Sarcomas represent 1-2% of all malignant renal tumors in adults, with an incidence that increases with advancing age. Renal sarcoma is less common, but more lethal than sarcoma of any other genitourinary site. The common signs and symptoms associated with renal sarcoma in adults include palpable mass, abdominal or flank pain and hematuria similar to those seen with large, rapidly growing renal cell carcinomas. Usually, radical nephrectomy remains the treatment of choice for these tumors, which exhibits an aggressive biological behavior and an unfavorable prognosis. We describe an unusual case of renal leiomyosarcoma that underwent nephron sparing surgery, in a 55-year-old white woman, who had a renal mass for 3 years. The size of the renal mass did not change during this period and no distant metastasis occurred. The patient is still alive without any symptoms of relapse.
Increased oxidative damage has been suggested to play an important role in the spermatogenesis and sperm function changes in patients with varicocele. However, changes in levels of nitric oxide (NO), asymmetric dimethylarginine (ADMA), malondialdehyde (MDA), iron (Fe), zinc (Zn) and copper (Cu) in blood and seminal plasma, and semen quality, are unknown. The aim of this study was to investigate the NO, ADMA, Fe, Cu, Zn and MDA levels from seminal plasma and peripheral and spermatic vein blood samples of patients with varicocele before and after varicocelectomy. In this before and after comparative study, 29 consecutive patients attending a training hospital in Tekirdag, Turkey, were recruited. MDA and NO levels were determined by spectrophotometric methods. The levels of ADMA were determined by enzyme-linked immunosorbent assay method. Trace element level was determined by atomic absorption spectrophotometric method. The levels of MDA in the seminal plasma and peripheral and spermatic vein samples were observed to decrease significantly in the comparison of before and after phases of the study group (p = 0.022, p = 0.001 and p = 0.034, respectively). Also, the levels of NO in the seminal plasma and spermatic vein samples decreased significantly in the comparison of before and after phases of the study group (p = 0.025 and p = 0.001, respectively), while the levels of ADMA in seminal plasma and spermatic vein samples increased significantly in the comparison of before and after phases of the study group (p = 0.003 and p = 0.001, respectively). There were no significant differences in the levels of trace elements and sperm count (p > 0.05). Oxidative stress is significantly higher in the spermatic vein and seminal plasma samples of patients with varicocele before varicocelectomy. In conclusion, these events may be evaluated accordingly for the potentially beneficial treatment methods.
Since more than 30 years, intrauterine contraceptive devices (IUCD) have been used for a contraceptive opportunity. Although they are termed to be a safe and effective method for contraception, they also have some type of complications and uterine perforation, septic abortion, pelvic abscess are the serious complications of these devices. The incidence of uterine perforation is very low, but in the literature nearly 100 cases were reported about the extra uterine localization of IUCD. Migration may occur to the adjacent organs. We here in describe a case of a 31 year-old woman who had an IUCD with stone formation in the bladder. In the literature all of the cases were reported as IUCD migration, but although it seems technically impossible, IUCD placement into the bladder should also be considered in misplaced IUCDs.
Nocturia is the most bothersome lower urinary tract symptom. It has a multifactorial etiology. It had been thought nocturia was a nonspecific symptom of lower urinary system dysfunction, but it has been determined that many diseases, related to different organ systems, might be reasons for this nonspecific symptom. Along with the importance of systemic diseases that cause nocturia, the symptom itself has adverse effects on patients’ health and quality of life. There are several studies reporting a direct relationship between nocturia and depression, cognitive dysfunction, mood disturbances, falls, and fractures. For this reason, it is important to treat nocturia both to increase quality of life and to decrease related complications. Treatment opportunities have been under investigation for 20 years. Most of the studies in the literature have reported the results of single-drug medication on nocturia, which may be insufficient for a situation that has such a multifactorial etiology. In this review, we evaluated the success of different treatment combinations on nocturia.
Urethral stricture is a common disease with high recurrence rate. Several manipulations were defined to prevent the recurrence but the results were disappointing. This study aimed to evaluate the efficacy of triamcinolone and mitomycin-C on urethral stricture formation and their effect on inhibition of urethral fibrosis. A total of 24 New Zealand rabbits were divided into 3 groups. Urethras of rabbits were traumatized with pediatric resectoscope. Resection area was irrigated with 10mL saline, swapped with a cotton wool soaked with 0.5mg/mL MMC and injected by 40mg triamcinolone in groups 1, 2 and 3 respectively. Retrograde urethrogram was performed at 28th day of procedure and the urethra was removed for histopathologic evaluation. There were significant differences in urethral diameters and in lumen reduction rate between the control and study groups (p<0.001). Compared to control group, all treatment groups showed mild fibrosis, less collagen bundle irregularity, and lower numbers of fibroblasts (p=0.003). The Tunnel assay showed that the number of apoptotic cells in the submucosal connective tissue was quantitatively higher in control groups (p=0.034). In the view of efficacy and safety, MMC and triamcinolone have the potential to replace the use of stents, clean intermittent catheterization, or long term catheters following internal urethrotomy. There were no statistically significant differences between two agents in terms of preventing urethral stricture formation in the present study. Mitomycin C and triamcinolone decreased the recurrence rates of urethral stricture.
BackgroundLaparoscopic simple nephrectomy is the standard procedure for the removal of non-functioning benign kidney. It can be performed transperitoneally or retroperitoneally. There are several studies comparing the results of transperitoneally or retroperitoneally laparoscopic nephrectomy but there are limited numbers of study comparing results of laparoscopic transperitoneal simple nephrectomy in non-inflammatory and inflammatory non-functioning kidneys. The aim of this study was to compare the results of laparoscopic transperitoneal simple nephrectomy in non-inflammatory and inflammatory non-functioning kidneys.ResultsWe retrospectively reviewed the records of patients who underwent laparoscopic nephrectomy for various inflammatory and non-inflammatory renal conditions at our institution from May 2012 to October 2015. We divided the patients in two groups. Group 2 involved the kidneys with stone disease and/or hydronephrosis, patients with previous renal surgery and patients with the history of recurrent infections. Group 1 involved the patients who had non-functioning kidney without these properties. All the surgeries were performed by transperitoneal approach and peroperative blood loss, operation time, hospitalization time, postoperative creatinine changes and haemoglobin drop were compared between groups. There were 22 patients with inflammatory and 27 patients with non-inflammatory non-functioning kidney. Operation time, peroperative blood loss, hospitalization time, postoperative haemoglobin drop and creatinine difference were not statistically different between groups. Surgical side and the presence of previous surgery did not affect the surgical results of inflammatory and non-inflammatory kidney nephrectomy. The only difference was postoperative fever which was more frequent after the nephrectomy of inflammatory kidney.ConclusionsOn the basis of our experience, surgical results of transperitoneal laparoscopic simple nephrectomy did not differ between inflammatory and non-inflammatory kidneys. Surgical times were higher in inflammatory group even if the difference was not significant.
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