Purpose: To assess the outcome of urologic evaluation in patients with voiding dysfunction due to multiple sclerosis (MS) and to determine the relationship between urological and neurological parameters of these patients. Materials and Methods:We retrospectively reviewed the medical records of 249 consecutive patients (162 female and 87 male) with MS who were referred to our clinic between 1991 and 2006, with a median time of 4 years (range 3 months to urinary tract symptoms were evaluated by Boyarsky symptom index. Results: All patients except 13 had lower urinary tract symptoms and 70% manifested mixed symptoms. Total, storage and voiding symptom scores correlated with expanded disability status scale scores (p < 0.05). Twelve patients (5%) had -relation was found between urodynamic diagnosis and upper tract deterioration and urinary symptom scores (p > 0.05). Conclusions:The prevalence of mixed symptoms in patients with MS is higher than storage or voiding symptoms alone. Although detrusor overactivity and detrusor-sphincter dyssynergia were the most common urodynamic diagnoses, upper urinary tract deterioration was rare in our series.

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ÖZEkstrapulmoner küçük hücreli karsinomlar nadir, agresif seyirli ve sık metastaz yapan malign neoplazilerdir. Bu tümörler başlıca üst solunum yolu, özefagus ve ürogenital sistemde ortaya çıkar. Küçük hücreli prostat karsinomları tüm prostat kanserleri içinde %1'den daha az orandadır. Bunlar, daha önceden prostatik adenokarsinom tanısı almış ve androjen deprivasyon tedavisi uygulanan hastalarda da gelişebilir. Prostat kanserinde nöroendokrin diferansiasyonu yakalamak ve saf küçük hücreli karsinomu kötü diferansiye asiner adenokarsinomdan ayırt etmek önemlidir. Bu yazıda, 3 yıl önce prostat adenokarsinomu tanısı almış, androjen deprivasyon tedavisi uygulanmış küçük hücreli prostat karsinomu olgusu, ayırıcı tanı kriterleri, önemli histopatolojik ve immünohistokimyasal özellikleri, tedavi ve prognozu açısından literatür bilgileri eşliğinde sunulmaktadır. Keywords: Ekstrapulmoner, küçük hücreli karsinom, prostat ABSTRACTExtrapulmonary small cell carcinomas are rare, aggressive malignant neoplasms with frequent metastases. These tumors mainly occur in the upper respiratory tract, esophagus and urogenital system. Small cell carcinomas of the prostate constitute less than 1% percentage of all prostate cancers. They can also develop in patients with previously diagnosed prostatic adenocarcinoma and treated with androgen deprivation therapy. It is important to detect neuroendocrine differentiation and distinguish pure small cell carcinoma from poorly differentiated acinar adenocarcinoma. In this article, a case of prostatic small cell carcinoma that applied to androgen deprivation therapy because of a former diagnosis of prostatic adenocarcinoma three years ago, is presented with associated differential diagnosis, major histopathologic and immunohistochemical features, treatment and the prognosis and literature knowledge.

Anahtar KelimelerÜreter Taşı; Kontrastsız Multidedektör Bilgisayarlı Tomografi; Spontan Pasaj Abstract Aim: The objective of this study is to determine tomographic measurement parametres that are effective on spontaneous passage (SP) of ureteral stones in patients who will undergo unenhanced multidetector computed tomographic examinations (MDCT). Material and Method: The patients who presented with complaints of renal colic to our clinic during 2013-2015 were retrospectively evaluated. The medical files of 813 patients were reviewed and the medical records of 331 cases who had undergone CT were examined. A total of 217 patients whose stone size was less than 10 mm were included in the study. The patients whose stones passed were included in Group 1, and those whose stones did not pass spontaneously were included in Group 2. Data about age and gender of the patients, location, laterality, history of spontaneous stone passage from the ipsilateral side, ureteroscopy, shock wave lithotripsy (SWL), anteroposterior (AP) diameter of the renal pelvis, diameter of the stone as measured on coronal and axial planes, stone volume, and average thickness of the renal parenchyma were evaluated. Parametres effecting passage of the stone were statistically analysed. Results: The mean age of the patients (female, n=152, and male, n=65) was 42.3 years. The patients had upper (n=73) and lower (n=144) ureteral stones. The median diameter of the renal pelvis (17.2 mm), stone diameter on the coronal plane (6.1 mm) and the axial plane (4.6 mm), and thickness of the renal parenchyma (20 mm) were measured. Statistical analysis revealed that the location, volume, diameter of the stone on the coronal and axial planes were influential factors on spontaneous stone passage. In logistic regression analysis, only the location of the stone and its diameter on the coronal plane were found to be independent effective factors on spontaneous stone passage. Discussion: In our study based on data retrieved from MDCT, the location and size of the stone were found to be independent factors affecting spontaneous stone passage. However, a surprising result is that the AP diameter of renal pelvis and renal parenchymal thickness, both of which are factors important for urologists, were not effective on SP.

Monopolar and bipolar transurethral resection of the prostate is currently the gold standard modality in the treatment of bladder outlet obstruction due to prostatic enlargement. A rare complication of transurethral resection is the explosion of the bladder as may occur during resection of the prostate. The etiology of explosion is thought to be a result of ignition due to mixture of oxygen and hydrogen gas occurring during the resection under increased pressure of the bladder. To the best of our knowledge, our case is the first report of bladder explosion during transurethral resection with bipolar energy using saline solution.