Metastatic Gastric Adenocarcinoma in the Inguinal Hernia Sac Diagnosed Radiologically: A Case Report.

Macroscopic tumor implants in the hernia sac are a very rare condition. They occur as a result of the implantation of malignant cells in the malignant ascites from the inguinal canal to the hernia sac. In this case report, we share the clinical and radiological findings of the macroscopic tumoral implants in the hernia sac at the level of the inguinal canal and scrotum in a male patient aged 65 years with a history of total gastrectomy for gastric adenocarcinoma and developing malignant ascites six months after the surgery.

Calcified clumped neodymium magnetic spheres as an intravesical foreign body: case report and literature review

Foreign bodies in the bladder can occur by self-insertion, and patients often hide the symptoms owing to embarrassment. The foreign bodies act as a nidus for calculus formation when not detected for a long time. Foreign bodies can declare symptoms such as frequency, dysuria, nocturia, hematuria, urethrorrhagia, obstruction, or retention. This case spotlights self-inserted intravesical neodymium magnetic spheres clumped and calcified due to delayed presentation which were removed by open cystotomy after a cystoscopic failure.

Los cuerpos extraños en la vejiga pueden ocurrir por autoinserción y los pacientes a menudo ocultan los síntomas por vergüenza. Los cuerpos extraños actúan como un nido para la formación de cálculos cuando no se detectan durante mucho tiempo. Los cuerpos extraños pueden manifestar síntomas como polaquiuria, disuria, nicturia, hematuria, uretrorragia, obstrucción o retención. Este caso destaca esferas magnéticas de neodimio intravesicales autoinsertadas, agrupadas y calcificadas debido a una presentación tardía que se extrajeron mediante cistotomía abierta después de una falla cistoscópica.

Arteriovenous malformation of the prostatic median lobe: a rare case treated by transurethral resection.

Arteriovenous malformation localised to the prostate is rare. Until recently, the gold standard for diagnosis was angiography; however, this changed with the use of computed tomography and magnetic resonance imaging, which quickly became the first-line diagnostic tool. Common complaints are haematuria and lower urinary tract symptoms, for which there are no well-defined management guidelines. We present the case of a 53-year-old male patient who was treated for clotted haematuria. While the bleeding was thought to originate from an enlarged prostate, cystoscopy displayed a non-pulsatile, exophytic, active bleeding mass on the median lobe. The mass was resected transurethrally and diagnosed as arteriovenous malformation. This case shows an aberrant presentation of a vascular malformation in the prostate. The mass seemed to be constrained to a compact area without a visible plurality of arterial feeders. Since the prostate is a rare location for arteriovenous malformation, there are no well-defined treatment options. Nevertheless, the mass appears to have been successfully extracted by transurethral resection.

How did COVID-19 affect acute urolithiasis? An inner Anatolian experience.

BACKGROUND: The COVID-19 pandemic has changed the number of patients seeking medical help from the emergency service (ES) with non-COVID complaints, consequencing in postponed presentations of different surgical and medical situations. Acute urinary stone disease is one of these situations and needs to be investigated in terms of the effect of COVID-19 on its presentation to the ES. METHODS: In this observational, retrospective, and single-center study, we scanned each abdominopelvic computed tomography requested in ES for possible acute urolithiasis during 1 year before and after the outbreak of COVID-19. We searched to state the number of abdominopelvic computed tomographies applied and the number of ratifying urinary stone positivity. We enrolled patients' gender, age, stone location, and stone size. We also recorded C-reactive protein, leukocyte count, and creatinine and noted how long the patients suffering from pain, the duration until the intervention, and the management option selected for each case. RESULTS: Total number of abdominopelvic computed tomographies performed was 1089. Of these, 517 were pre-pandemic and 572 were peri-pandemic. The number of pre and peri-pandemic stone-positive scans were, respectively, 363 (70.2%) and 379 (66.2%) (P=0.643). The females' percentage in the COVID-19 period (37.2%) was significantly lower than in the pre-pandemic period (54.3%) (P=0.013). The median size of ureter stones of the pre and peri-pandemic groups were, respectively, 4.8 mm and 3.9 mm depicting no significant difference (P=0.197). No significant difference was sighted between the pre and peri-pandemic groups concerning stone locations, blood parameters, painful duration, treatment options, and time to intervention. CONCLUSION: The COVID-19 pandemic resulted in neither sicker nor fewer patients suffering from acute ureteric colic in the ES.

COMPARISON OF LAPAROSCOPIC AND OPEN PYELOPLASTY IMPACT ON COMFORT AND SUCCESS: A RETROSPECTIVE, SINGLE CENTER STUDY.

Ureteropelvic junction obstruction causes hydronephrosis and may lead to renal parenchymal damage unless timely diagnosed and treated. Although open pyeloplasty is still the gold standard, it needs to be compared with new techniques. In this study, we compared laparoscopic and open pyeloplasty. Data on 113 patients who had undergone surgery between 2008 and 2014 were evaluated retrospectively. Thirty-nine patients had undergone laparoscopic pyeloplasty, and 74 had undergone open pyeloplasty. Ultrasonography was performed at 3 months and scintigraphy at 6 months postoperatively. Parameters such as the length of surgery, need for analgesics, length of hospital stay, complications, and success rates were compared. When compared to open pyeloplasty (mean 9.8 dexketoprofen 50 mg IV dose), the need for an analgesic was significantly lower in the laparoscopic pyeloplasty (mean 4.5, paracetamol 15 mg/kg IV dose) group (p<0.05). The length of hospital stay was also shorter in the laparoscopic pyeloplasty group (mean 4.0 days) than in the open pyeloplasty group (mean 7.3 days) (p<0.05). This study demonstrated that laparoscopic pyeloplasty could be safely used in the treatment of ureteropelvic junction obstruction with a lower need for analgesics and a shorter length of hospital stay than with open pyeloplasty.

Role of PSA Kinetics in Hormone-refractory Prostate Cancer.

OBJECTIVE: To demonstrate the predictive effect of PSA derivatives and time markers that is prostate-specific antigen (PSA) doubling time (PSADT) and PSA velocity (PSAV) on survival in men with hormone-refractory prostate cancer (HRPCa). STUDY DESIGN: Descriptive, analytical study. PLACE AND DURATION OF STUDY:  Department of Urology, Erciyes University, Faculty of Medicine, Kayseri, Turkey, between 2012 and 2020. METHODOLOGY: One hundred patients, who were treated with prostate cancer, were subjected. The PSA values were noted, nadir PSA values were detected, times to nadir PSA, HRPCa, and follow-up times were recorded. PSADT and PSAV were calculated. The relationships between the groups were analyzed. Kaplan-Meier curves were used to estimate overall survival between the groups. RESULTS:  The patients were grouped according to the mean PSADT, median PSAV, median nadir PSA, and mean time to HRPCA. The survival of those with high PSADT, low PSAV and low nadir PSA were found to be significantly longer (p=0.006, p<0.001, p<0.001). High PSAV was also associated with significantly increased PSA, nadir PSA and death (p<0.001, p=0.47, and p<0.001, p=0.52, respectively). The survival of those with a longer time to HPRCa was found to be significantly longer (p<0.001). There was no statistically significant difference in terms of survival between patients who received chemotherapy after HRPCa and those who did not (p=0.477). PSAV (p=0.007 HR: 1.004 95% CI: 1.001 - 1.007), bone metastasis at diagnosis (p=0.001 HR: 0.357 95% CI: 0.197 - 0.645) and time to HRPCa development (p=0.001 HR: 0.936 95% CI: 0.900 - 0.974) were significantly effective to the survival.              Conclusion: PSADT, PSAV, and nadir PSA serve as independent prognostic markers for survival in patients with HRPCa. These three PSA derived calculation products, with the help of other parameters, could work as prognostic factors, and help clinicians predict survival in men with HRPCa. Key Words: PSA kinetics, Hormone-refractory prostate cancer, Survival, Prognostic factors.

Psychoda albipennis myiasis as a rare cause of erectile dysfunction: A case report.

Urogenital myiasis occurring with the settlement of fly larvae of the order Diptera is facultative and is rarely encountered in humans. This study presents a case of urogenital myiasis caused by Psychoda albipennis in a 42-year-old male patient. The patient was admitted to our hospital with complaints of groin pain, pollakuria and erectile dysfunction and claimed that he saw motile larvae in his urine. Three larvae were collected from the patient's urine, microscopically examined and identified as fourth-stage larvae of P. albipennis. The patient's complaints ceased after the application of an antibiotic and urinary antiseptic. It was concluded that myiasis should be considered in patients with urogenital complaints.

What is the consistency between the results of needle biopsy and prostatectomy specimen pathology results? A pilot study

Background/aim: The aim of this study was to establish the relationship between the needle biopsy and the pathology result after radical prostatectomy administrated for prostate cancer. Materials and methods: We retrospectively analyzed 67 patients who had undergone radical prostatectomy from 2016 to 2019. All sur- geries and all biopsies were performed in the third author's urology department. Samples were collected through 12-core biopsy under local anesthesia. All specimens were studied in the pathology department of the third author's center. The results evaluated were needle biopsies' Gleason scores and prostatectomy specimens' Gleason scores. Results: Inclusion criteria were not having any neo-adjuvant treatment and being treated with surgery after needle biopsy. Gleason scores obtained from needle biopsies and prostatectomy specimens were evaluated. The comparison revealed that 39% of the tumors were undergraded, 7% were overgraded, and 54% had exact scoring in needle biopsies and prostatectomy specimens according to the detailed Gleason scoring as primary and secondary metrics. The patients were grouped into five categories according to the ISUP 2014 prostate cancer grading system. The relationship was strong with 64% of results staying in the same group after the operation; neverthe- less, the correlation remained weak based on the kappa coefficient. Conclusion: The information obtained from the needle biopsy is not a strong herald of the pathological result. Urologists should have awareness of this restraint when utilizing the needle biopsy's Gleason score in decision making and treatment planning.

Metabolic risk factors and the role of prophylaxis in pediatric urolithiasis.

Suppose that the recurrence in pediatric urolithiasis has a close relationship with metabolic abnormalities and is affected by residual burden and prophylaxis. If so, the recurrence rates could be reduced with effective surgery and appropriate prophylaxis. Here we retrospectively evaluate the metabolic risk factors data of 148 children who were operated on between January 2005 and March 2013 due to kidney stones. All patients underwent percutaneous nephrolithotomy (PCNL), and all were children. Thirteen children had a history of surgery performed to treat urological anomalies. Twenty-four-hour urine analysis, the residual status of surgery, BMI levels, and the number of metabolic abnormalities were noted. Only 18 (15%) of 122 patients without residual stones after PCNL had recurrence at follow-up whereas; nine (26%) of 26 patients with residual stones developed recurrence (p = 0.017). Recurrence was observed in 14 (16%) of 89 patients with a metabolic abnormality, and 13 (30%) of 44 patients with two or more metabolic abnormalities had recurrence at follow-up (p = 0.024). Those patients with no metabolic abnormalities did not develop recurrence. Stone recurrence was seen in six (8%) of 78 children who were given metabolic prophylaxis, compared to 21 (30%) of 70 patients who did not receive metabolic prophylaxis (p = 0.02). No stone recurrence was seen in nine children who were given Shohl's, whereas four (67%) of six patients who did not take Shohl's had recurrence (p = 0.022). Complete removal of stones by a suitable surgical method is essential to avoid recurrences. Detailed clinical and laboratory evaluations should be performed in children with urolithiasis. Appropriate specific prophylactic treatment (e.g., potassium citrate and Shohl's) and non-specific prophylactic treatment (e.g., avoiding animal proteins, salt, simple sugars, and increased water intake) should be given to prevent reformation of stones in patients with pediatric urolithiasis.