It was aimed to investigate the efficiency and reliability of the manual detorsion (MD) procedure in patients diagnosed with testicular torsion (TT). A retrospective analysis was made of the data of 57 patients diagnosed with TT, comprising 20 patients with successful MD (Group I), 28 patients who underwent emergency orchiopexy (Group II), and 9 patients applied with orchiectomy (Group III). The groups were compared in respect of age, and duration of pain. The success rate of MD, the time of testicular fixation (TF), any problems encountered in follow-up, and follow-up times were analyzed in Group I. Data were analyzed with P-P pilot, Mann-Whitney U, Kruskal Wallis and Chi-square tests. A value of p < 0.05 was considered statistically significant. MD was successful and detorsion could be achieved in 20 of 26 patients. The groups were similar in respect of age (p = 0.217). The median duration of pain was 3 (1–8), 4 (1–72), and 48 (12–144) hours in Groups I, II, and III, respectively, and determined as similar in Groups I and II (p = 0.257), although a statistically significant difference was determined between the 3 groups (p < 0.001). TF was applied to Group I after median 10 (0–45) days, and no parenchymal disorder was determined in the median follow-up period of 21.5 (2–40) months. MD that can be easily and immediately performed after the diagnosis of TT decreases ischemia time. This seems to be an efficient and reliable procedure when applied together with elective orchiopexy, as a part of the treatment.

Gorgel SN, et al. Investig Clin Urol. 2019 May;60(3):169-175. https://doi.org/10.4111/icu.2019.60.3.169

Amaç: Kadavra diseksiyonu tıp fakültesinde anatomi eğitiminin temel öğesidir. Bu çalışmamızda üro-anatomi diseksiyon kursunun üroloji asistan bilgisi üzerine etkisini tespit etmeyi amaçladık. Gereç ve yöntemler: 1-3 Haziran 2012 tarihlerinde Ege Üniversitesi Tıp Fakültesi Anatomi Kliniğinde 50 üroloji asistanına deneyimli eğitmenler tarafından 3 günlük kurs verildi. Kursun etkinliği, kurs öncesi ve sonrası yapılan çoktan seçmeli 20 sorudan oluşan test ile değerlendirildi. Bulgular: Soruların tamamını kurs öncesi ve sonrası yanıtlayan 25 asistan (%50) çalışmaya dahil edildi. Asistanlar kurs öncesi 20 sorudan ortalama 11,7 (%59) oranında soruya doğru cevap verirken bu oran kurs sonrası 13,0 (%65) olarak tespit edildi ve bu fark istatiksel olarak anlamlıydı (p<0,05). Kişisel analizde 16 asistan (%64) kendi ortalamasını yükseltirken, 4 (%16) asistanın aynı seviyede doğru cevap verdiği ve 5 (%20) asistanın doğru cevap oranının düştüğü izlenmiştir. 20 sorunun sadece altısında kurs takibinde doğru cevap oranında düşüş izlendi. Sonuç: Bu kadavra cerrahi anatomi kursu bütün asistanlarda olmasa da bir çoğunda cerrahi anatomi bilgisini artırmıştır. Bu öğretim yöntemi ilerde daha başarılı kursları tanımlamayı kolaylaştıracaktır.

Objectives. To compare the effectiveness and safety of ultrasonic and pneumatic lithotripters in the treatment of renal stone disease. Materials and Methods. A total of 227 consecutive percutaneous nephrolithotomy procedures for renal calculi were performed. In 107 patients ultrasonic lithotriptors were used (group I) and in 83 patients pneumatic lithotriptors were used (group II). In the remaining 37 patients, stones were managed with both pneumatic and ultrasonic lithotripters. Follow‐up studies included intravenous urography (IVU) and/or computed tomography (CT). Results. The mean operative time and duration of hospitalization were similar between the groups. In the ultrasonic treatment group, 100 (96.9%) patients were stone‐free on postoperative day 1 and 5 (4.6%) went on to undergo an additional treatment modality, resulting in a total stone‐free rate of 97.2%. In the pneumatic lithotripsy group, 68 (81.9%) patients were stone‐free after the primary procedure on the first day and 15 (18.1%) went on to undergo an additional treatment modality, resulting in a stone‐free rate of 91.5%. The final stone‐free rates at 3 months postoperatively in groups I, II, and III were 97.2%, 91.5%, and 87.9%, respectively (P = 0.826). Conclusions. We conclude that both ultrasonic and pneumatic lithotripters are effective and safe for intracorporeal lithotripsy. However, the ultrasonic lithotripter provides higher stone‐free rates with similar morbidity compared with pneumatic devices.