Vol 17 Issue 1

Objective: Bladder stones represent a significant part of urinary stone diseases, predominantly affecting men over 60, especially those with benign prostatic hyperplasia and neurological disorders with urinary dysfunction. Technological advancements have led to various treatment modalities for bladder stones, including transurethral cystolithotripsy, extracorporeal shock wave lithotripsy (ESWL), percutaneous cystolithotripsy, and open cystolithotomy. Mechanical lithotriptors, despite their long history and efficacy, have become less prominent in favor of newer technologies like laser lithotripsy. This study evaluates the effectiveness and safety of mechanical lithotriptors in the treatment of bladder stones.

Material and Methods: This retrospective study included 194 patients who underwent surgery for bladder stones at Kütahya Health Sciences University Evliya Çelebi Training and Research Hospital between January 2020 and January 2023. Inclusion criteria were male patients over 18 years undergoing endoscopic intervention with available preoperative and postoperative data. Patients who underwent open surgery or had incomplete data were excluded. Surgical methods included lithotripsy using a 30 Watt Holmium Laser and litholapaxy using Mauermayer’s Stone punch lithotriptor. Data on demographics, surgery duration, surgical equipment used, stone size, postoperative complications, and additional treatments were recorded and analyzed using SPSS 24.0.

Results: The mechanical lithotripsy group (n=140) had an average age of 65.44±14.74 years, while the laser lithotripsy group (n=54) had an average age of 67.91±14.58 years (p=0.297). In the mechanical group, 117 patients had spinal anesthesia and 23 had general anesthesia, compared to 44 spinal and 10 general anesthesia in the laser group (p=0.728). Additional surgical interventions were required in both groups with no significant difference (p=0.360). The average lithotripsy time was significantly shorter in the mechanical group (52.29±28.86 minutes) compared to the laser group (62.69±22.83 minutes) (p=0.01). No significant differences were found in stone size between groups. Complication rates were comparable, with 133 complication-free cases in the mechanical group and 52 in the laser group (p=0.809).

Conclusions: Mechanical lithotripsy offers a shorter surgery duration with comparable complication rates to laser lithotripsy. Despite being underutilized, mechanical lithotriptors continue to be a viable and effective option for treating bladder stones, particularly in centers with surgical expertise. The findings of this study support the safety and efficacy of mechanical lithotriptors in clinical practice, contributing to the existing literature on bladder stone treatment options.

Keywords: lithotripsy, laser lithotripsy, mechanical lithotripsy, urolithiasis

Objective: Testicular tumors, while rare, constitute 1-2% of all male malignancies, with germ cell tumors (GCTs) being the predominant subtype. This study retrospectively evaluates the clinicopathological characteristics of 102 patients who underwent radical orchiectomy for suspected testicular tumors between January 2016 and January 2021 at a single institution.

Material and Methods: Data, including demographic details, tumor markers, histopathological findings, and metastasis status, were analyzed.

Results: The mean patient age was 34.5 ± 11.5 years, with 51% of tumors located in the right testis. Germ cell tumors were identified in 88% of cases, with seminomas accounting for 46.1%.

Conclusion: Non-seminomatous mixed GCTs were found in 32.3% of patients. Notably, 8.8% of cases had a history of cryptorchidism, and lymphovascular invasion was observed in 46% of patients. The study also identified an unexpectedly higher incidence of Sertoli cell tumors, a rare variant of sex-cord stromal tumors, compared to existing literature. These findings contribute to the understanding of the clinicopathological spectrum of testicular tumors and underscore the importance of early diagnosis and treatment.

Keywords: Testicular tumor, seminoma, retrospective, prognosis, survival

Objective: Patients should understand their disease and patient-physician communication as well as active participation of patients in the treatment process, play a critical role in disease management. Our study aimed to determine the effectiveness of an informative form prepared by the European Association of Urology (EAU) regarding urinary system stone disease.

Material and Methods: Between March 2023 and July 2023, our study included 80 patients who underwent surgery for urinary system stone diseases at our clinic. Ureterorenoscopy (URS) and Retrograde Intrarenal Surgery (RIRS) operations were performed on patients with ureteral and kidney stones. The EAU’s urinary system stone disease informative form was presented to the patients, and their level of knowledge was assessed using a survey form.

Results: Out of 80 patients, 71 (88.75%) patients showed a significant increase in knowledge about stone formation after reading informative form (p:0.001, p<0.05). Following information about stone treatment. 66 (82.5%) patients reported improved knowledge. Anxiety levels were also evaluated, 16 (20%) patients experiencing an increase in anxiety (p:0.087, p>0.05) and 27 (33.75%) patients experiencing a decrease with the informative form (p:0.087, p>0.05). Additionally, 73 (91.25%) patients showed increased dietary information related to stone formation (p:0.001, p<0.05), and 41 patients (51.3%) found the patient information guide very useful.

Conclusion: The EAU Stone Information sheets prove to be an effective educational tool for patients, showing promise in enhancing overall patient satisfaction. The educational background of the patient also influences the information process.

Keywords: diet, anxiety, stone formation, informed consent, urinary stone