Background. Treatment of urethral strictures can be challenging, but, with appropriate preoperative evaluation and surgical planning it is possible to achieve successful results. Objectives. To analyze if the stricture length affects the success with dorsal onlay buccal mucosal graft urethroplasty technique. Material and Methods. Between January 2004 and June 2010 a total of 40 patients with anterior urethral stricture were treated with dorsal onlay buccal mucosal graft urethroplasty. Age, etiology of the stricture, stricture length (≤ 7 cm, and > 7 cm), and localization of the stricture were assessed as the factors affecting success rate. Results. The clinical outcome was defined as a failure when any operative instrumentation including dilatation was needed or the urine flow rate was less than 14 mL per second at the sixth month, postoperatively. The mean follow-up period was 43.44 months. Of 40 patients, 28 (70%) were successful and 12 (30%) were a failure. There was no statistically significant difference between the age groups, etiology of the stricture and success rate (p = 0.26 and p = 0.41). The statistical difference was significant for the localization and length of the stricture by means of success (p = 0.002 and p = 0.025). Conclusions. Our results show that the stricture length and localization are the most important variables for desirable success. Even though surgical techniques are constantly evolving, long strictures stay as a problem for urologists. Studies with larger number of patients with long urethral strictures may support our findings, and may prove the efficiency of these surgical techniques (Adv Clin Exp Med 2015, 24, 2, 297-300).
Introduction: The aim of the study is to reveal pathologic characteristics and clinical behaviour of patients 40 years old or younger diagnosed with and treated for urothelial bladder carcinoma. Methods: We retrospectively analyzed the clinical and pathologic data of 91 patients, initially diagnosed and treated at our institution from May 1996 to December 2014. Cancer recurrence was defined as new occurrence of bladder cancer at the same or different sites of the bladder. Cancer progression was defined as an increase in stage or grade in any of the recurrences. Results: The mean age was 33.8 (range: 17-40) years. The pathological examination after transurethral resection revealed 83 (91.2%) patients with non-muscle invasive urothelial bladder cancer, and 8 (8.8%) patients with muscle invasive urothelial bladder cancer. According to the distribution of grade, there were 75, 4 and 12 patients with grade 1, grade 2 and grade 3 diseases, respectively. Initial cancer staging was: pTa with 40 patients (43.9%), pT1 with 43 patients (47.2%), pT2 with 7 patients (7.6%), and pT3 with 1 patient (1.2%). While 17 (18.6%) patients recurred in the followup, 10 (10.9%) patients had progression. There were no differences in recurrence and progression rates in the Ta and T1 stages between groups (p = 0.233, p = 0.511, respectively). Conclusion:The risk of progression increased as the number of relapses increased. The clinical behaviour of high-stage and highgrade disease in younger patients is similar to the older group.
Purpose: To determine whether benign exophytic renal masses can be distinguished from malignant lesions by using the angular interface sign in ultrasonography (US) and computerized tomography (CT). Materials and Methods: A total of 71 cases with exophytic renal mass (2 cm or greater) were examined on the basis of angular interface in US (n = 23), CT (n = 21) and US + CT (n = 16) between January 2008 and June 2010 were included in this study. The renal interface relationships were examined by 2 radiologists and classified as having angular or wide interface. Results: No statistically significant difference was found between the findings of two readers. There was almost perfect interobserver agreement for the interface sign. For cystic lesions, the angular interface sign was determined in all but two Bosniak category 1 cases. Also, the angular interface sign was positive in all but one Bosniak category 2 - 3. For cystic lesions with solid component and pure solid lesions, in the benign group, the angular interface sign was positive in all except three cases (vascular malformation, oncocytoma and Xanthogranulomatous pyelonephritis). In the malignant group, the angular interface sign was determined in only two RCC cases; in other primary or metastatic malignant lesions there was a wide interface sign. Conclusion: Exophytic renal masses can be differentiated as malignant or benign with 87% accuracy using only the angular interface sign in US or CT and also in opposition to dynamic-contrast examinations. This method entails a lack of additional radiation or contrast media exposure, time-saving, and costeffectivity
Background: The true incidence of contralateral occult inguinal hernia (OIH) is a debate. The repair of contralateral OIH in the treatment context of clinical symptomatic unilateral inguinal hernia (IH) is controversial. This study aimed to assess the effect and clinical benefit of preoperative ultrasound (US) in the diagnosis of contralateral OIH performed before surgery. Methods:The retrospective data of 155 consecutive male patients who underwent IH repair between January 2014 and January 2020 were analyzed. The surgical procedures for IH and the clinical outcomes of the US were evaluated.Results: Of 155 patients, 29 (18.7%) presented with bilateral IH. Preoperative US was performed in 73 cases of clinical unilateral IH (n = 126), and 30 (23.8%) patients were found to have a contralateral OIH. The totally extrapreperitoneal (TEP) or Lichtenstein repair was conducted. Bilateral IH repair was proposed for all, but only 28 agreed and underwent bilateral repair. Patients with clinically bilateral hernia had more complications compared with patients diagnosed to have occult contralateral IH after the US (n = 3 vs. n = 0). In the overall group, the TEP procedure resulted in shorter hospital stay (P = 0.001) and less pain (P = 0.021). Conclusions:The preoperative US may be recommended to assess the presence of a contralateral OIH as it is a noninvasive, radiationfree, widely available, relatively cheap diagnostic method. The preoperative US may change the surgical approach in up to 1/4 patients with a clinical unilateral IH. Either Lichtenstein repair or TEP repair can be performed with an acceptable complication rate in the case of OIH.
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