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.

Purpose: To determine the effect of washing the biopsy needle with povidone-iodine solution on infection rates after transrectal ultrasonography-guided prostate biopsy. Patients and Methods: 180 patients with transrectal prostate biopsy were included. Infection was excluded with midstream urine culture before biopsy, and patients were divided into two groups. In group 1 (n = 84), the needle was washed with povidone-iodine after each material reception during biopsy, and in group 2 (n = 96), it was not. At day 3 and 2 weeks after the biopsy, patients were checked. On day 3, midstream urine was cultured and patients were checked for fever, hematuria, rectal hemorrhagia, hematospermia and urinary retention. Also, the effect of rectal preparation on infection rate was evaluated. Results: There was no significant difference between the patients’ ages, PSA levels and prostate volumes. In total, 11 patients (6.1%; 4 from group 1 and 7 from group 2) developed infectious complications. There was no statistically significant difference between the groups. Fever, asymptomatic bacteriuria and urinary system infection rates were also not statistically different between the groups. The most frequent complication was hematuria with 83 cases (46.1%), but they did not need hospitalization and no patient had acute urinary obstruction. Conclusions: Washing the biopsy needle with povidone-iodine did not have an effect on the infection rates. Antibiotic prophylaxis and cleaning the biopsy equipment is adequate for low infection rates.

Qmax and Qave values were significantly higher in the sitting position. Alpha blockers did not affect any change.

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.

Amaç: Anestezi ve anestezi doktoru, toplum tarafından daha tanınır hale gelmeye başlamıştır. Bu çalışmada operasyon, ağrı tedavisi veya sedasyon için anestezi polikliniğine başvuran hastalara anestezi ve anestezi doktoru ile ilgili bilgilerini, deneyimlerini ve kaygılarını belirlemek amacıyla bir anket hazırlandı. Gereç ve Yöntem:Katip Çelebi Üniversitesi Atatürk Eğitim Araştırma Hastanesi, anesteziyoloji polikliniğine başvuran 18-90 yaş arasındaki 249 hastaya yaş, cinsiyet, eğitim durumu, meslek gibi demografik bilgiler, önceki anestezi deneyimi, alerji öyküsü, anestezi yöntemleri ile ilgili bilgileri, anestezi doktorunun görevleri ile ilgili bilgileri ve anestezi ile ilgili korkuları içeren, 20 sorudan oluşan anket uygulandı. Bulgular:Olguların eğitim durumunda en fazla yüzdeyi %26.1 ile ilkokul mezunları oluşturuyordu. Anestezi deneyimi olanlar olguların %44.6'sı idi. Olguların %48.2'si anestezinin uzman doktor tarafından uygulandığını biliyordu. Anestezi ile ilgili korkular sorgulandığında en fazla olguların %29.3'ü ile "öleceğim" cevabı verildi.Sonuç: Anestezi doktoru ve anestezi ile ilgili sorulara verilen doğru cevaplar ile anestezi deneyimi ve eğitim düzeyi (lise, üniversite) arasında istatistiksel olarak anlamlı ilişki mevcuttu. Eğitim düzeyi yükseldikçe olguların anestezi konusundaki bilgilerinin arttığı sonucuna varıldı.Anahtar Sözcükler: Anesteziyoloji, anket, bilgi. Abstract Aim: Public interest in anesthesia and anesthesiologist is increasing. In this study a questionnaire was set up to reveal patients' knowledge who were consulted anesthesia clinic for sedation, analgesia or anesthesia about the role of an anesthesiologist and their concern about anesthesia. Materials and Methods: Two hundred and forty-nine patients, aged between 18-90, who were referred to Anesthesia Outpatient Clinic of Katip Çelebi University Atatürk Education and Research

Introduction:We assessed the effect of different voiding positions on uroflowmetric parameters and post-void residual (PVR) urine volume in symptomatic benign prostatic hyperplasia (BPH) patients. We also evaluated the effect of alpha blockers on PVR in different voiding positions. Methods:The study was performed with 110 BPH patients over 50 years old. In total, 4 uroflowmetries were performed in all patients: 2 patients in the sitting position and 2 in the standing position. PVR was measured with transabdominal ultrasonography. Also, patients were divided into two groups according to the alpha adrenergic blocker treatment; the effect of this treatment on their uroflowmetric parameters in different positions was evaluated. Results: Maximum flow rate (Qmax) and average flow rate (Qave) were significantly higher in patients in the sitting position, but there were no differences in other uroflowmetric parameters and PVR volume (Qmax: 15.5±5.9 mL/s vs. 13.7±5.2 mL/s, Qave: 11.4±4.6 mL/s vs. 10.7± 3.9 mL/s, respectively; p < 0.05). The Qmax and Qave were significantly higher in sitting position, compared to the standing position, in both alpha adrenergic treatment and non-treated groups; again, there were no differences in other uroflowmetric parameters and PVR volume. Conclusion: Qmax and Qave values were significantly higher in the sitting position. Alpha blockers did not affect any change.

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...

Cite as: Can Urol Assoc J 2014;8(11-12):e894-900. http://dx.doi.org/10.5489/cuaj.2208 Published online December 15, 2014. Abstract Introduction:We assess the effect of video-based education on patient anxiety during transrectal prostate biopsy. Methods: A total of 246 patients who underwent transrectal prostate biopsy were prospectively enrolled in the study. Group 1 included 123 patients who received both written and video-based education, while Group 2 included 123 patients who received only written instructions regarding prostate biopsies. State-Trait Anxiety Inventory (STAI) was used to assess state and trait anxiety (STAI-S/T) After completing the STAI-S and STAI-T questionnaires, all patients in Group 1 received written information and video-based education and they again completed STAI-S before the biopsy. On the contrary, after completing the STAI-S and STAI-T questionnaires, the patients in Group 2 received only written information and then they completed the STAI-S before the biopsy. Moreover, a visual analog scale (VAS) was used to assess pain scores during digital rectal examination, probe insertion, periprostatic local anesthesic infiltration, and biopsy. Results: No difference was noted between 2 groups regarding VAS scores. Comparing the 2 groups on baseline anxiety, we found that trait anxiety scores (STAI-T) were similar (p = 0.238). Preinformation STAI-S scores were similar in both groups (p = 0.889) and they both indicated high anxiety levels (score ≥42). While postinformation STAI-S scores remained high in Group 2, post-information STAI-S scores significantly decreased in Group 1 (p = 0.01). Conclusions: Undergoing a prostate biopsy is stressful and may cause anxiety for patients. Video-based education about the procedure can diminish patient anxiety.