Siddalingeshwar Neeli - Academia.edu (original) (raw)

Papers by Siddalingeshwar Neeli

Indian journal of health sciences and biomedical research KLEU, 2020

Objective: Retrograde urethrography (RGU) is the most commonly used imaging modality for the eval... more Objective: Retrograde urethrography (RGU) is the most commonly used imaging modality for the evaluation of the anterior urethra. Sonourethrography (SUG) is another modality that is not so frequently used, though several studies have suggested its higher degree of sensitivity and specificity in anterior urethral stricture evaluation. The present prospective study has been done to compare the results of SUG with that of RGU and to probe its effect in decision making. Patients and Methods: A total of 50 patients with anterior urethral stricture disease were evaluated with both SUG and RGU for stricture length, site location, and associated urethral pathologies. Collected information was used as a guide for the choice of surgery, and it was compared with operative findings. Results: The mean lengths of strictures on SUG, RGU, and surgery were 20.46 cm, 17.14 cm, and 20.35 cm, respectively. Overall sensitivity and accuracy of SUG in predicting correct stricture length was 95.55 and 97.33%, respectively, and overall sensitivity and accuracy of RGU in predicting correct stricture length was 77.22 and 85.33%, respectively. Spongiofibrosis was noted only with SUG in 78 to 88% accuracy. In 32% of cases, the surgical plan changed when SUG results were taken into consideration along with RGU. Conclusion: SUG is more accurate in measuring stricture length, especially that of the bulbar urethra. It simultaneously provides a better assessment of a diseased urethra. It should be used as an extension of the physical examination by the treating urologist as it helps in better preoperative surgical planning of anterior urethral strictures.

Journal of Nephrology and Urology, 2019

Indian Journal of Health Sciences and Biomedical Research (KLEU), 2021

Prostate-Specific Antigen (PSA), which has high organ specificity and poor cancer specificity, ha... more Prostate-Specific Antigen (PSA), which has high organ specificity and poor cancer specificity, has been widely utilized for the diagnosis and treatment of prostate cancer; though it is not an ideal tumor marker. Its extensive usage in screening programs has resulted in a large number of unwanted biopsies, over-diagnosis and over-treatment of indolent cancers as well. Hence, various PSA derivatives and PSA-based tests have evolved to improve the accuracy of prostate cancer diagnosis. This article provides an overview of PSA and PSA-based biomarkers and their current role in the screening and diagnosis of prostate cancer.

Journal of Urological Surgery, 2020

Continent urinary reservoirs are safe and accepted modes of urinary diversion in selected patient... more Continent urinary reservoirs are safe and accepted modes of urinary diversion in selected patients. However, they are associated with long-term complications such as recurrent pyelonephritis, metabolic acidosis, urolithiasis and stomal problems. We are reporting a patient who had undergone continent urinary diversion for the treatment of extrophy of the bladder and presented ten years later with formation of large pouch calculi and infection. The calculi were successfully retrieved by pouchotomy. The combined weight of the stones was 1,254 gms. To the best of our knowledge, this is the largest stone burden in continent urinary diversion reported in literature.

Urinary tract obstruction (UTO) is a relatively common problem. The obstruction to urinary flow m... more Urinary tract obstruction (UTO) is a relatively common problem. The obstruction to urinary flow may be acute or chronic, partial or complete, unilateral or bilateral, and may occur at any site in the urinary tract. The major causes of UTO vary with the age of the patient. From a practical standpoint, the diagnosis of urinary obstruction requires proof of increased resistance to urine flow. There are numerous tests available to the urologist for the diagnosis of obstruction. These include radiographic studies, such as plain film (KUB), intravenous urography (IVU) ultrasound, computed tomography, Lasix renogram, magnetic resonance (MR) urogram, Whitaker test and urinary biomarkers. Selection of a specific test depends on the acuity of obstruction and patient’s age and renal function. Consideration must also be made for cost of the test, reliability and feasibility of long term follow-up by repeated exams. The various tests differ substantially in their ability to provide both anatomic...

Asian Journal of Urology, 2021

Objectives To compare the efficacy of tamsulosin versus tamsulosin plus tadalafil in achieving cl... more Objectives To compare the efficacy of tamsulosin versus tamsulosin plus tadalafil in achieving clearance of fragments after shock wave lithotripsy (SWL) to treat renal calculi. Methods Between January 2016 to December 2017, 140 patients with solitary, non-branched, non-lower calyceal renal calculus and measuring less than 20 mm and treated with SWL were randomized to tamsulosin (group A) or tamsulosin plus tadalafil (group B). Therapy was given for a period of 4 weeks. Stone clearance rate, analgesic requirement, occurrence of steinstrasse, need for auxiliary procedures (endoscopic treatment), and adverse effects of drugs were recorded. Results The overall clearance rate was 72.5% (50/69) in the group A and 90.1% (64/71) in the group B (p=0.007). For stones up to 12 mm, the difference in the clearance rate was significant (p=0.039) while it was not so for stones larger than 12 mm (p=0.151). There was no statistically significant difference between the two groups with regards to analgesic requirement (p=0.94), occurrence of steinstrasse (p=0.101), need for auxiliary procedures (p=0.76), and adverse effects of the drugs (p=0.148). Conclusion Our study shows that adjunctive medical expulsive therapy with tamsulosin and tadalafil achieves better clearance rate than tadalafil alone in patients receiving SWL for renal stones.

African Journal of Urology, 2020

Background The presence of unilateral right-sided varicocele hints at a serious retroperitoneal d... more Background The presence of unilateral right-sided varicocele hints at a serious retroperitoneal disease such as renal cell neoplasm. Such tumors are usually associated with a thrombus in renal vein or spermatic vein. We report a rare presentation of right-sided renal tumor causing right-sided varicocele in the absence of thrombus in renal vein and spermatic vein but due to an anomalous vein draining from the tumor into the spermatic vein as demonstrated by computed tomography angiogram. Case presentation A 54-yr-old hypertensive male presented with unilateral grade 3 right-sided varicocele and no other signs and symptoms. Ultrasound examination of his abdomen showed the presence of a mass lesion in the lower pole of right kidney. Computed tomography confirmed the presence of right renal mass, absence of thrombus in right renal vein or inferior vena cava. The angiographic phase of CT scan showed an anomalous vein from the tumor draining into the pampiniform plexus causing varicocele....

Journal of Urological Surgery, 2020

Ureteral stents inserted to prevent obstruction to the flow of urine need to be removed after the... more Ureteral stents inserted to prevent obstruction to the flow of urine need to be removed after they serve the purpose of their insertion. The most commonly practiced method for stent removal is using a rigid cystoscope in an office setting. However, it is quite painful and may require general anesthesia especially in males. Due to their small caliber, rigid ureteroscope can reduce patient discomfort during ureteral stent retrieval procedure. In this study, we compared the pain scores during ureteral stent retrieval using a rigid cystoscope and a rigid ureteroscope. Materials and Methods: A prospective study was conducted with 64 male patients with ureteral stents who were divided into two groups. Group A had 36 patients who underwent stent retrieval with rigid cystoscope while group B had 28 patients who underwent with rigid ureteroscope. Pain experienced during the procedure and during the first void thereafter were recorded using visual analog scale. Results: The patients who underwent stent retrieval using rigid cystoscope (mean 7.05±1.21) had a significantly higher (p<0.0001) pain score compared to those who underwent it using rigid ureteroscope (mean 2.57±1.04). The pain scores during the first void after the procedure as reported by patients in groups A and B were 6.58±1.27 and 3.03±0.96 (p<0.0001), respectively. Conclusion: Rigid ureteroscopic stent retrieval is a less painful, safe, and dependable method, with a reduced requirement for postoperative analgesics as compared to rigid cystoscopic stent retrieval.

Journal of Urological Surgery, 2019

Amaç: Bu çalışmada intrakorporial pnömotik litotripsi sırasında taş migrasyonunun önlenmesi için ... more Amaç: Bu çalışmada intrakorporial pnömotik litotripsi sırasında taş migrasyonunun önlenmesi için semi-rijit üreteroskop kullanılarak, proksimal üst üreter taşına renkli lubrikant jel instilasyon etkinliğinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Bu prospektif, kontrollü çalışmaya üreter taşı olan 60 kişiyi dahil ettik. Alternatif hastalar, renkli lubrikant jel instilasyon grubu A (n=30) ve kontrol grubu B'ye (n=30) ayrıldı. Üreteroskopi, standart protokole göre 7,5 F semi-rijit üreteroskop ve pnömatik litotriptör ile taş parçalama yöntemi kullanılarak yapıldı. A grubundaki hastalara, üreter içerisine floroskopi altında 5 Fr kateter yerleştirildi ve 3-5 mL renkli lubrikant jel taş üzerine dağıtıldı. Retropülsiyon ve kalan parçaların varlığı 24 saatte ve iki haftada böbrekler, üreterler ve mesane düz bilgisayarlı tomografisi, X-ray ve ultrasonografi ile değerlendirildi. Migrate olan taşlar şok dalga litotripsi ile tedavi edildi. Her bir advers olay modifiye Clavien sınıflama sistemine göre rapor edildi ve derecelendirildi. Bulgular: İki grup benzer demografik ve taş özelliklerine sahipti. Lubrikant jel instilasyon grubu ve kontrol grubu arasında retropülsiyon oranları (%6,67'ye karşı %26,67, p=0,04) açısından istatistiksel olarak anlamlı farklılık vardı. İki grup arasında istatistiksel olarak anlamlı bir komplikasyon görülmedi. Bütün hastaların iki haftalık takip sonrasında taşı yoktu.

Indian Journal of Health Sciences and Biomedical Research (KLEU), 2017

Context: Extracorporeal shock wave lithotripsy (ESWL) commonly used procedure for treating upper ... more Context: Extracorporeal shock wave lithotripsy (ESWL) commonly used procedure for treating upper urinary tract stones may result in acute kidney injury (AKI) with release of biomarkers. Association of plasma total homocysteine (tHCy), serum high-sensitivity C-reactive protein (hs-CRP), and serum creatinine with renal dysfunction and their role as acute renal injury markers is to be assessed. Aim: The study aims to assess plasma tHCy as a marker of AKI in patients undergoing ESWL for renal stone disease and compare the same with other markers, i.e., serum creatinine and serum hs-CRP. Setting and Design: One-year cross-sectional study at a tertiary care teaching hospital. Subjects and Methods: Sixty-four patients undergoing ESWL for renal stone disease were investigated for plasma tHCy, serum creatinine, and serum hs-CRP 24 h before and after ESWL procedure. Patients were divided into AKI and non-AKI group. Statistical Analysis: SPSS statistical software, rates, ratios, percentages, and mean ± standard deviation. A P ͳ 0.05 at 95% confidence interval was considered as statistically significant. Results: Following ESWL, AKI developed in 56.25% of the patients. Post-ESWL mean plasma tHCy levels were significantly high in patients with AKI (21.01 ± 7.67 vs. 16.93 ± 7.44 μmol/L; P = 0.036) compared to those who did not develop AKI. The post-ESWL mean serum creatinine levels and mean change were significantly high in patients with AKI. The post-ESWL mean serum hs-CRP levels were comparable in patients with AKI and those who did not develop AKI. However, 72.22% of the patients with AKI had significant rise of serum hs-CRP (≥2-fold of baseline) level following ESWL which was the only insult on kidney in 24 h. Conclusion: Plasma tHcy, Serum hs-CRP, and Serum creatinine can be used as acute renal injury markers following ESWL in patients with renal stone disease.

The Laryngoscope, 1979

The twelfth case (in 25 years of literature) of alveolar soft part sarcoma of the head and neck i... more The twelfth case (in 25 years of literature) of alveolar soft part sarcoma of the head and neck is presented. It represents the seventh case to occur in the base of tongue and the second to be associated with pregnancy. The average age of onset is in the second decade with a 2:1 female preponderance and a marked tendency to right-sided occurrence. Treatment with surgery and/or radiotherapy is not curative. Local recurrence is common as are distant metastases, usually to lung, brain or bone. Theoretically, chemotherapy may offer better control of disease but few agents have shown dramatic response. The characteristics of the tumors are discussed and various chemotherapeutic agents are reviewed.

Journal of Case Reports, 2014

Urachal malignancy is a rare and represents less than one percent of bladder neoplasms. Urachal m... more Urachal malignancy is a rare and represents less than one percent of bladder neoplasms. Urachal mucinous neoplasms are still rare and include both villous adenomas and invasive adenoma carcinomas and they have insidious course and variable clinical presentation. We present a case report of 58 year old male who presented with lower abdominal mass since 6-8 months with no lower urinary tract symptoms, significant history of loss of weight and appetite. On examination the infra-umbilical midline mobile mass of 10×10 cms was palpable. CT showed lobulated cystic mass with internal septations and calcifications superior to bladder with indentation and without any local or distant metastasis. Mass was excised in toto with partial/ segmental cystectomy. Histology revealed mucinous cystadenoma of undetermined malignant potential, rarest histological variety and difficult to diagnose on basis of mucin histochemistry and immunohistology. Two-year follow-up did not show any local tumor recurrence.

UroToday International Journal, 2012

Objective: Retrograde urethrography (RGU) is the most commonly used imaging modality for the eval... more Objective: Retrograde urethrography (RGU) is the most commonly used imaging modality for the evaluation of the anterior urethra. Sonourethrography (SUG) is another modality that is not so frequently used, though several studies have suggested its higher degree of sensitivity and specificity in anterior urethral stricture evaluation. The present prospective study has been done to compare the results of SUG with that of RGU and to probe its effect in decision making. Patients and Methods: A total of 50 patients with anterior urethral stricture disease were evaluated with both SUG and RGU for stricture length, site location, and associated urethral pathologies. Collected information was used as a guide for the choice of surgery, and it was compared with operative findings. Results: The mean lengths of strictures on SUG, RGU, and surgery were 20.46 cm, 17.14 cm, and 20.35 cm, respectively. Overall sensitivity and accuracy of SUG in predicting correct stricture length was 95.55 and 97.33%, respectively, and overall sensitivity and accuracy of RGU in predicting correct stricture length was 77.22 and 85.33%, respectively. Spongiofibrosis was noted only with SUG in 78 to 88% accuracy. In 32% of cases, the surgical plan changed when SUG results were taken into consideration along with RGU. Conclusion: SUG is more accurate in measuring stricture length, especially that of the bulbar urethra. It simultaneously provides a better assessment of a diseased urethra. It should be used as an extension of the physical examination by the treating urologist as it helps in better preoperative surgical planning of anterior urethral strictures.

UroToday International Journal, 2011

Urethral leiomyomas are rare benign tumors arising from the smooth muscle of the urethra. We desc... more Urethral leiomyomas are rare benign tumors arising from the smooth muscle of the urethra. We describe 3 female patients aged 40, 38, and 35 years, respectively. Each presented with a mass protruding from the urethral meatus. Other characteristics included urethral bleeding, dysuria, and dyspareunia. There were no reports of obstructive voiding. We explain the procedures needed for differential diagnosis. All patients underwent transvaginal excision of the mass and were free of recurrence at the 2-or 3-year follow-up. Related literature is reviewed.

Journal of the Scientific Society, 2012

The parameatal cyst is a very benign condition seen in boys. We report a case of a parameatal ure... more The parameatal cyst is a very benign condition seen in boys. We report a case of a parameatal urethral cyst in a 12-year-old boy. The cyst was recognized during early childhood, but the boy presented to our clinic at the age of 12 years, when the mass had grown enough to cause spraying of urine and poor cosmesis. A complete surgical excision was performed. Histologically, the cyst wall was lined by a tall columnar epithelium. Good cosmetic results, with no recurrence, were obtained.

UroToday International Journal, 2010

UroToday International Journal, 2010

Indian Journal of Surgery, 2010

Journal of Pediatric Urology, 2010

Journal of Pediatric Urology, 2008

Hyponatremic hypertensive syndrome is a combination of renovascular hypertension and hyponatremia... more Hyponatremic hypertensive syndrome is a combination of renovascular hypertension and hyponatremia. Although reported in adults, it is rare in children. We report a 7-year-old boy having renal artery stenosis associated with hyponatremic hypertensive syndrome.

Indian journal of health sciences and biomedical research KLEU, 2020

Objective: Retrograde urethrography (RGU) is the most commonly used imaging modality for the eval... more Objective: Retrograde urethrography (RGU) is the most commonly used imaging modality for the evaluation of the anterior urethra. Sonourethrography (SUG) is another modality that is not so frequently used, though several studies have suggested its higher degree of sensitivity and specificity in anterior urethral stricture evaluation. The present prospective study has been done to compare the results of SUG with that of RGU and to probe its effect in decision making. Patients and Methods: A total of 50 patients with anterior urethral stricture disease were evaluated with both SUG and RGU for stricture length, site location, and associated urethral pathologies. Collected information was used as a guide for the choice of surgery, and it was compared with operative findings. Results: The mean lengths of strictures on SUG, RGU, and surgery were 20.46 cm, 17.14 cm, and 20.35 cm, respectively. Overall sensitivity and accuracy of SUG in predicting correct stricture length was 95.55 and 97.33%, respectively, and overall sensitivity and accuracy of RGU in predicting correct stricture length was 77.22 and 85.33%, respectively. Spongiofibrosis was noted only with SUG in 78 to 88% accuracy. In 32% of cases, the surgical plan changed when SUG results were taken into consideration along with RGU. Conclusion: SUG is more accurate in measuring stricture length, especially that of the bulbar urethra. It simultaneously provides a better assessment of a diseased urethra. It should be used as an extension of the physical examination by the treating urologist as it helps in better preoperative surgical planning of anterior urethral strictures.

Journal of Nephrology and Urology, 2019

Indian Journal of Health Sciences and Biomedical Research (KLEU), 2021

Prostate-Specific Antigen (PSA), which has high organ specificity and poor cancer specificity, ha... more Prostate-Specific Antigen (PSA), which has high organ specificity and poor cancer specificity, has been widely utilized for the diagnosis and treatment of prostate cancer; though it is not an ideal tumor marker. Its extensive usage in screening programs has resulted in a large number of unwanted biopsies, over-diagnosis and over-treatment of indolent cancers as well. Hence, various PSA derivatives and PSA-based tests have evolved to improve the accuracy of prostate cancer diagnosis. This article provides an overview of PSA and PSA-based biomarkers and their current role in the screening and diagnosis of prostate cancer.

Journal of Urological Surgery, 2020

Continent urinary reservoirs are safe and accepted modes of urinary diversion in selected patient... more Continent urinary reservoirs are safe and accepted modes of urinary diversion in selected patients. However, they are associated with long-term complications such as recurrent pyelonephritis, metabolic acidosis, urolithiasis and stomal problems. We are reporting a patient who had undergone continent urinary diversion for the treatment of extrophy of the bladder and presented ten years later with formation of large pouch calculi and infection. The calculi were successfully retrieved by pouchotomy. The combined weight of the stones was 1,254 gms. To the best of our knowledge, this is the largest stone burden in continent urinary diversion reported in literature.

Urinary tract obstruction (UTO) is a relatively common problem. The obstruction to urinary flow m... more Urinary tract obstruction (UTO) is a relatively common problem. The obstruction to urinary flow may be acute or chronic, partial or complete, unilateral or bilateral, and may occur at any site in the urinary tract. The major causes of UTO vary with the age of the patient. From a practical standpoint, the diagnosis of urinary obstruction requires proof of increased resistance to urine flow. There are numerous tests available to the urologist for the diagnosis of obstruction. These include radiographic studies, such as plain film (KUB), intravenous urography (IVU) ultrasound, computed tomography, Lasix renogram, magnetic resonance (MR) urogram, Whitaker test and urinary biomarkers. Selection of a specific test depends on the acuity of obstruction and patient’s age and renal function. Consideration must also be made for cost of the test, reliability and feasibility of long term follow-up by repeated exams. The various tests differ substantially in their ability to provide both anatomic...

Asian Journal of Urology, 2021

Objectives To compare the efficacy of tamsulosin versus tamsulosin plus tadalafil in achieving cl... more Objectives To compare the efficacy of tamsulosin versus tamsulosin plus tadalafil in achieving clearance of fragments after shock wave lithotripsy (SWL) to treat renal calculi. Methods Between January 2016 to December 2017, 140 patients with solitary, non-branched, non-lower calyceal renal calculus and measuring less than 20 mm and treated with SWL were randomized to tamsulosin (group A) or tamsulosin plus tadalafil (group B). Therapy was given for a period of 4 weeks. Stone clearance rate, analgesic requirement, occurrence of steinstrasse, need for auxiliary procedures (endoscopic treatment), and adverse effects of drugs were recorded. Results The overall clearance rate was 72.5% (50/69) in the group A and 90.1% (64/71) in the group B (p=0.007). For stones up to 12 mm, the difference in the clearance rate was significant (p=0.039) while it was not so for stones larger than 12 mm (p=0.151). There was no statistically significant difference between the two groups with regards to analgesic requirement (p=0.94), occurrence of steinstrasse (p=0.101), need for auxiliary procedures (p=0.76), and adverse effects of the drugs (p=0.148). Conclusion Our study shows that adjunctive medical expulsive therapy with tamsulosin and tadalafil achieves better clearance rate than tadalafil alone in patients receiving SWL for renal stones.

African Journal of Urology, 2020

Background The presence of unilateral right-sided varicocele hints at a serious retroperitoneal d... more Background The presence of unilateral right-sided varicocele hints at a serious retroperitoneal disease such as renal cell neoplasm. Such tumors are usually associated with a thrombus in renal vein or spermatic vein. We report a rare presentation of right-sided renal tumor causing right-sided varicocele in the absence of thrombus in renal vein and spermatic vein but due to an anomalous vein draining from the tumor into the spermatic vein as demonstrated by computed tomography angiogram. Case presentation A 54-yr-old hypertensive male presented with unilateral grade 3 right-sided varicocele and no other signs and symptoms. Ultrasound examination of his abdomen showed the presence of a mass lesion in the lower pole of right kidney. Computed tomography confirmed the presence of right renal mass, absence of thrombus in right renal vein or inferior vena cava. The angiographic phase of CT scan showed an anomalous vein from the tumor draining into the pampiniform plexus causing varicocele....

Journal of Urological Surgery, 2020

Ureteral stents inserted to prevent obstruction to the flow of urine need to be removed after the... more Ureteral stents inserted to prevent obstruction to the flow of urine need to be removed after they serve the purpose of their insertion. The most commonly practiced method for stent removal is using a rigid cystoscope in an office setting. However, it is quite painful and may require general anesthesia especially in males. Due to their small caliber, rigid ureteroscope can reduce patient discomfort during ureteral stent retrieval procedure. In this study, we compared the pain scores during ureteral stent retrieval using a rigid cystoscope and a rigid ureteroscope. Materials and Methods: A prospective study was conducted with 64 male patients with ureteral stents who were divided into two groups. Group A had 36 patients who underwent stent retrieval with rigid cystoscope while group B had 28 patients who underwent with rigid ureteroscope. Pain experienced during the procedure and during the first void thereafter were recorded using visual analog scale. Results: The patients who underwent stent retrieval using rigid cystoscope (mean 7.05±1.21) had a significantly higher (p<0.0001) pain score compared to those who underwent it using rigid ureteroscope (mean 2.57±1.04). The pain scores during the first void after the procedure as reported by patients in groups A and B were 6.58±1.27 and 3.03±0.96 (p<0.0001), respectively. Conclusion: Rigid ureteroscopic stent retrieval is a less painful, safe, and dependable method, with a reduced requirement for postoperative analgesics as compared to rigid cystoscopic stent retrieval.

Journal of Urological Surgery, 2019

Amaç: Bu çalışmada intrakorporial pnömotik litotripsi sırasında taş migrasyonunun önlenmesi için ... more Amaç: Bu çalışmada intrakorporial pnömotik litotripsi sırasında taş migrasyonunun önlenmesi için semi-rijit üreteroskop kullanılarak, proksimal üst üreter taşına renkli lubrikant jel instilasyon etkinliğinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Bu prospektif, kontrollü çalışmaya üreter taşı olan 60 kişiyi dahil ettik. Alternatif hastalar, renkli lubrikant jel instilasyon grubu A (n=30) ve kontrol grubu B'ye (n=30) ayrıldı. Üreteroskopi, standart protokole göre 7,5 F semi-rijit üreteroskop ve pnömatik litotriptör ile taş parçalama yöntemi kullanılarak yapıldı. A grubundaki hastalara, üreter içerisine floroskopi altında 5 Fr kateter yerleştirildi ve 3-5 mL renkli lubrikant jel taş üzerine dağıtıldı. Retropülsiyon ve kalan parçaların varlığı 24 saatte ve iki haftada böbrekler, üreterler ve mesane düz bilgisayarlı tomografisi, X-ray ve ultrasonografi ile değerlendirildi. Migrate olan taşlar şok dalga litotripsi ile tedavi edildi. Her bir advers olay modifiye Clavien sınıflama sistemine göre rapor edildi ve derecelendirildi. Bulgular: İki grup benzer demografik ve taş özelliklerine sahipti. Lubrikant jel instilasyon grubu ve kontrol grubu arasında retropülsiyon oranları (%6,67'ye karşı %26,67, p=0,04) açısından istatistiksel olarak anlamlı farklılık vardı. İki grup arasında istatistiksel olarak anlamlı bir komplikasyon görülmedi. Bütün hastaların iki haftalık takip sonrasında taşı yoktu.

Indian Journal of Health Sciences and Biomedical Research (KLEU), 2017

Context: Extracorporeal shock wave lithotripsy (ESWL) commonly used procedure for treating upper ... more Context: Extracorporeal shock wave lithotripsy (ESWL) commonly used procedure for treating upper urinary tract stones may result in acute kidney injury (AKI) with release of biomarkers. Association of plasma total homocysteine (tHCy), serum high-sensitivity C-reactive protein (hs-CRP), and serum creatinine with renal dysfunction and their role as acute renal injury markers is to be assessed. Aim: The study aims to assess plasma tHCy as a marker of AKI in patients undergoing ESWL for renal stone disease and compare the same with other markers, i.e., serum creatinine and serum hs-CRP. Setting and Design: One-year cross-sectional study at a tertiary care teaching hospital. Subjects and Methods: Sixty-four patients undergoing ESWL for renal stone disease were investigated for plasma tHCy, serum creatinine, and serum hs-CRP 24 h before and after ESWL procedure. Patients were divided into AKI and non-AKI group. Statistical Analysis: SPSS statistical software, rates, ratios, percentages, and mean ± standard deviation. A P ͳ 0.05 at 95% confidence interval was considered as statistically significant. Results: Following ESWL, AKI developed in 56.25% of the patients. Post-ESWL mean plasma tHCy levels were significantly high in patients with AKI (21.01 ± 7.67 vs. 16.93 ± 7.44 μmol/L; P = 0.036) compared to those who did not develop AKI. The post-ESWL mean serum creatinine levels and mean change were significantly high in patients with AKI. The post-ESWL mean serum hs-CRP levels were comparable in patients with AKI and those who did not develop AKI. However, 72.22% of the patients with AKI had significant rise of serum hs-CRP (≥2-fold of baseline) level following ESWL which was the only insult on kidney in 24 h. Conclusion: Plasma tHcy, Serum hs-CRP, and Serum creatinine can be used as acute renal injury markers following ESWL in patients with renal stone disease.

The Laryngoscope, 1979

The twelfth case (in 25 years of literature) of alveolar soft part sarcoma of the head and neck i... more The twelfth case (in 25 years of literature) of alveolar soft part sarcoma of the head and neck is presented. It represents the seventh case to occur in the base of tongue and the second to be associated with pregnancy. The average age of onset is in the second decade with a 2:1 female preponderance and a marked tendency to right-sided occurrence. Treatment with surgery and/or radiotherapy is not curative. Local recurrence is common as are distant metastases, usually to lung, brain or bone. Theoretically, chemotherapy may offer better control of disease but few agents have shown dramatic response. The characteristics of the tumors are discussed and various chemotherapeutic agents are reviewed.

Journal of Case Reports, 2014

Urachal malignancy is a rare and represents less than one percent of bladder neoplasms. Urachal m... more Urachal malignancy is a rare and represents less than one percent of bladder neoplasms. Urachal mucinous neoplasms are still rare and include both villous adenomas and invasive adenoma carcinomas and they have insidious course and variable clinical presentation. We present a case report of 58 year old male who presented with lower abdominal mass since 6-8 months with no lower urinary tract symptoms, significant history of loss of weight and appetite. On examination the infra-umbilical midline mobile mass of 10×10 cms was palpable. CT showed lobulated cystic mass with internal septations and calcifications superior to bladder with indentation and without any local or distant metastasis. Mass was excised in toto with partial/ segmental cystectomy. Histology revealed mucinous cystadenoma of undetermined malignant potential, rarest histological variety and difficult to diagnose on basis of mucin histochemistry and immunohistology. Two-year follow-up did not show any local tumor recurrence.

UroToday International Journal, 2012

Objective: Retrograde urethrography (RGU) is the most commonly used imaging modality for the eval... more Objective: Retrograde urethrography (RGU) is the most commonly used imaging modality for the evaluation of the anterior urethra. Sonourethrography (SUG) is another modality that is not so frequently used, though several studies have suggested its higher degree of sensitivity and specificity in anterior urethral stricture evaluation. The present prospective study has been done to compare the results of SUG with that of RGU and to probe its effect in decision making. Patients and Methods: A total of 50 patients with anterior urethral stricture disease were evaluated with both SUG and RGU for stricture length, site location, and associated urethral pathologies. Collected information was used as a guide for the choice of surgery, and it was compared with operative findings. Results: The mean lengths of strictures on SUG, RGU, and surgery were 20.46 cm, 17.14 cm, and 20.35 cm, respectively. Overall sensitivity and accuracy of SUG in predicting correct stricture length was 95.55 and 97.33%, respectively, and overall sensitivity and accuracy of RGU in predicting correct stricture length was 77.22 and 85.33%, respectively. Spongiofibrosis was noted only with SUG in 78 to 88% accuracy. In 32% of cases, the surgical plan changed when SUG results were taken into consideration along with RGU. Conclusion: SUG is more accurate in measuring stricture length, especially that of the bulbar urethra. It simultaneously provides a better assessment of a diseased urethra. It should be used as an extension of the physical examination by the treating urologist as it helps in better preoperative surgical planning of anterior urethral strictures.

UroToday International Journal, 2011

Urethral leiomyomas are rare benign tumors arising from the smooth muscle of the urethra. We desc... more Urethral leiomyomas are rare benign tumors arising from the smooth muscle of the urethra. We describe 3 female patients aged 40, 38, and 35 years, respectively. Each presented with a mass protruding from the urethral meatus. Other characteristics included urethral bleeding, dysuria, and dyspareunia. There were no reports of obstructive voiding. We explain the procedures needed for differential diagnosis. All patients underwent transvaginal excision of the mass and were free of recurrence at the 2-or 3-year follow-up. Related literature is reviewed.

Journal of the Scientific Society, 2012

The parameatal cyst is a very benign condition seen in boys. We report a case of a parameatal ure... more The parameatal cyst is a very benign condition seen in boys. We report a case of a parameatal urethral cyst in a 12-year-old boy. The cyst was recognized during early childhood, but the boy presented to our clinic at the age of 12 years, when the mass had grown enough to cause spraying of urine and poor cosmesis. A complete surgical excision was performed. Histologically, the cyst wall was lined by a tall columnar epithelium. Good cosmetic results, with no recurrence, were obtained.

UroToday International Journal, 2010

UroToday International Journal, 2010

Indian Journal of Surgery, 2010

Journal of Pediatric Urology, 2010

Journal of Pediatric Urology, 2008

Hyponatremic hypertensive syndrome is a combination of renovascular hypertension and hyponatremia... more Hyponatremic hypertensive syndrome is a combination of renovascular hypertension and hyponatremia. Although reported in adults, it is rare in children. We report a 7-year-old boy having renal artery stenosis associated with hyponatremic hypertensive syndrome.