Journal of Urological Surgery

Journal of Urological Surgery

Basic info

  • Publisher: Galenos Publishing House
  • Country of publisher: turkey
  • Date added to EuroPub: 2019/Aug/11

Subject and more

  • LCC Subject Category: Medicine, Surgery, Nephrology, Urology
  • Publisher's keywords: Urology, Pediatric Urology, Urooncology, Andrology, Urologic Radiology, Transplantation, Endourology
  • Language of fulltext: english, turkish

Publication charges

  • Article Processing Charges (APCs): No
  • Submission charges: No
  • Waiver policy for charges? No

Editorial information

Open access & licensing

  • Type of License: CC BY-NC-ND
  • License terms
  • Open Access Statement: Yes
  • Year open access content began: 2014
  • Does the author retain unrestricted copyright? False
  • Does the author retain publishing rights? False

Best practice polices

  • Permanent article identifier: DOI
  • Content digitally archived in: Other
  • Deposit policy registered in: None

This journal has '39' articles

Insights into the Management of Overactive Bladder: What Difference Can Mirabegron Make?

Insights into the Management of Overactive Bladder: What Difference Can Mirabegron Make?

Authors: Ömer Acar, Mustafa Levent Erton, Tufan Tarcan
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Abstract

Oral pharmacotherapy constitutes second-line treatment for overactive bladder (OAB) after lifestyle modifications, bladder retraining, and pelvic floor muscle exercises. Antimuscarinics have an established role in the treatment of OAB. However, antimuscarinics are known to have low persistence rates in clinical practice. Mirabegron is an oral β3-adrenoreceptor agonist which has emerged as an alternative to antimuscarinics for managing OAB. Overall, mirabegron has similar clinical efficacy to antimuscarinics and is superior to placebo. Mirabegron has been generally well tolerated in both interventional and non-interventional studies. Persistence has been shown to be higher with mirabegron than with antimuscarinics in realworld studies. Increased blood pressure is associated with mirabegron and therefore its use is contraindicated in patients with severe uncontrolled hypertension. However, a low rate of treatment cessation due to cardiovascular issues has been noted in clinical trials. Mirabegron’s utility in the elderly patient population has been well supported with promising efficacy and safety outcomes. New data from a prospective placebo-controlled randomized trial in older OAB patients is expected to be published soon. Mirabegron does not interfere with detrusor contractions during the emptying phase of the micturition cycle and hence lacks any significant effect on post-void residual volume. Mirabegron can be combined with antimuscarinics to synergize clinical effectiveness. Overall, mirabegron represents a well-tolerated and effective medical treatment option for OAB. Mirabegron could be used as an alternative to antimuscarinics, especially in patients who do not improve with antimuscarinics and/or experience bothersome side effects for whom anticholinergic load may be a relevant consideration.

Keywords: Overactive bladder, Pharmacotherapy, Antimuscarinic, Beta3 agonist, Side effects
Long-term Results of Patients with Testicular Tumors Undergoing Testis Sparing Surgery: A Single-center Experience

Long-term Results of Patients with Testicular Tumors Undergoing Testis Sparing Surgery: A Single-center Experience

Authors: Fuat Kızılay, Serdar Kalemci, Adnan Şimşir, Hamed Jafarzadeh Andabil, Banu Sarsık, Sait Şen, Çağ Çal, İbrahim Cüreklibatır
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Abstract

Objective: To determine the clinicopathologic and oncologic outcomes of testis-sparing surgery (TSS) by evaluating the data of patients who underwent TSS in our clinic. Materials and Methods: A total of 24 patients (27 testes) who underwent TSS in the last 16 years were included in the study. All the patients presented with a solitary testicular mass or bilateral testicular mass. Preoperative tumor markers were investigated and scrotal ultrasonography was performed in all patients. Surgery was performed with inguinal incision, temporary clamping of the spermatic cord and frozen section analysis (FSA) of the lesion. Intraoperative data, histopathological findings, and recurrence status were analyzed. Results: The mean follow-up period was 96 months. The mean age of the patients was 29.7 (18-66) years. The mean tumor diameter was 11 mm (2-18). TSS was performed bilaterally in 3 patients and unilaterally in 24 patients. According to the final pathology report, 18 (66.7%) of the masses were benign and 9 (33.3%) were malignant. Intraoperative FSA was performed in 17 patients (70.8%). FSA revealed malign histopathology in 6 patients and complementary orchiectomy was performed in 4 of these patients. 14 patients (51.9%) were detected to have positive surgical margins. Two of these patients had seminoma diagnosis and radical orchiectomy was performed due to recurrence on follow-up in these patients. TSS was performed in all patients without any significant intra-postoperative complications. Conclusion: TSS may have significant functional and cosmetic benefits without worsening oncologic results in appropriately selected patients.

Keywords: Testicular tumor, Testis-sparing surgery, Orchiectomy, Frozen section, Organ-sparing treatment, Positive surgical margin
A Modified Surgical Technique Using Cyanoacrylate Glue and Parenchymal Restoration Sutures without Tissue Approximation in Patients with Renal Tumors Who Underwent Open Partial Nephrectomy

A Modified Surgical Technique Using Cyanoacrylate Glue and Parenchymal Restoration Sutures without Tissue Approximation in Patients with Renal Tumors Who Underwent Open Partial Nephrectomy

Authors: Önder Kayıgil, Evren Işık, Emrah Okulu
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Abstract

Objective: To investigate the results of a modified open partial nephrectomy technique by using cyanoacrylate glue after the parenchymal restoration sutures without performing tissue reapproximation and to compare complications between risk groups according to the preoperative aspects and dimensions used for an anatomical (PADUA) classification in 50 patients. Materials and Methods: We performed open partial nephrectomy by using cyanoacrylate glue in 50 patients with a localized tumor and normal contralateral kidney between 2005 and 2012 with a mean follow-up of 40 months. All patients were evaluated by routine biochemical analyses and imaging modalities such as abdominal tomography and magnetic resonance when needed. PADUA scores were assessed according to the computed tomography images. Results: The mean blood loss was higher and the duration of surgery and ischemia was longer in high-risk group than in low-risk group. The difference was statistically significant (p=0.001, p=0.004, and p=0.0009, respectively. Intraoperative collecting system restoration was performed in 3 (9.9%) low-risk and 10 (50%) high-risk patients. Collecting system fistulization or chronic renal failure was not observed in any patient. Conclusion: Application of cyanoacrylate adhesive in nephron-sparing surgery is safe and effective in patients with a low PADUA risk score. Further randomized and controlled studies in a large series of patients will provide more conclusive results.

Keywords: Partial nephrectomy, Cyanoacrylate glue, Renal tumor, Nephron-sparing surgery
Can Neutrophil/Lymphocyte and Platelet/Lymphocyte Rates Predict Bone Metastasis in Prostate Cancer Patients?

Can Neutrophil/Lymphocyte and Platelet/Lymphocyte Rates Predict Bone Metastasis in Prostate Cancer Patients?

Authors: Yeşim Ceylan, Sevil Tatlıdil, Sait Şen, Banu Sarsık, Zehra Özcan
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Abstract

Objective: Bone metastasis is common in advanced prostate cancer (PCa). Recently, there has been a growing interest in the potential role of inflammatory markers, such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and neutrophil-to-monocyte ratio (NMR), in predicting advanced disease in patients with solid tumors. In the current study, we aimed to assess the relationship of bone metastasis detected on bone scintigraphy (BS) with NLR, PLR, and NMR in patients with Pca. Materials and Methods: The study group included 85 PCa patients. Patient characteristics, prostate-specific antigen (PSA) values, Gleason score, histopathological features, presence of metastatic focus on BS and complete blood count values were retrospectively evaluated. The relationship of the presence of bone metastasis on BS with clinicopathological features such as PSA, Gleason score, histopathological findings and NLR, PLR and NMR values were investigated. Results: Median NLR, PLR and NMR were 2.90, 125.69 and 8.38, respectively. Thirty-six patients had metastatic disease on BS. Our findings showed a statistically significant relationship between high NLR value and the presence of bone metastasis (p=0.018) and high Gleason score (p=0.034). However, no significant statistical relationship was found between clinicopathological features and PLR and NMR values (p>0.05). Conclusion: Despite the limited number of patients, a significant relationship between high NLR and metastatic bone disease was found. While high NLR has been generally considered an independent risk factor for poor PCa prognosis, we assume that larger scale studies are warranted to assess its value as a prognostic indicator in PCa patients.

Keywords: Bone scintigraphy, Prostate carcinoma, Neutrophil-to-lymphocyte ratio, NLR, Platelet-to-lymphocyte ratio, PLR, Neutrophil to monocyte ratio, NMR
Comparison of Ceftriaxone and Cefazolin Sodium Antibiotic Prophylaxis in Terms of SIRS/Urosepsis Rates in Patients Undergoing Percutaneous Nephrolithotomy

Comparison of Ceftriaxone and Cefazolin Sodium Antibiotic Prophylaxis in Terms of SIRS/Urosepsis Rates in Patients Undergoing Percutaneous Nephrolithotomy

Authors: Kerem Taken, Alper Aşık, Recep Eryılmaz, Rahmi Aslan, Muhammet İrfan Dönmez, Mustafa Güneş
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Abstract

Objective: The aim of this study is to compare ceftriaxone and cefazoline sodium antibiotic prophylaxis in terms of development of Systemic Inflammatory Response syndrome (SIRS)/urosepsis in patients undergoing percutaneous nephrolithotomy (PCNL). Materials and Methods: Patients who underwent PCNL between June 2015 and October 2015 in our hospital were prospectively randomized to ceftriaxone (n=30) and cefazoline sodium (n=32) antibiotic prophylaxis groups. Patients with predisposing conditions to SIRS were excluded. Intraoperative urine cultures from renal pelvis and stone cultures were obtained from all patients. Clinical and laboratory findings of the patients who developed postoperative fever were evaluated. SIRS and urosepsis rates were compared between two groups. Results: There were 7 patients in ceftriaxone group (23.3%) and 4 patients in cefazoline sodium group (12.5%) who developed SIRS (p=0.264). Sepsis was observed in 2 patients in both groups (p=0.826). Prolonged duration of surgery in ceftriaxone group and renal pelvis urine culture positivity in cefazoline group were found to be statistically significant in patients who developed SIRS (p=0.02, p=0.015, respectively). Conclusion: There was no significant difference between two groups in terms of SIRS and sepsis following PCNL. Therefore, cefazoline, which has a narrower antimicrobial spectrum, may be preferred for prophylaxis.

Keywords: Prospective, Percutaneous nephrolithotomy, Antibiotic prophylaxis, Systemic Inflammatory Response syndrome, Sepsis
Can We Predict Mortality in Patients with Fournier’s Gangrene Using Questionnaires? A Pilot Study with Eighty-seven Patients

Can We Predict Mortality in Patients with Fournier’s Gangrene Using Questionnaires? A Pilot Study with Eighty-seven Patients

Authors: Soner Yalçınkaya, Ali Yıldız, Mustafa Yüksel, Ekrem İslamoğlu, Nihat Ateş, Hüsnü Tokgöz, Murat Savaş
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Abstract

Objective: To investigate the validity and reliability of the Fournier’s gangrene severity index (FSGI) and Uludag Fournier’s gangrene severity index (UFGSI) scoring systems and their components in outcome prediction for patients with Fournier’s gangrene. Materials and Methods: Recods of 87 patients, who were diagnosed with Fournier’s gangrene in our clinic between March 2005 and May 2016, were retrospectively analyzed. The patients were divided into 2 groups as survivors and non-survivors. Parameters belonging to the groups were compared. Results: The overall mortality rate was 13.7%. There was no correlation between mortality and dissemination of disease to the rectum, lower abdomen or lower extremity (p>0.05). There was a significant difference in renal failure, heart rate, blood urea nitrogen, creatinine, calcium and serum bicarbonate (HCO₃) values, and FSGI and UFGSI scores between the survivor and non-survivor groups (p<0.05). In evaluation of mortality, a cut-off value of ≥9 had a positive predictive value of 77.8% and 42.9% and negative predictive value of 93.6% and 95.5% for FGSI and UFGSI, respectively. Conclusion: To predict the prognosis in Fournier’s gangrene, the FGSI and UFGSI are successful parameters especially in predicting mortality. In the light of these parameters, we assume that these scoring systems are useful in deciding which patient should receive more aggressive treatment.

Keywords: FGSI, Fournier’s gangrene, Mortality, UFGSI
Bacterial Colonization of Ureteral Double-J Stents in Patients with Negative Urine Culture

Bacterial Colonization of Ureteral Double-J Stents in Patients with Negative Urine Culture

Authors: Volkan Ülker, Nisel Yılmaz, Neval Ağuş, Ertan Can, Özgür Çakmak, Cem Yücel, Orçun Çelik, Yusuf Özlem İlbey
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Abstract

Objective: Ureteral double-J stents are extensively used in urology practice. We aimed to investigate the bacterial colonization rate and predominant microorganisms on ureteral double-J stents in patients with negative urine cultures in a prospective study. Materials and Methods: A total of 35 double-J ureteral stents from 35 consecutive patients were examined. The cyctoscopically removed stents were divided into three parts as upper, middle and lower then sent for the microbiologic examination with a urine sample just taken before stent removal. The samples were inoculated on sheep blood agar and eosin-methylene blue agar culture mediums. The growth of >1000 colony-forming units/mL was considered significant. The antimicrobial susceptibility test was performed with 10 broad spectrum antibiotics. Results: Bacterial colonies were found in 20% of 35 ureteral stents. The most frequently isolated bacteria was Staphylococcus epidermidis, followed by Escherischia coli and Enterococcus faecalis. Bacterial colonization was revealed in all parts of the stents in 71.4% cases. The stent indwellingtime was correlated with stent culture positivity (p=0.035). However, no correlation was detected with gender, age and stent colonization (p≥0.05). Conclusion: Negative urine culture result does not always rule out positive stent culture. Even not routinelly recommended, stent culture could be useful for treatment of a possible postoperative urinary tract infection and sepsis in high risk patients who undergo endourologic surgery.

Keywords: Ureteral stents, Bacterial colonization, Stent culture, Urine culture
Effect of Varicocelectomy on Restoration of Spermatogenesis in Patients with Non-obstructive Azoospermia

Effect of Varicocelectomy on Restoration of Spermatogenesis in Patients with Non-obstructive Azoospermia

Authors: Oktay Özman, Sinharib Çitgez, Fatih Şimşekoğlu, Berin Selçuk, Sami Berk Özden, Hamdi Özkara
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Abstract

Objective: The aim of this study was to investigate the effect of varicocelectomy on spermatogenesis in patients with non-obstructive azoospermia (NOA) and the presence of clinical factors for re-spermatogenesis. Materials and Methods: A total of 32 patients with clinically significant varicocele, who received the diagnosis of infertility, were included in this study. Microsurgical inguinal varicocelectomy and testicular biopsy were performed in all patients. After varicocelectomy, control spermiogram samples were collected from patients at 3rd, 6th and 12th months. The role of age, testicular volume, hormone parameters and pathological findings in predicting re-spermatogenesis were investigated. Results: The mean age of the patients who underwent surgery was 31.4±6.2 years. After varicocelectomy, sperm was detected in semen in 15.6% (5/32) of the patients. As a result of pathological evaluation, hypospermatogenesis, maturation arrest and germ cell aplasia were found in 34.4%, 31.2% and 34.4% of patients, respectively. The testicular volume was higher in patients with re-spermatogenesis (p=0,01). There was no statistically significant difference between responders and non-responders in terms of other investigated parameters. Conclusion: Varicocelectomy is an acceptable modality of treatment for patients with NOA with clinically significant varicocele. On the other hand, appropriate patient selection is crucial. In this study, testicular volume was found to be a predictive factor for recovery of spermatogenesis after varicocelectomy.

Keywords: Infertilty, Non-obstructive azospermia, Varicocelectomy
The Effect of Distal Ureteral Stone Size Measurements on Spontaneous Passage

The Effect of Distal Ureteral Stone Size Measurements on Spontaneous Passage

Authors: Şakir Ongün1, Murat Dursun
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Abstract

Objective: To investigate the relationship of spontaneous ureteral stone passage with stone size (width-length) and area. Materials and Methods: Patients who presented to the urology outpatient clinic with acute renal colic between January and December 2016 and were found to have a distal ureteral stone of 10 mm or smaller on unenhanced computed tomography (CT) were retrospectively evaluated. Using the CT images, the size of the stones was measured and the data of the patients were compared in terms of spontaneous passage status. Results: A total of 245 patients were included in the study. The mean stone size on the axial plane and coronal plane was 4.72±1.55 mm and 4.75±1.84 mm, respectively and the spontaneous passage rate was 77.6%. In logistic regression analysis, the most important factor in predicting spontaneous passage was the stone size on coronal measurement (p=0.020). The spontaneous passage rate was 70.8% in cases where the stone size on the axial plane was the same as or larger than on the coronal plane, 56.2% when the size on the the coronal plane was 1 mm greater than on the axial plane, and 34.7% when the stone size on the the coronal plane was 2 mm or more than 2 mm greater than on the axial size. Chi-square analysis revealed that the difference between spontaneous passage rates was statistically significant (p=0.001). Conclusion: When planning treatment for ureteral stones, the length of the stone in coronal measurement should be considered as a priority. It should be remembered that the probability of spontaneous passage is significantly low, especially if the length of the stone is 2 mm or more than 2 mm greater than its width.

Keywords: Spontaneous passage, Computerized tomography, Ureteral stone
Outcomes of Hypospadias Surgery Performed by Different Surgeons Under the Supervision of an Experienced Pediatric Urology Surgeon

Outcomes of Hypospadias Surgery Performed by Different Surgeons Under the Supervision of an Experienced Pediatric Urology Surgeon

Authors: Oktay Özman, Murat Kuru, Murat Gezer, Fatih Gevher, Bülent Önal
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Abstract

Objective: Hypospadias is one of the most common congenital anomalies among males. Hypospadias repair is still a challenging issue due to its results and frequently seen complications. The most commonly used techniques are the meatal advancement with glansplasty incorporated and tubularized incised plate urethroplasty. The experience of the surgeon is an important factor that influence the success of the surgery. In the literature, there are not enough data about the success of these operations done by different surgeons under the supervision of a pediatric urologist. Materials and Methods: Records of 98 patients who underwent hypospadias surgery performed under the supervision of a pediatric urologist between 2008 and 2015 were retrospectively investigated. Patients who developed fistula after operation and those who did not were divided into two groups. The two groups were compared according to hyposdias type, history, operation type and age. Results: A total of 98 patient were included in the study. The mean age was 8.58±8.3 years. Eighty six (88%) patients had distal and 12 (12%) had proximal hypospadiasis. Twenty two (22%) patients developed fistula. There was no statistically significant difference in history and type of hypospadias and age group (child vs adult) between the two groups. The mean age of the non-fistula group was statistically significantly lower than the fistula group (p=0.0169). Conclusion: The rates of success and complications of the hypospadias surgeries performed by different surgeons under the supervision of an experienced pediatric urologist are similar with the series done by experienced pediatric urologists.

Keywords: Hypospadias, Fistula, Hypospadias repair
The Largest Cystic Nephroma Treated by Laparoscopic Nephronsparing Surgery: A Case Report and Review of the Literature

The Largest Cystic Nephroma Treated by Laparoscopic Nephronsparing Surgery: A Case Report and Review of the Literature

Authors: Nejdet Karşıyakalı, Uğur Yücetaş, Hüseyin Aytaç Ateş, Sevim Baykal Koca, Ceyda Turan Bektaş, Mahmut Gökhan Toktaş
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Abstract

Cystic nephroma is a rare benign tumour of the kidney. The symptoms are often non-specific and the diagnosis of the disease is usually made incidentally. Definitive diagnosis can be possible with histopathological evaluation. Surgical resection provides curative treatment. We report a successful removal of cystic nephroma in a 67-year-old female which was managed by laparoscopic nephron-sparing surgery. When a renal mass including multiple cystic formations is visualized on radiological imaging, the clinician should consider cystic nephroma for differential diagnosis, and these cases should be evaluated in terms of nephron-sparing surgery.

Keywords: Cystic nephroma, Laparoscopy, Partial nephrectomy, Renal cyst, Renal tumour
Two Unique Cases of Peritoneal Carcinomatosis Following Robotic Assisted Radical Prostatectomy

Two Unique Cases of Peritoneal Carcinomatosis Following Robotic Assisted Radical Prostatectomy

Authors: Jacob Baber, Tara McLaughlin, Joseph Wagner, Anoop Meraney
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Abstract

We present two cases of peritoneal carcinomatosis following robotic assisted laparoscopic radical prostatectomy for prostate cancer. The first case is unique in that the carcinomatosis was found incidentally during a transperitoneal procedure for another malignancy. The patient did not possess high risk, adverse features and he experienced a 3-year period during which the prostate-specific antigen was undetectable. Our second case is unique in that, even though the patient had high risk disease, his margins were negative. It is possible that the transperitoneal nature of the surgeries may have contributed to the development of the metastases seen in these cases.

Keywords: Peritoneal carcinomatosis, Prostate cancer, Robot-assisted, Radical prostatectomy, Prostatectomy
Tamsulosin-induced Hyperprolactinemia in a Patient with Multiple Sclerosis: A Case Report

Tamsulosin-induced Hyperprolactinemia in a Patient with Multiple Sclerosis: A Case Report

Authors: Ahmet Görgel, Ahmet Soylu, Sacit Görgel, Mehmet Tecellioğlu, Mehmet Sarıer
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Abstract

Drug-induced hyperprolactinemia is one of the most common causes of non-physiologic hyperprolactinemia. In contrary to other anterior pituitary hormones, prolactin is not controlled via hypothalamic-pituitary negative feedback mechanism. Since prolactin secretion is inhibited mainly by dopamine, some drugs such as antipsychotics and prokinetics which block dopamine receptors may lead to hyperprolactinemia. Nevertheless, despite this well-known phenomenon, most of cases of drug-induced hyperprolactinemia are asymptomatic. On the other hand, hyperprolactinemia due to tamsulosin that is an alpha adrenergic receptor antagonist has not been reported yet. Herein, we present a 39-year-old woman with multiple sclerosis who developed hyperprolactinemia after starting treatment with tamsulosin for neurogenic bladder disease.

Keywords: Drug-induced Hyperprolactinemia, Tamsulosin, Multiple Sclerosis
An Unusual Cause of Chronic Scrotal Pain Coexisting with Hydrocele: Isolated Tuberculous Epididymitis

An Unusual Cause of Chronic Scrotal Pain Coexisting with Hydrocele: Isolated Tuberculous Epididymitis

Authors: İbrahim Kartal, Fatih Sandıkçı, Ünsal Han, Azmi Levent Sağnak, Hamit Ersoy
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Abstract

Isolated tuberculous epididymitis (ITE) is a rare condition affecting only the epididymis without clinical evidence of renal involvement. One of the causes of chronic scrotal pain can be ITE, which is usually only diagnosed in the presence of strong clinical suspicion, as it was in this case. The patient who had chronic scrotal pain and hydrocele and who did not respond to medical treatment for the diagnosis of epididymitis underwent scrotal exploration. The pathology material demonstrated necrotizing and non-necrotizing granulomas in the epididymis and around the small vessels. The Mantoux test performed for differential diagnosis produced a positive result. The polymerase chain reaction done on the pathology material also produced results compatible with mycobacterium tuberculosis. The patient, who did not have postoperative systemic complaints, had his scrotal pain and swelling resolved with the completion of a 6-month anti-tuberculosis medical treatment. In ITE, which is rarely encountered, patients usually present with a painless scrotal mass. It must be taken into account that ITE may unusually cause scrotal pain, and even though not emphasized thoroughly until now, it may be accompanied by hydrocele as in our patient.

Keywords: Chronic scrotal pain, Hydrocele, Isolated tuberculous epididymitis
Percutaneous Removal of a Broken Malecot Nephrostomy Tube

Percutaneous Removal of a Broken Malecot Nephrostomy Tube

Authors: Tariq Asi, Hasan Serkan Doğan
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Abstract

We report a case of a broken re-entry Malecot nephrostomy tube inserted after an uneventful percutaneous nephrolithotomy (PCNL) procedure. The remained parts within the renal pelvis and around the kidney were removed using a percutaneous approach under general anesthesia using the PCNL access tract. Although this complication did not cause severe morbidity, it converted a successful uneventful PCNL procedure to a grade IIIB complicated one according to the modified Clavien classification system. This complication should be held in mind and a percutaneous approach should be considered before attempting an open surgery.

Keywords: Broken percutaneous nephrostomy tube, Re-entry Malecot, Clavien IIIB, Endoscopic intervention

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