The smaller caliber of the working channel during TUCL, compared with PCCL, necessitates disintegration of the stones into smaller fragments. This elongates the duration of the intervention and results in increased urethral and bladder trauma. Combined TURP and PCCL is a safer, more effective, and much faster alternative to combined TURP and TUCL in patients with large bladder stones and prostate hyperplasia.

When PCNL is performed after previous open nephrolithotomy, the operative time lengthens. But there is no difference with respect to success rate and morbidities.

No abstract

To investigate that lemon juice could be an alternative to potassium citrate in the treatment of urinary calcium stones in patients with hypocitraturia, 30 patients with hypocitraturic urinary calcium stones were enrolled into study. The patients were divided into three groups equally. Exactly 60 mEq/day fresh lemon juice ( approximately 85 cc/day) and potassium citrate (60 mEq/day) were given to the patients of first and second group, respectively. Dietary recommendations were made for the third group. Blood and 24-h urine tests were performed before treatment and repeated 3 months later. The differences between demographic datas of groups were not significant. There was no significant difference between values of blood tests performed before and after treatment in all groups. Statistically significant differences were found between pre- and post-treatment urine values in each group. Although there was no significant difference between pre-treatment citrate levels of the groups. A significant difference was found between post-treatment citrate levels of the groups. There was 2.5-, 3.5- and 0.8-fold increase in urinary citrate level of lemon juice, potassium citrate and dietary recommendation groups, respectively. Urinary calcium level was decreased only in lemon juice and potassium citrate groups after treatment. While there was no significant difference between pre- and post-treatment urinary oxalate levels in all groups, a significant decrease in urinary uric acid levels was determined in all groups. We suggest that lemon juice can be an alternative in the treatment of urinary calcium stones in patients with hypocitraturia. Additionally, dietary recommendations can increase effectiveness of the treatment.

volunteers. The polymerase chain reaction (PCR) assay was used to determine the MMP-1 genotypes. Genomic DNA used for the assay was extracted from peripheral blood lymphocytes. RESULTSThe frequency of the MMP-1 2G/2G genotype, which results in the highest MMP-1 transcriptional level, was compared to that of the 1G/1G plus 1G/2G genotypes. Of the 102 cases with bladder cancer, 49 (48%) showed the 2G/2G genotype, whereas it was found in 22 of the 94 controls (23%); this difference was statistically significant ( P < 0.01; odds ratio 2.79, 95% confidence interval, CI, 1.53-5.60). However, there was no significant association between the 2G/2G genotype and tumour grade and pathological stage. We assessed the interaction between smoking status (former and current smokers, by their median pack years) and 2G/2G genotype; there was a significantly increased risk in heavy smokers ( P < 0.001; odds ratio 3.21; 95% CI 1.33-5.60). CONCLUSIONThese results suggest that the MMP-1 promoter polymorphism might be linked to susceptibility for bladder cancer. OBJECTIVETo explore the association between the promoter polymorphism (that influences the transcriptional level) of matrix metalloproteinase-1 (MMP-1, associated with tumour cell invasion and metastasis) and bladder cancer in a Turkish population. PATIENTS, SUBJECTS AND METHODSThe MMP-1 polymorphism was assessed in 102 transitional cell carcinomas of the bladder (50 Ta, 52 T2-4) and in 94 age-, smoking-and gender-matched healthy

Intravesical Hem-o-lok clip (HOLC) migration is a rare complication of prostatic surgery. We report two cases of migration of a HOLC into the bladder leading to stone formation. As such, these devices should be used with caution in the region of the vesicourethral anastomosis.

To investigate bone mineral densitometry findings in patients with normocalciuric urinary system stone disease, we compared 150 patients with normocalciuric calcium stone disease (group 1) and 60 subjects of a control group (group 2). The patients were compared according to bone mineral content (BMC), bone area (BA), bone mineral density (BMD), T-score and Z-score values of femur neck, total femur and lumbar spine (L2-L4) by dual energy absorptiometry. We found that 76.6% of the patients in group 1 and 20.0% in group 2 had low BMD; 11.3% of patients in group 1 had osteoporosis and 65.4% had osteopenia. In the control group, there was no osteoporosis, but 20.0% of the subjects had osteopenia. In group 1, there was hyperoxaluria in 26.0% of patients, hypocitraturia in 15.3% of patients, hyperuricosuria in 6.0% of patients, both hypocitraturia and hyperoxaluria in 8.6% of patients in a 24-h urine analysis. Urine analysis was normal in 44.0% of patients. Our results showed a severe loss of bone mass in patients with urinary system normocalciuric calcium stone disease. Thus, the necessary precautions concerning bone mass protection should be taken and the patients should be informed about this issue.

We report three cases of stone formation at the prostatic urethra after 80 W potassium-titanyl-phosphate laser ablation of the prostate for benign prostatic hyperplasia. These complications occurred several months after the procedure. The diagnosis was made by ultrasonography, plain radiography of the kidneys, ureters, and bladder, and cystoscopy in patients who were being evaluated after presenting with irritative voiding symptoms. The patients were treated by cystolithotripsy and resection of the calcified prostatic tissue.