Greater epidural use of tramadol may be preferred to morphine for postoperative analgesia under these circumstances.
Background/aim: To provide a comprehensive evaluation of sexual function and dysfunction in spinal cord-injured men based on self-reports of patients.Materials and methods: Forty-seven spinal cord-injured men who completed the spinal shock and rehabilitation period were included.Patients were asked to complete a questionnaire developed to assess social status, sexual activities, abilities, and sexuality education after injury. Neurologic levels of patients were classified according to American Spinal Cord Injury Association protocol. Erectile function was evaluated by International Index of Erectile Function-5 (IIEF-5) questionnaire. Results:Patients were aged between 20 and 62 years (mean: 35.2). Twenty-eight patients had T10 and above, 15 between T11 and L2, and 4 cauda conus injury. While 61.7% of the patients declared sexual activity, 93.6% declared some degree of erection. Mean IIEF-5 score was 5.3 and 87.3% of the patients had moderate to severe erectile dysfunction. Conclusion:Continuation of sexual activity after injury is very important and has a great impact on quality of life and interpersonal relationships for spinal cord-injured men. More attention must be given to sexuality after spinal cord injury. A very high rate of sexual dysfunction in spinal cord-injured patients was found and the importance of sexual education was emphasized in this study.
Congenital urethrocutaneous fistula of the male urethra is an extremely rare anomaly that is commonly seen in association with anorectal malformations or chordee. A case of congenital urethrocutaneous fistula not associated with other congenital anomalies is reported, discussing possible etiologies and surgical management.
The aim of this retrospective study was to present our experience in the treatment modalities of patients with vesicovaginal and ureterovaginal fistula. Between 1987 and 1997, 39 patients were diagnosed and operated on for vesicovaginal and ureterovaginal fistula. Of these patients, 31 had vesicovaginal, 7 had ureterovaginal and 1 had both vesicovaginal and ureterovaginal fistula. The ureterovaginal fistulas were repaired by simple ureteroneocystostomy with 100% success. Vesicovaginal and urethrovaginal fistulas were repaired transvaginally in 7 cases, transabdominally in 23 cases and endoscopically in two cases with 77% success at first attempt and 92% success with several attempts. The successful repair of urinary tract fistulas can be achieved in the majority of cases by adhering to the basic surgical principles. The optimum approach is that which works best in the surgeon's hands.
ÖZETIatrogenic suture materials within bladder cavity related to previous bladder surgeries or others with proximity to bladder may cause stone formation around themselves. This phenomenon has been well characterized with experimental animal studies. Though care related to choice of suture and technique of suturing is taken for, still such cases are reported after both urological and non-urological surgeries. In this report, such a case that had been operated for incontinence previously is presented for stone formation around the suture material within bladder cavity together with radiological examinations and endoscopical visualizations.
In this study, the effects of intraperitoneal 5-fluorouracil (5-FU), cisplatinum (Cis), adriamycin (Adr), and methotrexate (MTX) administration on rat intestinal anastomosis were compared. Cis and MTX led to significant weight loss in the first 5 days compared with the control group. Within 14 days all rats except the MTX group nearly reached their preoperative weight. No remarkable weight loss or systemic toxicity was observed among the 5-FU and Adr groups. The anastomosis bursting pressure (ABP) at 1 week was significantly lower than that of the control group (P < 0.01 and P < 0.005, respectively). On day 14 the anastomosis bursting pressure in the Cis group was similar to that of the control group but was significantly lower in the MTX group (P < 0.002). Histopathologically, MTX avoided the development of a mucosal layer at the anastomosis site and led to ulcer formation in some of the rats. The ABPs at 7 and 14 days were similar to those in the control group. Neither of the agents had any significant mechanical or histopathologic adverse effects on anastomosis. According to the results of our study, MTX impaired the healing of the anastomosis, and we thus conclude that the intraperitoneal administration of this agent is not safe. On the other hand, Cis showed a detrimental effect on the anastomosis, particularly in the early phase, but this effect disappeared in the late phase. Cis thus should not be administered in the early postoperative phase. As a result, 5-FU and Adr were found to be the safest agents as they did not delay wound healing and did not reduce the anastomotic strength.
In this study, the effects of intraperitoneal 5-fluorouracil (5-FU), cisplatinum (Cis), adriamycin (Adr), and methotrexate (MTX) administration on rat intestinal anastomosis were compared. Cis and MTX led to significant weight loss in the first 5 days compared with the control group. Within 14 days all rats except the MTX group nearly reached their preoperative weight. No remarkable weight loss or systemic toxicity was observed among the 5-FU and Adr groups. The anastomosis bursting pressure (ABP) at 1 week was significantly lower than that of the control group (P < 0.01 and P < 0.005, respectively). On day 14 the anastomosis bursting pressure in the Cis group was similar to that of the control group but was significantly lower in the MTX group (P < 0.002). Histopathologically, MTX avoided the development of a mucosal layer at the anastomosis site and led to ulcer formation in some of the rats. The ABPs at 7 and 14 days were similar to those in the control group. Neither of the agents had any significant mechanical or histopathologic adverse effects on anastomosis. According to the results of our study, MTX impaired the healing of the anastomosis, and we thus conclude that the intraperitoneal administration of this agent is not safe. On the other hand, Cis showed a detrimental effect on the anastomosis, particularly in the early phase, but this effect disappeared in the late phase. Cis thus should not be administered in the early postoperative phase. As a result, 5-FU and Adr were found to be the safest agents as they did not delay wound healing and did not reduce the anastomotic strength.
Objective:In spite of all efforts, prostate cancer is still the 2 nd highest cause of cancer-related deaths in men. For this reason new developments are needed in diagnosis, treatment and follow-up of prostate cancer. Neutrophil/lymphocyte (N/L) ratio is a cheap and effective parameter used for research into many solid tumors; but there are not enough studies on the reliability of this parameter in prostate cancer. In this study we researched the efficacy of N/L ratio in localized prostate cancer. Materials and Methods: Between March 9, 2012 and April 23, 2017, the data of 140 patients who underwent radical prostatectomy with localized prostate cancer were screened retrospectively. The patients' ages, preoperative prostate specific antigen (PSA) and N/L ratio, pathologic stage, pathologic Gleason score, tumor volume, lymph node involvement, surgical margin positivity and presence or absence of 3 rd month biochemical recurrence were noted. The correlations between N/L ratio with age, PSA, pathologic parameters, surgical margin positivity and biochemical recurrence were investigated. Results: The mean age of patients was 63.0±5.9 years, mean PSA value was 10.8±8.5 ng/mL and mean N/L ratio was 2.5±1.9. There was no correlation found between N/L ratio and PSA, pathologic stage, Gleason score, lymph node involvement, tumor volume, surgical margin positivity and biochemical recurrence (p>0.05). Conclusion: In our study investigating 140 patients with localized prostate cancer, we did not identify any correlation between N/L ratio and PSA, surgical stage and Gleason score, surgical margin positivity, and 3 rd month biochemical recurrence. When the literature is investigated, it appears that N/L ratio is effective for metastatic prostate cancer. To provide a more accurate judgment of the role of N/L ratio in localized prostate cancer, there is a need for new studies with broader patient series. Keywords: Inflammation, neutrophil-to-lymphocyte ratio, prostate cancer Amaç: Tüm uğraşılara rağmen prostat kanseri halen erkeklerde kanser nedenli ölümlerin 2. nedenidir. Bu sebeplerle prostat kanserinin tanı, tedavi ve izleminde yeni gelişmelere ihtiyaç duyulmaktadır. Nötrofil/ lenfosit (N/L) oranı birçok solid tümörde hakkında araştırma yapılan ucuz ve etkin bir parametredir, fakat prostat kanserinde bu parametrenin güvenilirliği konusunda yeterli sayıda çalışma bulunmamaktadır. Biz bu çalışmamızda lokalize prostat kanserinde N/L oranının etkinliğini araştırdık. Gereç ve Yöntem: 9 Mart 2012 ile 23 Nisan 2017 tarihleri arasında lokalize prostat kanseri tanısıyla radikal prostatektomi uygulanan 140 hastanın verileri retrospektif olarak tarandı. Hastaların yaş, preoperatif prostat spesifik antijen (PSA) ve N/L oranı, patolojik evre, patolojik Gleason skoru, tümör volümü, lenf nodu tutulumu, cerrahi sınır pozitifliği ve 3. ay biyokimyasal nüks bulunup bulunmadığı not edildi. N/L oranının yaş, PSA, patolojik parametreler, cerrahi sınır pozitifliği ve biyokimyasal nüks ile ilişkisi incelendi. Bulgular: Hastaların ortalama yaşı 63,0±...
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