Grand Journal of Urology
E-ISSN : 2757-7163

Articles in Press
Original Article
Urological Oncology, Online First: 10 March 2022
Grand J Urol 2022; DOI: 10.5505/GJU.2022.02986
Objective: To evaluate the impact of radical prostatectomy (RP) and extended pelvic lymph node dissection (EPLND) on the disease process in terms of oncological outcomes and quality of life in the treatment of clinical stage C T3N0M0 prostate cancer (PCa). Materials and Methods: The data of patients with cT3N0M0 who had undergone open radical prostatectomy and extended pelvic lymph node dissection in our clinic between January 2015 and March 2021 were analyzed retrospectively. Preoperative and postoperative data were compared in terms of oncological and functional outcomes. Biochemical recurrence was accepted as detection of PSA >0.2 ng/ml on consecutive measurements and biochemical disease-free survival time was calculated. Results: The mean age of 23 operated patients who met the study criteria, was 66.8±7.4 years. In the pathological staging, the organ-confined disease was detected in 10 (43.4%) patients. Surgical margin positivity was observed in 6 (26.2%), while lymph node positivity in 3 (13.1%) patients. Biochemical recurrence was detected in 7 (30.2%) patients during a mean follow-up period of 33.6±22.9 months. The mean biochemical disease-free survival time was 48.4±6.3 months. In the evaluations of the patients at the postoperative 6th months, a 3.2±2.2-point decrease was found in the International Prostate Symptom Score (IPSS) (p=0.001) and a 13.1±5.0 point decrease in the International Index of Erectile Function (IIEF) score (p=
Renal Transplantation, Online First: 23 March 2022
Grand J Urol 2022; DOI: 10.5505/GJU.2022.70288
Objective: This study aimed to evaluate whether computed tomography (CT) can replace scintigraphy for the preoperative evaluation of split renal function (SRF) and to determine the agreement between different CT volumetric measurement methods used so as to demonstrate this function. Materials and Methods: The split renal function (SRF) percentage of living kidney donor candidates was determined by diethylenetriamine pentaacetic acid (DTPA) perfusion scintigraphy. The modified ellipsoid volume (MELV), semi-automatic total kidney volume (STKV) and semi-automatic renal cortex volume (SRCV) of the candidates who underwent contrast-enhanced CT were measured and the percentages of both kidney volumes were calculated. The inter-method agreement was evaluated using Pearson's correlation test and the Bland-Altman plot test. Results: There was no correlation between the right and left kidney SRF and MELV (r=-0.033 and r=-0.092), MELV% (r=0.076 and r=0.076), STKV (r=-0.005 and r=-0.120), STKV% (r=0.175 and r=0.172), SRCV (r=-0.001 and r=0.130) and SRCV% (r=0.205 and r=0.183). There were significant correlations between the right MELV and STKV (r=0.855) and SRCV (r=0.813), and between the left MELV and STKV (r=0.787) and SRCV (r=0.770). Conclusion: Although CT provided detailed preoperative anatomical information, volumetric measurements did not show agreement with SRF. The agreement of each 3 volumetric examinations within themselves made us think that disagreement with SRF was independent of the volumetric method chosen.
Pediatric Urology, Online First: 25 April 2022
Grand J Urol 2022; DOI: 10.5505/GJU.2022.87596
Objective: In the present study, we aimed to investigate the relationship between primary monosymptomatic enuresis nocturna (MEN) and chronotypes in children. Materials and Methods: Fifty children diagnosed with primary MEN and 50 healthy children were included in the study. All participants underwent the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)-based psychiatric, and a semi-structured interview, the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version, K-SADS-PL. The information obtained from the socio-demographic data form and Children"s Chronotype Questionnaire (CCTQ) for the patient and the control groups were recorded and statistical analyses were carried out. Results: Evening chronotype was significantly more often observed in the patient group (X2=6,225, SD=2, p=0.044). No difference was found between the groups with regard to morning and intermediate chronotypes. In the patient group, the time of going to bed, turning off the lights, the time to start sleeping and mid-sleep time were significantly delayed in free days (p=0.001, p=0.005, p=0.004, and p=0.004, respectively). The sleep duration and the time spent in bed were also significantly shorter in the patient group (p=0.029, p=0.004, respectively). Conclusion: Primary MEN is associated with circadian rhythm disorders and evening chronotype. As the mechanisms that lead to this condition is not clear yet, further studies with randomized controlled design and larger sample size are required to determine etiopathogenesis and treatment options, and also to reveal the association between MEN and chronotypes.
Laparoscopic and Robotic Surgery, Online First: 06 May 2022
Grand J Urol 2022; DOI: 10.5505/GJU.2022.68077
Objective: Evaluation of surgical, oncological and functional results in patients with prostate cancer and enlarged median lobe who underwent robot- assisted radical prostatectomy (RARP). Materials and Methods: Medical records of 489 patients who underwent RARP between August 2009 and December 2013 were retrospectively evaluated. Among them, 40 patients who had enlarged median lobe were included in Group 1. Forty patients without median lobe hyperplasia were included with matched analysis (Group 2). Patients who were followed up for 12 months were assessed. Results: No significant differences were found between the two groups in terms of demographic values, erectile function, preoperative PSA levels, prostate dimensions, distribution of clinical stages, Gleason scores and D"Amico risk classification (p˃0,05). Perioperative data revealed that mean operative times were 219.9 ± 64.5 (130-360) min and 185.6 ± 57.1 (120-355) min in Groups 1 and 2, respectively which was significantly prolonged in Group 1 (p˂0.05). Bladder neck reconstruction was performed in Groups 1 (n=14: 5%) and 2 (n=1: 3%). Rates of full continence after removal of urethral catheter on day 7 and at the end of months 1, 3, 6 and 12 were similar in Groups 1 and 2 (p˃0.05). Rates of potency and biochemical recurrence were similar at the end of the postoperative 6 months and one year in Groups 1 and 2 (p˃0.05). Conclusion: RARP in patients with prostate cancer with an enlarged median lobe is a challenging operation with significantly longer operative times. With its inherent procedural difficulties, RARP is a good treatment option in patients with prostate cancer and an enlarged median lobe with its successful surgical dissection and anastomosis possibilities.
Case Report
Urological Oncology, Online First: 25 February 2022
Grand J Urol 2022; DOI: 10.5505/GJU.2022.18209
Cystic nephroma is a rare, multicystic, non-hereditary benign lesion that does not contain solid components. The fact that this entity can not be easily distinguished from other cystic tumors of kidney creates difficulties in diagnosis and treatment. We present a 37-year-old male case with incidentally detected two cystic masses in his left kidney. After nephron-sparing nephrectomy, the histopathology of one of the cystic mass of the patient was reported as renal cell cancer and the other as cystic nephroma. Cystic nephroma is a rare tumor of the kidney. Definitive diagnosis can be made histopathologically rather than using physical examination and imaging methods. We reviewed the literature by presenting our case that had 2 cystic lesions in the same kidney, one of which was renal cell cancer and the other was cystic nephroma.
Urological Oncology, Online First: 09 May 2022
Grand J Urol 2022; DOI: 10.5505/GJU.2022.14622
Splenogonadal fusion (SGF) is a very rarely seen congenital anomaly localized usually in the left testis and mimics a testicular tumor. There are two subtypes of SGF, as continuous and discontinuous SGF. Continuous SGF can usually be detected in childhood. The less common discontinious SGF may not be detected until adulthood, and may be mistaken for testicular tumor and cause unnecessary orchiectomies. In this case report, we aimed to present a patient who underwent orchiectomy due to a left testicular mass associated with hydrocele and was found to have discontinuous SGF in his histopathological evaluation.
General Urology, Online First: 13 May 2022
Grand J Urol 2022; DOI: 10.5505/GJU.2022.57441
Concurrence of emphysematous pyelonephritis related to renal tuberculosis and iliopsoas abscess is exceedingly rare, and its coexistence with COVID-19 pneumonia presented as "diabetic ketoacidosis" may have fatal consequences. A 46-year-old diabetic female patient was manifesting signs of septic shock; unconsciousness, febrile episodes, tachycardia and tachypneia when she was first admitted to our emergency department. She had positive real-time PCR test results for COVID-19 four days before her admission with symptoms of abdominal pain, fever, nausea, weakness, chest tightness, and shortness of breath persisting for a week. Blood test results were consistent with diabetic keto acidosis. Computed tomography (CT) showed left-sided emphysematous pyelonephritis and iliopsoas abscess. The patient was managed using percutaneous drainage and empirical antibiotics. Besides, renal tuberculosis was identified in the patient who did not respond to the treatment offered. A poor glycemic control may cause various fatal clinical complications. Concurrence of emphysematous pyelonephritis and iliopsoas abscess may be devastating for the patient that must be promptly managed to avoid any occurrence of septic shock. As the response to the treatment offered was inadequate, the coexistence of other disease states as renal tuberculosis was contemplated.
Letter to the Editor
Andrology (Male Sexual Disfunction, Infertility), Online First: 25 March 2022
Grand J Urol 2022; DOI: 10.5505/GJU.2022.36854