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    Color Doppler sonography examination of partially obstructed kidneys associated with ureteropelvic junction stone before and after percutaneous nephrolithotripsy
    (Blackwell Publishing Asia, 2005) Kiliç, S; Altinok, MT; Ipek, D; Beytur, A; Baydinç, YC; Günes, G
    Aim: To evaluate resistive index (RI) changes before and after unilateral percutaneous nephrolithotripsy in chronic partially obstructed kidneys due to ureteropelvic junction (UPJ) stones. Methods: Intrarenal RI of obstructed and contralateral normal kidneys of 18 patients were recorded immediately before the operations and at postoperative days 1, 7 and 30. Postoperative RI measurements were compared with baseline values for all patients without grouping and separately for different groups according to the preoperative RI value of the obstructed kidney. Results: Mean age and symptom duration were 27.5 years and 43.8 weeks, respectively. Preoperatively and at all postoperative controls, kidney diameters and renal parenchyma thicknesses were normal in all patients. Mean RI of obstructed kidneys decreased from 0.68 to 0.63 for all patients (P = 0.032), from 0.64 to 0.63 for those with preoperative RI < 0.70 (P = 0.850) and from 0.73 to 0.62 for those with preoperative RI >= 0.70 (P = 0.001). In patients with preoperative RI >= 0.70 in obstructed kidney, significant RI decreases were recorded at postoperative day 7 and RI differences between obstructed and contralateral kidneys disappeared after then. No difference was present pre- and postoperatively between the mean RI of obstructed and contralateral kidneys of the patients with RI < 0.70. Mean RI of contralateral kidneys were normal preoperatively and showed no significant change postoperatively. Conclusions: Preoperative RI levels may indirectly reflect the presence of functionally significant obstruction in chronic obstructed kidneys related to UPJ stones. Patients with RI >= 0.70 may have a good indication for a surgical approach. Normalization of high RI occurs rapidly after percutaneous nephrolithotripsy.
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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.