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    Bilateral kidney stones with ureteropelvic junction obstruction
    (Nature Publishing Group, 2005) Soylu, A; Ugras, YM; Günes, A; Baydinç, C
    Background A 56-year-old male with bilateral flank pain was admitted following diagnosis of bilateral kidney stone disease. He had previously undergone four separate pyelolithotomy sessions (two per kidney), the latest being 14 years prior. At presentation the patient had two stones in the right kidney and seven in the left kidney. The right renal pelvis was dilated, indicating obstruction of the ureteropelvic junction. Investigations Plain radiography, ultrasonography, intravenous pyelography, retrograde ureteropyelography and spiral tomography. Diagnosis Bilateral kidney stones and obstruction of the right ureteropelvic junction. Management Bilateral percutaneous nephrolithotomy and simultaneous right endopyelotomy; intraoperative antegrade nephrogram; preoperative and postoperative measurement of hemoglobin, blood urea nitrogen and creatinine; postoperative nephrostograms, plain X-ray, diuretic renogram and intravenous pyelography.
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    Effects of micronised purified flavonoid fraction on pain, spermiogram and scrotal color Doppler parameters in patients with painful varicocele -: Results of a pilot study
    (Karger, 2005) Kiliç, S; Günes, A; Ipek, D; Dusak, A; Günes, G; Balbay, MD; Baydinç, YC
    Purpose: Micronised purified flavonoid fraction (MPFF) is a phlebotropic drug improving venous tone, elasticity and lymphatic drainage, decreasing venous distensibility, venous emptying times, reflux time of venous blood and capillary hyperpermeability, and having antioxidant activities. Since varicocele is a venous pathology, we evaluated the effects of MPFF on pain, spermiogram and color Doppler parameters in patients with painful varicocele. Material and Methods: Semen analyses and Doppler sonography were performed in 16 patients ( aged 20 - 62 years, mean 31.2 +/- 10.9) before and after 1,000 mg/day MPFF treatment. Pain change was assessed with visual analogue scale scored between 0 and 10. Patient satisfaction with outcome and side effects were recorded. Results: Mean pain scores at 1, 3, and 6 months were 1.25 +/- 1.34, 0.25 +/- 0.68, and 0.12 +/- 0.34, respectively, all being significantly lower ( p < 0.001 for each) than baseline ( 4.93 +/- 1.77). Mean score at 12 months (0.93 +/- 1.06) was still lower than baseline ( p < 0.001) but higher than at 6 months ( p = 0.019). Respectively, 14 (87.5%) and 2 (12.5%) patients reported complete and very significant resolution of pain at the 6th month. All patients were very satisfied with the outcome. While semen volume, total sperm count, sperm concentration and morphology did not change significantly, motility increased significantly ( p = 0.009) due to decrease of grade 0 sperms ( p = 0.006) and increase of grade 3 + 4 sperms ( p < 0.001). Reflux time of left spermatic vein during the Valsalva maneuver decreased significantly ( p = 0.003). No significant change occurred in reflux time of the right spermatic vein. No side effect was recorded. Conclusions: Results of this preliminary study suggest the safety and efficacy of MPFF in the treatment of varicocele-associated pain. However, no recommendation for the use of MPFF in the treatment of pain associated with varicocele can be made before these preliminary results are confirmed by a randomized placebo-controlled trial. Copyright (C) 2005 S. Karger AG, Basel.
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    Eosinophilic cystitis -: A rare inflammatory pathology mimicking bladder neoplasms
    (Karger, 2003) Kiliç, S; Erguvan, R; Ipek, D; Gökçe, H; Günes, A; Aydin, NE; Baydinç, C
    Purpose:We present a large series of eosinophilic cystitis including 8 cases; 3 of them had tumor-like lesions. Materials and Methods: The archives of pathology clinic of Inonu University Medical Faculty were reviewed from 1988 to 2002. The characteristics of patients and their diseases were recorded. Data obtained from 180 cases (172 from the literature and 8 from the present series) was assessed. Results: Seven cases had symptoms such as dysuria, frequency, hematuria, suprapubic pain, and difficulty in voiding. One asymptomatic case with history of bladder carcinoma was diagnosed during routine cystoscopy. The findings were microhematuria in 6 cases, macrohematuria in 2, pyuria in 3, urinary infection in 1, eosinophilia in 1, hyperazotemia in 1, and bladder masses in 3. Cystoscopies detected edematous and erythematous areas in 5 cases and lesions mimicking bladder carcinoma in 3. One case did not take further treatment after cystoscopy and biopsy and completely recovered. Four cases underwent medical therapy with nonsteroidal anti-inflammatory drugs and antihistaminics. They became asymptornatic and control cystoscopies showed no abnormal finding. Two of three patients with mass lesions recovered after steroid therapy following transurethral resection. The lesion in the third recurred and he improved after a second course of steroid therapy. Conclusions: Eosinophilic cystitis is a rare pathology. Sometimes, it may simulate bladder malignancies. Biopsy is mandatory at diagnosis. Usually, it has a benign course and may be treated with fulguration, analgesics, antihistaminics and steroids, although recurrence is possible. Copyright (C) 2003 S. Karger AG, Basel.
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    Urothelial carcinoma featuring lipid cell and plasmacytoid morphology with poor prognostic outcome
    (Elsevier Science Inc, 2005) Soylu, A; Aydin, NE; Yilmaz, U; Kutlu, R; Günes, A
    An aggressive urothelial carcinoma classified as lipid cell variant with plasmacytoid features was diagnosed in a 67-year-old man. His overall survival was 18 months after limited surgery followed by chemotherapy. The histopathologic features were the same in the recurrences. (c) 2005 Elsevier Inc.