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Aim: To evaluate the oncological and functional outcomes of 167 patients who underwent laparoscopic radical prostatectomy (LRP). Materials and Methods: The retrospective study included 167 patients who were treated with LRP due to clinically localized prostate cancer between January 2007 and April 2012. Most of the patients were treated with the extraperitoneal approach. Preoperative evaluations included age, serum prostate-specific antigen (PSA) level, and biopsy Gleason score. Perioperative evaluations included duration of operative time and anastomosis time, blood loss (milliliter), and complications. Postoperative evaluations included length of hospital stay and catheterization time. Continence and erectile function were evaluated both pre- and postoperatively. The patients who used no pads or no more than one pad daily and the ones who had only a few urine leakages on effort or exertion were accepted as continent. Postoperative potency was defined as the ability to achieve sexual intercourse with or without the use of PDE-5 inhibitors. Results: Mean age and mean operative time were 62.4 ± 6.0 years and 220.5 ± 45.6 minutes, respectively. Mean anastomosis time was 35.6 ± 9.8 minutes. Mean serum PSA level and mean Gleason score were 17.5 ± 9.97 ng/mL and 6.16 ± 0.42, respectively. Pelvic lymphadenectomy was performed in 94 patients and nerve-sparing procedures in 61 patients. The pathological analysis revealed positive surgical margin in 35 patients (20.9%). Bilateral and unilateral nerve-sparing LRP procedures were performed in 51 (30.5%) and 10 (6%) patients, respectively. At 12 months after surgery, 3 (1.8%) patients were using 2 or more pads per day, 19 (26.4%) patients were satisfied with erection, hardness, and duration of intercourse, and 9 (12.5%) patients had an erection with insufficient hardness and duration. Conclusion: LRP is an acceptable method in localized prostate cancer due to its perioperative and early postoperative results. [ABSTRACT FROM AUTHOR]

Background/aim: The functional and oncological outcomes of zero ischemia robotic partial nephrectomy (RPN) procedures were evaluated. Materials and methods: A total of 56 patients underwent zero ischemia RPN transperitoneally, and their data were collected prospectively. Radius, exo/endophytic, nearness, anterior/posterior, location (R.E.N.A.L.) nephrometry, and PADUA scores were calculated. Patient and tumor characteristics were evaluated. Intra- and perioperative (0-30 days) complications were evaluated by Clavien classification. The change in serum creatinine, and estimated glomerular filtration rates (eGFR) were evaluated during preoperative, immediate postoperative periods, and at postoperative 6th months. Results: The mean age of the patients was 52.2 ± 8.1 (27-75) years. R.E.N.A.L. nephrometry and PADUA scores were 6.1 ± 1.3 and 7.3 ± 1.0, respectively. The duration of surgery was 108.4 ± 18.2 min and estimated blood loss was 166.2 ± 124.7 mL. There were no intraoperative complications in any of the patients. Clavien Grade 1 and 3 complications were seen in 2 patients in the perioperative period. In the perioperative period (1-30 days), one patient required blood transfusion and angiographic intervention due to postoperative bleeding (Clavien Grade 3), and one patient required hospitalisation due to prolonged subileus (Clavien Grade 1) that resolved conservatively. The radiological and pathological tumor sizes were 3.1 ± 1.1 cm and 2.8 ± 1.4 cm, respectively. The surgical margins were positive in two patients with tumour sizes of 1.5 and 4 cm. Neither local recurrence nor distant metastasis was detected, during 33.6 ± 12.3 (3-76) months. There were no statistically significant differences between preoperative eGFR and serum creatinine levels, compared with those of immediate postoperative and postoperative 6th month periods. Conclusion: Zero ischemia RPN is a safe and applicable method with acceptable oncological and functional outcomes in small renal tumors and even in selected larger renal tumors. [ABSTRACT FROM AUTHOR]

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Summary: Benign prostatic hyperplasia (BPH) is a common problem among elderly men. Recently, laser prostate enucleations have gained popularity with successful results; however, it requires steep learning curves. The initial 60 cases of ThuLEP performed at our centre were retrospectively enrolled. A 200 W CyberTM Thulium laser (Quanta System, Italy) with 550 µm fibre was used, and a single surgeon highly experienced with transurethral resection performed all procedures. Patients were divided into three consecutive groups. Preoperative variables such as prostate volume, prostate‐specific antigen and haemoglobin levels, International Prostate Symptom Score (IPSS), International Index of Erectile Function scores and uroflowmetry parameters were all noted. The enucleated tissue weight, enucleation and morcellation times with efficiencies, hospitalization and catheterization times were calculated. Perioperative complications were also observed. The postoperative 6th month uroflowmetry parameters were evaluated and compared with prior ones. Morcellation and enucleation efficiencies, hospitalization and catheterization times, postoperative IPSS were significantly different between the groups. Complications were also compared between the groups, and only short‐term perioperative complications were encountered. We aimed to evaluate initial cases of ThuLEP to provide information for beginners with management of early term possible complications. The learning curve for ThuLEP could be handled after exceeding 20 initial cases. [ABSTRACT FROM AUTHOR]

To present data on the prevalence of benign prostatic hyperplasia (BPH) in five Middle Eastern countries (Egypt, Turkey, Kuwait, Saudi Arabia, and the United Arab Emirates; the latter three forming a Gulf cluster). The SNAPSHOT programme was a multi-country, cross-sectional epidemiological survey conducted by telephone in a random sample of the adult general population. Subjects were considered to have BPH if they fulfilled the screening criteria, based on diagnosis, symptoms, and treatments received in the past 12 months. Current prevalence (last 12 months) was estimated. Association with co-morbidities was investigated via multivariate logistic regressions. Quality of life (QoL) was assessed using the three-level EuroQol five-dimensions questionnaire (EQ-5D-3 L). In total, 5034 of 33,486 subjects enrolled in the SNAPSHOT programme were men aged ≥50 years. In all, 998 of these men fulfilled the BPH screening criteria. The overall prevalence of BPH ranged from 13.84% (95% confidence interval[CI] 12.3–15.4%) in Turkey, to 23.76% (95% CI 21.8–25.6%) in Egypt, and 23.79% (95% CI 21.2–26.3%) in the Gulf cluster. Co-morbidities occurred more frequently in men with BPH compared to the non-BPH population (57% vs 31%; P < 0.001). Principal co-morbidities associated with BPH were cardiovascular, renal, and diabetes mellitus (P < 0.001). The men with BPH reported significantly reduced QoL, with lower EQ-5D-3 L utility values (0.8) compared to the male general population (0.9) aged ≥50 years (P < 0.001). The prevalence of BPH in these five Middle Eastern countries ranges from 13.84% to 23.79%. BPH has a negative impact on QoL and is associated with high levels of co-morbid diseases, indicating a need to better understand the management of the disease to reduce the impact on healthcare systems. [ABSTRACT FROM AUTHOR]

Objective: The aim of study was to compare the efficiency and safety of standard percutaneous nephro- lithotomy (sPNL) and miniaturized percutaneous nephrolithotomy (mPNL) in lower calyx and/or pelvic stones smaller than three centimeters. Material and methods: From October 2010 to August 2015, 108 mPNL and 176 sPNL procedures were performed for renal stones smaller than three cm and located in the lower calyx and/or renal pelvis. All patients were evaluated preoperatively with intravenous pyelography and/or computed tomography. Intraoperative parameters, post-operative results and complications were recorded. Postoperative success was defined as complete stone clearance and/or clinically insignificant residual fragments at 3rd month. Results: Preoperative characteristics were similar between sPNL and mPNL groups except previous renal stone operation history and gender. The mean operation time was significantly shorter in the sPNL group (p<0.001). The mean hemoglobin drop was significantly less in the mPNL group (p=0.001), we found a 1.27±1.4 and 0.5±1.3 decrease in mean hemoglobin levels (mg/dL) in the sPNL and mPNL groups, respectively. Transfusion rate was 1.9% in mPNL and 5.6% in sPNL groups, and the difference was statistically significant (p=0.048). Only one patient in the sPNL group needed angiography and embolization. Postoperative JJ stent insertion rate was significantly higher in the mPNL group (p=0.03). Conclusion: Both sPNL and mPNL are safe and effective surgical procedures for lower calyx and/or pelvis stones smaller than 3 cm. However, use of smaller caliber instruments was associated with a lesser hemoglobin drop and need for transfusion. [ABSTRACT FROM AUTHOR]

Objective: The Triple D scoring system is defined as novel and simple nomogram using the main parameters (skin-to-stone distance, stone density, and volume) to indicate most appropriate patients for extracorporeal shockwave lithotripsy (SWL). We aimed to evaluate the accuracy of the Triple D scoring system in predicting SWL success rates. Patients and Methods: In two tertiary academic centers, charts were retrospectively analyzed of patients who had, between January 2014 and May 2016, been treated by SWL for radiopaque kidney stones. A total of 200 patients were enrolled into the study. Parameters were calculated for each of the three specified variables. Since one point was assigned for any parameter that was less than the cutoff value, Triple D scores ranged from 0 (worst) to 3 (best). Results: Stone-free status was achieved in 115 patients (57.5%), and 85 patients had one or more residual fragments (42.5%). Differences in stone characteristics, including stone location, density, and volume, were statistically significant in patients whether SWL achieved stone-free status or not ( p < 0.001, p < 0.001, and p < 0.001, respectively). Triple D scores were significantly higher in patients treated with SWL compared with patients in whom SWL failed ( p < 0.001). Triple D scores of 0, 1, 2, and 3 correlated with stone-free rates of 41.7%, 33.7%, 69.4%, and 97%, respectively. The multivariate analyses revealed that Triple D score and stone location were identified as independent factors affecting SWL success ( p < 0.001 and p = 0.008, respectively). The mean number of SWL sessions was significantly higher in patients with SWL failure ( p = 0.003). Conclusion: Our study externally validates that the Triple D scoring system is associated with SWL success in the treatment of renal and ureteral stones. Further studies are warranted to assess clinical usefulness and the accuracy of this nomogram in different patient groups. [ABSTRACT FROM AUTHOR]

Objective: To assess and compare the applicability of the Resorlu-Unsal Stone Score (RUSS) and the Modified Seoul National University Renal Stone Complexity (S-ReSC) score for flexible ureterorenoscopy (f-URS). Patients and Methods: We retrospectively analyzed the hospital files of 719 patients who had been treated with f-URS for kidney stone at two referral centers between July 2012 and December 2015. The RUSS and Modified S-ReSC scores were calculated by the same surgeon for each patient by using imaging methods and were compared as to their predictive capability for postoperative success. Results: A total of 339 patients (168 men and 171 women) with a mean age of 46.5 - 16.1 (range:1-86) years and a mean body mass index of 27.1 - 4.1 (range: 12.8-38.5) were included in the study. The mean stone size was 14.4 - 5.4 (4-40) mm, and the mean stone surface area was 145.3 - 76.8 (20-658) mm2. The overall stonefree rate was 70.1%. The mean scores were 0.5 - 0.7 and 1.8 - 1.1 for the RUSS and Modified S-ReSC, respectively. In the logistic regression analysis, musculoskeletal deformity, stone size, and the RUSS were identified as independent predictive factors affecting stone-free status (p: 0, p: 0.014, p: 0.048, respectively). Among these parameters, the RUSS had the highest predictive capability (area under curve value 0.65, [95% confidence interval 589, 721]). Conclusions: Stone size, presence of musculoskeletal abnormalities, and the RUSS score are important factors affecting SF status after f-URS. Despite the RUSS being an independent predictive factor for SF status, more comprehensive systems with higher predictive capability are needed for clinical usage and academic reporting. [ABSTRACT FROM AUTHOR]