Scandinavian Journal of Urology and Nephrology, May 1, 2005
To perform Stoller afferent neurostimulation (SANS) with and without a low-dose anticholinergic (... more To perform Stoller afferent neurostimulation (SANS) with and without a low-dose anticholinergic (oxybutynin hydrochloride) in patients with detrusor overactivity and compare the results obtained with the two therapeutic approaches. A total of 43 patients with symptoms of detrusor overactivity (frequency, urgency, urge incontinence) underwent urodynamic studies (UDS). Those in whom UDS revealed phasic detrusor overactivity were evaluated using a quality of life questionnaire and voiding diaries. Patients were randomized into two groups: Group 1 received SANS alone; Group 2 received SANS combined with a low-dose anticholinergic (5 mg of oral oxybutynin hydrochloride). Both groups were re-evaluated following 8 weeks of therapy. There were 21 patients in Group 1 and 22 in Group 2. The treatment response rate was 61.6% and 83.2% in Groups 1 and 2, respectively. In both groups, the best symptomatic improvements were obtained in patients with urge incontinence. The percentage decreases in the mean number of symptoms of frequency and urgency were 36.7% and 46.1%, respectively in Group 1 and 44.2% and 61.1%, respectively in Group 2. However, there were no statistically significant differences in the effects on frequency and urgency between the two groups. The anticholinergic drug was well tolerated by all patients in Group 2. One patient reported local tenderness, and a small hematoma developed in another following SANS therapy. SANS is an easy and inexpensive therapeutic method with low morbidity in patients with an overactive bladder. Combination with a low-dose anticholinergic increases the success rate without causing any significant side-effects.
We evaluated the role of the seminal plasma PSA level in the prediction of the response to alpha-... more We evaluated the role of the seminal plasma PSA level in the prediction of the response to alpha-blocker treatment in patients with benign prostatic hyperplasia. 18 male patients with lower urinary tract symptoms were enrolled in the study. After their blood was sampled for PSA, ejaculates of all the subjects were obtained. Serum and seminal plasma PSA levels were calculated by Active PSA IRMA kit. Patients were given 4 mg/day doxazosin for a period of 6 weeks, following which their International Prostate Symptom Score (IPSS) evaluation was repeated. The correlation between serum PSA, seminal plasma PSA and PSA density levels and the percentage improvement in IPSS was investigated. The mean serum PSA level, the mean PSA density and the mean seminal PSA level of the patients were 2.7 +/- 1.2 ng/ml, 0.05 +/- 0.02 ng/ml/cm(3) and 0.7 +/- 0.39 g/l, respectively. The percentage improvement in IPSS varied from 26.9 to 53.5%. Serum PSA and serum PSA density were not useful in the predictio...
Introduction: Patients with ureteropelvic junction obstruction occasionally remain undiagnosed un... more Introduction: Patients with ureteropelvic junction obstruction occasionally remain undiagnosed until adulthood. There are no objective criteria to predict the results of pyeloplasty in adult patients. We have evaluated the results of pyeloplasty in adult patients and investigated whether these results are correlated with the histopathology of the surgical specimen. Materials and Methods: Histological sections from 26 patients with ureteropelvic junction obstruction were analyzed. Their mean age was 25.1 years. Diethylenetriamine-pentaacetic acid scans were used to determine the degree of renal obstruction and postoperative healing. Improvement in diuretic renography was defined as a greater than 20% decrease in the half-time of the preoperative value. To examine smooth muscle and collagen tissue, sections were stained using Masson’s trichrome. Smooth muscle ratio was identified by color image analysis. Results: 18 patients (69.2%) fulfilled the criteria of healing. Patients with an ...
Scandinavian Journal of Urology and Nephrology, 2003
To evaluate changes occurring in the mucosa of the neobladder over a period of 60 months in 24 pa... more To evaluate changes occurring in the mucosa of the neobladder over a period of 60 months in 24 patients with orthotopic ileal neobladder. A total of 36 male patients have undergone radical cystoprostatectomy and received an orthotopic ileal neobladder in our hospital during the last 10 years; 24 of these patients, all of whom completed a follow-up period of 60 months, are included in this study. All cases underwent a biopsy of the ileal mucosa at the time of surgery and their neobladder mucosa was then biopsied at 6, 12, 24, 36 and 60 months. The specimens were stained with hematoxylin-eosin in order to examine the changes in the thickness of the mucosa and its villi. Sections were also stained with Alcian blue and periodic acid-Schiff in order to determine the number of goblet cells. A morphometric scoring system was created to quantify the change in villi size. The mean thickness of the ileal mucosa at the initial biopsy was 270.9 +/- 35.9 microm and displayed a continuous decrease at all of the subsequent biopsies. The number of luminal goblet cells increased during follow-up. Villus atrophy was found to be a continuous process during follow-up. No dysplasia or malignancy was detected in any of the biopsies. During a follow-up period of 5 years, there were no neoplastic changes in our patients, but instead a protective response of the mucosa to its new environment was observed.
Prostatic carcinoma metastasizing to the penis is rare. A case of adenocarcinoma of the prostate ... more Prostatic carcinoma metastasizing to the penis is rare. A case of adenocarcinoma of the prostate with metastases to the penile shaft and glans penis is presented.
We evaluated the role of the seminal plasma PSA level in the prediction of the response to alpha-... more We evaluated the role of the seminal plasma PSA level in the prediction of the response to alpha-blocker treatment in patients with benign prostatic hyperplasia. 18 male patients with lower urinary tract symptoms were enrolled in the study. After their blood was sampled for PSA, ejaculates of all the subjects were obtained. Serum and seminal plasma PSA levels were calculated by Active PSA IRMA kit. Patients were given 4 mg/day doxazosin for a period of 6 weeks, following which their International Prostate Symptom Score (IPSS) evaluation was repeated. The correlation between serum PSA, seminal plasma PSA and PSA density levels and the percentage improvement in IPSS was investigated. The mean serum PSA level, the mean PSA density and the mean seminal PSA level of the patients were 2.7 +/- 1.2 ng/ml, 0.05 +/- 0.02 ng/ml/cm(3) and 0.7 +/- 0.39 g/l, respectively. The percentage improvement in IPSS varied from 26.9 to 53.5%. Serum PSA and serum PSA density were not useful in the predictio...
Silicone has been the standard prosthesis material for the last three decades but new materials a... more Silicone has been the standard prosthesis material for the last three decades but new materials are being searched because of the known disadvantages of silicone such as migration and high cost. We wanted to test in rats whether or not polymethylmethacrylate could be an alternative to silicone. We prepared polymethylmethacrylate and silicone testis prostheses which were similar to testis size of rats. Eleven rats were implanted with polymethylmethacrylate, 11 others were implanted with a silicone prosthesis and sham operation was performed in 10 rats. Three months later the scrotums of the animals were removed with the prosthesis for a quantitative analysis of the chronic inflammation and fibrotic reaction and to measure the thickness of the capsule. Rejection and infection were not observed in any of the prosthesis-implanted rats. Both prosthesis groups displayed increased vascularization, hemosiderin accumulation and fibrotic and hyalinized tissue formation that replaced the muscle. Chronic inflammation was measured and found to be higher in the polymethylmethacrylate group and the difference was not found to be significant. The average thicknesses of the capsules around the polymethylmethacrylate and silicone groups were found to be 58.4 and 46.8 microm, respectively, and that difference was not significant again. In the short term polymethylmethacrylate was equally well tolerated, but the low cost of polymethylmethacrylate made it more advantageous.
Patients with ureteropelvic junction obstruction occasionally remain undiagnosed until adulthood.... more Patients with ureteropelvic junction obstruction occasionally remain undiagnosed until adulthood. There are no objective criteria to predict the results of pyeloplasty in adult patients. We have evaluated the results of pyeloplasty in adult patients and investigated whether these results are correlated with the histopathology of the surgical specimen. Histological sections from 26 patients with ureteropelvic junction obstruction were analyzed. Their mean age was 25.1 years. Diethylenetriamine-pentaacetic acid scans were used to determine the degree of renal obstruction and postoperative healing. Improvement in diuretic renography was defined as a greater than 20% decrease in the half-time of the preoperative value. To examine smooth muscle and collagen tissue, sections were stained using Masson's trichrome. Smooth muscle ratio was identified by color image analysis. 18 patients (69.2%) fulfilled the criteria of healing. Patients with an improved scan had a mean smooth muscle percent (SMP) of 1.85+/-0.87 while subjects with no significant change in their diuretic scans had a mean SMP of 0.36+/-0.03 (p=0.001). There was a strong correlation between the SMP and the improvement. Adult pyeloplasty was found successful in about 70% of the cases. The SMP of the renal pelvis seems to be helpful in predicting the surgical outcome.
To evaluate the effects of adult circumcision on sexual function in men circumcised only for reli... more To evaluate the effects of adult circumcision on sexual function in men circumcised only for religious or cosmetic reasons. The study group consisted of 42 male patients with a median age of 22.3 years (range 19 to 28) referred for circumcision from June 2002 to January 2003. Of the 42 men, 39 desired circumcision for religious reasons. Before circumcision, their sexual performance was evaluated using the Brief Male Sexual Function Inventory (BMSFI) and ejaculatory latency time. The BMSFI evaluation and ejaculatory latency time measurements were repeated after a postoperative interval of at least 12 weeks. The scores in the five main sections of the BMSFI and the ejaculatory latency times before and after circumcision were analyzed. The differences in the mean BMSFI scores were not statistically significant in any of the five sections. However, the mean ejaculatory latency time was significantly longer after circumcision (P = 0.02). Adult circumcision does not adversely affect sexual function. The increase in the ejaculatory latency time can be considered an advantage rather than a complication.
Scandinavian Journal of Urology and Nephrology, 2003
To evaluate changes occurring in the mucosa of the neobladder over a period of 60 months in 24 pa... more To evaluate changes occurring in the mucosa of the neobladder over a period of 60 months in 24 patients with orthotopic ileal neobladder. A total of 36 male patients have undergone radical cystoprostatectomy and received an orthotopic ileal neobladder in our hospital during the last 10 years; 24 of these patients, all of whom completed a follow-up period of 60 months, are included in this study. All cases underwent a biopsy of the ileal mucosa at the time of surgery and their neobladder mucosa was then biopsied at 6, 12, 24, 36 and 60 months. The specimens were stained with hematoxylin-eosin in order to examine the changes in the thickness of the mucosa and its villi. Sections were also stained with Alcian blue and periodic acid-Schiff in order to determine the number of goblet cells. A morphometric scoring system was created to quantify the change in villi size. The mean thickness of the ileal mucosa at the initial biopsy was 270.9 +/- 35.9 microm and displayed a continuous decrease at all of the subsequent biopsies. The number of luminal goblet cells increased during follow-up. Villus atrophy was found to be a continuous process during follow-up. No dysplasia or malignancy was detected in any of the biopsies. During a follow-up period of 5 years, there were no neoplastic changes in our patients, but instead a protective response of the mucosa to its new environment was observed.
Scandinavian Journal of Urology and Nephrology, 2005
To perform Stoller afferent neurostimulation (SANS) with and without a low-dose anticholinergic (... more To perform Stoller afferent neurostimulation (SANS) with and without a low-dose anticholinergic (oxybutynin hydrochloride) in patients with detrusor overactivity and compare the results obtained with the two therapeutic approaches. A total of 43 patients with symptoms of detrusor overactivity (frequency, urgency, urge incontinence) underwent urodynamic studies (UDS). Those in whom UDS revealed phasic detrusor overactivity were evaluated using a quality of life questionnaire and voiding diaries. Patients were randomized into two groups: Group 1 received SANS alone; Group 2 received SANS combined with a low-dose anticholinergic (5 mg of oral oxybutynin hydrochloride). Both groups were re-evaluated following 8 weeks of therapy. There were 21 patients in Group 1 and 22 in Group 2. The treatment response rate was 61.6% and 83.2% in Groups 1 and 2, respectively. In both groups, the best symptomatic improvements were obtained in patients with urge incontinence. The percentage decreases in the mean number of symptoms of frequency and urgency were 36.7% and 46.1%, respectively in Group 1 and 44.2% and 61.1%, respectively in Group 2. However, there were no statistically significant differences in the effects on frequency and urgency between the two groups. The anticholinergic drug was well tolerated by all patients in Group 2. One patient reported local tenderness, and a small hematoma developed in another following SANS therapy. SANS is an easy and inexpensive therapeutic method with low morbidity in patients with an overactive bladder. Combination with a low-dose anticholinergic increases the success rate without causing any significant side-effects.
Objectives : The aim of the present study was to assess and compare pre-and postoperative scrotal... more Objectives : The aim of the present study was to assess and compare pre-and postoperative scrotal pain in patients with varicocele who underwent varicocelectomy with different approaches. Methods : The study included 144 consecutive patients with left-sided varicocele who had left scrotal pain for more than 3 months. All patients underwent varicocele ligation using either a subinguinal or inguinal approach with or without external spermatic vein ligation. We asked the patients to complete an 'Assesment Questionnaire for Scrotal Pain' both before and after the surgery.
Hydatid disease of the urinary tract is uncommon, accounting for only 2% to 1% of all hydatid dis... more Hydatid disease of the urinary tract is uncommon, accounting for only 2% to 1% of all hydatid diseases. We report 4 patients with hydatid cystic disease of the kidney. Nephrectomy was performed on 1 patient because of the destruction of renal parenchyma by the hydatid cyst. The other 3 patients were treated by cystectomy to preserve the normal renal parenchyma. In these cases, Casoni's intradermal test and indirect hemagglutination (IHA) test were not found to be helpful in the diagnosis, and eosinophilia was not significant. Diagnostic features of hydatid cysts were mixed echogenicity on ultrasonography, and multivesicular cyst with mixed density on computerized tomography (CT). CT was the most useful and specific investigation. No complications were noted during the first 3 months of the follow-up. Despite its rarity, hydatid disease should be considered in the differential diagnosis of space-occupying lesions of the urinary tract. Parenchyma-sparing surgery (cystectomy, partial nephrectomy) or nephrectomy are the main treatment modalities.
Prostatic carcinoma metastasizing to the penis is rare. A case of adenocarcinoma of the prostate ... more Prostatic carcinoma metastasizing to the penis is rare. A case of adenocarcinoma of the prostate with metastases to the penile shaft and glans penis is presented.
Scandinavian Journal of Urology and Nephrology, May 1, 2005
To perform Stoller afferent neurostimulation (SANS) with and without a low-dose anticholinergic (... more To perform Stoller afferent neurostimulation (SANS) with and without a low-dose anticholinergic (oxybutynin hydrochloride) in patients with detrusor overactivity and compare the results obtained with the two therapeutic approaches. A total of 43 patients with symptoms of detrusor overactivity (frequency, urgency, urge incontinence) underwent urodynamic studies (UDS). Those in whom UDS revealed phasic detrusor overactivity were evaluated using a quality of life questionnaire and voiding diaries. Patients were randomized into two groups: Group 1 received SANS alone; Group 2 received SANS combined with a low-dose anticholinergic (5 mg of oral oxybutynin hydrochloride). Both groups were re-evaluated following 8 weeks of therapy. There were 21 patients in Group 1 and 22 in Group 2. The treatment response rate was 61.6% and 83.2% in Groups 1 and 2, respectively. In both groups, the best symptomatic improvements were obtained in patients with urge incontinence. The percentage decreases in the mean number of symptoms of frequency and urgency were 36.7% and 46.1%, respectively in Group 1 and 44.2% and 61.1%, respectively in Group 2. However, there were no statistically significant differences in the effects on frequency and urgency between the two groups. The anticholinergic drug was well tolerated by all patients in Group 2. One patient reported local tenderness, and a small hematoma developed in another following SANS therapy. SANS is an easy and inexpensive therapeutic method with low morbidity in patients with an overactive bladder. Combination with a low-dose anticholinergic increases the success rate without causing any significant side-effects.
We evaluated the role of the seminal plasma PSA level in the prediction of the response to alpha-... more We evaluated the role of the seminal plasma PSA level in the prediction of the response to alpha-blocker treatment in patients with benign prostatic hyperplasia. 18 male patients with lower urinary tract symptoms were enrolled in the study. After their blood was sampled for PSA, ejaculates of all the subjects were obtained. Serum and seminal plasma PSA levels were calculated by Active PSA IRMA kit. Patients were given 4 mg/day doxazosin for a period of 6 weeks, following which their International Prostate Symptom Score (IPSS) evaluation was repeated. The correlation between serum PSA, seminal plasma PSA and PSA density levels and the percentage improvement in IPSS was investigated. The mean serum PSA level, the mean PSA density and the mean seminal PSA level of the patients were 2.7 +/- 1.2 ng/ml, 0.05 +/- 0.02 ng/ml/cm(3) and 0.7 +/- 0.39 g/l, respectively. The percentage improvement in IPSS varied from 26.9 to 53.5%. Serum PSA and serum PSA density were not useful in the predictio...
Introduction: Patients with ureteropelvic junction obstruction occasionally remain undiagnosed un... more Introduction: Patients with ureteropelvic junction obstruction occasionally remain undiagnosed until adulthood. There are no objective criteria to predict the results of pyeloplasty in adult patients. We have evaluated the results of pyeloplasty in adult patients and investigated whether these results are correlated with the histopathology of the surgical specimen. Materials and Methods: Histological sections from 26 patients with ureteropelvic junction obstruction were analyzed. Their mean age was 25.1 years. Diethylenetriamine-pentaacetic acid scans were used to determine the degree of renal obstruction and postoperative healing. Improvement in diuretic renography was defined as a greater than 20% decrease in the half-time of the preoperative value. To examine smooth muscle and collagen tissue, sections were stained using Masson’s trichrome. Smooth muscle ratio was identified by color image analysis. Results: 18 patients (69.2%) fulfilled the criteria of healing. Patients with an ...
Scandinavian Journal of Urology and Nephrology, 2003
To evaluate changes occurring in the mucosa of the neobladder over a period of 60 months in 24 pa... more To evaluate changes occurring in the mucosa of the neobladder over a period of 60 months in 24 patients with orthotopic ileal neobladder. A total of 36 male patients have undergone radical cystoprostatectomy and received an orthotopic ileal neobladder in our hospital during the last 10 years; 24 of these patients, all of whom completed a follow-up period of 60 months, are included in this study. All cases underwent a biopsy of the ileal mucosa at the time of surgery and their neobladder mucosa was then biopsied at 6, 12, 24, 36 and 60 months. The specimens were stained with hematoxylin-eosin in order to examine the changes in the thickness of the mucosa and its villi. Sections were also stained with Alcian blue and periodic acid-Schiff in order to determine the number of goblet cells. A morphometric scoring system was created to quantify the change in villi size. The mean thickness of the ileal mucosa at the initial biopsy was 270.9 +/- 35.9 microm and displayed a continuous decrease at all of the subsequent biopsies. The number of luminal goblet cells increased during follow-up. Villus atrophy was found to be a continuous process during follow-up. No dysplasia or malignancy was detected in any of the biopsies. During a follow-up period of 5 years, there were no neoplastic changes in our patients, but instead a protective response of the mucosa to its new environment was observed.
Prostatic carcinoma metastasizing to the penis is rare. A case of adenocarcinoma of the prostate ... more Prostatic carcinoma metastasizing to the penis is rare. A case of adenocarcinoma of the prostate with metastases to the penile shaft and glans penis is presented.
We evaluated the role of the seminal plasma PSA level in the prediction of the response to alpha-... more We evaluated the role of the seminal plasma PSA level in the prediction of the response to alpha-blocker treatment in patients with benign prostatic hyperplasia. 18 male patients with lower urinary tract symptoms were enrolled in the study. After their blood was sampled for PSA, ejaculates of all the subjects were obtained. Serum and seminal plasma PSA levels were calculated by Active PSA IRMA kit. Patients were given 4 mg/day doxazosin for a period of 6 weeks, following which their International Prostate Symptom Score (IPSS) evaluation was repeated. The correlation between serum PSA, seminal plasma PSA and PSA density levels and the percentage improvement in IPSS was investigated. The mean serum PSA level, the mean PSA density and the mean seminal PSA level of the patients were 2.7 +/- 1.2 ng/ml, 0.05 +/- 0.02 ng/ml/cm(3) and 0.7 +/- 0.39 g/l, respectively. The percentage improvement in IPSS varied from 26.9 to 53.5%. Serum PSA and serum PSA density were not useful in the predictio...
Silicone has been the standard prosthesis material for the last three decades but new materials a... more Silicone has been the standard prosthesis material for the last three decades but new materials are being searched because of the known disadvantages of silicone such as migration and high cost. We wanted to test in rats whether or not polymethylmethacrylate could be an alternative to silicone. We prepared polymethylmethacrylate and silicone testis prostheses which were similar to testis size of rats. Eleven rats were implanted with polymethylmethacrylate, 11 others were implanted with a silicone prosthesis and sham operation was performed in 10 rats. Three months later the scrotums of the animals were removed with the prosthesis for a quantitative analysis of the chronic inflammation and fibrotic reaction and to measure the thickness of the capsule. Rejection and infection were not observed in any of the prosthesis-implanted rats. Both prosthesis groups displayed increased vascularization, hemosiderin accumulation and fibrotic and hyalinized tissue formation that replaced the muscle. Chronic inflammation was measured and found to be higher in the polymethylmethacrylate group and the difference was not found to be significant. The average thicknesses of the capsules around the polymethylmethacrylate and silicone groups were found to be 58.4 and 46.8 microm, respectively, and that difference was not significant again. In the short term polymethylmethacrylate was equally well tolerated, but the low cost of polymethylmethacrylate made it more advantageous.
Patients with ureteropelvic junction obstruction occasionally remain undiagnosed until adulthood.... more Patients with ureteropelvic junction obstruction occasionally remain undiagnosed until adulthood. There are no objective criteria to predict the results of pyeloplasty in adult patients. We have evaluated the results of pyeloplasty in adult patients and investigated whether these results are correlated with the histopathology of the surgical specimen. Histological sections from 26 patients with ureteropelvic junction obstruction were analyzed. Their mean age was 25.1 years. Diethylenetriamine-pentaacetic acid scans were used to determine the degree of renal obstruction and postoperative healing. Improvement in diuretic renography was defined as a greater than 20% decrease in the half-time of the preoperative value. To examine smooth muscle and collagen tissue, sections were stained using Masson's trichrome. Smooth muscle ratio was identified by color image analysis. 18 patients (69.2%) fulfilled the criteria of healing. Patients with an improved scan had a mean smooth muscle percent (SMP) of 1.85+/-0.87 while subjects with no significant change in their diuretic scans had a mean SMP of 0.36+/-0.03 (p=0.001). There was a strong correlation between the SMP and the improvement. Adult pyeloplasty was found successful in about 70% of the cases. The SMP of the renal pelvis seems to be helpful in predicting the surgical outcome.
To evaluate the effects of adult circumcision on sexual function in men circumcised only for reli... more To evaluate the effects of adult circumcision on sexual function in men circumcised only for religious or cosmetic reasons. The study group consisted of 42 male patients with a median age of 22.3 years (range 19 to 28) referred for circumcision from June 2002 to January 2003. Of the 42 men, 39 desired circumcision for religious reasons. Before circumcision, their sexual performance was evaluated using the Brief Male Sexual Function Inventory (BMSFI) and ejaculatory latency time. The BMSFI evaluation and ejaculatory latency time measurements were repeated after a postoperative interval of at least 12 weeks. The scores in the five main sections of the BMSFI and the ejaculatory latency times before and after circumcision were analyzed. The differences in the mean BMSFI scores were not statistically significant in any of the five sections. However, the mean ejaculatory latency time was significantly longer after circumcision (P = 0.02). Adult circumcision does not adversely affect sexual function. The increase in the ejaculatory latency time can be considered an advantage rather than a complication.
Scandinavian Journal of Urology and Nephrology, 2003
To evaluate changes occurring in the mucosa of the neobladder over a period of 60 months in 24 pa... more To evaluate changes occurring in the mucosa of the neobladder over a period of 60 months in 24 patients with orthotopic ileal neobladder. A total of 36 male patients have undergone radical cystoprostatectomy and received an orthotopic ileal neobladder in our hospital during the last 10 years; 24 of these patients, all of whom completed a follow-up period of 60 months, are included in this study. All cases underwent a biopsy of the ileal mucosa at the time of surgery and their neobladder mucosa was then biopsied at 6, 12, 24, 36 and 60 months. The specimens were stained with hematoxylin-eosin in order to examine the changes in the thickness of the mucosa and its villi. Sections were also stained with Alcian blue and periodic acid-Schiff in order to determine the number of goblet cells. A morphometric scoring system was created to quantify the change in villi size. The mean thickness of the ileal mucosa at the initial biopsy was 270.9 +/- 35.9 microm and displayed a continuous decrease at all of the subsequent biopsies. The number of luminal goblet cells increased during follow-up. Villus atrophy was found to be a continuous process during follow-up. No dysplasia or malignancy was detected in any of the biopsies. During a follow-up period of 5 years, there were no neoplastic changes in our patients, but instead a protective response of the mucosa to its new environment was observed.
Scandinavian Journal of Urology and Nephrology, 2005
To perform Stoller afferent neurostimulation (SANS) with and without a low-dose anticholinergic (... more To perform Stoller afferent neurostimulation (SANS) with and without a low-dose anticholinergic (oxybutynin hydrochloride) in patients with detrusor overactivity and compare the results obtained with the two therapeutic approaches. A total of 43 patients with symptoms of detrusor overactivity (frequency, urgency, urge incontinence) underwent urodynamic studies (UDS). Those in whom UDS revealed phasic detrusor overactivity were evaluated using a quality of life questionnaire and voiding diaries. Patients were randomized into two groups: Group 1 received SANS alone; Group 2 received SANS combined with a low-dose anticholinergic (5 mg of oral oxybutynin hydrochloride). Both groups were re-evaluated following 8 weeks of therapy. There were 21 patients in Group 1 and 22 in Group 2. The treatment response rate was 61.6% and 83.2% in Groups 1 and 2, respectively. In both groups, the best symptomatic improvements were obtained in patients with urge incontinence. The percentage decreases in the mean number of symptoms of frequency and urgency were 36.7% and 46.1%, respectively in Group 1 and 44.2% and 61.1%, respectively in Group 2. However, there were no statistically significant differences in the effects on frequency and urgency between the two groups. The anticholinergic drug was well tolerated by all patients in Group 2. One patient reported local tenderness, and a small hematoma developed in another following SANS therapy. SANS is an easy and inexpensive therapeutic method with low morbidity in patients with an overactive bladder. Combination with a low-dose anticholinergic increases the success rate without causing any significant side-effects.
Objectives : The aim of the present study was to assess and compare pre-and postoperative scrotal... more Objectives : The aim of the present study was to assess and compare pre-and postoperative scrotal pain in patients with varicocele who underwent varicocelectomy with different approaches. Methods : The study included 144 consecutive patients with left-sided varicocele who had left scrotal pain for more than 3 months. All patients underwent varicocele ligation using either a subinguinal or inguinal approach with or without external spermatic vein ligation. We asked the patients to complete an 'Assesment Questionnaire for Scrotal Pain' both before and after the surgery.
Hydatid disease of the urinary tract is uncommon, accounting for only 2% to 1% of all hydatid dis... more Hydatid disease of the urinary tract is uncommon, accounting for only 2% to 1% of all hydatid diseases. We report 4 patients with hydatid cystic disease of the kidney. Nephrectomy was performed on 1 patient because of the destruction of renal parenchyma by the hydatid cyst. The other 3 patients were treated by cystectomy to preserve the normal renal parenchyma. In these cases, Casoni's intradermal test and indirect hemagglutination (IHA) test were not found to be helpful in the diagnosis, and eosinophilia was not significant. Diagnostic features of hydatid cysts were mixed echogenicity on ultrasonography, and multivesicular cyst with mixed density on computerized tomography (CT). CT was the most useful and specific investigation. No complications were noted during the first 3 months of the follow-up. Despite its rarity, hydatid disease should be considered in the differential diagnosis of space-occupying lesions of the urinary tract. Parenchyma-sparing surgery (cystectomy, partial nephrectomy) or nephrectomy are the main treatment modalities.
Prostatic carcinoma metastasizing to the penis is rare. A case of adenocarcinoma of the prostate ... more Prostatic carcinoma metastasizing to the penis is rare. A case of adenocarcinoma of the prostate with metastases to the penile shaft and glans penis is presented.
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