Presence of T2 and higher-stage tumors, high-grade tumors, and multifocality are combined risk factors for urinary bladder recurrence and distant organ metastasis. Patients with the additional risk factors of cigarette smoking (urinary bladder recurrence) and nodal disease (distant organ metastasis) should be followed up closely after surgery.
Prolonged erection is a rare problem in urology but it must be treated effectively. The most common etiological factor is intracavernosal vasoactive agent injection for diagnosis or treatment of erectile dysfunction. The aim of this study was to evaluate the ef®cacy of intracavernosal adrenalin injection alone in the treatment of priapism. Nineteen patients with prolonged erection were evaluated. Seventeen out of the 19 prolonged erections were due to intracavernosal vasoactive agent injection and the remaining two were idiopathic. In all cases 2 ml adrenalin (1a100 000) was injected in each cavernosal body. In the patients who did not respond to the ®rst injection, repeated adrenalin injections were performed at 20 min intervals. Blood pressure and heart rate were monitored during the injections. Detumescence was achieved in ten (53%) patients after the ®rst injection. Repeated adrenalin injections (2 ± 5 injections) were required in nine patients and eight (42%) of them achieved detumescence. Only one (5%) patient who had 26-h prolonged erection could not achieve detumescence. There was no signi®cant difference in blood pressure and heart rate during the monitoring of the patients when compared to the initial values. No standard treatment method has yet been described for prolonged erection. Repeated aspirations and irrigations for treatment of prolonged erection are problematical applications both for patients and urologist. Intracavernosal adrenalin injection alone can be used with high ef®cacy and safety for the treatment of prolonged erection especially in patients with a short duration of erection.
ESWL outcomes for the ureteral calculi support the use of lithotripsy particularly for stones <100 mm(2). Treatment efficacy was not significantly different among stones localized in proximal and distal ureters. Degree of obstruction did not affect the ESWL outcomes in the proximal ureter, but it adversely affected SFR in the distal ureter.
Objective: Ureterocutaneostomy (UCS) is a urinary diversion (UD) method which is used rarely in a carefully selected patient group. In this study, we aimed to present the data and long-term outcomes of patients who underwent UCS treatment in our clinic. Materials and Methods: A total of 36 patients who underwent UCS between January 2000 and December 2017 were included in the study. All patients had unilateral or bilateral ureteral-skin anastomosis. The demographic data, diagnoses, comorbidities, side of UCS (unilateral-bilateral), anesthesia method, operation time, and complications of the patients were recorded from the hospital registry system. The complications and survival status of the patients until the study date were evaluated. The study data were presented as mean (minimum-maximum) and number (percent). Results: Mean follow-up time was 128.5 (8-192) months. The mean American Society of Anesthesiologists score was 3.25. The patients had significant comorbidities, mainly hypertension, chronic obstructive pulmonary disease, and coronary artery disease. UCS was performed most frequently after radical cystectomy due to muscle-invasive bladder tumour (75%) and was usually bilateral (75%). The most common indications for UCS were significant comorbidities (55%). Only 3 (8.33%) patients developed ureteral-skin anastomosis, 6 (16.66%) patients developed pyelonephritis, and 9 patients died during the follow-up period. Conclusion: Although UCS is not a first-line UD method, it should still be kept in mind in the 21 st century for patients unable to tolerate segment excision from the gastrointestinal tract and postoperative complications due to comorbidities.
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