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Bozkurt YE, Akdeniz CB, Gümüş BH. Treatment of giant prostatic urethral stone with prostatolithotomy case report. Int J Surg Case Rep 2024; 114:109136. [PMID: 38134615 PMCID: PMC10800754 DOI: 10.1016/j.ijscr.2023.109136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION The patient with prostatic urethral stones of the size mentioned in the case report is very rare, and there is no standard surgical procedure for patients with giant stones in the prostatic urethra. PRESENTATION OF CASE A 62-year-old male patient presented to the emergency department with complaints of dysuria and hematuria. Computed tomography showed a prostatic urethral stone measuring 78x48x56 mm. Open prostatolithotomy was performed by extending the bladder incision towards the prostate capsule and the stone was removed. DISCUSSION Prostate stones can be classified into two types: true prostate stones, which form within the prostate's tissues, and urethral stones, which develop in the prostatic urethra. Urethral stones can be primary (forming in the urethra) or secondary (migrating from the upper urinary tract). CONCLUSION Treatment options vary based on stone size and patient history, with endoscopy recommended as the primary approach. However, in cases with large stone burdens, open surgical methods may be preferred.
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Affiliation(s)
- Yunus Erol Bozkurt
- Manisa Merkez Efendi State Hospital, Department of Urology, Manisa, Turkey.
| | | | - Bilali Habeş Gümüş
- Manisa Celal Bayar University Faculty of Medicine, Department of Urology, Manisa, Turkey
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Keske M, Canda AE, Karadag MA, Çiftçi H, Erturhan S, Kactan C, Soytas M, Özkaya F, Ozbey I, Ordek E, Atmaca AF, Yildirim A, Sahin S, Colakoglu Y, Boylu U, Erol B, Caskurlu T, Kiremit MC, Cakici OU, Sonmez G, Kılıçarslan H, Akbulut Z, Kaygısız O, Bedir S, Vuruskan H, Bozkurt YE, Aydin HR, Oguz U, Basok EK, Gumus BH, Tuncel A, Aslan Y, Hamidi N, Müslümanoğlu AY, Dinçer M, Balbay D, Albayrak S, Laguna MP. A Retrospective Analysis of 83 Patients with Testicular Mass Who Underwent Testis-Sparing Surgery: The Eurasian Uro-oncology Association Multicenter Study. Urol Int 2023; 107:857-865. [PMID: 37591208 DOI: 10.1159/000531645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/06/2023] [Indexed: 08/19/2023]
Abstract
INTRODUCTION Herein, we analyzed the histopathological, oncological and functional outcomes of testis-sparing surgery (TSS) in patients with distinct risk for testicular cancer. METHODS This is a multicenter retrospective study on consecutive patients who underwent TSS. Patients were categorized in high- or low-risk testicular germ cell tumor (TGCT) according to the presence/absence of features compatible with testicular dysgenesis syndrome. Histology was categorized per size and risk groups. RESULTS TSS was performed in 83 patients (86 tumors) of them, 27 in the high-risk group. Fifty-nine patients had a non-tumoral contralateral testis present. Sixty masses and 26 masses were benign and TGCTs, respectively. No statistical differences were observed in mean age (30.9 ± 10.32 years), pathological tumor size (14.67 ± 6.7 mm) between risk groups or between benign and malignant tumors (p = 0.608). When categorized per risk groups, 22 (73.3%) and 4 (7.1%) of the TSS specimens were malignant in the high- and low-risk patient groups, respectively. Univariate analysis showed that the only independent variable significantly related to malignant outcome was previous history of TGCT. During a mean follow-up of 25.5 ± 22.7 months, no patient developed systemic disease. Local recurrence was detected in 5 patients and received radical orchiectomy. Postoperative testosterone levels remained normal in 88% of those patients with normal preoperative level. No erectile dysfunction was reported in patients with benign lesions. CONCLUSION TSS is a safe and feasible approach with adequate cancer control, and preservation of sexual function is possible in 2/3 of patients harboring malignancy. Incidence of TGCT varies extremely between patients at high and low risk for TGCT requiring a careful consideration and counseling.
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Affiliation(s)
- Murat Keske
- University of Health Sciences Medical Faculty of Kayseri, Kayseri City Hospital, Kayseri, Turkey
| | | | - Mert Ali Karadag
- University of Health Sciences Medical Faculty of Kayseri, Kayseri City Hospital, Kayseri, Turkey
| | - Halil Çiftçi
- Department of Urology, School of Medicine, Harran University, Sanliurfa, Turkey
| | - Sakip Erturhan
- Department of Urology, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Cagri Kactan
- Department of Urology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Mustafa Soytas
- Department of Urology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Fatih Özkaya
- Department of Urology, School of Medicine, Atatürk University, Erzurum, Turkey
| | - Isa Ozbey
- Department of Urology, School of Medicine, Atatürk University, Erzurum, Turkey
| | - Eser Ordek
- Department of Urology, School of Medicine, Harran University, Sanliurfa, Turkey
| | - Ali Fuat Atmaca
- Department of Urology, Memorial Ankara Hospital, Ankara, Turkey
| | - Asif Yildirim
- Department of Urology, School of Medicine, Medeniyet University, Istanbul, Turkey
| | - Selcuk Sahin
- Department of Urology, University of Health Sciences Affiliated with Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Yunus Colakoglu
- Department of Urology, University of Health Sciences Affiliated with Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ugur Boylu
- Department of Urology, İstinye University Faculty of Medicine, Istanbul, Turkey
| | - Bulent Erol
- Department of Urology, School of Medicine, Medeniyet University, Istanbul, Turkey
| | - Turhan Caskurlu
- Department of Urology, School of Medicine, Medeniyet University, Istanbul, Turkey
| | - Murat Can Kiremit
- Department of Urology, School of Medicine, Koç University, Istanbul, Turkey
| | - Ozer Ural Cakici
- Department of Urology, Medical Park Ankara Hospital, Ankara, Turkey
| | - Gokhan Sonmez
- Department of Urology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Hakan Kılıçarslan
- Department of Urology, Uludag University, School of Medicine, Bursa, Turkey
| | - Ziya Akbulut
- Department of Urology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Onur Kaygısız
- Department of Urology, Uludag University, School of Medicine, Bursa, Turkey
| | - Selahattin Bedir
- Department of Urology, University of Health Sciences Affiliated with Gulhane Training and Research Hospital, Ankara, Turkey
| | - Hakan Vuruskan
- Department of Urology, Uludag University, School of Medicine, Bursa, Turkey
| | - Yunus Erol Bozkurt
- Department of Urology, Celal Bayar University, School of Medicine, Manisa, Turkey
| | - Hasan Riza Aydin
- Department of Urology, University of Health Sciences Affiliated with Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Ural Oguz
- Department of Urology, Giresun University, School of Medicine, Giresun, Turkey
| | - Erem Kaan Basok
- Department of Urology, Medical Park Izmir Hospital, Izmir, Turkey
| | - Bilal Habes Gumus
- Department of Urology, Celal Bayar University, School of Medicine, Manisa, Turkey
| | - Altug Tuncel
- Department of Urology, Ankara City Hospital, Ankara, Turkey
| | - Yilmaz Aslan
- Department of Urology, Ankara City Hospital, Ankara, Turkey
| | - Nurullah Hamidi
- Department of Urology, Ankara Abdurrahman Yurtaslan Oncology Hospital, Ankara, Turkey
| | | | - Murat Dinçer
- Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Derya Balbay
- Department of Urology, School of Medicine, Koç University, Istanbul, Turkey
| | - Selami Albayrak
- Department of Urology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Maria Pilar Laguna
- Department of Urology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
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Bozkurt YE, Gumus BH, Ozbay M, Duzgun F, Taneli F, Kurutep S. The Relationship of Testicular Sonoelastography with Gonadotropin Hormone Levels and Sperm Parameters. Niger J Clin Pract 2023; 26:586-590. [PMID: 37357474 DOI: 10.4103/njcp.njcp_390_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Background: Elastography is a non-invasive medical imaging technique that helps determine the stiffness of organs and other structures in our body. In this study, we investigated the effectiveness of elastography in the diagnosis of infertility. Aim In this study, we aimed to examine the relationship between testicular elastography and hormonal parameters and sperm parameters. Patients and Methods The study included 136 patients, 272 testicles were examined, and the mean age of the study participants was 30.1 years. Testicular tissue stiffness was measured by scrotal ultrasonographic shear wave elastography. Gonadotropin and testosterone hormones were measured from blood samples. Spermiogram parameters were studied manually. Results The control group included 66 patients, and the varicocele group consisted of 70 patients. Testicular stiffness degrees of the control group were measured as 4.29 kPa for the right testis and 4.23 kPa for the left testis. The varicocele group was divided into grades 1, 2, and 3 according to physical examination. In group 1 (grade 1), the right testis was 4.07 ± 1.24 kPa and the left testis was 3.77 ± 0.98 kPa. In group 2 (grade 2), the right testis was 4.31 ± 1.40 kPa and the left testis was 3.98 ± 0.93 kPa. In group 3 (grade 3), the right testis was 4.73 ± 1.50 kPa and the left testis was 3.99 ± 1.68 kPa. Hormone and sperm parameters were not statistically significant when comparing the control and varicocele groups. There was no statistical significance between the testicular tissue stiffness degrees of the control and varicocele groups. Hormone and spermiogram findings were also similar in groups. Conclusion It is known that varicocele leads to histological tissue changes in the testes. These changes result in tissue softness and loss while affecting sperm parameters and testosterone levels in a negative way. Before varicocele surgery, there is a need for new imaging methods with more sensitivity that can detect tissue changes in the testes.
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Affiliation(s)
- Yunus Erol Bozkurt
- Department of Urology, Manisa Merkez Efendi State Hospital, Manisa, Turkey
| | - Bilal H Gumus
- Department of Urology, Manisa Merkez Efendi State Hospital, Manisa, Turkey
| | - Mehmet Ozbay
- Department of Urology, Manisa Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Fatih Duzgun
- Department of Radiology, Manisa Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Fatma Taneli
- Department of Biochemistry, Manisa Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Semra Kurutep
- Department of Microbiology, Manisa Celal Bayar University Faculty of Medicine, Manisa, Turkey
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Bozkurt YE, Gümüş BH, Düzgün F, Neşe N. Comparison of preoperative penile elastographic ultrasound findings and pathological tissue results of patients implemented with penile prosthesis. J Ultrasound 2023; 26:99-105. [PMID: 35951284 PMCID: PMC10063753 DOI: 10.1007/s40477-022-00705-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/24/2022] [Indexed: 10/15/2022] Open
Abstract
OBJECTIVE Histopathological analysis of the relationship between penile elastography and erectile dysfunction. MATERIAL AND METHOD 12 patients who applied to our clinic for erectile dysfunction in the last 1 year and accepted this study were included. Preoperative two-dimensional shear wave elastography imaging was performed in 12 patients and recorded in the Pascal (kPa) unit. Approximately 0.5 × 0.5 × 0.5 cm tissue samples were taken from the right and left cavernous tissue during penile prosthesis implantation operation. Tissue samples were sent to the pathology department. The percentage of the area covered by muscle fibers and elastic fibers in the corpus cavernosum was noted semi-quantitatively (ratio of muscle fibers and cavernous body elastic fiber score). All data obtained were compared with each other. RESULTS Cavernous body elastic fiber score data(Grouped Score 1, 2 and 3) and percentage of cavernous body muscle fibers data (Grouped %10, %20, %30… %100) were compared with Shear wave elastography data (kPa). The results were not statistically significant according to the Kruskal Wallis Test. Cavernous body elastic fiber score and the percentage of cavernous body muscle fibers were also compared, it was not statistically significant according to the Kruskal Wallis test and Spearman's correlation test. CONCLUSIONS Penile shear wave elastography can be used clinically to quantitatively assess the amount of smooth muscle cells and elastic fibers in the penis, but it deserves to be studied with a larger number of patients and a more specific interpretation of the pathology preparation.
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Affiliation(s)
- Yunus Erol Bozkurt
- Department of Urology, Celal Bayar University Faculty of Medicine, Manisa, Turkey.
- Department of Urology, Manisa Merkez Efendi State Hospital, Manisa, Turkey.
| | - Bilal H Gümüş
- Department of Urology, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Fatih Düzgün
- Department of Radiology, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Nalan Neşe
- Department of Pathology, Celal Bayar University Faculty of Medicine, Manisa, Turkey
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