact test used for the categorical variables. Results: Among the 432 total patients analyzed in our study, there were 275 males (63.7%) and 157 females (36.3%). Mean laboratory values were CRP 2.73 ± 1.93 mg/ dL (normal less than 0.3), neutrophil count 4,23 ± 1.46/μL, lymphocyte count 1,61 ± 0,61/μL and NLR 2.64 ± 1.24. According to our data, statistically pretreatment NLR significantly correlated with CRP (p<0.0001). And tumor patologic stage (p=0.08), tumor histologic grade (p<0.001) was significantly associated with NLR. Discussion: We compared the relationship of preoperative NLR and NC parameters with RCC tumor stage and grade. And NLR were found to have statistically significant higher T stage and grade at RCC. Further studies with more patients are needed to confirm our study.

Purpose: The aim of this study was to evaluate the relationship between tumor size and grade with visceral adipose index (VAI) levels in patients with renal cell carcinoma. Materials and methods: We retrospectively reviewed the records of 310 consecutive patients with RCC who underwent radical nephrectomy at our institution between Janu-ary 2007 and May 2014. VAI was calculates for males and females seperately as this formula like previous study. The relationship between tumor size and nuclear grade with VAI levels were evaluated statisticaly. Analyses were completed using Chi-square tests and Logistic regression analysis. Results: Among the 310 total patients analyzed in our study, there were 176 males (56.8%) and 134 females (43.2%). VAI levels were statistically higher in men and women with high tumor size (p<0.001). VAI levels were statistically higher in men and women with high fuhrman grade (p<0.001). Conclusions: The components of VAI may have effect on tumor carcinogenesis in similar pathways. In our study patients with high VAI levels were found to have statistically significant higher nuclear grade and tumor size. VAI can be a useful index for the evaluation and calculation of renal cell cancer aggressiviness. Further studies with more patients are needed to confirm our study.

Introduction Transurethral resection (TUR) is the most common surgical technique for the diagnosis and initial treatment of bladder cancer. In this study, we evaluated two surgical techniques in terms of bladder injury due to obturator reflex in patients that underwent TUR for non-muscle invasive bladder cancer (NMIBC). Material and methods 93 patients who underwent TUR for bladder cancer were analyzed. Fifty patients underwent monopolar resection and 43 patients underwent plasmakinetic resection. Standard TUR were performed with conventional Storz monopolar resection using a U-shaped cutting loop, 120V cutting/80 V coagulation settings, 5% mannitol fluid was used for irrigation. For bipolar resection, an Olympus ESG-400 plasmakinetic loop bipolar device using a U-shaped cutting loop, 160V cutting/80V coagulation settings and normal saline for irrigation was used. Results In the monopolar resection group; obturator reflex was seen in 4 (8%) patients. Bladder perforation caused by the obturator reflex was seen in 4 (8%) patients, but hemorrhage and other major complications were not seen in this group. In the bipolar resection group; obturator reflex was seen in 15 (34%) patients. Bladder perforation caused by the obturator reflex was seen in 10 (23%) patients. Conclusions Bipolar transurethral resection of bladder tumor was not superior to monopolar resection with respect to obturator reflex and bladder perforation. We conclude that we do not yet have enough experience concerning the long-term complications and major complications associated with bipolar resection of bladder cancer. Key Words: bladder injury ‹› obturator reflex ‹› plasmakinetic ‹› transurethral resection ‹› monopolar

Background: Epidemiological evidence indicates that individuals with diabetes mellitus (DM) may have a
modestly increased risk of bladder cancer. In the present study, we aimed to show any association between DM
and risk of metastasis in patients with non-muscle-invasive bladder cancer (NMIBC). Materials and Methods:
We retrospectively analyzed 698 patients between January 2007 and December 2014 who were diagnosed with
and underwent transurethral resection of bladder tumors (TUR-BT). Comparisons of means was conducted by
independent samples t test, and relations between categorical variables were investigated by non-parametric chi-square test. A p value of 0.05 was accepted as statistically significant in comparisons.  Results: We analyzed 418
patients with non muscle invasive bladder cancer. 123 of whom were diabetic and 295 non-diabetic. In diabetic
patients, 13 were N1 stage and 11 M1 stage. When compared with non diabetic patients that was statistically
significant (p<0.001). TNM stages were more advanced in diabetic patients (p<0.001), but concurrent CIS (p=0.1)
and squamous metaplasia did not significantly differ between diabetic and non-diabetic cases (p=1). Conclusions:
Diabetic patients with non-muscle-invasive bladder cancer may suffer metastases earlier than expected although
they are non invasive. Therefore such patients must be followed-up carefully and early cystectomy decision may
be necessary. Further prospective studies with more patients are needed to confirm these findings

Introduction:  Diabetes  Mellitus  (DM)  is  increasing  worldwide  health  problems.  Several  studies  have
proposed  an  epidemiological  association  between  DM  and  bladder  cancer.  CIS  is  a  high-grade  carcinoma
with the potential for invasion and metastases. We aimed to reveal association between DM, CIS and tumour
characteristics of patients with bladder cancer.
Material  and  Method: We  retrospectively  analyzed  615  patients  between  January  2007  and  December
2014  who  diagnosed  bladder  cancer  and  performed  TUR-BT  or  radical  cystectomy. All  patients  with  bladder
cancer separated two groups as Non-Muscle Invasive Bladder Cancer (NMIBC) and Muscle Invasive Bladder
Cancer (MIBC). Each groups separated two groups inside them as diabetic or non diabetic.
Results: We analyzed 615 patients with bladder cancer. There was statistically significance for relapse
frequency was higher in diabetic patients than non-diabetic patients. T, N and M stages were more advance in
diabetic patients. Although concurrent CIS is higher in diabetic patients, squamous metaplasias between diabetic
and non-diabetic patients were not significant.
Discussion:  Diabetes is the critical worldwide health problem that has serious complications that can cause
much  kind  of  cancers.  We  revealed  that  there  is  negative  effect  of  diabetes  on  patients  with  bladder  cancer
especially patients with CIS.
Conclusion: Patients with diabetes had advanced stage, grade and concurrent CIS than patients without
diabetes. And also, diabetic patients have more recurrent disease than non-diabetic patients.

Objective: To evaluate the difference between testosterone and total prostate specific antigen (TPSA) serum levels between Arabic and Turkish people in the Middle East. Material and methods: The study included 3 groups of healthy men; Group I included 119 patients with a mean age of 52.73±7.53 years from east of Turkey. Group II consisted of 196 patients with a mean age of 50.32±7.84 years from west of Turkey. Group III consisted of 388, with mean age of 51±6 years from west bank in Palestine. The mean values of PSA and testosterone were calculated for each groups and a comparison were carried out. The relationships among testosterone and TPSA levels and patients' age were investigated.

Objective: To evaluate the effect of anterior suspension stitch during radical cystectomy and ileal neobladder urinary
diversion on continence.

Methods: 176male patients who underwent radical cystectomy and neobladder urinary diversion because of bladder
cancer  in  our  clinic.  We  analyzed  75  patientsretrospectively,  36  with  the  placement  of  anterior  suspension  stitch
Group 1 and 39 without anterior suspension stitch Group 2.  Both groups were compared in terms of age, maximum
urinary  flow  rate,  post  voiding  residual  urine  volume,  total,  nighttime  and  daytime  continence  status.  Incontinence
status was evaluated by International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) 

Results: The two groups had no significant differences in their age, post voiding residual urine volume and maximum
urinary  flow  rate.  Total,  nighttime  and  daytime  continence  rates  were  better  in  group  1.  The  mean  International
Consultation on Incontinence Questionnaire-Short Form score was significantly lower in group 1 (p<0.05). 

Conclusions: We  found  that  the  continence  rates  was  significantly  higher  in  patients  with  the  anterior  suspension
stitch. This technique improves the quality of life of patients in the way of incontinence. The anterior suspension stitch
during radical cystectomy and neobladder urinary diversion is a reliable and applicable procedure.

Objectives: To investigate relationship between the lymphovascular invasion(LVI) and tumor characteristics and to evaluate effect on survival of LVI in patients who underwent radical cystectomy because of bladder cancer. Materials and Methods: Five hundred and six patients were enrolled the study between 1990 and 2013. Patients were divided into two groups in terms of lymphovascular invasion at final pathology after radical cystectomy. There were 108 patients with LVI(group1) and 244 patients without LVI(group2). Both groups were compared in terms of clinicopathologic features and survival. Results: There was no statically different for gender in both group(p=0,222).Lymh node involvement, grade, and p T stage were higher significantly in group 1(p<0,05). Positive lymph node number was 2.3±3.1 in group 1 and 0.6 ± 2.1 in group 2(p<0.001). Lymph node density was 24.3±30.1 in group 1 and 5.6±9.2 in group 2 (p<0.001).Estimated mean survival time was 27.2±3.4 months in group 1 and 80.2 ± 8.1 months in group 2 (p<0.001). Conclusions: Lymphovascular invasion is an independent prognostic factor for disease specific survival and effects survival negatively in patients who underwent radical cystectomy for bladder cancer. Patients with lymphovascular invasion should be considered for close monitoring after cystectomy.

Objective: In this study, our main objective is to show the connection between metabolic syndrome (MetS) and bladder functions by using urodynamic evaluation in female MetS patients. Materials and Methods: 131 female patients referred to our clinic for urodynamic evaluation from April 2014 to December 2014 were included in our study. 85 of these patients were diagnosed with MetS (study group) meanwhile 46 patients did not meet MetS criteria (control group). MetS definitions were taken from National Cholesterol Education Program's Third Adult Treatment Panel criteria. SPSS 17.0 was used for statistical analysis of data and p<0.05 values were deemed as statistically significant. Results: Urodynamic results of 131 patients were analyzed and patients were divided into study and control groups in accordance with their MetS profile. 85 patients were included in the study group and rest 46 were used as the controls. A statistically significant difference was detected when IPSS results were separated into low, intermediate and severe between study and controls (p=0.007). Moreover, urge-type incontinence was more frequent in MetS patients when compared with control group (p<0.001). However, there was no significant difference between groups in terms of SEAPI scores and IPSS. Patients with MetS had significantly higher detrusor, vesical and abdominal pressure in comparison with control group (p<0.001). No significant difference was found in uninhibited contractions, first urinary sense, strong desire to urinate, Valsalva leak-point pressure (VLPP) and abdominal leak-point pressure (ALPP) parameters between the groups Conclusion: Our results showed that MetS and its components can be associated with neurogenic bladder symptoms due to peripheral neuropathy and urge incontinence. Female patients with MetS have significantly higher post-voiding residue and intravesical pressure in comparison with control group. Further clinical studies with longer and controlled series are necessary for clarification of the metabolic syndrome's effect on bladder dysfunction on a molecular level.

Amaç:Üretra darlığı nedeniyle internel üretratomi
operasyonu yapılan hastalarda spinal anestezi ihtiyacını
değerlendirmek.
Gereç ve Yöntem:Üretra darlığı nedeniyle internal
üretrotomi operasyonu yapılan 104 erkek hasta ve
sistoskopi yapılan 50 erkek hasta çalışmaya dahil edildi.
Tüm olgular preoperatif retrograd üretrografi ile
değerlendirildi. Dar segment uzunluğu 1 cm’den kısa ve
tek darlığı olan olgular çalışmaya dahil edildi. 46
hastaya lokal anestezi altında (Grup 1), 58 hastaya spinal
anestezi altında (Grup 2) internal üretrotomi operasyonu
uygulandı. Lokal anestezi ile opere edilen olguların ağrı
skoru sistoskopi yapılan hastalar ile karşılaştırıldı (Grup
3). Ağrı skoru VAS (visuel analog scale) ile
değerlendirildi. Üretrotomi operasyonu sonrası tüm
hastalara 20 Fr üretral kateter takıldı. Lokal anestezi için
lidokainli jel kullanıldı.
Bulgular :Grup 1’in yaş ortalaması 66±17.15, grup
2’nin 68±15.44, grup 3’ün 68±19.25 idi. (p=0.49).
Ortalama operasyon süresi; Grup 1’de 6.9 ± 3.1 dk iken
Grup 2’de 7.1± 4.2 dk idi (p=0.16). Grup 2’de ortalama
VAS skoru 3.2 ± 1.4 iken Grup 3’te 3.0 ± 1.5 idi
(p=0.52).
Sonuç : Lokal veya spinal anestezi altında internal
üretrotomi operasyonu yapılan hastalarda operasyon
süresi açısından anlamlı fark saptanmamıştır. Lokal
anestezi ile internal üretrotomi yapılan olguların ağrı
skoru sistoskopi ile benzerdi. Seçilmiş vakalarda (1
cm’den kısa ve tek darlık) spinal anesteziye gerek
kalmadan lokal anestezi ile internal üretrotomi
operasyonu güvenle yapılabilir.

GİRİŞ Üretra darlığı, üretra lümenini daraltan, korpus spongiosumda-ki subüretral dokunun skarlaşması sonucunda oluşmaktadır (1). Üretra darlığı, idrar akışına engel olarak hastanın yaşam kalitesini bozabilir ve ayrıca kronik idrar retansiyona bağlı böbrek yetmezli-ği gibi ciddi komplikasyonlara neden olabilir (2). Üretra darlıkları-nın nedeni sıklıkla idiyopatik olmakla birlikte, travma ve iatrojenik nedenlerle de üretrada darlık ortaya çıkabilmektedir (3). ÖZ Amaç: Üretra darlığı, üretra lümenini daraltan, korpus spongiosumdaki subüretral dokunun skarlaşması sonucunda oluşmaktadır. Üretra darlıklarının ne-deni sıklıkla idiyopatik olmakla birlikte, travma ve iatrojenik nedenlerle de üretrada darlık ortaya çıkabilmektedir. Çalışmamızda kliniğimizde üretra darlığı nedeniyle internal üretrotomi uygulanan hastalarda üriner kateterizasyon süresiyle ile rekürren darlık arasındaki ilişkiyi inceledik. Yöntemler: Kliniğimizde2014 yılında üretra darlığı nedeniyle endoskopik görüntüleme eşliğinde soğuk bıçakla internal üretrotomi uygulanan 157 hasta dahil edildi. Operasyon sonrası üriner kateterizasyon sürelerine göre 3 gün, 5 gün ve 7 gün olmak üzere 3 gruba randomize edildi. Gruplar arasında nüks ve post operatif Qmax değerleri Ki-kare testi ve Varyans analizi (ANOVA) ile değerlendirildi. Bulgular: 157 hastanın yaş ortalaması 63,51±13,86 yıl idi. Tüm hastaların ortalama preoperatif Qmax değerleri 6,07±2,70 mL/sn, darlık uzunlukları 2,61±2,19 cm ve post operatif Qmax değerleri 10,9±4,1mL/sn idi. Hastaların 49'unda (%31,2) nüks izlenirken, 108 (%68,8) hastada nüks darlık izlenmedi. Post operatif üriner kateter 3 gün bırakılan hastaların 17 (%36)'sinde, 5 gün bırakılan hastaların 12 (%22)'sinde, 7 gün bırakılan hastaların 20 (%35)'sinde nüks üretra darlığı izlendi. İstatistiksel analizde gruplar arasında tekrarlayan üretra darlığı ve post operatif Qmax değerleri açısından anlamlı fark bulunmadı. Sonuç: Günümüzde üretra darlıkları için tavsiye edilen altın standart tedavi yöntemi endoskopik internal üretrotomi yöntemidir. Literatürde birçok çalışma-da internal üretrotomi cerrahi tekniği ve sonuçları birbiriyle karşılaştırılmıştır. Yaptığımız çalışmada üretra darlığı sebebiyle soğuk bıçak yöntemiyle internal üretrotomi yaptığımız hastalarda post operatif üriner kateterizasyonun 3, 5 ve 7 gün bırakılması arasında istatistiksel olarak anlamlı bir fark saptamadık. Hastalarda post operatif üriner kateterizasyon süresinin uzatılmamasını, mümkün olan en kısa zamanda çıkarılmasını önermekteyiz. Operasyon sonrası sonda süresi makul olan en kısa sürede tutularak, hem hasta konforunun arttırılabileceğini, hem de üriner kateterizasyonun uzun süre kalmasına bağlı gelişebilecek rekürren darlıkların önlenebileceğini düşünmekteyiz. (JAREM 2015; 5: 121-4) Anahtar Kelimeler: Üretra, üretra darlığı, üriner kateterizasyon ABSTRACT Objective: Narrowing of the urethral lumen due to fibrosis, which occurs in the urethral mucosa and the surrounding tissue, is defined as urethral stricture. Even though the most common reason for urethral stricture is idiopathic, trauma and iatrogenic applications can also cause urethral stricture. In this study, we analyzed the association between recurrent stricture and urinary catheterization duration in patients who underwent direct vision internal urethrotomy for urethral stricture. Methods: In our clinic, in 2014, we analyzed 157 patients who underwent direct vision internal urethrotomy with a cold knife for urethral stricture. All patients were divided into the following three groups as 3 days, 5 days, and 7 days after the operation in terms of urinary catheterization duration. To analyze the association between recurrent and postoperative Qmax values, Chi-square test and one-way analysis of variance (ANOVA) were performed. Results: The mean age of 157 patients was 63.51±13.86 years. The mean preoperative Qmax, stricture length, and postoperative Qmax values of all patients were 6.07±2.70 mL/s, 2.61±2.19 cm, and 10.9±4.1 mL/s, respectively. Additionally, 49 (31.2%) patients had recurrent stricture and 108 (68.8%) patient had no recurrence. In total, 17 (36%) patients in the 3-day postoperative urinary catheterization group, 12 (22%) in the 5-day group, and 20 (35%) in the 7-day group had recurrent stricture. Statistical analyses revealed no statistical significance between groups in terms of recurrent stricture and postopera-tive Qmax values. Conclusion: Currently, the recommended gold standard treatment for urethral stricture is direct vision internal urethrotomy. In the literature, many studies have compared surgical techniques and results. In our study, we found no statistical significance between urinary catheterization duration (3, 5, or 7 days postoperatively) in patients who underwent direct vision cold knife internal urethrotomy. The duration of postoperative urinary catheterization should not be extended; we recommend that remove it as soon as possible. After the operation, we believe that urinary catheterization must remove reasonable period of time, so patient comfort can be increased and urinary catheterization for recurrent strictures that develop due to remaining for a long time, could have been avoided. (JAREM 2015; 5: 121-4)

Giriş Varikosel pampiniform pleksus venlerinin dilatasyonudur. Erişkin yaşta prevalansı %15-22 iken infertilite ile başvuran hastalarda bu oran %25-40, sekonder infertilite ile başvuran hastalarda ise %69-81 oranlarındadır. Ancak bu bulguların tersine varikoselli hastaların %80'inde infertilite görülmez. Varikosel %75-95 oranında sol tarafta görülür. Bilateral görülme olasılığı ise %10'dur. Ancak güncel literatürde Doppler Ultrasonografinin (USG) daha yaygın kullanılması ile birlikte subklinik varikoseller dahil bu oranın %30-80 düzeylerinde olduğu bildirilmektedir [1,2]. Etiyolojik olarak birçok faktör suçlanmakla birlikte günümüzde en bilinen ve kabul gören anatomik faktörlerdir. Sol sprematik venin sağa göre yaklaşık 8-10 cmdaha uzun olması, sol spermatik venin sol renal vene dik bir açı ile açılması, sol spermatik vendeki valvlerin disfonksiyonu ve " nutcracker " (fındıkkıran) fenomenidir. Bu fenomende proksimal tipte; sol renal ven aort ile süperior mezenterik arter arasında sıkışarak internal spermatik vende basınç artışı ve dilatasyon gelişmesi, distal tipte ise ilak arterin iliak vene bası yapması ile eksternal spermatik vende basınç artışı ve dilatasyon gelişmesi şelinde tanımlanmaktadır [2]. Amerika üroloji kılavuzlarında; Palpable varikosel varlığı, anormal semen parametre varlığı, dökümente edilmiş infertilite varlığı, kadın partnerin normal olması veya düzeltilebilir infertilitesinin olması durumlarının tümünün varlığında varikoselektomi önerilmektedir [3]. Avrupa üroloji kılavuzlarında ise; progresif testiküler gelişim bozukluğu varlığı olan adelosanlar, klinik varikoseli olan ve 2 yıldır süren açıklanamayan infertilite varlığında varikoselektomi önerilir iken, normal semen analizi olan ve subklinik varikoselli infertil hastalarda varikoselektomi önerilmemektedir [4]. Erkek infertilitesi ve varikosel ilişkisi net olarak bilinmemektedir, fakat son zamanlarda yapılan bir meta-analizde cerrahi tedavi sonrası semen paramatrelerinde iyileşme gözlenmiştir [5]. Varikoselektomi operasyonu sonrası sperm DNA hasarının da düzelebileceği gösterilmiştir [6]. Bu çalışmada varikoselektomi operasyonu sonrası sperm sayı ve hareketindeki değişikliğin yaş ile ilişkisini değerlendirmeyi amaçladık.

Amaç: Radikal nefrektomi yapılan hasta-larda yaş ve cinsiyetin sağ kalıma etkisini araş -tırmak.
Gereç ve Yöntemler:  1990 – 2012 tarihleri
arasında kliniğimizde böbrek tümörü nedeniy -le radikal nefrektomi operasyonu uygulanan
177 hasta retrospektif olarak değerlendirildi.
Hastalar yaş gruplarına göre 5 gruba (<49, 50-59, 60-69, 70-79, ≥80) ayrılarak yaş ve cinsiye -tin sağkalıma etkisi araştırıldı.
Bulgular: Hastaların 73’ü (%41,2) kadın,
104’ü (%58,8) erkekti. Tüm hastaların yaş or -talaması 69,11±12.42 yıl olarak hesaplandı.
Hastaların ortalama takip süresi 36,7 ±38.92
ay idi. Yaş gruplarına göre sağkalım değerlen -dirildiğinde ≤49 yaş grubunda median sağka-lım 29 ±28,65 ay, 50-59 yaş grubunda 46±11,34
ay, 60-69 yaş grubunda 48 ±8,11 ay, 70-79 yaş
grubunda 41±5,28 ay, ≥80 yaş grubunda 32±3,8
ay olarak hesaplandı ve gruplar arasında istatis -tiksel olarak anlamlı fark saptanmadı (p=0,684)
(Şekil 1). Kadınlarda median sağkalım 41
±12,55 ay, erkeklerde 44±6,78 ay olarak bulun-du (p=0,59)(Şekil 2).
  5 yıllık sağkalım analizlerinde erkek
cinsiyette median 31,2 ay, kadınlarda ise 29,3
ay  olarak hesaplandı. Yaş gruplarına göre 5 yıl -lık sağkalım analizlerine baktığımızda ≤49 yaş
grubunda median 48 ay, 50-59 yaş grubunda
29,2 ay, 60-69 yaş grubunda 36,6 ay, 70-79 yaş
grubunda 36,9 ay,  ≥80 yaş grubunda 35,5  ay
olarak hesaplandı.
Sonuç:  Çalışmamızda yaş ve cinsiyetin
sağ kalım üzerine etkisi olmadığı gözlendi. Bu
nedenle böbrek hücreli kanser nedeniyle ileri
yaşlarda da radikal nefrektomi operasyonunun
yapılabileceğini düşünmekteyiz.

Amaç:  Hematüri ürologların, aile hekimlerinin ve di -
ğer branşlardaki hekimlerin sıkça karşılaştığı bir du -
rumdur. Çalışmamızda hastanemizde, son bir yılda
acil servise ve üroloji polikliniğine ayaktan başvuran
ve hematüri tesbit edilen hastaları retrospektif olarak
inceledik.
Gereç ve yöntemler: Hastanemize 2014 yılında acil
servise ve üroloji polikliniğine ayaktan başvuran ve
hematüri tanısı alan hastalar, hastane kayıt sistemin -
den alınan bilgiler doğrultusunda retrospektif olarak
incelenerek analiz edildi. Hastalar hematüri türüne
göre makroskopik ve mikroskopik olarak iki gruba ay-
rılarak incelendi.
Bulgular:  Hastanemize başvuran 452 hastanın veri -
leri retrospektif olarak analiz edildi. Hastaların yaş
ortalaması 57,3±20,4 yıl idi. Makroskopik hematü -
rili hastaların 23(%34)’sinde sistit , 18(%27) hastada
mesane  malign  neoplazmı,  12(%18)’sinde  benign
prostatik hiperplazi ve 13(%11)’ünde diğer nedenle-
re bağlı hematüri izlendi. Mikroskopik hematüri ile
başvuran hastalarda ise, 203(%52) hastada üriner
enfeksiyona bağlı akut sistit, 40(%1) hastada mesane
malign neoplazmı, 33(%0,8) hastada benign prostat
hiperplazisi ve 109(%28) hastada diğer nedenlere
bağlı hematüri izlendi.
Sonuç:  Çalışmada hem mikroskopik hem de mak-
roskopik hematüriyle başvuran hastalarda en çok
üriner enfeksiyona bağlı akut sistit, görülmesine rağ -
men %13 oranında ürolojik maligniteye bağlı hema-
türi olduğunu tesbit ettik. %10 hastada ise başvuru
esnasında yapılan idrar tetkikinde normal değerler
bulunduğunu gördük. Makroskopik hematüri ile baş -
vuran hastalarda daha fazla ürolojik malignite tesbit
ettik. Makroskopik hematüri tesbit edilen hastaların
ileri incelemeye alınması, mikroskopik hematüriyle
başvuran hastalarda  ise tekrarlayan mikroskopik he -
matüri durumunda ileri tetkik ve değerlendirme ya -
pılmasını önermekteyiz.

Hidatik kist hastalığı, oral yolla alınarak ince bağırsak
mukozasına invaze olan Echinococcus granulosus lar-valarının kan ve lenf dolaşımı aracılığıyla organlara
yerleşmesiyle oluşan parazitik bir enfeksiyondur. Re-nal hidatik kist oldukça nadirdir ve olguların yalnızca
%2 sinde renal tutulum görülür. Biz de yazımızda, 30
yaşında sol yan ağrısı ile başvuran, köpek ve koyun -larla temas öyküsü olan erkek hastada yapılan tetkik-ler sonucunda tespit ettiğimiz karaciğer kist hidatiği
ile birlikte dev renal kist hidatik olgusunu sunduk