Articles in Press-Grand Journal of Urology

Articles in Press

Original Article (3) Case Report (3) Letter to the Editor (1)

Original Article

Urological Oncology, Online First: 10 October 2021

Grand J Urol 2022; DOI: 10.5505/GJU.2022.41636

The Relation Between Multifocality and Clinical, Pathological and Histological Results in Renal Tumors

Bahadir Ermec, Metin Ishak Ozturk, Bilal Eryildirim, Erbil Ergenekon

Objective: In this study, histological, pathological and clinical characteristics that may affect multifocality rate and multifocality in renal tumors were investigated. Materials and Methods: A total of 162 patients who underwent radical nephrectomy with the diagnosis of renal tumor from our urology clinic and urology clinics in two other hospitals between May 2002 and April 2006 and whose results were available were included in the study. Kidney samples were evaluated regarding multifocality through sections made macroscopically at an interval of 3 mm. Results: Of the patients included in the study, 92 (56.8%) were male and 70 (43.2%) were female. The mean age of the patients was 59.98 years (22-87). In 11 (6.7%) of 162 patients, a multifocality focus was pathologically observed. Satellite lesions were radiologically identified in two (18.2%) of the patients with multifocality. On the other hand, satellite lesions could not be identified radiologically in nine patients (5.5%). Univariate and multivariate analyzes were performed to determine the relation between pathological, histological, and clinical characteristics and multifocality. There was no significant relation between age, gender, smoking, the location of the tumor, pathological stage, lymph node involvement, the presence of metastasis, the size of the tumor, and histology of the tumor. Univariate analysis results showed a statistically significant relation between renal capsule involvement and renal vein involvement and multifocality (p=0.015 and p=0.004, respectively); however, only renal capsule involvement was found to be associated with multifocality in multiple logistic regression analysis (p=0.008). Conclusion: In our multicentric study including 162 patients, the multifocality rate in renal tumors was 6.7% (11 patients). There was a significant relationship between capsule involvement and multifocality (p=0.015 – p=0.008). Meta analysis is required to determine the rate of multifocality in renal tumors and identify with which clinical, pathological, and histological characteristics it is associated.

General Urology, Online First: 22 November 2021

Grand J Urol 2022; DOI: 10.5505/GJU.2022.58067

Evaluation of the Frequency of Acute Kidney Injury in Hospitalized Patients with Benign Prostatic Hyperplasia Due to COVID-19 Pneumonia

Muge Bilge, Isil Kibar Akilli, Sengul Aydin Yoldemir, Ramazan Korkusuz, Esra Canbolat Unlu, Ekrem Guner, Kadriye Kart Yasar

Objective: Benign prostatic hyperplasia (BPH)-related acute kidney injury (AKI) occurs in male patients as a natural result of aging and androgen exposure. In our study, we investigated the frequency of BPH-related AKI and its relationship with disease severity in patients hospitalized for COVID-19 pneumonia. Materials and Methods: This is a retrospective and observational study on 869 male patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), who were diagnosed with COVID-19 by real-time PCR testing and hospitalized due to COVID-19 pneumonia. None of the patients was admitted to the intensive care unit (ICU). 55 patients out of 869 had BPH. AKI was defined according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria. BPH and non-BPH groups were statistically compared with respect to the existence, frequency, hospitalization duration and in-hospital death. Results: Median age was 70 years for BPH group and BPH patients were significantly older than the non-BPH. Hypertension, coronary artery disease and heart failure were significantly more frequent in the BPH group. On admission, compared with normal serum creatinine, serum urea was significantly higher in the BPH patients. All AKI patients with BPH had three or more comorbidities. During hospitalization, AKI occurred in 7,3% of the BPH patients compared with the non-BPH (0,98%). The incidence of AKI was significantly higher in the patients with BPH (OR:7,94, 95% CI:2,31-27,25). In-hospital death occurred in 16,4% of the patients with BPH. The mortality was significantly lower in non-BPH group (8,6%) compared with the BPH. Our final analysis showed that age, arterial hypertension, prior coronary artery disease and heart failure were independent risk factors for occurred BPH-related AKI. Conclusions: Older male patients with common comorbidities showed a higher risk for mortality from COVID-19 pneumonia. Also, AKI patients with BPH had a poorer prognosis and higher mortality than the non-BPH patients.

Genitourinary Radiology, Online First: 06 December 2021

Grand J Urol 2022; DOI: 10.5505/GJU.2022. 87599

Relationship Between SUVmax and ADC Values of Metastatic Lymph Nodes Detected by Ga-68 PSMA PET/MR in Prostate Cancer Patients

Fuad Aghazada, Ali Kibar, Rabia Lebriz Uslu Besli, Muhammet Sait Sager, Haluk Burcak Sayman, Kerim Sonmezoglu

Objective: Our aim is to assess if there is a relationship between maximum standardized uptake (SUVmax) and apparent diffusion coefficient (ADC) values of reactive and metastatic lymph nodes, also to compare ADC values of reactive and metastatic lymph nodes in prostate cancer patients. Materials and Methods: We have retrospectively investigated 20 patients diagnosed with prostate cancer who underwent Ga-68 PSMA PET/MR imaging. Three metastatic and three reactive lymph nodes classified according to the level of PSMA Ga-68 uptake in PET/MR were chosen for each patient. SUVmax and ADCmean values were calculated for each lymph node separately. SPSS version 22 was used for statistical analysis. Results: A total of 120 lymph nodes in 20 prostate cancer patients were assessed. There was a moderate negative correlation between SUVmax values and ADCmean values of metastatic lymph nodes (p=0.009, r=-0.333). However, there was no significant correlation between SUVmax values and ADCmean values of reactive lymph nodes. ADCmean values of metastatic lymph nodes were significantly lower than those of reactive lymph nodes (p=0.0001). Conclusion: PET/MR, which combines both advantages of PET and MRI, is an important tool for the diagnosis and management of prostate cancer. We have found that SUVmax values of metastatic lymph nodes were inversely correlated with ADCmean values and combination of both parameters may increase the diagnostic accuracy of Ga-68 PSMA PET/MR in the detection of lymph node metastasis.

Case Report

Urological Oncology, Online First: 19 September 2021

Grand J Urol 2022; DOI: 10.5505/GJU.2022.69775

Sertoli Cell Nodule with Histomorphological and Immunohistochemical Features and its Differential Diagnosis: A Case Report

Oyku Dila Gemci, Halil Firat Baytekin, Ismail Evren, Omer Yildiz

Non-germ cell testicular tumors are rarely seen. Sex-cord stromal tumors, which make up the majority of testicular tumors other than germ cell tumors, share common immunohistochemical and histomorphological features. Our aim in presenting this case is to define the Sertoli cell nodule (SCN), which is one of the relatively rare primary testicular pathologies that can be detected in half of adult undescended testes, with its histomorphological and immunohistochemical features, and to make its differential diagnosis.

Urological Oncology, Online First: 27 September 2021

Grand J Urol 2022; DOI: 10.5505/GJU.2022.70299

Distant Metastases from a Small Renal Cell Carcinoma in a Renal Allograft Recipient with Prostate Carcinoma: A Case Report

Yunus Colakoglu, Deniz Noyan Ozlu, Serdar Karadag, Zehra Sibel Kahraman, Oznur Dilek Ciftci, Mehmet Dikec, Suheyla Apaydin, Ali Ihsan Tasci

Immunosuppressive therapy is related to the increasing frequency of malignancies after transplantation. A small percentage (4.6%) of malignancies seen in kidney transplant patients are renal cell carcinomas (RCC) which occur almost exclusively in native kidneys. The prognosis of RCC largely depends on the presence of metastasis. Metastatic disease is very rare in small renal masses. In this case report, we aimed to present our case of approximately 4 cm-mass of metastatic RCC in our kidney transplant patient. During the examination due to exhaustion and weight loss, multiple suspicious metastatic lesions were observed in non-contrast computed tomography. In the patient who had multiple bone metastases on the whole-body bone scintigraphy, prostate cancer metastasis was considered in the first plan due to a history of prostate cancer before transplantation. This diagnosis could not be supported with prostate-specific membrane antigen-positron emission tomography/computed tomography (PSMA-PET/CT) scan. Whole body 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) was performed. A hypermetabolic mass lesion in the left kidney, multiple hypermetabolic lesions in the liver, in the left aortorenal junction, and in the skeletal system were observed. A biopsy was performed from the metastatic mass in the right lobe of the liver and the result was reported as renal cell carcinoma metastasis. Immunohistochemistry evaluation demonstrated positive staining for PAX-8, CK19, CD10 and negative staining for CK7, CK20, GATA-3, NAPSIN A, TTF-1, PSAP, glutamine synthetase and arginase. With all these findings, it was thought that the primary of metastases was the 4-cm mass in the left native kidney.