Description

Urology

Kidney
Tumors

Kidney tumors are responsible for approximately 3% of
adult cancers. Kidney tumors occur most frequently between the ages of
50-60, the ratio of men to women is 2/1. Renal cell carcinoma (renal
adenocarcinoma) constitutes 85% of all primary renal neoplasms. Although
the cause of kidney tumors is unknown, various assumptions exist, covering the
effects of environmental and effects, diet, hormones, chromosomal abnormalities
and oncogenes. The only risk factor detected is smoking. The risk is
at least twice as high in smokers. Kidney tumors can grow very large
without causing any discomfort or pain. Macroscopic hematuria (blood in
urine), flank pain, palpable mass triad is seen only in 10-15% of patients and
is often a sign of advanced disease. Sometimes, a tumor in the kidney can
be seen during examinations performed for other reasons. This type of
cancer is called incidental cancer and their treatments are more successful
than others. Distant organ involvement is present in one third of the
patients at the first application, and lung involvement is the most common. Although
there are many assistive techniques in the diagnosis of kidney masses, Computed
Tomography (CT) continues to be the most important diagnostic method. Ultrasonography
(USG) is very effective in the diagnosis of solid and cystic kidney masses and
is used as the first diagnostic method. Although there are many assistive
techniques in the diagnosis of kidney masses, Computed Tomography (CT)
continues to be the most important diagnostic method. Ultrasonography
(USG) is very effective in the diagnosis of solid and cystic kidney masses and
is used as the first diagnostic method. Although there are many assistive
techniques in the diagnosis of kidney masses, Computed Tomography (CT)
continues to be the most important diagnostic method. Ultrasonography
(USG) is very effective in the diagnosis of solid and cystic kidney masses and
is used as the first diagnostic method.

Surgery constitutes the main treatment in kidney tumor. Detecting
the disease at an early stage and removing the tumor by radical nephrectomy
(removal of the target tumor and surrounding large normal tissue) or
nephron-sparing surgery (limited removal of the tumor area) is the preferred
and most effective treatment method in the first place. Treatment of
remote involvement or locally advanced stage disease is very difficult and
results can be obtained in very few patients.

Kidney tumors are one of the cancers with a high chance
of treatment when diagnosed early. Regular check-up is important for
patients who see blood in their urine to consult a urologist immediately.

Undescended Testis

Undescended testis is the condition in which one or
both testicles are not located in the scrotum. Testicles are located in
the abdomen close to the kidneys in the early stages of development in the
mother’s womb. It goes down in time and settles in the scrotum in the
period close to birth. Undescended testicle is one of the most common
congenital anomalies in boys. Although its incidence is approximately 3%
in newborns born at the age of 1 year, this frequency is 0.8-1% with spontaneous
strokes. Studies have shown that spontaneous descent is usually within the
first 6-9 months, after this period the possibility of spontaneous stroke is
quite low. Infants with low birth weight and premature birth are more
likely to have undescended testicles.

Unilateral undescended testis is more common than
bilateral undescended testis. In addition, it is more likely to be seen on
the right side than on the left. Undescended testis can be examined in two
groups as palpable (palpable during examination) and non-palpable. While
palpable testicles are usually in the groin area, some of those that cannot be
palpated are located in the groin area and some in the abdomen.

Undescended testicle is diagnosed by physical
examination. Physical examination should be done carefully in a warm
environment, with warm hands, both in a lying and cross-legged position. Apart
from that, it is useful to perform ultrasonography to support the diagnosis. Retractile
testis is a benign condition that should not be confused with undescended
testis. Retractile testis is the name given to the testis that goes up and
down to the groin area due to the overactive cremaster muscle reflex. During
the physical examination, the testicle in the groin area is easily lowered into
the scrotum and remains there for a while. Retractile testis is not a
condition that requires treatment, the patient is regularly examined and
followed up.

The treatment of undescended testicle is divided into
two as medical and surgical treatment. Various hormonal injections are
applied in medical treatment. In general, the success rate of medical
treatment is considered to be approximately 20%. In the surgical treatment
of undescended testis, the success rate is quite high. Surgical treatment
is recommended between 6 months and 1 year. Treatments applied later than
1 year increase the risk of infertility. If bilateral undescended testis
cases are not treated, they almost always result in infertility. Patients
with undescended testicles have an increased risk of testicular tumors. The
removal of the testicle by surgery does not reduce the risk of tumor
development, it only facilitates examination and follow-up. Therefore, all
children with undescended testicles should be examined at regular intervals,
even if treated promptly and correctly.

Prostate cancer

Prostate cancer ranks second (after skin cancer) among
the most frequently diagnosed cancers in men. Prostate cancer is the
second leading cause of cancer death (after lung cancer).

The prostate gland is a part of the male reproductive
system, located under the bladder, in front of the rectum (anus). Prostate
cancer is a malignant tumor that mostly occurs in the outer part of the
prostate gland. Although prostate cancer usually grows very slowly, it can
spread in the prostate over time and metastasize (spread) to other parts of the
body. Prostate cancer is a very insidious disease, especially in its early
stages, if the person does not have prostate enlargement and related
complaints, the cancer may not have any specific symptoms. Since most of
the early prostate cancers are asymptomatic, their diagnosis can be made by the
PSA blood test or a digital rectal examination. Prostate cancer risk
increases rapidly in those over the age of fifty. 80% of prostate cancer cases
are men over the age of 65. Family history of prostate cancer (a father or
sibling with prostate cancer) increases the risk of the disease. The
definitive diagnosis of prostate cancer is made by prostate biopsy.

Prostate cancer, which is the most common cancer in
men, is a disease with a high chance of recovery if diagnosed at an early
stage, with a correct and appropriate treatment. The choice of treatment
for men with prostate cancer, the stage and extent of the cancer; age of
the patient; the possibility of other medical problems and the short and
long term adverse effects of the treatment should be taken into account. Treatment
options for prostate cancer include:

Watching
Waiting 

Cancer
often grows slowly and may not cause significant problems in a man’s life. For
this reason, not treating immediately may be the preferred option at times.

Surgery

In radical
prostatectomy, the prostate gland is completely removed. If it has not spread
outside the gland, the tumor is completely removed with this procedure. There
is the possibility of long-term undesirable effects, including urinary
incontinence and impotence.

Radiation
Therapy

 It aims
to kill cancer cells in the prostate gland. It can be applied in two ways.

By direct application of radiation rays to the
prostate gland from outside the body

By planting small radioactive seeds inside the
prostate gland (Brachytherapy).

Hormone
Therapy 

Destroying
cancer cells with male sex hormones slows down the growth of prostate
cancer. In this treatment, either the testicles are surgically removed or
medication is applied. It does not cure cancer, but slows its growth and
is generally not administered until the cancer has spread outside of the prostate
gland. Treatment can lead to flushing, loss of sexual desire, and
impotence.

Prostate
cancer, which is the most common cancer in men, is a disease with a high chance
of recovery if diagnosed at an early stage, with a correct and appropriate
treatment. It is of great importance that all men aged 50 and over have a
digital rectal examination once a year and in addition to have a PSA test once
a year.

Infertility

Infertility is the inability to get pregnant for 12
months despite regular sexual intercourse and no contraception
method. Today, infertility is seen in approximately one of every seven
couples. Married couples should be examined together if pregnancy has not
occurred within a year despite their wishes. However, if one or both of
the couples are over the age of 35, the examinations should be done without
waiting for a year.

In
a couple who cannot conceive, the problem is related to 40% men and 20% both
men and women. The causes of male infertility are grouped under three main
categories:

There are production disorders that affect the
quality and quantity of sperm, a disorder in either the production or
maturation of the sperm.

Anatomical occlusions, varicocele

Other factors; For example, the inability of
sperm to move within the female production system due to immunological (immune)
factors.

Other
factors; For example, the inability of sperm to move within the female
production system due to immunological (immune) factors.

Variococele operation: Varicocele is an abnormal
enlargement of the vein of the testicle. Surgical procedure is applied in
case of varicocele that is clinically detected and causes deterioration in
sperm parameters.

Opening the blockage in the sperm conduction
channels

Insemination, Microinjection

Treatment with hormones and other drugs

Thanks
to the developments in assisted reproductive techniques, especially in recent
years, satisfactory results are obtained even in very serious cases of male
infertility.