Objective: To evaluate the accuracy of radiological staging, especially renal venous and perirenal fat invasion, in renal cell carcinoma (RCC). Material & Methods: Data of 4823 renal tumor patients from Renal Tumor Database of Association of Uro-oncology in Turkey were evaluated. Of 4823 patients, 3309 RCC patients had complete radiological and histopathological data were included to this study. The Pearson Chi-squared test (χ2) was used to compare radiological and histopathological stages. Results: The mean (SD) age of 3309 patients was 58 (12.3). Preoperative radiological imaging was performed using computed tomography (CT) (n=2510, 75.8%) or magnetic resonance imaging (MRI) (n=799, 24.2%). There was a substantial concordance between radiological and pathological staging (к=0.52, p<0.001). Sensitivities of radiological staging in stage I, II, III and IV were 90.7%, 67.3%, 27.7% and 64.2%, respectively. The sensitivity in stage III was lower than the other stages. Sub-analysis of stage IIIa cases revealed that, for perirenal fat invasion and renal vein invasion, sensitivity values were 15.4% and 11.3%, respectively. Conclusions: There was a substantial concordance between radiological (CT and/or MRI) and pathological T staging in RCC. However, this is not true for T3 cases. Sensitivity of preoperative radiological imaging in patients with pT3a tumors is insufficient and lower than the other stages. Consequently, preoperative imaging in patients with T3 RCC has to be improved, in order to better inform the patients regarding prognosis of their disease.
Aims The relationship between nutrition and overactive bladder (OAB) is known. This study investigates the relationship between Mediterranean type diet and OAB. Methods 14-Item Mediterranean Diet Adherence Screener(MeDAS) and OAB-V8 Bladder Inquiry Form, validated in Turkish, were presented to 500 patients over the age of 18 who applied to outpatient clinics other than urology outpatient clinics. Those with chronic diseases and urinary tract infections (by urinalysis and detailed medical history) were excluded. Results There was a negative correlation between the MeDAS and OAB-V8 scores. High OAB-V8 scoring was associated with obesity (BMI ≥ 30), being single and low education level. Conclusions Dietary patterns represent a broader perspective of food and nutrient consumption and may therefore be more predictive of disease risk. Mediterranean type diet should be recommended in the first-line treatment of patients with OAB symptoms. It is easily possible to determine the compliance of patients with this diet by using 14-Item MeDAS. Keywords: Mediterranean Diet , Overactive bladder, Nutrition
Objective: The aim of this study is to evaluate the outcome of ablation therapy in our clinic for the treatment of patients with small renal mass Materials and Methods: We retrospectively evaluated the technic and follow-up data of 30 patients with 36 tumors who underwent Radiofrequency Ablation (RFA) and Microwave Ablation (MWA) in our clinic. Demographic data, ablation type, tumor characteristics, peroperative and postoperative complications and treatment success of the patients were evaluated. Results: A total of 36 tumors who underwent ablation treatments, 23 were treated with RFA, 13 with MWA. The mean tumor size was 28.9 ± 6.92 mm in RFA and 29.3 ± 7.70 mm in MWA. 12 (52.1%) of the RFA procedures were applied to the right kidney while 11 (47.8%) were applied to the left kidney. 6 (46.1%) of the MWA procedures were performed on the right kidney and 7 (53.8%) on the left kidney. Of the 36 tumors, 4 (11.1%) were located central and 32 (88.8%) were peripheral. Complications occurred in 2 patients. In one of these patients, acute renal failure and urea creatinine were found to be elevated. In the other patient, local pain was found in the ablation side and minor bleeding was detected at the ablation site in USG. The mean follow-up period was 49.6 ± 24.7 months in patients with RFA and mean follow-up was 16 ± 8,05 months in MWA treatments. The overall success in MWA administration was calculated as 76.9%, while the overall success in RFA was 80%. Conclusion: Long-term oncologic efficacy of RFA appears to be successful in the treatment of T1a renal carcinomas. Further studies can be conducted to elucidate the influence of MWA on long-term oncological outcomes.
Objectives The aim of the present study was to investigate the effect of treatment on IL-1, IL-6, IL-8 and neopterin levels in patients with non-muscle invasive bladder cancer (NMIBC). Methods Thirty patients with NMIBC and 30 age-matched controls were included in the study. Preoperative, postoperative first control (at two weeks after second transurethral resection of bladder tumor (TURBT)) and second control (at the end of intravesical immunotherapy) blood samples were analyzed by ELISA to determine IL-1, IL-6, IL-8 and neopterin levels. The mean cytokine levels of the patients were statistically compared as well as comparing the patients’ and controls’ levels. Results There were no statistically significant differences between the mean IL-1, IL-6, IL-8 and neopterin levels of the patient and control group before initial TURBT. In the patient group, there were no statistically significant differences in the IL-6 and IL-8 levels after both TURBT and intravesical BCG therapy. The mean of preoperative IL-1 and neopterin levels significantly decrease after TURBT (p<0.05=). However this reduction do not continue after intravesical BCG instillations. Conclusions The finding of this study showed that the IL-1, IL-6, IL-8 and neopterin levels of the patients with NMIBC were similar to the levels of healthy controls. The IL-1 and neopterin levels significantly decreased after TURBT. But this reductions did not continue after intravesical BCG instillation. These findings demonstrate that IL-1 and neopterin levels decrease after TURBT due to the reduction of tumor weight or tumor removal.
Objectives: To compare pain, quality of life(QoL), sexual function and lower urinary tract symptoms(LUTS) between rigid(RC) and flexible cystoscopy(FC). Methods: Forty-one patients who were planned control cystoscopies were enrolled the study. At the first cystoscopy, 20 patients(Group 1) and other 21 patients(Group 2) were performed by using flexible(15,5Fr) and rigid cystoscope(15,5Fr), respectively. At the second cystoscopies, the patients in group 1 and group 2 were performed by using rigid and flexible cystosacope, respectively. In all the patients, pain was measured with visual pain scale(VPS) shortly after cystoscopy. Also SF, QoL and LUTS were assessed by using IIEF, SF-36 and MLUTS forms, respectively. Results: While 22 of the patients preferred FC, the other 19 preferred RC(p>0,05). There were no statistically differences between VPS, IIEF, SF-36 and MLUTS scores of the two groups. In multivariate analysis regarding quality of life, although sexual function, pain and cystoscopy type did not affect QoL, voiding symptoms affected independently QoL. After the both cystoscopy type, IIEF, SF-36 and MLUTS scores did not change statistically. Conclusion: The results showed that the effects on pain, sexual function, QoL and LUTS of RC and FC were similar. In general, cystoscopy did not affect negatively on QoL, sexual function and LUTS of the patients.
Purpose: To investigate the effect of mirabegron 50 mg/daily for JJ stent-related symptoms after ureteroscopic stone surgery. Methods: Medical records of 145 patients who were given a single daily oral dose of 50 mg of mirabegron for relieving stent-related symptoms were retrospectively analyzed. Demographic and clinical data and stone parameters were recorded. All participants completed the Turkish version of the Ureter Symptom Score Questionnaire (USSQ-T) on the postoperative seventh day, and again after at least three weeks, before JJ stent removal. The severity of stent-related symptoms was statistically compared before and after the mirabegron treatment. Results: The mean urinary symptoms score decreased significantly from 30.87 ± 9.43 to 22.61 ± 6.78 (p < 0.0001), mean body pain score decreased significantly from 21.82 ± 11.22 to 14.03 ± 7.52 (p < 0.0001), mean work performance score decreased from 10.50 ± 8.61 to 7.02 ± 6.51 (p < 0.0001), and mean general health score decreased significantly from 15.43 ± 6.50 to 11.12 ± 3.70 (p < 0.0001). The mean sexual matters score significantly decreased from 3.88 ± 3.40 to 2.48 ± 2.03 (p < 0.0001), the additional problem score decreased from 9.31 ± 4.61 to 6.51 ± 2.83 (p < 0.0001), and the overall quality of life (QoL) score decreased from 5.18 ± 1.94 to 4.23 ± 1.71 after mirabegron use (p < 0.0001). Conclusion: Daily use of 50g of mirabegron significantly improved stent-related symptoms, sexual matters, and quality of life.
Objective: To present a nation-wide analysis of the workload of urology departments in Turkey week-by-week during Covid-19 pandemic. Methodology: The centers participating in the study were divided into three groups as tertiary referral centers, state hospitals and private practice hospitals. The number of outpatients, inpatients, daily interventions and urological surgeries were recorded prospectively between 9-March-2020 and 31-May-2020. All these variables were recorded for the same time interval of 2019 as well. The weekly change of the workload of urology during pandemic period was evaluated; also the workload of urology and the distributions of certain urological surgeries were compared between the pandemic period and the same time interval of the year 2019. Results: A total of 51 centers participated in the study. The number of outpatients, inpatients, urological surgeries and daily interventions were found to be dramatically decreased by the third week of pandemics in state hospitals and tertiary referral centers; however the daily urological practice were similar in private practice hospitals throughout the pandemic period. When the workload of urology in pandemic period and the same time interval of the year 2019 were compared; a huge decrease was observed in all variables during pandemic period. However, temporary measures like ureteral stenting, nephrostomy placement and percutaneous cystostomy have been found to increase during Covid-19 pandemic compared to normal life. Conclusions: Covid-19 pandemic significantly effected the routine daily urological practice likewise other subspecialties and priority was given to emergent and non-deferrable surgeries by urologists in concordance with published clinical guidelines.
Objective: To identify pathophysiological mechanisms of nocturia and the correlation of these mechanisms with nocturia severity. Methodology: After approval by the local ethics committee, all patients with nocturia (≥1 nocturnal void/night) were included and filled the overactive bladder questionnaire (OABq), nocturia quality of life (N-QoL), ICIQ-MLUTS (male), ICIQ-FLUTS (female) and 3-day frequency-volume chart. Patients were divided into three groups according the severity of nocturia: group 1 consisted of patients with mild (1-2 voids/night), group 2 with moderate (3-4 voids/night) and group 3 with severe nocturia (>4 voids/night). Comparative analysis were performed between groups, p<0.05 was deemed as statistically significant. Results: 68.1%, 64.1% and 8.7% of the patients had nocturnal polyuria, reduced bladder capacity and global polyuria; respectively. 42.7% of the patients had mixed nocturia. 6.1% of the patients did not comply with the afore-mentioned subtypes and defined as isolated nocturia. Regarding the severity of nocturia; 155 (41%) patients had mild, 167 (45%) patients had moderate and 57 (15%) patients had severe nocturia. Increased nocturia severity was related with decreased quality of life; higher age, urinary tract symptom scores, nocturnal urine volume, evening fluid consumption and beta-blocker medication rates. Increased nocturia severity was also associated with higher nocturnal polyuria, global polyuria and reduced bladder capacity rates. Conclusions: Nocturia mechanisms may vary between mild and moderate to severe nocturia groups according to the present study. Nocturia grading with identification of subtypes may help for better standardization of the diagnostic and treatment approaches as well as for the design of future clinical trials.