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    A 53-year-old female with bladder leiomyoma: A rare case and review of the literature
    (Bayrakol Medical Publisher, 2021) Asdemir, Aydemir; Asdemir, Tugba Yildiz; Saygin, Huseyin; Korgali, Esat; Cicek, Resul
    Leiomyoma as a benign tumor of the urinary bladder, is uncommon and usually presents with obstructive voiding symptoms or irritative urinary symptoms. A 53-year-old woman was hospitalized to the general surgery clinic due to abdominal pain. During her contrast-enhanced computed tomography (CT) examination, incidentally, a mass on the left anterosuperolateral side of the bladder wall was revealed. No significant finding was detected on physical examination. There was only microscopic hematuria as a result of urinalysis. Contrast-enhanced CT confirmed the presence of a mass on the left anterosuperolateral side of the bladder wall without evidence of extravesical extension and showed a well-delineated 2,6 cm x 2,4 cm endovesical bladder tumor arising from the left anterosuperolateral bladder wall and there was a thickening of the urinary bladder wall. On cystoscopy, an intraluminally protruding, rounded, smooth, sessile solid mass, 2,5 cm in diameter and covered by normal bladder mucosa, was seen. She underwent an uneventful transurethral resection of bladder tumor (TURBT) and histological examination revealed intersecting fascicles of smooth muscle without any evidence of malignant change, and thus diagnosis of leiomyoma was confirmed. Confirmation of the diagnosis may be difficult due to the poor yield of cold cup biopsy. In our case, transurethral resection (TUR) was diagnostic.
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    Laparoscopic dismembered pyeloplasty combined with port entrance flexible renoscopic lithotripsy
    (BRAZILIAN SOC UROL, 2018) Gokcen, Kaan; Gokce, Gokhan; Dundar, Gokce; Cicek, Resul; Gulbahar, Halil; Gultekin, Emin Yener
    Introduction: Ureteropelvic junction obstruction and concomitant calculus disease may coexist. We demonstrate our use of flexible renoscopy during laparoscopic pyeloplasty for caliceal stone removal. Patient and methods: A 28-year-old female patient presented with recurrent attacks of flank pain of two years duration. When noncontrast-CT and DTPA were performed, the patient was diagnosed with ureteropelvic junction stenosis and 3 stones with a total burden of 14mm in the lower pole of right kidney. After pneumoperitoneum was established in right flank position, three 10mm trocars were placed including one camera port. 5mm trocar was placed for convenience to retraction and dissection. The surgery was uneventful, with no operative complications or evidence of intra-abdominal bleeding. Results: The duration of the surgery was 110 minutes. The amount of bleeding was 30ml. On the postoperative 2nd day, the urethral catheter was removed and the patient was discharged on the fourth day postoperatively. Stent removal was done on the 3rd postoperative week and retrograde pyelogram showed normal ureter. Post-operative follow-up with ultrasound showed that hydronephrosis had regressed. Conclusions: Laparoscopic pyeloplasty and concomitant flexible renoscopy through lowermost trocar with basket extraction is a simple, attractive alternative for the simultaneous treatment of ureteropelvic junction obstruction presenting with coexisting nephrolithiasis. This method is useful and feasible, with minimal invasiveness and an early post-operative recovery.
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    Late diagnosed congenital anterior urethral diverticulum in a male teenager: A case report
    (Bayrakol Medical Publisher, 2021) Asdemir, Aydemir; Saygin, Huseyin; Korgali, Esat; Cicek, Resul
    In this case report we present the case of an 18-year-old boy with a congenital anterior urethral diverticulum. This is a rare condition in males which can lead to obstructive lower urinary tract symptoms and urosepsis. Diagnosis is made by urethroscopy and radiological imaging. Surgical treatment can be open or endoscopic. Long-term follow up is required to check for reoccurrence of the obstruction.
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    Macro hematoma after micro percutaneous nephrolithotomy: A case report
    (Bayrakol Medical Publisher, 2021) Asdemir, Aydemir; Saygin, Huseyin; Korgali, Esat; Cicek, Resul
    The micropercutaneous nephrolithotomy (mPNL, microperc) method was developed in order to prevent complications. In our clinic, we performed microperc on a 39-year-old man who expelled renal stone. During the microperc procedure, lower pole calyceal access was successfully obtained to get direct access to the stone by using 4.8Fr microperc needle. The patient's hemoglobin dropped from 16.8 to 9.6 gr/dl about 6 hours after surgery. A new computerised tomography (CT) scan demonstrated a large retroperitoneal hematoma measuring 182x97x92 mm. When we performed retroperitoneal exploration, we saw a bleeding area due to the entrance of microperc needle. Then, we controlled the hemorrhage. The patient's hemodynamics remained stable and he did not need any blood transfusion after exploration. Based on this case, it appears reasonable to allow open surgery after microperc to control macro hematoma.