No abstract

Stents and catheters are widely used in urology. In this study, the frequency of double J (DJ) stent colonization and stent-associated bacteriuria was investigated. Between June 2011 and June 2012, 130 patients (17-72 years old) who underwent DJ stenting were enrolled in the study. Surgeries prior to stenting included stone extraction/lithotripsy, endopyelotomy, and diagnostic ureteroscopy. Prior to stenting, sterile urine samples were obtained, and urinary cultures were performed upon removal of the DJ stents, the second procedure. DJ stent cultures were also performed. Sixty-three stents were inserted into the right ureter and 67 into the left ureter of the patients. Cultures showed bacterial colonization in 10 (7.7%) cases. There was no significant association between positive stent culture and patient age, sex, or stent laterality. The rate of colonization was 2.2%, 2.9%, and 25% when indwelling time was less than 4 weeks, 4-6 weeks, and more than 6 weeks, respectively. In the present study, the rate of infection associated with a DJ stent and urinary infection was not very high. However, bacterial colonization increases significantly with indwelling time of the stent, and sterile culture of urine does not rule out colonization of the stent. Bacteriological investigation showed very low rates of colonization within 6 weeks after the insertion of stents, indicating that ureteral stents can be used safely within that time period.

Introduction:The discrepancy between prostate biopsy and prostatectomy Gleason scores is common. We investigate the predictive value of prostate biopsy features for predicting Gleason score (GS) upgrading in patients with biopsy Gleason scores ≤6 who underwent radical retropubic prostatectomy (RRP). Our aim was to determine predictors of GS upgrading and to offer guidance to clinicians in determining the therapeutic option. Methods: We performed a retrospective study of patients who underwent RRP for clinically localized prostate cancer at 2 major centres between January 2007 and March 2013. All patients with either abnormal digital examination or elevated prostate-specific antigen at screening underwent transrectal ultrasound-guided prostate biopsy. Variables were evaluated among the patients with and without GS upgrading. Our study limitations include its retrospective design, the fact that all subjects were Turkish and the fact that we had a small sample size. Results: In total, 321 men had GS ≤6 on prostate biopsy. Of these, 190 (59.2%) had GS≤6 concordance and 131 (40.8%) had GS upgrading from ≤6 on biopsy to 7 or higher at the time of the prostatectomy. Independent predictors of pathological upgrading were prostate volume <40 cc (p < 0.001), maximum percent of cancer in any core (p = 0.011), and >1 core positive for cancer (p < 0.001). Conclusions: When obtaining an extended-core biopsy scheme, patients with small prostates (≤40 cc), greater than 1 core positive for cancer, and an increased burden of cancer are associated with increased risk of GS upgrading. Patients with GS ≤6 on biopsy with these pathological parameters should be carefully counselled on treatment decisions.

None of the dilation methods was significantly superior in terms of surgical success, efficiency, or safety. Although balloon dilation was advantageous with respect to time parameters, the role of surgical experience should not be ignored.

MS as a comorbidity seems to diminish the effects of TURP. Further well-designed prospective, randomized studies with larger cohorts are needed to confirm the findings of this study.