We report a novel method of chylous clot removal using morcellator where other conventional methods fail. A 22-year male with recurrent chyluria presented in acute urinary retention. Clot evacuation using Toomey syringe, ellik evacuator and suction bridge have failed. Based on our use of morcellator (versa cut tissue morcellator, lumenis) during HoLeP procedure, we applied this morcellator to morcellate large and tenacious chylous clot. We successfully removed the clot using morcellator with suction (versa cut tissue morcellator, lumenis) used for morcellating prostate adenoma tissue in Holmium Laser Enucleation of Prostate (HoLeP).

Background: Double J (DJ) ureteral stent is being used in various urological and non-urological procedures. Indications for double J ureteric stents include; negotiating the obstruction and maintaining adequate drainage from kidneys, and as an adjunctive procedure to Extra Corporeal Shock Wave Lithotripsy (ESWL). A forgotten DJ stent is not uncommon in developing countries and is particularly seen in patients with poor socioeconomic status. These patients present with flank pain, hematuria, irritative voiding Lower Urinary Tract Symptoms (LUTS) and even lend up with features of renal failure. Management of forgotten DJ ureteral stents is not only important for patient’s perspective but also for the surgeon’s prospect due to its medico-legal implications.

Aim: To address a unique complication of forgotten DJ stent; its endourological management and preventive measures to avoid devastating complications.

Study design: Descriptive study.

Methods: Retrospective data search from 2008-2015 revealed 47 patients admitted with forgotten ureteral stent includes (broken and encrusted) were managed endoscopically. Patients were evaluated with X-ray, ultrasonography of Kidney Ureter and Bladder Region (KUB), Intravenous Urography (IVU) and non-contrast computed tomography, renal function test (where indicated). Endourological procedure for DJ stent removal was decided according to the location of stents.

Results: A total of 47 patients (males: 34, females: 13) were included in the study. The mean age of patients was 23.53 years (range 4-65 years); mean duration of stent insertion was 39 months (4-68 months). Fifteen patients (31.9%) had stent insertion following percutaneous nephrolithotomy, 8 (16.96%) following Ureteroscopic Lithotripsy (URSL), 3 (6.3%) following pyeloplasty, 10 (21.2%) following ureterolithotomy, 6(12.72%) following pyelolithotomy and 3 (6.3%) following ureteric re-implantation. Two patients (4.2%) had DJ insertion for bilateral upper ureteric calculus with deranged renal function. PCNL was performed in 10 (21.2%), combined PCNL and CLT in 15 (31.8%), URSL in 12 (25.44%), combined URSL and CLT in 18 (38.16%), CLT alone in 11 (23.32%) cases.

Conclusion: Forgotten double J ureteral stent still a common and preventable complication in developing nations, patients may lend up in renal failure. Its removal is a challenging task.

Technological advances, including laparoscopic and robotic surgery and diagnostic imaging, seem to have improved renal functional and oncological outcomes in patients undergoing nephron-sparing surgery. There is Level 1 evidence that nephron-sparing surgery is not superior to radical nephrectomy in terms of overall and cancer-specific survival; however, the indications for nephron-sparing surgery to treat renal cell carcinoma are expanding without substantive supportive evidence, and the updated guidelines accept that radical nephrectomy should not be used when nephron-sparing procedures are possible. Hypertension that develops after nephronsparing surgery is suspected to play a significant role in the survival benefit; therefore, there is a room to improve nephron-sparing surgery. Further efforts are necessary to achieve better survival, e.g., the procedure should be modified to prevent postoperative hypertension. Hereby, “renal denervation during nephron-sparing surgery” appears to minimize hypertensive complications after nephron-sparing surgery; therefore, more attention should be paid to preventing de novo hypertension in patients undergoing nephron-sparing surgery

Objectives: To assess the results of rehabilitation treatment on quality of life of patients undergoing radical prostate surgery.

Methods: We evaluated a cohort of men treated at our Rehabilitation Department after radical prostate surgery between 2007 and 2013. Assessment scales, Expanded Prostate Index Composite (EPIC), Sandvik and International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ), before and after rehabilitation treatment were analyzed.

Results: 33 patients completed the rehabilitation treatment. The mean age of patients was 64.5 years (49- 75). An improvement was observed before and after rehabilitation treatment in the ICIQ and Sandvik scales, and in the urinary and sexual domains of EPIC (p <0.005) and in the hormonal domain of EPIC (p 0.008); no significant differences in the intestinal domain of the EPIC (p 0.068) were found. No statistically significant correlation between the assessment scales and the use of protective was obtained. A statistically significant correlation between the days of bladder catheterization and bowel (p 0.028) and sexual (p 0.004) EPIC domains was found, but no correlation was found in the other domains of EPIC or the ICIQ and Sandvik scales. The number of rehabilitation sessions did not correlate with any of the scales evaluated.

Conclusion: Rehabilitation treatment may improve the quality of life of patients undergoing radical prostate surgery.

Background: We aimed to investigate the effect of blood groups and Rhesus factor on prognosis and survival in patients who underwent radical cystectomy due to bladder cancer.

Methods: Five hundred and twenty four patients who underwent radical cystectomy were enrolled the study between 1992 and 2014. The effect of blood groups and Rhesus factor on prognosis and survival was evaluated.

Results: Two hundred and twelve patients (41%) had A blood group, 184 patients (35%) had 0 blood group, 92 patients (17%) had B blood group, and 36 patients (7%) had AB blood group. Four hundred and fifty-six patients (87%) were Rhesus factor positive and 64 patients (13%) were Rhesus negative. The effect of rhesus factor on prognosis and survival was no statistically significant. Patients with B blood group had higher tumor grade than other blood groups (p=0.02). Disease-specific survival were similar in each blood group.

Conclusion: We found that B blood group was associated with high grade tumor in patients who underwent radical cystectomy. However there was no statistically significant on survival in multivariate analysis. In addition, blood groups and Rhesus factor were not associated with survival.