Yeni Üroloji Dergisi / The New Journal of Urology

7-10

Authors: Ekrem Güner , Coshgun Huseynov, Emre Şam , Yusuf Arıkan , Fatih Akkaş , Ali İhsan Taşçı

Objective: We aimed to demonstrate the relationship between urine analysis and culture of patients with DJ stents with significant urinary infection and thus prevent unnecessary antibiotic use and over-treatment. Material and Methods: The data of patients who had DJS insertion between 2016 and 2019 were investigated retrospectively. Results: A total of 152 patients were included in the study. The mean age of the patients was 48.9±14.9 years. Indications for DJS insertion were as follow: endoscopic ureter and kidney stone treatment was percutaneous nephrolithotomy in 108 (71.2%) patients, percutaneous nephrolithotomy in 20 (13.2%) patients and renal transplantation in 6 patients. The urine analysis of the patients revealed nitrite (+) in 8 patients and leukocyte esterase (+) in 117 patients (77%). In 20 patients (13.2%), various microorganism growths were observed in urine culture. 75% of patients with nitrite were positive in urine culture. No significant difference was found between urine cultures of patients with and without comorbidity (p = 0.132). In multivariate regression analysis, age, gender, catheter stay duration, and indications for DJS were not found top predict urinary tract infection (p> 0.05 for all variables). Conclusion: In patients with ureteral stent, nitrite positivity predicts urinary tract infection at a high rate and necessitate urine culture followed by appropriate antibiotic treatment.

19-26

Authors: Hatice ÖMERCİKOĞLU ÖZDEN , Asıf YILDIRIM , Gülin SUNTER , Dilek İNCE GÜNAL , Kadriye AĞAN

Purpose: Our aim is to determine the relationship between Multiple Sclerosis (MS) disease progression and urological symptoms Method: We enrolled patients with Newly Diagnosed MS (n: 11), RRMS (n: 9), SPMS (n:6) and healthy control subjects (n:10). Neurological examination was done in all groups. Furthermore patient groups were evaluated with EDSS (Expanded Disability Status Scale) and MSFC (functional capacity in multiple sclerosis scale). Routine blood biochemistry were done. All patients and the subjects in the control group were evaluated in regard to lower urinary tract symptoms by the following questionnaires: incontinence and sexual function in terms of IPSS (International Prostate Symptom Score), ICIQ -SF (International Incontinence Questionnaire), IIEF (International Index of Erectile Dysfunction Test) and FSFI (Female Sexual Function Index). In addition all the patients were evaluated by urodynamic studies in order to examine the voiding function. Results: There were no differences between the group in respect to age, years of education and gender. As the disease duration increase, the frequency of incontinence was found to increase. PSS, IPSS-QOL, ICIQ-SF scores of newly diagnosed MS, RRMS, SPMS and healthy control groups were statistically significant. There was a correlation between EDSS score and urological symptoms. There was no relationship between disease duration and urological symptoms. Due to inadequate number of male patients in the study, IIEF score did not differ significantly between the groups. There was no relationship between EDSS score, disease duration and IIEF .Due to inadequate number of the female patients in the study, FSFI score did not differ significantly between the groups. There was no relationship between EDSS score, disease duration and FSFI. The most attractive result of our study is the urodynamic detrusor overactivity (DO) .Bladder capacity was found to be low in SPMS. EDSS score and 25 step walk score increases while bladder capacity has been reduced. There was no relationship shown between duration of disease and bladder capacity. Conclusion: Patients with Multiple Sclerosis (MS) have a very high prevalence of lower urinary tract symptoms. These symptoms have a great impact on patient quality of life. Therefore early recognition and treatment is an important step in care of MS patients

33-38

Authors: Ergün ALMA, Hakan ERÇİL , Adem ALTUNKO] , Güçlü GÜRLEN , Ediz VURUŞKAN , Onur KÜÇÜKTOPÇU, Zafer Gökhan GÜRBÜZ

Objective: To evaluate the role of neutrophil-lymphocyte ratio in treatment resistance and follow-up in pregnant women with lower urinary tract infection. Materials and methods: The data of 88 pregnant women with UTI complaints between September 2016 and December 2018 were retrospectively reviewed. Patients with stone disease, JJ stent or nephrostomy placement, and urinary system anatomic malformation that complicate the etiology were excluded from the study. Patients were divided into two groups according to their first and third day medical treatment. Results: Group A consisted of 64 patients with a mean age of 23.7 ± 4.7 years and group B consisted of 24 patients with 24.4 ± 6.0 years. The mean NLR at the first visit was 4.7 + 1.2 in group A and 7.1 + 1.9 in group B. In group B, this value was 6.7 ± 2.1 on the third day after empirical treatment and the difference was not statistically significant (p> 0.05). At the end of the treatment period, the mean NLR in group A decreased to 2.4 + 1.0, and it decreased to 1.4 + 0.6 in group B(P <0.05). The cutoff value for NLR was 6.15 (sensitivity 0.76, specificity 0.86, and P <0.001). When all patients were compared according to this cutoff value, 9 (14%) and 19 (79.1%) patients in group A had NLR levels above this value at the first admission (P <0.001). Conclusion: NLR is a marker that can be useful to the clinician both in determining the treatment-resistant patient group and in following the response to treatment.

45-50

Authors: İbrahim KARABULUT, Fatih Kürşat YILMAZEL, Onur CEYLAN

Objective: We aimed to investigate the effect of the presence of median lobe (ML) in the learning curve on perioperative, oncologic and functional outcomes. Material and Methods: We analyzed 38 consecutive patients undergoing RALP in our clinic between July 2017 and October 2019.Patients were operated by the same surgical team on the first learning curve. They were analyzed in two groups according to the presence or absence of a ML determined during RARP. Perioperative, oncologic and functional results were compared between the groups. Results: Prostatic ML was detected in 10 (26.3%) of the patients included in the study.Prostate specific antigen (PSA), body mass index (BMI), length of hospital stay, perioperative and postoperative complication rates were similar in both groups (p <0.01). Surgical margin positivity rate was 20% (2/10) in the ML group and 10.7% (3/28) in the ML group.Numerical differences between the groups were not statistically significant (p <0.01). Nevertheless, prostate volume (p = 0.008) and estimated blood loss (TCC) (p = 0.001) were significant in favor of patients with median lobes. Although the mean cantilever time was slightly higher in patients with ML, these numerical differences were not statistically significant (p <0.01). Bladder neck reconstruction rates were 100% (100%) in the ML group and 14% (4/28) in the ML-free group (p = 0.001). Continence rates between patients with and without ML were at 4 weeks (20% to 35%) after catheter removal, at 12 weeks (70% to 64.2%) and at 24 weeks (90% to 89.2%). ) and no statistically significant difference was observed at all times. Conclusion: Learning curve, we think that RALP can be applied safely and effectively in challenging cases in centers without high surgical experience. When we compared the oncologic, functional and complication rates of patients without ML in our initial series, we obtained results consistent with the literature.

56-58

Authors: Ekrem AKDENİZ, Kemal ÖZTÜRK, Metin GÜR, Mahmut ULUBAY, Mustafa BAKIRTAŞ , Süleyman Tümer ÇALIŞKAN

Intestinal metaplasia of the bladder, characterized by the presence of an intestinal-type epithelium in the urothelium, is a glandular proliferation and extremely rare benign lesion. The pathogenesis of this uncommon entity is unclear, and its role as a precursor of adenocarcinoma is controversial. We present a case of a 45-year-old man admitted with macroscopic hematuria and mucosuria. Ultrasound showed a 32×25×6 mm hypoechoic nodule with regular contours on the posterior wall. Histopathological examination following transurethral resection revealed an intestinal metaplasia against a background of cystitis glandularis.