Vol 17 Issue 2

Objective: Early single dose chemotherapy may have a reducing effect on recurrence and progression. In this study, we aimed to compare non-muscle invasive patients diagnosed with bladder cancer who did not receive early single dose chemotherapy and those who received intravesical Epirubicin or Gemcitabine in terms of recurrence and progression.

Material and Methods: 116 patients were followed up for 48 months (May 2020-June 2022) with diagnosis of primary non-invasive bladder cancer. After transurethral resection of the bladder, patients were followed up with 3 groups: who received intravesical epirubicin, who received gemcitabine, who did not receive any chemotherapeutic agent.

Results: The mean age was 63. There were no statistically significant difference in age and, body mass index. Recurrence was determined 57.1% (n=20), 40% (n=18), and 41.7% (n=15) (p=0.263) of the patients, respectively who were not administered any intravesical agent, were administered Epirubicin and, Gemcitabine. While recurrence rates were observed 50%, 25%, 0% (p=0.177) respectively, in low-risk, no progression was detected. In intermediate risk group, 66.7%, 33.3%, 42.8% (p=0.378) recurrence, and 33.3%, 22.7%, 6.7% (p=0.282) progression were detected, respectively. High-risk group, recurrence was found in 56%, 64.2%, 56.2% (p=0.866) of the patients and progression 8%, 14.3%, 6.3% (p=0.723) respectively. In low-grade group, 35.7%, 42.9%, 21.4% (p=0.045) recurrence, and 16.6%, 12.1%, and 4.3% (p=0.164) progression were determined , respectively. In the high-grade group, 58.8%, 50%, 69.2% (p=0.982) recurrence, 5.9%, 16.6% and 7.7% (p=0.581) progression were detected, respectively.

Conclusion: These findings demonstrated that intravesical chemotherapeutics can delay or prevent recurrence and progression, should therefore be administered in early postoperative period. Gemcitabine is not in widespread use and has been found to be a good alternative.

Keywords: bladder cancer, recurrence, progression, epirubicin, gemcitabine

Objective: This study aimed to investigate the relationship between Fetuin-A glycoprotein, a known systemic and localized calcification inhibitor, and urinary system stone disease. 

Material and Methods: A total of 63 patients with urinary stone disease and 70 healthy controls were included. Serum Fetuin-A levels were measured using enzyme-linked immunosorbent assay, and various biochemical parameters were analyzed. Statistical comparisons were performed by using Pearson correlation to determine relationships, with significance set at p<0.05. 

Results: The mean serum Fetuin-A levels were slightly higher in the stone disease group (503.5 ± 87.6 mg/dL) compared to the control group (462.7 ± 101.6 mg/dL); however, the difference was not statistically significant (p>0.05). The mean age was 42.87 ± 11.0 years in the stone group and 41.6 ± 11.7 years in the control group (p=0.497). In the stone group, 65% were male and 35% female, while in the control group, 66% were male and 34% female, with no significant difference in gender distribution (p=0.831). Body mass index (BMI) was 25.3 ± 2.57 kg/m² in the stone group and 26.9 ± 3.08 kg/m² in the control group, also showing no significant difference (p=0.067). No correlations were found between serum Fetuin-A levels and other parameters such as age, BMI, or biochemical markers. 

Conclusion: Although some previous studies have suggested a relationship between Fetuin-A levels and urinary stone disease, this study found no significant association. Further research focusing on genetic polymorphisms of Fetuin-A may clarify its role in stone formation. 

Keywords: kidney calculi, urinary calculi, fetuins

Objective: Kidney stone disease is a significant health problem that substantially affects individuals’ quality of life. Approximately 30% of kidney stones are located in the lower pole, which presents challenges in accessing these stones during retrograde intrarenal surgery. In the surgical treatment of lower pole kidney stones, we aimed to evaluate the efficacy and success rates of single-use and reusable flexible ureterorenoscopes, and to determine the most optimal option based on these findings.

Material and Methods: This study included patients with lower pole kidney stones who underwent retrograde intrarenal surgery. Patients were divided into two groups based on the type of ureterorenoscope used: single-use or reusable. The collected data were compared between the two groups.

Results: A total of 61 patients, including 34 men and 27 women, were included in the study. Thirty-four patients were evaluated in the single-use group, and 27 patients in the reusable group. The median stone size was 78.5 mm² (50.3–127.6) mm² in the reusable group and 125.3 mm² (56.5–201.1) mm² in the single-use group. There was no statistically significant difference between the groups in terms of demographic characteristics, Clavien-Dindo scores, or postoperative complications (p > 0.05). However, vomiting was observed significantly less frequently in the single-use group compared to the reusable group (p < 0.05).

Conclusion: Flexible ureterorenoscopes are commonly used in the surgical management of lower pole kidney stones. When choosing between single-use and reusable flexible ureterorenoscopes, factors such as cost and ease of use should be taken into consideration. To better compare the advantages of each type and obtain more reliable results, larger case series and prospective studies are needed.

Keywords: ureteroscopes, urolithiasis, kidney stone

Objective: This study aims to evaluate the effectiveness, safety, and patient tolerance of penile prosthesis implantation (PPI) performed under local anesthesia (LA). The study investigates its impact on perioperative pain management, postoperative recovery, and overall patient satisfaction.

Material and Methods: This prospective study included 26 male patients who underwent PPI under LA between January 2024 and December 2024. Ethical approval was obtained from the Ethics Committee Antalya Training and Research Hospital No: 2/24, Date: 30.01.2025). Pain intensity was assessed using the Visual Analog Scale (VAS), while patient stability and intraoperative parameters were monitored. The American Society of Anesthesiologists (ASA) classification system was used for anesthesia risk assessment.

Results: The mean age of the patients was 67.25 ± 11.48 years. Diabetes mellitus and hypertension were present in 75% and 62.5% of patients, respectively. According to ASA classification, 46.2% were classified as ASA-II, while 53.8% were ASA-III. The mean intraoperative VAS score was 1.8 (mild pain), while the mean postoperative VAS score was 4.6 (mild-to-moderate pain). No patients required additional sedation or conversion to general anesthesia. No major intraoperative complications or postoperative prosthesis-related complications were observed.

Conclusion: Local anesthesia is a feasible and effective alternative for penile prosthesis implantation, offering benefits such as minimal intraoperative discomfort, avoidance of systemic anesthetic complications, and a favorable recovery profile. Further studies with larger cohorts are needed to optimize pain management strategies and evaluate long-term functional outcomes.

Keywords: penile prosthesis implantation, local anesthesia, erectile dysfunction, pain management

Percutaneous nephrolithotomy (PNL) is an important approach for removing kidney stones. Percutaneous nephrostomy drainage tube placement is performed to prevent extravasation and ensure hemostasis after PNL surgery. In this case, we will report on the successful conservative removal of the nephrostomy tube extending into the inferior vena cava, which was inserted to provide hemostasis after unilateral PNL surgery. Sometimes, as in our case, the catheter may perforate the renal parenchyma and extend into the renal vein or even the vena cava. In our case, the nephrostomy tube was located in the inferior vena cava (IVC). In case of possible massive bleeding that we could not control, the catheter was removed under fluoroscopy in the presence of the Cardiovascular Surgery-Interventional Radiology team. The patient had no problems during follow-up and was discharged successfully.

Keywords: percutaneous nephrolithotomy, renal stone, nephrostomy tube, inferior vena cava