Long-term follow-up results and complications in cancer patients with persistent nephrostomy due to malignant ureteral obstruction.

PURPOSE: We aimed to evaluate the long-term complications and predisposing factors for these complications in patients with malignant ureteral obstruction (MUO) treated with percutaneous nephrostomy (PN). METHODS: The records of patients with MUO treated with PN between January 2015 and 2018 were retrospectively reviewed for PN dislodgement, PN obstruction, PN replacement, pyelonephritis, hospitalizations due to PN complications, and other complications due to PN such as macroscopic hematuria, skin infections, or renal/perirenal abscess. RESULTS: Data for a total of 147 patients (229 renal units [RU], 107 males, 40 females) were evaluated. In 174 (76%) RU, PN was replaced due to PN dislodgement. The predisposing factors for PN dislodgement were follow-up time, body mass index (BMI), chemotherapy, diabetes mellitus (DM), low educational level (LEL), pyelonephritis, and catheter-related skin infections (CSRI). The PN was replaced in 40 RU due to obstruction. The predisposing factors for obstruction were follow-up time and BMI. Pyelonephritis developed at least once in 61 (41.5%) patients. Follow-up time, BMI, previous surgery, DM, and LEL were the predisposing factors for pyelonephritis. CSRI developed in 16 RU. Follow-up time, BMI, DM, and LEL were the predisposing factors for CSRI. Macroscopic hematuria developed in 11 patients. Follow-up time, previous surgery, DM, chemotherapy, and LEL were predisposing factors for macroscopic hematuria. CONCLUSION: The most common complication in patients with MUO treated with PN was PN dislodgement. However, life-threatening complications such as macroscopic hematuria and severe infections can also occur. Patients with DM, LEL, and chemotherapy are at high risk of PN-related complications.

Ultrasonographic Detection of Retrorenal Colon in Prone Position: An Alternative to Computed Tomography.

OBJECTIVE: To evaluate the correlation between ultrasonography (US) and computed tomography (CT) in prone position to detect retrorenal colon (RRC). MATERIALS AND METHODS: In this prospective study, we included 310 patients who presented to our clinic between April 2017 and June 2019. All patients were evaluated for RRC with US and CT in prone position. Kappa compliance coefficient (κ) was used to express the compliance between CT and US outcomes. RESULTS: This study included 119 (38%) female and 191 (62%) male patients with a mean age of 44.5 ± 16.1 years. With both CT and US, RRC was detected in a total of 42 (13.5%) patients. RRC was found in 9 patients (8%) on the right side, in 32 patients (18%) on the left side and in 1 patient on both sides with CT (P = .036). However, with US, it was detected in 10 patients (8%) on the right, in 31 patients on left side and in 1 patient on both sides (P = .083). The RRC detection compliance coefficients were excellent between US and CT (κ: 0.945). CONCLUSION: US used in prone position is a suitable and practical imaging alternative to CT for detection of RRC.

Ultrasound-Guided Shockwave Lithotripsy Reduces Radiation Exposure and Has Better Outcomes for Pediatric Cystine Stones.

Background/Aims/Objectives: To evaluate the outcomes and ionizing radiation (IR) exposure of children with cystine stones (CS) using different shockwave lithotripsy (SWL) guidance modalities. METHODS: Data from pediatric patients with renal stones treated between January 2009 and August 2015 were retrospectively reviewed. Outcome results and IR exposure in patients undergoing fluoroscopy (FL)-guided SWL and ultrasonography (US)-guided SWL were compared. First-time stone formers and those treated with SWL and with complete follow-up data, including post-treatment stone analysis confirming CS were included. RESULTS: Forty-four patients (16 girls and 28 boys) met the inclusion criteria. Results of SWL performed in 51 kidneys were analyzed. After the SWL, 41 (80.4%) of 51 kidneys were stone free, and 10 (19.6%) had clinically insignificant residual fragments (≤3 mm) or unfragmented stones. The success rates differed between patients in Group-FL (60%) and Group-US (93.5%) (p = 0.008). Single-session success rates were higher, and prospects of retreatment were lower in Group-US (p = 0.000 and p = 0.002, respectively). In addition, overall complications were significantly lower in Group-US (p = 0.042). Overall IR exposure was higher in Group-FL (p = 0.013). CONCLUSIONS: US-guided SWL is more effective for pediatric CS and should be considered a preferred treatment to reduce IR doses in children.

Bilateral renal leiomyoma with 5 year follow-up: Case report.

Renal leiomyomas are exceptionally rare benign tumours of the kidney. Although the renal leiomyomas usually do not metastasize, the differential diagnosis between renal leiomyomas and malign lesions (leiomyosarcoma or renal cell carcinoma) cannot be done by radiological examinations, but is possible by histological examination. Surgery is the preferred treatment. After surgery, the prognosis is excellent without recurrence. Although uterine leiomyomas can be multicentric, renal leiomyomas have been single lesions. We report an incidentally detected case of bilateral renal leiomyoma in a 50-year-old woman with a 5-year follow-up. We also review the literature and discuss clinical, radiological and histological features of renal leiomyomas.