Introduction: Percutaneous nephrolithotomy (PCNL) is the primary surgical intervention in kidney stone management. Even though it is performed quite often, the complication rates are also high. Arteriovenous fistulas following extended hemorrhages after PCNL are one of the most serious complications of this operation. Our main objective was to review the data of patients who required angiography and embolization. Methods: In total, we included 1405 patients who underwent PCNL between 2007 and 2014. All patient data were retrospectively reviewed. All patients went under PCNL using fluoroscopy. Following informed consent, all hemorrhagic patients underwent angiography in the interventional radiology department and embolization was performed in patients with a hemorrhage focus point. Results: A total of 147 patients (10.4%) required transfusion for post-PCNL hemorrhages. Of them, 14 (0.99%) underwent angiography and embolization (9 [64.2%] were male and 5 [35.8%] were female, with a mean age of 39.4 ± 10.2). The remaining 133 patients were conservatively managed (81 [60.9%] males and 52 [39.1%] females, with a mean age of 42.3 ± 12.4). When the predicting factors for angiography and embolization were reviewed, renal abnormalities and the mean size of stones were significant in both univariate and multivariate analysis (p < 0.001). Conclusion: Patients with extended and intermittent hematuria should be monitored closely for hemodynamics; if there is an ongoing necessity for transfusion, angiography should be considered.

PurposeTo assess probable structural changes using spectral domain optical coherence tomography (SD-OCT) on sickle-cell disease (SCD) and beta thalassemia major (B-TM) patients, without any retinal abnormalities.MethodsThis cross-sectional study included 32 B-TM, 34 SCD patients, and 44 healthy controls. One of the eyes of all participants was evaluated for SD-OCT and choroidal thickness, retinal nerve fiber layer (RNFL) thickness, central macular thickness (CMT), ganglion cell complex (GCC).ResultsAge, gender, and intraocular pressure (IOP) were not statistically different between the three groups. Hemoglobin (Hgb), hematocrite (Htc), and ferritin levels were not statistically different between the SCD and B-TM groups. Choroidal thickness at the subfoveal region was statistically higher in the control group (353.79 ± 71.93) than in the B-TM (317.41 ± 53.44) and SCD (283.21 ± 63.27) groups. In addition, it was statistically higher in the B-TM group than the SCD group (P = 0.05). CMT did not differ among the three groups, average RNFL was only significantly thinner in SCD than in controls, and GCC thickness was significantly thinner in SCD than in controls and B-TM.ConclusionIn both diseases, we can show early structural changes even if proliferative or non-proliferative retinopathy or other ocular manifestations were not developed yet.

Psoas abscess (PA) is a rare disease, presenting with high mortality and morbidity particularly when diagnosed late. PA should be considered in patients who had history of abdominal surgery and high fever resistant to treatment. Early diagnosis and treatment may decrease high mortality and morbidity rate. Contrary the literaure which stated that PA is more commen in patients younger than 20, we found the mean age as 58.5.

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Introduction: Many patients present to urology and emergency departments for acute renal colic complaints. There are many different imaging studies that can be used in patients with a pre-diagnosis of acute renal colic. In this study, we would like to assess the efficacy of using clinical and laboratory results in patients with flank pain complaint as a predictive factor of urinary system stone disease. Materials and methods: All patients were assessed using spinal non-contrast complete abdominal computerized tomography and urine analysis. Presence of stones and their number and size were recorded. Results: 516 patients who were included in the study were divided into 2 groups according to urinary stone presence. Group 1 (n = 388) consisted of patients with stones meanwhile patients in Group 2 (n = 128) were stone-free. According to these results, male sex, presence of microscopic hematuria, stone history in the family, nausea and emesis in addition to pain and accompanying urinary symptoms were detected as predictive factors in diagnosing urinary stone disease by multivariate analysis. Conclusion: From our study results, we can conclude that uroflowmetry is a very useful tool in monitoring lower urinary system complaints.KEY WORDS: Renal colic; Urolithiasis; Flank pain; Hematuria. MATERIALS AND METHODSPatients who presented to our clinic between May 2015 and September 2016 with acute renal colic complaint with a possible diagnosis of urinary system stone disease were included in the study. All patients were assessed using spiral non-contrast complete abdominal computerized tomography (CT). The patients' age varied from 17 to 68 years. CT results and urinalysis results were all reviewed. Non-contrast CT imaging was performed using GE Lightspeed 16 Pro CT machine with a spiral setting. Presence of stones and their number and size were recorded. In addition, patient symptoms, family histories, patient histories and visual analogue scale (VAS) scores were all reviewed. RESULTS516 patients who were included in the study were divided into 2 groups according to urinary stone presence. Group 1 (n = 388) consisted of patients with stones meanwhile patients in Group 2 (n = 128) were stonefree. Mean age in Group 1 was calculated as 38.53 ± 20.8 (17-68) meanwhile in Group 2, mean age was 32. 3 ± 18.8 (17-65). Male/female ratio in Group 1 was 248/140 and 64/64 in Group 2. Other findings are summarized on Table 1. According to these results, male sex, presence of microscopic hematuria, stone history in the family, nausea and emesis in addition to pain and accompanying urinary symptoms were detected as predictive factors in diagnosing urinary stone disease by multivariate analysis. DISCUSSIONUrinary stones cause severe colicky pain by the response of smooth muscle and by epithelial biological responses to a partial or complete obstruction and dilation of the urinary tract according to their localization and size. The pain is so severe that it usually requires ER admittance (3). Acute renal colic is one of the leading causes...

Objective: This study was conducted to research the factors determining biochemical recurrence (BCR) in low-risk localized prostate cancer patients who underwent radical prostatectomy (RP). Material and methods:We retrospectively analyzed the data of 504 patients who had undergone RP between 2003 and 2013 at our clinic. One hundred and fifty-two patients who underwent RP for low-risk prostate cancer were included in the study. Results:The mean follow-up period for patients was 58.7 (21-229) months. The mean age of the patients was 63.7±7.2 years (49-79). The mean prostate specific antigen (PSA) value was 5.25±4.22 ng/mL (3.58-9.45). The BCR rate after the operation was 25% (38/152). In the univariate analysis, recurrence determining factors were shown to include extracapsular involvement (ECI) (p= 0.004), capsular invasion (CI) (p= 0.001), age (p= 0.014), and tumor size (p= 0.006). However, only CI was found to be significant in multivariate analysis (p= 0.001). Conclusion:Capsular invasion is an independent risk factor in low-risk prostate cancer patients who underwent RP for BCR.

Introduction: As a minimally invasive surgical method, PNL displayed a great development in techniques as well as equipments in the course of time. A conservative approach is no longer accepted in the elderly kidney stone patient population. Percutaneous nephrolithotomy is indicated as an effective and safe treatment in all age groups. In this study, we present percutaneous nephrolithotomy results obtained from kidney stone patients aged 65 years and over.

ObjectiveTo evaluate the effects of previous unsuccessful extracorporeal shockwave lithotripsy (ESWL) treatment on the performance and outcome of percutaneous nephrolithotomy (PCNL).Patients and methodsOf 1625 PCNL procedures performed in our clinic, 393 renal units with similar stone burden and number of accesses was included in the present study. We categorised the study patients into two groups according to whether they underwent ESWL within 1 year prior to PCNL or not. Accordingly, Group 1 comprised 143 (36.3%) ESWL-treated patients and Group 2 comprised 250 (63.7%) non-ESWL-treated patients.ResultsResidual stones were detected in 36 (25.1%) of the ESWL-treated patients (Group 1) and in 60 (24%) of non-ESWL-treated patients (Group 2). There were no statistically significant differences between the groups for length of hospital stay (LOS), nephrostomy tube removal time, and the presence of residual stones. When we evaluated the groups for both the preoperative and postoperative haemoglobin (Hb) drop and blood transfusion rate, manifest Hb declines and more transfusions were required in the ESWL-treated patients (both P = 0.01).ConclusionsIn our study, previous ESWL treatment had no influence on the PCNL stone-free rate, operation time, incidence of postoperative complications, and LOS, in patients with similar stone burdens. However, bleeding during PCNL was more prevalent in the ESWL-treated patients, so close attention should be paid to bleeding in patients who have been pretreated with ESWL.