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Öğe Partial Nephrectomy of a Horseshoe Kidney With Renal-Cell Carcinoma and Cholecystectomy: a Case Report(Trakya Üniversitesi, 2020) Cengiz, Elif; Şişman, Fevzi Oktay; Koçyiğit, Beliz; Arıkan, Mehmet Gürkan; Aktoz, TevfikAims: Horseshoe kidneys are the most common type of renal fusion anomaly and it may be associated with other anomalies and complications. Our case aims to present the partial nephrectomy of a horseshoe kidney with renal-cell carcinoma and cholecystectomy. Case Report: A sixty-year-old male patient was admitted to our outpatient clinic with a 3 cm suspicious mass in the horseshoe kidney that was detected during an attack of acute cholecystitis. Computed tomography revealed a heteroge- neous hypodense lesion containing millimetric calcific foci of 35x31x33 mm in size at the ventral middle part of the right kid- ney. Partial nephrectomy was performed non-ischemically and then cholecystectomy was performed. Pathological examination revealed stage T1a clear cell renal carcinoma, WHO/ISUP Grade 2 with a negative surgical margin. During follow-up; urea, creatinine, and glomerular filtration rate were found to be normal. Conclusion: Horseshoe kidneys are fairly common among renal anomalies. Cholecystectomy following non-ischemic partial nephrectomy for a tumor in the horseshoe kidney is a rare case.Öğe A Case Report: Fournier’S Gangrene in a Patient With Type-1 Diabetes Mellitus(Trakya Üniversitesi, 2015) Emin, Ahmet; Dokuz, Oktay; Köksal, Cemal; Yıldız, Ali; Akdere, HakanAims: Fournier’s gangrene is a necrotizing fasciitis of the perinea and genital areas. Scrotal Fournier’s gangrene,while being rare, is an urological emergency and requires urgent surgery. In this case report, we aimed to investigate a patient with Fournier’s Gangrene (FG), caused by a cut to scrotumÖğe Case Report of An Incidental Unicentric Castleman Disease(Trakya Üniversitesi, 2021) Cengiz, Elif; Certel, Alperen Taha; Ayrık, Mert Yücel; Arıkan, Mehmet Gürkan; Mercan, Elif; Öz Puyan, Fulya; Atakan, İrfan HüseyinAims: To emphasize the hardship of diagnosing Castleman disease and present a potential treatment method. Case Report: A sixty-three-year-old male patient was admitted to the outpatient clinic with an attack of acute cholecystitis. The patient’s abdominal computed tomography revealed an incidentally detected lipid dense solid mass (64x53x37 mm) at the level of right renal hilum with 29x13 mm solid components in the middle. The patient was admitted to the urology department and underwent surgery where the mass was totally excised due to suspicion of a malignancy (liposarcoma). Histopathological examination later on resulted with unicentric Castleman disease, hyaline vascular subtype. Conclusion: Since unicentric Castleman disease has an asymptomatic clinical course and is quite rare, it is necessary to rule out many potential possibilities before reaching a proper diagnosis. However, unicentric Castleman disease usually exhibits a good prognosis after the removal of the affected lymph node. Still, Castleman disease should be a candidate considered in the differential diagnosis of patients with incidentally discovered lymphadenopathy. On the whole, for a better understanding of underlying pathophysiology, there still lies a gap to be filled with knowledge acquired through further studies.Öğe Renal cell carcinoma manifesting after extracorporeal shockwave lithotripsy, percutaneous nephrolithotomy and open surgery for cystine calculus(2010) Kaplan, Mustafa; Kleın, EricBöbrek taş hastalığının renal pelvis kanseri için önemli bir risk faktörü olduğu yönünde bir çok araştırma olsa da böbrek taş hastalığı ile renal hücreli karsinom birlikteliği çok iyi bilinmemekte ve bu konuda çok az olgu sunumu tarzında yayın mevcuttur. Biz burada bilateral böbrek taşı nedeniyle daha önce vücut dışı şok dalgaları, perkütan nefrolitotripsi ve açık cerrahi sonrası bilateral renal hücreli karsinom tanısı alan bir olguyu sunmaya çalıştık. Uzun süreli böbrek taşı bulunan olguların uygun yöntemlerle renal parankim tümörü açısından da izlenmesi gerekir.Öğe Retroperitoneal ganglioneuroma(2009) Aktoz, Tevfik; Kaplan, Mustafa; Usta, Ufuk; Atakan, İrfan Hüseyin; İnci, OsmanNöroblastom, ganglionöroblastom ve ganglionörom sempatik sinir sistemini oluşturan, değişik derecelerde olgunlaşmış, primordial nöral krest hücrelerinden köken alan heterojen bir grup tümördür. Abdominal distansiyon, sol üst kadran ağrısı ve daire şikayetleriyle başvuran 12 yaşındaki erkek hastaya yapılan tetkikler sonucu rastlantısal olarak primer retroperitoneal ganglionörom saptanmıştır.Öğe Rare Fibroepithelial Polyp Extending Along the Ureter: A Case Report(2018) Akdere, Hakan; Çevik, GökhanBackground: Fibroepithelial polyps of the urinary tract are rare tumors, and their occurrence in the upper urinary tract is highly unusual. Case Report: This study reports a 9-year-old boy who presented to our clinic with complaints of unilateral flank pain and macroscopic hematuria. The direct urinary system graph did not show stone formation; therefore, magnetic resonance urography was performed. This revealed a filling defect in the left proximal ureter. On cystoscopy, a polyp was seen in the orifice of the left ureter, extending along the ureter. The polyp was resected by laser ablation and removed from the ureter. Histopathologic examination revealed a fibroepithelial polyp comprising fibrovascular stroma covered with transitional epithelium. Conclusion: Although extremely rare, a fibroepithelial polyp should be considered in the differential diagnosis when a young patient presents with flank pain and macroscopic hematuria. Endoscopic procedures may be the treatment of choice for polyps located in the upper ureter.Öğe A case of urachal malacoplakia that seems like urachal cancer(2015) İnci, Osman; Taştekin, Ebru; Gençhellaç, Hakan; Arabacı, Özcan; İşler, Serap; Atakan, İrfan HüseyinBackground: Urachal masses observed in adults should be considered malignant unless they are confuted. It is very difficult to differentiate between malignant or benign lesions, including especially calcified foci and solid areas. Case Report: Our case was a 63-year-old male patient who was diagnosed as Behçet’s Disease 26 years ago. Upon clinical examination, he was also diagnosed with adenocarcinoma of prostate. He was examined by computerized tomography to define the stage of prostatic adenocarcinoma. The existence of a hypodense multiseptated cystic lesion with irregular margins and solid areas located between anterosuperior of bladder and umbilicus was reported. Hence, the lesion was evaluated as urachal carcinoma and locally advanced prostate cancer by the urooncology council. Resection of the mass, partial cystectomy and pelvic lymphadenectomy were performed as one of the surgical approach options in urachal carcinoma. After pathological examination, the mass was diagnosed as malakoplakia and metastasis of prostate adenocarcinoma was also detected in the right obdurator lymph nodule. In the literature, case reports of urachal malakoplakia are extremely rare. It is also interesting to note the absence of specific clinical symptoms for the urachal mass and the existence of concomitant adenocarcinoma in our case. Conclusion: Malakoplakia can only be diagnosed by pathological examination. Particularly, urachal malakoplakia should also be taken into consideration in the differential diagnosis of lesions which include solid areas and are located in the urachus. Keywords: Michaelis Gutmann bodies, urachal malacoplakia, urachal malacoplakia mimicking cancerÖğe Residual Fragments after Percutaneous Nephrolithotomy(2012) Özdedeli, Kaan; Çek, Mete1. Osman MM, Alfano Y, Kamp S, Haecker A, Alken P, Michel MS, et al. 5-year follow-up of patients with clinically insignificant residual fragments after extracorporeal shockwave lithotripsy. EurUrol 2005;47:860-4. [CrossRef] 2. Pearle MS, Watamull LM, Mullican MA. Sensitivity of noncontrast helical computerized tomography and plain film radiography compared to flexible nephroscopy for detecting residual fragments after percutaneous nephrostolithotomy. J Urol 1999;162:23-6. [CrossRef] 3. Skolarikos A, Papatsoris AG. Diagnosis and management of postpercutaneous nephrolithotomy residual stone fragments. JEndourol 2009;23:1751-5. [CrossRef] 4. Daggett LM, Harbaugh BL, Collum LA. Post-ESWL, clinically insignificant residual stones: Reality or myth? Urology 2002;59:20-4. [CrossRef] 5. Osman Y, El-Tabey N, Refai H, Elnahas A, Shoma A, Eraky I, et al. Detection of residual stones after percutaneous nephrolithotomy: Role of noneennhanced spiral computerized tomography. J Urol 2008;179:198-200. [CrossRef] 6. Rassweiler JJ, Renner C, Chaussy C, Thuroff S. Treatment of renal stones by extracorporeal shockwave lithotripsy: an update. EurUrol 2001; 39:187- 99. [CrossRef] 7. Carr LK, D’A Honey J, Jewett MA, Ibanez D, Ryan M, Bombardier C. New stone formation: A comparison of extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy. J Urol 1996;155:1565-7. [CrossRef] 8. Candau C, Saussine C, Lang H, Roy C, Faure F, Jacqmin D. Natural history of residual renal stone fragments after ESWL. EurUrol 2000;37:18-22. [CrossRef] 9. Ganpule A, Desai M. Fate of residual stones after percutaneous nephrolithotomy: A critical analysis. J Endourol2009; 23:399-403. [CrossRef] 10. Raman JD, Bagrodia A, Gupta A, Bensalah K, Cadeddu JA, Lotan Y, et al. Natural history of residual fragments following percutaneous nephrostolithotomy. J Urol 2009;181:1163-8. [CrossRef] 11. Altunrende F, Tefekli A, Stein RJ, Autorino R, Yuruk E, Laydner H, et al. Clinically insignificant residual fragments after percutaneous nephrolithotomy: medium-term follow-up. J Endourol 2011;25:941-5. [CrossRef] 12. Olcott EW, Sommer FG, Napel S. Accuracy of detection and measurement of renal calculi: in vitro comparison of three-dimensional spiral CT, radiography and nephrotomography. Radiology. 1997;204:19-25. 13. Ray AA, Ghiculete PKT, Honey RJ. Limitations to ultrasound in the detection and measurement of urinary tract calculi. Urology 2010;76:295-300. [CrossRef] 14. Dundee P, Bouchier-Hayes D, Haxhimolla H, Dowling R, Costello A. Renal tract calculi: comparison of stone size on plain radiography and noncontrast spiral CT scan. J Endourol 2006;20:1005-9. [CrossRef] 15. Van Appledorn S, Ball AJ, Patel VR, Kim S, Leveillee RJ. Limitations of noncontrast CT for measuring ureteral stones. J Endourol 2003;17:851-4. [CrossRef] 16. Sacks E, Fajardo L, Hillman B, Drach G, Gaines J, Claypool H, et al: Prospective comparison of plain abdominal radiography with conventional and digital renal tomography in assessing renal extracorporeal shock wave lithotripsy patients. J Urol 1990;144:1341-6. 17. Jewett M, Bombardier C, Caron D, Ryan M, Gray R, St. Louis E, et al. Potential for inter-observer and intra-observer variability in x-ray review to establish stone-free rates after lithotripsy. J Urol 1992;147:559-62. 18. Palmer J, Donaher E, O’Riordan M and Dell K. Diagnosis of pediatric urolithiasis: role of ultrasound and computerized tomography. J Urol 2005;174:1413-6. [CrossRef] 19. Park J, Hong B, Park T, Park HK. Effectiveness of non- contrast computed tomography in evaluation of residual stones after percutaneous nephrolithotomy. J Endourol 2007;21:684-7. [CrossRef] 20. Jackman SV, Potter SR, Regan F, Jarrett TW. Plain abdominal xray versus computerized tomography screening: sensitivity for stone localization after nonenhanced spiral computerized tomography. J Urol 2000;164:308-10. [CrossRef] 21. Eisner BH, McQuaid JW, Hyams E, Matlaga BR. Nephrolithiasis: what surgeons need to know. AJR 2011;196:1274-8. [CrossRef] 22. Portis AJ, Laliberte MA, Holtz C, Ma W, Rosenberg MS, Bretzke CA. Confident intra- operative decision making during percutaneous nephrolithotomy: Does this patient need a second look? Urology 2008;71:218-22 [CrossRef] 23. Hemal AK, Goel A, Aron M, Seth A, Dogra PN, Gupta NP. Evaluation of fragmentation with single or multiple pulse setting of Lithoclast for renal calculi during percutaneous nephrolithotripsy and its impact on clearance. Urol Int 2003;70:265-8. [CrossRef] 24. Preminger GM, Assimos DG, Lingeman JE. AUA guideline on management of staghorn calculi: diagnosis and treatment recommendations. J Urol 2005;173:1991-2000. [CrossRef] 25. Hegarty NJ, Desai MM. Percutaneous nephrolithotomy requiring multiple tracts: comparison of morbidity with single-tract procedures. J Endourol 2006;20:753-60. [CrossRef] 26. Aron M, Yadav R, Goel R, Kolla SB, Gautam G, Hemal AK, et al. Multi tract percutaneous nephrolithotomy for large complete staghorn calculi. UrolInt 2005;75:327-32. [CrossRef] 27. Akman T, Sari E, Binbay M, Yuruk E, Tepeler A, Kaba M, et al. Comparison of Outcomes After Percutaneous Nephrolithotomy of Staghorn Calculi in Those with Single and Multiple Accesses J Endourol. June 2010;24:955-60. 28. Kang DE, Maloney MM, Haleblian GE, et al. Effect of medical management on recurrent stone formation following percutaneous nephrolithotomy. J Urol 2007;177:1785-9. [CrossRef] 29. Lojanapiwat B; Tanthanuch M; Pripathanont C; Ratchanon S; Srinualnad S; Taweemonkongsap T; Kanyok S; Lammongkolkul. Alkaline citrate reduces stone recurrence and regrowth after shockwave lithotripsy and percutaneous nephrolithotomy. Int. braz j urol. vol.37 no.5 Rio de Janeiro Sept.Oct. 2011 30. Streem SB, Yost A, Dolmatch B. Combination ‘‘sandwich’’ therapy for extensive renal calculi in 100 consecutive patients: Immediate, long-term and stratified results from a 10-year experience. J Urol 1997;158:342-5. [CrossRef] 31. Merhej S, Jabbour M, Samaha E, Chalouhi E, Moukarzel M, Khour R, et al. Treatment of staghorn calculi by percutaneous nephrolithotomy and SWL: The Hotel Dieu de France experience. J Endourol 1998;12:5-8. [CrossRef] 32. Denstedt JD, Clayman RV, Picus DD. Comparison of endoscopic and radiological residual fragment rate following percutaneous nephrolithotripsy. J Urol 1991;145:703-5. 33. Pearle MS, Watamull LM, Mullican MA. Sensitivity of non- contrast helical computerized tomography and plain film radiography compared to flexible nephroscopy for detecting residual fragments after percutaneous nephrostolithotomy. J Urol 1999;162:23-6. [CrossRef] 234 Balkan Med J 2012; 29: 230-5 Özdedeli and Çek Residual Fragments after Percutaneous Nephrolithotomy 34. Breda A, Ogunyemi O, Leppert JT, Lam JS, Schulam PG. Flexible ureteroscopy and laser lithotripsy for single intrarenal stones 2 cm or greater - is this the new frontier? J Urol 2008;179:981-4. [CrossRef] 35. Traxer O, Dubosq F, Jamali K, Gattegno B, Thibault P. New- generation flexible ureterorenoscopes are more durable than previous ones. Urology 2006;68:276-80. [CrossRef] 36. Akman T, Binbay M, Ozgor F et al. Comparison of percutaneous nephrolithotomy and retrograde flexible nephrolithotripsy for the management of 2-4 cm stones: a matched-pair analysis. BJU Int 2011. 37. Valdivia Uría JG, Valle Gerhold J, López López JA, Villarroya Rodriguez S, Ambroj Navarro C, Ramirez Fabián M, et al. Technique and complications of percutaneous nephroscopy: experience with 557 patients in the supine position. J Urol 1998;160:1975-8. [CrossRef] 38. Ibarluzea G, Scoffone CM, Cracco CM, Poggio M, Porpiglia F, Terrone C, et al. Supine Valdivia and modified lithotomy position for simultaneous anterograde and retrograde endourological access. BJU Int 2007;100:233-6. [CrossRef] 39. Scoffone CM, Cracco CM, Cossu M, Grande S, Poggio M, Scarpa RM. Endoscopic combined intrarenal surgery in Galdakao-modified supine Valdivia position: a new standard for percutaneous nephrolithotomy? EurUrol 2008;54:1393-403. [CrossRef] 40. Hoznek A, Rode J, Ouzaid I, Faraj B, Kimuli M, de la Taille A, et al. Modified Supine Percutaneous Nephrolithotomy for Large Kidney and Ureteral Stones: Technique and Results. EurUrol 2012;61:164-70. [CrossRef] 41. Woodside JR, Stevens GF, Stark GL, Borden TA, Ball WS. Percutaneous stone removal in children.J Urol 1985;134:1166-7. 42. Jackman SV, Hedican SP, Peters CA, Docimo SG. Percutaneous nephrolithotomy in infants and preschool age children: experience with a new technique. Urology 1998;52:697-701. [Cross- Ref] 43. Desai MR, Kukreja RA, Patel SH, Bapat SD. Percutaneous nephrolithotomy for complex pediatric renal calculus disease. J Endourol 2004;18:23-7. [CrossRef] 44. Dawaba MS, Shokeir AA, Hafez AT, Shoma AM, El-Sherbiny MT, Mokhtar A, et al. Percutaneous nephrolithotomy in children: early and late anatomical and functional results. J Urol 2004;172:1078-81. [CrossRef] 45. Afshar K, McLorie G, Papanikolaou F, Malek R, Harvey E, Pippi- Salle JL, et al. Outcome of small residual stone fragments following shock wave lithotripsy in children. J Urol 2004;172:1600-3. [CrossRef]Öğe Protective effect of quercetin against renal toxicity induced by cadmium in rats(2012) Aktoz, Tevfik; Kanter, Mehmet; Uz, Yeşim Hülya; Aktaş, Cevat; Erboğa, Mustafa; Atakan, İrfam HüseyinAmaç: Çalışmamızda kadmiyumla (Cd) oluşturulan böbrek toksisitesine karşı quercetinin (QE) koruyucu etkinliğini göstermeyi amaçladık. Hastalar ve Yöntemler: Çalışmada 24 adet Wistar albino cinsi erişkin erkek sıçan kullanıldı. Sıçanlar her grupta 8 adet olmak üzere; kontrol, Cd ve Cd+QE olmak üzere 3 gruba ayrıldı. Cd grubuna her gün 1 mg/kg Cd, 2 ml/kg serum fizyolojik içerisinde çözündürüldükten sonra CdCl2 şeklinde 30 gün boyunca subkutan enjeksiyon olarak uygulandı. Cd ile birlikte QE tedavisi verilen gruba, Cd enjeksiyonundan 2 gün önce başlanarak 15 mg/kg QE, deney süresi boyunca intraperitoneal olarak uygulandı. Bulgular: Böbrek dokularının histolojik olarak değerlendirilmesi sonucu, kontrol grubuyla karşılaştırıldığında Cd verilen sıçanlarda mezengial hücrelerde artış, kapsüler, glomerüler ve tübüler basal membranlarda kalınlaşma ile birlikte periyodik asit Schiff (PAS)-pozitif alanların artışı gözlendi. Cd ile birlikte QE tedavisi verilen grupta sadece birkaç glomerüldeki genişleme dışında, Cd’ye bağlı böbrek yapısında oluşan değişikliklere karşı QE’nin belirgin koruyucu bir etkisinin olduğu saptandı. Bulgularımız, Cd ile birlikte QE tedavisi verilen grupta böbrek kortikal dokularında TdT-(terminal deoksinukleotidil transferaz)- aracılı deoksiuridin trifosfat işaretleme (TUNEL) aktivitesinde anlamlı bir azalma ile birlikte prolifere olmuş hücre nükleer antijeninin (PCNA) ekspresyonunda da artış olduğunu göstermiştir. Sonuç: Bu sonuçlar QE’nin Cd ile oluşturulan böbrek toksisitesini azaltabileceğini göstermiştir.Öğe Bilateral same-session flexible ureterorenoscopy for renal and/or ureteric stone disease treatment(Arab Assoc Urology, 2018) Arda, Ersan; Cakiroglu, BasriObjective: To evaluate the effectiveness and safety of bilateral same-session flexible ureterorenoscopy (f-URS) in the treatment of bilateral renal and/ or ureteric stone disease. Patients and methods: From October 2007 to December 2015, 62 patients who had undergone bilateral, same-session f-URS were included in the study. The procedures were performed under general anaesthesia, in lithotomy, and initiated on the side in which the patient was clinically symptomatic or on the side in which the stone was smaller. Plain abdominal radiography, intravenous urography, renal ultrasonography and/or non-contrast computed tomography scans were conducted in all patients. The success rate was defined as, patients who were stone-free or only had residual fragments of < 3 mm. Results: A total of 62 patients (43 male, 19 female), with a mean (SD) age of 39 (15.1) years, were included. The mean (SD) stone size was 23.2 (6.11) mm with a mean (SD) operative time of 58.8 (16.24) min. The stone-free rates were 90.3% and 100% after the first and second procedures, respectively. The mean (SD) hospital stay was 1.58 (0.72) days. There were minor complications (Clavien-Dindo grade I-II) in 10 (16%) patients and major complications (Clavien-Dindo III-IV), e.g. distal ureter laceration and laser injury of the ureter, in two patients. Conclusion: Same session bilateral f-URS is a successful and safe method for bilateral renal and/or ureteric stones. (C) 2018 Production and hosting by Elsevier B.V. on behalf of Arab Association of Urology.Öğe Chronic Bacterial Prostatitis in a Turkish Population: The Microbiological Etiology and Distribution(Aves, 2018) Arda, Ersan; Cakiroglu, Basri; Arikan, Mehmet Gurkan (Trakya author); Gozukucuk, RamazanObjective: To investigate the category 2 frequency and microorganism distribution of patients diagnosed with chronic prostatitis in a Turkish population. Methods: Data of 3200 patients diagnosed with chronic prostatitis in the urology outpatient clinic between 2009 and 2014 were retrospectively reviewed. The symptom scores were calculated considering the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) according to pain (0-21 points), quality of life (0-12 points), and urinary (0-10 points) subdomains to a total score of 0-43 points. All patients were checked for symptoms, urinalysis, expressed prostatic secretion (EPS), or urine after prostatic massage (VB3) culture and PCR (Polymerase Chain Reaction) of EPS or VB3 for Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, Mycoplasma genitalium, and Trichomonas vaginalis. Results: The mean age of the patients was calculated as 37.7 +/- 7.4 (range 22-65) years. The average of total NIH-CPSI score was determined as 9.08 (range 1-40). In 223 of 3200 patients, positive culture and/or PCR results were observed. The results were as follows: E. coli 27 (12.1%), E. faecalis 18 (8.1%), S. epidermidis 15 (6.7%), S. haemolyticus 10 (4.5%), S. aureus 5 (2.2%), S. agalactiae 4 (1.8%), Pseudomonas 3 (1.3%), C. trachomatis 24 (10.8%), U. urealyticum 95 (42.6%), M. genitalium 6 (2.7%), M. hominis 14 (6.3%), and T. vaginalis 2 (0.9%). Conclusion: In a Turkish population, category 2 patients constitute 7% of all chronic prostatitis patients. This ratio is consistent with the NIH classification of prostatitis data, but it differs etiologically with U. urealyticum, E. coli, and C. trachomatis being the most proliferated pathogens in our study.
