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In the present study, we assessed the efficacy and morbidity of periprostatic local anesthesia before transrectal ultrasound (TRUS)-guided biopsy of the prostate. From August 2001 to February 2002, 98 patients underwent TRUS-guided prostate biopsy at the Department of 2nd Urology, Ankara Numune Education and Research Hospital, Ankara, Turkey. Ninety patients who fulfilled the inclusion criteria were randomized into three groups of 30 patients each. Group 1 received no local anesthesia, while group 2 received a periprostatic saline injection 5 min before the biopsy and group 3 received periprostatic local anesthesia with 1% lidocaine. Pain-scale responses were analyzed for each aspect of the biopsy procedure using a visual analog scale. There were no differences in pain scores between the three groups during digital rectal examination, intramuscular injection and probe insertion. Mean pain scores during needle insertion in groups 1, 2 and 3 were 5.65 ± 2.35, 6.25 ± 2.04 and 3.16 ± 2.14, respectively. There was no significant difference between the pain scores of groups 1 and 2, whereas pain scores decreased significantly in group 3. Periprostatic local anesthesia before prostate biopsy is a safe and easy method to increase patient comfort during the procedure. [ABSTRACT FROM AUTHOR]

Purpose: To assess early and late-term outcomes of patients who had undergone pelvic exenteration and simultaneous fecal and urinary diversion with plain wet colostomy (PWC) or double-barrelled wet colostomy (DBWC)., Materials and Methods: The medical records of all patients who had undergone pelvic exenteration and urinary diversion between 2006 and 2017 at our hospital were reviewed retrospectively., Results: In total, 15 patients with a mean age of 56 ± 13 years were included in the study. Simultaneous urinary and fecal diversions were carried out as PWC (n = 8), or DBWC (n = 7). No significant differences were found between PWC and DBWC groups in terms of operation time (373.7 ± 66.5 versus 394.2 ± 133.2 min, P = .955), estimated blood loss (862.8 ± 462.4 versus 726.2 ± 489.4 mL, P = .613), length of hospital stay (13.2 ± 9.1 versus 14.1 ±6.9 days), early complications (25% versus 28.6%, P = 1.0) and late term complications (37.5% versus 42.9%, P = 1.0). The rate of recurrent pyelonephritis in PWC group was higher than DBWC group but not statistically significant (37.5% versus 14.3%, P = .569). Overall survival (OS) of the patients was 385 ± 91 days. There was no difference between OS of patients with PWC and DBWC (414 ± 165 versus 352 ± 70 days, P = .618)., Conclusion: PWC and DBWC are valid options for creating simultaneous urinary and fecal diversion after extensive pelvic surgery in patients with short life expectancy. DBWC might be superior to PWC in terms of decreased risk of recurrent pyelonephritis.

Purpose: The relative risk of germ cell testicular tumor is significantly higher in patients with a testicular tumor history. We reviewed histological and clinical features in 30 patients with bilateral tumors treated at 2 academic centers in Turkey., Materials and Methods: Of 987 patients with testicular germ cell tumors 30 (3.0%) were diagnosed with bilateral disease. Data on clinical information, histopathology and followup records were reevaluated. Contralateral testis biopsy was not performed in any patient at initial orchiectomy., Results: Of 30 patients 24 had sequential tumors at a median interval of 75 months (range 3 to 260) and 6 (20.0%) had synchronous tumors. Mean age at presentation was 32.3 and 26.7 years, respectively. The second tumor occurred within 2 and 5 years in 20.8% and 41.7% of patients, respectively. Patients with seminoma were at significantly higher risk for bilateral disease (4.5% vs 2.3%), whereas patients with nonseminoma had more advanced disease at presentation. Synchronous tumors had similar tumor histology on each side and more advanced stage at presentation than metachronous tumors. Most patients with metachronous tumors had stage 1 disease, including 81% originally and 95.2% subsequently. Primary tumors were significantly larger than secondary tumors (4.78 vs 2.59 cm). Median time after the first and second germ cell tumors was 128 and 47 months, respectively. At last followup all patients had no evidence of disease., Conclusions: The risk of contralateral testicular germ cell tumor in patients with seminoma was 2 times higher than in those without a history of tumor. Synchronous tumors present at advanced stage and have similar histology on each side. Clinical outcome is excellent with appropriate treatment. Contralateral testis biopsy at initial diagnosis is not mandatory.